Miotonachol

Miotonachol may be available in the countries listed below.

Ingredient matches for Miotonachol

Bethanechol

Bethanechol Chloride is reported as an ingredient of Miotonachol in the following countries:

• Argentina

International Drug Name Search

GNP Capsaicin Lotion

Pronunciation: kap-SAY-sin
Generic Name: Capsaicin
Brand Name: Examples include Castiva Warming and GNP Capsaicin

GNP Capsaicin Lotion is used for:

Temporary relief of muscle and joint pain associated with arthritis, simple backaches, sprains, strains, and bruises. It may also be used for other conditions as determined by your doctor.

GNP Capsaicin Lotion is a topical analgesic. Exactly how it works is unknown, but it is thought to decrease the amount of a certain substance (substance P) that transmits pain in the body.

Do NOT use GNP Capsaicin Lotion if:

• you are allergic to any ingredient in GNP Capsaicin Lotion

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

Before using GNP Capsaicin Lotion:

Some medical conditions may interact with GNP Capsaicin Lotion. 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 open wound or damaged, broken, or irritated skin

Some MEDICINES MAY INTERACT with GNP Capsaicin Lotion. Because little, if any, of GNP Capsaicin Lotion is absorbed into the blood, the risk of it interacting with another medicine is low.

Ask your health care provider if GNP Capsaicin Lotion 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 GNP Capsaicin Lotion:

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

• An extra patient leaflet is available with GNP Capsaicin Lotion. Talk to your pharmacist if you have questions about this information.


• Apply just enough medicine to cover the affected area. Gently massage the medicine into skin until it disappears.


• Wash your hands with soap and water immediately after using GNP Capsaicin Lotion unless your hands are part of the treated area.


• If you are using GNP Capsaicin Lotion on your hands, allow 30 minutes for the medicine to absorb before washing. During this time, avoid touching damaged or irritated skin, contact lenses, or your eyes, nose, mouth, or other mucous membranes. Wash hands after 30 minutes.


• Do not apply to wounds or damaged, broken (open), or irritated skin.


• Do not bandage or wrap the affected area.


• Do not use GNP Capsaicin Lotion with a heating pad.


• Do not expose the treated area to heat or direct sunlight. Warm or hot water or sunlight may increase the likelihood of burning or itching. Do not use GNP Capsaicin Lotion immediately after bathing, swimming, using a hot tub, sunbathing, or exposure to heat.


• If you miss a dose of GNP Capsaicin Lotion, use it as soon as you remember. Continue to use it as directed by your doctor or on the package label.

Ask your health care provider any questions you may have about how to use GNP Capsaicin Lotion.

Important safety information:

• For external use only. Avoid contact with the eyes, nose, and mouth. If GNP Capsaicin Lotion gets into your eyes, rinse immediately with cool water.


• Do not take more than the recommended dose, use for longer than prescribed, or use large amounts of GNP Capsaicin Lotion without checking with your doctor.


• Do not inhale any residue from GNP Capsaicin Lotion after it has dried. Coughing, sneezing, or throat or respiratory irritation may occur.


• GNP Capsaicin Lotion may be harmful if swallowed. If you may have taken GNP Capsaicin Lotion by mouth, contact your local poison control center or emergency room immediately.


• If condition worsens, or if symptoms persists for more than 7 days or clear up and occur again within a few days, stop use of this product and contact your health care provider.


• If redness is present or if irritation develops, check with your doctor before using any more of GNP Capsaicin Lotion.


• If severe burning or itching occurs, remove product by thoroughly washing the area with soap and cold water.


• GNP Capsaicin Lotion should not be used in CHILDREN younger than 18 years old without checking with the child's doctor; 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 GNP Capsaicin Lotion while you are pregnant. It is not known if GNP Capsaicin Lotion is found in breast milk. If you are or will be breast-feeding while you use GNP Capsaicin Lotion, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of GNP Capsaicin Lotion:

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:

Temporary burning or stinging at the application site that usually disappears in a few days.

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); difficulty breathing or swallowing; irritation, redness, blistering, or severe or persistent burning at the application site.

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: GNP Capsaicin 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. GNP Capsaicin Lotion may be harmful if swallowed.

Proper storage of GNP Capsaicin Lotion:

Store GNP Capsaicin Lotion at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Close cap tightly after use. Do not store in the bathroom. Keep GNP Capsaicin Lotion out of the reach of children and away from pets.

General information:

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


• GNP Capsaicin Lotion 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 GNP Capsaicin Lotion. 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 GNP Capsaicin resources

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

Compare GNP Capsaicin with other medications

• Burning Mouth Syndrome
• Diabetic Nerve Damage
• Osteoarthritis
• Pain
• Persisting Pain, Shingles

Zantac

Generic Name: Ranitidine Hydrochloride
Class: Histamine H2-Antagonists
VA Class: GA301
Chemical Name: N - [2 - [[[ - 5 - [(Dimethylamino)methyl] - 2 - furanyl]methyl]thio]ethyl] - N′ - methyl - 2 - nitro - 1,1 - ethenediamine hydrochloride
CAS Number: 66357-59-3

Introduction

Histamine H₂ receptor antagonist.¹

Uses for Zantac

Duodenal Ulcer

Short-term treatment of active duodenal ulcer (endoscopically or radiographically confirmed).^{1 2}

Maintenance of healing and reduction in recurrence of duodenal ulcer.^{1 4 120 121 136 178}

Pathologic GI Hypersecretory Conditions

Long-term treatment of Zollinger-Ellison syndrome, systemic mastocytosis, postoperative hypersecretion, “short-gut” syndrome.^{1 48 49 100 117}

Gastric Ulcer

Short-term treatment of active benign gastric ulcer.^{1 4 44 45 80 84 119 140}

Maintenance of healing and reduction in recurrence of gastric ulcer.¹

Gastroesophageal Reflux (GERD)

Treatment of GERD to achieve acid suppression, control symptoms, and prevent complications.^{1 4 6 86 124 126 128 132 134 135 136 137 138 179 280}

Treatment of erosive esophagitis (endoscopically diagnosed) in patients with GERD.¹

Maintain healing and decrease recurrence of erosive esophagitis.¹

Self-medication as initial therapy for less severe symptomatic GERD†.²⁸⁰

Short-term self-medication for treatment of heartburn (pyrosis) symptoms associated with acid indigestion and sour stomach in adults and adolescents ≥12 years of age.²⁸⁷

Short-term self-medication for prevention of heartburn symptoms associated with acid indigestion and sour stomach brought on by ingestion of certain foods and beverages in adults and children ≥12 years of age.²⁸⁷

Increasing Gastric pH in Neonates Undergoing Extracorporeal Membrane Oxygenation (ECMO)

May be useful for increasing gastric pH in neonates (<1 month of age) at risk for GI hemorrhage during ECMO†.^{b c}

Zantac Dosage and Administration

Administration

Administered orally.^{1 118}

Administered by IM or slow IV injection, or by intermittent or continuous IV infusion in hospitalized patients with pathologic GI hypersecretory conditions or intractable duodenal ulcer, or when oral therapy is not feasible.^{117 172}

Administered by slow IV injection or intermittent IV infusion in children 1 month to 16 years of age for the treatment of duodenal ulcer.^{117 172 286}

Administered by slow IV injection or intermittent or continuous IV infusion to decrease gastric pH in neonates <1 month of age receiving ECMO.^{117 172 286}

Oral Administration

Administer antacids concomitantly as necessary for relief of pain.¹

Dissolve each dose to be administered as 150-mg effervescent tablets in 180–240 mL (6–8 ounces) of water as directed prior to ingestion.¹ Effervescent tablets should not be chewed, swallowed whole, or dissolved on the tongue.¹

Dissolve each 25-mg effervescent tablet in ≥5 mL of water prior to administration.¹ Allow tablet to completely dissolve before administering to the infant or child.¹ May use a calibrated dropper or oral syringe to administer resultant solution in infants.¹

Administer tablets for self-medication with a glass of water.^{287 288}

IM Injection

May be administered undiluted.¹¹⁷

Intermittent Direct IV Injection

Dilution

Dilute 50-mg dose to a concentration no greater than 2.5 mg/mL (i.e., total of 20 mL) with 0.9% sodium chloride injection or other compatible IV solution before direct IV injection.^{117 172}

Rate of Administration

Inject the 20-mL diluted solution (containing 50 mg/20 mL) at rate ≤4 mL/minute (i.e., over at least 5 minutes).^{117 172}

Intermittent IV Infusion

Dilution

Dilute 50-mg dose to a concentration ≤0.5 mg/mL (i.e., 100 mL total) in 5% dextrose injection or other compatible IV solution.^{117 172}

No additional dilution required for commercially available infusion solution (50 mg ranitidine in 50 mL of 0.45% sodium chloride).¹¹⁷

Rate of Administration

Infuse 50 mg/100 mL dilution at ≤5–7 mL/minute (i.e., over 15–20 minutes).^{117 172}

Infuse commercially available infusion solution (50 mg in 50 mL of 0.45% sodium chloride) over 15–20 minutes.¹¹⁷

Continuous IV Infusion

Dilution

Dilute 150 mg in 250 mL of 5% dextrose injection or other compatible IV solution.^{91 117 172}

Dilute to concentration ≤2.5 mg/mL in 5% dextrose injection or other compatible IV solution for Zollinger-Ellison syndrome or other pathologic GI hypersecretory conditions.^{91 117 172}

Rate of Administration

Infuse 150 mg/250 mL dilution at 6.25 mg/hour over 24 hours.^{91 117 172}

Infuse dilution for Zollinger-Ellison syndrome or other pathologic GI hypersecretory conditions at initial rate of 1 mg/kg per hour; adjust subsequent rate to individual requirements.^{91 117 172}

Dosage

Available as ranitidine hydrochloride; dosage expressed in terms of ranitidine.^{1 117 172}

Pediatric Patients

Duodenal Ulcer

Treatment of Active Duodenal Ulcer

Oral

Children 1 month to 16 years of age: 2–4 mg/kg twice daily.¹

Maximum 300 mg daily.¹

IV

Children 1 month to 16 years of age: 2–4 mg/kg daily given as divided doses every 6–8 hours.^{117 172}

Maximum 50 mg every 6–8 hours.^{117 172}

Maintenance of Healing of Duodenal Ulcer

Oral

Children 1 month to 16 years of age: 2–4 mg/kg once daily.¹

Maximum 150 mg daily.¹

Gastric Ulcer

Treatment

Oral

Children 1 month to 16 years of age: 2–4 mg/kg twice daily.¹

Maximum 300 mg daily.¹

Maintenance of Healing of Gastric Ulcer

Oral

Children 1 month to 16 years of age: 2–4 mg/kg once daily.¹

Maximum 150 mg daily.¹

Gastroesophageal Reflux

Treatment of GERD

Oral

Children 1 month to 16 years of age: 5–10 mg/kg daily, usually administered as 2 equally divided doses.¹

Treatment of Erosive Esophagitis

Oral

Children 1 month to 16 years of age: 5–10 mg/kg daily, usually administered as 2 equally divided doses.¹

Self-medication for Heartburn

Oral

Children ≥12 years of age: 75 or 150 mg once or twice daily.^{287 288}

Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours; maximum 2 weeks of continuous use as self-medication.^{287 288}

Self-medication for Prevention of Heartburn

Oral

Children ≥12 years of age: 75 or 150 mg once or twice daily; administer 30–60 minutes before ingestion of causative food or beverage.^{287 288}

Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours; maximum 2 weeks of continuous use as self-medication.^{287 288}

Increase Gastric pH in Neonates Undergoing ECMO

IV

Neonates (<1 month of age) at risk for GI hemorrhage: Consider 2 mg/kg every 12–24 hours (or as continuous infusion).^{117 172}

A dose of 2 mg/kg usually is sufficient to increase gastric pH to >4 for at least 15 hours.^{117 172}

Adults

General Parenteral Dosage

Hospitalized Patients with Pathologic Hypersecretory Conditions or Intractable Duodenal Ulcer, or Short-term Use When Oral Therapy is not Feasible

IM

50 mg every 6–8 hours.^{117 172}

Increase dosage when necessary by administering 50 mg more frequently.^{117 172}

Maximum 400 mg daily.^{117 172}

Intermittent Direct IV Injection

50 mg every 6–8 hours.^{117 172}

Increase dosage when necessary by administering 50 mg more frequently.^{117 172}

Maximum 400 mg daily.^{117 172}

Intermittent IV Infusion

50 mg every 6–8 hours.^{117 172}

Increase dosage when necessary by administering 50 mg more frequently.^{117 172}

Maximum 400 mg daily.^{117 172}

Continuous IV Infusion

150 mg/24 hours (6.25 mg/hour).^{117 172} See Pathologic GI Hypersecretory Conditions under Dosage.

Duodenal Ulcer

Treatment of Active Duodenal Ulcer

Oral

Usual dosage: 150 mg twice daily.^{1 118}

Alternative: 300 mg daily after evening meal or at bedtime for optimum convenience and compliance.^{1 123 125 139 140}

100 mg twice daily reported to be as effective in healing ulcers as 150 mg twice daily.¹

Healing usually within 4 weeks; may occur in 2 weeks.¹²⁴

Additional 4 weeks of therapy may be beneficial.^{1 91 124}

Maintenance of Healing of Duodenal Ulcer

Oral

150 mg daily at bedtime.^{1 136 178}

Gastric Ulcer

Oral

150 mg twice daily.^{1 118}

Healing usually within 6 weeks.¹

Maintenance of Gastric Ulcer Healing

Oral

150 mg daily at bedtime.¹

Gastroesophageal Reflux

Treatment of GERD

Oral

150 mg twice daily.^{1 136 179}

Treatment of Erosive Esophagitis

Oral

150 mg 4 times daily.¹

Maintenance of Healing of Erosive Esophagitis

Oral

150 mg twice daily.¹

Self-medication for Heartburn

Oral

75 mg or 150 mg once or twice daily.^{287 288}

Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours; maximum 2 weeks of continuous use as self-medication.^{287 288}

Self-medication for Prevention of Heartburn

Oral

75 or 150 mg once or twice daily; administer 30–60 minutes before ingestion of causative food or beverage.^{287 288}

Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours; maximum 2 weeks of continuous use as self-medication.^{287 288}

Pathologic GI Hypersecretory Conditions

Oral

150 mg twice daily; may administer more frequently, if needed.^{1 100}

Adjust dosage according to patient response.^{1 100}

Dosages up to 6 g daily have been used for severe disease.^{1 100}

Continue as long as necessary.^{1 98 100}

Continuous IV Infusion

Initiate at 1 mg/kg per hour.^{91 117 172}

Titrate upward in 0.5 mg/kg per hour increments and redetermine gastric acid secretion if symptoms occur or gastric acid output is >10 mEq per hour after 4 hours.^{117 172}

Dosages up to 2.5 mg/kg per hour and infusion rates up to 220 mg/hour have been used.^{117 172}

Prescribing Limits

Pediatric Patients

Gastroesophageal Reflux

Self-medication for Heartburn

Oral

Adolescents ≥12 years of age: Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours; maximum 2 weeks of continuous use as self-medication.^{287 288}

Self-medication for Prevention of Heartburn

Oral

Adolescents ≥12 years of age: Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours; maximum 2 weeks of continuous use as self-medication.^{287 288}

Duodenal Ulcer

Treatment of Active Duodenal Ulcer

Oral

Children 1 month to 16 years of age: Maximum 300 mg daily.¹

IV

Children 1 month to 16 years of age: Maximum 50 mg every 6–8 hours.^{117 172}

Maintenance of Healing of Duodenal Ulcer:

Oral

Children 1 month to 16 years of age: Maximum 150 mg daily.¹

Gastric Ulcer

Treatment of Gastric Ulcer

Oral

Children 1 month to 16 years of age: Maximum 300 mg daily.¹

Maintenance of Healing of Gastric Ulcer

Oral

Children 1 month to 16 years of age: Maximum 150 mg daily.¹

Adults

General Parenteral Dosage

Hospitalized Patients with Pathologic Hypersecretory Conditions or Intractable Duodenal Ulcer, or Short-term Use When Oral Therapy is not Feasible

IM

Maximum 400 mg daily.^{117 172}

Maximum 50 mg per dose.^{117 172}

Intermittent Direct IV

Maximum 400 mg daily.^{117 172}

Maximum 50 mg per dose.^{117 172}

Maximum concentration 2.5 mg/mL (50 mg/20 mL).^{117 172}

Maximum injection rate: 4 mL/minute (i.e., over 5 minutes).^{117 172}

Intermittent IV Infusion

Maximum 400 mg daily.^{117 172}

Maximum 50 mg per dose.^{117 172}

Maximum concentration 0.5 mg/mL (50 mg/100 mL).^{117 172}

Maximum infusion rate: 5–7 mL/minute (100 mL over 15–20 minutes).^{117 172}

Commercially available infusion solution (50 mg in 50 mL of 0.45% sodium chloride): over 15–20 minutes.¹¹⁷

Gastroesophageal Reflux

Self-Medication for Heartburn

Oral

Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours; maximum 2 weeks of continuous use as self-medication.^{287 288}

Self-medication for Prevention of Heartburn

Oral

Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours; maximum 2 weeks of continuous use as self-medication.^{287 288}

Duodenal Ulcer

Treatment of Active Duodenal Ulcer

Oral

Safety and efficacy for >8 weeks have not been established.¹

Gastric Ulcer

Treatment of Active Benign Gastric Ulcer

Oral

Safety and efficacy for >6 weeks have not been established.¹

Pathologic GI Hypersecretory Conditions

Continuous IV Infusion

Zollinger-Ellison Syndrome: Maximum concentration 2.5 mg/mL.^{91 117 172}

Up to 2.5 mg/kg per hour or 220 mg/hour has been used.^{117 172}

Special Populations

Renal Impairment

Cl_cr <50 mL/minute

Oral

150 mg once every 24 hours.¹ If necessary, may cautiously increase dosage frequency to every 12 hours or more frequently.¹

IM

50 mg every 18–24 hours.^{117 172} If necessary, may cautiously increase dosage frequency to every 12 hours or more frequently.^{117 172}

Intermittent Direct IV

50 mg every 18–24 hours.^{117 172} If necessary, may cautiously increase dosage frequency to every 12 hours or more frequently.^{117 172}

Intermittent IV Infusion

50 mg every 18–24 hours.^{117 172} If necessary, may cautiously increase dosage frequency to every 12 hours or more frequently.^{117 172}

Continuous IV Infusion

Not evaluated.^{117 172}

Hemodialysis

Decreases blood levels; administer at the end of hemodialysis.^{1 4 117 124 172}

Geriatric Patients

Careful dosage selection recommended because of possible age-related decrease in renal function.^{a b c} (See Geriatric Use under Cautions.)

Cautions for Zantac

Contraindications

• 
  

  Known hypersensitivity to ranitidine or any ingredient in the formulation.^{1 91 124}

  
  


• 
  

  Do not use for self-medication if swallowing is difficult.²⁸⁷

  
  


• 
  

  Do not use for self-medication with other drugs that decrease gastric acid secretion.^{287 288}

  
  


• 
  

  Do not use for self-medication if difficulty or pain occurs when swallowing food, if experiencing vomiting with blood, or if passing bloody or blackened stools.²⁸⁸ Instead, consult a clinician since such manifestations may indicate presence of a serious condition requiring alternative treatment.²⁸⁸

  
  

Warnings/Precautions

General Precautions

Gastric Malignancy

Response to ranitidine does not preclude presence of gastric malignancy.¹

Hepatic Effects

Discontinue immediately in patients with hepatitis.^{1 117 124 172} Occasional hepatotoxicity, rarely, hepatic failure and death have been reported.^{1 161 162 163 164 165 166 167 168 169 170 171 b c}

Increased serum ALT concentrations have occurred with ≥5 days of histamine H₂-receptor antagonist therapy at higher than recommended IV dosages.¹¹⁷ Monitor serum ALT from day 5 to end of therapy when ranitidine is administered IV at dosages ≥400 mg daily for ≥5 days.¹¹⁷

Cardiovascular Effects

Rapid IV administration: associated rarely with bradycardia.^{117 172} Avoid rapid administration.^{117 172}

Acute Intermittent Porphyria

Ranitidine may precipitate acute porphyric attacks.^{1 117 172} Avoid use in such patients.^{1 117 172}

Respiratory Effects

Administration of H₂-receptor antagonists has been associated with an increased risk for developing certain infections (e.g., community-acquired pneumonia).^{283 284}

Phenylketonuria

Zantac EFFERdose tablets for solution contain aspartame (NutraSweet), which is metabolized in the GI tract to provide 2.81 or 16.84 mg of phenylalanine per 25- or 150-mg tablet, respectively.¹

Specific Populations

Pregnancy

Category B.^{1 117 172}

Self-medication in pregnant women: Consult clinician before using.^{287 288}

Lactation

Distributed into milk; use with caution.^{1 124}

Self-medication in nursing women: Consult clinician before using.^{287 288}

Pediatric Use

Oral: Safety and efficacy for erosive esophagitis healing maintenance or pathologic hypersecretory condition treatment not established in pediatric patients.¹

Oral: Safety and efficacy not established in neonates (< 1 month of age).¹

Oral: Safety and efficacy established in infants, children, and adolescents 1 month to 16 years of age for duodenal and gastric ulcer treatment and healing maintenance, GERD treatment, and erosive esophagitis treatment.¹

Parenteral: Safety and efficacy not established in pediatric patients for treatment of pathologic hypersecretory conditions.^{117 172}

Parenteral: Safety and efficacy established in infants, children, and adolescents 1 month to 16 years of age for duodenal ulcer treatment.^{117 172}

Parenteral (IV) use in neonates (< 1 month of age) receiving extracorporeal membrane oxygenation (ECMO): Limited data in neonates suggest that ranitidine may be safe and useful to increase gastric pH in infants at risk of GI hemorrhage.^{117 172}

Geriatric Use

No substantial differences in safety and efficacy relative to younger adults, but increased sensitivity cannot be ruled out.^{1 117 172}

Use with caution due to greater frequency of decreased renal function observed in the elderly.^{1 117 172}

Select dosage with caution; monitoring renal function may be useful.^{1 117 172}

Hepatic Impairment

Use with caution.¹ (See Hepatic Effects under Cautions.)

Renal Impairment

Use with caution; dosage adjustment necessary based on degree of renal impairment.¹ (See Renal Impairment under Dosage and Administration.)

Common Adverse Effects

Oral or parenteral therapy: Headache, sometimes severe.^{1 2 4 5 81 88 97 117 124 147 172}

IM therapy: Transient pain at injection site.^{117 172}

IV therapy: Transient local burning or itching.^{117 172}

Interactions for Zantac

Binds weakly to hepatic CYP isoenzyme system in vitro.^{1 117 172}

Affinity for CYP isoenzyme system is about 10% that of cimetidine; inhibition of CYP isoenzyme system is 2.4 times less than cimetidine.^{54 101}

Does not inhibit CYP isoenzymes at recommended dosages.^{1 117 172}

May minimally inhibit hepatic metabolism of some drugs,^{1 2 4 5 74 101 105 112} or affect bioavailability by another mechanism (e.g., pH-dependent absorption, altered volume of distribution).^{1 117 172}

Specific Drugs, Foods, and Laboratory Tests

Drug, Food, or Test	Interaction	Comments
Acetaminophen	Dose-dependent inhibition of acetaminophen metabolism in vitro96 108
Alcohol	Moderate alcohol consumption by individuals receiving concurrent ranitidine unlikely to result in clinically important alterations of blood alcohol concentration and/or alcohol metabolism77 238 239 240 241 244 247	Controversy about psychomotor impairment potential;238 239 240 241 242 243 248 observe usual precautions about alcohol intake and hazardous tasks requiring mental alertness or physical coordination239 240 243
Antacids	Low doses (10–15 mEq HCl neutralizing capacity/10 mL) do not appear to decrease absorption or plasma concentrations of ranitidine1 2 4 5 6 38 76 Higher doses (e.g., 150 mEq HCl neutralizing capacity/30 mL) decrease absorption by 33%, decrease plasma concentrations, and AUC76
Atenolol	Atenolol pharmacokinetics apparently not affected72
Benzodiazepines (e.g., diazepam, lorazepam, midazolam, triazolam)	Diazepam AUC, mean half-life not substantially affected2 Lorazepam elimination half-life, volume of distribution, clearance unaffected106 Midazolam oral bioavailability may be increased by ranitidinef Triazolam oral bioavailability may be increased by elevated gastric pH 1 117 124 172 clinical importance unknown1 b c	Observe carefully for signs of midazolam-induced respiratory and CNS depression; decrease midazolam dosage if requiredf
Food	Does not appear to decrease absorption or plasma concentrations of ranitidine1 2 4 5 6 38 76
Metoprolol	Increased metoprolol AUC, peak serum concentration, elimination half-life72 73
Multistix, test for urine protein	False positive1	Use sulfosalicylic acid reagent for urinary protein determinations while using ranitidine1
Nifedipine	Nifedipine AUC increased by 30%72
Phenytoin	Phenytoin serum concentrations unaffected107
Propantheline	Appears to delay absorption and increases peak serum concentrations of ranitidine; biovailability increased about 23% with concomitant administration2
Propranolol	Propranolol mean serum concentrations not substantially affected2 101
Smoking	Adversely affects duodenal ulcer healing and decreases ranitidine efficacy;67 87 number of cigarettes/day apparently does not influence healing rate67
Theophylline	Ranitidine apparently does not alter theophylline clearance71 105
Vitamin B12	Vitamin B12 malabsorption and deficiency may occur with long-term ranitidine therapy16
Warfarin	Increased or decreased PT reported1 91 117 122 172	Pharmacokinetic studies: up to 400 mg daily had no effect on warfarin clearance or PT1 91 117 122 172

Zantac Pharmacokinetics

Absorption

Bioavailability

Rapidly absorbed after oral^{2 5 6 37 40} or IM¹¹⁷ administration.

Oral bioavailability: About 50%;^{1 2 4 5 6 39 42 88 139} similar in children 3.5–16 years of age.¹⁶⁰

Oral: Peak plasma concentration attained within 2–3 hours in adults and geriatric patients and within 1.6–2 hours in children 1 month to 16 years of age.¹

IM: about 90–100% absorption.¹¹⁷

Commercially available oral solution, effervescent tablets, and conventional tablets are bioequivalent.¹

Duration

Following oral administration of a single 150-mg dose, substantial inhibition of gastric acid secretion reportedly continues for about 9.5 hours.⁵

In pediatric patients, oral administration of 6–10 mg/kg daily (in 2 or 3 divided doses), maintained gastric pH throughout the dosing interval.¹

Following a single 150-mg oral dose, serum concentrations required to inhibit 50% of stimulated gastric acid secretion are maintained for up to 12 hours.^{1 4}

IM or IV: Following a 50-mg dose, serum concentrations required to inhibit 50% of stimulated gastric acid secretion are maintained for 6–8 hours.¹¹⁷

Food

Food does not appear to substantially affect absorption or peak plasma concentrations.^{1 2 4 5 6 38}

Special Populations

Oral: In geriatric individuals, AUC may be substantially increased.¹⁵⁹

In individuals with cirrhosis, oral bioavailability appears to increase to about 70% and peak serum ranitidine concentrations appear to be higher because of reduced first-pass metabolism;^{2 6 42} considered minor, clinically unimportant.¹

Distribution

Extent

Widely distributed throughout body.^{1 2 4 39 88 103 249}

Distributed into CSF following oral administration;^{4 5 33 158} CSF concentrations in individuals with uninflamed meninges are about 3–5% of concurrent peak serum concentrations.^{4 5 33 158}

Distributed into human milk;¹ milk concentrations appear to be 25–100% of concurrent serum concentrations.⁴

Plasma Protein Binding

10–19%.^{1 2 4 39 88 103 249}

Special Populations

In individuals with cirrhosis, minor but clinically unimportant alterations in distribution occur following oral administration.¹

Elimination

Metabolism

Extensive first-pass metabolism after oral administration.^{1 2 4 5 6 39 42 88 103}

Metabolized in the liver to ranitidine N-oxide, desmethyl ranitidine, and ranitidine S-oxide.^{1 2 3}

Elimination Route

Excreted principally in urine.^{1 3 37 88}

Following oral administration, excretion of unchanged ranitidine in urine is dose-dependent; about 16–36% (unchanged) is excreted in urine within 24 hours.^{1 3 37 43}

Following oral administration, about 4% as ranitidine N-oxide, 1–2% as desmethyl ranitidine, and 1% as ranitidine S-oxide is excreted in urine within 24 hours.^{1 3 4 5 249}

Most of the urinary excretion occurs within the first 6 hours after administration.⁴

The remainder of an orally administered dose is eliminated in feces.^{1 3}

Following IV administration, approximately 70% is excreted in urine as unchanged drug.¹¹⁷

Half-life

Adults: Averages 1.7–3.2 hours^{1 2 4 5 6 37 39 40 41 88 103 104 159} and may be positively correlated with age.¹⁵⁹

Children 3.5–16 years of age: Averages 1.8–2 hours (range: 1.4–2.9 hours).^{117 160 172}

Neonates (<1 month of age): Averages 6.6 hours.^{117 172}

Special Populations

In patients with renal impairment, plasma clearance appears to be decreased⁹⁴ and elimination half-life prolonged.^{2 94}

In patients with cirrhosis, minor but clinically unimportant alterations in half-life and reduced clearance occur following oral administration.^{1 42}

In geriatric individuals, clearance appears to be reduced and half-life prolonged because of decreased renal function; although half-life reported to be 3–4 hours following oral or parenteral administration in geriatric patients, ^{1 117 172} in one clinical study it was about 6 hours following an oral 100-mg dose.⁴²

Stability

Storage

Oral

Tablets and Tablets for Self-medication

Tablets: 15–30°C in tight, light resistant container.¹ Replace cap securely after opening.¹

Tablets for self-administration: 20–25°C.^{287 288}

Tablets, Effervescent for Solution (foil-packaged)

2–30°C.^{1 157}

Solution

4–30°C in tight, light resistant container.^{1 124 157}

Parenteral

Injection

4–25°C; may be exposed to temperatures up to 30°C.¹⁷²

Protect from light.^{117 157 172}

Protect from freezing.^{117 157}

Darkening of undiluted injection does not affect potency.^{117 172}

Dilutions in most IV solutions: stable for up to 48 hours at room temperature.^{117 157 172}

Injection for IV infusion only

2–25°C.^{117 157} Brief exposure to temperatures up to 40°C does not affect stability.¹¹⁷

Protect from light.^{117 157}

Protect from freezing.^{117 157}

Compatibility

For information on systemic interactions resulting from concomitant use, see Interactions.

Parenteral

Solution Compatibility^HID

Compatible
Amino acids 8.5%
Dextrose 5% in sodium chloride 0.45%
Dextrose 5 or 10% in water
Fat emulsion 10%, IV
Sodium chloride 0.9%
Variable
Dextrose 5% in Ringer’s injection, lactated. (stable for 48 hours)117

Drug Compatibility

Admixture CompatibilityHID

Compatible
Acetazolamide sodium
Amikacin sulfate
Aminophylline
Chloramphenicol sodium succinate
Chlorothiazide sodium
Ciprofloxacin

zoledronic acid Intravenous

zoe-le-DRON-ik AS-id

Commonly used brand name(s)

In the U.S.

• Reclast


• Zometa

Available Dosage Forms:

• Solution


• Powder for Solution

Therapeutic Class: Calcium Regulator

Chemical Class: Bisphosphonate

Uses For zoledronic acid

Zoledronic acid injection is used to treat hypercalcemia (high levels of calcium in the blood) that may occur in patients with some types of cancer. It is also used to treat a cancer called multiple myeloma (tumors formed by the cells of the bone marrow) or certain types of bone metastases (the spread of cancer to the bone).

Zoledronic acid injection is used to treat Paget's disease of the bone in men and women. It is also used in men with osteoporosis and in women with osteoporosis who have gone through menopause. zoledronic acid is used to reduce the risk of having more fractures in patients who have had a recent hip fracture.

zoledronic acid is to be administered only by or under the supervision of your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, zoledronic acid is used in certain patients with the following medical conditions:

• Bone loss, in men, from taking certain medicines for prostate cancer.


• Bone loss, in breast cancer patients, from hormone therapy (prevention).

Before Using zoledronic acid

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

Allergies

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

Pediatric

Zoledronic acid injection is not indicated for use in children.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of zoledronic acid injection in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution in patients receiving zoledronic acid injection.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	D	Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

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

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

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

Other Medical Problems

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

• Anemia or


• Bleeding problems or


• Cancer, history of or


• Dental or tooth problems or


• Dental procedures or


• Poor oral hygiene, or


• Surgery (e.g., dental surgery)—May increase risk for severe jaw problems.

• Asthma, aspirin-sensitive or


• Heart disease or


• Kidney disease or


• Mineral imbalance (e.g., high or low calcium, magnesium, phosphorus, or potassium in the blood)—Use with caution. May make these conditions worse.

• Bowel resection or


• Parathyroid disease (e.g., hypoparathyroidism) or


• Parathyroid surgery or


• Stomach absorption problems or


• Thyroid surgery—These conditions may increase your risk of having hypocalcemia (low levels of calcium in the blood).

• Dehydration (not enough water or fluid in your body)—May increase risk of severe kidney problems.

• Hypocalcemia (low calcium in the blood) or


• Kidney disease, severe (e.g., kidney failure)—Should not be used in patients with these conditions.

Proper Use of zoledronic acid

A nurse or other trained health professional will give you zoledronic acid. zoledronic acid is given through a needle placed in one of your veins. The medicine must be injected slowly, so your IV tube will need to stay in place for at least 15 minutes.

For hypercalcemia, zoledronic acid is usually given only once. If your doctor decides that you need additional doses, you will receive the medicine again after at least 7 days have passed. This treatment will continue until your body responds to the medicine.

For bone cancer and multiple myeloma, zoledronic acid is usually given every 3 to 4 weeks. This treatment will continue until your body responds to the medicine.

For osteoporosis, zoledronic acid is usually given once a year and will continue until your body responds to the medicine.

You may also receive other medicines to help keep your body from losing too much fluid.

Your doctor may also give you vitamins containing Vitamin D and calcium. Tell your doctor if you are unable to take these supplements.

Drink extra fluids so you will pass more urine while you are using zoledronic acid. This will keep your kidneys working well and help prevent kidney problems. However, it is very important to not drink too much liquid. Talk to your doctor about the right amount of liquids for you.

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

Precautions While Using zoledronic acid

It is very important that your doctor check your progress at regular visits after you have received zoledronic acid injection. If your condition has improved, your progress must still be checked. The results of laboratory tests or the occurrence of certain symptoms will tell your doctor if your condition is coming back and if a second treatment is needed. You will need a yearly dose of zoledronic acid if you are being treated for postmenopausal osteoporosis, so check with your doctor regularly.

Using zoledronic acid while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

You should not use other medicines that also contain zoledronic acid, such as Reclast® or Zometa®. Using these medicines together may increase your chance for more serious side effects.

zoledronic acid may rarely cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth after receiving the medicine.

zoledronic acid may cause low calcium in your blood. Check with your doctor immediately if you have numbness or tingling around the mouth, or if you have muscle spasms.

Tell your doctor right away if you have agitation; blood in the urine; confusion; decreased urine output; depression; dizziness; headache; irritability; lethargy; muscle twitching; nausea; rapid weight gain; seizures; stupor; swelling of the face, ankles, or hands; or unusual tiredness or weakness. These could be symptoms of serious kidney problems.

Your doctor will need to know if you have a history of problems with your mouth or teeth (e.g., gum disease). Make sure your doctor knows if you have been treated with a bisphosphonate medicine, such as alendronate (Fosamax®), etidronate (Didronel®), pamidronate (Aredia®), risedronate (Actonel®), or tiludronate (Skelid®) in the past.

You may need to have a dental exam before you start using zoledronic acid.

It is important that you check with your doctor before having any dental procedures or surgeries done while you are receiving zoledronic acid. Tell your doctor right away if you have jaw tightness, swelling, numbing, or pain or a loose tooth. This could be symptoms of a severe problem of your jaw.

Make sure you tell your doctor about any new medical problems, especially with your teeth or jaws. Tell your doctor if you have severe muscle, bone, or joint pain after receiving zoledronic acid.

zoledronic acid may increase your risk of developing fractures of the thigh bone. This may be more common if you use it for a long time. Check with your doctor right away if you have a dull or aching pain in the thighs, groin, or hips.

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

zoledronic acid Side Effects

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

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

More common

• Agitation


• black, tarry stools


• blurred vision


• chest pain


• chills


• coma


• confusion


• convulsions


• cough


• depression


• difficult or labored breathing


• dizziness


• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position


• fever


• irregular heartbeat


• irritability


• lack or loss of strength


• lethargy


• lower back or side pain


• mood or mental changes


• muscle pain or cramps


• muscle trembling or twitching


• nausea or vomiting


• numbness and tingling around the mouth, fingertips, or feet


• painful or difficult urination


• pale skin


• rapid weight gain


• seizures


• shaking of the hands, arms, feet, legs, or face


• shortness of breath


• skin rash, cracks in the skin at the corners of the mouth, or soreness or redness around the fingernails and toenails


• sore throat


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


• stupor


• sudden sweating


• swollen glands


• tightness in the chest


• trouble breathing with exercise


• unusual bleeding or bruising


• unusual tiredness or weakness


• wheezing

Less common

• Feeling of constant movement of self or surroundings


• muscle cramps in the hands, arms, feet, legs, or face


• muscle spasms


• neck pain


• pounding in the ears


• rapid breathing


• sensation of spinning


• slow or fast heartbeat


• sunken eyes


• tingling of the hands or feet


• tremor

Incidence not known

• Blurred vision or other change in vision


• decreased frequency or amount of urine


• decreased vision


• eye pain


• eye tenderness


• heavy jaw feeling


• increased blood pressure


• increased tearing


• increased thirst


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


• loosening of a tooth


• pain, swelling, or numbness in the mouth or jaw


• redness of the eye


• sensitivity of the eye to light


• severe eye pain


• swelling of the face, hands, fingers, lower legs, or ankles


• troubled breathing


• weight gain

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

More common

• Abdominal or stomach pain


• anxiety, nervousness, restlessness, or irritability


• back pain


• bad, unusual, or unpleasant (after) taste


• bladder pain


• blistering, crusting, irritation, itching, or reddening of the skin


• bloody or cloudy urine


• bone pain


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


• change in taste


• constipation


• cracked lips


• cracked, dry, or scaly skin


• diarrhea


• difficulty with swallowing


• discouragement


• dry mouth


• ear congestion


• fear or nervousness


• feeling sad or empty


• frequent urge to urinate


• hair loss or thinning hair


• headache


• hyperventilation


• joint pain or swollen joints


• loss of appetite


• loss of interest or pleasure


• loss of voice


• muscle stiffness or difficulty with moving


• nasal congestion or runny nose


• pain, swelling, or redness in the joints


• partial loss of feeling


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


• sleepiness or unusual drowsiness


• sleeplessness, trouble sleeping, or unable to sleep


• swelling or inflammation of the mouth


• thirst


• trouble with concentrating


• unusually cold, shivering


• vomiting


• weight loss

Less common

• Acid or sour stomach


• belching


• heartburn


• indigestion


• red streaks on the skin


• stomach discomfort or upset


• swelling, tenderness, or pain at the injection site


• unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness


• wrinkled skin

Rare

• Burning, dry, or itching eyes


• discharge or excessive tearing


• redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid


• throbbing pain

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

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

See also: zoledronic acid Intravenous side effects (in more detail)

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

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

More zoledronic acid Intravenous resources

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

Compare zoledronic acid Intravenous with other medications

• Hypercalcemia of Malignancy
• Osteolytic Bone Lesions of Multiple Myeloma
• Osteolytic Bone Metastases of Solid Tumors
• Osteoporosis
• Paget's Disease
• Prevention of Osteoporosis

Zypram Cream with Cleansing Wipes

Pronunciation: HYE-droe-KOR-ti-sone AS-e-tate/pram-OX-een
Generic Name: Hydrocortisone Acetate/Pramoxine
Brand Name: Zypram

Zypram Cream with Cleansing Wipes is used for:

Treating inflammation and itching of the anal area due to certain skin conditions.

Zypram Cream with Cleansing Wipes is a combination topical corticosteroid and local anesthetic. It works by reducing skin inflammation (redness, swelling, itching, and irritation) in a way that is not exactly understood. It also decreases pain in the affected area.

Do NOT use Zypram Cream with Cleansing Wipes if:

• you are allergic to any ingredient in Zypram Cream with Cleansing Wipes


• you have a rectal obstruction, abscess, or perforation

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

Before using Zypram Cream with Cleansing Wipes:

Some medical conditions may interact with Zypram Cream with Cleansing Wipes. 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 any kind of skin infection, cuts, scrapes, or lessened blood flow to your skin in the affected area


• if you have a parasitic, bacterial, fungal, or viral infection; diabetes; diarrhea; swelling of the esophagus; stomach or intestinal problems (eg, blockage, colostomy, fistula, inflammation, perforation, ulcer); inflammation of the lining of the abdomen; measles; tuberculosis (TB); a positive TB skin test; chickenpox; shingles; herpes infection of the eye; or kidney problems; or if you have received a recent vaccination


• if you have a history of congestive heart failure or heart attack


• if you have had a recent intestinal surgery or procedure

Some MEDICINES MAY INTERACT with Zypram Cream with Cleansing Wipes. Because little, if any, of Zypram Cream with Cleansing Wipes is absorbed into the blood, the risk of it interacting with another medicine is low.

Ask your health care provider if Zypram Cream with Cleansing Wipes 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 Zypram Cream with Cleansing Wipes:

Use Zypram Cream with Cleansing Wipes as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Zypram Cream with Cleansing Wipes is for use around the rectal area only.


• Wash your hands immediately before and after using Zypram Cream with Cleansing Wipes.


• Gently clean the affected area with the cleansing wipe provided.


• Fill the applicator with Zypram Cream with Cleansing Wipes as directed. Gently insert the tip of the filled applicator about ½ inch into the anal area and apply Zypram Cream with Cleansing Wipes as directed. Do not insert the applicator too far into the anus or rectum.


• If you miss a dose of Zypram Cream with Cleansing Wipes, apply it as soon as possible. If you do not remember until the next day, 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 Zypram Cream with Cleansing Wipes.

Important safety information:

• Avoid getting Zypram Cream with Cleansing Wipes in your eyes. If you get Zypram Cream with Cleansing Wipes in your eyes, immediately flush them with cool tap water.


• If your symptoms do not get better within 2 to 3 weeks or if they get worse, check with your doctor.


• Do not use more than the recommended dose or use for longer than prescribed without checking with your doctor.


• Do not use Zypram Cream with Cleansing Wipes for other rectal conditions at a later time.


• Check with your doctor before having vaccinations while you are using Zypram Cream with Cleansing Wipes.


• Corticosteroids may affect growth rate in CHILDREN and teenagers in some cases. They may need regular growth checks while they use Zypram Cream with Cleansing Wipes.


• Caution is advised when using Zypram Cream with Cleansing Wipes in CHILDREN; they may be more sensitive to its effects.


• Serious side effects may occur if too much of Zypram Cream with Cleansing Wipes is absorbed through the skin. This may be more likely to occur if you use Zypram Cream with Cleansing Wipes over a large area of the body. It may also be more likely if you wrap or bandage the area after you apply Zypram Cream with Cleansing Wipes. The risk is greater in children. Do not use more than the prescribed dose. Contact your doctor right away if you develop unusual weight gain (especially in the face), muscle weakness, increased thirst or urination, confusion, unusual drowsiness, severe or persistent headache, or vision changes. Discuss any questions or concerns with your doctor.


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

Possible side effects of Zypram Cream with Cleansing Wipes:

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:

Mild burning, dryness, itching, or irritation at the application site.

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); acne-like rash; excessive hair growth; fever or other signs of infection; inflamed hair follicles; muscle weakness; rectal pain, burning, cracking, itching, bleeding, peeling, or irritation not present before using Zypram Cream with Cleansing Wipes; thinning, softening, or discoloration of the skin; unusual weight gain, especially in the face.

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: Zypram 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 increased thirst or urination; muscle weakness; unusual weight gain, especially in the face.

Proper storage of Zypram Cream with Cleansing Wipes:

Store Zypram Cream with Cleansing Wipes between 68 and 77 degrees F (20 and 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. Keep Zypram Cream with Cleansing Wipes out of the reach of children and away from pets.

General information:

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


• Zypram Cream with Cleansing Wipes 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 Zypram Cream with Cleansing Wipes. 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 Zypram resources

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

Compare Zypram with other medications

• Hemorrhoids

Promox

Promox may be available in the countries listed below.

Ingredient matches for Promox

Amoxicillin

Amoxicillin trihydrate (a derivative of Amoxicillin) is reported as an ingredient of Promox in the following countries:

• Bangladesh


• Hong Kong

International Drug Name Search

Pandomil

Pandomil may be available in the countries listed below.

Ingredient matches for Pandomil

Sertraline

Sertraline is reported as an ingredient of Pandomil in the following countries:

• Colombia

International Drug Name Search

GoLYTELY Solution (Packet)

Pronunciation: pol-ee-ETH-i-leen GLYE-kole/e-LECK-troe-lites
Generic Name: Polyethylene Glycol/Electrolytes
Brand Name: GoLYTELY

GoLYTELY Solution (Packet) is used for:

Cleaning out the bowel before surgery or other procedures. It may also be used for other conditions as determined by your doctor.

GoLYTELY Solution (Packet) is a laxative. It works by causing the colon to move contents along more quickly.

Do NOT use GoLYTELY Solution (Packet) if:

• you are allergic to any ingredient in GoLYTELY Solution (Packet)


• you have appendicitis or certain stomach or bowel problems (eg, blockage, retention, perforation, toxic inflammation, megacolon, ileus)

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

Before using GoLYTELY Solution (Packet):

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

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


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


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


• if you have a throat (esophagus) disease, ulcerative colitis, heart disease (eg, irregular heartbeat, congestive heart failure), swallowing problems (eg, history of aspiration or regurgitation), impaired gag reflex, electrolyte imbalances (eg, high blood potassium levels), or rectal bleeding of unknown cause


• if you have a history of alcohol use

Some MEDICINES MAY INTERACT with GoLYTELY Solution (Packet). However, no specific interactions with GoLYTELY Solution (Packet) are known at this time.

Ask your health care provider if GoLYTELY Solution (Packet) 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 GoLYTELY Solution (Packet):

Use GoLYTELY Solution (Packet) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Your doctor will tell you when to start using GoLYTELY Solution (Packet). Do not eat any solid foods for at least 2 hours before beginning GoLYTELY Solution (Packet). It is preferred that you do not eat for 3 to 4 hours before beginning GoLYTELY Solution (Packet).


• Drink only clear liquids and do not eat any solid foods from the time you start GoLYTELY Solution (Packet) until your procedure is complete.


• Before using GoLYTELY Solution (Packet), mix the contents of this packet with 1 gallon of water or as directed by your doctor. Use lukewarm water to mix GoLYTELY Solution (Packet) to help the medicine dissolve faster. Shake well.


• Chilling GoLYTELY Solution (Packet) improves the taste. Do not add sugar, sweetening agents, or other additives to GoLYTELY Solution (Packet).


• Shake well before each use.


• Drink 8 ounces (240 mL) of GoLYTELY Solution (Packet) every 10 minutes until the stool is watery, clear, and free of all solid matter, or until the medicine is gone. At least 3 liters is usually required to produce the watery stool. It is best to drink all of GoLYTELY Solution (Packet). Be sure to follow the instructions provided by your doctor. It is best to drink each portion quickly rather than sipping it. Rinsing your mouth with mouthwash after each glass of medicine may help get rid of the taste.


• Other medicines taken by mouth within 1 hour of taking GoLYTELY Solution (Packet) may not be absorbed or be effective. Contact your doctor or pharmacist with any concerns you might have about taking your other medicines.


• If you miss a dose of GoLYTELY Solution (Packet), take it as soon as you remember. Continue to take it as directed by your doctor. Notify your doctor right away if you are unable to finish taking GoLYTELY Solution (Packet) before your test.

Ask your health care provider any questions you may have about how to use GoLYTELY Solution (Packet).

Important safety information:

• The first bowel movement usually occurs about 1 hour after you begin drinking GoLYTELY Solution (Packet).


• Keep all doctor and lab appointments while you are taking GoLYTELY Solution (Packet).


• Use GoLYTELY Solution (Packet) with caution in patients who are unconscious or partially conscious because they may be at greater risk for vomiting and inhaling GoLYTELY Solution (Packet).


• Use GoLYTELY Solution (Packet) with caution in the ELDERLY; they may be more sensitive to its effects.


• GoLYTELY Solution (Packet) should be used with extreme caution in CHILDREN; safety and effectiveness in 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 GoLYTELY Solution (Packet) while you are pregnant. It is not known if GoLYTELY Solution (Packet) is found in breast milk. If you are or will be breast-feeding while you use GoLYTELY Solution (Packet), check with your doctor. Discuss any possible risks to your baby.

Possible side effects of GoLYTELY Solution (Packet):

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:

Bloating; nausea; rectal irritation; stomach fullness or cramps; vomiting.

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); chest pain; muscle weakness; persistent or severe nausea and vomiting; severe bloating or abdominal swelling; severe stomach pain; slow or irregular heartbeat; vomiting of blood.

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: GoLYTELY (Packet) 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 GoLYTELY Solution (Packet):

Before mixing, store GoLYTELY Solution (Packet) at room temperature, 59 and 86 degrees F (15 and 30 degrees C), in a tightly closed container. Store away from heat, moisture, and light. After preparing the solution, store GoLYTELY Solution (Packet) in the refrigerator in a tightly closed container. Use within 48 hours. Discard any unused portion of GoLYTELY Solution (Packet). Keep GoLYTELY Solution (Packet) out of the reach of children and away from pets.

General information:

• If you have any questions about GoLYTELY Solution (Packet), please talk with your doctor, pharmacist, or other health care provider.


• GoLYTELY Solution (Packet) 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 GoLYTELY Solution (Packet). 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 GoLYTELY Solution (Packet) resources

• GoLYTELY Solution (Packet) Side Effects (in more detail)
• GoLYTELY Solution (Packet) Use in Pregnancy & Breastfeeding
• GoLYTELY Solution (Packet) Support Group
• 5 Reviews for GoLYTELY (Packet) - Add your own review/rating

Compare GoLYTELY Solution (Packet) with other medications

• Bowel Preparation
• Constipation, Chronic
• Gastrointestinal Decontamination