Jul
26
Betaxolol
July 26, 2009 | Leave a Comment
Generic Name
Betaxolol (bay-TAX-0-101) IN
Brand Names
Betoptic Kerlone Betoptic S
The information in this profile also applies to the following drugs:
Generic Ingredient: Carteolol Ocupress
Generic Ingredient: Levobunolol 92
AK Beta Betagan
Generic Ingredient: Metipranolol Optipranolol
Type of Drug
Beta-adrenergic blocking agent. Prescribed For
High blood pressure and glaucoma.
General Information
betaxololhydrochloride is one of many beta-adrenergic blocking drugs, or beta blockers, which interfere with the action of a specific part of the nervous system. Beta receptors are found all over the body and affect many body functions. Each beta blocker has particular characteristics that make it more suitable for certain conditions or people. Beta-blocker eyedrops reduce ocular pressure (pressure inside the eye) by slowing the production of eye fluids and by slightly increasing the rate at which these fluids flow through and leave the eye. Small amounts of these drugs are absorbed into the general blood circulation after they are instilled in the eye and may affect areas of the body other than the eye.
Cautions and Warnings
Q(3 M *e betaxolol if you are allergic or sensitive to any of its ingredients. You should be cautious about taking betaxolol if you have asthma, chronic bronchitis, emphysema, severe heart failure, a very slow heart rate, or heart block (disruption of the electrical impulses that control heart rate) because the drug may aggravate these conditions.
People with angina risk aggravating their angina if they suddenly stop taking the drug. These people should have their betablocker eyedrops dosage reduced gradually over 1-2 weeks.
Liver or kidney problems may reduce your ability to eliminate beta-blocker eyedrops from your body.
Beta-blocker eyedrops may mask the physical signs of hypoglycemia (low blood sugar). People with diabetes who must take insulin or oral medications to lower blood sugar and those subject to hypoglycemia should use beta-blocker eyedrops with caution.
Beta-blocker eyedrops may reduce the amount of blood your heart pumps with each beat. This reduction in blood flow may aggravate the condition of people with poor circulation or circulatory disease.
If you are undergoing major surgery, your doctor may want you to stop using beta-blocker eyedrops at least 2 days before surgery.
Betaxolol eyedrops should be avoided by people who cannot take oral beta-blocking drugs such as propranolol.
People with a history of severe anaphylactic reaction to allergens may be unresponsive to usual doses of epinephrine while taking beta blockers.
Possible Side Effects
Side effects are relatively uncommon and usually mild.
✓ Common: discomfort in the eye.
✓ Less common: blurred vision, inflammation of the cornea, sensation of having something in the eye, sensitivity to light, tearing, itching, dry eye, redness, inflammation, discharge, eye pain, cloudy vision, and crusting of the lashes.
✓ Rare: unusual tiredness or weakness, slow heartbeat, heart failure, dizziness, breathing difficulties, bronchospasm, depression, rash, and hair loss. Contact your doctor if you experience any side effect not listed above.
I
OMg ITAGractions
Beta-blocker eyedrops may interact with surgical anesthetics to increase the risk of heart problems during surgery. Some anesthesiologists recommend gradually stopping the drug Combining beta-blocker eyedrops and oral beta blockers will increase the effects of each drug. These drugs should be combined cautiously.
• Cocaine may reduce the effectiveness of all beta-blocker eyedrops.
• Betaxolol will counteract thyroid hormone replacements.
• Calcium channel blockers, reserpine, phenothiazine compounds, and quinidine may increase the amount of betablocker eyedrops in the bloodstream and lead to low blood pressure and heart rate disturbances.
• Betaxolol should not be taken within 2 weeks of taking a monoamine oxidase inhibitor (MAOI) antidepressant.
• Combining betaxolol with digitalis drugs can result in ex-
cessive slowing of the heart, possibly causing heart block.
• If you use other glaucoma eye medications, separate your doses to avoid physically combining them.
• Small amounts of beta-blocker eyedrops are absorbed into the bloodstream and may interact with other drugs in the same way as oral beta blockers, although this is unlikely.
• Beta blockers may block the effects of epinephrine.
• If you stop smoking while taking betaxolol, your dose may have to be reduced because your liver will break down the drug more slowly afterward.
Food Interactions
None known. Usual Dose
Adult
Glaucoma: 1-2 drops in the affected eye twice a day.
Hypertension: 10 mg tablet a day. May increase to 20 mg a day after 7-14 days. For seniors or people with severe kidney impairment, starting dose is 5 mg.
Child: not recommended. Overdosage
If Q\4tCqOSZ Occurs in the eye, flush it with water or saline. If accidentally ingested, symptoms of overdose of beta-blockers taken orally may occur. These include changes in heartbeat—unusually slow, unusually fast, or irregular—severe dizziness or fainting, breathing difficulties, bluish-colored fingernails or palms, low blood pressure, heart failure, shock, and seizures. If these symptoms occur, the victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container with you.
Special Information
Call your doctor at once if you develop back or joint pain, breathing difficulties, cold hands or feet, depression, rash, or changes in heartbeat. Beta-blocker eyedrops may produce an undesirable lowering of blood pressure, leading to dizziness or fainting; call your doctor if this happens to you. Also call your doctor if you experience persistent or bothersome anxiety, diarrhea, constipation, impotence, headache, itching, nausea or vomiting, nightmares or vivid dreams, upset stomach, trouble sleeping, stuffy nose, frequent urination, unusual tiredness, or weakness.
Do not use with your contact lenses in your eye. Do not touch the dropper to any surface.
If you forget a dose of beta-blocker eyedrops, administer it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: In animal studies, betaxolol given orally at doses much higher than is absorbed through administration in the eye was associated with miscarriage. There is little information about the effects of betaxolol in pregnant women. Betaxolol should be used during pregnancy only if the benefit outweighs the risk.
Some beta blockers pass into breast milk. Nursing mothers taking beta-blocker eyedrops should use infant formula.
Seniors: Seniors may take betaxolol without special precautions.
Jul
26
Baclofen
July 26, 2009 | Leave a Comment
Generic Name
Baclofen (BAK-loe-fen)
Brand Name Kemstro
Type of Drug
Skeletal muscle relaxant.
Prescribed For
Muscle spasms associated with multiple sclerosis (MS), spinal cord injury or disease, or other nervous system conditions; may also be used to treat trigeminal neuralgia (tic douloureux), hiccups, acid reflux, and as migraine prevention.
QeCttt!b% %iftTimation
Baclofen may work by interfering with nervous system reflexes at the spinal cord, although it may also have some effect outside the spinal cord. Baclofen is chemically similar to a natural nerve transmitter known as GABA; baclofen’s effect on muscle spasm may be related to its effect on GABA nerve receptors.
cautions and Warnings
Do not take baclofen if you are allergic or sensitive to any of its ingredients. It should not be taken for muscle spasm resulting from rheumatic disease, stroke, cerebral palsy, or Parkinson’s disease because its benefit in these situations has not been proven. The condition of people with epilepsy or psychotic disorders may worsen while taking baclofen.
About 4% of women with MS who take baclofen for less than 1 year develop ovarian cysts that usually disappear on their own. This is within the normal range for all women-1-5%—for developing ovarian cysts.
Baclofen is excreted primarily through the kidneys, so patients with kidney disease or impaired kidney function should use baclofen with caution.
Abruptly stopping baclofen can lead to hallucinations and seizure. Dosage should always be gradually reduced, except in cases of severe side effects.
Possible Side Effects
Baclofen may affect lab tests for liver function and can raise blood sugar levels.
♦ Most common: drowsiness, low blood pressure, weakness, dizziness, lightheadedness, nausea and vomiting, headache, and sleeplessness.
♦ Less common: frequent urination, fatigue or lethargy, confusion, euphoria, excitement, depression, hallucinations, tingling in the hands or feet, muscle pain, ringing or buzzing in the ears, coordination difficulties, tremors, rigidity, weakness, loss of muscle tone, unusual eye movement and other muscle-control problems, double vision, pinpoint or wide-open pupils, breathing difficulties, heart palpitations, dry mouth, appetite loss, changes in sense of taste, abdominal pain, diarrhea, bedwetting, difficulty u6- nating, painful urination, impotence, gash, Itching, swelling of the ankle, excessive sweating, weight gain, and stuffy
MSe.
• Rare: slurred speech, blurred vision, seizure, fainting, chest pain, blood in the urine, and testing positive for blood in the stool. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Avoid alcoholic beverages and other nervous system depressants such as antihistamines, sedatives, or narcotic pain relievers while taking baclofen.
• Combining a monoamine oxidase inhibitor (MA01) antidepressant with baclofen may cause drowsiness, nervous system depression, and low blood pressure.
• Combining a tricyclic antidepressant with baclofen may lead to severe muscle weakness.
• Baclofen may increase blood sugar. Diabetics may need to increase their dosage of antidiabetic drugs to account for this effect.
• Combining blood-pressure-lowering drugs with baclofen may lead to dizziness or fainting due to severe lowering of blood pressure.
Food Interactions
This drug may be taken without regard to food or meals.
Usual Dose
Adult and Child: 5 mg 3 times a day for 3 days, gradually increased every 3 days until the desired effect is achieved, usually at 40-80 mg a day. People with kidney disease require lower doses.
Overdosage
Symptoms of baclofen overdose include vomiting, loss of muscle tone, twitching, convulsions, pinpoint or wide-open pupils, drowsiness, blurred or double vision, breathing difficulties, seizure, and coma. Overdose victims should be taken to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.
Special Information
Baclofen is a nervous system depressant. Take care when driving or doing anything that requires concentration and physical coordination.
Call your doctor if you develop persistent symptoms such as a frequent u((;e, t0 %,miwale, painful urination, constipation, nausea, headache, sleeplessness, or confusion.
Do not stop taking baclofen on your own. Abruptly stopping this drug may lead to hallucinations or seizure.
Your pharmacist may prepare a baclofen liquid. This mixture should be kept in the refrigerator and must be thrown away after I month.
If you forget a dose of baclofen and remember within 1 hour of your scheduled time, take it immediately. If you do not remember until more than 1 hour later or it 1()u JoTgetft completely. skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Baclofen increases the chances of certain birth defects in lab animals. Pregnant women should only take baclofen after carefully weighing its possible benefits against its risks.
Baclofen taken by mouth passes into breast milk. Nursing mothers who must take this drug should use infant formula or receive the drug by injection directly into the spinal cord, because baclofen administered by injection does not pass into breast milk.
Seniors: Seniors may be more sensitive to nervous system side effects including hallucinations, depression, drowsiness, and confusion.
Jul
24
Amiodarone
July 24, 2009 | Leave a Comment
Amiodarone
Prescribed For Abnormal heart rhythms.
General Information
Amiodarone should be prescribed only in situations where the abnormal rhythm is so severe as to be life-threatening and does not respond to other drug treatments. Amiodarone works by decreasing the sensitivity of heart tissue to nervous impulses within the heart. It has not been proven that people taking this drug will live longer than those with similar conditions who do not take it. Amiodarone may exert its effects 2-5 days after you start taking it, but often takes 1-3 weeks to affect your heart. Amiodarone’s antiarrhythmic effects can last for weeks or months after you stop taking it.
Cautions and Warnings
Do not take amiodarone if you are allergic or sensitive to any of its ingredients or if you have heart block or a very slow heart rate. Amiodarone can also cause heart block, a drastic slowing of electrical impulse movement between major areas of the heart, or extreme slowing of the heart rate. Amiodarone heart block occurs about as often as heart block caused by some other antiarrhythmic drugs, but its effects may last longer than those of the other drugs. Amiodarone can also worsen existing abnormal heart rhythms in 2-5% of people who take the drug. These effects can be fatal.
Amiodarone can cause potentially fatal drug side effects. At high doses, 10% or more of people taking this drug can develop potentially fatal lung and respiratory effects, beginning with cough and progressive breathing difficulties. Liver damage caused by amiodarone is usually mild. In rare cases, amiodarone has been associated with liver failure that resulted in death.
People taking amiodarone may develop optic nerve irritation, leading to partial or complete loss of vision. Most adults who take amiodarone for 6 months or more develop tiny deposits in the corneas of their eyes. These deposits may cause blurred vision or t1dil’O'S 111 Up to 10% of people taking amiodarone. Some people develop dry eyes and sensitivity to bright light.
One in ten people taking amiodarone can experience unusual sensitivity to the effects of the sun. Use an appropriate sunscreen product and reapply it frequently.
Amiodarone can cause thyroid abnormalities. It may worsen an already sluggish thyroid gland in 2-10% of people taking the drug,and increase thyroid activity in 2% of people taking it. Amiodarone has also been associated with an increase in risk of thyroid tumors.
Antiarrhythmic drugs are less effective and cause abnormal rhythms if blood potassium is low.
Possible Side Effects
About 75% of people taking 400 mg or more of amiodarone a day develop some drug side effects. As many as 18% have to stop taking the drug because of a side effect.
♦ Common: fatigue, not feeling well, tremors, unusual involuntary movements, loss of coordination, an unusual walk, muscle weakness, low blood pressure, dizziness, tingling in the hands or feet, reduced sex drive, sleeplessness, headache, nervous-system problems, nausea, vomiting, constipation, appetite loss, abdominal pain, dry eyes, unusual sensitivity to bright light, and seeing halos around bright lights. Unusual sun sensitivity is the most common skin reaction to amiodarone, but people taking this drug can develop a blue skin discoloration that may not go away completely when the drug is stopped. Other skin reactions are sun rashes, hair loss, and black-and-blue spots.
V Rare: inflammation of the lung or fibrous deposits in the lungs, changes in thyroid function, changes in taste or smell, bloating, unusual salivation, and changes in blood clotting. Amiodarone can cause heart failure, reduced heart rate, and abnormal rhythms. Up to 9% of people taking amiodarone develop abnormalities in liver function. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Amiodarone increases the effects of metopvoko% and other beta blockem Calcium channel blockers such as verapamil and diltiazem, cyclosporine, dextromethorphan, digoxin, disopyramide, flecainide, fentanyl, lidocaine, methotrexate, procainamide, quinidine, theophylline, and warfarin and other anticoagulants. These interactions can take from 2 or 3 days to several weeks to develop. Some can be life threatening, and for others, drug dosage adjustments may be enough to avoid a serious problem.
• Fluoroquinolones, azole antifungals, and macrolide antibiotics increase the effects of amiodarone, which can cause life-threatening abnormal heart rhythms.
• When amiodarone and phenytoin are taken together, both drugs can be affected. Amiodarone can be antagonized by phenytoin and other hydantoin anticonvulsants, and the effect of phenytoin can be increased by amiodarone.
• Cholestyramine interferes with the absorption of amiodarone into the bloodstream.
• Cimetidine and ritonavir interfere with the breakdown of amiodarone, leading to high drug blood levels and the increased possibility of side effects.
• Azithromycin can interfere with the effectiveness of amiodarone. This interaction may lead to dizziness and cardiac instability.
Food Interactions
Amiodarone should be taken on an empty stomach, as food delays its absorption into your bloodstream. If amiodarone upsets your stomach, however, you may take it with food but then always take it with food to be consistent. Do not drink grapefruit juice during treatment with amiodarone because grapefruit juice affects how amiodarone is absorbed in the stomach.
Usual Dose
Starting dose-800-1600 mg a day, taken in 1 or 2 doses, usually for 1-3 weeks. Then, 600-800 mg a day for approximately a month. Maintenance dose-400 mg a day. You should take the lowest effective dose in order to minimize side effects.
Overdosage
The effects of amiodarone overdose include low blood pressure, shock, slow heartbeat, and liver toxicity. Overdose victims should be taken to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.
Special Information
Side effects are very common with amiodarone; 75% of people taking the drug will experience some drug-related problem. Amiodarone stays in the body for months, so side effects may remain even after the drug is stopped.
Call your doctor if you develop chest pain, breathing difficulties, spitting up blood, nausea, vomiting, abnormal heartbeat,bloating in your feet or legs, tremors, fever, chills, sore throat, unusual bleeding or bruising, changes in skin color, unusual sunburn, or any other unusual side effect. See your doctor for an eye exam if your vision changes at all while taking amiodarone.
Amiodarone can make you dizzy or lightheaded. Take care while driving a car or performing complex tasks.
If you take amiodarone once a day and forget to take a dose, but remember within 12 hours, take it as soon as possible. If you do not remember until later, skip the dose you forgot and continue with your regular schedule. If you take amiodarone twice a day and remember within 6 hours of your regular dose, take it as soon as you remember. Call your doctor if you forget to take 2 or more doses in a row. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: In high doses, amiodarone has been found to be toxic to animal fetuses. Women of childbearing age should use an effective contraceptive while taking amiodarone. If you are or might be pregnant and this drug is considered crucial by your doctor, its potential benefits must be weighed against its risks.
Amiodarone passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Dosage reduction may be needed in seniors with poor liver function.