Jul
26
Bicalutamide
July 26, 2009 | Leave a Comment
Generic Name
Bicalutamide (bye-kal-UTE-uh-mide)
Brand tjSMb Casodex
The information in this profile also applies to the following drug:
Generic Ingredient: Nilutamide Nilandron
Type of Drug Antiandrogen.
Prescribed For Prostate cancer.
General Information
Antiandrogens are prescribed together with another hormone product for prostate cancer. Bicalutamide competes with testosterone and other natural androgens (male hormones) by binding to the same places in body tissue where androgens normally bind. Prostate cancer is androgen sensitive and responds to treatments that counteract the effects of androgen or remove the sources of androgen.
Cautions and Warnings
Do not take this drug if you are allergic or sensitive to it or any of its ingredients.
People taking this medication may develop severe liver injury. People with liver disease may be at greater risk for serious side effects.
Almost 40% of men taking bicalutamide as single therapy for prostate cancer develop breast pain and enlargement. Bicalutamide may also reduce sperm count.
Two of every 100 people taking nilutamide develop interstitial pneumonitis (symptoms include cough, chest pain, fever, and breathing difficulties). People with lung disease and Asians may be at greater risk. Report any breathing difficulty or worsening of pre-existing breathing difficulty to your doctor immediately.
Isolated cases of aplastic anemia (a potentially fatal blood disorder) have been reported in people taking nilutamide, but the relationship between the drug and the disease is not established.
Possible Side Effects
♦ Most common’. hot dashes, hot flushes, general pain, headache, weakness, back pain, nausea, constipation, sleeplessness, breathing difficulties, and swollen breasts. Nilutamide–difficulty seeing in the dark and loss of testicle function.
V Common: diarrhea and pelvic pain.
Possible Side Effects (continued)
♦ Less common: vomiting, abdominal pains, chest pain, flu-like symptoms, high blood pressure, swelling in the ankles or lower legs, high blood sugar, weight loss, dizziness, tingling in the hands or feet, sweating, rash, nighttime urination, blood in the urine, urinary or other infection, loss of libido, impotence, breast pain, painful urination, anemia, and bone pain.
♦ Rare: Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Bicalutamide and nilutamide increase the effect of oral anticoagulant (blood-thinning) drugs such as warfarin. Dosage adjustment may be necessary.
• Nilutamide may increase the risk of the potentially serious side effects of phenytoin, theophylline, or vitamin K antagonists.
Food Interactions
None known. Usual Dose
Bicalutamide
Adult: 50 mg once a day, morning or night.
Nilutamide
Adult: 300 mg a day, reduced to 150 mg a day after 30 days.
Overdosage
Symptoms of overdose may include nausea, vomiting, tiredness, headache and dizziness. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the presc6pktm bottle or container,
Special Information
Report anything unusual to your doctor, especially pain or tenderness in the upper right abdomen, yellowing of skin or whites of eyes, severe itching, dark urine, persistent appetite loss, and unexplained flu-like symptoms. These may be signs of severe liver toxicity. Also report any breathing difficulties, cough, chest pain,
orfever.
Up to half of people taking nilutamide can take from a few sec-
onds to a few minutes to adapt to darkness. This can be a problem especially when driving at night or through tunnels. Wearing tinted glasses will minimize this effect.
Up to 5% of people taking nilutamide may experience intolerance to alcohol. Symptoms include flushing, tiredness, and lightheadedness. If you experience this reaction, you should avoid alcohol.
Bicalutamide should be taken at the same time each day for best results. If you forget a dose of bicalutamide, take 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. Call your doctor if you forget to take more than 1 dose.
Special Populations
PregnancylBreast-feeding: Antiandrogens are not intended for use by women.
Seniors: Seniors may take this drug without special precaution.
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
Benazepril
July 26, 2009 | Leave a Comment
Generic Name
Benazepril (ben-AY-zuh-pril) [’Qj
Brand Name Lotensin
Combination Product
Generic Ingredients: Benazepril + Hydrochlorothiazide Lotensin HCT
Type of Drug
Angiotensin- convert i ng enzyme (ACE) inhibitor.
Prescribed For
High blood pressure. Also prescribed for renal failure, kidney hypertension, heart failure, post-heart attack management, the management of people with a high risk of heart disease, diabetes, chronic kidney disease, prevention of a second stroke, and non-diabetic neuropathy.
General Information
1616wepril hydrochloride and other ACE inhibitors prevent the conversion of a hormone called angiotensin I to another hormone called angiotensin II, a potent blood-vessel constrictor. Preventing this conversion relaxes blood vessels, thus reducing blood pressure and relieving symptoms of heart failure. Benazepril also affects the production of other hormones and enzymes that participate in the regulation of blood-vessel dilation. Benazepril starts working in 1 hour and continues to work for about 24 hours.
Cautions and Warnings
Do not take benazepril if you are allergic or sensitive to any of its ingredients.
Swelling of the face, extremities, or throat has been known to occur with benazepril, which can be dangerous (see “Special Information”).
Benazepril occasionally causes very low blood pressure.
Benazepril may affect kidney function. Your doctor should check your urine for protein content during the first few months of treatment. Dosage adjustment is necessary if you have reduced kidney function.
Benazepril can affect white-blood-cell counts, possibly increasing your susceptibility to infection. Your doctor should monitor your blood counts periodically.
Benazepril can cause serious injury or death to the fetus if taken during pregnancy. Pregnant women should not take benazepril.
ACE inhibitors may be less effective in some black patients with high blood pressure, especially when dietary salt intake is high. Nevertheless, they should still be considered useful blood pressure treatments. Swelling beneath the skin to form welts is more common among black patients.
Possible Side Effects
✓ Most common: dizziness, tiredness, headache, nausea, and chronic cough. The cough usually goes away a few days after you stop taking the medication.
✓ Rare: Rare side effects can occur in almost any part of the body. Contact your doctor if you develop any side effect not listed above.
Drug Interactions
• Combining 325 mg a day or more of aspirin with benazepril carries a higher risk of death than taking lower doses (less than 160 mg a day). People taking aspirin to prevent a heart attack should use the lower dose.
• Mixing any ACE inhibitor with an NSAID pain reliever can increase the chance of kidney failure.
• Benazepril may increase the effect of lithium; this combination should be used with caution.
• Severe sensitivity reactions with an ACE inhibitor can occur in hemodialysis patients, in patients undergoing venom immunization, or in those taking allopurinol.
• The blood-pressure-lowering effect of benazepril is additive
with diuretics and beta Mockers. Any other drug that causes
a rapid drop in blood pressure should be used with caution
if you are taking benazepril.
• Benazepril may increase blood-potassium levels, especially ff taken with dyazide or other potassium-sparing diuretics. Left untreated, this can be fatal.
• Antacids and benazepril should be taken at least 2 hours apart.
• Capsaicin may trigger or aggravate the cough associated with benazepril therapy.
• Indomethacin may reduce the blood-pressure-lowering effects of benazepril.
• Phenothiazine sedatives and antivomiting drugs may increase the effects of benazepril.
• Combining allopurinol and benazepril increases the risk of side effects.
• Benazepril increases blood levels of digoxin, which may increase the chance of digoxin-related side effects.
Food Interactions
You may take benazepril with food if it upsets your stomach.
Usual Dose
Adult: maintenance dose-20-40 mg a day as a single dose or in 2 equally divided doses. People with poor kidney function may need less medication.
Child (age 6 and over): 0.045-0.27 mg per lb. of body weight once a day.
Child (under age 6): not recommended.
Overdosage
The principal effect of benazepril overdose is a rapid drop in blood pressure, as evidenced by dizziness or fainting. Take the overdose victim to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Benazepril can cause swelling of the face, lips, hands, and feet. This swelling can also affect the larynx (throat) and tongue and interfere with breathing. If this happens, go to a hospital at once. Call your doctor if you develop a sore throat, mouth sores, abnormal heartbeat, sudden difficulty breathing, chest pain, persistent rash, or loss of taste perception.
Some people who start taking benazepril after they are already on a diuretic (agent that increases urination) experience a rapid drop in blood pressure after their first dose or when their dosage is increased. To prevent this from happening, your doctor may tell you to stop taking your diuretic 2 or 3 days before starting benazepril or to increase your salt intake during that time. The diuretic may then be restarted gradually.
You may get dizzy if you rise to your feet too quickly from a sitting or lying position when taking benazepril.
Avoid strenuous exercise or very hot weather because heavy sweating or dehydration can cause a rapid drop in blood pressure.
While taking benazepril, avoid over-the-counter diet pills, decongestants, and other stimulants that can raise blood pressure. Also, do not use potassium supplements or salt substitutes containing potassium without consulting your doctor.
If you take benazepril once a day and forget a dose, take it as soon as you remember. If it is within 8 hours of your next dose, skip the dose you forgot and continue with your regular schedule. If you take benazepril twice a day and miss a dose, take the missed dose right away. If it is within 4 hours of your next dose, take 1 dose immediately and another in 5 or 6 hours, and then go back to your regular schedule. Never take a double dose.
Special Populations
Pregnancy/Breast-feeding: ACE inhibitors can cause fetal injury or death. Women who are or might become pregnant should not take ACE inhibitors. If you become pregnant, stop taking the medication and call your doctor immediately.
Small amounts Qt tei)wzepfil pass into breast milk. Nursing mothers who must take this drug should consider using infant formula.
Seniors: Seniors may be more sensitive to the effects of this drug due to age-related losses in kidney or liver function.