Edecrin

Edecrin is a strong "water pill" (diuretic). Using too much of Edecrin can lead to serious water and mineral loss. Therefore, it is important that you be monitored by your doctor. Promptly notify your doctor if you become very thirsty, have a dry mouth, become confused, or develop muscle cramps/weakness.

            Edecrin is used for:

Treating swelling due to congestive heart failure, liver problems, and severe kidney problems. It may also be used for other conditions as determined by your doctor.

Edecrin is a loop diuretic. It works by making the kidneys eliminate larger amounts of electrolytes (especially sodium and potassium salts) and water than normal (diuretic effect). It is useful for treating many conditions in which salt and water retention (eg, edema, swelling) is a problem.

Do NOT use Edecrin if:

you are allergic to any ingredient in Edecrin or to sulfonamides

you are unable to urinate

you are taking an aminoglycoside antibiotic (eg, gentamicin) or cephalosporin (eg, cephalexin)

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

Before using Edecrin :

Some medical conditions may interact with Edecrin . 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 fluid in your abdomen, hearing problems, liver disease, diabetes, low urine output, high blood uric acid levels or gout, a blood disorder, kidney disease, lupus, heart problems or you have had a heart attack, or you are dehydrated

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

Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen, indomethacin) because the effectiveness of Edecrin may be decreased

Angiotensin-converting enzyme (ACE) inhibitors (eg, captopril), aminoglycosides (eg, gentamicin), cephalosporin (eg, cephalexin), or salicylates (eg, aspirin) because serious side effects to the kidneys (decreased ability to urinate) and ears (hearing loss) may occur

Chloral hydrate or corticosteroids (eg, prednisone) because the risk of side effects, such as excessive sweating, rapid heartbeat, stomach bleeding, and changes in blood pressure may be increased

Anticoagulants (eg, warfarin), digoxin, or lithium because the side effects may be increased by Edecrin

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

Edecrin may be taken with or without food.

When you first start taking Edecrin , it may cause an increase in urine or in frequency of urination. If you are taking 1 dose daily, take it in the morning to prevent Edecrin from affecting your sleep. If you are taking more than 1 dose, take the last dose no later than 6 pm.

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

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

Edecrin may cause dizziness, lightheadedness, or fainting. Alcohol, hot weather, exercise, and fever can increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness, lightheadedness, or weakness.

Your doctor may have also prescribed a potassium supplement for you. If so, follow the dosing carefully. Do not start taking additional potassium on your own or change your diet to include more potassium without first checking with your doctor.

Patients being treated for high blood pressure often feel tired or rundown for a few weeks after beginning therapy. Continue taking your medicine even though you might not feel quite "normal." Contact your health care provider or pharmacist about any new symptoms.

Patients being treated for high blood pressure should avoid using nonprescription medicines that contain stimulants, such as products used for dieting (appetite suppressants) or relieving cold symptoms (eg, pseudoephedrine).

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

Diabetes patients - Edecrin may affect your blood sugar. Check blood sugar levels closely and ask your doctor before adjusting the dose of your diabetes medicine.

LAB TESTS, including complete blood cell counts and blood pressure monitoring, may be performed to monitor your progress. Be sure to keep all doctor and lab appointments.

Use Edecrin with caution in the ELDERLY because they may be more sensitive to its effects.

Caution is advised when using Edecrin in CHILDREN because they may be more sensitive to its effects.

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

Possible side effects of Edecrin :

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:

Dizziness; headache; lightheadedness; loss of appetite; nausea; restlessness; tiredness or weakness; upset stomach; vomiting.

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

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision; confusion; diarrhea; drowsiness; dry mouth; excessive urination; fever; hearing loss; loss of appetite; muscle pain/cramps/weakness; muscle spasm; rapid or irregular heartbeat; restlessness; ringing in the ears; seeing a yellow color; seizures; severe dizziness; sudden joint pain; unusual bleeding or bruising; unusual thirst; unusual tiredness or weakness; vomiting; yellowing of the skin or eyes.

         Store Edecrin at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Keep in a tight, light-resistant container. Exposure to light may cause a slight discoloration. Do not take discolored tablets. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Edecrin out of the reach of children and away from pets.

Dalteparin

Tell your doctor you use Dalteparin before you have any type of spinal puncture or epidural/spinal anesthesia. Patients who have these procedures while they use Dalteparin are at risk of developing a blood clot on or near the spinal cord. This could result in long-term or permanent paralysis.

The risk is increased in patients who have an indwelling epidural catheter, traumatic or repeated epidural or spinal puncture, a history of a deformed spine or spinal surgery, and in patients who use medicines that may affect blood clotting such as warfarin, aspirin, platelet inhibitors (eg, clopidogrel), and nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen, naproxen).

If you have a spinal puncture or epidural/spinal anesthesia while you use Dalteparin , tell your doctor immediately if you notice any signs or symptoms of nerve problems, such as numbness or tingling, muscle weakness, or paralysis.

           Dalteparin is used for:

Preventing blood clots in patients who have certain illnesses or who will be having certain types of surgeries. It is also used along with aspirin to prevent certain problems caused by heart attacks or unstable angina (chest pain). It is also used to reduce the recurrence of blood clots in certain cancer patients. It may also be used for other conditions as determined by your doctor.

Dalteparin is a low molecular weight heparin (LMWH). It works by blocking the formation of blood clots.

Do NOT use Dalteparin if:

you are allergic to any ingredient in Dalteparin

you are allergic to heparin, benzyl alcohol, or pork products

you have active severe high blood pressure, major bleeding, or a history of low platelets or bleeding problems due to the use of heparin

you are receiving Dalteparin for unstable chest pain or heart attack and will be receiving local anesthesia

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

Before using Dalteparin :

Some medical conditions may interact with Dalteparin . 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 history of kidney problems, liver problems, stomach or intestinal problems (eg, ulcers), stroke, or vision problems caused by diabetes or high blood pressure

if you have inflammation of the heart due to a bacterial infection, or severe, uncontrolled high blood pressure

if you have a bleeding disorder, a history of brain bleeding or blood conditions, or von Willebrand disease

if you have recently had or are scheduled to have brain, spine, or eye surgery, an epidural catheter, or a spinal puncture

if you are taking medicines that affect platelets (eg, aspirin, clopidogrel, ticlopidine)

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

Activated protein C, anticoagulants (eg, warfarin), dextran, dipyridamole, direct factor XA inhibitors (eg, rivaroxaban), direct thrombin inhibitors (eg, dabigatran), injectable cephalosporins (eg, cephazolin), injectable penicillins (eg, ampicillin), NSAIDs (eg, ibuprofen, ketorolac, naproxen), platelet inhibitors (eg, clopidogrel, ticlopidine), salicylates (eg, aspirin), sulfinpyrazone, or thrombolytics (eg, streptokinase) because the risk of side Use Dalteparin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Dalteparin is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using Dalteparin at home, carefully follow the injection procedures taught to you by your health care provider.

Do not use Dalteparin if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.

Dalteparin should be given while sitting or lying down.

Use the proper technique taught to you by your doctor. Inject deep under the skin, NOT into muscle.

Dalteparin may be injected in a U-shape around the navel, the upper outer thigh, or the upper outer section of the buttock. The injection site should be changed daily. When injection around the navel or thigh is used, a fold of skin must be held by the thumb and forefinger while the injection is given. The entire needle should be injected at a 45- to 90-degree angle.

Fixed dose syringes - To ensure delivery of the full dose, do not expel the air bubble from the prefilled syringe before injection. Hold the syringe assembly by the open sides of the device. Remove the needle shield. Insert the needle into the injection area. Depress the plunger of the syringe while holding the finger flange until the entire dose remaining in the syringe has been given. The needle guard will not be activated unless the entire dose has been given. Remove the needle from the patient. Let go of the plunger and allow the syringe to move up inside the device until the entire needle is guarded. Discard the assembly in approved containers.

Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.

If you miss a dose of Dalteparin , contact your doctor immediately.

Ask your health care provider any questions you may have about how to use Dalteparin .

Important safety information:

Dalteparin may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.

Tell your doctor or dentist that you take Dalteparin before you receive any medical or dental care, emergency care, or surgery.

Before you begin taking any new prescription or nonprescription medicine, check the label to see if it has aspirin or ibuprofen in it. If it does or you are not sure, contact your doctor or pharmacist.

Some forms of Dalteparin contain benzyl alcohol. Do not use medicine with benzyl alcohol in NEWBORNS or INFANTS. It may cause serious and sometimes fatal side effects. If you have questions, check with your doctor or pharmacist.

If you have ever had an allergic reaction to benzyl alcohol, ask your doctor or pharmacist if your medicine has benzyl alcohol in it.

Dalteparin may affect certain lab tests, including liver enzyme tests. Be sure your doctor and lab personnel know you are using Dalteparin .

Lab tests, including complete blood cell counts (eg, platelet counts) and tests for blood in the stool, may be performed while you use Dalteparin . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Use Dalteparin with caution in the ELDERLY; they may be more sensitive to its effects, especially bleeding.

Dalteparin should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.

PREGNANCY and BREAST-FEEDING: Dalteparin may contain the preservative benzyl alcohol, which can cause harm to the fetus. If you become pregnant, use a formulation without this preservative. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Dalteparin while you are pregnant. Dalteparin is found in breast milk. If you are or will be breast-feeding while you are using Dalteparin , check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Dalteparin :

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 bleeding, bruising, irritation, pain, redness, or swelling at the injection site.

                       Store Dalteparin at room temperature, between 66 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Keep Dalteparin out of the reach of children and away from pets.       

               

Caffeine

Caffeine is used for:

Restoring mental alertness or wakefulness if you are experiencing fatigue or drowsiness. It may also be used for other conditions as determined by your doctor.

Caffeine is a central nervous system stimulant. It works by stimulating the brain.

Do NOT use Caffeine if:

·         you are allergic to any ingredient in Caffeine

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

Before using Caffeine :

Some medical conditions may interact with Caffeine . 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 anxiety, liver problems, insomnia (trouble sleeping), or heart disease

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

·         Quinolones (eg, ciprofloxacin) because side effects such as problems sleeping, nervousness, jitteriness, or anxiety may occur

·         Theophylline because its actions and side effects may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Caffeine 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.

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

·         Caffeine may be taken with or without food.

·         Do not exceed the recommended dose or take Caffeine on a regular basis without checking with your doctor. Exceeding the recommended dose or taking Caffeine regularly may be habit-forming.

·         If you miss a dose of Caffeine and you are taking it regularly, take it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up, unless advised by your health care provider. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Caffeine .

Important safety information:

·         Caffeine may cause dizziness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Caffeine . Using Caffeine alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.

·         Avoid large amounts of caffeine-containing foods and beverages, such as coffee, tea, cocoa, cola drinks, and chocolate. This includes any medicines that contain caffeine.

·         Caffeine is not to be used as a substitute for sleep.

·         Diabetes patients - Caffeine may affect your blood sugar. Check blood sugar levels closely and ask your doctor before adjusting the dose of your diabetes medicine.

·         Caffeine is not recommended for use in CHILDREN younger than 12 years of age. Safety and effectiveness in this age group have not been confirmed.

·         PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Caffeine , discuss with your doctor the benefits and risks of using Caffeine during pregnancy. It is unknown if Caffeine is excreted in breast milk. If you are or will be breast-feeding while you are using Caffeine , check with your doctor or pharmacist to discuss the risks to your baby.

When used for long periods of time or at high doses, some people develop a need to continue taking Caffeine . This is known as DEPENDENCE or addiction.

If you suddenly stop taking Caffeine , you may experience WITHDRAWAL symptoms including dizziness, headache, unusual tiredness, irritability, muscle tension, or nausea.

Possible side effects of Caffeine :

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:

Dizziness; irritability; nausea; nervousness.

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); diarrhea; shakiness; trouble sleeping; vomiting.

                        Store Caffeine at room temperature, between 59 and 86 degrees F (15 and 30 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Caffeine out of the reach of children and away from pets.
          Soak the red dot in vinegar

Bactrim

Bactrim contains a combination of sulfamethoxazole and trimethoprim and is supplied in tablets and a liquid suspension. Sulfamethoxazole and trimethoprim are both antibiotics that treat different types of infection caused by bacteria.Bactrim is used to treat ear infections, urinary tract infections, bronchitis, traveler's diarrhea, and Pneumocystis carinii pneumonia.                

You should not use Bactrim if you are allergic to sulfamethoxazole or trimethoprim, if you are pregnant or breast-feeding, or if you have anemia (lack of red blood cells) caused by folic acid deficiency.

Before using Bactrim, tell your doctor if you have kidney or liver disease, a folic acid deficiency, asthma or severe allergies, AIDS, a glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency), or if you are malnourished.

Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Bactrim will not treat a viral infection such as the common cold or flu.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Avoid exposure to sunlight, sunlamps, or tanning beds. This medication can make your skin more sensitive to sunlight, and a sunburn may result. Wear protective clothing and use sunscreen (SPF 15 or higher) when you are outdoors.

                         You should not use Bactrim if you are allergic to sulfamethoxazole or trimethoprim, if you are pregnant or breast-feeding, or if you have anemia (lack of red blood cells) caused by folic acid deficiency.

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before using Bactrim, tell your doctor if you have:

·         kidney or liver disease;

·         a folic acid deficiency;

·         asthma or severe allergies;

·         AIDS;

·         a glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency); or

·         if you are malnourished.                       

             Take Bactrim exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Take Bactrim for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Bactrim will not treat a viral infection such as the common cold or flu. Drink plenty of fluids to prevent kidney stones while you are taking trimethoprim and sulfamethoxazole. Store the tablets and liquid at room temperature away from moisture, heat, and light.

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

·         fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;

·         the first sign of any skin rash, no matter how mild;

·         pale skin, easy bruising or bleeding;

·         cough, feeling short of breath;

·         diarrhea that is watery or bloody;

·         feeling restless or irritable, confusion, hallucinations, seizure;

·         slow heart rate, weak pulse, severe tingling, numbness, muscle pain or weakness;

·         nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

·         fever, chills, body aches, flu symptoms; or

·         urinating less than usual or not at all.

Less serious Bactrim side effects may include:

·         painful or swollen tongue;

·         dizziness, spinning sensation;

·         ringing in your ears;

·         joint pain; or

·         sleep problems (insomnia).

                          Tell your doctor about all other medications you use, especially:

·         seizure medication such as phenytoin (Dilantin);

·         a diuretic (water pill);

·         a blood thinner such as warfarin (Coumadin);

·         methotrexate (Trexall, Rheumatrex); or

·         an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

                             

Abacavir

Abacavir has caused severe and sometimes fatal allergic reactions. Contact your doctor right away if you develop fever; rash; nausea, vomiting, diarrhea, or stomach pain; cough; sore throat, or trouble breathing; unusual tiredness or achiness; or general feeling of being unwell. Do NOT take Abacavir again or take any other medicine that contains abacavir if you have had an allergic reaction to Abacavir . You may be at risk for an even more severe allergic reaction.
Patients who have a certain gene type called HLA-B*5701 have an increased risk of allergic reaction. A lab test may be performed before you start Abacavir to see if you have this gene type. Discuss any questions or concerns with your doctor.
Abacavir may cause severe and sometimes fatal liver problems or high blood acid levels (lactic acidosis). Contact your doctor right away if you develop yellowing of the skin or eyes; dark urine; pale stools; stomach pain; nausea; vomiting; diarrhea; persistent loss of appetite; fast or difficult breathing; slow or irregular heartbeat; unusual weakness or tiredness; muscle pain or tenderness; unusual feeling of cold (eg, in arms or legs); or unusual drowsiness, dizziness, or lightheadedness.
Abacavir is used for:
Treating HIV infection with other medications.
Abacavir is a nucleoside analog reverse transcriptase inhibitor (NRTI). It works by slowing down the growth of HIV, the virus that causes AIDS.
Do NOT use Abacavir if:
you are allergic to any ingredient in Abacavir
you have had a recent abnormal liver function test or have moderate to severe liver problems
Contact your doctor or health care provider right away if any of these apply to you.
Before using Abacavir :
Some medical conditions may interact with Abacavir . 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 or thinking about 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 history of heart problems (eg, heart attack), high blood pressure, high cholesterol, diabetes, or smoking
if you have been tested and know whether or not you have a gene type called HLA-B*5701
Some MEDICINES MAY INTERACT with Abacavir . Tell your health care provider if you are taking any other medicines, especially any of the following:
Alcohol because it may increase the risk of Abacavir 's side effects and toxic effects
Methadone because its effectiveness may be decreased by Abacavir
How to use Abacavir :
Use Abacavir as directed by your doctor. Check the label on the medicine for exact dosing instructions.
• Abacavir comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Abacavir refilled.
• Abacavir comes with a warning card that provides information about recognition of allergic reactions. Carry the warning card of allergy symptoms with you. Tell your health care provider immediately about any side effects you experience while taking Abacavir .
• Take Abacavir by mouth with or without food.
• Using Abacavir at the same times each day will help you remember to take it.
• Continue to take Abacavir even if you feel well. Do not miss any doses.
• If you miss a dose of Abacavir , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Abacavir .
Important safety information:
• Talk to your doctor before you take Abacavir if you drink more than 3 drinks with alcohol per day.
• Tell your doctor or dentist that you take Abacavir before you receive any medical or dental care, emergency care, or surgery.
• If you must stop taking Abacavir for any reason other than a serious allergic reaction, do not start taking Abacavir again without talking with your health care provider. If your health care provider decides that you may take Abacavir again, you should do so only in a setting with other people in case you need immediate access to a doctor.
• When your medicine supply is low, get more from your doctor or pharmacist as soon as you can. Do not stop taking Abacavir , even for a short period of time. If you do, the virus may grow resistant to the medicine and become harder to treat.
• Changes in body fat (eg, an increased amount of fat in the upper back, neck, breast, and trunk, and loss of fat from the legs, arms, and face) may occur in some patients taking Abacavir . The cause and long-term effects of these changes are unknown. Discuss any concerns with your doctor.
• Abacavir does not stop the spread of HIV to others through blood or sexual contact. Use barrier methods of birth control (eg, condoms) if you have HIV infection. Do not share needles, injection supplies, or items like toothbrushes or razors.
• Abacavir is not a cure for HIV infection. Patients may still get illnesses and infections associated with HIV. Remain under the care of your doctor.
• Lab tests, including liver function and monitoring for hypersensitivity reactions, may be performed while you use Abacavir . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Abacavir with caution in the ELDERLY; they may be more sensitive to its effects, especially liver, kidney, or heart problems.
• Caution is advised when using Abacavir in CHILDREN; they may be more sensitive to its effects, especially fever; chills; rash; or ear, nose, or throat infection.
• Abacavir should not be used in CHILDREN younger than 3 months old; safety and effectiveness in these children have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Abacavir while you are pregnant. It is not known if Abacavir is found in breast milk. Mothers infected with HIV should not breast-feed. There is a risk of passing the HIV infection or Abacavir to the baby.
Possible side effects of Abacavir :
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:
Headache; lack of energy; mild nausea; tiredness; trouble sleeping; unusual dreams; 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); burning, numbness, or tingling of the skin; change in the amount of urine produced; chest pain or discomfort, numbness of an arm or leg, or sudden vision changes; ear pain; eye pain, redness, or swelling; fainting; fever or chills; general feeling of being unwell; mental or mood changes (eg, depression); mouth sores; red, swollen, blistered, or peeling skin; severe or persistent dizziness; severe or persistent nausea, vomiting, or diarrhea; shortness of breath, cough, or sore throat; stomach pain; swollen lymph nodes; symptoms of lactic acidosis (eg, fast breathing; muscle pain; unusual cold feeling in the arms or legs; sluggishness; unusual drowsiness, dizziness, or lightheadedness); symptoms of liver problems (eg, yellowing of the skin or eyes, dark urine, pale stools, loss of appetite, severe or persistent tiredness); unusual achiness or swelling.
Proper storage of Abacavir :
Store Abacavir at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Abacavir out of the reach of children and away from pets.

ACTEMRA

ACTEMRA (tocilizumab) Injection
Company: Genentech USA, Inc.
Date of Approval: January 8, 2010
Treatment for: Rheumatoid Arthritis
Actemra (tocilizumab) is a humanized interleukin-6 (IL-6) receptor-inhibiting monoclonal antibody for the treatment of moderate to severe rheumatoid arthritis in adults.

FDA Approves Actemra

The United States (US) Food and Drug Administration (FDA) approved Actemra (tocilizumab, RoActemra in the European Union) for the treatment of adult patients with moderately to severely active rheumatoid arthritis (RA) who have had an inadequate response to one or more tumor necrosis factor (TNF) antagonist therapies. Actemra, the result of a research & development collaboration with Chugai, is the first interleukin-6 (IL-6) receptor-inhibiting monoclonal antibody approved to treat RA, may be used alone or in combination with methotrexate or other disease modifying anti-rheumatic drugs (DMARDs).

Actemra Medication Guide

Read this Medication Guide before you start Actemra and before each infusion. There may be new information. This Medication Guide does not take the place of talking with your healthcare provider about your medical condition or your treatment.

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

Actemra can cause serious side effects including:
1. Serious Infections
Actemra is a medicine that affects your immune system. Actemra can lower the ability of your immune system to fight infections. Some people have serious infections while taking Actemra, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections.
o Your doctor should test you for TB before starting Actemra.
o Your doctor should monitor you closely for signs and symptoms of TB during treatment with Actemra.
You should not start taking Actemra if you have any kind of infection unless your healthcare provider says it is okay.

Before starting Actemra, tell your healthcare provider if you:
o think you have an infection or have symptoms of an infection such as:
 fever, sweating, or chills
 muscle aches
 cough
 shortness of breath
 blood in phlegm
 weight loss
 warm, red, or painful skin or sores on your body
 diarrhea or stomach pain
 burning when you urinate or urinating more often than normal
 feel very tired
o are being treated for an infection
o get a lot of infections or have infections that keep coming back
o have diabetes, HIV, or a weak immune system. People with these conditions have a higher chance for infections.
o have TB, or have been in close contact with someone with TB
o live or have lived, or have traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance for getting certain kinds of fungal infections (histoplasmosis, coccidiomycosis, or blastomycosis). These infections may happen or become more severe if you use Actemra. Ask your healthcare provider, if you do not know if you have lived in an area where these infections are common.
o have or have had hepatitis B.
After starting Actemra, call your healthcare provider right away if you have any symptoms of an infection. Actemra can make you more likely to get infections or make worse any infection that you have.
2. Tears (perforation) of the stomach or intestines.
o Before taking Actemra, tell your healthcare provider if you have had diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines. Some people taking Actemra get tears in their stomach or intestine. This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or methotrexate.
o Tell your healthcare provider right away if you have fever and stomach-area pain that does not go away, and a change in your bowel habits.
3. Changes in certain laboratory test results. Your healthcare provider should do blood tests before you start receiving Actemra and every 4 to 8 weeks during treatment to check for the following side effects of Actemra:
o low neutrophil count. Neutrophils are white blood cells that help the body fight off bacterial infections.
o low platelet count. Platelets are blood cells that help with blood clotting and stop bleeding.
o increase in certain liver function tests.
You should not receive Actemra if your neutrophil or platelet counts are too low or your liver function tests are too high.
Your healthcare provider may stop your Actemra treatment for a period of time or change your dose of medicine if needed because of changes in these blood test results. You may also have changes in other laboratory tests, such as your blood cholesterol levels. Your healthcare provider should do blood tests to check your cholesterol levels 4 to 8 weeks after you start receiving Actemra, and then every 6 months after that. Normal cholesterol levels are important to good heart health.
4. Cancer.
Actemra may decrease the activity of your immune system. Medicines that affect the immune system may increase your risk of certain cancers. Tell your healthcare provider if you have ever had any type of cancer. See "What are the possible side effects with Actemra?" for more information about side effects.


What is Actemra?
Actemra is a prescription medicine called an Interleukin-6 (IL-6) receptor inhibitor. Actemra is used to treat adults with moderately to severely active rheumatoid arthritis (RA) after at least one other medicine called a Tumor Necrosis Factor (TNF) antagonist has been used and did not work well.
It is not known if Actemra is safe and effective in children.
What should I tell my healthcare provider before receiving Actemra?
Actemra may not be right for you. Before starting Actemra, tell your healthcare provider if you:
• have an infection. See "What is the most important information I should know about Actemra?"
• have liver problems
• have any stomach-area (abdominal) pain or been diagnosed with diverticulitis or ulcers in your stomach or intestines
• have or had a condition that affects your nervous system, such as multiple sclerosis
• have recently received or are scheduled to receive a vaccine. People who take Actemra should not receive live vaccines. People taking Actemra can receive non-live vaccines
• plan to have surgery or a medical procedure
• have any other medical conditions
• plan to become pregnant or are pregnant. It is not known if Actemra will harm your unborn baby.
• Pregnancy Registry: Genentech has a registry for pregnant women who take Actemra. The purpose of this registry is to check the health of the pregnant mother and her baby. If you are pregnant or become pregnant while taking Actemra, talk to your healthcare provider about how you can join this pregnancy registry or you may contact the registry at 1-877-311-8972 to enroll.
• plan to breast-feed or are breast-feeding. You and your healthcare provider should decide if you will take Actemra or breast-feed. You should not do both.
Tell your healthcare provider about all of the medicines you take, including prescription and nonprescription medicines, vitamins and herbal supplements. Actemra and other medicines may affect each other causing side effects.
Especially tell your healthcare provider if you take:
• any other medicines to treat your RA. You should not take etanercept (Enbrel), adalimumab (Humira), infliximab (Remicade), rituximab (Rituxan), abatacept (Orencia), anakinra (Kineret), certolizumab (Cimzia), or golimumab (Simponi), while you are taking Actemra. Taking Actemra with these medicines may increase your risk of infection.
• medicines that affect the way certain liver enzymes work. Ask your healthcare provider if you are not sure if your medicine is one of these.
Know the medicines you take. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.
How will I receive Actemra?
• You will receive Actemra from a healthcare provider through a needle placed in a vein in your arm (IV or intravenous infusion). The infusion will take about 1 hour to give you the full dose of medicine.
• You will receive a dose of Actemra about every 4 weeks.
• If you miss a scheduled dose of Actemra, ask your healthcare provider when to schedule your next infusion.
• While taking Actemra, you may continue to use other medicines that help treat your rheumatoid arthritis such as methotrexate, non-steroidal anti-inflammatory drugs (NSAIDs) and prescription steroids, as instructed by your healthcare provider.
• Keep all of your follow-up appointments and get your blood tests as ordered by your healthcare provider.

What are the possible side effects with Actemra?
Actemra can cause serious side effects, including:
• See "What is the most important information I should know about Actemra?"
• Hepatitis B infection in people who carry the virus in their blood. If you are a carrier of the hepatitis B virus (a virus that affects the liver), the virus may become active while you use Actemra. This happens with other biologic medicines used to treat RA. Your doctor may do blood tests before you start treatment with Actemra and while you are using Actemra. Tell your healthcare provider if you have any of the following symptoms of a possible hepatitis B infection:
o feel very tired
o skin or eyes look yellow
o little or no appetite
o vomiting
o clay-colored bowel movements
o fevers
o chills
o stomach discomfort
o muscle aches
o dark urine
o skin rash
• Nervous system problems. Multiple Sclerosis has been diagnosed rarely in people who take Actemra. It is not known what effect Actemra may have on some nervous system disorders.
• Allergic Reactions. Serious allergic reactions can happen with Actemra. These reactions may not happen with your first infusion, and may happen with future infusions of Actemra. Tell your healthcare provider right away if you have any of the following signs of a serious allergic reaction:
o shortness of breath or trouble breathing
o skin rash
o swelling of the lips, tongue, or face
o chest pain
o feeling dizzy or faint
Common side effects of Actemra include:
• upper respiratory tract infections (common cold, sinus infections)
• headache
• increased blood pressure (hypertension)
Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all of the possible side effects of Actemra. For more information, ask your healthcare provider or pharmacist.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects to Genentech at 1-888-835-2555.
See also: Actemra side effects in more detail
General information about Actemra
Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. This Medication Guide summarizes the most important information about Actemra.
If you would like more information, talk to your healthcare provider. You can ask your pharmacist or healthcare provider for information about Actemra that is written for health professionals.
For more information, go to www.actemra.com or call 1-800-ACTEMRA.
What are the ingredients in Actemra?
Active ingredient: tocilizumab
Inactive ingredients: sucrose, polysorbate 80, disodium phosphate dodecahydrate, sodium dihydrogen phosphate dihydrate.

Xiaflex

Xiaflex (collagenase clostridium histolyticum)
Company: BioSpecifics Technologies Corp.
Date of Approval: February 3, 2010
Treatment for: Dupuytren's Contracture
Xiaflex (collagenase clostridium histolyticum) is a collagenase product for the treatment of Dupuytren's contracture, a condition that affects the connective tissue that lies beneath the skin in the palm.

Victoza

Victoza
Generic Name: liraglutide
Date of Approval: January 25, 2010
Company: Novo Nordisk A/S
DA Approves Victoza
The United States Food and Drug Administration (FDA) has approved Victoza (liraglutide) once-daily injection for treating type 2 diabetes. Victoza is indicated to help lower blood sugar levels when coupled with diet, exercise and other diabetes medicines. It is not recommended as an initial therapy for patients who have not been able to control their diabetes with diet and exercise alone.
Victoza Medication Guide
Read this Medication Guide and Patient Instructions for Use that come with Victoza before you start using Victoza and each time you get a refill. There may be new information. This Medication Guide does not take the place of talking with your healthcare provider about your medical condition or your treatment. If you have questions about Victoza after reading this information, ask your healthcare provider or pharmacist.
What is the most important information I should know about Victoza?
Serious side effects may happen in people who take Victoza, including:
1. Possible thyroid tumors, including cancer. During the drug testing process, the medicine in Victoza caused rats and mice to develop tumors of the thyroid gland. Some of these tumors were cancers. It is not known if Victoza will cause thyroid tumors or a type of thyroid cancer called medullary thyroid cancer in people. If medullary thyroid cancer occurs, it may lead to death if not detected and treated early. If you develop tumors or cancer of the thyroid, your thyroid may have to be surgically removed.
o Before you start taking Victoza, tell your healthcare provider if you or any of your family members have had thyroid cancer, especially medullary thyroid cancer, or Multiple Endocrine Neoplasia syndrome type 2. Do not take Victoza if you or any of your family members have medullary thyroid cancer, or if you have Multiple Endocrine Neoplasia syndrome type 2. People with these conditions already have a higher chance of developing medullary thyroid cancer in general and should not take Victoza.
o While taking Victoza, tell your healthcare provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer.
2. Inflammation of the pancreas (pancreatitis), which may be severe and lead to death.
Before taking Victoza, tell your healthcare provider if you have had:
o pancreatitis
o stones in your gallbladder (gallstones)
o a history of alcoholism
o high blood triglyceride levels
These medical conditions can make you more likely to get pancreatitis in general. It is not known if having these conditions will lead to a higher chance of getting pancreatitis while taking Victoza.
While taking Victoza:
Stop taking Victoza and call your healthcare provider right away if you have pain in your stomach area (abdomen) that is severe and will not go away. The pain may happen with or without vomiting. The pain may be felt going from your abdomen through to your back. This type of pain may be a symptom of pancreatitis.


What is Victoza?
• Victoza is an injectable prescription medicine that may improve blood sugar (glucose) in adults with type 2 diabetes mellitus, and should be used along with diet and exercise.
• Victoza is not recommended as the first choice of medication for treating diabetes.
• Victoza is not insulin.
• It is not known if Victoza is safe and effective when used with insulin.
• Victoza is not for use in people with type 1 diabetes or people with diabetic ketoacidosis.
• It is not known if Victoza is safe and effective in children. Victoza is not recommended for use in children.
Who should not use Victoza?
Do not use Victoza if:
• you or any of your family members have a history of medullary thyroid cancer.
• you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). This is a disease where people have tumors in more than one gland in their body. Talk with your healthcare provider if you are not sure if you have any of these conditions.
What should I tell my healthcare provider before using Victoza?
Before taking Victoza, tell your healthcare provider if you:
• have any of the conditions listed in the section "What is the most important information I should know about Victoza?"
• are allergic to liraglutide or any of the other ingredients in Victoza. See the end of this Medication Guide for a list of ingredients in Victoza.
• have severe problems with your stomach, such as slowed emptying of your stomach (gastroparesis) or problems with digesting food.
• have or have had kidney or liver problems.
• have any other medical conditions.
• are pregnant or plan to become pregnant. It is not known if Victoza will harm your unborn baby. Tell your healthcare provider if you become pregnant while taking Victoza.
• are breastfeeding or plan to breastfeed. It is not known if Victoza passes into your breast milk. You and your healthcare provider should decide if you will take Victoza or breastfeed. You should not do both without talking with your healthcare provider first.
Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Victoza slows stomach emptying and can affect medicines that need to pass through the stomach quickly. Victoza may affect the way some medicines work and some other medicines may affect the way Victoza works. Tell your healthcare provider if you take other diabetes medicines, especially sulfonylurea medicines or insulin.
Know the medicines you take. Keep a list of them with you to show your healthcare provider and pharmacist each time you get a new medicine.
How should I use Victoza?
• Use Victoza exactly as prescribed by your healthcare provider. Your dose should be increased after using Victoza for one week. After that, do not change your dose unless your healthcare provider tells you to.
• Victoza is injected 1 time each day, at any time during the day.
• You can take Victoza with or without food.
• Victoza comes in a prefilled pen.
• Your healthcare provider must teach you how to inject Victoza before you use it for the first time. If you have questions or do not understand the instructions, talk to your healthcare provider or pharmacist. See the Patient Instructions for Use that come with this Medication Guide for detailed information about the right way to use your Victoza pen.
• Pen needles are not included. You may need a prescription to get pen needles from your pharmacist. Ask your healthcare provider which needle size is best for you.
• When starting a new prefilled Victoza pen, you must follow the "First Time Use for Each New Pen" (see the detailed Patient Instructions for Use that comes with this Medication Guide). You only need to do this 1 time with each new pen. You should also do this if you drop your pen. If you do the "First Time Use for Each New Pen" before each injection, you will run out of medicine too soon.
• Inject your dose of Victoza under the skin (subcutaneous injection) in your stomach area (abdomen), upper leg (thigh), or upper arm, as instructed by your healthcare provider. Do not inject into a vein or muscle.
• If you take too much Victoza, call your healthcare provider right away. Too much Victoza may cause severe nausea and vomiting.
• Follow your healthcare provider’s instructions for diet, exercise, how often to test your blood sugar, and when to get your HbA1c checked. If you stop using Victoza your blood sugar levels may increase. First talk to your healthcare provider if you want to stop taking Victoza.
• Your dose of diabetes medicines may need to be changed if your body is under certain types of stress. Tell your healthcare provider if you:
o have fever
o have trauma
o have an infection
o plan to have or have had surgery
• Never share your Victoza pen or needles with another person. You may give an infection to them, or get an infection from them.
Victoza side effects
Victoza may cause serious side effects, including:
• See "What is the most important information I should know about Victoza?"
• Low blood sugar (hypoglycemia). Your risk for getting low blood sugar is higher if you take Victoza with another medicine that can cause low blood sugar, such as a sulfonylurea. In some people, the blood sugar may get so low that they need another person to help them. The dose of your sulfonylurea medicine may need to be lowered while you use Victoza. Signs and symptoms of low blood sugar may include:
o shakiness
o sweating
o headache
o drowsiness
o weakness
o dizziness
o confusion
o irritability
o hunger
o fast heartbeat
o feeling jittery
Talk to your healthcare provider about how to recognize and treat low blood sugar. Make sure that your family and other people who are around you a lot know how to recognize and treat low blood sugar.
Common side effects of Victoza include:
• headache
• nausea
• diarrhea
Nausea is most common when first starting Victoza, but decreases over time in most people as their body gets used to the medicine.
Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
These are not all the side effects with Victoza. For more information, ask your healthcare provider or pharmacist.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Victoza side effects in more detail
How should I store Victoza?
Before use:
• Store your new, unused Victoza pen in the refrigerator at 36ºF to 46ºF (2ºC to 8ºC).
• Do not freeze Victoza or use Victoza if it has been frozen. Do not store Victoza near the refrigerator cooling element.
Pen in use:
• Store your Victoza pen for 30 days either at 59ºF to 86ºF (15ºC to 30ºC), or in a refrigerator at 36ºF to 46ºF (2°C to 8°C).
• When carrying the pen away from home, store the pen at a temperature between 59ºF to 86ºF (15ºC to 30ºC) and keep it dry.
• If Victoza has been exposed to temperatures above 86ºF (30ºC), it should be thrown away.
• Protect your Victoza pen from heat and sunlight.
• Keep the pen cap on when your Victoza pen is not in use.
• Use your Victoza pen within 30 days after the first day it is stored outside the refrigerator. After these 30 days, throw away your Victoza pen even if some medicine is left in the pen.
• Do not use Victoza after the expiration date printed on the carton. Do not store the Victoza pen with the needle attached. Always safely remove and safely throw away the needle after each injection. This may help prevent contamination, infection and leakage. It also helps to make sure that you get the correct dose of Victoza. See the Patient Instructions for Use for information about how to dispose of used pen needles and used Victoza pens.
Keep your Victoza pen, pen needles, and all medicines out of the reach of children.
General information about Victoza
Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use Victoza for a condition for which it was not prescribed. Do not give Victoza to other people, even if they have the same symptoms you have. It may harm them.
This Medication Guide summarizes the most important information you should know about using Victoza. If you would like more information, talk with your healthcare provider. You can ask your pharmacist or healthcare provider for information about Victoza that is written for health professionals. For more information, go to victoza.com or call 1-877-484-2869.
What are the ingredients in Victoza?
Active Ingredient: liraglutide
Inactive Ingredients: disodium phosphate dihydrate, propylene glycol, phenol and water for injection.