Gadoteridol

This information applies to the following medicines:

1. Gadodiamide (gad-oh-DYE-a-mide)

2. Gadopentetate (gad-o-PEN-te-tate)†

3. Gadoteridol (gad-oh-TER-i-dol)†

4. Gadoversetamide (gad-oh-ver-SET-a-mide)†

MRI (magnetic resonance imaging) contrast agents (also called paramagnetic agents) are used to help provide a clear picture during MRI. MRI is a special kind of diagnostic procedure. It uses magnets and computers to create images or ``pictures'' of certain areas inside the body. Unlike x-rays, it does not involve ionizing radiation.

MRI contrast agents are given by injection before or during MRI to help diagnose problems or diseases of the brain or the spine. In addition, gadopentetate is used to help diagnose problems in other parts of the body, such as the bones and joints, breast, liver, soft tissues, and uterus. Gadoversetamide is also used to help diagnose problems in the liver.

MRI contrast agents may also be used to diagnose other conditions as determined by your doctor.

MRI contrast agents are injected into a vein. The doses of these agents will be different for different patients depending on the weight of the person.

These agents are to be used only by or under the supervision of a doctor.

In deciding to use a diagnostic test, any risks of the test must be weighed against the good it will do. This is a decision you and your doctor will make. Also, test results may be affected by other things. For MRI contrast agents, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to contrast agents such as gadodiamide, gadopentetate, gadoteridol, or gadoversetamide. Also, tell your doctor if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Studies have not been done in pregnant women. However, in animal studies, MRI contrast agents caused a delay in development of the animal fetus, increased the risk of losing the fetus, and caused birth defects and other side effects in the offspring when these agents were given to the mother in doses many times the human dose. Also, it is not known yet what effect the magnetic field used in MRI might have on the development of the fetus. Be sure you have discussed this with your doctor.

Breast-feeding—It is not known what amount of MRI contrast agents passes into the breast milk. However, your doctor may want you to stop breast-feeding for some time after you receive an MRI contrast agent. Be sure you have discussed this with your doctor.

Children—Although there is no specific information comparing use of MRI contrast agents in children with use in other age groups, these agents are not expected to cause different side effects or problems in children than they do in adults.

Older adults—These contrast agents have been tested and have not been shown to cause different side effects or problems in older people than they do in younger adults.

Other medical problems—The presence of other medical problems may affect the use of MRI contrast agents. Make sure you tell your doctor if you have any other medical problems, especially:

* Allergies or asthma (history of)—If you have a history of allergies or asthma, you may be at greater risk of having an allergic reaction to the contrast agent

* Anemia or

* Low blood pressure—MRI contrast agents may make these conditions worse

* Epilepsy—There may be an increased chance of seizures

* Heart disease—There may be an increased chance of developing an irregular heart beat

* Kidney disease (severe)—Kidney disease can cause the MRI agent to stay in the body longer than usual, which may increase the chance of side effects

* Sickle cell disease—There may be a greater risk of blockage of the blood vessels in patients with this condition

Fareston for breast cancer treatment

Fareston is used for:

Treating breast cancer in women past menopause with estrogen-dependent tumors or unknown tumors. It may also be used for other conditions as determined by your doctor.

Fareston is an antiestrogen. It works by blocking the effects of estrogen on certain body tissues, including breast tissue. This helps block the growth of estrogen-activated tumors.

                      Some medical conditions may interact with Fareston . 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 bone cancer or a growth of the endometrium

    * if you have a history of blood clots, cancer, or decreased blood platelets or white blood cells

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

    * Ketoconazole or macrolide antibiotics (eg, erythromycin) because the actions and side effects of Fareston may be increased

    * Fluorouracil, mitomycin C, or thiazide diuretics (eg, hydrochlorothiazide) because the risk of side effects may be increased

    * Carbamazepine, phenobarbital, or rifampin because the effectiveness of Fareston may be decreased

    * Anticoagulants (eg, warfarin) or hydantoins (eg, phenytoin) because the actions and side effects of these medicines may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Fareston 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 Fareston as directed by your doctor. Check the label on the medicine for exact dosing instructions.

    * Fareston may be taken with or without food.

    * If you miss a dose of Fareston , 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 Fareston .

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

    * If Fareston causes nausea or vomiting, ask your doctor or pharmacist about ways to minimize this effect.

    * LAB TESTS, including complete blood cell counts, calcium levels, and liver function tests, may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.

    * Fareston is not recommended for use in CHILDREN. Safety and effectiveness have not been confirmed.

    * PREGNANCY and BREAST-FEEDING: Fareston has been shown to cause harm to the fetus. If you become pregnant, discuss with your doctor the benefits and risks of using Fareston during pregnancy. It is unknown if Fareston is excreted in breast milk. If you are or will be breast-feeding while you are using Fareston , check with your doctor or pharmacist to discuss the risks to your baby.

                          Store Fareston at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Fareston out of the reach of children and away from pets.

Econopred Plus Drops

Econopred Plus Drops is used for:

Treating inflammation of the eyes and eyelids due to certain conditions. It may also be used for other conditions as determined by your doctor.

Econopred Plus Drops is an ophthalmic corticosteroid. Exactly how Econopred Plus Drops works is not known.

                   Do NOT use Econopred Plus Drops if:

    * you are allergic to any ingredient in Econopred Plus Drops or to other corticosteroids (eg, prednisone)

    * you have certain eye infections (eg, herpes, tuberculosis, fungal, or viral infections), chickenpox, or an infection due to smallpox vaccination (vaccinia)

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

                   Some medical conditions may interact with Econopred Plus Drops. 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 diabetes, glaucoma, optic nerve damage, or thinning of the cornea or other eye tissues

Some MEDICINES MAY INTERACT with Econopred Plus Drops. Because little, if any, of Econopred Plus Drops is absorbed into the blood, the risk of it interacting with another medicine is low.

Ask your health care provider if Econopred Plus Drops 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 Econopred Plus Drops as directed by your doctor. Check the label on the medicine for exact dosing instructions.

    * Shake well before each use.

    * To use Econopred Plus Drops in the eye, first, wash your hands. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eyelid for 1 to 2 minutes. Do not blink. Remove excess medicine around your eye with a clean, dry tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them.

    * To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including the eye. Keep the container tightly closed.

    * If your doctor prescribed more than 1 eye medicine, ask the best order for using each medicine.

    * Do not wear contact lenses while you are using Econopred Plus Drops. Take care of your contact lenses as directed by the manufacturer. Check with your doctor before you use them.

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

Ask your health care provider any questions you may have about how to use Econopred Plus Drops.

                          * Econopred Plus Drops may cause blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Econopred Plus Drops with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

    * Some of these products contain sulfites. Sulfites may cause an allergic reaction in some patients (eg, asthma patients). If you have ever had an allergic reaction to sulfites, ask your pharmacist if your product has sulfites in it.

    * Do NOT use more than the recommended dose or use for future eye problems without checking with your doctor.

    * Lab tests, including eye exams, may be performed while you use Econopred Plus Drops. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

    * Econopred Plus Drops should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.

    * PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Econopred Plus Drops while you are pregnant. It is not known if Econopred Plus Drops is found in breast milk. Do not breast-feed while taking Econopred Plus Drops.

                       Store Econopred Plus Drops 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 freeze. Do not store in the bathroom. Keep Econopred Plus Drops out of the reach of children and away from pets.

                  

Dalmane, treats sleep disorders

Dalmane is used for:

Treating sleep disorders. It may also be used for other conditions as determined by your doctor.

Dalmane is a benzodiazepine. It works by depressing the central nervous system (brain), causing drowsiness to aid in falling asleep.

Do NOT use Dalmane if:

* you are allergic to any ingredient in Dalmane

* you are pregnant

* you have acute narrow-angle glaucoma, severe liver disease, or a mental state in which contact with reality is lost (psychosis)

* you are taking an HIV protease inhibitor (eg, ritonavir) or sodium oxybate (GHB)

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

Some medical conditions may interact with Dalmane . 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 glaucoma or a predisposition for glaucoma, kidney or liver problems, lung problems or chronic obstructive pulmonary disease (COPD), muscle problems, poor health, depression, suicidal tendencies, the blood disorder porphyria, or a history of substance abuse or dependence

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

* Aprepitant, clozapine, disulfiram, HIV protease inhibitors (eg, ritonavir), kava, nefazodone, omeprazole, oral contraceptives (birth control pills), sodium oxybate (GHB), or valproic acid because they may increase the risk of Dalmane 's side effects * Hydantoins (eg, phenytoin) or rifampin because they may decrease Dalmane 's effectiveness

* Clozapine, digoxin, hydantoins (eg, phenytoin), or nondepolarizing muscle relaxants (eg, vecuronium) because the risk of their side effects may be increased by Dalmane

This may not be a complete list of all interactions that may occur. Ask your health care provider if Dalmane 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 Dalmane as directed by your doctor. Check the label on the medicine for exact dosing instructions.

* Take Dalmane by mouth with or without food.

* Take Dalmane at bedtime with a full glass of water (8 oz/240 mL).

* If you miss a dose of Dalmane , take it when you remember if you are still able to get at least 7 to 8 hours of sleep. If you are no longer able to get at least 7 to 8 hours of sleep when you remember, 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 Dalmane .

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

* Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Dalmane ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.

* If your symptoms do not get better within 7 to 10 days or if they get worse, check with your doctor.

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

* Some patients taking Dalmane have performed certain activities while they were not fully awake. These have included sleep driving, making and eating food, making phone calls, and having sex. Patients often do not remember these events after they happen. Such an event may be more likely to occur if you use a high dose of Dalmane . It may also be more likely if you drink alcohol or take other medicines that may cause drowsiness while you use Dalmane . Tell your doctor right away if such an event happens to you.

* Use Dalmane with caution in the ELDERLY; they may be more sensitive to its effects, especially confusion, daytime drowsiness, dizziness, falling, and staggering.

* Dalmane should not be used in CHILDREN younger than 15 years old; safety and effectiveness in these children have not been confirmed.

* PREGNANCY and BREAST-FEEDING: Do not use Dalmane if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Dalmane is found in breast milk. Do not breast-feed while taking Dalmane .

When sleep medicines are used every night for more than a few weeks, they may lose their effectiveness to help you sleep. This is known as TOLERANCE. Sleep medicines should usually be used only for short periods of time, such as a few days and generally no longer than 1 or 2 weeks. If your sleep problems continue, contact your doctor.

When used for longer than a few weeks or at high doses, some people develop a need to continue taking Dalmane . This is known as DEPENDENCE or addiction.

If you stop taking Dalmane suddenly, you may have WITHDRAWAL symptoms. This may include unpleasant feelings. In more severe cases, you may have stomach and muscle cramps, vomiting, sweating, and shakiness. Seizures may rarely occur. If you take Dalmane for more than 1 to 2 weeks, do not stop taking it without talking to your doctor.

Store Dalmane 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 Dalmane out of the reach of children and away from pets.

Cafergot, migraine curer

Serious and sometimes life-threatening decreases in the blood supply to the extremities (eg, hands, feet) or brain may occur if Cafergot is taken with certain other medicines, including HIV protease inhibitors (eg, ritonavir) and macrolide antibiotics (eg, erythromycin). Do not use Cafergot if you are also taking these other medicines. Inform your doctor of all the medicines that you are taking.

                     Cafergot is used for:

Preventing and treating certain kinds of headaches (eg, migraines, migraine variants, "histaminic cephalalgia"). It may also be used for other conditions as determined by your doctor.

Cafergot is a combination of 2 vasoconstrictors. It works by constricting blood vessels in the lining of the brain, which helps to decrease the pain from migraine headaches.

                      Do NOT use Cafergot if:

    * you are allergic to any ingredient in Cafergot

    * you are pregnant or may become pregnant

    * you are in labor

    * you have blood vessel problems (eg, peripheral vascular disease), coronary heart disease, high blood pressure, liver or kidney problems, or severe infection (eg, sepsis)

    * you are taking an azole antifungal (eg, itraconazole, ketoconazole, voriconazole), delavirdine, HIV protease inhibitors (eg, delavirdine, indinavir, nelfinavir, ritonavir), efavirenz, a ketolide antibiotic (eg, telithromycin), a macrolide antibiotic (eg, clarithromycin, erythromycin), or selective 5-HT agonists (eg, sumatriptan, eletriptan)

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

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

    * if you are 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 blood problems (eg, porphyria), stroke, anxiety, trouble sleeping, or heart problems

    * if you smoke

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

    * Clotrimazole, fluconazole, fluoxetine, fluvoxamine, , metronidazole, nefazodone, saquinavir, or zileuton because side effects of Cafergot may be increased

    * Azole antifungals (eg, itraconazole, ketoconazole, voriconazole), beta-blockers (eg, propranolol), delavirdine, HIV protease inhibitors (eg, delavirdine, indinavir, nelfinavir, ritonavir), efavirenz, ketolide antibiotics (eg, telithromycin), macrolide antibiotics (eg, erythromycin, clarithromycin), or selective 5-HT agonists (eg, sumatriptan , eletriptan) because the risk of severe side effects, including irregular heartbeat or decreased oxygen to the extremities (eg, hands, feet) or brain, may be increased

    * Pressor agents (eg, norepinephrine) or sympathomimetics (eg, pseudoephedrine, albuterol) because risk of side effects, including severe high blood pressure, may be increased

    * Quinolones (eg, levofloxacin) because risk of side effects, such as nervousness, sleeplessness, and fast heartbeat, may be increased

    * Theophylline because actions and side effects may be increased by Cafergot

This may not be a complete list of all interactions that may occur. Ask your health care provider if Cafergot 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 Cafergot as directed by your doctor. Check the label on the medicine for exact dosing instructions.

    * Cafergot may be taken with or without food.

    * Eating grapefruit or drinking grapefruit juice may affect the amount of Cafergot in your blood. Talk with your doctor before including grapefruit or grapefruit juice in your diet.

    * Cafergot is only to be used as needed for a migraine attack.

    * Take Cafergot at the first sign of a headache. If the initial dose does not relieve your headache, additional doses may be needed according to your doctor's instructions. Do not take a dose of Cafergot within 30 minutes of your last dose.

    * Do not take more than 6 tablets for a single migraine headache or more than 10 tablets during any 7-day period without first checking with your doctor.

    * If you miss a dose of Cafergot and you still have a headache, take it as soon as you remember. Do not take a dose of Cafergot within 30 minutes of your last dose. Do not take 2 doses at once.

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

                           * Do NOT exceed the recommended dose or take Cafergot for longer than prescribed without checking with your doctor. Cafergot is not for long-term daily use.

    * Do not take Cafergot for any other kind of headaches. Cafergot is not effective in treating other types of headaches.

    * Use of nicotine may increase the risk of severe side effects with Cafergot . Talk to you doctor before using Cafergot if you smoke or use any other kind of nicotine.

    * Use Cafergot with extreme caution in CHILDREN. Safety and effectiveness have not been confirmed.

    * PREGNANCY and BREAST-FEEDING: Do not use Cafergot if you are pregnant. If you suspect that you could be pregnant, contact your doctor immediately. Cafergot should not be taken during labor and delivery. Cafergot is excreted in breast milk. If you are or will be breast-feeding while you are using Cafergot , 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 Cafergot . This is known as DEPENDENCE or addiction. It is important that you take Cafergot as instructed by your doctor. Cafergot is not for long-term daily use.

                          Store Cafergot at room temperature, between 59 and 86 degrees F (15 and 30 degrees C), in a tight, light-resistant container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Cafergot out of the reach of children and away from pets.