Acebutolol hydrochloride

Generic name: Acebutolol hydrochloride
Brand names: Sectral

Why is Acebutolol hydrochloride prescribed?

Sectral, a type of medication known as a beta blocker, is used in the treatment of high blood pressure and abnormal heart rhythms. When used to treat high blood pressure, it is effective used alone or in combination with other high blood pressure medications, particularly with a thiazide-type diuretic. Beta blockers decrease the force and rate of heart contractions, thus reducing pressure within the circulatory system.

Most important fact about Acebutolol hydrochloride

If you have high blood pressure, you must take Sectral regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Sectral; and you must continue taking it even if you are feeling well. Sectral does not cure high blood pressure; it merely keeps it under control.

How should you take Acebutolol hydrochloride?

Sectral can be taken with or without food. Take it exactly as prescribed, even if your symptoms have disappeared.

Try not to miss any doses. If Acebutolol hydrochloride is not taken regularly, your condition may worsen.

--If you miss a dose...

Take the forgotten dose as soon as you remember. If it's within 4 hours of your next scheduled dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

Store at room temperature. Keep the container tightly closed. Protect from light.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Sectral.

More common side effects may include:
Abnormal vision, chest pain, constipation, cough, decreased sexual ability, depression, diarrhea, dizziness, fatigue, frequent urination, gas, headache, indigestion, joint pain, nasal inflammation, nausea, shortness of breath or difficulty breathing, strange dreams, swelling due to fluid retention, trouble sleeping, weakness

Why should Acebutolol hydrochloride not be prescribed?

If you have heart failure, inadequate blood supply to the circulatory system (cardiogenic shock), heart block (a type of irregular heartbeat), or a severely slow heartbeat, you should not take Acebutolol hydrochloride.

Special warnings about Acebutolol hydrochloride

If you have had severe congestive heart failure in the past, Sectral should be used with caution.

Sectral should not be stopped suddenly. This can cause increased chest pain and heart attack. Dosage should be gradually reduced.

If you suffer from asthma, seasonal allergies, other bronchial conditions, coronary artery disease, or kidney or liver disease, Acebutolol hydrochloride should be used with caution.

Ask your doctor if you should check your pulse while taking Sectral. This medication can cause your heartbeat to become too slow.

This medication may mask the symptoms of low blood sugar or alter blood sugar levels. If you are diabetic, discuss this with your doctor.

Notify your doctor or dentist that you are taking Sectral if you have a medical emergency, or before you have any surgery.

Tell your doctor if you are taking over-the-counter cold medications and nasal drops. They may interact with Sectral.

If you experience difficulty breathing, or develop hives or large areas of swelling, seek medical attention immediately. You may be having a serious allergic reaction to the medicine. Sectral can also make other severe allergies worse.

Possible food and drug interactions when taking Acebutolol hydrochloride

If Sectral is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Sectral with the following:

Albuterol (the airway-opening drug Ventolin)
Certain blood pressure medicines such as reserpine (Diupres)
Certain over-the-counter cold remedies and nasal drops such as Afrin, Neo-Synephrine, and Sudafed
Nonsteroidal anti-inflammatory drugs such as Motrin and Voltaren
Oral diabetes drugs such as Micronase

Special information if you are pregnant or breastfeeding

The effects of Sectral during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Sectral appears in breast milk and could affect a nursing infant. If Acebutolol hydrochloride is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with Sectral is finished.

Recommended dosage

ADULTS

Hypertension

The usual initial dose for mild to moderate high blood pressure is 400 milligrams per day. It may be taken in a single daily dose or in 2 doses of 200 milligrams each. The usual daily dosage ranges from 200 to 800 milligrams.

People with severe high blood pressure may take up to 1,200 milligrams per day divided into 2 doses. Sectral may be taken alone or in combination with another high blood pressure medication.

Irregular heartbeat

The usual starting dosage is 400 milligrams per day divided into 2 doses. Your doctor may gradually increase the dose to 600 to 1,200 milligrams per day. If your doctor wants you to stop taking Acebutolol hydrochloride, he or she will have you taper off over a period of 2 weeks.

CHILDREN

The safety and effectiveness of Sectral have not been established in children.

OLDER ADULTS

Your doctor will determine the dosage based on your particular needs. Do not take more than 800 milligrams per day.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

There is no specific information available on Sectral; however, overdose symptoms seen with other beta blockers include:
Difficulty breathing, extremely slow heartbeat, irregular heartbeat, low blood pressure, low blood sugar, seizures, severe congestive heart failure

Accutane

Generic name: Isotretinoin
Brand names: Amnesteem, Accutane

Why is Accutane prescribed?

Accutane, a chemical cousin of vitamin A, is prescribed for the treatment of severe, disfiguring cystic acne that has not cleared up in response to milder medications such as antibiotics. It works on the oil glands within the skin, shrinking them and diminishing their output. You take Accutane by mouth every day for several months, then stop. The antiacne effect can last even after you have finished your course of medication.

Most important fact about Accutane

Because Accutane can cause severe birth defects, including mental retardation and physical malformations, a woman must not become pregnant while taking it. Before starting Accutane therapy, women of childbearing age will be asked to read a pamphlet, watch a video, and sign a detailed consent form regarding the danger of birth defects. You must have two negative pregnancy tests before beginning Accutane therapy, and must take monthly pregnancy tests while using Accutane.

In addition, you must use 2 forms of birth control during Accutane therapy, and for 1 month before and after. Each prescription for Accutane must bear a yellow qualification sticker signifying that you meet these requirements. Scientists have not ruled out the possibility that hormone-based contraceptives (birth control pills and implants) may be less reliable when taken with Accutane, so a second form of birth control should always be used while taking Accutane. If you accidentally become pregnant while taking Accutane, you should immediately consult your doctor.

How should you take Accutane?

Take Accutane two times a day with a meal, unless your doctor tells you otherwise. Swallow the capsule. Don't suck or chew it. Take it with a full glass of water, milk, or other nonalcoholic liquid. Follow your doctor's instructions carefully.

Depending on your reaction to Accutane, your doctor may need to adjust the dosage upward or downward. If you respond quickly and very well, your doctor may take you off Accutane even before the 15 or 20 weeks are up.

After you finish taking Accutane, there should be at least a 2-month "rest period" during which you are off the drug. This is because your acne may continue to get better even though you are no longer taking the medication. Once the 2 months are up, if your acne is still severe, your doctor may want to give you a second course of Accutane. If you are still growing, your doctor may recommend a longer "rest period."

Avoid consumption of alcoholic beverages.

Read the patient information leaflet available with the product.

Do not crush the capsules.

Do not share Accutane with anyone because of the risk of birth defects and other serious side effects.

--If you miss a dose...

Take the forgotten dose as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at the same time.

--Storage instructions...

Store at room temperature, away from light.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Accutane.

More common side effects may include:
Abnormal hair growth or loss, allergic reaction, bleeding gums, blood in urine, bowel inflammation and pain, bruising, changes in blood sugar or cholesterol levels, changes in skin pigmentation, chest pain, decreased night vision, decreased tolerance to contact lenses, delay in wound healing, depression, difficulty sleeping, dizziness, drowsiness, dry or fragile skin, dry or cracked lips, dry mouth, dry nose, fatigue, flushing, headache, hearing problems, heartbeat irregularities, herpes, inflammation or sores in the esophagus, itching, joint pain, liver disorders, menstrual changes, muscle wasting, nail disorders, nausea, nervousness, nosebleeds, peeling palms or soles, pinkeye, rash, skin infections, stomach and intestinal discomfort, stroke, sudden drop in blood pressure (causing unconsciousness), sunburn-sensitive skin, suppression of growth, sweating, swelling due to fluid retention, tendon and ligament problems, urinary discomfort, vision problems, vomiting, weakness, weight loss

Why should Accutane not be prescribed?

If Accutane gives you an allergic reaction, you will not be able to use it.

If you are a woman of childbearing age, you should not take Accutane if you are pregnant, if you think there is a possibility you might get pregnant during the treatment, or if you are unable to keep coming back to the doctor for monthly checkups, including pregnancy testing.

Special warnings about Accutane

Stop taking Accutane and notify your doctor immediately at the first sign of a skin rash or any other allergic reaction. Although they are rare, serious and even fatal allergic reactions have been known to occur.

When you first start taking Accutane, it is possible that your acne will get worse before it starts to get better.

Accutane may cause depression or other mental problems. In rare cases, it has prompted thoughts of suicide. If you begin to feel depressed or become troubled by suicidal thoughts, contact your doctor immediately.

Before starting Accutane therapy, all patients must sign a consent form noting that they are aware of the possibility of mental side effects, the danger of birth defects, and the need for certain other precautions.

If you are a woman of childbearing age and you are considering taking Accutane, you will be given both spoken and written warnings about the importance of avoiding pregnancy during the treatment. You will also be asked to sign a second consent form noting that:

You must not take Accutane if you are pregnant or may become pregnant during treatment;
If you get pregnant while taking Accutane, your baby will be at high risk for birth defects;
If you take Accutane, you must use 2 effective forms of birth control from 1 month before the start of treatment through 1 month after the end of treatment;
You must have 2 negative pregnancy tests (one just before starting Accutane therapy), and must be tested every month during therapy;
You may participate in a program that includes an initial free pregnancy test and birth control counseling session;
If you become pregnant, you must immediately stop taking Accutane and see your doctor;
You have read and understood the Accutane patient brochure and asked your doctor any questions you had;
You have been invited to participate in a survey of women being treated with Accutane.

Some people taking Accutane, including some who simultaneously took tetracycline, have experienced headache, nausea, and visual disturbances caused by increased pressure within the skull. Avoid taking tetracycline while using Accutane. See a doctor immediately if you have these symptoms; if the doctor finds swelling of the optic nerve at the back of your eye, you must stop taking Accutane at once and see a neurologist for further care.

Be careful driving at night. Some people have experienced a sudden decrease in night vision.

Accutane affects the body's processing of fats and sugars. It should be used cautiously by people with diabetes, excess weight, high triglyceride or cholesterol levels, or a tendency to drink too much alcohol. If you have any of these conditions, your doctor will monitor you closely during Accutane therapy.

You may not be able to tolerate your contact lenses during and after your therapy with Accutane.

You should stop taking Accutane immediately if you have abdominal pain, bleeding from the rectum, or severe diarrhea. You may have an inflammatory disease of the bowel.

You should not donate blood during your therapy with Accutane and for a month after you stop taking it.

You may become more sensitive to light while taking Accutane. Try to stay out of the sun as much as possible.

You should not use wax hair removal treatments or skin resurfacing procedures (dermabrasion, laser treatments) while taking Accutane or for 6 months after completing therapy.

Some people taking Accutane develop vision or hearing problems. If you notice changes in your vision or hearing, stop taking Accutane and contact your doctor.

Possible food and drug interactions when taking Accutane

While taking Accutane, do not take vitamin supplements containing vitamin A. Accutane and vitamin A are chemically related; taking them together is like taking an overdose of vitamin A.

Remember, too, that Accutane should not be combined with tetracycline antibiotics such as Doryx, Minocin, and Vibramycin.

Special information if you are pregnant or breastfeeding

Accutane causes birth defects; do not use it while pregnant. Nursing mothers should not take Accutane because of the possibility of passing the drug on to the baby via breast milk.

Recommended dosage

The recommended dosage range for Accutane is 0.5 to 1 milligram per 2.2 pounds of body weight, divided into 2 doses daily, for 15 to 20 weeks. For very severe cases, the doctor may increase the daily dose to as much as 2 milligrams per 2.2 pounds.

If after a period of 2 months or more off therapy, severe cystic acne persists, your doctor may prescribe a second course of therapy.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose of Accutane, seek medical attention immediately.

Overdosage of Accutane, like overdosage of vitamin A, can cause:
Abdominal pain, dizziness, dry or cracked lips, facial flushing, incoordination and clumsiness, headache, vomiting


Image : Accutane

Accuretic

Generic name: Quinapril hydrochloride, Hydrochlorothiazide
Brand names: Accuretic

Why is Accuretic prescribed?

Accuretic combines two types of blood pressure medication. The first, quinapril hydrochloride, is an ACE (angiotensin-converting enzyme) inhibitor. It works by preventing a chemical in your blood called angiotensin I from converting into a more potent form (angiotensin II) that increases salt and water retention in the body and causes the blood vessels to constrict--two actions that tend to increase blood pressure.

To aid in clearing excess water from the body, Accuretic also contains hydrochlorothiazide, a diuretic that promotes production of urine. Diuretics often wash too much potassium out of the body along with the water. However, the ACE inhibitor part of Accuretic tends to keep potassium in the body, thereby canceling this unwanted effect.

Accuretic is not used for the initial treatment of high blood pressure. It is saved for later use, when a single blood pressure medication is not sufficient for the job. In addition, some doctors are using Accuretic along with other drugs to treat congestive heart failure.

Most important fact about Accuretic

You must take Accuretic regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Accuretic; and you must continue taking it even if you are feeling well. Accuretic does not cure high blood pressure; it merely keeps it under control.

How should you take Accuretic?

You can take Accuretic with or without meals.

Take Accuretic exactly as prescribed, and see your doctor regularly to make sure the drug is working properly without unwanted side effects. Do not stop taking Accuretic without first consulting your doctor.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

Store at room temperature in a tightly closed container. Protect from moisture and light.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Accuretic.

More common side effects may include:
Cough, dizziness, headache

Why should Accuretic not be prescribed?

If you are unable to urinate, avoid Accuretic.

You should not take Accuretic if you are sensitive to or have ever had an allergic reaction to any of the following: Accupril, thiazide diuretics such as HydroDIURIL and Esidrix, ACE inhibitors such as Capoten and Vasotec, or sulfa or other sulfonamide-derived drugs such as Bactrim and Septra. If you have a history of allergies, you may be at greater risk for an allergic reaction to Accuretic. Make sure your doctor is aware of any drug reactions you have experienced.

Special warnings about Accuretic

If you develop swelling of the face, lips, tongue or throat, or of your arms and legs, or have difficulty swallowing or breathing, stop taking the medication and contact your doctor immediately. You may need emergency treatment.

If you develop abdominal pain with or without nausea and vomiting, contact your doctor. ACE inhibitors such as Accuretic have been known to cause intestinal swelling.

You may feel light-headed, especially during the first few days of Accuretic therapy. If this occurs, notify your doctor. If you actually faint, stop taking the medication until you have consulted with your doctor.

Dehydration, excessive sweating, vomiting, or diarrhea can all deplete your body's fluids and cause your blood pressure to drop. If this leads to light-headedness or fainting, you should check with your doctor.

Inform your doctor or dentist that you are taking Accuretic before undergoing surgery or anesthesia.

Do not use potassium supplements or salt substitutes containing potassium without consulting your doctor.

If you develop any type of infection such as a sore throat or fever, contact your doctor immediately. It could indicate a more serious illness.

If you are taking Accuretic, your doctor will do a complete assessment of your kidney function and will watch it closely as long as you are taking Accuretic. If you have kidney disease, Accuretic should be used with caution.

Caution is warranted, too, if you have liver disease. If you notice a yellow tinge to your skin and the whites of your eyes, stop taking the drug and notify your doctor. This could be a sign of liver damage.

Accuretic may increase your blood sugar levels if you have diabetes. It can also trigger gout or the connective tissue disease lupus erythematosus. Use Accuretic cautiously if you have any of these problems.

The safety and effectiveness of Accuretic in children have not been established.

Possible food and drug interactions when taking Accuretic

If Accuretic is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Accuretic with the following:

Barbiturates such as phenobarbital
Cholestyramine (Questran)
Colestipol (Colestid)
Corticosteroids such as prednisone or ACTH
Diabetes medications such as insulin or Micronase
Digoxin (Lanoxin)
Diuretics such as HydroDIURIL and Lasix
Lithium (Eskalith, Lithobid)
Narcotics such as Percocet
Nonsteroidal anti-inflammatory drugs such as Naprosyn
Norepinephrine (Levophed)
Other high blood pressure medications such as Aldomet
Potassium-sparing diuretics such as Aldactone, Dyazide, and Moduretic
Potassium supplements such as Slow-K and K-Dur
Salt substitutes containing potassium
Tetracycline (Achromycin V, Sumycin)

Alcohol may increase the effect of Accuretic, and could cause dizziness or fainting. Check with your doctor before drinking alcoholic beverages.

Special information if you are pregnant or breastfeeding

ACE inhibitors such as the one in Accuretic have been shown to cause injury and even death to the unborn child when used in pregnancy during the second and third trimesters. If you are pregnant, your doctor should discontinue Accuretic as soon as possible. If you plan to become pregnant, make sure your doctor knows you are taking Accuretic. The diuretic component of Accuretic, when taken during pregnancy, can cause jaundice (yellowing of the skin and whites of the eyes) and abnormal bruising and bleeding in newborns.

Accuretic appears in breast milk and could affect a nursing infant. Because of potential harm to the baby, you'll need to choose between breastfeeding and continuing your treatment with Accuretic.

Recommended dosage

ADULTS

Accuretic is usually taken once a day. Your doctor will adjust the dosage depending on how your blood pressure responds. Daily doses of up to 80 milligrams of quinapril and 50 milligrams of hydrochlorothiazide may be prescribed, but doctors aim for the smallest dose that proves effective.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

Symptoms of Accuretic overdose may include:
A severe drop in blood pressure, dry mouth, excessive thirst, muscle pain or cramps, nausea and vomiting, weak or irregular heartbeat, weakness and dizziness


Image : Accuretic

Accupril

Generic name: Quinapril hydrochloride
Brand names: Accupril

Why is Accupril prescribed?

Accupril is used in the treatment of high blood pressure. It can be taken alone or in combination with a thiazide type of water pill such as HydroDIURIL. Accupril is in a family of drugs known as "ACE inhibitors." It works by preventing a chemical in your blood called angiotensin I from converting into a more potent form that increases salt and water retention in your body. Accupril also enhances blood flow throughout your blood vessels. Along with other drugs, Accupril is also prescribed in the treatment of congestive heart failure.

Most important fact about Accupril

You must take Accupril regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Accupril; and you must continue taking it even if you are feeling well. Accupril does not cure high blood pressure; it merely keeps it under control.

How should you take Accupril?

You can take Accupril with or without meals.

Alcohol may increase the effect of Accupril, and could cause dizziness or fainting. Avoid alcoholic beverages until you have checked with your doctor.

Take Accupril exactly as prescribed, and see your doctor regularly to make sure the drug is working properly without unwanted side effects. Do not stop taking Accupril without first consulting your doctor.

--If you miss a dose...

Take the forgotten dose as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never try to "catch up" by doubling the dose.

--Storage instructions...

Accupril can be stored at room temperature. Protect from light.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Accupril.

More common side effects may include:
Dizziness, headache

Why should Accupril not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Accupril or similar drugs, such as Capoten and Vasotec, you should not take Accupril. Make sure your doctor is aware of any drug reactions you have experienced.

Special warnings about Accupril

If you develop swelling of the face, lips, tongue, or throat, or of your arms and legs, or have difficulty swallowing or breathing, you should contact your doctor immediately. You may need emergency treatment.

If you develop abdominal pain with or without nausea and vomiting, contact your doctor. ACE inhibitors such as Accupril have been known to cause intestinal swelling.

You may feel light-headed, especially during the first few days of Accupril therapy. If this occurs, notify your doctor. If you actually faint, stop taking the medication until you have consulted with your doctor.

Vomiting, diarrhea, and heavy perspiration can all deplete your body fluid; and dehydration can cause your blood pressure to drop. If this leads to light-headedness or fainting, you should check with your doctor.

Inform your doctor or dentist that you are taking Accupril before undergoing surgery or anesthesia.

Do not use potassium supplements or salt substitutes containing potassium without consulting your doctor.

If you develop a sore throat, fever, or any other sign of infection, contact your doctor immediately. It could indicate a more serious illness.

If you are taking Accupril, your doctor will do a complete assessment of your kidney function and will watch it closely as long as you are taking Accupril.

If you notice a yellow tinge to your skin and the whites of your eyes, stop taking the drug and notify your doctor immediately. This could be a sign of liver damage.

The safety and effectiveness of Accupril in children have not been established.

Possible food and drug interactions when taking Accupril

If Accupril is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Accupril with the following:

Diuretics such as Lasix
Lithium (Eskalith, Lithobid)
Magnesium
Potassium-sparing diuretics such as Aldactone, Dyazide, and Moduretic
Potassium supplements such as Slow-K and K-Dur
Salt substitutes containing potassium
Tetracycline (Sumycin)

Special information if you are pregnant or breastfeeding

ACE inhibitors such as Accupril have been shown to cause injury and even death to the unborn child when used in pregnancy during the second and third trimesters. If you are pregnant, your doctor should discontinue Accupril as soon as possible. If you plan to become pregnant, make sure your doctor knows you are taking Accupril. Accupril appears in breast milk and could affect a nursing infant. If Accupril is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished.

Recommended dosage

HIGH BLOOD PRESSURE

The usual starting dose is 10 or 20 milligrams taken once a day. If you have any problems with your kidneys or if you are also taking a diuretic, your starting dose may be lower. For adults over age 65, the usual starting dose is 10 milligrams. Depending on how your blood pressure responds, your doctor may increase your dose up to a total of 80 milligrams a day taken once a day or divided into two doses.

CONGESTIVE HEART FAILURE

The usual starting dose is 5 milligrams taken twice a day. Your doctor may increase the dose from week to week, up to as much as 20 to 40 milligrams daily, divided into 2 equal doses. If you have kidney problems, the dosage will be lower.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

A severe drop in blood pressure is the primary sign of an Accupril overdose.

Image : Accupril

AccuNeb

Generic name: Albuterol sulfate
Brand names: VoSpire Extended-Release Tablets, Volmax Extended-Release Tablets, Ventolin HFA, Proventil HFA, AccuNeb, Proventil

Why is AccuNeb prescribed?

Drugs containing albuterol are prescribed for the prevention and relief of bronchial spasms that narrow the airway. This especially applies to the treatment of asthma. Some brands of AccuNeb are also used for the prevention of bronchial spasm due to exercise.

Most important fact about AccuNeb

Do not take albuterol more frequently than your doctor recommends. Increasing the number of doses can be dangerous and may actually make symptoms of asthma worse.

If the dose your doctor recommends does not provide relief of your symptoms, or if your symptoms become worse, consult your doctor immediately.

How should you take AccuNeb?

If you are taking extended-release tablets, swallow them whole with some liquid--never chew or crush them.

Shake the inhalation aerosol canister well before using and make sure it's firmly seated in the plastic mouthpiece. Before using it for the first time, prime the canister with 4 sprays into the air away from your face. Prime it with 2 sprays whenever it has not been used for at least 4 days. Use only the adapter that comes with the product; do not use this adapter with any other product. Wash the plastic mouthpiece with warm running water at least once a week to prevent medication buildup and blockage.

If you are using an inhalation solution, be sure to protect it from contamination. Keep the tip of the dropper away from the lip of the bottle or any other surface. Do not use the solution if it changes color or becomes cloudy.

--If you miss a dose...

Take the forgotten dose as soon as you remember; then take any remaining doses for that day at equally spaced intervals. Never take a double dose.

--Storage instructions...

AccuNeb, Proventil syrup, and Proventil solution for inhalation can be kept in the refrigerator or at room temperature. Proventil aerosol can be stored at temperatures as low as 60 degrees Fahrenheit, but should be at room temperature before use. Protect from excessive heat.

Ventolin nebules must be used within 2 weeks of being removed from the refrigerator.

Store VoSpire tablets at room temperature in a tight, light-resistant container.

Volmax tablets should be kept refrigerated.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking albuterol.

More common side effects may include:
Aggression, agitation, allergic reaction, anxiety, back pain, chest pain or discomfort, chills and fever, coordination problems, cough, decreased appetite, depression, difficulty speaking, diabetes, diarrhea, dizziness, drowsiness, dry mouth and throat, excitement, fluid retention and swelling, flushing, general bodily discomfort, headache, heart palpitations, heartburn, hives, increased appetite, increased blood pressure, increased difficulty breathing, indigestion, irritability, labored breathing, leg cramps, light-headedness, muscle cramps, muscle spasm, nasal inflammation, nausea, nervousness, nightmares, nosebleed, overactivity, rapid heartbeat, rash, respiratory infection or disorder, restlessness, ringing in the ears, shakiness, sleeplessness, slowed movement, stomachache, stuffy nose, sweating, swelling of mouth and throat, taste sensation on inhalation, throat irritation, tooth discoloration, tremors, unusual taste, urinary problems, vomiting, weakness, wheezing

Why should AccuNeb not be prescribed?

If you are sensitive to or have ever had an allergic reaction to albuterol or other bronchodilators, you should not take AccuNeb. Make sure that your doctor is aware of any drug reactions that you have experienced.

Special warnings about AccuNeb

When taking albuterol inhalation aerosol, you should not use other inhaled medications before checking with your doctor.

Make sure the doctor is aware of it if you have a heart condition, seizure disorder, high blood pressure, abnormal heartbeat, overactive thyroid gland, or diabetes. Call your doctor immediately if you notice any change in heartbeat or pulse while taking AccuNeb.

You may have an immediate, serious allergic reaction to the first dose of albuterol, causing symptoms such as hives, rash, and swelling of the mouth, throat, lips, and tongue. The drug has been known to cause life-threatening bronchial spasms, especially with the first dose from a new canister or vial. There have also been rare reports of skin reddening and peeling in children taking albuterol syrup.

Do not exceed your doctor's recommended dose of albuterol. If you need more than usual, check with your doctor. Your asthma may be getting unstable, and you may need another medication. Do not, however, change your medication without first consulting your doctor or pharmacist.

Possible food and drug interactions when taking AccuNeb

Use albuterol inhalation aerosol with other aerosol bronchodilators only if your doctor recommends it.

If albuterol is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining albuterol with the following:

Antidepressants classified as MAO inhibitors, such as Nardil and Parnate, and tricyclic antidepressants such as Elavil, Norpramin, Pamelor, and Tofranil.
Beta blockers (heart and blood pressure drugs such as Inderal, Tenormin, and Sectral)
Digoxin (Lanoxin)
Drugs similar to albuterol, such as Alupent, Brethine, Isuprel, and epinephrine
Drugs that lower potassium levels (water pills such as Lasix or HydroDIURIL)

Special information if you are pregnant or breastfeeding

The effects of albuterol during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. It is not known whether albuterol appears in breast milk. If AccuNeb is essential to your health, your doctor may advise you to stop nursing your baby until your treatment is finished.

Recommended dosage

ADULTS

Inhalation Aerosol

If you are being treated for a sudden or severe bronchial spasm or the prevention of asthma symptoms, the usual dosage of albuterol inhalation aerosol is 2 inhalations repeated every 4 to 6 hours. More frequent use is not recommended. In some individuals, 1 inhalation every 4 hours may be sufficient.

To prevent exercise-induced bronchial spasm, the usual dosage is 2 inhalations, 15 minutes prior to exercise.

Tablets

The usual starting dose for adults and children 12 years of age and older is 2 or 4 milligrams 3 to 4 times a day. Dosage should not exceed 32 milligrams per day.

Syrup

The usual starting dose for adults and children over 12 years of age is 1 or 2 teaspoonfuls 3 or 4 times a day. Dosage should not exceed 4 teaspoonfuls 4 times a day.

Proventil Inhalation Solution

The usual dosage for adults and children 12 years of age and older is 2.5 milligrams administered 3 to 4 times daily by nebulization. Do not use more often or in higher doses. To administer 2.5 milligrams, use the entire contents of a unit-dose bottle of the 0.083% solution or dilute 0.5 milliliter of the 0.5 percent solution with 2.5 milliliters of sterile normal saline solution.

Proventil Repetabs, Volmax Extended-Release Tablets, and VoSpire Extended-Release Tablets

The usual recommended dosage for adults and children 12 years of age and older is 8 milligrams every 12 hours. In some people, 4 milligrams every 12 hours may be sufficient. If the desired effect is not achieved with the standard dosage, your doctor may increase doses to a maximum of 32 milligrams per day, divided into two 16-milligram doses spaced 12 hours apart. Those taking standard tablets or syrup can switch to extended-release tablets. One extended-release tablet every 12 hours is equivalent to one 2-milligram standard tablet every 6 hours.

CHILDREN

Inhalation Aerosol

The usual dose of albuterol inhalation aerosol for children aged 4 and over (12 and over for Proventil) is 2 inhalations every 4 to 6 hours. To prevent exercise-induced bronchial spasm, the dose is 2 inhalations 15 minutes prior to exercise.

Tablets

The usual starting dose for children 6 to 12 years of age is 2 milligrams 3 or 4 times a day. The dose can be increased with caution but should not exceed 24 milligrams per day. Safety and effectiveness in children under 6 have not been established.

Syrup

The usual starting dose for children 6 to 12 years of age is 1 teaspoonful 3 to 4 times a day. The dosage should not exceed 3 teaspoonfuls 4 times a day. For children 2 to 6 years of age, the starting dose is 0.1 milligram per 2.2 pounds of body weight, to a maximum of 4 milligrams, 3 times a day.

Proventil Repetabs, Volmax Extended-Release Tablets, and VoSpire Extended-Release Tablets

The usual starting dosage for children 6 to 12 years of age is 4 milligrams every 12 hours. The dosage can be increased with caution but should not exceed 24 milligrams per day.

AccuNeb Inhalation Solution

The usual starting dose for children 2 to 12 years of age is 0.63 or 1.25 milligrams 3 or 4 time daily by nebulization. To administer, use the entire contents of the prescribed unit-dose vial. The 1.25 milligram dosage may be more helpful for children 6 to 12 with more severe asthma, and for children 11 to 12.

OLDER ADULTS

Oral Dosage

The usual starting dose of tablets or syrup is 2 milligrams 3 or 4 times a day. If needed, the dosage may be increased gradually to as much as 8 milligrams 3 or 4 times a day.

Overdosage

Symptoms of albuterol overdose may include:
Dizziness, dry mouth, fatigue, general feeling of illness, headache, high or low blood pressure, insomnia, nausea, nervousness, radiating chest pain, rapid or irregular heartbeat, seizures, tremors

Heart attack and even death have been associated with abuse of albuterol inhalation. Exaggerated side effects may also be a sign of an overdose. If you suspect an overdose, seek medical attention immediately.

Accolate

Generic name: Zafirlukast
Brand names: Accolate

Why is Accolate prescribed?

Accolate helps prevent asthma attacks. It is prescribed for long-term treatment.

Most important fact about Accolate

Accolate will not stop an asthma attack once it starts. You will still need to use an airway-opening medication when an attack occurs.

How should you take Accolate?

Accolate should be taken twice every day, whether or not you have had any recent asthma attacks. Do not take the medication with food. Allow at least 1 hour to pass before eating, or wait for 2 hours after a meal. You can continue to take Accolate while using another medication to stop an attack.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

--Storage instructions...

Store at room temperature in a dark, dry place.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Accolate.

More common side effects may include:
Headache, infection, nausea

Why should Accolate not be prescribed?

If you have had an allergic reaction to Accolate or to any of its ingredients, avoid Accolate.

Special warnings about Accolate

While taking Accolate, you should not stop--or even cut down on--any other asthma medication you are using unless your doctor recommends it. Remember that Accolate is not an airway-opening medication. You will still need an inhaler to stop an attack.

If you have been taking an oral steroid drug and your doctor does decide to cut back the dosage, there is a remote chance that complications will follow. Inform your doctor of any new symptoms.

Also call your doctor if you develop any of the following: pain in the upper right abdomen, nausea, fatigue, lethargy, loss of appetite, itching, flu-like symptoms, or jaundice (yellowing of the skin and eyes). These are signs of a liver problem--a rare side effect of Accolate that tends to develop more often in women. If tests show the problem to be serious, you'll have to stop using the drug. The symptoms will disappear once you stop.

Possible food and drug interactions when taking Accolate

A full stomach can reduce Accolate's effectiveness. Do not take with meals.

If Accolate is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Accolate with the following:

Aspirin (Ecotrin, Genuine Bayer, others)
Astemizole (Hismanal)
Blood-thinning drugs such as Coumadin
Carbamazepine (Tegretol)
Cyclosporine (Sandimmune, Neoral)
Erythromycin (E.E.S., E-Mycin, others)
Heart and blood pressure medications called calcium channel blockers, including Calan, Cardizem, and Procardia
Phenytoin (Dilantin)
Terfenadine (Seldane)
Theophylline (Theo-Dur, others)
Tolbutamide (Orinase)

Special information if you are pregnant or breastfeeding

Accolate should be taken during pregnancy only if clearly needed. If you are pregnant or plan to become pregnant, inform your doctor immediately.

Accolate does find its way into breast milk and should not be taken by nursing mothers.

Recommended dosage

ADULTS

The usual dose for adults and children 12 years of age and over is 20 milligrams twice a day.

CHILDREN

The usual dose for children 5 to 11 years of age is 10 milligrams twice a day. Safety and effectiveness in children under 5 years of age have not been established.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

Symptoms of Accolate overdose may include:
Rash, upset stomach

Acarbose

Generic name: Acarbose
Brand names: Precose

Why is Acarbose prescribed?

Precose is an oral medication used to treat type 2 (noninsulin-dependent) diabetes when high blood sugar levels cannot be controlled by diet alone. Precose works by slowing the body's digestion of carbohydrates so that blood sugar levels won't surge upward after a meal. Precose may be taken alone or in combination with certain other diabetes medications such as Diabinese, Micronase, Glucophage, and Insulin.

Most important fact about Acarbose

Always remember that Precose is an aid to, not a substitute for, good diet and exercise. Failure to follow the diet and exercise plan recommended by your doctor can lead to serious complications such as dangerously high or low blood sugar levels. If you are overweight, losing pounds and exercising are critically important in controlling your diabetes. Remember, too, that Precose is not an oral form of insulin and cannot be used in place of insulin.

How should you take Acarbose?

Do not take more or less of Acarbose than directed by your doctor. Precose is usually taken 3 times a day with the first bite of each main meal.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time. Taking Precose with your 3 main meals will help you to remember your medication schedule.

--Storage instructions...

Keep the container tightly closed. Protect from temperatures above 77°F. Store away from moisture.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Precose.

If side effects do occur, they usually appear during the first few weeks of therapy and generally become less intense and less frequent over time. They are rarely severe.

More common side effects may include:
Abdominal pain, diarrhea, gas

Why should Acarbose not be prescribed?

Do not take Precose when suffering diabetic ketoacidosis (a life-threatening medical emergency caused by insufficient insulin and marked by mental confusion, excessive thirst, nausea, vomiting, headache, fatigue, and a sweet fruity smell to the breath).

You should not take Precose if you have cirrhosis (chronic degenerative liver disease). Also avoid Precose therapy if you have inflammatory bowel disease, ulcers in the colon, any intestinal obstruction or chronic intestinal disease associated with digestion, or any condition that could become worse as a result of gas in the intestine.

Special warnings about Acarbose

Every 3 months during your first year of treatment, your doctor will give you a blood test to check your liver and see how it is reacting to Precose. While you are taking Precose, you should check your blood and urine periodically for the presence of abnormal sugar (glucose) levels.

Even people with well-controlled diabetes may find that stress such as injury, infection, surgery, or fever results in a loss of control over their blood sugar. If this happens to you, your doctor may recommend that Precose be discontinued temporarily and injected insulin used instead.

When taken alone, Precose does not cause hypoglycemia (low blood sugar), but when you take it in combination with other medications such as Diabinese or Glucotrol, or with insulin, your blood sugar may fall too low. If you have any questions about combining Precose with other medications, be sure to discuss them with your doctor.

If you are taking Precose along with other diabetes medications, be sure to have some source of glucose, such as Glutose tablets, available in case you experience any symptoms of mild or moderate low blood sugar. (Table sugar won't work because Precose inhibits its absorption.)

Symptoms of mild hypoglycemia may include:
Cold sweat, fast heartbeat, fatigue, headache, nausea, and nervousness


Symptoms of more severe hypoglycemia may include:
Coma, pale skin, and shallow breathing

Severe hypoglycemia is an emergency. Contact your doctor immediately if the symptoms occur.

Possible food and drug interactions when taking Acarbose

When you take Precose with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before taking Precose with the following:

Airway-opening drugs such as Proventil
Calcium channel blockers (heart and blood pressure medications such as Cardizem and Procardia)
Charcoal tablets
Digestive enzyme preparations such as Creon 20 and Donnazyme
Digoxin (Lanoxin)
Estrogens such as Premarin
Isoniazid (Rifamate)
Major tranquilizers such as Compazine and Mellaril
Nicotinic acid (Nicobid, Nicolar)
Oral contraceptives
Phenytoin (Dilantin)
Steroid medications such as Deltasone and Prelone
Thyroid medications such as Synthroid and Thyrolar
Water pills (diuretics) such as HydroDIURIL, Enduron, Moduretic

Special information if you are pregnant or breastfeeding

The effects of Precose during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, tell your doctor immediately. Since studies suggest the importance of maintaining normal blood sugar levels during pregnancy, your doctor may prescribe injected insulin. It is not known whether Precose appears in breast milk. Because many drugs do appear in breast milk, you should not take Precose while breastfeeding.

Recommended dosage

ADULTS

The recommended starting dose of Precose is 25 milligrams (half of a 50-milligram tablet) 3 times a day, taken with the first bite of each main meal. Some people need to work up to this dose gradually and start with 25 milligrams only once a day. Your doctor will adjust your dosage at 4- to 8-week intervals, based on blood tests and your individual response to Precose. The doctor may increase the medication to 50 milligrams 3 times a day or, if needed, 100 milligrams 3 times a day. You should not take more than this amount. If you weigh less than 132 pounds, the maximum dosage is 50 milligrams 3 times a day.

If you are also taking another oral antidiabetic medication or insulin and you show signs of low blood sugar, your doctor will adjust the dosage of both medications.

CHILDREN

Safety and effectiveness of Precose in children have not been established.

Overdosage

An overdose of Precose alone will not cause low blood sugar. However, it may cause a temporary increase in gas, diarrhea, and abdominal discomfort. The symptoms will disappear quickly.

Image : Acarbose