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Perindopril (per in' doe pril) Other names: Aceon

Why is this medication prescribed?

Perindopril is used alone or in combination with other medications to treat high blood pressure. Perindopril is in a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It makes blood flow more smoothly by preventing the production of certain natural chemicals that tighten the blood vessels.
How should this medication be used?

Perindopril comes as a tablet to take by mouth. It is usually taken once or twice a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take perindopril exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may start you on a low dose of perindopril and gradually increase your dose.

Perindopril controls high blood pressure but does not cure it. Continue to take perindopril even if you feel well. Do not stop taking perindopril without talking to your doctor.
Are there other uses for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Other names

* Aceon®

What special precautions should I follow?

Before taking perindopril,

* tell your doctor and pharmacist if you are allergic to perindopril, benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), quinapril (Accupril), ramipril (Altace), trandolapril (Mavik), or any other medications.
* tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: cyclosporine (Neoral, Sandimmune), diuretics ('water pills'), heparin, indomethacin (Indocin), lithium (Eskalith, Lithobid), and potassium supplements (K-Dur, Klor-Con, others). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
* tell your doctor if you are on dialysis and if have or have ever had heart failure; lupus (SLE); scleroderma; diabetes; swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, and/or lower legs (angioedema); or kidney or liver disease.
* tell your doctor if you plan to become pregnant or are breast-feeding.
* you should know that diarrhea, vomiting, not drinking enough fluids, and sweating a lot can cause a drop in blood pressure, which may cause lightheadedness and fainting.

What special dietary instructions should I follow?

Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.

What side effects can this medication cause?

Perindopril may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

* cough
* headache
* weakness
* dizziness
* diarrhea
* stomach pain
* upset stomach

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

* swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
* hoarseness
* difficulty swallowing or breathing
* lightheadedness
* fainting
* fever, sore throat, chills, and other signs of infection
* irregular or rapid heartbeats

Perindopril may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
What should I do if I forget to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What should I do in case of overdose?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
What storage conditions are needed for this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
What other information should I know?

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Important warning

Do not take perindopril if you are pregnant. If you become pregnant while taking perindopril, call your doctor immediately. Perindopril may harm the fetus.

Acebutolol (a se byoo' toe lole) Other names: Sectral

Why is this medication prescribed?

Acebutolol is used to treat high blood pressure.Acebutolol also is used to treat an irregular heartbeat. It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
How should this medication be used?

Acebutolol comes as a capsule to take by mouth. It usually is taken once or twice a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take acebutolol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Acebutolol controls your condition but does not cure it. Continue to take acebutolol even if you feel well. Do not stop taking acebutolol without talking to your doctor.
Are there other uses for this medicine?

Acebutolol is also used sometimes to treat chest pain (angina). Talk to your doctor about the possible risks of using this drug for your condition.
Other names

* Sectral®

What special precautions should I follow?

Before taking acebutolol,

* tell your doctor and pharmacist if you are allergic to acebutolol or any other drugs.
* tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially medications for migraine headaches, diabetes, asthma, allergies, colds, or pain; other medications for high blood pressure or heart disease; reserpine; and vitamins.
* tell your doctor if you have or have ever had heart, kidney, or liver disease; asthma or other lung diseases; diseases of the blood vessels; severe allergies; diabetes; or an overactive thyroid gland.
* tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking acebutolol, call your doctor.
* if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking acebutolol.
* you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
* remember that alcohol can add to the drowsiness caused by this drug.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What side effects can this medication cause?

Acebutolol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

* dizziness
* lightheadedness
* excessive tiredness
* headache
* constipation
* diarrhea
* upset stomach
* muscle aches

If you experience any of the following symptoms, call your doctor immediately:

* shortness of breath or wheezing
* swelling of the feet and lower legs
* chest pain

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
What should I do if I forget to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What should I do in case of overdose?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
What storage conditions are needed for this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
What other information should I know?

Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to acebutolol. Your doctor may ask you to check your pulse (heart rate). Ask your pharmacist or doctor to teach you how to take your pulse. If your pulse is faster or slower than it should be, call your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Important warning

Do not stop taking acebutolol without talking to your doctor first. If acebutolol is stopped suddenly, it may cause chest pain or heart attack in some people.

Isotretinoin (eye soe tret' i noyn) Other names: Accutane, Amnesteem, Claravis, Sotret

Why is this medication prescribed?

Isotretinoin is used to treat severe recalcitrant nodular acne (a certain type of severe acne) that has not been helped by other treatments, such as antibiotics. Isotretinoin is in a class of medications called retinoids. It works by slowing the production of certain natural substances that can cause pimples to form.
How should this medication be used?

Isotretinoin comes as a capsule to take by mouth. Isotretinoin is usually taken twice a day with meals. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take isotretinoin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the capsules whole with a full glass of liquid. Do not chew or suck on the capsules.

Your doctor will probably start you on an average dose of isotretinoin and increase or decrease your dose depending on how well you respond to the medication and the side effects you experience. Follow these directions carefully and ask your doctor or pharmacist if you are not sure how much isotretinoin you should take.

It may take several weeks or longer for you to feel the full benefit of isotretinoin. Your acne may get worse during the beginning of your treatment with isotretinoin. This is normal and does not mean that the medication is not working.
Are there other uses for this medicine?

Isotretinoin has been used to treat certain other skin conditions and some types of cancer. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.
Other names

* Accutane®
* Amnesteem®

* Claravis®
* Sotret®

What special precautions should I follow?

Before taking isotretinoin,

* tell your doctor and pharmacist if you are allergic to isotretinoin, any other medications, parabens (a preservative), or any of the ingredients in isotretinoin capsules. Ask your pharmacist or check the Medication Guide for a list of the inactive ingredients.
* tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, herbal products, and nutritional supplements you are taking or plan to take. Be sure to mention medications for seizures such as phenytoin (Dilantin); oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); tetracycline antibiotics such as demeclocycline (Declomycin), doxycycline (Monodox, Vibramycin, others), minocycline (Minocin, Vectrin), oxytetracycline (Terramycin), and tetracycline (Sumycin, Tetrex, others); and vitamin A supplements. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
* tell your doctor if you or anyone in your family has thought about or attempted suicide and if you or anyone in your family has or has ever had depression, mental illness, diabetes, asthma, osteoporosis (a condition in which the bones are fragile and break easily) or other conditions that cause weak bones, a high triglyceride (fats in the blood) level, anorexia nervosa (an eating disorder in which very little is eaten), or heart or liver disease.
* do not breast-feed while you are taking isotretinoin and for 1 month after you stop taking isotretinoin.
* plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Isotretinoin may make your skin sensitive to sunlight.
* you should know that isotretinoin may cause changes in your thoughts, behavior, or mental health. Some patients who took isotretinoin have developed depression or psychosis (loss of contact with reality), have become violent, have thought about killing or hurting themselves, and have tried or succeeded in doing so. You or your family should call your doctor right away if you experience any of the following symptoms: anxiety,sadness, crying spells, loss of interest in activities you used to enjoy, poor performance at school or work, sleeping more than usual, difficulty falling asleep or staying asleep, irritability, anger, aggression, changes in appetite or weight, difficulty concentrating, withdrawing from friends or family, lack of energy, feelings of worthlessness or guilt, thinking about killing or hurting yourself, acting on dangerous thoughts, or hallucinations (seeing or hearing things that do not exist). Be sure that your family members know which symptoms are serious so that they can call the doctor if you are unable to seek treatment on your own.
* you should know that isotretinoin may cause your eyes to feel dry and make wearing contact lenses uncomfortable during and after your treatment.
* you should know that isotretinoin may limit your ability to see in the dark. This problem may begin suddenly at any time during your treatment and may continue after your treatment is stopped. Be very careful when you drive or operate machinery at night.
* plan to avoid hair removal by waxing, laser skin treatments, and dermabrasion (surgical smoothing of the skin) while you are taking isotretinoin and for 6 months after your treatment. Isotretinoin increases the risk that you will develop scars from these treatments. Ask your doctor when you can safely undergo these treatments.
* talk to your doctor before you participate in hard physical activity such as sports. Isotretinoin may cause the bones to weaken or thicken abnormally and may increase the risk of certain bone injuries in people who perform some types of physical activity. If you break a bone during your treatment, be sure to tell all your healthcare providers that you are taking isotretinoin.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What side effects can this medication cause?

Isotretinoin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

* red, cracked, and sore lips
* dry skin, eyes, mouth, or nose
* nosebleeds
* changes in skin color
* peeling skin, especially on the palms and soles
* changes in the nails
* slowed healing of cuts or sores
* bleeding or swollen gums
* hair loss or unwanted hair growth
* sweating
* flushing
* voice changes
* tiredness
* cold symptoms

Some side effects can be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

* headache
* blurred vision
* dizziness
* nausea
* vomiting
* seizures
* slow or difficult speech
* weakness or numbness of one part or side of the body
* stomach pain
* chest pain
* difficulty swallowing or pain when swallowing
* new or worsening heartburn
* diarrhea
* rectal bleeding
* yellowing of the skin or eyes
* dark colored urine
* back, bone, joint or muscle pain
* muscle weakness
* difficulty hearing
* ringing in the ears
* vision problems
* painful or constant dryness of the eyes
* unusual thirst
* frequent urination
* trouble breathing
* fainting
* fast or pounding heartbeat
* fever
* rash
* red patches or bruises on the legs
* swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs

Isotretinoin may cause the bones to stop growing too soon in teenagers. Talk to your child's doctor about the risks of giving this medication to your child.

Isotretinoin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
What should I do if I forget to take a dose?

Skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What should I do in case of overdose?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

* vomiting
* flushing
* severe chapped lips
* stomach pain
* headache
* dizziness
* loss of coordination

Anyone who has taken an overdose of isotretinoin should know about the risk of birth defects caused by isotretinoin and should not donate blood for 1 month after the overdose. Pregnant woman should talk to their doctors about the risks of continuing the pregnancy after the overdose. Women who can become pregnant should use 2 forms of birth control for 1 month after the overdose. Men whose partners are or may become pregnant should use condoms or avoid sexual contact with that partner for 1 month after the overdose because isotretinoin may be present in the semen.
What storage conditions are needed for this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to isotretinoin.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Important warning

For all patients:

Isotretinoin must not be taken by patients who are pregnant or who may become pregnant. There is a high risk that isotretinoin will cause loss of the pregnancy, or will cause the baby to be born too early, to die shortly after birth, or to be born with birth defects (physical problems that are present at birth).

A program called iPLEDGE has been set up to make sure that pregnant women do not take isotretinoin and that women do not become pregnant while taking isotretinoin. All patients, including women who cannot become pregnant and men, can get isotretinoin only if they are registered with iPLEDGE, have a prescription from a doctor who is registered with iPLEDGE and fill the prescription at a pharmacy that is registered with iPLEDGE. Do not buy isotretinoin over the internet.

You will receive information about the risks of taking isotretinoin and must sign an informed consent sheet stating that you understand this information before you can receive the medication. You will need to see your doctor every month during your treatment to talk about your condition and the side effects you are experiencing. At each visit, your doctor may give you a prescription for up to a 30 day supply of medication with no refills. You must have this prescription filled within 7 days. If you do not have your prescription filled within 7 days and you are a woman who can become pregnant, you will not be able to get isotretinoin until it is time for your next office visit, 23 days after the 7 days have passed. If you are a man or if you are a woman who cannot become pregnant, you will need to visit your doctor again to talk about the safe use of isotretinoin and to get a new prescription. You may have the new prescription filled right away.

Tell your doctor if you do not understand everything you were told about isotretinoin and the iPLEDGE program or if you do not think you will be able to keep appointments or fill your prescription on schedule every month.

Your doctor will give you an identification number and card when you start your treatment. You will need this number to fill your prescriptions and to get information from the iPLEDGE website and phone line. Keep the card in a safe place where it will not get lost. If you do lose your card, you can ask for a replacement through the website or phone line.

Do not donate blood while you are taking isotretinoin and for 1 month after your treatment.

Do not share isotretinoin with anyone else, even someone who has the same symptoms that you have.

Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with isotretinoin and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs), the manufacturer's website, or the iPLEDGE program website (http://www.ipledgeprogram.com) to obtain the Medication Guide.

Talk to your doctor about the risks of taking isotretinoin.

For female patients:

If you can become pregnant, you will need to meet certain requirements during your treatment with isotretinoin. You need to meet these requirements even if you have not started menstruating (having monthly periods) or have had a tubal ligation ('tubes tied'; surgery to prevent pregnancy). You may be excused from meeting these requirements only if you have not menstruated for 12 months in a row and your doctor says you have passed menopause (change of life) or you have had surgery to remove your uterus and/or both ovaries. If none of these are true for you, then you must meet the requirements below.

You must use 2 acceptable forms of birth control for 1 month before you begin to take isotretinoin, during your treatment, and for 1 month after your treatment. Your doctor will tell you which forms of birth control are acceptable, and will give you written information about birth control. You can also have a free visit with a doctor or family planning expert to talk about birth control that is right for you. You must use these 2 forms of birth control at all times unless you can promise that you will not have any sexual contact with a male for 1 month before your treatment, during your treatment, and for 1 month after your treatment.

If you choose to take isotretinoin, it is your responsibility to avoid pregnancy for 1 month before, during, and for 1 month after your treatment. You must understand that any form of birth control can fail. Therefore, it is very important to decrease the risk of accidental pregnancy by using 2 forms of birth control. Tell your doctor if you do not understand everything you were told about birth control or you do not think that you will be able to use 2 forms of birth control at all times.

If you plan to use oral contraceptives (birth control pills) while taking isotretinoin, tell your doctor the name of the pill you will use. Isotretinoin interferes with the action of microdosed progestin ('minipill') oral contraceptives (Ovrette, Micronor, Nor-QD). Do not use this type of birth control while taking isotretinoin.

If you plan to use hormonal contraceptives (birth control pills, patches, implants, injections, rings, or intrauterine devices), be sure to tell your doctor about all the medications, vitamins, and herbal supplements you are taking. Many medications interfere with the action of hormonal contraceptives. Do not take St. John's wort if you are using any type of hormonal contraceptive.

You must have 2 negative pregnancy tests before you can begin to take isotretinoin. Your doctor will tell you when and where to have these tests. You will also need to be tested for pregnancy in a laboratory each month during your treatment, when you take your last dose, and 30 days after you take your last dose.

You will need to contact the iPLEDGE system by phone or the internet every month to confirm the 2 forms of birth control you are using and to answer 2 questions about the iPLEDGE program. You will only be able to continue to get isotretinoin if you have done this, if you have visited your doctor to talk about how you are feeling and how you are using your birth control and if you have had a negative pregnancy test within the past 7 days.

Stop taking isotretinoin and call your doctor right away if you think you are pregnant, you miss a menstrual period, or you have sex without using 2 forms of birth control. If you become pregnant during your treatment or within 30 days after your treatment, your doctor will contact the iPLEDGE program, the manufacturer of isotretinoin, and the Food and Drug Administration (FDA). You will also talk with a doctor who specializes in problems during pregnancy who can help you make choices that are best for you and your baby. Information about your health and your baby's health will be used to help doctors learn more about the effects of isotretinoin on unborn babies.

For male patients:

A very small amount of isotretinoin will probably be present in your semen when you take prescribed doses of this medication. It is not known if this small amount of isotretinoin may harm the fetus if your partner is or becomes pregnant. Tell your doctor if your partner is pregnant, plans to become pregnant, or becomes pregnant during your treatment with isotretinoin.

Quinapril (kwin' a pril) Other names: Accupril, Accuretic , Quinaretic

Why is this medication prescribed?

Quinapril is used alone or in combination with other medications to treat high blood pressure. It is used in combination with other medications to treat heart failure. Quinapril is in a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly and the heart can pump blood more efficiently.
How should this medication be used?

Quinapril comes as a tablet to take by mouth. It is usually taken once or twice a day. To help you remember to take quinapril, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take quinapril exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor will probably start you on a low dose of quinapril and gradually increase your dose, not more than once every one or two weeks.

Quinapril controls high blood pressure and heart failure but does not cure them. Continue to take quinapril even if you feel well. Do not stop taking quinapril without talking to your doctor.
Are there other uses for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Other names

* Accupril®
* Accuretic® (as a combination product containing Quinapril, Hydrochlorothiazide)

* Quinaretic® (as a combination product containing Quinapril, Hydrochlorothiazide)

What special precautions should I follow?

Before taking quinapril,

* tell your doctor and pharmacist if you are allergic to quinapril, benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), ramipril (Altace), trandolapril (Mavik), or any other medications.
* tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: diuretics ('water pills'); lithium (Eskalith, Lithobid); potassium supplements; and tetracycline (Sumycin). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
* tell your doctor if you have or have ever had heart, liver, or kidney disease; lupus; scleroderma; diabetes; or angioedema, a condition that causes difficulty swallowing or breathing and painful swelling of the the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs.
* tell your doctor if you plan to become pregnant or are breast-feeding.
* if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking quinapril.
* you should know that diarrhea, vomiting, not drinking enough fluids, and sweating a lot can cause a drop in blood pressure, which may cause lightheadedness and fainting.

What special dietary instructions should I follow?

Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.

What side effects can this medication cause?

Quinapril may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

* dizziness
* excessive tiredness
* cough
* upset stomach
* vomiting

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

* swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
* hoarseness
* difficulty breathing or swallowing
* yellowing of the skin or eyes
* fever, sore throat, chills, and other signs of infection
* chest pain
* lightheadedness
* fainting

Quinapril may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
What should I do if I forget to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What should I do in case of overdose?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

* lightheadedness
* fainting

What storage conditions are needed for this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
What other information should I know?

Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to quinapril. Your doctor may order certain lab tests to check your body's response to quinapril.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Important warning

Do not take quinapril if you are pregnant. If you become pregnant while taking quinapril, call your doctor immediately. Quinapril may harm the fetus.

Albuterol Inhalation (al byoo' ter ole) Other names: Accuneb, Proair HFA, Proventil HFA, Ventolin HFA

Why is this medication prescribed?

Albuterol is used to prevent and treat wheezing, difficulty breathing and chest tightness caused by lung diseases such as asthma and chronic obstructive pulmonary disease (COPD; a group of diseases that affect the lungs and airways). Albuterol inhalation aerosol is also used to prevent breathing difficulties during exercise. Albuterol is in a class of medications called bronchodilators. It works by relaxing and opening air passages to the lungs to make breathing easier.
How should this medication be used?

Albuterol comes as a solution (liquid) to inhale by mouth using a nebulizer (machine that turns medication into a mist that can be inhaled) and as an aerosol to inhale by mouth using an inhaler. When the inhalation aerosol is used to treat or prevent symptoms of lung disease, it is usually used every 4 to 6 hours as needed. When the inhalation aerosol is used to prevent breathing difficulty during exercise, it is usually used 15 to 30 minutes before exercise. The nebulizer solution is usually used three or four times a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use albuterol exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Call your doctor if your symptoms worsen or if you feel that albuterol inhalation no longer controls your symptoms. If you were told to use albuterol as needed to treat your symptoms and you find that you need to use the medication more often than usual, call your doctor.

Albuterol controls symptoms of asthma and other lung diseases but does not cure them. Do not stop using albuterol without talking to your doctor.

If you are using the inhaler, your medication will come in canisters. Each canister of albuterol aerosol is designed to provide 200 inhalations. After the labeled number of inhalations has been used, later inhalations may not contain the correct amount of medication. Throw away the canister after you have used the labeled number of inhalations even if it still contains some liquid and continues to release a spray when it is pressed.

Your inhaler may come with an attached counter that keeps track of the number of sprays you have used. If you have this type of inhaler, you should not try to change the numbers or remove the counter from the canister. When the number that shows on the counter is 020, you should call your doctor or pharmacist to refill your prescription. When the number that shows on the counter is 000, you should not use that canister anymore. Throw away the empty canister.

If your inhaler does not come with an attached counter, you will need to keep track of the number of inhalations you have used. You can divide the number of inhalations in your inhaler by the number of inhalations you use each day to find out how many days your inhaler will last. Do not float the canister in water to see if it still contains medication.

The inhaler that comes with albuterol aerosol is designed for use only with a canister of albuterol. Never use it to inhale any other medication, and do not use any other inhaler to inhale albuterol.

Be careful not to get albuterol inhalation into your eyes.

Do not use your albuterol inhaler when you are near a flame or source of heat. The inhaler may explode if it is exposed to very high temperatures.

Before you use albuterol for the first time, read the written instructions that come with the inhaler or nebulizer. Ask your doctor, pharmacist, or respiratory therapist to show you how to use it. Practice using the inhaler or nebulizer while he or she watches.

If your child will be using the inhaler, be sure that he or she knows how to use it. Watch your child each time he or she uses the inhaler to be sure that he or she is using it correctly.

To use the aerosol inhaler, follow these steps:

1. Remove the protective dust cap from the end of the mouthpiece. If the dust cap was not placed on the mouthpiece, check the mouthpiece for dirt or other objects. Be sure that the canister is fully and firmly inserted in the mouthpiece.
2. If you are using the inhaler for the first time or if you have not used the inhaler in more than 14 days, you will need to prime it. You may also need to prime the inhaler if it has been dropped. Ask your pharmacist or check the manufacturer's information if this happens. To prime the inhaler, shake it well and then press down on the canister 4 times to release 4 sprays into the air, away from your face. Be careful not to get albuterol in your eyes.
3. Shake the inhaler well.
4. Breathe out as completely as possible through your mouth.
5. Hold the canister with the mouthpiece on the bottom, facing you and the canister pointing upward. Place the open end of the mouthpiece into your mouth. Close your lips tightly around the mouthpiece.
6. Breathe in slowly and deeply through the mouthpiece.At the same time, press down once on the container to spray the medication into your mouth.
7. Try to hold your breath for 10 seconds. remove the inhaler, and breathe out slowly .
8. If you were told to use 2 puffs, wait 1 minute and then repeat steps 3-7.
9. Replace the protective cap on the inhaler.

To inhale the solution using a nebulizer, follow these steps;

1. Remove one vial of albuterol solution from the foil pouch. Leave the rest of the vials in the pouch until you are ready to use them.
2. Look at the liquid in the vial. It should be clear and colorless. Do not use the vial if the liquid is cloudy or discolored.
3. Twist off the top of the vial and squeeze all of the liquid into the nebulizer reservoir. If you are using your nebulizer to inhale other medications, ask your doctor or pharmacist if you can place the other medications in the reservoir along with albuterol.
4. Connect the nebulizer reservoir to the mouthpiece or face mask.
5. Connect the nebulizer to the compressor.
6. Place the mouthpiece in your mouth or put on the face mask. Sit in an upright, comfortable position and turn on the compressor.
7. Breathe in calmly, deeply, and evenly for about 5-15 minutes until mist stops forming in the nebulizer chamber.

Clean your inhaler or nebulizer regularly. Follow the manufacturer's directions carefully and ask your doctor or pharmacist if you have any questions about cleaning your inhaler or nebulizer.If you do not clean your inhaler properly, the inhaler may become blocked and may not spray medication. If this happens, follow the manufacturer's directions for cleaning the inhaler and removing the blockage.
Are there other uses for this medicine?

Inhaled albuterol is also sometimes used to treat or improve muscle paralysis (inability to move parts of the body) in patients with a condition that causes attacks of paralysis. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Other names

* Accuneb®
* Proair HFA®

* Proventil® HFA
* Ventolin HFA®

What special precautions should I follow?

Before using albuterol inhalation,

* tell your doctor and pharmacist if you are allergic to albuterol (Vospire ER, in Combivent, in Duoneb), levalbuterol (Xoponex), or any other medications.
* tell your doctor and pharmacist what prescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); digoxin (Lanoxin); diuretics ('water pills'); epinephrine (Epipen, Primatene Mist); other inhaled medications used to relax the air passages such as metaproterenol (Alupent) and levalbuterol (Xoponex); and medications for colds. Also tell your doctor or pharmacist if you are taking the following medications or have stopped taking them within the past 2 weeks: antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); and monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), and tranylcypromine (Parnate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
* tell your doctor if you have or have ever had an irregular heartbeat, heart disease, high blood pressure, hyperthyroidism (condition in which there is too much thyroid hormone in the body), diabetes, or seizures.
* tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using albuterol, call your doctor.
* you should know that albuterol inhalation sometimes causes wheezing and difficulty breathing immediately after it is inhaled. If this happens, call your doctor right away. Do not use albuterol inhalation again unless your doctor tells you that you should.

What side effects can this medication cause?

Albuterol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

* uncontrollable shaking of a part of the body
* nervousness
* headache
* nausea
* vomiting
* cough
* throat irritation
* muscle, bone, or back pain

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

* fast, pounding, or irregular heartbeat
* chest pain
* rash
* hives
* itching
* swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
* increased difficulty breathing
* difficulty swallowing
* hoarseness

Albuterol may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
What should I do if I forget to take a dose?

If you have been told to use albuterol inhalation on a regular schedule, use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.
What should I do in case of overdose?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

* seizures
* chest pain
* fast, irregular or pounding heartbeat
* nervousness
* headache
* uncontrollable shaking of a part of the body
* dry mouth
* nausea
* dizziness
* excessive tiredness
* lack of energy
* difficulty falling asleep or staying asleep

What storage conditions are needed for this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Keep unused vials of nebulizer solution in the foil pouch until you are ready to use them. Store the medication at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. If you are using the nebulizer solution, throw away vials one week after you remove them from the foil pouch. If you are using the inhaler with an attached counter, throw away the inhaler 2 months after you remove it from the foil pouch. Talk to your pharmacist about the proper disposal of your medication. Do not puncture the aerosol canister, and do not discard it in an incinerator or fire.
What other information should I know?

Keep all appointments with your doctor.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Brompheniramine (brome fen ir' a meen) Other names: Brovex, Dimetane, J-Tan PD, Siltane, Vazol, AccuHist PDX , Alacol , Alenaze-D

Why is this medication prescribed?

Brompheniramine relieves red, irritated, itchy, watery eyes; sneezing; and runny nose caused by allergies, hay fever, and the common cold. Brompheniramine helps control symptoms, but does not treat the cause of the symptoms or speed recovery. Brompheniramine should not be used to cause sleepiness in children. Brompheniramine is in a class of medications called antihistamines. It works by blocking the action of histamine, a substance in the body that causes allergic symptoms.
How should this medication be used?

Brompheniramine comes in combination with other cough and cold medications as a chewable tablet, an extended-release (long-acting) capsule, an extended-release (long-acting) tablet, and a liquid to be taken by mouth. The chewable tablet and liquid are usually taken every 4 to 6 hours as needed. The extended-release tablets and capsules are usually taken every 8 or 12 hours as needed. Follow the directions on the package label or on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take brompheniramine exactly as directed. Do not take more or less of it or take it more often than directed by the package label or prescribed by your doctor.

Brompheniramine comes in combination with other cough and cold medications. Ask your doctor or pharmacist for advice on which product is best for your symptoms. Check nonprescription cough and cold product labels carefully before taking two or more products at the same time. These products may contain the same active ingredient(s) and taking them together could cause you to receive an overdose. This is especially important if you will be giving cough and cold medications to a child.

Nonprescription cough and cold combination products, including products that contain brompheniramine, can cause serious side effects or death in young children. Do not give these products to children younger than 6 years of age. If you give these products to children 6-11 years of age, use caution and follow the package directions carefully.

If you are giving a product that contains brompheniramine to a child, read the package label carefully to be sure that it is the right product for a child of that age. Do not give brompheniramine products that are made for adults to children.

Before you give a brompheniramine product to a child, check the package label to find out how much medication the child should receive. Give the dose that matches the child's age on the chart. Ask the child's doctor if you don't know how much medication to give the child.

If you are taking the liquid, do not use a household spoon to measure your dose. Use the measuring spoon or cup that came with the medication or use a spoon made especially for measuring medication.

If you are taking the extended-release tablets or capsules swallow them whole; do not crush, break, or chew them.

Stop taking brompheniramine and call your doctor if your symptoms last longer than 7 days or if you have a fever.
Are there other uses for this medicine?

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Other names

* AccuHist® PDX (as a combination product containing Brompheniramine, Dextromethorphan, Guaifenesin, Phenylephrine)
* Alacol® (as a combination product containing Brompheniramine, Phenylephrine)
* Alenaze-D® (as a combination product containing Brompheniramine, Phenylephrine)
* Allanhist® PDX (as a combination product containing Brompheniramine, Dextromethorphan, Guaifenesin, Phenylephrine)
* Balacall® DM (as a combination product containing Brompheniramine, Dextromethorphan, Phenylephrine)
* Betatan® (as a combination product containing Brompheniramine, Carbetapentane, Phenylephrine)
* Bromaphedrine® (as a combination product containing Brompheniramine, Phenylephrine)
* Bromhist® PDX (as a combination product containing Brompheniramine, Dextromethorphan, Guaifenesin, Phenylephrine)
* Bromtuss® DM (as a combination product containing Brompheniramine, Dextromethorphan, Phenylephrine)
* Brovex®
* Brovex® DM (as a combination product containing Brompheniramine, Dextromethorphan, Phenylephrine)
* Dimaphen® DM (as a combination product containing Brompheniramine, Dextromethorphan, Phenylephrine)
* Dimetane®
* Dimetane® Decongestant (as a combination product containing Brompheniramine, Phenylephrine)
* Dimetapp® DM Cold & Cough (as a combination product containing Brompheniramine, Dextromethorphan, Phenylephrine)
* Duravent-DPB® (as a combination product containing Brompheniramine, Dextromethorphan, Phenylephrine)
* Endacof AC® (as a combination product containing Brompheniramine, Codeine)

* EndaCof-DH® (as a combination product containing Brompheniramine, Dihydrocodeine, Phenylephrine)
* J-Tan® D (as a combination product containing Brompheniramine, Phenylephrine)
* J-Tan® PD
* Lohist-DM® (as a combination product containing Brompheniramine, Dextromethorphan, Phenylephrine)
* Lortuss® DM (as a combination product containing Brompheniramine, Dextromethorphan, Phenylephrine)
* Nalex® AC (as a combination product containing Brompheniramine, Codeine)
* Pulmari® (as a combination product containing Brompheniramine, Carbetapentane, Phenylephrine)
* Seradex® (as a combination product containing Brompheniramine, Carbetapentane, Phenylephrine)
* Siltane®
* Trexbrom® (as a combination product containing Brompheniramine, Carbetapentane, Phenylephrine)
* Tusdec® DM (as a combination product containing Brompheniramine, Dextromethorphan, Phenylephrine)
* Tusnel® (as a combination product containing Brompheniramine, Dextromethorphan, Guaifenesin)
* Vazobid® (as a combination product containing Brompheniramine, Phenylephrine)
* Vazol®
* Vazotan® (as a combination product containing Brompheniramine, Carbetapentane, Phenylephrine)
* V-Cof® (as a combination product containing Brompheniramine, Carbetapentane, Phenylephrine)
* V-Hist® (as a combination product containing Brompheniramine, Phenylephrine)

What special precautions should I follow?

Before taking brompheniramine,

* tell your doctor and pharmacist if you are allergic to brompheniramine or any other medications.
* tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: medications for colds, hay fever, or allergies; medications for depression or seizures; monoamine oxidase (MAO) inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate); muscle relaxants; narcotic medications for pain; sedatives; sleeping pills; and tranquilizers.
* tell your doctor if you have or have ever had asthma, emphysema, chronic bronchitis, or other breathing problems; glaucoma (a condition in which increased pressure in the eye can lead to gradual loss of vision); ulcers; difficulty urinating (due to an enlarged prostate gland); heart disease; high blood pressure; seizures; or an overactive thyroid gland.
* tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking brompheniramine, call your doctor.
* if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking brompheniramine.
* you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
* talk to your doctor about the safe use of alcohol while you are taking brompheniramine. Alcohol can make the side effects of brompheniramine worse.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What side effects can this medication cause?

Brompheniramine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

* drowsiness
* dry mouth, nose, and throat
* nausea
* headache
* chest congestion

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

* vision problems
* difficulty urinating

Brompheniramine may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
What should I do if I forget to take a dose?

Brompheniramine is usually taken as needed. If your doctor has told you to take brompheniramine regularly, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What should I do in case of overdose?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
What storage conditions are needed for this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
What other information should I know?

Ask your pharmacist any questions you have about brompheniramine.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Zafirlukast (za fir' loo kast) Other names: Accolate

Why is this medication prescribed?

Zafirlukast is used to prevent asthma symptoms. Zafirlukast is in a class of medications called leukotriene receptor antagonists (LTRAs). It works by blocking the action of certain natural substances that cause swelling and tightening of the airways.
How should this medication be used?

Zafirlukast comes as a tablet to take by mouth. It is usually taken two times a day, 1 hour before or 2 hours after meals. Try to take zafirlukast at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take zafirlukast exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Do not use zafirlukast to treat a sudden attack of asthma symptoms. Your doctor will prescribe a short-acting inhaler to use during attacks. Talk to your doctor about how to treat symptoms of a sudden asthma attack.

Continue to take or use all other medications that your doctor has prescribed to treat your asthma. Do not stop taking any of your medications or change the doses of any of your medications unless your doctor tells you that you should.

Zafirlukast may help control asthma symptoms, but it does not cure asthma. Continue to take zafirlukast even if you feel well. Do not stop taking zafirlukast without talking to your doctor.
Are there other uses for this medicine?

Zafirlukast is also sometimes used to treat allergic rhinitis (hay fever; runny nose, watery eyes, and other symptoms caused by an allergic reaction to pollen or other substances in the air). Zafirlukast is also sometimes used to prevent breathing difficulties during exercise in people who have asthma.
Other names

* Accolate®

What special precautions should I follow?

Before taking zafirlukast,

* tell your doctor and pharmacist if you are allergic to zafirlukast or any other medications.
* tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); aspirin or aspirin-containing products; calcium channel blockers such as amlodipine (Norvasc, in Caduet), diltiazem (Cardizem, Tiazac), felodipine (Plendil), isradipine (Dynacirc), nicardipine (Cardene), nifedipine (Adalat, Procardia, others), nimodipine (Nimotop), nisoldipine (Sular), or verapamil (Calan, Covera, Isoptin, Verelan); carbamazepine (Equetro, Tegretol); cisapride (Propulsid) (not available in the U.S.); cyclosporine (Neoral, Sandimmune); erythromycin (E.E.S, Erythrocin); phenytoin (Dilantin); theophylline (Theo-Dur, others); and tolbutamide. Other medications may also interact with zafirlukast, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you more carefully for side effects.
* tell your doctor if you have or have ever had liver disease.
* tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking zafirlukast, call your doctor.
* do not breastfeed while you are taking zafirlukast.
* you should know that your mental health may change in unexpected ways while you are taking zafirlukast. You should call your doctor right away if you experience any of the following symptoms: agitation, aggressive behavior, anxiety, irritability, unusual dreams, hallucinations (seeing things or hearing voices that do not exist), depression, difficulty falling asleep or staying sleep, restlessness, suicidal behavior (thinking about harming or killing yourself or planning or trying to do so), or tremor (uncontrollable shaking of a part of the body). Your doctor will decide if you should continue taking zafirlukast.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What side effects can this medication cause?

Zafirlukast may cause side effects. Tell your doctor if this symptom is severe or does not go away.

* headache

Some side effects can be serious. If you experience any of the following symptoms or those listed in the SPECIAL PRECAUTIONS section, call your doctor immediately.

* nausea
* loss of appetite
* pain in the right upper part of your stomach
* excessive tiredness
* lack of energy
* itching
* yellowing of the skin or eyes
* flu-like symptoms
* rash
* swelling of the eyes, face, lips, tongue, or throat
* difficulty breathing or swallowing
* hoarseness
* pain, burning, numbness, or tingling in the hands or feet

Zafirlukast may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.
What should I do if I forget to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What should I do in case of overdose?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

* nausea
* rash

What storage conditions are needed for this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat, and moisture (not in the bathroom) . Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your response to zafirlukast.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Acarbose (ay' car bose) Other names: Prandase, Precose

Why is this medication prescribed?

Acarbose is used (with diet only or diet and other medications) to treat type 2 diabetes (condition in which the body does not use insulin normally and therefore cannot control the amount of sugar in the blood) . Acarbose works by slowing the action of certain chemicals that break down food to release glucose (sugar) into your blood. Slowing food digestion helps keep blood glucose from rising very high after meals.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
How should this medication be used?

Acarbose comes as a tablet to take by mouth. It is usually taken three times a day. It is very important to take each dose with the first bite of each main meal. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take acarbose exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Continue to take acarbose even if you feel well. Do not stop taking acarbose without talking to your doctor.
Other names

* Prandase®

* Precose®

What special precautions should I follow?

Before taking acarbose,

* tell your doctor and pharmacist if you are allergic to acarbose or any other drugs.
* tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially other medications for diabetes, digoxin (Lanoxin), diuretics ('water pills'), estrogens, isoniazid, medications for high blood pressure or colds, oral contraceptives, pancreatic enzymes, phenytoin (Dilantin), steroids, thyroid medications, and vitamins.
* tell your doctor if you have or have ever had ketoacidosis, cirrhosis, or intestinal disease such as inflammatory bowel disease or bowel obstruction.
* tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking acarbose, call your doctor.
* if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking acarbose.

What special dietary instructions should I follow?

Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. It is important to eat a healthful diet.

Alcohol may cause a decrease in blood sugar. Ask your doctor about the safe use of alcoholic beverages while you are taking acarbose.

What side effects can this medication cause?

When used in combination with insulin or other medications used to treat diabetes, acarbose may cause excessive lowering of blood sugar levels.

If you have any of these symptoms, glucose products (Insta-Glucose or B-D Glucose tablets) should be used and you should call your doctor. Because acarbose blocks the breakdown of table sugar and other complex sugars, fruit juice or other products containing these sugars will not help to increase blood sugar. It is important that you and other members of your household understand this difference between acarbose and other medications used to treat diabetes.

* shakiness
* dizziness or lightheadedness
* sweating
* nervousness or irritability
* sudden changes in behavior or mood
* headache
* numbness or tingling around the mouth
* weakness
* pale skin
* hunger
* clumsy or jerky movements

If hypoglycemia is not treated, severe symptoms may develop. Be sure that your family, friends, and other people who spend time with you know that if you have any of the following symptoms, they should get medical treatment for you immediately.

* confusion
* seizures
* loss of consciousness

Call your doctor immediately if you have any of the following symptoms of hyperglycemia (high blood sugar):

* extreme thirst
* frequent urination
* extreme hunger
* weakness
* blurred vision

If high blood sugar is not treated, a serious, life-threatening condition called diabetic ketoacidosis could develop. Call your doctor immediately if you have any of the these symptoms:

* dry mouth
* upset stomach and vomiting
* shortness of breath
* breath that smells fruity
* decreased consciousness

What should I do if I forget to take a dose?

Take the missed dose as soon as you remember it. If you will be having a snack soon, take a dose with the snack. If it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What should I do in case of overdose?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
What storage conditions are needed for this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to acarbose. Your doctor will also tell you how to check your response to this medication by measuring your blood or urine sugar levels at home. Follow these instructions carefully

You should always wear a diabetic identification bracelet to be sure you get proper treatment in an emergency.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Clindamycin and Benzoyl Peroxide Topical (klin da mye' sin) (ben' zoe ill per ox' ide) Other names: Acanya , BenzaClin , Duac

Why is this medication prescribed?

The combination of clindamycin and benzoyl peroxide is used to treat acne. Clindamycin and benzoyl peroxide are in a class of medications called topical antibiotics. The combination of clindamycin and benzoyl peroxide works by killing the bacteria that cause acne.
How should this medication be used?

The combination of clindamycin and benzoyl peroxide comes as a gel to apply to the skin. It is usually applied twice a day, in the morning and evening. To help you remember to use clindamycin and benzoyl peroxide gel, apply it at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use clindamycin and benzoyl peroxide gel exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

To use the gel, follow these steps:

1. Wash the affected area with warm water and gently pat dry with a clean towel.
2. Use you fingertips to spread a thin layer of gel evenly over the affected area. Avoid getting the gel in your eyes, nose, mouth, or other body openings. If you do get the gel in your eyes, wash with warm water.
3. Look in the mirror. If you see a white film on your skin, you have used too much medication.
4. Wash your hands.

Are there other uses for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Other names

* Acanya® (as a combination product containing Benzoyl Peroxide, Clindamycin)
* BenzaClin® (as a combination product containing Benzoyl Peroxide, Clindamycin)

* Duac® (as a combination product containing Benzoyl Peroxide, Clindamycin)

What special precautions should I follow?

Before using clindamycin and benzoyl peroxide,

* tell your doctor and pharmacist if you are allergic to clindamycin (Cleocin, Clinda-Derm, C/D/S), benzoyl peroxide (Benzac, Desquam, PanOxyl, Triaz, others), lincomycin, or any other medications.
* tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: erythromycin (E.E.S., E-Mycin, Erythrocin) and other topical medications for acne. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
* tell your doctor if you have or have ever had stomach problems, ulcerative colitis, or severe diarrhea caused by antibiotics.
* tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using clindamycin and benzoyl peroxide, call your doctor.
* plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Clindamycin and benzoyl peroxide may make your skin sensitive to sunlight.
* ask your doctor or pharmacist to recommend a moisturizer to keep your skin soft during treatment.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What side effects can this medication cause?

Clindamycin and benzoyl peroxide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

* dry skin
* itching
* peeling skin
* red skin

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

* severe diarrhea
* blood or mucus in the stool
* severe stomach pain or cramps
* changes in your skin or nails that may be signs of infection with a fungus

Clindamycin and benzoyl peroxide may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
What should I do if I forget to take a dose?

Apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not apply a double dose to make up for a missed one.
What storage conditions are needed for this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any unused medication after 10 weeks. Talk to your pharmacist about the proper disposal of your medication.
What other information should I know?

Keep all appointments with your doctor.

Avoid getting clindamycin and benzoyl peroxide gel on your hair or clothing. Clindamycin and benzoyl peroxide may bleach hair or colored fabric.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Acamprosate (a kam' pro sate) Other names: Campral

Why is this medication prescribed?

Acamprosate is used along with counseling and social support to help people who have stopped drinking large amounts of alcohol (alcoholism) to avoid drinking alcohol again. Drinking alcohol for a long time changes the way the brain works. Acamprosate works by helping the brains of people who have drunk large amounts of alcohol to work normally again. Acamprosate does not prevent the withdrawal symptoms that people may experience when they stop drinking alcohol. Acamprosate has not been shown to work in people who have not stopped drinking alcohol or in people who drink large amounts of alcohol and also overuse or abuse other substances such as street drugs or prescription medications.
How should this medication be used?

Acamprosate comes as a delayed-release tablet to take by mouth. It is usually taken with or without food three times a day. To help you remember to take acamprosate, take it around the same times every day. Taking acamprosate with breakfast, lunch, and dinner may help you to remember all three doses. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take acamprosate exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the tablets whole; do not split, chew, or crush them.

Acamprosate helps to prevent you from drinking alcohol only as long as you are taking it. Continue to take acamprosate even if you do not think you are likely to start drinking alcohol again. Do not stop taking acamprosate without talking to your doctor.

If you drink alcohol while you are taking acamprosate, continue to take the medication and call your doctor. Acamprosate will not cause you to have an unpleasant reaction if you drink alcohol during treatment.
Are there other uses for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Other names

* Campral®

What special precautions should I follow?

Before taking acamprosate,

* tell your doctor and pharmacist if you are allergic to acamprosate, any other medications, or sulfites.
* tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention antidepressants ('mood elevators'). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
* tell your doctor if you are thinking of, or have ever thought of, harming or killing yourself, if you have ever tried to do so, or if you use or have ever used street drugs or have overused prescription medications. Also tell your doctor if you have or have ever had depression or kidney disease.
* tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking acamprosate, call your doctor.
* if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking acamprosate.
* you should know that acamprosate may affect your thinking, ability to make decisions, and coordination. Do not drive a car or operate machinery until you know how this medication affects you.
* you should know that people who drink large amounts of alcohol often become depressed and sometimes try to harm or kill themselves. Taking acamprosate does not decrease and may increase the risk that you will try to harm yourself. You may develop depression while you are taking acamprosate even if you do not go back to drinking. You or your family should call the doctor right away if you experience symptoms of depression such as feelings of sadness, anxiousness, hopelessness, guilt, worthlessness, or helplessness; loss of interest or pleasure in activities you once enjoyed; lack of energy; difficulty concentrating, making decisions, or remembering; irritability; sleep problems; changes in appetite or weight; restlessness; or thinking about harming or killing yourself or planning or trying to do so. Be sure that your family knows which symptoms may be serious so they can call the doctor right away if you are unable to seek treatment on your own.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What side effects can this medication cause?

Acamprosate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

* diarrhea
* gas
* upset stomach
* loss of appetite
* dry mouth
* dizziness
* itching
* weakness

Some side effects can be serious. The following symptoms are uncommon, but if you experience either of them or those mentioned in the SPECIAL PRECAUTIONS section, call your doctor immediately:

* burning, tingling, or numbness in the hands, feet, arms, or legs
* rash

Acamprosate may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
What should I do if I forget to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What should I do in case of overdose?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

* diarrhea

If you take too much acamprosate regularly for a long time, you may experience certain symptoms. Call your doctor if you experience any of these symptoms:

* loss of appetite
* upset stomach
* constipation
* extreme thirst
* tiredness
* muscle weakness
* restlessness
* confusion

What storage conditions are needed for this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
What other information should I know?

Keep all appointments with your doctor and counselor or support group.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Paclitaxel Injection (pak'' li tax' el) Other names: Abraxane, Taxol

Why is this medication prescribed?

Paclitaxel manufactured with human albumin is used to treat breast cancer that has not improved or that has come back after treatment with other medications. Paclitaxel manufactured with Cremophor EL is used to treat ovarian cancer (cancer that begins in the female reproductive organs where eggs are formed), breast cancer, and lung cancer. Paclitaxel with Cremophor EL is also used to treat Kaposi's sarcoma (a type of cancer that causes patches of abnormal tissue to grow under the skin) in people who have acquired immunodeficiency syndrome (AIDS). Paclitaxel is in a class of medications called antimicrotubule agents. It works by stopping the growth and spread of cancer cells.
How should this medication be used?

Paclitaxel comes as a liquid to be given intravenously (into a vein) by a doctor or nurse in a hospital or clinic. It is usually given once every 3 weeks. When paclitaxel manufactured with Cremophor EL is used to treat Kaposi's sarcoma, it may be given once every 2 or 3 weeks.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.
Are there other uses for this medicine?

Paclitaxel is also sometimes used to treat cancer of the head and neck, esophagus (tube that connects the mouth and stomach), bladder, endometrium (lining of the uterus), and cervix (opening of the uterus). Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Other names

* Abraxane®

* Taxol®

What special precautions should I follow?

Before using paclitaxel,

* tell your doctor and pharmacist if you are allergic to paclitaxel, any other medications, human albumin, Cremophor EL, or medications that contain Cremophor EL such as cyclosporine injection (Sandimmune) and teniposide (Vumon). Ask your doctor or pharmacist if you do not know if a medication that you are allergic to contains human albumin or Cremophor EL.
* tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amiodarone (Cordarone, Pacerone); aripiprazole (Abilify); buspirone (Buspar); certain antibiotics such as clarithromycin (Biaxin), erythromycin (E.E.S., E-Mycin), and telithromycin (Ketek); certain benzodiazepines such as alprazolam (Xanax), diazepam (Valium), midazolam, and triazolam (Halcion); certain antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); certain calcium channel blockers such as amlodipine (Norvasc, in Azor, in Caduet, in Lotrel), diltiazem (Cardizem, Dilacor, Tiazac), nifedipine (Adalat, Procardia), nisoldipine (Sular), and verapamil (Calan, Tarka, Verelan); certain cholesterol-lowering medications (statins) such as atorvastatin (Lipitor), lovastatin (Mevacor), and simvastatin (Zocor); cimetidine (Tagamet); cisplatin (Platinol); cyclosporine (Gengraf, Neoral, Sandimmune); doxorubicin (Doxil); fluvoxamine; gemfibrozil (Lopid); imatinib (Gleevec); methadone (Dolophine); montelukast (Singulair); nefazodone; pimozide (Orap); protease inhibitors used to treat human immunodeficiency virus (HIV) such as indinavir (Crixivan), ritonavir (Norvir, in Kaletra), nelfinavir (Viracept), and saquinavir (Invirase); quinidine; quinine (Qualaquin); sildenafil (Viagra); tacrolimus (Prograf); tamoxifen (Nolvadex); trazodone; and vincristine. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with paclitaxel, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
* tell your doctor if you have or have ever had liver or heart disease.
* tell your doctor if you are pregnant or plan to become pregnant, or if you plan to father a child. You or your partner should not become pregnant while you are using paclitaxel. You should use birth control to prevent pregnancy in yourself or your partner during your treatment with paclitaxel. Talk to your doctor about birth control methods that will work for you. If you or your partner become pregnant while using paclitaxel, call your doctor. Paclitaxel may harm the fetus.
* do not breast-feed while you are using paclitaxel.
* if you are having surgery, including dental surgery, tell the doctor or dentist that you are using paclitaxel.
* if you are using paclitaxel manufactured with Cremophor EL, you should know that the medication contains alcohol. Do not drive a car or operate machinery until you know how this medication affects you. Talk to your doctor about the safe use of alcoholic beverages or medications that may affect your thinking or judgment during your treatment.
* talk to your doctor before you receive any vaccinations during your treatment with paclitaxel.
* you should know that paclitaxel may make it more difficult for your body to fight infection. Wash your hands often and avoid crowds and people who are sick during your treatment with paclitaxel.
* you should know that paclitaxel may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.

What special dietary instructions should I follow?

Talk to your doctor about eating grapefruit and drinking grapefruit juice while using this medicine.

What side effects can this medication cause?

Paclitaxel may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

* pain, redness, swelling, or sores in the place where the medication was injected
* weakness
* nausea
* vomiting
* diarrhea
* sores in the mouth
* hair loss

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

* numbness, burning, or tingling in the hands or feet
* pale skin
* excessive tiredness
* unusual bruising or bleeding
* chest pain
* irregular heartbeat
* blistering or peeling skin

Paclitaxel may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
What should I do if I forget to take a dose?

Call your doctor right away if you are unable to keep an appointment to receive a dose of paclitaxel.
What should I do in case of overdose?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

* pale skin
* shortness of breath
* excessive tiredness
* sore throat, fever, chills, and other signs of infection
* unusual bruising or bleeding
* numbness, burning, or tingling of the hands and feet
* sores in the mouth

What other information should I know?

Keep all appointments with your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Important warning

Paclitaxel injection must be given in a hospital or medical facility under the supervision of a doctor who is experienced in giving chemotherapy medications for cancer.

Paclitaxel may cause a large decrease in the number of white blood cells (a type of blood cell that is needed to fight infection) in your blood. This increases the risk that you will develop a serious infection. You should not receive paclitaxel if you already have a low number of white blood cells. Your doctor will order laboratory tests before and during your treatment to check the number of white blood cells in your blood. Your doctor will delay or interrupt your treatment if the number of white blood cells is too low. Call your doctor immediately if you develop a temperature greater than 100.4ยบ F, a sore throat, cough, chills, or other signs of infection during your treatment with paclitaxel.

Paclitaxel is manufactured with additional ingredients to allow the medication to reach parts of the body where it is needed. One form of paclitaxel (Abraxane) is manufactured with human albumin, and the other form of paclitaxel (Taxol) is manufactured with a solvent called Cremophor EL (polyoxyethylated castor oil). There are important differences between the two forms of paclitaxel, so these products should not be substituted for each other.

If you are using the form of paclitaxel that is manufactured with Cremophor EL, you may experience a serious or life-threatening allergic reaction. You will receive certain medications to help prevent an allergic reaction before you receive each dose of paclitaxel. Tell your doctor if you experience any of the following symptoms of an allergic reaction: rash; hives; itching; swelling of the eyes, face, throat, lips, tongue, hands, arms, feet, or ankles; difficulty breathing or swallowing; dizziness; or fainting.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain tests to check your body's response to paclitaxel.

Talk to your doctor about the risks of using paclitaxel.

AbobotulinumtoxinA Injection (ay boh bot' yoo li num tox' in A) Other names: Dysport

Why is this medication prescribed?

AbobotulinumtoxinA injection is used to relieve the symptoms of cervical dystonia (spasmodic torticollis; uncontrollable tightening of the neck muscles that may cause neck pain and abnormal head positions). AbobotulinumtoxinA injection is also used to temporarily smooth frown lines (wrinkles between the eyebrows). AbobotulinumtoxinA injection is in a class of medications called neurotoxins. It works by blocking the nerve signals that cause uncontrollable tightening and movement of the muscles.
How should this medication be used?

AbobotulinumtoxinA injection comes as a powder to be mixed with a liquid and injected into affected muscles by a doctor. Your doctor will choose the best place to inject the medication in order to treat your condition. You may receive additional injections of abobotulinumtoxinA every 3 to 4 months, depending on your condition and how long the effects of the treatment last.

If you are receiving abobotulinumtoxinA injection for cervical dystonia, your doctor will probably start you on a low dose and gradually change your dose according to your response to the medication.

One brand or type of botulinum toxin cannot be substituted for another.

AbobotulinumtoxinA injection may help control your condition but will not cure it. If you are using abobotulinumtoxinA to treat cervical dystonia, it may take 2 weeks or longer before you feel the full benefit of abobotulinumtoxinA injection.
Are there other uses for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Other names

* Dysport®

What special precautions should I follow?

Before receiving abobotulinumtoxinA injection,

* tell your doctor and pharmacist if you are allergic to abobotulinumtoxinA, incobotulinumtoxinA (Xeomin), onabotulinumtoxinA (Botox), rimabotulinumtoxinB (Myobloc), any other medications, cow's milk protein, or any of the ingredients in abobotulinumtoxinA injection. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
* tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: certain antibiotics such as amikacin, clindamycin (Cleocin), colistimethate (Coly-Mycin), gentamicin, kanamycin, lincomycin (Lincocin), neomycin (Neo-Fradin, Neo-Rx), polymyxin, streptomycin, and tobramycin (Tobi); cholinesterase inhibitors such as ambenonium (Mytelase), donepezil (Aricept), galantamine (Razadyne), neostigmine (Prostigmin), physostigmine, pyridostigmine (Mestinon, Regonol), rivastigmine (Exelon), and tacrine (Cognex); ipratropium (Atrovent); magnesium sulfate; medications for allergies, colds, irritable bowel disease, motion sickness, Parkinson's disease, sleep, ulcers, or urinary problems; muscle relaxants; and quinidine. Also tell your doctor if you have received injections of any botulinum toxin product in the past four months. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
* tell your doctor if you have swelling or other signs of infection in the area where abobotulinumtoxinA will be injected. Your doctor will not inject the medication into an infected area.
* tell your doctor if you have ever had eye or face surgery; or any side effect from any botulinum toxin product and if you have or have ever had any changes in the way your face looks; bleeding problems; diabetes; or a slow or irregular heartbeat.
* if you will be receiving abotulinumtoxinA to treat wrinkles, your doctor will examine you to see if the medication is likely to work for you. AbotulinumtoxinA may not smooth your wrinkles or may cause other problems if you have drooping eyelids; trouble raising your eyebrows; excess skin on your eyelids; deeply scarred, thick, or oily skin; or if your wrinkles cannot be smoothed by spreading them apart with your fingers.
* tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while receiving abobotulinumtoxinA injection, call your doctor.
* if you are having surgery, including dental surgery, tell the doctor or dentist that you are receiving abobotulinumtoxinA injection.
* you should know that abobotulinumtoxinA injection may cause loss of strength or muscle weakness all over the body; blurred vision; or drooping eyelids. If you have any of these symptoms, do not drive a car, operate machinery, or do other dangerous activities.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What side effects can this medication cause?

AbobotulinumtoxinA injection may cause side effects. Ask your doctor which side effects you are most likely to experience since some side effects may be related to (or occur more often in) the part of the body where you received the injection. Tell your doctor if any of these symptoms are severe or do not go away:

* pain or tenderness in the place where you received the injection
* headache
* swelling of the inside of the nose and throat
* dry mouth
* neck, bone, or muscle pain
* tiredness
* nausea

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

* vision changes
* eyelid swelling
* itching
* rash
* hives
* dizziness
* fainting

AbobotulinumtoxinA injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
What should I do in case of overdose?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose usually do not appear right after receiving the injection. If you received too much abobotulinumtoxinA or if you swallowed the medication, tell your doctor right away and also tell your doctor if you experience any of the following symptoms during the next several weeks:

* weakness
* difficulty moving any part of your body
* difficulty breathing

What other information should I know?

Keep all appointments with your doctor.

Ask your pharmacist any questions you have about abobotulinumtoxinA injection.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Important warning

AbobotulinumtoxinA injection may spread from the area of injection and cause symptoms of botulism, including severe or life-threatening difficulty breathing or swallowing. People who develop difficulty swallowing during their treatment with this medication may continue to have this difficulty for several weeks, may need to be fed through a feeding tube, and may breathe food or drink into their lungs. Symptoms can occur within hours of an injection with abobotulinumtoxinA or as late as several weeks after treatment. Symptoms may occur in people of any age being treated for any condition, but the risk is probably highest in children being treated for abnormal muscle tightening. Tell your doctor if you have or have ever had any swallowing problems or breathing problems, such as asthma or emphysema, or any condition that affects your muscles or nerves such as amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease; condition in which the nerves that control muscle movement slowly die, causing the muscles to shrink and weaken), motor neuropathy (condition in which the muscles weaken over time), myasthenia gravis (condition that causes certain muscles to weaken, especially after activity), or Lambert-Eaton syndrome (condition that causes muscle weakness that may improve with activity). If you experience any of the following symptoms, call your doctor immediately: loss of strength or muscle weakness all over the body; double or blurred vision; drooping eyelids; difficulty swallowing, breathing, or speaking; or inability to control urination.

Your doctor will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with abobotulinumtoxinA injection and each time you receive treatment. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.