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Meningococcal Vaccine

What is meningococcal disease?
Meningococcal disease is a serious bacterial illness. It is a leading cause of bacterial meningitis in children 2 through 18 years of age in the United States.
Meningitis is an infection of fluid surrounding the brain and the spinal cord. Meningococcal disease also causes blood infections.
About 1,000 to 2,600 people get meningococcal disease each year in the US. Even when they are treated with antibiotics, 10 to 15% of these people die. Of those who live, another 11 to 19 % lose their arms or legs, become deaf, have problems with their nervous systems, become mentally retarded, or suffer seizures or strokes.
Anyone can get meningococcal disease. But it is most common in infants less than one year of age and people with certain medical conditions, such as lack of a spleen. College freshmen who live in dormitories and teenagers 15 to 19 years of age have an increased risk of getting meningococcal disease.
Meningococcal infections can be treated with drugs such as penicillin. Still, about 1 out of every 10 people who get the disease dies from it, and many others are affected for life. This is why preventing the disease through use of meningococcal vaccine is important for people at highest risk.
Meningococcal vaccine
There are two kinds of meningococcal vaccine in the US:
Meningococcal conjugate vaccine (MCV4) was licensed in 2005. It is the preferred vaccine for people 2 to 55 years of age.
Meningococcal polysaccharide vaccine (MPSV4) has been available since the 1970s. It may be used if MCV4 is not available, and is the only meningococcal vaccine licensed for people older than 55.
Both vaccines can prevent 4 types of meningococcal disease, including 2 of the 3 types most common in the United States and a type that causes epidemics in Africa. Meningococcal vaccines cannot prevent all types of the disease. But they do protect many people who might become sick if they didn't get the vaccine.
Both vaccines work well, and protect about 90% of those who get it. MCV4 is expected to give better, longer-lasting protection.
MCV4 should also be better at preventing the disease from spreading from person to person.
Who should get meningococcal vaccine and when?
A dose of MCV4 is recommended for all children and adolescents 11 to 18 years of age.
This dose is normally given during the routine preadolescent immunization visit (at 11 to 12 years of age). But those who did not get the vaccine during this visit should get it at the earliest opportunity.
Meningococcal vaccine is also recommended for other people at increased risk for meningococcal disease:
College freshmen living in dormitories.
Microbiologists who are routinely exposed to meningococcal bacteria.
US military recruits.
Anyone traveling to, or living in, a part of the world where meningococcal disease is common, such as parts of Africa.
Anyone who has a damaged spleen, or whose spleen has been removed.
Anyone who has terminal complement component deficiency (an immune system disorder).
People who might have been exposed to meningitis during an outbreak.
MCV4 is the preferred vaccine for people 2 to 55 years of age in these risk groups. MPSV4 can be used if MCV4 is not available and for adults over 55.
People 2 years of age and older should get 1 dose. Sometimes an additional dose is recommended for people who remain at high risk. Ask your provider.
MPSV4 may be recommended for children 3 months to 2 years of age under special circumstances. These children should get 2 doses, 3 months apart.
Who should not get meningococcal vaccine or should wait?
Anyone who has ever had a severe (life-threatening) allergic reaction to a previous dose of either meningococcal vaccine should not get another dose.
Anyone who has a severe (life threatening) allergy to any vaccine component should not get the vaccine. Tell your doctor if you have any severe allergies.
Anyone who is moderately or severely ill at the time the shot is scheduled should probably wait until they recover. Ask your doctor or nurse. People with a mild illness can usually get the vaccine.
Anyone who has ever had Guillain-Barré Syndrome should talk with their doctor before getting MCV4.
Meningococcal vaccines may be given to pregnant women. However, MCV4 is a new vaccine and has not been studied in pregnant women as much as MPSV4 has. It should be used only if clearly needed.
Meningococcal vaccines may be given at the same time as other vaccines.
What are the risks from meningococcal vaccines?
A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. The risk of meningococcal vaccine causing serious harm, or death, is extremely small.
Mild Problems:
Up to about half of people who get meningococcal vaccines have mild side effects, such as redness or pain where the shot was given.
If these problems occur, they usually last for 1 or 2 days. They are more common after MCV4 than after MPSV4.
A small percentage of people who receive the vaccine develop a fever.
Severe Problems:
Serious allergic reactions, within a few minutes to a few hours of the shot, are very rare.
A serious nervous system disorder called Guillain-Barré Syndrome (or GBS) has been reported among some people who received MCV4. This happens so rarely that it is currently not possible to tell if the vaccine might be a factor. Even if it is, the risk is very small.
What if there is a moderate or severe reaction?
What should I look for?
Any unusual condition, such as a high fever, weakness, or behavior changes. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heartbeat or dizziness.
What should I do?
Call a doctor, or get the person to a doctor right away.
Tell your doctor what happened, the date and time it happened, and when the vaccination was given.
Ask your healthcare provider to file a Vaccine Adverse Event Reporting System (VAERS) form if you have any reaction to the vaccine. Or call VAERS yourself at 1-800-822-7967, or visit their website at http://vaers.hhs.gov.
The National Vaccine Injury Compensation Program
In the rare event that you or your child has a serious reaction to a vaccine, a federal program has been created to help pay for the care of those who have been harmed.
For details about the National Vaccine Injury Compensation Program, call 1-800-338-2382 or visit the program's website at http://www.hrsa.gov/vaccinecompensation.
How can I learn more?
Ask your doctor or other healthcare provider. They can give you the vaccine package insert or suggest other sources of information.
Call your local or state health department's immunization program.
Contact the Centers for Disease Control and Prevention (CDC): call 1-800-232-4636 (1-800-CDC-INFO) or visit the National Immunization Program's website at http://www.cdc.gov/vaccines.
Meningococcal Vaccine Information Statement. U.S. Department of Health and Human Services/Centers for Disease Control and Prevention National Immunization Program. 1/28/08.
Other names
Menactra®
Meningovax®
Menomune®

Memantine

Why is this medication prescribed?
Memantine is used to treat the symptoms of Alzheimer's disease. Memantine is in a class of medications called NMDA receptor antagonists. It works by decreasing abnormal activity in the brain. Memantine can help people with Alzheimer's disease to think more clearly and perform daily activities more easily, but it is not a cure and does not stop the progression of the disease.
How should this medication be used?
Memantine comes as a tablet to take by mouth. It is usually taken once or twice a day with or without food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. To help you remember to take memantine, take it at around the same time(s) every day. Take memantine 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 memantine and gradually increase your dose, not more than once every week.
Memantine controls Alzheimer's disease but does not cure it. Continue to take memantine even if you feel well. Do not stop taking memantine 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
Namenda®
Namenda® Titration Pak


What special precautions should I follow?
Before taking memantine,
tell your doctor and pharmacist if you are allergic to memantine 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: acetazolamide (Diamox); amantadine (Symmetrel); brinzolamide (Azopt); cimetidine (Tagamet); dextromethorphan (Robitussin, others); dichlorphenamide (Daranide); dorzolamide (Trusopt); methazolamide (GlaucTabs, Nepatazane); nicotine (Nicoderm, Nicorette, others); potassium citrate and citric acid (Cytra-K, Polycitra-K); ranitidine (Zantac); sodium bicarbonate (Soda Mint, baking soda); sodium citrate and citric acid (Bicitra, Oracit); and quinidine (Quinaglute, Quinidex). 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 asthma, seizures, kidney disease, or repeated urinary tract infections.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking memantine, call your doctor.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking memantine.
you should know that memantine may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this medication.
What special dietary instructions should I follow?
Tell your doctor if you are a vegetarian or if you usually eat large amounts of citrus fruits, vegetables, beans, or peas. Your doctor will tell you if you need to change your diet. If you do not regularly eat these foods, continue your normal diet.


What side effects can this medication cause?
Memantine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
extreme tiredness
dizziness
confusion
headache
sleepiness
constipation
vomiting
pain anywhere in your body, especially your back
coughing
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
shortness of breath
hallucination (seeing things or hearing voices that do not exist)
Memantine 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:
restlessness
hallucination (seeing things or hearing voices that do not exist)
sleepiness
loss of consciousness
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.

Melphalan

About your treatment
Your doctor has ordered the drug melphalan to help treat your illness. The drug can be taken as tablets by mouth on an empty stomach or it can be given by injection into a vein.
This medication is used to treat:
multiple myeloma
ovarian carcinoma
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Melphalan is in a class of drugs known as alkylating agents; it slows or stops the growth of cancer cells in your body. The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have.
Are there other uses for this medicine?
Melphalan is also used in the treatment of breast cancer, polycythemia vera, amyloidosis, scleromyxedema, chronic myelogenous leukemia, osteogenic sarcoma, advanced prostatic carcinoma, and testicular seminoma. Talk to your doctor about the possible risks of using this drug for your condition.
Other names
Alkeran®


What special precautions should I follow?
Before taking melphalan,
tell your doctor and pharmacist if you are allergic to melphalan, chlorambucil (Leukeran), or any other drugs.
tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially aspirin and vitamins.
you should know that melphalan may interfere with the normal menstrual cycle (period) in women and may stop sperm production in men. However, you should not assume that you cannot get pregnant or get someone else pregnant. Women who are pregnant or breast-feeding should tell their doctors before they begin taking this drug. You should not plan to have children while receiving chemotherapy or for a while after treatments. (Talk to your doctor for further details.) Use a reliable method of birth control to prevent pregnancy. Melphalan may harm the fetus.
do not have any vaccinations (e.g., measles or flu shots) without talking to your doctor.



What side effects can this medication cause?
Side effects from melphalan are common and include:
loss of appetite or weight
weakness
blistering skin or acne
Tell your doctor if either of these symptoms is severe or lasts for several hours:
mouth blistering
fatigue
If you experience any of the following symptoms, call your doctor immediately:
unusual bruising or bleeding
black, tarry stools
red urine
cough
sore throat
congestion
difficulty breathing
fever
dizziness
chills
shortness of breath
rash or itching
nausea and vomiting
missed menstrual periods
yellowing of the skin or eyes
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.
What storage conditions are needed for this medication?
Keep melphalan 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.



Important warning
Melphalan can cause a decrease in the number of blood cells in your bone marrow. Your doctor will order tests before, during, and after your treatment to see if your blood cells are affected by this drug.
Melphalan has been associated with the development of other types of cancers. Talk with your doctor about the potential risk of developing a new cancer.

Meloxicam

Why is this medication prescribed?
Meloxicam is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). Meloxicam is also used to relieve the pain, tenderness,swelling, and stiffness caused by juvenile rheumatoid arthritis (a type of arthritis that affects children) in children 2 years of age and older. Meloxicam is in a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by stopping the body's production of a substance that causes pain, fever, and inflammation.
How should this medication be used?
Meloxicam comes as a tablet and suspension (liquid) to take by mouth. It is usually taken once a day with or without food. Take meloxicam at 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 meloxicam exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Shake the suspension well before each use to mix the medication evenly.
Are there other uses for this medicine?
Meloxicam is also used sometimes to treat ankylosing spondylitis (arthritis that mainly affects the spine). 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
Mobic®


What special precautions should I follow?
Before taking meloxicam,
tell your doctor and pharmacist if you are allergic to meloxicam, aspirin or other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), 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 the medications listed in the IMPORTANT WARNING section and any of the following: angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), and quinapril (Accupril); cholestyramine (Questran); diuretics ('water pills'); lithium (Eskalith, Lithobid, others); and methotrexate (Rheumatrex). 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 asthma, especially if you have frequent stuffed or runny nose or nasal polyps (swelling of the lining of the nose); swelling of the hands, feet, ankles, or lower legs; or kidney or liver disease.
tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, you plan to become pregnant, or you are breast-feeding. If you become pregnant while taking meloxicam, call your doctor.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking meloxicam.


What side effects can this medication cause?
Meloxicam may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
diarrhea
constipation
gas
sore throat
cough
runny nose
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately. Do not take any more meloxicam until you speak to your doctor:
fever
blisters
rash
hives
itching
swelling of the eyes, face, tongue, lips, throat, arms, hands, feet, ankles, or lower legs
difficulty breathing or swallowing
hoarseness
pale skin
fast heartbeat
unexplained weight gain
nausea
excessive tiredness
lack of energy
yellowing of the skin or eyes
pain in the right upper part of the stomach
flu-like symptoms
cloudy, discolored, or bloody urine
back pain
difficult or painful urination
Meloxicam 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:
lack of energy
drowsiness
nausea
vomiting
stomach pain
bloody, black, or tarry stools
vomit that is bloody or looks like coffee grounds
difficulty breathing
seizures
coma
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?
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
People who take nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as meloxicam may have a higher risk of having a heart attack or a stroke than people who do not take these medications. These events may happen without warning and may cause death. This risk may be higher for people who take NSAIDs for a long time. Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke, if you smoke, and if you have or have ever had high cholesterol, high blood pressure, or diabetes. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of the body, or slurred speech.
If you will be undergoing a coronary artery bypass graft (CABG; a type of heart surgery), you should not take meloxicam right before or right after the surgery.
NSAIDs such as meloxicam may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who take NSAIDs for a long time, are older in age, have poor health, or drink large amounts of alcohol while taking meloxicam. Tell your doctor if you take any of the following medications: anticoagulants ('blood thinners') such as warfarin (Coumadin); aspirin; other NSAIDs such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn); or oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone). Also tell your doctor if you have or have ever had ulcers or bleeding in your stomach or intestines, or other bleeding disorders. If you experience any of the following symptoms, stop taking meloxicam and call your doctor: stomach pain, heartburn, vomit that is bloody or looks like coffee grounds, blood in the stool, or black and tarry stools.
Keep all appointments with your doctor and the laboratory. Your doctor will monitor your symptoms carefully and will probably order certain tests to check your body's response to meloxicam. Be sure to tell your doctor how you are feeling so that your doctor can prescribe the right amount of medication to treat your condition with the lowest risk of serious side effects.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with meloxicam 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) or the manufacturer's website to obtain the Medication Guide.

Megestrol

Why is this medication prescribed?
Megestrol tablets are used to relieve the symptoms and reduce the suffering caused by advanced breast cancer and advanced endometrial cancer (cancer that begins in the lining of the uterus). Megestrol suspension is used to treat loss of appetite, malnutrition, and severe weight loss in patients with acquired immunodeficiency syndrome (AIDS). Megestrol should not be used to prevent loss of appetite and severe weight loss in patients who have not yet developed this condition. Megestrol is a man-made version of the human hormone progesterone. It treats breast cancer and endometrial cancer by affecting female hormones involved in cancer growth. It increases weight gain by increasing appetite.
How should this medication be used?
Megestrol comes as a tablet, a suspension (liquid), and a concentrated suspension (Megace ES) to take by mouth. The tablets and suspension are usually taken several times a day. The concentrated suspension is usually taken once a day. Take megestrol at around the same time(s) 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 megestrol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Shake the liquid well before each use to mix the medication evenly.
The concentrated suspension is used in different dosages than the regular suspension. Do not switch from one to the other without talking to your doctor.
Do not stop taking megestrol without talking to your doctor.
Are there other uses for this medicine?
Megestrol is also sometimes used to treat malnutrition in patients with cancer, prostatic hypertrophy (enlargement of a male reproductive gland called the prostate), endometriosis (condition in which the type of tissue that lines the uterus grows in other areas of the body), and endometrial hyperplasia (overgrowth of the lining of the uterus). Talk to your doctor about the risks of using this medication for your condition.
Other names
Megace®
Megace® ES


What special precautions should I follow?
Before taking megestrol,
tell your doctor and pharmacist if you are allergic to megestrol, any other medications, or any of the inactive ingredients in megestrol tablets, suspension, or concentrated suspension. Ask your doctor or pharmacist for a list of the inactive ingredients.
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 antibiotics and indinavir (Crixivan). Your doctor may need to adjust the doses of your medications or monitor you carefully for side effects.
tell your doctor if you have or have ever had a blood clot anywhere in the body, a stroke, diabetes, or kidney or liver disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking megestrol, call your doctor immediately. Megestrol may harm the fetus. Do not breast-feed while you are taking megestrol.
you should know that megestrol may interfere with the normal menstrual cycle (period) in women. However, you should not assume that you cannot become pregnant. Use a reliable method of birth control to prevent pregnancy.
if you are having surgery, including dental surgery, during or shortly after your treatment, tell the doctor or dentist that you are taking megestrol.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.


What side effects can this medication cause?
Megestrol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
impotence
decreased sexual desire
unexpected vaginal bleeding
difficulty falling asleep or staying asleep
gas
rash
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
nausea
vomiting
dizziness
weakness
blurred vision
extreme thirst
frequent urination
extreme hunger
leg pain
difficulty breathing
sharp, crushing chest pain or heaviness in chest
slow or difficult speech
weakness or numbness of an arm or leg
Megestrol may cause other side effects. Call your doctor if you have any unusual problems while 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.
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 may order certain lab tests to check your body's response to megestrol.
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.

Mefloquine

Why is this medication prescribed?
Mefloquine is used to treat malaria (a serious infection that is spread by mosquitoes in certain parts of the world and can cause death) and to prevent malaria in travelers who visit areas where malaria is common. Mefloquine is in a class of medications called antimalarials. It works by killing the organisms that cause malaria.
How should this medication be used?
Mefloquine comes as a tablet to take by mouth. If you are taking mefloquine to prevent malaria, you will probably take it once a week (on the same day each week). You will begin treatment 1 to 3 weeks before you travel to an area where malaria is common and should continue treatment for 4 weeks after you return from the area. If you are taking mefloquine to treat malaria, your doctor will tell you exactly how often you should take it. Always take mefloquine with food (preferably your main meal) and at least 8 ounces (240 milliliters) of water. Children may take smaller but more frequent doses of mefloquine. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take mefloquine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
The tablets may be swallowed whole or crushed and mixed with a liquid such as water, milk, or sugar water.
If you are taking mefloquine to treat malaria, you may vomit soon after you take the medication. If you vomit less than 30 minutes after you take mefloquine, you should take another full dose of mefloquine. If you vomit 30 to 60 minutes after you take mefloquine, you should take another half dose of mefloquine. If you vomit again after taking the extra dose, call 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
Lariam®


What special precautions should I follow?
Before taking mefloquine,
tell your doctor and pharmacist if you are allergic to mefloquine, chloroquine (Aralen), hydroxychloroquine (Plaquenil), quinidine (Quinadex), quinine 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: anticoagulants ('blood thinners'); antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); antihistamines; calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor, Tiazac, others), felodipine (Plendil), isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan, Isoptin, Verelan); beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); chloroquine (Aralen); halofantrine (Halfan); hydroxychloroquine (Plaquenil); medication for diabetes, mental illness, seizures and upset stomach; medications for irregular heartbeat such as quinidine (Quinaglute, Quinidex); and quinine. 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 a mental illness such as depression, generalized anxiety disorder, psychosis (losing touch with reality), or schizophrenia (abnormal thoughts or feelings); seizures; or eye, liver or heart disease.
tell your doctor if you are pregnant or plan to become pregnant. You should use birth control while you are visiting an area where malaria is common and while you are taking mefloquine and for 3 months after you stop taking it. If you become pregnant while taking mefloquine, call your doctor. You should not breast-feed while taking mefloquine.
you should know that mefloquine may make you drowsy and dizzy. These symptoms may continue for a while after you stop taking mefloquine. Do not drive a car or operate machinery until you know how this medication affects you.
you should know that mefloquine decreases your risk of becoming infected with malaria but does not guarantee that you will not become infected. You still need to protect yourself from mosquito bites by wearing long sleeves and long pants and using mosquito repellant and a bednet while you are in an area where malaria is common.
you should know that the first symptoms of malaria are fever, chills, muscle pain, and headaches. If you are taking mefloquine to prevent malaria, call your doctor immediately if you develop any of these symptoms. Be sure to tell your doctor that you may have been exposed to malaria.
you should plan what to do in case you experience serious side effects from mefloquine and have to stop taking the medication, especially if you are not near a doctor or pharmacy. You will have to get another medication to protect you from malaria. If no other medication is available, you will have to leave the area where malaria is common, and then get another medication to protect you from malaria.
if you are taking mefloquine to treat malaria, your symptoms should improve within 48 to 72 hours after you finish your treatment. Call your doctor if your symptoms do not improve after this time.
do not have any vaccinations (shots) without talking to your doctor. Your doctor may want you to finish all of your vaccinations 3 days before you start taking mefloquine.
you should know that mefloquine may damage your liver or eyes if you take it for a long time. Your doctor will tell you if you should have your eyes and liver checked while taking mefloquine.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.


What side effects can this medication cause?
Mefloquine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
nausea
vomiting
diarrhea
stomach pain
loss of appetite
muscle pain
dizziness
loss of balance
ringing in ears
headache
sleepiness
difficulty falling or staying asleep
unusual dreams
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
tingling in your fingers or toes
difficulty walking
seizures
shaking of arms or legs that you cannot control
nervousness or extreme worry
depression
changes in mood
panic attack
forgetfulness
confusion
hallucinations (seeing things or hearing voices that do not exist)
violent behavior
losing touch with reality
feeling that others want to harm you
thoughts of hurting or killing yourself
rash
Mefloquine may cause other side effects. You may continue to experience side effects for some time after you take your last dose. 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:
nausea
vomiting
diarrhea
stomach pain
dizziness
loss of balance
headache
sleepiness
difficulty falling or staying asleep
unusual dreams
tingling in your fingers or toes
difficulty walking
seizures
changes in mental health
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 may order certain lab tests and periodic eye examinations to check your body's response to mefloquine.
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.

Mefenamic Acid

Why is this medication prescribed?
Mefenamic acid is used to relieve mild to moderate pain, including menstrual pain (pain that happens before or during a menstrual period). Mefenamic acid is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.
How should this medication be used?
Mefenamic acid comes as a capsule to take by mouth. It is usually taken with food every 6 hours as needed for up to 1 week. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take mefenamic acid exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
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
Ponstel®


What special precautions should I follow?
Before taking mefenamic acid,
tell your doctor and pharmacist if you are allergic to mefenamic acid, aspirin or other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), any other medications, or any of the inactive ingredients in mefenamic acid capsules. Ask your pharmacist for a list of the inactive ingredients.
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 the medications listed in the IMPORTANT WARNING section and any of the following: antacids; angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); amiodarone (Cordarone, Pacerone); atazanavir (Reyataz); clopidogrel (Plavix); diuretics ('water pills'), efavirenz (Sustiva); fluconazole (Diflucan); fluvastatin (Lescol); metronidazole (Flagyl); lithium (Eskalith, Lithobid); lovastatin (Mevacor); methotrexate (Rheumatrex); ritonavir (Norvir, in Kaletra); sulfamethoxazole (in Bactrim, in Septra); sulfinpyrazone (Anturane); trimethoprim (Proloprim); and zafirlukast (Accolate). 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 any of the conditions mentioned in the IMPORTANT WARNING section or asthma, especially if you also have frequent stuffed or runny nose or nasal polyps (swelling of the inside of the nose); swelling of the hands, feet, ankles, or lower legs (fluid retention); or liver or kidney disease.
tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, you plan to become pregnant, or you are breast-feeding. If you become pregnant while taking mefenamic acid, call your doctor.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking mefenamic acid.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.


What side effects can this medication cause?
Mefenamic acid may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
diarrhea
constipation
gas or bloating
headache
dizziness
nervousness
ringing in the ears
Some side effects can be serious. If you experience any of the following symptoms or those mentioned in the IMPORTANT WARNING section, call your doctor immediately. Do not take any more mefenamic acid until you speak to your doctor.
blurred vision
unexplained weight gain
fever
blisters
rash
itching
hives
swelling of the eyes, face, lips, tongue, throat, hands, arms, feet ankles, or lower legs
difficulty breathing or swallowing
pale skin
fast heartbeat
excessive tiredness
unusual bleeding or bruising
lack of energy
nausea
loss of appetite
pain in the upper right part of the stomach
flu-like symptoms
yellowing of the skin or eyes
cloudy, discolored, or bloody urine
back pain
difficult or painful urination
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:
extreme tiredness
nausea
vomiting
stomach pain
vomit that is bloody or looks like coffee grounds
black, tarry, or bloody stools
slowed breathing
coma (loss of consciousness for a period of time)
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?
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking mefenamic acid.
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
People who take nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as mefenamic acid may have a higher risk of having a heart attack or a stroke than people who do not take these medications. These events may happen without warning and may cause death. This risk may be higher for people who take NSAIDs for a long time. Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke, if you smoke, and if you have or have ever had high cholesterol, high blood pressure, or diabetes. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of the body, or slurred speech.
If you will be undergoing a coronary artery bypass graft (CABG; a type of heart surgery), you should not take mefenamic acid right before or right after the surgery.
NSAIDs such as mefenamic acid may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who take NSAIDs for a long time, are older in age, have poor health, or who drink large amounts of alcohol while taking mefenamic acid. Tell your doctor if you take any of the following medications: anticoagulants ('blood thinners') such as warfarin (Coumadin); aspirin; other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); or oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone). Also tell your doctor if you have or have ever had ulcers, bleeding in your stomach or intestines, or other bleeding disorders. If you experience any of the following symptoms, stop taking mefenamic acid and call your doctor: stomach pain, heartburn, vomit that is bloody or looks like coffee grounds, blood in the stool, or black and tarry stools.
Keep all appointments with your doctor and the laboratory. Your doctor will monitor your symptoms carefully and will probably order certain tests to check your body's response to mefenamic acid. Be sure to tell your doctor how you are feeling so that your doctor can prescribe the right amount of medication to treat your condition with the lowest risk of serious side effects.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with mefenamic acid 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) or the manufacturer's website to obtain the Medication Guide.

Medroxyprogesterone Injection

Why is this medication prescribed?
Medroxyprogesterone intramuscular (into a muscle) injection and medroxyprogesterone subcutaneous (under the skin) injection are used to prevent pregnancy. Medroxyprogesterone subcutaneous injection is also used to treat endometriosis (a condition in which the type of tissue that lines the uterus (womb) grows in other areas of the body and causes pain, heavy or irregular menstruation [periods], and other symptoms). Medroxyprogesterone is in a class of medications called progestins. It works to prevent pregnancy by preventing ovulation (the release of eggs from the ovaries). Medroxyprogesterone also thins the lining of the uterus. This helps to prevent pregnancy in all women and slows the spread of tissue from the uterus to other parts of the body in women who have endometriosis. Medroxyprogesterone injection is a very effective method of birth control but does not prevent the spread of human immunodeficiency virus (HIV, the virus that causes acquired immunodeficiency syndrome [AIDS]) or other sexually transmitted diseases.
How should this medication be used?
Medroxyprogesterone intramuscular injection comes as a suspension (liquid) to be injected into the buttocks or upper arm. It is usually given once every 3 months (13 weeks) by a healthcare provider in an office or clinic. Medroxyprogesterone subcutaneous injection comes as suspension to be injected just under the skin. It is usually injected once every 12 to 14 weeks by a healthcare provider in an office or clinic.
You must receive your first medroxyprogesterone subcutaneous or intramuscular injection only at a time when there is no possibility that you are pregnant. Therefore, you may only receive your first injection during the first 5 days of a normal menstrual period, during the first 5 days after you give birth if you are not planning to breast-feed your baby, or during the sixth week after giving birth if you are planning to breast-feed your baby. If you have been using a different method of birth control and are switching to medroxyprogesterone injection, your doctor will tell you when you should receive your first injection.
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
Depo-Provera®
depo-subQ provera 104®
Lunelle® (as a combination product containing Estradiol, Medroxyprogesterone)



What special precautions should I follow?
Before using medroxyprogesterone injection,
tell your doctor and pharmacist if you are allergic to medroxyprogesterone (Depo-Provera, depo-subQ provera 104, Provera, in Prempro, in Premphase) 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 the medications listed in the IMPORTANT WARNING section and aminoglutethimide (Cytadren). 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 or has ever had breast cancer or diabetes. Also tell your doctor if you have or have ever had problems with your breasts such as lumps, bleeding from your nipples, an abnormal mammogram (breast x-ray), or fibrocystic breast disease (swollen, tender breasts and/or breast lumps that are not cancer); unexplained vaginal bleeding;irregular or very light menstrual periods; excessive weight gain or fluid retention before your period; blood clots in your legs, lungs, brain, or eyes; stroke or mini-stroke; migraine headaches; seizures; depression; high blood pressure; heart attack; asthma; or heart, liver, or kidney disease.
tell your doctor if you think you might be pregnant, you are pregnant, or you plan to become pregnant. If you become pregnant while using medroxyprogesterone injection, call your doctor immediately. Medroxyprogesterone may harm the fetus.
tell your doctor if you are breast-feeding. You may use medroxyprogesterone injection while you are breast-feeding as long as your baby is 6 weeks old when you receive your first injection. Some medroxyprogesterone may be passed to your baby in your breast milk but this has not been shown to be harmful. Studies of babies who were breast-fed while their mothers were using medroxyprogesterone injection showed that the babies were not harmed by the medication.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are using medroxyprogesterone injection.
you should know that your menstrual cycle will probably change while you are using medroxyprogesterone injection. At first, your periods will probably be irregular, and you may experience spotting between periods. If you continue to use this medication, your periods may stop completely. Your menstrual cycle will probably return to normal some time after you stop using this medication.
What special dietary instructions should I follow?
You should eat plenty of foods that are rich in calcium and vitamin D while you are receiving medroxyprogesterone injection to help decrease the loss of calcium from your bones. Your doctor will tell you which foods are good sources of these nutrients and how many servings you need each day. Your doctor also may prescribe or recommend calcium or vitamin D supplements.


What side effects can this medication cause?
Medroxyprogesterone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
changes in menstrual periods (See SPECIAL PRECAUTIONS)
weight gain
weakness
tiredness
nervousness
irritability
depression
difficulty falling asleep or staying asleep
hot flashes
breast pain, swelling, or tenderness
stomach cramps or bloating
leg cramps
back or joint pain
acne
loss of hair on scalp
swelling, redness, irritation, burning, or itching of the vagina
white vaginal discharge
changes in sexual desire
cold or flu symptoms
pain, irritation, lumps, redness or scarring in the place where the medication was injected
Some side effects can be serious. The following side effects are uncommon, but if you experience any of them, call your doctor immediately:
sudden shortness of breath
sudden sharp or crushing chest pain
coughing up blood
severe headache
nausea
vomiting
dizziness or faintness
change or loss of vision
double vision
bulging eyes
difficulty speaking
weakness or numbness in an arm or leg
seizure
yellowing of the skin or eyes
extreme tiredness
pain, swelling, warmth, redness, or tenderness in one leg only
menstrual bleeding that is heavier or lasts longer than normal
severe pain or tenderness just below the waist
rash
hives
itching
difficulty breathing or swallowing
swelling of the hands, feet, ankles, or lower legs
difficult, painful, or frequent urination
constant pain, pus, warmth, swelling, or bleeding in the place where the medication was injected
If you are younger than 35 years old and began to receive medroxyprogesterone injection in the last 4 to 5 years, you may have a slightly increased risk that you will develop breast cancer. Medroxyprogesterone injection may also increase the chance that you will develop a blood clot that moves to your lungs or brain. Talk to your doctor about the risks of using this medication.
Medroxyprogesterone injection is a long-acting birth control method. You might not become pregnant for some time after you receive your last injection. Talk to your doctor about the effects of using this medication if you plan to become pregnant in the near future.
Medroxyprogesterone 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 if I forget to take a dose?
If you miss an appointment to receive an injection of medroxyprogesterone, call your doctor. You may not be protected from pregnancy if you do not receive your injections on schedule. If you do not receive an injection on schedule, your doctor will tell you when you should receive the missed injection. Your doctor will probably administer a pregnancy test to be sure that you are not pregnant before giving you the missed injection. You should use a different method of birth control, such as condoms until you receive the injection that you missed.
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?
Your doctor will store the medication in his or her office.
What other information should I know?
You should have a complete physical exam, including blood pressure measurements, breast and pelvic exams, and a Pap test, at least yearly. Follow your doctor's directions for self-examining your breasts; report any lumps immediately.
Before you have any laboratory tests, tell the laboratory personnel that you are using medroxyprogesterone.
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
Medroxyprogesterone injection may decrease the amount of calcium stored in your bones. The longer you use this medication, the more the amount of calcium in your bones may decrease. The amount of calcium in your bones may not return to normal even after you stop using medroxyprogesterone injection.
Loss of calcium from your bones may cause osteoporosis (a condition in which the bones become thin and weak) and may increase the risk that your bones might break at some time in your life, especially after menopause (change of life).
The amount of calcium in the bones usually increases during the teenage years. A decrease in bone calcium during this important time of bone strengthening may be especially serious. It is not known whether your risk of developing osteoporosis later in life is greater if you start to use medroxyprogesterone injection when you are a teenager or young adult. Tell your doctor if you or anyone in your family has osteoporosis; if you have or have ever had any other bone disease or anorexia nervosa (an eating disorder); or if you drink a lot of alcohol or smoke a great deal. Tell your doctor if you take any of the following medications: corticosteroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); or medications for seizures such as carbamazepine (Tegretol), phenytoin (Dilantin), or phenobarbital (Luminal, Solfoton).
You should not use medroxyprogesterone injection for a long time (e.g., more than 2 years) unless no other method of birth control is right for you or no other medication will work to treat your condition. Your doctor may test your bones to be sure they are not becoming too thin before you continue to use medroxyprogesterone injection.
Keep all appointments with your doctor and the laboratory. Your doctor will monitor your health carefully to be sure you do not develop osteoporosis.
Talk to your doctor about the risks of using medroxyprogesterone injection.

Medroxyprogesterone

Why is this medication prescribed?
Medroxyprogesterone is used to treat abnormal menstruation (periods) or irregular vaginal bleeding. Medroxyprogesterone is also used to bring on a normal menstrual cycle in women who menstruated normally in the past but have not menstruated for at least 6 months and who are not pregnant or undergoing menopause (change of life). Medroxyprogesterone is also used to prevent overgrowth of the lining of the uterus (womb) and may decrease the risk of cancer of the uterus in patients who are taking estrogen. Medroxyprogesterone is in a class of medications called progestins. It works by stopping the growth of the lining of the uterus and by causing the uterus to produce certain hormones.
How should this medication be used?
Medroxyprogesterone comes as a tablet to take by mouth. It is usually taken once a day on certain days of a regular monthly cycle. To help you remember to take medroxyprogesterone, take it at around the same time every day on the days you are scheduled to take it. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take medroxyprogesterone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Medroxyprogesterone may control your condition but will not cure it. Continue to take medroxyprogesterone according to your monthly schedule even if you feel well. Do not stop taking medroxyprogesterone 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
Amen®
Curretab®
Cycrin®
Premphase® (as a combination product containing Medroxyprogesterone Acetate and Conjugated Estrogens)
Prempro® (as a combination product containing Medroxyprogesterone Acetate and Conjugated Estrogens)
Prodroxy®
Provera®


What special precautions should I follow?
Before taking medroxyprogesterone,
tell your doctor and pharmacist if you are allergic to medroxyprogesterone (Provera, Depo-Provera), any other medications, or corn.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention aminoglutethimide (Cytadren). 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 cancer of the breasts or female organs; unexplained vaginal bleeding; a missed abortion (a pregnancy that ended when the unborn child died in the uterus but was not expelled from the body); blood clots in your legs, lungs, brain, or eyes; stroke or mini-stroke; seizures; migraine headaches; depression; asthma; diabetes; or heart, kidney, or liver disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking medroxyprogesterone, call your doctor immediately. Medroxyprogesterone should never be used to test for pregnancy or to prevent miscarriage during the first few months of pregnancy. Medroxyprogesterone has not been shown to prevent miscarriage and may harm the fetus.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking medroxyprogesterone.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.


What side effects can this medication cause?
Medroxyprogesterone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
breasts that are tender or produce a liquid
changes in menstrual flow
irregular vaginal bleeding or spotting
acne
growth of hair on face
loss of hair on scalp
difficulty falling asleep or staying asleep
drowsiness
upset stomach
weight gain or loss
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
pain, swelling, warmth, redness, or tenderness in one leg only
slow or difficult speech
dizziness or faintness
weakness or numbness of an arm or leg
shortness of breath
coughing up blood
sudden sharp or crushing chest pain
fast or pounding heartbeat
sudden vision changes or loss of vision
double vision
blurred vision
bulging eyes
missed periods
depression
yellowing of the skin or eyes
fever
hives
skin rash
itching
difficulty breathing or swallowing
swelling of the hands, feet, ankles, or lower legs
Some laboratory animals who were given medroxyprogesterone developed breast tumors. It is not known if medroxyprogesterone increases the risk of breast cancer in humans. Medroxyprogesterone may also increase the chance that you will develop a blood clot that moves to your lungs or brain. Talk to your doctor about the risks of taking this medication.
Medroxyprogesterone 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.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking medroxyprogesterone.
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.

Meclofenamate

Why is this medication prescribed?
Meclofenamate is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). It is also used to relieve other types of mild to moderate pain, including menstrual pain (pain that happens before or during a menstrual period). It also may be used to decrease bleeding in women who have abnormally heavy menstrual blood loss. Meclofenamate is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.
How should this medication be used?
Meclofenamate comes as a capsule to take by mouth. It is usually taken three or four times a day for arthritis, three times a day for heavy menstrual blood loss, or every 4 to 6 hours as needed for pain. Meclofenamate may be taken with food or milk to prevent nausea. If you take meclofenamate regularly, take it at 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 meclofenamate exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
If you are taking meclofenamate to reduce heavy menstrual bleeding, your bleeding should decrease during your treatment. Call your doctor if your bleeding does not decrease or if you experience spotting or bleeding between menstrual periods.
If you are taking meclofenamate to relieve the symptoms of arthritis, your symptoms may begin to improve within a few days. It may take 2 to 3 weeks or longer for you to feel the full benefit of meclofenamate.
Are there other uses for this medicine?
Meclofenamate is also used to treat ankylosing spondylitis (arthritis that mainly affects the spine), gouty arthritis (joint pain caused by a build-up of certain substances in the joints), and psoriatic arthritis (arthritis that occurs with a long-lasting skin disease that causes scaling and swelling). Talk to your doctor about the risks of using this medication to treat your condition.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.



What special precautions should I follow?
Before taking meclofenamate,
tell your doctor and pharmacist if you are allergic to meclofenamate, aspirin, or other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), any other medications, or any of the inactive ingredients in meclofenamate capsules. Ask your pharmacist for a list of the inactive ingredients.
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 the medications listed in the IMPORTANT WARNING section and any of the following: angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); diuretics ('water pills'); lithium (Eskalith, Lithobid); and methotrexate (Rheumatrex). 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 any of the conditions mentioned in the IMPORTANT WARNING section or asthma, especially if you also have frequent stuffed or runny nose or nasal polyps (swelling of the lining of the nose); swelling of the hands, feet, ankles, or lower legs; or liver or kidney disease.
tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, you plan to become pregnant, or you are breast-feeding. If you become pregnant while taking meclofenamate, call your doctor.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking meclofenamate.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.


What side effects can this medication cause?
Meclofenamate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
diarrhea
constipation
gas
sores in the mouth
headache
ringing in the ears
Some side effects can be serious. If you experience any of the following symptoms, or those mentioned in the IMPORTANT WARNING section, call your doctor immediately. Do not take any more meclofenamate until you speak to your doctor.
blurred vision
unexplained weight gain
fever
blisters
rash
itching
hives
swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs
hoarseness
difficulty breathing or swallowing
yellowing of the skin or eyes
excessive tiredness
unusual bleeding or bruising
lack of energy
nausea
loss of appetite
pain in the upper right part of the stomach
flu-like symptoms
pale skin
fast heartbeat
cloudy, discolored, or bloody urine
back pain
difficult or painful urination
Meclofenamate 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 overdoses may include:
behavior that does not make sense
agitation
seizures
decreased urination
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?
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
People who take nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as meclofenamate may have a higher risk of having a heart attack or a stroke than people who do not take these medications. These events may happen without warning and may cause death. This risk may be higher for people who take NSAIDs for a long time. Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke, if you smoke, and if you have or have ever had high cholesterol, high blood pressure, or diabetes. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of the body, or slurred speech.
If you will be undergoing a coronary artery bypass graft (CABG; a type of heart surgery), you should not take meclofenamate right before or right after the surgery.
NSAIDs such as meclofenamate may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who take NSAIDs for a long time, are older in age, have poor health, or drink large amounts of alcohol while taking meclofenamate. Tell your doctor if you take any of the following medications: anticoagulants ('blood thinners') such as warfarin (Coumadin); aspirin; other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); or oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone). Also tell your doctor if you have or have ever had ulcers, bleeding in your stomach or intestines, or other bleeding disorders. If you experience any of the following symptoms, stop taking meclofenamate and call your doctor: stomach pain, heartburn, vomit that is bloody or looks like coffee grounds, blood in the stool, or black and tarry stools.
Keep all appointments with your doctor and the laboratory. Your doctor will monitor your symptoms carefully and will probably order certain tests to check your body's response to meclofenamate. Be sure to tell your doctor how you are feeling so that your doctor can prescribe the right amount of medication to treat your condition with the lowest risk of serious side effects.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with meclofenamate 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) to obtain the Medication Guide.

Meclizine

Why is this medication prescribed?
Meclizine is used to prevent and treat nausea, vomiting, and dizziness caused by motion sickness. It is most effective if taken before symptoms appear.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
How should this medication be used?
Meclizine comes as a regular and chewable tablet and a capsule. For motion sickness, meclizine should be taken 1 hour before you start to travel. Doses may be taken every 24 hours if needed. For dizziness caused by an ear condition, follow your doctor's directions. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take meclizine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
The chewable tablets may be chewed or swallowed whole.
Other names
Antivert®
Bonine®
Dramamine® Less Drowsy
Meni-D®


What special precautions should I follow?
Before taking meclizine,
tell your doctor and pharmacist if you are allergic to meclizine or any other drugs.
tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially amobarbital (Amytal), medications for colds or allergies, pain medications, phenobarbital, sedatives, seizure medications, sleeping pills, tranquilizers, and vitamins. These drugs may increase the drowsiness caused by meclizine.
tell your doctor if you have or have ever had glaucoma, an enlarged prostate, urinary tract blockage, or asthma.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking meclizine, call your doctor.


What side effects can this medication cause?
Meclizine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
drowsiness or fatigue
dry mouth
If you experience the following symptom, call your doctor immediately:
blurred vision
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.

Mechlorethamine

About your treatment
Your doctor has ordered the drug mechlorethamine to help treat your illness. The drug is given by injection into a vein.
This medication is used to treat:
Hodgkin's disease
lymphosarcoma
chronic myelocytic or chronic lymphocytic leukemia
polycythemia vera
mycosis fungoides
bronchogenic carcinoma
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Mechlorethamine is in a class of drugs known as alkylating agents; it slows or stops the growth of cancer cells in your body. The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have.
Are there other uses for this medicine?
Mechlorethamine is also used in the treatment of non-Hodgkin's lymphomas, malignant melanoma, breast cancer, renal cell carcinoma, and carcinoma of the GI tract. Mechlorethamine has been applied to the skin to treat mycosis fungoides and psoriasis. Talk to your doctor about the possible risks of using this drug for your condition.
Other names
Mustargen®


What special precautions should I follow?
Before taking mechlorethamine,
tell your doctor and pharmacist if you are allergic to mechlorethamine or any other drugs.
tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially aspirin and vitamins.
you should know that mechlorethamine may interfere with the normal menstrual cycle (period) in women and may stop sperm production in men. However, you should not assume that you cannot get pregnant or that you cannot get someone else pregnant. Women who are pregnant or breast-feeding should tell their doctors before they begin taking this drug. You should not plan to have children while receiving chemotherapy or for a while after treatments. (Talk to your doctor for further details.) Use a reliable method of birth control to prevent pregnancy. Mechlorethamine may harm the fetus.
do not have any vaccinations (e.g., measles or flu shots) without talking to your doctor.
tell your doctor about any infectious disease you have.
be aware that mechlorethamine has been associated with the development of other types of cancers. Talk with your doctor about the potential risk of developing a new cancer.


What side effects can this medication cause?
Side effects from mechlorethamine are common and include:
loss of appetite or weight
weakness
Tell your doctor if either of these symptoms is severe or lasts for several hours:
fatigue
diarrhea
If you experience any of the following symptoms, call your doctor immediately:
pain and redness at the injection site
unusual bruising or bleeding
black, tarry stools
red urine
cough
sore throat
fever
chills
dizziness, lightheadedness, or drowsiness
numbness or tingling in the fingertips or toes
nausea and vomiting
shortness of breath or wheezing
rash
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.


Important warning
When mechlorethamine is administered into a vein, it may leak into and irritate surrounding tissue. Your doctor or nurse will monitor your administration site for this reaction.

Mebendazole

Why is this medication prescribed?
Mebendazole, an antiworm medication, kills parasites. It is used to treat roundworm, hookworm, pinworm, whipworm, and other worm infections.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
How should this medication be used?
Mebendazole comes as a chewable tablet. It usually is taken twice a day, in the morning and evening, for 3 days or as a single (one-time) dose. You may chew the tablets, swallow them whole, or crush and mix them with food. Treatment may have to be repeated in 2-3 weeks. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take mebendazole exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Other names
Vermox®


What special precautions should I follow?
Before taking mebendazole,
tell your doctor and pharmacist if you are allergic to mebendazole or any other drugs.
tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially carbamazepine (Tegretol), phenytoin (Dilantin), and vitamins.
tell your doctor if you have or have ever had stomach or liver disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking mebendazole, call your doctor.


What side effects can this medication cause?
Mebendazole may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
diarrhea
stomach pain
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 doctor will order certain lab tests to check your response to mebendazole.
Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the mebendazole, call 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.

Maraviroc

Why is this medication prescribed?
Maraviroc is used with other medications to treat human immunodeficiency virus (HIV) in patients with or without acquired immunodeficiency syndrome (AIDS). Maraviroc is in a class of antiviral medications called CCR5 co-receptor antagonists. It works by slowing the spread of HIV in the body. Maraviroc does not cure HIV and may not prevent you from developing HIV-related illnesses, including other infections. Maraviroc does not prevent the spread of HIV to other people.
How should this medication be used?
Maraviroc comes as a tablet to take by mouth. It is usually taken with or without food two times a day. Take maraviroc 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 maraviroc exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow maraviroc tablets whole; do not split, chew, or crush them.
Continue to take maraviroc even if you feel well. Do not stop taking maraviroc without talking to your doctor. If you miss doses, take less than the prescribed dose, or stop taking maraviroc, your condition may become more difficult to treat. When your supply of maraviroc starts to run low, get more from your doctor or pharmacist.
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
Selzentry®


What special precautions should I follow?
Before taking maraviroc,
tell your doctor and pharmacist if you are allergic to maraviroc, any other medications, or any of the ingredients in maraviroc tablets. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
do not take St. John's wort while you are taking maraviroc.
tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: antifungal medications such as ketoconazole (Nizoral) and itraconazole (Sporanox); clarithromycin (Biaxin, in Prevpac); medications to treat HIV or AIDS; medications to treat high blood pressure;certain medications to treat seizures such as carbamazepine (Carbatrol, Epitol, Tegretol), phenobarbital (Luminal, others), and phenytoin (Dilantin, Phenytek); nefazodone; rifampin (Rifadin, Rimactane, Rifamate, others); and telithromycin (Ketek). 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 low blood pressure, chest pain, diabetes, a heart attack, high cholesterol or fats in the blood, or heart or kidney disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking maraviroc, call your doctor. You should not breast-feed if you are infected with HIV or if you are taking maraviroc.
you should know that your body fat may increase or move to different areas of your body, such as your breasts and upper back, while you are taking maraviroc.
you should know that maraviroc may cause dizziness, lightheadedness, or fainting when you get up too quickly from a lying position. To help avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. Do not drive a car or operate heavy machinery if you are dizzy while taking maraviroc.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.


What side effects can this medication cause?
Maraviroc may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
cough, runny nose, or other cold symptoms
muscle or joint pain
pain, burning, numbness, or tingling in the hands or feet
dizziness
diarrhea
constipation
painful or difficult urination
white sores and/or pain in the mouth or esophagus (tube between the mouth and stomach)
difficulty falling asleep or staying asleep
sleep walking, sleep talking, sleep terrors, or acting out in your sleep
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:
sore throat, fever, chills, or other signs of infection
chest pain, pressure, or discomfort
pain in one or both arms, back, neck, jaw, or stomach
shortness of breath
sweating
During treatment with maraviroc you may be more likely to experience an infection. Call your doctor if you have symptoms of an infection while taking maraviroc.
Maraviroc may cause other side effects. Call your doctor if you have any unusual problems while 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 less than 6 hours before your 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:
dizziness, lightheadedness, or fainting when getting up too quickly from a lying position
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
Maraviroc may cause damage to your liver. You may experience an allergic reaction to maraviroc before you develop liver damage. Tell your doctor if you have or have ever had hepatitis or other liver disease. If you experience any of the following symptoms, stop taking maraviroc and call your doctor immediately: itchy rash; yellowing of the skin or eyes; dark-colored (tea-colored) urine; vomiting; or upper right stomach pain. If you experience any of the following symptoms, continue to take maraviroc, but call your doctor right away: nausea, fever, flu-like symptoms, or excessive tiredness.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with maraviroc 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) to obtain the Medication Guide.
Talk to your doctor about the risks of taking maraviroc.

Maprotiline

Why is this medication prescribed?
Maprotiline is used to treat depression, bipolar disorder (manic depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods), and anxiety. Maprotiline is in a class of medications called tetracyclic antidepressants. It works by increasing the amounts of certain natural substances in the brain that are needed to maintain mental balance.
How should this medication be used?
Maprotiline comes as a tablet to take by mouth. It is usually taken one to three times a day and may be taken with or without food. Take maprotiline at around the same time(s) 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 maprotiline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
It may take a few weeks or longer for you to feel the full benefit of maprotiline. Continue to take maprotiline even if you feel well. Do not stop taking maprotiline without talking to your doctor. Your doctor will probably want to decrease your dose gradually.
Are there other uses for this medicine?
This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.


What special precautions should I follow?
Before taking maprotiline,
tell your doctor and pharmacist if you are allergic to maprotiline or any other medications.
tell your doctor if you are taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have taken an MAO inhibitor during the past 14 days. Your doctor will probably tell you that you should not take maprotiline.
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); antihistamines; estrogens; fluoxetine (Prozac); levodopa (Sinemet, Larodopa); lithium (Eskalith, Lithobid); medication for high blood pressure, seizures, Parkinson's disease, asthma, colds, or allergies; methylphenidate (Ritalin); muscle relaxants; oral contraceptives; sedatives; sleeping pills; thyroid medication; and tranquilizers. 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 glaucoma (an eye condition), an enlarged prostate (a male reproductive gland), difficulty urinating, seizures, a brain tumor, a head injury, an overactive thyroid gland, or liver, kidney, or heart disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking maprotiline, call your doctor.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking maprotiline.
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.
remember that alcohol can add to the drowsiness caused by this medication.
tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this medication.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.


What side effects can this medication cause?
Maprotiline may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
nausea
drowsiness
weakness or tiredness
nightmares
dry mouth
skin more sensitive to sunlight than usual
changes in appetite or weight
constipation
difficulty urinating
frequent urination
blurred vision
changes in sex drive or ability
excessive sweating
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:
jaw, neck, and back muscle spasms
slow or difficult speech
shuffling walk
uncontrollable shaking of a part of the body
fever, chills, sore throat, or flu-like symptoms
difficulty breathing or swallowing
rash
yellowing of the skin or eyes
irregular heartbeat
Maprotiline 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?
Take the missed dose as soon as you remember it. However, if it is almost time for your 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 maprotiline.
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
A small number of children, teenagers, and young adults (up to 24 years of age) who took antidepressants ('mood elevators') such as maprotiline during clinical studies became suicidal (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions. However, experts are not sure about how great this risk is and how much it should be considered in deciding whether a child or teenager should take an antidepressant. Children younger than 18 years of age should not normally take maprotiline, but in some cases, a doctor may decide that maprotiline is the best medication to treat a child's condition.
You should know that your mental health may change in unexpected ways when you take maprotiline or other antidepressants even if you are an adult over 24 years of age. You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.
Your healthcare provider will want to see you often while you are taking maprotiline, especially at the beginning of your treatment. Be sure to keep all appointments for office visits with your doctor.
The doctor or pharmacist will give you the manufacturer's patient information sheet (medication guide) when you begin treatment with maprotiline. Read the information carefully and ask your doctor or pharmacist if you have any questions. You also can obtain the Medication Guide from the FDA website: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273.
No matter what your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments. You should also talk about the risks and benefits of not treating your condition. You should know that having depression or another mental illness greatly increases the risk that you will become suicidal. This risk is higher if you or anyone in your family has or has ever had bipolar disorder (mood that changes from depressed to abnormally excited) or mania (frenzied, abnormally excited mood) or has thought about or attempted suicide. Talk to your doctor about your condition, symptoms, and personal and family medical history. You and your doctor will decide what type of treatment is right for you.