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Vincristine

About your treatment
Your doctor has ordered the drug vincristine to help treat your illness. The drug is given by injection into a vein.
This medication is used to treat:
leukemia
Hodgkin's disease
non-Hodgkin's lymphomas
neuroblastoma
rhabdomyosarcoma
Wilms' tumor
Kaposi's sarcoma related to acquired immunodeficiency syndrome (AIDS)
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Vincristine is in a class of drugs known as vinca alkaloids. 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?
Vincristine is also used to treat some types of sarcoma, small cell lung cancer, osteogenic sarcoma, Ewing's sarcoma, Burkitt's lymphoma, brain medulloblastoma, multiple myeloma, idiopathic thrombocytopenia purpura, and autoimmune hemolytic anemia. Talk to your doctor about the possible risks of using this drug for your condition.
Other names
Oncovin®
Vincasar®



What special precautions should I follow?
Before taking vincristine,
tell your doctor and pharmacist if you are allergic to vincristine or any other drugs.
tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially aspirin, itraconazole (Sporanox), and vitamins.
tell your doctor if you have or have ever had heart, liver, nerve, or muscle disease.
tell your doctor if you are currently receiving radiation therapy.
you should know that vincristine 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. Vincristine 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 vincristine are common and include:
nausea and vomiting
stomach pain and cramps
constipation
diarrhea
jaw pain, headache, or other aches
thinned or brittle hair
Tell your doctor if either of these symptoms is severe or lasts for several hours:
fatigue
mouth blistering
If you experience any of the following symptoms, call your doctor immediately:
tingling, numbness, and cramping in the legs or arms for longer than a few days
severe abdominal or muscle cramping
difficulty walking
hoarseness
vision problems
change in normal bowel habits for more than 2 days
sore throat
swelling of the feet and ankles
difficulty controlling bladder
increased, painful, or difficult urination
redness, pain, or swelling at the injection site
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
Vincristine when administered into a vein may leak into surrounding tissue. Your doctor or nurse will monitor your administration site for this reaction.

Vinblastine

About your treatment
Your doctor has ordered the drug vinblastine to help treat your illness. The drug is given by injection into a vein.
This medication is used to treat:
Hodgkin's disease
non-Hodgkin's lymphomas
mycosis fungoides
testicular cancer
Kaposi's sarcoma related to acquired immunodeficiency syndrome (AIDS)
Letterer-Siwe disease
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Vinblastine is in a class of drugs known as vinca alkaloids. 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?
Vinblastine is also used to treat non-small cell lung cancer, bladder cancer, head and neck cancer, cervical cancer, idiopathic thrombocytopenia purpura, and autoimmune hemolytic anemia. Talk to your doctor about the possible risks of using this drug for your condition.
Other names
Velban®



What special precautions should I follow?
Before taking vinblastine,
tell your doctor and pharmacist if you are allergic to vinblastine or any other drugs.
tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially aspirin, itraconazole (Sporanox), phenytoin (Dilantin), and vitamins.
tell your doctor if you have or have ever had liver disease.
you should know that vinblastine 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. Vinblastine 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 vinblastine are common and include:
nausea and vomiting which usually lasts less than 24 hours
stomach pain
constipation
diarrhea
jaw pain, headache, or other aches
thinned or brittle hair
exposed areas of the skin may become easily sunburned
Tell your doctor if either of these symptoms is severe or lasts for several hours:
fatigue
mouth blistering
If you experience any of the following symptoms, call your doctor immediately:
unusual bleeding or bruising
tingling, numbness, and cramping in the legs or arms for longer than a few days
severe abdominal or muscle cramping
difficulty walking
hoarseness
fever
chills
change in normal bowel habits for more than 2 days
sore throat or mouth
difficulty controlling bladder
increased, painful, or difficult urination
redness, pain, or swelling at the injection site
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 vinblastine is administered into a vein, it may leak into surrounding tissue. Your doctor or nurse will monitor your administration site for this reaction.

Vilazodone

Why is this medication prescribed?
Vilazodone is used to treat depression. Vilazodone is in a class of medications called selective serotonin reuptake inhibitors (SSRIs) and is also a 5HT1A receptor partial agonist. It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.
How should this medication be used?
Vilazodone comes as a tablet to take by mouth. It is usually taken with food once a day. Take vilazodone at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take vilazodone 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 vilazodone and gradually increase your dose, not more than once every 7 days.
Vilazodone controls depression but does not cure it. It may take several weeks before you feel the full benefit of vilazodone. Continue to take vilazodone even if you feel well. Do not stop taking vilazodone without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking vilazodone, you may experience withdrawal symptoms such as dizziness; nausea; headache; confusion; irritability; agitation; difficulty falling asleep or staying asleep; anxiety; extreme tiredness; seizures; pain, burning, or tingling in the hands or feet; or sweating. Tell your doctor if you experience any of these symptoms while you are decreasing your dose of vilazodone or soon after you stop taking vilazodone.
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
Viibryd®



What special precautions should I follow?
Before taking vilazodone,
tell your doctor and pharmacist if you are allergic to vilazodone, any other medications, or any of the ingredients in vilazodone tablets. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
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 stopped taking one of these medications within the past 14 days. Your doctor will probably tell you that you should not take vilazodone. If you stop taking vilazodone, your doctor will tell you that you should wait at least 14 days before you start to take an MAO inhibitor.
tell your doctor and pharmacist what other prescription and nonprescription medications, and vitamins you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); certain antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); antihistamines; aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Naprosyn, others); buspirone (BuSpar); clarithromycin (Biaxin, in PrevPac); diuretics ('water pills'); erythromycin (E.E.S., E-Mycin, Erythrocin); lithium (Eskalith, Lithobid); medications for anxiety, mental illness, or nausea; certain medications for human immunodeficiency virus (HIV) such as indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir); medications for migraine such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig); medications for seizures such as mephenytoin (Mesantoin); metoclopramide (Reglan); nefazodone; sedatives; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil, Pexeva), and sertraline (Zoloft); selective serotonin and norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Pristiq), duloxetine (Cymbalta), and venlafaxine (Effexor); sleeping pills; tramadol (Ultram); tranquilizers; and tricyclic antidepressants such as amitriptyline, amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with vilazodone, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
tell your doctor what herbal products and nutritional supplements you are taking, especially St. John's wort and tryptophan.
tell your doctor if you have or have ever had bleeding problems, seizures, or liver disease.
tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant or are breast-feeding. If you become pregnant while taking vilazodone, call your doctor. Vilazodone may cause problems in newborns following delivery if it is taken during the last months of pregnancy.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking vilazodone.
you should know that vilazodone may make you drowsy and affect your judgment and thinking. Do not drive a car or operate machinery until you know how this medication affects you.
ask your doctor about the safe use of alcoholic beverages while you are taking vilazodone. Alcohol can make the side effects from vilazodone worse.
What special dietary instructions should I follow?
Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medication.



What side effects can this medication cause?
Vilazodone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
dry mouth
increased appetite
heartburn
gas
dizziness
pain, burning, or tingling in the hands or feet
uncontrollable shaking of a part of the body
unusual dreams
tiredness
joint pain
changes in sexual desire or ability
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:
rash
hives
swelling
difficulty breathing
loss of consciousness
seizures
fever, sweating, confusion, fast or irregular heartbeat, and severe muscle stiffness
diarrhea
nausea
vomiting
unusual bleeding or bruising
nosebleeds
small red or purple dots on the skin
hallucinations (seeing things or hearing voices that do not exist)
headache
difficulty concentrating
memory problems
weakness
problems with coordination
increased falls
fainting
Vilazodone 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 the following:
fever, sweating, confusion, fast or irregular heartbeat, and severe muscle stiffness
hallucinations (seeing things or hearing voices that do not exist)
lack of energy
restlessness
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
A small number of children, teenagers, and young adults (up to 24 years of age) who took antidepressants ('mood elevators') such as vilazodone 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 vilazodone, but in some cases, a doctor may decide that vilazodone 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 vilazodone 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; frenzied abnormal excitement; or any other changes in your usual thoughts, mood, or behavior. 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 vilazodone, especially at the beginning of your treatment. Be sure to keep all appointments for office visits with your doctor.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with vilazodone 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/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.
No matter 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.

Vigabatrin

Why is this medication prescribed?
Vigabatrin tablets are used in combination with other medications to control certain types of seizures in adults whose seizures were not controlled by several other medications. Vigabatrin powder is used to control infantile spasms (a type of seizure that babies and children can have) in babies 1 month to 2 years of age. Vigabatrin is in a class of medications called anticonvulsants. It works by decreasing abnormal electrical activity in the brain.
How should this medication be used?
Vigabatrin comes as a powder to be mixed with water and as a tablet to take by mouth. It is usually taken twice a day with or without food. Take vigabatrin 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 vigabatrin 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 vigabatrin and gradually increase your dose, not more often than once every 3 days for babies receiving the powder mixed with water and once a week for adults taking tablets.
Vigabatrin may help control your condition but will not cure it. Continue to take vigabatrin even if you feel well. Do not stop taking vigabatrin without talking to your doctor. If you suddenly stop taking vigabatrin, your seizures may happen more often. Your doctor will probably decrease your dose gradually, not more often than once every 3-4 days for babies receiving the powder mixed with water and once a week for adults taking tablets. Tell your doctor immediately if your seizures happen more often while you are stopping vigabatrin.
If you are taking the powder, you must mix it with cold or room temperature water immediately before taking it. Do not mix the powder with any other liquid or food. The doctor will tell you how many packets of vigabatrin powder to use and how much water to mix it with. The doctor will also tell you how much of the mixture to take for each dose. Do not use a household spoon to measure your dose. Use the oral syringe that came with the medication. Carefully read the manufacturer's instructions that describe how to mix and take a dose of vigabatrin. Be sure to ask your pharmacist or doctor if you have any questions about how to mix or take this medication.
Talk to the doctor about what to do if your baby vomits, spits up, or only takes part of the dose of vigabatrin.
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
Sabril®



What special precautions should I follow?
Before taking vigabatrin,
tell your doctor and pharmacist if you are allergic to vigabatrin, any other medications, or any of the ingredients in vigabatrin tablets or powder. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention either of the following: clonazepam (Klonopin) or phenytoin (Dilantin, Phenytek). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with vigabatrin, so be sure to tell your doctor about all the medications you are taking, even those that do not appear here.
tell your doctor if you have or have ever had kidney disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking vigabatrin, call your doctor.
you should know that vigabatrin may make you drowsy or tired. Do not drive a car or operate machinery until you know how this medication affects you. If your vision is damaged by vigabatrin, talk with your doctor about whether or not you can drive safely.
you should know that your mental health may change in unexpected ways and you may become suicidal (thinking about harming or killing yourself or planning or trying to do so) while you are taking vigabatrin. A small number of adults and children 5 years of age and older (about 1 in 500 people) who took anticonvulsants like vigabatrin to treat various conditions during clinical studies became suicidal during their treatment. Some of these people developed suicidal thoughts and behavior as early as 1 week after they started taking the medication. There is a risk that you may experience changes in your mental health if you take an anticonvulsant medication such as vigabatrin, but there may also be a risk that you will experience changes in your mental health if your condition is not treated. You and your doctor will decide whether the risks of taking an anticonvulsant medication are greater than the risks of not taking the medication. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: panic attacks; agitation or restlessness; new or worsening irritability, anxiety, or depression; acting on dangerous impulses; difficulty falling asleep or staying asleep; aggressive, angry, or violent behavior; mania (frenzied, abnormally excited mood); thinking about or trying to hurt yourself or end your life; or any other unusual changes in behavior or mood. 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.
you should know that in some babies that have taken vigabatrin there were changes in pictures of the brain taken by magnetic resonance imaging (MRI). These changes were not seen in older children or adults. Usually these changes went away when treatment was stopped. It is not known if these changes are harmful.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.



What side effects can this medication cause?
Vigabatrin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
sleepiness
dizziness
uncontrollable shaking of a part of the body
weakness
joint or muscle pain
problems walking or feeling uncoordinated
memory problems and not thinking clearly
weight gain
swelling of the hands, feet, ankles, or lower legs
pain, burning, or tingling in the hands or feet
fever
irritability
diarrhea
nausea
vomiting
constipation
stomach pain
heartburn
severely painful cramps during menstrual period
Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections, call your doctor immediately:
confusion
tiredness
pale skin
fast heartbeat
difficulty breathing
hives
itching
Vigabatrin 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 the following:
drowsiness
loss of consciousness
What storage conditions are needed for this medication?
Keep vigabatrin tablets and vigabatrin powder in the container they came in, tightly closed, and out of reach of children. Store them 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 eye doctor.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking vigabatrin.
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
Vigabatrin can cause permanent vision damage, including loss of peripheral vision and having blurry vision. Although vision loss is possible with any amount of vigabatrin, your risk may be greater with the more vigabatrin that you take daily and the longer you take it. Vision loss can happen at any time during treatment with vigabatrin. Tell your doctor if you have or have ever had any vision problems. If you experience any of the following symptoms, call your doctor immediately: think you are not seeing as well as before taking vigabatrin; start to trip, bump into things, or are more clumsy than usual; are surprised by people or things coming in front of you that seem to come out of nowhere; blurry vision; double vision; eye movements you can't control; eye pain; and headache. Vision loss is not likely to be noticed in infants before it is severe. Be sure to call your doctor immediately if you think your baby is not seeing as well as before taking vigabatrin or is acting differently than normal.
Vigabatrin is only available through a special program called SHARE. You and your doctor will need to be enrolled in this program before you can receive vigabatrin. You will need to get vigabatrin from a specialty pharmacy that is enrolled in the program. Your doctor will give you more information about the program, will have you sign an enrollment form, and will answer any questions you have about the program and your treatment with vigabatrin.
As part of the SHARE program, an eye doctor will test your vision within 4 weeks of starting vigabatrin, at least every 3 months during treatment, and 3-6 months after stopping treatment. Vision testing is difficult in infants and may not find vision loss before it is severe. Vision tests cannot prevent vision damage but they are important to decrease further damage from occurring by stopping vigabatrin if vision changes are found. Once detected, vision loss is not reversible. It is possible that further damage can occur after stopping vigabatrin.
Also as part of the SHARE program, your doctor will assess your response to and continued need for vigabatrin. This is done within 2-4 weeks of starting treatment in infants and children, within 3 months of starting treatment in adults, and then on a regular basis as needed for all patients. If your doctor determines that vigabatrin is not working for you, then your treatment should be stopped.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with vigabatrin 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/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.
Talk to your doctor about the risks of taking vigabatrin.

Verteporfin Injection

Why is this medication prescribed?
Verteporfin injection is used in combination with photodynamic therapy (PDT; treatment with a laser light) to treat abnormal growth of leaky blood vessels in the eye caused by wet age-related macular degeneration (AMD; an ongoing disease of the eye that causes loss of the ability to see straight ahead and may make it more difficult to read, drive, or perform other daily activities), pathologic myopia (a serious form of nearsightedness that worsens with time), or histoplasmosis (a fungal infection) of the eye. Verteporfin is in a class of medications called photosensitizing agents. When verteporfin is activated by light, it closes up the leaking blood vessels.
How should this medication be used?
Verteporfin injection comes as a solid powder cake to be made into a solution to be injected intravenously (into a vein) by a doctor. Verteporfin is usually infused over 10 minutes. Fifteen minutes after the start of the verteporfin infusion, your doctor will administer a special laser light to your eye. If both of your eyes need treatment, the doctor will administer the laser light to your second eye immediately after the first eye. If you have never used verteporfin before and both your eyes need treatment, the doctor will treat only one eye with the laser light on your first visit. If you do not have any serious problems due to the treatment, the doctor will treat your second eye 1 week later with another verteporfin infusion and laser light treatment.
Your doctor will examine your eyes 3 months after verteporfin and PDT treatment to decide whether you need another treatment.
Are there other uses for this medicine?
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Other names
Visudyne®



What special precautions should I follow?
Before receiving verteporfin injection,
tell your doctor and pharmacist if you are allergic to verteporfin, any other medications, or any of the ingredients in verteporfin injection. Ask your pharmacist for a list of the 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 any of the following: anticoagulants ('blood thinners'); antihistamines; aspirin or other pain medications; beta carotene; 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); diuretics ('water pills'); griseofulvin (Fulvicin-U/F, Grifulvin V, Gris-PEG ); medications for diabetes, mental illness, and nausea; polymyxin B; sulfa antibiotics; and tetracycline antibiotics such as demeclocycline (Declomycin), doxycycline (Doryx, Vibramycin), minocycline (Dynacin, Minocin), and tetracycline (Sumycin). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
tell your doctor if you have porphyria (a condition that causes sensitivity to light). Your doctor will probably tell you not to use verteporfin injection.
tell your doctor if you are being treated with radiation therapy and if you have or have ever had gallbladder or liver disease or any other medical condition.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using verteporfin injection, call your doctor.
if you are having surgery, including dental surgery, within 5 days of a verteporfin infusion, tell the doctor or dentist that you have used verteporfin.
you should know that verteporfin may cause vision problems. Do not drive a car or operate machinery until you know how this medication affects you.
you should know that verteporfin will make your skin very sensitive to sunlight (likely to get sunburn). Wear a wristband to remind you to avoid exposure of the skin and eyes to direct sunlight or bright indoor light (e.g. tanning salons, bright halogen lighting, and high power lighting used in operating rooms or dental offices) for 5 days after the verteporfin infusion. If you must go outdoors in the daylight during the first 5 days after verteporfin infusion, protect all parts of your body by wearing protective clothing, including a wide-brimmed hat and gloves, and dark sunglasses. Sunscreen will not protect you from sunlight during this time. Do not avoid light entirely during this time; you should expose your skin to soft indoor light.
talk to your doctor about testing your vision at home during your treatment. Check your vision in both eyes as directed by your doctor, and call your doctor if there are any changes in your vision.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.



What side effects can this medication cause?
Verteporfin injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
pain, redness, swelling, or discoloration at the site of the injection
back pain during the infusion
dry eye
itchy eye
dry, itchy skin
constipation
nausea
muscle pain or weakness
decreased sensitivity to touch
decreased hearing
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
blurred vision
decrease or changes in vision
seeing flashes of light
black spots in vision
redness and swelling of the eyelid
pink eye
chest pain
fainting
sweating
dizziness
rash
shortness of breath
flushing
rapid or irregular heartbeat
headache
lack of energy
hives and itching
Verteporfin injection may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
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 other information should I know?
Keep all appointments with your doctor.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Verapamil

Why is this medication prescribed?
Verapamil is used to treat high blood pressure and to control angina (chest pain). The immediate-release tablets are also used alone or with other medications to prevent and treat irregular heartbeats. Verapamil is in a class of medications called calcium-channel blockers. It works by relaxing the blood vessels so the heart does not have to pump as hard. It also increases the supply of blood and oxygen to the heart and slows electrical activity in the heart to control the heart rate.
How should this medication be used?
Verapamil comes as a tablet, an extended-release (long-acting) tablet, and an extended-release capsule to take by mouth. The regular tablet is usually taken three to four times a day. The extended-release tablets and capsules are usually taken once or twice a day. Take verapamil at around the same time(s) every day. Certain verapamil products should be taken in the morning and others at bedtime. Ask your doctor what the best time is for you to take your medication. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take verapamil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the extended-release tablets and capsules whole. Do not chew or crush them. Ask your pharmacist if the tablets may be split in half, as the instructions vary by product.
If you can not swallow the extended-release capsules you may carefully open the capsule and sprinkle the entire contents onto a spoonful of applesauce. The applesauce should not be hot, and it should be soft enough to be swallowed without chewing. Swallow the applesauce immediately without chewing, and then drink a glass of cool water to make sure that you have swallowed all of the medicine. Do not store the mixture for future use.
Your doctor will probably start you on a low dose of verapamil and gradually increase your dose.
Verapamil controls arrhythmias, high blood pressure, and angina but does not cure these conditions. Continue to take verapamil even if you feel well. Do not stop taking verapamil without talking to your doctor.
Are there other uses for this medicine?
Verapamil is also sometimes used to treat certain other heart problems. Talk to your doctor about the risks of using this medication for your condition.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Other names
Calan®
Covera®
Isoptin®
Verelan®



What special precautions should I follow?
Before taking verapamil,
tell your doctor and pharmacist if you are allergic to verapamil or any other medications.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: alpha blockers such as prazosin (Minipress); antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); aspirin; beta blockers such as atenolol (Tenormin), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), propranolol (Inderal), and timolol (Betimol, Istalol, Timoptic, in Cosopt); carbamazepine (Tegretol); cimetidine (Tagamet); clarithromycin (Biaxin, in Prevpac); cyclosporine (Neoral, Sandimmune); digoxin (Lanoxin, Lanoxicaps); disopyramide (Norpace); diuretics (''water pills'');erythromycin (E.E.S., E-Mycin, Erythrocin); flecainide (Tambocor); certain HIV protease inhibitors such as indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir, in Kaletra); quinidine (Quinaglute, Quinidex); lithium (Eskalith, Lithobid); medications to treat high blood pressure; nefazodone; phenobarbital; pioglitazone (Actos, in Duetact); rifampin (Rifadin, Rimactane); telithromycin (Ketek); and theophylline (Theolair, Uniphyl). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with verapamil, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
tell your doctor what herbal products you are taking, especially St. John's wort.
tell your doctor if you have or have ever had narrowing or blockage of your digestive system or any other condition that causes food to move through your digestive system more slowly; heart failure; heart, liver, or kidney disease; muscular dystrophy (inherited disease that causes gradual weakening of muscles); or myasthenia gravis (condition that causes certain muscles to weaken).
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking verapamil, call your doctor.
if you are having surgery, including dental surgery, tell your doctor or dentist that you are taking verapamil.
talk to your doctor about the safe use of alcoholic beverages during your treatment with verapamil. Verapamil may cause the effects of alcohol to be more severe and longer-lasting.
What special dietary instructions should I follow?
Talk to your doctor about eating grapefruit or drinking grapefruit juice while taking this medicine.


What side effects can this medication cause?
Verapamil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
constipation
heartburn
dizziness or lightheadedness
headache
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
swelling of the hands, feet, ankles, or lower legs
difficulty breathing or swallowing
slow heartbeat
fainting
blurred vision
rash
nausea
extreme tiredness
unusual bleeding or bruising
lack of energy
loss of appetite
pain in the upper right part of the stomach
yellowing of the skin or eyes
flu-like symptoms
fever
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:
dizziness
blurred vision
slow, fast, or irregular heartbeat
seizures
confusion
difficulty breathing or swallowing
What storage conditions are needed for this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to verapamil. Your doctor may also order certain lab tests to check your body's response to verapamil.
If you are taking certain extended-release tablets (Covera HS), you may notice something that looks like a tablet in your stool. This is just the empty tablet shell, and this does not mean that you did not get your complete dose of medication.
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.

Venlafaxine

Why is this medication prescribed?
Venlafaxine is used to treat depression. Venlafaxine extended-release (long-acting) capsules are also used to treat generalized anxiety disorder (GAD; excessive worrying that is difficult to control), social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life), and panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks). Venlafaxine is in a class of medications called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). It works by increasing the amounts of serotonin and norepinephrine, natural substances in the brain that help maintain mental balance.
How should this medication be used?
Venlafaxine comes as a tablet or extended-release capsule to take by mouth. The tablet is usually taken two or three times a day with food. The extended-release capsule is usually taken once daily in the morning or evening with food. Take venlafaxine 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 venlafaxine exactly as directed. Do not take more or less of it or take it more often or for a longer period of time than prescribed by your doctor.
Swallow the extended-release capsule whole; do not split, chew, or crush it, or place it in water. If you cannot swallow the extended-release capsule, you may carefully open the capsule and sprinkle the entire contents on a spoonful of applesauce. Swallow (without chewing) this mixture immediately after preparation and then drink a glass of water to make sure that you have swallowed all of the medication.
Your doctor will probably start you on a low dose of venlafaxine and gradually increase your dose, not more often than once every 4 to 7 days. Tell your doctor how you are feeling during your treatment so that your doctor can adjust your dose properly.
Venlafaxine controls depression but does not cure it. It may take 6 to 8 weeks or longer for you to feel the full benefit of this medication. Continue to take venlafaxine even if you feel well. Do not stop taking venlafaxine without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking venlafaxine, you may experience withdrawal symptoms such as agitation; anxiety; confusion; sad mood; irritability; frenzied or abnormal excitement; lack of coordination; trouble falling asleep or staying asleep; nightmares; nausea; vomiting; loss of appetite; diarrhea; dry mouth; sweating; ringing in the ears; seizures; or burning, tingling, numbness, or electric shock-like feelings in any part of the body. Tell your doctor if you experience any of these symptoms while you are decreasing your dose of venlafaxine or soon after you stop taking venlafaxine.
Are there other uses for this medicine?
Venlafaxine is also sometimes used to treat hot flashes (hot flushes; sudden strong feelings of heat and sweating) in women who have experienced menopause ('change of life'; the end of monthly menstrual periods) or who are taking medication to treat breast cancer. Talk to your doctor or pharmacist about the risks of using venlafaxine to treat your condition.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Other names
Effexor®
Effexor® XR



What special precautions should I follow?
Before taking venlafaxine,
tell your doctor and pharmacist if you are allergic to venlafaxine, any other medications, or any of the ingredients in venlafaxine tablets or extended-release capsules. Ask your pharmacist for a list of the ingredients.
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 stopped taking one of these medications within the past 14 days. Your doctor will probably tell you that you should not take venlafaxine. If you stop taking venlafaxine, your doctor will tell you that you should wait at least 7 days before you start to take an MAO inhibitor.
tell your doctor and pharmacist what other prescription and nonprescription medications, and vitamins you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); amiodarone (Cordarone, Pacerone); other antidepressants; cimetidine (Tagamet); clozapine (Clozaril); diuretics ('water pills'); duloxetine (Cymbalta); haloperidol (Haldol); imipramine (Tofranil); indinavir (Crixivan); ketoconazole (Nizoral); linezolid (Zyvox); lithium; medications for anxiety, mental illness, pain, seizures, or weight loss; medications for migraine such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig); methadone (Dolophine); phentermine (Adipex P, Ionamin); ritonavir (Norvir); sedatives; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); sibutramine (Meridia); sleeping pills; tramadol (Ultram); and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
tell your doctor what nutritional supplements and herbal products you are taking, especially St. John's wort and tryptophan.
tell your doctor if you have ever used illegal drugs or overused prescription medications. Also tell your doctor if you have recently had a heart attack and if you have or have ever had high blood pressure, high blood cholesterol glaucoma (an eye disease), high pressure in the eyes (a condition that can lead to glaucoma), seizures, or heart, kidney, liver, or thyroid disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking venlafaxine, call your doctor.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking venlafaxine.
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.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.




What side effects can this medication cause?
Venlafaxine may cause side effects. Call your doctor if any of the following symptoms are severe or do not go away:
drowsiness
weakness or tiredness
dizziness
headache
nightmares
nausea
vomiting
stomach pain
constipation
diarrhea
gas
heartburn
burping
dry mouth
change in ability to taste food
loss of appetite
weight loss
uncontrollable shaking of a part of the body
pain, burning, numbness, or tingling in part of the body
muscle tightness
twitching
yawning
sweating
hot flashes or flushing
frequent urination
difficulty urinating
sore throat, chills, or other signs of infection
ringing in the ears
changes in sexual desire or ability
enlarged pupils (black circles in the middle of the eyes)
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:
rash
hives
itching
difficulty breathing or swallowing
chest pain
fast, pounding, or irregular heartbeat
seizures
unusual bruising or bleeding
small purple spots on the skin
eye pain or redness
changes in vision
fever, sweating, confusion, fast or irregular heartbeat, and severe muscle stiffness
fever
problems with coordination
hallucinations (seeing things or hearing voices that do not exist)
coma (loss of consciousness for a period of time)
Venlafaxine may slow growth and weight gain in children. If your child is taking venlafaxine, your child's doctor will watch your child's growth carefully. Talk to your child's doctor about the risks of giving venlafaxine to your child.
Venlafaxine 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. If you are taking the extended-release capsules, do not take more than one dose per day.
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
nausea
vomiting
burning, tingling, or numbness of the hands and feet
increased size of the pupil (black center of the eye)
muscle pain
hot and cold spells
sleepiness
seizures
fast, slow, or irregular heartbeat
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?
Keep all appointments with your doctor and the laboratory. Your doctor will check your blood pressure often and order certain lab tests to check your response to venlafaxine.
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 venlafaxine 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 venlafaxine, but in some cases, a doctor may decide that venlafaxine 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 venlafaxine 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 venlafaxine, 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 venlafaxine. 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 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.

Enalapril

Why is this medication prescribed?
Enalapril is used alone or in combination with other medications to treat high blood pressure. It is also used in combination with other medications to treat heart failure. Enalapril is in a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly and the heart can pump blood more efficiently.
How should this medication be used?
Enalapril comes as an immediate and extended release tablet to take by mouth. It is usually taken once or twice a day with or without food. To help you remember to take enalapril, take it 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 enalapril 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 enalapril and gradually increase your dose.
Enalapril controls high blood pressure and heart failure but does not cure them. Continue to take enalapril even if you feel well. Do not stop taking enalapril without talking to your doctor.
Are there other uses for this medicine?
Enalapril is also sometimes used to treat kidney disease related to diabetes. 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
Lexxel® (as a combination product containing Enalapril, Felodipine)
Teczem® (as a combination product containing Diltiazem, Enalapril)
Vasotec®


What special precautions should I follow?
Before taking enalapril,
tell your doctor and pharmacist if you are allergic to enalapril, benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), trandolapril (Mavik), or any other medications.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as indomethacin (Indocin); diuretics ('water pills'); lithium (Eskalith, Lithobid); and potassium supplements. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
tell your doctor if you have or have ever had heart or kidney disease; lupus; scleroderma; diabetes; or angioedema, a condition that causes difficulty swallowing or breathing and painful swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs.
tell your doctor if you plan to become pregnant or are breast-feeding.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking enalapril.
you should know that diarrhea, vomiting, not drinking enough fluids, and sweating a lot can cause a drop in blood pressure, which may cause lightheadedness and fainting.
What special dietary instructions should I follow?
Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.



What side effects can this medication cause?
Enalapril may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
cough
dizziness
rash
weakness
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
hoarseness
difficulty breathing or swallowing
yellowing of the skin or eyes
fever, sore throat, chills, and other signs of infection
lightheadedness
fainting
Enalapril may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
What should I do if I forget to take a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What should I do in case of overdose?
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
lightheadedness
fainting
What storage conditions are needed for this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to enalapril. Your doctor may order certain lab tests to check your body's response to enalapril.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.


Important warning
Do not take enalapril if you are pregnant. If you become pregnant while taking enalapril, call your doctor immediately. Enalapril may harm the fetus.

Varenicline

Why is this medication prescribed?
Varenicline is used to help people stop smoking. Varenicline is in a class of medications called smoking cessation aids. It works by blocking the pleasant effects of nicotine (from smoking) on the brain.
How should this medication be used?
Varenicline comes as a tablet to take by mouth. It is usually taken once or twice a day with a full glass of water after eating. Take varenicline at around the same time(s) every day. If you are taking varenicline twice a day, take one dose in the morning and one dose in the evening. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take varenicline 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 varenicline and gradually increase your dose over the first week of treatment.
Set a quit date to stop smoking, and start taking varenicline 1 week before that date. You may continue to smoke during this first week, but make sure to try to stop smoking on the date you have chosen.
It may take several weeks for you to feel the full benefit of varenicline. You may slip and smoke during your treatment. If this happens, you may still be able to stop smoking. Continue to take varenicline and to try not to smoke.
You will probably take varenicline for 12 weeks. If you have completely stopped smoking at the end of 12 weeks, your doctor may tell you to take varenicline for another 12 weeks. This may help keep you from starting to smoke again.
If you have not stopped smoking at the end of 12 weeks, talk to your doctor. Your doctor can try to help you understand why you were not able to stop smoking and make plans to try to quit again.
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
Chantix®



What special precautions should I follow?
Before taking varenicline,
tell your doctor and pharmacist if you are allergic to varenicline or any other medications.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); insulin; other medications to help you stop smoking such as bupropion (Wellbutrin, Zyban) and nicotine gum, inhaler, lozenges, nasal spray, or skin patches; and theophylline (Theo-24). Your doctor may need to change the doses of some of your medications once you stop smoking.
tell your doctor if you have or have ever had kidney disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking varenicline, call your doctor.
you should know that varenicline may make you drowsy, dizzy, or have difficulty concentrating. There have been reports of traffic accidents, near-miss accidents, and other types of injuries in people who were taking varenicline. Do not drive a car or operate machinery until you know how this medication affects you.
ask your doctor for advice and for written information to help you stop smoking. You are more likely to stop smoking during your treatment with varenicline if you get information and support from your doctor.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.


What side effects can this medication cause?
Varenicline may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
nausea
constipation
gas
vomiting
heartburn
bad taste in the mouth
increased or decreased appetite
trouble falling asleep or staying asleep
unusual dreams or nightmares
drowsiness
headache
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:
swelling of the face, tongue, lips, gums, throat, arms, or legs
difficulty swallowing or breathing
rash
swollen, red, peeling or blistering skin
blisters in the mouth
Varenicline may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
What should I do if I forget to take a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What should I do in case of overdose?
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
What storage conditions are needed for this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
What other information should I know?
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.


Important warning
Some people have had changes in behavior, hostility, agitation, depressed mood, and suicidal thoughts (thinking about harming or killing oneself or planning or trying to do so) while taking varenicline. The role of varenicline in causing these mood changes is unclear since people who quit smoking with or without medication may experience changes in their mental health due to nicotine withdrawal. However, some of these symptoms occurred in people who were taking varenicline and continued to smoke. Some people had these symptoms when they began taking varenicline, and others developed them after several weeks of treatment or after stopping varenicline. These symptoms have occurred in people without a history of mental illness and have worsened in people who already had a mental illness. Tell your doctor if you have or have ever had depression, bipolar disorder (mood that changes from depressed to abnormally excited), schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions), or other mental illnesses. If you experience any of the following symptoms, stop taking varenicline and call your doctor immediately: suicidal thoughts or actions; new or worsening depression, anxiety, or panic attacks; agitation; restlessness; angry or violent behavior; acting dangerously; mania (frenzied, abnormally excited or irritated mood); abnormal thoughts or sensations; hallucinations (seeing things or hearing voices that do not exist); feeling that people are against you; feeling confused; or any other sudden or unusual changes in behavior. 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 doctor will monitor you closely until your symptoms get better.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with varenicline 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/downloads/Drugs/DrugSafety/ucm088569.pdf) or the manufacturer's website to obtain the Medication Guide.
Talk to your doctor about the risks and benefits of taking varenicline.
Notification
[Posted 06/16/2011] ISSUE: FDA notified healthcare professionals and patients that the Prescribing Information for this drug product will be strengthened to inform the public that use of varenicline (Chantix) may be associated with a small, increased risk of certain cardiovascular adverse events in patients who have cardiovascular disease. This safety information will be added to the Warnings and Precautions section and the patient Medication Guide.
BACKGROUND: FDA reviewed a randomized, double-blind, placebo-controlled clinical trial of 700 smokers with cardiovascular disease who were treated with varenicline or placebo. While cardiovascular adverse events were infrequent overall, certain events, including heart attack, were reported more frequently in patients treated with varenicline than in patients treated with placebo. The events included angina pectoris, nonfatal myocardial infarction, need for coronary revascularization, and new diagnosis of peripheral vascular disease or admission for a procedure for the treatment of peripheral vascular disease. FDA is continuing to evaluate the cardiovascular safety of varenicline and is requiring the manufacturer to conduct a large, combined analysis (meta-analysis) of randomized, placebo-controlled trials. FDA will update the public when additional information is available.
RECOMMENDATION: See the Data Summary section of the Drug Safety Communication for additional information.
Healthcare professionals should be aware that smoking is an independent and major risk factor for cardiovascular disease, and smoking cessation is of particular importance in this patient population. The known benefits of varenicline should be weighed against its potential risks when deciding to use the drug in smokers with cardiovascular disease.
Patients are encouraged to read the Medication Guide they receive along with their varenicline prescription. For more information visit the FDA website at: http://www.fda.gov/Safety/MedWatch/SafetyInformation and http://www.fda.gov/Drugs/DrugSafety.

Vardenafil

Why is this medication prescribed?
Vardenafil is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Vardenafil is in a class of medications called phosphodiesterase (PDE) inhibitors. It works by increasing blood flow to the penis during sexual stimulation. This increased blood flow can cause an erection. Vardenafil does not cure erectile dysfunction or increase sexual desire. Vardenafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV).
How should this medication be used?
Vardenafil comes as a tablet and a rapidly disintegrating (dissolves in the mouth and is swallowed without water) tablet to take by mouth. It is usually taken as needed, with or without food, 60 minutes before sexual activity. Vardenafil usually should not be taken more often than once every 24 hours. If you have certain health conditions or are taking certain medications, your doctor may tell you to take vardenafil less often. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take vardenafil 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 the rapidly disintegrating tablet, check the blisterpack before you take your first dose. Do not use any of the medication from the pack if any of the blisters are torn, broken, or do not contain tablets. Follow the package directions to remove the tablet from the blister package. Do not try to push the tablet through the foil. After you remove the tablet from the blister package, immediately place it on your tongue and close your mouth. The tablet will quickly dissolve. Do not take the rapidly disintegrating tablet with water or other liquids.
Your doctor will probably start you on an average dose of vardenafil tablets and increase or decrease your dose depending on your response to the medication. If you are taking the rapidly disintegrating tablets, your doctor will not be able to adjust your dose because the rapidly disintegrating tablets are only available in one strength. If you need a higher or lower dose, your doctor may prescribe the regular tablets instead. Tell your doctor if vardenafil is not working well or if you are experiencing side effects.
Vardenafil rapidly disintegrating tablets cannot be substituted for vardenafil tablets. Be sure that you receive only the type of vardenafil that was prescribed by your doctor. Ask your pharmacist if you have any questions about the type of vardenafil you were given.
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
Levitra®
Staxyn®



What special precautions should I follow?
Before taking vardenafil,
tell your doctor and pharmacist if you are allergic to vardenafil or any other medications.
do not take vardenafil if you are taking or have recently taken nitrates such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, ISMO), and nitroglycerin (Nitro-BID, Nitro-Dur, Nitroquick, Nitrostat, others). Nitrates come as tablets, sublingual (under the tongue) tablets, sprays, patches, pastes, and ointments. Ask your doctor if you are not sure if any of your medications contain nitrates.
do not take street drugs containing nitrates such as amyl nitrate and butyl nitrate ('poppers') while taking vardenafil.
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: alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), tamsulosin (Flomax), and terazosin (Hytrin);amiodarone (Cordarone, Pacerone); antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral); clarithromycin (Biaxin);; disopyramide (Norpace); erythromycin (E.E.S., E-Mycin, Erythrocin) haloperidol (Haldol); HIV protease inhibitors including atazanavir (Reyataz), indinavir (Crixivan),ritonavir (Norvir, in Kaletra), and saquinavir (Fortovase, Invirase);medications for high blood pressure or irregular heartbeat;other medications or treatments for erectile dysfunction; methadone (Dolophine); moxifloxacin (Avelox); pimozide (Orap); procainamide (Procanbid, Pronestyl); quinidine (Quinidex); sotalol (Betapace); thioridazine;and verapamil (Calan, Covera, Isoptin, Verelan).Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may interact with vardenafil, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
tell your doctor what herbal products you are taking, especially St. John's wort.
tell your doctor if you smoke and if you have ever had an erection that lasted more than 4 hours. Also tell your doctor if you have or have ever had a condition that affects the shape of the penis, such as angulation, cavernosal fibrosis, or Peyronie's disease; diabetes; high cholesterol; high or low blood pressure; irregular heartbeat; a heart attack; angina (chest pain); a stroke; ulcers in the stomach or intestine; a bleeding disorder; blood cell problems such as sickle cell anemia (a disease of the red blood cells), multiple myeloma (cancer of the plasma cells), or leukemia (cancer of the white blood cells); seizures; and liver, kidney, or heart disease. Also tell your doctor if you or any of your family members have or have ever had long QT syndrome (a heart condition) or retinitis pigmentosus (an eye disease) or if you have ever had severe vision loss, especially if you were told that the vision loss was caused by a blockage of blood flow to the nerves that help you see. Tell your doctor if you have ever been advised by a health care professional to avoid sexual activity for medical reasons.
you should know that vardenafil is only for use in males. Women should not take vardenafil, especially if they are or could become pregnant or are breast-feeding. If a pregnant woman takes vardenafil, she should call her doctor.
if you are having surgery, including dental surgery or any dental procedure, tell the doctor or dentist that you are taking vardenafil.
you should know that sexual activity may be a strain on your heart, especially if you have heart disease. If you have chest pain during sexual activity, call your doctor immediately and avoid sexual activity until your doctor tells you otherwise.
tell all your health care providers that you are taking vardenafil. If you ever need emergency medical treatment for a heart problem, the health care providers who treat you will need to know when you last took vardenafil.
if you have phenylketonuria (PKU, an inherited condition in which a special diet must be followed to prevent mental retardation), you should know that the rapidly disintegrating tablets are sweetened with aspartame, a source of phenylalanine.
if you have fructose intolerance (an inherited condition in which the body lacks the protein needed to break down fructose,[a fruit sugar found in certain sweeteners such as sorbitol]), you should know that the the rapidly disintegrating tablets are sweetened with sorbitol. Tell your doctor if you have fructose intolerance.
What special dietary instructions should I follow?
Talk to your doctor about eating grapefruit or drinking grapefruit juice while taking this medicine.



What side effects can this medication cause?
Vardenafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
headache
upset stomach
heartburn
flushing
stuffy or runny nose
flu-like symptoms
Some side effects can be serious. If you experience any of the following symptoms , call your doctor immediately:
erection that lasts longer than 4 hours
sudden severe loss of vision (see below for more information)
blurred vision
changes in color vision (seeing blue tinge on objects, difficulty telling the difference between blue and green, or difficulty seeing at night)
dizziness
sudden decrease or loss of hearing
ringing in ears
swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
hoarseness
difficulty breathing or swallowing
fainting
hives
rash
Vardenafil may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
Some patients experienced a sudden loss of some or all of their vision after they took vardenafil or other medications that are similar to vardenafil. The vision loss was permanent in some cases. It is not known if the vision loss was caused by the medication. If you experience a sudden loss of vision while you are taking vardenafil, call your doctor immediately. Do not take any more doses of vardenafil or similar medications such as sildenafil (Viagra) or tadalafil (Cialis) until you talk to your doctor.
Some patients experienced a sudden decrease or loss of hearing after they took vardenafil or other medications that are similar to vardenafil. The hearing loss usually involved only one ear and may not get better. It is not known if the hearing loss was caused by the medication. If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking vardenafil, call your doctor immediately. Do not take any more doses of vardenafil or similar medications such as sildenafil (Viagra) or tadalafil (Cialis) until you talk to your doctor.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
What should I do in case of overdose?
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
back or muscle pain
blurred vision
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.

Vancomycin Hydrochloride Injection

About your treatment
Your doctor has ordered vancomycin, an antibiotic, to help treat your infection. The drug will be added to an intravenous fluid that will drip through a needle or catheter placed in your vein for 60 or more minutes, two to four times a day.
Vancomycin eliminates bacteria that cause many kinds of infections, including pneumonia and skin, bone, blood, and heart valve infections. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and side effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments with your doctor and the laboratory. The length of treatment depends on how your infection and symptoms respond to the medication.
Other names
Vancocin®




What special precautions should I follow?
Before administering vancomycin,
tell your doctor and pharmacist if you are allergic to vancomycin or any other drugs.
tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antibiotics and vitamins.
tell your doctor if you have or have ever had kidney disease, vertigo, hearing loss, or ringing in the ears.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking vancomycin, call your doctor.



What side effects can this medication cause?
Vancomycin may cause side effects. Do not administer your vancomycin faster than directed by your health care provider. If you experience any of the following symptoms, call your health care provider as soon as possible:
lightheadedness or faintness
flushing
back and neck muscle pain
a rash on the face, neck, chest, or upper arms or legs
itching
difficulty breathing
Tell your health care provider if either of these symptoms is severe or does not go away:
upset stomach
vomiting
If you experience any of the following symptoms, call your health care provider immediately:
dizziness
vertigo
ringing in the ears
hearing loss
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?
Your health care provider probably will give you several days supply of vancomycin. If you are receiving vancomycin intravenously (in your vein), you probably will be told to store it in the refrigerator or freezer.
Take your next dose from the refrigerator 1 hour before using it; place it in a clean, dry area to allow it to warm to room temperature.
If you are told to store additional vancomycin in the freezer, always move a 24-hour supply to the refrigerator for the next day's use.
Do not refreeze medications.
If you are receiving vancomycin intramuscularly (in your muscle), your health care provider will tell you how to store it properly.
Store your medication only as directed. Make sure you understand what you need to store your medication properly.
Keep your supplies in a clean, dry place when you are not using them, and keep all medications and supplies out of reach of children.Your health care provider will tell you how to throw away used needles, syringes, tubing, and containers to avoid accidental injury.

Vancomycin

Why is this medication prescribed?
Vancomycin is used to treat colitis (inflammation of the intestine caused by certain bacteria) that may occur after antibiotic treatment. Vancomycin is in a class of medications called glycopeptide antibiotics. It works by killling bacteria in the intestines. Vancomycin will not kill bacteria or treat infections in any other part of the body when taken by mouth. Antibiotics will not work for colds, flu, or other viral infections.
How should this medication be used?
Vancomycin comes as a capsule to take by mouth. It is usually taken 3-4 times a day for 7-10 days. To help you remember to take vancomycin, take it 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 vancomycin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Take vancomycin until you finish the prescription, even if you feel better. If you stop taking vancomycin too soon or miss doses, your infection may not be completely cured and bacteria may become resistant to antibiotics.
Are there other uses for this medicine?
This medication should not be prescribed for other uses; ask your doctor or pharmacist for more information.
Other names
Vancocin®


What special precautions should I follow?
Before taking vancomycin,
tell your doctor and pharmacist if you are allergic to vancomycin, 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 amikacin (Amikin), amphotericin B (Fungizone), bacitracin, cisplatin (Platinol), colistin, gentamicin (Garamycin), kanamycin (Kantrex), polymyxin B, streptomycin, and tobramycin (Nebcin).
tell your doctor if you have or have ever had inflammatory bowel disease (swelling of the intestine that can cause painful cramps or diarrhea), including Crohn's disease and ulcerative colitis; hearing loss; or kidney disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking Vancomycin, call your doctor.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.



What side effects can this medication cause?
Vancomycin may cause side effects. Tell your doctor if this symptom is severe or does not go away:
upset stomach
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
sore throat, fever, chills, and other signs of infection
hives
skin rash
itching
difficulty breathing or swallowing
redness of the skin above the waist
pain and muscle tightness of the chest and back
unusual bleeding or bruising
fainting
dizziness
blurred vision
ringing in the ears
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. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the vancomycin, 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.