Ranacid may be available in the countries listed below.
Ranitidine hydrochloride (a derivative of Ranitidine) is reported as an ingredient of Ranacid in the following countries:
International Drug Name Search
Codeisan Jarabe may be available in the countries listed below.
Codeine phosphate hemihydrate (a derivative of Codeine) is reported as an ingredient of Codeisan Jarabe in the following countries:
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Ramiwin HCT may be available in the countries listed below.
Hydrochlorothiazide is reported as an ingredient of Ramiwin HCT in the following countries:
Ramipril is reported as an ingredient of Ramiwin HCT in the following countries:
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Zilip may be available in the countries listed below.
Penciclovir is reported as an ingredient of Zilip in the following countries:
International Drug Name Search
Generic Name: prenatal multivitamins (PRE nay tal VYE ta mins)
Brand Names: Advance Care Plus, Bright Beginnings, Cavan Folate, Cavan One, Cavan-Heme OB, Cenogen Ultra, CitraNatal Rx, Co Natal FA, Complete Natal DHA, Complete-RF, CompleteNate, Concept OB, Docosavit, Dualvit OB, Duet, Edge OB, Elite OB 400, Femecal OB, Folbecal, Folcaps Care One, Folivan-OB, Foltabs, Gesticare, Icar Prenatal, Icare Prenatal Rx, Inatal Advance, Infanate DHA, Kolnatal DHA, Lactocal-F, Marnatal-F, Maternity, Maxinate, Mission Prenatal, Multi-Nate 30, Multinatal Plus, Nata 29 Prenatal, Natachew, Natafort, Natelle, Neevo, Nestabs, Nexa Select with DHA, Novanatal, NovaStart, O-Cal Prenatal, OB Complete, OB Natal One, Ob-20, Obtrex DHA, OptiNate, Paire OB Plus DHA, PNV Select, PNV-Total, PR Natal 400, Pre-H-Cal, Precare, PreferaOB, Premesis Rx, PrenaCare, PrenaFirst, PrenaPlus, Prenatabs OBN, Prenatabs Rx, Prenatal 1 Plus 1, Prenatal Elite, Prenatal Multivitamins, Prenatal Plus, Prenatal S, Prenatal-U, Prenate Advanced Formula, Prenate DHA, Prenate Elite, Prenavite FC, PreNexa, PreQue 10, Previte Rx, PrimaCare, Pruet DHA, RE OB Plus DHA, Renate, RightStep, Rovin-NV, Se-Care, Se-Natal One, Se-Plete DHA, Se-Tan DHA, Select-OB, Seton ET, Strongstart, Stuart Prenatal with Beta Carotene, Tandem OB, Taron-BC, Tri Rx, TriAdvance, TriCare, Trimesis Rx, Trinate, Triveen-PRx RNF, UltimateCare Advance, Ultra-Natal, Vemavite PRX 2, VeNatal FA, Verotin-BY, Verotin-GR, Vinacal OR, Vinatal Forte, Vinate Advanced (New Formula), Vinate AZ, Vinate Care, Vinate Good Start, Vinate II (New Formula), Vinate III, Vinate One, Vitafol-OB, VitaNatal OB plus DHA, Vitaphil, Vitaphil Aide, Vitaphil Plus DHA, Vitaspire, Viva DHA, Vol-Nate, Vol-Plus, Vol-Tab Rx, Vynatal F.A., Zatean-CH, Zatean-PN
There are many brands and forms of prenatal vitamin available and not all brands are listed on this leaflet.
Prenatal vitamins are a combination of many different vitamins that are normally found in foods and other natural sources.
Prenatal vitamins are used to provide the additional vitamins needed during pregnancy. Minerals may also be contained in prenatal multivitamins.
Prenatal vitamins may also be used for purposes not listed in this medication guide.
There are many brands and forms of prenatal vitamin available and not all brands are listed on this leaflet.
Many multivitamin products also contain minerals such as calcium, iron, magnesium, potassium, and zinc. Minerals (especially taken in large doses) can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling. Read the label of any multivitamin product you take to make sure you are aware of what it contains.
Overdose symptoms may include stomach pain, vomiting, diarrhea, constipation, loss of appetite, hair loss, peeling skin, tingly feeling in or around your mouth, changes in menstrual periods, weight loss, severe headache, muscle or joint pain, severe back pain, blood in your urine, pale skin, and easy bruising or bleeding.
Before taking prenatal vitamins, tell your doctor about all of your medical conditions.
Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.
Many multivitamin products also contain minerals such as calcium, iron, magnesium, potassium, and zinc. Minerals (especially taken in large doses) can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling. Read the label of any multivitamin product you take to make sure you are aware of what it contains.
Swallow the regular tablet or capsule whole. Do not break, chew, crush, or open it.
The chewable tablet must be chewed or allowed to dissolve in your mouth before swallowing. You may also allow the chewable tablet to dissolve in drinking water, fruit juice, or infant formula (but not milk or other dairy products). Drink this mixture right away.
Use prenatal vitamins regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
Overdose symptoms may include stomach pain, vomiting, diarrhea, constipation, loss of appetite, hair loss, peeling skin, tingly feeling in or around your mouth, changes in menstrual periods, weight loss, severe headache, muscle or joint pain, severe back pain, blood in your urine, pale skin, and easy bruising or bleeding.
Avoid the regular use of salt substitutes in your diet if your multivitamin contains potassium. If you are on a low-salt diet, ask your doctor before taking a vitamin or mineral supplement.
When taken as directed, prenatal vitamins are not expected to cause serious side effects. Less serious side effects may include:
upset stomach;
headache; or
unusual or unpleasant taste in your mouth.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Vitamin and mineral supplements can interact with certain medications, or affect how medications work in your body. Before taking a prenatal vitamin, tell your doctor if you also use:
diuretics (water pills);
heart or blood pressure medications;
tretinoin (Vesanoid);
isotretinoin (Accutane, Amnesteen, Clavaris, Sotret);
trimethoprim and sulfamethoxazole (Cotrim, Bactrim, Gantanol, Gantrisin, Septra, TMP/SMX); or
an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), meloxicam (Mobic), and others.
This list is not complete and other drugs may interact with prenatal vitamins. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
Revion may be available in the countries listed below.
Ciprofloxacin hydrochloride (a derivative of Ciprofloxacin) is reported as an ingredient of Revion in the following countries:
International Drug Name Search
Trimezol may be available in the countries listed below.
Sulfamethoxazole is reported as an ingredient of Trimezol in the following countries:
Trimethoprim is reported as an ingredient of Trimezol in the following countries:
International Drug Name Search
Paclitaxel Delta may be available in the countries listed below.
Paclitaxel is reported as an ingredient of Paclitaxel Delta in the following countries:
International Drug Name Search
Lipur may be available in the countries listed below.
Gemfibrozil is reported as an ingredient of Lipur in the following countries:
International Drug Name Search
Dopamin Ebewe may be available in the countries listed below.
Dopamine hydrochloride (a derivative of Dopamine) is reported as an ingredient of Dopamin Ebewe in the following countries:
International Drug Name Search
Chemacin may be available in the countries listed below.
Amikacin is reported as an ingredient of Chemacin in the following countries:
International Drug Name Search
Dehydratin may be available in the countries listed below.
Hydrochlorothiazide is reported as an ingredient of Dehydratin in the following countries:
International Drug Name Search
Sylimarol may be available in the countries listed below.
Silibinin is reported as an ingredient of Sylimarol in the following countries:
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Generic Name: sotalol (Oral route)
SOE-ta-lol
To minimize the risk of induced arrhythmia, patients initiated or reinitiated on sotalol should be placed for a minimum of three days (on their maintenance dose) in a facility that can provide continuous cardiac resuscitation and ECG monitoring. Creatinine clearance should be calculated prior to dosing. Sotalol marketed under the brand name Betapace(R) is indicated for the treatment of documented life-threatening ventricular arrhythmias. Sotalol marketed under the brand name Betapace AF(R) is indicated for the maintenance of normal sinus rhythm (delay in time to recurrence of atrial flutter (AFIB/AFL)) in patients with symptomatic AFIB/AFL who are currently in sinus rhythm. Betapace(R) and Betapace AF(R) cannot be substituted for each other because of significant differences in labeling (eg, indications, patient package insert, dosing administration, and safety information) .
In the U.S.
Available Dosage Forms:
Therapeutic Class: Cardiovascular Agent
Pharmacologic Class: Beta-Adrenergic Blocker, Nonselective
Sotalol is used to control rapid heartbeats and abnormal heart rhythms .
This medicine is a beta-blocker. It works by affecting the response to nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and at a regular rhythm .
This medicine is available only with your doctor's prescription .
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of sotalol in the pediatric population. Safety and efficacy have not been established .
No information is available on the relationship of age to the effects of sotalol in geriatric patients .
| Pregnancy Category | Explanation | |
|---|---|---|
| All Trimesters | B | Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus. |
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
This section provides information on the proper use of a number of products that contain sotalol. It may not be specific to Betapace AF. Please read with care.
For the first three days, you will receive this medicine in a hospital where your heart rhythm can be monitored .
Do not interrupt or stop taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. Some conditions may become worse when the medicine is stopped suddenly, which can be dangerous .
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects .
Sotalol may cause heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort; dilated neck veins; extreme fatigue; irregular breathing; an irregular heartbeat; shortness of breath; swelling of the face, fingers, feet, or lower legs; weight gain; or wheezing .
This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests .
Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests .
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Get emergency help immediately if any of the following symptoms of overdose occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Betapace AF side effects (in more detail)
The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.
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Efikas-MR may be available in the countries listed below.
Gliclazide is reported as an ingredient of Efikas-MR in the following countries:
International Drug Name Search
Dioxopromethazine Haiderun Pharm may be available in the countries listed below.
Dioxopromethazine hydrochloride (a derivative of Dioxopromethazine) is reported as an ingredient of Dioxopromethazine Haiderun Pharm in the following countries:
International Drug Name Search
Meradexon may be available in the countries listed below.
Dexamethasone 21-(disodium phosphate) (a derivative of Dexamethasone) is reported as an ingredient of Meradexon in the following countries:
International Drug Name Search
Vigantoletten may be available in the countries listed below.
Colecalciferol is reported as an ingredient of Vigantoletten in the following countries:
International Drug Name Search
Neostigmina Bromuro L.CH. may be available in the countries listed below.
Neostigmine bromide (a derivative of Neostigmine) is reported as an ingredient of Neostigmina Bromuro L.CH. in the following countries:
International Drug Name Search
Diclox may be available in the countries listed below.
Diclofenac sodium salt (a derivative of Diclofenac) is reported as an ingredient of Diclox in the following countries:
International Drug Name Search
Ran Lich may be available in the countries listed below.
Ranitidine hydrochloride (a derivative of Ranitidine) is reported as an ingredient of Ran Lich in the following countries:
International Drug Name Search
Lypor may be available in the countries listed below.
In some countries, this medicine may only be approved for veterinary use.
Temefos is reported as an ingredient of Lypor in the following countries:
International Drug Name Search
In the US, Bisac-Evac (bisacodyl systemic) is a member of the drug class laxatives and is used to treat Bowel Preparation and Constipation.
US matches:
Bisacodyl is reported as an ingredient of Bisac-Evac in the following countries:
International Drug Name Search
Eparose may be available in the countries listed below.
Icosapent ethyl ester (a derivative of Icosapent) is reported as an ingredient of Eparose in the following countries:
International Drug Name Search
Brompéridol may be available in the countries listed below.
Brompéridol (DCF) is also known as Bromperidol (Rec.INN)
International Drug Name Search
Glossary
| DCF | Dénomination Commune Française |
| Rec.INN | Recommended International Nonproprietary Name (World Health Organization) |
Nitrendypina may be available in the countries listed below.
Nitrendipine is reported as an ingredient of Nitrendypina in the following countries:
International Drug Name Search
Ergotam-CT may be available in the countries listed below.
Dihydroergotamine mesilate (a derivative of Dihydroergotamine) is reported as an ingredient of Ergotam-CT in the following countries:
International Drug Name Search
Nifedipina L.P. Genven may be available in the countries listed below.
Nifedipine is reported as an ingredient of Nifedipina L.P. Genven in the following countries:
International Drug Name Search
Ponstil Mujer may be available in the countries listed below.
Ibuprofen is reported as an ingredient of Ponstil Mujer in the following countries:
International Drug Name Search
Enterasin may be available in the countries listed below.
Mesalazine is reported as an ingredient of Enterasin in the following countries:
International Drug Name Search
Sinex may be available in the countries listed below.
Oxymetazoline hydrochloride (a derivative of Oxymetazoline) is reported as an ingredient of Sinex in the following countries:
International Drug Name Search
D-Calcium may be available in the countries listed below.
Calcium Carbonate is reported as an ingredient of D-Calcium in the following countries:
Colecalciferol is reported as an ingredient of D-Calcium in the following countries:
International Drug Name Search
Chemiscrub may be available in the countries listed below.
Chlorhexidine digluconate (a derivative of Chlorhexidine) is reported as an ingredient of Chemiscrub in the following countries:
International Drug Name Search
Septilisin may be available in the countries listed below.
Cefalexin monohydrate (a derivative of Cefalexin) is reported as an ingredient of Septilisin in the following countries:
International Drug Name Search
Rec.INN
N06AA05
0000315-72-0
C23-H29-N3-O
363
Antidepressant, tricyclic
1-Piperazineethanol, 4-[3-(5H-dibenz[b,f]azepin-5-yl)propyl]-
International Drug Name Search
Glossary
| BAN | British Approved Name |
| BANM | British Approved Name (Modified) |
| DCF | Dénomination Commune Française |
| DCIT | Denominazione Comune Italiana |
| IS | Inofficial Synonym |
| OS | Official Synonym |
| Rec.INN | Recommended International Nonproprietary Name (World Health Organization) |
| USAN | United States Adopted Name |
Ciplatec may be available in the countries listed below.
Enalapril maleate (a derivative of Enalapril) is reported as an ingredient of Ciplatec in the following countries:
International Drug Name Search
Dolorstad may be available in the countries listed below.
Sumatriptan is reported as an ingredient of Dolorstad in the following countries:
Sumatriptan succinate (a derivative of Sumatriptan) is reported as an ingredient of Dolorstad in the following countries:
International Drug Name Search
Laxygal may be available in the countries listed below.
Sodium Picosulfate is reported as an ingredient of Laxygal in the following countries:
International Drug Name Search
Bacproin may be available in the countries listed below.
Ciprofloxacin hydrochloride (a derivative of Ciprofloxacin) is reported as an ingredient of Bacproin in the following countries:
International Drug Name Search
Levocaine may be available in the countries listed below.
Levobupivacaine hydrochloride (a derivative of Levobupivacaine) is reported as an ingredient of Levocaine in the following countries:
International Drug Name Search
Abricort may be available in the countries listed below.
Fluocinolone Acetonide is reported as an ingredient of Abricort in the following countries:
International Drug Name Search
Ceftriaxon-ratiopharm may be available in the countries listed below.
Ceftriaxone disodium salt (a derivative of Ceftriaxone) is reported as an ingredient of Ceftriaxon-ratiopharm in the following countries:
International Drug Name Search
Hipoartel Plus may be available in the countries listed below.
Enalapril maleate (a derivative of Enalapril) is reported as an ingredient of Hipoartel Plus in the following countries:
Hydrochlorothiazide is reported as an ingredient of Hipoartel Plus in the following countries:
International Drug Name Search
Hydrokortison may be available in the countries listed below.
Hydrocortisone is reported as an ingredient of Hydrokortison in the following countries:
International Drug Name Search
Nootropil may be available in the countries listed below.
UK matches:
Piracetam is reported as an ingredient of Nootropil in the following countries:
International Drug Name Search
Glossary
| SPC | Summary of Product Characteristics (UK) |
Ondansetron Vipharm may be available in the countries listed below.
Ondansetron is reported as an ingredient of Ondansetron Vipharm in the following countries:
International Drug Name Search
Zalban may be available in the countries listed below.
Buprenorphine hydrochloride (a derivative of Buprenorphine) is reported as an ingredient of Zalban in the following countries:
International Drug Name Search
Lanso may be available in the countries listed below.
Lansoprazole is reported as an ingredient of Lanso in the following countries:
International Drug Name Search
In the US, Plavix (clopidogrel systemic) is a member of the drug class platelet aggregation inhibitors and is used to treat Acute Coronary Syndrome, Heart Attack, Ischemic Stroke, Ischemic Stroke - Prophylaxis and Platelet Aggregation Inhibition.
US matches:
UK matches:
Clopidogrel is reported as an ingredient of Plavix in the following countries:
Clopidogrel hydrogen sulfate (a derivative of Clopidogrel) is reported as an ingredient of Plavix in the following countries:
International Drug Name Search
Glossary
| SPC | Summary of Product Characteristics (UK) |
Hespercorbin may be available in the countries listed below.
Glucosamine sulfate (a derivative of Glucosamine) is reported as an ingredient of Hespercorbin in the following countries:
International Drug Name Search
Generic Name: fentanyl (Transdermal route)
FEN-ta-nil
Fentanyl transdermal system is contraindicated in patients who are not opioid-tolerant, in the management of acute or postoperative pain (including use in outpatient surgeries), and in the management of mild or intermittent pain. Should not be used in children under 2 years of age. The concomitant use of fentanyl transdermal system with any CYP3A4 inhibitor may cause potentially fatal respiratory depression. Fentanyl transdermal systems are intended for transdermal use (on intact skin) only. Using damaged or cut fentanyl transdermal systems can lead to the rapid release of the contents of the fentanyl transdermal system and absorption of a potentially fatal dose of fentanyl to the patient and/or caregiver. Fentanyl transdermal system has an abuse liability similar to other opioid analgesics . Due to potential temperature-dependent increases in fentanyl release from the system, avoid exposing the application site and surrounding areas to direct heat sources (such as electric blankets, tanning lamps, hot baths and sunbathing). Development of fever or increased core body temperature due to strenuous exercise may also result in increase release of fentanyl .
In the U.S.
Available Dosage Forms:
Therapeutic Class: Analgesic
Chemical Class: Opioid
Fentanyl belongs to the group of medicines called narcotic analgesics. Narcotic analgesics are used to relieve pain. The transdermal system (skin patch) form of fentanyl is used to treat chronic pain (pain that continues for a long time).
Fentanyl acts on the central nervous system (CNS) to relieve pain. Some of its side effects are also caused by actions in the CNS.
When a narcotic medicine is used for a long time, it may become habit-forming, causing mental or physical dependence. However, people who have continuing pain should not let the fear of dependence keep them from using narcotics to relieve their pain. Mental dependence (addiction) is not likely to occur when narcotics are used for this purpose. Physical dependence may lead to withdrawal side effects if treatment is stopped suddenly. However, severe withdrawal side effects can usually be prevented by gradually reducing the dose over a period of time before treatment is stopped. completely.
This medicine is available only with your doctor's prescription.
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of transdermal fentanyl in children 2 years of age and older. However, pediatric patients must be opioid-tolerant before using transdermal fentanyl. Safety and efficacy have not been established in children less than 2 years of age.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of transdermal fentanyl in the elderly. However, elderly patients are more likely to have age-related lung problems, which may require an adjustment in the dose for patients receiving transdermal fentanyl.
| Pregnancy Category | Explanation | |
|---|---|---|
| All Trimesters | C | Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women. |
Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
This section provides information on the proper use of a number of products that contain fentanyl. It may not be specific to Duragesic. Please read with care.
Fentanyl skin patches are for use in opioid-tolerant patients only. If you are uncertain whether or not you are opioid-tolerant, check with your doctor before using this medicine.
Transdermal fentanyl comes with patient instructions. Read them carefully before using the product. If you do not receive any printed instructions with the medicine, or do not understand the instructions, check with your nurse or doctor.
To use the :
After a patch is applied, fentanyl passes into the skin a little at a time. A certain amount of the medicine must build up in the skin before it is absorbed into the body. Up to a full day (24 hours) may pass before the first dose begins to work. Your doctor may need to adjust the dose during the first few weeks before finding the amount that works best for you. Even if you feel that the medicine is not working, do not increase the amount of transdermal fentanyl that you apply. Instead, check first with your doctor.
You will probably need to take a faster-acting narcotic by mouth to relieve pain during the first few days of transdermal fentanyl treatment. You may continue to need another narcotic while your dose of fentanyl is being adjusted, and also to relieve any "breakthrough" pain that occurs later on. Be sure that you do not take more of the other narcotic, and do not take it more often, than directed. Taking other narcotics together with fentanyl can increase the chance of serious side effects.
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
If you miss a dose of this medicine, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.
Remove the new patch 3 days after applying it.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
To dispose of this medicine, first fold the patch in half, with the sticky side inside. If the patch has not been used, take it out of the pouch and remove the liner that covers the sticky side of the patch before folding it in half. Then flush it down the toilet right away. Do not flush the pouch or the protective liner down the toilet. Put them in a trash can.
Do not touch the sticky side of the patch or the gel. Fentanyl can be quickly absorbed through the eyes and mouth and can be extremely dangerous. If you do touch the sticky side of the patch or gel, let your nurse or doctor know right away and rinse the area with large amounts of water. Do not use soaps or other cleansers.
Check with your doctor at regular times while using fentanyl. Be sure to report any side effects.
After you have been using this medicine for awhile, "breakthrough" pain may occur more often than usual, and it may not be relieved by your regular dose of medicine. If this occurs, do not increase the amount of transdermal fentanyl or other narcotic that you are taking without first checking with your doctor.
This medicine will add to the effects of alcohol and other CNS depressants (medicines that can make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; other prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. You will probably be directed to take other pain relievers if you still have pain while using transdermal fentanyl. Check with your doctor before taking any of the other medicines listed above while you are using this medicine.
Fentanyl may cause some people to become drowsy, dizzy, or lightheaded, or to feel a false sense of well-being. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert and clearheaded. These effects usually go away after a few days of treatment, when your body gets used to the medicine. However, check with your doctor if drowsiness that is severe enough to interfere with your activities continues for more than a few days.
Dizziness, lightheadedness, or even fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem. Also, lying down for a while may relieve dizziness or lightheadedness.
Nausea or vomiting may occur, especially during the first several days of treatment. Lying down for a while may relieve these effects. However, if they are especially bothersome or if they continue for more than a few days, check with your doctor. You may be able to take another medicine to help prevent these problems.
Using narcotics for a long time may cause severe constipation. To prevent this, your doctor may tell you to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems.
Heat can cause the fentanyl in the patch to be absorbed into your body faster. This may increase the chance of serious side effects or an overdose. While you are using this medicine, do not use a heating pad, a sunlamp, or a heated water bed, and do not sunbathe, or take long baths or showers in hot water. Also, check with your doctor if you get a fever.
Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist-in-charge that you are using this medicine. Serious side effects can occur if your medical doctor or dentist gives you certain other medicines without knowing that you are using fentanyl.
You may bathe, shower, or swim while wearing a fentanyl skin patch. However, be careful to wash and dry the area around the patch gently. Rubbing may cause the patch to get loose or come off. If this does occur, throw away the patch and apply a new one in a different place. Make sure the area is completely dry before applying the new patch.
If you have been using this medicine regularly for several weeks or more, do not suddenly stop using it without first checking with your doctor. You may be directed to gradually reduce the amount you are using before stopping treatment completely, or to take another narcotic for a while, to lessen the chance of withdrawal side effects.
In young children or persons with decreased mental alertness, the patch should be put on the upper back to decrease the chance that the patch will be removed and placed in the mouth.
If the patch comes off and accidentally sticks to the skin of another person, they should take the patch off immediately and wash the exposed area with water. The exposed person should then seek medical attention.
Using too much transdermal fentanyl, or taking too much of another narcotic while using transdermal fentanyl, may cause an overdose. If this occurs, get emergency help right away. An overdose can cause severe breathing problems (breathing may even stop), unconsciousness, and death. Serious signs of an overdose include very slow breathing (fewer than 8 breaths a minute) and drowsiness that is so severe that you are not able to answer when spoken to or, if asleep, cannot be awakened. Other signs of an overdose may include cold, clammy skin; low blood pressure; pinpoint pupils of eyes; and slow heartbeat. It may be best to have a family member or a friend check on you several times a day when you start using a narcotic regularly, and whenever your dose is increased, so that he or she can get help for you if you cannot do so yourself.
Do not use transdermal fentanyl if you have taken a monoamine oxidase (MAO) inhibitor (isocarboxazid [Marplan], phenelzine [Nardil], selegiline [Eldepryl], or tranylcypromine [Parnate]) in the past 2 weeks. If you do, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, a sudden high temperature, an extremely high blood pressure, or severe convulsions.
Grapefruits and grapefruit juice may increase the effects of transdermal fentanyl by increasing the amount of this medicine in your body. You should not eat grapefruit or drink grapefruit juice while you are using this medicine.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Get emergency help immediately if any of the following symptoms of overdose occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Duragesic side effects (in more detail)
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