acetaminophen/ chlorpheniramine/ dextromethorphan/ phenylpropanolamine

Generic Name: acetaminophen/ chlorpheniramine/ dextromethorphan/ phenylpropanolamine (a seet a MIN oh fen/klor fen IR a meen/dex troe meth OR fan/fen ill proe pa NOLE a meen)

Brand Names: Comtrex Cold and Flu Maximum Strength, Comtrex Maximum Strength Cold Relief, Contac Severe Cold and Flu Maximum Stength

What is acetaminophen/ chlorpheniramine/ dextromethorphan/ phenylpropanolamine?

Acetaminophen is a pain reliever and a fever reducer. It is used to treat many conditions, such as headache, muscle aches, arthritis, backache, toothaches, colds, and fevers.

Chlorpheniramine is an antihistamine. It blocks the effects of the naturally occurring chemical histamine in the body. Chlorpheniramine prevents sneezing; itchy, watery eyes and nose; and other symptoms of allergies and hay fever.

Dextromethorphan is a cough suppressant. It suppresses an area in the brain that causes coughing.

Phenylpropanolamine is a decongestant. It constricts (shrinks) blood vessels (veins and arteries) allowing nasal passages to open up.

Acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine is used to treat nasal congestion, sinusitis (inflammation of the sinuses), runny nose, watery eyes, headache, body aches, and coughs associated with allergies, hay fever, and the common cold.

Phenylpropanolamine, an ingredient in this product, has been associated with an increased risk of hemorrhagic stroke (bleeding into the brain or into tissue surrounding the brain) in women. Men may also be at risk. Although the risk of hemorrhagic stroke is low, the U.S. Food and Drug Administration (FDA) recommends that consumers not use any products that contain phenylpropanolamine.

Acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about acetaminophen/ chlorpheniramine/ dextromethorphan/ phenylpropanolamine?

Phenylpropanolamine, an ingredient in this product, has been associated with an increased risk of hemorrhagic stroke (bleeding into the brain or into tissue surrounding the brain) in women. Men may also be at risk. Although the risk of hemorrhagic stroke is low, the U.S. Food and Drug Administration (FDA) recommends that consumers not use any products that contain phenylpropanolamine.

Use caution when driving, operating machinery, or performing other hazardous activities. Acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine. Alcohol may also cause damage to the liver when it is taken with acetaminophen.

Who should not take acetaminophen/ chlorpheniramine/ dextromethorphan/ phenylpropanolamine?

Do not take this medication without first talking to your doctor if you drink more than three alcoholic beverages per day or if you have had alcoholic liver disease. You may not be able to take acetaminophen.

Do not take this medication if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Before taking this medication, tell your doctor if you have

• kidney disease,


• liver disease,


• 
  

  diabetes,

  
  


• 
  

  glaucoma,

  
  


• 
  

  any type of heart disease or high blood pressure,

  
  


• 
  

  thyroid disease,

  
  


• 
  

  emphysema or chronic bronchitis, or

  
  


• 
  

  difficulty urinating or an enlarged prostate.

  
  

You may not be able to take acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

It is not known whether acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. This medication passes into breast milk and may harm a nursing infant. Do not take this medication without first talking to your doctor if you are breast-feeding a baby. Read the package label for directions or consult your doctor or pharmacist before treating a child with this medication. Children are more susceptible than adults to the effects of medicines and may have unusual reactions. If you are over 60 years of age, you may be more likely to experience side effects from acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine.

How should I take acetaminophen/ chlorpheniramine/ dextromethorphan/ phenylpropanolamine?

Take acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine exactly as directed. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water. Do not take more of this medication than is recommended. An overdose of this medication can cause serious harm. The maximum amount of acetaminophen for adults is 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day. Taking more acetaminophen could cause damage the liver. If you drink more than three alcoholic beverages per day, talk to your doctor before taking acetaminophen and never take more than 2 grams (2000 mg) per day.

Do not take acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine for longer than 7 days in a row. If your symptoms do not improve, if they get worse, or if you have a fever, see your doctor.

Store acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of an acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine overdose include a dry mouth, large pupils, flushing, sweating, nausea, vomiting, diarrhea, abdominal pain, seizures, confusion, an irregular heartbeat, hyperactivity, or hallucinations.

What should I avoid while taking acetaminophen/ chlorpheniramine/ dextromethorphan/ phenylpropanolamine?

Use caution when driving, operating machinery, or performing other hazardous activities. Acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine. Alcohol may also cause damage to the liver when it is taken with acetaminophen.

Acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, other antihistamines, pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine is taken with any of these medications.

Acetaminophen/ chlorpheniramine/ dextromethorphan/ phenylpropanolamine side effects

If you experience any of the following rare but serious side effects, stop taking acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine and seek emergency medical attention or notify your doctor immediately:

• 
  

  an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

  
  


• 
  

  liver damage (yellowing of the skin or eyes, nausea, abdominal pain or discomfort, unusual bleeding or bruising, or severe fatigue);

  
  


• 
  

  blood problems (easy or unusual bleeding or bruising); or

  
  


• 
  

  low blood sugar (fatigue, increased hunger or thirst, dizziness, or fainting).

  
  

Other, less serious side effects may be more likely to occur. Continue to take acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine and talk to your doctor or try another similar medication if you experience

• 
  

  dryness of the eyes, nose, and mouth;

  
  


• 
  

  drowsiness or dizziness;

  
  


• 
  

  blurred vision;

  
  


• 
  

  difficulty urinating; or

  
  


• 
  

  excitation in children.

  
  

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect acetaminophen/ chlorpheniramine/ dextromethorphan/ phenylpropanolamine?

Do not take acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Urine glucose tests may produce false results while you are taking acetaminophen. Talk to your doctor if you are diabetic and you notice changes in your glucose levels during treatment.

Do not take other over-the-counter cough, cold, allergy, diet, pain, or sleep medicines while taking acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine without first talking to your doctor or pharmacist. Other medications may also contain chlorpheniramine, phenylpropanolamine, acetaminophen, or other similar drugs, and you may accidentally take too much of these medicines.

Acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, other antihistamines, pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine is taken with any of these medications.

Drugs other than those listed here may also interact with acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

More acetaminophen/ chlorpheniramine/ dextromethorphan/ phenylpropanolamine resources

• Acetaminophen/ chlorpheniramine/ dextromethorphan/ phenylpropanolamine Drug Interactions
• Acetaminophen/ chlorpheniramine/ dextromethorphan/ phenylpropanolamine Support Group
• 0 Reviews · Be the first to review/rate this drug

Where can I get more information?

• Your pharmacist has additional information about acetaminophen/chlorpheniramine/ dextromethorphan/phenylpropanolamine written for health professionals that you may read.

What does my medication look like?

Acetaminophen/chlorpheniramine/dextromethorphan/phenylpropanolamine is available over the counter under the brand name Comtrex. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Atrovent Nasal

Generic Name: ipratropium nasal (IP ra TRO pee um)

Brand Names: Atrovent Nasal

What is Atrovent Nasal (ipratropium nasal)?

Ipratropium nasal is used to treat runny nose caused by seasonal allergies (hay fever). This medication will not treat stuffy nose, sneezing, or cough.

Ipratropium nasal may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Atrovent Nasal (ipratropium nasal)?

Before using this medication, tell your doctor if you have narrow-angle glaucoma, or an enlarged prostate or bladder obstruction. If you have any of these conditions, you may not be able to use ipratropium nasal or you may need a dosage adjustment or special tests during treatment.

Use this medication exactly as it was prescribed for you. Do not use it in larger doses or for longer than recommended by your doctor. Follow the directions on your prescription label.

What should I discuss with my healthcare provider before using Atrovent Nasal (ipratropium nasal)?

Before using this medication, tell your doctor if you have:

• 
  

  narrow-angle glaucoma; or

  
  


• 
  

  an enlarged prostate or a bladder obstruction.

  
  

If you have any of these conditions, you may need a dose adjustment or special tests to safely use ipratropium nasal.

FDA pregnancy category B: This medication is not expected to be harmful to an unborn baby. Do not use ipratropium nasal without telling your doctor if you are pregnant or plan to become pregnant during treatment. It is not known if ipratropium passes into breast milk or if it could harm a nursing baby. Do not use ipratropium nasal without telling your doctor if you are breast-feeding a baby. Ipratropium nasal should not be used by a child younger than 6 years of age.

How should I use Atrovent Nasal (ipratropium nasal)?

Use this medication exactly as it was prescribed for you. Do not use it in larger doses or for longer than recommended by your doctor. Follow the directions on your prescription label.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

When using the nasal spray for the first time, prime it by spraying 7 test sprays into the air, away from your face. Prime with 2 sprays if you have not used the medicine in 1 to 6 days. Prime with 7 sprays if you have not used it for a week or longer.

Store ipratropium nasal at room temperature away from moisture and heat. Keep the cap tightly closed when not in use. Do not allow the medicine to freeze.

What happens if I miss a dose?

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Ipratropium nasal is not expected to cause overdose symptoms.

What should I avoid while using Atrovent Nasal (ipratropium nasal)?

Do not use other nasal sprays, nasal gels, or nasal inhalers unless approved by your doctor.

Avoid getting ipratropium nasal in your eyes. If this happens, rinse with water.

Atrovent Nasal (ipratropium nasal) side effects

Stop using ipratropium nasal and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a fast, pounding heartbeat.

Less serious side effects may include:

• 
  

  headache;

  
  


• 
  

  dry nose;

  
  


• 
  

  nosebleeds; or

  
  


• 
  

  blurred vision.

  
  

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Atrovent Nasal (ipratropium nasal)?

Before using ipratropium nasal, tell your doctor if you are using any of the following medicines:

• 
  

  atropine (Donnatal, and others),

  
  


• 
  

  belladonna,

  
  


• 
  

  clidinium (Quarzan),

  
  


• 
  

  dicyclomine (Bentyl),

  
  


• 
  

  glycopyrrolate (Robinul),

  
  


• 
  

  hyoscyamine (Anaspaz, Cystospaz, Levsin, and others)

  
  


• 
  

  mepenzolate (Cantil),

  
  


• 
  

  methantheline (Provocholine),

  
  


• 
  

  methscopolamine (Pamine), and

  
  


• 
  

  propantheline (Pro-Banthine), or

  
  


• 
  

  scopolamine (Transderm-Scop).

  
  

This list is not complete and there may be other drugs that can interact with ipratropium nasal. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

More Atrovent Nasal resources

• Atrovent Nasal Side Effects (in more detail)
• Atrovent Nasal Use in Pregnancy & Breastfeeding
• Atrovent Nasal Drug Interactions
• Atrovent Nasal Support Group
• 1 Review for Atrovent Nasal - Add your own review/rating

Compare Atrovent Nasal with other medications

• Rhinorrhea

Where can I get more information?

• Your pharmacist can provide more information about ipratropium nasal.

See also: Atrovent Nasal side effects (in more detail)

Sentry AV Ornacycline

Dosage Form: FOR ANIMAL USE ONLY
Broad-spectrum, fruit flavored antibiotic for use in drinking water as an aid in the treatment of respiratory and intestinal bacterial infections of pet birds.

INDICATIONS & USAGE

Aids in the treatment of respiratory and intestinal bacterial infections of pet birds. 

• Treats most common bird respiratory ailments and intestinal bacterial infections   
  


• Special formulation for birds


• Citrus flavored, fast dissolving powder


• Safe to use with all species of birds

Obvious changes in a bird's appearance or behavior indicate the bird is sick.  Symptoms include not eating, ruffled feathers, labored breathing, sneezing, diarrhea.

INSTRUCTIONS

Ailing birds - For small birds (i.e. canary) use one packet per eight ounces of water.  For larger birds (i.e. mynah), use two packets per eight ounces of water.  Use as the bird's only drinking water for five days.  Make a fresh solution every day.  For best results, use distilled water.  If no water is consumed for 48-72 hours or bird's condition gets worse, consult your veterinarian.

Precautions

Read instructions before using.  This product is intended for exclusive use with pet birds and is not intended for use with poultry for human consumption.  Not for human consumption.

KEEP OUT OF REACH OF CHILDREN

How is Sentry AV Ornacycline Supplied

8 Powder Packets

Each Packet Contains:  0.021 oz. (0.6 g)


Contents:  Each powder packet contains 250 mg of tetracycline hydrochloride, natural orange and other fruit flavors.

PACKAGE LABEL PRINCIPAL DISPLAY PANEL

Distributed by:


Sergeant's Pet Care Products, Inc., Omaha NE 68130


Made in USA


www.sentrypetcare.com

Sentry AV Ornacycline  tetracycline hydrochloride  powder

Product Information Product Type OTC ANIMAL DRUG NDC Product Code (Source) 21091-811 Route of Administration ORAL DEA Schedule

Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength TETRACYCLINE HYDROCHLORIDE (TETRACYCLINE) TETRACYCLINE HYDROCHLORIDE 250 mg  in 0.6 g

Inactive Ingredients Ingredient Name Strength No Inactive Ingredients Found

Product Characteristics Color      Score      Shape Size Flavor ORANGE (Natural Orange) , FRUIT Imprint Code Contains

Packaging # NDC Package Description Multilevel Packaging 1 21091-811-08 8 PACKET In 1 CARTON contains a PACKET 1 0.6 g In 1 PACKET This package is contained within the CARTON (21091-811-08)

Marketing Information
Marketing Category	Application Number or Monograph Citation	Marketing Start Date	Marketing End Date
unapproved drug other		10/15/2008

Labeler - Sergeant's Pet Care Products, Inc. (876995171)

Revised: 03/2010Sergeant's Pet Care Products, Inc.

Epipen Jr

Generic Name: epinephrine (Injection route)

ep-i-NEF-rin

Commonly used brand name(s)

In the U.S.

• Adrenaclick


• Adrenalin


• Adrenalin Chloride


• Epipen


• Epipen Jr


• Twinject

Available Dosage Forms:

• Injectable


• Solution

Therapeutic Class: Anaphylaxis Agent

Pharmacologic Class: Adrenergic

Chemical Class: Alkylarylamine

Uses For Epipen Jr

Epinephrine injection is used for emergency treatment of severe allergic reactions (including anaphylaxis) to insect bites or stings, medicines, foods, or other substances. It is also used to treat anaphylaxis caused by unknown substances or triggered by exercise.

This medicine is available only with your doctor's prescription.

Before Using Epipen Jr

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:

Allergies

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.

Pediatric

No information is available on the relationship of age to the effects of epinephrine injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

No information is available on the relationship of age to the effects of epinephrine injection in geriatric patients. However, elderly patients are more likely to have age-related heart disease which may require caution in patients receiving epinephrine injection.

Pregnancy

	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.

Breast Feeding

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.

Interactions with Medicines

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.

• Dihydroergotamine


• Isocarboxazid


• Linezolid


• Phenelzine


• Tranylcypromine

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.

• Amitriptyline


• Amoxapine


• Bucindolol


• Carteolol


• Carvedilol


• Clomipramine


• Desipramine


• Dilevalol


• Dothiepin


• Doxepin


• Entacapone


• Halothane


• Imipramine


• Levobunolol


• Lofepramine


• Metipranolol


• Nadolol


• Nortriptyline


• Opipramol


• Oxprenolol


• Penbutolol


• Pindolol


• Propranolol


• Protriptyline


• Rasagiline


• Sotalol


• Tertatolol


• Timolol


• Trimipramine

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.

• Labetalol

Interactions with Food/Tobacco/Alcohol

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.

Other Medical Problems

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:

• Angina pectoris (severe chest pain) or


• Blood vessel problems or


• Diabetes mellitus (sugar diabetes) or


• Heart attack or


• Heart disease or


• Heart rhythm problems or


• Hypertension (high blood pressure) or


• Overactive thyroid or


• Parkinson's disease—Use with caution. May make these conditions worse.

Proper Use of epinephrine

This section provides information on the proper use of a number of products that contain epinephrine. It may not be specific to Epipen Jr. Please read with care.

Use this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

If you are using this medicine at home, make sure you or any of your family members understand exactly how to give them. Also, tell your doctor if you or your caregiver has severe arthritis of the hands. If you have any questions about this, check with your doctor.

This medicine is injected under your skin or into the muscle of your outer thigh only. Do not inject this medicine into a vein or into the muscle of your buttocks. To do so, may increase the chance of having serious side effects.

This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions.

This medicine comes in an auto-injector syringe and needle kit that contains the correct dose of medicine your doctor has prescribed.

You may need to use more than one injection if your allergic reaction does not get better after the first shot.

Carry this medicine with you at all times for emergency use in case you have a severe allergic reaction.

Dosing

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.

• For injection dosage form:
  
  • For allergic reactions:
    
    • Adults and children weighing above 30 kilograms (66 pounds)—0.3 milligram (mg) injected under the skin or into the muscle of your thigh.
    
    
    • Adults and children weighing 15 to 30 kilograms (33 to 66 pounds)—0.15 milligram (mg) injected under the skin or into the muscle of your thigh.
    
    
  
  

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Store the injection kits at room temperature, away from heat, moisture, and direct light. Do not store the medicine in the refrigerator or freezer. Keep the auto-injector in its case or tube.

Check the injection kits regularly to make sure that the liquid has not changed its color. Do not use this medicine if the liquid has changed its color, or if there are solids in the liquid.

Do not reuse the remaining portion of the medicine that is left in the auto-injector. Throw away the auto-injector after you have used it.

Precautions While Using Epipen Jr

If your symptoms do not improve within a few days or if they become worse, check with your doctor.

Anaphylaxis is a life-threatening reaction and requires immediate medical attention. Check with your doctor right away, or go to an emergency room as soon as possible, even if you feel better after using this medicine.

This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.

Do not inject this medicine into your hands or feet. There is already less blood flow to the hands and feet, and epinephrine could make that worse and cause damage to these tissues. If you accidentally inject epinephrine into your hands or feet, check with your doctor or go to the hospital emergency room right away.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Epipen Jr Side Effects

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:

Incidence not known

• Abnormal or decreased touch sensation


• arm, back or jaw pain


• bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site


• blurred vision


• chest pain or discomfort


• chest tightness or heaviness


• dizziness


• fainting fast, irregular, pounding, or racing heartbeat or pulse


• fear or nervousness


• headache


• nausea or vomiting


• paleness of the skin


• pounding in the ears


• restlessness


• shakiness in the legs, arms, hands, or feet


• shortness of breath


• slow or fast heartbeat


• stroke


• sweating


• trembling or shaking of the hands or feet


• troubled breathing


• unusual tiredness or weakness


• wheezing

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

• Agitation


• coldness of the skin


• coma


• confusion


• decreased urine output


• depression


• drowsiness


• hostility


• irritability


• lethargy


• lightheadedness, dizziness, or fainting


• muscle twitching


• pounding, slow heartbeat


• rapid weight gain


• rapid, deep breathing


• seizures


• stomach cramps


• stupor


• swelling of the face, ankles, or hands

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: Epipen Jr 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.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Epipen Jr resources

• Epipen Jr Side Effects (in more detail)
• Epipen Jr Use in Pregnancy & Breastfeeding
• Epipen Jr Drug Interactions
• Epipen Jr Support Group
• 0 Reviews for Epipen Jr - Add your own review/rating

Compare Epipen Jr with other medications

• Adams-Stokes Syndrome
• Allergic Reactions
• Asthma, acute
• Asystole
• AV Heart Block
• COPD, Acute
• Electromechanical Dissociation
• Shock

fennel

Generic Name: fennel (FEH nell)

Brand Names:

What is fennel?

The use of fennel in cultural and traditional settings may differ from concepts accepted by current Western medicine. When considering the use of herbal supplements, consultation with a primary health care professional is advisable. Additionally, consultation with a practitioner trained in the uses of herbal/health supplements may be beneficial, and coordination of treatment among all health care providers involved may be advantageous.

Fennel is also known as Foeniculum vulgare, large fennel, sweet fennel, wild fennel, fenkel, bitter fennel, carosella, Florence fennel, finocchio, and garden fennel.

Fennel has been used to treat cough, bronchitis, stomach discomfort, flatulence, and sinus congestion. Fennel has also been used to stimulate lactation.

Fennel has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of fennel may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. There have been instances where herbal/health supplements have been sold which were contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Fennel may also have uses other than those listed in this product guide.

What is the most important information I should know about fennel?

Do not take fennel without first talking to your doctor if you have epilepsy or another seizure disorder or if you take any medication to treat seizures. Fennel may increase the risk of seizures.

Fennel has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of fennel may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. There have been instances where herbal/health supplements have been sold which were contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

What should I discuss with my health care provider before using fennel?

Do not take fennel without first talking to your doctor if you have epilepsy or another seizure disorder or if you take any medication to treat seizures. Fennel may increase the risk of seizures.

Before taking fennel, talk to your doctor, pharmacist, or health care professional if you have allergies (especially to celery or other plants), have any medical condition, or if you take other medicines or other herbal/health supplements. Fennel may not be recommended in some situations.

Do not take fennel without first talking to your doctor if you are pregnant or could become pregnant. It is not known whether fennel will harm an unborn baby. Fennel has been used to stimulate lactation. Talk to your doctor or other health care professional before taking fennel if you are breast-feeding a baby. There is no information available regarding the use of fennel by children. Do not give any herbal/health supplement to a child without first talking to the child's doctor.

How should I take fennel?

The use of fennel in cultural and traditional settings may differ from concepts accepted by current Western medicine. When considering the use of herbal supplements, consultation with a primary health care professional is advisable. Additionally, consultation with a practitioner trained in the uses of herbal/health supplements may be beneficial, and coordination of treatment among all health care providers involved may be advantageous.

If you choose to take fennel, use it as directed on the package or as directed by your doctor, pharmacist, or other health care provider.

Standardized extracts, tinctures, and solid formulations of herbal/health supplements may provide a more reliable dose of the product.

Take the pill forms of fennel with a full glass of water.

To ensure the correct dose, measure the liquid forms of fennel with a dropper or a dose-measuring spoon or cup.

Some forms of fennel can be brewed to form a tea for drinking.

Do not use different formulations (e.g., tablets, liquids, teas, and others) of fennel at the same time, unless specifically directed to do so by a health care professional. Using different formulations together increases the risk of an overdose of fennel.

Store fennel as directed on the package. In general, fennel should be protected from light.

What happens if I miss a dose?

Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra fennel to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking fennel?

Follow your healthcare provider's instructions about any restrictions on food, beverages, or activity.

Fennel side effects

Although rare, allergic reactions to fennel may occur. Stop taking fennel and seek emergency medical attention if you experience symptoms of a serious allergic reaction including difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives.

Rash and increased sensitivity of the skin to sunlight has also been reported with the use of fennel.

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.

What other drugs will affect fennel?

Do not take fennel without first talking to your doctor if you take a medication to treat seizures such as

• 
  

  phenytoin (Dilantin);

  
  


• 
  

  carbamazepine (Tegretol, Carbatrol, Epitol) or oxcarbazepine (Trileptal);

  
  


• 
  

  gabapentin (Neurontin);

  
  


• 
  

  valproic acid (Depakene) or divalproex sodium (Depakote);

  
  


• 
  

  felbamate (Felbatol);

  
  


• 
  

  tiagabine (Gabitril);

  
  


• 
  

  levetiracetam (Keppra);

  
  


• 
  

  topiramate (Topamax);

  
  


• 
  

  lamotrigine (Lamictal);

  
  


• 
  

  zonisamide (Zonegran);

  
  


• 
  

  ethosuximide (Zarontin);

  
  


• 
  

  and others.

  
  

Fennel may increase the risk of seizures.

Interactions between fennel and other prescription or over-the-counter medicines or herbal/health supplements may also occur. Talk to your doctor, pharmacist, or health care professional before taking fennel if you are taking any other medicines or supplements.

More fennel resources

• Fennel Support Group
• 0 Reviews for Fennel - Add your own review/rating

• Fennel Natural MedFacts for Professionals (Wolters Kluwer)


• Fennel Natural MedFacts for Consumers (Wolters Kluwer)

Compare fennel with other medications

• Bronchitis
• Cough
• Gas
• Herbal Supplementation
• Nasal Congestion
• Sinus Symptoms

Where can I get more information?

• Consult with a licensed healthcare professional before using any herbal/health supplement. Whether you are treated by a medical doctor or a practitioner trained in the use of natural medicines/supplements, make sure all your healthcare providers know about all of your medical conditions and treatments.

Isopto Hyoscine Drops

Pronunciation: skoe-PAHL-ah-meen
Generic Name: Scopolamine
Brand Name: Isopto Hyoscine

Isopto Hyoscine Drops are used for:

Temporarily dilating the pupil and paralyzing certain parts of the eye for diagnostic procedures. It may be used before or after surgery to treat certain types of eye inflammation. It may also be used for other conditions as determined by your doctor.

Isopto Hyoscine Drops are an anticholinergic agent. It works by stopping the eye muscles from reacting to certain substances found in the body, which causes the pupil to dilate (widen).

Do NOT use Isopto Hyoscine Drops if:

• you are allergic to any ingredient in Isopto Hyoscine Drops


• you have glaucoma or you are at risk for glaucoma

Contact your doctor or health care provider right away if any of these apply to you.

Before using Isopto Hyoscine Drops:

Some medical conditions may interact with Isopto Hyoscine Drops. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have nerve problems or difficulty urinating

Some MEDICINES MAY INTERACT with Isopto Hyoscine Drops. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Phenothiazines (eg, thioridazine) because their effectiveness may be decreased by Isopto Hyoscine Drops

This may not be a complete list of all interactions that may occur. Ask your health care provider if Isopto Hyoscine Drops may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Isopto Hyoscine Drops:

Use Isopto Hyoscine Drops as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Isopto Hyoscine Drops are only for the eye. Do not get it in your nose or mouth.


• To use Isopto Hyoscine Drops in the eye, first, wash your hands. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eyelid for 1 to 2 minutes. Do not blink. Remove excess medicine around your eye with a clean, dry tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them.


• To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including the eye. Keep the container tightly closed.


• If you miss a dose of Isopto Hyoscine Drops, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Isopto Hyoscine Drops.

Important safety information:

• Isopto Hyoscine Drops may cause drowsiness or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Isopto Hyoscine Drops with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Isopto Hyoscine Drops may make your eyes more sensitive to sunlight. It may help to wear sunglasses.


• If you have an appointment for an eye examination and your doctor has told you that you will receive Isopto Hyoscine Drops, be sure to make arrangements to have someone drive you home in case your vision is blurry.


• Isopto Hyoscine Drops should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Isopto Hyoscine Drops while you are pregnant. It is not known if Isopto Hyoscine Drops are found in breast milk. Do not breast-feed while using Isopto Hyoscine Drops.

Possible side effects of Isopto Hyoscine Drops:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Blurred vision; burning, stinging, or redness; drowsiness; dry mouth; inflammation.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); difficulty urinating; eye pain; eye pus; fever; flushing or dryness of the skin; irregular or rapid heartbeat; visual hallucinations.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Isopto Hyoscine side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Isopto Hyoscine Drops may be harmful if swallowed.

Proper storage of Isopto Hyoscine Drops:

Store Isopto Hyoscine Drops at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Isopto Hyoscine Drops out of the reach of children and away from pets.

General information:

• If you have any questions about Isopto Hyoscine Drops, please talk with your doctor, pharmacist, or other health care provider.


• Isopto Hyoscine Drops are to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Isopto Hyoscine Drops. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Isopto Hyoscine resources

• Isopto Hyoscine Side Effects (in more detail)
• Isopto Hyoscine Use in Pregnancy & Breastfeeding
• Isopto Hyoscine Drug Interactions
• Isopto Hyoscine Support Group
• 0 Reviews for Isopto Hyoscine - Add your own review/rating

Compare Isopto Hyoscine with other medications

• Pupillary Dilation

Keralac Emulsion

Pronunciation: you-REE-ah
Generic Name: Urea
Brand Name: Examples include Carmol 40 and Keralac

Keralac Emulsion is used for:

Promoting the healing of certain skin conditions (eg, hyperkeratotic conditions). It may also be used for certain other skin conditions (eg, corns; calluses; rough, dry skin) as determined by your doctor.

Keralac Emulsion is a debriding agent. It works by helping the breakdown of dead skin and pus, which helps to loosen and shed hard and scaly skin.

Do NOT use Keralac Emulsion if:

• you are allergic to any ingredient in Keralac Emulsion

Contact your doctor or health care provider right away if any of these apply to you.

Before using Keralac Emulsion:

Some medical conditions may interact with Keralac Emulsion. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances

Some MEDICINES MAY INTERACT with Keralac Emulsion. Because little, if any, of Keralac Emulsion is absorbed into the blood, the risk of it interacting with another medicine is low.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Keralac Emulsion may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Keralac Emulsion:

Use Keralac Emulsion as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Keralac Emulsion is for external use only.


• Shake well before using.


• Wash hands before and after using Keralac Emulsion unless your hands are part of the treated area.


• Apply a small amount of Keralac Emulsion to the affected area as directed by your doctor. If you get Keralac Emulsion on any skin that is not part of the treated area, wash it off thoroughly.


• You may cover the affected area unless directed otherwise by your doctor.


• If you miss a dose of Keralac Emulsion, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Keralac Emulsion.

Important safety information:

• Keralac Emulsion is for external use only. Do not get it in the eyes, nose, or mouth. If you get Keralac Emulsion in the eyes, rinse them immediately with a generous amount of cool water.


• Do not apply to broken or severely irritated skin.


• Do not exceed the recommended dose, use Keralac Emulsion for longer than prescribed, or use Keralac Emulsion for other skin conditions without checking with your doctor.


• PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Keralac Emulsion, discuss with your doctor the benefits and risks of using Keralac Emulsion during pregnancy. It is unknown if Keralac Emulsion is excreted in breast milk. If you are or will be breast-feeding while you are using Keralac Emulsion, check with your doctor or pharmacist to discuss the risks to your baby.

Possible side effects of Keralac Emulsion:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Mild skin irritation; temporary burning, stinging, or itching.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); redness; severe or persistent irritation.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Keralac side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Keralac Emulsion:

Store Keralac Emulsion at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Protect from freezing. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Keralac Emulsion out of the reach of children and away from pets.

General information:

• If you have any questions about Keralac Emulsion, please talk with your doctor, pharmacist, or other health care provider.


• Keralac Emulsion is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Keralac Emulsion. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Keralac resources

• Keralac Side Effects (in more detail)
• Keralac Use in Pregnancy & Breastfeeding
• Keralac Support Group
• 0 Reviews for Keralac - Add your own review/rating

Compare Keralac with other medications

• Dermatological Disorders
• Dry Skin
• Pityriasis rubra pilaris

Vivelle 37.5 Mcg

Generic Name: estradiol (Transdermal route)

es-tra-DYE-ol

Transdermal route(Emulsion)

Estrogens increase the risk of endometrial cancer; monitor for abnormal vaginal bleeding. Estrogens with or without progestins should not be used for the prevention of cardiovascular disease or dementia. Increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50 to 79 years of age) have been reported. An increased risk of developing probable dementia in postmenopausal women 65 years of age or older has also been reported. Risks should be assumed to be similar for other doses, combinations, and dosage forms of estrogens and progestins. Estrogens, with or without progestins, should be prescribed at the lowest effective doses and for the shortest duration possible .

Transdermal route(Patch, Extended Release)

Estrogens increase the risk of endometrial cancer; monitor for abnormal vaginal bleeding. Estrogens with or without progestins should not be used for the prevention of cardiovascular disease or dementia. Increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50 to 79 years of age) have been reported. An increased risk of developing probable dementia in postmenopausal women 65 years of age or older has also been reported. Risks should be assumed to be similar for other doses, combinations, and dosage forms of estrogens and progestins. Estrogens, with or without progestins, should be prescribed at the lowest effective doses and for the shortest duration possible.

Transdermal route(Gel/Jelly)

Estrogens increase the risk of endometrial cancer; monitor for abnormal vaginal bleeding. Estrogens with or without progestins should not be used for the prevention of cardiovascular disease. Increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50 to 79 years of age) have been reported. Risks should be assumed to be similar for other doses, combinations, and dosage forms of estrogens and progestins. Estrogens, with or without progestins, should be prescribed at the lowest effective doses and for the shortest duration possible .

Transdermal route(Spray)

Unopposed estrogens increase the risk of endometrial cancer. Adding a progestin will reduce the risk of endometrial hyperplasia, which may be a precursor to endometrial cancer. Diagnostic measures should be undertaken to rule out malignancy in postmenopausal women with undiagnosed persistent or recurring abnormal genital bleeding. Estrogens with or without progestins should not be used for the prevention of cardiovascular disease or dementia. Increased risks of stroke and deep vein thrombosis in postmenopausal women (50 to 79 years of age) using estrogen alone have been reported. Increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50 to 79 years of age) using estrogens combined with progestins have been reported. An increased risk of developing probable dementia in postmenopausal women 65 years of age or older has also been reported in women receiving estrogen alone or estrogen combined with progestins. Risks should be assumed to be similar for other doses, combinations, and dosage forms of estrogens and progestins. Estrogens, with or without progestins, should be prescribed at the lowest effective doses and for the shortest duration possible. Breast budding and breast masses in prepubertal females and gynecomastia and breast masses in prepubertal males have been reported following unintentional secondary exposure. Patients should strictly adhere to recommended instructions for use .

Commonly used brand name(s)

In the U.S.

• Alora


• Climara


• Divigel


• Elestrin


• Esclim


• Estraderm


• Estrasorb


• EstroGel


• Evamist


• Menostar


• Vivelle


• Vivelle-Dot

In Canada

• Estradot Transdermal


• Estradot Transdermal Therapeutic System


• Estradot Transdermal Therapeutic System


• Oesclim


• Rhoxal-Estradiol Derm 50


• Rhoxal-Estradiol Derm 75


• Roxal-Estradiol Derm 100


• Vivelle 100 Mcg


• Vivelle 25 Mcg


• Vivelle 37.5 Mcg

Available Dosage Forms:

• Patch, Extended Release


• Gel/Jelly


• Spray


• Emulsion

Therapeutic Class: Endocrine-Metabolic Agent

Pharmacologic Class: Estrogen

Uses For Vivelle 37.5 Mcg

Estradiol transdermal spray is used to treat moderate to severe hot flashes and other symptoms of menopause or low amounts of estrogen.

Estradiol is an estrogen hormone. The hormone from the spray is absorbed through your skin into your body. It works by preventing symptoms, such as feelings of warmth in the face, neck, and chest, or sudden strong feelings of heat and sweating ("hot flashes") in women during menopause.

This medicine is available only with your doctor's prescription.

Before Using Vivelle 37.5 Mcg

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:

Allergies

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.

Pediatric

Use of estradiol transdermal spray is not indicated in the pediatric population. Safety and efficacy have not been established.

Geriatric

Although appropriate studies on the relationship of age to the effects of estradiol transdermal spray have not been performed in the geriatric population, no geriatric-specific problems have been documented to date. However, elderly patients are more likely to have breast cancer, stroke, or dementia, which may require caution in patients receiving estradiol transdermal spray.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	X	Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit.

Breast Feeding

Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

Interactions with Medicines

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 receiving 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 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.

• Isotretinoin


• Theophylline


• Tizanidine


• Tranexamic Acid

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.

• Alprazolam


• Amoxicillin


• Ampicillin


• Amprenavir


• Aprepitant


• Atazanavir


• Bacampicillin


• Betamethasone


• Bexarotene


• Bosentan


• Carbamazepine


• Clarithromycin


• Colesevelam


• Cyclosporine


• Darunavir


• Delavirdine


• Doxycycline


• Efavirenz


• Etravirine


• Fosamprenavir


• Fosaprepitant


• Fosphenytoin


• Ginseng


• Griseofulvin


• Itraconazole


• Ketoconazole


• Lamotrigine


• Levothyroxine


• Licorice


• Minocycline


• Modafinil


• Mycophenolate Mofetil


• Mycophenolic Acid


• Nelfinavir


• Nevirapine


• Oxcarbazepine


• Oxytetracycline


• Phenobarbital


• Phenytoin


• Pioglitazone


• Prednisolone


• Primidone


• Rifabutin


• Rifampin


• Rifapentine


• Ritonavir


• Rosuvastatin


• Rufinamide


• Selegiline


• St John's Wort


• Tacrine


• Telaprevir


• Tetracycline


• Tipranavir


• Topiramate


• Troglitazone


• Troleandomycin


• Voriconazole


• Warfarin

Interactions with Food/Tobacco/Alcohol

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 may cause an increased risk of certain side effects 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.

• Caffeine


• Grapefruit Juice

Other Medical Problems

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:

• Abnormal or unusual vaginal bleeding or


• Blood clots (e.g., deep vein thrombosis, pulmonary embolism), active or history of or


• Breast cancer, known or suspected, or a history of or


• Heart attack, active or recent (within the past 12 months) or


• Liver disease or


• Stroke, active or recent (within the past 12 months) or


• Surgery with a long period of inactivity or


• Tumors (estrogen-dependent), known or suspected—Should not be used in patients with these conditions.

• Asthma or


• Cancer, history of or


• Diabetes or


• Edema (fluid retention or body swelling) or


• Endometriosis or


• Epilepsy (seizures) or


• Gallbladder disease or


• Heart disease or


• Hypercalcemia (high calcium in the blood) or


• Hypertension (high blood pressure) or


• Hypertriglyceridemia (high triglycerides or fats in the blood) or


• Hypocalcemia (low calcium in the blood), severe or


• Hypothyroidism (an underactive thyroid) or


• Jaundice during pregnancy or from using hormonal therapy in the past or


• Liver tumors or


• Migraine headache or


• Porphyria (an enzyme problem) or


• Systemic lupus erythematosus (SLE)—Use with caution. May make these conditions worse.

Proper Use of estradiol

This section provides information on the proper use of a number of products that contain estradiol. It may not be specific to Vivelle 37.5 Mcg. Please read with care.

It is very important that you use this medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may cause unwanted side effects.

This medicine is for use on the skin only. Do not get it in your eyes, nose, mouth, breast, or vagina. Do not use it on skin areas that have cuts, scrapes, or burns. If it does get on these areas, rinse it off right away with water.

This medicine comes with a patient information insert. Read and follow the instructions in the insert carefully. Ask your doctor if you have any questions.

Wash your hands with soap and water before and after using this medicine.

To use the spray:

• The spray form of this medicine comes in an applicator that delivers a measured amount of estradiol to the skin with each spray. When using a new spray applicator, prime the pump by holding the spray upright and pumping 3 times. Priming is only necessary the first time you use a new spray applicator; do not prime again.


• Apply the medicine to clean, dry, and unbroken skin on the inside of the forearm between the elbow and the wrist. Do not apply the medicine directly to your breasts or in or around the vagina.


• Allow the medicine to dry for at least 2 minutes before dressing, and at least 1 hour before washing.


• If your doctor tells you to increase your dose, move the applicator to an area of the skin next to your previous application site, before applying the second or third spray.


• Do not rub Evamist® spray into your skin.


• Do not allow your child to touch the area of the arm where the medicine was sprayed. If you cannot avoid being close with your child, wear clothes with long sleeves to cover the application site.


• If your child comes in direct contact with the arm where the medicine was sprayed, wash your child's skin right away with soap and water.


• Do not allow your pets to lick or touch the arm where the medicine was sprayed.


• Always place the protective cover back on the applicator of the spray.


• Do not use the applicator for more than 75 sprays.


• Apply sunscreen at least 1 hour before applying Evamist®.

The spray contains alcohol and is flammable. Avoid using it near an open flame or while smoking.

Dosing

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.

• For transdermal dosage form (spray):
  
  • For hot flashes and other symptoms caused by menopause:
    
    • Adults—At first, one spray once a day, usually in the morning. Your doctor may adjust your dose as needed.
    
    
    • Children—Use is not recommended.
    
    
  
  

Missed Dose

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.

Do not use Evamist® spray if it has been more than 12 hours since you missed your last dose.

Storage

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.

Precautions While Using Vivelle 37.5 Mcg

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and does not cause unwanted effects. Pelvic exam, breast exam, and mammogram (breast x-ray) may be needed to check for unwanted effects, unless your doctor tells you otherwise.

It is unlikely that a postmenopausal woman may become pregnant. But, you should know that using this medicine while you are pregnant could harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away.

Using large doses of this medicine over a long period of time may increase your risk of heart attack, stroke, blood clots, dementia, breast cancer, or uterine cancer. Talk with your doctor about this risk. If you still have your uterus (womb), ask your doctor if you should also use a progestin medicine.

Your risk of heart disease or stroke from this medicine is higher if you smoke. Your risk is also increased if you have diabetes or high cholesterol, or if you are overweight. Talk with your doctor about ways to stop smoking. Keep your diabetes under control. Ask your doctor about diet and exercise to control your weight and blood cholesterol level.

Tell the medical doctor or dentist in charge that you are using this medicine before any kind of surgery (including dental surgery) or emergency treatment. Your doctor will decide whether you should continue using this medicine.

This medicine may also increase your risk of certain types of cancer. Talk to your doctor if you have concerns about this risk.

Using this medicine alone may increase your risk of getting cancer of the uterus (womb). Check with your doctor right away if you have unusual vaginal bleeding while you are using this medicine.

Stop using this medicine and check with your doctor immediately if severe headache or sudden loss of vision or any other change in vision occurs while you are using this medicine. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

Check with your child's doctor right away if your child starts to have the following symptoms: nipple or breast swelling or tenderness in females, or enlargement of the breasts in males. Your child may have been exposed to this medicine.

Do not allow your pets to lick or touch the arm where this medicine was applied. Small pets may be sensitive to this medicine. Call your pet's veterinarian if your pet starts to have the following symptoms: nipple or breast enlargement, swelling of the vulva, or any signs of illness.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.

Do not take other medicines or drink grapefruit juice unless you discuss it with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (e.g., St. John's wort) or vitamin supplements.

Vivelle 37.5 Mcg Side Effects

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:

Incidence not known

• Abdominal or stomach cramps or pain


• acid or sour stomach


• anxiety


• backache


• belching


• blistering, peeling, or loosening of the skin


• bloating


• blurred vision


• breast tenderness, enlargement, pain, or discharge


• change in vaginal discharge


• changes in skin color


• changes in vision


• chest pain or discomfort


• chills


• clay-colored stools


• clear or bloody discharge from the nipple


• confusion


• constipation


• convulsions


• cough


• darkening of the urine


• diarrhea


• difficulty with breathing


• difficulty with swallowing


• dimpling of the breast skin


• dizziness or lightheadedness


• double vision


• fainting


• fast heartbeat


• fever


• fluid-filled skin blisters


• full or bloated feeling or pressure in the stomach


• headache


• headache, severe and throbbing


• heartburn


• hives


• indigestion


• inverted nipple


• irregular heartbeats


• itching of the skin


• itching of the vagina or genital area


• joint or muscle pain


• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs


• light-colored stools


• loss of appetite


• loss of bladder control


• lump in the breast or under the arm


• migraine headache


• mood or mental changes


• muscle cramps in the hands, arms, feet, legs, or face


• muscle spasm or jerking of all extremities


• nausea


• noisy breathing


• numbness and tingling around the mouth, fingertips, or feet


• pain during sexual intercourse


• pain in the ankles or knees


• pain or discomfort in the arms, jaw, back, or neck


• pain or feeling of pressure in the pelvis


• pain, redness, or swelling in the arm, foot, or leg


• painful, red lumps under the skin, mostly on the legs


• pains in the stomach, side, or abdomen, possibly radiating to the back


• persistent crusting or scaling of the nipple


• poor insight and judgment


• problems with memory or speech


• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue


• rash


• red, irritated eyes


• redness or swelling of the breast


• sensitivity to the sun


• shortness of breath


• skin thinness


• sore on the skin of the breast that does not heal


• sore throat


• sores, ulcers, or white spots in the mouth or on the lips


• stomach discomfort, upset, or pain


• sudden loss of consciousness


• sudden shortness of breath or troubled breathing


• sweating


• swelling


• swelling of the abdominal or stomach area


• thick, white vaginal discharge with no odor or with a mild odor


• tightness in the chest


• tremor


• trouble recognizing objects


• trouble thinking and planning


• trouble walking


• unexpected or excess milk flow from the breasts


• unpleasant breath odor


• unusual tiredness or weakness


• unusually heavy or unexpected menstrual bleeding


• vaginal bleeding or spotting


• vomiting


• vomiting of blood


• wheezing


• yellow eyes or skin

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:

Less common

• Back pain


• difficulty with moving


• muscle aches


• muscle pain or stiffness


• stuffy or runny nose

Incidence not known

• Decreased interest in sexual intercourse


• heavy bleeding


• hives or welts


• inability to have or keep an erection


• increased hair growth, especially on the face


• increased in sexual ability, desire, drive, or performance


• increased interest in sexual intercourse


• irritability


• leg cramps


• loss in sexual ability, desire, drive, or performance


• loss of scalp hair


• mental depression


• mood disturbances


• patchy brown or dark brown discoloration of the skin


• redness of the skin


• twitching, uncontrolled movements of the tongue, lips, face, arms, or legs


• weight changes

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.

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.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

Vynatal F.A.

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

What are Vynatal F.A. (prenatal multivitamins)?

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.

What is the most important information I should know about prenatal vitamins?

There are many brands and forms of prenatal vitamin available and not all brands are listed on this leaflet.

Never take more than the recommended dose of a multivitamin. Avoid taking any other multivitamin product within 2 hours before or after you take your prenatal vitamins. Taking similar vitamin products together at the same time can result in a vitamin overdose or serious side effects.

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.

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of vitamins A, D, E, or K can cause serious or life-threatening side effects and can also harm your unborn baby. Certain minerals contained in a prenatal multivitamin may also cause serious overdose symptoms or harm to the baby if you take too much.

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.

Do not take this medication with milk, other dairy products, calcium supplements, or antacids that contain calcium. Calcium may make it harder for your body to absorb certain ingredients of the multivitamin.

What should I discuss with my healthcare provider before taking prenatal vitamins?

Many vitamins can cause serious or life-threatening side effects if taken in large doses. Do not take more of this medication than directed on the label or prescribed by your doctor.

Before taking prenatal vitamins, tell your doctor about all of your medical conditions.

You may need to continue taking prenatal vitamins if you breast-feed your baby. Ask your doctor about taking this medication while breast-feeding.

How should I take prenatal vitamins?

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.

Never take more than the recommended dose of prenatal vitamins.

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.

Take your prenatal vitamin with a full glass of water.

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.

Store at room temperature away from moisture and heat. Keep prenatal vitamins in their original container. Storing vitamins in a glass container can ruin the medication.

What happens if I miss a dose?

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.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of vitamins A, D, E, or K can cause serious or life-threatening side effects and can also harm your unborn baby. Certain minerals contained in a prenatal multivitamin may also cause serious overdose symptoms or harm to the baby if you take too much.

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.

What should I avoid while taking prenatal vitamins?

Avoid taking any other multivitamin product within 2 hours before or after you take your prenatal vitamins. Taking similar vitamin products together at the same time can result in a vitamin overdose or serious side effects.

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.

Do not take this medication with milk, other dairy products, calcium supplements, or antacids that contain calcium. Calcium may make it harder for your body to absorb certain ingredients of the prenatal vitamin.

Prenatal vitamins side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

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.

What other drugs will affect prenatal vitamins?

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.

More Vynatal F.A. resources

• Vynatal F.A. Use in Pregnancy & Breastfeeding
• Vynatal F.A. Drug Interactions
• Vynatal F.A. Support Group
• 0 Reviews for Vynatal F.A. - Add your own review/rating

• Cal-Nate MedFacts Consumer Leaflet (Wolters Kluwer)


• CareNatal DHA MedFacts Consumer Leaflet (Wolters Kluwer)


• CitraNatal 90 DHA MedFacts Consumer Leaflet (Wolters Kluwer)


• CitraNatal Assure Prescribing Information (FDA)


• CitraNatal Harmony Prescribing Information (FDA)


• Concept DHA Prescribing Information (FDA)


• Docosavit Prescribing Information (FDA)


• Duet DHA with Ferrazone MedFacts Consumer Leaflet (Wolters Kluwer)


• Folbecal MedFacts Consumer Leaflet (Wolters Kluwer)


• Folcal DHA Prescribing Information (FDA)


• Folcaps Care One Prescribing Information (FDA)


• Gesticare DHA Prescribing Information (FDA)


• Gesticare DHA MedFacts Consumer Leaflet (Wolters Kluwer)


• Inatal Advance Prescribing Information (FDA)


• Inatal Ultra Prescribing Information (FDA)


• Multi-Nate DHA Prescribing Information (FDA)


• Multi-Nate DHA Extra Prescribing Information (FDA)


• MultiNatal Plus MedFacts Consumer Leaflet (Wolters Kluwer)


• Natelle One Prescribing Information (FDA)


• Neevo Caplets MedFacts Consumer Leaflet (Wolters Kluwer)


• Neevo DHA MedFacts Consumer Leaflet (Wolters Kluwer)


• OB Complete 400 MedFacts Consumer Leaflet (Wolters Kluwer)


• Paire OB Plus DHA Prescribing Information (FDA)


• PreNexa MedFacts Consumer Leaflet (Wolters Kluwer)


• PreNexa Prescribing Information (FDA)


• PreferaOB Prescribing Information (FDA)


• Prenatal Plus Prescribing Information (FDA)


• Prenatal Plus Iron Prescribing Information (FDA)


• Prenate Elite Prescribing Information (FDA)


• Prenate Elite MedFacts Consumer Leaflet (Wolters Kluwer)


• Prenate Elite tablets


• Prenate Essential Prescribing Information (FDA)


• PrimaCare Advantage MedFacts Consumer Leaflet (Wolters Kluwer)


• PrimaCare ONE capsules


• PrimaCare One MedFacts Consumer Leaflet (Wolters Kluwer)


• Renate DHA Prescribing Information (FDA)


• Se-Natal 19 Chewable Tablets MedFacts Consumer Leaflet (Wolters Kluwer)


• Se-Natal 19 Prescribing Information (FDA)


• Tandem DHA Prescribing Information (FDA)


• Tandem OB Prescribing Information (FDA)


• TriAdvance Prescribing Information (FDA)


• Triveen-One MedFacts Consumer Leaflet (Wolters Kluwer)


• Triveen-PRx RNF Prescribing Information (FDA)


• UltimateCare ONE NF Prescribing Information (FDA)


• Ultra NatalCare MedFacts Consumer Leaflet (Wolters Kluwer)


• Vinate AZ Prescribing Information (FDA)


• Vitafol-One MedFacts Consumer Leaflet (Wolters Kluwer)


• Zatean-CH Prescribing Information (FDA)

Compare Vynatal F.A. with other medications

• Vitamin/Mineral Supplementation during Pregnancy/Lactation

Where can I get more information?

• Your pharmacist can provide more information about prenatal vitamins.