guarana

Generic Name: guarana (GWAR ah na)

Brand Names:

What is guarana?

The use of guarana 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.

Guarana is also known as Paullinia cupana, paullinia, Brazilian cocoa, guarana bread, guarana paste or gum, and zoom. Guarana is also present in some soft drinks imported from South America in a manner similar to American soft-drinks fortified with caffeine.

Guarana contains very high concentrations of caffeine and has been used as a stimulant and appetite suppressant.

Guarana has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of guarana 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.

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

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

Guarana, or its active constituent caffeine, should not be taken when formulated with ephedrine in diet aids or performance-enhancing supplements. Potentially fatal irregular heartbeats have been reported to occur.

Guarana has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of guarana 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 taking guarana?

Guarana, or its active constituent caffeine, should not be taken when formulated with ephedrine in diet aids or performance-enhancing supplements. Potentially fatal irregular heartbeats have been reported to occur.

Talk to your doctor or health care provider before taking guarana if you have

• 
  

  heart problems or high blood pressure,

  
  


• 
  

  kidney disease,

  
  


• 
  

  an overactive thyroid (hyperthyroidism), or

  
  


• 
  

  an anxiety or nervous disorder.

  
  

Guarana contains a large amount of caffeine which may be problematic if used by people with any of the conditions listed above. You may not be able to use guarana, or your doctor or health care provider may recommend a lower dose or special monitoring.

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

Do not take guarana without first talking to your doctor if you are pregnant or could become pregnant. Guarana contains a large amount of caffeine. Do not take guarana without first talking to your doctor if you are breast-feeding a baby. Guarana contains a large amount of caffeine, which may cause restlessness, sleep disorders, and other effects in breast-feeding infants. There is no information available regarding the use of guarana by children. Guarana contains a large amount of caffeine, which may cause anemia and other problems in children. Do not give any herbal/health supplement to a child without first talking to the child's doctor.

How should I take guarana?

The use of guarana 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 guarana, use it as directed on the package or as directed by your doctor, pharmacist, or other health care provider.

Standardized formulations of herbal/health supplements may provide a more reliable dose of the product.

Guarana is usually taken as a powder, mixed with water or another beverage.

Store guarana as directed on the package. In general, guarana should be protected from light and moisture.

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 guarana 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.

Symptoms of a guarana overdose are not well known but might include painful urination, restlessness, tremor, vomiting, and abdominal spasms.

What should I avoid while taking guarana?

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

Guarana side effects

Although rare, serious side effects from guarana have been reported. Stop taking guarana and seek emergency medical attention if you experience

• 
  

  a serious allergic reaction including difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives; or

  
  


• 
  

  irregular heartbeats or chest pain.

  
  

Other less serious side effects may also reported with the use of guarana. Talk to your doctor or health care provider if you experience

• 
  

  heartburn;

  
  


• 
  

  upset stomach;

  
  


• 
  

  loss of appetite;

  
  


• 
  

  constipation or diarrhea;

  
  


• 
  

  nervousness, irritability, or anxiety;

  
  


• 
  

  sleeplessness;

  
  


• 
  

  irregular heartbeats; or

  
  


• 
  

  headache.

  
  

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 guarana?

Guarana, or its active constituent caffeine, should not be taken when formulated with ephedrine in diet aids or performance-enhancing supplements. Potentially fatal irregular heartbeats have been reported to occur.

Interactions between guarana and other prescription or over-the-counter medicines or herbal/health supplements have not been reported. Talk to your doctor, pharmacist, or health care professional before taking guarana if you are taking any other medicines or supplements.

More guarana resources

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

• Guarana Natural MedFacts for Professionals (Wolters Kluwer)


• Guarana Natural MedFacts for Consumers (Wolters Kluwer)


• Guarana MedFacts Consumer Leaflet (Wolters Kluwer)

Compare guarana with other medications

• Herbal Supplementation
• Obesity
• Weight Loss

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.

See also: guarana side effects (in more detail)

Salvax

salicylic acid

Dosage Form: topical foam
Salvax

Hydrating Topical Foam

(salicylic acid in a water and lipid based foam, 6%)


Rx Only

Salvax Description

Salvax is applied topically and used in the removal of excessive keratin in hyperkeratotic skin disorders. Each gram of Salvax contains salicylic acid 6% as the active ingredient, and the following inactive ingredients: dimethicone, ethylparaben, glycerin, methylcellulose, methylparaben, phenoxyethanol, polyoxyl 40 stearate, polysorbate 20, polysorbate 80, povidone, propylene glycol, propylparaben, purified water, sodium citrate, sodium hydroxide, stearic acid, and trolamine and in propellants butane and propane.

CHEMICAL STRUCTURE

Salicylic acid is the 2-hydroxy derivative of benzoic acid having the following chemical structure:

Salvax-img-01

Salvax - Clinical Pharmacology

Salicylic acid has been shown to produce desquamation of the horny layer of skin while not affecting qualitative or quantitative changes in structure of the viable epidermis. The mechanism of action has been attributed to dissolution of intercellular cement substance. In a study of the percutaneous absorption of salicylic acidfrom Salvax infour patients with extensive active psoriasis, Taylor and Halprin showed that peak serum salicylate levels never exceeded 5 mg/100 ml even though more than 60% of the applied salicylic acid was absorbed. Systemic toxic reactions are usually associated with much higher serum levels(30 to 40mg/100ml). Peak serum levels occurred within 5 hours of the topical application under occlusion. The sites were occluded for 10 hours over the entire body surface below the neck. Since salicylates are distributed in the extracellular space, patients with a contracted extracellular space due to dehydration or diuretics have higher salicylate levels than those with a normal extracellular space. (See PRECAUTIONS).

The major metabolites identified in the urine after topical administration are salicyluric acid (52%), salicylate glucuronides (42%), and free salicylic acid (6%). The urinary metabolites after percutaneous absorption differ from those after oral salicylate administration; those derived from percutaneous absorption contain more glucuronides and less salicyluric and salicylic acid.  Almost 95% of a single dose of salicylate is excreted within 24 hours of its entrance into the extracellular space.

Fifty to eighty percent of salicylate is protein bound to albumin. Salicylates compete with the binding of several drugs and can modify the action of these drugs. By similar competitive mechanisms other drugs can influence the serum levels of salicylate. (See PRECAUTIONS).

PHARMACOKINETICS

The mechanism of action of topically applied salicylic acid has been attributed to the dissolution of intercellular cement substance.

Indications and Usage for Salvax

For Dermatologic Use: Salvax is a topical aid in the removal of excessive keratin in hyperkeratotic skin disorders, including verrucae and the various ichthyoses, keratosis palmaris and plantaris, keratosis pilaris, pityriasis rubra pilaris, and psoriasis.

For Podiatric Use: Salvax is a topical aid in the removal of excessive keratin on dorsal and plantar hyperkeratotic lesions.

Contraindications

Salvax should not be used in any patient known to be sensitive to salicylic acid or any other listed ingredients. Salvax should not be used in children under 2 years of age.

Warnings

Salvax is for external use only. It is not for ophthalmic, oral, anal or intravaginal use. Contact with eyes, lips, broken or inflamed skin, and all mucous membranes should be avoided. Salvax should not be used by persons who have a known hypersensitivity to salicylic acid or any of the other listed ingredients.

Prolonged use over large areas, especially in children and those patients with significant renal or hepatic impairment could result in salicylism. Concomitant use of other drugs which may contribute to elevated serum salicylate levels should be avoided where the potential for toxicity is present.  In children under 12 years of age and those patients with renal or hepatic impairment, the area to be treated should be limited and the patient monitored closely for signs of salicylate toxicity: nausea, vomiting, dizziness, loss of hearing, tinnitus, lethargy, hyperpnoea, diarrhea, psychic disturbances. In the event of salicylic acid toxicity, the use of Salvax should be discontinued.  Fluids should be administered to promote urinary excretion. Treatment with sodium bicarbonate (oral or intravenous) should be instituted as appropriate.

Considering the potential risk of developing Reye’s syndrome, salicylate products should not be administered to children or teenagers with varicella or influenza, unless directed by a physician.

Precautions

Salvax should be used only as directed by a physician and should not be used to treat any condition other than that for which it is prescribed. Salvax should not be used on any skin area where inflammation or exudation is present as increased absorption may occur. If redness or irritation occurs, discontinue use and consult with prescribing physician.

Drug Interactions

I. Due to the competition of salicylate with other drugs forbinding to serum albumin the following drug interactions may occur:

Drug	Description of Interaction
Tolbutamide; Sulfonylureas	Hypoglycemia potentiated
Methotrexate	Decreases tubular reabsorption; clinical toxicity from methotrexate can result
Oral Anticoagulants	Increased Bleeding

II. Drugs changing salicylate levels by altering renal tubular reabsorption:

Drug	Description of Interaction
Corticosteroids	Decreases plasma salicylate level; tapering doses of steroids may promote salicylism
Ammonium Sulfate	Increases plasma salicylate level

III. Drugs with complicated interactions with salicylates:

Drug	Description of Interaction
Heparin	Salicylate decreases platelet adhesiveness and interferes with hemostasis in heparin­-treated patients
Pyrazinamide	Inhibits pyrazinamide-­induced hyperuricemia
Uricosuric Agents	Effect of probenecid, sulfinpyrazone and phenylbutazone inhibited

The following alterations of laboratory tests have been reported during salicylate therapy:

 

Laboratory Tests	Effects of Salicylates
Thyroid Function	Decreased PBI; increased T3 uptake
Urinary Sugar	False negative with glucose oxidase; false positive with Clinitest with high­dose salicylate  therapy (2­-5 g qd)
5 Hydroxyindole AceticAcid	False negative with fluorometric test
Acetone, Ketone Bodies	False positive FeCl3 inGerhardt reaction; red color persists with boiling
17-­OH Corticosteroids	False reduced values with >4.8 g qd salicylate
Vanilmandelic Acid	False reduced values
Uric Acid	May increase or decrease depending on dose
Prothrombin	Decreased levels; slightly increased prothrombin time

Pregnancy (Category C)

Salicylic acid has been shown to be teratogenic in rats and monkeys. It is difficult to extrapolate from oral doses of acetylsalicylic acid used in these studies to topical administration as the oral dose to monkeys may represent 4 times the maximum daily human dose of salicylic acid (as supplied in one tube, 40 g of Salvax) when applied topically over a large body surface. There are no adequate and well ­controlled studies in pregnant women. Salvax should be used during pregnancy only if the potential benefit justifies the risk to the fetus.

Nursing Mothers

It is not known whether topically applied salicylic acid is excreted in human milk. Due to the fact that many drugs are excreted in human milk, caution should be exercised by physicians when administering Salvax to nursing mothers and nursing mothers should certainly not apply Salvax to the chest area or any other part of the body with which the nursing child’s mouth is likely to come in contact.

Because of the potential for serious adverse reactions in nursing infants from the mother’s use of Salvax, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Carcinogenesis, Mutagenesis, Impariment of Fertility

No data are available concerning potential carcinogenic or reproductive effects of Salvax.  It has been shown to lack mutagenic potential in the Ames Salmonella test.

KEEP THIS AND ALL OTHER MEDICATIONS OUT OF THE REACH OF CHILDREN.

Adverse Reactions

Transient stinging, burning, itching or irritation is possible. Peeling of the skin may increase as the salicylic acid works to loosen excess keratin. If excessive burning, stinging or peeling occurs, discontinue use and consult your physician.

DOSAGE - See WARNINGS

Salvax Dosage and Administration

Unless otherwise directed by a prescribing physician, Salvax should be applied to affected area twice a day. Salvax should be rubbed into the skin until it is completely absorbed.

Salvax should be shaken vigorously before each application and inverted to administer.

Salvax-img-02

How is Salvax Supplied

Salvax is supplied in a 70 gram or 2.5 ounce aerosolized canister bearing the NDC Number 23710-­006­-70, a 200 gram or 7.1 ounce aerosolized canister bearing the NDC Number 23710­-006­-02, a 22 gram or 0.79 ounce aerosolized canister bearing the NDC Number 23710-006-20, and a 10 gram or 0.36 ounce aerosolized canister bearing the NDC Number 23710­-006­-01. The 10 gram canister is a physician­ dispensed sample product.

Store at controlled room temperature 15° - 25°C (59° - 77°F).

Contains flammable materials. Contents under pressure. Do not puncture and/or incinerate the containers. Do not expose to temperatures over 120°F (48°C) even when empty.

U.S. PATENT PENDING FOR Salvax.

Salvax is manufactured for Quinnova Pharmaceuticals, Inc., Newtown, PA 18940, (877) 660-6263, www.QUINNOVA.com

Prescribing Information as of April 2009.

SALVX014    4/09

Salvax-img-03

Salvax  salicylic acid  aerosol, foam

Product Information Product Type HUMAN PRESCRIPTION DRUG NDC Product Code (Source) 23710-006 Route of Administration TOPICAL DEA Schedule

Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength SALICYLIC ACID (SALICYLIC ACID) SALICYLIC ACID 3.88 g  in 70 g

Inactive Ingredients Ingredient Name Strength WATER   PROPYLENE GLYCOL   DIMETHICONE   CARBOXYMETHYLCELLULOSE   POLYOXYL 40 STEARATE   POLYSORBATE 20   POLYSORBATE 80   POVIDONE K30   SODIUM CITRATE   SODIUM HYDROXIDE   STEARIC ACID   TROLAMINE   GLYCERIN   ETHYLPARABEN   PROPYLPARABEN   PHENOXYETHANOL   METHYLPARABEN   BUTANE

Product Characteristics Color      Score      Shape Size Flavor Imprint Code Contains

Packaging # NDC Package Description Multilevel Packaging 1 23710-006-01 10 g In 1 CANISTER None 2 23710-006-02 200 g In 1 CANISTER None 3 23710-006-20 22 g In 1 CANISTER None 4 23710-006-70 70 g In 1 CANISTER None

Marketing Information
Marketing Category	Application Number or Monograph Citation	Marketing Start Date	Marketing End Date
UNAPPROVED DRUG OTHER		01/01/2009

Labeler - Quinnova Pharmaceuticals, Inc. (607183766)

Revised: 06/2010Quinnova Pharmaceuticals, Inc.

More Salvax resources

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

• Salvax Topical Advanced Consumer (Micromedex) - Includes Dosage Information


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• Acne
• Dermatological Disorders

Prialt solution for infusion

Prialt 100 micrograms/ml solution for infusion

Ziconotide

Read all of this leaflet carefully before you start using this medicine.

• Keep this leaflet. You may need to read it again.


• If you have any further questions, please ask your doctor.


• This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.


• If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor.

In this leaflet

• 1. What Prialt is and what it is used for


• 2. Before you use Prialt


• 3. How to use Prialt


• 4. Possible side effects


• 5. How to store Prialt


• 6. Further information

What Prialt Is And What It Is Used For

Prialt belongs to a group of medicines, called analgesics or ‘painkillers’. Prialt is used for the treatment of long-term pain when your existing treatment is not effective or causes severe side effects.

Before You Use Prialt

Do not use Prialt

• If you are allergic (hypersensitive) to ziconotide or any of the other ingredients of Prialt.


• If you are receiving an anticancer medicine into the space around your spinal cord.

Take special care with Prialt

• The effects of long-term treatment of Prialt are uncertain at this time and the possibility of toxic effects on the spinal cord have not yet been ruled out. In case of a need for long term treatment, monitoring may be necessary (as decided by your doctor).


• If you are receiving Prialt via a pump worn outside your body, it is important you check once daily for any signs of infection at the point where the tube enters your body.


• If you observe any signs of infection around the tube, such as skin redness, swelling, pain or discharge, you must tell your doctor immediately and seek treatment for the infection.


• If you develop any tenderness in the area around the tube without signs of infection, you should seek advice from your doctor as soon as possible as tenderness may be an early sign of infection.


• If you are receiving Prialt via a pump worn outside your body and any part of the infusion tubing becomes disconnected, you must contact your doctor immediately.


• If you have any of the following symptoms: high temperature, headache, stiff neck, tiredness, confusion, feeling sick, vomiting or occasional fits, these may be signs of meningitis. You must tell your doctor immediately if you experience any of the above symptoms.


• If you notice any adverse change in your thinking, mood or memory, please tell your doctor.


• If you are receiving chemotherapy please tell your doctor.


• You may have an increased level of an enzyme called creatine kinase in your blood and although this does not usually cause any symptoms or problems, your doctor is likely to monitor its level. In addition, you may also occasionally experience muscular problems. If such is the case, you should immediately notify your doctor, as he/she may decide to halt your Prialt treatment.


• Severe allergic reactions have not been seen in clinical studies so far, however it is not yet possible to say for certain that a severe allergic reaction will not happen when you are given Prialt. You should tell your doctor immediately if you experience any of the following symptoms after receiving your treatment; sudden wheeziness, difficulty in breathing, pain in the chest, swelling of eyelids, face or lips, rash or itching (especially affecting the whole body).


• In patients that suffer from severe long term pain, there is a higher likelihood of suicide and attempted suicide than in the general population. Prialt may also cause or worsen depression in people that are already susceptible.


• You may experience drowsiness or may not be fully aware of your surroundings whilst receiving treatment. If this happens, you should immediately notify your doctor, as he/she may decide to halt your Prialt treatment.


• Not recommended for use in children and adolescents.

Taking other medicines

Please tell your doctor if you are taking or have recently taken any other medicines (for example, baclofen, clonidine, bupivacaine or propofol), including medicines obtained without a prescription.

You may feel drowsy if you are given Prialt with certain other medicines used to treat pain.

Pregnancy and breast-feeding

If you are pregnant, think you may be pregnant, or are breast-feeding ask your doctor for advice before taking any medicine.

Prialt should not be used during pregnancy or breast-feeding unless clearly necessary.

Driving and using machines

The use of Prialt has been reported to cause confusion and drowsiness. Ask your doctor for advice before you drive or operate machinery.

How To Use Prialt

Your treatment with Prialt will be managed by a doctor who has experience of giving medicines into the space around the spinal cord, and in the use of internal and external infusion pumps.

Prialt is given as a very slow continuous injection into the space surrounding the spinal cord. The medicine will be administered continuously from a pump either implanted into your abdominal wall or placed externally in a belt pouch. Your doctor will discuss with you the kind of pump that will be most suitable for you and when you need to have your pump refilled.

The recommended starting dose is no more than 2.4 micrograms per day. Your doctor will adjust the dose of Prialt according to the severity of your pain in dose increments of ≤ 2.4 micrograms/day. The maximum dose is 21.6 micrograms/day. At the start of your treatment your doctor may increase your dose every 1 to 2 days or more. If needed, the dose may be decreased or injection stopped if the side effects are too great.

If you feel that you are still in too much pain while taking Prialt, or that the side effects are too great, talk to your doctor.

Before giving you Prialt, your doctor might decide to slowly stop giving you opiates (other types of medicinal product which are used to treat pain) into your spinal cord and instead replace with alternative pain medicinal products.

If you use more Prialt than you should

If you receive more Prialt than your doctor intended, you may feel unwell with signs such as confusion, problems with speech, word finding difficulties, excessive shaking, light-headedness, excessive sleepiness, feeling or being sick. If this happens, consult your doctor or hospital
immediately.

Possible Side Effects

Like all medicines, Prialt can cause side effects, although not everybody gets them.

The frequency of possible side effects listed below is defined using the following convention:

Very common (affects more than 1 user in 10)

Common (affects 1 to 10 users in 100)

Uncommon (affects 1 to 10 users in 1,000)

Very common:

Confusion, dizziness, blurred vision, headache, rapid back-and-forth movement of the eyes, loss or impairment of memory (forgetfulness), difficulty walking, vomiting, nausea, general weakness and drowsiness.

Common:

Decreased appetite, anxiety or worsened anxiety, hallucinations, inability to fall or stay asleep, agitation, disorientation, depression or worsened depression, nervousness, mood swings, mental status changes (thinking abnormal, confusion), paranoia, irritability, worsened confusion, difficulty with learning, memory or thinking, reflexes absent or impaired, problems expressing or understanding words, slurred speech, difficulty with speech or loss of ability to speak, sluggishness, balance or coordination impaired, burning sensation, increased pain sensitivity, reduced level of consciousness (unresponsive or almost unconscious), sedation, difficulty in concentrating, problems with the sense of smell, odd or no sense of taste, shaking, pins and needles, double vision, visual disturbance, intolerance to light, tinnitus (ringing in the ears), dizziness or spinning sensation, lightheadedness or dizziness when standing, low blood pressure, shortness of breath, dry mouth, abdominal pain, worsened nausea, diarrhoea, constipation, sweating, itching, muscle weakness, muscle spasms, muscle cramp, muscle or joint pain, difficult or painful urination, difficulty starting or controlling urination, feeling jittery, falling, pain or pain exacerbated, fatigue, feeling cold, swelling of the face, legs or feet, chest pain, fever, blood chemistry changes, mental impairment and weight decreased.

Uncommon

Infection of the blood stream, meningitis, delirium (feeling of mental confusion), psychotic disorder (abnormal thinking and perceptions), suicidal thought or attempt, thought disorders, abnormal dreams, incoherence (inability to make sense), loss of consciousness, coma, stupor (unresponsive/difficult to arouse), convulsions (fits), stroke, encephalopathy (brain disorder), abnormal heart rhythm, difficulty breathing, indigestion, rash, muscle breakdown (rhabdomyolysis), muscle inflammation, back pain, muscle twitching, neck pain, acute kidney failure, abnormal heart trace measurements (ECG), raised body temperature.

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

How To Store Prialt

Keep out of the reach and sight of children.

Do not use Prialt after the expiry date stated on the label and carton after EXP. The expiry date refers to the last day of that month.

Store unopened vial in refrigerator (2°C – 8°C).

Do not freeze.

Keep the vial in the outer carton in order to protect from light.

Chemical and physical in use stability has been demonstrated for 60 days at 37°C.

From a microbiological point of view, if the product is diluted it should be transferred to the infusion pump immediately. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user and would normally not be longer than 24 hours at 2°C – 8°C, unless dilution has taken place in controlled and validated aseptic conditions.

Further Information

What Prialt contains

• The active substance is ziconotide.


• One ml solution contains 100 micrograms ziconotide (as acetate).


• One vial of 1 ml contains 100 micrograms; one vial of 2 ml contains 200 micrograms; one vial of 5 ml contains 500 micrograms.


• The other ingredients are methionine, sodium chloride, water for injections, hydrochloric acid and sodium hydroxide.

What Prialt looks like and contents of the pack

Prialt is a solution for infusion. The solution is clear and colourless. Prialt is supplied in packs containing a single vial of either 1 ml, 2 ml or 5 ml. Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder:

Eisai Ltd.

Mosquito Way

Hatfield

Herts

AL10 9SN

United Kingdom

Manufacturer:

Eisai Manufacturing Limited

Mosquito Way

Hatfield

Herts

AL10 9SN

United Kingdom

For any information about this medicinal product, please contact the local representative of the Marketing Authorisation Holder:

United Kingdom

Eisai Ltd.

Tel: 0208 600 1400

This leaflet was last approved in 01/2010.

This medicine has been authorised under “Exceptional Circumstances”. This means that because of the rarity of the disease it has been impossible to get complete information on this medicine. The European Medicines Agency (EMEA) will review any new information on the medicine every year and this leaflet will be updated as necessary.

Detailed information on this medicine is available on the European Medicines Agency (EMEA) web site: http://www.emea.europa.eu/. There are also links to other websites about rare diseases and treatments.

Cilostazol

Pronunciation: sye-LOE-sta-zol
Generic Name: Cilostazol
Brand Name: Pletal

Medicines similar to Cilostazol have shortened the lives of people with certain types of heart failure. Do not use Cilostazol if you have any type of heart failure.

Cilostazol is used for:

Reducing symptoms of intermittent claudication (pain, cramping, numbness, or weakness in the legs) that may occur with walking. It may also be used for other conditions as determined by your doctor.

Cilostazol is a phosphodiesterase type 3 inhibitor. Cilostazol works by widening blood vessels to increase blood flow. It also decreases the ability of platelets to stick together and form clots.

Do NOT use Cilostazol if:

• you are allergic to any ingredient in Cilostazol


• you have heart failure, bleeding problems or a disorder that causes the inability to form blood clots, or active bleeding (eg, bleeding peptic ulcer, bleeding in the brain)

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

Before using Cilostazol:

Some medical conditions may interact with Cilostazol. 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 liver or kidney problems, or low blood platelet levels


• if you have recently had surgery or any type of bleeding

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

• Antiplatelet medicines (eg, clopidogrel) because the risk of bleeding may be increased


• Certain azole antifungals (eg, ketoconazole), diltiazem, esomeprazole, certain macrolide antibiotics (eg, erythromycin), nefazodone, omeprazole, protease inhibitors (eg, boceprevir, ritonavir), certain selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine, fluvoxamine, sertraline), or telithromycin because they may increase the risk of Cilostazol's side effects

This may not be a complete list of all interactions that may occur. Ask your health care provider if Cilostazol 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 Cilostazol:

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

• An extra patient leaflet is available with Cilostazol. Talk to your pharmacist if you have questions about this information.


• Take Cilostazol by mouth at least 30 minutes before or 2 hours after eating.


• Check with your doctor before you eat grapefruit or drink grapefruit juice while you take Cilostazol.


• The effects of Cilostazol are not immediate. Although you may experience the benefits of Cilostazol 2 to 4 weeks after beginning treatment, treatment for up to 12 weeks may be necessary before Cilostazol takes effect. Do not stop taking Cilostazol or change your dose without checking with your doctor.


• Cilostazol works best if it is taken at the same time(s) each day.


• If you miss a dose of Cilostazol, take 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. If more than 1 dose is missed, contact your health care provider or pharmacist.

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

Important safety information:

• Cilostazol may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Cilostazol with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Cilostazol may rarely reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.


• Cilostazol may rarely lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.


• Tell your doctor or dentist that you take Cilostazol before you receive any medical or dental care, emergency care, or surgery.


• Lab tests, including complete blood cell counts, may be performed while you take Cilostazol. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


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


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

Possible side effects of Cilostazol:

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:

Abnormal stools; back pain; diarrhea; dizziness; gas; headache; increased cough; indigestion; light-headedness; mild sore throat; muscle aches; nausea; runny nose; stomach pain.

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); black, tarry stools; chest, jaw, or left arm pain; confusion; fainting; fast or irregular heartbeat; fever, chills, or persistent cough or sore throat; numbness of an arm or leg; one-sided weakness; red, swollen, blistered, or peeling skin; severe or persistent dizziness or light-headedness; shortness of breath; slurred speech; sudden, severe headache or vomiting; sudden, unusual weight gain; swelling of the hands, ankles, or feet; unusual bruising or bleeding; vision changes (eg, blindness, double vision); vomiting material that looks like coffee grounds.

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: Cilostazol 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. Symptoms may include diarrhea; fainting; fast or irregular heartbeat; severe headache, dizziness, or light-headedness.

Proper storage of Cilostazol:

Store Cilostazol between 68 and 77 degrees F (20 and 25 degrees C). Store in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Cilostazol out of the reach of children and away from pets.

General information:

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


• Cilostazol 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 Cilostazol. 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 Cilostazol resources

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

• Cilostazol Prescribing Information (FDA)


• Cilostazol Monograph (AHFS DI)


• Cilostazol Professional Patient Advice (Wolters Kluwer)


• cilostazol Concise Consumer Information (Cerner Multum)


• cilostazol Advanced Consumer (Micromedex) - Includes Dosage Information


• Pletal Prescribing Information (FDA)

Compare Cilostazol with other medications

• Intermittent Claudication

Atropine Drops

Pronunciation: AT-row-peen
Generic Name: Atropine
Brand Name: Atropin-Care

Atropine Drops are used for:

Widening (dilating) the pupils for an eye exam or to treat certain inflammatory conditions of the eye. It may also be used for other conditions as determined by your doctor.

Atropine Drops are an anticholinergic agent. It works by blocking the chemical acetylcholine, which relaxes the ciliary muscle of the eye and causes the pupil to dilate.

Do NOT use Atropine Drops if:

• you are allergic to any ingredient in Atropine Drops


• you have glaucoma or are at risk for glaucoma

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

Before using Atropine Drops:

Some medical conditions may interact with Atropine 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 numbness due to nerve damage, a blockage of the bladder, prostate problems, or difficulty urinating


• if you have cornea problems or Down syndrome

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

• Antihistamines (eg, diphenhydramine), medicine for Parkinson disease (eg, benztropine), or tricyclic antidepressants (eg, amitriptyline) because they may increase the risk of Atropine Drops's side effects

This may not be a complete list of all interactions that may occur. Ask your health care provider if Atropine 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 Atropine Drops:

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

• An extra patient leaflet is available with Atropine Drops. Talk to your pharmacist if you have questions about this information.


• To use Atropine 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 Atropine 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 use 2 doses at once.

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

Important safety information:

• Atropine Drops may cause harm if it is swallowed. If you may have taken it by mouth, contact your poison control center or emergency room right away.


• Atropine Drops may cause blurred vision. Use Atropine Drops with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


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


• Lab tests, including eye exams, may be performed while you use Atropine Drops. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Use Atropine Drops with caution in the ELDERLY; they may be more sensitive to its effects.


• Atropine 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 Atropine Drops while you are pregnant. It is not known if Atropine Drops are found in breast milk. If you are or will be breast-feeding while you use Atropine Drops, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Atropine 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; eye itching, burning, or stinging; irritation at the application site.

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; dry mouth; eye pain; fever; flushing or dryness of the skin; irregular or rapid heartbeat; unsteadiness on your feet.

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.

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. Symptoms may include hallucinations; loss of muscle coordination; rapid or irregular pulse.

Proper storage of Atropine Drops:

Store Atropine Drops at room temperature, between 46 and 86 degrees F (8 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Atropine Drops out of the reach of children and away from pets.

General information:

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


• Atropine 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 Atropine 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 Atropine resources

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

Compare Atropine with other medications

• Pupillary Dilation
• Refraction, Assessment
• Uveitis

Azasan

Generic Name: azathioprine (ay za THYE oh preen)

Brand Names: Azasan, Imuran

What is Azasan (azathioprine)?

Azathioprine lowers your body's immune system. The immune system helps your body fight infections. The immune system can also fight or "reject" a transplanted organ such as a liver or kidney. This is because the immune system treats the new organ as an invader.

Azathioprine is used to prevent your body from rejecting a transplanted kidney. It is also used to treat symptoms of rheumatoid arthritis.

Azathioprine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Azasan (azathioprine)?

Do not use azathioprine if you are pregnant. It could harm the unborn baby. Some people using azathioprine have developed a rare fast-growing type of lymphoma (cancer). This condition affects the liver, spleen, and bone marrow, and it can be fatal. This has occurred mainly in teenagers and young adults using azathioprine or similar medicines to treat Crohn's disease or ulcerative colitis. Call your doctor at once if you have any of the following symptoms: fever, night sweats, itching, loss of appetite, weight loss, tiredness, feeling full after eating only a small amount, pain in your upper stomach that may spread to your shoulder, nausea, easy bruising or bleeding, pale skin, feeling light-headed or short of breath, rapid heart rate, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes). Azathioprine can lower blood cells that help your body fight infections. Your blood may need to be tested often. Avoid being near people who are sick or have infections. Avoid activities that may increase your risk of bleeding injury. Tell your doctor at once if you develop signs of infection.

If you need to have surgery, tell the surgeon ahead of time that you are using azathioprine. You may need to stop using the medicine for a short time.

This medication can affect fertility (your ability to have children), whether you are a man or a woman. Talk with your doctor if you have concerns about this.

Do not receive a "live" vaccine while you are being treated with azathioprine and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you.

What should I discuss with my healthcare provider before taking Azasan (azathioprine)?

You should not take this medication if you are allergic to azathioprine. Some people using azathioprine have developed a rare fast-growing type of lymphoma (cancer). This condition affects the liver, spleen, and bone marrow, and it can be fatal. This has occurred mainly in teenagers and young adults using azathioprine or similar medicines to treat Crohn's disease or ulcerative colitis.

However, people with autoimmune disorders (including rheumatoid arthritis, Crohn's disease, ankylosing spondylitis, and psoriasis) may have a higher risk of lymphoma. Talk to your doctor about your individual risk.

To make sure you can safely take azathioprine, tell your doctor if you have any of these other conditions:

• 
  

  liver disease;

  
  


• 
  

  any type of viral, bacterial, or fungal infection; or

  
  


• 
  

  if you have recently received chemotherapy treatments with medications such as cyclophosphamide (Cytoxan), chlorambucil (Leukeran), melphalan (Alkeran).

  
  

FDA pregnancy category D. Do not use azathioprine if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. Azathioprine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using azathioprine.

This medication can affect fertility (your ability to have children), whether you are a man or a woman. Talk with your doctor if you have concerns about this.

How should I take Azasan (azathioprine)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take azathioprine with a full glass of water. Take azathioprine with food to lessen stomach upset. Azathioprine can lower blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Your blood may need to be tested often. Visit your doctor regularly. If you need surgery, tell the surgeon ahead of time that you are using azathioprine. You may need to stop using the medicine for a short time. Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

If you take this medicine once daily and you 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.

If you take this medicine more than once daily and you miss a dose, take the medicine as soon as you remember. If it is almost time for the next dose, take both doses together, then go back to your regular dosing schedule.

Call your doctor if you have missed more than one dose.

What happens if I overdose?

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

Overdose symptoms may include nausea, vomiting, stomach pain, diarrhea, bleeding, fever, chills, and other signs of infection.

What should I avoid while taking Azasan (azathioprine)?

Avoid being near people who have colds, the flu, or other contagious illnesses. Contact your doctor at once if you develop signs of infection.

Do not receive a "live" vaccine while using azathioprine, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you. Live vaccines include measles, mumps, rubella (MMR), Bacillus Calmette-Guérin (BCG), oral polio, rotavirus, smallpox, typhoid, yellow fever, varicella (chickenpox), H1N1 influenza, and nasal flu vaccine.

Azasan (azathioprine) 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. Stop using azathioprine and call your doctor right away if you have any of these symptoms of lymphoma:

• 
  

  fever, night sweats, weight loss, tiredness;

  
  


• 
  

  feeling full after eating only a small amount;

  
  


• 
  

  pain in your upper stomach that may spread to your shoulder;

  
  


• 
  

  easy bruising or bleeding, pale skin, feeling light-headed or short of breath, rapid heart rate; or

  
  


• 
  

  nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

  
  

Stop using azathioprine and call your doctor at once if you have any of these other serious side effects:

• 
  

  signs of infection (fever, chills, sore throat, body aches, weakness, muscle pain, flu symptoms);

  
  


• 
  

  severe nausea, vomiting, or diarrhea;

  
  


• 
  

  pain or burning with urination; or

  
  


• 
  

  white patches or sores inside your mouth or on your lips.

  
  

Less serious side effects may include:

• 
  

  mild upset stomach, nausea, diarrhea, loss of appetite;

  
  


• 
  

  hair loss; or

  
  


• 
  

  skin rash.

  
  

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 Azasan (azathioprine)?

Before taking azathioprine, tell your doctor if you are taking, have taken, or need to take any of the following medicines:

• 
  

  allopurinol (Zyloprim);

  
  


• 
  

  mercaptopurine (Purinethol);

  
  


• 
  

  methotrexate (Rheumatrex, Immunex);

  
  


• 
  

  a blood thinner such as warfarin (Coumadin, Jantoven);

  
  


• 
  

  cyclosporine (Gengraf, Neoral, Sandimmune);

  
  


• 
  

  olsalazine (Dipentum), or sulfasalazine (Azulfidine);

  
  


• 
  

  sulfamethoxasole and trimethoprim (Bactrim, Septra, Sulfatrim, SMX-TMP, others); or

  
  


• 
  

  an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

  
  

This list is not complete and other drugs may interact with azathioprine. 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 Azasan resources

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

• Azasan MedFacts Consumer Leaflet (Wolters Kluwer)


• Azasan Advanced Consumer (Micromedex) - Includes Dosage Information


• Azasan Prescribing Information (FDA)


• Azathioprine Prescribing Information (FDA)


• Azathioprine Monograph (AHFS DI)


• Azathioprine Professional Patient Advice (Wolters Kluwer)


• Imuran Prescribing Information (FDA)


• azathioprine Intravenous Advanced Consumer (Micromedex) - Includes Dosage Information

Compare Azasan with other medications

• Atopic Dermatitis
• Autoimmune Hepatitis
• Chronic Active Hepatitis
• Chronic Inflammatory Demyelinating Polyradiculoneuropathy
• Crohn's Disease
• Crohn's Disease, Acute
• Crohn's Disease, Maintenance
• Inflammatory Bowel Disease
• Multiple Sclerosis
• Organ Transplant, Rejection Prophylaxis
• Renal Transplant
• Rheumatoid Arthritis
• Sarcoidosis
• Systemic Lupus Erythematosus
• Takayasu's Arteritis
• Ulcerative Colitis
• Uveitis

Where can I get more information?

• Your pharmacist can provide more information about azathioprine.

See also: Azasan side effects (in more detail)

Visine Multi-Symptom Relief

Generic Name: tetrahydrozoline and zinc ophthalmic (TET ra hye DROZ oh leen and ZINK off THAL mik)

Brand Names: Irritation & Redness Relief, Visine A.C., Visine Multi-Symptom Relief

What is Visine Multi-Symptom Relief (tetrahydrozoline and zinc ophthalmic)?

Tetrahydrozoline causes constriction (narrowing) of blood vessels in the eyes. It also decreases itching and irritation of the eyes.

Zinc is used as an astringent to gently clear proteins and mucus from the outer surface of the eye.

The combination of tetrahydrozoline and zinc ophthalmic (for the eyes) is used to relieve eye redness, burning, irritation, and itching caused by airborne irritants such as pollen, dust, and ragweed.

Tetrahydrozoline and zinc ophthalmic may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Visine Multi-Symptom Relief (tetrahydrozoline and zinc ophthalmic)?

Do not allow the dropper tip to touch any surface, including the eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye.

Do not use this medication while wearing contact lenses. Tetrahydrozoline and zinc ophthalmic may contain a preservative that can discolor soft contact lenses. Wait at least 15 minutes after using tetrahydrozoline and zinc ophthalmic before putting your contact lenses in.

Do not use this medication for longer than 72 hours in a row without a doctor's advice. Long-term use of tetrahydrozoline and zinc ophthalmic could damage the blood vessels in your eyes. Contact your doctor if your symptoms do not improve or if they get worse while using this medication. If you have glaucoma, do not use tetrahydrozoline and zinc ophthalmic without medical advice.

Stop using this medication and call your doctor if you have severe burning, stinging, eye pain, or other irritation after using the eye drops, or if you have vision changes, worsening eye redness or irritation, or dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

What should I discuss with my healthcare provider before using Visine Multi-Symptom Relief (tetrahydrozoline and zinc ophthalmic)?

If you have narrow-angle glaucoma, do not use tetrahydrozoline and zinc ophthalmic without medical advice.

Ask a doctor or pharmacist if it is safe for you to use this medicine if you have:

• 
  

  heart disease;

  
  


• 
  

  high blood pressure;

  
  


• 
  

  asthma; or

  
  


• 
  

  glaucoma.

  
  

It is not known whether tetrahydrozoline and zinc is harmful to an unborn baby. Do not use this medication without medical advice if you are pregnant. It is not known whether tetrahydrozoline and zinc passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use Visine Multi-Symptom Relief (tetrahydrozoline and zinc ophthalmic)?

Use this medication exactly as directed on the label, or as prescribed by your doctor. Do not use it in larger amounts or for longer than recommended.

Do not use this medication while wearing contact lenses. Tetrahydrozoline and zinc ophthalmic may contain a preservative that can discolor soft contact lenses. Wait at least 15 minutes after using tetrahydrozoline and zinc ophthalmic before putting your contact lenses in. Wash your hands before using the eye drops.

To apply the eye drops:

• 
  

  Tilt your head back slightly and pull down your lower eyelid to create a small pocket. Hold the dropper above the eye with the dropper tip down. Look up and away from the dropper as you squeeze out a drop, then close your eye.

  
  


• 
  

  Use only the number of drops your doctor has prescribed.

  
  


• 
  

  Gently press your finger to the inside corner of the eye (near your nose) for about 1 minute to keep the liquid from draining into your tear duct. If you use more than one drop in the same eye, wait about 5 minutes before putting in the next drop.

  
  


• 
  

  Do not allow the dropper tip to touch any surface, including the eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye.

  
  

Do not use this medication for longer than 72 hours in a row without a doctor's advice. Long-term use of tetrahydrozoline and zinc ophthalmic could damage the blood vessels in your eyes. Contact your doctor if your symptoms do not improve or if they get worse while using this medication.

Do not use the eye drops if the liquid has changed colors or looks cloudy. Call your doctor for a new prescription.

Store at room temperature away from heat and moisture. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Since tetrahydrozoline and zinc ophthalmic is used on an as needed basis, you are not likely to miss a dose. Do not use this medication for longer than 72 hours in a row without a doctor's advice.

What happens if I overdose?

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

An overdose of tetrahydrozoline and zinc used in the eyes is not likely to occur unless you use too much and your body absorbs the medication. Overdose symptoms may include increased eye redness, pinpoint pupils, dilated pupils, nausea, vomiting, fast heart rate, feeling restless or irritable, weak or shallow breathing, tremors, or seizure (convulsions).

What should I avoid while using Visine Multi-Symptom Relief (tetrahydrozoline and zinc ophthalmic)?

Avoid using any other eye medications that your doctor has not recommended or prescribed.

Visine Multi-Symptom Relief (tetrahydrozoline and zinc ophthalmic) 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. Stop using this medication and call your doctor at once if you have a serious side effect such as:

• 
  

  severe burning, stinging, or other irritation after using the eye drops;

  
  


• 
  

  eye pain;

  
  


• 
  

  vision changes;

  
  


• 
  

  worsening eye redness or irritation; or

  
  


• 
  

  dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

  
  

Less serious side effects may include:

• 
  

  slight tingling in the eyes;

  
  


• 
  

  tearing or blurred vision; or

  
  


• 
  

  temporarily blurred vision.

  
  

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 Visine Multi-Symptom Relief (tetrahydrozoline and zinc ophthalmic)?

The following drugs may interact with tetrahydrozoline. Tell your doctor if you are using any of these:

• 
  

  furazolidone (Furoxone);

  
  


• 
  

  isocarboxazid (Marplan);

  
  


• 
  

  phenelzine (Nardil);

  
  


• 
  

  rasagiline (Azilect);

  
  


• 
  

  selegiline (Eldepryl, Emsam); or

  
  


• 
  

  tranylcypromine (Parnate).

  
  

It is not likely that other drugs you take orally or inject will have an effect on tetrahydrozoline and zinc ophthalmic used in the eyes. But many drugs can interact with each other. Tell your doctor about all medicines you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More Visine Multi-Symptom Relief resources

• Visine Multi-Symptom Relief Side Effects (in more detail)
• Visine Multi-Symptom Relief Use in Pregnancy & Breastfeeding
• Visine Multi-Symptom Relief Drug Interactions
• 2 Reviews for Visine Multi-Symptom Relief - Add your own review/rating

Compare Visine Multi-Symptom Relief with other medications

• Eye Redness/Itching

Where can I get more information?

• Your pharmacist can provide more information about tetrahydrozoline and zinc ophthalmic.

See also: Visine Multi-Symptom Relief side effects (in more detail)