Section 2

Profiles of 50 Drugs

What these symbols mean ?

­
- Effect of the drug under consideration increases.

¯
- Effect of the drug under consideration decreases.

s- Effect of other drugs (those mentioned under the column “Drugs/Drug Class”) increases.

t- Effect of the other drug decreases.

Any one of the above-mentioned four symbols may be present for each drug interaction under the column
“Effects”. When none is applicable, the column is left blank and explanation of the interaction is given under
the column “Notes”.

These symbols are used in the detailed drug profiles only.

Profiles of 50 Drugs 363

List of 50 Drugs with Detailed Profiles
Aluminium Hydroxide Frusemide
Amoxycillin Gentian Violet
Ampicillin Glibenclamide
Aspirin Glyceryl Trinitrate
Atropine Ibuprofen
Benzoic Acid and Salicyclic Acid Insulin
Benzyl Benzoate Isoniazid
Betamethasone Loperamide
Bisacodyl Mebendazole
Calamine Lotion Methyldopa
Chlorhexidene Metronidazole
Chloroquine Phosphate Miconazole
Chlorpheniramine Maleate Oral Contraceptives/Birth Control Pills
Co-trimoxazole ORS
Codeine Paracetamol
Dapsone Promethazine
Diazepam Propranolol
Digoxin Pyrimethamine & Sulfadoxine
Diphenhydramine Quinine
Ephedrine Ranitidine
Ergotamine Reserpine
Erythromycin Rifampicin
Ethambutol ` Salbutamol
Ferrous Sulphate Tetracycline
Folic Acid (Vitamin B) Vitamin A

364 A Lay Person's Guide

ALUMINIUM HYDROXIDE

Drug Group: Antacid
Principal Uses
It provides relief in the treatment of heartburn, indigestion and stomach pain, often associated with peptic
ulcers, hyperacidity and dyspepsia. Also used in treatment of hyperphosphataemia (high concentration of
phosphates in circulating blood).

It has a constipating effect and is therefore combined with magnesium-containing antacids (magnesium
hydroxide, magnesium trisilicate) which have a laxative effect and thus they cancel each other’s unwanted
effect.

Fixed-dose combinations of aluminium hydroxide with any other drug besides magnesium antacids is
considered unnecessary.

How this Drug Works
It counteracts the acid secreted in the stomach and thus reduces the degree of acidity, there by relieving
heartburn and indigestion. It reduces the action of an enzyme (chemical) ‘pepsin’ in the stomach, thereby
promoting the healing of peptic ulcer.

Dosage and Usage Information
Available Dosage Forms: Tablets and liquids with magnesium trisilicate, with others.

Dosage Adults 300-600 mg (1-2 tablets OR 1-2 teaspoonful) 3-6 times daily

How and When to Take

Stomach keeps on emptying itself and the action of the antacid lasts only for a short while, irrespective of
the dose taken. Hence it is important to take an antacid at frequent intervals as well as delay stomach
emptying. Food delays stomach emptying and prolongs the duration of antacid action.

It is best taken between meals and at bedtime. For continuous effect, take 1 hour after eating, followed by a
sip of water.

Tablets should be well chewed. Suspension should be shaken well before use. Do not swallow the tablet
whole.

What if you Exceed the Dose
The effects include nausea, vomiting and constipation. Consult your doctor if the symptoms are unusually
severe or the overdose is exceptionally large.

Profiles of 50 Drugs 365

Discuss with your doctor. Over 60: Increased likelihood of adverse effects. eggs. Pregnancy: Safety not established. Avoid drug or refrain from nursing. milk and milk products. measurements of blood calcium and phosphorous levels should be done. Food: Maintain regular intake of high-phosphate foods such as meat. Do not take this drug for more than 2 weeks without physician’s guidance. Reduced dose is necessary. Tobacco: Should be avoided as it may increase stomach acidity. fish. Possible Adverse Effects Symptoms/Effects Frequency What to do Constipation Common Discuss with doctor. Breast feeding: This drug passes into breast milk. Alcohol: Should be avoided as it may increase stomach acidity.Precautions Be sure to tell your doctor if you have (i) long-term kidney problems (ii) constipation (iii) bone disease Do not swallow chewable tablets and shake all liquid preparations of antacids. During long-term use. Interactions Drugs/Drug Class Effects Notes Blood-thinners t Digitalis drugs t Penicillamine t Phenytoin t 366 A Lay Person's Guide . only if severe Nausea Rare " Vomiting " Discuss with doctor as soon as possible Bone pain " " Muscle Weakness " " Intestinal obstruction " Stop taking the drug and consult your doctor. Infants and Children: Not recommended in children under 6 years except on the advice of a doctor.

beclomethasone) Beta-blockers t (e.propranolol) Tetracyclines t Iron preparations t Phenothiazines t Sodium polystyrene t Sulfonate t Enteric-coated tablets . gonorrhoea (a sexually transmitted disease) and soft tissue infections. cystitis (inflamation of the bladder. kid tablets. usually urinary bladder). Children: 8-15 mg/kg dose every 8 hours. since it is absorbed better and can be given thrice a day.g. Amoxycillin is preferred over ampicillin. Penicillin Principal Uses It is used to treat infections of ear. How this Drug Works It destroys the infecting bacteria by interfering with their ability to multiply and grow. Effects of Long-term Use Decreased levels of blood phosphates resulting in loss of calcium and phosphate from bone with weakening AMOXYCILLIN Drug Group: Antibiotic. Dosage and Usage Information Available Dosage Forms: Capsules.Drugs/Drug Class Effects Notes Chloroquine t Corticosteroids t (e. Dosage Adults: 250-500 mg every 8 hours. dry syrup. injections. when it is to be given by mouth. Profiles of 50 Drugs 367 . tablets.Enteric coating is broken up leading to stomach irritation. nose and throat. Incidence of diarrhoea with amoxycillin is less.g. respiratory tract infections.

do not take any diarrhoea medicine without checking with your doctor. Possible Adverse Effects Symptoms/Effects Frequency What to do Skin rash. hives) . Others: If diarrhoea occurs (as a side-effect of this drug). bleeding problems .). it may cause rash. previous hypersensitivity (allergy) to drug . Breast feeding: Continue nursing. hay fever. What if you Miss a Dose Take as soon as possible. penicillin allergy Pregnancy: No evidence of risk. Space the missed dose and the next dose 8 hours apart. Check with your doctor before changing your diet/dose of medicine. etc. This will help to keep a constant amount of medicine in the blood/urine and enable it to work well. hives. The drug must be discontinued if it causes diarrhoea. Precautions Be sure to tell your doctor if you have: . How to Stop Using this Drug Do not stop using this drug without consulting your doctor. general allergy (asthma. sore throat. Infants and Children: If it is given during an episode of infectious mononucleosis (a condition marked by fever.How and When to Take May be taken before or after food. even if you feel better in a few days. itching Rare Discuss with your doctor only if severe Irritations of mouth & tongue " " Black tongue " " Nausea " " Vomiting " " 368 A Lay Person's Guide . Diabetics: This drug may cause false positive test results with some urine sugar tests.

Interactions Drugs/Drug Class Effects Notes Birth control pills t Use an additional means of birth control while you are taking this drug Antacids ¯ Chloramphenicol ¯ Erythromycin ¯ Tetracyclines ¯ Effects of Long-term Use Super-infections. AMPICILLIN Drug Group: Antibiotic. dry syrup. Note: The dose. Dosage and Usage Information Available Dosage Forms: Tablets. injectables. Profiles of 50 Drugs 369 . capsules. Penicillin Principal Uses It is used to treat variety of infections such as that of soft tissues. often due to yeast organisms. It is also used to treat certain types of meningitis.. How this Drug Works It destroys the infecting bacteria by interfering with their ability to multiply and grow. intestine (eg. respiratory tract. typhoid) and urinary tract. often depends on the severity of infection and body weight of patients and not on body weight alone.Symptoms/Effects Frequency What to do Diarrhoea Rare Discuss with your doctor as soon as possible Drug fever " " Swollen painful joints " " Note: Black tongue is temporary and will go away as soon as you stop taking this drug.

hives) . 370 A Lay Person's Guide . This will help to keep a constant amount of medicine in the blood/urine and enable it to work well. Dose in Gonorrhoea: Adults: 3. Diabetics: This drug may cause false positive test results with some urine sugar tests. it may cause rash. Breast feeding: Continue.Dosage Adults: 250-500 mg every 6 hours Children: 12. Check with your doctor before changing your diet/dose of medicine. Children: 200-400 mg/kg a day. do not take any diarrhoea medicine without checking with your doctor. Precautions Be sure to tell your doctor if you have: . Space the missed dose and the next dose 5-6 hours apart. 1 hour before or 2 hours after eating. Infants and Children: If it is given during an episode of infectious mononucleosis.bleeding problems . How and When to Take Best taken on an empty stomach.general allergy (asthma.penicillin allergy Pregnancy: No evidence of risk.kidney disease . What if you Miss a Dose Take as soon as possible.5 gm 4 times a day for 1-3 months. Dose in Typhoid Carrier Stage: 1.5-25 mg/kg/dose every 6 hours Dose in Meningitis: Adults: 6-12 gm/day in 4 divided doses.previous hypersensitivity (allergy) to drug . Others: If diarrhoea occurs (as a side-effect of this drug). hay fever.5 gm single dose preceded by 1 gm of probenecid half an hour before.

Drug fever " " Swollen painful joints " " Note: Black tongue is temporary and will go away as soon as you stop taking this drug. Interactions Drugs/Drug Class Effects Notes Birth control Pills t Use an additional means of birth control while you are taking this drug. itching Common Discuss with your doctor only if severe. Irritations of mouth & tongue " " Black tongue " " Nausea " " Vomiting " " Diarrhoea " Discuss with your doctor as soon as possible. Antacids ¯ Chloramphenicol ¯ Erythromycin ¯ Tetracyclines ¯ Profiles of 50 Drugs 371 .Possible Adverse Effects Symptoms/Effects Frequency What to do Skin rash. hives.

blurred vision. Do not exceed 3.6 gm in a day For prevention of subsequent heart attacks: 75 to 150 mg every day. What if you Exceed the Dose If restlessness. In small doses. How and When to Take Take with food. lowers fever. breathing problems. The full effects of this medicine will be seen after 2-3 weeks. Do not exceed 6 gms in a day. milk or plenty of water to avoid stomach irritation. ringing noises in ears. It prevents aggregation (coming together) of blood platelets/blood vessels. seek medical help immediately. reduces swelling and relieves rheumatic fever. fits or vomiting occurs. How this Drug Works It reduces the amount of chemicals which produce swelling and pain in the body. Note: Take it regularly. stomach pain. Dosage and Usage Information Available Dosage Forms: Tablets. Children (over 12 years only): For pain/fever: 10-15 mg/kg as and when required or at an interval of 4-6 hours. thus preventing clotting of blood. It alters those centres in the brain that regulate body temperature and also causes sweating which leads to reduction of fever.ASPIRIN Drug Group: Pain killer. Anti-fever Principal Uses It relieves pain. it helps the prevention of subsequent heart attacks. Enteric-coated tablets (aspirin tablets may have a enteric-coating so that they do not cause stomach irritation) should not be crushed before use. For rheumatic fever : 100 mg/kg daily in 4-6 divided doses for 1-2 weeks and then 60-75 mg/kg daily as long as needed (or for 3-6 weeks). 372 A Lay Person's Guide . Adults: For pain/fever: 300-600 mg (1-2 tablets) as and when required or at an interval of 4 hours. Not to be given in children under 12 years.

Possible Adverse Effects Symptoms/Effects Frequency What to do Nausea/vomiting Common Discuss with your doctor only if severe Indigestion/Abdominal Rare Discuss with your doctor immediately discomfort Asthma-like attack " " Anemia " " Ulcer " " Interactions Drugs/Drug Class Effects Notes Beta-blockers t eg.Precautions Be sure to tell your doctor if you have: .gout .liver problems .kidney problems .heart problems . but at normal doses adverse effects on the baby are unlikely.planned to undergo any surgery Pregnancy: Avoid. Alcohol: Avoid.blood clotting problems . Use a safer alternative drug. Over 60: Increased incidence of side-effects especially bleeding from stomach and anemia.asthma . Use cautiously.overactive thyroid .stomach ulcer . Infants and Children: Not to be used for children under 12 years except in juvenile rheumatoid (resembling rheumatism) arthritis and rheumatic fever. Propranolol Profiles of 50 Drugs 373 .anemia .nasal polyps (bulging tissue) . Increased likelihood of stomach irritation. Breast feeding: The drug passes into the breast milk.

It reduces frequency/urgency of urination. How this Drug Works It blocks the action of the chemical ‘acetylcholine’. along with antacids like aluminium hydroxide or magnesium trisilicate. Anti-Spasmodics Principal Uses Atropine (as Sulphate) is useful in relieving pain in the stomach arising due to spasms (frequent contractions) of the intestine/muscles of the urinary tract or due to dysentery/diarrhoea. It is used in patients suffering from insecticide poisoning. Effects of Long-term Use Except when prescribed for prevention of heart attack. It is also used in patients with non-ulcer dyspepsia. irritable bowel syndrome and diverticular disease (diverticulum is a pouch or sac opening from any organ resembling a tube or a sac such as gut or bladder). 374 A Lay Person's Guide . thus preventing the contraction of muscles and secretion of the glands in the organs involved. aspirin should not be taken for longer than 10 days in a row.Drugs/Drug Class Effects Notes Vitamin C ­ Aspirin toxicity Medicines for diabetes s (taken by mouth) Antacids ¯ Corticosteroids ¯ Also increased stomach irritation (cortisone-like medicines) Urinary alkalizers ¯ Increased excretion. ATROPINE Drug Group: Anticholinergic. This leads to prevention or relief of muscle spasms (hence called anticholinergic). It is used as eye drops to dilate pupil before eye checkup and to treat certain eye conditions such as allergy/corneal burns. It is also used to relieve pain associated with stomach ulcer.

How to Stop Using this Drug Do not stop without consulting your doctor as the dose may have to be gradually reduced. Avoid completely in the first 3 months of pregnancy. dry mouth and throat.enlargement of prostate gland . high fever. Precautions Be sure to tell your doctor if you have: . If it is almost time for your next dose. fits.Dosage and Usage Information Available Dosage Forms: Tablets 0. profound unconsciousness. Profiles of 50 Drugs 375 .chronic bronchitis (breathing problems) . injections 0. Take the tablet with a full glass of water.hernia or stomach ulcer . What if you Exceed the Dose The symptoms include enlarged eye.urinary difficulties . Seek immediate medical advice.25 and 0. Avoid the drug as far as possible. urinary problems.5 mg/ml Usual Dosage Range for Pain: Adults: 0.3 mg as required For Insecticide Poisoning: According to severity of poisoning For eye: 1-2 drops. 2-3 times daily How and When to Take For tablets : It should be taken 30-60 minutes before eating so that maximum drug is absorbed in the blood. skip the missed dose and go back to your regular dosing schedule.6 mg as required Children: 0.5 mg. Breast feeding: The drug passes into the breast milk and may affect the baby. confusion.myasthenia gravis .heart problems or high BP . increased heart rate.glaucoma .planned to undergo surgery in the near future Pregnancy: Avoid the drug as safety in pregnancy is not established.long-term liver/kidney problems . What if you Miss a Dose Take as soon as possible. vision problems.

Diet: Avoid food that causes constipation. Possible Adverse Effects Symptoms/Effects Frequency What to do Blurred vision Common Discuss with your doctor only if severe Dry mouth " " Reduced sweating Rare " Constipation Common " Dizziness Rare " Increased heart rate " Discuss with your doctor as soon as possible Confusion " " Urinary problems " " Headache/eye pain " " Skin rash " " Interactions Drugs/Drug Class Effects Notes Other atropine-like drugs s (anticholinergics) Ketoconazole tIncreased dose of ketoconazole may be necessary.Infants and Children: Increased chances of atropine toxicity. Not prescribed for children under 2 years of age. Over 60: This drug can increase urinary problems associated with prostate gland enlargement (a common disorder in elderly men). 376 A Lay Person's Guide . Haloperidol t Phenothiazines t Pilocarpine eye drops t Effects of Long-term Use Chronic constipation (constipation should be treated promptly with effective laxatives). Avoid such activities until you know how you react to this drug. Avoid large amounts of tea. Driving and Hazardous Activities: It may cause blurred vision and impaired concentration. especially in children with Down’s syndrome or brain damage. Dose is increased gradually as needed and tolerated in older children.

Possible Adverse Effects Symptoms/Effects Frequency What to do Mild swelling Rare Discuss with your doctor only if severe Skin irritation " Discuss with your doctor in all cases starting after the therapy Profiles of 50 Drugs 377 . Dosage and Usage Information Available Dosage Forms: Topical applicatio How to Stop Using this Drug Continue using this medicine till the infection is completely cured. This suppresses the fungal growth and also aids in the penetration of benzoic acid. keratolytic (related to shedding of skin) Principal Uses It is used to treat mild superficial fungal infections. unusual warts with hair growing on them or warts on the face. particularly tinea corporis (tinea circinata). ringworm infections.BENZOIC ACID AND SALICYLIC ACID Drug Group: Benzoic Acid : Antifungal Salicylic Acid: Antiseptic. Do not stop the treatment in-between or else the infection may return. moles. birthmarks. which exerts antifungal action (destroys the fungus). Salicyclic acid sheds off the dead skin. How this Drug Works Benzoic acid and salicyclic acid when used together give beneficial effects as compared to their effects when used alone. Precautions Others Avoid use on inflamed skin.

BENZYL BENZOATE

Drug Group: Scabicide (Anti-scabies)
Principal Uses

It should be used to treat scabies and sometimes in treatment against body lice. If skin infection is also
present along with scabies or develops, then it may be used with sulphadimidine.

How this Drug Works

When applied to the body, it kills the itch mite, a tiny insect that causes scabies. The itch mite usually resides
between the fingers, on the wrist flexures and in between the buttocks. It is also found in palms, soles, breasts
and the penis and causes sores with intense itching. Scabies is a disease caused by unhygienic conditions and
spreads through close body contact and infected clothes.

Dosage and Usage Information

Available Dosage Forms: Emulsion (25%).

Dosage Adults: Use as supplied.

Children: Dilute with an equal volume (1:1) of clean water.

Infants: One part is mixed with 3 parts of water

How and When to Take

Apply over the whole body below the neck preferably after a hot scrub/bath. Paint the application on the dry
skin and leave for 24 hours. Every time the hands are washed, apply the emulsion again. Repeat once, without
a further bath. At the end of two days, all the lotion is scrubbed off in a hot water bath.

Precautions

Do not apply to face or neck.

Others: All members in the patient’s family or at least those sharing the patient’s bed should be treated at the
same time. It is necessary to cover the body below the neck with benzyl benzoate to ensure complete cure.
The itch may sometimes persist for as long as 3 weeks but the application must not be repeated during the
period. (Your doctor may give you medicine like chloropheniramine to control itching). All infected clothing
and bedding should be disinfected by boiling, steaming or airing in the hot sun. Avoid getting benzyl
benzoate in the eyes. Any secondary infection or complications have to be treated after basic treatment is
over.

378 A Lay Person's Guide

Possible Adverse Effects

Symptoms/Effects Frequency What to do

Skin irritation Common Discuss with your doctor

BETAMETHASONE
Drug Group: Corticosteroid
Principal Uses

It is used to treat a variety of conditions caused by allergy/inflammation, such as skin problems, asthma or
arthritis.

Replaces corticosteroid deficiencies. It may be given by mouth to treat corticosteroid deficiency. Your body
naturally produces certain cortisone-like hormones which are necessary to maintain good health. If your
body does not produce enough, which may be due to pituitary or adrenal gland disorders, then your doctor
may prescribe this medicine to help make up the differences).

It should be taken only under medical supervision.

How this Drug Works

It stimulates the production of certain chemicals (enzymes) in the body, which are responsible for reducing
the body response to inflammation and thus prevent its symptoms (swelling, pain, redness).

Dosage and Usage Information

Available Dosage Forms: Tablets, injectables, cream, oral drops.

Note: Reduce dose for maintenance of minimum effective dose.

Profiles of 50 Drugs 379

How and When to Take

Tablets - Take with food to help prevent stomach upset

Cream - Be careful that this medicine does not enter your eyes.

Do not bandage or wrap the affected area. If your doctor has ordered an occlusive (closed) dressing, make
sure how you apply it. Since occlusive dressings increase the amount of medicine absorbed through your skin
and the possibility of side-effects, so use them only as directed.

What if you Miss a Dose

For tablets: If your dosing schedule is -

Every other day - take as soon as possible if you remember it the same morning, then go back to your regular
dosing schedule. If you do not remember, the missed dose until later, wait and take it the following morning.
Then skip a day and start your regular dosing schedule again.

Once a day - take as soon as possible, then go back to your regular dosing schedule. If you do not remember
until the next day, skip the missed dose and do not double the next one.

Several times a day - take as soon as possible, then go back to your regular dosing schedule. If you do not
remember until your next dose is due, double the next dose.

For cream: Apply as soon as possible. If almost time for next dose, skip the missed dose and apply the next
dose.

What if you Exceed the Dose

Headache, convulsions, heart failure are some of the symptoms. Seek immediate medical help.

How to Stop Using this Drug

Do not stop the tablets without consulting your doctor, who may supervise a gradual reduction in dosage.
Sudden stopping of long-term treatment may cause adrenal collapse. Drug affects your response to surgery,
illness, injury or stress for 2 years after discontinuing. Inform your doctor within 2 years.

Precautions

Be sure to tell your doctor if you have -

- an infection at the place of treatment - bone disease
- recently had surgery or a serious injury - colitis
- diabetes - fungus infection

380 A Lay Person's Guide

herpes simplex infection of the eye . Risk to unborn child outweighs drug benefits. It may cause the baby to have problems after birth such as slower growth. Also. Over 60: Reduced dose may be necessary. It may increase the risk of peptic ulcers. Others: While taking this medicine.B. since there is a chance they could pass the polio virus onto you.high cholesterol levels . avoid close contact with other people at school/work who have recently taken oral polio vaccine. If you have taken an injection in your joint.swelling of hands/legs (for injection only) . Profiles of 50 Drugs 381 . Possible toxicity. Also. Alcohol: Avoid.high BP .planned to undergo a skin test and/or any kind of surgery Pregnancy: Avoid. Tobacco: Increased betamethasone effect.glaucoma . Consult your doctor if you have any problems regarding this. Diet: Your doctor may want you to follow a low-salt and/or potassium rich diet.stomach ulcer .heart disease . (active/non-active/past) .myasthenia gravis .. other people living in your home should not receive oral polio vaccine. For drops: reduced dose may be necessary For creams: The doctor must observe the child closely since this medicine may be absorbed through the skin and affect the child’s growth. avoid using tight fitting diapers/plastic pants on the child as it may increase the absorption of this drug and cause side-effects. If this medicine is used in the diaper area. be careful not to put too much stress or strain on it for a while. and after you stop taking it. Diabetics: It may cause your blood sugar levels to rise.liver disease .kidney disease .T. Infants and Children: Use only under medical supervision. do not have any immunizations without your doctor’s approval. even if it begins to feel better. diabetes or ulcers and may cause cataracts and osteoporosis.thyroid problems (overactive/underactive) . Breast feeding: It passes into the breast milk and may cause problems with growth or other unwanted effects in infants or mothers taking this medicine. Avoid drug or refrain from nursing. May aggravate edema.

Fainting even after Continuous loss of appetite immediately Continuous Headache you stop Muscle weakness taking the Weight loss drug For Cream : Irritation on skin Rare Discuss with your doctor as soon as possible Pain redness. Discuss with your doctor immediately. Stomach/Back pain May occur Discuss with your doctor immediately.Possible Adverse Effects Symptoms/Effects Frequency What to do False sense of well being Common Discuss with your doctor only if severe Increase in appetite " " Indigestion " " Nervousness " " Trouble with sleeping " " Darkening/Lightening of skin Rare " colour Dizziness/Lightheadedness " " Headache " " Increase in hair growth on body/ " " face Vision problems " Discuss with your doctor as soon as possible Slow growth (in children) " " Frequent urination " " Increased thirst " " Mood changes " “ Mental depression " " Skin rash " " Acne " " Bloody/black stools " Stop drug now. blisters " " 382 A Lay Person's Guide .

All these are however indications for an emollient (soothing to skin) purgative like liquid paraffin. high blood pressure and hernia) when straining should be avoided. (iv) during preparation for examination or surgery.Interactions Drugs/Drug Class Effects Notes Digoxin Increased risk of adverse effects with digoxin Insulin t Blood thinner (taken by mouth) Altered effects of blood thinners Vaccines Serious reaction can occur Medicines for High BP t Medicines for depression Increased mental disturbances Folic Acid Requirement increase with long-term therapy. The fully evacuated bowels become inactive (atonic) and constipation usually follows for which a milder purgative is again needed. it should not be used in habitual treatment of constipation. Folic Acid supplements to be used Aspirin/Similar medicines t Increased dose of aspirin required. Profiles of 50 Drugs 383 . It may be used to provide relief: (i) in case of worm infestations along with the drugs that kill worm. The evacuation is invariably associated with griping. Water pills t Potassium depletion Effects of Long-term Use BISACODYL Drug Group: Laxative/ Purgative Principal Uses It is used. and (vi) following surgery or other medical problems (heart disease. (ii) during pregnancy. (iii) for a few days after child birth. Bisacodyl is preferably avoided in pregnancy. For this reason. on the advice and supervision of a doctor. to relieve constipation by causing complete evacuation of the bowels. (v) for constipation of bed-fast patients.

constipation is often remedied by adjustment of the diet. It increases the muscle contractions that help to propel the stool mass. Laxatives are also of value in drug induced constipation. pp nos. In infants. Dosage Adults: 5-10 mg (1-2 tablets) at bedtime. Misconception about bowel habits have led to excessive laxative use. Prolonged treatment of constipation is seldom necessary except occasionally in the elderly. Some people tend to consider themselves constipated if they do not have a bowel movement each day. About Laxatives in General Before prescribing laxatives it is important to be sure that the patient is constipated and that the constipation is not secondary to an underlying undiagnosed complaint. non-functioning colour. for the expulsion of parasites after anthelminthic treatment and to clear alimentary tract before surgery and radiological procedures. Moreover. Thus laxatives should be generally avoided except where straining will exacerbate a condition (such as angina) or increase the risk of anal bleeding as in piles. free of normal tension). Source: BNF. suppositories of 5 and 10 mg. Children: The use of laxatives in children is undesirable and the introduction of fruit into diet may be sufficient to regulate bowel action. 39-41 Note: Although there are products that contain more than one laxative in combination. Stimulant laxatives: Should seldom be needed. It is also important for those who complain of constipation to understand that bowel habit can vary considerably in frequency without doing harm. Dosage and Usage Information Available Dosage Forms: Tablets of 5 mg. Abuse may lead to hypokalaemia (low potassium) and an atonic (relaxed. 1993. Number 26 Sept. combination products are more likely to cause side-effects. A useful definition of constipation is the passage of hard stools less frequently than the patient’s own normal pattern and this can be explained to the patient. It is important to recognise that improved mobility and provision of time and privacy for going to the toilet may be all that is required. such products are not as advantageous. Tablets act in 10-12 hours and suppositories in 20-60 minutes. 384 A Lay Person's Guide . liquids. How this Drug Works It encourages bowel movements by acting on the intestinal wall.

To protect this coating.bloating . If taken on empty stomach it may cause intestinal cramping as it causes increased intestinal motility. .diabetes .anal bleeding like piles .For Radiology: 10 mg (2 tablets) by mouth at bedtime 2 days before examination and if necessary.stomach pain .nausea or vomiting. . Breast feeding: Consult your doctor before using it. if you have signs of appendicitis (lower stomach pain.high blood pressure . a 10 mg suppository one hour before examination. Inform your doctor if you notice a sudden change in bowel habits or function that lasts longer than 2 weeks or that keeps returning off and on. Consult your doctor before using.cramping in stomach area . Pregnancy: It may cause unwanted effects in a pregnant women if improperly used. . . mild fever vomiting. It is advisable to drink plenty of water during constipation so as to make the stool softer. Bisacodyl (enteric coated) tablets should not be given to children up to 6 years of age. just to clean out your system. if you miss a bowel movement for a day or two. Do not Take this Drug .swallowing difficulty .heart disease . for more than one or two days without medical advice (even if you have had no results from it).laxative habit . do not chew. Precautions Be sure to tell your doctor if you have . . the next morning) with water. Profiles of 50 Drugs 385 . How and When to Take It is taken at bedtime (to produce results. in intestinal obstructions.soreness in anal area . bloating). as they may chew the tablet leading to stomach irritation. Bisacodyl tablets are often coated to allow them to work properly without causing irritation and/or nausea (enteric coated). crush or take the tablets within an hour of milk or medicines used for acidity. within 2 hours of taking other medicine since the desired effect of other medicine is reduced.

muscles. Effects of Long-term use It leads to dependence on the laxative action to produce bowel movement ("laxative habit"). they dissolve enteric acidity hyperacidity or ulcer) coating of bisacodyl causing stomach irritation. over use of some laxatives may damage the nerves. Potassium Supplements t Antacids (drugs used in ¯ If given within 1 hour. unless prescribed by a physician. Possible Adverse Effects Symptoms/Effects Frequency What to do Breathing difficulty Rare Discuss with your doctor as soon as possible. 386 A Lay Person's Guide . Over 60: Weakness and lack of coordination may increase on repeated use of laxatives. Burning or urination " " Confusion " " Headache " " Irregular Heartbeat " " Mood/Mental change " " Muscle Cramps " " Skin rash " " Weakness " " Belching " Discuss with your doctor only if severe. Interactions Drugs/Drug Class Effects Notes Waterpills t Their effect is nullified as laxatives cause (Potassium sparing diuretics) excessive potassium loss. and tissues of the intestine and bowel. rebound constipation and occasional diarrhoea. bisacodyl is relatively non-toxic. Cramping " " Diarrhoea " " Nausea " " Except griping.Infants and Children: In general. any laxative should not be given to children up to 6 years of age. In severe cases. Above mentioned adverse drug effects are very very rare.

CALAMINE LOTION

Drug Group : Antiseptic
Antipruritic (Anti-itch)

Principal Uses

It is used to produce a soothing and protective effect on skin lesions caused by sun burn, eczema or allergic
rash, for itching and irritant conditions of skin. It my be applied to insect bites or stings for its smoothing
effect. It is not effective in fungal infections.

How this Drug Works

It protects and soothens the affected skin. The lotion is initially watery. When it is applied to the skin, the
evaporation of water produces a cooling effect, and oozing of pus is reduced.

Dosage and Usage Information

Available Dosage Forms: Pink-coloured lotion containing 15 gm calamine, 5 gm zinc oxide, 3 gm bentonite, 0.5
gm sodium citrate, 0.5 gm liquified phenol and 5 ml glycerol in 100 ml freshly boiled and cooled water.

Usual dosage: Apply as and when required.

How and When to Take

Apply to the affected area with clean cotton, without rubbing. If pus is oozing from the skin, the lotion
should be applied repeatedly, so that the skin does not become excessively dry.

Precautions

Do not apply to ulcers and infected skin lesions.

Profiles of 50 Drugs 387

CHLORHEXIDENE

Drug Group: Antiseptic
Principal Uses

Effective against a wide range of bacteria, some fungi and some viruses. It is used to treat superficial skin
infections such as superficial ulcers, and abrasions. It is used as an antiseptic solution to clean the skin, for
example, in the cleaning of the vulva and perineum (the area between vulva and anus in females) during
labour. It can also be used for gingivitis (swollen gums) and the prevention of plaque, mouth washes and for
the washing of hands before carrying out any surgical procedures.

How this Drug Works

It is an antiseptic and is effective against many bacteria. Thus it is useful for treating or preventing skin
infections. It is not effective against bacteria that cause TB as well as against fungus, eg., ringworm infections.

For general disinfectant purposes, chlorhexidine gluconate is commonly used in combination with
cetrimide.

Dosage and Usage Information

Available Dosage Forms: Mouthwash, dental gel, oral spray, powder form

Hospital concentrate: 20 %; acqueous solution 5 %; cream (water soluble) 1 %.

Dosage

For ulcers and skin-infections: 1% solution or powder/ointment as needed. For cleaning the skin and washing
hands before surgery: 0.5%.

For mouth wash: 0.1% thrice daily.

For bathing mothers and babies in maternity units and for cleaning wounds: 0.02%

How and When to Take

Hospital concentrate solution of 20% or powder form are available. The solutions of the required strength
(which varies as per use) are made and used. The dilutions from 20% concentrate are made as follows:

1.00% : dilute 5 ml of 20% concentrate to 100 ml with water.

0.50% : dilute one part of 20% solution with 39 parts of water

0.02% : dilute one part 0.5% solution with 24 volumes of clean water

388 A Lay Person's Guide

0.10% : dilute 1 ml of 20% concentrate to 200 ml with clean water or 2 ml of 0.5%: dilute solution to 10 ml
with clean water.

Note: Always use freshly boiled and cooled water for preparation of the solution. Old solutions lose potency.

Precautions

Others: At least 30 minutes should be allowed to elapse between the use of tooth paste and oral chlorhexidine.

Do not swallow.
Do not mix it with soap.
Do not store the diluted solution for more than 2 days.
Do not use cork/cork liners to close the containers containing chlorhexidine
Do not use it in the ears of patients with perforated ear drums.

Possible Adverse Effects

Symptoms/Effects Frequency What to do

Allergic rash Rare Discontinue use. Discuss with your doctor immediately.
Irritation of the mucous Rare "
membranes

CHLOROQUINE PHOSPHATE

Drug Group: Anti-malarial
Principal Uses

It is highly effective in most cases of malaria. In a few cases, it can fail. This occurs when the malaria parasites
are resistant to chloroquine. It is also used to treat lepra (related to leprosy) reactions, rheumatoid (like
rheumatism) arthritis and lupus erythematosus (see Glossary), not controlled by other drugs.

How this Drug Works

Anti-Malaria: It kills the microorganisms (germs) that cause malaria.
Rheumatoid Arthritis: It reduces the inflammation (swelling).

Dosage and Usage Information

Available Dosage Forms: Tablets, liquids, injectables

Profiles of 50 Drugs 389

g.G-6PD deficiency . Infants and Children: Reduced dose necessary as per schedule. Rheumatoid Arthritis: 150 mg base (one tablet) daily for 6-12 months or longer. etc. Prevention: 300 mg base (2 tablets) to be taken once in a week (e.psoriasis (a condition characterised by reddish lesions on elbows. Dosage Adults: 600 mg base (4 tablets to be given immediately followed by 300 mg base (2 tablets) after six hours.alcohol habit . Children: First day 10 mg/kg followed by 5 mg/kg after six hours. Then 300 mg base (2 tablets) to be given for two subsequent days in the morning. fits) .nerve/brain disease (e. Lepra Reactions: 150 mg base (one tablet) three times a day for two weeks. loss consciousness (can even lead to death within 2 hours) Seek immediate medical help in all cases..porphyria (a disorder of porphyrin metabolism) .liver disease . Precautions Be sure to tell your doctor if you have : . excitability. Avoid such activities during therapy. Prevention: 5 mg base/kg/week. Second and third day: 5 mg/kg/day as single dose. What if you Exceed the Dose The symptoms include vision problems.any blood disease . Alcohol: Avoid. Liver problems are likely to occur when you drink alcohol while taking this drug. Chloroquine is to be used when other drugs are ineffective or when they cannot be used.vision problems . Breast feeding: Although it passes into the breast-milk. in nursing mothers. fits.g. trunk. Preferred drug is hydroxychloroquine sulphate to be given in a dose of 400-600 mg initially for 1-3 months and then in the dose of 200-400 mg. on every Sunday). (Clofazimine/aspirin is preferred over chloroquine).Note: Choroquine base 150 mg is equivalent to chloroquine sulphate 200 mg which in turn is equivalent to chloroquine phosphate 250 mg. 390 A Lay Person's Guide .) Pregnancy: Can be used. Driving and Hazardous Activities: This drug causes dizziness and vision problems when taken in high doses. How and When to Take Take after meals or with milk to avoid nausea and vomiting due to stomach irritation. How to Stop Using this Drug Keep taking this medicine for the full course of treatment even if you begin to feel better after a few doses. it can be safely used..

particularly Drug induced pain can be managed Drug induced gastritis Quinine. mimicking acute rarely abdominal abdominal syndromes. Quinine. in behaviour and malaria. In the young. can be tried. be used. Betahistine etc. And this can hyperpyrexia. Primaquine Chloroquine. By then the of parasitemia and the patient may fever and presence of have other symptoms and signs of malarial parasites may be severe malaria viz. pyramidal signs. anemia. Vomiting is even otherwise Anti emetics like Domperidone and Quinine. metaclopramide can cause extra- Vomiting Halofantrine. there may be acute with antacids or H2 receptor blockers causes mild Mefloquine. so Promethazine Tetracyclines. Profiles of 50 Drugs 391 . occur on treatment for any type of malaria. Usually mild. etc. can Dizziness Mefloquine. These symptoms can be due to Watchful expectancy. hypotension. falciparum.Interactions Drugs/Drug Class Effects Notes Antacids ¯ Kaolin (antidiarrhoeal) ¯ Phenylbutazone Severe skin reactions Gold salts ( like those used in ayurvedic medicines) “ Effects of Long-term Use Eye damage Drug Induced Problems in Malaria Problem Drug/s Differentiation from Treatment severe malaria Chloroquine. pain over upper abdomen or right discomfort and very Primaquine lower abdomen. Chloroquine. if needed. dehydration and postural like Cinnarazine. common in malaria. severe falciparum infection or due tranquilizers like Haloperidol can be Drug induced alterations Mefloquine to high grade fever in any type of used. In malaria. if bothersome. usually at the Metaclopramide. height of fever. hallucinations. then consciousness usually peripheral blood should show appear after 24-48 hrs of falciparum infection. drugs Quinine. lower. Could be due to high fever. jaundice etc. cramps Altered behaviour. Halofantrine Itching Chloroquine Anti histamines can be tried Pain abdomen Chloroquine. If these problems are changes in the level of caused by severe infection. high degree starting tt. Mefloquine.

Drug Induced Problems in Malaria

Problem Drug/s Differentiation from Treatment
severe malaria
Convulsions Chloroquine, In severe malaria, convulsions Anticonvulsants like
Some antimalarials can Quinine, may be recurrent and may lead to phenobarbitone for recurrent
induce convulsions. It Mefloquine unarousable coma. convulsions. Mefloquine is better
may also be due to avoided in known epileptics.
hypoglycemia induced
by quinine.

Coma Quinine can In cerebral malaria, coma persists 25-50% dextrose, 50-100 ml
cause even after infusion of 50% intravenously.
hypoglycemia, dextrose.
which may
present as
coma.
Quinine In severe falciparum malaria, 25-50% dextrose, 50-100 ml
Hypoglycemia
especially in pregnancy and intravenously.
children, hypoglycemia can occur
even without quinine therapy.
Primaquine: It Anemia is a common feature in Usually self-limiting; withdraw the
Anemia can cause malaria, especially in children. drug; blood or packed cell
massive transfusion if needed.
hemolysis in
patients with
Glucose 6-
phosphate
dehydrogenase
deficiency
Jaundice Primaquine Severe malaria can cause Withdraw the drug.
may cause hemolytic jaundice, or rarely
hemolytic malarial hepatitis.
jaundice in
patients with
Glucose 6-
phosphate
dehydrogenase
deficiency
Hemoglobinuria Primaquine
(same group
as above)

Fever Artemisinin In cases of resistant malaria, with Self-limiting, disappears after the
Continuing even after derivatives the continuation of fever, the drug is stopped.
improvement in general general condition deteriorates
condition and significant and malarial parasite count
reduction in malarial increases.
parasites.
Source: <http://www.malariasite.com/malaria/DrugProblems.htm>

392 A Lay Person's Guide

CHLORPHENIRAMINE MALEATE

Drug Group : Antiallergic
Principal Uses

It is used to treat symptomatic relief of allergies (itching, swelling, redness) such as hay fever, urticaria,
hives, allergic swelling and allergic conjunctivitis (itching and redness of eyes).

It reduces sneezing and runny nose and depresses mucus secretion and thus provides relief in common cold
and cough. (It does not cure common cold.)

Other Uses

It may be used to treat allergic reactions to blood transfusions or x-ray contrast material and along with
adrenaline injection to treat acute allergic shock.

Its combination with pain killers, antidiarrhoeals, tranquilisers (sleeping drugs) steroids and other anti-
allergics are considered to be irrational.

How this Drug Works

It works by preventing the effects of a substance called histamine, which when produced in abnormal
amounts, in the body, may give rise to skin irritation, swelling and other symptoms of allergy.

Dosage and Usage Information

Available Dosage Forms: Tablets, liquids, injectables

Dosage

Adults: 4 mg ( 1 tablet or 1 teaspoonful) every 6 hours daily, but adjust the schedule to waking/sleeping
pattern.

Children: Above 6 years: 2 mg ( 2.5 ml or 1/2 teaspoonful) every 6 hours daily. Under 6 years: 1 mg ( 1.25 ml or
1/4 teaspoonful) every 6 hours daily.

How and When to Take

Take it with food or a glass of milk to lessen stomach irritation.

What if you Miss a Dose

Take as soon as you remember. If your next dose is due within 2 hours take a single dose now and skip the
next. Do not double the doses.

Profiles of 50 Drugs 393

What if you Exceed the Dose

Large overdose may lead to:

- drowsiness or agitation

- feeling faint

- flushing redness of face seeing, hearing or feeling things that are not there

- troubled breathing, seizures. Consult your doctor immediately.

Precautions

Be sure to tell your doctor if you have:

- long term liver problems, epileptic fits, glaucoma, urinary difficulties asthma, enlarged prostate, to
undergo any skin tests for allergies (the results of the tests may be affected).

Do not use this drug in premature/new born infants as serious side-effects may occur in to them.

Pregnancy: Safety is not established. Avoid this drug.

Breast feeding: Drug passes into the breast milk, and may cause unusual excitement or irritability in the infant.
It also tends to decrease the flow of breast milk sometimes. Use is not recommended.

Infants and Children: Reduced dose necessary.

Over 60: Reduced dose may be necessary. Increased likelihood of adverse effects.

Driving and Hazardous Activities: Machine operation should be avoided as this drug causes some people to
become drowsy and less alert.

Alcohol: Should be avoided as this drug adds up to the sedative (drowsy) effects of alcohol and other sedative
drugs.

Others: This drug may cause dryness of mouth, nose and throat. If dry mouth continues for more than 2
weeks, check with your dentist since it may increase the chance of dental disease.

Paradoxical stimulation in high doses in children.

When applied to skin, it causes allergic reactions. Avoid topical use.

394 A Lay Person's Guide

nose. Unusual bleeding /bruising " " Unusual weakness " " Excitation (children) " Discuss with your doctor immediately and stop drug now. ­ " Anaesthetics ­ “ Profiles of 50 Drugs 395 .Possible Side-effects Symptoms/Effects Frequency What to do Sore throat and Fever Rare Discuss with your doctor immediately. Rash " " Drowsiness Common Discuss with your doctor only if severe (reduce dose) Change in vision Rare " Urinary difficulties " " Dry mouth. throat " " Loss of appetite " " Stomach upset " " Shaking / Tremor " " Ringing or buzzing sound in ears " " Thickening of bronchial Common " secretions Increased sensitivity to Sun Rare " Increased sweating " " Fast heartbeat " " Interactions Drugs/Drug Class Effects Notes Sedatives (Sleeping Medicines) ­ Increased drowsiness Medicine for Stomach Cramps ­ (Atropine and atropine-like drugs) Betahistine t Increased drowsiness Seizure medicine ­ " Pain Medicine ­ " Medicine that relax muscles.

dizziness. CO-TRIMOXAZOLE Drug Group: Antibacterial combination Principal Uses Co-trimoxazole (trimethoprim plus sulphamethoxazole) is used in the treatment of urinary tract infections. action on ear (e. A different anti-allergic (antihistamine) may be recommended by your doctor. ­ Concurrent use not recommended. phenelzine. aspirin in etc.Drugs/Drug Class Effects Notes All medicines that have toxic Toxic effects like ringing in ears. How this Drug Works It is a mixture of two drugs: 5 parts of sulphamethoxazole (a sulfa drug) and 1 part of trimethoprim. large doses). in acute respiratory infections.. pargyline. The combination is not effective in virus infections such as common cold and flu. in the treatment of bacillary dysentery caused by bacteria. possibly causing drowsiness). procarbazine. Furazolidone.. CNS depressants or s Increased drowsiness ­ (Medicines that slow down the nervous system. are covered up by this drug. in chancroid (a sexually transmitted disease). and in the treatment of typhoid. 396 A Lay Person's Guide . isocarboxazid. They work synergistically by preventing the growth and multiplication of the bacteria that cause the infection and thus cure the infection.g. in abscess and skin infections. tranylcypromine) Effects of Long-term Use The effect of the drug may become weaker with prolonged use over a period of weeks or months as the body gets used to it.

Notify your doctor as soon as possible. At normal doses it is safe but discuss with your doctor. dizziness and confusion. Breast feeding: Drug passes into breast milk. Note: Use for 15 days in typhoid fever and continue for 3 months in typhoid carrier cases. Children: 25 mg/kg/dose sulphamethoxazole and 5 mg/kg/dose trimethoprim given at 12 hours interval for 7-10 days. vomiting. Pregnancy: Avoid. What if you Miss a Dose Take as soon as you remember.Dosage and Usage Information Available Dosage Forms: Tablets. How and When to Take It is best taken with a full glass of water. Drinking lots of extra water every day will help to prevent its unwanted effects.blood disorders . injectables Dosage Adults: 800 mg sulphamethoxazole and 160 mg trimethoprim every 12 hours for 7 to 10 days.long-term kidney/liver problems . What if you Exceed the Dose The signs include abdominal pain. It may cause birth defects in the baby. liquids. Precautions Be sure to tell your doctor if you have: . Then take next dose after 12 hours.porphyria Do not use: in patients hypersensitive (allergy) to sulfonamides (sulfa drugs). Do not stop without consulting your doctor. How to Stop Using this Drug Take the full course even if you feel better within a few days. Actual dosage schedule must be determined for each patient individually. Profiles of 50 Drugs 397 .

Rash/itching " " Severe skin reactions Rare " Sore tongue " " Headache/dizziness " " Jaundice (liver damage) " " Interactions Drugs/Drug Class Effects Notes Anticoagulants. Antidiabetic drugs  Excessive lowering of blood sugar levels. Possible Adverse Effects Symptoms/Effects Frequency What to do Diarrhoea Common Discuss with your doctor only if severe. Methotrexate  Diuretics  May lead to some blood disorder. 398 A Lay Person's Guide . Warfarin  Warfarin’s dose must be reduced. Effects of Long-term Use Not advisable without medical advice.Infants and Children: Not to be used in infants below the age of 2 months.. Phenytoin  Phenytoin’s dose must be reduced. (taken by mouth) Adjust the dose. Nausea/vomiting " Stop drug now. Do not use previously or simultaneously.g. Discuss with your doctor immediately. e. Methenamine Do not use (to treat urinary tract infections) simultaneously.

brain disease.planned to have surgery (also dental surgery) . vertigo. agitation.seizure disorder.heart disease. Dosage and Usage Information Available Dosage Forms: Tablets.urination problems (enlarged prostate). . liquids. . Should be avoided in children under one year altogether. nausea. vomiting. injectables. Consult your doctor immediately as overdose may lead to unconsciousness or death. Dosage Adults: Pain killer: 15-60 mg every 3-6 hours as needed.gall bladder disease.CODEINE PHOSPHATE Drug Group: Narcotic pain killer Anti-diarrhoeal. restlessness. nasal drops. dry mouth. Not generally recommended in children. How this Drug Works It suppresses the perception to pain and calms the emotional response to pain.underactive thyroid.history of drug abuse or alcoholism. Cough-Suppressant (liquid preparations 15 mg /5 ml) : 3mg/kg per day in 3-4 divided doses.lung disease (asthma) . weakness. Profiles of 50 Drugs 399 .liver/kidney problems.5 mg/kg body weight/dose. seizures. Children: Pain-killer: 0. Causes constipation in repeated dosing. . Cough Suppressant : 10-12 mg every 4-6 hours. Precautions Be sure to tell your doctor if you have: . It also reduces the sensitivity of the cough reflex. . 4 times daily. It is also used to suppress dry irritating cough. lethargy. coma. . . . Cough Suppressant Dependence rating : Medium Principal Uses It is used to relieve mild to moderate pain. Overdosage Symptoms include drowsiness.

Others: It may cause dryness of mouth. Sleeping drugs and Antiallergics ­ Furazolidone ­ Use with caution in reduced dosage. Antipsychotics. Breast feeding: It passes into the breast milk. Alcohol: Avoid. Avoid.. Infants and Children: Do not use in children under 2 years of age. Effects of Long-term Use Psychological and physical dependence as well as chronic constipation may occur. Possible Side-effects Symptoms/Effects Frequency What to do Drowsiness Common Discuss with your doctor only if severe Nausea/vomiting Common " Constipation Common " Urinary problems Rare " Interactions Drugs/Drug Class Effects Notes Medicines with sedative effects ­ Increased Sedation. Antidepressants.g. Alcohol may increase the sedative (depressing) effects of this drug. (that slow down the nervous system) e. If it continues for more than 2 weeks. Pregnancy: Safety not established. It should be preferably used for short term only. 400 A Lay Person's Guide . check with your dentist as dry mouth may increase the chance of dental disease. Over 60: Reduced dose may be necessary as they are more susceptible to adverse effects.Do not take this drug : If you are having an acute attack of asthma. Avoid hazardous activities accordingly. Driving and Hazardous Activities: This drug may cause dizziness and drowsiness.

It delays the elimination of the germs that cause diarrhoea by slowing down the movement of intestinal tract. This may lead to serious reactions in children. How this Drug Works It inhibits the growth and multiplication of micro-organisms (germs) that cause leprosy. a skin problem. clofazimine and/or rifampicin depending on the nature of leprosy. it is a constipating drug and is used in short term control of diarrhoea. this use is irrational. Although. Profiles of 50 Drugs 401 . It is used as a constipating drug in selected circumstances. DAPSONE Drug Group: Anti-infective. Although. Antileprotic Principal Uses It helps the body to overcome leprosy (Hansen’s disease) and to help control dermatitis herpetiformis. A daily dose of 100 mg may continue up to 6 months or 2 years depending on the treatment regimen. Dosage and Usage Information Available Dosage Forms: Tablets of 100 mg.Note : Its use in the treatment of productive cough is not considered to be rational. Dosage Taken along with ethambutol. the combination is thought to be irrational. it is often combined with antiallergics.

Possible Adverse Effects Symptoms/Effects Frequency What to do Fever Common Discuss with your doctor immediately Loss of appetite " " Pale skin " " Skin rash " " Unusual tiredness or weakness " " Bluish fingernails. Vomiting " " 402 A Lay Person's Guide .How and When to Take To help clear up leprosy completely and permanently. it is important to take this medicine every day for the full time of treatment (6 months or 2 years depending on the nature of infection). Breast feeding: It passes into the breast milk. " " loss of hair Mood changes " " Sore throat " " Yellow eyes or skin " " Headache. lips or skin Rare Discuss with your doctor only if severe Troubled breathing " " Itching/scaling of skin.liver/kidney problems . What if you Miss a Dose Take as soon as possible.severe anemia . Precautions Be sure to tell your doctor if you have: . and then follow regular schedule.G-6PD and/or methaemoglobin reductase (enzymes) deficiency. so you do not miss any doses. Diet: For dermatitis herpetiformis : Your doctor may want you to follow a “gluten-free” diet. Discuss with your doctor. It is best to take each dose at the same time every day.

Anti-anxiety. Anticonvulsant Dependence Rating : High Principal Uses It is used to relieve nervousness or tension.Interactions Drugs/Drug Class Effects Notes Para Aminobenzoic acid ¯ In treatment of leprosy (alone). Muscle relaxant. How this Drug Works It depresses activity in the part of the brain that controls emotion. the effect of (PABA) dapsone is nullified Any medicine that causes ¯ Increased chances of toxic side-effects of dapsone blood disorders DIAZEPAM Drug Group: Benzodiazepines. by promoting the action of a chemical nerve transmitter (GABA) which in turn prevents excessive brain activity that causes anxiety. to treat epilepsy (convulsions) to relieve the symptoms of acute alcohol withdrawal and to sedate (induce sleep in) people undergoing certain medical procedures like anaesthesia. Profiles of 50 Drugs 403 . to treat anxiety and anxiety related sleeplessness. to relax muscles or to relieve muscle spasms.

Commoner with injection. staggering. .epilepsy or history of seizures. if you remember later. confusion.) . Note: Dose may be increased cautiously as needed and tolerated. skip the missed dose and go back to your regular schedule. asthma etc. Dosage Range Adults: 2-10 mg. . How and When to Take May be taken on empty stomach or with food or milk. What if you Miss a Dose Take it immediately if you remember within one hour. unusually slow heart rate and troubled breathing.or had serious depression or mental illness.myasthenia gravis. Notify your doctor immediately. .prescribed for a child under 6 months of age. tremor. sweating and vomiting. The prolonged action capsule should not be opened before administration. How to Stop Using this Drug Do not discontinue the drug abruptly if taken continuously for more than 4 weeks. 404 A Lay Person's Guide . Total daily dose should not exceed 60 mg.long-term liver or kidney problems. Do not take this drug if : .or had serious breathing problems (emphysema. slurred speech. liquids.you have acute narrow angle glaucoma . However. Dosage should be reduced gradually. so as to prevent withdrawal syndrome that include depression.had problems with alcohol or drug abuse . 2-3 times daily (usually administered at night). seizures. Do not double your dose. injectables.Dosage and Usage Information Available Dosage Forms: Tablets. What if you Exceed the Dose The symptoms include severe drowsiness and weakness. Actual dosage and administration schedule must be determined by the physician for each patient individually. muscle cramping. Precautions Be sure to tell your doctor if you have : .

Tobacco: Avoid. excitement) Mental depression/confusion " " Skin rash " " Sore throat and fever " " Yellowing of eyes/skin " " Unusual bleeding/bruising " " Drowsiness Common Discuss with your doctor only if severe Dizziness/Unsteadiness " " Headache Rare " Vision problems " " Slurred speech " " Dry mouth " " Stomach upset " " Menstrual irregularity " " Urinary problems " " Unusual Weakness " " Profiles of 50 Drugs 405 . It reduces the calming action of this drug.6 months of age (ii) hyperactive or psychotic child of any age Over 60: Increased chances of adverse effects.Pregnancy: Avoid use during the entire term of pregnancy. Infants and Children: Reduced dose necessary. It increases the chances of birth defects and may cause the baby to become dependent on it. It increases sedative effects of this drug. Possible Side-effects Symptoms/Effects Frequency What to do Behaviour problems Rare Discuss with your doctor immediately (anger. Avoid drug or refrain from nursing. Alcohol: Avoid. Not to be used for (i) children one months . Reduced dose may be necessary. Others: It produces psychological and/or physical dependence if used in large doses for long time. Breast feeding: It passes into the breast-milk and causes drowsiness or breathing problems in babies of mothers taking this drug.

¯ Blood pressure falls down severely. Increased sedation. muscle relaxants.. pargyline.Interactions Drugs/Drug Class Effects Notes Digoxin Digoxin toxicity Phenytoin Phenytoin toxicity Levodopa ¯ Reduced effectiveness Cimetidine ¯ " Disulfuram ¯ " Isoniazid ¯ " Oral Contraceptives ¯ " Valproic Acid ¯ " Rifampicin ¯ " Sedatives ­ Increased sedation (e. depression medicine. procarbazine (MAO inhibitors) Effects of Long-term Use Regular use of this drug over several weeks can lead to a reduction in its effect as the body gets used to it. seizure medicine. It may be habit forming when taken for very long periods. Furazolidone. verapamil. etc) Water pills Cardiac drugs (diltiazem. sleeping medicine. antiallergics. 406 A Lay Person's Guide . nifedipine) Maprotiline Depressant effects High blood pressure medicine Blood pressure falls down severely. narcotics.g.

For digoxin: To be taken by mouth. Children: Reduce dose according to age and weight.DIGOXIN Drug Group: Digitalis group of medicine.125-0. Return to your normal schedule the next day. The amount to be taken is to be measured accurately with a specially marked dropper.25 mg. How this Drug Works It restores the normal rate of the heart so that each beat is more effective in pumping blood. If your next dose is due within four hours. What if you Miss a Dose Take as soon as you remember.25 mg daily divided in 2-3 doses given 6-8 hours in one day. Injectables : 1 mg/ml Dosage Adults: 0. It should be used only under doctor’s supervision. It may be taken with or after food (but not milk and milk products). Maintenance : 10-20 mg/kg body weight in single/divided doses. Antiarrhythmic heart Medicine Principal Uses It is given in the treatment of congestive heart failure and in the maintenance of normal heart rate and rhythm. Profiles of 50 Drugs 407 . It thus improves the strength and efficiency of the heart. How and When to Take Take at the same time each day or preferably on an empty stomach. breathlessness and swelling of hands and ankles in patients with such problems. This leads to better blood circulation. controls tiredness. Note: Actual dosage and administration schedule should be determined by the doctor for each patient individually. Dosage and Usage Information Available Dosage Forms: Tablets 0. take both doses now and skip the next. Dose: 10-20 mg/kg body weight every 6 hours.

The symptoms include loss of appetite. rheumatic fever. Infants and Children: Reduced dose necessary.What if you Exceed the Dose The amount needed to help most people is very close to the amount that could cause serious problems from overdose. large amount of fiber. How to Stop Using this Drug Do not discontinue without consulting your doctor. Driving and Hazardous Activities: Do not drive until you know how this drug affects you. discuss with your doctor. This drug may be more toxic if potassium levels fall. severe weakness. nausea. Observe for irregular heart rate and rhythm in case of overdose. Pregnancy: This medicine passes from mother to fetus. Reduced dose may therefore be necessary. Although at normal doses. effects on the baby are unlikely. Hence include fruit and vegetables in your diet. heart attack. Monitor nursing infant for adverse effects and discontinue dry or refrain from nursing. Precautions Be sure to tell your doctor if you have kidney/liver the following problems: thyroid. tea. such as bran in your diet. headache. diarrhoea. loss of consciousness. Breast feeding: Small amount of drug passes into the breast milk. disturbances of heart rate and rhythm. confusion. Diet: Avoid milk and milk products for 2 hours before and after taking this drug. Tobacco: It can lead to serious disturbances of the heart rhythm. 408 A Lay Person's Guide . Avoid: caffeine containing beverages : Coffee. as other signs are not clearly seen in children. lung. Seek immediate medical advice in all cases. Avoid all forms of tobacco. plan to undergo any surgery. Over 60 years: Increased likelihood of adverse effects. Stopping suddenly may cause a serious change in heart function. chest pain. Safety not established. vomiting. It can cause drowsiness and mental confusion.

are not real Heart rhythm disturbances Common " Visual problems Common " Tiredness Common Discuss with your doctor only if severe. Skin rash Rare " Confusion Rare " Headache Rare " Urinary problems Rare " Dryness of skin and mouth Rare " Interactions Drugs/Drug Class Effects Notes Water pills (other than Serious heart rhythm disturbances.Possible Adverse Effects Symptoms/Effects Frequency What to do Nausea. spironolactone and triamterene) Quinidine Cortisone like medicines ¯ Calcium toxicity Amiodarone ­ Increased digoxin concentration. Diltiazem ­ Erythromycin ­ Methimazole ­ Propylthiouracil ­ Quinine ­ Tetracyclines ­ Verapamil ­ Profiles of 50 Drugs 409 . Seeing. vomiting Common Discuss with your doctor in all cases Constipation Rare " Stomach pain " " Bloating " " Loss of appetite Common " (May indicate a more serious problem with your bowels). hearing things which Rare Discuss with your doctor immediately.

skin allergies (hives). It is being used in the treatment of Parkinson’s disease and movement disorders. without your doctor’s advice. drug or insect stings. antidiarrhoeals. 410 A Lay Person's Guide . motion sickness. It is thought to relieve cough also. It is combination with painkillers. It is used to treat vomiting and vertigo. It also relieves nausea and vomiting. Reduces stiffness and tremors in Parkinson’s disease.Drugs/Drug Class Effects Notes Antacids ¯ Bleomycin ¯ Carmustine ¯ Cholestyramine ¯ Colestipol ¯ Cyclophosphamide ¯ Cytarabine ¯ Doxorubicin ¯ Methotrexate ¯ Penicillamine ¯ Procarbazine ¯ Thyroid hormones ¯ Vincristine ¯ Note: Since many drugs interact with digoxin. (It does not treat ‘cough’). DIPHENHYDRAMINE Drug Group: Anti allergy Anti-vomit. do not take any medication along with digoxin. and adverse effects due to food. tranquilizers (sleeping drugs). Anti-Parkinsonism Principal Uses It is used to treat allergies like allergic rhinitis (cold due to allergy). steroids and other antiallergics are considered to be irrational. Used as a sedative.

glaucoma . difficult breathing. while it’s sedative effects are used to induce drowsiness/sleep. How and When to Take Take with or following food to reduce stomach irritation.enlarged prostate . Its natural side-effects are used to advantage: it’s atropine-like effects are used in management of motion sickness and Parkinsonism.5-25 mg ( 5-10 ml or 1-2 teaspoonful syrup) 3-4 times daily. If your next dose is due within 2 hours take a single dose and skip the next. Note: Actual dosage and administration schedule must be determined by the physician for each patient individually. in the body may give rise to skin irritation. swelling and symptoms of allergy.kidney problems . liquids Dosage Adults: 25-50 mg/every 4-6 hours till symptoms are relieved. (preferably 1 to 2 hours) before you begin to travel. flushed face. Precautions Be sure to tell your doctor if you have : . Notify your doctor as soon as possible. long-term liver problems. unsteadiness. profound unconsciousness. weak pulse. What if you Exceed the Dose The symptoms include severe drowsiness. dilated eyes. Dosage and Usage Information Available Dosage Forms: Tablets. which when produced in abnormal amounts. confusion in coordination. What if you Miss a Dose Take as soon as you remember. agitation.How this Drug Works It works by preventing the effects of a substance called histamine. asthma . then 25-50 mg daily.peptic ulcer . . Profiles of 50 Drugs 411 . Children: 12. For motion sickness: Take at least 30 minutes. fever. muscle tremors. surgery within 2 months including dental surgery.

Over 60: Reduced dose may be necessary. and possible death). This drug may make you more sensitive to sun. Use cautiously. Do not use this drug if you have asthma or other lung problems. Reduced dose necessary. Alcohol: Avoid. Such as urination difficulty. This drug causes dry mouth. since there are chances it may cause unusual excitement or irritability in the infant. flu-like infection or Reye’s syndrome (a condition in children marked by loss of consciousness. Driving and Hazardous Activities: Avoid such activities until you know how the drug affects you because the drug can cause drowsiness. because it thickens the secretions in the lung and makes it more difficult to remove (by absorption/ coughing). Use sparingly during the first six months only if clearly needed. Possible Side-effects Symptoms/Effects Frequency What to do Sore throat and fever Rare Discuss with doctor immediately Unusual bleeding or bruising " " Unusual tiredness or weakness " " Urinary problems " " Disorientation/excitation " " Drowsiness Common Discuss with doctor Dry mouth " Nausea/abdominal pain Rare Vision problems " Skin rash " Increased sweating " 412 A Lay Person's Guide . Others: Discontinue this drug five days before diagnostic skin testing procedures in order to prevent false negative test results. Infants and Children: Not given to premature and newborn infants. Its use is not recommended. Alcohol may increase the sedative (drowsy. sleepy) effects of this drug. Not used in children with chicken pox. If this continues for more than 2 weeks. Increased likelihood of adverse effects. Besides. diminished alertness and other brain and nervous system symptoms. Avoid drug or refrain from nursing. check with your dentist since dry mouth may lead to dental disease.Pregnancy: Avoid drug during the last three months. Breast feeding: This drug passes into the breast-milk. it decreases the secretions of the body and hence it is possible that the flow of breast milk may also be reduced.

Symptoms/Effects Frequency What to do Ringing in ears " Headache Rare Nightmares " Confusion " Interactions Drugs/Drug Class Effects Notes All medicines with sedative s Oversedation (drowsy. Although it is effective in asthma. action is prolonged. How this Drug Works It opens up the bronchial tubes (air ways) of the lungs by relaxing the muscles around them and thus Profiles of 50 Drugs 413 .) Note: Continuous use of nasal sprays may worsen the condition leading to rebound congestion. which have lesser side-effects but are costlier) are taken in rotation during successive weeks. isocarboxazid.. pargyline. in mild cases of allergic rash and itching and as nasal spray to relieve the blocking of nostrils occurring during an attack of common cold. aminophylline. tranylcypromine) Effects of Long-term Use The effect of this drug may become weaker with prolonged use over a period of weeks or months as the body adapts. etc. Fixed-dose combination with other bronchodilators must be avoided. phenelzine. sleepy effect) Atropine and Atropine-like s medicines MAO-inhibitors ­ Elimination of this drug is delayed and thus its (eg.. furazolidone. It may be used to treat low blood pressure certain mental depression and narcolepsy (uncontrolled desire to sleep. EPHEDRINE Drug Group: Bronchodilators Principal Uses It is used in the treatment and prevention of asthma. salbutamol. its continual use may lead to development of tolerance. Hence it is better if other drugs for asthma (eg.

Diazepam is usually given along with it to avoid sleeplessness.mental disease . For allergy: 30 mg (1 tablet) thrice daily for 5 days. Dosage and Usage Information Available Dosage Forms: Tablets. chills. syrups. fever. For Nasal blockade: 1-2 drops into each nostril as and when required. vision problems. nausea.fits 414 A Lay Person's Guide .overactive thyroid .diabetes . muscle cramps. injectables Dosage: Adults 15 mg to 60 mg. anxiety.enlarged prostate . Similarly it also opens up the nostrils blocked during common cold. Avoid repeated and excessive dose. What if you Exceed the Dose Signs (not all of them will occur). fits.brain damage . large pupils. chest pain. inhalers.high blood pressure .take the tablet at bed time to avoid asthma attack at night.heart or blood vessel disease .Parkinson’s disease . If you have exceeded a total dose of 240 mg/day and/or the above signs are observed. Precautions Be sure to tell your doctor if you have: .facilitates easy breathing. three times daily For Asthma: 30 mg (1 tablet) repeated after six hours if necessary For Prevention of Asthma: 30 mg (1 tablet) twice daily. Then use any remaining doses for that day at regularly-spaced intervals. notify your doctor immediately. headache (severe). For asthma . irregular heart beat. pale cold skin and weakness. Blue coloured skin. dizziness high/low BP. Children: 3 mg/kg/day every 6-8 hours. troubled breathing. What if you Miss a Dose Use it as soon as possible. How and When to Take Take the last dose a few hours before bed time to avoid sleeplessness.

symptoms may return after sometime in an aggravated condition). Cardiac Patients: Avoid in patients who have heart problem or high BP Possible Adverse Effects Symptoms/Effects Frequency What to do Stomach upset Rare Discuss with your doctor only if severe Difficulty in passing urine " Discuss with your doctor as soon as possible Sleeplessness " " Tremors " " Increased heart rate " " Mental disturbances and " " hallucinations Retention of urine (in patients " " with enlarged prostate) Interactions Drugs/Drug Class Effects Notes MAO Inhibitors Dangerous rise in BP Digitalis drugs Increased risk fast heart rate Medicines for high BP t Effects of Long-term Use For asthma: Tolerance may develop to this drug. Must be used only if clearly needed.Pregnancy: Safety for use has not been established. especially if he has chest pain and is sweating since he may be having a heart attack and must be referred to the doctor immediately.e. For nasal blockade: Rebound congestion (i. Also do not use to treat asthma on elderly who develops breathing difficulty for the first time. Discuss with your doctor. Do not use the drug it refrain from nursing. Over 60: Avoid. Breast feeding: Safety for use has not been established. It causes retention of urine. Profiles of 50 Drugs 415 ..

Ergot drug Principal Uses It is used to treat migraine headaches and some kinds of throbbing headaches. until complete relief is obtained. depression. drink or smoke while a tablet is dissolving. 416 A Lay Person's Guide .ERGOTAMINE Drug Group: Anti-Migraine. Use carefully under physician’s guidance. etc. How this Drug Works When the blood vessels in the head dilate (expand) they release certain chemicals which produce pain. dark room for at least 2 hours after taking it. Ergotamine relieves pain by narrowing the dilated blood vessels.) are not rational. The sublingual tablet should not be chewed or swallowed since it works much faster when absorbed through the lining of the mouth. subsequently every 30 minutes. It is not used to prevent headaches but is used to treat an attack once it has started. Lie down in a quiet. How and When to Take Take it at the first sign of headache or migraine attack. Do not eat. Note: It should not be used prophylactically (for prevention of migraine). Overdose is dangerous. It is most effective if taken at the first sign of that a migraine is going to occur. Not more than 6 tablets daily. Dosage and Usage Information Available Dosage Forms: Tablets Dosage Adults: 1-2 mg (2 tablets) daily. it is less likely to be effective and may cause a stomach upset and increase the nausea of migraine. For sublingual (under-the-tongue) tablets: Dissolve the tablet under your tongue. Its fixed dose combination with other medicines (for vomiting. Once headache and nausea are established. It is used along with caffeine to increase its effectiveness but a fixed dose combination is not required.

used ergotamine within 48 hours prior to .What if you Miss a Dose Regular doses of this drug are not necessary and may be dangerous.overactive thyroid any surgery Pregnancy: Since it can stimulate labour. vomiting. Notify your doctor as soon as possible.heart problem . Infants and Children: Not to be used Over 60: Use with caution.had a recent heart attack . your headaches may return or worsen. Hidden heart or circulatory problems may be aggravated. seizures. diarrhoea. Alcohol: Best avoided.kidney disease .high blood pressure . cold skin. What if you Exceed the Dose Symptoms such as nausea.liver disease . profound unconsciousness (coma) may occur. confusion.asthma .poor blood circulation . which could result in miscarriage. How to Stop Using this Drug If you have used it for a very long time (although it should not be used do not stop taking it without checking with your doctor. Besides some drinks provoke migraine in some people and alcohol may be one of those drinks. It may also reduce the milk supply. Diet: Changes in diet do not affect the action of this drug but certain foods may provoke migraine attacks in some people. loss of limbs. Tobacco: Best avoided as it may increase the harmful effects of this medicine. gangrene (tissue death) of fingers or toes.infection . Profiles of 50 Drugs 417 . Breast feeding: It passes into the milk and may have adverse effects on the baby. numb and painful hands or feet. Take only when you have symptoms of migraine. If stopped suddenly. Precautions Be sure to tell your doctor if you have: . Others: Your doctor may want to evaluate the circulation (blood flow) to your hands and feet. Alcohol can make headaches worse.

418 A Lay Person's Guide .Possible Side-effects Symptoms/Effects Effects What to do Localised swellings Common Discuss with your doctor only if severe Itching Rare " Chest pain " " Numbness and tingling of " " fingers and toes Muscle pains in arms or legs " " Nausea/vomiting " " Diarrhoea " " Headache " " Depression " " Dizziness " " Numbness and tingling of " " fingers and toes * Red/violet blisters on skin of hands/feet * " " Stomach pain/bloating (Gangrene of intestine) " " Due to Gangrene of hands/feet: Emergency surgery required * Interactions Drugs/Drug Class Effects Notes Erythromycin s Increased likelihood of adverse effects Beta blockers (heart medicine) Circulatory (Blood flow) problems may increase Cold remedies Some ingredients in these products cause dangerous rise in BP Nitroglycerine t It is unable to prevent or relieve angina pain Effects of Long-term Use Headaches (after drug is discontinued following long term use) and poor circulation (blood flow) to hands and feet.

capsules.3 or more doses a day . syphilis and other sexually transmitted diseases (v) amoebic dysentery. (iv) gonorrhoea. This will help to keep a constant amount of medicine in the blood. Note: Actual dosage and administration schedule must be determined by the physician for each patient individually. What if you Miss a Dose Take it as soon as possible. certain brands of erythromycin such as erythromycin estolate and erythromycin ethyl succinate or enteric-coated tablets should be taken on full or empty stomach (without regard to food). injectables Dosage : Adults: 250 mg to 1000 mg every 6 hours. However. Then go back to your regular dosing schedule. chlamydial infections. Children: 3-8 years 100-200 mg 3-4 times daily. (vi) for long-term prevention of recurrences of rheumatic fever.2 doses a day. syrups. How this Drug Works This drug prevents the growth and multiplication of susceptible organisms by interfering with their formation of essential proteins. How and When to Take It is best taken with a full glass of water on an empty stomach (eg. middle ear and chest infections. 1 hour before or 3/4 hours after meals). including some rare types of pneumonia such as mycoplasma pneumonia and Legionnaires disease and (iii) in treatment of diphtheria. Dosage and Usage Information Available Dosage Forms: Tablets.ERYTHROMYCIN Drug Group: Antibiotic Principal Uses It is used to treat a broad variety of common infections.. The important ones are (i) skin infections (ii) throat.space the missed dose and the next dose 2-4 hours apart or double your next dose. However. according to severity and nature of infection. if it is almost time for your next dose and your dosing schedule is: . space the missed dose and the next dose 5-6 hours apart . Profiles of 50 Drugs 419 .

the original infection may still be present and symptoms may recur if treatment is stopped soon.What if you Exceed the Dose Possible nausea. Infants and Children: More prone to stomach irritation. Monitor nursing infant closely and discontinue drug or nursing if adverse effect develop. Even if you feel better. Notify your doctor. Driving and Hazardous Activities: This drug may cause nausea and/or diarrhoea. Alcohol: Avoid if you are taking erythromycin estolate. Restrict activities as necessary. May be taken with milk. Others: Your doctor may want to check your liver function by performing a test if you are being given erythromycin estolate.if you have liver problem . diarrhoea and stomach upset are the symptoms of overdose. Precautions Be sure to tell your doctor: . Breast feeding: This drug passes into the breast milk. Beverages: Avoid fruit juices and carbonated beverages for 1 hour after taking any nonenteric coated preparation. Reduced dose necessary. Possible Adverse Effects Symptoms/Effects Frequency What to do Nausea/vomiting Common Discuss with your doctor immediately Diarrhoea " " Stomach cramps Rare " 420 A Lay Person's Guide . except for erythromycin estolate which can cause toxic liver reactions and hence should be avoided. Over 60: Itching reactions in the genital and anal regions as well as loss of hearing may occur. vomiting. How to Stop Using this Drug Take the full course.if you have loss of hearing Pregnancy: Generally thought to be safe during pregnancy.

Rash/itching Common Stop drug and discuss with your doctor Fever Rare " Loss of hearing " " Jaundice (yellowing of eyes More common " and skin) with use of erythromycin estolate) Interactions Drugs/Drug Class Effects Note Carbamazepine s Toxicity Digoxin s " Ergotamine Impaired blood circulation to extremities Methyl Prednisolone s Excess steroid effects Theophylline s Toxicity Warfarin s Increased risk of bleeding Clindamycin t Lincomycin t Penicillin t Effects of Long-term Use Courses of longer than 10 days may increase the risk of liver damage. Profiles of 50 Drugs 421 .

gout . What if you Miss a Dose Continue regular dose as soon as you remember. Do not stop using it even if you begin to feel better after a few weeks.kidney disease . and skip the next dose. Dosage and Usage Information Available Dosage Forms: Tablets. If the next dose is within 4 hours. You may have to take every day for as long as 1 to 2 years or more. Dosage Initial: 15 mg/kg body weight daily as single dose. How to Stop Using this Drug Take this medicine for full time of treatment. What if you Exceed the Dose Large overdoses may cause headache and abdominal pain.cataracts or eye problems 422 A Lay Person's Guide . Given in conjunction with other antitubercular drugs. it helps to boost their effect. Re-treatment: 25 mg/kg body weight as a single dose for 60 days and then 15 mg/kg body weight. take the next dose now. capsules (singly or in combination with other anti-tuberculosis drugs). Consult your doctor. How this Drug Works It prevents the growth and multiplication of the germs that cause tuberculosis (TB).ETHAMBUTOL Drug Group: Anti-tubercular Principal Uses It is used in the treatment of tuberculosis. Precautions Be sure to tell your doctor if you have - .

Discuss with your doctor. Have periodic eye-checks. over affected " " joints Blurred vision/loss of vision Rare " eye pain (more common with high dose) Numb/tingling hands/feet " " Dizziness " Discuss with your doctor only if severe Skin rash " " Stomach upset " " Interactions Drugs/Drug Class Effects Notes Antacids (that contain ¯ aluminium) All medicines that cause eye Increased toxic effects on eye toxicity (check with your doctor) Effects of Long-term Use It may increase the risk of eye damage. knee) Tense. Driving and Hazardous Activities: This medicine may cause vision problems and dizziness. hot skin. Reduced dose may be necessary. Infants and Children: Do not give to children under 6 years. Profiles of 50 Drugs 423 . Breast feeding: It passes into the breast milk. Discuss with your doctor immediately Pain and swelling of " " joints (toe. Be sure how you react to this medicine before performing such activities. Possible Adverse Effects Symptoms/Effects Frequency What to do Chills Common Stop drug. ankle. Discuss with your doctor. but at normal doses adverse effects on the baby are unlikely.Pregnancy: Safety is not established. Over 60: Increased likelihood of adverse effects.

424 A Lay Person's Guide . which is necessary for the production of hemoglobin (Hb). 60 mg of elemental iron is made available. loss of blood during menstruation. Dosage and Usage Information Available Dosage Forms: Tablets. It’s combination with folic acid is used especially in anemia resulting from under nutrition/pregnancy/lactation. In every 200 mg tablet of ferrous sulphate. use liquid preparation.) * Weight-wise : 6 mg/kg/day every 8 hours. It is also used to prevent anemia in pregnant women. Combinations of iron with other vitamins and minerals are irrational and only add to cost and toxicity. stomach ulcer. if available. 2. Note: The actual cause of anemia must be determined and treated accordingly. Vitamin B12 and other vitamins/minerals. capsules and liquids (in combination with other drugs). young children and in women who complain of heavy blood loss during menstruation. It is used in the treatment of iron deficiency anemia. The iron-deficiency may occur due to undernutrition. It is customary to give this as dried ferrous sulphate. The oral dose of elemental iron for deficiency should be 100 to 200 mg daily. Deficiency of iron causes deficiency of hemoglobin resulting in anemia. It is often available in combination with folic acid. hookworm infection.FERROUS SULPHATE Drug Group: Antianemic Principal Uses Iron salts should be given by mouth unless there are good reasons for using another route. Dosage: Adults: 200 mg thrice daily Children: Age (years) Dose Up to 1 1/4 tablet twice daily 1-5 1/2 tablet twice daily 6-12 1 tablet twice daily (If impractical. repeated pregnancies. which gives red colour to the blood. Ferrous salts show only marginal differences between one another in efficiency of absorption of iron. 1. How this Drug Works It contains iron. bleeding piles. This medicine corrects this deficiency and cures the anemia.

Iron stains can be removed by brushing with baking soda or medicinal peroxide. Profiles of 50 Drugs 425 . if desired. How and When to Take It is best taken with water 1 hour before or 2 hours after meals. convulsions. blue-lips and finger-nails. During the last 6 months. Prevention Adults : 1 tablet (200 mg of ferrous sulphate) daily. Do not wait for the signs to appear. in order to meet the increased needs of the developing baby an iron supplement may be recommended. Do not double the doses. Precautions Be sure to tell your doctor if you have: -arthritis . in water. Children : 1 mg/kg/day every 12 hours. a proper diet provides enough iron. shallow breathing.Continue treatment for 6 months. dilute the dose. Discuss with your doctor before using it. Get emergency help immediately. Early signs of overdose may not appear for up to 60 minutes. Breast feeding: Although it passes in to the breast milk it is not known to cause problems. While using liquid-form of iron. weakness. What if you Exceed the Dose The signs include diarrhoea (may contain blood). rapid heartbeat. However if stomach upset occurs. coma. drowsiness. take with food or immediately after meals. absorption is poor in chronic arthritis) -asthma/allergies -blood disease -kidney infection -pancreatitis (swelling of pancreas) -intestinal problems -liver disease -stomach ulcer Pregnancy: During the first 3 months. What if you Miss a Dose Skip the missed dose and go back to your regular dosing schedule. then increase the dose depending upon tolerance. begin with 1 tablet daily. pale cleaning skin. Avoid staining your teeth with the iron medicine by placing the spoon/dropper well back on the tongue.(only for parenteral iron.

As few as 3 to 4 iron tablets can cause serious poisoning. they are costly and cause serious adverse effects. The belief that iron injectables may cause rapid response is baseless and besides being painful. Alcohol: Avoid completely.whole grain items. tingling hands and feet " " Stomach cramps Common with tablets " (dark coloured stools) 426 A Lay Person's Guide . Overdose can prove dangerous. The so called slow- release iron tablets are also not justified and must be avoided. This effect ceases once you stop using the medicine.cheese . Others: Insist on taking tablets.tea/coffee . Iron medicine colour the stools black. Over 60: May need larger doses than usual. Possible Adverse Effects Symptoms/Effects Frequency What to do Nausea/Vomiting Rare Discuss with your doctor only if severe Constipation Common " Diarrhoea " " Heartburn Rare " Backache Common (with Discuss with doctor as soon as possible injection only) Chills " " Dizziness " " Headache " " Troubled breathing " " Skin rash " " Numb. Do not take them simultaneously with iron .yogurt/milk . Ask doctor’s advice.eggs . Diet: Avoid the following foods or take in very small amount at least 1 hour before or 2 hours after taking iron.Infants and Children: Keep out of reach of children.cereals .

It is used to treat folic acid deficiency which leads to a particular type of anemia.Premature or low birth-weight infants . Space them at least 1-2 hours apart to get full benefit. FOLIC ACID Drug Group: Vitamins Principal Uses Folic acid has few indications for long-term therapy since most causes of folate deficiency are self-limiting or can yield to a short course of treatment. vomiting. Additional folic acid supplements are to be given in the following conditions/ patients: .Infants who feed on goat milk Profiles of 50 Drugs 427 . The main symptoms are fatigue.Interactions Drugs/Drug Class Effects Notes Antacids ¯ Tetracyclines t Calcium supplements Do not take together. hair loss and mouth sores. It should not be used in undiagnosed megaloblastic anemia (a type of severe anemia) unless Vitamin B12 is administered concurrently. It is also given along with iron during pregnancy and lactation to prevent anemia (since pregnant women and lactating mothers are prone to get anemia). Loss of appetite nausea. It may also lead to poor growth in infants and children.

Patient with blood disorders/psoriasis/other condition in which absorption of nutrients from intestine is impaired .100 mcg/day Children 4-6 years of age . one millionth of a gram) Children 0-6 months .For folic acid deficiency and malnutrition: 5 mg (1 tablet) thrice daily for 3 weeks and then 5 mg (1 tablet) daily for another 2 weeks.400 mcg/day Pregnant females . Usual Children’s Dose For folic acid deficiency : Age (years) Dose Up to 1 2.Patients who are taking anticonvulsants (medicine for tremors/fits) deplete folic acid during pregnancy to prevent a particular defect in the developing baby..500 mcg/day Usual Adult Dose .5 mg daily 1-5 5 mg daily 6-10 10 mg daily 428 A Lay Person's Guide . syrup (either singly or in combination with iron sulphate. etc.45 mcg/day Children 1-3 years .30 mcg/day Children 6 months-1 year . Dosage and Usage Information Available Dosage Forms : Tablets. the actual cause of anemia must be found out and corrected by the doctor. Note: Although folic acid and iron correct anemia.5 mg daily from the 4th month onwards in combination with 200 mg of ferrous sulphate (iron).200 mcg/day Adult males .) Dosage Normal dietary requirements (in mcg-micrograms.400 mcg/day Adult females .Patient on haemodialysis .For preventing anemia in pregnancy and lactation: 0.800 mcg/day Breast feeding females . .

What if you Exceed the Dose Although some people believe that taking very large doses of vitamin is useful for treating certain medical conditions.pernicious anemia (a special blood problem).What if you Miss a Dose Continue usual dosage.alcohol habit . nuts. minerals. carbohydrates and fat (found in food) for the vitamins to work properly. . Diet: The best sources are green leafy vegetables. root vegetables. dried pulses and egg yolks. oranges. it is not true.diarrhoea (prolonged) .liver disease . liver. Breast feeding: It is important that you receive the right amount of vitamins so that your baby will also get the vitamins needed to grow properly. Possible Adverse Effects Symptoms/Effects Frequency What to do Fever Rare Discuss with your doctor as soon as possible. Large doses should be taken only under doctor’s directions. Heat may reduce the amount of folic acid in foods. Precautions Be sure to tell your doctor if you have: . A balanced diet should provide all vitamins you need. mushrooms. Skin rash " " Profiles of 50 Drugs 429 . especially folic acid throughout your pregnancy. You need proteins. Take supplements only if you cannot get enough vitamins from your diet.haemolytic anemia (caused due to abnormal destruction of red blood cells) Pregnancy: It is important that you receive the right amount of vitamins.

It can be used to treat high blood pressure (BP) but along with other medicines for high BP that lower BP. Children: 1-2 mg/kg body weight daily. To avoid night time urination. It is particularly useful for people with kidney problems because they do not respond to other diuretics (water pills). if you are taking more than one dose daily. Thus it reduces the volume of fluid in the blood and body tissues and lowers the sodium content in the body. take it in the morning. injectables 20 mg per 2 ml. How and When to Take May be taken with or following meals to reduce stomach irritation. if you are taking a single dose daily. 430 A Lay Person's Guide . it increases the elimination of salt (sodium) and water from the body. For patients with kidney problems: High dose (up to 2 gm daily) may be required. If it is time for the next dose. if necessary. By doing so. Dosage Adults: To relieve water retention: 20-80 mg as a single dose initially. skip the missed dose and go back to regular dosing schedule. In hypertension (high BP): 40 mg once or twice daily. Do not exceed 600 mg per day. and increases the flow of urine. Dosage and Usage Information Available Dosage Forms: Tablets usually 40 mg. These changes also help to lower the blood pressure.FUROSEMIDE (FRUSEMIDE) Drug Group: Loop Diuretic (Water Pill) Principal Uses It is used primarily to increase the volume of urine and thereby relieve the body of excessive water retention (edema) that is commonly associated with heart failure and some form of liver disease and kidney disease. What if you Miss a Dose Take as soon as you remember. increase the dose by 20-40 mg/6-8 hours. How this Drug Works It acts on the kidneys. A less frequent use is to increase the amount of calcium excreted in the urine when the blood level of calcium is abnormally high. Or take the last dose no late than 6 pm.

thirst. Breast feeding: It passes into the breast milk. Avoid drug or refrain from nursing. Extra potassium may not be necessary in some cases. To help prevent this.kidney disease . Over 60: Increased likelihood of adverse effects. orange or other citrus fruit juices). Avoid completely during the first 3 months.plan to have surgery in the near future Pregnancy: It should not be used in pregnancy unless it has to be used for some serious complications.. Make sure how you react to the drug before doing such activities. Note: Discuss your diet with your doctor. Profiles of 50 Drugs 431 . symptoms may return. Avoid as far as possible.prostate trouble . drowsiness. lethargy. muscle cramping. vomiting. diarrhoea. What if you Exceed the Dose The symptoms include dry mouth.liver disease . Diet: This drug may cause a loss of potassium from your body resulting in nausea.g. weakness. too much potassium could be harmful.pancreatic disease . Precautions Be sure to tell your doctor if you have: . Reduced dose necessary. weakness. Driving and Hazardous Activities: This drug causes vision problems and dizziness. profound unconsciousness. confusion.gout . Infants and Children: Avoid overdosage that could cause serious dehydration. Sun: Some people become more sensitive to sun while using this drug. This is important if you are already on a special diet (as for diabetes) or if you are taking a potassium supplement or a medicine to reduce potassium loss. nausea. Avoid too much sun.hearing problems . Reduced dose may therefore be necessary. How to Stop Using this Drug Do not stop the drug without consulting your doctor. eat or drink foods that have high potassium content (e.Avoid taking any dose if you remember late in the day (after 6 pm). Alcohol: It increases the likelihood of dehydration and hangovers after drinking alcohol. loss of appetite.diabetes .

To avoid excessive lowering. Lithium s Lithium toxicity Anti-inflammatory drugs ¯ (medicines for swelling and pain) e. hives Rare Discuss with your doctor only if severe Headaches " " Dizziness Common " Blurred/Yellow vision Rare " Ringing in ears " " Numbness and Tingling " " Reduced appetite " " Indigestion " " Nausea/vomiting " " Diarrhoea " " Jaundice " Discuss with your doctor immediately in all cases Fluid accumulation in lungs Rare " Temporary hearing loss " " Severe abdominal pain " " Abnormal bleeding/bruising " " Weakness " " Sore throat and fever " " Interactions Drugs/Drug Class Effects Notes Medicines for diabetes t Increased blood sugar level. Medicines for blood pressure s Lowers blood pressure. affecting control of diabetes. indomethacin 432 A Lay Person's Guide . It increases blood uric level.. dose must be adjusted. Possible Side-effects Symptoms/Effects Frequency What to do Skin rashes. Your doctor may want to check your kidney function and levels of body salts (if used for long term). affecting control of gout.Others: It increases blood sugar level.g. dose should be adjusted.

If time for next dose.g. such as potassium. sodium and calcium. While applying to a child’s mouth. Dosage and Usage Information Available Dosage Forms: Aqueous solution: 0. boils. GENTIAN VIOLET Drug Group: Antifungals Antiseptic Principal Uses Gentian violet (or crystal violet) is used on the skin or inner lining of the mouth to treat some types of fungal infections inside the mouth (thrush) and of the skin (e.5-0. may occasionally become depleted during prolonged use. but levels of salts. etc. as antiseptic in boils. What if you Miss a Dose Apply it as soon as possible. burns). Do not apply an occlusive dressing/airtight covering since it may cause irritation of the skin.1 % for local application. Profiles of 50 Drugs 433 . skip the missed dose and go back to regular dosing schedule. Not to be swallowed.Drugs/Drug Class Effects Notes Digoxin Potassium Increased disturbances of heart rhythm levels of blood fluctuate Aminoglycoside antibiotics Increased risk of hearing problems. How and When to Take Using a cotton swab. take care that it is not swallowed. Effects of Long-term Use Serious problems are unlikely. impetigo (a contagious skin infection). apply enough gentian violet to cover only the affected area..

Dosage and Usage Information Available Dosage Forms: Tablets of 5 mg Dosage: Adults : Initially 2. Precautions It will stain the skin and clothing. It is usually used only by adults who develop diabetes after 30 years of age and whose diabetes cannot be controlled by diet alone and who do not require insulin injections (or who do not require more than 20 units of insulin a day) to control their condition.How to Stop Using this Drug To help clear up infection completely. keep using this medicine for the full time of treatment even though your condition may have improved. How this Drug Works It stimulates the production of a substance called insulin from pancreas (an organ in the body) which is responsible for the uptake of sugar in the body cells. Possible Adverse Effects Symptoms/Effects Frequency What to do Skin irritation Rare Discuss with your doctor as soon as possible (not present before using this medicine) GLIBENCLAMIDE Drug Group: Antidiabetic Principal Uses It is used to control certain types of diabetes mellitus (sugar diabetes). In the UK it is now restricted to application to unbroken skin because of concern about animal carcinogenicity and is no longer recommended for application to mucous membranes or open wounds. This type is called non-insulin dependent diabetes mellitus/maturity onset/adult diabetes.5 mg daily with breakfast 434 A Lay Person's Guide . Restrictions do not apply however for skin marking prior to surgery. Thus it lowers the blood sugar levels and controls diabetes (or disorder where blood sugar levels rise). Avoid getting the medicine on your clothes.

Precautions Be sure to tell your doctor if you have: . Pediatric dose : Not recommended for children. How and When to Take Take the medicine daily with breakfast. Take emergency action if fits or loss of consciousness occur. stopping the drug suddenly may lead to worsening of diabetes. If it is almost time for next dose. Breast feeding: It is thought that it passes into the breast milk. What if you Exceed the Dose Seek immediate medical advice in all cases. nausea or headache occur. Infants and Children: Not prescribed.thyroid disease Pregnancy: Should not be used because poor diabetic control.ulcer . skip the missed dose and follow regular dosing schedule. If maintenance dose is 10 mg or more. Blood sugar levels should be taken so as to prevent any adverse effects (brain damage) due to fall in blood sugar level. If early warning symptoms of excessively low blood sugar such as faintness.liver disease .infection of severe type . confusion. May lead to birth defects or death of foetus. How to Stop Using this Drug Do not stop using this drug without consulting your doctor.adrenal (near or upon the kidney) disease .Maintenance : Dose may be increased at 7-day intervals by 2. sweating. Over 60: Reduced dose may be necessary. Profiles of 50 Drugs 435 . What if you Miss a Dose Take before your next meal. Insulin is substituted as it gives better diabetic control.kidney disease .5 mg daily as needed and tolerated till a maximum of 15 mg daily. eat or drink something sugary. Avoid drug or refrain from nursing.pituitary disease . weakness. trembling. divide into 2 equal doses: one with morning meal and one with evening meals.planned to undergo any surgery/dental treatment . Your doctor should check your progress regularly.

skip/delay meals. hunger. exercise much more than usual. Diet: A low carbohydrate. Driving and Hazardous Activities: Avoid these activities if you have warning signs of low blood sugar. weakness. confusion. nausea. low fat diet must be maintained by diabetic patients. Others: This drug may loose its effectiveness after certain period of time. headaches. Some people find their skin to be more sensitive to direct sunlight because of this medicine. Signs of low blood sugar include: Sweating. Alcohol may increase the drug's effect leading to fall in blood sugar. drowsiness. Many diabetic patients are able to control their condition by following the advice of their doctors. This drug may cause intolerance of alcohol leading to stomach upset. redness of face and skin. Possible Adverse Effects Symptoms/Effects Frequency What to do Dark urine Rare Stop the drug. cannot eat because of nausea. sweating. Sun: Use caution. headache. Test for sugar in your blood/urine as directed by the doctor to make sure your diabetes is being controlled. Yellowing of eyes/skin " " Unusual bleeding/bruising " " Sore throat and fever " " Weakness " " Stomach upset Common Discuss with your doctor only if severe Headache Rare " Skin rash " " Interactions Drugs/Drug Class Effects Notes Corticosteroids ¯ (Cortisone-like medicine) 436 A Lay Person's Guide . Eat or drink something containing sugar if sign of low blood sugar occur. diet and exercise advice should be properly followed. These signs occur if you . In order for the drug to be fully effective. Discuss with your doctor immediately. drink significant amount of alcohol.Alcohol: Avoid.

capsules. It is thought that it may cause heart and blood disorders (although such reports are not conclusive)..Drugs/Drug Class Effects Notes Water Pills ¯ Rifampicin ¯ Estrogens ¯ Blood thinners (e. Profiles of 50 Drugs 437 . ointments.3-1 mg. It thus prevents angina attacks from occurring.g. and it may have to be taken for long periods of time. 0. It is not a cure for heart disease. it can only relieve symptoms. Dosage Adults: Sublingually (under the tongue). Dosage and Usage Information Available Dosage Forms: Tablets. Warfarin) ­ Low blood sugar Sulfa medicines ­ " Aspirin ­ " Beta blockers (Heart Medicines) ­ "“ Effects of Long-term Use Reduced function of the thyroid gland. GLYCERYL TRINITRATE Drug Group: Anti-angina Principal Uses It is used to relieve the pain of angina attacks. repeated as required. How this Drug Works It relaxes the blood vessels and increases the supply of blood and oxygen to the heart while reducing its work load. The slow-release form of this medicine is used to prevent the development of angina.

Ointment: Before applying a new dose of ointment. cuts or irritation. How and When to Take Capsules: Take this medicine with a full glass of water on an empty stomach. 2-3 times daily. 10 mg 3 times a day. Then go back to your regular dosing schedules.Apply the patch to a clean.3 cm thrice daily or more as required.Apply each dose to a different area of skin to prevent skin problems. Transdermal Patch: Do not try to trim or cut the adhesive patch to adjust the dosage. . covering an area of the same size each time it applied. Transdermal patch (delivery 5 mg or 10 mg per 24 hours): Initially TTS-5 once daily. . sustained release): Take it as soon as possible.Do not rub or massage the ointment into the skin. Ointment: 1.By mouth: 2. IV: 10- 200 micrograms/minute. . if the next scheduled dose is within 2 hours (or within 6 hours for extended release capsules/tablets) skip the missed dose and go back to your regular dosing schedule. . Patch: Apply as soon as possible.Use a paper (cut as per the length mentioned in the dose) to measure the length of ointment. 438 A Lay Person's Guide .Apply to skin that has little or no hair. . However. it will start working sooner. If taken either 1 hour before or 2 hours after meals. Tablets should not be crushed or chewed and capsules should not be opened before swallowing if the tablets/capsules are sustained release. Increase if required gradually up to TTS-10 twice daily. severe angina. Remove the previous patch before applying a new one.Apply a new patch if the first one becomes loose or falls off. Spread in a thin.5 . remove any ointment remaining on the skin from a previous dose to allow the fresh ointment to release the drug properly. dry skin area with little or no hair and free of scars. Do not double doses.4 mg as modified-release tablets. Ointment: Apply as soon as possible unless the next scheduled dose is within 2 hours. . Children: Not recommended. . What if you Miss a Dose Capsules/tablets (regular.6-6.Each dose is best applied to a different area to avoid skin problems. Then go back to regular dosing schedule. even layer.

intestinal problems. severe headache. Driving and Hazardous Activities: This drug may cause dizziness or faintness.What if you Exceed the Dose Large overdoses may cause dizziness. Alcohol: Avoid. exercise or if the weather is hot. Infants and Children: Not usually prescribed. Notify your doctor. Tobacco: Avoid. dizziness. glaucoma. fits or loss of consciousness. Precautions Be sure to tell your doctor if you have anemia (blood disorders). Discuss with your doctor. Discuss with your doctor. Breast feeding: The drug passes into the breast milk and may affect the baby. How to Stop Using this Drug Do not stop using this drug after long-term use without asking your doctor. “black-out” spells. Restrict activities as necessary. so be cautious. had an heart attack recently. vomiting. Over 60: They are more susceptible to the development of flushing. to stand for long time. The dose is gradually reduced over 4-6 weeks. low blood pressure. headache. Alcohol may increase dizziness due to lowered blood pressure. overactive thyroid. Your doctor may want to check your blood pressure and internal eye pressure as well as test your blood for iron (hemoglobin) while you are using this drug for long time so as to check the effectiveness of this drug. It reduces the effectiveness of this drug. Pregnancy: Safety not established. fainting and falling. Others: The dizziness or fainting caused by this drug is more likely to occur when you get up quickly from a lying or sitting position. Possible Adverse Effects Symptoms/Effects Frequency What to do Blurred vision Rare Discuss with your doctor immediately Dry mouth " " Headache (severe or prolonged) " " Dizziness Common " Profiles of 50 Drugs 439 .

Aspirin ¯ Because they speed up the heart rate. It reduces fever also. sprains.) (mimicking action of sympathetic system) Effects of Long-term Use The development of tolerance and temporary loss of effectiveness.P. and gout (although it does not cure it). Sympathomimetics t Results in hypotension (lowered B. Anti-inflammatory Principal Uses It relieves pain. It is similar to aspirin in the way it can be used. IBUPROFEN Drug Group: Mild pain killer Non-steroidal. it rarely causes bleeding in the stomach. stiffness and inflammation. It relieves mild to moderate headaches. Vomiting " " Rapid heartbeat " " Skin rash Rare " Interactions Drugs/Drug Class Effects Notes Medicines that reduce blood ­ Excessive lowering of blood pressure. menstrual pains. It is used to provide relief in rheumatoid arthritis. pressure Dosage adjustments should be made. that may accompany a number of disorders. Unlike aspirin.Symptoms/Effects Frequency What to do Flushing of face and neck Common Discuss with your doctor immediately. How this Drug Works It is thought that it reduces the amount of chemicals involved in the production of inflammation (swelling) and pain. osteoarthritis. 440 A Lay Person's Guide . pain from injuries of muscles/bones and pain following operations.

dizziness. skip the missed dose and go back to your regular dosing schedule. if it is almost time for your next dose. Profiles of 50 Drugs 441 . Children: 20 mg/kg body weight in three divided doses. unsteadiness and finally profound unconsciousness are the symptoms. Notify your doctor as soon as possible.asthma . Take with a full glass of water and remain upright (do not lie down) for 30 minutes. ringing in ears. it will get into the blood more quickly. Note: If taken 30 minutes before meals or 2 hours after meals. it can be safely stopped as soon as you no longer need it.liver disease . Discuss with your doctor. What if you Exceed the Dose Drowsiness. Note: Actual dosage and administration schedule must be determined by the physician for each patient individually. it may take one week or even more. stomach upset. It is better to avoid drug or refrain from nursing. How and When to Take May be taken with food or milk to prevent stomach irritation. How to Stop Using this Drug When taken for short term pain relief. What if you Miss a Dose Take as soon as you remember. If prescribed for long term use (for arthritis). for severe cases. However.allergy to aspirin Pregnancy: It may cause defects in the unborn baby and may prolong labour.high blood pressure . Dosage: Adults: 200-400 mg thrice daily.acidity .heart disease . capsules and liquid syrups. do not stop taking this drug without consulting your doctor (in case of arthritis. Precautions Be sure to tell your doctor if you have: .stomach ulcer .Dosage and Usage Information Available Dosage Forms: Tablets.kidney disease . Breast feeding: It does pass into the breast milk in minute amounts. before you begin to feel better).

Driving and Hazardous Activities: This drug may cause drowsiness or dizziness. Restrict activities as necessary. Use caution. weakness " " Sore throat and fever " " 442 A Lay Person's Guide . If your fever does not improve within 3 days or returns (when used to bring down fever) if the painful area becomes red or swollen. It may increase the risk of stomach problems. Reduced doses necessary. Alcohol: Avoid. Possible Adverse Effects Symptoms/Effects Frequency What to do Skin rash Common Discuss with your doctor in all cases Headaches " Discuss with your doctor only if severe Dizziness " Discuss with your doctor as soon as possible Vision problem Rare Discuss with your doctor in all cases as soon as possible Ringing in the ears " " Depression " " Mouth sores " " Indigestion Common Discuss with your doctor only if severe Nausea/vomiting " " Severe skin reactions Rare Stop the drug now. Reduced doses may be necessary. bloody urine. Discuss with your doctor immediately Severe headache with fever and stiff neck " " Stomach ulcer " " Jaundice/liver problems " " Kidney damage with " " painful urination.Infants and Children: Safety and effectiveness in children below 10 years is not established. Fatigue. Sun: It is thought that it may make some people sensitive to sunlight. Over 60: Increased likelihood of adverse effects. Others: Check with your doctor. reduced urine formation.

Symptoms/Effects Frequency What to do Bleeding/bruising Rare Discuss with your doctor in all cases as soon as possible Wheezing/breathlessness " " Interactions Drugs/Drug Class Effects Notes Lithium s Lithium toxicity Digoxin s Water pills t Medicines for BP t Acetaminophen s Kidney damage Blood thinner Increased risk Dose adjustment necessary of bleeding Corticosteroids " " Other Non-Steroidal Anti-inflammatory drugs " " (NSAIDs) Aspirin " " Valproic acid " " Sulfinpyrozone " "“ Effects of Long-term Use Ulcers in stomach and/or bowel. fluid retention. Profiles of 50 Drugs 443 .

irritability. It is advisable to do blood glucose estimation before adjusting insulin dose. Dosage Adults: The dose ( and type) of insulin is determined according to the needs of the individual patient. loss of consciousness. hunger. headache. abnormal behaviour (resembling alcoholic intoxication). the voluntary muscles. How this Drug Works Not completely known. fits. confusion. Its symptoms include fatigue. The timing and frequency of injections will vary with the type of insulin prescribed. When used along with a special meal plan and exercise. How and When to Take Inject insulin subcutaneously (under the skin) according to the schedule prescribed by your doctor. Dosage and Usage Information Available Dosage Forms: Injectables There are some drugs like sodium valproate that give false urine positive test. The table overleaf of insulin action will help you understand the treatment schedule prescribed to you. the heart muscle and the liver. It is to be used only under doctor’s observation. It facilitates the transport of sugar to the place where it is utilized. 444 A Lay Person's Guide . sweating. What if you Miss a Dose Sugar will go up again. This occurs primarily in the brain. it can effectively control diabetes.INSULIN Drug Group: Hormones. nervousness. lack of concentration. antidiabetic Principal Uses Insulin is the only effective treatment in juvenile (insulin-dependent) type of diabetes. It may also be prescribed in adult (maturity-onset) diabetes. tremors. What if you Exceed the Dose Hypoglycaemia (lowering of blood sugar levels) may occur. weakness.

plan to undergo a surgery . Actrepid Clear 1/4 hour " 8-12 hrs b) Medium-acting and medium-term effect 1. Semilente Milky " " " 4. To preserve the health of the mother and the welfare of the fetus every effort must be made to establish the optimal dosage of insulin necessary for “good control” and to prevent episodes of hypoglycaemia.infection . Repitard Clear Within 3 hrs " 18-20 hrs c) Slow-acting and long-term effect 1. Diabetes that is insulin-dependent requires continual treatment on a regular basis. Protamine Zinc Milky 4-8 hrs 12-24 hrs Upto 36 hrs Insulin 2.kidney disease .H. Poor control of diabetes increase the risk of birth defects. etc. Globin Clear Within 1 hr 8-10 hrs 18-20 hrs 2. Profiles of 50 Drugs 445 .thyroid disease . Pregnancy: Insulin is the drug of choice for managing diabetes during pregnancy.giddiness.liver disease . Crystalline Clear Within 1 hour 3-4 hrs 5-8 hrs (Mostly 1/2 hr) 2. Ultralente Milky 6-8 hrs 16-24 hrs " How to Stop Using this Drug Do not discontinue using this drug without consulting your doctor. Omission of insulin may result in life-threatening coma (profound unconsciousness). Type Appearance Onset of Action Peak Action Duration of Action a) Fast-acting and short-term effect 1. Precautions Be sure to tell your doctor if you have : . Lente " " " 24-30 hrs 4. sweating. Milky Within 2 hrs " 24-30 hrs 3. Iso-insulin " Within 1 hour " 12-14 hrs 3. N.P.

sickness ( especially with vomiting/diarrhoea) . excessive hunger. It may cause low blood sugar and upset diabetic control. Blood tests: Many patients have learned to measure their own blood sugar levels. follow directions carefully. Tobacco: Regular smoking increases insulin requirements.Breast feeding: It does not pass into the breast milk. Insulin treatment of the mother has no adverse effects on the nursing infant. taking certain medicines. Exercise: Your doctor may tell you what kind of exercise to do. The aging brain adapts well to higher blood sugar levels. confusion. To treat these symptoms always keep a readily available form of 446 A Lay Person's Guide . cold sweats difficulty in concentration. The symptoms include anxiety chills. the best time of day to do it. Over 60: Insulin requirement may change with aging. once you are on insulin therapy. using too much insulin. If you have not quit smoking initially and decide to quit smoking long after having started insulin therapy. Attempts to maintain strict normal blood sugar levels may cause a fall in blood sugar levels. headache. Infants and Children: Reduced dose as necessary. Your doctor may want you to test your urine for acetone. Driving and Hazardous Activities: Usually no problem. . which on repeatedly occurring may cause brain damage. The symptoms of hypoglycaemia (low blood sugar) may develop suddenly and may result from: . . drinking alcohol . drowsiness. Alcohol: Avoid. Try to avoid smoking. Diet: The success of your treatment depends on your closely following the diet of your doctor. Others: Special care of your feet will help to prevent possible future trouble. Two urine tests for sugar are widely used: the tablet urine test and the paper-strip urine test. vision problems. Urine tests: These tests are used to guide you in the control of your condition and must be done properly. but strenuous exercise alters your insulin and sugar requirements. and how much you should do daily. If you are taking blood tests. exercising more than usual just before a meal . delaying or missing a scheduled snack/meal. Avoid these activities if your blood sugar is not well controlled. first consult your doctor who may want to change your insulin dose.

Discuss with doctor immediately. you still need insulin. Weakness/Sweating " " Thinning of tissue at Rare " injection-site Rash/facial swelling " Stop drug now. loss of appetite. increased urination. rapid weight loss. diarrhoea or fever. troubled breathing. drowsiness. The symptoms of hyperglycaemia (high blood sugar) occur more slowly than those of hypoglycaemia. you overeat or do not follow a proper diet or have fever/infection. Possible Adverse Effects Symptoms/Effects Frequency What to do Injection-site irritation Common Discuss with your doctor as soon as possible. tiredness. vomiting. especially with vomiting. dry skin. if you skip a dose. They are dry mouth. if you will not be having a snack/meal for an hour or more. Fenfluramine ­ MAO inhibitor drugs. You should eat something or drink a glass of milk. ­ Profiles of 50 Drugs 447 . etc. prolonged " " hypoglycaemia. sugar cubes. If you can’t eat solid foods then drink fruit juices/soups.sugar such as candy. peppermint. Improvement in vision may occur initially during the insulin treatment. Regular monitoring of sugar levels in the urine and/or blood is required. Consult your doctor. So continue taking your insulin and try to stay on a regular diet. etc. ( to avoid low blood sugar). These symptoms occur if you do not take enough insulin. If you become sick. Shortness of breath " " Severe. stomach ache. Allergic reactions " " (anaphylaxis) Interactions Drug/Drug Class Effects Notes Aspirin and other similar ­ drugs Beta blockers ­ Prolong the hypoglycaemia caused by insulin. unusual thirst. Defer examination for spectacles for 6 weeks after starting insulin.

i. 4. Take up the syringe once again. Wash hands well with soap and water. 2. When they have cooled. Remove the articles from the saucepan. Boil for five minutes. Push the plunger in and out several times until all the water is completely removed from the syringe. 5. and cotton ball. (With the use of disposable syringe steps 3. Preferably use disposable syringe (which is discarded after each use) that are now available in India. alcohol. plunger and needle in a strainer or wrap in a clean napkin and place in saucepan with water and cover with a lid. Wipe the top of the stopper of bottle with a cotton swab moistened with alcohol.. Organise everything in one place. insert the plunger in the barrel and fasten needle to syringe with a slight twist. Put syringe. 3. By pulling back the plunger.e.) Preparing the Dose 1.4. take air into to syringe. 3. 4. equal to the dose of insulin required. insulin. 2.5 are not necessary.Drug/Drug Class Effects Notes Medicines for diabetes ¯ (taken by mouth) Cortisone-like drugs ¯ Chlortalidone ¯ Furosemide ¯ Birth Control Pills ¯ Phenytoin ¯ Thiazide diuretics ¯ Thyroid preparations ¯ Insulin Injection Technique Taking insulin is easier than one thinks: 1. Note syringe marking units: 40 or 100 units. Identify the type of insulin dose per ml. Now place these on the inverted cover of the saucepan. 448 A Lay Person's Guide . Gently roll the insulin bottle several times by holding in both hands.

withdraw intermediate or long acting insulin first and follow the same procedure for withdrawing plain or quick acting insulin. 11 65-67 Profiles of 50 Drugs 449 . If not. 5. then thigh.M. Source: Learning to Live with Diabetes. Ahuja. If blood comes into the syringe. M. Pick up syringe with other hand and hold it as you would a pencil. stabilise the skin by spreading it or pinching up a large area of skin. gently tap the syringe so that all the air bubbles collect together and then with the syringe still pointing upward. To avoid tissue changes. 6..S. plush the plunger to expel the air. If using combination. 6. In case air bubbles are present in the syringe. Keeping the syringe still inside the bottle. Now withdraw the plunger. 3. 7. Press alcohol swab over injection site for several seconds. Cleanse the skin where the injection is to be made. Hold alcohol swab near the needle and pull the needle straight out of the skin. change the site of injection. invert the bottle of insulin and pull the plunger to withdraw insulin equal to the dose required. Injecting the Dose 1. With one hand. Insert the needle straight into the skin (900 angle). 8. inject the insulin by pushing the plunger all the way down. always change the site for each injection. Inject this air into the bottle of insulin.) 2. the thigh or abdomen or arm (best site is abdomen. 4. Be sure to insert needle all the way. i. then arm. Take the needle out of the bottle.e. 5.

What if you Exceed the Dose The symptoms include nausea. Also with thiacetazone. since the infection may return if treatment is stopped too soon. blurred vision. pyrazinamide. Also in combination with rifampicin. slurred speech. 300 mg tablets. breathing difficulties. skip the missed dose and go back to your regular dosing schedule. 450 A Lay Person's Guide . Isoniazid to be taken along with rifampicin and pyrazinamide (and if necessary with ethambutol) to avoid rapid development of resistance and as advised by physician. However. Dosage and Usage Information Available Dosage Forms: 100 mg. It is used in combination with other medicines such as rifampicin. Treatment regimes separate for unsupervised and immunocompromised patients. child 10 mg/kg to 20 mg/kg daily (max. Notify your doctor immediately. How this Drug Works It is thought that this drug destroys susceptible TB germs by disrupting their cell wall. pyrazinamide and ethambutol. Do not stop using it without consulting your doctor. In longer regimes isoniazid is taken along with thiacetazone and streptomycin. ethambutol (which work in a way different from isoniazid). fits and loss of consciousness. even if you feel better. It is not to be used alone. What if you Miss a Dose Take as soon as you remember. 300 mg) daily.ISONIAZID Drug Group: Anti-tuberculosis (TB) Principal Uses It is used to treat the development of active tuberculosis disease. How and When to Take Take the full course (you may have to take it every day for as long as 6 -12 months). dizziness. Liquid: 100 mg per 5 ml Dosage Standard unsupervised treatment of isoniazid (for 6 months)- Adults: 300 mg daily. vomiting. for the treatment of TB. if it is almost time for your next dose.

Others: Your doctor may want to check your blood.Precautions Be sure to tell your doctor if you have: . Possible Adverse Effects Symptoms/Effects Frequency What to do Nausea/vomiting Common Discuss with your doctor only if severe.diabetes .kidney problems .g.plan to undergo surgery very soon. Over 60: Increased likelihood of adverse effects. Pregnancy: Safety is not established. Check with your doctor before changing your diet or the dosage of your diabetes medicine. Discuss with your doctor.liver problems . Driving and Hazardous Activities: Be sure how you react to this medicine before performing such activities. phenytoin) . eye and liver functions while you are on this drug. Infants and Children: Use cautiously in children who get fits. Loss of appetite " Fatigue/weakness " Numbness/tingling " Dizziness " Yellowing of eyes and skin Rare Discuss with your doctor immediately (hepatitis) Mental and behavioural changes " Twitching fits " Profiles of 50 Drugs 451 . Diabetes: This medicine may cause false test results with some urine sugar tests. Reduced dose necessary.fits . There is a greater risk of liver damage.taken other medicines on long-term basis (e.drink alcoholic beverages every day.. Breast feeding: Continue nursing. Use caution. . Alcohol: Avoid.

g. It is often used for people with colostomies or ileotomies (cutting into the colon/ileum) to reduce the fluid loss from the stomach (outlet). diabetic . capsules and liquids. it is not recommended for diarrhoea caused by infection because it may delay the expulsion of harmful substances (which have caused diarrhoea) from the bowels.Interactions Drugs/Drug Class Effects Notes Anticonvulsants s (Medicine for fits/convulsions e. Supplements of Vitamin B-6 in the dose of 10 mg daily are given. phenytoin) Cortisone medicines Effects of Long-term Use Vitamin B-6 (pyridoxine) deficiency may occur and lead to nerve damage. suffering from renal failure LOPERAMIDE Drug Group: Anti-diarrhoeal Principal Uses It is used along with other measures to treat severe diarrhoea.. 452 A Lay Person's Guide . malnourished . How this Drug Works It reduces the loss of water and salts from the bowel and slows bowel activity (movement and contraction) resulting in the passage of firmer bowel movements at less frequent intervals and thus relieving diarrhoea and stomach cramping. However. Dosage and Usage Information Available Dosage Forms: Tablets. carbamazepine. particularly in patients who are - . alcoholic .

There is an increased risk of blockage of the intestine. fluid loss caused by diarrhoea may result in severe condition.48 mg/kg body weight and only after a loose motion. Over 60: Use with caution. Total dose should not be more than 16 mg for 5 days. lethargy.liver problem . Chronic diarrhoea: 2-8 mg daily in 2-3 divided doses. How and When to Take May be taken on an empty stomach or with food if stomach irritation occurs. Precautions Be sure to tell your doctor if you have: .are taking antibiotics (some antibiotics may cause diarrhoea. What if you Exceed the Dose The symptoms include drowsiness. It should not be given to children below 2 years of age. Discuss with your doctor. depression.kidney problem . Note: Use cautiously (only on physician’s guidance) for children. Pregnancy: Safety is not established. Infants and Children: In babies and children. Do not use at all for children under 2 years of age.Dosage Adults: Acute diarrhoea: 4 mg initially. Notify your doctor as soon as possible. Go back to your regular dosing schedule. So avoid giving this medicine. Besides in persons over 60 years Profiles of 50 Drugs 453 . vomiting. So avoid drug or refrain from nursing. This medicine may make the diarrhoea caused by antibiotics worse or make it last longer). then 2 mg after each loose motion until diarrhoea is not controlled. Children: In divided doses at 0. dry mouth. Note: ORS (Oral Rehydration Salt) is the best measure to treat diarrhoea in children.had recent stomach surgery . What if you Miss a Dose Do not take the missed dose. Breast feeding: It is thought that it passes into the breast milk and could affect the baby.ulcer (colitis) .

of age. Restrict activities as necessary. the fluid loss caused by diarrhoea may result in severe condition and hence they should not take any anti-diarrhoeal medicine unless prescribed by their doctor. Others: Check with your doctor if your diarrhoea does not stop after a few days or if you develop fever. 454 A Lay Person's Guide . Stomach pain " " Interactions Drugs/Drug Class Effects Notes Narcotic pain killers Severe constipation Effects of Long-term Use This drug is not usually taken for prolonged periods (except for persons with ileotomies) but special problems are not expected during long-term use. Driving and Hazardous Activities: This drug may cause drowsiness or dizziness. Possible Adverse Effects Symptoms/Effects Frequency What to do Bloating Rare Discuss with your doctor only if severe. Constipation " " Dizziness " " Drowsiness " " Dry mouth " " Fever " " Loss of appetite " " Nausea/vomiting " " Skin rash " Discuss with your doctor only if severe.

Profiles of 50 Drugs 455 . laxatives or enemas are required during or after taking mebendazole. e. hookworm. If it is almost time for your next dose skip the missed dose and go back to your regular dosing schedule. hookworm. Precautions Be sure to tell your doctor if you have Crohn’s disease (a kind of regional enteritis. It is used for hydatid cyst but as a prolonged treatment. In hydatid cyst: 400-500 mg (4-5 tablets) thrice daily for 21-30 days. check with your doctor. milk. For high doses: Take with fatty meals. If you are on low-fat diet. liquids Dosage Adults: In roundworm. whip worm.. roundworm. It may be repeated after 3 weeks if necessary.. It can be taken with food. Children: Same as Adult dose.MEBENDAZOLE Drug Group: Anthelminthic Principal Uses It is used in the treatment of single or mixed worm infestation with pin worm.g. or inflammation of the intestine). How to Stop Using this Drug Stop only after a full course. How this Drug Works It works by keeping the worm from absorbing sugar (glucose). Dosage and Usage Information Available Dosage Forms: Tablets. e. special diets fasting. and whip worm infestations: 1 tablet (100 mg) twice daily for 3 days. What if you Miss a Dose Take as soon as you remember. so that the medicine is absorbed better.g. How and When to Take No special preparation.

discuss with your doctor. Breast feeding: Quite safe. Others: Pinworms may be easily passed from one person to another. Driving and Hazardous Activities: Be sure how you react to this drug before performing such activities since this drug may produce dizziness. For hookworms and whipworm infestation: Anemia may also develop for which your doctor may prescribe iron supplements for you. Infants and Children: Avoid in children below 2 years of age. Possible Adverse Effects Symptoms/Effects Frequency What to do Stomach upset Rare Discuss with your doctor only if severe Dizziness " " Headache " " Nausea " " Skin rash " " 456 A Lay Person's Guide . This helps to prevent infection or reinfection of other household members. especially in a household. For use in the last 5-6 months. Therefore all household members may have to be treated at the same time. You may have to take iron regularly for as long as 6 months after you stopped taking mebendazole.Pregnancy: It should not be used in first 3-4 months of pregnancy.

confusion. Since it does not reduce blood flow to the kidneys. Maintenance dose: 0. 2/3 times a day for 2 days. Notify your doctor immediately. then adjust dose as required. If this continues for long time. This helps to lower blood pressure. Dosage and Usage Information Available Dosage Forms: Tablets Dosage Adults: Initially 250 mg. How and When to Take May be taken without regard to food. it is given to people with kidney disorders. Medicines like water pills (to reduce fluid retention) or other medicines that lower BP are used along with it to enhance its effect. How this Drug Works High blood pressure adds to the workload of the heart and blood vessels (that carry blood).METHYLDOPA Drug Group: Antihypertensive Medicine to lower blood pressure (BP) Principal Uses It is used to treat varying degrees (moderate to severe) of blood pressure. This medicine works by controlling nerve impulses.2 gm in 2-4 divided doses. However.5 mg . As a result. the heart and blood vessels stop working properly. Profiles of 50 Drugs 457 . weakness. Hence it is necessary to control blood pressure. skip the missed dose and go back to your regular dosing schedule. It may also lead to heart attack or kidney failure. This can damage blood vessels of the brain. heart and kidneys. profound unconsciousness. vomiting. It should not be used in case of mild and uncomplicated rise in BP. What if you Miss a Dose Take it as soon as possible. if it is almost time for your next dose. What if you Exceed the Dose The symptoms include marked drowsiness. nausea. it relaxes blood vessels so that blood passes through them more easily.

Driving and Hazardous Activities: It can cause drowsiness and fatigue. headache. nasal congestion.How to Stop Using this Drug Do not stop using this drug without consulting your doctor. inadequate feeding or any adverse effects. profuse sweating. Inform your surgeon that you are on this drug and ask for guidance for stopping this drug. use cautiously. angina . Observe infants for drowsiness. Restrict activities as necessary. This drug can cause Parkinsonism (motion sickness) or intensify the existing Parkinsonism.depression . who may reduce the dose gradually. Your doctor may want you to stop using the drug 5-7 days before surgery (under general anesthesia). pheochranocytoma leading to hypertension. Pregnancy: It is to be used only if clearly needed. Avoid as far as possible. Others: Your doctor may want to check your blood pressure as well as check your blood and urine regularly while you are on this drug. kidney problem . Over 60: Use cautiously. Dizziness " " Rash Rare "“ 458 A Lay Person's Guide . etc. If drug is necessary. It can cause marked sedation (sleeping effect) and excessive fall in BP. Precautions Be sure to tell your doctor if you have: . Breast feeding: It passes into the breast milk. Then stop drug or refrain from nursing. palpitation. Alcohol: Avoid. reduced mental activity. liver problems .plan to undergo surgery under general anesthesia . Stopping the drug suddenly may cause increase in BP.anemia . Possible Adverse Effects Symptoms/Effects Frequency What to do Headache Common Discuss with your doctor only if bothersome. Use the minimum effective dose. dry mouth are common. Infants and Children: Reduced dose necessary. nausea. Adverse effects like drowsiness.

Symptoms/Effects Frequency What to do Joint and muscle discomfort Rare Discuss with your doctor only if bothersome. Fever Common " Dry mouth " " Nausea/vomiting Rare "“ Diarrhoea " " Stomach pain with fever " Discuss with your doctor as soon as possible and vomiting Swelling of feet and hand Common " Swelling of breasts " " Decreased sexual ability Rare " Jaundice " " Weakness " " Sore Throat " " Abnormal bleeding or " " bruising Depression/confusion Common " Nightmares Rare Stop drug immediately and notify your doctor High fever (shortly after " " starting to take this medicine) Interactions Drugs/Drug Class Effects Notes Medicine for diabetes s Excessive lowering of blood sugar levels such as tolbutamide Medicine that cause sedation s Excessive sedation Tricylic Antidepressants t Haloperidol Disorientation. abnormal behaviour MAO Inhibitors High BP and behaviour change (seeing and hearing things which are really not there) Phenothiazines High BP Effects of Long-term Use Liver and blood problems may occur (rarely). Profiles of 50 Drugs 459 . Water retention may occur (if not taken with a water pill).

What if you Miss a Dose Take as soon as possible.2 gm as single dose or 1 gm twice every 12 hours.METRONIDAZOLE Drug Group: Antibacterial and Antiprotozoal (anti-infective) Principal Uses It is used to treat certain infections of the vagina. For giardiasis: 600 mg twice daily for 5-10 days or 2 gm once daily for 3 days. Dosage and Usage Information Available Dosage Forms: Tablets. If you are taking multiple doses. 460 A Lay Person's Guide . and injectables. Seven-day course: 200 mg thrice daily for 7 days. How this Drug Works It destroys essential components that are necessary for the cell life and growth of infecting organisms. It is used to treat amoebic dysentery and giardiasis (a kind of smelly dysentery). Children: 7. syrups. How and When to Take May be taken with or following food. IV fluids. skip the missed dose and go back to your regular dosing schedule. Note: 7-day course is preferred. to avoid stomach irritation. However.5 mg/kg for dysentery and giardiasis. For vaginal infection/genito-urinary infection: one-day course . try to take at evenly spaced time intervals to keep a constant amount of medicine in the blood. Dosage Adults: For amoebic dysentery: 600 mg twice daily for 5-10 days. abdomen. It is also used to treat septicaemia (marked by fever and pus forming organisms in blood). In high doses. It may prevent and treat infections following surgery. Do not double the doses. if it is almost time for your next dose. it can enter the brain and is used to treat abscesses occurring there. pelvis and gums. infected leg ulcers and pressure sores.

Profiles of 50 Drugs 461 . numbness/tingling. This will help keep you from getting the infection back again. For temporary relief. check with your dentist since it may increase the chances of dental disease. stomach irritation. an unpleasant or sharp metallic taste. Note: If you refrain from nursing. Avoid drug or refrain from nursing. Precautions Be sure to tell your doctor if you have: .central nervous system disorders such as epilepsy (fits) Pregnancy: Safety is not established. confusion.What if you Exceed the Dose The symptoms include weakness. If dry mouth continues for more than 2 weeks.heart problem . Discuss with your doctor. Breast feeding: It passes into the breast milk and causes adverse effects in the baby.liver problem . Over 60: Infections in the genital and anal regions may occur. Avoid completely in the first three months of pregnancy. Infants and children: Reduced dose necessary. Notify your doctor as soon as possible. When taken along with metronidazole. vomiting. disorientation. it may cause flushing. and a change in taste sensation. How to Stop Using this Drug Take the full course. use gum/candy/ice bits. Avoid in children with blood disorders. nausea. Also. Resume breast feeding after one or two days after you stop taking this drug. Driving and Hazardous Activities: This drug may cause dizziness or light-headedness. the breast milk must be squeezed out or sucked out with a breast pump and thrown away. Report the development of rashes and itching promptly to your doctor. it may be desirable for your partner to wear a condom during intercourse. abdominal pain and headache.blood disorders . Restrict activities as necessary. While using this medicine for vaginal infection (trichomoniasis) your sexual partner must also be treated even if he has no symptoms. Others: It may cause dryness of mouth.kidney problem . Even if you feel better the infection may still be present and symptoms may return if treatment is stopped too soon. vomiting. nausea. Alcohol: Avoid.

Unsteadiness " " Skin rash " Sore throat/fever Any vaginal irritation/discharge/ dryness (not present before using this drug) " " Note: This drug may cause dark urine. 462 A Lay Person's Guide . Adjust dose as required and patient is observed closely for 1st 10 days of simultaneous use. alcohol habit) Effects of Long-term Use Not usually used for longer than 10 days. Interactions Drugs/Drug Class Effects Notes Blood thinners (e. Discuss with your doctor immediately.. Seizure (fits) Rare " Mood changes " Discuss with your doctor as soon as possible. Possible Adverse Effects Symptoms/Effects Frequency What to do Nausea/loss of appetite Common Discuss with your doctor only if bothersome Stomach pain/stomach upset " " Headache " " Dizziness " " Dry mouth Rare " Sharp metallic taste " " Weakness " " Numbness/tingling Common Stop drug now. This is only temporary and will go away when you stop this medicine. Phenytoin s Cimetidine (anti-ulcer antacid) ¯ Disulfuram (drug used to treat Severe emotional and behaviour changes. Prolonged use may cause temporary loss of sensation in the hands and feet and may reduce the reduction of white blood cells.Your doctor may want to test your blood (cell count of blood) while you are on this medicine. warfarin) s Abnormal bleeding.g.

check with your doctor. It is a safe antifungal agent. How and When to Take Apply twice daily over affected area (covering it completely) and by rubbing it gently.V. including fungal infections of the skin. Dosage and Usage Information Available Dosage Forms: Topical creams Dosage Adults: 2% cream is applied twice daily. What if you Miss a Dose Apply it as soon as possible. depending on infection) even though your condition may have improved because sudden stopping may cause return of symptoms.2 gm per infusion. Profiles of 50 Drugs 463 .MICONAZOLE Drug Group: Antifungal Principal Uses It is used to treat certain fungal infections. I. skip the missed dose and go back to your regular dosing schedule. How this Drug Works It destroys/may prevent the growth and multiplication of the fungus which causes the infection. Do not cover it with any occlusive (closed) dressing or airtight covering. infusion: 200 mg to 1. if it is almost time for your next dose. If your skin problem has not improved after you have used miconazole for 4 weeks. Precautions Keep this medicine away from the eyes. Apply cream and cover them with non-perforated occlusive dressing for 24 hours. How to Stop Using this Drug Do not stop using it without consulting your doctor. However. For nail infections: Clip nails as short as possible. Keep using this medicine for the full time of treatment (1 week to 1 month.

redness Rare Discuss with your doctor as soon as or other signs of skin irritation possible. blistering. (not present before using the cream form of this medicine) On systemic use Fever and chills Common " Skin rash/itching " " Unusual bleeding/bruising Rare " Unusual tiredness/weakness " " Wheezing/troubled breathing " " Nausea/vomiting Common Discuss with your doctor only if severe Diarrhoea Rare " Drowsiness " " Flushing/redness of face/skin " " Loss of appetite " " Interactions Drugs/Drug Class Effects Notes Blood thinners ­ Dose adjustment necessary Phenytoin s Phenytoin toxicity. 464 A Lay Person's Guide .Possible Adverse Effects Symptoms/Effects Frequency What to do On local application Skin rash.

Follow with 1 tablet daily (taken at the same time each day) for 21 consecutive days. How this Drug Works When the combination of an estrogen and a progesterone (hormones which occur naturally in the female body) are taken in correct dosage regularly. Besides it also leads to resistance to the passage of sperm as well as resistance to implantation (placement) of the egg (if at all ovulation occurs). Profiles of 50 Drugs 465 . Dosage and Usage Information Available Dosage Forms: Tablets Dosage: 1 tablet daily How and When to Take Start treatment with the first tablet on the fifth day after the onset of menstruation (periods). This.ORAL CONTRACEPTIVES/BIRTH CONTROL PILLS Drug Group: Female Sex Hormones Other name: Estrogens/Progestogens Principal Uses This drug is considered a very effective method of preventing pregnancy. If you do not remember until the next day. use a second method of birth control to make sure that you are fully protected for the rest of the cycle. then continue your regular dosing schedule. heavy menstrual flow and some problems of the uterus. such as menstrual irregularity. prevents the ovulation (formation and release of an egg from the ovary). However.). It is also used in the treatment of conditions that benefit from added hormones. take the missed tablet plus the tablet that is regularly scheduled for that day (2 tablets on the same day). The tablet may be taken with or after food to avoid stomach irritation/vomiting. in turn. In addition. menstrual and menopausal disorders. For 2 days in a row: Take 2 tablets a day for each of the next 2 days. All these factors lead to prevention of pregnancy. it neither prevents nor cures venereal disease (V. the levels of hormones increase to those levels that occur during pregnancy.D. Then continue your regular dosing schedule. What if you Miss a Dose For 1 day: Take as soon as you remember. The schedule is to take the drug daily for three weeks and to omit it for one week. Resume the treatment on eight day following the last tablet taken during the preceding cycle.

swelling of hands and feet occurs.For 3 days or more in a row: Stop taking the medicine completely and use another method of birth control until your period begins or until your doctor determines that you are not pregnant.heart problems.asthma .mental depression or any other psychiatric problem . Breast feeding: It passes into the breast milk and reduces the quality and quantity of milk.menstrual problems .Crohn’s disease Pregnancy: Avoid this medicine completely during pregnancy.varicose veins . 466 A Lay Person's Guide . Diet: Avoid excessive intake of salt if fluid retention. fluid retention. angina (heart pain).family history of ischaemic heart disease.planned to undergo surgery . How to Stop Using this Drug Do not discontinue this drug if spotting occurs. Precautions Be sure to tell your doctor if you have: . heart attack. Discuss this thoroughly with your doctor. abnormal vaginal bleeding.gallstones . A preparation with a higher estrogen content may be required. If it continues for more than one week.abnormal vaginal bleeding .kidney problems . .lumps in breasts . high BP. vomiting. Prefer other methods of contraception. What if you Exceed the Dose The symptoms include headache.liver problems . after discontinuing this medicine. drowsiness. Your doctor may allow to use this medicine after you have been breast feeding for a while. Tobacco: Avoid smoking cigarettes or use of tobacco in any other form completely during the use of this drug.long-term immobilisation . breast enlargement and discomfort. blood circulation problems. Avoid drug during lactational amenorrhoea. It is advisable to avoid pregnancy for 3 to 6 months. Then restart protection with a new cycle of tablets.diabetes .migraine headaches .cancer . ischaemic cerebral vascular accident . It may cause defects in the child. nausea. consult your physician. Omitting this drug for only 1 day may not cause pregnancy.epilepsy (fits) .problems of uterus .

Avoid too much sun/sunlight until you know how you react to it.if you have taken this medicine for a long time (2 years or more) and then stopped the use. If delayed by longer than 12 hours contraception protection may be lost.if medicine is not adjusted properly for your needs . . Possible Adverse Effects Symptoms/Effects Frequency What to do Coughing up blood Rare Stop drug now. Headache (severe and sudden) “ " Loss of co-ordination " " Vision problems " " Pains in chest/groin/leg " "“ Profiles of 50 Drugs 467 . (Use another method of birth control that time). It takes some time for the effects of this drug to wear off even after you stop using it. Exposure to Sun: A few people may become more sensitive to sunlight while on the pill. your body will require at least 7 days to adjust before pregnancy will be prevented. Missed periods may occur : . If you develop brown blotchy spots on exposed areas. Hence it may cause birth defects in the child of a woman who gets pregnant immediately after stopping the drug. therefore you should use a second method of birth control for the first cycle (or 3 weeks) to ensure full protection. it is very important that you wait at -least 3 months before becoming pregnant. This risk increases with the age of the patient and is greater in women of 35 years to the age of menopause. Diarrhoea lasting more than a few hours can impair the effectiveness of this medicine. Tablet should be taken at approximately same time each day. or stroke. heart attack.Doing so may increase the risk of serious side-effects affecting the heart and/or blood circulation such as dangerous blood clots. When you stop using this medicine. Check with your doctor if you miss a period so that the cause can be determined. Get emergency help now.if you have not taken the medicine exactly as scheduled (pregnancy may be a possibility). So adopt another method of birth control. do not worry as they will disappear slowly when you stop the medicine. Others: Once you begin this medicine.

pain or tenderness in " " upper stomach Uncontrolled jerks " " Unusual dark mole " " Thick. Bulging eyes " Discuss with your doctor as soon as possible Changes in vaginal bleeding " " Double vision " " Fainting " " Urinary problems " " Increased blood pressure " " Lumps in or discharge Rare " from breast Mental depression " " Stomach pain " " Skin rash " " Swelling. numbness or pain in " " arm/leg Key: All these symptoms could lead to heart attack or death.Symptoms/Effects Frequency What to do Breathing problems " " Slurring speech " " Weakness. white vaginal discharge " " Yellowing of eyes/skin " " Acne (less common after Common Discuss with your doctor only if severe or first 3 months) bothersome. Bloating of stomach " " Cramps of lower stomach " " Loss of appetite " Nausea " Swelling of ankles/feet " Swelling & tenderness of breast " Unusual weight gain " Brown blotchy spots on Rare exposed skin Mild diarrhoea " 468 A Lay Person's Guide .

g.. Diazepam s Excessive sedation (sleep) Profiles of 50 Drugs 469 . sleep-inducing drugs) " Valproic acid ¯ " Benzodiazepines. Vomiting " Interactions Drugs/Drug Class Effects Notes Cortisone-like medicines ¯ Use another method of birth control. Irritability " Some loss of scalp hair " Unusual decrease/increase " in sexual desire. Migraine headaches " Increased body or facial hair " Increased sensitivity to contact " lenses. e.Symptoms/Effects Frequency What to do Dizziness Rare Discuss with your doctor only if severe or bothersome. Barbiturates ¯ " Carbamazepine ¯ " Dihydroergotamine ¯ " Griseofulvin ¯ " Mineral Oil ¯ " Neomycin ¯ " Penicillins ¯ " Phenytoin ¯ " Primidone ¯ " Phenylbutazone ¯ " Oxyphenbutazone ¯ " Sulfonamides ¯ " Rifampicin ¯ " Tetracyclines ¯ " Tranquilizers ¯ (calming.

If vomiting occurs within 3 hours of taking the tablets. It involves taking two tablets each containing ethinyloestradiol 50 micrograms (mcg) and levonorgestrel 25 mcg. Medicines for diabetes Changes in blood sugar levels. Troleandomycin (TAO) Increased liver toxicity and jaundice. growths/tumors in uterus. Antidepressants Adverse effect increases and effectiveness decreases. Effects of Long-term Use High blood pressure. menstrual problems. Blood thinners Changes in the blood-clotting mechanism. disease with stones. two replacement tablets can be given with an anti-emetic. followed 12 hours later by a further two tablets. infertility. gall bladder. The method has only been established as effective if the first dose is taken within 72 hours (3 days) of the unprotected intercourse. Emergency Contraception Hormonal method: The hormonal (yuzpe) method of emergency contraception is suitable for occasional use.Drugs/Drug Class Effects Notes Metoprolol s Prednisolone and Prednisone s Theophyllines s Toxicity of theophyllines may occur. 470 A Lay Person's Guide .

Respiration Normal Deep Deep and rapid Pulse Normal Rapid. Sudden loss of water and salt (dehydration) causes marked weakness. they promptly replace the water and salts lost during diarrhoea and correct dehydration. Oral rehydration salts (ORS) contain sugar and mineral salts needed by the body. How this Drug Works A person who passes frequent watery stools loses a large amount of water and salts from the body. restless or lethargic limp. Severe diarrhoea causes decreased urine output. increased pulse rate and unconsciousness resulting in death. It is estimated that about one out of every 10 children born in developing countries dies of diarrhoea before reaching the age of 5. restless Drowsy or comatose. feet aroused. When taken dissolved in water. Eyes Normal Sunken Very sunken Skin Pinch Pinch. cold. retracts retracts slowly very slowly (2 sec) immediately Mucous membranes Moist Dry Very dry Urine flow Normal Reduced None and dark Profiles of 50 Drugs 471 .ORAL REHYDRATION SALTS (ORS) Drug Group: Antidiarrhoeal Principal Uses Oral rehydration salts (ORS) are specifically intended for the replacement of water and salts lost in acute diarrhoea. weak Rapid and weak or undetectable Fontanelle. Dosage and Usage Information Initial Treatment The degree of dehydration is determined from the general appearance of the child and the following signs: General Appearance Mild Moderate Severe and Condition of Dehydration Dehydration Dehydration Infant or Child General condition Thirsty. irritable when bluish hands. particularly in infants and young children. It is vital that these losses are rectified as rapidly as possible. sweaty. retracts Pinch. thirst and sunken eye-balls. Thirsty.

common salt. How and When to Take The child should be offered its normal food as soon as possible. 40 gm of table sugar (about 8 teaspoons) is equivalent to 20 gm (4 teaspoons) of glucose. . 1000 ml is one litre. 1. Fruit juices. When intravenous infusion is not possible an attempt can be made to administer ORS by mouth using a dropper at a rate of about 20 ml/kg body weight an hour. bananas or coconut-water are particularly useful in repairing losses of potassium. Infants over 4 months should be started on semisolid foods. Instead of glucose. ORS solution can also be prepared from home ingredients mentioned above .Usage and Dosage Range Degree of Amount of Approximate total fluid deficit (ml) Dehydration Fluid needed ml/kg 1-2 5-8 9-12 1-2 2-4 months months months months months Moderate 100 200-400 400-600 600-800 1000 1200 Severe Intravenous fluid replacement needed Note: 200 ml is 1 glass approximately. either as breast feeds or as a supplement of equal volumes of milk and clean water. The maximum rate of fluid replacement for small children is about 300 ml per hour. Mix 8 teaspoonful of sugar with 1 teaspoonful of baking soda together with 1 litre of boiled and cooled water or clean drinking water. give the child any one of the following every 24 hours: 472 A Lay Person's Guide . Replacement of Continued Fluid Loss After initial rehydration the child should be given: . baking soda and sugar. Up to one third of the total fluid intake can be given as equal volumes of milk and clean water.ORS in a quantity that matches the fluid loss in the stools. use sucrose (common table sugar) or even crude sugar called gur or jaggery.Plus the normal fluid intake. Give to child as indicated for packaged ORS. If the preformulated ORS packets as above are not available. As potassium chloride is not usually available.

the rate of fluid loss as long as the diarrhoea persists Profiles of 50 Drugs 473 . Packets are recommended.0 gm Dissolve. Give instructions to the relatives regarding the preparation and administration of ORS solution.5 gm Glucose 20. pour away and make it again with less salt.bicarbonate ORS . The volume of fluid required and the rate at which it should be given depend upon: . For this take salt in a teaspoon. If not. the crude sugar. if available.citrate Sodium chloride 3. 3. If the above things are not available. 4.5 gm Sodium chloride 3. Thums-Up or milk bottles) with known capacity may be available.the initial degree of dehydration . each containing: ORS . use clean drinking water. If a litre measure is not available. use a glass. immediately before use. 2 large size bananas (mashed) 3 small size bananas (mashed) 3 cups of coconut water 2 cups of orange juice 2 cups of mashed papaya or 5 medium size ripe tomatoes Gur. because the sizes of packets vary. boiled cooled water.0 gm Glucose 20.5 gm Potassium chloride 1. Level it with a knife or a flat object. 2. one packet in one litre of clean. in the quantity of water indicated on the packet. If it tastes more salty than tears. Taste the mixture. also contains varying amounts of potassium. prepare the solution with ordinary salt and sugar. Add one level spoonful of salt to one litre of water and mix.5 gm Trisodium citrate. boiled water is preferable.5 gm Sodium bicarbonate 2. dihydrate 2. For making the solution. Even rice water can be used in place of sugar. Sometimes soft drink bottles (for example.9 gm Potassium chloride 1.the weight (age) of the child . Finally add 8 level teaspoons full of sugar and mix it well. Average medium size glass has about 180-200 ml capacity. or.

Precautions Others 1. 474 A Lay Person's Guide . If you have a limited supply of ORS. Possible Adverse Effects Used properly. Continue ORS therapy till the diarrhoea stops or the patient is referred to the doctor. It should be kept covered in a cool place. 2. It can still be used provided it dissolves completely in water. 5. All cases of moderate or severe dehydration should be started on ORS fluid as mentioned above and referred to the doctor. sweetened fruit drinks. If the ORS has turned to a brown colour it should not be used. Examples of fluids which are potentially dangerous and should be avoided: commercial soft drinks. purgatives. do not throw away ORS that has become caked. If ORS packets are stored at high temperature (more than 30 °C) and high humidity for a long time. sweetened tea. it is quite safe. During ORS administration. medicinal teas or infusions. coffee. A patient who has received adequate amounts of ORS will pass the normal (usual) amount (1500-2000 ml) of urine daily. The solution should be prepared fresh every day using a clean utensil and spoons and after washing hands thoroughly. the product is likely to cake. 3. measure the amount of urine passed. Failure to increase urine output suggests a need for administering more ORS. 4.

Alcohol: Prolonged heavy intake of alcohol with paracetamol may increase the risk of liver injury. 3 to 4 times daily Children: 16-20 mg/kg/dose. Seek immediate medical advice in all cases. It does not cause stomach upset or bleeding problems. Section 1 of this book. Chronic intake may produce drug-induced liver damage. 3 to 4 times daily. Dosage and Usage Information Available Dosage Forms: Tablets and syrups (125 mg/5ml) Dose Adults: 500 mg-1gm. Precautions Be sure to tell your doctor if you have kidney/liver problems. Profiles of 50 Drugs 475 . drowsiness. Do not take this drug for more than 10 days in a row. Note: Although it is often combined with other painkillers and medicines used to treat allergy. Possible Adverse Effects Acute over dose produces liver damage. cold and muscular pain. in case of children up to 12 years of age. Unlike aspirin. and is therefore an useful alternative. What if you Exceed the Dose The effects include vomiting. antipyretic Principal Uses Paracetamol (acetaminophen) is used to relieve mild to moderate pain and to reduce fever.PARACETAMOL Drug Group: Non-opioid analgesic. See also Annexures 4 and 5. if you are an adult or for more than 5 days in a row. like aspirin. Chapter 3. violent contractions of muscles. stomach pain. Over 60: Do not exceed a total dose of 2500 mg per day since excessive doses may cause liver and kidney damage. lethargy. liver damage. profound unconsciousness (in 2-5 days after large overdose). How this Drug Works It reduces the formation of chemicals (prostaglandins) that produce pain and fever. it is not useful in treating the swelling of joints. such combinations are not rational and should be avoided as far as possible.

What if you Miss a Dose Take it as soon as possible. coma (profound unconsciousness).PROMETHAZINE Drug Group: Anti-allergic Anti-vomit Principal Uses It is to relieve or prevent the symptoms of rhinitis and other types of allergy. vomiting. Also used as anti-tussive (anticough) in children. deep sleep. It prevents motion sickness. Dosage and Usage Information Available Dosage Forms: Tablets. Dosage Adults: 12. 476 A Lay Person's Guide . It is used to reduce itching in a variety of skin conditions including urticaria (hives). Seek medical help immediately. weakness. nausea. However. How and When to Take Take with or following food to reduce stomach irritation. skip the missed dose and go back to your regular dosing schedule. Children: 0. diarrhoea. fits. and as a preanaesthetic medication. take 1-2 hours before travel. liquids and injectables. What if you Exceed the Dose The symptoms include marked drowsiness. For motion sickness. if it is almost time for your next dose. then every 4-6 hours as necessary. unsteadiness. and produces sleep in some people when used as nighttime sedation. How this Drug Works It blocks the actions of histamine (chemical producing allergy). Used in psychiatry as an antipsychotic. It slows down the activity of the vomiting center in the brain.0 mg/kg/day every 6 to 8 hours by mouth or intra-muscular injection. chickenpox and eczema.5-2.5 mg to 25 mg every 4-6 hours daily as necessary Note: Actual dose must be determined by the physician for each patient individually. agitation.

Avoid drug or refrain from nursing.enlarged prostate . Alcohol may increase the sedative effects of this drug.blood disease Pregnancy: Avoid use of this drug during the first and last 3 months. lethargy and impaired thinking judgement and memory. Avoid exposure to excessive sunlight until you know how you react to this drug. It should not be used in newborn infants. Driving and Hazardous Activities: This drug can cause drowsiness. Infants and Children: Reduced dose necessary. neck.liver problems .ulcer . Possible Adverse Effects Symptoms/Effects Frequency What to do Drowsiness. dizziness. so avoid activities until you know how you react to this drug.urinary problems . This drug can increase the symptoms of prostatism. bleeding in the newborn infant. Alcohol: Avoid.kidney problems . Breast feeding: It passes into the breast milk. back. Others: It may cause dryness of the mouth. use sugar/ice-bits in your mouth. lethargy Common Discuss with your doctor only if severe Dry mouth " " Blurred vision " " Headache Rare " Profiles of 50 Drugs 477 . legs and hands in such children. Over 60: Increased likelihood of adverse effect such as drowsiness. check with your doctor since it can lead to dental disease. nose and throat.asthma/lung problems . Sun: This drug may cause some people to become sensitive to sun.Precautions Be sure to tell your doctor if you have: . The property is utilised for drying secretions in nasal cattarh (simple inflammation of mucous membrane). it can cause jaundice/muscle tremor. The drug is preferred at bed time.heart problems . For temporary relief. If dry mouth lasts for more than 2 weeks. It should not be used to control vomiting in children with flu/measles/chicken pox or other infections since it may cause muscle pain of face.

sore throat. back " " hands and legs Blood diseases: Bruising. it may cause abnormal movements of face and limbs (Parkinsonism) which disappears when drug is stopped.Symptoms/Effects Frequency What to do Stomach upset Rare Discuss with your doctor only if severe Rapid heart rate " " Low BP " " Chest tightness " " Jaundice Discuss with your doctor as soon as possible Hysteria " " Muscle pain of face. May retain antacid for longer duration in the stomach. If taken for long time. neck. 478 A Lay Person's Guide . Long-term use may lead to loss of effectiveness of this drug. fever Skin rash due to sun " Stop taking the drug and discuss with your doctor Interactions Drugs/Drug Class Effects Notes Sedative (sleep-inducing drugs) s Atropine and Atropine-like drugs s Antacids ¯ Take the two drugs at least 1 hour apart. Effects of Long-term Use Long-term use of this drug is unnecessary. " " Bleeding.

As a result. 120-240 mg daily (maintenance dose) . they decrease the need of blood and oxygen by the heart by reducing its workload. Food enhances the absorption of propranolol.PROPRANOLOL Drug Group: Antihypertensive. To prevent harmless possible numbing effect. How to Use this Drug Preferably taken soon after eating to maximize absorption of drug into the blood. Swallow the tablet or capsule whole.For high BP: 80-160 mg daily Note: Actual dose may be determined by the doctor for each patient individually. They also help the heart to beat more regularly. Do not double the doses. mix with soft food and swallow promptly. symptoms of overactive thyroid gland. What if you Miss a Dose Take it as soon as possible. skip the missed dose and go back to your regular dosing schedule). How this Drug Works It works by affecting the response to some nerve impulses in certain parts of the body. angina and abnormal heart rhythms. Beta blocker (medicine to treat blood pressure and heart problems) Principal Uses It is used to treat raised blood pressure.For treating irregular heart rhythm :30-160 mg daily. symptoms of anxiety and nervous tension (such as sweating and tremors). break or chew before swallowing. It is also useful in controlling fast heart rate.Anti-angina: 80-120 mg daily (starting dose) in 2-4 divided doses. Do not crush. However if your next dose is within 4 hours (8 hours for slow-release/prolonged action capsules). . Profiles of 50 Drugs 479 . Dosage and Usage Information Available Dosage Forms: Tablets Dosage . preventing migraine headaches and in treatment of chronic alcoholism.

planned a surgery in the near future. The nursing infant must be closely observed by the doctor. Abrupt stopping may lead to worsening of the underlying condition. bronchitis.myasthenia gravis . Alcohol: Use cautiously. asthma.kidney problems . Avoid completely in the first three months of pregnancy. emphysema) .overactive thyroid . seizures (fits).poor circulation in the legs . Alcohol may increase the drug’s ability to lower the blood pressure and may increase its mild sedative effect. cold and sweaty skin. difficulty in breathing.liver problems . fainting. dizziness. Pregnancy: Safety in pregnancy not established.breathing problems (lung disorders. How to Stop Using this Drug Do not stop the drug without consulting your doctor.. What if you Exceed the Dose The symptoms include irregular heart beat. Seek immediate medical advice in all cases.diabetes . low BP. e. Their progress must be regularly observed ( monitored) by the doctor. Precautions Be sure to tell your doctor if you have: . difficulty in breathing. bluish-coloured fingernails.mental depression . Breast feeding: The drug passes into the breast milk. Discuss with your doctor for use in the other six months of pregnancy.Do not discontinue this drug abruptly. Tobacco: It may reduce the drug’s efficiency in treating heart disorders and also reduce drug’s blood levels 480 A Lay Person's Guide . A gradual reduction of dose over a period of 2 weeks is recommended. Infants and Children : Safety and effectiveness is not established for children under 12 years of age. Discontinue drug or nursing if adverse effects develop.heart problems . Use caution. collapse or profound unconsciousness.g. Over 60: Increased risk of adverse effects.

" " Lethargy Common " Headache Rare " Dizziness Common " Indigestion Rare " Nausea/vomiting " " Diarrhoea " " Sleeplessness Common " Vivid dreams Rare " Breathing problems " Discuss with your doctor as soon as possible. Diabetic patients should take this drug cautiously. it enhances the loss of circulation to hands and feet due to this drug. Besides this drug may increase the breathing problems caused by smoking.by increasing it’s elimination from the body. Possible Adverse Effects Symptoms/Effects Frequency What to do Skin rash Rare Discuss with your doctor only if severe/bother some. Others: Avoid hot environment. Temporary loss of hair " " Drug-induced fever " " Dry. Avoid exercise and exertion that produces light-headedness. or muscle cramping. sore eyes " " Stuffy nose " " Numbness/tingling of fingers and toes. it enhances the fall in blood pressure due to this drug. So determine how you react to this drug before performing such activities. Cold hands and feet Common " Mental depression Rare " Slow pulse rate " " Profiles of 50 Drugs 481 . Avoid cold environments. excessive fatigue. Driving and Hazardous Activities: This drug may cause dizziness and fall in blood pressure.

slow heart rate. Verapamil s Causes excessive depression of heart function Theophyllines t Reduced anti-allergic effect of theophyllines Clonidine Rebound high BP if clonidine is stopped and propranolol is still being taken. Insulin May mask the ‘low-blood glucose level’ effect of insulin. Dose adjustments necessary. slowing of heart rate and lowering of blood pressure. Lidocaine s Reserpine s Causes sedation. Chlorpromazine ­ Cimetidine ­ Propylthiouracil ­ Barbiturates ¯ Indomethacin ¯ Rifampicin ¯ Effects of Long-term Use Rarely in patients with advanced heart disease.Symptoms/Effects Frequency What to do Anxiety Rare Discuss with your doctor as soon as possible. Reduced heart reserve and eventual heart failure in susceptible individuals with advanced heart disease. 482 A Lay Person's Guide . eventual heart failure may occur. depression. Decreased sexual ability " " Behaviour changes " " Chest pain " " Fever and sore throat " " Abnormal bleeding. bruising " " Interactions Drugs/Drug Class Effects Notes Other Medicines that lower BP s Excessive lowering of BP. Epinephrine High BP.

Avoid the drug. It should not be used for long-term or regular prophylaxis (prevention) of malaria or for vivax malaria.25 mg/kg pyrimethamine or 25 mg/kg sulfadoxine single dose.liver or kidney problems . Profiles of 50 Drugs 483 . Children: 9-14 years: 2 tablets daily 4-8 years: 1 tablet daily 1-3 years: 1/2 tablet daily 2-11 months: 1/4 tablet daily Weight-wise: 1. Pregnancy: Avoid.anemia .epileptic fits . How to Take this Drug Take the prescribed dose once only. Dosage and Usage Information Available Dosage Forms: Tablets Dosage Adults: 3 tablets (each tablet contains 25 mg pyrimethamine and 500 mg sulfadoxine) as a single dose. Principal Uses This combination is used only in the treatment of falciparum malaria that is resistant to (not cured by) chloroquine. Precautions Be sure to tell your doctor if you have: . Breast feeding: It is secreted in breast milk.blood disorders. How this Drug Works It interferes with and inhibits the growth of the germs that cause malaria.PYRIMETHAMINE AND SULFADOXINE Drug Group: Antimalarial.

redness Common " (with high doses) Swelling of tongue " " Sore throat/fever " " Ulcers in mouth " " Interactions Drugs/Drug Class Effects Notes Oral Antidiabetics s Fall in blood effect sugar levels. Reduced dose of antidiabetics may be necessary. Effects of Long-term Use Long-term use not advisable (may lead to serious skin and blood disorders).Possible Adverse Effects Symptoms/Effects Frequency What to do Loss of appetite Common Discuss with your doctor only if severe Vomiting " " Weakness/fatigue Rare Discuss with your doctor as soon as possible Skin Rash " " Bleeding/Bruising " " Soreness. 484 A Lay Person's Guide .

till the patient is able to take the tablet. How to Stop Using this Drug For malaria . Precautions Be sure to tell your doctor if you have: . How and When to Take Take with or after meals to avoid stomach upset. Children: 10 mg/kg body weight thrice daily for seven days followed if necessary by pyrimethamine/sulfadoxine tablets.V. thrice daily for 7-10 days or I. then 10 mg/kg is infused every 8 hours.QUININE Drug Group: Antimalarial Principal Uses It is used in the treatment of falciparum malaria resistant to chloroquine. To help clear up the infection completely take the full course even if you begin to feel better within a few days. injectables Dosage Adults: 600 mg. Infusion: 20 mg/kg quinine diluted in other fluid (like dextrose) is infused for 4 hours.asthma .Do not stop without consulting your doctor.myasthenia gravis . What if you Exceed the Dose Take medical advice immediately if breathing problems.kidney problems Profiles of 50 Drugs 485 . fits or loss of consciousness occurs.heart disease . Dosage and Usage Information Available Dosage Forms: Tablets. It is also used in cerebral malaria. How this Drug Works It kills the malarial parasites.

Breast feeding: Although it passes into the breast milk. Possible Adverse Effects Symptoms/Effects Frequency What to do Vision problems Common Discuss with your doctor as soon as possible Headache " " Ringing or buzzing in ears " " Loss of hearing " " Skin rash with intense itching Rare " Diarrhoea " Discuss with your doctor only if severe Nausea/vomiting Common " Stomach upsets Rare " Interactions Drugs/Drug Class Effects Notes Quinidine t Cinchonism (poisoning by quinine. It may cause hypoglycaemia (lowering of blood sugar). Driving and Hazardous Activities: This drug causes blurring of vision. the quantity is too little to affect the child. Pregnancy: Can be safely used in therapeutic doses. cinchona) occurs Digoxin s 486 A Lay Person's Guide . and may impair those activities.Quinine should be used cautiously in diabetics.

Profiles of 50 Drugs 487 . so as to obtain the longest period of stomach acid reduction. whereby many drugs are broken down. Dosage For treatment of ulcer: 150 mg twice daily for 45 days For prevention of ulcer: 150 mg daily at night. Rantac. Dosage and Usage Information Available Dosage Forms: Tablets 150 mg and 300 mg orally in single dose and syrup ranitidine hydrochloride 50 mg/2 ml orally and IV slowly. Unlike cimetidine. fits and profound unconsciousness. ranitidine does not affect the actions of certain enzymes in the liver. It is also used in a disease called Zollinger-Ellison syndrome. Ranitin Drug Group: Anti-ulcer Principal Uses It is used in the prevention and treatment of peptic ulcer.RANITIDINE Common Brand Names: Zantac. drowsiness. sweating. How to Use this Drug The drug should be taken with or immediately following meals. slurred speech. However. This means that ranitidine can be taken with other drugs without causing an interaction that may reduce the effectiveness of treatment. For Zollinger-Ellison Syndrome: 600-900 mg daily in divided doses. allowing the ulcers to heal. skip the missed dose and go back to your regular dosing schedule. muscle twitching. Notify your doctor as soon as possible. flushing. What if you Miss a Dose Take it as soon as possible. if it is almost time for your next dose. What if you Exceed the Dose The symptoms include confusion. How this Drug Works It acts by reducing the amount of acid produced by the stomach. in which the stomach produces too much acid. preferably at bed time. a similar drug. delirium.

How to Stop Using this Drug Do not stop the drug without consulting your doctor. It is advisable to avoid the drug or refrain from nursing. Avoid if possible. Precautions Be sure to tell your doctor if: . Driving and Hazardous Activities: This drug may cause dizziness. Alcohol: Avoid.you have liver problems. Others: If you have been using the drug for a long time. Infants and children: Not usually prescribed since safety and effectiveness is not established. Restrict activities as necessary. Possible Adverse Effects Symptoms/Effects Frequency What to do Skin rash Rare Discuss with your doctor only if severe/bothersome Headache " " Dizziness " " Nausea " " 488 A Lay Person's Guide . nausea and vomiting).you have kidney problems Pregnancy: Safety in pregnancy not established. This drug may also lead to the formation of masses of undigested vegetable fibers (patients with poor chewing ability/missing teeth and those who have had stomach surgery are more prone to this and may show symptoms such as loss of appetite. stomach fullness. Tobacco: Avoid completely or at least after taking the last dose of the day since it reduces the drug’s effectiveness. your doctor may want to check your blood and liver function. Diet: Protein-rich foods produce maximal stomach acid secretion and hence should be avoided. symptoms may recur. Over 60: They must be observed for the development of nervous agitation or confusion. Certain food and drinks that irritate the stomach may make your problem worse. Breast feeding: The drug passes into the breast milk. It may increase the stomach acidity and reduce the effectiveness of this drug.

Symptoms/Effects Frequency What to do Constipation Rare D i s c u s s w i t h yo u r d o c t o r o n l y i f s e ve r e / bothersome Stomach pain " Discuss with your doctor as soon as possible Confusion " " Sore throat and fever " " Unusual bleeding or bruising " " Irregular heart beat " " Unusual tiredness/weakness. Continuous use of the drug for longer than 1 year is not recommended except in exceptional circumstances because the safety of this drug for prolonged use has not yet been confirmed. Effects of Long-term Use Courses of longer than 8 weeks are not usually necessary although repeat courses may be required in case the symptoms return. " " sexual impotence Interactions Drugs/Drug Class Effects Notes Antacids ¯ Do not take any antacids within 1 hour of taking this drug. Profiles of 50 Drugs 489 . Ketoconazole t Take ranitidine at least 2 hours after ketoconazole. Medicines that are enteric-coated Enteric coating dissolves too rapidly.

Its use should be restricted. clonidine or propranolol are ineffective or produce adverse effects. if it is almost time for your next dose. Dosage Adults: 0. breathing problems. As a result. are added one after the other depending upon the response and severity of symptoms. slow pulse.) Because of high incidence of adverse effects with reserpine. 490 A Lay Person's Guide . However. It is started with a Step 1 medicine and then other medicines. tremors. skip the missed dose and go back to your regular dosing schedule.0. What if you Miss a Dose Take it as soon as possible. Dosage and Usage Information Available Dosage Forms: Tablets as part of combination drugs. incoordination. Step 2. that is. How and When to Take Take with or following food to reduce stomach irritation. profound unconsciousness. it is used only in those cases in which methyldopa.1 . What if you Exceed the Dose Marked drowsiness.5 mg daily for 1-2 weeks Note: Dose is adjusted by the doctor as needed and depending on tolerance. diarrhoea. 3 and 4 medicines.RESERPINE Drug Group: Antihypertensive Medicine for high blood pressure (BP) Principal Uses Used primarily as a Step 2 medicine to control high BP (the treatment of hypertension is done in a step-by- step method. it acts on the heart and blood vessels to lower blood pressure. How this Drug Works It works by controlling nerve impulses along certain nerve pathways. flushed skin.

heart disease . Profiles of 50 Drugs 491 . Alcohol: Avoid. Diet: Avoid excessive sodium (salt) intake.migraine headaches . Use it only if clearly needed after discussing with your doctor.epilepsy (seizure problems) . Avoid exposure to cold. Infants and Children: They must be observed carefully for excessive drowsiness. Restrict activities as necessary. Avoid this drug during the first 3 months and the last month. This medicine does not cure high BP but it does control it. nasal congestion. Avoid drug or refrain from nursing. Use caution. This drug can increase the intoxicating effects of alcohol and eventually depress brain function. anxiety. breathing problems and poor feeding in the new born infant.recently had a stroke . Breast feeding: This drug passes into the breast milk. So one must continue to take it as directed if you expect to lower your BP and keep it down. Driving and Hazardous Activities: This drug may impair mental alertness and judgement. Precautions Be sure to tell your doctor if you have: . emotional instability on gastrointestinal disturbances. nausea.planned to undergo surgery under general anesthesia .How to Stop Using this Drug Do not stop using this drug without consulting your doctor.ulcerative colitis .stomach ulcer .mental depression .).allergies/breathing problems such as asthma .Parkinson’s disease . Over 60: Increased likelihood of adverse effects. Pregnancy: Use of this drug during the last month of pregnancy can cause lethargy. etc.pheochromocytoma (a cell related disorder leading to high BP.gall stones . You may have to take this medicine for the rest of your life.kidney disease .

Possible Side-effects Symptoms/Effects Frequency What to do Skin rash Rare Discuss with your doctor only if severe Headache " " Dizziness Common " Nose bleeds " " Nausea/Vomiting " " Diarrhoea " " Altered menstrual pattern Rare " Bruising " Discuss with your doctor immediately Agitation " " Nervousness " " Confusion " " Breathing problems " " Depression " " Reduced Sexual ability " " Ulcer " " Breast enlargement " " Interactions Drugs/Drug Group Effects Notes Levodopa Medicine for seizures (fits) t Alteration in the seizure patterns of the patients Digitalis drugs Heart rhythm disorders Quinidine " Blood thinners t With short-term use s With long-term use 492 A Lay Person's Guide .

liquids Adults: TB: 450-600 mg once daily (according to weight). Even if you feel better. Precautions Be sure to tell your doctor if you : . Meningitis: 600 mg once daily for 4 days. How this Drug Works It kills the germs that cause tuberculosis (TB). Profiles of 50 Drugs 493 . It is used for leprosy in combination with other drugs such as dapsone and clofazimine. the original infection may still be present and the symptoms may return if treatment is stopped too soon. you may take it with food. leprosy. Anti-Tuberculosis. Anti-Leprosy Principal Uses Rifampicin (rifampin) is used to treat tuberculosis (TB). However if it upsets your stomach. tablets. It may be occasionally used in serious infections such as artificial heart valve infections (endocarditis) and bone infections (osteomyelitis) along with other antibiotics so as to prevent the development of bacteria that will resist the actions of the drug. Leprosy: 600 mg once a month for either 6 months or 24 months. Children: 10-15 mg/kg body weight once daily. Take the full course (which can be several months to years). It is also used in contacts of patients of meningococcal meningitis to prevent the disease. etc.RIFAMPICIN Drug Class: Antibiotic. Dosage and Usage Information Available Dosage Forms: Capsules. It is given in combination with other drugs to enhance its effectiveness. How and When to Take It is best taken with a full glass (8 ounces) of water on an empty stomach either 1 hour before or 2 hours after eating.have long-term liver problems.

Possible Adverse Effects Note: Some adverse effects are more common with intermittent therapy or after restarting interrupted treatment. saliva. stool. semen and tears to turn reddish-orange or reddish-brown colour. sputum. It causes urine.) Pregnancy: It is claimed safe in pregnancy. . Infants and Children: Must be observed closely for possible liver toxicity or blood problems. so as to reduce the risk of liver problems. sweat.. fever (flu-like Rare Discuss with your doctor immediately. So wear hard contact lenses instead of soft contact lenses. Stomach cramps " " Skin rash Rare Discuss with your doctor only if severe. symptoms) Difficult breathing " " Dizziness " " Muscle and bone pain " " Bloody/cloudy urine " " Jaundice " " Sore throat " " Abnormal bruising/bleeding " " 494 A Lay Person's Guide . Breast feeding: Continue nursing. Alcohol: Avoid. It is important that you do not miss any doses. Chills. Reduced dose may be necessary.are taking oral contraceptive (an alternate method of contraception is advised. It also colours soft contact lenses permanently.drink alcoholic beverage everyday. Over 60: Increased likelihood of adverse effects. Others: You may have to take this medicine everyday for as long as prescribed. Reduced dose may be necessary. Symptoms/Effects Frequency What to do Diarrhoea Common Discuss with your doctor only if severe.

chlorpropamide) Theophyllines t Antacids ¯ Effects of Long-term Use Prolonged use may cause liver damage.g.Interactions Drugs/Drug Class Effects Notes Anticoagulants t Beta blockers such as t propranolol. metoprolol Cortisone-like drugs t Cyclosporin t Digitoxin t Birth Control Pills t Phenytoin t Quinidine t Oral antidiabetics t (e. Fungal infection of mouth/tongue may also occur.. Profiles of 50 Drugs 495 .

01 . How and When to Take For inhalation: Keep spray away from eyes because it may cause irritation. it does not have any unwanted effects on the heart or blood pressure. It is also used in delaying of premature labour.0. How this Drug Works It relaxes the muscles surrounding the bronchioles (air ways in the lung) and thus facilitate easy breathing. 496 A Lay Person's Guide . Dosage and Usage Information Available Dosage Forms: Tablets. and is thus used in the delaying of labour. How to Stop Using this Drug Do not stop the drug without consulting your doctor. Unlike similar drugs. Children: 0. Allow 1-2 minutes after the first inhalation to make certain that a second inhalation is necessary. liquids. Then use any regular doses for that day at regularly-spaced intervals. What if you Miss a Dose Take it as soon as possible. inhalers. injectables Dosage Tablets Adults: 2 to 4 mg per dose every 6-8 hours. 3-4 times daily) Children: 100 micrograms every 6-8 hours Note: It is more effective and safe by inhalation than by mouth. Do not take more than 2 inhalations of the medicine at any one time.e. It relaxes the muscles of the uterus. unless your doctor has asked you to do so.1 mg/kg/dose every 8 hours. One microgram = one millionth of a gram. 1-2 inhalations.SALBUTAMOL Drug Group: Bronchodilator Other name: Albuterol (Medicine for Asthma) Principal Uses It is used in the treatment of asthma and other breathing disorders such as bronchitis and emphysema. Inhalers Adults: 400-800 micrograms daily (i.

brain damage . Discuss with your doctor. Drowsiness " Discuss with your doctor only if severe Nausea/vomiting " " Sweating " " Note: Salbutamol may cause a bad taste in the mouth which will go away once you stop taking it. it cannot prevent or stop the labour completely. but does not cause any adverse effect on the nursing baby.enlarged prostate .Precautions Be sure to tell your doctor if you have: . Over 60: Increased likelihood of adverse effects.overactive thyroid . Breast feeding: It passes into the breast milk.Parkinson’s disease .heart or blood vessel disease .fits Pregnancy: Avoid this drug.mental disease . Driving and Hazardous Activities: Avoid such drugs until you know how the drug affects you before performing such activities because this drug causes tremors. Interactions Drugs/Drug Class Effects Notes Sympathomimetics (medicines s Increased adverse effects similar to salbutamol) Beta blockers (medicines t or ¯ for high BP.) Profiles of 50 Drugs 497 . Although it can delay labour. Reduced dose may therefore be necessary.diabetes . Safety is not established. Possible Adverse Effects Symptoms/Effects Frequency What to do Anxiety Common Discuss with your doctor only if severe Palpitation " " Muscle Cramp " " Tremors " " Restlessness " " Headache Rare " Fast heart beat " Discuss with your doctor in all cases.

It is used along with other drugs to treat malaria when chloroquine is not effective as well as problems of the eye such as trachoma. conjunctivitis and sty. The tube used for one patient should not be used for another patient to avoid cross infections. brucellosis plague.TETRACYCLINE Drug Group: Antibiotic Principal Uses It is used in the treatment of certain infections like rickettsial infections. Note: For brucellosis. Do not touch the tip of the applicator to the eye. sexually transmitted diseases (STDs) such as gonorrhoea. Increasingly tetracycline resistant bacteria are seen. and syphilis (when penicillin cannot be used). it must be used for 2 weeks to 2 months. tablets. it must be used for 6 weeks. 498 A Lay Person's Guide . Eye ointment: The eye should be thoroughly cleaned with water before every fresh application of ointment. How and When to Take Take with lot of water at least 1 hour before or 2 hours after meals. pimples and respiratory tract infections (not responding to other antimicrobials). for STD it must be used for 15-30 days. IV injectables Dosage Adults: Capsules: 250 mg to 500 mg every six hours. Doxycycline is the preferred alternative. How this Drug Works Tetracycline kills bacterial organisms. Dosage and Usage Information Available Dosage Forms: Capsules. Eye Ointment Conjunctivitis: 4 times a day for 7-10 days. What if you Miss a Dose Take as soon as you remember. cholera. Trachoma: 3-4 times a day for 6 weeks. Space the missed dose and the next dose 6 hours apart. for chlamydial infections. Note: Not recommended in children below 12 years of age.

Sun: Avoid too much sun or sunlamp unless you know how you react to the sun especially if you tend to burn as easily. Consult your doctor if severe reaction occurs. Pregnancy: Avoid. Discuss with your doctor. Possible Adverse Effects Symptoms/Effects Frequency What to do Nausea/vomiting Common Discuss with your doctor only if severe Diarrhoea " " Light sensitive rash Rare Stop the drug now. Diet: Do not take milk or milk products within 1-2 hours of the time you take this drug by mouth since it may keep this medicine from working well. Sun-sensitivity may continue for several months after you stop taking this drug. Infants and Children: Not recommended for children below 12 years of age. Discuss with your doctor immediately Rash/itching " " Liver toxicity “ " Kidney damage Rare but common " with outdated/ improperly stored preparations Profiles of 50 Drugs 499 .kidney problems .liver problems. It is necessary to take the full course of treatment even if you feel better within a few days. It discolours the teeth of the developing baby. Others: Do not use improperly stored preparations or preparations after expiry date. Precautions Be sure to tell your doctor if you have: . Breast feeding: It passes into the breast milk and may discolour the infant’s teeth.How to Stop Using this Drug Do not stop taking this drug without consulting your doctor.

lowering drugs. It is used as a supplement in the following conditions when the Vitamin A requirement increases above normal: cystic fibrosis. Severe deficiency leads to blindness (due to ulcers in the eye) weak bones and teeth. obstruction of bile duct. Others are dry. low resistance to diseases. diarrhoea. loss of appetite. The government programme advocates Vitamin A drops every six month till child reaches 5 years of age. overactive thyroid gland. Symptoms of deficiency : Night blindness (difficulty in seeing in dim light) is an early sign. 500 A Lay Person's Guide . rough skin. chronic diarrhoea.Interactions Drugs/Drug Class Effects Notes Birth control pills t Use alternative method Iron ¯ Penicillins Tetracycline interferes with anti-bacterial action of penicillin Antacids ¯ Anticoagulants s VITAMIN A Drug Group: Vitamins Principal Uses It is useful in correcting Vitamin A deficiency. Night-blindness is the commonest cause of blindness in India and therefore judicious prophylactic (preventive) use of Vitamin A can reduce the incidence of blindness in India. long-term and use of lipid (fat) . dry and swollen eyes.

000 IU of Vitamin A orally every 3-6months 3.000 IU Vitamin A orally Profiles of 50 Drugs 501 . capsules. Adult females: 4000 IU per day.000 IU Vitamin A orally 2 weeks later 200.6 years 200. Children less than Immediately 100.000 IU Vitamin A orally 2.000 IU Vitamin A orally less than 8 kg 3.000 IU Vitamin A orally The next day 200.000 IU once a week pregnant women 2. Older children Immediately 200.000 IU Vitamin A orally and adults The next day 200. Pregnant females: 5000 IU per day. Undernourished 20. Lactating females: 6000 IU per day. Lactating Mothers 200. Children 1 . syrups.000 IU Vitamin A orally children with weight 4 weeks later 100.000 IU (international units) Normal Daily Requirements Children 4-6 years of age : 2500 IU per day.000 IU Vitamin A orally 4 weeks later 200. Adult males: 5000 IU per day.000 IU Vitamin A orally 1 year age and older The next day 100.000 IU of Vitamin A orally every 3-6months age and children weighing less than 8 kg 4.000 IU of Vitamin A orally once at delivery or during (Breast feeding) next 2 months Vitamin A Deficiency Treatment 1.Dosage and Usage Information Available Dosage Forms: Tablets. injectables Usual Dosage: Range 2500 to 200. Vitamin A Deficiency Prevention (W H O Guidelines) 1. Infants 6 -12 months 100. Adults Immediately 200.

About as mentioned above. UK.B virus is gross 4) If we want to take up Hepatitis B vaccination overestimation based on a paper. Anbumani Ramadoss cirrhosis and hepato-cellular carcinoma (HCC) is Cabinet Minister much less than what is generally believed (5). “Ministry take place at home. 2005) perinatal (vertical) transmission from hepatitis-B 'Hepatitis-B threat bigger than AIDS' we came to know positive mothers requires that newborns at risk be about the decision of the Health Ministry to launch the given the first dose of the vaccine within 12 hours of programme throughout India to give hepatitis B birth (8). hep B infection -acute hepatitis. HBeAg positive carriers are far 90% of infected infants become carriers. As socially concerned after birth with the first dose of the triple vaccine in the experts working in the field of Public Health. since 77% births problem than AIDS” and the news says. chronic persistent In India. This is because is much lower than what has been claimed (3). But carriers more dangerous to public health. Ministry of Health & Family Welfare Government of India. programme would cost one fourth of the Universal However. Using the same data correctly HBsAg positive mothers through antenatal screening the actual 'hep. Immunization Programme. whereas untreated HIV infection is 100% Strategy. in case of Hepatitis B infection only 10% of should be measured in terms of cost per highly infected adults become chronic carriers and the infectious carriers (HBeAg positive) prevented and average fatality rate due to Hepato Cellular Carcinoma not HBsAg positive carriers prevented. Hence the WHO. variety of hep. which has programme at all then the Selective Vaccination surprisingly made an elementary arithmetical mistake Strategy should be used like in other low prevalence and also has unscientifically assumed that all those who countries like Japan. which is the most dangerous type of infection. chronic active hepatitis (CAH). Netherlands.(9) The cost-efficacy of HB Vaccination fatal. This decision seems to be the first dose of hep.42% (1). Why we do not need to give Hepatitis B Vaccine for all newborns : Letter to Health Minister Dr. This highly cost-effective selective 502 A Lay Person's Guide . the newborns from the risk of HBeAg positivity by vaccinating only the 3% of the newborns. the first dose of hep.B vaccine records also say that one in every 20 people in India is a would not be given immediately after birth but 6 weeks carrier of this deadly virus”. In India 2-3 % of mothers are hep. only 65% of women get any health-care hepatitis (CPH).B infection and which has the highest chances of becoming carriers (6. 1) The claim that 4. Hence in this programme 77% Rational Drug Policy in India.B positive.to-child mode of infection. during pregnancy. Prevention of this Through the news in the Times of India (Sep 6.B infection at birth from New Delhi-110011 their hepB positive mothers have the highest risk of getting HBeAg infection which the most infectious Dear Dr. and this 2) Hepatitis B is much more infectious than HIV. and National Programme. Ramadoss.B carrier rate' works out to be only and vaccinating their newborns within 24 hours of 1. Nirman Bhavan 3) Newborns who get hep. the American Academy of vaccine to all newborns by including it in the National Pediatrics have recommended that for such newborns. The Selective are found to be positive for hep.7% of the Indian population is chronically infected with hep. we would like to point of the newborns will not be protected from the out the following . In India.B vaccine must be given not later based on the impression that “hepatitis B is a bigger than 48 hours after birth.B infection are chronic Vaccination strategy which consists of identifying the carriers of this infection.7). vaccination of all newborns only for countries where and this selective strategy would protect about 40% of this carrier rate is more than 2% (2). mother. as they are far more eliminate the hep B infection at an annual rate of up to infectious and are far more likely to develop serious 2% (4) and the overall incidence of the damage due to chronic liver disease later than mere HBsAg positives. The WHO has recommended hep-B birth.

Law M. substantial issues cost-effectiveness of universal hepatitis B immunization in a mentioned above. patients in need of dialysis/ repeated blood transfusion and persons exposed to 7) Diseases of the liver and biliary system. page 308 hep. . This is equal to our Volume 70. cc. 38:205-222. P 1679. transmission nor is it good economics. Kale Ashok. 125 crores Pediatrics. Vineet Tyagi and Sangeeta 5) With 25 million babies being born every year in Gupta. Review of Disease Epidemiology.4(3):117-27. An appraisal of the efficacy and cost that too 6 weeks after birth. Peter R Mansfield before taking a final decision. A cost efficacy of this programme is also unfavourable . Sheila Sherlock and unsafe sexual relations should be vaccinated against James Doolley.B on a priority along with newborns of hepatitis positive mothers. 50/.McGraw-Hill. Routine Hepatitis B Immunization in India: Cost India. invite us for a detailed discussion with the concerned officials/experts in 11) Universal Hepatitis-B Vaccination in India . 2003.A your Ministry and initiate a public debate on this issue Questionable Strategy. WHO Strategy for the global diminution of vaccinated in the Universal Vaccination Programme. (leave aside. 20 per life year saved for the measles vaccination (11). Indian Journal of less than the current price). Vol. Eds. it will not eradicate Indian Pediatr 2002. 39: 787. budget for TB-control programme (the number one 4) Mendel (ed. about Rs. Giving this vaccine to all newborns. 3rd edn. hep B infection. much Effectiveness Needs Reassessment. it would cost Rs. HBV Carrier Rate in India. Secondly. 6) Those medical professionals who come in close 1998. et al. substantially improved. Riju Mittal. 700 per life year saved (10) compared to 38:349-371. Ashok Kale. Jain Yogesh et al. 4. it new will take at least 65 years to eradicate hepatitis-B cases of hepatitis B. 1990. Source: medico friend circle bulletin. combined cost of other 6 vaccines given to infants. 10) Aggarwal Rakesh A. vaccination programme will not be very effective even References for control of Hep. even assuming that the cost of hepB vaccine per child in this programme to be only Rs. immunization Programme. Issue 313-314. Indian Pediatrics 2001.8:S129-133 infection in India.child Screen 1997. Isslebacher. Ministry of Health & Family Welfare Profiles of 50 Drugs 503 . etc. pp. e. we request you to stall your decision low-income country with intermediate endemicity using a to include the hepatitis B vaccination in the National Markov model. Vaccine 1990. The 5) Lodha Rakesh. it's eradication from India) unless this coverage is 1) Phadke Anant. Phadke Anant. annually for the vaccine alone. 14th edition. mother-to. J Hepatol.199-207. B. p. 9th edition. Selective Versus Universal Hepatitis B Vaccination In India. Assessment of In view of the very serious. Uday G. 1211- killer of Indian adults) and is almost equal to the 1215.. Fauci. But any way even if all newborns are 2) Ghendon Y. Puliyel.) Infectious Diseases. infection. contact with blood. (unpublished paper) Sincerely yours. is neither effective in effectiveness of antenatal screening for hepatitis B. Braunwald. February. (i. J Med preventing the most dangerous.January 2006. Paediatrics Today. professionals through their usual techniques. 8) Jordan R. The Secretary. 2003. 6) Harrison's Principles of Internal Medicine. It will primarily benefit the manufacturers of this vaccine who have 9) Kale Ashok. Anant Phadke. around Rs. October 2005 . Subhash N. succeeded in convincing a section of the medical July 02. 3) Jacob M. Hepatitis B in India.

Are injections necessary? Hardly ever ! Courtesy: Indian Academy of Pediatrics most oral preparations are as effective as injections DRUGS ARE RARELY NECESSARY 504 A Lay Person's Guide .