Drug Information Abjad P

Drug Information: Paclitaxel
(pak' li tax el)
About your treatment
Your doctor has ordered the drug paclitaxel to help treat your illness. The drug is given by
injection into a vein.
This medication is used to treat:
 metastatic breast cancer

 metastatic ovarian cancer
 Kaposi's sarcoma
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for
more information.
Paclitaxel is in a class of drugs known as taxanes. It slows or stops the growth of cancer cells
in your body. The length of treatment depends on the types of drugs you are taking, how well
your body responds to them, and the type of cancer you have.
Other uses for this medicine
Paclitaxel has been used to treat head and neck cancer, non-small cell lung cancer, small cell
lung cancer, and bladder cancer. Talk to your doctor about the possible risks of using this drug
for your condition.
Precautions
Before taking paclitaxel,
 tell your doctor and pharmacist if you are allergic to paclitaxel, cyclosporine (Neoral,
Sandimmune), teniposide (Vumon), other drugs containing Cremophor EL
(polyoxyethylated castor oil) or any other drugs.
 tell your doctor and pharmacist what prescription and nonprescription medications you
are taking, especially aspirin and vitamins.
 tell your doctor if you have or have ever had heart or liver disease.
 you should know that paclitaxel may interfere with the normal menstrual cycle
(period) in women and may stop sperm production in men. However, you should not
assume that you cannot get pregnant or that you cannot get someone else pregnant.
Women who are pregnant or breast-feeding should tell their doctors before they begin
taking this drug. You should not plan to have children while receiving chemotherapy
or for a while after treatments. (Talk to your doctor for further details.) Use a reliable
method of birth control to prevent pregnancy. Paclitaxel may harm the fetus.
 do not have any vaccinations (e.g., measles or flu shots) without talking to your
doctor.
 your doctor will prescribe a medication called dexamethasone (Decadron) which must
be taken before your treatment. If you forget to take the dexamethasone, tell your
doctor as soon as possible.
Side effects
Side effects from paclitaxel are common, and include:
 nausea and vomiting

 loss of appetite
 change in taste
 thinned or brittle hair
 pain in the joints of the arms or legs lasting 2-3 days
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 changes in the color of the nails
 tingling in the hands or toes
Tell your doctor if either of these symptoms is severe or lasts for several hours:
 mouth blistering
 fatigue
If you experience any of the following symptoms, call your doctor immediately:
 unusual bruising or bleeding

 pain, redness, or swelling at the injection site
 change in normal bowel habits for more than 2 days
 fever
 chills
 cough
 sore throat
 difficulty swallowing
 dizziness
 shortness of breath
 severe exhaustion
 skin rash
 facial flushing
 chest pain
If you experience a serious side effect, you or your doctor may send a report to the Food and
Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at
http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].
In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has
collapsed or is not breathing, call local emergency services at 911.
Special instructions
 The most common side effect of paclitaxel is a decrease of blood cells. Your doctor
may order tests before, during, and after your treatment to see if your blood cells are
affected by the drug.
Brand names
 Onxol®  Taxol®
Last Revised - 04/01/2003
Drug Information : Paclitaxel Injection

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pak'' li tax' el
IMPORTANT WARNING:
Paclitaxel injection must be given in a hospital or medical facility under the supervision of a
doctor who is experienced in giving chemotherapy medications for cancer.
Paclitaxel may cause a large decrease in the number of white blood cells (a type of blood cell
that is needed to fight infection) in your blood. This increases the risk that you will develop a
serious infection. You should not receive paclitaxel if you already have a low number of white
blood cells. Your doctor will order laboratory tests before and during your treatment to check
the number of white blood cells in your blood. Your doctor will delay or interrupt your
treatment if the number of white blood cells is too low. Call your doctor immediately if you
develop a temperature greater than 100.4º F, or a sore throat, cough, chills, or other signs of
infection during your treatment with paclitaxel.
Paclitaxel is manufactured with additional ingredients to allow the medication to reach parts of
the body where it is needed. One form of paclitaxel (Abraxane) is manufactured with human
albumin, and the other form of paclitaxel (Taxol) is manufactured with a solvent called
Cremophor EL (polyoxyethylated castor oil). There are important differences between the two
forms of paclitaxel, so these products should not be substituted for each other.
If you are using the form of paclitaxel that is manufactured with Cremophor EL, you may
experience a serious or life-threatening allergic reaction. You will receive certain medications
to help prevent an allergic reaction before you receive each dose of paclitaxel. Tell your doctor
if you experience any of the following symptoms of an allergic reaction: rash; hives; itching;
swelling of the eyes, face, throat, lips, tongue, hands, arms, feet, or ankles; difficulty breathing
or swallowing; dizziness; or fainting.
Keep all appointments with your doctor and the laboratory. Your doctor will order certain tests
to check your body's response to paclitaxel.
Talk to your doctor about the risks of using paclitaxel.
Why is this medication prescribed?
Paclitaxel manufactured with human albumin is used to treat breast cancer that has not
improved or that has come back after treatment with other medications. Paclitaxel
manufactured with Cremophor EL is used to treat ovarian cancer (cancer that begins in the
female reproductive organs where eggs are formed), breast cancer, and lung cancer. Paclitaxel
with Cremophor EL is also used to treat Kaposi's sarcoma (a type of cancer that causes
patches of abnormal tissue to grow under the skin) in people who have acquired
immunodeficiency syndrome (AIDS). Paclitaxel is in a class of medications called
antimicrotubule agents. It works by stopping the growth and spread of cancer cells.
How should this medicine be used?
Paclitaxel comes as a liquid to be given intravenously (into a vein) by a doctor or nurse in a

hospital or clinic. It is usually given once every 3 weeks. When paclitaxel manufactured with
Cremophor EL is used to treat Kaposi's sarcoma, it may be given once every 2 or 3 weeks.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.
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Paclitaxel is also sometimes used to treat cancer of the head and neck, esophagus (tube that
connects the mouth and stomach), bladder, endometrium (lining of the uterus), and cervix
(opening of the uterus). Talk to your doctor about the risks of using this medication for your
condition.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more
information.
What special precautions should I follow?
Before using paclitaxel,
 tell your doctor and pharmacist if you are allergic to paclitaxel, any other medications,
human albumin, Cremophor EL, or medications that contain Cremophor EL such as
cyclosporine injection (Sandimmune) and teniposide (Vumon). Ask your doctor or
pharmacist if you do not know if a medication that you are allergic to contains human
albumin or Cremophor EL.
 tell your doctor and pharmacist what prescription and nonprescription medications,
vitamins, nutritional supplements, and herbal products you are taking or plan to take.
Be sure to mention any of the following: amiodarone (Cordarone, Pacerone);
aripiprazole (Abilify); buspirone (Buspar); certain antibiotics such as clarithromycin
(Biaxin), erythromycin (E.E.S., E-Mycin), and telithromycin (Ketek); certain
benzodiazepines such as alprazolam (Xanax), diazepam (Valium), midazolam, and
triazolam (Halcion); certain antifungals such as itraconazole (Sporanox) and
ketoconazole (Nizoral); certain calcium channel blockers such as amlodipine
(Norvasc, in Azor, in Caduet, in Lotrel), diltiazem (Cardizem, Dilacor, Tiazac),
nifedipine (Adalat, Procardia), nisoldipine (Sular), and verapamil (Calan, Tarka,
Verelan); certain cholesterol-lowering medications (statins) such as atorvastatin
(Lipitor), lovastatin (Mevacor), and simvastatin (Zocor); cimetidine (Tagamet);
cisplatin (Platinol); cyclosporine (Gengraf, Neoral, Sandimmune); doxorubicin
(Doxil); fluvoxamine; gemfibrozil (Lopid); imatinib (Gleevec); methadone
(Dolophine); montelukast (Singulair); nefazodone; pimozide (Orap); protease
inhibitors used to treat human immunodeficiency virus (HIV) such as indinavir
(Crixivan), ritonavir (Norvir, in Kaletra), nelfinavir (Viracept), and saquinavir
(Invirase); quinidine; quinine (Qualaquin); sildenafil (Viagra); tacrolimus (Prograf);
tamoxifen (Nolvadex); trazodone; and vincristine. Your doctor may need to change the
doses of your medications or monitor you carefully for side effects. Many other
medications may also interact with paclitaxel, so be sure to tell your doctor about all
the medications you are taking, even those that do not appear on this list.
 tell your doctor if you have or have ever had liver or heart disease.
 tell your doctor if you are pregnant or plan to become pregnant, or if you plan to father
a child. You or your partner should not become pregnant while you are using
paclitaxel. You should use birth control to prevent pregnancy in yourself or your
partner during your treatment with paclitaxel. Talk to your doctor about birth control
methods that will work for you. If you or your partner become pregnant while using
paclitaxel, call your doctor. Paclitaxel may harm the fetus.
 do not breast-feed while you are using paclitaxel.
 if you are having surgery, including dental surgery, tell the doctor or dentist that you
are using paclitaxel.
 if you are using paclitaxel manufactured with Cremophor EL, you should know that
the medication contains alcohol. Do not drive a car or operate machinery until you
know how this medication affects you. Talk to your doctor about the safe use of
alcoholic beverages or medications that may affect your thinking or judgment during
your treatment with Cremophor EL.
 talk to your doctor before you receive any vaccinations during your treatment with
paclitaxel.
 you should know that paclitaxel may make it more difficult for your body to fight
infection. Wash your hands often and avoid crowds and people who are sick during
your treatment with paclitaxel.
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 you should know that paclitaxel may cause dizziness, lightheadedness, and fainting
when you get up too quickly from a lying position. To avoid this problem, get out of
bed slowly, resting your feet on the floor for a few minutes before standing up.
What special dietary instructions should I follow?
Talk to your doctor about eating grapefruit and drinking grapefruit juice while using this
medicine.
What should I do if I forget a dose?
Call your doctor right away if you are unable to keep an appointment to receive a dose of
paclitaxel.
What side effects can this medication cause?
Paclitaxel may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 pain, redness, swelling, or sores in the place where the medication was injected
 weakness
 nausea
 vomiting
 diarrhea
 sores in the mouth
 hair loss
Some side effects can be serious. If you experience any of these symptoms or those listed in
the IMPORTANT WARNING section, call your doctor immediately:
 numbness, burning, or tingling in the hands or feet

 pale skin
 excessive tiredness
 chest pain
 irregular heartbeat
 blistering or peeling skin
Paclitaxel may cause other side effects. Call your doctor if you have any unusual problems
while using this medication.
http://www.fda.gov/MedWatch/index.html] or by phone [1-800-332-1088].
Symptoms of overdose may include:
 pale skin
 sore throat, fever, chills, and other signs of infection
 numbness, burning, or tingling of the hands and feet
 sores in the mouth
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What other information should I know?
Keep all appointments with your doctor.
It is important for you to keep a written list of all of the prescription and nonprescription
(over-the-counter) medicines you are taking, as well as any products such as vitamins,
minerals, or other dietary supplements. You should bring this list with you each time you visit
a doctor or if you are admitted to a hospital. It is also important information to carry with you
in case of emergencies.
Brand names
 Abraxane®  Taxol®

Last Reviewed - 08/01/2007
Drug Information: Pantoprazole
(pan toe' pra zole)
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Pantoprazole is used to treat gastroesophageal reflux disease (GERD), a condition in which

backward flow of acid from the stomach causes heartburn and injury of the food pipe
(esophagus). It is also used to treat conditions where the stomach produces too much acid,
such as Zollinger-Ellison syndrome. Pantoprazole is in a class of medications called proton-
pump inhibitors. It works by decreasing the amount of acid made in the stomach.
Pantoprazole comes as a delayed-release (long-acting) tablet to take by mouth. It is usually

taken once or twice a day with or without food. To help you remember to take pantoprazole,
take it around the same time every day. Follow the directions on your prescription label
carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take
pantoprazole exactly as directed. Do not take more or less of it or take it more often than
prescribed by your doctor.
Swallow the tablets whole; do not split, chew, or crush them.
Continue to take pantoprazole even if you feel well. Do not stop taking pantoprazole without
talking to your doctor.
This medicine may be prescribed for other uses; ask your doctor or pharmacist for more
information.
Before taking pantoprazole,
 tell your doctor and pharmacist if you are allergic to pantoprazole or any other
medications.
vitamins, nutritional supplements, and herbal products you are taking. Be sure to
mention any of the following: ampicillin (Omnipen, Polycillin, Totacillin);
ketoconazole (Nizoral); and vitamins containing iron. Your doctor may need to change
the doses of your medications or monitor you carefully for side effects.
 tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If
you become pregnant while taking pantoprazole, call your doctor.
Unless your doctor tells you otherwise, continue your normal diet.
Take the missed dose as soon as you remember it. However, if it is almost time for your next
dose, skip the missed dose and continue your regular dosing schedule. Do not take a double
dose to make up for a missed dose.
Pantoprazole may cause side effects. Tell your doctor if any of these symptoms are severe or
do not go away:
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 diarrhea
 headache
 stomach pain
 gas or bloating
Pantoprazole may cause other side effects. Call your doctor if you have any unusual problems
while taking this medication.
What storage conditions are needed for this medicine?
Keep this medication in the container it came in, tightly closed, and out of reach of children.
Store it at room temperature and away from excess heat and moisture (not in the bathroom).
Throw away any medication that is outdated or no longer needed. Talk to your pharmacist
about the proper disposal of your medication.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are
taking pantoprazole.
Do not let anyone else take your medicine. Ask your pharmacist any questions you have about
refilling your prescription.
Brand names
 Protonix®

Drug Information: Papaverine
(pa pav' er een)
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Papaverine is used to improve blood flow in patients with circulation problems. It works by
relaxing the blood vessels so that blood can flow more easily to the heart and through the
body.
more information.
Papaverine comes as a tablet and extended-release (long-acting) capsule to take by mouth.

The tablet usually is taken three to five times a day at evenly spaced intervals. The extended-
release capsule usually is taken every 8-12 hours. Do not crush, chew, or divide the extended-
release capsules. Follow the directions on your prescription label carefully, and ask your
doctor or pharmacist to explain any part you do not understand. Take papaverine exactly as
directed.
Papaverine may be habit-forming. Do not take larger doses, take it more often, or for a longer
period than your doctor tells you to.
Papaverine controls high blood pressure but does not cure it. Continue to take papaverine
even if you feel well. Do not stop taking papaverine without talking to your doctor.
Papaverine is also used to treat impotence in men. Talk to your doctor about the possible risks
of using this drug for your condition.
Before taking papaverine,
 tell your doctor and pharmacist if you are allergic to papaverine or any other drugs.
are taking, especially levodopa (Larodopa, Sinemet) and vitamins.
 tell your doctor if you have or have ever had heart disease, an AV block (a heart
rhythm disturbance), or glaucoma.
you become pregnant while taking papaverine, call your doctor.
are taking papaverine.
 you should know that this drug may make you drowsy or dizzy. Do not drive a car or
operate machinery until you know how it affects you.
 ask your doctor about the safe use of alcohol while you are taking papaverine. Alcohol
can make the side effects from papaverine worse.
Take the missed dose as soon as you remember it. However, if it is almost time for the next
dose to make up for a missed one.
Papaverine may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 flushing (feeling of warmth)
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 sweating
 headache
 tiredness
 dizziness
 skin rash
 upset stomach
 diarrhea
 constipation
 stomach pain
If you experience either of the following symptoms, call your doctor immediately:
 yellowing of the skin or eyes

Store at room temperature and away from excess heat and moisture (not in the bathroom).
Keep all appointments with your doctor and the laboratory. Your doctor may order certain
tests to monitor your liver function.
Do not let anyone else take your medication. Ask your pharmacist any questions you have
about refilling your prescription.
Brand names
 Para-Time® SR
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Drug Information: Paroxetine
(pa rox' e teen)
IMPORTANT WARNING:
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A small number of children, teenagers, and young adults (up to 24 years of age) who took
antidepressants ('mood elevators') such as paroxetine during clinical studies became suicidal
(thinking about harming or killing oneself or planning or trying to do so). Children, teenagers,
and young adults who take antidepressants to treat depression or other mental illnesses may be
more likely to become suicidal than children, teenagers, and young adults who do not take
antidepressants to treat these conditions. However, experts are not sure about how great this
risk is and how much it should be considered in deciding whether a child or teenager should
take an antidepressant. Children younger than 18 years of age should not normally take
paroxetine, but in some cases, a doctor may decide that paroxetine is the best medication to
treat a child's condition.
You should know that your mental health may change in unexpected ways when you take
paroxetine or other antidepressants even if you are an adult over age 24. You may become
suicidal, especially at the beginning of your treatment and any time that your dose is increased
or decreased. You, your family, or your caregiver should call your doctor right away if you
experience any of the following symptoms: new or worsening depression; thinking about
harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic
attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting
without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your
family or caregiver knows which symptoms may be serious so they can call the doctor when
you are unable to seek treatment on your own.
Your healthcare provider will want to see you often while you are taking paroxetine, especially
at the beginning of your treatment. Be sure to keep all appointments for office visits with your
doctor.
The doctor or pharmacist will give you the manufacturer's patient information sheet
(Medication Guide) when you begin treatment with paroxetine. Read the information carefully
and ask your doctor or pharmacist if you have any questions. You also can obtain the
Medication Guide from the FDA website:
http://www.fda.gov/cder/drug/antidepressants/antidepressants_MG_2007.pdf.
No matter what your age, before you take an antidepressant, you, your parent, or your
caregiver should talk to your doctor about the risks and benefits of treating your condition with
an antidepressant or with other treatments. You should also talk about the risks and benefits of
not treating your condition. You should know that having depression or another mental illness
greatly increases the risk that you will become suicidal. This risk is higher if you or anyone in
your family has or has ever had bipolar disorder (mood that changes from depressed to
abnormally excited) or mania (frenzied, abnormally excited mood) or has thought about or
attempted suicide. Talk to your doctor about your condition, symptoms, and personal and
family medical history. You and your doctor will decide what type of treatment is right for you.
Paroxetine tablets, suspension (liquid), and extended-release (long-acting) tablets are used to
treat depression, panic disorder (sudden, unexpected attacks of extreme fear and worry about
these attacks), and social anxiety disorder (extreme fear of interacting with others or
performing in front of others that interferes with normal life). Paroxetine tablets and oral
solution are also used to treat obsessive compulsive disorder (bothersome thoughts that won't
go away and the need to perform certain actions over and over), generalized anxiety disorder
(excessive worrying that is difficult to control), and posttraumatic stress disorder (disturbing
psychological symptoms that develop after a frightening experience). Paroxetine extended-
release tablets are also used to treat premenstrual dysphoric disorder (PMDD, physical and
psychological symptoms that occur before the onset of the menstrual period each month).
Paroxetine is in a class of medications called selective serotonin reuptake inhibitors (SSRIs).
It works by increasing the amount of serotonin, a natural substance in the brain that helps
maintain mental balance.
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Paroxetine comes as a tablet, a suspension (liquid), and a controlled-release (long-acting)

tablet to take by mouth. It is usually taken once daily in the morning or evening, with or
without food. You may want to take paroxetine with food to stop it from upsetting your
stomach. Take paroxetine at around the same time every day. Follow the directions on your
prescription label carefully, and ask your doctor or pharmacist to explain any part you do not
understand. Take paroxetine exactly as directed. Do not take more or less of it or take it more
often than prescribed by your doctor.
Shake the liquid well before each use to mix the medication evenly.
Swallow the extended-release and Pexeva® brand tablets whole; do not split, chew, or crush
them.
Your doctor may start you on a low dose of paroxetine and gradually increase your dose, not
more than once a week.
Paroxetine controls your condition but does not cure it. It may take several weeks or longer
before you feel the full benefit of paroxetine. Continue to take paroxetine even if you feel
well. Do not stop taking paroxetine without talking to your doctor. Your doctor will probably
decrease your dose gradually. If you suddenly stop taking paroxetine, you may experience
withdrawal symptoms such as depression; mood changes; frenzied or abnormally excited
mood; irritability; anxiety; confusion; dizziness; headache; tiredness; numbness or tingling in
the arms, legs, hands, or feet; unusual dreams; difficulty falling asleep or staying asleep;
nausea; or sweating. Tell your doctor if you experience any of these symptoms when your
dose of paroxetine is decreased.
Paroxetine is also sometimes used to treat chronic headaches, tingling in the hands and feet
caused by diabetes, and certain male sexual problems. Paroxetine is also used with other
medications to treat bipolar disorder (mood that changes from depressed to abnormally
excited ). Talk to your doctor about the possible risks of using this drug for your condition.
information.
Before taking paroxetine,
 tell your doctor and pharmacist if you are allergic to paroxetine or any other
medications.
 tell your doctor if you are taking monoamine oxidase (MAO) inhibitors, including
isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar),
and tranylcypromine (Parnate), or have stopped taking them within the past 2 weeks,
or if you are taking thioridazine or pimozide (Orap). Your doctor will probably tell you
not to take paroxetine. If you stop taking paroxetine, you should wait at least 2 weeks
before you start to take an MAO inhibitor.
 tell your doctor and pharmacist what other prescription and nonprescription
medications, and vitamins you are taking or plan to take. Be sure to mention any of the
following: anticoagulants ('blood thinners') such as warfarin (Coumadin);
antidepressants (mood elevators) such as amitriptyline (Elavil), amoxapine (Asendin),
clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan),
imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and
trimipramine (Surmontil); antihistamines; aspirin and other nonsteroidal anti-
inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin), and naproxen
(Aleve, Naprosyn); atomoxetine (Straterra), atazanavir (Reyataz); bromocriptine
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(Parlodel); bupropion (Wellbutrin); buspirone (Buspar); celecoxib (Celebrex);
chlorpromazine (Thorazine); cimetidine (Tagamet); clopidogrel (Plavix); codeine
(found in many cough and pain medications); dexamethasone (Decadron);
dextromethorphan (found in many cough medications); diazepam (Valium);
dicloxacillin (Dynapen); digoxin (Lanoxin); dipyridamole (Persantine); diuretics
('water pills'); haloperidol (Haldol); isoniazid (INH, Nydrazid); lithium (Eskalith,
Lithobid); medications for irregular heartbeat such as amiodarone (Cordarone,
Pacerone), encainide (Enkaid), flecainide (Tambocor), mexiletine (Mexitil),
moricizine (Ethmozine): propafenone (Rythmol), and quinidine (Quinidex);
medications for mental illness and nausea; medications for migraine headaches such as
almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge),
rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig);medications for
seizures such as phenobarbital and phenytoin (Dilantin); meperidine (Demerol);
methadone (Dolophine); metoclopramide (Reglan); metoprolol (Lopressor, Toprol
XL); ondansetron (Zofran); other selective serotonin reuptake inhibitors such as
citalopram (Celexa), fluoxetine (Prozac, Sarafem); fluvoxamine (Luvox); and
sertraline (Zoloft); procyclidine (Kemadrin); propoxyphene (Darvon); propranolol
(Inderal); ranitidine (Zantac); rifampin (Rifadin, Rimactane); risperidone (Risperdal);
ritonavir (Norvir); sibutramine (Meridia); tamoxifen (Nolvadex); terbinafine
(Lamisil); theophylline (Theobid, Theo-Dur); ticlopidine (Ticlid); timolol (Blocadren);
tramadol (Ultram); trazodone (Desyrel); and venlafaxine (Effexor). Your doctor may
need to change the doses of your medications or monitor you carefully for side effects.
 tell your doctor what herbal products and nutritional supplements you are taking,
especially St. John's wort and tryptophan.
 tell your doctor if you use or have ever used street drugs or have overused prescription
medications, if you have recently had a heart attack, and if you have or have ever had
glaucoma (an eye disease); seizures; bleeding from your stomach or esophagus (tube
that connects the mouth and stomach) or liver, kidney, or heart disease.
you become pregnant while taking paroxetine, call your doctor.
 you should know that paroxetine may make you drowsy and affect your judgment and
thinking. Do not drive a car or operate machinery until you know how this medication
affects you.
 ask your doctor about the safe use of alcoholic beverages while you are taking
paroxetine.
Paroxetine may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 headache
 dizziness
 weakness
 difficulty concentrating
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 nervousness
 forgetfulness
 confusion
 sleepiness or feeling "drugged"
 nausea
 vomiting
 diarrhea
 constipation
 gas
 stomach pain
 heartburn
 changes in ability to taste food
 decreased appetite
 weight loss or gain
 changes in sex drive or ability
 dry mouth
 sweating
 yawning
 sensitivity to light
 runny nose
 cough
 lump or tightness in throat
 pain in the back, muscles, joints, or anywhere in the body
 muscle weakness or tightness
 flushing
 problems with teeth
 unusual dreams
 painful or irregular menstruation
Some side effects can be serious. If you experience any of the following symptoms or those
listed in the IMPORTANT WARNING section, call your doctor immediately:
 blurred vision
 rapid, pounding, or irregular heartbeat
 chest pain
 seizure
 abnormal bleeding or bruising
 uncontrollable shaking of a part of the body
 sudden muscle twitching or jerking that you cannot control
 numbness or tingling in your hands, feet, arms, or legs
 difficult, frequent, or painful urination
 swelling, itching, burning, or infection in the vagina
 painful erection that lasts for hours
 sudden upset stomach, vomiting, weakness, cramping, bloating, swelling, tightness in
hands and feet, dizziness, headache and/or confusion
 hives
 skin rash
 itching
 swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
 hoarseness
 difficulty breathing or swallowing
 black and tarry stools
 red blood in stools
 bloody vomit
 vomiting material that looks like coffee grounds
Paroxetine may cause other side effects. Call your doctor if you have any unusual problems
251
 drowsiness
 coma
 upset stomach
 fast, pounding, irregular, or slow heartbeat
 confusion
 vomiting
 dizziness
 seizures
 fainting
 blurred vision
 extreme tiredness
 lack of energy
 pain in the upper right part of the stomach
 flu-like symptoms
 yellowing of the skin and eyes
 aggressive behavior
 muscle pain, stiffness or weakness
 sudden muscle twitching or jerking that you cannot control
 dark red or brown urine
 difficulty urinating
 diarrhea
 frenzied, abnormally excited mood
 sweating
 fever
 difficulty walking
252
Brand names
 Paxil®  Paxil® CR  Pexeva®
Drug Information: Penicillin G Potassium or Sodium Injection
(pen i sill' in)
Your doctor has ordered penicillin, an antibiotic, to help treat your infection. The drug will be
either injected into a large muscle (such as your buttock or hip) or added to an intravenous
fluid that will drip through a needle or catheter placed in your vein for 30 minutes or more,
four to six times a day.
253
Penicillin eliminates bacteria that cause many kinds of infections, including pneumonia;
meningitis; and skin, bone, joint, stomach, blood, and heart valve infections. This medication
is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and
side effects of your treatment using laboratory tests and physical examinations. It is important
to keep all appointments with your doctor and the laboratory. The length of treatment depends
on how your infection and symptoms respond to the medication.
Precautions
Before administering penicillin,
 tell your doctor and pharmacist if you are allergic to penicillin, cephalosporins [e.g.,
cefaclor (Ceclor), cefadroxil (Duricef), or cephalexin (Keflex)], or any other drugs.
are taking, especially other antibiotics, anticoagulants ('blood thinners') such as
warfarin (Coumadin), aspirin or other nonsteroidal anti-inflammatory medications
such as naproxen (Anaprox) or ibuprofen (Motrin), atenolol (Tenormin), diuretics
('water pills'), oral contraceptives, probenecid (Benemid), and vitamins.
 tell your doctor if you have or have ever had kidney or liver disease, allergies, asthma,
blood disease, colitis, stomach problems, or hay fever.
you become pregnant while taking penicillin, call your doctor.
 if you have diabetes and regularly check your urine for sugar, use Clinistix or TesTape.
Do not use Clinitest tablets because penicillin may cause false positive results.
Administering your medication
Before you administer penicillin, look at the solution closely. It should be clear and free of
floating material. Gently squeeze the bag or observe the solution container to make sure there
are no leaks. Do not use the solution if it is discolored, if it contains particles, or if the bag or
container leaks. Use a new solution, but show the damaged one to your health care provider.
It is important that you use your medication exactly as directed. Do not stop your therapy on
your own for any reason because your infection could worsen and result in hospitalization. Do
not change your dosing schedule without talking to your health care provider. Your health care
provider may tell you to stop your infusion if you have a mechanical problem (such as a
blockage in the tubing, needle, or catheter); if you have to stop an infusion, call your health
care provider immediately so your therapy can continue.
Side effects
Penicillin may cause side effects. Tell your health care provider if either of these symptoms is
severe or does not go away:
 upset stomach
 diarrhea
If you experience any of the following symptoms, call your health care provider immediately:
 rash
 itching
254
 fever
 chills
 facial swelling
 wheezing
 difficulty breathing
 unusual bleeding or bruising
 dizziness
 seizures
 sore mouth or throat
Storing your medication
 Your health care provider probably will give you a several-day supply of penicillin at a
time. If you are receiving penicillin intravenously (in your vein), you probably will be
told to store it in the refrigerator or freezer.
 Take your next dose from the refrigerator 1 hour before using it; place it in a clean, dry
area to allow it to warm to room temperature.
 If you are told to store additional penicillin in the freezer, always move a 24-hour
supply to the refrigerator for the next day's use.
 Do not refreeze medications.
If you are receiving penicillin intramuscularly (in your muscle), your health care provider will
tell you how to store it properly.
Store your medication only as directed. Make sure you understand what you need to store
your medication properly.
Keep your supplies in a clean, dry place when you are not using them, and keep all
medications and supplies out of reach of children. Your health care provider will tell you how
to throw away used needles, syringes, tubing, and containers to avoid accidental injury.
Signs of infection
If you are receiving penicillin in your vein or under your skin, you need to know the
symptoms of a catheter-related infection (an infection where the needle enters your vein or
skin). If you experience any of these effects near your intravenous catheter, tell your health
care provider as soon as possible:
 tenderness
 warmth
 irritation
 drainage
255
 redness
 swelling
 pain
Brand names
 Pfizerpen®

Drug Information: Penicillin V Potassium Oral
(pen i sil' in)
Penicillin V potassium is an antibiotic used to treat certain infections caused by bacteria such
as pneumonia, scarlet fever, and ear, skin, and throat infections. It also is used to prevent
recurrent rheumatic fever and chorea. Antibiotics will not work for colds, flu, or other viral
infections.
256
more information.
Penicillin V potassium comes as a tablet and liquid to take by mouth. It is usually taken every
6 hours (four times a day) or every 8 hours (three times a day). Follow the directions on your
understand. Take penicillin V potassium exactly as directed. Do not take more or less of it or
take it more often than prescribed by your doctor.
Shake the liquid well before each use to mix the medication evenly.
The tablets should be swallowed whole and taken with a full glass of water.
Continue to take penicillin V potassium even if you feel well. Do not stop taking penicillin V
potassium without talking to your doctor.
Before taking penicillin V potassium,
 tell your doctor and pharmacist if you are allergic to penicillin V potassium, tartrazine
(a yellow dye in some processed foods and drugs), or any other drugs.
are taking, especially other antibiotics, anticoagulants ('blood thinners') such as
warfarin (Coumadin), atenolol (Tenormin), aspirin or other nonsteroidal anti-
inflammatory medicine such as naproxen (Anaprox) or ibuprofen (Motrin), oral
contraceptives, probenecid (Benemid), and vitamins.
 tell your doctor if you have or have ever had kidney or liver disease, allergies, asthma,
blood disease, colitis, stomach problems, or hay fever.
you become pregnant while taking penicillin V potassium, call your doctor.
are taking penicillin V potassium.
Take penicillin V potassium at least 1 hour before or 2 hours after meals.
Penicillin V potassium may cause side effects. Tell your doctor if any of these symptoms are
severe or do not go away:
 upset stomach
 diarrhea
 vomiting
 mild skin rash
257
 severe skin rash
 itching
 hives
 wheezing
 vaginal infection
Store the tablets at room temperature and away from excess heat and moisture (not in the
bathroom). Throw away any medication that is outdated or no longer needed. Keep liquid
medicine in the refrigerator, tightly closed, and throw away any unused medication after 14
days. Do not freeze. The liquid is good for 7 days at room temperature. Talk to your
pharmacist about the proper disposal of your medication.
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab
tests to check your response to penicillin V potassium.
If you are diabetic, use Clinistix or TesTape (not Clinitest) to test your urine for sugar while
taking this drug.
Do not let anyone else take your medication. Your prescription is probably not refillable. If
you still have symptoms of infection after you finish the penicillin V potassium, call your
doctor.
Brand names
 Beepen-VK®  Pen-Vee K®  Veetids®

 Betapen-VK®  Robicillin VK®
 Ledercillin VK®  V-Cillin K®

258
Drug Information: Pentobarbital Oral and Rectal
(pen toe bar' bi tal)
IMPORTANT WARNING:
[Posted 03/14/2007] FDA notified healthcare professionals of its request that all manufacturers
of sedative-hypnotic drug products, a class of drugs used to induce and/or maintain sleep,
strengthen their product labeling to include stronger language concerning potential risks. These
259
risks include severe allergic reactions and complex sleep-related behaviors, which may include
sleep-driving. Sleep driving is defined as driving while not fully awake after ingestion of a
sedative-hypnotic product, with no memory of the event. FDA also requested that each product
manufacturer send letters to health care providers to notify them about the new warnings, and
that manufacturers develop Patient Medication Guides for the products to inform consumers
about risks and advise them of potential precautions that can be taken. For more information
visit the FDA website at: http://www.fda.gov/medwatch/safety/2007/safety07.htm#Sedative
and http://www.fda.gov/bbs/topics/NEWS/2007/NEW01587.html.
See the MedWatch notification at the beginning of the monograph.
Pentobarbital, a barbiturate, is used in the short-term treatment of insomnia (to help you fall
asleep and stay asleep for a proper rest). It is also used as a sedative to relieve anxiety and
induce sleep before surgery.
more information.
Pentobarbital comes as a capsule and liquid to take by mouth and as a suppository to be used
rectally. The capsule or liquid is taken at bedtime as needed for insomnia or two to four times
a day for anxiety. Take pentobarbital on an empty stomach, at least 1 hour before or 2 hours
after meals. The suppositories are inserted at bedtime as needed for insomnia or two to four
times a day for anxiety. Follow the directions on your prescription label carefully, and ask
your doctor or pharmacist to explain any part you do not understand. Take pentobarbital
exactly as directed.
Pentobarbital can be habit-forming; do not take a larger dose, take it more often, or for a
longer time than your doctor tells you to. Do not stop taking pentobarbital without talking to
your doctor, especially if you have taken large doses for a long time. Your doctor probably
will decrease your dose gradually.
To insert a pentobarbital suppository, follow these steps:
 Remove the wrapper.

 Dip the tip of the suppository in water.
 Lie down on your left side and raise your right knee to your chest. (A left-handed
person should lie on the right side and raise the left knee.)
 Using your finger, insert the suppository into the rectum, about 1/2 to 1 inch in infants
and children and 1 inch in adults. Hold it in place for a few moments.
 Stand up after about 15 minutes. Wash your hands thoroughly and resume your normal
activities.
Before taking pentobarbital,
 tell your doctor and pharmacist if you are allergic to pentobarbital, aspirin, tartrazine
(a yellow dye in some processed foods and drugs), or any other drugs.
260
are taking, especially acetaminophen (Tylenol), antihistamines, chloramphenicol
(Chloromycetin), digitoxin (Crystodigin), diuretics ('water pills'), doxycycline
(Vibramycin), griseofulvin (Grisactin), medications for depression or seizures,
metronidazole (Flagyl), oral contraceptives, propranolol (Inderal), quinidine, rifampin,
sedatives, sleeping pills, steroids (for asthma), theophylline (Theo-Dur), tranquilizers,
and vitamins.
 tell your doctor if you have a fever or pain or if you have or have ever had liver or
kidney disease, asthma, hyperthyroidism, diabetes, anemia, a history of alcoholism or
drug abuse, or heart or lung problems.
you become pregnant while taking pentobarbital, call your doctor.
are taking pentobarbital.
 you should know that this drug may make you drowsy. Do not drive a car or operate
machinery until you know how this drug affects you.
 remember that alcohol can add to the drowsiness caused by this drug.
Do not take a missed dose when you remember it. Skip the missed dose and continue your
regular dosing schedule. Do not take a double dose to make up for a missed one.
Pentobarbital may cause side effects. Tell your doctor if any of these symptoms are severe or
do not go away:
 drowsiness
 headache
 depression
 excitement
 joint or muscle pain
 upset stomach
 diarrhea
 constipation
 skin rash
 itching
 sore throat
 fever
 easy bruising
 bloody nose
 unusual bleeding
261
Brand names
 Nembutal®  Nembutal® Sodium  Nembutal® Sodium

Solution

Drug Information: Pentoxifylline
(pen tox i' fi leen)
Pentoxifylline is used to improve blood flow in patients with circulation problems to reduce
aching, cramping, and tiredness in the hands and feet. It works by decreasing the thickness
(viscosity) of blood. This change allows your blood to flow more easily, especially in the
small blood vessels of the hands and feet.
262
more information.
Pentoxifylline comes as an extended-release (long-acting) tablet to take by mouth. It usually

is taken three times a day. Do not break, crush, or chew the tablets; swallow them whole.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist
to explain any part you do not understand. Take pentoxifylline exactly as directed. Do not take
more or less of it or take it more often than prescribed by your doctor.
Although you may feel the effects of this medication in 2-4 weeks, you may need to take it for
up to 8 weeks before you feel the full effect of pentoxifylline.
Pentoxifylline controls the symptoms of circulation problems, but does not cure them.
Continue to take pentoxifylline even if you feel well. Do not stop taking pentoxifylline
without talking to your doctor.
Pentoxifylline also is used for leg ulcers, strokes, high-altitude sickness, eye and ear disorders,
and sickle cell disease and to treat pain from diabetic neuropathy. Talk to your doctor about
the possible risks of using this drug for your condition.
Before taking pentoxifylline,
 tell your doctor and pharmacist if you are allergic to caffeine-containing products
(coffee, tea, colas), pentoxifylline, theobromine, theophylline (Theo-Dur), or any other
drugs.
are taking, especially anticoagulants ('blood thinners') such as warfarin (Coumadin)
and vitamins.
 tell your doctor if you have or have ever had kidney disease.
you become pregnant while taking pentoxifylline, call your doctor.
are taking pentoxifylline.
 you should know that this drug may make you drowsy or dizzy. Do not drive a car or
operate machinery until you know how it affects you.
Take pentoxifylline with meals to prevent upset stomach. If symptoms continue, tell your
doctor. Your dose may need to be decreased.
Pentoxifylline may cause side effects. Tell your doctor if any of these symptoms are severe or
do not go away:
263
 upset stomach
 vomiting
 gas
 dizziness
 headache
If you experience either of the following symptoms, call your doctor immediately:
 chest pain
 fast heartbeat
Keep all appointments with your doctor and the laboratory. Your blood pressure may need to
be checked regularly, especially if you are taking other heart medications.
Brand names
 Pentoxil®  Trental®

Drug Information: Perindopril
(per in' doe pril)
IMPORTANT WARNING:
Do not take perindopril if you are pregnant. If you become pregnant while taking perindopril,
call your doctor immediately. Perindopril may harm the fetus.
264
Perindopril is used alone or in combination with other medications to treat high blood
pressure. Perindopril is in a class of medications called angiotensin-converting enzyme (ACE)
inhibitors. It makes blood flow more smoothly by preventing the production of certain natural
chemicals that tighten the blood vessels.
Perindopril comes as a tablet to take by mouth. It is usually taken once or twice a day. Follow
the directions on your prescription label carefully, and ask your doctor or pharmacist to
explain any part you do not understand. Take perindopril exactly as directed. Do not take
Your doctor may start you on a low dose of perindopril and gradually increase your dose.
Perindopril controls high blood pressure but does not cure it. Continue to take perindopril
even if you feel well. Do not stop taking perindopril without talking to your doctor.
information.
Before taking perindopril,
 tell your doctor and pharmacist if you are allergic to perindopril, benazepril
(Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril
(Prinivil, Zestril), moexipril (Univasc), quinapril (Accupril), ramipril (Altace),
trandolapril (Mavik), or any other medications.
mention any of the following: cyclosporine (Neoral, Sandimmune), diuretics ('water
pills'), heparin, indomethacin (Indocin), lithium (Eskalith, Lithobid), and potassium
supplements (K-Dur, Klor-Con, others). Your doctor may need to change the doses of
your medications or monitor you carefully for side effects.
 tell your doctor if you are on dialysis and if have or have ever had heart failure; lupus
(SLE); scleroderma; diabetes; swelling of the face, throat, tongue, lips, eyes, hands,
feet, ankles, and/or lower legs (angioedema); or kidney or liver disease.
 tell your doctor if you plan to become pregnant or are breast-feeding.
 you should know that diarrhea, vomiting, not drinking enough fluids, and sweating a
lot can cause a drop in blood pressure, which may cause lightheadedness and fainting.
Talk to your doctor before using salt substitutes containing potassium. If your doctor
prescribes a low-salt or low-sodium diet, follow these directions carefully.
265
Perindopril may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 cough
 headache
 weakness
 dizziness
 diarrhea
 stomach pain
 upset stomach
Some side effects can be serious. The following symptoms are uncommon, but if you
experience any of them, call your doctor immediately:
 hoarseness
 difficulty swallowing or breathing
 lightheadedness
 fainting
 fever, sore throat, chills, and other signs of infection
 irregular or rapid heartbeats
Perindopril may cause other side effects. Call your doctor if you have any unusual problems
266
Brand names
 Aceon®

Drug Information: Perphenazine Oral
(per fen' a zeen)
IMPORTANT WARNING:
[Posted 06/16/2008] FDA notified healthcare professionals that both conventional and atypical
antipsychotics are associated with an increased risk of mortality in elderly patients treated for
267
dementia-related psychosis. In April 2005, FDA notified healthcare professionals that patients
with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased
risk of death. Since issuing that notification, FDA has reviewed additional information that
indicates the risk is also associated with conventional antipsychotics. Antipsychotics are not
indicated for the treatment of dementia-related psychosis. The prescribing information for all
antipsychotic drugs will now include the same information about this risk in a BOXED
WARNING and the WARNINGS section. For more information visit the FDA website at:
http://www.fda.gov/medwatch/safety/2008/safety08.htm#Antipsychotics,
http://www.fda.gov/cder/drug/InfoSheets/HCP/antipsychotics_conventional.htm and
http://www.fda.gov/bbs/topics/NEWS/2008/NEW01851.html.
Perphenazine is used to treat schizophrenia and symptoms such as hallucinations, delusions,

and hostility.
more information.
Pending revision, the material in this section should be considered in light of more recently
available information in the MedWatch notification at the beginning of this monograph.
Perphenazine comes as a tablet and liquid concentrate to take by mouth. It usually is taken
three times a day. Follow the directions on your prescription label carefully, and ask your
doctor or pharmacist to explain any part you do not understand. Take perphenazine exactly as
directed. Do not take more or less of it or take it more often than prescribed by your doctor.
The liquid concentrate must be diluted before use. It comes with a specially marked dropper
for measuring the dose. Ask your pharmacist to show you how to use the dropper if you have
difficulty. To dilute the liquid concentrate, add it to at least 2 ounces of milk, water, or orange
soda or pineapple, apricot, prune, orange, tomato, or grapefruit juice just before you take it.
Do not add it to drinks with caffeine (cola, coffee), tannics (tea), or pectinates (apple juice). If
any of the drink gets on the dropper, rinse the dropper with tap water before replacing it in the
bottle. Do not allow the liquid concentrate to touch your skin or clothing; it can irritate your
skin. If you spill the liquid concentrate on your skin, wash it off immediately with soap and
water.
Continue to take perphenazine even if you feel well. Do not stop taking perphenazine without
talking to your doctor, especially if you have taken large doses for a long time. Your doctor
probably will decrease your dose gradually. This drug must be taken regularly for a few weeks
before its full effect is felt.
Before taking perphenazine,
 tell your doctor and pharmacist if you are allergic to perphenazine, sulfites, or any
other drugs.
268
are taking, especially antacids, antihistamines, appetite reducers (amphetamines),
benztropine (Cogentin), bromocriptine (Parlodel), carbamazepine (Tegretol),
dicyclomine (Bentyl), fluoxetine (Prozac), guanethidine (Ismelin), lithium,
medications for colds, medications for depression, meperidine (Demerol), methyldopa
(Aldomet), phenytoin (Dilantin), propranolol (Inderal), sedatives, trihexyphenidyl
(Artane), valproic acid (Depakene), and vitamins.
 tell your doctor if you have or have ever had depression; seizures; shock therapy;
asthma; emphysema; chronic bronchitis; problems with your urinary system or
prostate; glaucoma; history of alcohol abuse; thyroid problems; bad reaction to insulin;
angina; irregular heartbeat; problems with your blood pressure; blood disorders; blood
vessel, heart, kidney, liver, or lung disease.
you become pregnant while taking perphenazine, call your doctor.
are taking perphenazine.
 plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective
clothing, sunglasses, and sunscreen. Perphenazine may make your skin sensitive to
sunlight.
Perphenazine may cause an upset stomach. Take perphenazine with food or milk.
Take the missed dose as soon as you remember it and take any remaining doses for that day at
evenly spaced intervals. However, if you remember a missed dose when it is almost time for
your next scheduled dose, skip the missed dose. Do not take a double dose to make up for a
missed one.
Side effects from perphenazine may occur. Your urine may turn pink or reddish-brown; this
effect is not harmful. Tell your doctor if any of these symptoms are severe or do not go away:
 drowsiness
 dizziness
 blurred vision
 dry mouth
 upset stomach
 vomiting
 diarrhea
 constipation
 restlessness
 headache
 weight gain
 tremor
 restlessness or pacing
 fine worm-like tongue movements
269
 unusual face, mouth, or jaw movements
 shuffling walk
 seizures or convulsions
 fast, irregular, or pounding heartbeat
 difficulty urinating
Protect the liquid from light. Throw away any medication that is outdated or no longer
needed. Talk to your pharmacist about the proper disposal of your medication.
tests to check your response to perphenazine.
Brand names
 Trilafon®

Drug Information: Phenobarbital
(fee noe bar' bi tal)
Phenobarbital, a barbiturate, is used to control epilepsy (seizures) and as a sedative to relieve

anxiety. It is also used for short-term treatment of insomnia to help you fall asleep.
270
more information.
Phenobarbital comes as a tablet, capsule, and elixir (liquid) to take by mouth. You may obtain
a specially marked measuring spoon from your pharmacist to be sure of an accurate dose of
the liquid. It usually is taken one to three times a day and may be taken with or without food.
If you take phenobarbital once a day, take it at bedtime. Follow the directions on your
understand. Take phenobarbital exactly as directed. If you are taking phenobarbital to control
convulsions or seizures, follow the exact schedule prescribed by your doctor.
Phenobarbital can be habit-forming. Do not use phenobarbital for more than 2 weeks if it is
being used to help you sleep. Do not take a larger dose, take it more often, or for a longer time
than your doctor tells you to. Tolerance may develop with long-term or excessive use, making
the drug less effective. This medication must be taken regularly to be effective. Do not skip
doses even if you feel that you do not need them. Call your doctor if you have convulsions or
seizures while taking phenobarbital. Do not stop taking this drug without talking to your
doctor, especially if you have been taking it for a long time. Stopping the drug suddenly can
cause withdrawal symptoms (anxiousness, sleeplessness, and irritability). Your doctor
probably will decrease your dose gradually.
Before taking phenobarbital,
 tell your doctor and pharmacist if you are allergic to phenobarbital or any other drugs.
are taking, especially acetaminophen (Tylenol); anticoagulants such as warfarin
(Coumadin); carbamazepine (Tegretol); chloramphenicol (Chloromycetin);
clonazepam (Klonopin); disulfiram (Antabuse); doxycycline (Vibramycin); felodipine
(Plendil); fenoprofen (Nalfon); griseofulvin (Fulvicin); MAO inhibitors [phenelzine
(Nardil) or tranylcypromine (Parnate)]; medications for depression, seizures, pain,
asthma, colds, or allergies; metoprolol (Lopressor); metronidazole (Flagyl); muscle
relaxants; phenylbutazone (Azolid, Butazolidin); propranolol (Inderal); quinidine;
rifampin (Rifadin); sedatives; sleeping pills; steroids; theophylline (Theo-Dur);
tranquilizers; valproic acid (Depakene); verapamil (Calan); and vitamins. These
medications may add to the drowsiness caused by phenobarbital.
 tell your doctor if you have or have ever had anemia or seizures, or lung, heart, or liver
disease.
 use a method of birth control other than oral contraceptives while taking this
medication. Phenobarbital can decrease the effectiveness of oral contraceptives.
you become pregnant while taking phenobarbital, call your doctor immediately.
are taking phenobarbital.
If you take several doses per day, take the missed dose as soon as you remember it and take
any remaining doses for that day at evenly spaced intervals. However, if it is almost time for
the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a
double dose to make up for a missed one.
271
Side effects from phenobarbital may occur and include:
 drowsiness
 headache
 dizziness
 depression
 excitement (especially in children)
 upset stomach
 vomiting
Tell your doctor if any of these symptoms are severe or do not go away:
 nightmares
 increased dreaming
 constipation
 joint or muscle pain
 seizures
 mouth sores
 sore throat
 easy bruising
 bloody nose
 fever
tests to check your response to phenobarbital.
If you are taking phenobarbital to control seizures and have an increase in their frequency or
severity, call your doctor. Your dose may need to be adjusted. If you use phenobarbital for
272
seizures, carry identification (Medic Alert) stating that you have epilepsy and that you are
taking phenobarbital.
Brand names
 Luminal® Sodium

Drug Information: Phenylephrine
(fen il ef' rin)
273
Phenylephrine is used to relieve nasal discomfort caused by colds, allergies, and hay fever. It
is also used to relieve sinus congestion and pressure. Phenylephrine should not be used to
treat children younger than 2 years of age because it may cause serious or life-threatening side
effects in young children. Phenylephrine should be used carefully in children 2 to 11.
Phenylephrine will relieve symptoms but will not treat the cause of the symptoms or speed
recovery. Phenylephrine is in a class of medications called nasal decongestants. It works by
reducing swelling of the blood vessels in the nasal passages.
Phenylephrine comes as a tablet or a dissolving strip to take by mouth. It is usually taken

every 4 hours as needed. Follow the directions on your prescription label or the package label
carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take
phenylephrine exactly as directed. Do not take more or less of it or take it more often than
prescribed by your doctor or directed on the label.
Phenylephrine comes alone and in combination with other medications. Ask your doctor or
pharmacist for advice on which product is best for your symptoms. Check nonprescription
cough and cold product labels carefully before using two or more products at the same time.
These products may contain the same active ingredient(s) and taking them together could
cause you to receive an overdose. This is especially important if you will be giving cough and
cold medications to a child.
If your symptoms do not get better within 7 days or if you have a fever, stop taking
phenylephrine and call your doctor.
If you are taking the dissolving strips, place one strip on your tongue and allow it to dissolve.
information.
Before taking phenylephrine,
 tell your doctor and pharmacist if you are allergic to phenylephrine or any other
medications.
 do not take phenylephrine if you are taking a monoamine oxidase (MAO) inhibitors,
such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam,
Zelapar), and tranylcypromine (Parnate), or if you have stopped taking one of these
medications within the past 2 weeks.
medications, vitamins, nutritional supplements, and herbal products you are taking or
plan to take.
 tell your doctor if you have or have ever had high blood pressure, diabetes, trouble
urinating because of an enlarged prostate gland, or thyroid or heart disease.
you become pregnant while taking phenylephrine, call your doctor.
are taking phenylephrine.
 if you have phenylketonuria (PKU, an inherited condition in which a special diet must
be followed to prevent mental retardation), you should know that some phenylephrine
products may be sweetened with aspartame, a source of phenylalanine.
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This medication is usually taken as needed. If your doctor has told you to take phenylephrine
regularly, take the missed dose as soon as you remember it. However, if it is almost time for
Phenylephrine may cause side effects. Some side effects can be serious. If you experience any
of these symptoms, stop using phenylephrine and call your doctor:
 nervousness
 dizziness
 sleeplessness
Phenylephrine may cause other side effects. Call your doctor if you have any unusual
problems while taking this medication.
Ask your pharmacist any questions you have about phenylephrine.
Brand names
 Sudafed PE®
Brand names of combination products
 Actifed® Cold and Allergy (containing Chlorpheniramine Maleate and Phenylephrine

Hydrochloride)

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Drug Information: Phytonadione
(fye toe na dye' one)
Phytonadione (vitamin K) is used to prevent bleeding in people with blood clotting problems
or too little vitamin K in the body. Phytonadione is in a class of medications called vitamins.
It works by providing vitamin K that is needed for blood to clot normally in the body.
276
Phytonadione comes as a tablet to take by mouth. It should be taken as directed by your

doctor. Your doctor may sometimes prescribe another medication (bile salts) to take with
phytonadione. Follow the directions on your prescription label carefully, and ask your doctor
or pharmacist to explain any part you do not understand. Do not stop taking phytonadione
without talking to your doctor. Take phytonadione exactly as directed. Do not take more or
less of it or take it more often than prescribed by your doctor.
more information.
Before taking phytonadione,
 tell your doctor and pharmacist if you are allergic to phytonadione, any other
medications, or any of the ingredients in phytonadione tablets. Ask your pharmacist
for a list of the ingredients.
 Do not take anticoagulants ('blood thinners') such as warfarin (Coumadin) while you
are taking phytonadione unless told to do so by your doctor.
Be sure to mention any of the following: antibiotics; salicylate pain relievers such as
aspirin or aspirin-containing products, choline magnesium trisalicylate, choline
salicylate (Arthropan), diflunisal (Dolobid), magnesium salicylate (Doan's, others),
and salsalate (Argesic, Disalcid, Salgesic). Your doctor may need to change the doses
of your medications or monitor you carefully for side effects.
 if you are taking orlistat (Xenical), take it 2 hours before or 2 hours after
phytonadione.
you become pregnant while taking phytonadione, call your doctor.
Talk to your doctor about the amount of vitamin K-rich foods to include in your diet while
taking phytonadione. Do not increase or decrease your normal intake of foods such as green
leafy vegetables, liver, broccoli, and cauliflower without checking with your doctor.
dose, skip the missed dose and continue your regular dosing schedule. Tell your doctor if you
miss any doses. Do not take a double dose to make up for a missed one.
Phytonadione may cause side effects. If you experience the following symptom, call your
doctor immediately:
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You should always protect phytonadione from light. Store it at room temperature and away
from excess heat and moisture (not in the bathroom). Throw away any medication that is
outdated or no longer needed. Talk to your pharmacist about the proper disposal of your
medication.
tests to check your response to phytonadione.
Brand names
 Mephyton®
Other names
 Vitamin K1

Drug Information: Pilocarpine
(pye'' loe kar' peen)
Pilocarpine is used to treat dry mouth caused by radiotherapy in people with head and neck
cancer and to treat dry mouth in people with Sjogren's syndrome (a condition that affects the
immune system and causes dryness of certain parts of the body such as the eyes and mouth).
278
Pilocarpine is in a class of medications called cholinergic agonists.It works by increasing the
amount of saliva in the mouth.
Pilocarpine comes as a tablet to take by mouth. When pilocarpine is used to treat dry mouth
caused by radiotherapy in people who have head and neck cancer, it is usually taken three
times a day. When pilocarpine is used to treat dry mouth in people who have Sjogren's
syndrome, it is usually taken four times a day. Take pilocarpine at around the same times
every day. Follow the directions on your prescription label carefully, and ask your doctor or
pharmacist to explain any part you do not understand. Take pilocarpine exactly as directed.
Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor may start you on an average dose of pilocarpine and adjust your dose depending
on how well your symptoms are controlled and the side effects you experience. Be sure to tell
your doctor how you are feeling during your treatment with pilocarpine.
Pilocarpine will control your symptoms but will not cure your condition. Continue to take
pilocarpine even if you feel well. Do not stop taking pilocarpine without talking to your
doctor.
information.
Before taking pilocarpine,
 tell your doctor and pharmacist if you are allergic to pilocarpine (Pilopine HS,
Salagen)or any other medications.
plan to take. Be sure to mention any of the following: ambenonium (Mytelase);
antihistamines; atropine (Motofen, in Lomotil, in Lonox); beta blockers such as
atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL),
nadolol (Corgard), and propranolol (Inderal); bethanechol (Urecholine); cevimeline
(Evoxac); donepezil (Aricept); galantamine (Razadyne); ipratropium (Atrovent, in
Combivent, in Duoneb); medications for irritable bowel disease, motion sickness,
Parkinson's disease, ulcers, or urinary problems; neostigmine (Prostigmin);
physostigmine (Mestinon); rivastigmine (Exelon) and tacrine (Cognex). Your doctor
may need to change the doses of your medications or monitor you carefully for side
effects.
 tell your doctor if you have asthma, acute iritis (uveitis; swelling and irritation inside
the eye), or glaucoma (an eye disease).Your doctor may tell you not to take
pilocarpine.
 tell your doctor if you have or have ever had chronic bronchitis or another type of
chronic obstructive pulmonary disease (COPD; a group of lung diseases that includes
chronic bronchitis and emphysema); kidney stones; gallstones; mental illness; any
condition that affects your ability to think; or gallbladder, heart, or liver disease.
you become pregnant while taking pilocarpine, call your doctor.
 you should know that pilocarpine may cause decreased fertility in men and women.
Talk to your doctor before you take pilocarpine if you or your partner would like to
become pregnant.
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are taking pilocarpine.
 you should know that pilocarpine may cause changes in vision, especially at night, or
when there is not enough light. Be careful when driving at night, or when performing
dangerous activities in low lighting.
 you should know that pilocarpine may cause you to sweat a great deal, which can
cause dehydration.Be sure to drink plenty of water and call your doctor right away if
you are having difficulty drinking enough fluid or if you think you may be dehydrated.
Pilocarpine may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 sweating
 nausea
 runny nose
 diarrhea
 chills
 flushing
 frequent urination
 dizziness
 weakness
 headache
 vomiting
 heartburn
 stomach pain
 swelling of the arms, hands, feet, ankles, or lower legs
Some side effects can be serious. If you experience any of these symptoms, call your doctor
immediately:
 changes in vision
 fast or slow heartbeat
Pilocarpine may cause other side effects. Call your doctor if you have any unusual problems
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 headache
 tearing of eyes
 GI spasm
 confusion
Brand names
 Salagen®
Drug Information: Pilocarpine Ophthalmic
(pye loe kar' peen)
Pilocarpine is used to treat glaucoma, a condition in which increased pressure in the eye can
lead to gradual loss of vision. Pilocarpine relieves the symptoms of glaucoma.
more information.
281
Pilocarpine comes in eyedrops, eye gel, and a controlled-release system (Ocusert Pilo). The
eyedrops usually are applied two to four times daily. The gel usually is applied once daily and
at bedtime. The controlled-release system is used once a week and should be applied at
bedtime. Follow the directions on your prescription label carefully, and ask your doctor or
pharmacist to explain any part you do not understand. Use pilocarpine exactly as directed. Do
not use more or less of it or use it more often than prescribed by your doctor.
Pilocarpine controls glaucoma, but does not cure it. Continue to use pilocarpine even if you
feel well. Do not stop using pilocarpine without talking to your doctor.
To use the eyedrops, follow these steps:
 Wash your hands thoroughly with soap and water.

 Use a mirror or have someone else put the drops in your eye.
 Remove the protective cap. Make sure that the end of the dropper is not chipped or
cracked.
 Avoid touching the dropper tip against your eye or anything else.
 Hold the dropper tip down at all times to prevent drops from flowing back into the
bottle and contaminating the remaining contents.
 Lie down or tilt your head back.
 Holding the bottle between your thumb and index finger, place the dropper tip as near
as possible to your eyelid without touching it.
 Brace the remaining fingers of that hand against your cheek or nose.
 With the index finger of your other hand, pull the lower lid of the eye down to form a
pocket.
 Drop the prescribed number of drops into the pocket made by the lower lid and the
eye. Placing drops on the surface of the eyeball can cause stinging.
 Close your eye and press lightly against the lower lid with your finger for 2-3 minutes
to keep the medication in the eye. Do not blink.
 Replace and tighten the cap right away. Do not wipe or rinse it off.
 Wipe off any excess liquid from your cheek with a clean tissue. Wash your hands
again.
To use the eye gel, follow these instructions:

 Use a mirror or have someone else apply the gel.
 Remove the protective cap. Avoid touching the tip of the tube against your eye or
anything else. The gel must be kept clean.
 Tilt your head forward slightly.
 Holding the tube between your thumb and index finger, place the tube as near as
possible to your eyelid without touching it.
 With the index finger of your other hand, pull the lower lid of your eye down to form a
pocket.
 Place a small amount of gel into the pocket made by the lower lid and the eye. A 1/2-
inch strip of gel usually is enough unless otherwise directed by your doctor.
 Gently close your eyes and keep them closed for 1-2 minutes to allow the medication
to be absorbed.
 Replace and tighten the cap right away.
 Wipe off any excess gel from your eyelids and lashes with a clean tissue. Wash your
hands again.
To use the controlled-release system,
 Wash your hands thoroughly with soap and water before handling it.
 Follow the written patient instructions, and place the system in your eye at bedtime.
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 Place the system either in the pocket formed at the lower part of the eye by the lower
eyelid and eyeball or, preferably, at the upper part of the eye under the upper eyelid. (It
is less likely to come out when placed at the upper part of the eye.)
 The system is to stay in your eye for 7 days. If it comes out, rinse it with cool tap
water and replace it in your eye. Discard the system if it is damaged or contaminated,
and insert a new one.
 To prevent the system from coming out at night, work the system from the lower part
of your eye to the upper part (under the upper eyelid) by gently pressing it (with a
clean finger) through your closed eyelid at bedtime.
 Check to be sure that the system is in place each night when you go to bed and when
you wake up. If one becomes lost, you can either replace it or replace the systems in
both eyes so that both eyes are on the same replacement schedule.
Before using pilocarpine eyedrops,
 tell your doctor and pharmacist if you are allergic to pilocarpine or any other drugs.
are taking, including vitamins.
 if you are using another eyedrop medication, use the eye medications at least 10
minutes apart.
 tell your doctor if you have or have ever had asthma, intestinal disease, ulcers, high
blood pressure, heart disease, an overactive thyroid gland, seizures, Parkinson's
disease, or an obstruction in the urinary tract.
you become pregnant while using pilocarpine, call your doctor immediately.
are using pilocarpine.
Apply the missed drops or gel as soon as you remember it. However, if it is almost time for
the next dose, skip the missed dose and continue your regular dosing schedule.
Do not apply a double dose to make up for a missed one.
Pilocarpine may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 blurred or dim vision

 stinging, burning, or discomfort in the eye
 itching or redness of the eye
 tearing or swelling of the eye
 redness of the eyelids
 headache
 sweating
 muscle tremors
 upset stomach
 vomiting
 diarrhea
 watering of the mouth
 dizziness
283
 weakness
Keep the drops and gel in the container they came in, tightly closed, and out of reach of
children. Store them at room temperature and away from excess heat and moisture (not in the
bathroom). Store the controlled-release system in the refrigerator. Throw away any
medication that is outdated or no longer needed. Talk to your pharmacist about the proper
disposal of your medication.
Keep all appointments with your doctor. Your doctor will order certain eye tests to check your
response to pilocarpine.
Do not let anyone else use your medication. Ask your pharmacist any questions you have
Brand names
 Isopto® Carpine  Pilopine HS®

Drug information: Piroxicam
(peer ox' i kam)
IMPORTANT WARNING:
People who take nonsteroidal anti-inflammatory medications (NSAIDs) (other than aspirin)
such as piroxicam may have a higher risk of having a heart attack or a stroke than people who
do not take these medications. These events may happen without warning and may cause
death. This risk may be higher for people who take NSAIDs for a long time. Tell your doctor if
284
you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke, if
you smoke, and if you have or have ever had high cholesterol, high blood pressure, or diabetes.
Get emergency medical help right away if you experience any of the following symptoms:
chest pain, shortness of breath, weakness in one part or side of the body, or slurred speech.
If you will be undergoing a coronary artery bypass graft (CABG; a type of heart surgery), you
should not take piroxicam right before or right after the surgery.
NSAIDs such as piroxicam may cause ulcers, bleeding, or holes in the stomach or intestine.
These problems may develop at any time during treatment, may happen without warning
symptoms, and may cause death. The risk may be higher for people who take NSAIDs for a
long time, are older in age, have poor health, or drink large amounts of alcohol while you are
taking piroxicam. Tell your doctor if you take any of the following medications: anticoagulants
('blood thinners') such as warfarin (Coumadin); aspirin; other NSAIDs such as ibuprofen
(Advil, Motrin) and naproxen (Aleve, Naprosyn); or oral steroids such as dexamethasone
(Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone). Also tell your
doctor if you have or have ever had ulcers or bleeding in your stomach or intestines or other
bleeding disorders. If you experience any of the following symptoms, stop taking piroxicam
and call your doctor: stomach pain, heartburn, vomiting a substance that is bloody or looks like
coffee grounds, blood in the stool, or black and tarry stools.
Keep all appointments with your doctor and the laboratory. Your doctor will monitor your
symptoms carefully and will probably order certain tests to check your body's response to
piroxicam. Be sure to tell your doctor how you are feeling so that your doctor can prescribe the
right amount of medication to treat your condition with the lowest risk of serious side effects.
Your doctor or pharmacist will give you the manufacturer's patient information sheet
(Medication Guide) when you begin treatment with piroxicam and each time you refill your
prescription. Read the information carefully and ask your doctor or pharmacist if you have any
questions. You can also visit the Food and Drug Administration (FDA) website
(http://www.fda.gov/cder) or the manufacturer's website to obtain the Medication Guide.
Piroxicam is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis
(arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis
caused by swelling of the lining of the joints). Piroxicam is in a class of medications called
NSAIDs. It works by stopping the body's production of a substance that causes pain, fever,
and inflammation.
Piroxicam comes as a capsule to take by mouth. It is usually taken once or twice a day. Take
piroxicam at around the same time(s) every day. Follow the directions on your prescription
label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
Take piroxicam exactly as directed. Do not take more or less of it or take it more often than
Piroxicam will help control your symptoms but will not cure your condition. It may take 8-12
weeks or longer before you feel the full benefit of piroxicam.
285
Piroxicam is also sometimes used to treat gouty arthritis (attacks of severe joint pain and
swelling caused by a build-up of certain substances in the joints) and ankylosing spondylitis
(arthritis that mainly affects the spine). It is also sometimes used to relieve muscle pain and
swelling, menstrual pain, and pain after surgery or childbirth. Talk to your doctor about the
risks of using this medication for your condition.
Before taking piroxicam,
 tell your doctor and pharmacist if you are allergic to piroxicam, aspirin,or other
NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), or any
other medications.
Be sure to mention the medications listed in the IMPORTANT WARNING section and
any of the following: angiotensin-converting enzyme (ACE) inhibitors such as
benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril),
lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril
(Accupril), ramipril (Altace), and trandolapril (Mavik); diuretics ('water pills'); lithium
(Eskalith, Lithobid); medications for diabetes; methotrexate (Rheumatrex); and
phenytoin (Dilantin) .
 tell your doctor if you have or have ever had asthma, especially if you also have
frequent stuffy or runny nose or nasal polyps (swelling of the lining of the nose);
swelling of the hands, feet, ankles, or lower legs ; or liver, or kidney disease.
 tell your doctor if you are pregnant, especially if you are in the last few months of
your pregnancy, you plan to become pregnant, or you are breast-feeding. If you
become pregnant while taking piroxicam, call your doctor.
are taking piroxicam.
Piroxicam may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 diarrhea
 constipation
 gas
 headache
 dizziness
 ringing in the ears
286
mentioned in the IMPORTANT WARNING section, call your doctor immediately. Do not
take any more piroxicam until you speak to your doctor.
 vision problems
 unexplained weight gain
 fever
 blisters
 joint pain
 rash
 itching
 hives
 swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs
 hoarseness
 pale skin
 fast hearbeat
 lack of energy
 upset stomach
 cloudy, discolored, or bloody urine
 back pain
 difficult or painful urination
Piroxicam may cause other side effects. Call your doctor if you have any unusual problems
 lack of energy
 drowsiness
 upset stomach
 vomiting
 stomach pain
 bloody, black, or tarry stools
 vomiting a substance that is bloody or looks like coffee grounds
 coma (loss of consciousness for a period of time)
287
Brand names
 Feldene®

Drug Information: Polio Vaccine
What is polio?
Polio is a disease caused by a virus. It enters a child's (or adult's) body through the mouth.
Sometimes it does not cause serious illness. But sometimes it causes paralysis (can't move
arm or leg). It can kill people who get it, usually by paralyzing the muscles that help them
breathe.
Polio used to be very common in the United States. It paralyzed and killed thousands of
people a year before we had a vaccine for it.
288
Why get vaccinated?
Inactivated Polio Vaccine (IPV) can prevent polio.
History: A 1916 polio epidemic in the United States killed 6,000 people and paralyzed 27,000
more. In the early 1950's there were more than 20,000 cases of polio each year. Polio
vaccination was begun in 1955. By 1960 the number of cases had dropped to about 3,000, and
by 1979 there were only about 10. The success of polio vaccination in the U.S. and other
countries sparked a world-wide effort to eliminate polio.
Today: No wild polio has been reported in the United States for over 20 years. But the disease
is still common in some parts of the world. It would only take one case of polio from another
country to bring the disease back if we were not protected by vaccine. If the effort to
eliminate the disease from the world is successful, some day we won't need polio vaccine.
Until then, we need to keep getting our children vaccinated.
Why is Oral Polio Vaccine no longer recommended?
There are two kinds of polio vaccine: IPV, which is the shot recommended in the United
States today, and a live, oral polio vaccine (OPV), which is drops that are swallowed.
Until recently OPV was recommended for most children in the United States. OPV helped us
rid the country of polio, and it is still used in many parts of the world.
Both vaccines give immunity to polio, but OPV is better at keeping the disease from
spreading to other people. However, for a few people (about one in 2.4 million), OPV actually
causes polio. Since the risk of getting polio in the United States is now extremely low, experts
believe that using oral polio vaccine is no longer worth the slight risk, except in limited
circumstances which your doctor can describe. The polio shot (IPV) does not cause polio.
Who should get polio vaccine and when?
IPV is a shot, given in the leg or arm, depending on age. Polio vaccine may be given at the
same time as other vaccines.
Children: Most people should get polio vaccine when they are children. Children get 4 doses
of IPV, at these ages: 2 months, 6-18 months, 4 months, 4-6 years.
Adults: Most adults do not need polio vaccine because they were already vaccinated as
children. But three groups of adults are at higher risk and should consider polio vaccination:
(1) people traveling to areas of the world where polio is common, (2) laboratory workers who
might handle polio virus, and (3) health care workers treating patients who could have polio.
Adults in these three groups who have never been vaccinated against polio should get 3 doses
of IPV: the first dose at any time, the second dose 1 to 2 months later, the third dose 6 to 12
months after the second.
Adults in these three groups who have had 1 or 2 doses of polio vaccine in the past should get
the remaining 1 or 2 doses. It doesn't matter how long it has been since the earlier dose(s).
Adults in these three groups who have had 3 or more doses of polio vaccine (either IPV or
OPV) in the past may get a booster dose of IPV.
Ask your health care provider for more information.
Who should not get IPV or should wait?
These people should not get IPV:
289
 Anyone who has ever had a life-threatening allergic reaction to the antibiotics
neomycin, streptomycin or polymyxin B should not get the polio shot.
 Anyone who has a severe allergic reaction to a polio shot should not get another one.
These people should wait:
 Anyone who is moderately or severely ill at the time the shot is scheduled should
usually wait until they recover before getting polio vaccine. People with minor
illnesses, such as a cold, may be vaccinated.
What are the risks from IPV?
Some people who get IPV get a sore spot where the shot was given. The vaccine used today
has never been known to cause any serious problems, and most people don't have any
problems at all with it.
However, a vaccine, like any medicine, could cause serious problems, such as a severe
allergic reaction. The risk of a polio shot causing serious harm, or death, is extremely small.
What if there is a serious reaction?
What should I look for?
 Look for any unusual condition, such as a serious allergic reaction, high fever, or
unusual behavior.
 If a serious allergic reaction occurred, it would happen within a few minutes to a few
hours after the shot. Signs of a serious allergic reaction can include difficulty
breathing, weakness, hoarseness or wheezing, a fast heart beat, hives, dizziness,
paleness, or swelling of the throat.
What should I do?
 Call a doctor, or get the person to a doctor right away.

 Tell your doctor what happened, the date and time it happened, and when the
vaccination was given.
 Ask your health care provider to file a Vaccine Adverse Event Reporting System
(VAERS) form if you have any reaction to the vaccine. Or call VAERS yourself at 1-
800-822-7967, or visit their website at http://vaers.hhs.gov.
The National Vaccine Injury Compensation Program
In the rare event that you or your child has a serious reaction to a vaccine, a federal program
has been created to help pay for the care of those who have been harmed.
For details about the National Vaccine Injury Compensation Program, call 1-800-338-2382 or
visit the program's website at http://www.hrsa.gov/vaccinecompensation.
How can I learn more?
 Ask your doctor or other health care provider. They can give you the vaccine package
insert or suggest other sources of information.
 Call your local or state health department's immunization program.
 Contact the Centers for Disease Control and Prevention (CDC): call 1-800-232-4636
(1-800-CDC-INFO) or visit the National Immunization Program's website at
http://www.cdc.gov/vaccines.
Polio Vaccine Information Statement. U.S. Department of Health and Human

Services/Centers for Disease Control and Prevention National Immunization Program.
1/1/2000.
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 IPOL®  containing
Other names
 IPV  OPV
Drug Information: Potassium
(poe tass' i um)
Potassium is essential for the proper functioning of the heart, kidneys, muscles, nerves, and
digestive system. Usually the food you eat supplies all of the potassium you need. However,
certain diseases (e.g., kidney disease and gastrointestinal disease with vomiting and diarrhea)
and drugs, especially diuretics ('water pills'), remove potassium from the body. Potassium
supplements are taken to replace potassium losses and prevent potassium deficiency.
more information.
291
Potassium comes in oral liquid, powder, granules, effervescent tablets, regular tablets,
extended-release (long-acting) tablets, and extended-release capsules. It usually is taken two
to four times a day, with or immediately after meals. Follow the directions on your
understand. Take potassium exactly as directed. Do not take more or less of it or take it more
Take all forms of potassium with a full glass of water or fruit juice.
Add the liquid to water. Dissolve the powder, granules, or effervescent tablets in cold water or
fruit juice according to the manufacturer's directions or the directions on your prescription
label; mix the drug well just before you take it. Cold liquids help mask the unpleasant taste.
Swallow extended-release tablets and capsules whole. Do not chew them or dissolve them in
your mouth.
Before taking potassium,
 tell your doctor and pharmacist if you are allergic to potassium or any other drugs.
are taking, especially angiotensin converting enzyme (ACE) inhibitors such as
captopril (Capoten), enalapril (Vasotec),and lisinopril (Prinivil, Zestril); diuretics
('water pills'); and vitamins. Do not take potassium if you are taking amiloride
(Midamor), spironolactone (Aldactone), or triamterene (Dyrenium).
 tell your doctor if you have or have ever had heart, kidney, or Addison's (adrenal
gland) disease.
you become pregnant while taking potassium, call your doctor.
are taking potassium.
If you are using a salt substitute, tell your doctor. Many salt substitutes contain potassium.
Your doctor will consider this source in determining your dose of potassium supplement. Your
doctor may advise you to use a potassium-containing salt substitute and to eat potassium-rich
foods (e.g., bananas, prunes, raisins, and milk).
evenly spaced intervals. Do not take a double dose to make up for a missed one.
Potassium may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 upset stomach
 vomiting
 diarrhea
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 mental confusion
 listlessness
 tingling, prickling, burning, tight, or pulling sensation of arms, hands, legs, or feet
 heaviness or weakness of legs
 cold, pale, gray skin
 stomach pain
 unusual stomach bulging
 black stools
tests to check your response to potassium. You may have electrocardiograms (EKGs) and
blood tests to see if your dose needs to be changed.
Brand names
 Glu-K®  K-Dur® 10  K-Lyte/CL®

 K+ 10®  K-Dur® 20 Effervescent Tablets
 K+ 8®  K-Lor®  K-Lyte® DS
 K+ Care®  Klor-Con® 10 Effervescent Tablets
 K+ Care® Effervescent  Klor-Con® 8  K-Lyte® Effervescent
Tablets  Klor-Con® Powder Tablets
 Kaochlor® 10%  Klor-Con®/25 Powder  K-Tab® Filmtab®
 Kaon® Elixir  Klor-Con®/EF  Micro-K®
 Kaon-Cl® 20% Elixir  Klotrix®  Quic-K®
 Kaon-Cl-10®  Rum-K®
 K-Lyte/CL® 50  Slow-K®
 Kay Ciel® Effervescent Tablets  Tri-K®
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 Twin-K®
Other names
 KCl

Drug Information: Pravastatin
(pra' va stat in)
Pravastatin is used together with lifestyle changes (diet, weight-loss, exercise) to reduce the
amount of cholesterol (a fat-like substance) and other fatty substances in the blood.
Pravastatin is in a class of medications called HMG-CoA reductase inhibitors (statins). It
works by slowing the production of cholesterol in the body.
Buildup of cholesterol and other fats along the walls of the blood vessels (a process known as
atherosclerosis) decreases blood flow and, therefore, the oxygen supply to the heart, brain,
and other parts of the body. Lowering blood levels of cholesterol and other fats may help to
decrease your chances of getting heart disease, angina (chest pain), strokes, and heart attacks.
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In addition to taking a cholesterol-lowering medication, making certain changes in your daily
habits can also lower your cholesterol blood levels. You should eat a diet that is low in
saturated fat and cholesterol (see SPECIAL DIETARY), exercise 30 minutes on most, if not
all days, and lose weight if you are overweight.
Pravastatin comes as a tablet to take by mouth. It is usually taken once a day with or without
food. Take pravastatin at around the same time every day. Follow the directions on your
understand. Take pravastatin exactly as directed. Do not take more or less of it or take it more
Your doctor may start you on a low dose of pravastatin and gradually increase your dose, not
more than once every 4 weeks.
Continue to take pravastatin even if you feel well. Do not stop taking pravastatin without
information.
Before taking pravastatin,
 tell your doctor and pharmacist if you are allergic to pravastatin or any other
medications.
Be sure to mention any of the following: cimetidine (Tagamet); cyclosporine (Neoral,
Sandimmune); ketoconazole (Nizoral); other cholesterol-lowering medications such as
fenofibrate (Tricor), gemfibrozil (Lopid), and niacin (nicotinic acid, Niacor, Niaspan);
and spironolactone (Aldactone). Your doctor may need to change the doses of your
medications or monitor you carefully for side effects.
 if you are taking cholestyramine (Questran) or colestipol (Cholestid), take them 4
hours before or 1 hour after pravastatin. If you are taking antacids, take them 1 hour
before pravastatin.
 tell your doctor if you have liver disease. Your doctor will probably tell you not to take
pravastatin.
 tell your doctor if you drink large amounts of alcohol, if you have ever had liver
disease or if you have or have ever had kidney disease.
 tell your doctor if you are pregnant or plan to become pregnant. If you become
pregnant while taking pravastatin, stop taking pravastatin and call your doctor
immediately. Pravastatin may harm the fetus.
 do not breast-feed while you are taking this medication.
are taking pravastatin.
pravastatin. Alcohol can increase the risk of serious side effects.
Eat a low-cholesterol, low-fat diet. This kind of diet includes cottage cheese, fat-free milk,
fish (not canned in oil), vegetables, poultry, egg whites, and polyunsaturated oils and
margarines (corn, safflower, canola, and soybean oils). Avoid foods with excess fat in them
such as meat (especially liver and fatty meat), egg yolks, whole milk, cream, butter,
295
shortening, lard, pastries, cakes, cookies, gravy, peanut butter, chocolate, olives, potato chips,
coconut, cheese (other than cottage cheese), coconut oil, palm oil, and fried foods.
dose, skip the missed dose and continue the regular dosing schedule. Do not take a double
Pravastatin may cause side effects. Tell your doctor if either of these symptoms is severe or
does not go away:
 heartburn
 headache
 muscle pain, tenderness, or weakness

 lack of energy
 fever
 nausea
 rash
 hives
 itching
 hoarseness
Pravastatin may cause other side effects. Call your doctor if you have any unusual problems
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tests before and during treatment to check your body's response to pravastatin.
taking pravastatin.
Brand names
 Pravachol®  Pravigard® PAC

Drug Information: Pioglitazone
(pye oh gli' ta zone)
IMPORTANT WARNING:
Pioglitazone and other similar medications for diabetes may cause or worsen congestive heart
failure (condition in which the heart is unable to pump enough blood to the other parts of the
body). Before you start to take pioglitazone, tell your doctor if you have or have ever had
congestive heart failure, especially if your heart failure is so severe that you must limit your
activity and are only comfortable when you are at rest or you must remain in a chair or bed.
Also tell your doctor if you were born with a heart defect, and if you have or have ever had
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swelling of the arms, hands, feet, ankles, or lower legs; heart disease; high cholesterol or fats in
the blood; high blood pressure; coronary artery disease (narrowing of the blood vessels that
lead to the heart); a heart attack; or an irregular heartbeat. Your doctor may tell you not to take
pioglitazone or may monitor you carefully during your treatment.
If you develop congestive heart failure, you may experience certain symptoms. Tell your
doctor immediately if you have any of the following symptoms, especially when you first start
taking pioglitazone or after your dose is increased: large weight gain in a short period of time;
shortness of breath; swelling of the arms, hands, feet, ankles, or lower legs; swelling or pain in
the stomach; waking up short of breath during the night; needing to sleep with extra pillows in
order to breathe while lying down; frequent dry cough; or increased tiredness.
Talk to your doctor about the risks of taking pioglitazone.
Pioglitazone is used with a diet and exercise program and sometimes with other medications,
to treat type 2 diabetes (condition in which the body does not use insulin normally and
therefore cannot control the amount of sugar in the blood). Pioglitazone is in a class of
medications called thiazolidinediones. It works by increasing the body's sensitivity to insulin,
a natural substance that helps control blood sugar levels. Pioglitazone is not used to treat type
1 diabetes (condition in which the body does not produce insulin and, therefore, cannot
control the amount of sugar in the blood) or diabetic ketoacidosis (a serious condition that
may develop if high blood sugar is not treated).
Pioglitazone comes as a tablet to take by mouth. It is usually taken once daily with or without
meals. Take pioglitazone at around the same time every day. Follow the directions on your
understand. Take pioglitazone exactly as directed. Do not take more or less of it or take it
more often than prescribed by your doctor.
Your doctor may start you on a low dose of pioglitazone and gradually increase your dose.
Pioglitazone controls type 2 diabetes but does not cure it. It may take 2 weeks for your blood
sugar to decrease and several weeks longer for you to feel the full effect of pioglitazone.
Continue to take pioglitazone even if you feel well. Do not stop taking pioglitazone without
information.
Before taking pioglitazone,

 tell your doctor and pharmacist if you are allergic to pioglitazone or any other medications.
 tell your doctor and pharmacist what prescription and nonprescription medications, vitamins,
nutritional supplements and herbal products you are taking or plan to take. Be sure to mention
any of the following: atorvastatin (Lipitor), gemfibrozil (Lopid), hormonal contraceptives (birth
control pills, patches, rings, implants, and injections), ketoconazole (Nizoral), midazolam,
montelukast (Singulair), nifedipine (Procardia), and rifampin (Rifadin, Rifater, in Rifamate).
Your doctor may need to change the doses of your medications or monitor you carefully for
side effects.
 tell your doctor if you have or have ever had any of the conditions mentioned in the
IMPORTANT WARNING section or liver disease.
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 tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you
become pregnant while taking pioglitazone, call your doctor. Do not breastfeed while you are
taking pioglitazone.
 if you have not yet experienced menopause (change of life; end of monthly periods) you
should know that pioglitazone may increase the chance that you will become pregnant even if
you do not have regular monthly periods or you have a condition that prevents you from
ovulating (releasing an egg from the ovaries). Talk to your doctor about methods of birth
control that will work for you.
 if you will be having surgery, including dental surgery, tell the doctor or dentist that you are
taking pioglitazone.
 ask your doctor what to do if you get sick, develop an infection or fever, experience unusual
stress, or are injured. These conditions can affect your blood sugar and the amount of
pioglitazone you may need.
Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian.
It is important to eat a healthy diet, exercise regularly, and lose weight if necessary. This will
help to control your diabetes and help pioglitazone work more effectively.
Alcohol may cause a decrease in blood sugar. Ask your doctor about the safe use of alcoholic
beverages while you are taking pioglitazone.
If you remember that same day, take the missed dose as soon as your remember it. However,
if you do not remember until the next day, skip the missed dose and continue your regular
dosing schedule. Do not take more than one dose in one day and do not take a double dose to
make up for a missed one.
This medication may cause changes in your blood sugar. You should know the symptoms of
low and high blood sugar and what to do if you have these symptoms.
You may experience hypoglycemia (low blood sugar) if you are taking this medication in
combination with other medications used to treat diabetes. Your doctor will tell you what you
should do if you develop hypoglycemia. He or she may tell you to check your blood sugar, eat
or drink a food or beverage that contains sugar, such as hard candy or fruit juice, or get
medical care. Follow these directions carefully if you have any of the following symptoms of
hypoglycemia:
 shakiness
 dizziness or lightheadedness
 sweating
 nervousness or irritability
 sudden changes in behavior or mood
 headache
 numbness or tingling around the mouth
 weakness
 pale skin
 hunger
 clumsy or jerky movements
If hypoglycemia is not treated, severe symptoms may develop. Be sure that your family,
friends, and other people who spend time with you know that if you have any of the following
symptoms, they should get medical treatment for you immediately.
 confusion
 seizures
 loss of consciousness
Call your doctor immediately if you have any of the following symptoms of hyperglycemia
(high blood sugar):
 extreme thirst
 frequent urination
 extreme hunger
299
 weakness
 blurred vision
If high blood sugar is not treated, a serious, life-threatening condition called diabetic
ketoacidosis could develop. Call your doctor immediately if you have any of these symptoms:
 dry mouth
 upset stomach and vomiting
 breath that smells fruity
 decreased consciousness
Pioglitazone may cause side effects. Tell your doctor if any of these symptoms are severe or
do not go away:
 runny nose and other cold symptoms
 headache
 muscle pain
 tooth or mouth pain
 sore throat
mentioned in the IMPORTANT WARNING section, call your doctor immediately:
 nausea
 vomiting
 dark urine
 yellowing of the skin or whites of the eyes
 blurred vision
 vision loss
In clinical studies, more people who took pioglitazone developed bladder cancer than people
who did not take pioglitazone. Talk to your doctor about the risk of taking this medication.
In clinical studies, more women who took pioglitazone developed fractures, especially of the
hands, arms, feet, ankles, and lower legs than women who did not take pioglitazone. Men who
took pioglitazone did not have a greater risk of developing fractures than men who did not
take the medication. If you are a woman, talk to your doctor about the risk of taking this
medication.
Pioglitazone may cause other side effects. Call your doctor if you have any unusual problems
while you are taking this medication.
Keep all appointments with your doctor, your eye doctor, and the laboratory. Your doctor will
probably order regular eye examinations and certain laboratory tests to check your body's
response to pioglitazone. Your blood sugar and glycosolated hemoglobin should be checked
regularly to determine your response to pioglitazone. Your doctor will also tell you how to
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check your response to pioglitazone by measuring your blood or urine sugar levels at home.
Follow these directions carefully.
You should always wear a diabetic identification bracelet to be sure you get proper treatment
in an emergency.
Brand names
 Actos®
 ActoPLUSMet® (containing pioglitazone  Duetact® (containing pioglitazone and

and metformin) glimepiride)

Drug Information: Prazosin
(pra' zoe sin)
Prazosin is used alone or in combination with other medications to treat high blood pressure.
Prazosin is in a class of medications called alpha-blockers. It works by relaxing the blood
vessels so that blood can flow more easily through the body.
Prazosin comes as a capsule to take by mouth. It usually is taken two or three times a day at
evenly spaced intervals. The first time taking prazosin, you should take it before you go to
bed. Follow the directions on your prescription label carefully, and ask your doctor or
pharmacist to explain any part you do not understand. Take prazosin exactly as directed. Do
not take more or less of it or take it more often than prescribed by your doctor.
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Your doctor will probably start you on a low dose of prazosin and gradually increase your
dose.
Prazosin controls high blood pressure but does not cure it. Continue to take prazosin even if
you feel well. Do not stop taking prazosin without talking to your doctor.
Prazosin is also used to treat benign prostatic hyperplasia (BPH, noncancerous enlargement of
the prostate), congestive heart failure, pheochromocytoma (adrenal gland tumor), and
Raynaud's disease (condition where the fingers and toes change skin color from white to blue
to red when exposed to hot or cold temperatures). Talk to your doctor about the possible risks
of using this medication for your condition.
information.
Before taking prazosin,
 tell your doctor and pharmacist if you are allergic to prazosin, alfuzosin (Uroxatral),
doxazosin (Cardura), terazosin (Hytrin), or any other medications.
plan to take. Be sure to mention: beta-blockers such as propranolol (Inderal);
medications for erectile dysfunction (ED) such as sildenafil (Viagra), tadalafil (Cialis),
or vardenafil (Levitra);and other medications for high blood pressure.
 tell your doctor if you have narcolepsy (a sleep disorder that may cause extreme
sleepiness, sudden uncontrollable urge to sleep during daily activities) or if you have
or have ever had prostate cancer or liver disease.
you become pregnant while taking prazosin, call your doctor.
are taking prazosin. If you need to have eye surgery at any time during or after your
treatment, be sure to tell your doctor that you are taking or have taken prazosin.
 you should know that this drug may make you drowsy or dizzy. Do not drive a car,
operate machinery, or perform dangerous tasks for 24 hours after the first time you
take prazosin or after your dose is increased.
prazosin. Alcohol can make the side effects from prazosin worse.
 you should know that prazosin may cause dizziness, lightheadedness, and fainting
when you get up too quickly from a lying position. This is more common when you
first start taking prazosin, when your dose is increased, or when another blood
pressure medication is added to your treatment. To help avoid this problem, get out of
bed slowly, resting your feet on the floor for a few minutes before standing up. If you
experience these symptoms, sit or lie down. These symptoms may also occur if you
drink alcohol, stand for long periods of time, exercise, or if the weather is hot. If these
symptoms do not improve, call your doctor.
Follow your doctor's directions for your meals, including advice for a reduced salt (sodium)
diet.
302
dose to make up for a missed one. Check with your doctor if you have missed two or more
doses.
Prazosin may cause side effects. Tell your doctor if any of these symptoms or those listed in
the SPECIAL PRECAUTIONS section are severe or do not go away:
 weakness
 tiredness
 headache
 nausea
Some side effects can be serious. If you experience any of the following symptoms, call your
doctor immediately:
 hives
 rash
 itching
 fast, pounding, or irregular heartbeat
 chest pain
 painful erection of the penis that lasts for hours
 drowsiness
 decreased reflexes
 dizziness
 lightheadedness
 fainting
Keep all appointments with your doctor and the laboratory. Your blood pressure should be
checked regularly to determine your response to prazosin.
taking prazosin.
303
Brand names
 Minipress®

Drug Information: Prednisolone Ophthalmic
(pred niss' oh lone)
Prednisolone reduces the irritation, redness, burning, and swelling of eye inflammation caused
by chemicals, heat, radiation, infection, allergy, or foreign bodies in the eye. It sometimes is
used after eye surgery.
more information.
304
Prednisolone comes as eyedrops and eye ointment. Follow the directions on your prescription
Use prednisolone exactly as directed. Do not use more or less of it or use it more often than
If you are using the suspension form of prednisolone eyedrops (Pred Forte, Pred Mild,
Econopred, Econopred Plus), shake the bottle well before each dose. It is not necessary to
shake prednisolone eyedrop solution (AK-Pred, Inflamase Mild, Inflamase Forte).
Continue to use prednisolone even if you feel well. Do not stop using prednisolone without
To use the eyedrops, follow these instructions:

 Use a mirror or have someone else put the drops in your eye.
 If using prednisolone suspension eyedrops, shake the bottle well for 10 seconds.
 Remove the protective cap. Make sure that the end of the dropper is not chipped or
cracked.
 Avoid touching the dropper tip against your eye or anything else.
 Hold the dropper tip down at all times to prevent drops from flowing back into the
bottle and contaminating the remaining contents.
 Lie down or tilt your head back.
 Holding the bottle between your thumb and index finger, place the dropper tip as near
as possible to your eyelid without touching it.
 With the index finger of your other hand, pull the lower lid of the eye down to form a
pocket.
 Drop the prescribed number of drops into the pocket made by the lower lid and the
eye. Placing drops on the surface of the eyeball can cause stinging.
 Close your eye and press lightly against the lower lid with your finger for 2-3 minutes
to keep the medication in the eye. Do not blink.
 Replace and tighten the cap right away. Do not wipe or rinse it off.
 Wipe off any excess liquid from your cheek with a clean tissue. Wash your hands
again.
To use the eye ointment, follow these instructions:

 Use a mirror or have someone else apply the ointment.
 Avoid touching the tip of the tube against your eye or anything else. The ointment
must be kept clean.
 Tilt your head forward slightly.
 Holding the tube between your thumb and index finger, place the tube as near as
possible to your eyelid without touching it.
 With the index finger of your other hand, pull the lower lid of your eye down to form a
pocket.
 Place a small amount of ointment into the pocket made by the lower lid and the eye. A
1/2-inch strip of ointment usually is enough unless otherwise directed by your doctor.
 Gently close your eyes and keep them closed for 1-2 minutes to allow the medication
to be absorbed.
 Replace and tighten the cap right away.
 Wipe off any excess ointment from your eyelids and lashes with a clean tissue. Wash
your hands again.
Before using prednisolone eyedrops or eye ointment,
305
 tell your doctor and pharmacist if you are allergic to prednisolone or any other drugs.
are taking, including vitamins.
 tell your doctor if you have or have ever had glaucoma or diabetes.
you become pregnant while using prednisolone, call your doctor immediately.
Apply the missed dose as soon as you remember it. Use any remaining doses for that day at
evenly spaced intervals. However, if you remember a missed dose at the time the next one is
due, use only the regularly scheduled dose. Do not apply a double dose to make up for a
missed one.
Prednisolone may cause side effects. Tell your doctor if any of these symptoms are severe or
do not go away:
 temporary eye burning or stinging

 temporary blurred vision
If you experience the following symptom, call your doctor immediately:
 eye pain
Do not let anyone else use your medication. Ask your pharmacist any questions you have
If you still have symptoms of eye irritation after you finish the prednisolone, call your doctor.
Brand names
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 AK-Pred®  Inflamase® Forte  Pred Mild®
 Blephamide®  Inflamase® Mild  Pred-G®
 Blephamide®  Poly-Pred®
Liquifilm® Liquifilm®  Pred-G® Liquifilm®
 Econopred® Plus  Pred Forte®
 Vcontaining Prednisolone Sodium Phosphate and Sulfacetamide Sodium

Drug Information: Prednisone
(pred' ni sone)
Prednisone is used alone or with other medications to treat the symptoms of low
corticosteroid levels (lack of certain substances that are usually produced by the body and are
needed for normal body functioning). Prednisone is also used to treat other conditions in
patients with normal corticosteroid levels. These conditions include certain types of arthritis;
severe allergic reactions; multiple sclerosis (a disease in which the nerves do not function
properly); lupus (a disease in which the body attacks many of its own organs); and certain
conditions that affect the lungs, skin, eyes, kidneys blood, thyroid, stomach, and intestines.
Prednisone is also sometimes used to treat the symptoms of certain types of cancer.
Prednisone is in a class of medications called corticosteroids. It works to treat patients with
low levels of corticosteroids by replacing steroids that are normally produced naturally by the
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body. It works to treat other conditions by reducing swelling and redness and by changing the
way the immune system works.
Prednisone comes as a tablet, a solution (liquid), and a concentrated solution to take by

mouth. Prednisone is usually taken with food one to four times a day or once every other day.
Your doctor will probably tell you to take your dose(s) of prednisone at certain time(s) of day
every day. Your personal dosing schedule will depend on your condition and on how you
respond to treatment. Follow the directions on your prescription label carefully, and ask your
doctor or pharmacist to explain any part you do not understand. Take prednisone exactly as
directed. Do not take more or less of it or take it more often or for a longer period of time than
If you are taking the concentrated solution, use the specially marked dropper that comes with
the medication to measure your dose. You may mix the concentrated solution with juice, other
flavored liquids, or soft foods such as applesauce.
Your doctor may change your dose of prednisone often during your treatment to be sure that
you are always taking the lowest dose that works for you. Your doctor may also need to
change your dose if you experience unusual stress on your body such as surgery, illness,
infection, or a severe asthma attack. Tell your doctor if your symptoms improve or get worse
or if you get sick or have any changes in your health during your treatment.
If you are taking prednisone to treat a long-lasting disease, the medication may help control
your condition but will not cure it. Continue to take prednisone even if you feel well. Do not
stop taking prednisone without talking to your doctor. If you suddenly stop taking prednisone,
your body may not have enough natural steroids to function normally. This may cause
symptoms such as extreme tiredness, weakness, slowed movements, upset stomach, weight
loss, changes in skin color, sores in the mouth, and craving for salt. Call your doctor if you
experience these or other unusual symptoms while you are taking decreasing doses of
prednisone or after you stop taking the medication.
Prednisone is also sometimes used with antibiotics to treat a certain type of pneumonia in
patients with acquired immunodeficiency syndrome (AIDS). Talk to your doctor about the
risks of using this drug for your condition.
information.
Before taking prednisone,
 tell your doctor and pharmacist if you are allergic to prednisone, any other
medications, or any of the inactive ingredients in prednisone tablets or solutions. Ask
your doctor or pharmacist for a list of the inactive ingredients.
vitamins, and nutritional supplements you are taking or plan to take. Be sure to
mention any of the following: amiodarone (Cordarone, Pacerone); anticoagulants
('blood thinners') such as warfarin (Coumadin); certain antifungals such as fluconazole
(Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral) and voriconazole
(Vfend);aprepitant (Emend); aspirin; carbamazepine (Carbatrol, Epitol, Tegretol);
cimetidine (Tagamet); clarithromycin (Biaxin, in Prevpak); cyclosporine (Neoral,
Sandimmune); delavirdine (Rescriptor); diltiazem (Cardizem, Dilacor, Tiazac, others);
308
dexamethasone (Decadron, Dexpak); diuretics ('water pills'); efavirenz (Sustiva);
fluoxetine (Prozac, Sarafem); fluvoxamine (Luvox); griseofulvin (Fulvicin, Grifulvin,
Gris-PEG); HIV protease inhibitors including atazanavir (Reyataz), indinavir
(Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra),
and saquinavir (Fortovase, Invirase); hormonal contraceptives (birth control pills,
patches, rings, implants, and injections); lovastatin (Altocor, Mevacor); medications
for diabetes; nefazodone; nevirapine (Viramune); phenobarbital; phenytoin (Dilantin,
Phenytek); rifabutin (Mycobutin), rifampin (Rifadin, Rimactane, in Rifamate);
sertraline (Zoloft); troleandomycin (TAO); verapamil (Calan, Covera, Isoptin,
Verelan); and zafirlukast (Accolate).Your doctor may need to change the doses of your
 tell your doctor what herbal products you are taking or plan to take, especially St.
John's wort.
 tell your doctor if you have an eye infection now or have ever had eye infections that
come and go and if you have or have ever had threadworms (a type of worm that can
live inside the body); diabetes; high blood pressure; emotional problems; mental
illness; myasthenia gravis (a condition in which the muscles become weak);
osteoporosis (condition in which the bones become weak and fragile and can break
easily); seizures; tuberculosis (TB); ulcers; or liver, kidney, intestinal, heart, or thyroid
disease.
you become pregnant while taking prednisone, call your doctor.
 if you are having surgery, including dental surgery, or need emergency medical
treatment, tell the doctor, dentist, or medical staff that you are taking or have recently
stopped taking prednisone. You should carry a card or wear a bracelet with this
information in case you are unable to speak in a medical emergency.
 do not have any vaccinations (shots to prevent diseases) without talking to your
doctor.
 you should know that prednisone may decrease your ability to fight infection and may
prevent you from developing symptoms if you get an infection. Stay away from
people who are sick and wash your hands often while you are taking this medication.
Be sure to avoid people who have chicken pox or measles. Call your doctor
immediately if you think you may have been around someone who had chicken pox or
measles.
Your doctor may instruct you to follow a low-salt, high potassium, or high calcium diet. Your
doctor may also prescribe or recommend a calcium or potassium supplement. Follow these
directions carefully.
Talk to your doctor about eating grapefruit and drinking grapefruit juice while you are taking
this medication.
When you start to take prednisone, ask your doctor what to do if you forget to take a dose.
Write down these instructions so that you can refer to them later. Call your doctor or
pharmacist if you miss a dose and do not know what to do. Do not take a double dose to make
up for a missed dose.
Prednisone may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 headache
 dizziness
 difficulty falling asleep or staying asleep
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 inappropriate happiness
 extreme changes in mood
 changes in personality
 bulging eyes
 acne
 thin, fragile skin
 red or purple blotches or lines under the skin
 slowed healing of cuts and bruises
 increased hair growth
 changes in the way fat is spread around the body
 weak muscles
 irregular or absent menstrual periods
 decreased sexual desire
 heartburn
 increased sweating
doctor immediately:
 vision problems
 eye pain, redness, or tearing
 sore throat, fever, chills, cough, or other signs of infection
 seizures
 depression
 loss of contact with reality
 confusion
 muscle twitching or tightening
 shaking of the hands that you cannot control
 numbness, burning, or tingling in the face, arms, legs, feet, or hands
 upset stomach
 vomiting
 lightheadedness
 sudden weight gain
 shortness of breath, especially during the night
 dry, hacking cough
 swelling or pain in the stomach
 swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs
 rash
 hives
 itching
Prednisone may slow growth and development in children. Your child's doctor will watch his
or her growth carefully. Talk to your child's doctor about the risks of giving prednisone to
your child.
Prednisone may increase the risk that you will develop osteoporosis. Talk to your doctor about
the risks of taking prednisone and about things that you can do to decrease the chance that you
will develop osteoporosis.
Some patients who took prednisone or similar medications developed a type of cancer called
Kaposi's sarcoma. Talk to your doctor about the risks of taking prednisone.
Prednisone may cause other side effects. Call your doctor if you have any unusual problems
while you are taking this medication.
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tests to check your body's response to prednisone.
If you are having any skin tests such as allergy tests or tuberculosis tests, tell the doctor or
technician that you are taking prednisone.
Brand names
 Prednisone Intensol®  Sterapred®  Sterapred® DS

Drug Information: Pregabalin
(pre gab' a lin)
Pregabalin is used to relieve neuropathic pain (pain from damaged nerves) that can occur in
your arms, hands, fingers, legs, feet, or toes if you have diabetes or in the area of your rash if
you have had shingles (a painful rash that occurs after infection with herpes zoster). It is also
used to treat fibromyalgia (a long-lasting condition that may cause pain, muscle stiffness and
tenderness, tiredness, and difficulty falling asleep or staying asleep). Pregabalin is used with
other medications to treat certain types of seizures in people with epilepsy. Pregabalin is in a
class of medications called anticonvulsants. It works by decreasing the number of pain signals
that are sent out by damaged nerves in the body.
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Pregabalin comes as a capsule to take by mouth. It is usually taken with or without food two
or three times a day. Take pregabalin at around the same times every day. Follow the
directions on your prescription label carefully, and ask your doctor or pharmacist to explain
any part you do not understand.
Your doctor will probably start you on a low dose of pregabalin and may gradually increase
your dose during the first week of treatment.
Take pregabalin exactly as directed. Pregabalin may be habit forming. Do not take a larger
dose, take it more often, or take it for a longer period of time than prescribed by your doctor.
Pregabalin may help control your symptoms but will not cure your condition. It may take
several weeks or longer before you feel the full benefit of pregabalin. Continue to take
pregabalin even if you feel well. Do not stop taking pregabalin without talking to your doctor.
If you suddenly stop taking pregabalin, you may experience withdrawal symptoms, including
trouble falling asleep or staying asleep, nausea, diarrhea, headaches, or seizures. Your doctor
will probably decrease your dose gradually over at least one week.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.
information.
Before taking pregabalin,
 tell your doctor and pharmacist if you are allergic to pregabalin, any other
medications, or any of the ingredients in pregabalin capsules. Ask your pharmacist for
a list of the ingredients.
plan to take. Be sure to mention any of the following: angiotensin converting enzyme
(ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril (Capoten, in
Capozide), enalapril (Vasotec, in Vaseretic, Lexxel), fosinopril (Monopril), lisinopril
(Prinivil, Zestril, in Prinzide, Zestoretic), moexipril (Univasc, in Uniretic), perindopril
(Aceon), quinapril (Accupril, in Accuretic, Quinaretic), ramipril (Altace), and
trandolapril (Mavik, in Tarka); antidepressants; antihistamines; medications for
anxiety, including lorazepam (Ativan); medications for mental illness or seizures;
certain medications for diabetes such as pioglitazone (Actos, in Duetact) and
rosiglitazone (Avandia, in Avandaryl, Avandamet); narcotic pain medications,
including oxycodone (OxyContin, in Percocet, others); sedatives; sleeping pills; and
tranquilizers. Your doctor may need to change the doses of your medications or
monitor you carefully for side effects.
 tell your doctor if you drink or have ever drunk large amounts of alcohol, use or have
ever used street drugs, or have overused prescription medications. Also tell your
doctor if you have or have ever had swelling of the eyes, face, lips, tongue, or throat;
problems with your vision, bleeding problems or a low number of platelets (type of
blood cell needed for blood clotting) in your blood, or heart or kidney disease.
 tell your doctor if you are pregnant, or if you or your partner plans to become
pregnant. Also tell your doctor if you are breast-feeding. If you or your partner
becomes pregnant while you are taking pregabalin, call your doctor. Pregabalin has
caused decreased fertility in male animals and birth defects in the offspring of male
and female animals who were treated with the medication. There is not enough
information to tell if pregabalin causes these problems in humans.
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are taking pregabalin.
 you should know that pregabalin may make you dizzy or drowsy. Do not drive a car
operate machinery, or do other dangerous activities until you know how this
medication affects you.Ask your doctor when you may do these activities.
 Do not drink alcohol while taking pregabalin. Alcohol can add to the drowsiness
caused by this medication.
 you should know that your mental health may change in unexpected ways, and you
may become suicidal (thinking about harming or killing yourself or planning or trying
to do so) while you are taking pregabalin for the treatment of epilepsy, mental illness,
or other conditions. A small number of adults and children 5 years of age and older
who took antiepileptics such as pregabalin during clinical studies were found to be
twice as likely to become suicidal than people who did not take the medication. This
increased risk of suicidal behavior was seen as early as one week after starting the
medication. You, your family, or your caregiver should call your doctor right away if
you experience any of the following symptoms: anxiety, agitation, hostility, mania
(frenzied, abnormally excited mood), talking or thinking about wanting to hurt
yourself or end your life, withdrawing from friends and family, new or worsening
depression, preoccupation with death and dying, or giving away prized possessions.
Be sure that your family or caregiver knows which symptoms may be serious so they
can call the doctor if you are unable to seek treatment on your own.
If you forget to take a dose and remember a few hours later, take the missed dose as soon as
you remember it. However, if it is almost time for the next dose, skip the missed dose and
continue your regular dosing schedule. Do not take a double dose to make up for a missed
one.
Pregabalin may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 tiredness
 dizziness
 headache
 dry mouth
 nausea
 vomiting
 constipation
 gas
 bloating
 "high" or elevated mood
 speech problems
 difficulty concentrating or paying attention
 confusion
 difficulty remembering or forgetfulness
 anxiety
 lack of coordination
 loss of balance or unsteadiness
 uncontrollable shaking or jerking of a part of the body
 muscle twitching
 weakness
 increased appetite
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 weight gain
 swelling of the arms, hands, feet, ankles, or lower legs
 back pain
immediately:
 blurred vision, double vision, or other changes in eyesight

 hives
 rash
 itching
 blisters
 swelling of the eyes face, throat, mouth, lips, gums, tongue, head or neck
 wheezing
 muscle pain, tenderness, soreness, or weakness, especially if it comes along with fever
 chest pain
If you have diabetes, you should know that pregabalin has caused skin sores in animals. Pay
extra attention to your skin while taking pregabalin, and tell your doctor if you have any
sores, redness, or skin problems.
Pregabalin may cause other side effects. Call your doctor if you have any unusual problems
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab
tests to check your body's response to pregabalin.
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Brand names
 Lyrica®
Drug Information: Primaquine
prim' a kwin
Primaquine is used alone or with another medication to treat malaria (a serious infection that
is spread by mosquitoes in certain parts of the world and can cause death) and to prevent the
disease from coming back in people that are infected with malaria. Primaquine is in a class of
medications called antimalarials. It works by killing the organisms that cause malaria.
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Primaquine comes as a tablet to take by mouth. It is usually taken once a day for 14 days.
Take primaquine at around the same time every day. Follow the directions on your
understand. Take primaquine exactly as directed. Do not take more or less of it or take it more
often or for a longer period of time than prescribed by your doctor.
Take primaquine until you finish the prescription, even if you feel better. If you stop taking
primaquine too soon or skip doses, your infection may not be completely treated.
Primaquine is also sometimes used to treat Pneumocystis jiroveci pneumonia (lung disease
caused by fungus). Talk to your doctor about the risks of using this drug for your condition.
information.
Before taking primaquine,
 tell your doctor and pharmacist if you are allergic to primaquine, any other
medications, or any of the ingredients in primaquine tablets. Ask your pharmacist for a
list of the ingredients.
 tell your doctor if you are taking penicillin; cephalosporins such as cephalexin
(Keflex), cefaclor, cefuroxime (Ceftin), cefdinir (Omnicef), or cefpodoxime (Vantin);
levodopa (in Sinemet); medications to treat cancer;methyldopa (Aldomet); or
quinidine. Your doctor will probably tell you not to take primaquine. Also do not take
primaquine if you are taking or have recently taken quinacrine (not available in the
US).
plan to take.
 tell your doctor if you have or have ever had rheumatoid arthritis, hemolytic anemia (a
condition with an abnormally low number of red blood cells), lupus erythematosus (a
disease that occurs when the body's tissues are attacked by antibodies from its own
immune system), methemoglobinemia (a condition with defective red blood cells that
are unable to carry oxygen to the tissues in the body),nicotinamide adenine
dinucleotide (NADH) deficiency (a genetic condition), glucose-6-phosphate
dehydrogenase (G6PD) deficiency (a genetic condition), or if you or someone in your
family has had a reaction after eating fava beans.
you become pregnant while taking primaquine, call your doctor.
316
Primaquine may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 nausea
 vomiting
 heartburn
 abdominal cramps
immediately:
 tiredness
 pale skin
 fast heartbeat
 dark colored urine
 headache
 lack of energy
 grey-bluish color of lips and/or skin
 nervousness
 seizure
 weak pulse
 confusion
 sore throat, fever, cough, or other signs of infection
 fainting
 dizziness
 blurred vision
Primaquine may cause other side effects. Call your doctor if you have any unusual problems
 abdominal cramps
 vomiting
 heartburn
 grey-bluish color of lips and/or skin
 headache
 lack of energy
 nervousness
 seizure
 weak pulse
317
 confusion
 fainting
 dizziness
 blurred vision
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab
tests to check your body's response to primaquine.
taking primaquine.
Drug Information: Primidone
(pri' mi done)
Primidone is used to control seizures.
more information.
318
Primidone comes as a tablet and suspension (liquid) to take by mouth. It usually is taken once
a day at bedtime when you first use it, and then the dosage is gradually increased to three or
four times a day. It may be taken with food. Shake the suspension well before each use.
to explain any part you do not understand. Take primidone exactly as directed. Do not take
more or less of it or take it more often than your doctor tells you to.
This medication must be taken regularly to be effective. Do not skip doses even if you feel
that you do not need them. Do not stop taking this drug until your doctor specifically tells you
to do so. Stopping the drug abruptly can cause seizures. Your doctor probably will decrease
your dose gradually.
Primidone is also used to treat tremors. Talk to your doctor about the possible risks of using
this drug for your condition.
Before taking primidone,
 tell your doctor and pharmacist if you are allergic to primidone or any other drugs.
Also, tell your doctor if you ever had a bad reaction to amobarbital (Amytal),
butabarbital (Butisol), pentobarbital (Nembutal), phenobarbital, or secobarbital
(Seconal).
are taking, especially acetazolamide (Diamox); anticoagulants ('blood thinners') such
as warfarin (Coumadin); antihistamines; carbamazepine (Tegretol); disulfiram
(Antabuse); doxycycline (Vibramycin); griseofulvin (Fulvicin); isoniazid (INH,
Laniazid, Nydrazid); MAO inhibitors [phenelzine (Nardil) or tranylcypromine
(Parnate)]; medications for depression, seizures, pain, asthma, colds, or allergies;
muscle relaxants; nicotinamide; oral contraceptives; phenytoin (Dilantin); sedatives;
sleeping pills; steroids; tranquilizers; valproic acid (Depakene); and vitamins.
 tell your doctor if you have or have ever had anemia or lung, kidney, or liver disease.
 use a method of birth control other than oral contraceptives while taking this
medication. Primidone can decrease the effectiveness of oral contraceptives.
you become pregnant while taking primidone, call your doctor immediately.
are taking primidone.
evenly spaced intervals. However, if you remember a missed dose at the time you are
scheduled to take the next one, skip the missed dose completely. Do not take a double dose to
make up for the missed one.
Side effects from primidone may occur and include:
 drowsiness
 incoordination
319
 irritability
 excitement (in children)
 upset stomach
 tiredness
 headache
 changes in appetite
Tell your doctor if any of these symptoms are severe or do not go away:
 restlessness or excitement
 hair loss
 swollen eyelids or legs
 double vision
 blurred vision
 changes in sex drive or ability
 seizures
 sore throat
 fever
 dark urine
 bloody nose
 tiny purple skin spots
 easy bruising
Do not freeze the suspension. Throw away any medication that is outdated or no longer
tests to check your response to primidone. Your dose may need to be adjusted frequently,
especially when you first take primidone.
Differences in effectiveness may be seen with different brands of this medication. Switching
brands is not recommended without the advice of your pharmacist. Call your doctor if you
continue to have seizures. Carry identification (Medic Alert) stating that you have epilepsy
and that you are taking primidone.
320
Brand names
 Mysoline®

Drug Information: Procainamide Oral
(proe kane a' mide)
IMPORTANT WARNING:
Antiarrhythmic drugs, including procainamide, may increase the risk of death. Tell your doctor
if you have had a heart attack within the past two years. Procainamide should be used only to
treat life-threatening arrhythmias (irregular heartbeats).
321
Procainamide may cause a decrease in the number of cells in your bone marrow. Procainamide
may also cause symptoms of lupus.
tests to check your response to procainamide.
If you experience any of the following symptoms, call your doctor immediately: fever, chills,
sore throat, bruising, bleeding, muscle aches or weakness, stomach or chest pain, skin rash, or
blisters on the cheek, tongue and lips.
Talk to your doctor about the risks of taking procainamide.
Procainamide is used to treat abnormal heart rhythms. It works by making your heart more
resistant to abnormal activity.
Procainamide comes as a capsule and tablet to take by mouth. Immediate-acting procainamide

usually is taken every 3 or 4 hours. The long-acting product is usually taken every 6 or 12
hours. Do not cut, crush, or chew extended-release (long-acting) tablets; swallow them whole.
You may see a waxy core in your stool if you are taking the extended-release product; this is
normal.
to explain any part you do not understand. Take procainamide exactly as directed. Do not take
Procainamide helps control your condition but will not cure it. Continue to take procainamide
even if you feel well. Do not stop taking procainamide without talking to your doctor.
This medication should not be prescribed for other uses; ask your doctor or pharmacist for
more information.
Before taking procainamide,
 tell your doctor and pharmacist if you are allergic to procainamide, anesthetics,
aspirin, or any other drugs.
are taking, especially digoxin (Lanoxin) or drugs for high blood pressure, and
vitamins.
 in addition to the condition listed in the IMPORTANT WARNING section, tell your
doctor if you have or have ever had lupus, heart disease, high blood pressure, kidney
or liver disease, or myasthenia gravis.
you become pregnant while taking procainamide, call your doctor.
are taking procainamide.
 you should know that this drug may make you dizzy. Do not drive a car or operate
 remember that alcohol can add to the dizziness caused by this drug.
322
 talk to your doctor about the use of cigarettes and caffeine-containing beverages.
These products may increase the irritability of your heart and interfere with the action
of procainamide.
Procainamide may cause side effects. Tell your doctor if any of these symptoms are severe or
do not go away:
 upset stomach
 vomiting
 bitter taste
If you experience the following symptom or any of those listed in the IMPORTANT
WARNING section, call your doctor immediately:
Keep all appointments with your doctor and the laboratory. Your doctor will need to
determine your response to procainamide.
Take procainamide at the same time each day in regularly spaced intervals. Changing the time
of your doses prevents procainamide from working effectively.
323
Brand names
 Procanbid®

Drug Information: Procarbazine
(proe kar' ba zeen)
Your doctor has ordered the drug procarbazine to help treat your illness. The drug is taken by
mouth with capsules.
324
This medication is used to treat:
 Hodgkin's disease
more information.
Procarbazine is in a class of drugs known as hydrazine derivatives. It slows or stops the

growth of cancer cells in your body. The length of treatment depends on the types of drugs
you are taking, how well your body responds to them, and the type of cancer you have.
Procarbazine is also used to treat non-Hodgkin's lymphomas, diffuse histiocytic lymphoma,

mycosis fungoides, brain tumors, and small cell lung cancer. Talk to your doctor about the
possible risks of using this drug for your condition.
Precautions
Before taking procarbazine,
 tell your doctor and pharmacist if you are allergic to procarbazine or any other drugs.
are taking, especially aspirin, aspirin-substitute products, blood pressure medications,
cough and cold products (particularly nose drops), medications for depression or pain,
sleeping pills, tranquilizers, and vitamins.
 you should know that procarbazine may interfere with the normal menstrual cycle
(period) in women and may stop sperm production in men. However, you should not
assume that you cannot get pregnant or that you cannot get someone else pregnant.
Women who are pregnant or breast-feeding should tell their doctors before they begin
taking this drug. You should not plan to have children while receiving chemotherapy
or for a while after treatments. (Talk to your doctor for further details.) Use a reliable
method of birth control to prevent pregnancy. Procarbazine may harm the fetus.
 while being treated with procarbazine, avoid tea, coffee, cola drinks, cheese, yogurt,
bananas, cigarettes, and alcoholic beverages (including wine and beer). Drinking
alcohol with procarbazine can cause severe nausea and vomiting.
 do not have any vaccinations (e.g., measles or flu shots) without talking to your
doctor.
Side effects
Side effects from procarbazine are common and include:
 nausea and vomiting

 diarrhea
 constipation
325
 abdominal pain
 dryness of mouth
 headache
Tell your doctor if either of these symptoms is severe or lasts for several hours:
 fatigue or weakness
 mouth blistering
 unusual bruising or bleeding (especially nosebleeds)

 fever
 chills
 sore throat
 cough
 rash
 dizziness
 tingling or numbness
 confusion
Special instructions
 The most common side effect of procarbazine is a decrease of blood cells. Your doctor
may order tests before, during, and after your treatment to see if your blood cells are
affected by the drug.
Brand names
 Matulane®

Drug Information: Prochlorperazine
(proe klor per' a zeen)
IMPORTANT WARNING:
326
[Posted 06/16/2008] FDA notified healthcare professionals that both conventional and atypical
antipsychotics are associated with an increased risk of mortality in elderly patients treated for
dementia-related psychosis. In April 2005, FDA notified healthcare professionals that patients
with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased
risk of death. Since issuing that notification, FDA has reviewed additional information that
indicates the risk is also associated with conventional antipsychotics. Antipsychotics are not
indicated for the treatment of dementia-related psychosis. The prescribing information for all
antipsychotic drugs will now include the same information about this risk in a BOXED
WARNING and the WARNINGS section. For more information visit the FDA website at:
http://www.fda.gov/medwatch/safety/2008/safety08.htm#Antipsychotics,
http://www.fda.gov/cder/drug/InfoSheets/HCP/antipsychotics_conventional.htm and
http://www.fda.gov/bbs/topics/NEWS/2008/NEW01851.html.
Prochlorperazine is used to treat the nausea and vomiting caused by radiation therapy, cancer
chemotherapy, surgery, and other conditions. It is also used to treat psychotic symptoms such
as hallucinations and hostility.
more information.
Prochlorperazine comes as a tablet, extended-release (long-acting) capsule, oral liquid, and

rectal suppository. Prochlorperazine usually is taken three or four times a day (tablets), or
once or twice a day (extended-release capsules). Follow the directions on your prescription
Take prochlorperazine exactly as directed. Do not take more or less of it or take it more often
than prescribed by your doctor.
Although prochlorperazine is not habit-forming, do not stop taking it abruptly, especially if

you have been taking it for a long time. Your doctor probably will decrease your dose
gradually.
Do not open extended-release capsules; swallow them whole.
Do not allow the liquid to touch your skin; it can cause irritation.
If you are to insert a rectal suppository, follow these steps:
 If the suppository feels soft, hold it under cold, running water for 1 minute. Then
remove the wrapper.
 Using your finger, insert the suppository into the rectum, about 1/2 to 1 inch in
children and 1 inch in adults. Hold the suppository in place for a few moments.
activities.
327
Before taking prochlorperazine,
 tell your doctor and pharmacist if you are allergic to prochlorperazine, any
tranquilizer, or any other drugs.
are taking, especially antihistamines, lithium (Eskalith, Lithobid), medications for
depression and Parkinson's disease, muscle relaxants, narcotics (pain medication),
sedatives, seizure medication, sleeping pills, and vitamins.
 be sure a child younger than 16 years of age does not have symptoms of Reye's
syndrome (sudden, severe, and persistent vomiting; unusual behavior; fever; and
seizures). Call your child's doctor immediately if your child experiences any of these
symptoms. Do not give prochlorperazine or aspirin to the child.
 tell your doctor if you have or have ever had heart, liver, or kidney disease; a bad
reaction to insulin; shock therapy; glaucoma; an enlarged prostate; difficulty urinating;
asthma, emphysema, chronic bronchitis, or lung disease; Parkinson's disease; or
seizures.
you become pregnant while taking prochlorperazine, call your doctor.
are taking prochlorperazine.
clothing, sunglasses, and sunscreen. Prochlorperazine may make your skin sensitive to
sunlight.
Prochlorperazine may cause side effects. Tell your doctor if this symptom is severe or does
not go away:
 drowsiness
 jaw, neck, and back muscle spasms

 fine worm-like tongue movements
 rhythmic face, mouth, or jaw movements
 slow or difficult speech
 restlessness and pacing
 tremors
 shuffling walk
 skin rash
328
Brand names
 Compazine®  Compazine® Syrup
 Compazine® Spansule®  Compro®

Drug Information: Progesterone
proe jes' ter one
329
Progesterone is used as a part of hormone replacement therapy in women who have passed
menopause (the change of life) and have not had a hysterectomy (surgery to remove the
uterus). Hormone replacement therapy usually includes estrogen, which is used to treat
symptoms of menopause and reduce the risk of developing certain diseases. However,
estrogen can also cause abnormal thickening of the lining of the uterus and increase the risk of
developing uterine cancer. Progesterone helps to prevent this thickening and decreases the risk
of developing uterine cancer. Progesterone is also used to bring on menstruation (period) in
women of childbearing age who have had normal periods and then stopped menstruating.
Progesterone is in a class of medications called progestins (female hormones). It works as part
of hormone replacement therapy by decreasing the amount of estrogen in the uterus. It works
to bring on menstruation by replacing the natural progesterone that some women are missing.
Progesterone comes as a capsule to take by mouth. It is usually taken once a day in the
evening or at bedtime. You will probably take progesterone on a rotating schedule that
alternates 10-12 days when you take progesterone with 16-18 days when you do not take the
medication. Your doctor will tell you exactly when to take progesterone. To help you
remember to take progesterone, take it around the same time in the evening. Follow the
directions on your prescription label carefully, and ask your doctor or pharmacist to explain
any part you do not understand. Take progesterone exactly as directed. Do not take more or
less of it or take it more often than prescribed by your doctor.
Continue to take progesterone as directed even if you feel well. Do not stop taking
progesterone without talking to your doctor.
information.
Before taking progesterone,
 tell your doctor and pharmacist if you are allergic to progesterone, oral contraceptives
(birth control pills), hormone replacement therapy, any other medications, or peanuts.
medications, vitamins, and nutritional supplements you are taking. Be sure to mention
any of the following: amiodarone (Cordarone, Pacerone); antifungals such as
fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral);
cimetidine (Tagamet); clarithromycin (Biaxin); cyclosporine (Neoral, Samdimmune);
danazol (Danocrine); delaviridine (Rescriptor); diltiazem (Cardizem, Dilacor, Tiazac);
erythromycin (E.E.S, E-Mycin, Erythrocin); fluoxetine (Prozac, Sarafem);
fluvoxamine (Luvox); HIV protease inhibitors such as indinavir (Crixivan), ritonavir
(Norvir), and saquinavir (Fortovase); isoniazid (INH, Nydrazid); lansoprazole
(Prevacid, Prevpac); metronidazole (Flagyl); nefazodone (Serzone); omeprazole
(Prilosec); oral contraceptives (birth control pills); ticlopidine (Ticlid); troleandomycin
(TAO); verapamil (Calan, Covera, Isoptin, Verelan); and zafirlukast (Accolate). Your
doctor may need to change the doses of your medications or monitor you carefully for
side effects.
 tell your doctor what herbal products you are taking, especially St. John's wort.
 tell your doctor if you have or have ever had unexplained vaginal bleeding between
periods; a miscarriage in which some tissue was left in the uterus; cancer of the breasts
or female organs; seizures; migraine headaches; asthma; diabetes; depression; blood
clots in the legs, lungs, eyes, brain, or anywhere in the body; stroke or ministroke;
vision problems; or liver, kidney, heart, or gallbladder disease .
you become pregnant while taking progesterone, call your doctor.
330
are taking progesterone.
 you should know that progesterone may make you dizzy or drowsy. Do not drive a car
or operate machinery until you know how this medication affects you. If progesterone
does make you dizzy or drowsy, take your daily dose at bedtime.
 you should know that progesterone may cause dizziness, lightheadedness, and fainting
when you get up too quickly from a lying position. This is more common when you
first start taking progesterone. To avoid this problem, get out of bed slowly, resting
your feet on the floor for a few minutes before standing up.
Talk to your doctor about drinking grapefruit juice while taking this medication.
Progesterone may cause side effects. Tell your doctor if any of these symptoms are severe or
do not go away:
 headache
 breast tenderness or pain
 upset stomach
 vomiting
 diarrhea
 constipation
 tiredness
 muscle, joint, or bone pain
 mood swings
 irritability
 excessive worrying
 runny nose
 sneezing
 cough
 vaginal discharge
 problems urinating
 breast lumps
 migraine headache
 severe dizziness or faintness
 slow or difficult speech
 weakness or numbness of an arm or leg
 lack of coordination or loss of balance
 fast heartbeat
 sharp chest pain
 coughing up blood
 leg swelling or pain
 loss of vision or blurred vision
 bulging eyes
 double vision
331
 unexpected vaginal bleeding
 shaking hands that you cannot control
 seizures
 stomach pain or swelling
 depression
 hives
 skin rash
 itching
 hoarseness
Laboratory animals who were given progesterone developed tumors. It is not known if
progesterone increases the risk of tumors in humans. Talk to your doctor about the risks of
taking this medication.
Medications like progesterone may cause abnormal blood clotting. This may cut off the blood
supply to the brain, heart, lungs, or eyes and cause serious problems. Call your doctor if you
experience any of the symptoms listed above as serious side effects. Talk to your doctor about
the risks of taking this medication.
Progesterone may cause other side effects. Call your doctor if you have any unusual problems
Before having any laboratory test or biopsy (removal of tissue for testing), tell your doctor
and the laboratory personnel that you are taking progesterone.
Brand names
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 Prometrium®
Drug Information: Progestin-Only Oral Contraceptives
(pro jes' tin)
Progestin-only oral contraceptives are used to prevent pregnancy. Progestin is a female

hormone. It works by preventing the release of eggs from the ovaries (ovulation) and
333
changing the cervical mucus and the lining of the uterus. Progestin-only oral contraceptives
are a very effective method of birth control, but they do not prevent the spread of AIDS and
other sexually transmitted diseases.
Progestin-only oral contraceptives come as tablets to take by mouth. They are taken once a
day, every day at the same time. Follow the directions on your prescription label carefully,
and ask your doctor or pharmacist to explain any part you do not understand. Take progestin-
only oral contraceptives exactly as directed. Do not take more or less of it or take it more
Progestin-only oral contraceptives come in packs of 28 pills. Begin the next pack the day after
the last pack is finished.
It is best to start taking progestin-only oral contraceptives on the first day of your menstrual
period. If you start taking progestin-only oral contraceptives on another day, use a backup
method of birth control (such as a condom and/or a spermicide) for the next 48 hours. If you
have had a miscarriage or an abortion, you can start taking progestin-only oral contraceptives
the next day.
Progestin-only oral contraceptives are safe for use by breast-feeding mothers. If you are fully
breastfeeding (not giving your baby any food or formula), you may start taking this
medication 6 weeks after delivery. If you are partially breast-feeding (giving your baby some
food or formula), you should start taking this medication by 3 weeks after delivery.
Before taking progestin-only oral contraceptives, ask your pharmacist or doctor for a copy of
the manufacturer's information for the patient and read it carefully.
information.
Before taking progestin-only oral contraceptives,
 tell your doctor and pharmacist if you are allergic to progestins, aspirin, tartrazine (a
yellow food coloring), or any other medications.
mention any of the following: carbamazepine (Tegretol), phenobarbital (Luminal,
Solfoton), phenytoin (Dilantin), and rifampin (Rifadin). Your doctor may need to
change the doses of your medications or monitor you carefully for side effects.
 tell your doctor if you have or have ever had breast lumps or breast cancer, vaginal
bleeding between menstrual periods, liver tumors, liver disease, or diabetes.
pregnant while taking progestin-only contraceptives, call your doctor.
 tell your doctor if you use tobacco products. Cigarette smoking may increase the risk
of heart attacks and strokes. You should not smoke while taking this medication.
334
Take the missed dose as soon as you remember it, and go back to taking progestin-only
contraceptives at your regular time. If you take a dose more than 3 hours late, be sure to use a
backup method of birth control for the next 48 hours. If you are not sure what to do about the
pills you have missed, keep taking progestin-only contraceptives and use a backup method of
birth control until you speak to your doctor.
Progestin-only oral contraceptives may cause side effects. Tell your doctor if any of these
symptoms are severe or do not go away:
 irregular menstrual periods

 headache
 breast pain
 upset stomach
 dizziness
 acne
 increased hair growth
 bleeding that lasts a long time

 lack of menstrual periods
 severe stomach pain
Combined estrogen and progestin oral contraceptives may increase the risk of getting breast
cancer, endometrial cancer, and liver tumors. It is not known whether progestin-only oral
contraceptives also increase the risks of these conditions. Talk to your doctor about the risks
of taking this medication.
Progestin-only oral ontraceptives may cause other side effects. Call your doctor if you have
any unusual problems while taking this medication.
335
Before you have any laboratory tests, tell the laboratory personnel that you take progestin-
only oral contraceptives, as this medication may interfere with some laboratory tests.
Rarely, women can become pregnant even if they are taking oral contraceptives. You should
get a pregnancy test if it has been more than 45 days since your last period or if your period is
late and you missed one or more doses or took them late and had sex without a backup
method of birth control.
If you want to become pregnant, stop taking progestin-only contraceptives. Progestin-only

contraceptives should not delay your ability to get pregnant.
Brand names
 Micronor®  Nor-Q.D.®  Ovrette®
Other names
 Birth-control pills  norethindrone  POP
 minipill  norgestrel

Drug Information: Promethazine
(proe meth' a zeen)
336
IMPORTANT WARNING:
Promethazine may cause breathing to slow or stop, and may cause death in children.
Promethazine should not be given to babies or children who are younger than 2 years old and
should be given with caution to children who are 2 years of age or older. Combination products
containing promethazine and codeine should not be given to children younger than 16 years
old. Promethazine should not routinely be used to treat vomiting in children; it should only be
used in specific cases when a doctor decides that it is needed. Tell your child's doctor if your
child has any condition that affects his/her breathing such as lung disease, asthma, or sleep
apnea (stops breathing for short periods of time during sleep). Tell your doctor or pharmacist
about all the medications your child is taking, especially barbiturates such as phenobarbital
(Luminal), medications for anxiety, narcotic medications for pain, sedatives, sleeping pills, and
tranquilizers. Call your child's doctor immediately and get emergency medical treatment if
your child has difficulty breathing, wheezes, slows or pauses in breathing, or stops breathing.
Talk to your doctor about the risks of giving promethazine to your child.
Promethazine is used to relieve the symptoms of allergic reactions such as allergic rhinitis
(runny nose and watery eyes caused by allergy to pollen, mold or dust), allergic conjunctivitis
(red, watery eyes caused by allergies), allergic skin reactions, and allergic reactions to blood
or plasma products. Promethazine is used with other medications to treat anaphylaxis (sudden,
severe allergic reactions) and the symptoms of the common cold such as sneezing, cough, and
runny nose. Promethazine is also used to relax and sedate patients before and after surgery,
during labor, and at other times. Promethazine is also used to prevent and control nausea and
vomiting that may occur after surgery, and with other medications to help relieve pain after
surgery. Promethazine is also used to prevent and treat motion sickness. Promethazine helps
control symptoms, but will not treat the cause of the symptoms or speed recovery.
Promethazine is in a class of medications called phenothiazines. It works by blocking the
action of a certain natural substance in the body.
Promethazine comes as a tablet and syrup (liquid) to take by mouth and as a suppository to
use rectally.When promethazine is used to treat allergies, it is usually taken one to four times
daily, before meals and/or at bedtime. When promethazine is used to relieve cold symptoms, it
is usually taken every 4-6 hours as needed. When promethazine is used to treat motion
sickness, it is taken 30-60 minutes before travel and again after 8-12 hours if needed. On
longer trips, promethazine is usually taken in the morning and before the evening meal on
each day of travel. When promethazine is used to treat or prevent nausea and vomiting it is
usually taken every 4-6 hours as needed. Promethazine may also be taken at bedtime the night
before surgery to relieve anxiety and produce quiet sleep. Follow the directions on your
understand. Take promethazine exactly as directed. Do not take more or less of it or take it
more often than prescribed by your doctor.
Promethazine suppositories are for rectal use only. Do not try to swallow the suppositories or
insert in any other part of your body.
If you are taking promethazine liquid, do not use a household spoon to measure your dose.
Use the measuring spoon or cup that came with the medication or use a spoon made
especially for measuring medication.
To insert a promethazine suppository, follow these steps:
 If the suppository feels soft, hold it under cold, running water for 1 minute. Remove
the wrapper.
337
 Using your finger, insert the suppository into the rectum, about ½ to 1 inch in children
who are 2 years of age older and 1 inch in adults. Hold it in place for a few moments.
activities.
information.
Before taking promethazine,
 tell your doctor and pharmacist if you are allergic to promethazine, other
phenothiazines (certain medications used to treat mental illness, nausea, vomiting,
severe hiccups, and other conditions) or any other medications. Also tell your doctor
and pharmacist if you have ever had an unusual or unexpected reaction when you took
promethazine, another phenothiazine, or any other medication. Ask your doctor or
pharmacist if you do not know if a medication you are allergic to is a phenothiazine.
vitamins, nutritional supplements and herbal products you are taking or plan to take.
Be sure to mention any of the following: antidepressants ('mood elevators') such as
amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine
(Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline
(Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil);
antihistamines; azathioprine (Imuran);barbiturates such as phenobarbital (Luminal);
cancer chemotherapy; epinephrine (Epipen); ipratropium (Atrovent)medications for
anxiety, irritable bowel disease, mental illness, motion sickness, Parkinson's disease,
seizures, ulcers, or urinary problems; monoamine oxidase inhibitors (MAOIs) such as
isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and
selegiline (Eldepryl, Emsam, Zelapar); narcotics and other pain medication; sedatives;
sleeping pills;and tranquilizers. Your doctor may need to change the doses of your
 tell your doctor if you have or have ever had an enlarged prostate (a male reproductive
gland); glaucoma (a condition in which increased pressure in the eye can lead to
gradual loss of vision); seizures; ulcers; blockage in the passage between the stomach
and intestine; blockage in the bladder; asthma or other lung disease; sleep apnea;
cancer;any condition that affects the production of blood cells in your bone marrow; or
heart or liver disease. If you will be giving promethazine to a child, also tell the child's
doctor if the child has any of the following symptoms before he or she receives the
medication: vomiting, listlessness, drowsiness, confusion, aggression, seizures,
yellowing of the skin or eyes, weakness, or flu-like symptoms. Also tell the child's
doctor if the child has not been drinking normally, has had excessive vomiting or
diarrhea, or appears dehydrated.
pregnant while taking promethazine, call your doctor. Do not breastfeed while you are
taking promethazine.
are taking promethazine.
 you should know that this medication may make you drowsy. Do not drive a car or
operate machinery until you know how this medication affects you. If you are giving
promethazine to a child, watch the child to be sure he or she does not get hurt while
riding a bike or participating in other activities that could be dangerous.
 remember that alcohol can add to the drowsiness caused by this medication.
338
clothing, sunglasses, and sunscreen. Promethazine may make your skin sensitive to
sunlight.
Promethazine can cause side effects. Tell your doctor if any of these symptoms are severe or
do not go away:
 dry mouth
 drowsiness
 listlessness
 difficulty falling asleep or staying asleep
 nightmares
 dizziness
 ringing in ears
 blurred or double vision
 loss of coordination
 upset stomach
 vomiting
 nervousness
 restlessness
 hyperactivity
 abnormally happy mood
 stuffy nose
 itching
doctor immediately:
 wheezing
 slowed breathing
 breathing stops for a short time
 fever
 sweating
 stiff muscles
 decreased alertness
 fast or irregular pulse or heartbeat
 faintness
 abnormal or uncontrollable movements
 hallucinations (seeing things or hearing voices that do not exist)
 confusion
 overwhelming or unmanageable fear or emotion
 seizures
 uncontrolled eye movements
 tongue sticking out
339
 abnormal neck position
 inability to respond to people around you
 rash
 hives
 swelling of the face, eyes, lips, tongue, throat, arms, hands, feet, ankles, or lower legs
 hoarseness
Promethazine may cause other side effects. Call your doctor if you experience any unusual
problems while you are taking this medication.
Keep this medication in the carton or container it came in, tightly closed, and out of reach of
children. Store promethazine tablets and liquid at room temperature and away from excess
heat and moisture (not in the bathroom). Store promethazine suppositories in the refrigerator.
Protect the medication from light. Throw away any medication that is outdated or no longer
 slowed or stopped breathing
 dizziness
 lightheadedness
 fainting
 loss of consciousness
 fast heartbeat
 tight muscles that are difficult to move
 loss of coordination
 continuous twisting movements of the hands and feet
 dry mouth
 wide pupils (black circles in the middle of the eyes)
 flushing
 upset stomach
 constipation
 abnormal excitement or agitation
 nightmares
340
Promethazine can interfere with the results of home pregnancy tests. Talk to your doctor if
you think you might be pregnant while you are taking promethazine. Do not try to test for
pregnancy at home.
taking promethazine.
Brand names
 Phenergan®  Promacot®  Promethegan®
 Prometh® VC Syrup (containing Promethazine Hydrochloride and Phenylephrine

Hydrochloride)
Drug Information: Propoxyphene
(proe pox' i feen)
IMPORTANT WARNING:
341
Propoxyphene in high doses, taken by itself or in combination with other drugs, has been
associated with drug-related deaths. Do not take propoxyphene in combination with other
drugs that cause drowsiness: alcohol, tranquilizers, sleep aids, antidepressant drugs, or
antihistamines. Do not take a larger dose, take it more often, or for a longer period than your
doctor tells you to.
Propoxyphene is used to relieve mild to moderate pain.
more information.
Propoxyphene comes as a tablet, capsule, and liquid to take by mouth. It usually is taken
every 4 hours as needed. Follow the directions on your prescription label carefully, and ask
your doctor or pharmacist to explain any part you do not understand. Take propoxyphene
exactly as directed.
Propoxyphene can be habit-forming.
Shake the liquid well before each use.
Before taking propoxyphene,
 tell your doctor and pharmacist if you are allergic to propoxyphene or any other drugs.
are taking, especially other pain relievers; anticoagulants ('blood-thinners') such as
warfarin (Coumadin); antidepressants; antihistamines; medications for cough, cold, or
allergies; muscle relaxants; sedatives; seizure medications; sleeping pills;
tranquilizers; and vitamins.
 tell your doctor if you have or have ever had liver or kidney disease, or a history of
alcoholism.
you become pregnant while taking propoxyphene, call your doctor.
are taking propoxyphene.
Propoxyphene usually is taken as needed. If your doctor has told you to take propoxyphene
Propoxyphene may cause side effects. Tell your doctor if any of these symptoms are severe or
do not go away:
 dizziness
342
 lightheadedness
 drowsiness
 upset stomach
 vomiting
 constipation
 stomach pain
 skin rash
 mood changes
 headache
If you experience the following symptom, call your doctor immediately:
Brand names
 Darvon® Compound-  Darvon-N®  PC-CAP®

65 Pulvules®
 E-Lor®  Wygesic®
 Darvon® Pulvules®
 Darvocet A500® containing  Darvocet-N® 50 containing

Propoxyphene Napsylate and Propoxyphene Napsylate and
Acetaminophen Acetaminophen
343
 Darvocet-N® 100 containing  Propocet® 100 containing
Propoxyphene Napsylate and Propoxyphene Napsylate and
Acetaminophen Acetaminophen

Drug Information: Propranolol Oral
(proe pran' oh lole)
IMPORTANT WARNING:
344
Do not stop taking propranolol without talking to your doctor first. If propranolol is stopped
suddenly, it may cause chest pain or heart attack in some people.
Propranolol is used to treat high blood pressure. It is also used to prevent angina (chest pain)
and heart attacks. It works by relaxing your blood vessels so your heart doesn't have to pump
as hard. Propranolol is also used to treat abnormal heart rhythms.
Propranolol is also used to prevent migraine headaches and tremors.
more information.
Propranolol comes as a tablet or capsule to take by mouth. It also comes as a solution or

concentrate. The extended-release (long-acting) product usually is taken once a day.
Immediate-acting propranolol may be taken two, three, or four times a day. The number of
doses depends on why it is being taken.
Do not cut, crush, or chew extended-release tablets; swallow them whole. Dilute the
concentrated oral liquid with water, juice, or soft drinks, or mix it with applesauce or pudding
just before taking it.
to explain any part you do not understand. Take propranolol exactly as directed. Do not take
Propranolol helps control your condition but will not cure it. Continue to take propranolol
even if you feel well. Do not stop taking propranolol without talking to your doctor.
Before taking propranolol,
 tell your doctor and pharmacist if you are allergic to propranolol or any other drugs.
are taking, especially cimetidine (Tagamet); medications for migraine headaches,
asthma, allergies, colds, or pain; other medications for heart disease or high blood
pressure; reserpine; and vitamins.
 tell your doctor if you have or have ever had asthma or other lung disease; heart, liver,
or kidney disease; diabetes; severe allergies; or thyroid problems.
you become pregnant while taking propranolol, call your doctor.
are taking propranolol.
Talk to your doctor before using salt substitutes containing potassium. If your doctor
prescribes a low-salt or low-sodium diet, follow these directions carefully.
345
Propranolol may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 difficulty sleeping
 upset stomach
 vomiting
 rash
 diarrhea
 constipation
 sore throat
 swelling of the feet or hands
 unusual weight gain
 chest pain
 slow, irregular heartbeat
Keep all appointments with your doctor and the laboratory. Your doctor will need to
determine your response to propranolol. Your doctor may ask you to check your pulse (heart
rate). Ask your pharmacist or doctor to teach you how to take your pulse. If your pulse is
faster or slower than it should be, call your doctor.
346
Brand names
 Inderal®  Inderide®  Propranolol

Hydrochloride
 Inderal® LA  Innopran® XL Intensol®

Drug Information: Propylthiouracil
(proe pill thye oh yoor' a sill)
Propylthiouracil is used to treat hyperthyroidism, a condition that occurs when the thyroid
gland produces too much thyroid hormone. It also is taken before thyroid surgery or
radioactive iodine therapy.
347
Propylthiouracil comes as a tablet and is usually taken three times a day, approximately every
8 hours, with food. Follow the directions on your prescription label carefully, and ask your
doctor or pharmacist to explain any part you do not understand. Take propylthiouracil exactly
as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
information.
Before taking propylthiouracil,
 tell your doctor and pharmacist if you are allergic to propylthiouracil or any other
drugs.
are taking, especially anticoagulants ('blood thinners') such as warfarin (Coumadin),
diabetes medications, digoxin (Lanoxin), and vitamins.
 tell your doctor if you have or have ever had any blood disease, such as decreased
white blood cells (leukopenia), decreased platelets (thrombocytopenia), or aplastic
anemia, or liver disease (hepatitis, jaundice).
you become pregnant while taking propylthiouracil, call your doctor immediately.
are taking propylthiouracil.
dose, skip the missed dose and continue your regular dosing schedule at evenly spaced, 8-
hour intervals. Do not take a double dose to make up for a missed one.
Propylthiouracil may cause side effects. Tell your doctor if any of these symptoms are severe
or do not go away:
 skin rash
 itching
 abnormal hair loss
 upset stomach
 vomiting
 loss of taste
 abnormal sensations (tingling, prickling, burning, tightness, and pulling)
 swelling
 joint and muscle pain
 drowsiness
 dizziness
 decreased white blood cells
 decreased platelets
348
 sore throat
 fever
 headache
 chills
 right-sided abdominal pain with decreased appetite
 skin eruptions
Propylthiouracil may cause other side effects. Call your doctor if you have any unusual
problems while taking this medication.
Keep all appointments with your doctor and the laboratory.
Other names
 PTU

349
Drug Information: Pseudoephedrine
(soo doe e fed' rin)
Pseudoephedrine is used to relieve nasal congestion caused by colds, allergies, and hay fever.
It is also used to temporarily relieve sinus congestion and pressure. Pseudoephedrine should
not be used in children younger than 2 years of age because serious or life-threatening side
350
effects may occur in young children. Pseudoephedrine extended-release tablets should not be
used in children younger than 12 years old. Other pseudoephedrine products should be used
carefully in children 2-11 years of age. Pseudoephedrine will relieve symptoms but will not
treat the cause of the symptoms or speed recovery. Pseudoephedrine is in a class of
medications called nasal decongestants. It works by causing narrowing of the blood vessels in
the nasal passages.
Pseudoephedrine comes as a regular tablet, a chewable tablet, a 12-hour extended-release

(long-acting) tablet, a 24-hour extended-release tablet, and a solution (liquid) to be taken by
mouth. The regular tablets, chewable tablets, and liquid are usually taken every 4 to 6 hours.
The 12-hour extended-release tablets usually are taken every 12 hours, and you should not
take more than two doses in a 24-hour period. The 24-hour extended-release tablets usually
are taken once a day, and you should not take more than one dose in a 24-hour period. To help
prevent trouble sleeping, take the last dose of the day several hours before bedtime. Follow
the directions on the package label or on your prescription label carefully, and ask your doctor
or pharmacist to explain any part you do not understand. Take pseudoephedrine exactly as
directed. Do not take more or less of it or take it more often than prescribed by your doctor or
directed on the label.
Pseudoephedrine comes alone and in combination with other medications. Ask your doctor or
pharmacist for advice on which product is best for your symptoms. Check nonprescription
cough and cold product labels carefully before using two or more products at the same time.
These products may contain the same active ingredient(s) and taking them together could
cause you to receive an overdose. This is especially important if you will be giving cough and
cold medications to a child.
If your symptoms do not get better within 7 days or if you have a fever, stop taking
pseudoephedrine and call your doctor.
Swallow the extended-release tablets whole; do not break, crush, or chew them.
If you are taking the liquid, do not use a household spoon to measure your dose. Use the
measuring spoon or cup that came with the medication or use a spoon made especially for
measuring medication.
This medication is also sometimes used to prevent ear pain and blockage caused by pressure
changes during air travel or underwater diving. Talk to your doctor or pharmacist for more
information.
more information.
Before taking pseudoephedrine,
 tell your doctor and pharmacist if you are allergic to pseudoephedrine, any other
medications, or any of the inactive ingredients in the pseudoephedrine product you
plan to take. Check the package label for a list of the ingredients.
 do not take pseudoephedrine if you are taking a monoamine oxidase (MAO) inhibitors
such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam,
351
Zelapar), and tranylcypromine (Parnate), or if you have stopped taking one of these
medications within the past 2 weeks.
Be sure to mention medications for diet or appetite control, asthma, colds, or high
blood pressure.
 tell your doctor if you have or have ever had high blood pressure, glaucoma (a
condition in which increased pressure in the eye can lead to gradual loss of vision),
diabetes, difficulty urinating (due to an enlarged prostate gland), or thyroid, or heart
disease. If you plan to take the 24-hour extended-release tablets, tell your doctor if you
have had a narrowing or blockage of your digestive system.
you become pregnant while taking pseudoephedrine, call your doctor.
are taking pseudoephedrine.
 if you have phenylketonuria (PKU, an inherited condition in which a special diet must
be followed to prevent mental retardation), you should know that the chewable tablets
may be sweetened with aspartame, a source of phenylalanine.
Foods and drinks that contain large amounts of caffeine can make the side effects of
pseudoephedrine worse.
This medication is usually taken as needed. If you doctor has told to take pseudoephedrine
Pseudoephedrine may cause side effects. Tell your doctor if any of these symptoms are severe
or do not go away:
 restlessness
 nausea
 vomiting
 weakness
 headache
doctor immediately:
 nervousness
 dizziness
 difficulty sleeping
 stomach pain
 fast, pounding or irregular heartbeat
Pseudoephedrine may cause other side effects. Call your doctor if you have any unusual
problems while you are taking this medication.
352
The chewable tablets should be protected from light; store in the outer carton until the
medication is used. Throw away any medication that is outdated or no longer needed. Talk to
your pharmacist about the proper disposal of your medication.
If you are taking the 24-hour extended-release tablets, you may notice something that looks
like a tablet in your stool. This is just the empty tablet shell, and this does not mean that you
did not get your complete dose of medication.
Ask your pharmacist any questions you have about pseudoephedrine.
Brand names
 Decofed®  Simply Stuffy®  Suphedrin®

 Drixoral® Nasal  Sudafed® 12 Hour  Su-Phedrin®
Decongestant Caplets®  Suphedrin® Children's
 Efidac 24®  Sudafed® 24 Hour
Pseudoephedrine  Sudafed® Children's  Triaminic® AM
 Genaphed® Nasal Decongestant Decongestant Syrup
 Pedia Relief®  Sudafed® Nasal

Decongestant
 Actifed® Cold and Sinus (containing Chlorpheniramine Maleate, Pseudoephedrine

Hydrochloride, and Acetaminophen)
Drug Information: Pyrantel
(pi ran' tel)
Pyrantel, an antiworm medication, is used to treat roundworm, hookworm, pinworm, and

other worm infections.
353
more information.
Pyrantel comes as a capsule and a liquid to take by mouth. It usually is taken as a single dose
for pinworm and roundworm infections. The dose usually is repeated after 2 weeks for
pinworm infections. For hookworm infections, pyrantel usually is taken once a day for 3 days.
Pyrantel may be taken with food, juice, or milk or on an empty stomach.
Shake the liquid well to mix the medication evenly. Pyrantel may be mixed with milk or fruit
juice. Follow the directions on your prescription label carefully, and ask your doctor or
pharmacist to explain any part you do not understand. Take pyrantel exactly as directed. Do
Before taking pyrantel,
 tell your doctor and pharmacist if you are allergic to pyrantel or any other drugs.
are taking, especially piperazine (another antiworm medication), and vitamins.
 tell your doctor if you have or have ever had anemia or liver disease.
you become pregnant while taking pyrantel, call your doctor.
Pyrantel may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 upset stomach
 vomiting
 diarrhea
 stomach cramps
 stomach pain
 straining and pain during bowel movements
tests to check your response to pyrantel.
Do not let anyone else take your medication. Your prescription is probably not refillable. If
you still have symptoms of infection after you finish the pyrantel, call your doctor.
354
Brand names
 Ascarel®  Reese's® Pinworm Medicine
 Pin-X®  Reese's® Pinworm Medicine Caplets®

Drug Information: Pyrazinamide
(peer a zin' a mide)
Pyrazinamide kills or stops the growth of certain bacteria that cause tuberculosis (TB). It is
used with other drugs to treat tuberculosis.
355
more information.
Pyrazinamide comes as a tablet to take by mouth. It usually is taken once a day (at the same
time each day) or in larger doses twice a week. Pyrazinamide may be taken with or without
food. Follow the directions on your prescription label carefully, and ask your pharmacist or
doctor to explain any part you do not understand. Take pyrazinamide exactly as directed. Do
Before taking pyrazinamide,
 tell your doctor and pharmacist if you are allergic to pyrazinamide, niacin,
ethionamide (Trecator-SC), or any other drugs.
are taking, especially allopurinol (Zyloprim), colchicine and/or probenecid (Col-
Probenecid, Benemid), ethionamide (Trecator-SC), and vitamins.
 tell your doctor if you have or have ever had gout, liver or kidney disease, or diabetes.
you become pregnant while taking pyrazinamide, call your doctor.
clothing, sunglasses, and sunscreen. Pyrazinamide may make your skin sensitive to
sunlight.
dose, skip the missed dose and take only your regularly scheduled dose. Do not take a double
Pyrazinamide may cause side effects. Tell your doctor if any of these symptoms are severe or
do not go away:
 upset stomach
 fatigue
 skin rash
 fever
 vomiting
 darkened urine
 pain and swelling in the joints
 difficult urination
356
tests to check your response to pyrazinamide.
If you have diabetes, pyrazinamide may interfere with urine ketone tests. If you use urine
ketone tests, check with your doctor about using other types of tests while taking
pyrazinamide.

Drug Information: Pyridoxine
(peer i dox' een)
Pyridoxine, vitamin B6, is required by your body for utilization of energy in the foods you eat,
production of red blood cells, and proper functioning of nerves. It is used to treat and prevent
357
vitamin B6deficiency resulting from poor diet, certain medications, and some medical
conditions.
more information.
Pyridoxine comes in regular and extended-release (long-acting) tablets. It usually is taken

once a day. Follow the directions on your prescription label or package label carefully, and
ask your doctor or pharmacist to explain any part you do not understand. Take pyridoxine
exactly as directed. Do not take more or less of it or take it more often than prescribed by your
doctor.
Do not chew, crush, or cut extended-release tablets; swallow them whole.
Before taking pyridoxine,
 tell your doctor and pharmacist if you are allergic to pyridoxine or any other drugs.
are taking, especially levodopa (Larodopa, Sinemet), phenobarbital, phenytoin
(Dilantin), and other vitamins.
you become pregnant while taking pyridoxine, call your doctor.
Your doctor may tell you to eat more foods containing vitamin B6, especially whole-grain
cereals, fish, vegetables, beans, and liver and other organ meat.
Pyridoxine may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 upset stomach
 headache
 sleepiness
 tingling, prickling, burning, or sensation of tightness of the hands and feet
358
tests to check your response to pyridoxine.
Other names
 Vitamin B6

359

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Drug Information: Paclitaxel

(pak' li tax el)

About your treatment

This medication is used to treat:

 metastatic breast cancer

Other uses for this medicine

Before taking paclitaxel,

Side effects from paclitaxel are common, and include:

 nausea and vomiting

 unusual bruising or bleeding

Last Revised - 04/01/2003

Drug Information : Paclitaxel Injection

Talk to your doctor about the risks of using paclitaxel.

Why is this medication prescribed?

How should this medicine be used?

Paclitaxel comes as a liquid to be given intravenously (into a vein) by a doctor or nurse in a

Other uses for this medicine

What special precautions should I follow?

Before using paclitaxel,

What special dietary instructions should I follow?

What should I do if I forget a dose?

What side effects can this medication cause?

 numbness, burning, or tingling in the hands or feet

Symptoms of overdose may include:

Keep all appointments with your doctor.

Last Revised - 01/01/2008

Drug Information: Pantoprazole

(pan toe' pra zole)

Pantoprazole is used to treat gastroesophageal reflux disease (GERD), a condition in which

How should this medicine be used?

Pantoprazole comes as a delayed-release (long-acting) tablet to take by mouth. It is usually

Swallow the tablets whole; do not split, chew, or crush them.

Other uses for this medicine

What special precautions should I follow?

Before taking pantoprazole,

What special dietary instructions should I follow?

What should I do if I forget a dose?

What side effects can this medication cause?

What storage conditions are needed for this medicine?

What other information should I know?

Keep all appointments with your doctor.

Last Revised - 07/01/2003

Drug Information: Papaverine

(pa pav' er een)

Why is this medication prescribed?

How should this medicine be used?

Papaverine comes as a tablet and extended-release (long-acting) capsule to take by mouth.

Other uses for this medicine

What special precautions should I follow?

Before taking papaverine,

What should I do if I forget a dose?

What side effects can this medication cause?

 flushing (feeling of warmth)

 yellowing of the skin or eyes

What storage conditions are needed for this medicine?

What other information should I know?

Drug Information: Paroxetine

(pa rox' e teen)

Why is this medication prescribed?

Paroxetine comes as a tablet, a suspension (liquid), and a controlled-release (long-acting)

Other uses for this medicine

What special precautions should I follow?

Before taking paroxetine,