Product info: Anti-Depressant
Cymbalta (DULOXETINE) is an antidepressant recently approved by the FDA that has also been approved to treat peripheral neuropathy. People who suffer from depression will often experience pain; people with depression are more sensitive to pain, and treating depression improves one’s threshold for pain. Cymbalta not only treats the emotional effects of depression, but the physical pain of depression as well.
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†Not commercially available in Canada.
Category
Antidepressant
antineuralgic
Description
Duloxetine (du-LOX-uh-teen) is used to treat mental depression. It is also used for pain caused by nerve damage associated with diabetes.
Duloxetine belongs to a group of medicines known as selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). These medicines are thought to work by increasing the activity of chemicals called serotonin and norepinephrine in the brain.
This medicine is available only with your doctor's prescription, in the following dosage forms:
Oral
Delayed-release capsules (U.S.)
Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For duloxetine, the following should be considered:
Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to duloxetine. Also tell your doctor and pharmacist if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy—Duloxetine has not been studied in pregnant women. Duloxetine should only be used during pregnancy if the potential benefit outweighs the potential risk to the baby. Before taking this medicine, make sure your doctor knows if you are pregnant (especially if it is the third trimester) or if you may become pregnant.
Breast-feeding—Duloxetine passes into the milk of rats. It is not known whether it passes into human milk. Because the effects of this medicine in nursing babies is not known and because of the risks, duloxetine is not recommended if you are breast-feeding.
Children—Children should not usually take duloxetine. However, if your doctor prescribes duloxetine for your child to treat depression, caution must be used. Studies have shown occurrences of children thinking about suicide or attempting suicide in clinical trials for this medicine. More study is needed to be sure duloxetine is safe and effective in children.
Older adults—This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults. However, elderly patients are more likely to be sensitive than younger adults to the effects of duloxetine.
Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking duloxetine, it is especially important that your doctor and pharmacist know if you are taking any of the following:
Antidepressants (fluoxetine [e.g., Prozac], paroxetine [e.g., Paxil])—Taking certain medicines for depression with duloxetine may increase your chance for side effects.
Antiarrhythmics (flecainide [e.g., Tambocor], propafenone [e.g., Rythmol], Quinidine [e.g., Quinaglute, Quinidex])—Taking certain medicines for an uneven heartbeat together with duloxetine may increase the chance of getting serious side effects.
Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])—Do not take duloxetine while you are taking or within 2 weeks of taking an MAO inhibitor , or you may develop serious side effects. At least 14 days should be allowed between stopping treatment with one medicine (duloxetine or the MAO inhibitor) and starting treatment with the other
Phenothiazines (e.g., Compazine, Phenergan, Thorazine)—Taking phenothiazines together with duloxetine may increase the risk of side effects.
Tricyclic antidepressants (amitriptyline [e.g., Elavil], desipramine [e.g., Norpramin], imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl])—Taking certain tricyclic antidepressants together with duloxetine may increase the risk of side effects.
Thioridazine (e.g., Mellaril)—Taking thioridazine with duloxetine may cause serious heart problems.
Other medical problems—The presence of other medical problems may affect the use of duloxetine. Make sure you tell your doctor if you have any other medical problems, especially:
Bipolar disorder (mood disorder with alternating episodes of mania and depression) or risk of—May make condition worse. Your doctor will check you for this condition.
Diabetes mellitus (sugar diabetes)—May increase your blood sugar
Kidney disease, severe—Higher blood levels of duloxetine may occur, increasing the chance of side effects.
Liver disease, severe—You should not take this medicine because it may make your liver disease worse.
Mania (history of)—The condition may be activated.
Narrow-angle glaucoma—May increase your chance of getting blurred vision
Seizures (history of)—The risk of seizures may be increased.
More Cymbalta Delayed-Release Capsules resources
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Hot Flashes, Anxiety, Pain, Fibromyalgia, Bipolar Disorder, Depression, Diabetic Nerve Damage, Chronic Fatigue Syndrome, Peripheral Neuropathy, Urinary Incontinence
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Product info: Blood Pressure
Accupril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme.
Accupril is used to treat high blood pressure (hypertension) and heart failure.
Accupril may also be used for purposes other than those listed in this medication guide.
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Use Accupril as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Take Accupril by mouth on an empty stomach at least 1 hour before or 2 hours after eating, or with a light meal. High-fat meals, however, may decrease the absorption of the medicine into your bloodstream.
If you are taking a tetracyclines (eg, doxycycline) or fluoroquinolones (eg, ciprofloxacin), take it at least 3 hours apart from Accupril . This product contains magnesium, which can interfere with absorption of these antibiotics.
If a dose is missed, take it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up, unless advised by your health care provider. If more than one dose is missed, contact your health care provider or pharmacist.
Ask your health care provider any questions you may have about how to use Accupril .
Important safety information:
Accupril may cause dizziness, lightheadedness, or fainting. These effects may be worse if you take it with alcohol or certain medicines. Use Accupril with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
Accupril has magnesium in it. Before you start any new medicine, check the label to see if it has magnesium in it too. If it does or if you are not sure, check with your doctor or pharmacist.
Accupril may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Accupril . Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
Check with your doctor before you use a salt substitute or a product that has potassium in it.
Dehydration, excessive sweating, vomiting, or diarrhea may lead to a fall in blood pressure. Contact your health care provider at once if any of these occur.
Accupril may not work as well in black patients. They may also be at greater risk of side effects. Contact your doctor if your symptoms do not improve or if they become worse.
Tell your doctor or dentist that you take Accupril before you receive any medical or dental care, emergency care, or surgery.
Lab tests, including electrolyte levels, may be performed while you use Accupril . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
Accupril should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
PREGNANCY and BREAST-FEEDING: Do not use Accupril if you are pregnant. It has been shown to cause death to the fetus and newborn. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. It is not known if Accupril is found in the breast milk. If you are or will be breast-feeding while you use Accupril , check with your doctor. Discuss any possible risks to your baby.
Product info: General Health
Accutane (ISOTRETINOIN) is a drug used for the treatment of severe, disfiguring cystic acne that has not cleared up in response to milder medications such as antibiotics.
It works on the oil glands within the skin, shrinking them and diminishing their output. Accutane derives from vitamin A and is found in small quantities naturally in the body.
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Generic name: Isotretinoin
Brand names: Amnesteem, Accutane
Why is Accutane prescribed?
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Compare with other drugs.
Accutane, a chemical cousin of vitamin A, is prescribed for the treatment of severe, disfiguring cystic acne that has not cleared up in response to milder medications such as antibiotics. It works on the oil glands within the skin, shrinking them and diminishing their output. You take Accutane by mouth every day for several months, then stop. The antiacne effect can last even after you have finished your course of medication.
Most important fact about Accutane
Because Accutane can cause severe birth defects, including mental retardation and malformations of the face, eyes, ears, skull, nervous system, cardiovascular system, and glands, a woman must not become pregnant while taking it. Before starting Accutane therapy, women of childbearing age will be asked to read a pamphlet, watch a video, and sign a detailed consent form regarding the danger of birth defects. You must have two negative pregnancy tests before beginning Accutane therapy, and must take monthly pregnancy tests while using Accutane.
In addition, you must use 2 forms of birth control during Accutane therapy, and for 1 month before and after. Each prescription for Accutane must bear a yellow qualification sticker signifying that you meet these requirements. Scientists have not ruled out the possibility that hormone-based contraceptives (birth control pills and implants) may be less reliable when taken with Accutane, so a second form of birth control should always be used while taking Accutane. If you accidentally become pregnant while taking Accutane, you should immediately consult your doctor.
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