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Duo-Vil 2-25

Generic Name: perphenazine and amitriptyline (Oral route)

per-FEN-a-zeen, am-i-TRIP-ti-leen hye-droe-KLOR-ide

Oral route(Tablet)

Elderly patients with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased risk of death compared to placebo. Although the causes of death in clinical trials were varied, most of the deaths appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature. Observational studies suggest that antipsychotic drugs may increase mortality. It is unclear from these studies to what extent the mortality findings may be attributed to the antipsychotic drug as opposed to patient characteristics. Perphenazine and amitriptyline hydrochloride is not approved for the treatment of patients with dementia-related psychosis. Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies with major depressive disorder (MDD) and other psychiatric disorders. Short term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. This risk must be balanced with the clinical need. Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Perphenazine and amitriptyline hydrochloride is not approved for use in pediatric patients .

Commonly used brand name(s)

In the U.S.

Duo-Vil 2-10

Duo-Vil 2-25

Etrafon

Available Dosage Forms:

Tablet

Therapeutic Class: Tricyclic Antidepressant/Phenothiazine Combination

Pharmacologic Class: Phenothiazine

Chemical Class: Piperazine (class)

Uses For Duo-Vil 2-25

Perphenazine and amitriptyline combination is used to treat certain mental and emotional conditions.

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

Before Using Duo-Vil 2-25

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Certain side effects, such as muscle spasms of the face, neck, and back, tic-like or twitching movements, inability to move the eyes, twisting of the body, or weakness of the arms and legs, are more likely to occur in children, who are usually more sensitive than adults to some of the side effects of perphenazine and amitriptyline combination.

The perphenazine and amitriptyline combination must be used with caution in children with depression. 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 the perphenazine and amitriptyline combination is safe and effective in children

Geriatric

Confusion, vision problems, dizziness or fainting, drowsiness, dryness of mouth, constipation, problems in urinating, trembling of the hands and fingers, and symptoms of tardive dyskinesia (such as uncontrolled movements of the mouth, tongue, jaw, arms, and/or legs) are especially likely to occur in elderly patients. Older patients are usually more sensitive than younger adults to the effects of perphenazine and amitriptyline combination.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Bepridil

Cisapride

Clorgyline

Dronedarone

Droperidol

Furazolidone

Grepafloxacin

Iproniazid

Isocarboxazid

Levomethadyl

Linezolid

Mesoridazine

Methylene Blue

Metoclopramide

Moclobemide

Nialamide

Pargyline

Phenelzine

Pimozide

Procarbazine

Ranolazine

Selegiline

Sparfloxacin

Terfenadine

Thioridazine

Toloxatone

Tranylcypromine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acecainide

Alfuzosin

Amiodarone

Amisulpride

Amoxapine

Amprenavir

Apomorphine

Aprindine

Arsenic Trioxide

Asenapine

Astemizole

Atazanavir

Azimilide

Azithromycin

Bretylium

Chloral Hydrate

Chloroquine

Chlorpromazine

Ciprofloxacin

Citalopram

Clarithromycin

Clomipramine

Clonidine

Clozapine

Crizotinib

Dasatinib

Desipramine

Dextromethorphan

Disopyramide

Dofetilide

Dolasetron

Droperidol

Enflurane

Epinephrine

Erythromycin

Etilefrine

Fentanyl

Flecainide

Fluconazole

Fluoxetine

Foscarnet

Gatifloxacin

Gemifloxacin

Halofantrine

Haloperidol

Halothane

Hydromorphone

Ibutilide

Iloperidone

Imipramine

Indacaterol

Isoflurane

Isradipine

Lapatinib

Levofloxacin

Levorphanol

Lidoflazine

Lithium

Lopinavir

Lorcainide

Lumefantrine

Mefloquine

Methadone

Methoxamine

Metrizamide

Midodrine

Milnacipran

Moricizine

Morphine

Morphine Sulfate Liposome

Moxifloxacin

Nefazodone

Nefopam

Nilotinib

Norepinephrine

Norfloxacin

Nortriptyline

Octreotide

Ofloxacin

Ondansetron

Oxilofrine

Oxycodone

Paliperidone

Pazopanib

Pentamidine

Perflutren Lipid Microsphere

Phenylephrine

Posaconazole

Procainamide

Procarbazine

Prochlorperazine

Promethazine

Propafenone

Protriptyline

Quetiapine

Quinidine

Quinine

Rasagiline

Risperidone

Saquinavir

Sematilide

Sertindole

Sertraline

Sodium Phosphate

Sodium Phosphate, Dibasic

Sodium Phosphate, Monobasic

Solifenacin

Sorafenib

Sotalol

Spiramycin

Sulfamethoxazole

Sultopride

Sunitinib

Tapentadol

Tedisamil

Telavancin

Telithromycin

Tetrabenazine

Toremifene

Tramadol

Trazodone

Trifluoperazine

Trimethoprim

Trimipramine

Vandetanib

Vardenafil

Vasopressin

Vemurafenib

Venlafaxine

Voriconazole

Ziprasidone

Zolmitriptan

Zotepine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acenocoumarol

Arbutamine

Atomoxetine

Belladonna

Belladonna Alkaloids

Betel Nut

Bethanidine

Carbamazepine

Cimetidine

Cinacalcet

Clozapine

Diazepam

Dicumarol

Evening Primrose

Fluvoxamine

Galantamine

Guanethidine

Meperidine

Midodrine

Orphenadrine

Paroxetine

Phenprocoumon

Phenylalanine

Phenytoin

Procyclidine

Rifapentine

Ritonavir

S-Adenosylmethionine

St John's Wort

Topiramate

Trihexyphenidyl

Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Ethanol

Proper Use of perphenazine and amitriptyline

This section provides information on the proper use of a number of products that contain perphenazine and amitriptyline. It may not be specific to Duo-Vil 2-25. Please read with care.

To lessen stomach upset, take this medicine immediately after meals or with food, unless your doctor has told you to take it on an empty stomach.

Do not take more of this medicine and do not take it more often than your doctor ordered. This is particularly important for elderly patients, since they are more sensitive to the effects of this medicine.

Sometimes perphenazine and amitriptyline combination must be taken for several weeks before its full effect is reached.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets):
- For certain mental and emotional conditions:
  - Adults—At first, 1 tablet taken three or four times a day. Your doctor may increase your dose if needed.
  - Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using Duo-Vil 2-25

Your doctor should check your progress at regular visits to allow dose adjustments and help reduce side effects.

Do not stop taking this medicine without first checking with your doctor. Your doctor may want you to reduce gradually the amount you are taking before stopping completely. This is to prevent side effects and to prevent your condition from becoming worse.

Do not take this medicine within two hours of taking antacids or medicine for diarrhea. Taking these products too close together may make this medicine less effective.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that cause drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

Before having any kind of surgery, dental treatment, or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine. Taking perphenazine and amitriptyline combination together with medicines that are used during surgery or dental or emergency treatments may increase the CNS depressant effects.

The perphenazine and amitriptyline combination may cause some people to be agitated, irritable or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these adverse effects, tell your doctor right away.

This medicine may cause some people to become drowsy or less alert than they are normally, especially during the first few weeks of treatment. Even if this medicine is taken only at bedtime, it may cause some people to feel drowsy or less alert on arising. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If the problem continues or gets worse, check with your doctor.

This medicine may make you sweat less, causing your body temperature to increase. Use extra care not to become overheated during exercise or hot weather while you are taking this medicine, since overheating may result in heat stroke. Also, hot baths or saunas may make you feel dizzy or faint.

Perphenazine and amitriptyline combination may cause dryness of the mouth. For temporary relief, use sugarless gum or candy, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Perphenazine may cause your skin to be more sensitive to sunlight than it is normally. Exposure to sunlight, even for brief periods of time, may cause a skin rash, itching, redness or other discoloration of the skin, or a severe sunburn. When you begin taking this medicine:

Stay out of direct sunlight, especially between the hours of 10:00 a.m. and 3:00 p.m., if possible.

Wear protective clothing, including a hat. Also, wear sunglasses.

Apply a sun block product that has a skin protection factor (SPF) of at least 15. Some patients may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your health care professional.

Apply a sun block lipstick that has an SPF of at least 15 to protect your lips.

Do not use a sunlamp or tanning bed or booth.

If you have a severe reaction from the sun, check with your doctor.

Duo-Vil 2-25 Side Effects

Along with its needed effects, perphenazine (included in this combination medicine) can sometimes cause serious side effects. Tardive dyskinesia (a movement disorder) may occur and may not go away after you stop using the medicine. Signs of tardive dyskinesia include fine, worm-like movements of the tongue, or other uncontrolled movements of the mouth, tongue, cheeks, jaw, or arms and legs. Other serious but rare side effects may also occur. These include severe muscle stiffness, fever, unusual tiredness or weakness, fast heartbeat, difficult breathing, increased sweating, loss of bladder control, and seizures (neuroleptic malignant syndrome). You and your doctor should discuss the good this medicine will do as well as the risks of taking it.

Stop taking this medicine and get emergency help immediately if any of the following effects occur:

Rare

Convulsions (seizures)

difficulty in breathing

fast heartbeat

fever

high or low blood pressure

increased sweating

loss of bladder control

muscle stiffness (severe)

unusual tiredness or weakness

unusually pale skin

Check with your doctor as soon as possible if any of the following side effects occur:

More common

Blurred vision or any change in vision

difficulty in speaking or swallowing

fainting

inability to move eyes

lip smacking or puckering

loss of balance control

mask-like face

muscle spasms, especially of face, neck, and back

nervousness, restlessness, or need to keep moving

puffing of cheeks

rapid or fine, worm-like movements of tongue

shuffling walk

stiffness of arms and legs

trembling and shaking of fingers and hands

tic-like or twitching movements

twisting movements of body

uncontrolled chewing movements

uncontrolled movements of arms or legs

weakness of arms and legs

Less common

Confusion

constipation

difficult urination

eye pain

hallucinations (seeing, hearing, or feeling things that are not there)

increased skin sensitivity to sun

shakiness

slow pulse or irregular heartbeat

Rare

Abdominal or stomach pain

aching muscles or joints

back or leg pain

fever and chills

hair loss

hot, dry skin or lack of sweating

irritability

loss of appetite

muscle weakness or twitching

nausea, vomiting, or diarrhea

nosebleeds

prolonged, painful, inappropriate penile erection

ringing, buzzing, or other unexplained noises in ears

skin discoloration

skin rash and itching

sore throat and fever

swelling of face and tongue

swelling of testicles

unusual bleeding or bruising

yellow eyes or skin

Symptoms of overdose

Agitation

confusion

convulsions (seizures)

drowsiness (severe)

enlarged pupils

fast, slow, or irregular heartbeat

fever

hallucinations (seeing, hearing, or feeling things that are not there)

shortness of breath or troubled breathing

unusual tiredness or weakness (severe)

vomiting (severe)

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Decreased sweating

dizziness

drowsiness

dryness of mouth

headache

increased appetite for sweets

nasal congestion

tiredness or weakness (mild)

unpleasant taste

weight gain (unusual)

Less common

Changes in menstrual period

decreased sexual ability

heartburn

increased sweating

swelling or pain in breasts or unusual secretion of milk

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

Dizziness

nausea or vomiting

stomach pain

trembling of fingers and hands

symptoms of tardive dyskinesia, including lip smacking or puckering, puffing of cheeks, rapid or fine, worm-like movements of tongue, uncontrolled chewing movements, or uncontrolled movements of arms or legs

Diarrhea

headache

irritability

restlessness

trouble in sleeping, with vivid dreams

unusual excitement

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Duo-Vil 2-25 side effects (in more detail)

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More Duo-Vil 2-25 resources

Duo-Vil 2-25 Side Effects (in more detail)
Duo-Vil 2-25 Use in Pregnancy & Breastfeeding
Duo-Vil 2-25 Drug Interactions
Duo-Vil 2-25 Support Group
0 Reviews for Duo-Vil 2-25 - Add your own review/rating

Etrafon 2-10 Concise Consumer Information (Cerner Multum)

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Agitation
Anxiety
Depression

Dulcolax Suppositories

Pronunciation: bis-AK-oh-dil
Generic Name: Bisacodyl
Brand Name: Examples include Bisa-Lax and Dulcolax

Dulcolax Suppositories are used for:

Relieving occasional constipation and irregularity. It may also be used for other conditions as determined by your doctor.

Dulcolax Suppositories are a stimulant laxative. It acts directly on the bowels, stimulating the bowel muscles to cause a bowel movement.

Do NOT use Dulcolax Suppositories if:

you are allergic to any ingredient in Dulcolax Suppositories

you have severe stomach pain; appendicitis; severe constipation; stomach, intestinal, or rectal bleeding; or intestinal blockage

you are having abdominal surgery

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

Before using Dulcolax Suppositories:

Tell your health care provider if you have any medical conditions, especially if any of the following apply to you:

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

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

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

if you have heart failure, abnormal levels of fluids or electrolytes in your body, nausea, vomiting, or undiagnosed stomach pain

Some MEDICINES MAY INTERACT with Dulcolax Suppositories. However, no specific interactions with Dulcolax Suppositories are known at this time.

Ask your health care provider if Dulcolax Suppositories may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Dulcolax Suppositories:

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

Remove the wrapper from the suppository.

Insert suppository well up into the rectum as directed by your doctor or on the package labeling. Retain the suppository for 15 to 20 minutes.

If you have hemorrhoids, coat the tip of the suppository with petroleum jelly before inserting.

Drinking extra fluids while you are using Dulcolax Suppositories are recommended. Check with your doctor for instructions.

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

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

Important safety information:

Do not use for longer than 1 week without checking with your doctor. Using Dulcolax Suppositories for a long time may result in loss of normal bowel function.

Do not take additional laxatives or stool softeners with Dulcolax Suppositories unless directed by your doctor.

Rectal bleeding or failure to have a bowel movement after use of a laxative may be a sign of a serious condition. Stop use and contact your doctor.

If you develop nausea, vomiting, or stomach pain, stop using Dulcolax Suppositories and check with your doctor.

If you notice a sudden change in bowel habits that lasts for 2 weeks or more, do not continue using Dulcolax Suppositories. Instead, check with your doctor.

Use Dulcolax Suppositories with caution in the ELDERLY; they may be more sensitive to its effects.

Dulcolax Suppositories are not recommended for use in CHILDREN younger than 6 years old; safety and effectiveness in these children have not been confirmed.

PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Dulcolax Suppositories while pregnant. It is not known if Dulcolax Suppositories are found in breast milk. If you are or will be breast-feeding take Dulcolax Suppositories, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Dulcolax Suppositories:

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

Cramps; faintness; stomach discomfort.

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

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

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

See also: Dulcolax side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include diarrhea; stomach cramps.

Proper storage of Dulcolax Suppositories:

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

General information:

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

Dulcolax Suppositories are to be used only by the patient for whom it is prescribed. Do not share it with other people.

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

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

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

Issue Date: February 1, 2012

Database Edition 12.1.1.002

More Dulcolax resources

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

Compare Dulcolax with other medications

Bowel Preparation
Constipation

Dulcolax

Generic Name: bisacodyl (bis AK oh dil)

Brand Names: Alophen, Bisac-Evac, Bisco-Lax, Carters Little Pills, Correctol, Doxidan Tablet, Dulcolax Laxative, Evac-U-Gen, Ex-lax Ultra, Feen-A-Mint, Fleet Bisacodyl, Gen Lax, Gentlax Tablet, Gentle Laxative, Laxative Gentle Suppositories, Magic Bullet, Modane, Veracolate

What is Dulcolax (bisacodyl)?

Bisacodyl is a laxative that stimulates bowel movements.

Bisacodyl is used to treat constipation or to empty the bowels before surgery, colonoscopy, x-rays, or other intestinal medical procedure.

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

What is the most important information I should know about Dulcolax (bisacodyl)?

Do not use bisacodyl if you have stomach (abdominal) pain, nausea, or vomiting, unless directed by a doctor.

If you notice a sudden change in bowel habits that persists over a period of 2 weeks, consult your healthcare provider before using a laxative.

Bisacodyl products should not be used for longer than one week, unless otherwise directed by your healthcare provider.

Rectal bleeding or failure to have a bowel movement after use of a laxative may indicate a more serious condition. Stop using bisacodyl and contact your healthcare provider.

What should I discuss with my healthcare provider before using Dulcolax (bisacodyl)?

You should not use this medication if you are allergic to bisacodyl, or if you have:

severe stomach pain, nausea, or vomiting;

a perforated bowel;

a blockage in your intestines;

fructose or galactose intolerance;

an allergy to yellow food dye;

severe constipation or dehydration;

inflammatory bowel disease, toxic megacolon; or

a sudden change in bowel habits lasting 2 weeks or longer.

People with eating disorders (such as anorexia or bulimia) should not use this medication without the advice of a doctor.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use bisacodyl:

kidney disease;

trouble swallowing;

a history of bowel obstruction, diverticulitis, ulcerative colitis, or other intestinal disorder; or

if you are taking a diuretic ("water pill").

Do not use bisacodyl without telling your doctor if you are pregnant. Do not use bisacodyl without telling your doctor if you are breast-feeding a baby. Do not give this medication to a child without the advice of a doctor.

When used to treat constipation, bisacodyl is only part of a complete program of treatment that may also include diet and exercise. Follow your doctor's instructions very closely.

How should I use Dulcolax (bisacodyl)?

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

For best results, take bisacodyl on an empty stomach, or at bedtime. Do not crush, chew, or break the enteric-coated tablet. Swallow it whole. The enteric-coated pill has a special coating to protect your stomach. Breaking the pill could damage this coating. Do not take a bisacodyl rectal (enema or suppository) by mouth. It is for use only in your rectum.

Try to use the rectal form of this medicine at a time when you can lie down afterward and hold the medicine in. Avoid using the bathroom during this time.

If you are using bisacodyl before surgery or a medical procedure, follow your doctor's instructions about the timing of your dose (the number of days or hours) before your procedure.

Remove the outer wrapper from the suppository before inserting it. Avoid handling the suppository too long or it will melt in your hands.

Lie on your side and gently insert the suppository pointed end first. For best results, hold in the suppository for a 15 to 20 minutes. The suppository will melt quickly once inserted and you should feel little or no discomfort while holding it in. Avoid using the bathroom just after you have inserted the suppository.

Shake the rectal enema gently just before use. Remove the protective cap from the applicator tip. You may use the enema lying down or seated on a toilet. Gently insert the tip into your rectum and lightly squeeze the bottle to release the enema. Hold the enema in for a few minutes and then release into the toilet.

The rectal forms of bisacodyl should produce a bowel movement within 15 minutes to 1 hour.

The tablet form of bisacodyl should produce a bowel movement within 6 to 12 hours, or overnight when taken at bedtime.

Call your doctor if you do not have a bowel movement after using this medication. Do not use bisacodyl for more than 7 days in a row unless your doctor tells you to. Store bisacodyl at room temperature away from moisture and heat.

What happens if I miss a dose?

Since bisacodyl is used only once or as needed, you are not likely to be on a dosing schedule.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include watery diarrhea, stomach cramps, muscle weakness, or urinating less than usual.

What should I avoid while using Dulcolax (bisacodyl)?

Avoid using any other medications within 2 hours before or after using bisacodyl.

Avoid drinking milk within 1 hour after using bisacodyl.

Dulcolax (bisacodyl) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

urinating less than usual or not at all;

drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea and vomiting;

swelling, weight gain, feeling short of breath;

rectal bleeding;

severe stomach pain or cramps, severe or ongoing diarrhea or vomiting; or

low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling).

Less serious side effects may include:

dizziness, weakness;

increased thirst;

mild stomach pain, gas, indigestion;

diarrhea or loose stools;

mild nausea; or

skin rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Dulcolax (bisacodyl)?

There may be other drugs that can interact with bisacodyl. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

More Dulcolax resources

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

Compare Dulcolax with other medications

Bowel Preparation
Constipation

Where can I get more information?

Your pharmacist can provide more information about bisacodyl.

See also: Dulcolax side effects (in more detail)

Duet Chewable

Generic Name: prenatal multivitamins (PRE nay tal VYE ta mins)

Brand Names: Advance Care Plus, Bright Beginnings, Cavan Folate, Cavan One, Cavan-Heme OB, Cenogen Ultra, CitraNatal Rx, Co Natal FA, Complete Natal DHA, Complete-RF, CompleteNate, Concept OB, Docosavit, Dualvit OB, Duet, Edge OB, Elite OB 400, Femecal OB, Folbecal, Folcaps Care One, Folivan-OB, Foltabs, Gesticare, Icar Prenatal, Icare Prenatal Rx, Inatal Advance, Infanate DHA, Kolnatal DHA, Lactocal-F, Marnatal-F, Maternity, Maxinate, Mission Prenatal, Multi-Nate 30, Multinatal Plus, Nata 29 Prenatal, Natachew, Natafort, Natelle, Neevo, Nestabs, Nexa Select with DHA, Novanatal, NovaStart, O-Cal Prenatal, OB Complete, OB Natal One, Ob-20, Obtrex DHA, OptiNate, Paire OB Plus DHA, PNV Select, PNV-Total, PR Natal 400, Pre-H-Cal, Precare, PreferaOB, Premesis Rx, PrenaCare, PrenaFirst, PrenaPlus, Prenatabs OBN, Prenatabs Rx, Prenatal 1 Plus 1, Prenatal Elite, Prenatal Multivitamins, Prenatal Plus, Prenatal S, Prenatal-U, Prenate Advanced Formula, Prenate DHA, Prenate Elite, Prenavite FC, PreNexa, PreQue 10, Previte Rx, PrimaCare, Pruet DHA, RE OB Plus DHA, Renate, RightStep, Rovin-NV, Se-Care, Se-Natal One, Se-Plete DHA, Se-Tan DHA, Select-OB, Seton ET, Strongstart, Stuart Prenatal with Beta Carotene, Tandem OB, Taron-BC, Tri Rx, TriAdvance, TriCare, Trimesis Rx, Trinate, Triveen-PRx RNF, UltimateCare Advance, Ultra-Natal, Vemavite PRX 2, VeNatal FA, Verotin-BY, Verotin-GR, Vinacal OR, Vinatal Forte, Vinate Advanced (New Formula), Vinate AZ, Vinate Care, Vinate Good Start, Vinate II (New Formula), Vinate III, Vinate One, Vitafol-OB, VitaNatal OB plus DHA, Vitaphil, Vitaphil Aide, Vitaphil Plus DHA, Vitaspire, Viva DHA, Vol-Nate, Vol-Plus, Vol-Tab Rx, Vynatal F.A., Zatean-CH, Zatean-PN

What are Duet Chewable (prenatal multivitamins)?

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

Prenatal vitamins are a combination of many different vitamins that are normally found in foods and other natural sources.

Prenatal vitamins are used to provide the additional vitamins needed during pregnancy. Minerals may also be contained in prenatal multivitamins.

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

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

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

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

Many multivitamin products also contain minerals such as calcium, iron, magnesium, potassium, and zinc. Minerals (especially taken in large doses) can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling. Read the label of any multivitamin product you take to make sure you are aware of what it contains.

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

Overdose symptoms may include stomach pain, vomiting, diarrhea, constipation, loss of appetite, hair loss, peeling skin, tingly feeling in or around your mouth, changes in menstrual periods, weight loss, severe headache, muscle or joint pain, severe back pain, blood in your urine, pale skin, and easy bruising or bleeding.

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

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

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

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

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

How should I take prenatal vitamins?

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

Never take more than the recommended dose of prenatal vitamins.

Take your prenatal vitamin with a full glass of water.

Swallow the regular tablet or capsule whole. Do not break, chew, crush, or open it.

The chewable tablet must be chewed or allowed to dissolve in your mouth before swallowing. You may also allow the chewable tablet to dissolve in drinking water, fruit juice, or infant formula (but not milk or other dairy products). Drink this mixture right away.

Use prenatal vitamins regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

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

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

What should I avoid while taking prenatal vitamins?

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

Avoid the regular use of salt substitutes in your diet if your multivitamin contains potassium. If you are on a low-salt diet, ask your doctor before taking a vitamin or mineral supplement.

Prenatal vitamins side effects

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

When taken as directed, prenatal vitamins are not expected to cause serious side effects. Less serious side effects may include:

upset stomach;

headache; or

unusual or unpleasant taste in your mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect prenatal vitamins?

Vitamin and mineral supplements can interact with certain medications, or affect how medications work in your body. Before taking a prenatal vitamin, tell your doctor if you also use:

diuretics (water pills);

heart or blood pressure medications;

tretinoin (Vesanoid);

isotretinoin (Accutane, Amnesteen, Clavaris, Sotret);

trimethoprim and sulfamethoxazole (Cotrim, Bactrim, Gantanol, Gantrisin, Septra, TMP/SMX); or

an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), meloxicam (Mobic), and others.

This list is not complete and other drugs may interact with prenatal vitamins. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More Duet Chewable resources

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

Cal-Nate MedFacts Consumer Leaflet (Wolters Kluwer)

CareNatal DHA MedFacts Consumer Leaflet (Wolters Kluwer)

CitraNatal 90 DHA MedFacts Consumer Leaflet (Wolters Kluwer)

CitraNatal Assure Prescribing Information (FDA)

CitraNatal Harmony Prescribing Information (FDA)

Concept DHA Prescribing Information (FDA)

Docosavit Prescribing Information (FDA)

Duet DHA with Ferrazone MedFacts Consumer Leaflet (Wolters Kluwer)

Folbecal MedFacts Consumer Leaflet (Wolters Kluwer)

Folcal DHA Prescribing Information (FDA)

Folcaps Care One Prescribing Information (FDA)

Gesticare DHA Prescribing Information (FDA)

Gesticare DHA MedFacts Consumer Leaflet (Wolters Kluwer)

Inatal Advance Prescribing Information (FDA)

Inatal Ultra Prescribing Information (FDA)

Multi-Nate DHA Prescribing Information (FDA)

Multi-Nate DHA Extra Prescribing Information (FDA)

MultiNatal Plus MedFacts Consumer Leaflet (Wolters Kluwer)

Natelle One Prescribing Information (FDA)

Neevo Caplets MedFacts Consumer Leaflet (Wolters Kluwer)

Neevo DHA MedFacts Consumer Leaflet (Wolters Kluwer)

OB Complete 400 MedFacts Consumer Leaflet (Wolters Kluwer)

Paire OB Plus DHA Prescribing Information (FDA)

PreNexa MedFacts Consumer Leaflet (Wolters Kluwer)

PreNexa Prescribing Information (FDA)

PreferaOB Prescribing Information (FDA)

Prenatal Plus Prescribing Information (FDA)

Prenatal Plus Iron Prescribing Information (FDA)

Prenate Elite Prescribing Information (FDA)

Prenate Elite MedFacts Consumer Leaflet (Wolters Kluwer)

Prenate Elite tablets

Prenate Essential Prescribing Information (FDA)

PrimaCare Advantage MedFacts Consumer Leaflet (Wolters Kluwer)

PrimaCare ONE capsules

PrimaCare One MedFacts Consumer Leaflet (Wolters Kluwer)

Renate DHA Prescribing Information (FDA)

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

Se-Natal 19 Prescribing Information (FDA)

Tandem DHA Prescribing Information (FDA)

Tandem OB Prescribing Information (FDA)

TriAdvance Prescribing Information (FDA)

Triveen-One MedFacts Consumer Leaflet (Wolters Kluwer)

Triveen-PRx RNF Prescribing Information (FDA)

UltimateCare ONE NF Prescribing Information (FDA)

Ultra NatalCare MedFacts Consumer Leaflet (Wolters Kluwer)

Vinate AZ Prescribing Information (FDA)

Vitafol-One MedFacts Consumer Leaflet (Wolters Kluwer)

Zatean-CH Prescribing Information (FDA)

Compare Duet Chewable with other medications

Vitamin/Mineral Supplementation during Pregnancy/Lactation

Where can I get more information?

Your pharmacist can provide more information about prenatal vitamins.

doxorubicin hydrochloride liposome Intravenous

dox-oh-ROO-bi-sin hye-droe-KLOR-ide LYE-poh-some

Intravenous route(Solution)

Myocardial damage may lead to congestive heart failure and may be encountered as the total cumulative dose of doxorubicin hydrochloride (HCl) approaches 550 mg/m(2). Cardiac toxicity may also occur at lower cumulative doses with mediastinal irradiation or concurrent cardiotoxic agents. Serious and sometimes life-threatening or fatal allergic/anaphylactoid-like infusion reactions have been reported. Administer at an initial rate of 1 mg/min to minimize the risk of infusion reactions. Severe myelosuppression may occur with therapy. Reduce dosage in patients with impaired hepatic function. Doxorubicin HCl liposome should not be substituted for doxorubicin HCl on a mg per mg basis .

Commonly used brand name(s)

In the U.S.

Doxil

Available Dosage Forms:

Solution

Therapeutic Class: Antineoplastic Agent

Chemical Class: Anthracycline

Uses For doxorubicin hydrochloride liposome

Liposomal doxorubicin belongs to the general group of medicines known as antineoplastics. It is used to treat patients with ovarian cancer, and Kaposi's Sarcoma in patients with human immunodeficiency virus (HIV). Liposomal doxorubicin is also used together with bortezomib to treat multiple myeloma in patients who have not yet received bortezomib in the past and have received at least one prior treatment .

Liposomal doxorubicin seems to interfere with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by liposomal doxorubicin, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.

Before you begin treatment with liposomal doxorubicin, you and your doctor should talk about the good doxorubicin hydrochloride liposome will do as well as the risks of using it.

Liposomal doxorubicin is to be administered only by or under the immediate supervision of your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, liposomal doxorubicin is used in certain patients with the following medical conditions:

Cancer of the breast

Multiple myeloma, in combination with vincristine and dexamethasone

Before Using doxorubicin hydrochloride liposome

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 doxorubicin hydrochloride liposome, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to doxorubicin hydrochloride liposome or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

There is no specific information comparing the use of liposomal doxorubicin in children with use in any other age group. Safety and efficacy of liposomal doxorubicin in children have not been established. However, problems are more likely to occur in children younger than 2 years of age, who are usually more sensitive to the effects of the active ingredient, doxorubicin.

Geriatric

doxorubicin hydrochloride liposome has been tested in a limited number of patients 60 years of age or older and has not been shown to cause different side effects in older people than it does in younger adults. However, problems are more likely to occur in the elderly, who are usually more sensitive to the effects of the active ingredient, doxorubicin. The elderly are also more likely to have blood problems.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving doxorubicin hydrochloride liposome, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using doxorubicin hydrochloride liposome with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Rotavirus Vaccine, Live

Using doxorubicin hydrochloride liposome with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Adenovirus Vaccine Type 4, Live

Adenovirus Vaccine Type 7, Live

Bacillus of Calmette and Guerin Vaccine, Live

Cisplatin

Influenza Virus Vaccine, Live

Measles Virus Vaccine, Live

Mumps Virus Vaccine, Live

Rotavirus Vaccine, Live

Rubella Virus Vaccine, Live

Smallpox Vaccine

Trastuzumab

Typhoid Vaccine

Varicella Virus Vaccine

Yellow Fever Vaccine

Using doxorubicin hydrochloride liposome with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Paclitaxel

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use of doxorubicin hydrochloride liposome

Liposomal doxorubicin is sometimes given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to take them at the right times.

While you are receiving liposomal doxorubicin, your doctor may want you to drink extra fluids so that you will pass more urine. This will help prevent kidney problems and keep your kidneys working well.

doxorubicin hydrochloride liposome often causes nausea and vomiting. However, it is very important that you continue to receive it, even if you begin to feel ill. Ask your health care professional for ways to lessen these effects.

Dosing

The dose of doxorubicin hydrochloride liposome will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of doxorubicin hydrochloride liposome. If your dose is different, do not change it unless your doctor tells you to do so.

Precautions While Using doxorubicin hydrochloride liposome

It is very important that your doctor check your progress at regular visits to make sure that doxorubicin hydrochloride liposome is working properly. Your doctor will need to check your blood for unwanted effects .

Check with your doctor immediately if you are having chest pain or discomfort, fast or irregular heartbeat, shortness of breath, swelling of the feet and lower legs, or troubled breathing. These could be symptoms of a serious heart problem .

Acute infusion-related reactions can occur during treatment with doxorubicin hydrochloride liposome. Symptoms of this reaction include: flushing; shortness of breath; swelling of the face; headache; chills; chest pain; back pain; tightness in chest and throat; fever; itching skin; rash; bluish color of fingernails, lips, skin, palms, or nail beds; difficulty breathing; wheezing; fainting; lightheadedness; or fast, pounding, or irregular heartbeat or pulse .

doxorubicin hydrochloride liposome may cause hand-foot syndrome. Check with your doctor right away if you experience tingling or burning, redness, swelling, blistering, or small sores on the palms of your hands or soles of your feet.

You should not receive doxorubicin hydrochloride liposome if you are pregnant or breastfeeding. Using doxorubicin hydrochloride liposome while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away .

While you are being treated with liposomal doxorubicin, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Liposomal doxorubicin may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral poliovirus vaccine since there is a chance they could pass the poliovirus on to you. Also, avoid persons who have taken oral poliovirus vaccine. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and the mouth.

Liposomal doxorubicin can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.

Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.

Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.

Avoid contact sports or other situations where bruising or injury can occur.

If liposomal doxorubicin accidentally seeps out of the vein into which it is injected, it may damage some tissues and cause scarring. Tell the doctor or nurse right away if you notice redness, pain, or swelling at the place of injection.

Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.

doxorubicin hydrochloride liposome Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

More common–in any treatment group

Black, tarry stools

blistering, peeling, redness, and/or swelling of palms of hands or bottoms of feet

blood in urine or stools

chills

cough or hoarseness

facial swelling

fever

headache

loss of strength and energy

low blood pressure

lower back or side pain

numbness, pain, tingling, or unusual sensations in palms of hands or bottoms of feet

painful or difficult urination

pinpoint red spots on skin

shortness of breath

sore throat

sores in mouth and on lips

unusual bleeding or bruising

unusual tiredness or weakness

Less common–in any treatment group

Skin rash or itching

Rare–in any treatment group

Chest pain

decreased urine output

dilated neck veins

extreme fatigue

irregular breathing

irregular heartbeat

shortness of breath

swelling of face, fingers, feet, or lower legs

tightness in chest

troubled breathing

weight gain

wheezing

yellowing of the eyes and skin

Less common—for patients being treated for Kaposi's sarcoma

Cough

fever

pain at place of injection

troubled breathing

wheezing

Rare—for patients being treated for Kaposi's sarcoma

Blurred or loss of vision

eye pain

flushed, dry skin

frequent urination

fruit-like breath odor

unusual thirst

Less common—for patients being treated for ovarian cancer

Bloating or swelling of face, hands, lower legs, and/or feet

chest pain

cough or hoarseness

decreased urination

fever or chills

lower back or side pain

painful or difficult urination

rapid weight gain

Rare—for patients being treated for ovarian cancer

Cough

difficulty swallowing

hives

pain at place of injection

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

shortness of breath

tightness in chest

wheezing

Symptoms of overdose

Black, tarry stools

blood in urine or stools

cough or hoarseness accompanied by fever or chills

fever or chills

lower back or side pain accompanied by fever or chills

painful or difficult urination accompanied by fever or chills

pinpoint red spots on skin

sores in mouth and on lips

unusual bleeding or bruising

More common–in any treatment group

Diarrhea

nausea

vomiting

Less common–in any treatment group

Back pain

difficulty swallowing

dizziness

More common—for patients being treated for Kaposi's sarcoma

Creamy white, curd-like patches in mouth or throat

pain when eating or swallowing

Less common—for patients being treated for Kaposi's sarcoma

Constipation

headache

More common—for patients being treated for ovarian cancer

Abdominal or stomach pain

changes in the lining of the mouth or nose

constipation

headache

loss of appetite

pain

rash

sore throat

tingling, burning, or prickly sensations

Less common—for patients being treated for ovarian cancer

Anxiety

bad, unusual, or unpleasant (after)taste

burning, dry, or itching eyes

change in taste

difficulty swallowing

excessive tearing

itching skin

muscle aches

redness, pain, swelling of eye, eyelid, or inner lining of eyelid

trouble sleeping

Rare—for patients being treated for ovarian cancer

Change in sense of smell

chills

clumsiness, unsteadiness, trembling, or other problems with muscle control or coordination

cough

fever

general feeling of discomfort or illness

increased white vaginal discharge

joint pain

nausea

shakiness and unsteady walk

shivering

sore throat

sweating

thinking abnormal

vomiting

Liposomal doxorubicin causes the urine to turn reddish in color, which may stain clothes. This is not blood. It is to be expected and only lasts for 1 or 2 days after each dose is given.

More common—for patients being treated for ovarian cancer

Dry skin

Less common—for patients being treated for ovarian cancer

Change in skin color

doxorubicin hydrochloride liposome often causes a temporary and total loss of hair. After treatment with liposomal doxorubicin has ended, normal hair growth should return.

After you stop using doxorubicin hydrochloride liposome, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

Fast or irregular heartbeat

shortness of breath

swelling of feet and lower legs

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: doxorubicin hydrochloride liposome Intravenous side effects (in more detail)

More doxorubicin hydrochloride liposome Intravenous resources

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

Compare doxorubicin hydrochloride liposome Intravenous with other medications

Kaposi's Sarcoma
Multiple Myeloma
Ovarian Cancer

Doss-Relief

Generic Name: docusate (DOK ue sate)

Brand Names: Calcium Stool Softener, Colace, Correctol Softgel Extra Gentle, D-S Caps, Diocto, Doc-Q-Lace, Docu, Docu Soft, Doculase, Docusoft S, DocuSol, DOK, DOS, DSS, Dulcolax Stool Softener, Enemeez Mini, Fleet Sof-Lax, Kao-Tin, Kaopectate Stool Softener, Kasof, Phillips Stool Softener, Silace, Sur-Q-Lax

What is Doss-Relief (docusate)?

Docusate is a stool softener. It makes bowel movements softer and easier to pass.

Docusate is used to treat or prevent constipation, and to reduce pain or rectal damage caused by hard stools or by straining during bowel movements.

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

What is the most important information I should know about Doss-Relief (docusate)?

You should not use docusate if you are allergic to it, or if you have a blockage in your intestines. Do not use docusate while you are sick with nausea, vomiting, or stomach pain. Do not take mineral oil while using docusate, unless your doctor tells you to.

Ask a doctor or pharmacist before using docusate if you are on a low-salt diet, if you are pregnant or breast-feeding, or if you have recently had a sudden change in your bowel habits lasting for longer than 2 weeks.

What should I discuss with my healthcare provider before using Doss-Relief (docusate)?

Ask a doctor or pharmacist if it is safe for you to take docusate:

if you are on a low-salt diet; or

if you have recently had a sudden change in your bowel habits lasting for longer than 2 weeks.

It is not known whether docusate will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether docusate passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medication to a child younger than 2 years old without the advice of a doctor.

How should I use Doss-Relief (docusate)?

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

Take docusate tablets or capsules with a full glass of water. Drink plenty of liquids while you are taking docusate. Do not crush, chew, or break a docusate capsule. Swallow it whole.

Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. Mix the liquid with 6 to 8 ounces of milk, fruit juice, or infant formula and drink the mixture right away.

Do not take docusate rectal enema by mouth. It is for use only in your rectum. Wash your hands before and after using docusate rectal enema.

Try to empty your bowel and bladder just before using the enema.

Twist off the applicator tip. Lie down on your left side with your knees bent, and gently insert the tip of the enema applicator into the rectum. Squeeze the tube to empty the entire contents into the rectum. Throw away the tube, even if there is still some medicine left in it.

After using docusate, you should have a bowel movement within 12 to 72 hours. Call your doctor if you have not had a bowel movement within 1 to 3 days.

Do not use docusate for longer than 7 days unless your doctor has told you to. Overuse of a stool softener can lead to serious medical problems. Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Since docusate is used as needed, you may not be on a dosing schedule. If you are using the medication regularly, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

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

Overdose symptoms may include nausea, vomiting or stomach pain.

What should I avoid while using Doss-Relief (docusate)?

Avoid using laxatives or other stool softeners unless your doctor has told you to.

Avoid using the bathroom just after using docusate enema.

Doss-Relief (docusate) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using docusate and call your doctor at once if you have a serious side effect such as:

rectal bleeding or irritation;

numbness or a rash around your rectum;

severe diarrhea or stomach cramps; or

continued constipation.

Less serious side effects may include:

mild diarrhea; or

mild nausea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Doss-Relief (docusate)?

There may be other drugs that can interact with docusate. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More Doss-Relief resources

Doss-Relief Side Effects (in more detail)
Doss-Relief Use in Pregnancy & Breastfeeding
Doss-Relief Drug Interactions
Doss-Relief Support Group
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Docusate Professional Patient Advice (Wolters Kluwer)

Colace MedFacts Consumer Leaflet (Wolters Kluwer)

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Compare Doss-Relief with other medications

Constipation

Where can I get more information?

Your pharmacist can provide more information about docusate.

See also: Doss-Relief side effects (in more detail)

Doxycycline Hyclate eent

Class: Antibacterials
Chemical Name: 4 - (Dimethylamino) - 1,4,4a,5,5a,6,11,12a - octahydro - 3,5,10,12,12a - pentahydroxy - 6 - methyl - 1,11 - dioxo - 2 - naphthacenecarboxamide monohydrochloride
Molecular Formula: (C₂₂H₂₄N₂O₈•HCl)₂
CAS Number: 24390-14-5
Brands: Atridox, Periostat

Introduction

Semisynthetic tetracycline antibiotic.¹

Uses for Doxycycline Hyclate

Periodontitis

Used orally as an adjunct to scaling and root planing to promote attachment-level gain and to reduce pocket depth in adults with periodontitis.¹⁴ ¹⁵ ¹⁶

Used subgingivally in treatment of chronic periodontitis in adults to reduce pocket depth, gain clinical attachment level, and reduce bleeding associated with probing.¹ ² ³ ⁴ ⁵ ⁷ ¹⁰ ¹¹

Doxycycline Hyclate Dosage and Administration

Administration

Oral Administration

Administered orally as 20-mg tablets for adjunctive treatment of periodontitis.¹⁴

Administer doses in the morning and evening and at least 1 hour prior to or 2 hours after meals.¹⁴

Give with adequate amounts of fluids to reduce risk of esophageal irritation and ulceration.¹⁴

Subgingival Administration

Administered subgingivally (as an extended-release preparation containing the drug incorporated into a bioresorbable polymer) into periodontal pockets by an oral health-care professional.¹ ⁴ ¹⁰ ¹¹

Each pair of syringes is intended for single use only.¹

Administration does not require local anesthesia.¹

Preparation does not have to be manually removed; preparation solidifies upon contact with gingival crevicular fluid and is bioabsorbed or expelled naturally.¹

Reconstitution

Mix contents of the 2 paired syringes (liquid polymeric delivery system [syringe A]; doxycycline hyclate powder [syringe B]) together prior to administration.¹ Remove syringes from the refrigerator at least 15 minutes prior to mixing.¹

Couple syringes together and inject contents of syringe A into syringe B and then back into syringe A to complete 1 mixing cycle.¹ Perform 100 mixing cycles (approximately 1 mixing cycle per second) prior to administration.¹

If not administered immediately, store coupled syringes in resealable pouch at room temperature for up to 3 days; an additional 10 mixing cycles is required just prior to administration.¹

After mixing, hold coupled syringes vertically with syringe A (indicated by a purple stripe) at the bottom.¹ Pull down on the plunger of syringe A and allow contents to flow down the barrel for several seconds into syringe A.¹ Uncouple syringes and attach the blunt cannula supplied in the package to syringe A prior to administration.¹ Bend cannula to resemble a periodontal probe.¹

Subgingival Administration Technique

Using the syringe with bent cannula, position tip of cannula near the base of the periodontal pocket and administer preparation into the pocket until the formulation reaches the top of the gingival margin.¹

After administration is completed, withdraw cannula from the pocket and cover pocket with periodontal dressing or dental adhesive.¹

Dosage

Available as doxycycline hyclate; dosage expressed in terms of doxycycline; 50 mg of doxycycline hyclate equivalent to 42.5 mg of doxycycline.¹

Adults

Periodontitis

Oral

20 mg every 12 hours.¹⁴

Safety of >12 months of treatment and efficacy of >9 months of treatment have not been established.¹⁴

Subgingival

Dosage varies depending on the size, shape, and number of periodontal pockets treated.¹ May repeat treatment 4 months after the initial treatment.¹

Cautions for Doxycycline Hyclate

Contraindications

Known hypersensitivity to doxycycline or other tetracyclines.¹ ¹⁴

Warnings/Precautions

Warnings

Dental and Bone Effects

Avoid use during tooth development (e.g., the last half of pregnancy, infancy, childhood up to 8 years of age); potential for permanent tooth discoloration or enamel hypoplasia.¹ ¹⁴

Tetracyclines form a stable calcium complex in any bone-forming tissue.¹⁴ Reversible decrease in fibula growth rate has occurred in premature infants receiving oral tetracycline.¹⁴

Sensitivity Reactions

Photosensitivity Reactions

Possible photosensitivity reactions (e.g., exaggerated sunburn reaction).¹ ¹⁴ Discontinue oral or subgingival therapy at the first sign of skin erythema.¹³ ¹⁴

General Precautions

Precautions Related to Subgingival Doxycycline

Not studied for use in the regeneration of alveolar bone, either in preparation for or in conjunction with placement of endosseous (dental) implants or in the treatment of failing implants.¹

Not studied in patients with extremely severe periodontal defects with little remaining periodontium.¹

Not studied in immunocompromised patients (e.g., those with diabetes or HIV infection, those receiving chemotherapy or radiation therapy).¹

Oral Candidiasis

Possible overgrowth of nonsusceptible organisms, including fungi.¹ ¹⁴ Use with caution in patients with a history of or predisposition to oral candidiasis.¹ ¹⁴ Safety and efficacy not established in patients with concomitant oral candidiasis.¹ ¹⁴

Specific Populations

Pregnancy

Category D.¹ ¹⁴

Lactation

Distributed into milk.¹ ¹⁴ Discontinue nursing or the drug.¹ ¹⁴

Pediatric Use

Do not use oral doxycycline in children <8 years of age.¹⁴

Safety and efficacy of subgingival doxycycline not established in children <18 years of age.¹ ² ¹³

Possible permanent tooth discoloration (see Dental and Bone Effects under Cautions).¹

Common Adverse Effects

Oral: Headache, common cold, flu symptoms, toothache, GI symptoms (diarrhea, nausea, dyspepsia), joint pain.¹⁴

Subgingival: Headache; common cold; gum discomfort, pain or soreness, loss of attachment, or increased pocket depth; toothache or pressure sensitivity; periodontal abscess, exudate, infection, drainage, extreme mobility, or suppuration; thermal tooth sensitivity.¹

Interactions for Doxycycline Hyclate

Drug interactions reported involve oral doxycycline.¹⁴ No formal drug interaction studies have been performed with doxycycline hyclate polymer for subgingival administration.¹

Specific Drugs

Drug	Interaction	Comments
Antacids (aluminum-, calcium-, or magnesium-containing)	Decreased doxycycline absorption¹⁴
Anticoagulants, oral	Possible decreased prothrombin activity¹⁴	Adjust anticoagulant dosage as needed¹⁴
Anticonvulsants (barbiturates, carbamazepine, phenytoin)	Possible decreased doxycycline half-life¹⁴
Bismuth subsalicylate	Possible decreased doxycycline absorption¹⁴
Hormonal contraceptives	Possible decreased effectiveness of oral contraceptives¹ ¹⁴
Iron-containing preparations	Possible decreased doxycycline absorption¹⁴
Methoxyflurane	Fatal renal toxicity reported with concomitant use of tetracycline and methoxyflurane¹⁴
Penicillins	Possible antagonism¹⁴	Avoid concomitant use¹⁴

Doxycycline Hyclate Pharmacokinetics

Absorption

Bioavailability

Oral: Doxycycline hyclate rapidly and almost completely absorbed from GI tract.¹⁴ In adults receiving 20-mg tablets of doxycycline hyclate, peak serum doxycycline concentrations attained within 1.4 hours after a single dose or within 2 hours of a dose at steady-state.¹⁴

Subgingival: Concentrations in gingival crevicular fluid (GCF) peaked 2 hours following administration and remained >1000 mcg/mL through 18 hours.¹ GCF concentrations then declined gradually but remained >MIC for periodontal pathogens (≤6 mcg/mL) through 7 days; serum concentrations remained ≤0.1 mcg/mL.¹

Stability

Storage

Oral

Tablets

15–30°C in tight, light-resistant container.¹⁴

Subgingival

For liquid, extended-release polymer

2–8°C.¹

Actions and SpectrumActions

Usually is bacteriostatic.¹

Inhibits protein synthesis in susceptible organisms.¹

Active in vitro at concentrations of ≤6 mcg/mL against Porphyromonas gingivalis, Prevotella intermedia, Campylobacter rectus, and Fusobacterium nucleatum.¹

No evidence of doxycycline or multidrug resistance in subgingival plaque or saliva in a clinical study of 6 months’ duration of subgingival doxycycline hyclate.¹ ⁶

Advice to Patients

When taking doxycycline hyclate tablets, importance of drinking sufficient amounts of fluids to reduce the risk of esophageal irritation and ulceration.¹⁴

Doxycycline hyclate polymer for subgingival administration is not meant for self-administration; only qualified oral health-care professionals familiar with administration of the subgingival preparation should administer the drug.¹

Importance of not using mechanical oral hygiene procedures (i.e., brushing teeth, flossing) for 7 days following administration of the subgingival preparation.¹

Importance of avoiding exposure to direct sunlight or UV light while receiving oral or subgingival doxycycline hyclate; importance of notifying clinician and of discontinuing therapy at the first sign of skin erythema.¹ ¹³

Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.¹

Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant diseases.¹

Importance of informing patients of other important precautionary information.¹ (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Doxycycline Hyclate
Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Tablets	20 mg (of doxycycline)	Periostat	CollaGenex
	Tablets, film-coated	20 mg (of doxycycline)*	Doxycycline Hyclate Tablets	Teva
Subgingival	For liquid, extended-release polymer	10% w/w (to deliver 42.5 mg [of doxycycline])	Atridox (available in a 2-syringe Atrigel Delivery System)	CollaGenex

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

References

1. CollaGenex Pharmaceuticals. Atridox (doxycycline hyclate 10%) prescribing information. Newtown, PA; 1998 Sep.

2. Wennström JL, Newman HN, MacNeill SR et al. Utilisation of locally delivered doxycycline in non-surgical treatment of chronic periodontitis. J Clin Periodontol. 2001; 28:753-761.

3. Garrett S, Adams DF, Bogle G et al. The effect of locally delivered controlled-release doxycycline or scaling and root planing on periodontal maintenance patients over 9 months. J Periodontol. 2000; 71:22-30. [PubMed 10695935]

4. Garrett S, Johnson L, Drisko CH et al. Two multi-center studies evaluating locally delivered doxycycline hyclate, placebo control, oral hygiene, and scaling and root planing in the treatment of periodontitis. J Periodontol. 1999; 70:490-503. [PubMed 10368053]

5. Drisko CH. The use of locally-delivered doxycycline in the treatment of periodontitis. Clinical results. J Clin Periodontol. 1998; 25:947-52. [PubMed 9839851]

6. Walker CB, Godowski KC, Borden L. The effects of sustained release doxycycline on anaerobic flora and antibiotic-resistant patterns in subgingival plaque and saliva. J Periodontol. 2000; 71:768-74. [PubMed 10872958]

7. Wolinsky LE, Camargo PM, Polson A et al. The significance of prior mechanical therapy for changes of periodontal status achieved by local delivery of a doxycycline-hyclate containing gel. J Clin Periodontol. 2001; 28:1115-20. [PubMed 11737508]

8. Stoller NH, Johnson LR, Trapnell S et al. The pharmacokinetic profile of a biodegradable controlled-release delivery system containing doxycycline compared to systemically delivered doxycycline in gingival crevicular fluid, saliva, and serum. J Periodontol. 1998; 69:1085-91. [PubMed 9802705]

9. Ryder MI, Pons B, Adams D et al. Effects of smoking on local delivery of controlled-release doxycycline as compared to scaling and root planing. J Clin Periodontol. 1999; 26:683-91. [PubMed 10522780]

10. Greenstein G, Tonetti M and the Research, Science, and Therapy Committee of the American Academy of Periodontology. Position Paper. The role of controlled drug delivery for periodontitis. J Periodontol. 2000; 71:125-40. [PubMed 10695948]

11. Greenstein G, Polson A. The role of local drug delivery in the management of periodontal diseases: a comprehensive review. J Periodontol. 1998; 69:507-520. [PubMed 9623893]

12. Garrett S. Local delivery of doxycycline for the treatment of periodontitis. Compendium. 1999; 20:437-46. [PubMed 10650359]

13. CollaGenex Pharmaceuticals, Inc. Newtown, PA; Personal communication.

14. CollaGenex Pharmaceuticals. Periostat (doxycycline hyclate) 20 mg tablets prescribing information. Newtown, PA; 2003 Oct.

15. Greenstein G. The role of Periostat in the management of adult periodontitis: a critical assessment. Compend Contin Educ Dent. 1999; 20:664,666-8,670,672,574,676-8. [PubMed 10650384]

16. Caton JG. Evaluation of Periostat for patient management. Compend Contin Educ Dent. 1999; 20:451-2,454-6,458-63. [PubMed 10650360]

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Acne
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Wednesday, October 5, 2016

Commonly used brand name(s)

Uses For Duo-Vil 2-25

Before Using Duo-Vil 2-25

Allergies

Pediatric

Geriatric

Breast Feeding

Interactions with Medicines

Interactions with Food/Tobacco/Alcohol

Other Medical Problems

Proper Use of perphenazine and amitriptyline

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Missed Dose

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Duo-Vil 2-25 Side Effects

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Before using Dulcolax Suppositories:

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Important safety information:

Possible side effects of Dulcolax Suppositories:

If OVERDOSE is suspected:

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Uses For doxorubicin hydrochloride liposome

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Allergies

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Geriatric

Interactions with Medicines

Interactions with Food/Tobacco/Alcohol

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Proper Use of doxorubicin hydrochloride liposome

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Precautions While Using doxorubicin hydrochloride liposome

doxorubicin hydrochloride liposome Side Effects

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What is Doss-Relief (docusate)?

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How should I use Doss-Relief (docusate)?

What happens if I miss a dose?

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