drug information Best answer on the web
I would like a distillation of the following information available on the 'net, for each of the following medications she is currently prescribed:
- manufacturer's information sheets
- information concerning possible inter-reactions between her medications - a distillation of possible side-effects for each medication
- links to anecdotal information for each medication e.g. usenet articles - 'scare stories', 'success stories'...
I am aiming to educate myself about each of these medications in a broad sense. My relative is currently under the care of a fully accredited medical specialist & I would like to maximise the benefit of discussions I have with him, by improving my own knowledge.
the medications are:
'zoton' 30mg twice daily
'aspirin enteric' 75mg daily
'adalat LA' 30mg daily
'atenolol' 100mg daily
'mirtazapine' 30mg at night
'chloral hydrate' at night 5ml, concentration unknown
'olanzapine' 2.5mg at night
...'didronel' 400mg daily as part of HRT
...'cacit' 500mg daily as part of HRT
didronel & cacit alternate every 14 days, hormone replacement therapy.
Due to the nature of your question you will be getting a lot of quotes. It is our policy not to use quotes heavily but in this case I hope I will be forgiven as the information contained is sensitive and paraphrasing is certain to lead to errors.
1 - "What you need to know about ZOTON
Please read this leaflet carefully before you start to take your medicine. It does not tell you everything about your medicine. If you have any questions, please ask your doctor or chemist (pharmacist). Keep this leaflet while you are taking your ZOTON. You may want to read it again. Things to remember about your medicine
As well as helping you, a medicine may have some effects you don’t want. You can find more information about this in this leaflet.
Take your medicine exactly as your doctor tells you.
Keep taking your medicine until your doctor tells you to stop.
Keep your medicine where children cannot see or reach it.
To find out more about your medicine, please read on.
What’s in your medicine?
The active ingredient of ZOTON is Lansoprazole. Lansoprazole belongs to a group of medicines known as proton pump inhibitors. ZOTON Capsules come in two strengths containing either 15mg or 30mg of the active ingredient lansoprazole. Each strength of capsule is a different colour; 15mg capsules are yellow, 30mg capsules are two tone lilac/purple. ZOTON Suspension 30mg is provided as gastro-resistant granules for oral suspension. It is available as a single dose sachet containing 30mg of the active ingredient lansoprazole. Each sachet contains granules which should be mixed well with two tablespoons (30ml) of tap water. When mixed with water the granules produce a pink suspension with a strawberry flavour. ZOTON Capsules also contain the following ingredients: Magnesium carbonate, sucrose, maize starch, low substituted hydroxypropyl cellulose, hydroxypropylcellulose, methacrylic acid-ethyl acrylate copolymer (1:1) dispersion 30 per cent, talc, macrogol, titanium dioxide, polysorbate 80, colloidal anhydrous silica, gelatin and colours: Opacode black ink and E171 plus either E127 and E132 (30mg capsules) or E172 (15mg capsules). ZOTON Suspension also contains the following ingredients: Magnesium carbonate, sucrose, maize starch, low substituted hydroxypropyl cellulose, hydroxypropylcellulose, methacrylic acid-ethyl acrylate copolymer (1:1) dispersion 30 per cent, talc, macrogol, titanium dioxide, polysorbate 80, colloidal anhydrous silica, mannitol, docusate sodium, crospovidone, xanthan gum, strawberry flavour, citric acid, magnesium stearate, E171 and E172. Each sachet provides 2.5g of sucrose (sugar). If you are taking two or more sachets a day, ZOTON Suspension will provide 5g or more of sucrose. Do not use if you are known to suffer from a bowel or other condition that makes you intolerant to certain sugars such as sucrose, fructose, glucose or galactose. Ask your doctor if you are unsure. ZOTON Capsules 15mg are available in packs of 28 or 56 capsules.
ZOTON Capsules 30mg are available in packs of 2, 7, 14, 28 or 56 capsules. ZOTON Suspension 30mg is available in packs of 2 or 28 sachets.
The product licence holder of ZOTON Capsules and Suspension is Cyanamid of Great Britain Limited, Fareham Road, Gosport, Hants, PO13, 0AS. The manufacturer of the capsules is Wyeth Medica Ireland, Little Connell, Newbridge, County Kildare, Ireland. The manufacturer of Zoton Suspension is Wyeth Lederle SpA., via Nettunense 90, Aprilia, Italy. Your doctor has prescribed ZOTON, which works by reducing the amount of acid your stomach produces. It helps to heal peptic ulcers or a condition called reflux oesophagitis and to prevent them from recurring. It may be used to relieve symptoms of dyspepsia such as heartburn, stomach ache, nausea or bloating, caused by too much acid in the stomach. ZOTON can be used to treat or prevent stomach or duodenal ulcers while you continue to take NSAIDs. It can also provide relief of symptoms associated with taking NSAIDs such as abdominal pain. ZOTON may also be used with antibiotics to treat infection with a bacterium called Helicobactor pylori. (See over to find out more about these conditions). Please ask your doctor if you would like more information. Before taking your medicine
If the answer to any of the following questions is “yes”, please tell your doctor or chemist. ZOTON may not be suitable for you.
are you pregnant or breast feeding?
do you have liver problems?
are you taking any other medicines, in particular the contraceptive pill, phenytoin, carbamazepine, theophylline, warfarin or indigestion mixtures?
are you allergic to any of the ingredients contained in ZOTON Capsules or Suspension?
How to take your medicine
Always take your medicine as your doctor tells you to. Read the chemist’s label to remind you how many sachets or capsules you should take and how often you should take them. If you are taking one capsule or sachet a day, you should try to take it at the same time each day. If possible, you should take it first thing in the morning before breakfast. You should swallow ZOTON Capsules whole with water. Do not crush or chew them. ZOTON Suspension sachets should be emptied into a small cup or glass containing two tablespoonfuls (30ml) of tap water, and stirred until it has an even consistency. The mixture should be swallowed immediately. WW 228/2 The usual adult dose for Helicobacter pylori infection is ZOTON 30mg twice a day, one dose in the morning and the other in the evening. ZOTON should not be used alone to treat Helicobacter pylori infection. Your doctor will also prescribe two antibiotics to be taken at the same time. The usual adult dose for dyspepsia is ZOTON 30mg once a day for 2 to 4 weeks. The usual adult dose for peptic ulcer or reflux oesophagitis is ZOTON 30mg once a day for 4 or 8 weeks. After this time, if you are able to take capsules, the dose may be reduced to 15mg once a day. If you are prescribed ZOTON to treat an ulcer whilst continuing to take an NSAID, your doctor will advise you of the correct dose depending on your symptoms. This is usually either one dose of 15mg or one dose of 30mg a day for 4 or 8 weeks. If you are taking ZOTON to prevent an ulcer from forming whilst you are taking an NSAID, you will usually be asked to take one 15mg dose or one 30mg dose a day. Your doctor will tell you how long to take ZOTON for. If your stomach produces far too much acid, you will usually be asked to take two 30mg capsules or two sachets a day to start with. Your doctor may then increase or decrease this, depending on your response. You will usually feel better before you are completely healed. Therefore, it is important that you take all the sachets or capsules that your doctor has prescribed for you. If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue taking the remaining sachets or capsules as normal. Do not take a double dose. If you take more ZOTON than your doctor or chemist advised, you should seek medical advice quickly. After taking your medicine
Occasionally, ZOTON may cause side effects. Such side-effects do not usually last for long. However, please see your doctor if any of the following become severe or troublesome: Headaches, diarrhoea, stomach pain, feelings of sickness, vomiting, taste disturbances, dizziness, vertigo, confusion, blurred vision, hallucinations, feeling unwell, constipation, wind, dry or sore mouth or throat, tiredness, burning or prickling feeling, itching, hair thinning, muscle or joint pains, fluid retention, swelling, depression. As with other acid-reducing drugs, men taking lansoprazole may occasionally experience temporary breast swelling or impotence. You should contact your doctor immediately if you develop a rash, or reddening or blistering of the skin. The majority of rashes are mild and self-limiting but sensitivity to sunlight and more severe blistering rashes have occurred rarely which may require medical treatment. You should also see your doctor at once if you get a fever, any unexplained bruising or bleeding, extreme fatigue, difficulty in urinating, if your skin or whites of your eyes become more yellow than usual or if you experience symptoms of an allergic reaction such as shortness of breath or face swelling. As natural acid in the stomach helps to kill bacteria, the lowering of acid by acid-reducing drugs such as ZOTON may make some people more liable to suffer from certain stomach infections. If you suffer from severe persistent diarrhoea and/or vomiting whilst taking ZOTON you should consult your doctor. Other rare side effects include kidney problems, inflammation of the liver or changes in kidney or liver function. Please tell your doctor if you have any unwanted event not listed above. Before you have any kind of surgery or emergency treatment, tell the doctor in charge that you are taking ZOTON. Storing your medicine
Keep your medicine in a safe place where children cannot see or reach it. Keep your medicine in a dry place at room temperature (below 25°C) in the original container. Do not put it in the fridge. If any sachets or capsules are left at the end of your treatment, please take them back to your chemist, who will get rid of them. Do not use this medicine after the expiry date which is printed on your pack. This leaflet was revised in October 2000 Other Information
Remember: This medicine is for you. Only a doctor can prescribe it for you. Never give it to anybody else, even if their symptoms are the same as yours. It could harm them. *Trademark of and under Licence Agreement from Takeda Chemical Industries Ltd., Japan. †Trade mark
ZOTON is distributed by Wyeth Laboratories,
Huntercombe Lane South,
Taplow, Maidenhead, Berkshire SL6 0PH"
http://pharma.bmj.com/en/1/otherzotonpal.html - A commercial website for health professionals.
2 - Enteric Asprin is an asprin with a safety coating to protect the stomach. Side effects of aspirin may be: "Aspirin is a drug that has some key benefits, but it can also cause some serious problems. Aspirin has been used by the human race for many years. It was first produced by the Bayer company.
It is has been thought that aspirin gets in the way of prostaglandin production and causes a reduction in inflammation and pain. Prostaglandin affects the flow of blood platelets, which are the key in blood clotting. If plaque tears inside a coronary artery, then clotting begins at that site. This may then cause cardiac arrest or a myocardial infraction. In today’s day and age doctors can prescribe medicine such as aspirin to patients that have a history of heart disease. This can then reduce that person’s risk of a second event. Aspirin is called an analgesic drug because it is a pain reliever. Aspirin has many side effects that other pain relievers do not have. Aspirin can cause gastro-intestinal discomfort if taken in large doses. Another side effect is that is prevent blood from clotting. Aspirin is not used in hospitals because of this reasoning. When you are about to go into surgery your doctor will remind you not to take aspirin 24 hours before surgery because this may cause complications during surgery." http://allsands.com/Health/historyofaspi_wvw_gn.htm - Aspirin Side Effects - - There are several brands and manufacturers.
3 - Adalat LA is a trade name for Nifedipine which is a calcium blocker. "Calcium channel blockers are used to treat high blood pressure, angina, arrhythmias (irregular heart rhythm), Raynaud's phenomenon (a narrowing of the blood vessels in the fingers, toes, ears and nose) and to prevent vascular spasms in those who have had a subarachnoid haemorrhage (bleeding into the space surrounding the brain).
How do they work?
Calcium channel blockers reduce the flow of calcium into the heart and smooth muscle cells (found in many tissues and organs in the body). The body needs calcium in order for muscles to function correctly, but decreasing the amount of calcium that reaches the muscles can help blood vessel walls to relax and blood to flow more freely into the heart. In turn, this can lower blood pressure and relieve angina pain. Calcium channel blockers can also slow the electrical impulses that pass through heart muscle and consequently can stabilise abnormal heart rhythms.
Other drugs
If you are taking water tablets or ACE inhibitors, the hypotensive (lowering of blood pressure) effect of calcium channel blockers can become greater. Nifedipine can occasionally make glucose tolerance worse if you are taking an oral hypoglycaemic tablet (taken for Type 2 diabetes). If you are also taking other anti-hypertensive (anti high blood pressure) drugs, there can be an enhanced hypotensive effect.
Side effects
Side effects common to a majority of the calcium channel blockers are headaches, dizziness, flushing, nausea, oedema (accumulation of fluid in the body tissue) and palpitations."
With this drug, according to all the information I can find, you must speak with your doctor about additional side effects and interactions.
4 - Atenolol - there is a lot of information available here. So, rather than try to quote several pages of text, I am simply going to send you to the Atenolol Home Page. http://www.sunderland.ac.uk/~hs0dad/profile/atenolol/atenhmpg.htm - - You will fine information ranging from chemical formulation to effects. To read the general overviews which contain what you are looking for, click on "type of drug." You will find full information as to interactions and precautions.
5 - mirtazapine - Once again I am going to send you to a page. These pages contain several articles covering what the drug is, does, and many clinical reports relating to tests, success and failure. Here is the abstract:
"Mirtazapine is a presynaptic alpha-2 antagonist that has dual action by increasing noradrenergic and serotonergic neurotransmission. The enhancement of serotonergic neurotransmission is specifically mediated via 5-HT1 receptors because mirtazapine is a postsynaptic serotonergic 5-HT2 and 5-HT3 antagonist. In addition, mirtazapine has only a weak affinity for 5-HT1 receptors and has very weak muscarinic anticholinergic and histamine (H1) antagonist properties. As a consequence of its unique pharmacodynamic properties, mirtazapine is an effective, safe and well-tolerated addition to the antidepressant armamentarium. Mirtazapine is well absorbed from the gastrointestinal tract following oral administration, and it is extensively metabolized in the liver to four metabolites via demethylation and hydroxylation, followed by glucuronide conjugation. The unconjugated desmethyl metabolite is pharmacologically less active than the parent compound. Mirtazapine lacks auto-induction of hepatic isoenzymes. Although mirtazapine is a substrate of P450 isoenzymes 1A2, 2D6 and 3A4, in vitro studies show that it is not a potent inhibitor or inducer of any of these enzymes. Mirtazapine has been evaluated in a worldwide clinical development program involving approximately 4500 patients. Controlled clinical trials involving almost 2800 mirtazapine-treated patients have demonstrated the compound to be effective for the treatment of moderate-to-serve major depression. Mirtazapine was consistently superior to placebo, and equivalent in efficacy to the tricyclic antidepressants amitriptyline, doxepin and clomipramine, but with an improved tolerability profile. Mirtazapine has shown a rapid onset of action in patients with predominantly severe depressive illness in a comparative study against fluoxetine. Mirtazapine has a unique tolerability profile, since the specific postsynaptic 5-HT2 and 5-HT3 receptor blockade of mirtazapine provides early antidepressant effects without causing unwanted serotonin-related side-effects. Transient somnolence, hyperphagia and weight gain are the most commonly reported adverse events, which may be attributed to the antihistaminic (H1) activity of mirtazapine at low doses. Somnolence, the most commonly reported side-effect, appears to be less frequent at higher dosages. Mirtazapine also demonstrates important anxiolytic and sleep-improving effects, which may be related to its pharmacodynamic properties. In addition, mirtazapine does not appear to be associated with sexual dysfunction. Mirtazapine has shown no significant cardiovascular adverse effects at multiples of 7 to 22 times the maximum recommended dose. Mirtazapine is a unique addition to the antidepressant armamentarium as first-line therapy in patients with major depression and symptoms of anxiety/agitation or anxiety/somatization or complaints of insomnia and as a useful alternative in depressed patients who do not adequately respond to or are intolerant of tricyclic antidepressants or serotonin-specific reuptake inhibitors." http://www.biopsychiatry.com/mirtazapine.html - the page name is: "Review of the results from clinical studies on the efficacy, safety and tolerability of mirtazapine for the treatment of patients with major depression "
6 - Chloral Hydrate, sometimes simply called "knock out drops"
"Chloral Hydrate - Chloral Hydrate ( Noctec ) is a sedative with a long history of use. Used as a sleeping pill, but most the time only prescribed if the person can not take benzodiazepines.
Warnings
This drug may increase the action of anticoagulant drugs. Be very cautious when combining this drugs.
The liver may loss the ability to remove this drug if combined with: Ulcer drugs, Birth control pills, propranolol or disulfiram.
Check with your physician if you are taking central nervous system depressants like antihistamines, hay fever medicines, sedatives, narcotics, anesthetics, barbiturates or muscle relaxants.
The habit-forming potential is moderate to high.
Do not take this drug if you are pregnant.
Do not take this drug if planning to become pregnant. Do not take if you are breast-feeding. - Since your friend is in her 60s I doubt very much if these last two warnings apply. However, the next line will be very important.
Do not give this drug to children or infants. If over sixty only use drug for a brief time and with close monitoring.
Do not use if: You had negative reactions to this drug in the past or if you have kidney or liver disease.
Inform your Doctor if: You had negative reactions to this drug in the past. If you are taking any other prescription or nonprescription drug. If you plan to be under anesthesia or having any surgery in the next few months, also if you will be undergoing any medical tests. If you have a history of drug or alcohol dependence.
Chloral Hydrate ( Symptoms or Effects )
Common: Nausea/vomiting or drowsiness.
Rare: Stomach pain, dizziness/lightheadedness, diarrhea, rash, confusion, anxiety/restlessness, memory loss or irritability.
See physician always: Stomach pain, drowsiness, dizziness/lightheadedness, diarrhea, rash, confusion, anxiety/restlessness, memory loss or irritability.
See physician if severe: Nausea/vomiting.
Stop taking and see physician NOW: Rash"
http://www.psyweb.com/Drughtm/noctec.html - a commercial website Psyweb.com
7 - Olanzapine - Once again I'm sending you to a website due to the amount of information. You will find information on everything from drug identification and clinical trials and results to manufacturer information. http://www.priory.com/focus3.htm - the website is "Focus on Olanzapine"
8 - didronel - another trip to a website. This is a multipage article in PDF format so you will have to download a free Acrobat Reader if you don't already have one. The website is Proctor and gamble Pharmaceuticals. the PDF report is mid page, just click on it and you will find the full manufacturers report on the product. http://www.pgpharma.com/consumer_didronel.shtml
9 - cacit - Another PDF file containing information about the drug, its actions and interactions. http://www.nos.org.uk/InfoSheets/CYCLICALETIDRONATE.pdf
Search - Google
Terms - I used your drug list
websites used are included in the text of the answer.
I certainly hope the above answers many of your questions and gives you some "ammunition" with which to approach the doctor.
If I may clarify anything, please ask before you rate the answer.
Cheers
digsalot
Thanks for the research you've carried out for me so far - just wondering if, before I give a rating, you might be able to provide some links to usenet or forum discussions relating to mirtazapine, especially where related to use in an attempt to relieve clinical depression with no suggestion of a schizophrenic component. Patient's anecdotal reports, that type of thing.. What are the users themselves saying about this drug?
Thanks,
Here is a site containing opinions of those who use mirtazapine. Users rate the drug between 1 and 10 along with giving anecdotal accounts of how they fared taking the drug. Most of the ratings are between 7 and 10 and the most common side effect complained of is weight gain. http://remedyfind.com/hc-Sleep-Disorders.asp - The website is by Remedyfind Inc. and the Mirtzapine link is the 8th one down. Just click on the link to be taken to the ratings. You will also find ratings for similar drugs.
The title of this article is "Researchers Find Quicker Onset of Action in Mirtazapine Compared to Paroxetine in Elderly Patients With Depression" - This is a membership website but registration is free and you may find it to be a good resource for some of your future research. The website is "Medscape from WebMD" http://www.medscape.com/viewarticle/445590
This is a page from a Yahoo discussion group. You will find a link to Mirtazapine about a third of the way down the page squeezed in between two ads. - A quote:
"These side effects that drive younger patients away can be a boon to the elderly who are less concerned about their weight but who suffer from anxiety and insomnia. "Depressed people who are older often have agitation," Schatzberg said. "Mirtazapine calmed these patients and helped them sleep, especially early on." - http://groups.yahoo.com/group/nibbs-newsletter/message/49 - - - The homepage for this group is http://groups.yahoo.com/group/nibbs-newsletter/ - it is kind of an online newsletter covering many aspects of behaviorial science and is part of the Human Nature Daily Review. You must join the group to actively participate though their postings may be read without joining.
I would suggest that the first of the listing above may be closest to what you are looking for.
If I may be of further help, please ask. I will also look around a little more for related discussion groups, etc. Some may be listed under other topics than the name Mirtazapine such as sleep disorder discussions. Would you be interested in such discussions if Mirtazapine were not necessarily the main drug in the conversation? If so, I will simply post them in the "comments" section below.
Cheers
digs
#If you have any other info about this subject , Please add it free.# |
July 30th, 2010 edit