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Showing posts with label Anti Depressants. Show all posts
Showing posts with label Anti Depressants. Show all posts

Wellbutrin (Bupropion)

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Synonyms: Bupron, Wellbatrin

What is the most important information I should know about Wellbutrin?



•You should not take Wellbutrin if you have epilepsy or a seizure disorder, an eating disorder such as anorexia or bulimia, if you are using a second form of Wellbutrin, or if you have suddenly stopped using alcohol or sedatives. Do not take Wellbutrin if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), or tranylcypromine (Parnate) in the last 14 days.



•You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are 18 years of age or younger. Talk with your doctor about this risk. While you are taking this medication you will need to be monitored for worsening symptoms of depression and/ or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.



•Contact your doctor if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/ or physical hyperactivity), or thoughts of suicide or hurting yourself.



•Do not stop taking Wellbutrin without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.



•Avoid using Wellbutrin to treat more than one condition at a time. If you take Wellbutrin for depression, do not also take Zyban to quit smoking. Too much of this medicine can increase your risk of a seizure.



•Do not smoke at any time if you are using a nicotine product along with Zyban. Too much nicotine can cause serious side effects.



•Avoid drinking alcohol while taking Wellbutrin. Alcohol may increase your risk of a seizure while you are taking Wellbutrin. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. Wellbutrin can cause seizures in people who drink a lot of alcohol and then suddenly quit drinking when they start using the medication.



•There are many other drugs that can affect Wellbutrin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.



What is Wellbutrin?



Wellbutrin is an antidepressant medication.



Wellbutrin is used to treat major depressive disorder and seasonal affective disorder.



•At least one brand of Wellbutrin (Zyban) is used to help people stop smoking by reducing cravings and other withdrawal effects.



Wellbutrin may also be used for purposes other than those listed in this medication guide.



What should I discuss with my healthcare provider before taking Wellbutrin?



•Do not take Wellbutrin if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), or tranylcypromine (Parnate) in the last 14 days.



•You should not take Wellbutrin if you have:



◦epilepsy or a seizure disorder;



◦an eating disorder such as anorexia or bulimia;



◦if you are using a second form of Wellbutrin; or



◦if you have suddenly stopped using alcohol or sedatives (such as Valium).



Wellbutrin may cause seizures, especially if you have any of the following conditions:



◦head injury, brain or spinal cord tumor;



◦bipolar disorder (manic depression);



◦diabetes for which you use insulin or take oral medication;



◦current use of steroids, theophylline (Theo-Dur, Slo-Bid, Bronkodyl Theolair, Respbid), or medicine to treat depression or mental illness; or



◦recent use of alcohol, sedatives (such as Valium), narcotic pain medicines, diet pills, or street drugs such as “speed” or cocaine.



•Before taking Wellbutrin, tell your doctor if you have high blood pressure, heart disease, liver disease, kidney disease, or severe liver disease (especially cirrhosis).



•You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. While you are taking Wellbutrin, you will need to be monitored for worsening symptoms of depression and/ or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.



•Contact your doctor if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/ or physical hyperactivity), or thoughts of suicide or hurting yourself.



•FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.



Wellbutrin passes into breast milk and could be harmful to a nursing baby. Do not take Wellbutrin without telling your doctor if you are breast-feeding a baby.



•You should not smoke if you use inhaled insulin (Exubera) to treat diabetes. Smoking may cause you to have low blood sugar (hypoglycemia) while using Exubera. Do not use Exubera unless you have been smoke-free for at least 6 months. Do not start smoking again or you will have to stop using Exubera.



How should I take Wellbutrin?



•Take Wellbutrin exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.



Wellbutrin can be taken with or without food.



•Take each dose with a full glass of water.



•Do not crush, chew, or break the extended-release tablet (Wellbutrin SR, Wellbutrin XL, Zyban SR). Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.



•If you take Zyban to help you stop smoking, you may continue to smoke for about 1 week after you start the medicine. Set a date to quit smoking during the second week of Zyban treatment. By that time you will have enough of the medicine in your blood stream to help you quit smoking. Talk to your doctor if you are having trouble quitting after you have used Zyban for at least 7 weeks.



•Your doctor may prescribe nicotine patches or gum to help support your smoking cessation treatment. Be sure you read all directions and safety information for the nicotine product. Using nicotine with Zyban may raise your blood pressure and your doctor may want to check your blood pressure regularly. Do not smoke at any time if you are using a nicotine product along with Zyban. Too much nicotine can cause serious side effects.



•Do not stop taking Wellbutrin without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.



•If you use the Wellbutrin extended-release tablet, the tablet shell may pass into your stools (bowel movements). This is normal and does not mean that you are not receiving enough of the medicine.



•Store Wellbutrin at room temperature away from moisture and heat.



What happens if I miss a dose?



•Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.



What happens if I overdose?



•Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a Wellbutrin overdose may include seizures, muscle stiffness, hallucinations, fainting, fast or uneven heartbeat, shallow breathing, heart failure, or coma.



What should I avoid while taking Wellbutrin?



•Avoid drinking alcohol while taking Wellbutrin. Alcohol may increase your risk of a seizure while you are taking Wellbutrin. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. Wellbutrin can cause seizures in people who drink a lot of alcohol and then suddenly quit drinking when they start using the medication.



•Avoid using Wellbutrin to treat more than one condition at a time. If you take Wellbutrin for depression, do not also take Zyban to quit smoking. Too much of this medicine can increase your risk of a seizure.



Wellbutrin can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.



•You should not smoke if you use inhaled insulin (Exubera) to treat diabetes. Smoking may cause you to have low blood sugar (hypoglycemia) while using Exubera. Do not use Exubera unless you have been smoke-free for at least 6 months. Do not start smoking again or you will have to stop using Exubera.



What are the possible side effects of Wellbutrin?



•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 Wellbutrin and call your doctor at once if you have a seizure (convulsions) or fast, uneven heartbeats.



•Continue taking Wellbutrin and talk to your doctor if you have any of these less serious side effects:



◦headache or migraine;



◦sleep problems (insomnia);



◦nausea, vomiting, constipation, dry mouth;



◦confusion, dizziness, agitation, tremors (shaking);



◦appetite changes, weight loss or gain;



◦mild itching or skin rash, increased sweating; or



◦loss of interest in sex.



•Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.



What other drugs will affect Wellbutrin?



•Do not take Wellbutrin if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), or tranylcypromine (Parnate) in the last 14 days.



•There are many other drugs that can affect Wellbutrin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
 

Trivastal (Piribedil)

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Synonyms: Trivistal

Indications



Treatment of Parkinsons disease either as monotherapy or in combination with L-dopa therapy, in the early stages as well as in advanced stages. Treatment of Pathological cognitive deficits in the elderly. Treatment of Dizziness in the elderly. Treatment of retinal ischemic manifestations. Adjuvant treatment in intermittent claudication due to peripheral occlusive arterial disease of the lower limbs.



Contraindication



Cardiogenic shock. Acute Phase mycordial infraction.



Side Effects



Rare side effects: minor gastrointestinal disorders in predisposed individuals, or under taken between meals.



Tofranil (Imipramine)

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Synonyms: Antideprin, Berkomine, Censtim, Depsonil, Dimipressin, Dynaprin, Estraldine, Eupramin, Imavate, Imipramina

What is the most important information I should know about Tofranil?



Do not use Tofranil if you have recently had a heart attack, or if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days.



You may have suicidal thoughts or behavior when you start taking an antidepressant, especially if you are under 18 years old. You will need to be monitored for worsening symptoms of depression or suicidal thoughts. Your doctor should check you at regular visits during the first 12 weeks of treatment, or whenever your dose is changed.



Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/or physical hyperactivity), thoughts of suicide or hurting yourself.



What is Tofranil?



Tofranil is in a group of drugs called tricyclic antidepressants. Tofranil affects chemicals in the brain that may become unbalanced.



Tofranil is used to treat symptoms of depression.



Tofranil may also be used for purposes other than those listed in this medication guide.



What should I discuss with my healthcare provider before taking Tofranil?



Do not use this medication if you are allergic to Tofranil, or if you have recently had a heart attack. Do not use Tofranil if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take Tofranil before the MAO inhibitor has cleared from your body.



Before taking Tofranil, tell your doctor if you are allergic to any drugs, or if you have:



•heart disease;



•a history of heart attack, stroke, or seizures;



•bipolar disorder (manic-depression);



•kidney or liver disease;



•overactive thyroid;



•diabetes (Tofranil may raise or lower blood sugar);



•adrenal gland tumor (pheochromocytoma);



•glaucoma; or



•problems with urination.



If you have any of these conditions, you may not be able to use Tofranil, or you may need a dosage adjustment or special tests during treatment.



You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. While you are taking Tofranil, you will need to be monitored for worsening symptoms of depression and/or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed.



In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.



Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/or physical hyperactivity), thoughts of suicide or hurting yourself. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Tofranil can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medication. Do not give this medication to anyone under 18 years old without the advice of a doctor.



How should I take Tofranil?



Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Follow the directions on your prescription label.



If you need to have any type of surgery, tell the surgeon ahead of time that you are taking Tofranil. You may need to stop using the medicine for a short time.



Do not stop using Tofranil without first talking to your doctor. You may need to use less and less before you stop the medication completely. Stopping this medication suddenly could cause you to have unpleasant side effects. It may take up to 3 weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 3 weeks of treatment. Store Tofranil at room temperature away from moisture and heat.



What happens if I miss a dose?



Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.



What happens if I overdose?



Seek emergency medical attention if you think you have used too much of this medicine. An overdose of Tofranil can be fatal.



Symptoms of an Tofranil overdose may include uneven heartbeats, extreme drowsiness, agitation, vomiting, blurred vision, sweating, muscle stiffness, swelling, shortness of breath, blue lips or fingernails, feeling light-headed, fainting, seizure (convulsions), or coma.



What should I avoid while taking Tofranil?



Avoid drinking alcohol. It can cause dangerous side effects when taken together with Tofranil.



Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, medicine for seizures, or other antidepressants). They can add to sleepiness caused by Tofranil.



Grapefruit and grapefruit juice may interact with Tofranil. Discuss the use of grapefruit products with your doctor before increasing or decreasing the amount of grapefruit products in your diet.



Tofranil can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Tofranil can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.



What are the possible side effects of Tofranil?



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. Call your doctor at once if you have any of these serious side effects:



•fast, pounding, or uneven heart rate;



•chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;



•sudden numbness or weakness, especially on one side of the body;



•sudden headache, confusion, problems with vision, speech, or balance;



•feeling short of breath, even with mild exertion;



•swelling, rapid weight gain;



•confusion, hallucinations, or seizure (convulsions);



•easy bruising or bleeding, unusual weakness;



•restless muscle movements in your eyes, tongue, jaw, or neck;



•urinating more or less than usual;



•extreme thirst with headache, nausea, vomiting, and weakness;



•skin rash, bruising, severe tingling, numbness, pain, or muscle weakness.



Less serious side effects may be more likely to occur, such as:

•nausea, vomiting, stomach pain, loss of appetite;



•constipation or diarrhea;



•dry mouth, unpleasant taste;



•weight changes;



•weakness, lack of coordination;



•feeling anxious, restless, dizzy, drowsy, or tired;



•sleep problems (insomnia), nightmares;



•blurred vision, headache, ringing in your ears;



•breast swelling (in men or women); or



•decreased sex drive, impotence, or difficulty having an orgasm.



Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.



What other drugs will affect Tofranil?



Before taking Tofranil, tell your doctor if you have used an SSRI antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).



Before taking Tofranil, tell your doctor if you are currently using any of the following drugs:



•cimetidine (Tagamet);



•clonidine (Catapres);



•guanethidine (Ismelin);



•methylphenidate (Concerta, Ritalin, Daytrana); or



•heart rhythm medications such as flecainide (Tambocor), propafenone (Rhythmol), or quinidine (Cardioquin, Quinidex, Quinaglute).



If you are using any of these drugs, you may not be able to use Tofranil, or you may need dosage adjustments or special tests during treatment.



There are many other medicines that can interact with Tofranil. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.



Sinequan (Doxepin)

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Synonyms: Doxin, Doxipin, Spectra, Adapin, Aponal, Curatin, Quitaxon, Triadapin, Zonalon

What is the most important information I should know about Sinequan?



•While you are taking Sinequan you may need to be monitored for worsening symptoms of depression and/ or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking Sinequan. In patients younger than 18 years, the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/ or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/ or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with Sinequan. Do not stop taking Sinequan.



•Use caution when driving, operating machinery, or performing other hazardous activities. Sinequan may cause drowsiness or dizziness. If you experience drowsiness or dizziness, avoid these activities.



•Dizziness is likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.



•Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking Sinequan.



What is Sinequan?



Sinequan is in a class of drugs called tricyclic antidepressants. Sinequan affects chemicals in the brain that may become unbalanced and cause depression.



Sinequan is used to relieve symptoms of depression and anxiety such as feelings of sadness, worthlessness, or guilt; loss of interest in daily activities; changes in appetite; tiredness; sleeping too much; insomnia, and thoughts of death or suicide.



Sinequan may also be used for purposes other than those listed in this medication guide.



What should I discuss with my healthcare provider before taking Sinequan?



•Do not take Sinequan if you have taken a monoamine oxidase inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) within the last 14 days.



•Before taking Sinequan, tell your doctor if you have



◦liver disease,



◦kidney disease,



◦asthma,



◦thyroid disease,



◦diabetes,



◦stomach or intestinal problems,



◦high blood pressure or heart disease,



◦had a heart attack in the last 6 weeks,



◦an enlarged prostate or difficulty urinating, or



◦glaucoma.



•You may not be able to take Sinequan, or you may require a dosage adjustment or special monitoring during therapy if you have any of the conditions listed above.



•While you are taking Sinequan you may need to be monitored for worsening symptoms of depression and/ or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking Sinequan. In patients younger than 18 years, the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/ or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/ or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with Sinequan. Do not stop taking Sinequan.



•It is not known whether Sinequan will be harmful to an unborn baby. Do not take Sinequan without first talking to your doctor if you are pregnant or could become pregnant during treatment.



Sinequan passes into breast milk and may affect a nursing baby. Do not take Sinequan without first talking to your doctor if you are breast-feeding a baby.



•If you are over 60 years of age, you may be more likely to experience side effects such as drowsiness, dizziness, unsteadiness, feeling uncoordinated, and low blood pressure. Your doctor may prescribe a lower dose of this medication.



How should I take Sinequan?



•Take Sinequan exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.



•Take each dose with a full glass (8 oz) of water.



Sinequan may be taken several times a day or in one daily dose (usually at bedtime). Follow your doctor's instructions.



•It may be several weeks before you start to feel better, but do not stop taking Sinequan without first talking to your doctor.



•Store Sinequan at room temperature away from moisture and heat.



What happens if I miss a dose?



•Take the missed dose as soon as you remember. If it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take a double dose of this medication unless otherwise directed by your doctor.



What happens if I overdose?



•Seek emergency medical attention if an overdose is suspected.



•Symptoms of an Sinequan overdose include seizures, confusion, drowsiness, agitation, hallucinations, and low blood pressure (dizziness, fatigue, fainting).



What should I avoid while taking Sinequan?



•Use caution when driving, operating machinery, or performing other hazardous activities. Sinequan may cause drowsiness or dizziness. If you experience drowsiness or dizziness, avoid these activities.



•Dizziness is likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.



•Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking Sinequan.



•Do not stop taking Sinequan suddenly. This could cause symptoms such as nausea, headache, and malaise.



What are the possible side effects of Sinequan?



•If you experience any of the following serious side effects, stop taking Sinequan and contact your doctor immediately or seek emergency medical treatment:



◦an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, face, or tongue; or hives);



◦seizures;



◦a fast or irregular heartbeat;



◦a heart attack;



◦high blood pressure (blurred vision, severe headache);



◦difficulty urinating; or



◦fever with increased sweating, muscle stiffness, or severe muscle weakness.



•Other, less serious side effects may be more likely to occur. Continue to take Sinequan and talk to your doctor if you experience



◦drowsiness or dizziness;



◦dry mouth and eyes;



◦constipation;



◦mild tremor;



◦sweating;



◦mild agitation, weakness, or headache;



◦ringing in the ears;



◦nausea; or



◦loss of weight or appetite.



•Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.



What other drugs will affect Sinequan?



•Do not take Sinequan if you have taken a monoamine oxidase inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) within the last 14 days.



Sinequan may increase the effects of other drugs that cause drowsiness, including other antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other prescription or over-the-counter medicines without first talking to your doctor.



•Drugs other than those listed here may also interact with Sinequan. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.
 

Sinemet (Carbidopa + Levodopa)

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Synonyms: Sundopa

What is the most important information I should know about Sinemet?



•Do not stop taking Sinemet suddenly. It may take several weeks before you feel the full effects of this medicine. Stopping suddenly could make your condition much worse.



•Do not crush or chew any controlled-release forms of Sinemet (Sinemet CR). They are specially formulated to release slowly into your system. If necessary, the tablets can be split in half where they are scored, then swallowed without crushing or chewing.



•Use caution when driving, operating machinery, or performing other hazardous activities. Sinemet may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.



•Call your doctor immediately if you have uncontrollable movements of the mouth, tongue, cheeks, jaw, arms, or legs; fever; or increased body heat.



What is Sinemet?



Sinemet is a medication used to treat Parkinson's disease. Parkinson's disease is believed to be related to low levels of a chemical called dopamine (DOE pa meen) in the brain. Levodopa is turned into dopamine in the body. Carbidopa is used with levodopa to prevent the breakdown (metabolism) of levodopa before it can reach the brain and take effect.



Sinemet is used to treat the stiffness, tremors, spasms, and poor muscle control associated with Parkinson's disease. This medication is also used to treat the same muscular conditions when they are caused by carbon monoxide and/or manganese intoxication.



Sinemet may also be used for purposes other than those listed in this medication guide.



What should I discuss with my healthcare provider before taking Sinemet?



•If you are already taking levodopa (Larodopa, Dopar), you will have to stop taking it at least 12 hours before you take your first dose of Sinemet.



•Do not take Sinemet if you are taking or have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the past 14 days.



•Do not take this medication if you have



◦narrow-angle glaucoma (angle closure glaucoma), or



◦current or past history of malignant melanoma (a type of skin cancer).



•Before taking this medication, tell your doctor if you have:



◦any kind of heart disease, including high blood pressure, arteriosclerosis (hardening of the arteries), a previous heart attack, or an irregular heartbeat;



◦respiratory disease, including asthma and chronic obstructive pulmonary disease (COPD);



◦liver disease;



◦kidney disease;



◦an endocrine (hormonal) disease;



◦a stomach or intestinal ulcer;



◦wide-angle glaucoma; or



◦depression or any other psychiatric disorder.



•You may not be able to take Sinemet, or you may need a lower dose or special monitoring during treatment if you have any of the conditions listed above.



•Parcopa 10/100 mg and 25/100 mg tablets each contain 3.4 mg of phenylalanine; Parcopa 25/250 mg tablet contains 8.4 mg of phenylalanine. Talk to your doctor if you have phenylketonuria or have a family history of phenylketonuria.



Sinemet is in the FDA pregnancy category C. This means that it is not known whether Sinemet will harm an unborn baby. Do not take Sinemet without first talking to your doctor if you are pregnant.



•It is also not known whether Sinemet will harm a nursing infant. Do not take Sinemet without first talking to your doctor if you are breast-feeding a baby.



How should I take Sinemet?



•Do not stop taking Sinemet suddenly. It may take several weeks before you feel the full effects of this medicine. Stopping suddenly could make your condition much worse.



Sinemet can be taken with or without food.



•Take Sinemet exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.



•Take each dose with a full glass of water.



•Use dry hands to place Parcopa (Sinemet orally disintegrating tablets) onto your tongue where it will dissolve in seconds and can then be swallowed. Parcopa can be taken with or without water.



•Do not crush or chew any controlled-release forms of Sinemet (Sinemet CR). They are specially formulated to release slowly into your system. If necessary, the tablets can be split in half where they are scored, then swallowed without crushing or chewing.



•The regular-release formulations can be broken or crushed to make them easier to swallow.



•It is important to take Sinemet regularly to get the most benefit.



•Store Sinemet at room temperature away from moisture and heat.



What happens if I miss a dose?



•Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and only take your next regularly scheduled dose. Do not take a double dose of this medication.



What happens if I overdose?



•Seek emergency medical attention.



•Symptoms of a Sinemet overdose include muscle spasms or weakness, spasms of the eyelid, nausea, vomiting, diarrhea, irregular heartbeat, confusion, agitation, hallucinations, and unconsciousness.



What should I avoid while taking Sinemet?



•Use caution when driving, operating machinery, or performing other hazardous activities. Sinemet may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.



•Do not change the amount of protein in your diet without first talking to your doctor (high protein foods include meats, eggs, cheese and others). Protein may reduce the amount of Sinemet that gets absorbed into your body.



What are the possible side effects of Sinemet?



•If you experience any of the following serious side effects, stop taking Sinemet and seek emergency medical attention:



◦an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);



◦uncontrolled movements of a part of your body;



◦seizures;



◦severe nausea, vomiting, or diarrhea;



◦an irregular heartbeat or fluttering in your chest;



◦unusual changes in mood or behavior; or



◦depression or suicidal thoughts.



•Other, less serious side effects may be more likely to occur. Continue to take Sinemet and talk to your doctor if you experience



◦mild nausea, vomiting, or decreased appetite;



◦constipation, dry mouth, or blurred vision;



◦hand tremor;



◦muscle twitches;



◦dizziness or drowsiness;



◦insomnia, confusion, or nightmares;



◦agitation or anxiety;



◦darkening of your urine, sweat, or saliva; or



◦fatigue.



•Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.



What other drugs will affect Sinemet?



•You cannot take Sinemet if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the past 14 days.



•If you are already taking levodopa (Larodopa, Dopar) you will have to stop taking it at least 12 hours before you take your first dose of Sinemet.



•Before taking Sinemet, tell your doctor if you are taking any of the following medicines:



◦antacids;



◦iron supplements or vitamin supplements containing iron;



◦metoclopramide (Reglan);



◦isoniazid (Nydrazid);



◦phenytoin (Dilantin);



◦a medicine to treat high blood pressure (hypertension);



◦a tricyclic antidepressant such as amitriptyline (Elavil), doxepin (Sinequan), nortriptyline (Pamelor), desipramine (Norpramin), amoxapine (Asendin), and others; or



◦a medicine used to treat psychiatric conditions (and nausea and vomiting) such as chlorpromazine (Thorazine), prochlorperazine (Compazine), promethazine (Phenergan), fluphenazine (Prolixin), mesoridazine (Serentil), thioridazine (Mellaril), trifluoperazine (Stelazine), or haloperidol (Haldol).



•You may not be able to take Sinemet, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.



•Levodopa may interfere with urine tests for sugar and ketones. If you are diabetic and notice changes in your urine test results, talk to your doctor before making any changes in your diabetes medication.



•Drugs other than those listed here may also interact with Sinemet. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.