Zyloprim (Allopurinol)

Synonyms: Louric, Zyloric, Adenock, Ailural, Allopur, Allozym, Aloprim, Aloral, Anzief, Apurin

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

•To reduce the risk that kidney stones will form, drink 8 to 10 full glasses (8-ounce glasses) of fluid every day, unless your doctor directs otherwise.

•Avoid alcohol. It may worsen your condition.

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

What is Zyloprim?

•Zyloprim reduces the production of uric acid in your body.

•Zyloprim is used to treat gout, increased levels of uric acid caused by cancer treatment, and kidney stones that are caused by high levels of uric acid.

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

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

•Before taking Zyloprim, tell your doctor if you have kidney or liver disease. You may need a lower dose of Zyloprim or special monitoring during your therapy.

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

•Zyloprim passes into breast milk. Do not take Zyloprim without first talking to your doctor if you are breast-feeding a baby.

How should I take Zyloprim?

•Take Zyloprim 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. Also, to reduce the risk that kidney stones will form, drink 8 to 10 full glasses (8-ounce glasses) of fluid every day, unless your doctor directs otherwise.

•Take Zyloprim with food or milk to lessen stomach upset.

•Store Zyloprim 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 dose you missed and take only 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 an Zyloprim overdose are not known.

What should I avoid while taking Zyloprim?

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

•Avoid alcohol. It may worsen your condition.

•Follow your doctor's recommendations about diet.

What are the possible side effects of Zyloprim?

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

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

◦blood in your urine or pain when you urinate;

◦a rash;

◦eye irritation;

◦fever, chills, or joint aches; or

◦severe nausea or vomiting.

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

◦upset stomach or diarrhea;

◦headache, dizziness, or drowsiness; or

◦an acute attack of gouty arthritis.

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

What other drugs will affect Zyloprim?

•Taking ampicillin (Principen, Omnipen, others) or amoxicillin (Amoxil, Augmentin, Trimox, Wymox, others) may increase the risk that a rash will develop during Zyloprim therapy. Tell your doctor that you are taking Zyloprim if you need to take ampicillin or amoxicillin.

•Thiazide diuretics (water pills) may increase the amount of Zyloprim in your blood. Tell your doctor if you are taking a diuretic such as

◦hydrochlorothiazide (Hydrodiuril, Hygroton, HCTZ, others),

◦chlorothiazide (Diuril, others),

◦chlorthalidone (Thalitone, others), or

◦indapamide (Lozol).

•Zyloprim may also increase the effects of the certain other drugs. Before taking Zyloprim, tell your doctor if you are taking any of the following medicines:

◦azathioprine (Imuran),

◦mercaptopurine (Purinethol),

◦drugs used to treat cancer,

◦cyclosporine (Sandimmune, Neoral),

◦chlorpropamide (Diabinese),

◦warfarin (Coumadin), or

◦theophylline (Theochron, Theolair, Theo-Dur, others).

•You may require a dosage adjustment or special monitoring if you are taking any of the drugs listed above.

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

 

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Arcoxia (Etoricoxib)

Synonyms: Etori, Etoshine, Etozox

Common uses

This medicine can be used to treat acute gouty arthritis, osteoarthritis and other conditions as determined by your doctor.

Before using

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine.

This medicine may be taken with low-dose (75mg daily) aspirin. However, the combination may carry an increased risk of ulceration or bleeding in the stomach or intestines compared to taking Arcoxia on its own. Arcoxia should not be taken with higher daily doses of aspirin. For more information and advice ask your doctor or pharmacist.

This medicine should not be taken with other non-steroidal anti-inflammatory drugs (NSAIDs), eg ibuprofen, diclofenac, as using more than one NSAID together may also increase the risk of side effects on the gut.

This medicine may increase the anti-blood-clotting effect of warfarin. People taking warfarin or other anticoagulant medicines at the same time as this medicine should therefore have their blood-clotting time (INR) regularly monitored, particularly in the first few days of treatment with Arcoxia and following any dose changes. This medicine may reduce the effect of diuretics and other medicines for high blood pressure (antihypertensives).

There may be an increased risk of side effects on the kidneys if this medicine is taken with any of the following, and people taking any of these medicines in combination with Arcoxia should have their kidney function monitored: ACE inhibitors, eg enalapril, captopril, ciclosporin, diuretics, tacrolimus.

This medicine may increase the blood levels of the following medicines: lithium (your lithium blood level should be monitored if you are starting, changing dose, or stopping Arcoxia while taking lithium), methotrexate (people taking methotrexate should be well monitored for any side effects of methotrexate while taking Arcoxia, ethinylestradiol in oral contraceptives (this may increase the risk of side effects from these pills. Discuss this with your doctor), digoxin. Rifampicin may decrease the blood level of this medicine.

Directions

Follow the directions for using this medicine provided by your doctor. If you miss a dose of this medicine and you remember the same day, take it as soon as possible. If you do not remember until the next day, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Keep your tablets in the blister pack until it is time to take them. If you take the tablets out of the blister pack they may not keep well. Keep this mwgwcine in a cool dry place where the temperature stays below 30°C. Do not store it or any other medicine in the bathroom or near a sink. Do not leave it in the car or on window sills. Heat and dampness can destroy some medicines. Keep it where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Cautions

This medicine can sometimes cause liver problems. Consult your doctor promptly if you develop unexplained itching, yellowing of the skin or eyes, unusually dark urine, nausea and vomiting, abdominal pains, loss of appetite or flu-like symptoms.

Stop taking this medicine and consult your doctor if you develop any of the following symptoms while taking this medicine: skin rash, skin blistering or peeling, sores inside your mouth, other signs of an allergic reaction, or signs of bleeding in the stomach or intestine, such as passing a black or blood-stained bowel movement or vomiting blood.

This medicine may hide fever, which is a sign of infection. This may make you think mistakenly that an infection is getting better when it isn't, or that an infection is less serious than it is. For this reason you should tell your doctor if you get an infection while you are taking this medicine.

People with impaired kidney, liver or heart function should have their kidney function monitored while taking this medicine. Your blood pressure should be regularly monitored while you are taking this medicine.

This medicine may cause fatigue and dizziness. You should take care when performing potentially hazardous activites, such as driving or operating machinery, until you know how this medicine affects you and are sure you can perform such activities safely.

The use of this medicine is not recommended if you have active peptic ulcer, Bleeding from the stomach or intestines, Inflammatory bowel disease such as ulcerative colitis or Crohn's disease, Uncontrolled high blood pressure (hypertension), Moderate to severe heart failure, Heart disease caused by inadequate blood flow to the heart (ischaemic heart disease), eg angina or history of heart attack, Disease of the blood vessels in and around the brain (cerebrovascular disease), eg history of stroke, Moderate to severely decreased kidney function, severely decreased liver function, pregnancy, breastfeeding, people who have developed asthma, nasal inflammation (rhinitis), nasal polyps, swelling of the face, lips and tongue (angioedema) or itchy rash (urticaria) following the use of aspirin or other NSAIDs, rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malsorption.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.Possible side effects

The following are some of the side effects that are known to be associated with this medicine: headache, dizziness, disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain, weakness or loss of strength (asthenia), fatigue, cold or flu-like symptoms, rash, blurred vision, difficulty in sleeping (insomnia), muscle cramps, weight gain, excessive fluid retention in the body tissues, resulting in swelling, nosebleeds (epistaxis), difficulty in breathing (dyspnoea), high blood pressure (hypertension), chest pain, heart failure, anxiety, ulceration or bleeding of the stomach or intestine, liver or kidney disorders.

If you take too much

If overdose is suspected, contact your local poison control center or emergency room immediately.

Additional information

Do not share this medicine with others for whom it was not prescribed. Do not use this medicine for other health conditions. Keep this medicine out of the reach of children. If using this medicine for an extended period of time, obtain refills before your supply runs out.

Drug interactions

Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Some medicines or medical conditions may interact with this medicine. Inform your doctor or pharmacist of all prescription and over-the-counter medicine that you are taking.

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Arava (Leflunomide)

Synonyms: Lefumide, Leflunomidum, Lefunomide

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

•Arava is in the FDA pregnancy category X. There is an increased risk of birth defects and death of the unborn baby while taking Arava. Do not take this medication if you are pregnant or could become pregnant during treatment. Notify your doctor immediately if you think you have become pregnant during treatment. Birth control must be used during treatment with Arava. Discuss with your doctor the procedure for removing Arava from the body following treatment before becoming pregnant. Without the proper drug elimination procedure, it may take up to two years before Arava is at sufficiently low levels in the body so as to reduce the risk of harm to an unborn baby. It is not known whether Arava imposes an increased risk of fetal harm when taken by a man. Men wishing to father a child while taking Arava should discuss their options with their doctor.

What is Arava?

•Arava affects the immune system and decreases inflammation.

•Arava is used to reduce the signs and symptoms of rheumatoid arthritis, reduce damage to the joints caused by rheumatoid arthritis, and to improve physical function in people with rheumatoid arthritis.

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

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

•Before taking Arava, tell your doctor if you have

◦liver disease or a history of hepatitis;

◦a history of significant alcohol use;

◦kidney disease;

◦an immune system disease;

◦recently received a live vaccine;

◦poor bone marrow function; or

◦a current or chronic infection.

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

•Arava is in the FDA pregnancy category X. There is an increased risk of birth defects and death of the unborn baby while taking Arava. Do not take this medication if you are pregnant or could become pregnant during treatment. Notify your doctor immediately if you think you have become pregnant during treatment. Birth control must be used during treatment with Arava. Discuss with your doctor the procedure for removing Arava from the body following treatment before becoming pregnant. Without the proper drug elimination procedure, it may take up to two years before Arava is at sufficiently low levels in the body so as to reduce the risk of harm to an unborn baby. It is not known whether Arava imposes an increased risk of fetal harm when taken by a man. Men wishing to father a child while taking Arava should discuss their options with their doctor.

•It is not known whether Arava passes into breast milk. There is a potential for serious side effects in a nursing baby from Arava. Do not take Arava if you are breast-feeding a baby.

How should I take Arava?

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

•Take each dose with a full glass of water.

•Arava can be taken with or without food or milk.

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

•Your doctor may want you to have blood tests or other medical evaluations while taking Arava to monitor side effects and progress.

•Store Arava 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 only take your next regularly scheduled dose. 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 a Arava overdose may include diarrhea, abdominal pain, blood problems, and liver problems.

What should I avoid while taking Arava?

•Discuss with your doctor the use of alcohol while taking Arava. Alcohol and Arava can both be damaging to the liver.

•Arava can lower the activity of the immune system making you more susceptible to infection. Avoid contact with people who have colds, the flu, or other contagious illnesses. In addition, do not receive vaccines that contain a live strain of the virus (e.g., live oral polio vaccine) and avoid contact with individuals who have recently been vaccinated with a live virus.

What are the possible side effects of Arava?

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

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

◦changes in liver function (may be detected by blood tests or cause symptoms such as yellowing of the skin or eyes; pale colored stools or dark colored urine; unusual fatigue; or abdominal pain);

◦decreased bone marrow function or blood problems (may be detected by blood tests or cause symptoms such as extreme or unusual fatigue; easy bruising or bleeding; black, bloody or tarry stools; fever or chills; or signs of infection such as fever; chills, or sore throat); or

◦skin rash; or

◦sores in the mouth.

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

◦headache;

◦increased blood pressure;

◦muscle aches;

◦nausea;

◦diarrhea; or

◦hair loss.

•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 Arava?

•Before taking Arava, tell your doctor if you are taking any of the following drugs:

◦cholestyramine (Questran, Prevalite, LoCHOLEST);

◦methotrexate (Rheumatrex); or

◦rifampin (Rifadin, Rimactane).

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

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

 

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