The Pdr (R) Family Guide to Prescription Drugs (R): 6th Edition

But today’s potent medicines are not without their risks. For certain people, at certain times, some drugs can cause problems. And for all people, misusing a medication is an invitation to trouble. The purpose of this book is to alert you to those times and those conditions which should make you wary, and to help you use all of your medications safely and effectively.

This book is not a substitute for a visit to the doctor. Only a doctor can weigh all the diverse aspects of your condition and choose the treatment most likely to meet your needs. What we hope this book can do, however, is help you sort out the facts and questions that deserve further discussion. Your doctor, after all, can respond only to the problems and concerns you mention. And a seemingly unimportant question could turn out to be a crucial aspect of your particular case.

The book is divided into two major parts. In the first section, you’ll find profiles of the more frequently prescribed medications. The second section gives you an overview of common diseases and disorders, and the types of treatments to expect.

The Drug Profiles
The profiles in this section are designed to give you detailed information on the nation’s most frequently prescribed prescription drugs, plus a few widely used over-the-counter medications. Though the section covers more than 1,000 products, it is not all-inclusive. If you do not find a profile for a particular prescription you’ve received, you shouldn’t be concerned. There are a number of specialized, yet valuable drugs in current use that have been omitted here due to lack of space.

Most prescription products have two names–a generic chemical name and a manufacturer’s brand name. Both are listed alphabetically in this book, with a profile of the drug appearing under the more familiar of the two. In most instances, that means the brand name. In a few cases–such as insulin, for example–the generic name heads the profile. In either case, the drug’s other name gives you a cross-reference to the profile.

If there is more than one brand of a drug, you’ll usually find the profile under the name that’s most frequently prescribed. For example, information on amoxicillin can be found in the profile of Amoxil, the nation’s leading brand. Other brands of amoxicillin, such as Wymox and Polymox, are cross-referenced to the Amoxil entry.

The drug profiles begin with correct pronunciation of the name, followed by the other brand and generic names for the drug. The information that follows these names is divided into 10 sections.

PREMARIN
Brand name: Premarin
Pronounced: PREM-uh-rin
Generic name: Conjugated estrogens
Other brand names: Premphase, Prempro

Why is this drug prescribed?
Premarin is an estrogen replacement drug. The tablets are used to reduce symptoms of menopause, including feelings of warmth in face, neck, and chest, and the sudden intense episodes of heat and sweating known as “hot flashes.” They also may be prescribed for teenagers who fail to mature at the usual rate, and to relieve the symptoms of certain types of cancer, including some forms of breast and prostate cancer.

In addition, either the tablets or Premarin vaginal cream can be used for other conditions caused by lack of estrogen, such as dry, itchy external genitals and vaginal irritation.

Along with diet, calcium supplements, and exercise, Premarin tablets are also prescribed to prevent osteoporosis, a condition in which the bones become brittle and easily broken.

The addition of progesterone to estrogen-replacement therapy has been shown to reduce the risk of uterine cancer. Prempro combines estrogen and progesterone in a single tablet taken once daily. Premphase is a 28-day supply of tablets. The first 14 contain only estrogen. The second 14 supply both estrogen and progesterone.

Most important fact about this drug
Because estrogens have been linked with increased risk of endometrial cancer (cancer in the lining of the uterus), it is essential to have regular checkups and to report any unusual vaginal bleeding to your doctor immediately.

How should you take this medication?
Take Premarin exactly as prescribed. Do not share it with anyone else.

If you are taking calcium supplements as a part of the treatment to help prevent brittle bones, check with your doctor about how much to take.

You should take a few moments to read the patient package insert provided with your prescription.
If you are using Premarin vaginal cream, apply it as follows:
Remove cap from tube.
Screw nozzle end of applicator onto tube.
Gently squeeze tube from the bottom to force sufficient cream into the barrel to provide the prescribed dose. Use the marked stopping points on the applicator as a guide.
Unscrew applicator from tube.
Lie on back with knees drawn up. Gently insert applicator deeply into the vagina and press plunger downward to its original position.

To cleanse the applicator, pull the plunger to remove it from the barrel, then wash with mild soap and warm water. Do not boil or use hot water.
If you miss a dose…
Take the forgotten dose as soon as you remember. If it is almost time for the next dose, skip the one you missed and go back to your regular schedule. Never try to “catch up” by doubling the dose.
StoStorage instruction.
Store at room temperature.

What side effects may occur?
Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor immediately. Only your doctor can determine whether it is safe to continue taking Premarin.
Side effects may include:
Abdominal cramps, abnormal vaginal bleeding, bloating, blood clots, breast swelling and tenderness, depression, dizziness, enlargement of benign tumors in the uterus, fluid retention, gallbladder disease, hair loss from the scalp, increased body hair, inflammation of the pancreas, intolerance to contact lenses, migraine headache, nausea, vomiting, sex-drive changes, skin darkening, especially on the face, skin rash or redness, swelling of wrists and ankles, vaginal yeast infection, vomiting, weight gain or loss, yellow eyes and skin
Other possible side effects of Premphase and Prempro:
Appetite changes, backache, changes in blood pressure, excessive flow of breast milk, eye disorders, fatigue, fever, headache, nervousness, sleep disturbances, twitching

Why should this drug not be prescribed?
Do not take Premarin if you have ever had a bad reaction to it, or have undiagnosed abnormal vaginal bleeding.
Except in certain special circumstances, you should not be given Premarin if you have breast cancer or any other “estrogen-dependent” cancer.

Do not take Premarin if you have had any heart or circulation problem including a tendency for abnormal blood clotting.

Special warnings about this medication
The risk of cancer of the uterus increases when estrogen is used for a long time or taken in large doses.

There may be an increased risk of breast cancer in women who take estrogen for a long time. If you have a family history of breast cancer or have ever had an abnormal mammogram, you need to have more frequent breast examinations.

Women who take Premarin after menopause are more likely to develop gallbladder disease.

Premarin also increases the risk of blood clots. These blood clots can cause stroke, heart attack, or other serious disorders.

While taking Premarin, get in touch with your doctor right away if you notice any of the following:
Abdominal pain, tenderness, or swelling
Abnormal bleeding from the vagina
Breast lumps
Coughing up blood
Pain in your chest or calves
Severe headache, dizziness, or faintness
Sudden shortness of breath
Vision changes
Yellowing of the skin
If you have high levels of fat in your blood, Premphase and Prempro are more likely to cause side effects in the pancreas.

Possible food and drug interactions when taking this medication
If Premarin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Premarin with the following:
Barbiturates such as phenobarbital
Blood thinners such as Coumadin
Drugs used for epilepsy, such as Dilantin
Major tranquilizers such as Thorazine
Oral diabetes drugs such as Micronase
Rifampin (Rifadin)
Steroid medications such as Deltasone
Thyroid preparations such as Synthroid
Tricyclic antidepressants such as Elavil and Tofranil
Vitamin C

Special information if you are pregnant or breastfeeding
If you are pregnant or plan to become pregnant, notify your doctor immediately. Premarin should not be taken during pregnancy because of the possibility of harm to the unborn child. Premarin cannot prevent a miscarriage. Estrogens can decrease the quantity and quality of breast milk, and progestins appear in breast milk. Your doctor may advise you not to breastfeed while you are taking this drug.

Recommended dosage
Your doctor will start therapy with this medication at a low dose. He or she will want to check you periodically at 3- to 6-month intervals to determine the need for continued therapy.

PREMARIN TABLETS
Hot Flashes Associated with Menopause
The usual dosage is 0.3 to 1.25 milligrams daily. If you are still having periods, the doctor will start the Premarin on the fifth day of your cycle, have you take it for 3 weeks, then give you 1 week off.

Tissue Degeneration in the Vagina
The usual dosage is 0.3 to 1.25 milligrams or more daily. The drug is taken cyclically (3 weeks on and 1 week off).