Amalis Hernandez Cabrera July 4, 2017

Nova Southeastern University, College of Pharmacy

Walgreens, Palm Beach Gardens

Most dispense drugs in the pharmacy:

1)Lidocane

Uses:

This medication is used on the skin to stop itching and pain from certain skin conditions (e.g.,

scrapes, minor burns, eczema, insect bites) and to treat minor discomfort and itching caused

by hemorrhoids and certain other problems of the genital/anal area (e.g., anal fissures, itching

around the vagina/rectum). Some forms of this medication are also used to decrease discomfort

or pain during certain medical procedures/exams (e.g., sigmoidoscopy, cystoscopy). Lidocaine is

a local anesthetic that works by causing temporary numbness/loss of feeling in the skin

and mucous membranes.

Side Effects:

Nausea, vomiting, headache, abdominal cramps/bloating, breast tenderness, swelling of

the ankles/feet (retaining fluid), or weight change may occur. If any of these effects persist or

worsen, tell your doctor or pharmacist promptly.

Many women will not have regular periods while taking this medication. This is normal. Vaginal

bleeding/spotting is likely to occur, especially during the first few months of use. If bleeding is

unusually heavy or lasts for more than 7 days in a row, contact your doctor promptly.

This medication may raise your blood pressure. Check your blood pressure regularly and tell

your doctor if the results are high.

Tell your doctor right away if you have any serious side effects, including: lumps in the breast,

mental/mood changes (such as new/worsening depression), unusual changes in vaginal bleeding

(such as continuous spotting, sudden heavy bleeding), severe pain in

the stomach/abdomen/pelvis, dark urine, yellowing eyes/skin.

Precautions:

Before using lidocaine, tell your doctor or pharmacist if you are allergic to it; or to other amide

type anesthetics (e.g., bupivacaine, prilocaine); or if you have any other allergies. This product

may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to

your pharmacist for more details. Before using this medication, tell your doctor or pharmacist

your medical history, especially of: broken skin/infection in the area where lidocaine is to be

used, heart disease, liver disease.

Caution is advised when using this drug in children because they may be more sensitive to the

side effects of the drug. During pregnancy, this medication should be used only when clearly

needed. Discuss the risks and benefits with your doctor.

This medication passes into breast milk, but is unlikely to harm a nursing infant. Consult your

doctor before breast-feeding.

Interactions:

Drug interactions may change how your medications work or increase your risk for serious side

effects. This document does not contain all possible drug interactions. Keep a list of all the

products you use (including prescription/nonprescription drugs and herbal products) and share it

with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines

without your doctor's approval.

2) Zaleplon

Uses:

Short-term treatment of insomnia.

Zaleplon is a hypnotic agent. It works by depressing the central nervous system (brain), causing

drowsiness to aid in falling asleep.

Side Effects:

Dizziness, drowsiness, short-term memory loss, or lack of coordination may occur, especially

during the first 2 hours after you take the medication. Taking the medication properly just before

falling asleep will reduce your risk of these effects. If any of these effects persist or worsen,

notify your doctor or pharmacist promptly.

Tell your doctor right away if any of these unlikely but serious side effects occur: mental/mood

changes (e.g., agitation, confusion, seeing/hearing things that are not there, rare thoughts

of suicide), unusual behavior.

Rarely, after taking this drug, people have gotten out of bed and driven vehicles while not fully

awake ("sleep-driving"). People have also sleepwalked, prepared/eaten food, made phone calls,

or had sex while not fully awake. Often, these people do not remember these events. This

problem can be dangerous to you or to others. If you find out that you have done any of these

activities after taking this medication, tell your doctor right away. Your risk is increased if you

use alcohol or other medicationsthat can make you drowsy while taking zaleplon.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention

if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling

(especially of the face/tongue/throat), severe dizziness, trouble breathing.

Interactions:

Drug interactions may change how your medications work or increase your risk for serious side

effects. This document does not contain all possible drug interactions. Keep a list of all the

products you use (including prescription/nonprescription drugs and herbal products) and share it

with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines

without your doctor's approval. Some products that may interact with this drug

include: melatonin, drugs affecting liver enzymes that remove zaleplon from your body (e.g.,

azole antifungals such as ketoconazole, cimetidine, rifamycins such as rifabutin/rifampin, certain

anti-seizuremedicines such as phenytoin, carbamazepine, phenobarbital), sodium oxybate.

The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/dizziness)

may be increased if this medication is taken with other products that may also cause drowsiness

or breathing problems. Tell your doctor or pharmacist if you are taking other products such

as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, other drugs

for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such

as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Precautions:

Do NOT use zaleplon if you are allergic to any ingredient in zaleplon,

you are taking sodium oxybate (GHB) .Before taking zaleplon, tell your doctor or pharmacist if

you are allergic to it; or if you have any other allergies. This product may contain inactive

ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for

more details. Before using this medication, tell your doctor or pharmacist your medical history,

especially of: liver problems, very high/low blood pressure, breathing

problems (e.g., asthma), depression, history of drug/alcohol abuse. This drug may make you

dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you

are sure you can perform such activities safely. Avoid alcoholic beverages. Before having

surgery, tell your doctor or dentist that you are using this medication. Older adults may be more

sensitive to the side effects of this drug, especially memory problems, confusion, dizziness, lack

of coordination. Dizziness and lack of coordination can increase the risk of falling. This

medication should be used only when clearly needed during pregnancy. Discuss the risks and

benefits with your doctor.

3) Nitroglycerin (Sublingual tablet)

Use:

Treating high blood pressure during surgery, controlling congestive heart failure associated with

heart attack, treating chest pain in certain patients, and lowering blood pressure during surgery.

Nitroglycerin is a nitrate. It works by relaxing (widening) blood vessels. Chest pain occurs when

the heart needs more oxygen than it can get. Relaxing blood vessels allows blood to flow more

easily. This reduces the heart's workload and the amount of oxygen needed by the heart.

Side Effects:

Bloating or swelling of the face, arms, hands, lower legs, or feet, burning, crawling, itching,

numbness, prickling, "pins and needles", or tingling feelings, difficult or labored

breathing, feeling faint, dizzy, or lightheadedness, feeling of warmth or heat, flushing or redness

of the skin, especially on the face and neck, headache, rapid weight gain, sweating, tightness in

the chest, tingling of the hands or feet, and unusual weight gain or loss.

Precautions:

Do NOT take this medication if you are allergic to any ingredient in nitroglycerin, you have had

a stroke or other bleeding in the brain, swelling of the sac surrounding the heart, or interference

of blood returning to the heart.

4) Warfarin

Use: Warfarin is an anticoagulant (blood thinner). Warfarin reduces the formation of blood clots.

Warfarin is used to treat or prevent blood clots in veins or arteries, which can reduce the risk

of stroke, heart attack, or other serious conditions. Many drugs (including some over-the-counter medicines and herbal products) can affect your INR and may increase the risk of bleeding if you take them with warfarin

Side effects: Warfarin is an anticoagulant (blood thinner). Warfarin reduces the formation of

blood clots. Warfarin is used to treat or prevent blood clots in veins or arteries, which can reduce

the risk of stroke, heart attack, or other serious conditions.Many drugs (including some over-

the-counter medicines and herbal products) can affect your INR and may increase the risk

of bleeding if you take them with warfarin

Interactions:

Using warfarin together with ethanol can cause you to bleed more easily. If you take warfarin

you should avoid large amounts of alcohol, but moderate consumption (one to two drinks per

day) are not likely to affect the response to warfarin if you have normal liver function. You may

need a dose adjustment in addition to testing of your prothrombin time or International

Normalized Ratio (INR).

Rarely, vitamin supplements containing vitamin K may reduce the effectiveness of warfarin.

This may be more likely to occur in individuals who have low levels of vitamin K in their blood.

Before using any vitamin supplement, you should check the label to make sure it does not

contain vitamin K. If it does, let your doctor know before you start using it. You may need more

frequent monitoring of your INR after starting the supplement or whenever it is discontinued,

and appropriate adjustments made in your dosage if necessary. increasing vitamin K levels in the

body can promote clotting and reduce the effectiveness of warfarin. While there is no need to

avoid products that contain vitamin K, you should maintain a consistent level of consumption of

these products. Foods rich in vitamin K include beef liver, broccoli, Brussels sprouts, cabbage,

collard greens, endive, kale, lettuce, mustard greens, parsley, soy beans, spinach, Swiss chard,

turnip greens, watercress, and other green leafy vegetables. Moderate to high levels of vitamin K

are also found in other foods such as asparagus, avocados, dill pickles, green peas, green tea,

canola oil, margarine, mayonnaise, olive oil, and soybean oil. However, even foods that do not

contain much vitamin K may occasionally affect the action of warfarin.

International Normalised Ratio (INR) testing is well established as an integral part of

warfarin treatment. INR has a critical role in maintaining the warfarin response within a

therapeutic range, to provide the benefits of anticoagulation, while avoiding the risks of

haemorrhage.

Precautions:

Warfarin blocks the formation of vitamin K-dependent clotting factors, thereby decreasing the

body's ability to form blood clots - often described as "thinning the blood"

5) Valsartan

Use: Treating high blood pressure alone or with other medicines. It is used to treat heart failure.

It is used in certain patients to decrease the risk of death after a heart attack. It may also be used

for other conditions as determined by your doctor. Valsartan is an angiotensin II receptor

blocker. It works by relaxing the blood vessels. This helps to lower blood pressure.

Side effects: If any of the following side effects occur while taking valsartan, check with

your doctor immediately:

Bloody urine, cold sweats, confusion, decreased frequency or amount of urine, difficult

breathing, dizziness, faintness, or lightheadedness when getting up from a lying position

fainting, increased thirst, irregular heartbeat, loss of appetite, lower back or side pain, nausea,

nervousness, numbness or tingling in the hands, feet, or lips, swelling of the face, fingers, or

lower legs, unusual tiredness or weakness, vomiting and weight gain.

Interactions:

If you are taking valsartan you should avoid potassium-containing salt substitutes or over-the-

counter potassium supplements without first talking to your doctor. This can cause high levels of

potassium in your blood. High levels of potassium can cause weakness, irregular heartbeat,

confusion, tingling of the extremities, or feelings of heaviness in the legs.

Precautions: Do NOT use valsartan if you are allergic to any ingredient in valsartan, you are pregnant, the

patient is a child who has severe kidney problems or is on dialysis, you are taking a medicine

that contains aliskiren and you also have diabetes or kidney problems. Check with your doctor or

pharmacist if you are not sure if a medicine you take contains aliskiren

6)Temazepam

Use: Temazepam is used to treat insomnia symptoms, such as trouble falling asleep or staying

asleep. Do not use temazepam if you are pregnant. This medicine can cause birth defects or

life-threatening withdrawal symptoms in a newborn. Temazepam may cause a severe allergic

reaction. Stop taking this medicine and get emergency medical help if you have any of these

signs of an allergic reaction.

Side effects: Temazepam may cause a severe allergic reaction. Stop taking this medicine and 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. Take this medication only when you are

getting ready for several hours of sleep. You may fall asleep very quickly after taking the

medicine. If any of the following side effects occur while taking temazepam, check with

your doctor immediately: False or unusual sense of well-being, fear or nervousness, mood or

mental changes Also difficult or labored breathing, fast, irregular, pounding, or racing heartbeat

or pulse, large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex

organs loss of appetite, loss of memory, nightmares and problems with memory.

Precautions: Do not use temazepam if you are pregnant. This medicine can cause birth

defects or life-threatening withdrawal symptoms in a newborn. Temazepam may be habit-

forming and should be used only by the person it was prescribed for. This medicine should never

be shared with another person, especially someone who has a history of drug abuse or addiction.

Keep the medication in a secure place where others cannot get to it. Misuse of habit-forming

medicine can cause addiction, overdose, or death.

7) Synthroid (Levothyroxine)

Use: Synthroid (levothyroxine) is a thyroid medicine that replaces a hormone normally

produced by your thyroid gland to regulate the body's energy and metabolism. Levothyroxine is

given when the thyroid does not produce enough of this hormone on its own. Synthroid

treats hypothyroidism (low thyroid hormone). Synthroid is also used to treat or

prevent goiter (enlarged thyroid gland), which can be caused by hormone imbalances, radiation

treatment, surgery, or cancer.

Side effects: If any of the following side effects occur while taking levothyroxine, check with

your doctor immediately: Chest pain or discomfort, decreased urine output, difficult or labored

breathing, difficulty with swallowing, dilated neck veins, extreme fatigue, fainting, fast, slow,

irregular, pounding, or racing heartbeat or pulse, fever, heat intolerance, hives or welts, skin

itching, rash, or redness, irregular breathing, irritability, menstrual changes, nausea, pain or

discomfort in the arms, jaw, back, or neck, sweating, swelling of the eyes, face, lips, throat, or

tongue, tightness in the chest and tremors.

Interactions:

Using multivitamin with minerals together with levothyroxine may decrease the effects of

levothyroxine. You should separate the administration of levothyroxine and multivitamin with

minerals by at least 4 hours. If your doctor does prescribe these medications together, you may

need a dose adjustment or special test to safely use both medications. It is important to tell your

doctor about all other medications you use, including vitamins and herbs. Do not stop using any

medications without first talking to your doctor.

Precautions: Synthroid should not be used to treat obesity or weight problems. Dangerous

side effects or death can occur from the misuse of levothyroxine, especially if you are taking any

other weight-loss medications or appetite suppressants.

8)Prednisone

Uses: Prednisone is a corticosteroid. It prevents the release of substances in the body that cause

inflammation. It also suppresses the immune system. Prednisone is used as an anti-inflammatory

or an immunosuppressant medication. Prednisone treats many different conditions such as

allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, or breathing

disorders.

Side effects: Most common side effects are:Aggression, agitation, blurred vision, decrease in

the amount of urine, dizziness, fast, slow, pounding, or irregular heartbeat or pulse, headache,

irritability, mood changes noisy, rattling breathing, numbness or tingling in the arms or legs,

pounding in the ears shortness of breath, swelling of the fingers, hands, feet, or lower legs,

trouble thinking, speaking, or walking and troubled breathing at rest.

Precautions: Many drugs can interact with prednisone. Not all possible interactions are listed

here. Tell your doctor about all your medications and any you start or stop using during

treatment with prednisone, especially:

Amphotericin B; cyclosporine; digoxin, digitalis; St. John's wort; an antibiotic such as

clarithromycin or telithromycin; antifungal medication such as itraconazole, ketoconazole,

posaconazole, voriconazole; birth control pills and other hormones; a blood thinner such as

warfarin, Coumadin; a diuretic or "water pill"; the hepatitis C medications boceprevir or

telaprevir; HIV or AIDS medicine such as atazanavir, delavirdine, efavirenz, fosamprenavir,

indinavir, nelfinavir, nevirapine, ritonavir, saquinavir.

9)Sulfasalazine

Uses: Sulfasalazine is used to treat a certain type of bowel disease called ulcerative colitis.

This medication does not cure this condition, but it helps decrease symptoms such as

fever, stomach pain, diarrhea, and rectal bleeding. After an attack is treated, sulfasalazine is also

used to increase the amount of time between attacks. This medication works by reducing

irritation and swelling in the large intestines.

Before taking sulfasalazine, tell your doctor or pharmacist if you are allergic to it; or to sulfa

drugs; or to aspirin and related drugs (salicylates, NSAIDs such as ibuprofen); or to mesalamine;

or if you have any other allergies. This product may contain inactive ingredients, which can

cause allergic reactions or other problems. Talk to your pharmacist for more details.

Side effects:

Stomach upset, nausea, vomiting, loss of appetite, headache, dizziness, or unusual tiredness may

occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

This medication may cause your skin and urine to turn orange-yellow. This effect is harmless

and will disappear when the medication is stopped.Rarely, delayed-release tablets

of sulfasalazine may appear whole or only partly dissolved in your stool. If this occurs, tell your

doctor right away so your treatment can be changed.

Interactions:

Drug interactions may change how your medications work or increase your risk for serious side

effects. This document does not contain all possible drug interactions. Keep a list of all the

products you use (including prescription/nonprescription drugs and herbal products) and share it

with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines

without your doctor's approval.

Precautions:

Before taking sulfasalazine, tell your doctor or pharmacist if you are allergic to it; or to sulfa

drugs; or to aspirin and related drugs (salicylates, NSAIDs such as ibuprofen); or to mesalamine;

or if you have any other allergies. This product may contain inactive ingredients, which can

cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using

this medication, tell your doctor or pharmacist your medical history, especially of: intestinal

blockage, urinary blockage, kidney disease, liver disease, blood disorders (such as aplastic

anemia, porphyria), a certain genetic condition (G6PD deficiency), asthma, severe allergies,

current/recent/returning infections.

10) Lisinopril

Uses: Lisinopril is an ACE inhibitor. ACE stands for angiotensin converting enzyme. Lisinopril

is used to treat high blood pressure (hypertension) in adults and children who are at least 6

years old. Lisinopril is also used to treat congestive heart failure in adults, or to improve survival

after a heart attack.

Side effects:

Commonly reported side effects of lisinopril include: dizziness, hypotension, hyperkalemia,

increased blood urea nitrogen, and increased serum creatinine. Other side effects

include: headache, and hyperkalemia. See below for a comprehensive list of adverse effects.

You should check with your doctor immediately if any of these side effects occur when

taking Lisinopril: Blurred vision, cloudy urine, confusion, decrease in urine output or decrease

in urine-concentrating ability, dizziness, faintness, or lightheadedness when getting up suddenly

from a lying or sitting position, sweating and unusual tiredness or weakness.

Precautions:

Do not use lisinopril if you are pregnant. It could harm the unborn baby. Stop using this

medicine and tell your doctor right away if you become pregnant.You should not use this

medicine if you have hereditary angioedema.If you have diabetes, do not use lisinopril together

with any medication that contains aliskiren (such as Amturnide, Tekturna, Tekamlo).

11) Losartan

Uses: Losartan (Cozaar) belongs to a group of drugs called angiotensin II receptor antagonists. It

keeps blood vessels from narrowing, which lowers blood pressure and improves blood flow.

Losartan is used to treat high blood pressure (hypertension). It is also used to lower the risk of

stroke in certain people with heart disease. Losartan is used to slow long-term kidney damage in

people with type 2 diabetes who also have high blood pressure. Losartan may also be used for

purposes not listed in this medication guide.

Side effects:

Commonly reported side effects of losartan include: asthenia, chest pain, diarrhea, fatigue,

and hypoglycemia. Other side effects include: hyperkalemia, hypotension, and orthostatic

hypotension. See below for a comprehensive list of adverse effects. Abdominal or stomach pain,

anxiety, bladder pain, bloody or cloudy urine, blurred vision, chills, cold sweats, coma,

confusion, cool, pale skin, depression, difficult breathing, difficult, burning, or painful urination,

dizziness, fast heartbeat and frequent urge to urinate.

Precautions:

You should not use losartan if you are allergic to it. If you have diabetes, do not use losartan

together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo, Valturna).

You may also need to avoid taking this medicine with aliskiren if you have kidney disease. To

make sure losartan is safe for you, tell your doctor if you have: kidney disease; liver disease;

congestive heart failure; an electrolyte imbalance (such as low levels of potassium in your

blood); or if you are dehydrated.

12) Sertraline

Uses: Sertraline is an antidepressant in a group of drugs called selective serotonin reuptake

inhibitors (SSRIs). The way this medicine works is still not fully understood. It is thought to

positively affect communication between nerve cells in the central nervous system and/or restore

chemical balance in the brain. Sertraline is used to treat depression, obsessive-compulsive

disorder, panic disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and

premenstrual dysphoric disorder (PMDD).

Side effects:

Commonly reported side effects of sertraline include: diarrhea, dizziness, drowsiness,

dyspepsia, fatigue, insomnia, loose stools, nausea, tremor, headache, paresthesia, anorexia,

decreased libido, delayed ejaculation, diaphoresis, ejaculation failure, and xerostomia. Other

side effects include: abdominal pain, agitation, pain, vomiting, anxiety, hypouricemia, and

malaise. See below for a comprehensive list of adverse effects.

Precautions:

You should not use sertraline if you also take pimozide, or if you are being treated with

methylene blue injection. Do not use sertraline if you have taken an MAO inhibitor in the

past 14 days. A dangerous drug interaction could occur. MAO inhibitors include

isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

13)Zolpidem

Uses: Zolpidem is a sedative, also called a hypnotic. It affects chemicals in the brain that may be

unbalanced in people with sleep problems (insomnia). Zolpidem is used to treat insomnia. The

immediate-release forms are Ambien, Intermezzo, Edluar, and Zolpimist, which are used to help

you fall asleep. The extended-release form of zolpidem is Ambien CR, which has a first layer

that dissolves quickly to help you fall asleep, and a second layer that dissolves slowly to help you

stay asleep.

Side effects:

Commonly reported side effects of zolpidem include: dizziness and drowsiness. Other side

effects include:myalgia, visual hallucination, anxiety, hallucination, and nausea. See below for a

comprehensive list of adverse effects.

Precautions:

Zolpidem may cause a severe allergic reaction. Stop taking zolpidem and 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.Do not share this medication with another person,

even if they have the same symptoms you have. The recommended doses of zolpidem are not the

same in men and women, and this drug is not approved for use in children. Misuse of this

medication can result in dangerous side effects.

14) Atenolol

Uses: Atenolol (Tenormin) is a beta-blocker that affects the heart and circulation (blood flow

through arteries and veins). Atenolol is used to treat angina (chest pain) and hypertension(high

blood pressure). Atenolol is also used to lower the risk of death after a heart attack.

Side effects:

Commonly reported side effects of atenolol include: cardiac failure, bradycardia, dizziness,

fatigue, and cold extremities. See below for a comprehensive list of adverse effects. Blurred

vision, cold hands or feet, confusion difficult or labored breathing, dizziness, faintness, or

lightheadedness when getting up from a lying or sitting position suddenly, shortness of breath,

sweating, tightness in chest, unusual tiredness or weakness and wheezing.

Interactions:

Atenolol and ethanol may have additive effects in lowering your blood pressure. You may

experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate.

These side effects are most likely to be seen at the beginning of treatment, following a dose

increase, or when treatment is restarted after an interruption. Let your doctor know if you

develop these symptoms and they do not go away after a few days or they become troublesome.

Precautions:

You should not use this atenolol if you have a serious heart condition such as "AV block," very

slow heartbeats, or heart failure. Do not stop taking atenolol without first talking to your doctor.

Stopping suddenly may make your condition worse.

15) Atorvastatin

Uses: Atorvastatin is in a group of drugs called HMG CoA reductase inhibitors, or "statins."

Also, Atorvastatin reduces levels of "bad" cholesterol (low-density lipoprotein, or LDL) and

triglycerides in the blood, while increasing levels of "good" cholesterol (high-density lipoprotein,

or HDL). Atorvastatin is used to treat high cholesterol, and to lower the risk of stroke, heart

attack, or other heart complications in people with type 2 diabetes, coronary heart disease, or

other risk factors. Atorvastatin is used in adults and children who are at least 10 years old.

Side effects:

Commonly reported side effects of atorvastatin include: hemorrhagic stroke, arthralgia,

diarrhea, and nasopharyngitis. Other side effects include: urinary tract infection, insomnia, limb

pain, muscle spasm, musculoskeletal pain, myalgia, and nausea. See below for a comprehensive

list of adverse effects.

Interactions:

Grapefruit juice can increase the blood levels of atorvastatin. This can increase the risk of side

effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves

the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney

damage and even death. You should limit your consumption of grapefruit juice to no more than 1

quart per day during treatment with atorvastatin. Let your doctor know immediately if you have

unexplained muscle pain, tenderness, or weakness during treatment, especially if these symptoms

are accompanied by fever or dark colored urine

Precautions:

You should not take atorvastatin if you are pregnant or breast-feeding, or if you have liver

disease. Stop taking this medication and tell your doctor right away if you become

pregnant. Serious drug interactions can occur when certain medicines are used together with

atorvastatin. Tell each of your healthcare providers about all medicines you use now, and any

medicine you start or stop using. In rare cases, atorvastatin can cause a condition that results in

the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if

you have unexplained muscle pain, tenderness, or weakness especially if you also have fever,

unusual tiredness, and dark colored urine.

16) Lyrica

Uses:

Lyrica (pregabalin) is an anti-epileptic drug, also called an anticonvulsant. It works by slowing

down impulses in the brain that cause seizures. Lyrica also affects chemicals in the brain that

send pain signals across the nervous system.Lyrica is used to control seizures and to treat

fibromyalgia. It is also used to treat pain caused by nerve damage in people with diabetes

(diabetic neuropathy), herpes zoster (post-herpetic neuralgia, or neuropathic pain associated with

spinal cord injury. Lyrica may also be used for other purposes not listed in this medication guide.

Side effects:

Common side effects of Lyrica include: infection, ataxia, blurred vision, constipation, diplopia,

dizziness, drowsiness, fatigue, headache, peripheral edema, tremor, weight gain, visual field loss,

accidental injury, and xerostomia. Other side effects include: abnormal gait, abnormality in

thinking, amnesia, arthralgia, asthenia, cognitive dysfunction, confusion, edema, neuropathy,

sinusitis, speech disturbance, vertigo, visual disturbance, myasthenia, amblyopia, increased

appetite, and twitching. See below for a comprehensive list of adverse effects.

Precautions:

There have been postmarketing reports of angioedema in patients during initial and chronic

treatment with LYRICA. Specific symptoms included swelling of the face, mouth (tongue, lips,

and gums), and neck (throat and larynx). There were reports of life-threatening angioedema with

respiratory compromise requiring emergency treatment. Discontinue LYRICA immediately in

patients with these symptoms.Exercise caution when prescribing LYRICA to patients who have

had a previous episode of angioedema. In addition, patients who are taking other drugs

associated with angioedema (e.g., angiotensin converting enzyme inhibitors [ACE-inhibitors])

may be at increased risk of developing angioedema.

17) Tramadol

Uses: ramadol is a narcotic-like pain reliever. Tramadol is used to treat moderate to severe

pain. The extended-release form of tramadol is for around-the-clock treatment of pain. This

form of tramadol is not for use on an as-needed basis for pain.

Side effects:

Commonly reported side effects of tramadol include: pruritus, agitation, anxiety, constipation,

diarrhea, hallucination, nausea, tremor, vomiting, and diaphoresis. Other side effects

include: insomnia, pruritus, and diaphoresis. See below for a comprehensive list of adverse

effects.

Precautions:

You should not take tramadol if you have severe breathing problems, a blockage in your stomach

or intestines, or if you have recently used alcohol, sedatives, tranquilizers, narcotic medication,

or an MAO inhibitor (isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline,

selegiline, tranylcypromine, and others).Tramadol can slow or stop your breathing, and may be

habit-forming. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE,

OR DEATH, especially in a child or other person using the medicine without a

prescription.

18) Zinc Oxide Ointment USP

Zinc oxide ointment can relieve a variety of mild skin conditions such as diaper rash, pimples

and minor burns, including sunburn. Zinc oxide acts as skin barrier to prevent and heal skin

irritation. It is used in a variety of skin creams and ointments.

Users generally apply a generous amount of of zinc oxide ointment to completely cover the

treatment area. Melasma is a common skin condition that causes brownish-colored spots on the

face especially on the nose, cheeks, chin upper lips and forehead. Some 90 percent of melasma

cases occur in women. Its most prevalent in people with darker complexions.

Minor skin irritations such as cuts, burns, scrapes and poison ivy often benefit from the anti-

inflammatory properties contained in zinc oxide ointment. You can apply a thin layer of zinc

oxide to the affected skin as often as needed to relieve irritation and promote healing.

19) Trivora (Levonorgestrel Ehinyl Estradiol Tablets)

Oral contraceptives are indicated for the prevention of pregnancy in women who elect to use this

product as a method of contraception.

Oral contraceptives are highly effective. Table II lists the typical accidental pregnancy rates for

users of combination oral contraceptives and other methods of contraception. The efficacy of

these contraceptive methods, except sterilization and the IUD, depends upon the reliability with

which they are used. Correct and consistent use of methods can result in lower failure rates.

20) Amoxicillin

Uses:

Amoxicillin is a penicillin antibiotic that fights bacteria.Amoxicillin is used to treat many

different types of infectioncaused by bacteria, such as tonsillitis, bronchitis, pneumonia,

gonorrhea, and infections of the ear, nose, throat, skin, or urinary tract. Amoxicillin is also

sometimes used together with another antibiotic called clarithromycin (Biaxin) to treat stomach

ulcers caused by Helicobacter pylori infection. This combination is sometimes used with a

stomach acid reducer called lansoprazole (Prevacid).There are many brands and forms of

amoxicillin available and not all brands are listed on this leaflet.

Side effects:

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking

amoxicillin:

Incidence not known: • Abdominal or stomach cramps or tenderness

• back, leg, or stomach pains

• black, tarry stools

• bleeding gums

• blistering, peeling, or loosening of the skin

• bloating

• blood in the urine

• bloody nose

• chest pain

• chills

• clay-colored stools

• cough

• dark urine

• diarrhea

• diarrhea, watery and severe, which may also be bloody

• difficulty with breathing

• difficulty with swallowing

• dizziness

Precautions:

Do not use this medication if you are allergic to amoxicillin or to any other penicillin antibiotic,

such as ampicillin (Omnipen, Principen), dicloxacillin (Dycill, Dynapen), oxacillin (Bactocill),

penicillin (Beepen-VK, Ledercillin VK, Pen-V, Pen-Vee K, Pfizerpen, V-Cillin K, Veetids), and

others.Before using amoxicillin, tell your doctor if you are allergic to cephalosporins such as

Omnicef, Cefzil, Ceftin, Keflex, and others. Also tell your doctor if you have asthma, liver or

kidney disease, a bleeding or blood clotting disorder, mononucleosis (also called "mono"), or any

type of allergy.

21) Vytorin

Uses: Vytorin contains a combination of ezetimibe and simvastatin. Ezetimibe reduces the

amount of cholesterol absorbed by the body. Simvastatin is in a group of drugs called HMG CoA

reductase inhibitors, or "statins." Ezetimibe and simvastatin reduce the blood levels of "bad"

cholesterol (low-density lipoprotein, or LDL) and triglycerides, while increasing levels of "good"

cholesterol (high-density lipoprotein, or HDL)

.Many drugs can interact with Vytorin. Not all possible interactions are listed here. Tell your

doctor about all your medications and any you start or stop using during treatment with Vytorin,

especially: colchicine; lomitapide; fenofibrate, fenofibric acid; a blood thinner (warfarin,

Coumadin, Jantoven); heart rhythm medicine - amiodarone or dronedarone; a>heart or blood

pressure medicine - amlodipine, diltiazem, ranolazine, verapamil; or medicines that contain

niacin, or vitamin B3, such as Advicor, Niaspan, Niacor, Simcor, Slo-Niacin, and others.

Side effects:

If any of the following side effects occur while taking ezetimibe / simvastatin, check with your

doctor immediately:

Incidence not known:

• Abdominal or stomach fullness

• bloating

• chills

• constipation

• darkened urine

• fast heartbeat

• fever

• hives

• hoarseness

• indigestion

• itching

• joint pain

22) Meloxicam

Uses: Meloxicam is used to treat arthritis. It reduces pain, swelling, and stiffness of the joints.

Meloxicam is known as a nonsteroidal anti-inflammatory drug (NSAID).If you are treating a

chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using

other medications to treat your pain. See also Warning section.Read the Medication Guide

provided by your pharmacist before you start taking meloxicam and each time you get a refill. If

you have any questions, ask your doctor or pharmacist.

Side effects:

Stomach upset, nausea, dizziness, or diarrhea may occur. If any of these effects persist or

worsen, tell your doctor or pharmacist promptly.Remember that your doctor has prescribed

this medication because he or she has judged that the benefit to you is greater than the risk of

side effects. Many people using this medication do not have serious side effects. This medication

may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the

results are high.

Precautions:

Before taking meloxicam, tell your doctor or pharmacist if you are allergic to it; or to aspirin or

other NSAIDs (such as ibuprofen, naproxen, celecoxib); or if you have any other allergies. This

product may contain inactive ingredients, which can cause allergic reactions or other problems.

Talk to your pharmacist for more details.Before using this medication, tell your doctor or

pharmacist your medical history, especially of: asthma (including a history of worsening

breathing after taking aspirinor other

NSAIDs), liver disease, stomach/intestine/esophagus problems (such as bleeding, ulcers,

recurring heartburn), heart disease (such as history of heart attack), high blood

pressure, stroke, blood disorders (such as anemia, bleeding/clotting problems), growths in the

nose (nasal polyps).

23) Metformin

Uses:

Metformin is an oral diabetes medicine that helps control blood sugar levels. Metformin is used

to improve blood sugar control in people with type 2 diabetes. It is sometimes used in

combination with insulin or other medications, but this medicine is not for treating type 1

diabetes. Metformin may also be used for purposes not listed in this medication guide.

Side effects:

You should check with your doctor immediately if any of these side effects occur when

taking metformin:

More common: • Abdominal or stomach discomfort

• cough or hoarseness

• decreased appetite

• diarrhea

• fast or shallow breathing

• fever or chills

• general feeling of discomfort

• lower back or side pain

Precautions:

You should not use metformin if you are allergic to it, or if you have:

• severe kidney disease; or

• if you are in a state of diabetic ketoacidosis (call your doctor for treatment with

insulin).

If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, you

will need to temporarily stop taking metformin.

To make sure metformin is safe for you, tell your doctor if you have:

• kidney disease;

• liver disease;

• a history of heart disease or recent heart attack

24) Ondasertron:

Uses:

Ondansetron blocks the actions of chemicals in the body that can trigger nausea and

vomiting.Ondansetron is used to prevent nausea and vomiting that may be caused by surgery,

cancer chemotherapy, or radiationtreatment. Ondansetron may be used for purposes not listed in

this medication guide.

Side effects:

Serious side effects of ondansetron include blurred vision or temporary vision loss (lasting from

only a few minutes to several hours), slow heart rate, trouble breathing, anxiety, agitation,

shivering, feeling like you might pass out, and urinating less than usual or not at all. Stop taking

this medicine and call your doctor at once if you have any of these side effects. Ondansetron may

impair your thinking or reactions. Be careful if you drive or do anything that requires you to be

alert.

Precautions:

You should not use ondansetron if:

• you are also using apomorphine (Apokyn); or

• you are allergic to ondansetron or similar medicines (dolasetron, granisetron,

palonosetron).

To make sure ondansetron is safe for you, tell your doctor if you have:

• liver disease;

• an electrolyte imbalance (such as low levels of potassium or magnesium in your

blood);

• congestive heart failure, slow heartbeats;

• a personal or family history of long QT syndrome; or

• a blockage in your digestive tract (stomach or intestines).

25) Diazepam

Uses:

Diazepam is a benzodiazepine (ben-zoe-dye-AZE-eh-peens). It affects chemicals in the brain that

may be unbalanced in people with anxiety. Diazepam is used to treat anxiety disorders, alcohol

withdrawalsymptoms, or muscle spasms. Diazepam is sometimes used with other medications to

treat seizures. Diazepam may also be used for purposes not listed in this medication guide.

Side effects:

Commonly reported side effects of diazepam include: drowsiness and hypotonia. See below

for a comprehensive list of adverse effects. You should check with your doctor immediately if

any of these side effects occur when taking diazepam:

More common: • Shakiness and unsteady walk

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

Precautions:

You should not use this medicine if you are allergic to diazepam or similar medicines (Ativan,

Klonopin, Restoril, Xanax, and others), or if you have myasthenia gravis, severe liver disease,

narrow-angle glaucoma, a severe breathing problem, or sleep apnea.Before you take diazepam,

tell your doctor if you have glaucoma, asthma or other breathing problems, kidney or liver

disease, seizures, or a history of drug or alcohol addiction, mental illness, depression, or suicidal

thoughts.Do not start or stop taking diazepam during pregnancy without your doctor's advice.

Diazepam may cause harm to an unborn baby, but having a seizure during pregnancy could harm

both the mother and the baby. Tell your doctor right away if you become pregnant while taking

diazepam for seizures.

26) Omeprazole

Uses:

Omeprazole (Prilosec, Zegerid) belongs to group of drugs called proton pump inhibitors. It

decreases the amount of acid produced in the stomach. Omeprazole is used to treat symptoms

of gastroesophageal reflux disease (GERD) and other conditions caused by excess stomach

acid. It is also used to promote healing of erosive esophagitis (damage to your esophagus caused

by stomach acid).Omeprazole may also be given together with antibiotics to treat gastric ulcer

caused by infection with helicobacter pylori (H. pylori).

Side effects:

f any of the following side effects occur while taking omeprazole, check with your doctor

immediately:

Rare • Back, leg, or stomach pain

• bleeding or crusting sores on the lips

• blisters

• bloody or cloudy urine

• chills

• continuing ulcers or sores in the mouth

• difficult, burning, or painful urination

• fever

• frequent urge to urinate

• general feeling of discomfort or illness

• joint pain

Precautions:

Omeprazole is not for immediate relief of heartburn symptoms. Heartburn is often confused with

the first symptoms of a heart attack. Seek emergency medical attention if you have chest pain or

heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, and a general ill feeling.

You should not take this medication if you are allergic to omeprazole or to any other

benzimidazole medication such as albendazole or mebendazole.

27)Ibuprofen

Uses:

Ibuprofen is used to relieve pain from various conditions such as headache, dental

pain, menstrual cramps, muscle aches, or arthritis. It is also used to reduce fever and to relieve

minor aches and pain due to the common cold or flu. Ibuprofen is a nonsteroidal anti-

inflammatory drug (NSAID). It works by blocking your body's production of certain natural

substances that cause inflammation. This effect helps to decrease swelling, pain, or fever.

If you are treating a chronic condition such as arthritis, ask your doctor about non-drug

treatments and/or using other medications to treat your pain. See also Warning section.

Side effects:

Upset stomach, nausea, vomiting, headache, diarrhea, constipation, dizziness, or drowsiness may

occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.If your

doctor has prescribed this medication, remember that he or she has judged that the benefit to you

is greater than the risk of side effects. Many people using this medication do not have serious

side effects.This medication may raise your blood pressure. Check your blood pressure regularly

and tell your doctor if the results are high.

Precautions:

Before taking ibuprofen, tell your doctor or pharmacist if you are allergic to it; or to aspirin or

other NSAIDs (such as naproxen, celecoxib); or if you have any other allergies. This product

may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to

your pharmacist for more details.

Before taking this medication, tell your doctor or pharmacist your medical history, especially

of: asthma (including a history of worsening breathing after taking aspirinor other

NSAIDs), blood disorders (such as anemia, bleeding/clotting problems), growths in the nose

(nasal polyps), heart disease (such as previous heart attack), high blood

pressure, liver disease, stroke, throat/stomach/intestinal problems (such as bleeding, heartburn,

ulcers).

28)Digoxin

Uses:

Digoxin is used to treat heart failure, usually along with other medications. It is also used to treat

certain types of irregular heartbeat (such as chronic atrial fibrillation). Treating heart failure may

help maintain your ability to walk and exercise and may improve the strength of your heart.

Treating an irregular heartbeat can decrease the risk for blood clots, an effect that may reduce

your risk for a heart attack or stroke.Digoxin belongs to a class of medications called cardiac

glycosides. It works by affecting certain minerals (sodium and potassium) inside heart cells. This

reduces strain on the heart and helps it maintain a normal, steady, and strong heartbeat.

Side effects:

Nausea, vomiting, headache, dizziness, loss of appetite, and diarrhea may occur. If any of these

effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the

benefit to you is greater than the risk of side effects. Many people using this medication do not

have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: weakness,

mental/mood changes, vision changes (such as blurred or yellow/green vision),

enlarged/tender breasts in men.

Precautions:

Before taking digoxin, tell your doctor or pharmacist if you are allergic to it; or to similar drugs

(such as digitoxin); or if you have any other allergies. This product may contain inactive

ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for

more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially

of: kidney problems, thyroid problems (underactive or overactive).

This drug may make you dizzy or cause blurred vision. Do not drive, use machinery, or do any

activity that requires alertness or clear vision until you are sure you can perform such activities

safely.

29)Vancomycin

Uses:

Vancomycin is an antibiotic. When taken by mouth it fights bacteria in the intestines.

Vancomycin is used to treat an infection of the intestines caused by Clostridium difficile, which

can cause watery or bloody diarrhea. It is also used to treat staph infections that can cause

inflammation of the colon and small intestines.

Oral vancomycin works only in the intestines. This medicine is not normally absorbed into the

body and will not treat other types of infection. An injection form of this medication is available

to treat serious infections in other parts of the body.

Vancomycin may also be used for purposes not listed in this medication guide

Precautions:

Oral vancomycin works only in the intestines and will not treat infections in other parts of the

body. Follow all directions on your medicine label and package. Tell each of your healthcare

providers about all your medical conditions, allergies, and all medicines you use.Vancomycin

can cause temporary or permanent hearing loss. Stop using this medication and call your doctor

at once if you have any hearing problems or ringing in your ears.

30) Furosemide

Uses:

Furosemide is a loop diuretic (water pill) that prevents your body from absorbing too much salt.

This allows the salt to instead be passed in your urine.Furosemide is used to treat fluid retention

(edema) in people with congestive heart failure, liver disease, or a kidney disorder such as

nephrotic syndrome. Furosemide is also used to treat high blood pressure(hypertension).

Side effects:

You should check with your doctor immediately if any of these side effects occur when

taking furosemide:

Rare • Chest pain

• chills

• cough or hoarseness

• fever

• general feeling of tiredness or weakness

• headache

• lower back or side pain

• painful or difficult urination

• shortness of breath

• sore throat

• sores, ulcers, or white spots on the lips or in the mouth

• swollen or painful glands

• tightness in the chest

• unusual bleeding or bruising

• unusual tiredness or weakness

• wheezing

Precaution:

You should not use furosemide if you are unable to urinate.Do not take more than your

recommended dose. High doses of furosemide may cause irreversible hearing loss.Before using

furosemide, tell your doctor if you have kidney disease, enlarged prostate, urination problems,

cirrhosis or other liver disease, an electrolyte imbalance, high cholesterol, gout, lupus, diabetes,

or an allergy to sulfa drugs.Tell your doctor if you have recently had an MRI (magnetic

resonance imaging) or any type of scan using a radioactive dye that is injected into your veins.

Do not take more of this medication than is recommended.