1A.PATIENT DRUG INFORMATION - (REGROUPED) - Antacids, Antireflux agents
Drug Name:1A.PATIENT DRUG INFORMATION - (REGROUPED) - Antacids, Antireflux agents
List Of Brands:
Indication Type Description:
Drug Interaction
Indication
Adverse Reaction
Contra-Indications
Dosages/ Overdosage Etc
Other Information
Drug Interaction:
1.GASTROINTESTINAL & HEPATOBILIARY SYSTEM
1A. ANTACIDS,ANTIREFLUX AGENTS & ANTIULCERANTS
i.ALUMINIUM HYDROXIDE
ii.ESOMEPRAZOLE
iii.FAMOTIDINE
iv.LANZOPOSOLE
v.MISOPRAZOLE
vi.OMEPRAZOLE
vii,PANTOPRAZOLE
viii.RABEPRAZOLE
ix. RANITIDINE
x. ROXATIDINE
xi. SUCRALFATE
i,ALUMINIUN HYDROXIDE
As per US FDA guidelines as per USPDA 1997
It is the intention to bring out the salient features. Hence relevent details as prescribed by US FDA guidelines as per USPDA 1997 are brought out clearly in the following chapters.
Descriptons are detailed only to the Group Head and the indiviual items can be seen by visiting the Web Site
ANTACIDS-
Antacids are taken by mouth to relieve heartburn, sour stomach, or acid indigestion. They work by neutralising excess acid. Some antacid combinations also contain simethicone which may relieve the symptoms of excess gas
Antacids alone or in combinations with simethicone may also be used to treat the symptoms of stomach or duodenal ulcers
This information applies to the following medicines-
1.Aluminium Hydroxide,Bismuth Subsalicylate, Calcium Carbonate,Famotidine,Magaldrate, Magnesium Hydroxide,Sodium Bicarbonate
Aluminium Hydroxide
General Information
1.Chew tablets throughly before swallowing,follow it with a glass of water
2.Ulcer patients should adhere strictly to prescribed drug schedule
3.Antacids may impair the absorption of many drugs. Do not take other oral drugs within 1 or 2 hours of antacid administration.
3.Magnesium- containing products have a laxative effect and may cause diarrhoea. Aluminium and calcium containing products may cause constipation
4.Inform your doctor,if relief is not obtained or if there are any symptoms that suggest bleeding, such as black tarry stools or coffee ground vomitus.
5. Allergies- Tell your doctor if you are allergic to any other substances such as foods, preservatives or dyes.
6. Diet- Make sure that your doctor knows if you are on a low sodium diet. Some antacids contain large amounts of sodium.
7. Pregnancy- There have been reports of antacids causing side efects in babies whose mothers took antacids for a long time especially in high doses during pregnancy. Also sodium containing medicines should be avoided if you to tend to retain body water.
8. Breast feeding- some aluminium, calcium or magnesium containing products may pass into breast milk. However, these medicines have not been reported to cause problems in nursing babies.
9. Children- anatcids should not be given to children (under 6 years of age) unless ordered by the doctor.
10. Elderly- aluminium containing products should not be used in elderly persons with bone problems or with Alzeheimers disease.
11. Other medicines- When your are taking antacids it is important that your doctor knows thaty ou are taking any other medicines.
12. Tell your doctor if you have any other medical problems, to avoid any ill effects.
13. Dosage- Dose of antacids will be different for different patients. Follow your doctors orders.
14. Missed dose-
Follow the medicine as given by the doctor. If you miss a dose take it as soon as possible. Hoever if it is time for the next dose, skip the mised dose and go back to your regular schedule.
Do not double doses.
15. Take with or without food
ii. ESOMEPRAZOL
Refer - Omeprazole
Patient Information
Elderly- No dosage adjustments required
Renal function impairment- For patients with severe hepatic impairment (Child- Pugh class C) , do not exceed a dose of esomeprazole 20mg.
No dosage adjustment is necessary in patients with mild to moderate liver impairment (Child- Pugh calsses A and B)
Administration- Take espomeprazole at least 1 before eating
Delayed Release Capsules- Capsules can be swaollowed whole or can be opened and mixed with applesauce
Difficulty in swallowing - Add 1 tablte spoon of applesauce to an empty bowl and open the delayed release capsule . Carefully empty the granules inside the capsule onto to the applesauce. Granules should be mixed with the applesauce and swallowed immediately. The applesauce must not be hot and should be soft enough to be swallowed immediately without chewing. Do not store the granules/applesauce for future use
Administration of capsule for nasogastric tube- The delayed release capsule can be opened and the intact mixture can be emptied into a 60ml Cathether tipped syringe and mixed with 50 L of water. It is important to only use a catherter tipped syringe when administering esmoprezole through a naso-gastric (NG) tube.
Replace the plunger and shake the syringe vigourously for 15 seconds. Hold the syringe up and check for granules remaining in the tip. Attach the syringe to an NG tube and deliver the contents of the syringe through the NG tube into the stomach.
After administering the granules , flesh the NG tube with additional water. Do not administer the granules if they have dissolved or disintrgrated. The suspension must be usedimmediately after preparation.
Indication:
iii. FAMOTIDINE
Refer - Cimetidine
1.For patients taking one dose a day- take it at bed time,unless otherwise directed
2.For patients taking two doses- take one in the morning and one at bed time.
3.Take the medicines for the full time of treatment,even if you begin to feel better.
4.Tell your doctor if you ever had any allergic reaction to the medicine.
iv.LANZOPRAZOLE
Refer - Omeprazole
1.Take Lanzoprazole before a meal,preferably in the morning.
2. Swallow the capsule whole .Do not crush,break or chew the capsule
3.Take the medicine for the full time of treatment, even if you begin to feel better
4.Allergies- tell your doctor if you have ever had any unusual or allergic reaction to
lanzoprazole. Also tell your doctor if you are allergic to any other substances,
such as foods, preservatives or dyes.
5.Pregnancy - studies not done in humans. However, studies in animals have not shown that lanzoprazole causes harm to the fetus.
6.Breast feeding- since this medicine has been shown to cause unwanted effects in animals, it may be necesary to take another medicine or stop breast feeding during treatment.
7 Children - no specific information comparing use of indapamide in children with use in other age groups
8. Elderly- lanzoprazole did not cause different side effects or problems than it did in younger adults.
9. Other medicines - Let your doctor know what other medicines you are taking, other medicines so that he can advice you accordingly.
Sucralfate - lanzoprazole should be taken at least 30 minutes before sucralfate so
that lanzoprazole will be properly absorbed
10. Missed dose -
If you miss a dose of this medicine, take it as soon as possible. however, if it is almost time for the next dose, skip the missed dose. Do not double doses.
11. Storage - Keep out of reach of children. Store away from heat or direct sunlight. Do not store the capsule in bathroom, near the kitchen sink, or in other damp places.
12. Outdated medicines - Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of reach of children.
Adverse Reaction:
v. MISOPRESTOL
MISOPROSTOL- PROSTAGLANDINS
1. Misoprostol can cause miscarriage, often associated with potentially dangerous bleeding.
This can result in hospitalisation, surgery, infertility, or death. Do not take misoprostol, if pregnant, and do not become pregnant while taking the medication. If pregnancy occurs during therapy, discontinue the drug and contact physician
2. Take misoprostol only according to the directions of the physician.
3. Do not give misoprostol to any one else.
5. Allergy- tell your doctor if you ever had any unusual or allergic reactions.to misoprostol or any other substances such as foods, presevative or dyes.
6. Pregnancy- Misprostol must not be used during pregnancy
7. Breast feeding- Not recommended for use during breast feeding becaue it may cause diarrhea in nursng babies
7. Children- No specific information comparing use of misoprostol in children with use with other age groups.
8. Older patients- Medicine has been tested and has not shown to cause different side effects or problems in older people than it does in younger adults.
9. Other medicines- Although certain medicines should not be used at all , in other cases two different medicines may be used together even if an interaction might occur.
Tell you doctor if you are taking any other prescription or nonprescription medicines
(OTC)
10. Other medical problems- Presence of other medical problems may affect the use of
misoprostol. Tell your doctor if you have any other medical problems especially-
Blood vessel disease- medicines similar to misoprosol have been shown to make this condtion worse
11. Dosing - dosing of misoprostol may be different for different patients. Follow your doctors orders If your dose is different do not change unless told by your doctor.
To prevent stomach ulcer in patients taking anti-inflammatory medicines including
aspirin- Tablets- Adults- 200mcg ( micromilligrams) four a day with or after meals and at bed time, or 400mcg two times a day, with last dose takem at bed time.
Children and teen agers- dose may be determined by the doctor.
12. Missed dose-If you have missed a dose of this medicine, take it as s soon as possible.
If it is almost time for the next dose,skip the dose and follow the regular schedule.
Never double doses.
13. Storage-
Do not store in bath room or near the kitchen or in damp places. Heat and moisture
may affect the medicine and cause to break down.
Do not keep outdated medicines or medicines no longer in use
Make sure that you keep outdated medicines out of reach of children.
vi.OMEPRAZOLE
Refer - Omeprazole
1.Swallow the capsule form of Omeprazole whole.Do not crush,break,chew or open the capsule.
2.Take this for the full time of treatment, even if you begin to feel better.
3.If you miss a dose of this medicine take it as soon as possible. However,if it is almost time for the next dose,skip the missed dose and go back to your regular dosing schedule. Do not double dose.
4.Allergies- tell your doctor if you have ever had any unusual or allergic reaction to omeprazole Also tell your doctor if you are allergic to any other substances, such as foods, presevatives or dyes.
5.Pregnancy - studies in animals have shown that omeprazole may cause harm to fetus.
6.Breast feeding- omeprazole may paas into breast milk. make sure that you have discussed the risks and benefits of the medicine with your doctor.
7. Children - no specific information comparing use of nitrates in children with use in other age groups
8.Elderly- no specific information comparing use of omeprazole in the elderly with use in other age groups
9. Other medicines - Antocoagulants or Diazepam or Phenytoin - use with omeprazole may cause high blood levels of these medicines which may increase the chance of side effects.
10. Other medical problems - Tell your doctor if you have any other medical problems especially - Liver disease or history of liver disease- the condition may cause ompeprazole to build up in the body.
11. Missed dose - If you miss a dose of this medicine, take it as soon as possible. however, if it is almost time for the next dose, skip the missed dose. Do not double doses.
12. Storage - Keep out of reach of children. Store away from heat or direct sunlight. Do not store the capsule in bathroom, near the kitchen sink, or in other damp places.
13. Outdated medicines - Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of reach of children.
Contra-Indications:
vii. PANTOPRAZOLE
Refer - Omeprazole
viii. RABEPRAZOLE
Refer - Omeprazole
Dosages/ Overdosage Etc:
ix. RANITIDINE
Refer - Cimetidine
1.For patients taking one dose a day- take it at bed time unless otherwise directed
2.For patients taking two doses a day- take one in the morning and and one at bed time.
3.For patients taking several doses a day- take them with meals and one at bed time
4.Take the medicines for the full course of treatment, even if you begin to feel better.
5.Tell your doctor if you had any previous allergic reaction to the medicine.
Histamine H2 receptor Antagonists -systemic
1. Allergy- Tell you doctor if you ever had allergic reaction to cimetidine, famotidie, nizatidine, ranitidine
2. Pregnancy- In animal studies famotidine and ranitidine have not been shown to
cause birth defects or other problems. Make sure that your doctor kows if you
are pregnant or you may become pregnant before taking H2 blockers
3.Breast feeding- Cimetidine, famotidine, nizatiidine and ranitidine pass into te breast milk
and may cause unwanted effects. It may be necessary to take anothermedicine or stop
breast feeding during treatment. Make sure that you discuss the risks and benefits
of the medicine with your doctor.
4. Children- This medicine has been tested in effective doses , and has not shown to
cause different side effects or problems than it does in adults when used for
short periods of time.
5. Older patients- Confusion and dizziness may be respecially likely to occur in elderly
patients who are more sensitive than younger adults to the effects of H2 blockers.
6. Other medicines- Certain medicines should not be used together at all- It is important that your
doctor know if you are taking any of the following medicines-
7. Other medical problems- Presence of other medical problems may affect the use
H2 blockers- Tell your Doctor about other medical problems
8. Dosing- Dosing of H2 receptor antagonists will be different for different patients.
If your is different do not change unless the doctor tells you to do so.
Do not take the maximun daily dose contonously for more than 2 weeks unless
directed by your doctor.
If you have trouble in swallowing or persistent abdominal pain, see your doctor
promptly. These may signs of a serious condition that need different treatment.
One dose a day- take it at bed time unless otherwise directed
Two doses a day- take one in the moring and and one at bed time.
Several doses a day-take them with meals and at bedtime for best results.
9. Missed dose- if you miss a dose take it as soon as possible
However, ift is almosttime for next dose, skipthe dose and and go back to your schedule.
Do not double doses.
x ROXATIDINE
Histamine H2 Antagonists include- Cimetidine, Famotidine, Nizatidine, Ranitidine, Roxatidine Refer - Cimetidine
Other Information:
xi. SUCRALFATE
1.Take on an empty stomach at least 1 hour before or 2 hours after meals and bed time.
2.Do not take antacids half an hour before or after taking sucralfate
3. Allergies- tell your doctor if you have ever had any unusual or allergic reaction to sucralfate. Also tell your doctor if you are allergic to any other substances, such as foods, presevatives
or dyes.
4.Pregnancy- sucralfate has not been shown to cause birth defects or other problems in
animal studies.
5.Breast feeding- sucralfate has not been to cause problems in nursing babies.
6.Children- this medicine is not expected to cause different side effects or problems
in children than it does in adults.
7.Elderly- this medicine is not expected to cause different side effects or problems
in children than it does in adults.
8. Other medicines - Tell your Doctor the other medicines you are taking other medicines
9. Other medical problems - Tell your doctor if you have any other medical problems
10. Missed dose - If you miss a dose of this medicine, take it as soon as possible.
however, if it is almost time for the next dose, skip the missed dose.
Do not double doses.
11. Storage - Keep out of reach of children. Store away from heat or direct sunlight.
Do not store the capsule in bathroom, near the kitchen sink, or in other damp places.
12. Outdated medicines - Do not keep outdated medicine or medicine no longer needed.
Be sure that any discarded medicine is out of reach of children.