2pd Top 200 Patient Counseling Points

Amoxicillin

"Complete full course of therapy.

For the suspension, shake well and store in the refrigerator. Note short expiration after reconstitution. Can take with food if causes upset stomach.

Avoid mixing suspension with food or beverages and use with measuring device that comes with prescription.

Symptoms should improve within 2-3 d; if they worsen, seek follow-up with health-care practitioner.

May decrease effectiveness of oral contraceptives; encourage patients to use backup contraceptive method (eg, condom)."

Amoxicillin/Clavulanate

"Complete full course of therapy.

Take dose with food to ensure proper absorption.

For the suspension, shake well and store in the refrigerator. Note short expiration after reconstitution of 10 d.

Avoid mixing suspension with food or beverages. Symptoms should improve within 2-3 d; if they worsen, seek follow-up with health-care practitioner.

May decrease effectiveness of oral contraceptives; encourage patients to use backup contraceptive method (eg, condom)"

Azithromycin

"Complete full course of therapy.

Take tablets with or without food, although some patients report increased tolerability when given with food.

Avoid mixing suspension with food or beverages, but food can be taken afterward.

Symptoms should improve within 2-3 d; if they worsen, seek follow-up with health-care practitioner."

Cefdinir

"Complete full course of therapy.

For the suspension, shake well and can be stored at room temperature. Note 10 d expiration after reconstitution.

Avoid mixing suspension with food or beverages, but food can be taken afterward.

Symptoms should improve within 2-3 d; if they worsen, seek follow-up with HCP.

Separate administration of antacids, iron, and vitamins by 2 h."

Cephalexin

"Seek medical attention if rash develops.

Complete full course of therapy.

For the suspension, shake well and store in the refrigerator. Note short expiration after reconstitution.

Avoid mixing suspension with food or beverages, but food can be taken afterward.

Symptoms should improve within 2-3 d; if they worsen, seek follow-up with health-care practitioner."

Ciprofloxacin

"Seek medical attention if decreased urination, yellowing of eyes, blistering skin rash or extreme fatigue, unusual bruising or bleeding, shortness of breath or chest pain, tendon pain, ...

... muscle weakness, a "pins and needles" tingling or pricking sensation, numbness in the arms or legs, confusion or hallucinations.

Take with or without food, but not with milk or other dairy products.

Take ciprofloxacin at least 2 h before or 6 h after antacids, sucralfate, or mineral supplements and multivitamins with calcium, iron, or zinc.

If using the suspension, shake well before use; suspension may be stored at room temperature."

Levofloxacin

"Seek medical attention if decreased urination, yellowing of eyes, blistering skin rash or extreme fatigue, unusual bruising or bleeding, shortness of breath or chest pain, tendon pain ...

... muscle weakness, a "pins and needles" tingling or pricking sensation, numbness in the arms or legs, confusion or hallucinations.

Take with or without food, but not with milk, yogurt, or other dairy products or calcium-fortified products (some juices and breads).

If using antacids, sucralfate, or mineral supplements and multivitamins with calcium, iron, or zinc, take levofloxacin at least 2 h before or 6 h after these medicines"

Clindamycin

"Complete full course of therapy.

Symptoms should improve within 2-3 d; if they worsen, seek follow-up with HCP.

Take with full glass of water.

Remain upright for 30 min after dose to minimize risk of GI ulceration."

Doxycycline

"May take with food that does not contain calcium.

Complete full course of therapy.

Symptoms should improve within 2-3 d.

May cause photosensitivity; discontinue at first sign of skin erythema.

Wear sunscreen and avoid prolonged exposure to sunlight and ultraviolet light. Administer with 240 mL of water."

Nitrofurantoin

"May make urine brown; this is not harmful and is a breakdown product of the drug.

Complete full course of therapy.

For the suspension, shake well and store at room temperature, use within 30 d.

Avoid mixing suspension with food or beverages, but food can be taken afterward. Symptoms should improve within 2-3 d; if they worsen, seek follow-up care."

Sulfamethoxazole; Trimethoprim

"Complete full course of therapy.

For the suspension, shake well and store at room temperature and protect from light.

Symptoms should improve within 2-3 d; if they worsen, seek follow-up with health-care practitioner.

May cause photosensitivity; use sunscreen. Maintain adequate hydration during therapy to prevent kidney complications.

Seek medical attention for severe diarrhea, dark urine, yellowing of skin or eye, unusual bruising or bleeding, blistering skin rash, or shortness of breath."

Acyclovir

"Complete full course of therapy.

Ensure adequate hydration.

For HSV, initiate treatment as soon as possible at first sign of lesion (treatment most effective if initiated within 24 h of lesion onset).

For VZV, treatment should begin within 24 h of appearance of rash. Symptoms should improve within 2-3 d; if they worsen, seek follow-up with HCP.

If using for prophylaxis or suppression of infection, this medication should reduce the number of breakouts.

Maintain adequate hydration during therapy."

Valacyclovir

"Seek medical attention if decreased urination, unusual bruising or bleeding, blistering skin rash, or shortness of breath.

Symptoms should improve within 2-3 d; if they worsen, seek follow-up with HCP.

If using for prophylaxis, this medication should reduce the number of breakouts.

Maintain adequate hydration during therapy to prevent renal complications."

Fluconazole

"Many medications, including OTC medications, interact with fluconazole.

Do not take any new medications without consulting your doctor or pharmacist.

If taking a weekly dose, take on same day and time each week."

Ketoconazole

"Apply thin layer to affected area of skin. Skin should be intact.

Do not get it in your eyes, nose, mouth, or vagina. Do not wash the areas where you applied this medicine for at least 3 h after application.

Cosmetics (makeup or sunscreens) may be put on the affected areas 20 min after application.

Topical products are alcohol based and flammable immediately after application"

Metronidazole

"Avoid alcohol while taking this medicine and for 3 d after, may cause severe disulfiram-like reaction.

Complete full course of therapy.

Symptoms should improve within 2-3 d; if they worsen, seek follow-up with HCP.

May be administered with food to minimize stomach upset"

Mupirocin

"Instruct patients on proper application technique.

Avoid drug exposure to open wounds, burns, or eyes."

Nystatin

"Apply to affected area of skin

Skin should be intact

Do not get in eyes, nose, or mouth

Avoid occlusive dressings, tight-fitting diapers, and plastic pants if using on diaper area of children

"

Oseltamivir Phosphate

"Complete full course of therapy. Symptoms should improve within 2-3 d; if they worsen, seek care.

Suspension is available in a 6 mg/mL concentration and is packaged with an oral syringe calibrated in milliliters up to a total of 10 mL.

Instructions to the patient should be provided based on these units of measure (ie, mL).

When providing oseltamivir suspension for children

Atenolol

"Take on an empty stomach.

Avoid abrupt discontinuation; exacerbations of angina may occur.

Report signs/symptoms of bradycardia, hypotension, heart failure, or exacerbation of angina with initial dosing and dose changes.

May cause dizziness or drowsiness.

Diabetic patients to carefully follow blood sugar levels as β-blockers may mask symptoms of hypoglycemia.

Drug may cause sexual side effects, fatigue, and depression."

Nebivolol Hydrochloride

"Report signs/symptoms of hypotension, worsening heart failure, or bronchospastic disease.

Diabetic patients should carefully monitor blood sugar levels as beta-blockers may mask symptoms of hypoglycemia.

Do not discontinue drug abruptly, as this may cause rebound angina or, in some cases, AMI."

Propranolol Hydrochloride

"Take immediate-release tablets on an empty stomach; ER can be taken with or without food but administer consistently with respect to food.

Avoid alcohol. Avoid abrupt discontinuation; exacerbations of angina may occur.

Report signs/symptoms of hypotension, CHF, or exacerbation of angina with initial dosing and dose changes.

This medicine may cause dizziness. Diabetic patients should carefully follow blood glucose as beta-blockers may mask symptoms of hypoglycemia."

Metoprolol

"Take on an empty stomach and avoid alcohol.

Avoid abrupt discontinuation, exacerbations of angina may occur.

Instruct patients to report signs/symptoms of hypotension, heart failure, or exacerbation of angina with initial dosing and dose changes.

Advise diabetic patients to carefully follow blood sugar levels as beta-blockers may mask symptoms of hypoglycemia."

Carvedilol

"Take carvedilol with food or milk.

Report signs/symptoms of heart failure, bradyarrhythmias, bronchospasm, hypotension, syncope, or exacerbation of angina with initial dosing and dose changes.

Avoid abrupt discontinuation, may cause rebound HTN.

Avoid driving, using machinery, or doing anything else that could be dangerous if not alert.

Diabetic patients should carefully follow blood sugar levels as beta-blockers may mask symptoms of hypoglycemia"

Labetalol

"Report signs/symptoms of hypotension with initial dosing and dose changes.

Avoid alcohol while taking drug. May cause dizziness.

Instruct patient to rise slowly from a sitting/supine position, as labetalol may cause orthostatic hypotension.

Report signs/symptoms of bronchospasm, slow HR, hepatotoxicity, or syncope.

Advise diabetic patients to carefully follow blood sugar levels as beta-blockers may mask symptoms of hypoglycemia.

Advise patients against sudden discontinuation of drug as this may cause rebound HTN."

Irbesartan

"Seek medical attention if angioedema (swelling of the face, eyes, lips, tongue, or throat), excessive fluid loss (vomiting, diarrhea, or excessive perspiration),

hyperkalemia (confusion, body weakness, uneven heartbeat, or numbness/tingling in hands or feet), reduction in urination, jaundice, or skin rash occurs.

Avoid pregnancy. Avoid abrupt discontinuation.

Use potassium supplements or salt substitutes only under medical supervision.

This medicine may cause dizziness. Avoid alcohol or driving."

Losartan Potassium

"Avoid pregnancy. Avoid sudden discontinuation; rebound HTN can occur.

Use potassium supplements or salt substitutes only under medical supervision.

May cause dizziness that may worsen if dehydrated.

Seek medical attention if angioedema, excessive fluid loss, hyperkalemia, reduction in urination, or jaundice occurs."

Olmesartan

"Avoid pregnancy.

Use potassium supplements or salt substitutes only under medical supervision.

May cause dizziness that may worsen if dehydrated.

Seek care if angioedema, excessive fluid loss, hyperkalemia, reduction in urination, or jaundice occurs. May cause orthostatic hypotension"

Valsartan

"Do not discontinue abruptly.

Use potassium supplements or salt substitutes only under medical supervision.

This medicine may cause dizziness.

Avoid driving, using machinery, or doing anything else that could be dangerous if not alert. Recommend avoiding alcohol and NSAIDs while taking this drug"

Benazepril Hydrochloride

"Avoid pregnancy.

Seek medical attention immediately if you experience any facial swelling.

Most common adverse effect is dry cough.

Use potassium supplements or salt substitutes only under medical supervision. May cause dizziness that may worsen if dehydrated. Take at the same time daily."

Enalapril Maleate

"Use potassium supplements or salt substitutes only under medical supervision.

Report signs/symptoms of angioedema.

May cause dizziness that may worsen if dehydrated. Use caution rising from sitting or lying position, especially when initiating treatment."

Lisinopril

"Avoid pregnancy.

Use potassium supplements or salt substitutes only under medical supervision.

May cause dizziness that may worsen if dehydrated."

Ramipril

"Avoid pregnancy.

Use potassium supplements or salt substitutes only under medical supervision.

May cause dizziness that may worsen if dehydrated."

Amlodipine

"Instruct patient to report signs/symptoms of hypotension or exacerbation of angina with initial dosing and dose changes.

Avoid alcohol while taking drug.

Report signs/symptoms of peripheral edema, fatigue, hypotension, or hepatic dysfunction.

This medicine may cause dizziness.

Avoid activities that could be dangerous if dizziness occurs at initiation of therapy.

Dizziness may be worse if too much water is lost from the body due to excessive sweating, diarrhea, or vomiting."

Nifedipine

"Take Adalat CC on an empty stomach.

Report signs/symptoms of hypotension, exacerbation of angina, peripheral edema, fatigue, or hypotension.

Avoid sudden discontinuation of drug as this may cause rebound HTN.

May cause dizziness; avoid driving or using hazardous machinery until effects are known.

Avoid grapefruit juice.

May see tablet or shell of dosage form in stool."

Verapamil Hydrochloride

"Do not crush or chew extended-release products.

Contents of extended-release capsules may be sprinkled on food and swallowed without chewing, followed by water.

Report symptomatic hypotension, bradyarrhythmia, peripheral edema, or syncope.

Avoid sudden discontinuation of drug, as this may precipitate hypertensive rebound/crisis.

Rise slowly from a sitting or lying position to avoid dizziness.

Avoid alcohol and grapefruit juice.

Calcium channel blockers are not drugs of first choice for hypertension, but may be used in combination with other agents in patients with inadequate blood pressure response."

Diltiazem

Report symptomatic hypotension, bradyarrhythmia, peripheral edema, or syncope.

This drug is available in multiple brand names with varying properties by brand.

Instruct patient to follow administration instructions specific to the prescribed brand with regard to meals and timing.

Do not drink alcohol while taking this drug. Some products may be opened and sprinkled on a spoonful of applesauce (applesauce should not be hot, and should be swallowed without chewing, followed by a glass of water).

Administer at same time of day, either morning or evening.

Furosemide

"Avoid alcohol and NSAIDs.

Increased risk of sun-sensitivity; use sunscreen and avoid tanning.

Avoid activities requiring coordination until drug effects are realized, as drug may cause dizziness, vertigo, or blurred vision.

Report signs/symptoms of hypotension, decreased urine output, or ototoxicity; severe skin reactions.

Eat high-potassium foods, as directed by health-care professional."

Chlorthalidone

"Take in the morning with food.

Instruct patient to report signs/symptoms of dyspnea, hypotension, gout, or heart failure.

Avoid alcohol (may cause hypotension) and NSAIDs (may decrease effectiveness).

This medicine may cause dizziness or blurred vision. Avoid driving, using machinery, or doing anything else that could be dangerous if not alert"

Hydrochlorothiazide

"May be taken with or without food.

Take early in the day to avoid nocturia, even if taken more than once/d (eg, bid administration at 8 am and 2 pm).

May cause dizziness. Report signs/symptoms of hypotension.

Eat high-potassium foods during therapy. Avoid alcohol and using NSAIDs"

Spironolactone

"May cause dizziness.

Avoid driving, using machinery, or doing anything else that could be dangerous if not alert.

Report signs/symptoms of hyperkalemia (muscle weakness, fatigue, bradycardia) and hyponatremia (confusion, dry mouth, thirst, weakness, hypotension, decreased urination).

Avoid potassium supplements, foods/salt substitutes that are high in potassium.

Avoid alcohol and NSAIDs."

Hydrochlorothiazide; Triamterene

"May cause dizziness.

Rise slowly from a sitting or lying position to avoid dizziness.

Avoid foods that are high in potassium, potassium supplements, or potassium-containing salt substitutes.

Avoid alcohol and NSAIDs. May cause photosensitivity; use sunscreen. Use with caution in patients with sulfonamide allergy."

Valsartan/Sacubitril

"Sacubitril >> PRODRUG that inhibits neprilysin through the active metabolite LBQ657, leading to increased levels of peptides, including natriuretic peptides.

Valsartan >> selective, reversible, competitive antagonist of the angiotensin II receptor, which is responsible for the physiologic effects of angiotensin II...

...including vasoconstriction, aldosterone secretion, sympathetic outflow, and stimulation of renal sodium reabsorption."

Clonidine

"Stimulates presynaptic α2-adrenergic receptors and blocks postsynaptic α2-adrenergic receptors in the CNS by activating inhibitory neurons to decrease sympathetic outflow.

NOT a complete agonist, so some of its effects might result from antagonist actions at presynaptic α-receptors.

These actions reduce peripheral vascular resistance, renal vascular resistance, HR, and BP"

Hydralazine Hydrochloride

"Patient should not drink alcohol while taking drug.

Advise patient against sudden discontinuation of drug as this may cause rebound HTN.

This medicine may cause dizziness.

Patient should report chest pain, palpitations, signs/symptoms of tachyarrhythmia, hypotension, agranulocytosis, systemic lupus erythematosus, or hepatotoxicity to HCP."

Fenofibrate

"Fenoglide tablets and Lipofen R capsules should be given with food; others can be taken without food.

Take 1 h before or 4-6 h after a bile acid binding resin.

Products are not interchangeable.

Do not use if you have severe kidney disease or liver disease."

Ezetimibe

"Take with or without food and may be taken at the same time as a concurrent statin.

In patients receiving a bile acid sequestrant concurrently, ezetimibe should be taken at least 2 h before or 4 h after the bile acid sequestrant is taken."

Pravastatin Sodium

"Take in the evening.

Avoid concurrent heavy alcohol use.

Pravastatin does not take the place of diet and exercise to lower cholesterol levels."

Rosuvastatin

"Do not drink alcohol.

Rosuvastatin does not take the place of diet and exercise to lower cholesterol levels.

May be taken without regard for food."

Lovastatin

"Immediate-release tablets should be taken with the evening meal. Extended-release tablets should be taken at bedtime. Swallow extended-release tablets whole; do not chew, crush, or cut.

Avoid alcohol, grapefruit, and grapefruit juice. Report signs/symptoms of rhabdomyolysis, jaundice (yellowing of skin or eyes), or renal failure.

There are multiple significant drug-drug interactions with lovastatin. Consult a HCP prior to starting any new prescription or OTC medications.

Lovastatin does not take the place of lifestyle changes (diet, exercise) to lower cholesterol levels"

Atorvastatin

"Avoid excessive alcohol, grapefruit, and grapefruit juice (>1 L/d) consumption while taking drug.

Atorvastatin does not take the place of lifestyle changes (diet, exercise) to lower cholesterol levels.

Notify HCP if unexplained muscle tenderness or weakness occurs."

Simvastatin

"Avoid excessive alcohol.

There are multiple significant drug-drug interactions with simvastatin.

Consult a HCP prior to starting any new medications, including OTC and herbal drugs.

Simvastatin does not take the place of lifestyle changes (diet, exercise) to lower cholesterol levels"

Apixaban

"Seek medical attention if any unexpected bleeding or trouble breathing.

Take with or without food.

Do not stop taking apixaban without talking with your HCP; stopping early may increase the risk of stroke, especially in patients with atrial fibrillation.

Apixaban should be interrupted 24-48 h prior to dental and surgical procedures and re-started after hemostasis.

Avoid OTC NSAIDs and high-dose aspirin; they increase the risk of bleeding."

Rivaroxaban

"Educate patient on signs and symptoms of bleeding and interactions with other anticoagulant or antiplatelet medications, including OTC medications.

Warn of risks of epidural (spinal) anesthesia while taking rivaroxaban.

Doses ≥15 mg should be taken with food.

If taking for nonvalvular atrial fibrillation, take with evening meal."

Warfarin

"Report signs/symptoms of hemorrhage, skin and tissue necrosis.

Avoid situations/activities in which cuts, bruising, or injury is likely to occur.

Many significant drug-drug interactions; consult health-care professional prior to new prescription or OTC use.

Avoid alcohol, cranberry products, and drastic changes in vitamin K consumption from diet (cruciferous vegetables)."

Nitroglycerin

"Sit prior to using sublingual tablets, lingual aerosol, or spray. Tablet should be dissolved under tongue or in buccal pouch at first sign of angina; do not swallow or chew tablet.

Do not eat or drink after placement of tablets. Spray should be sprayed onto or under tongue; do not inhale; do not spit out or rinse mouth after use.

Rise slowly from a sitting position in order to prevent light-headedness.

Allow a 10- to 12-h/d drug-free interval to avoid development of nitrate tolerance for both patches and extended-release capsules.

Avoid concurrent use of alcohol, CNS depressants, antihypertensives, or other drugs that cause hypotension.

Do not use with PDEIs, which may result in hypotension.

The ointment may stain clothing. When treating acute angina, instruct patient to call 911 if symptoms are not resolved by the first dose."

Isosorbide Mononitrate

"Take medicine on an empty stomach with at least half a glass of water. Swallow the extended-release tablet whole. Do not break, crush, or chew it.

This medicine can cause headaches, which is a sign that the medicine is working. Acetaminophen may be used to relieve the headache. Contact HCP if headache is severe.

This medicine can cause dizziness. Avoid driving, using machines, or doing anything else that could be dangerous if not alert.

Stand up slowly if this medicine causes light-headedness from orthostatic hypotension.

Do not stop using this medicine suddenly without consulting HCP. The dose may need to be slowly decreased before stopping it completely.

Avoid concomitant use of PDEIs as this may increase risk of severe hypotension.

Avoid drinking alcohol while taking this drug. Scored tablets may be split. Doses of immediate release formulation should be taken at least 7 h apart."

Clopidogrel

"Report signs/symptoms of bleeding, especially if used concomitantly with anticoagulant therapy.

Do not stop therapy abruptly without first talking with prescriber to minimize the risk of re-thrombosis, particularly after stent placement."

Amiodarone

"Use sunscreen; avoid tanning beds and prolonged sun exposure.

Report signs/symptoms of cardiac arrhythmias, pulmonary toxicity, or liver toxicity.

Multiple drug interactions so inform providers about all medications you are taking.

Take consistently with regard to meals but avoid taking with grapefruit or grapefruit juice. Patient medication guide must be dispensed with this medication."

Aspirin

"Avoid additional aspirin, NSAIDs, or aspirin-containing products during use; unless recommended by HCP

Avoid ≥ 3 alcoholic drinks per day as risk of GI bleeds increase

Use should be discontinued temporarily in advance of dental procedures"