Consultation Notes & Potential Risks

Generic (Brand)

• (1*) PROMPTLY contact a physician if side effects become severe/persistent

ALL medications

• (2*) store tab(s)/cap(s) in cool, dry place away from sunlight & children

ALL NON-refrigerated dosage forms

• (3*) SHAKE suspension WELL before use

ALL oral suspensions

• (4*) cases of pseudomembranous colitis, C. Diff., & secondary bacterial infections have occurred during treatment OR due to prolonged use

RISK of oral broad-spectrum antibiotics

• (5*) Complete FULL course of therapy unless otherwise directed

ALL antibiotics

• (6*) may cause tendinitis, tendon rupture, peripheral neuropathy, increased intracranial pressure, convulsions, psychosis, CNS effects, fatal hypersensitivity reactions, & exacerbation of myasthenia gravis

• (6*) increased risk of aneurysm & dissection for up to 2 months following use

• (6*) D/C & contact physician if a rash develops or experience pain, inflammation, or rupture of tendon

RISK of ALL oral fluoroquinolone antibiotics

• take IMMEDIATELY upon arising for the day

• take with a full glass of water

• take at least 30 min. before 1st food, beverage, or medication of the day

• do NOT lie down for 30 min. after taking NOR before 1st food of the day is consumed

• do NOT crush, chew, or suck on tablet

• do NOT double doses if dose is missed, skip it, & then return to dosing schedule

• PROMPTLY report ANY upper GI distress to physician/pharmacist

• (1*)

• (2*)

Alendronate Sodium (Fosamax)

• D/C 72 hr. PRIOR to & DURING periods of prolonged immobilization

• AVOID prolonged restrictions of movement during travel

• advisable to take calcium & vitamin D supplements IF dietary intake is inadequate

• PROMPTLY report any signs of blood clots to physician

• signs of blood clots include pains in the calves/leg swelling, sudden chest pain, SOB/coughing blood, or changes in vision

• D/C if pregnancy is suspected

• take ASAP if dose is missed & return to dosing schedule

• (1*)

• (2*)

Raloxifene HCl (Evista)

• PREFERABLY taken on an empty stomach at least 1 hour BEFORE or 2 hours AFTER meal

• take with a full glass of water

• take ATC

• keep suspension REFRIGERATED; discard any remainder after 14 days

• (1*)

• (2*)

• (3*)

• (4*)

• (5*)

Amoxicillin Trihydrate (Amoxil, Moxatag, & Trimox)

• PREFERABLY taken at the START of meals to ENHANCE absorption & DECREASE GI upset

• take ATC

• keep suspension REFRIGERATED; discard any remainder after 10 days

• if a dose is MISSED, take it ASAP

• (1*)

• (2*)

• (3*)

• (4*)

• (5*)

Amoxicillin with Clavulanate Potassium (Augmentin & Augmentin XR)

• tab(s) & susp PREFERABLY taken with food

• Zmax SPECIFICALLY should be taken on an EMPTY stomach 1 hr BEFORE or 2 hr AFTER meal

• do NOT take antacids w/in 1 hr of dose

• if a dose MISSED, take it ASAP

• do NOT refrigerate suspension; discard any remainder after course of therapy completed

• (1*)

• (2*)

• (3*)

• (4*)

• (5*)

Azithromycin Dihydrate (Zithromax & Zmax)

• do NOT take antacids NOR iron supplements w/in 2 hr of dose

• do NOT refrigerate suspension; discard any remainder after 10 days of MIXING

• (1*)

• (2*)

• (3*)

• (4*)

• (5*)

Cefdinir (Omnicef)

• PREFERABLY taken on an EMPTY stomach 1 hr BEFORE or 2 hr AFTER meal

• take ATC

• keep suspension REFRIGERATED; discard any remainder after 14 days

• if a dose MISSED, take it ASAP

• (1*)

• (2*)

• (3*)

• (4*)

• (5*)

Cephalexin Monohydrate (Keflex)

• AVOID prolonged exposure of skin to sunlight

• drink a full glass of water after each dose

• PREFERABLY taken 2 hr after meal

• do NOT take antacids NOR products containing calcium, zinc, nor iron AT THE SAME TIME as dose; take either 2 hr BEFORE or 6 hr AFTER

• refrigeration of suspension UNNECESSARY, but may help w/ taste; discard any remainder after 14 days

• may cause dizziness/light headedness, so USE CAUTION when operating machinery/mental alertness required

• do NOT chew, crush, NOR split XR tab

• (1*)

• (2*)

• (3*)

• (5*)

• (6*)

Ciprofloxacin HCl (Cipro & Cipro XR)

• if a dose MISSED, take ASAP, BUT if closer to next dose, SKIP it, & return to dosing schedule; do NOT double doses

• drink a full glass of water after dose

• either take w/ or w/out meals

• (1*)

• (2*)

• (5*)

Clindamycin HCl (Cleocin)

• PREFERABLY taken on an EMPTY stomach 1 hr BEFORE or 2 hr AFTER meal

• take dose w/ a full glass of water

• MAY be taken w/ food or milk IF GI upset occurs

• take ATC

• AVOID prolonged exposure to sunlight

• if a dose missed, take it ASAP

• do NOT refrigerate suspension; discard any remainder after course of therapy complete

• (1*)

• (2*)

• (3*)

• (4*)

• (5*)

Doxycycline Hyclate (Vibramycin & Doryx)

• if dose MISSED, take it ASAP, BUT if closer to next dose, SKIP it, & return to dosing schedule; do NOT double doses

• drink a full glass of water after dose

• take either w or w/o meal

• do NOT take antacids, sucralfate, metal cations such as iron, NOR MVI containing zinc w/in 2 hr of dose

• AVOID prolonged exposure of skin to sunlight drink

• (1*)

• (2*)

• (5*)

• (6*)

Levofloxacin (Levaquin)

• PREFERABLY taken on an EMPTY stomach 1 hr BEFORE or 2 hr AFTER meal

• take w/ a full glass of water

• MAY be taken w/ food or milk IF GI upset occurs

• take ATC

• if a dose MISSED, take it ASAP

• (1*)

• (2*)

• (4*)

• (5*)

Minocycline HCl (Minocin, Dynacin, & Solodyn ER)

• report dermatitis or swelling to physician

• cover area w/ a SMALL film

• do NOT rub in

• do NOT use in NOR around eyes

• do NOT use nasal ointment w/ ANY other nasal medications

• (1*)

• (2*)

• (4*)

• (5*)

Mupirocin (Bactroban)

• to INSTILL drops: LIE DOWN or TILT HEAD BACK & LOOK UP, hold dropper above eye, drop solution inside LOWER EYELID(s) & make sure dropper does NOT come in contact with eye NOR fingers, release lid, keep eye OPEN for at least 30 sec, & apply pressure to inside corner of eye for at least 1 min

• WAIT at least 5 min BEFORE instilling OTHER ophthalmic medications

• AVOID tightly closing eyes AFTER instillation

• if a dose MISSED, instill it ASAP

• (1*)

• (2*)

• (4*)

• (5*)

Ofloxacin (Ocuflox)

• PREFERABLY taken on an EMPTY stomach 1 hr BEFORE or 2 hr AFTER meal

• take dose w/ a full glass of water

• AVOID prolonged exposure to sunlight

• do NOT refrigerate suspension; discard any remainder after course of therapy complete

• (1*)

• (2*)

• (3*)

• (5*)

Sulfamethoxazole with Trimethoprim (Bactrim & Septra)

• PREFERABLY taken on an EMPTY stomach

• stay WELL hydrated

• AVOID alcohol/salicylates & prolonged exposure to natural/artificial light

• follow appropriate contraceptive measures during therapy and for 3 months (male) & 1 ovulatory cycle (female) after completing therapy

• if a dose MISSED & on a weekly schedule, take it ASAP & restart weekly schedule from that date

• if a dose MISSED & on daily schedule, contact physician

• get PERIODIC lab work during therapy

• report to physician any diarrhea, vomiting, abdominal pain, black stools, jaundice, unexplained muscle pain, any type of infection, sore throat, cough, dyspnea, hypoxemia, fever, or any type of unknown skin reaction

• (1*)

• (2*)

Methotrexate (Trexall)

• take ONLY as prescribed

• do NOT STOP therapy unless directed to do so by physician

• may take with food or milk if GI upset occurs

• if a dose MISSED, take it ASAP

• do NOT undergo any form of immunization w/ live NOR live-attenuated vaccines

• (1*)

• (2*)

Dexamethasone (Decadron), Methylprednisolone (Medrol), & Prednisone (Deltasone): Anti-Inflammatory

• may reduce BMD because it lowers circulating estrogen levels

• may increase total cholesterol levels

• if dose MISSED, take it ASAP, BUT if closer to next dose, SKIP it, & return to dosing schedule; do NOT double doses

• report to physician marked weakness, drowsiness, pain/swelling of legs, blurred vision, or SOB

• (1*)

• (2*)

Anastrozole (Arimidex) & Tamoxifen Citrate (Nolvadex)

• take WITH food to enhance absorption

• take ATC

• may cause discoloration of the urine (rare)

• if a dose MISSED, skip it, & return to dosing schedule

• (1*)

• (2*)

• (4*)

• (5*)

Nitrofurantoin (Macrodantin, Macrobid, & Furadantin)

• may take with food or milk IF GI upset occurs

• AVOID alcohol DURING therapy & for 1 day AFTER therapy due to disulfiram-type reactions

• use of condom us recommended during the treatment of trichomoniasis to avoid reinfection

• if a dose MISSED, take ASAP, BUT if closer to next dose, SKIP it, & return to dosing schedule; do NOT double doses

• contact physician if experiencing numbness/paresthesia of an extremity

• (1*)

• (2*)

• (4*)

• (5*)

Metronidazole (Flagyl)

• may be taken WITHOUT regards to meal(s)

• if a dose MISSED, take ASAP, BUT if taken w/in 12 hr of the next dose, SKIP it, & return to dosing schedule

• do NOT take OTC cough nor cold remedies w/o first checking with physician/pharmacist

• do NOT STOP therapy unless directed to do so by physician

• (1*)

• (2*)

Amlodipine Besylate (Norvasc)

• may be taken WITHOUT regards to meal(s)

• do NOT STOP therapy unless directed to do so by physician

• do NOT take OTC cough nor cold remedies w/o first checking with physician/pharmacist

• AVOID salt substitutes containing potassium

• report ANY facial swelling, difficulty breathing, or infection

• if a dose MISSED, take ASAP, BUT if closer to next dose, SKIP it, & return to dosing schedule; do NOT double doses

• (1*)

• (2*)

Amlodipine Besylate with Benazepril HCl (Lotrel)

• take dose on an EMPTY stomach at least 1 hr BEFORE or 2 hr AFTER meal unless otherwise directed by physician

• do NOT STOP therapy unless directed to do so by physician

• if a dose MISSED, take ASAP, BUT if closer to next dose, SKIP it, & return to dosing schedule; do NOT double doses

• may cause dizziness

• use CAUTION while operating machinery/mental alertness required

• (1*)

• (2*)

Diltiazem HCl (Cardizem (CD), Cartia, Dilacor, Dilt-XR, & Tiazec)

• take with food or milk to increase plasma levels

• AVOID OTC products containing decongestants or sodium salts UNLESS recommended by physician/pharmacist

• may cause HA or palpitations during the first few days of therapy

• if a dose MISSED, take it ASAP, BUT if closer to next dose, SKIP it, & return to dosing schedule; do NOT double doses

• do NOT STOP therapy unless directed to do so by physician

• (1*)

• (2*)

Hydralazine HCl (Apresoline)

• take 1st dose HS due to the possibility of orthostatic hypotension

• if a dose MISSED, take it ASAP, BUT if closer to next dose, SKIP it, & return to dosing schedule; do NOT double doses

• do NOT STOP therapy unless directed to do so by physician

• may cause DROWSINESS; USE CAUTION when operating machinery/mental alertness required

• AVOID OTC products containing decongestants or sodium salts UNLESS recommended by physician/pharmacist

• (1*)

• (2*)

Prazosin HCl (Minipress)

• take 1st dose HS to AVOID syncope

• AVOID activities that require alertness for 12 hr following INITIAL dose

• if a dose MISSED, take it ASAP, BUT if closer to next dose, SKIP it, & return to dosing schedule; do NOT double doses

• do NOT STOP therapy unless directed to do so by physician

• AVOID OTC products containing decongestants or sodium salts UNLESS recommended by physician/pharmacist

Terazosin HCl (Hytrin)

• do NOT wear contact lens if eye(s) red

• allow AT LEAT 10 minutes AFTER using & BEFORE inserting contact lens

• WASH HANDS prior to application

• to INSTILL drops: LIE DOWN or TILT HEAD BACK & LOOK UP, hold dropper above eye, drop solution inside LOWER EYELID(s) & make sure dropper does NOT come in contact with eye NOR fingers, release, & keep eye OPEN for at least 30 sec

• contact physician if experience eye pain, changes in vision, or eye irritation

• (1*)

• (2*)

Olopatadine HCl (Patanol, Pataday, & Pazeo)

• re-evaluate therapy IF improvement is NOT seen in 2 days

• contact physician if experience aggravated pain or discomfort during therapy

• MANDATORY use w/ an anti-infective in cases of bacterial infections

• do NOT STOP therapy unless directed to do so by physician

• (1*)

• (2*)

• (3*)

Prednisolone Acetate (Pred Forte, Pred Mild, & Omnipred)

• do NOT swallow the solution, use ONYL through a jet nebulizer

• do NOT use more than twice daily

• do NOT STOP therapy unless directed to do so by physician

• do NOT use for acute symptoms

• if a dose MISSED, take it ASAP, BUT if closer to next dose, SKIP it, & return to dosing schedule; do NOT double doses

• store in the refrigerator in the original foil pouch & keep out of reach of children

• do NOT freeze the solution

• vials may be stored for up to 6 weeks at room temp

• seek immediate medical attention if you breathing quickly becomes worse

• (1*)

Arformoterol (Brovana)

• if a dose MISSED, take it ASAP, BUT if closer to next dose, SKIP it, & return to dosing schedule; do NOT double doses

• (1*)

• directions for aerosol use:

  • shake thoroughly

  • enclose mouthpiece with the lips, canister base up

  • keep eyes closed

  • exhale deeply, then inhale slowly while pressing firmly on the canister base

  • continue to inhale deeply

  • hold breath for a few seconds after inhalation

  • repeat after 15 seconds as directed

  • wash mouthpiece with hot water

  • inhalation solution may be mixed with albuterol if used within 1 hour

  • not intended for occasional use; use consistently for maximum effectiveness

• directions for nasal spray priming:

  • if not used for more than 24 hours, the pump will required 2 actuations

  • if not used for more than 7 days, the pump will require 7 actuations

Ipratropium Bromide (Atrovent)

• do NOT take more frequently than recommended

• AVOID contact with the eyes

• follow the directions which accompany your nebulizer for administration techniques

• not intended for occasional use; use consistently for maximum effectiveness

• (1*)

• directions for aerosol use:

  • shake thoroughly

  • enclose mouthpiece with lips, canister base up

  • keep eyes closed

  • exhale deeply, then inhale slowly while pressing firmly on the canister base

  • continue to inhale deeply

  • hold breath for a few seconds after inhalation

  • repeat after 15 seconds as directed

  • if not used for more than 24 hours, the MDI will require 3 actuations to prime

Ipratropium Bromide with Albuterol Sulfate (Combivent & DuoNeb)

• if a dose MISSED, take it ASAP, BUT if closer to next dose, SKIP it, & return to dosing schedule; do NOT double doses

• unused capsules should remain in the blister strip & be used over the next 2 consecutive days

• not intended for occasional use; use daily for maximum effectiveness

• (1*)

• (2*)

• direction for Handihaler use:

  • open 1 blister strip to expose 1 capsule only

  • open the dust cap & mouthpiece to expose the center chamber

  • place the capsule in the center chamber & close the mouthpiece until a click is heard

  • press the piercing button completely in once & release

  • exhale completely

    • do NOT breath into the mouthpiece at any time

  • place lips tightly around the mouthpiece

  • breath in slowly & deeply until lungs are full

    • should hear the capsule vibrate

  • remove the mouthpiece from lips & exhale

  • repeat [place lips tightly around the mouthpiece, breath in slowly & deeply until lungs are full, should hear the capsule vibrate, remove the mouthpiece from lips & exhale] up to 5 times

  • open mouthpiece & discard the empty capsule

Tiotropium Bromide (Spiriva)

• not intended to be used to relive acute symptoms

• do NOT use if allergic to milk proteins

• do NOT shake inhaler

• check the counter before & after each dose to ensure dose is loaded properly

  • the dose counter should decrease by one each time

• inhaler expires 6 weeks after removing from the foil-covered tray

  • document the day the tray was opened & calculated expiration date on inhaler

• if a dose MISSED, take it ASAP, BUT if closer to next dose, SKIP it, & return to dosing schedule; do NOT double doses

• (1*)

• inhalation directions for proper use:

  • load a dose by fully opening the cover of the inhaler until a click is heard

    • do NOT open the cover until ready to use it

      • if cover closed before using inhaler, loaded dose will be lost

  • breathe out fully

    • do NOT breathe into the mouthpiece

  • put mouthpiece between lips & close lips around it

    • do NOT cover vents on inhaler

  • take a long, steady, deep breath in through the mouth

    • do NOT breath through the nose

  • remove the inhaler & hold breath for about 3 to 4 seconds

  • breathe out slowly & gently

  • close the cover

    • may need to clean the mouthpiece with a dry tissue before closing

Umeclidinium Bromide (Incruse Ellipta)

• properly train on how to use the breath-activated device

• if a dose MISSED, SKIP it, & return to dosing schedule

• not intended to provide immediate relief of bronchospasm

• to receive the full benefits of therapy, use on a regular basis

  • although benefits can be seen after 2 days of treatment, up to 4 weeks ay be needed to observe benefits

• contact physician if effectiveness decreases

• (1*)

• (2*)

Umeclidinium and Vilanterol (Anoro Ellipta)

• AVOID contact w/ eyes

• if a dose MISSED, SKIP it, & return to dosing schedule

• NOT intended to provide immediate relief of bronchospasm

• to receive the full benefits of therapy, use REGULARLY

  • although benefits can be seen after 2 days of treatment, up to 4 weeks may be needed to observe benefits

• use ANY prescribed bronchodilator a few minutes prior to using

• follow enclosed instructions for inhalation technique:

  • (1) prime the inhaler the 1st time it is used by holding it in an upright position (mouthpiece up), turn the brown grip fully to the right and then to the left until it clicks

  • (2) to load a dose, hold it in an upright position (mouthpiece up), turn the brown grip fully to the right and then to the left until it clicks

  • (3) hold the Turbohaler in the upright or horizontal position, place the mouthpiece between the lips and inhale forcefully & deeply

    • exhale through the nose & do NOT shake the inhaler

• Respules should be gently shaken before use in an approved jet nebulizer & should NOT be mixed with other solutions.

• rinse the mouth out without swallowing after each use

• a red mark will appear in the indicator window when there is 20 or fewer doses left in the Turbohaler

• AVOID exposure to chicken pox or measles & if exposed should, promptly notify their physician

• NOT to be used with a spacer

• (1*)

• (2*)

Budesonide (Pulmicort)

• AVOID contact w/ eyes

• if a dose MISSED, SKIP it, & return to dosing schedule

• NOT intended to provide immediate relief of bronchospasm

• to receive the full benefits of therapy, use REGULARLY

  • although benefits can be seen after 2 days of treatment, up to 4 weeks may be needed to observe benefits

• use ANY prescribed bronchodilator a few minutes prior to using

• follow enclosed instructions for inhalation technique:

  • (1) shake the inhaler well & move it into inhaler position

  • (2) breathe out as fully as comfortably can, hold the inhaler upright, place the mouthpiece in mouth, close lips tightly around the mouthpiece

  • (3) while breathing in deeply, press down on the cartridge & hold breath as long as possible while the inhaler is still in mouth

  • (4) take finger off the cartridge, remove the mouthpiece from mouth, & breath out gently

    • wait 1 minute b/w puffs & repeat steps 2-4 if indicated

  • (5) rinse mouth or gargle after dose complete

  • (6) clean inhaler at least once a day by removing cartridge & rinsing plastic case in warm, running water

    • dry case & replace cartridge

  • (7) discard inhaler after date calculated by physician/pharmacist

• (1*)

• (2*)

Fluticasone Propionate (Flovent)

• take regularly even if asymptomatic

• NOT intended to treat asthmatic attacks, so have appropriate measures at hand to treat said attacks

• for phenylketonurics, chewable tablets contain phenylalanine

• if dose MISSED, take ASAP, & return to dosing schedule

• granules can be mixed w/ spoonful of soft food

• (1*)

• (2*)

Montelukast Sodium (Singulair)

• AVOID contact w/ eyes

• rinse mouth after each use

• contact a physician if effectiveness decreases

• if a dose MISSED, SKIP it, & return to dosing schedule

• NOT intended to provide immediate relief of bronchospasm

• to receive the full benefits of therapy, use REGULARLY

  • although benefits can be seen after 2 days of treatment, up to 4 weeks may be needed to observe benefits.

• train patient on appropriate use of device

• (1*)

• (2*)

• Budesonide and Formoterol Fumarate Dihydrate (Symbicort)

• Fluticasone Furoate and Vilanterol (Breo Ellipta)

• Fluticasone Propionate with Salmeterol Xinafoate (Advair)

• Fluticasone Furoate, Umeclidinium Bromide, and Vilanterol (Trelegy Ellipta)

• do NOT take more frequently than recommended

• contact a physician if effectiveness decreases or need more frequently than usual

• avoid contact w/ eyes

• shake canister well before each inhalation

• follow enclosed instructions of inhalation technique

• clean mouthpiece at least once a week by removing canister, running warm water through it for 30 sec, & letting it air dry thoroughly

• (1*)

• (2*)

Albuterol Sulfate (Proventil, Ventolin, & Proair)

• do NOT take more frequently than recommended

• do NOT chew or crush ER tab

• contact a physician if effectiveness decreases or need more frequently than usual

• (1*)

• (2*)

Albuterol Sulfate (Proventil)

• may cause drowsiness

  • use caution while operating machinery/mental alertness required

• AVOID alcohol while taking

• may take w/ food or milk to avoid GI upset

• do NOT exceed prescribed dosage

• may become habit-forming

• if a dose MISSED, SKIP it, & return to dosing schedule

• (1*)

• (2*)

Butalbital, Acetaminophen, and Caffeine (Fioricet)

• may cause drowsiness

  • use caution when operating machinery/mental alertness required

• AVOID alcohol while taking

• do NOT split, crush, or chew ER tab

• may take w/ food or milk to avoid GI upset although analgesia may be delayed

• continuous use may produce psychic & physical dependence of the morphine-type

• do NOT exceed prescribed dosage

• if a dose MISSED, SKIP it, & return to dosing schedule

• (1*)

• (2*)

Tramadol HCl (Ultram & Ultram ER)

• take WITH food to increase absorption

• TRY to take at the SAME time daily

• do NOT chew nor crush tab

• may cause dizziness or drowsiness

  • use care when driving, operating machinery, or when mental alertness is required

• if dose missed, SKIP it, & return to normal dosing schedule

• (1*)

• (2*)

Alfuzosin HCl (Uroaxatral)

• may be taken with OR without food

• women who are pregnant should NOT come into contact with medication

• men should NOT donate blood until at least 6 months after last dose

• if dose missed, SKIP it, & return to normal dosing schedule

• contact physician if side effects are severe or persistent PAST 6 months of treatment

• (1*)

• (2*)

Dutasteride (Avodart)

• women who ARE or PLAN to become PREGNANCT should NOT handle this crushed medication NOR be exposed to semen from a patient who is taking this medication

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• (1*)

• (2*)

Finasteride (Proscar)

• take dose 30 minutes following the same meal EVERY day

• if dose missed, SKIP it, & return to normal dosing schedule

• may cause dizziness, especially when rising from sitting position

• use caution when perform any any hazardous tasks

• do NOT discontinue NOR skip therapy unless otherwise directed by physician

• (1*)

• (2*)

Tamsulosin HCl (Flomax)

• do NOT discontinue medication unless otherwise directed by physician

• AVOID nonprescription cough, cold, & allergy medications unless otherwise directed

• AVOID salt substitutes containing potassium & stay hydrated during therapy

• report ANY signs of facial swelling, difficulty in breathing, or infection to physician

• do NOT take if pregnant or planning to become pregnant

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• (1*)

• (2*)

Benazepril HCl (Lotensin)

• may be taken WITHOUT regard to meals

• STOP use & contact physician if ANY signs of swelling occur

• AVOID non-prescription cough, cold, & allergy medications unless otherwise directed

• AVOID salt substitutes containing potassium & stay hydrated during therapy

• report ANY signs of neutropenia to physician

• do NOT take if pregnant or planning to become pregnant

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• (1*)

• (2*)

• Enalapril Maleate (Vasotec & Epaned)

• do NOT take antacids within 1-2 hours of medication

• do NOT discontinue medication unless otherwise directed by physician

• AVOID nonprescription cough, cold, & allergy medications unless otherwise directed

• AVOID salt substitutes containing potassium & stay hydrated during therapy

• report ANY signs of facial swelling, difficulty in breathing, or infection to physician

• do NOT take if pregnant or planning to become pregnant

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• (1*)

• (2*)

Fosinopril Sodium (Monopril)

• may be taken WITHOUT regard to meals

• do NOT discontinue medication unless otherwise directed by physician

• contact physician if ANY signs of swelling occur

• AVOID non-prescription cough, cold, & allergy medications unless otherwise directed

• AVOID salt substitutes containing potassium

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• (1*)

• (2*)

Lisinopril (Prinivil & Zestril)

• may be taken WITHOUT regard to meals

• do NOT discontinue medication unless otherwise directed by physician

• timing of dose is important because of increased diuresis

  • usually given early morning

• AVOID excessive exposure to sunlight

• AVOID non-prescription cough, cold, & allergy medications unless otherwise directed

• AVOID salt substitutes containing potassium

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• contact physician if ANY signs of swelling occur

• (1*)

• (2*)

Lisinopril with HCTZ (Zestoretic & Prinzide)

• do NOT discontinue therapy unless otherwise directed by physician

• capsules may be swallowed whole or their contents sprinkled over soft food & consumed w/o chewing

  • may also be mixed into water or apple juice & consumed

    • pre-mixed solutions are table for 24 H at room temp & 48 H under refrigeration

• AVOID non-prescription cough, cold, & allergy medications unless otherwise directed

• AVOID salt substitutes containing potassium

• report ANY signs of facial swelling, difficulty in breathing, or infection to physician

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• (1*)

• (2*)

Ramipril (Altace)

• may be taken with OR without food

• when pregnancy is detected, discontinue drug ASAP

• (1*)

• (2*)

Irbesartan (Avapro)

• may be taken with OR without food

• if pregnancy is detected, D/C use ASAP

• if dose missed, SKIP it, & return to normal dosing schedule

• (1*)

• (2*)

Losartan Potassium (Cozaar)

• may be taken with OR without food

• timing of dose is important because of increased diuresis

  • usually given early morning

• (1*)

• (2*)

Losartan Potassium with HCTZ (Hyzaar)

• may be taken with OR without food

• may cause dizziness

  • use care when operating machinery

• if pregnancy detected, D/C use ASAP

• (1*)

• (2*)

Olmesartan Medoxomil (Benicar)

• may be taken with OR without food

• do NOT remove tab from individual blister UNTIL immediately prior to taking

• if pregnancy detected, D/C use ASAP

• (1*)

• (2*)

Telmisartan (Micardis)

• may be taken with OR without food, although it may be best to take WITHOUT for consistent plasma levels

• if pregnancy detected, D/C use ASAP

• dizziness may occur during the 1st few days of therapy

  • report its persistence to physician

• (1*)

• (2*)

Valsartan (Diovan)

• discuss the uses & dangers of estrogen therapy

• do NOT take during pregnancy

• closely follow cyclic administration

• water will NOT affect patches

• AVOID application sites that are oily, damaged, irritated, or wet

• if dose missed, apply it ASAP

  • do NOT double doses

• (1*)

• (2*)

Estradiol (Vivelle-Dot, Alora, Climara, Estrace, Divigel, Femring, Estring, & Vagifem)

• discuss the uses & dangers of estrogen therapy

• do NOT take during pregnancy

• closely follow cyclic administration

• if dose missed, take it ASAP

  • do NOT double doses

• (1*)

• (2*)

Estradiol (Estrace)

• MAY be taken with food or milk IF GI upset occurs

• read patient information sheet carefully

• D/C therapy & consult physician if pregnancy is suspected

• if dose missed, take it ASAP, & return to normal dosing schedule

• report any severe side effects to your physician, including pains in the legs, coughing blood, abnormal vaginal bleeding, skin yellowing, & abdominal pain

• (1*)

• (2*)

Estrogens, Conjugated (Premarin)

• do NOT D/C therapy without first consulting physician

• take on an EMPTY stomach, 1 hour BEFORE or 2 hours AFTER a meal

• notify physician if signs of HYPERthyroidism (overdosage) occurs

• transient loss of hair MAY be seen in children, but recovery usually occurs

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• (1*)

• (2*)

Levothyroxine Sodium (Synthroid, Levoxyl, & Levothroid)

• may be taken WITHOUT regard to food or meals

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• successful therapy is determined by COMPLIANCE

  • every effort should be made to NOT skip or miss doses

• (1*)

• (2*)

Liothyronine Sodium (Cytomel & Triostat)

• MAY be taken with food or milk IF GI upset occurs

• use with CAUTION in diabetic patients because glucose tolerance may be DECREASED

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• (1*)

• (2*)

Medroxyprogesterone Acetate (Provera)

• do NOT take if allergic to peanuts

• MAY cause dizziness or drowsiness

  • use CAUTION when performing activities requiring alertness

• MAY be taken with food or milk IF GI upset occurs

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• contact a physician if experience leg or calf pain, loss of vision, difficulty in breathing, breast lumps, abnormal vaginal bleeding, severe HA, vomiting, changes in speech, or numbness in an arm or leg

• (1*)

• (2*)

Progesterone (Prometrium)

• apply to clean, dry skin ONCE daily

• DECREASE the risk of transferring the gel to others by applying to areas of the upper body (upper arms & shoulders) which are covered by a short-sleeved shirt

  • do NOT apply to genital area

• wash hands BEFORE & AFTER application

• allow area to dry BEFORE covering with clothes

• women & children should AVOID contact with unwashed or unclothed areas of application

• AVOID showering or swimming for 2 hours AFTER application

• if dose missed, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• notify physician if having trouble starting to urinate or if experiencing increased urination at night

• report to physician any UNUSUAL swelling or pain in the legs, ankles, or feet

• (1*)

• (2*)

Testosterone Gel (Androgel, Fortesta, & Testim)

• doses should be taken consistently in regards to meals, PREFERABLY with meals

• notify physician IMMEDIATELY if experience shortness of breath, wheezing, coughing, passing of dark-color urine, yellowing of the eyes, chest or stomach pain, abnormal heart rhythm, or faintness

• AVOID overexposure to sunlight due to possibility of photosensitivity

  • use sunscreen & appropriate clothing until level of sensitivity is determined

• do NOT become pregnant during therapy

  • if pregnancy occurs or is suspected, D/C medication & consult physician

• do NOT take OTC medications, including herbal drugs, WITHOUT 1st checking with pharmacist or physician

• AVOID grapefruit & grapefruit juice while on this medication

• do NOT D/C treatment WITHOUT the knowledge of physician

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• (1*)

• (2*)

Amiodarone (Cordarone, Pacerone, & Nexterone)

• MAY be taken WITHOUT regards to meals

• do NOT abruptly D/C therapy or change dose WITHOUT 1st consulting physician

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• contact physician if experience faintness, dizziness, fast heartbeat, severe diarrhea, vomiting, or increased thirst

• (1*)

• (2*)

Dofetilide (Tikosyn)

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• do NOT D/C therapy WITHOUT 1st consulting physician

• may cause dizziness/drowsiness

  • use CAUTION while operating machinery or when mental alertness is required

• AVOID nonprescription cough, cold, & allergy medications unless otherwise directed

• (1*)

• (2*)

Flecainide (Tambocor)

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• do NOT D/C therapy WITHOUT 1st consulting physician

• patients with diabetes need to be aware that this agent can cause masking of hypoglycemic symptoms

• may cause dizziness/drowsiness

  • use CAUTION while operating machinery or when mental alertness is required

• AVOID nonprescription cough, cold, & allergy medications unless otherwise directed

• (1*)

• (2*)

Sotalol HCl (Betapace)

• do NOT D/C medication WITHOUT 1st consulting physician

• do NOT take ANY nonprescription cough or cold medicines, antacids, laxatives, or antidiarrheals WITHOUT 1st consulting pharmacist or physician

• if dose missed, take ASAP, but if closer to next dose, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• (1*)

• (2*)

Digoxin (Lanoxin & Digitek)

• do NOT swallow the dental cream

  • spit out excess after brushing

• do NOT use more often than prescribed by dentist or physician

• do NOT eat, drink, nor rinse for 30 minutes AFTER use

• (1*)

• (2*)

Sodium Fluoride Paste (SF 5000 Plus)

• PREFERABLY taken on an EMPTY stomach

  • HIGH fat meals DELAY onset of action

• because of the rapid onset of action, take IMMEDIATELY BEFORE bedtime

• because of induced drowsiness, do NOT operate machinery nor engage in activities when mental alertness is required

• AVOID alcohol while taking this medication

• WARNING: this medication MAY be habit-forming

• a rapid DECREASE or ABRUPT discontinuations of therapy MAY precipitate withdrawal symptoms

• (1*)

• (2*)

Eszopiclone (Lunesta)

• because of induced drowsiness, do NOT operate machinery nor engage in activities when mental alertness is required

• AVOID alcohol while taking this medication

• WARNING: this medication MAY be habit-forming

• if dose missed, SKIP it, & return to normal dosing schedule

  • do NOT double doses

• this medication is NOT intended to be used for longer than 10 consecutive days

• (1*)

• (2*)

Temazepam (Restoril)

• CR tablets should be swallowed WHOLE, & NOT divided, crushed, nor chewed

• because of induced drowsiness, do NOT operate machinery nor engage in activities when mental alertness is required

• AVOID alcohol while taking this medication

• WARNING: this medication MAY be habit-forming

• (1*)

• (2*)

Zolpidem Tartrate (Ambien (CR) & Intermezzo)

• because of the rapid onset of action, take IMMEDIATELY BEFORE bedtime

• sleep at least 4 hours to AVOID psychomotor impairment

• because of induced drowsiness, do NOT operate machinery nor engage in activities when mental alertness is required

• AVOID alcohol while taking this medication

• WARNING: this medication MAY be habit-forming

• (1*)

• (2*)

Zaleplon (Sonata)