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Olanzapine is used for:

Treating schizophrenia or bipolar disorder. It may also be used for other conditions as determined by your doctor.

Olanzapine is an atypical antipsychotic. Exactly how it works is not known. It is thought to affect certain substances in the brain.

Do NOT use Olanzapine if:

• you are allergic to any ingredient in Olanzapine

Contact your doctor or health care provider right away if any of these apply to you.

Before using Olanzapine:

Some medical conditions may interact with Olanzapine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a history of seizures, heart problems (eg, heart failure; fast, slow, or irregular heartbeat), abnormal electrocardiogram (ECG), heart attack, stroke, blood vessel problems, high blood cholesterol levels, or high or low blood pressure
• if you have a history of liver problems, stomach or bowel problems (eg, decreased muscle movement), enlarged prostate, narrow-angle glaucoma, neuroleptic malignant syndrome (NMS), aspiration pneumonia, or suicidal thoughts or attempts
• if you have Alzheimer disease, dementia, or trouble swallowing
• if you have diabetes or are very overweight, or if a family member has had diabetes
• if you have had high blood prolactin levels or a history of certain types of cancer (eg, breast, pancreas, pituitary), or if you are at risk for breast cancer
• if you are dehydrated, drink alcohol, or smoke, or you will be exposed to high temperatures

Some MEDICINES MAY INTERACT with Olanzapine. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Alpha blockers (eg, doxazosin), diazepam, or medicine for high blood pressure because the risk of low blood pressure and fainting may be increased
• Anticholinergics (eg, scopolamine), fluvoxamine, or lorazepam because they may increase the risk of Olanzapine’s side effects
• Carbamazepine, HIV protease inhibitors (eg, ritonavir), omeprazole, or rifampin because they may decrease Olanzapine’s effectiveness
• Dopamine receptor agonists (eg, pramipexole) or levodopa because their effectiveness may be decreased by Olanzapine

This may not be a complete list of all interactions that may occur. Ask your health care provider if Olanzapine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Olanzapine:

Use Olanzapine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Olanzapine by mouth with or without food.
• Drinking extra fluids while you are taking Olanzapine is recommended. Check with your doctor for instructions.
• Continue to take Olanzapine even if you feel well. Do not miss any doses.
• If you miss a dose of Olanzapine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Olanzapine.

Important safety information:

• Olanzapine may cause dizziness, drowsiness, or decreased vision. These effects may be worse if you take it with alcohol or certain medicines. Use Olanzapine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do not drink alcohol while you are using Olanzapine.
• Talk with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Olanzapine; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Olanzapine may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
• Do not become overheated in hot weather or while you are being active; heatstroke may occur.
• Olanzapine may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away.
• Neuroleptic malignant syndrome (NMS) is a possibly fatal syndrome that can be caused by Olanzapine. Symptoms may include fever; stiff muscles; confusion; abnormal thinking; fast or irregular heartbeat; and sweating. Contact your doctor at once if you have any of these symptoms.
• Some patients who take Olanzapine may develop muscle movements that they cannot control. This is more likely to happen in elderly patients, especially women. The chance that this will happen or that it will become permanent is greater in those who take Olanzapine in higher doses or for a long time. Muscle problems may also occur after short-term treatment with low doses. Tell your doctor at once if you have muscle problems with your arms; legs; or your tongue, face, mouth, or jaw (eg, tongue sticking out, puffing of cheeks, mouth puckering, chewing movements) while taking Olanzapine.
• Lab tests, including fasting blood sugar levels and liver function, may be performed while you use Olanzapine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Olanzapine with caution in the ELDERLY; they may be more sensitive to its effects, especially uncontrolled muscle movements.
• Olanzapine should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Olanzapine while you are pregnant. Olanzapine is found in breast milk. Do not breast-feed while taking Olanzapine.

Possible side effects of Olanzapine:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Back or joint pain; constipation; cough; dizziness; drowsiness; dry mouth; increased appetite; indigestion; lightheadedness; numbness or tingling of the skin; restlessness; sore throat; weakness; weight gain.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal thoughts; chest pain; confusion; decreased urination; fainting; fast, slow, or irregular heartbeat; fever; increased saliva production or drooling; increased sweating; memory loss; menstrual changes; muscle pain, weakness, or stiffness; new or worsening mental or mood changes (eg, depression, hallucinations); seizures; severe or prolonged dizziness or headache; shortness of breath; swelling of the hands, legs, or feet; symptoms of high blood sugar (eg, increased thirst, hunger, urination; unusual weakness); tremor; trouble concentrating, speaking, or swallowing; trouble sitting still; trouble walking or standing; uncontrolled muscle movements (eg, arm or leg movements, twitching of the face or tongue, jerking or twisting); unusual bruising; vision changes; yellowing of the eyes or skin.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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Fluvoxamine is used for:

Treating obsessive-compulsive disorder (OCD). It may also be used for other conditions as determined by your doctor.

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) type of antidepressant. It works by increasing the activity of a naturally occurring chemical in the brain called serotonin, which affects behavior.

Do NOT use Fluvoxamine if:

• you are allergic to any ingredient in Fluvoxamine
• you are taking alosetron, cisapride, cyproheptadine, dextromethorphan, fenfluramine and its derivatives, pimozide, astemizole, terfenadine, tramadol, l-tryptophan, a phenothiazine (eg, thioridazine), sibutramine, St. John’s wort, or tizanidine
• you are taking or have taken a monoamine oxidase (MAO) inhibitor (eg, phenelzine) within the last 14 days

Contact your doctor or health care provider right away if any of these apply to you.

Before using Fluvoxamine :

Some medical conditions may interact with Fluvoxamine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have stomach bleeding, seizures, mania, or a history of suicidal thoughts or behaviors

Some MEDICINES MAY INTERACT with Fluvoxamine. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Cyproheptadine or risperidone because the effectiveness of Fluvoxamine may be decreased
• Anorexiants (eg, phentermine), buspirone, butyrophenones (eg, haloperidol), dextromethorphan, fenfluramine and its derivatives, l-tryptophan, linezolid, lithium, metoclopramide, MAO inhibitors (eg, phenelzine), selegiline, sumatriptan, tetracyclic antidepressants (eg, trazodone), or tramadol because serotonin syndrome (unexpected irritability, increased muscle tone, altered consciousness) may be increased
• Alosetron, anticoagulants (eg, warfarin), aripiprazole, aspirin, atypical antipsychotics (eg, clozapine), benzodiazepines (eg, diazepam), beta-blockers (eg, propranolol), butyrophenones (eg, haloperidol), carbamazepine, cisapride, cyclosporine, galantamine, H₁ antagonists (eg, astemizole, terfenadine), hydantoins (eg, phenytoin), lithium, methadone, mexiletine, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), nefazodone, phenothiazines (eg, thioridazine), pimozide, propafenone, risperidone, serotonin norepinephrine reuptake inhibitors (eg, atomoxetine), sibutramine, tacrine, tetracyclic antidepressants (eg, trazodone), theophylline, tizanidine, or tricyclic antidepressants (eg, amitriptyline) because the actions and side effects of these medicines may be increased
• Cisapride or sumatriptan because the effectiveness may be decreased by Fluvoxamine
• St. John’s wort or trazodone because unexpected side effects may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if Fluvoxamine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Fluvoxamine :

Use Fluvoxamine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Fluvoxamine comes with an additional patient information sheet called a Medication Guide. Read it carefully and reread it each time you get Fluvoxamine refilled.
• Fluvoxamine may be taken with or without food.
• Avoid eating grapefruit or drinking grapefruit juice while taking Fluvoxamine.
• Continue to take Fluvoxamine even if you feel better.
• Do not miss any doses. If you miss a dose of Fluvoxamine and you are taking 1 dose daily, take the missed dose if you remember the same day. If you miss a dose of Fluvoxamine and you are taking more than 1 dose daily, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Fluvoxamine.

Important safety information:

• Fluvoxamine may cause dizziness or lightheadedness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Fluvoxamine. Using Fluvoxamine alone, with certain other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.
• Fluvoxamine will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
• Antidepressants can increase suicidal thoughts and behaviors in some children and teenagers. This risk may be higher in individuals with bipolar illness (also called manic-depressive illness), a family history of bipolar illness, or a history of attempting suicide. Pay close attention to changes in moods or actions, especially if changes occur suddenly. Contact your health care provider right away if any of the following effects occur or worsen: depression, anxiety, restlessness or irritability, panic attacks, thoughts or attempts of suicide, or other unusual changes in behavior or mood.
• Several weeks (up to 8 weeks) may pass before you feel the full effect of Fluvoxamine.
• If you drink more than 3 alcohol-containing drinks a day, do not take Fluvoxamine without first discussing it with your doctor.
• Fluvoxamine is not recommended for use in CHILDREN younger than 8 years of age. Safety and effectiveness in this age group have not been confirmed. Use Fluvoxamine with extreme caution in CHILDREN between 8 and 18 years of age.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Fluvoxamine , especially during the third trimester. Fluvoxamine is excreted in breast milk. Do not breast-feed while taking Fluvoxamine.

Do not suddenly stop taking Fluvoxamine without your doctor’s approval. Stopping Fluvoxamine suddenly may cause serious WITHDRAWAL symptoms, including a state of feeling unwell or unhappy, abnormal skin sensations, agitation, anxiety, confusion, dizziness, sudden emotional swings, headache, inability to sleep, irritability, lethargy, nausea, or sweating. If use of Fluvoxamine is to be stopped, your doctor will gradually decrease the dose.

Possible side effects of Fluvoxamine :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Change in taste; changes in sexual function; chills; constipation; delayed ejaculation; diarrhea; dizziness; drowsiness; dry mouth; fatigue; flu-like symptoms; flushing; frequent urination; gas; headache; impotence; inability to have an orgasm; indigestion; lightheadedness; loss of appetite; nausea; nervousness; sweating; tiredness; tooth disorder; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bizarre behavior; difficulty swallowing; fast heartbeat; fever; impulsive behavior or other unusual changes in behavior; mental or mood changes (eg, agitation, panic, hostility, irritability); pounding in the chest; seizures; severe nervousness or anxiety; severe restlessness; sleeplessness; suicidal thoughts or behaviors; tremor; vision problems; worsening of depression.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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Drug Name

Loxitane (Loxapine)

Drug Uses

This medication is used to treat symptoms of certain types of mental conditions. It acts in the brain to block chemicals involved with nerve sensitivity and improves concentration and self control.

How Taken

Take with food or milk if stomach upset occurs, unless directed otherwise by your doctor. The liquid concentrate must be measured carefully and diluted with 4 ounces or more of water, milk, juice, or carbonated beverage. It can be mixed into applesauce or pudding. Do not dilute with coffee, tea, or colas – the medication may lose effectiveness. Take immediately after diluting. Take this medication as prescribed. Do not stop taking this drug suddenly without consulting your doctor.

Some conditions may worsen if the medication is suddenly stopped. It may take up to two weeks for the full effects of this medication to be noticed.

Drug Class and Mechanism

Loxitane is a tricyclic antipsychotic. Loxitane is an anti psychotic drug of intermediate-potency. Used in the treatment of disorganized and psychotic thinking. Also used to help treat false perceptions ( e.g. hallucinations or delusions ).

Missed Dose

If you miss a dose, take it as soon as remembered; do not take if it is almost time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not “double-up” the dose to catch up.

Storage

Store at room temperature away from sunlight and moisture. Avoid freezing.

Warnings/Precautions

Tell your doctor your medical history, especially of:

• epilepsy,
• Parkinson’s disease,
• depression,
• heart disease,
• glaucoma,
• prostate trouble or difficulty urinating,
• alcohol and substance abuse history.

Use caution performing tasks that require alertness. This medication can increase sensitivity to sunlight. Avoid prolonged sun exposure and wear a sunscreen and protective clothing if needed. Limit alcohol intake, as it may intensify the drowsiness effect of this medication. This medication can reduce sweating making you more susceptible to heat stroke.

Avoid strenuous work or exercise in hot weather. The oral concentrate form can cause redness and irritation of the skin. Be careful not to spill it on your skin or clothing. Loxitane should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. It is not known if loxitane is excreted into breast milk. Consult your doctor before breast-feeding.

Possible Side Effects

May cause drowsiness, dizziness or blurred vision. Other side effects include stomach upset, loss of appetite, headache, drooling, dry mouth, sleep disturbances or restlessness. If these effects persist or worsen, notify your doctor promptly.

Unlikely but notify your doctor promptly if you develop:

• chest pain,
• a rapid heart rate,
• difficult or fast breathing,
• aching muscles and joints,
• tremors,
• rash,
• involuntary movements (such as chewing, puckering or a twitching tongue).

If you notice other effects not listed above, contact your doctor or pharmacist.

More Information

Do not share this medicine with others for whom it was not prescribed. Do not use this medicine for other health conditions.

If you will be taking this medicine for an extended period of time, be sure to obtain necessary refills before your supply runs out.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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What is sertraline?

• Sertraline is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Sertraline affects chemicals in the brain that may become unbalanced and cause depression, panic, anxiety, or obsessive-compulsive symptoms.
• Sertraline is used to treat depression, obsessive-compulsive disorder, panic disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD).
• Sertraline may also be used for purposes other than those listed in this medication guide.

What should I discuss with my doctor before taking sertraline?

• You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. Talk with your doctor about this risk. While you are taking sertraline you will need to be monitored for worsening symptoms of depression and/ or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
• Do not use sertraline if you are using pimozide (Orap), or an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with sertraline. You must wait at least 14 days after stopping an MAO inhibitor before you can take sertraline.
• Before taking sertraline, tell your doctor if you have:
  • liver or kidney disease;
  • seizures or epilepsy;
  • bipolar disorder (manic depression); or
  • a history of drug abuse or suicidal thoughts.
• If you have any of these conditions, you may not be able to use sertraline, or you may need a dosage adjustment or special tests during treatment.
• FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
• It is not known whether sertraline passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take sertraline?

• Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.
• Take each tablet with water.
• Try to take the medicine at the same time each day.
• Try to take sertraline at the same time each day.
• Sertraline may be taken with or without food.
• It may take 4 weeks or more for you to start feeling better. Do not stop using sertraline without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.
• Store sertraline at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

• Seek emergency medical attention if you think you have taken too much of this medication. Symptoms of a sertraline overdose may include dizziness, drowsiness, nausea, vomiting, rapid heartbeat, agitation, tremor, confusion, seizures, and coma.

What should I avoid while taking sertraline?

• Do not take sertraline together with pimozide (Orap), isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).
• Avoid drinking alcohol, which can increase some of the side effects of sertraline.
• Avoid using other medicines that make you sleepy (such as cold medicine, other pain medication, muscle relaxants). They can add to sleepiness caused by sertraline.
• Sertraline can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What are the possible side effects of sertraline?

• Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
• Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/ or physical hyperactivity), thoughts of suicide or hurting yourself.
• Call your doctor at once if you have any of these serious side effects:
  • seizure (convulsions);
  • tremors, shivering, muscle stiffness or twitching;
  • problems with balance or coordination; or
  • agitation, confusion, sweating, fast heartbeat.
• Other less serious side effects are more likely to occur, such as:
  • feeling nervous, restless, or unable to sit still;
  • drowsiness, dizziness, weakness;
  • sleep problems (insomnia);
  • nausea, diarrhea, dry mouth, or changes in appetite or weight; or
  • decreased sex drive, impotence, or difficulty having an orgasm.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What drug(s) may interact with sertraline?

Sertraline has the potential to interact with a variety of medications, check with your healthcare professional. The following list contains some of these interactions.

Do not take sertraline with any of the following medications:

• astemizole (Hismanal®)
• cisapride (Propulsid®)
• pimozide (Orap®)
• terfenadine (Seldane®)
• thioridazine (Mellaril®)
• medicines called MAO inhibitors-phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), selegiline (Eldepryl®)

Sertraline may also interact with the following medications:

• amphetamine
• bosentan
• carbamazepine
• certain diet drugs (dexfenfluramine, fenfluramine, phentermine, sibutramine)
• certain migraine headache medicines (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan)
• cimetidine
• cyclosporine
• dextroamphetamine
• dextromethorphan
• diazepam
• doxercalciferol
• furazolidone
• linezolid
• other medicines for mental depression, mania, anxiety, psychosis or difficulty sleeping
• phenobarbital
• prescription pain medications
• procarbazine
• rifabutin
• rifampin
• rifapentine
• selegiline
• St. John’s wort
• tolbutamide
• tramadol
• warfarin

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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Escitalopram is used for:

Treating depression and anxiety. It may also be used for other conditions as determined by your doctor.

Escitalopram is a selective serotonin reuptake inhibitor (SSRI) type of antidepressant. It works by increasing the activity of a chemical in the brain called serotonin, which helps to elevate mood.

Do NOT use Escitalopram if:

• you are allergic to any ingredient in Escitalopram or to citalopram
• you are taking or have taken a monoamine oxidase (MAO) inhibitor (eg, phenelzine) in the last 14 days
• you are taking citalopram, linezolid, pimozide, selegiline, tramadol, or any weight loss medicines (eg, phentermine)

Contact your doctor or health care provider right away if any of these apply to you.

Before using Escitalopram :

Some medical conditions may interact with Escitalopram. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any other prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have or have a history of a bipolar condition (mania or manic-depression) or suicidal thoughts or behaviors
• if you have or have a history of kidney or liver problems, a heart attack, seizures (convulsions), or stomach or intestinal bleeding

Some MEDICINES MAY INTERACT with Escitalopram. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Citalopram should not be taken with Escitalopram because they have the same chemical formula
• MAO inhibitors (eg, phenelzine), linezolid, or selegiline because they can cause serious, sometimes fatal, reactions, including restlessness, fever, excessive sweating, confusion, twitching, and seizures. Do NOT takeMAO inhibitors (eg, phenelzine), linezolid, or selegiline within 2 weeks of taking Escitalopram.
• Lithium, St. John’s wort, tramadol, sumatriptan, orweight loss medicines (eg, phentermine because side effects such as restlessness, fever, excessive sweating, confusion, twitching, and seizures which can rarely be life-threatening, may occur
• Beta-blockers (eg, propranolol, metoprolol) because side effects such as very slow heart rate may be increased by Escitalopram
• Nonsteroidal anti-inflammatory agents (NSAIDs; eg, ibuprofen, celecoxib), oral anticoagulants (eg, warfarin), or salicylates (eg, aspirin) because the risk of stomach bleeding may be increased by Escitalopram
• Pimozide because side effects such as racing heartbeat, dizziness, fainting, life-threatening irregular heartbeat leading to unconsciousness and lack of heartbeat may increase by Escitalopram

This may not be a complete list of all interactions that may occur. Ask your health care provider if Escitalopram may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Escitalopram :

Use Escitalopram as directed by your doctor. Check the label on the medicine for exact dosing instructions. Check the label on the medicine for exact dosing instructions.

• Escitalopram comes with an additional patient information sheet called a Medication Guide. Read it carefully and reread it each time you get Escitalopram refilled.
• Escitalopram may be taken with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
• Several weeks may pass before Escitalopram reaches full effect. Continue to use Escitalopram even if you feel well. Do not miss any doses.
• If you miss a dose of Escitalopram , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Escitalopram.

Important safety information:

• Escitalopram may cause drowsiness, dizziness, and lightheadedness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Escitalopram. Using Escitalopram alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
• Avoid drinking alcohol or taking other medications that cause drowsiness (eg, sedatives, tranquilizers) while taking Escitalopram. Escitalopram will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
• Antidepressants can increase suicidal thoughts and actions in some children and teenagers. This risk may be higher in individuals with bipolar illness (also called manic-depressive illness), a family history of bipolar illness, or a history of attempting suicide. Pay close attention to changes in moods or actions, especially if changes occur suddenly. Contact your doctor right away if any of the following effects occur or worsen: depression, anxiety, restlessness or irritability, panic attacks, thoughts or attempts of suicide, or other unusual changes in behavior or mood.
• Use Escitalopram with caution in the ELDERLY because they may be more sensitive to its effects.
• Escitalopram is not recommended for use in CHILDREN. Safety and effectiveness have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Escitalopram , especially during the third trimester. Escitalopram is excreted in breast milk. If you are or will be breast-feeding while you are using Escitalopram , check with your doctor or pharmacist to discuss the risks to your baby.

Do NOT suddenly stop taking Escitalopram without your doctor’s approval. Stopping Escitalopram suddenly may cause serious WITHDRAWAL symptoms, including abnormal skin sensations, agitation, anxiety, a state of feeling unwell or unhappy, confusion, dizziness, headache, inability to sleep, irritability, lethargy, nausea, sudden emotional swings, and sweating. If therapy with Escitalopram is to be stopped, your doctor will gradually decrease your dose.

Possible side effects of Escitalopram :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Back pain; constipation; decreased sex drive; diarrhea; delay in ejaculation; dizziness; drowsiness; dry mouth; impotence; increased sweating; lack of orgasms; loss of appetite; nausea; trouble sleeping; unusual fatigue; upset stomach; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); agitation; anxiety; black or tarry stools; changes in amount of urine; chest pain; hostility; impulsiveness; irritability; mania; muscle cramps; painful or prolonged erection; panic attacks; restlessness; seizures; sleeplessness; stomach pain; suicidal thoughts; thoughts of hurting yourself; uncontrolled movements (tremors); unusual bleeding or bruising; unusual or severe mental/mood changes; unusually fast or slow heartbeat; vision changes; vomit that looks like coffee grounds; worsening of depression.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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Ziprasidone is used for:

Treating acute agitation in patients with schizophrenia who require an injectable medicine. It may also be used for other conditions as determined by your doctor.

Ziprasidone is an antipsychotic. It may work by altering the balance of certain chemicals that occur naturally in the brain, which are responsible for thinking and behavior.

Do NOT use Ziprasidone if:

• you are allergic to any ingredient in Ziprasidone
• you have certain heart diseases, including long QT syndrome, a recent heart attack, severe heart failure, or certain irregularities of heart rhythm
• you are taking cisapride, dofetilide, H₁ antagonists (eg, diphenhydramine), halofantrine, macrolide immunosuppressives (eg, tacrolimus), mefloquine, methadone, pentamidine, pimozide, probucol, procainamide, quinidine, serotonin receptor antagonist antiemetics (eg, ondansetron), sotalol, or sparfloxacin

Contact your doctor or health care provider right away if any of these apply to you.

Before using Ziprasidone :

Some medical conditions may interact with Ziprasidone. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines or other substances
• if you have considered or attempted suicide
• if you have heart disease, a slow heartbeat, low blood potassium or magnesium levels, low blood volume, a drug-induced movement disorder, diabetes, kidney or liver problems, a history of stroke, a history of low blood pressure, seizures, difficulty swallowing, Alzheimer disease, or breast cancer, or if you are overweight

Some MEDICINES MAY INTERACT with Ziprasidone. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Carbamazepine because the effectiveness of Ziprasidone may be decreased
• Arsenic, cisapride, class III antiarrhythmics (eg, amiodarone, sotalol), dofetilide , droperidol, H₁ antagonists (eg, diphenhydramine), halofantrine, IA and IC antiarrhythmics (eg, procainamide, quinidine, flecainide, propafenone), macrolide immunosuppressives (eg, tacrolimus), macrolides and ketolides (eg, erythromycin, azithromycin), mefloquine, methadone, pentamidine, phenothiazines (eg, thioridazine), pimozide, probucol, quinolones (eg, ciprofloxacin), serotonin receptor antagonist antiemetics (eg, ondansetron), sparfloxacin , or streptogramins (eg, mitomycin, pristinamycin) because the risk of side effects of these medicines, such as abnormal heart rhythms, may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Ziprasidone may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Ziprasidone :

Use Ziprasidone as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Ziprasidone is usually administered as an injection at your doctor’s office, hospital, or clinic.
• If you are using Ziprasidone at home, carefully follow the injection procedures taught to you by your health care provider. If the medicine contains particles, is discolored, or if the vial/container is cracked or damaged in any way, do not use it.
• Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor, nurse, or pharmacist to explain local regulations for proper disposal.
• If you miss a dose of Ziprasidone , use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Ziprasidone.

Important safety information:

• Ziprasidone may cause drowsiness, dizziness, or lightheadedness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Ziprasidone. Using Ziprasidone alone, with certain other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.
• Avoid drinking alcohol or taking other medications that cause drowsiness (eg, sedatives, tranquilizers) while taking Ziprasidone. Ziprasidone will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
• Ziprasidone may cause dizziness, lightheadedness, or fainting. Alcohol, hot weather, exercise, and fever can increase these effects. To prevent them, sit or stand up slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness, lightheadedness, or weakness.
• Do not become overheated in hot weather or during exercise or other activities; heatstroke may occur.
• Ziprasidone is intended for short-term control of acute agitation symptoms. If you require continuous treatment for your condition, your doctor may switch you to an oral medicine.
• Ziprasidone may increase your risk for developing diabetes or increase blood sugar levels. High blood sugar levels can cause serious problems if left untreated.
• Diabetes patients – Ziprasidone may alter your blood sugar. Check blood sugar levels closely and ask your doctor before adjusting the dose of your diabetes medicine.
• LAB TESTS, such as electrolyte levels or fasting blood sugar levels, may be performed to monitor your progress. Be sure to keep all doctor and lab appointments.
• Use Ziprasidone with caution in the ELDERLY because they may be more sensitive to its effects, especially dizziness and lightheadedness upon sitting or standing up.
• Ziprasidone is not recommended for use in CHILDREN. Safety and effectiveness have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Ziprasidone during pregnancy. It is unknown if Ziprasidone is excreted in breast milk. Do not breast-feed while taking Ziprasidone..

Possible side effects of Ziprasidone :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; drowsiness; dry mouth; feeling unusually tired or sleepy; headache; increased cough or runny nose; loss of appetite; nausea; pain at the injection site; upset stomach.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); altered mental abilities, including lack of response to your surroundings; change in amount of urine; change in vision; difficulty swallowing; fainting or loss of consciousness; fever; high blood sugar (increased thirst, increased urination, confusion, flushing, rapid breathing, or fruity breath odor); inability to move; increased body heat; increased heart rate; irregular heart rhythm; muscle rigidity; muscle spasms or twitching; pounding in the chest; prolonged or painful erection; seizures; sweating; uncontrolled movements (especially of face or tongue).

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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What is/are Doxepin Capsules?

DOXEPIN is used to treat depression and anxiety. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care providers before I take this medicine?

They need to know if you have any of these conditions:

bipolar disorder or schizophrenia difficulty passing urine glaucoma kidney or liver disease thoughts or plans of suicide or a previous suicide attempt or family history of suicide attempt an unusual or allergic reaction to doxepin, sulfites, tartrazine dye, other medicines, foods, dyes, or preservatives pregnant or trying to get pregnant breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on the advice of your doctor or health care professional.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 12 years for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

Note: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following:

arsenic trioxide certain medicines used to regulate abnormal heartbeat or to treat other heart conditions cisapride halofantrine levomethadyl MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate other medicines for mental depression phenothiazines like perphenazine, thioridazine and chlorpromazine pimozide procarbazine sparfloxacin St. John’s Wort ziprasidone

This medicine may also interact with the following:

cimetidine tolazamide

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What side effects may I notice from this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

abnormal production of milk in females allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue breast enlargement in both males and females breathing problems confusion, hallucinations excessive thirst and/or hunger fast, irregular or pounding heartbeat fever with sweating muscle stiffness, or spasms passing urine more times in a day seizures suicidal thoughts or other mood changes swelling of the testicles tingling, pain, or numbness in the feet or hands trouble passing urine or change in the amount of urine yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

change in sex drive or performance constipation, or diarrhea nausea, vomiting weight gain or loss

This list may not describe all possible side effects.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. It can take several days before you feel the full effect of this medicine. If you have been taking this medicine regularly for some time, do not suddenly stop taking it. You must gradually reduce the dose or you may get severe side effects. Ask your doctor or health care professional for advice. Even after you stop taking this medicine it can still affect your body for several days.

Patients and their families should watch out for worsening depression or thoughts of suicide. Also watch out for sudden or severe changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of antidepressant treatment or after a change in dose, call your health care professional.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may increase dizziness and drowsiness. Avoid alcoholic drinks.

Do not treat yourself for coughs, colds, or allergies without asking your doctor or health care professional for advice. Some ingredients can increase possible side effects.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

This medicine may cause dry eyes and blurred vision. If you wear contact lenses you may feel some discomfort. Lubricating drops may help. See your eye doctor if the problem does not go away or is severe.

This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.

Where should I keep this medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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Drug Name

Endep (Amitriptyline)

Drug Uses

Endep is used to treat symptoms of depression. Endep may also be used for purposes other than those listed in this medication guide.

How Taken

Take Endep exactly as it was prescribed for you. Do not take Endep in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Follow the directions on your prescription label.

Drug Class and Mechanism

Endep is in a group of drugs called tricyclic antidepressants. Endep affects chemicals in the brain that may become unbalanced.

Missed Dose

If you miss a dose of this medicine and you are using it regularly, take it as soon as possible. If you do not remember until later, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Storage

Store at the room temperature away from moisture and sunlight. Keep out of the reach of children.

Warnings/Precautions

Avoid drinking alcohol. It can cause dangerous side effects when taken together with Endep.

Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, medicine for seizures, or other antidepressants). They can add to sleepiness caused by Endep.

Grapefruit and grapefruit juice may interact with Endep. Discuss the use of grapefruit products with your doctor before increasing or decreasing the amount of grapefruit products in your diet.

Endep can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds).

Endep can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.

Possible Side Effects

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.

Call your doctor at once if you have any of these serious side effects:

• fast, pounding, or uneven heart rate;
• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
• sudden numbness or weakness, especially on one side of the body;
• sudden headache, confusion, problems with vision, speech, or balance;
• confusion, hallucinations, or seizures (convulsions);
• restless muscle movements in your eyes, tongue, jaw, or neck;
• uncontrollable shaking or tremor;
• skin rash, severe tingling, numbness, pain, muscle weakness;
• easy bruising or bleeding;
• extreme thirst with headache, nausea, vomiting, and weakness;
• feeling light-headed, fainting; orurinating less than usual or not at all.

Less serious side effects may be more likely to occur, such as:

• nausea, vomiting, constipation, diarrhea, loss of appetite;
• dry mouth, unpleasant taste;
• numbness or tingly feeling;
• lack of coordination;
• feeling anxious, dizzy, drowsy, or tired;
• trouble concentrating;
• sleep problems (insomnia), nightmares;
• blurred vision, headache, ringing in your ears; mild skin rash;
• breast swelling (in men or women);
• or decreased sex drive, impotence, or difficulty having an orgasm.

More Information

Before taking Endep, tell your doctor if you are allergic to any drugs, or if you have:

• heart disease;
• a history of heart attack, stroke, or seizures;
• bipolar disorder (manic-depression);
• schizophrenia or other mental illness;
• diabetes (Endep may raise or lower blood sugar);
• overactive thyroid;
• glaucoma;
• or problems with urination.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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