Archives February 2023

Medroxyprogesterone as common brand name Depo Provera is an intramuscular and subcutaneous injection used to as a contraceptive to prevent pregnancy.

Medroxyprogesterone subcutaneous injection is also used to treat endometriosis- (a condition in which the type of tissue that lines the uterus (womb) grows in other areas of the body and causes pain, heavy or irregular menstruation [periods], and other symptoms).

Medroxyprogesterone is in a class of medications called progestins. It works to prevent pregnancy by preventing ovulation (the release of eggs from the ovaries). Medroxyprogesterone also thins the lining of the uterus. This helps to prevent pregnancy in all women and slows the spread of tissue from the uterus to other parts of the body in women who have endometriosis.

Depo injection is a very effective method of birth control but does not prevent the spread of human immunodeficiency virus (HIV, the virus that causes acquired immunodeficiency syndrome [AIDS]) or other sexually transmitted diseases.

WARNING

Medroxyprogesterone injection may decrease the amount of calcium stored in your bones. The amount of calcium in your bones may not return to normal even after you stop using the injection and this may cause osteoporosis even after menopause.

How should this medicine be used?

Medroxyprogesterone intramuscular injection comes as a suspension (liquid) to be injected into the buttocks or upper arm. It is usually given once every 3 months (13 weeks) by a healthcare provider in an office or clinic.

Medroxyprogesterone subcutaneous injection comes as suspension to be injected just under the skin. It is usually injected once every 12 to 14 weeks by a healthcare provider in an office or clinic.

You must receive your first medroxyprogesterone subcutaneous or intramuscular injection only at a time when there is no possibility that you are pregnant. Therefore, you may only receive your first injection during the first 5 days of a normal menstrual period, during the first 5 days after you give birth if you are not planning to breast-feed your baby, or during the sixth week after giving birth if you are planning to breast-feed your baby.

If you have been using a different method of birth control and are switching to this injection, your doctor will tell you when you should receive your first injection.

What special precautions should I follow?

Before using medroxyprogesterone injection,
tell your doctor and pharmacist if:

You are allergic to medroxyprogesterone (Depo-Provera, depo-subQ provera 104, Provera, in Prempro, in Premphase) or any other medications.

Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.

Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

Tell your doctor if you or anyone in your family has or has ever had breast cancer or diabetes.

Also tell your doctor if you have or have ever had problems with your breasts such as lumps, bleeding from your nipples, an abnormal mammogram (breast x-ray), or fibrocystic breast disease (swollen, tender breasts and/or breast lumps that are not cancer); unexplained vaginal bleeding;irregular or very light menstrual periods; excessive weight gain or fluid retention before your period; blood clots in your legs, lungs, brain, or eyes; stroke or mini-stroke; migraine headaches; seizures; depression; high blood pressure; heart attack; asthma; or heart, liver, or kidney disease.

Tell your doctor if you think you might be pregnant, you are pregnant, or you plan to become pregnant. If you become pregnant while using medroxyprogesterone injection, call your doctor immediately. Medroxyprogesterone may harm the fetus.

Tell your doctor if you are breast-feeding. You may use medroxyprogesterone injection while you are breast-feeding as long as your baby is 6 weeks old when you receive your first injection. Some medroxyprogesterone may be passed to your baby in your breast milk but this has not been shown to be harmful. Studies of babies who were breast-fed while their mothers were using medroxyprogesterone injection showed that the babies were not harmed by the medication.

Tell your doctor if you or anyone in your family has osteoporosis; if you have or have ever had any other bone disease or anorexia nervosa (an eating disorder); or if you drink a lot of alcohol or smoke a great deal.

Tell your doctor if you take any of the following medications: corticosteroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); or medications for seizures such as carbamazepine (Tegretol), phenytoin (Dilantin), or phenobarbital (Luminal, Solfoton).

If you are having surgery, including dental surgery, tell the doctor or dentist that you are using medroxyprogesterone injection.

You should know that your menstrual cycle will probably change while you are using medroxyprogesterone injection. At first, your periods will probably be irregular, and you may experience spotting between periods. If you continue to use this medication, your periods may stop completely. Your menstrual cycle will probably return to normal some time after you stop using this medication.

What special dietary instructions should I follow?

You should eat plenty of foods that are rich in calcium and vitamin D while you are receiving medroxyprogesterone injection to help decrease the loss of calcium from your bones.

Your doctor will tell you which foods are good sources of these nutrients and how many servings you need each day. Your doctor also may prescribe or recommend calcium or vitamin D supplements.

What should I do if I forget a dose?

If you miss an appointment to receive an injection of medroxyprogesterone, call your doctor. You may not be protected from pregnancy if you do not receive your injections on schedule. If you do not receive an injection on schedule, your doctor will tell you when you should receive the missed injection.

Your doctor will probably administer a pregnancy test to be sure that you are not pregnant before giving you the missed injection. You should use a different method of birth control, such as condoms until you receive the injection that you missed.

What side effects can this Medroxyprogesterone cause?

Medroxyprogesterone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
changes in menstrual periods
weight gain
weakness
tiredness
nervousness
irritability
depression
difficulty falling asleep or staying asleep
hot flashes
breast pain, swelling, or tenderness
stomach cramps or bloating
leg cramps
back or joint pain
acne
loss of hair on scalp
swelling, redness, irritation, burning, or itching of the vagina
white vaginal discharge
changes in sexual desire
cold or flu symptoms
pain, irritation, lumps, redness or scarring in the place where the medication was injected
Some side effects can be serious.

The following side effects are uncommon, but if you experience any of them, call your doctor immediately:
sudden shortness of breath
sudden sharp or crushing chest pain
coughing up blood
severe headache
nausea
vomiting
dizziness or faintness
change or loss of vision
double vision
bulging eyes
difficulty speaking
weakness or numbness in arm
seizure
yellowing of the skin or eyes
extreme tiredness
pain, swelling, warmth, redness, or tenderness in one leg only
menstrual bleeding that is heavier or lasts longer than normal
severe pain or tenderness just below the waist
rash
hives
itching
difficulty breathing or swallowing
swelling of the hands, feet, ankles, or lower legs
difficult, painful, or frequent urination
constant pain, pus, warmth, swelling, or bleeding in the place where the medication was injected

If you are younger than 35 years old and began to receive medroxyprogesterone injection in the last 4 to 5 years, you may have a slightly increased risk that you will develop breast cancer.

Medroxyprogesterone injection may also increase the chance that you will develop a blood clot that moves to your lungs or brain.

Talk to your doctor about the risks of using this medication.
Medroxyprogesterone injection is a long-acting birth control method. You might not become pregnant for some time after you receive your last injection.

Talk to your doctor about the effects of using this medication if you plan to become pregnant in the near future.

Medroxyprogesterone injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication.

WARNINGS
Medroxyprogesterone injection may decrease the amount of calcium stored in your bones. The longer you use this medication, the more the amount of calcium in your bones may decrease. The amount of calcium in your bones may not return to normal even after you stop using medroxyprogesterone injection.

Loss of calcium from your bones may cause osteoporosis (a condition in which the bones become thin and weak) and may increase the risk that your bones might break at some time in your life, especially after menopause (change of life).

Acetaminophen also as Paracetamol, is used to relieve mild to moderate pain from headaches, muscle aches, menstrual periods, colds and sore throats, toothaches, backaches, and reactions to vaccinations (shots), and to reduce fever.

Acetaminophen may also be used to relieve the pain of osteoarthritis (arthritis caused by the breakdown of the lining of the joints). Acetaminophen is in a class of medications called analgesics (pain relievers) and antipyretics (fever reducers). It works by changing the way the body senses pain and by cooling the body.

How should this medicine be used?

Acetaminophen comes as a tablet, capsule, suspension or solution (liquid), extended-release (long-acting) tablet, and orally disintegrating tablet (tablet that dissolves quickly in the mouth), to take by mouth, with or without food.

Acetaminophen is available without a prescription, but your doctor may prescribe acetaminophen to treat certain conditions. Follow the directions on the package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

If you are giving acetaminophen to your child, read the package label carefully to make sure that it is the right product for the age of the child. Do not give children acetaminophen products that are made for adults. Some products for adults and older children may contain too much acetaminophen for a younger child.

Check the package label to find out how much medication the child needs. If you know how much your child weighs, give the dose that matches that weight on the chart. If you don’t know your child’s weight, give the dose that matches your child’s age. Ask your child’s doctor if you don’t know how much medication to give your child.

Acetaminophen comes in combination with other medications to treat cough and cold symptoms. Ask your doctor or pharmacist for advice on which product is best for your symptoms.

Check nonprescription cough and cold product labels carefully before using two or more products at the same time. These products may contain the same active ingredient(s) and taking them together could cause you to receive an overdose.

This is especially important if you will be giving cough and cold medications to a child. Swallow the extended-release tablets whole; do not split, chew, crush, or dissolve them.

Place the orally disintegrating tablet (‘Meltaways’) in your mouth and allow to dissolve or chew it before swallowing.

Shake the suspension well before each use to mix the medication evenly. Always use the measuring cup or syringe provided by the manufacturer to measure each dose of the solution or suspension.

Do not switch dosing devices between different products; always use the device that comes in the product packaging.

Stop taking acetaminophen and call your doctor if your symptoms get worse, you develop new or unexpected symptoms, including redness or swelling, your pain lasts for more than 10 days, or your fever gets worse or lasts more than 3 days.

Also stop giving acetaminophen to your child and call your child’s doctor if your child develops new symptoms, including redness or swelling, or your child’s pain lasts for longer than 5 days, or fever get worse or lasts longer than 3 days.

Do not give acetaminophen to a child who has a sore throat that is severe or does not go away, or that occurs along with fever, headache, rash, nausea, or vomiting. Call the child’s doctor right away, because these symptoms may be signs of a more serious condition.

Other uses for this medicine
Acetaminophen may also be used in combination with aspirin and caffeine to relieve the pain associated with migraine headache.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking acetaminophen,
Tell your doctor and pharmacist if you are allergic to acetaminophen, any other medications, or any of the ingredients in the product. Ask your pharmacist or check the label on the package for a list of ingredients.

Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, or herbal products you are taking or plan to take. Be sure to mention anticoagulants (‘blood thinners’) such as warfarin (Coumadin); isoniazid (INH); certain medications for seizures including carbamazepine (Tegretol), phenobarbital, and phenytoin (Dilantin); medications for pain, fever, coughs, and colds; and phenothiazines (medications for mental illness and nausea).

Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

Tell your doctor if you have ever developed a rash after taking acetaminophen.

Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking acetaminophen, call your doctor.

If you drink three or more alcoholic beverages every day, do not take acetaminophen. Ask your doctor or pharmacist about the safe use of alcoholic beverages while taking acetaminophen.

You should know that combination acetaminophen products for cough and colds that contain nasal decongestants, antihistamines, cough suppressants, and expectorants should not be used in children younger than 2 years of age. Use of these medications in young children can cause serious and life-threatening effects or death.

In children 2 through 11 years of age, combination cough and cold products should be used carefully and only according to the directions on the label.

If you have phenylketonuria (PKU, an inherited condition in which a special diet must be followed to prevent damage to your brain that can cause severe intellectual disability), you should know that some brands of acetaminophen chewable tablets may be sweetened with aspartame. a source of phenylalanine.

What should I do if I forget a dose?

This medication is usually taken as needed. If your doctor has told you to take acetaminophen regularly, take the missed dose as soon as you remember it.

However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this Acetaminophen cause?

Acetaminophen may cause side effects.
Some side effects can be serious. If you experience any of the following symptoms, stop taking acetaminophen and call your doctor immediately or get emergency medical attention:
red, peeling or blistering skin
rash
hives
itching
swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
hoarseness
difficulty breathing or swallowing

Acetaminophen may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

If someone takes more than the recommended dose of acetaminophen, get medical help immediately, even if the person does not have any symptoms.

Symptoms of overdose may include the following:
nausea
vomiting
loss of appetite
sweating
extreme tiredness
unusual bleeding or bruising
pain in the upper right part of the stomach
yellowing of the skin or eyes
flu-like symptoms

Why is this medication prescribed?

HCTZ is used alone or in combination with other medications to treat high blood pressure. Hydrochlorothiazide is used to treat edema (fluid retention; excess fluid held in body tissues) caused by various medical problems, including heart, kidney, and liver disease and to treat edema caused by using certain medications including estrogen and corticosteroids.

Hydrochlorothiazide is in a class of medications called diuretics (‘water pills’). It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine.

High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure.

These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.

How should this medicine be used?

Hydrochlorothiazide as 12.5mg, 25mg, or 50mg comes as a tablet, capsule, and solution (liquid) to take by mouth. It usually is taken once or twice a day. When used to treat edema, hydrochlorothiazide may be taken daily or only on certain days of the week. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

Take hydrochlorothiazide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Hydrochlorothiazide controls high blood pressure but does not cure it.

Continue to take hydrochlorothiazide even if you feel well. Do not stop taking hydrochlorothiazide without talking to your doctor.
Other uses for this medicine
Hydrochlorothiazide may also be used to treat patients with diabetes insipidus and to prevent kidney stones in patients with high levels of calcium in their blood. Talk to your doctor about the possible risks of using this medicine for your condition.

This medicine is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking hydrochlorothiazide,
tell your doctor and pharmacist :

If you are allergic to hydrochlorothiazide, ‘sulfa drugs’, penicillin, or any other drugs.

Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: barbiturates such as phenobarbital and secobarbital (Seconal); corticosteroids such as betamethasone (Celestone), budesonide (Entocort), cortisone (Cortone), dexamethasone (Decadron, Dexpak, Dexasone, others), fludrocortisone (Florinef), hydrocortisone (Cortef, Hydrocortone), methylprednisolone (Medrol, Meprolone, others), prednisolone (Prelone, others), prednisone (Deltasone, Meticorten, Sterapred, others), and triamcinolone (Aristocort, Azmacort); corticotropin (ACTH, H.P., Acthar Gel); insulin and oral medications for diabetes; lithium (Eskalith, Lithobid); medications for high blood pressure or pain; nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Naprosyn, others).

Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

If you are taking cholestyramine or colestipol, take them 1 hour before or 4 hours after taking hydrochlorothiazide.

Tell your doctor if you have kidney disease. Your doctor may tell you not to take hydrochlorothiazide.

Tell your doctor if you have or have ever had diabetes, asthma, gout, systemic lupus erythematosus (SLE, a chronic inflammatory condition), high cholesterol, or kidney or liver disease.

Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking hydrochlorothiazide, call your doctor immediately.

Plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Hydrochlorothiazide may make your skin sensitive to sunlight and increase your risk of a certain types of skin cancer. Your doctor will check your skin for skin cancers during your treatment with hydrochlorothiazide. Call your doctor if you notice any new skin changes or growths.
you should know that hydrochlorothiazide may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking hydrochlorothiazide.

To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. Alcohol can add to these side effects.

What special dietary instructions should I follow?

If your doctor prescribes a low-salt or low-sodium diet, or to eat or drink increased amounts of potassium-rich foods (e.g., bananas, prunes, raisins, and orange juice) in your diet, follow these instructions carefully.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule.

Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Tell your doctor if any of these symptoms are severe or do not go away:
frequent urination
diarrhea
loss of appetite
headache
hair loss
If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:
dry mouth; thirst; nausea; vomiting; weakness, tiredness; drowsiness; restlessness; confusion; muscle weakness, pain, or cramps; fast heartbeat and other signs of dehydration and electrolyte imbalance
blisters or peeling skin
hives
rash
itching
difficulty breathing or swallowing
unusual bleeding or bruising
ongoing pain that begins in the stomach area, but may spread to the back
joint pain or swelling
changes in vision, eye pain, or swelling or redness in or around the eye