Intermittent constipation t/m: best by high fiber diet, fluid intake, regular exercise.

  1. Bulk forming laxatives:
  • indigestible
  • hydrophilic water absorbing colloids & forms bulky gels that distent colon & permits peristalsis.
  • Natural plant products… Psyllium, methylcellulose & synthetic fibers, polycarbophil increased bloating, flatulence with plant … Bacterial digestion within the colon.
  1. Stool softeners or surfactant agents:
  • Rectal or oral
  • docusate & glycerin suppositories.
  • Mineral oil a viscous oil lubricating fecal material & prevents water absorption from the stool. Long use impairs absorption of fat-soluble vitamins  (A,D,E, K)
  1. Osmotic laxatives:
  • For prevention small doses mixed with juice.
  • PEG for complete colonic cleansing before GI endoscopy.
  • Adequate hydration needed.
  • Mg citrate & Na phosphate.
  • Sorbitol & lactulose non absorbable sugars to treat or prevent chronic constipation. Metabolized by colonic bacteria. Produces cramps & flatulence.
  • MgOH(milk of magnesia) falls under this category but is not for renal impaired patients.
  • osm lax are soluble but nonabsorbable which increases stool liquidity by increasing fecal fluid.
  • Fecal water is isotonic throughout colon.
  • Stimulant lax: 
  • aloe, senna.
  • Lubiprostone a prostanoic acid derivative…for Chronic constipation & IBW, opioid induced const.
  • Acts by stimulating type 2 Chloride channel in small intestines, increasing chloride rich fluid secretion in intestines & increases motility.
  • Causes nausea & is not for pregnant women.
  • Not very effective, constipation returns after stoppage & no efficacy on long term.

Patient Information on XOPENEX (levalbuterol tartrate)

Manufacturing company:  Sunovion Pharmaceuticals Inc.

 Employments of this medication:

 It is made for the treatment in adults (both men and women) and children of more than 4 years for   bronchospasm i.e. constricted airways and for the prevention of asthmatic attacks. The bronco spastic conditions can take place due to multiple reasons, and every patient presents with his/her own clinical reasons for it.

Correct usage of the medicine: When using the product for the first time, or if using after 3-5 days, shake the container and prime it by discharging some mist into the air. After the first inhalation wait for some seconds and then inhale the second one. You should always keep the container clean and free from any kind of uncleanness. Always after one week wash the actuator with boiled water and then let it dry in the air. Keep the container away from heat and flame as it is inflammable and could otherwise burst. Store the vessel at 680-770 F.

Important information related to the drug:

  • If ever on using Xopenex HFA you develop skin reactions such as rash, swollen nasal, and oral cavities, or experience difficulty in breathing and severe tightening of your airways, immediately contact 911 and seek emergency medical help.
  • You will not only be put on Xopenex HFA but you will also need to take some other medicines (inhalational corticosteroids) for a full treatment of asthma.
  • This drug can cause variations in your cardiac (heart) functioning, therefore it is important you undergo ECG testing.
  • You should never exceed the dosage of Xopenex HFA than recommended as it could prove life-threatening and can lead to the stoppage of the heart.
  • You will be asked to have your electrolytes tested as this drug can cause a deficiency of potassium in the body and for this very reason never take Xopenex HFA with blood pressure lowering drugs which also potentiate potassium removal from the body e.g. thiazide diuretics.
  • If your asthma is exacerbating and you are not getting any favorable position from this drug, immediately inform your doctor as you may require modifications in your treatment.
  • If you attain respiratory infection consult a health professional and do not try to treat it with levalbuterol as it is has no anti-biotic properties.
  • Do not use Xopenex HFA if you have a deteriorating kidney status.

Drug interactions of Xopenex HFA:

It has following clinically significant drug interactions;

  • With digoxin: levalbuterol can increase the levels of digoxin in the plasma.
  • With epinephrine: can yield adversarial cardiovascular effects.
  • With MAO (mono-amine oxidase) inhibitors: e.g. This very combination can lead to a hypertensive crisis (blood pressure 180/120 or above) which is lethal.
  • With diuretics: Xopenex HFA when given with diuretics that likewise diminishes the levels of potassium can bring about serious potassium lack in the body.

Adverse effects: are produced on various systems;

  • Neurological: headache, anxiety, tremor.
  • Infections:
  • Respiratory: inflammation of sinuses, throat infections, difficulty in breathing, cold, asthma, flu.
  • Gastric: nausea, vomiting, acid reflux, unsettled stomach.
  • Muscles: difficulty in speaking, twinges, pain.
  • Heart: chest pain, irregular beats, rapid beats.
  • Skin: rash, itching, swelling.


It is highly restricted if you had experienced an immune reaction to the albuterol in the form of any other preparation.

Precautions: you need to be cautious in the following;

  • Low potassium levels
  • If asthmatic conditions not improving
  • any heart and ECG-related problems
  • Elevated blood pressures
  • Sudden onset or tightening of air passages on the introduction of the drug.

Mode of activity: it is a beta 2 receptor agonist. These receptors are present in the lungs, and when acted upon and activated by levalbuterol causes the smooth muscles of the lungs to relax and dilate thus allowing easy passage of the air through the lungs.

Absorption and elimination: it takes 5-10 minutes to demonstrate its impacts and continues laboring for 3-4 hours and has a half-life of 3.4 hours after which its concentration gets reduced to is mostly excreted from the urine.

Activity in specific populations:

  • In renal failure: it is removed through the kidneys. If the kidney is not functioning properly it could lead to the lesser clearance and more plasma grouping of the drug.
  • In liver impairment: it is not knowledgeable whether liver problems have an impact on this drug. Still, it is sensible to not use Xopenex HFA in severe liver failure.
  • In pregnancy: it is a category C drug and also, has turned out to be hurtful to the baby in mice and rats. It is only used in humans when the benefits are in more ratio than the risks.
  • While breast-feeding: nursing mothers should not use levalbuterol.
  • In older people: start taking the medicine from lower doses e.g. one puff or inhalation and then increase the dosage as required.
  • In children: it can only be used if the child has passed his/her 4th

Toxic profile:

Studies conducted on racemic albuterol are considered for levalbuterol as well. Albuterol formed benign tumors in heart and uterus of the mice and rats but did not cause any mutations in the genetic makeup of the animals and also did not make the animals sterile.

Inform your doctor about;

  • Your kidney and liver conditions if any
  • If you are a heart patient
  • Are you taking any other medications for your asthma
  • If pregnant
  • If breast-feeding
  • If smokes
  • Your BMI (body mass index) if obese.



Patient information on Suboxone (buprenorphine and naloxone)


 Here the word Drug would be referred to a narcotic substance.

Manufacturing company: Indivior Inc.

Uses of Suboxone: it is used for treating the patients who are addicted to opioids (morphine, heroin) or abuse such drugs. This medicine is a part of the treatment of opioid dependence along with behavioral and psychological education and counseling. If you have an addiction problem it does not mean that you are a wrong or a bad person but it is important to understand that it is okay to talk about it to your family, and seek proper clinical help as there are now various treatments available in this respect.   

You should be aware of the adverse effects of a drug addiction. It leads to the development of violent behavior, theft, physical, psychological problems, illegal activities, various health problems, transmission of diseases due to the use of contaminated syringes and needles, family and work-related complications, accidents, overdosing and death. Suboxone is indicated for people who have become addicted to heroin, morphine, codeine, oxycodone, and fentanyl.

Factors or conditions that usually play role in a person becoming addicted to illegitimate drugs involve;

Stress which could be either family or work related, community where drugs are sold and abused, joblessness, people who have a rough childhood and have an abusive child life, whose parents or siblings or spouse abuses drugs, self-diagnosis and self-medication with drugs that can have effects on mental health, people with an underlying mental or a psychological illness, deficit in neurotransmitters in brain e.g. endorphin.

Dosing of Suboxone: it should be taken into account that this medicine can only be prescribed by those doctors who are registered under DATA (drug addiction treatment act) and Suboxone will be prescribed to you by taking into account various clinical and behavioral factors. You should only take Suboxone in quantities as guided by your doctor and should never taper the dose by yourself.


The regimen is usually altered and adjusted by monitoring;

  • the event that the patient has been securely and proficiently taking care of the medicinal use
  • Has not experienced any sort of adverse effects concerning physical and mental health
  • Has not been overdosing or abusing the medicine
  • Has undergone improvements.
  • Has been following the treatment properly and regularly as instructed.

Correct administration:

  • Always put the whole intact in the mouth. Do not chew or swallow it.
  • Do not eat anything while you have placed Suboxone in the mouth, for the prevention of an accidental swallow.
  • Buccal administration: place the tablet inside the cheek on either side. If more than one tablet is to be placed, place one tablet in the right cheek and another tablet in the left cheek. Do not move the tablets from their place after placing them inside. Let them stay until completely dissolved.
  • Sub-lingual administration: place one film on either right or left side under the tongue until dissolved. If you need to place another film along with it for adequate dosing (prescribed by the doctor) put it on the opposite side under the tongue, ensuring that they do not touch or join each other.
  • If you are supposed to place a 3rd tablet or film, administer it after one side has dissolved.
  • You can easily switch from sub-lingual to the buccal site of administration without risking the fluctuation in the dosage levels.
  • But do not switch strengths and potency of the product without consulting your respective doctor as the concentrations of the agents can vary and lead to unwanted effects.

Suboxone in special populations:

  • In pregnancy: it falls under the category C. It should only be used under the supervision and recommendations of the specified doctor.
  • During lactation: buprenorphine gets excreted in human milk and so should be used if the benefits of taking the medicine are more than its risks. Monitor your baby for increased lethargy, or any breathing problems.
  • In children: it should not be used by young kids due to the danger of respiratory failure.
  • In older people: although considered safe should be started at lowest doses possible.
  • In liver failure: Suboxone can cause hepatitis, jaundice, damage to the liver cells (necrosis), which leads to lesser clearance and enhanced exposure of Naloxone. As it is a combination dosage form and the dose of a single agent can’t be adjusted alone, hence, Suboxone should be avoided in patients having a moderate-severe liver failure.
  • In unstable patients: people who do not respond to the medication or start abusing it are transferred to the rehabilitation centers.

Contra-indications to Suboxone use:

  • Promptly contact restorative help if on taking Suboxone you face breathing challenges, swelling, rash, blushed skin, hives as it is the indications of a hypersensitive response to the medication.
  • Do not give Suboxone to children as it is could produce fatal breathing issues in them. Always make sure the medicine is placed in a secure place away from the child’s reach.
  • Suboxone is not for pain relieving use specifically in people who are opioid naïve i.e. have not used any kind of opioid preparation in the past.

Precautions and Warnings related to Suboxone:

  • You should always take Suboxone as described by your doctor. Taking it in increased amounts can lead to addiction as well. You will be kept under supervision during the initiation of the treatment. You should talk to your doctor if you start experiencing addictive behavior towards Suboxone which may include joyousness and euphoria, the presence of many multiple Suboxone packages in the house, decreased desire for other opiates (heroin, morphine etc.), need for regular refills of Suboxone, distracted and unusual behavior.
  • You should not self-inject CNS depressants such as benzodiazepines, anesthetics, or consume alcohol, tranquilizers with Suboxone as it could result in severe respiratory collapse, nervous system shut down, coma and even death.
  • You should never discontinue Suboxone on your own as an abrupt stoppage of the medication can cause severe withdrawal symptoms such as nausea, vomiting, weariness, aggression, muscle pain, sleeplessness, restlessness, nervousness, and headache.
  • It should be given with extreme care if the patient has stomach issues and disorders, if alcoholic, has bile malfunction, cranial injuries, breathing problems.
  • Do not drive after taking Suboxone. Prevent doing heavy machine work as well.
  • Neonatal opioid withdrawal syndrome (NOWS): babies who are born to women who abuse opioids suffer from NOWS which includes severe diarrhea, non-stop crying, convulsions, sleep disturbances, tremors, sneezing, fever, and increased tone of muscle.

Adverse effects:

Suboxone can cause the following side effects;

Withdrawal symptoms, weakness, diarrhea, chills, vomiting, nausea, edema, swelling, respiration problems, pain, insomnia, constipation, excessive sweating, cough, headache, infections, abdominal aches, inflammation of the tongue, oral cavities.

Drug interactions:

  • With benzodiazepines: use of Suboxone with such agents leads to shut down of the respiratory systems.
  • With anti-retroviral: decreased dose of buprenorphine is used with Protease inhibitors like ritonavir and atazanavir. No adjustments are required with Nucleoside reverse transcriptase inhibitors. Non‐nucleoside reverse transcriptase inhibitors such as delavirdine, nevirapine, efavirenz, etravirine can increase or decrease the Suboxone levels in plasma.
  • With CYP3A4 affecting agents: Suboxone should be used carefully with medicines that can induce or inhibit these enzymes as the inhibition could lead to increased levels of Suboxone and increased sedation whereas the induction can lead to low levels and sub-therapeutic effects. You can contact your pharmacist to know which drugs come under this category.

Mode of action:

Naloxone: it is a strong antagonist at mu opioid receptors

Buprenorphine: it is a partial agonist and partial antagonist of mu, delta receptors and kappa opioid receptors respectively.

Mu receptors when activated can cause relief in pain, low blood pressure, itching, euphoria, sedation, nausea, constipation, reduced respiration, and constricted pupils.

Delta receptors cause physical dependence, intense happiness, and convulsions.

Kappa produces depression, dysphoria (extreme sadness), lethargy, stress, constriction of the pupils.

Absorption: Suboxone undergoes full absorption after 0.77-0.81 hours for naloxone and 1.53-1.72 hours for buprenorphine.

Distribution: naloxone binds to the albumin whereas buprenorphine binds to alpha and beta globulin proteins of the plasma.

Metabolism: naloxone undergoes metabolism through glucuronidation whereas buprenorphine is subjected to CYP3A4 enzymes.

Excretion: it gets removed from the body through feces and urine.

Storage: store it at room temperature at a place where children can’t reach the product.

Ingredients: buprenorphine and naloxone, sodium citrate, lime flavor, Sunset Yellow FCF and a white printing ink, hypromellose, acesulfame potassium, citric acid, polyethylene oxide, and maltitol solution.


  • It did not produce any changes in the genetic makeup of the animals during pre-clinical studies.
  • Suboxone decreased the rate of pregnancy in female rats.
  • It also up the levels and rates of adenomas in rats.

 Inform your doctor:

Before starting treatment with Suboxone, inform your doctor of the following;

  • Time length of your addiction
  • How and when you got addicted
  • If you abuse any other drugs apart from opioids
  • If you suffer from psychological disorders
  • About respiratory problems if any
  • If has a liver disease
  • If pregnant or
  • Breast-feeding



Patient information on RELPAX (eletriptan hydrobromide)

Manufaqctured by: Pfizer

What is the dosage form and potwncy of RELPax?

You can find it as 20mg and 40mg strength tablets.

What is Relpax? You use Relpax for treating migraine attacks or migraine headache. Migraine is a severely disturbing single sided headache that can cause nausea, vomiting and tiredness and may or may not worsen with the exposure to light, noise, and various odors etc. This kind of headache can take place at any time can hinder a person from daily work routine. Relpax can be used by both genders.

What should you know about Relpax?

There are some important points you should always keep in mind while taking this drug;

  • It is a very good practice to always read the medication guide.
  • You should avoid using this drug for the sole purposes of preventing the headaches.
  • Relpax is specifically to be used for migraine. Never use this medicine for any other type of headaches.
  • If you feel no difference in your headache after taking the first tablet, avoid taking another dose and consult your physician as you might require further diagnosis or changes in your regimen.
  • If your headache subsides after taking the first dose but recurs then you can take another tablet after the gap of 2 hours from the first dose.
  • Do not drive or operate heavy machinery after taking Relpax.
  • You need to promptly consult your doctor on developing signs of pain, tightness, pressure in your throat, neck, jaws, or chest because this drug is well known for its vessel spasm producing properties.
  • Do not administer Relpax if you have any other nervous system related disorder.
  • You must immediately stop treatment with Relpax and contact the emergency numbers if you get an allergic reaction to the drug. The symptoms could range from minor coughing, rash to serious wheezing, swelling and tightened airways which would lead to difficulty in breathing.
  • You should never treat your migraines with Relpax if you had a stroke in the past, or are paralyzed as it could double your risk for having another stroke.
  • This drug can raise the blood pressure in your body, so don’t take Relpax if you suffer from uncontrollable high blood pressure.
  • This medicine is not to be used if you have a major depression, anxiety or any other related condition and you are getting treatment for it due to the reason of serious interaction of Relpax with the medicines used for treating such conditions.
  • Defer from using this drug if you have an inflammatory problem in your digestive system.
  • Never under any condition ingest the tablets of Relpax with any other ergotamine containing compounds such as methylergonovine (Methergine), dihydroergotamine (D.H.E. 45, Migranal), methysergide (Sansert), caffeine and ergotamine (Cafergot0.
  • This drug is not for you if you have angina (chest pains on exertion), history of a heart attack, a condition that involves irregular beating of the heart called arrhythmias.
  • This medicine does not cause fat deposition in the body.
  • Consult your pharmacist to learn which drugs can be taken and which are to be avoided with Relpax.

How to use this medicine?

You should always;

  • Take the doses according to your doctor’s recommendations. Taking it in higher doses can cause or worsen the already existing headaches.
  • Bring one tablet with a glass of water when you begin detecting the indications of the cerebral pains. If your headaches don’t improve after taking the first tablet or you accidently take more than prescribed, talk to your doctor.
  • Swallow the whole tablet.
  • It can be taken with or without sustenance. If your migraine is accompanied with nausea and vomiting, take the tablet on an empty stomach.
  • Place the tablets at room temperature away from direct sunlight.

Does Relpax interact with other medicines?

If given with other compounds that contain ergot can cause additive effects of vasospasm and constriction of the blood vessels that leads to elevated blood pressures. If given with medicines that are used for psychiatry purposes e.g.  tricyclic anti-depressants or atypical anti depression medicines can cause a phenomenon called Serotonin Syndrome (which results in tremors, convulsions, high grade fever, diarrhea, fastened heartbeat, confusion etc.) due to the increased amount of serotonin in the body.  The medicinal agents which increase the levels of Relpax should not be used in tandem. Such drugs include clarithromycin, glucocorticoids, diltiazem, anastrozole, disulfiram, isoniazid, erythromycin etc.

 Side effects produced by Relpax:

Apart from the desired effects, you can also experience the following side effects produced by this drug;

Redness, headache, heart burn and indigestion, tightened muscles, dizziness, weakness, pain, shivering, sleepiness, palpitations, dried oral cavities, nausea, numbness in the fingers and toes, convulsions, heart attack.

In which cases Relpax should be avoided?

This drug is highly prohibited in the following conditions;

  • Allergy to ergot and ergot like compounds
  • Past history of stroke either ischemic or hemorrhagic
  • Paralysis
  • Psychiatric and nervous system disorders and medicines for their treatment
  • High blood pressure which is not responding to general anti-hypertensive medications
  • Abnormal heart and vasculature state
  • Inflamed digestive tract
  • With other agents constituting ergot
  • With certain medicines that inhibit the functioning of cytochrome iso-enzymes n the body. [see drug interactions]

How can this medication work?

A person experiences migraine due to the nearby cranial vasodilation and the arrival of tangible neuropeptides.  Eletriptan helps in these conditions by binding to the serotonin receptors and constricting the widened blood vessels in the brain and also represses the release of inflammatory substances.

What does the body do to the drug (pharmacokinetics)?

Absorption: following the primary tablet almost 50% of the active drug becomes available in the body for its desired action with the peak response seen at 1.5-2 hours.

Distribution: about 138L of the drug gets distributed throughout the body out of which 85% binds to the blood proteins.

Metabolism an excretion: the metabolic processes of this drug take place in the liver and the metabolites get excreted via bile and feces.

Utilization of this medication in particular populaces:

  • In pregnancy: it has a place with the classification C of drugs. It is only utilized if the benefits overweigh the dangers because there are no human trials available and in animal studies it has appeared that Eletriptan can harm the fetus during its developmental stages and can cause deformities in the body structure.
  • In nursing mothers: Relpax does get discharged in the human milk so it should not be used by mothers while they are breast-feeding.
  • In elderly patients: it is okay to be used by people above 60 years. Because older patients are more prone to the high blood pressure, it is necessary they monitor their blood pressure regularly.
  • In younger patients: this drug can produce detrimental effects in children, therefore, avoid use.
  • Gender differences: it can be used by men and women both.
  • Ethnic differences: patients of Japanese descendants have lower levels of this drug than Western people. The exposure is same for Caucasians and non-Caucasians.
  • Kidney and liver problems: you should not take Relpax if you have severe kidney and liver impairment.

Toxicity profile:

Amid animal testing of Relpax it produced testicular cancer in male rats and in female rats it caused cancer of liver cells but it did not show any adverse effects on the genetic levels. It influenced just the female regenerative capacities.

What should you tell your specialist about?

Inform your doctor if you have;

  • High blood pressure
  • pregnant or breast-feeding a child
  • Have any sort of depressive conditions
  • Diabetes
  • Kidney or liver related problems
  • Smoking problems
  • Your menstrual stop

Which ingredients are present in this medicine?

It contains eletriptan hydrobromideas a major ingredient and contains microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, titanium dioxide, hypromellose, triacetin, and FD&C Yellow No. 6 aluminum lake as supplementary ingredients.






Patient Information on Patanol (olopatadine hydrochloride ophthalmic solution)

Manufacturers: Alcon

Patanol uses: it is utilized for the correction and relief from a condition called allergic conjunctivitis. If you develop this ailment you may experience redness, itching, swelling of the eyelids, heavy water discharge from the eyes.  It usually occurs when the sensitive layer of the conjunctiva in our eyes get irritated by various allergens like pollen, mold spores, dander etc.

Measures while using Patanol: Make sure you don’t infect the tip of the container by touching it to eyelids or any other surfaces as it could prove to be an excellent method of transferring germs to your eyes and worsening the condition.

Do not blink eyes rapidly after putting the drops.

It is very crucial that you remove your contact lenses prior to instilling the drops as it could otherwise damage the lens, you can reinsert them after 15 minutes if you don’t feel your eyes getting red.

Mode of action: histamine, an inflammatory modulator binds to H1 receptors and produces the cascades for the allergic reactions. Olopatadine inhibits the binding capacity and operation of these receptors and prevent the release of histamine from its stores and thus helps in bringing down the irritation.

Pharmacokinetics (alterations of the drug in the body): only a small quantity of drug gets absorbed into the blood stream. After 3 hours half of the drug completes its action and gets eliminated 60% through urine and approximately 17% from the fecal route.

Things you should know about Patanol:

  • It can be used by both genders but not by children.
  • if you feel that after administering the drops you feel extreme stinging, burning and pain, stop taking it and talk to you doctor because you may be developing an allergic reaction.
  • Do not self-diagnose or sell-treat yourself with this medicine every time you experience a similar eye condition. Because there are multiple forms of conjunctivitis (e.g. bacterial and viral) which require stronger and longer therapeutic regimen.
  • Patanol is specifically designed to be taken through the ocular route. You should not administer it through mouth or nose.
  • The contents present in this solution and can get absorbed by your contact lenses and destroy them. So you ought to expel your contacts before ingraining the drops.

Adverse effects of this drug:

  • Since, it is an ocular preparation so the maximum side effects are associated with the eye. They include… swelling of the eyelids, blurred site, inflammation in other parts of the eye, redness, itching, and pain in the eyes.
  • And the side effects which are not specifically related to the eyes constitute of sinusitis, alterations in the taste, flu, cough, scratchy throat, nausea, pain in the back muscles and weakness.

Use in specific populations:

  • Pregnancy and lactation: it is a class C medicine when it comes to pregnancy. Although not proven teratogenic or harmful to the baby during animal studies, it still is to be used with supreme care in pregnant women because it is not known that how would this drug affect the human child. Same is the case for nursing mothers because oral administration of this drug has shown the presence of olopatadine in human milk.
  • Pediatrics and geriatrics: although safe for adults and elderly, Patanol cannot be given to young children explicitly those who are under 3.


Patanol is neither carcinogenic nor mutagenic which means it does not cause cancer or mutations. It also did not have any dire effects on the reproductive system.

Inform your doctor: if you have cataract, glaucoma, recent eye surgery or injury, nasal infections, any immune system related issues, if pregnant or breast-feeding., if on sodium strict diet.

Ingredients in Patanol: olopatadine hydrochloride, sodium chloride, isotonic solution of 1.0 mg/ml or 0.1%, sodium phosphate (dibasic) and purified water.

Patient Information on Nasonex (Mometasone furoate monohydrate)

 Manufactured by: Merck & Co., Inc.

What is Nasonex utilized for?

Nasonex is used for treating seasonal allergies and flu-like conditions. It is given to following patients;

  • Those who require occasional prophylaxis against unfavorably susceptible rhinitis, which includes the bodily fluid film of nose getting kindled.
  • For treating blockage of the nasal passages which could be the consequence of inflamed and swollen blood vessels of the nose.
  • Those who have developed nasal polyps; growth of small sized benign growths in the inside lining of the nose. These growths do not have cancerous properties.

What is the dosage form and potency (strength) of Nasonex?

You can find Nasonex in the type of a nasal spread holding 50 mcg from claiming mometasone furoate for each 100 microliter spread.

 What should you know about Nasonex?

  • Completely read the prescription aide before taking any pharmaceutical.
  • Before you use it make suure to shake it well.
  • You should discontinue Nasonex on experiencing any kind of allergic reactions e.g. redness, swollen lips, tongue, mouth, wheezing, shortness of breath, rash.
  • Try not to utilize Nasonex on the off chance that you had a nasal surgery, nasal injury or nasal septum ulcers (until mended).Avoid using this drug if you suffer from nose bleeds.
  • While you are using Nasonex, your doctor may need to examine you to make sure the medicine is not harming your nose or sinuses.
  • If you develop any sort of infection in the throat, stop taking Nasonex and get your doctor’s advice.
  • If you are taking Nasonex for more than a week, it is important that you visit your ophthalmologist periodically to make sure you are not developing cataracts.
  • Donot take this drug if you have life-threatening diseases, for example, tuberculosis, viral contaminations.
  • Do not provide this drug to children who are in their growing age.

 How do you take the drug?

  • You should only take the amount told by your doctor. Refrain from taking it in large amounts.
  • Only take Nasonex through nose and not from the mouth.
  • Before using it the first time, shake the bottle and spray two or three mists in the air.
  • Store it at 25°C (77°F).

To use the Nasonex nasal spray:

  • Tilt your head backwards and place the bottle’s nozzle in your nostril while shutting the other nostril with the assistance of your fingers.
  • Gently spray and do not blow your nose for 5-10 minutes to prevent wastage of the drug.

Contra-indications and precautions:

Do not administer this drug if you;

  • Are allergic to the whole drug or any other ingredient present in it.
  • Have nose bleeds, nasal surgery, injured nasal cavity, and ulcerated nasal membranes.
  • Have developed eye related conditions
  • Are currently suffering from pathogenic infections.
  • In children

How does it adversely affect you?

You may experience any of the given effects;

  • respiratory: infectious throat, cough, shortness of breath, flu-like syndrome.
  • eyes and ear: redness in the eyes, infections of the middle ear.
  • muscles: pain in the muscles
  • gastrointestinal system: diarrhea and vomiting.
  • Nose: nose bleeds, nasal fungal infections, burning and irritation of nose.
  • Others: viral infection, painful menstruation, suppressed growth
  • Post-Marketing Experience: nasal burning and irritation, hypersensitive reaction, disturbances in taste and smell.

How can Nasonex interact with the other drugs?

Drug interactions with Nasonex are yet to be conducted. However, CYP3A4 inhibitors (ketoconazole) may affect the metabolism of Nasonex.

Can this drug be used in the specific populations?

  • In pregnancy: this drug belongs to the category It should only be used in pregnant women when truly needed in the absence of other safer alternatives.
  • In Nursing Mothers: corticosteroids get secreted in human milk; therefore, Nasonex should not be used by such women.
  • In pediatrics: you should not give your child Nasonex for sole preventive purposes from flu.
  • In geriatrics: Nasonex can be safely used by elderly.

What is the mode of action of Nasonex?

It is an anti-inflammatory drug i.e. suppresses the immune system of the body. It rectifies the symptoms of rhinitis by depressing various inflammation causing cells, like mast cells and histamine.

What is the pharmacokinetics of this drug? Pharmacokinetics involve all those processes that a drug undergoes after its administration.

Absorption: only small ampunt of this drug gets swallowed

Distribution: about 98% to 99% of this drug binds to the plasma proteins.

Metabolism and Elimination: it gets metabolized by CYP3A4 enzymes of cytochrome system. Mometasone has a half-life of about 5.8 hours and any absorbed portion of the drug gets excreted via the bile.

How do different patient populations affect the Pharmacokinetics of this drug?

  • Levels and effects of Nasonex can increase in hepatic impairment.
  • gender, race, age, and renal impairment effects on this drug are still to be studied.

 What is the toxicology profile of this drug?

  • When it was subjected to non-human testing, Nasonex did not produce tumors or mutations in them.
  • It didn’t create any reproductive insufficiencies in rats subjected to testing of this medication. Nasonex produced difficulties in labor and caused a reduction in the birth weight of the animals treated with this drug.

What should you inform your doctor before using Nasonex?

Before taking Nasonex, a patient should inform his/her doctor about;

  • Infections if any
  • Cataracts
  • Tuberculosis infection
  • If had a nasal surgery, trauma or sores.




Patient Information on Myrbetriq (mirabegron)

Manufactured by: Astellas Pharma Inc.

When is Myrbetriq used? You will need to use Myrbetriq if you develop urinary incontinence due to an enlarged or over functioning bladder which leads to frequent bathroom visits and sometimes leakage of the urine on coughing, sneezing or laughing. It can be used by all genders.

How is it supplied? It is an orally taken dosage form as 25mg and 50 mg tablets. You can easily differentiate the two forms by looking at their colors. 25mg is of brown color whereas 50mg tablet is in the yellow coloring.

What is the drug’s dosing information? Never take Myrbetriq if you are in the end stage renal disease or have a severe liver failure.

How should the tablets be taken? You can ingest these tablets either on an empty stomach or within or after the meal (as suitable). Always swallow the tablet as a whole with a glass of water without chewing or breaking it. Make sure to stick to the regimen for full time as counseled by the doctor as this drug can take up to eight weeks to fully show its anticipated actions. Keep the tablets at the room temperature.

Which things should you be cautioned of about Myrbetriq?

While using this drug you should readily consult a pharmacist or a physician if you develop skin associated reactions (swollen lips, throat, face or tongue), any breathing difficulties, an uncontrollable rise in blood pressure, or inability to pass the urine. You should regularly measure your blood pressure to ensure no ascent in it due to this medicine.

What types of side effects Myrbetriq has? It can have the following noxious and disturbing adverse actions and you may experience one or more than one of these side effects.

High blood pressure, urethral infections, constipation, pain in the muscles particularly back muscles, flu, lightheadedness, bladder inflammation, stomachache, loose watery stools, throat inflammation and infections, rapid heartbeats, tiredness, increased ocular pressure, abnormal liver enzymes functioning, stone formation in the kidneys, skin rash, hives, vaginal infections, angioedema, headache, sinus blockage, heart burn, purple coloring of the skin, and abnormal cell growth.

What kind of medications does it interact with? It can safely be given with rifampicin (anti-TB), tamsulosin (for prostate enlargement), and ketoconazole (anti-fungal), oral contraceptives (birth control pills), solifenacin (incontinence).

The drugs with which it requires alterations include digoxin (start at lowest dosage of digoxin), metoprolol and desipramine (use alternative or closely monitor owing to the fact that mirabegron is a CYP2D6 enzyme inhibitor and these two drugs undergo metabolism via this specific class of isoenzymes), warfarin (may increase the levels of it, thus requires monitoring).

What precautionary measures should be taken with Myrbetriq?

Firstly, you should absolutely never take Myrbetriq in the cases of allergies to one of its components, if your blood pressure is not under control, if have any sort of a blockade in the bladder, if you are using anti-muscarinic drugs (atropine, scopolamine etc.) to prevent failure of urine expulsion and with any other such drugs with which Myrbetriq can interact.

What is the toxicological report of Myrbetriq? Mirabegron has not proven to be carcinogenic or mutagenic at non-lethal doses in the rats and has not affected their reproduction either.

Pups born to the mothers who were given Myrbetriq had enlarged heart and bone deformities. And the baby rats and mice who were subjected to breast milk of such mothers had mirabegron accumulated in their kidneys, lungs, and liver.

What is the pharmacodynamics of this drug?

Pharmacodynamics involves the processes that take place during the drug’s activities. Mirabegron attaches to the beta-3 adrenergic receptors residing in the bladder and on activation, these receptors relaxes the smooth muscles of the bladder and expands its urine holding capacity.

What is the pharmacokinetics of Myrbetriq? Pharmacokinetics involves the processes that undergo after the drug has shown its actions. Mirabegron, about 29-35% gets available in the body, with highest concentrations available after 4 hours. It has 1670L Vd (volume for distribution in the tissues) and undergoes hepatic metabolism. It is a moderate inhibitor of 2D6 isoenzymes of cytochrome enzymatic systems. Has a half-life of 50 hours (stays in the body for a longer time) and gets removed by feces (34%) and urine (55%) from the body.

Can Myrbetriq be used in different patients?

It belongs to C category and should only be used by pregnant or lactating women if truly required in the absence of any other options. Its use is safe for elderly people but is marked harmful for kids. Japanese people have more levels of Myrbetriq in their blood as compared to Americans. In terms of body weight, females have more exposure than their male partners.

What should you inform your doctor about? Before taking Myrbetriq tell your doctor if you have any eye, kidney, liver, heart, bladder diseases. If your blood pressure ranges to 180/120.  If pregnant or feeding.

Which compounds are used in the tablets? It has mirabegron, yellow ferric oxide, and red ferric oxide, polyethylene glycol, hydroxypropyl cellulose, magnesium stearate, hypromellose, butylated hydroxytoluene, polyethylene oxide.