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"New" Gyn
Procedures
The LASH procedure (laparoscopic
supracervical hyst) - this is an alternative to hysterectomy,
used primarily
for bleeding problems. It is a laparoscopic procedure,
where the upper portion of the uterus is removed, leaving
cervix and ovaries. It has become popular, because of
the stigma of “hysterectomy”, controversies
regarding pelvic support and sexual response, and a shorter
recovery. It compares favorably to even laparoscopic
hysterectomy, because there is no vaginal incision and
faster recovery. It is not indicated in patients with
some pain syndromes, cervical disease or possible cancers.
These patients need the usual cervix cancer screening,
don’t need contraception, have no period and are
usually 80% recovered after 1-2 weeks.
Endometrial Ablation - this is a hysterectomy alternative used ONLY for
bleeding issues in patients
with a “normal” uterus,
where electrocautery or heated water is used to heat-treat
the lining in the uterus, rendering it inactive. This
usually results in no period or, at the very least, a
much decreased flow. It is a minor surgery similar to
a D and C in recovery time. Commonly we do this in conjunction
with tubal sterilization and there is generally no effect
on hormones or cycles, except less or no bleeding.
Clinical Physician - performed specialty
ultrasound (CPPSU) - In our office, when indicated, we
offer a vaginal probe
pelvic ultrasound test, done by the physician. We are
accredited and peer-reviewed by University of South Florida.
This specialized testing offers an immediate clinical
correlation with exam findings that exceeds the quality
of most pelvic ultrasound testing. We also offer a similar
breast ultrasound test and fine needle aspiration for
evaluating lumps and mammogram abnormalities.
Urinary Incontinence, Interstitial Cystitis
and New Technologies - A significant number of women,
when asked,
will complain of problematic bladder leakage or pain/frequency
syndrome. There has been a new wave of interest in this
arena and its associated testing, drug therapy and minimally-invasive
procedures. Traditionally, these patients were referred
to urologists with mixed results. Now, select gynecologists
are taking an active role in evaluating and treating
these patients. We have in-office urodynamics, IC evaluation
and related therapies that have provided many patients
with successful outcomes for their bladder dysfunction.
We suggest patients bring up pertinent problems with
urine leakage, bladder pain and frequency, and request
the option of a thoughtful workup and treatment from
a Gyn specialist.
E-Stim - Pelvic Floor Therapy / Electronic
Impulse Stimulation - This new treatment program was
modeled after urogynecology
protocols at the Mayo Clinic. We use computer planning
and electronic impulse stimulation to strengthen and
train the pelvic floor muscles. The treatments are non-surgical
and painless, and provided in our private clinic by our
expert professional staff.
^Top^ Recent Controversies
Menopausal Hormone and
Estrogen Controversy - We believe that recent studies
and the media have exaggerated
the
risks of hormone therapy. The pharmaceutical companies
and overzealous doctors have perhaps exaggerated the
benefits of hormones. The real facts are that for some
women, hormone therapy is essential for quality of life,
and for other women, they are dangerous and should be
avoided. For the majority of women, an individualized
approach should be taken with a careful analysis of that
patient’s needs, risks and experience. Also, this
should be reanalyzed regularly (yearly) because options,
needs, situations and alternatives change too. Hormones
carry a potential risk of accelerating breast cancer
growth, increasing thromboembolic risks, gall bladder
risks and may increase EXISTING cardiovascular disease
(synthetic progestins, especially Provera are believed
by many to be the culprit in lipid change and CVD risk).
Hormones definitely help bone strength, bladder and
vaginal tissues and probably help healthy vascular systems.
Most researchers believe there is a benefit in cognitive
(brain) function. If vasomotor symptoms (hot flashes
and night sweats) are a significant issue, then consideration
should be given to using hormones for that alone, if
lesser treatment has been unsuccessful. If a woman has
a uterus, then estrogen should be balanced with progesterone
in some way. The exception is when low dose topical estrogen
is used, such as Estrace cream, Estring or Vagifem. Generally,
we like non-oral routes if the patient agrees, such as
patches and rings, although this is not a big issue in
the scope of the treatment planning. Newer formulations
are lower dose and theoretically safer that those used
in the past. Brand new ultra-low dose options are available
now, in gel, lotion and micropatch forms.
Formulated or Compounded
hormones may have some advantages over “off-the-shelf” drugs, but are not as
well tested and may not be as dependable in quality assurance
and consistency. They do have the distinct advantage
of being “customizable” with regards to active
ingredients and dosages, and many patients have requested
this option due to the perception that they are a safer
route to take.
Calcium Supplement
Controversy - Newly-published articles in JAMA and
other peer-reviewed
literature have generated
new thinking regarding our recommendations on calcium
supplements for patients who aren’t getting adequate
calcium intake in their diet alone. Since calcium is
critical in bone health, menopause symptoms, PMS, weight
management and dysmennorhea, many patients are looking
for a high quality supplement that dissolves easily,
is absorbed and made bioavailable. Many commonly recommended
calcium supplements fail these criteria and also contain
traces of lead. Since calcium is a mineral and difficult
to make available in the body for use, it is important
to take a supplement that is of the highest quality with
special chelated manufacturing techniques. We have researched
this extensively and found what we consider the best
one for the money from American Health Sciences in Vienna,
Virginia. The name of the product is Osteoguard and it
contains magnesium, boron and other important trace minerals,
and is lead-free. It is USP quality and can be ordered
by mail via www.MDchoiceVitamins.com or via a faxed order
form. Most non-mineral supplements are easy to find in
high quality and usability, but this calcium/magnesium
product is unique.
PAP Testing Recommendations and Evaluation
of Abnormal PAPs - recent changes in the recommended
frequency of
screening and algorithms for workup of abnormal results
have caused confusion among patients and doctors. Some
patients do in fact qualify for less than yearly screening.
These criteria include Medicare-age patients with a long
history of normal PAPs, who can be tested every 2 years,
and also “low risk” younger patients. Since
a detailed annual sexual history would be needed to determine
who these patients are, we still believe it is the better
part of valor to offer annual screening to all patients
less than 65 and to willing patients 65 and older. Even
post-hysterectomy patients benefit from PAP screening
since cytology helps detect VAIN (vaginal intraepithelial
neoplasia), infections and urogenital atrophy (low hormone
changes). The PAP maturation index is still the best
test marker for overall estrogen level and effect on
a patient's body.
When a PAP reveals ASCUS
(squamous atypia), we either do reflex HPV testing
to detect “high-risk” HPV
or at least repeat a PAP in 3 months. If the high-risk
HPV is positive, or the 3 month PAP is also positive,
then we ALWAYS recommend colposcopy. A significant number
of these patients will have precancerous lesions. If
a PAP reveals AGUS (glandular atypia), then the patient
needs endocervical and endometrial evaluation. There
is no second chance with another PAP. Appropriate follow-up
for AGUS is vaginal ultrasound and biopsy as many of
these patients will have a polyp or endometrial lesion.
Another possibility is adenocarcinoma and this is more
common as a patient ages. We have seen a number of patients
who were “missed” in this regard and needlessly
progressed to a more advanced lesion. Bottom line is “any
question- call a Gyn” and get expert advice.
As of August 2006, we are offering THREE new treatments related to HPV and precancerous changes in the cervix. We are offering participation in clinical studies to qualified patients, that treat CIN 2-3 / moderate or severe dysplasia with non-surgical therapy. We also offer new vaccines for PREVENTING infection with certain HPV strains and significantly reducing the future risk of cervical cancer. Please call for more info....
Breast Cancer - One
of the biggest problems in women's health care is the
missed diagnosis
of breast cancer.
The most common scenario is a lump or abnormal finding
on exam and a normal mammogram result. I tell patients
that the normal screening program for breast cancer after
40 is self exam monthly, clinician exam and mammogram
yearly. If ANY of the three suggest a new finding that
might be abnormal, then the least that is recommended
is a short term follow up exam, such as one month. This
is true in younger patients too. We also use the GAIL
model to provide a risk assessment on appropriate patients.
We have found breast cancers on ultrasound that mammogram
missed, and insisted on biopsies (that proved positive)
when the exam just wasn’t reassuring. Again, the
rule of thumb is if you have any concerns about your
self breast exam or a doctors findings, then have a specialist
check it out.
^Top^
FDA alerts changes in Prescription Drug information
January 2006
MedWatch - The FDA Safety Information and Adverse Event Reporting Program
The FDA warned consumers not to use two unapproved drug products that are
being marketed as dietary supplements for weight loss. Emagrece Sim Dietary
Supplement, also known as the Brazilian Diet Pill, and Herbathin Dietary
Supplement may contain several active ingredients, including controlled
substances, found in prescription drugs that could lead to serious side
effects or injury. They contain chlordiazepoxide HCl (the active ingredient
in Librium), and fluoxetine HCl (the active ingredient in Prozac). Emagrece
Sim and Herbathin were also found to contain Fenproporex, a stimulant that
is not approved for marketing in the United States. Consumers are advised
not to use the Emagrece Sim and Herbathin products and to return them to the
suppliers. There may be other manufacturers or suppliers of imported
Emagrece Sim and Herbathin, and consumers should exercise caution in using
any of these imported products.
November 2005
MedWatch - The FDA Safety Information and Adverse Event Reporting Program
FDA notified healthcare professionals and patients of revisions to the label
for Ortho Evra, a skin patch approved for birth control, that includes a
bolded warning about higher exposure to estrogen for women using the weekly
patch compared to taking a daily birth control pill containing 35 micrograms
of estrogen. A woman on Ortho Evra may be exposed to approximately 60% more
estrogen than if she were taking a typical 35 microgram estrogen birth
control pill. Estrogen use is linked to blood clots in the legs and lungs
and other clotting problems such as strokes and heart attacks. It is not
known if women using Ortho Evra have a higher risk of serious side effects
than women taking the typical 35 microgram estrogen pills.
Read the complete MedWatch 2005 Safety Summary, including links to the FDA
News Release and Drug Information page, at:
http://www.fda.gov/medwatch/safety/2005/safety05.htm#evra
GlaxoSmithKline (GSK) and FDA notified healthcare professionals of changes
to the Pregnancy/PRECAUTIONS section of the Prescribing Information for
Paxil and Paxil CR Controlled-Release Tablets to describe the results of a
GSK retrospective epidemiologic study of major congenital malformations in
infants born to women taking antidepressants during the first trimester of
pregnancy. This study suggested an increase in the risk of overall major
congenital malformations for paroxetine as compared to other antidepressants
[OR 2.2; 95% confidence interval, 1.34-3.63]. Healthcare professionals are
advised to carefully weigh the potential risks and benefits of using
paroxetine therapy in women during pregnancy and to discuss these findings
as well as treatment alternatives with their patients.
FDA and GlaxoSmithKline notified healthcare professionals of revisions to
the WARNINGS and PRECAUTIONS sections of Wellbutrin (bupropion
hydrochloride) labeling to alert healthcare professionals that patients with
major depressive disorder, both adult and pediatric, may experience
worsening of their depression and/or the emergence of suicidal ideation and
behavior (suicidality), whether or not they are taking antidepressant
medications. The warning recommends patients being treated with
antidepressants be observed closely for clinical worsening and suicidality,
especially at the beginning of a course of drug therapy, or at the time of
dose changes, either increases or decreases.
November 2004
Detailed View: Safety Labeling Changes Approved
By FDA Center for Drug Evaluation and Research (CDER) --
The detailed view includes drug products
with safety labeling changes to the CONTRAINDICATIONS,
BOXED WARNING, WARNINGS, PRECAUTIONS, or ADVERSE REACTIONS
sections. The prescribing information may be accessed by
clicking on the drug name.
| Brand (Generic) Name |
Sections Modified |
Summary of Changes to Contraindications
and Warnings
|
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Bextra
(valdecoxib) Tablets
(click product
name to read prescribing information)
|
CONTRAINDICATIONS
BOXED WARNING
WARNINGS
- Coronary Artery Bypass
Graft Surgery
PRECAUTIONS
ADVERSE REACTIONS
|
CONTRAINDICATIONS
Bextra is
contraindicated for the treatment of post-operative
pain immediately following coronary artery
bypass graft (CABG) surgery and should not
be used in this setting.
BOXED WARNING
Serious skin
reactions (e.g., toxic epidermal necrolysis,
Stevens-Johnson syndrome, and erythema multiforme)
have been reported in patients receiving Bextra.
Some of these reactions have resulted in death.
Patients
appear to be at higher risk for these events
within the first two weeks of treatment,
but these may occur at any time during treatment.
The reported
rate of these serious skin events appears to
be greater for Bextra as compared to other
COX-2 agents.
Bextra should
be discontinued at the first appearance of
skin rash, mucosal lesions, or any other sign
of hypersensitivity.
WARNINGS
Patients
treated with Bextra for pain following coronary
artery bypass graft surgery have a higher risk
for cardiovascular/thromboembolic events, deep
surgical infections or sternal wound complications.
Bextra is therefore contraindicated for the
treatment of postoperative pain following CABG
surgery.
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| Canasa
(mesalamine, USP) Rectal Suppositories
(click product name
to read prescribing information)
|
CONTRAINDICATIONS
PRECAUTIONS
- Initial Paragraph
- Nursing Mothers
ADVERSE REACTIONS
- Clinical Adverse
Experience
|
Canasa 500
mg and 1000 mg suppositories are contraindicated
in patients who have demonstrated hypersensitivity
to mesalamine (5-aminosalicylic acid) or to the
suppository vehicle [saturated vegetable fatty
acid esters (Hard Fat, NF)], or to salicylates
(including aspirin).
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Cosmegen
(dactinomycin for injection)
(click product name to
read prescribing information)
|
CONTRAINDICATIONS
PRECAUTIONS
ADVERSE REACTIONS
|
Hypersensitivity
to any component of this product.....
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Depo-Provera
Contraceptive Injection (medroxyprogesterone
acetate injectable suspension)
(click product
name to read prescribing information)
|
CONTRAINDICATIONS
BOXED WARNING
WARNINGS
- Loss of Bone Mineral
Density
PRECAUTIONS
ADVERSE REACTIONS
|
CONTRAINDICATIONS
Significant liver disease
BOXED WARNING
Women who
use Depo-Provera Contraceptive Injection may
lose significant bone mineral density. Bone
loss is greater with increasing duration of
use and may not be completely reversible.
It is unknown
if use of Depo-Provera Contraceptive Injection
during adolescence or early adulthood, a critical
period of bone accretion, will reduce peak
bone mass and increase the risk for osteoporotic
fracture in later life.
Depo-Provera
Contraceptive Injection should be used as a
long-term birth control method (longer than
two years) only if other birth control methods
are inadequate.
WARNINGS
Use of Depo-Provera
CI reduces serum estrogen levels and is associated
with significant loss of bone mineral density
(BMD) as bone metabolism accommodates to a
lower estrogen level. This loss of BMD is of
particular concern during adolescence and early
adulthood, a critical period of bone accretion......
(See prescribing information.)
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| Naprosyn
(naproxen suspension)
Naprosyn
(naproxen tablets)
EC-Naprosyn
(naproxen delayed -release tablets)
Anaprox/Anaprox
DS (naproxen sodium) Tablets
(click product name to read prescribing information)
|
CONTRAINDICATIONS
WARNINGS
- Gastrointestinal (GI) Effects
- Anaphylactoid Reactions
- Advanced Renal Disease
- Pregnancy
PRECAUTIONS
- General
- Hepatic Effects
- Renal Effects
- Hematologic Effects
- Fluid Retention and Edema
- Preexisting Asthma
- Information for Patients
- Laboratory Tests
- Drug Interactions
- Aspirin
- Methotrexate
- ACE-inhibitors
- Furosemide
- Lithium
- Warfarin
- Other Information
Concerning Drug Interactions
- Pregnancy
- Labor and Delivery
- Nursing Mothers
- Pediatric Use
- Geriatric Use
ADVERSE REACTIONS
- In patients taking
NSAIDs, the following adverse experiences
have also been reported in approximately
1 to 10% of patients
- Gastrointestinal
(GI) Experiences
- General
- Dermatologic
- In patients taking
NSAIDs, the following adverse experiences
have also been reported in <1% of patients
- Body as a Whole
- Cardiovascular
- Gastrointestinal
- Hemic and Lymphatic
- Metabolic and
Nutritional
- Nervous System
- Respiratory
- Dermatologic
- Special Senses
- Urogenital
|
CONTRAINDICATIONS
......It is also contraindicated
in patients in whom aspirin or other nonsteroidal
anti-inflammatory/analgesic drugs induce the
syndrome of asthma, rhinitis, and nasal polyps.
Both types of reactions have the potential of
being fatal..... Therefore, careful questioning
of patients for such things as asthma, nasal
polyps, urticaria, and hypotension associated
with nonsteroidal anti-inflammatory drugs before
starting therapy is important. In addition, if
such symptoms occur during therapy, treatment
should be discontinued.
WARNINGS
Extensive revisions
to the WARNINGS/Gastrointestinal (GI) Effects
section. (See prescribing information.)
Anaphylactoid Reactions: As
with other NSAIDs, anaphylactoid reactions may
occur in patients without known prior exposure
to naproxen. Naproxen should not be given to
patients with the aspirin triad. This symptom
complex typically occurs in asthmatic patients
who experience rhinitis with or without nasal
polyps, or who exhibit severe, potentially fatal
bronchospasm after taking aspirin or other NSAIDs.
Advanced Renal
Disease: In cases with advanced kidney
disease, treatment with naproxen is not recommended.
If NSAID therapy, however, must be initiated,
close monitoring of the patient’s kidney function
is advisable.
Pregnancy: In late pregnancy,
as with other NSAIDs, naproxen should be avoided
because it may cause premature closure of the ductus
arteriosus.
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Norditropin
Cartridges (somatropin [rDNA origin] injection)
(click product
name to read prescribing information)
|
CONTRAINDICATIONS
PRECAUTIONS
- General
- Pediatric Patients
- Adult Patients
- Laboratory Tests
- Drug Interactions
- Geriatric use
- Information for Patients
ADVERSE REACTIONS
- Growth Hormone Deficient Pediatric
Patients
- Growth Hormone Deficient
Adult Patients
|
Norditropin
is contraindicated in patients with a known hypersensitivity
to somatropin or any of its excipients.
In general,
somatropin is contraindicated in the presence
of active neoplasia. Any preexisting neoplasia
should be inactive and its treatment complete
prior to instituting therapy with Norditropin.
Norditropin should be discontinued if there is
evidence of recurrent activity. Since growth
hormone deficiency may be an early sign of the
presence of a pituitary tumor (or, rarely, other
brain tumors), the presence of such tumors should
be ruled out prior to initiation of treatment.
Norditropin should not be used in patients with
any evidence of progression or recurrence of
an underlying intracranial space-occupying lesion.
Available information suggests that the rate
of tumor recurrence is not increased by growth
hormone therapy.....
.....Norditropin
is contraindicated in patients with proliferative
or preproliferative diabetic retinopathy.....
.....Norditropin should not be used
for growth promotion in pediatric patients with
closed epiphyses.
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Phenergan
(promethazine HCl) Tablets and Suppositories
(click product name to
read prescribing information)
|
CONTRAINDICATIONS
WARNINGS
- Initial Statement (enclosed in box)
- Use in Pediatric
Patients
PRECAUTIONS
|
CONTRAINDICATIONS
Phenergan Tablets and Suppositories
are contraindicated for use in pediatric patients
less than two years of age.....
WARNINGS
Phenergan should not be used in pediatric patients
less than two years of age because of the potential
for fatal respiratory depression...... (See prescribing
information.)
.....Respiratory depression and apnea,
sometimes associated with death, are strongly associated
with promethazine products and are not directly
related to individualized weight-based dosing,
which might otherwise permit safe administration.....
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| Robinul
(glycopyrrolate injection, USP) Injection
(click product name
to read prescribing information)
|
CONTRAINDICATIONS
WARNINGS
PRECAUTIONS
-
General
-
Information for the Patient
-
Drug Interactions
-
Anticholinergics
-
Potassium Chloride
-
Carcinogenesis,
Mutagenesis, Impairment of Fertility
-
Pregnancy
-
Teratogenic
Effects
-
Nonteratogenic
Effects
-
Nursing Mothers
-
Pediatric Use
ADVERSE REACTIONS
- Xerostomia
- Photophobia
- Dilation of the Pupil
- Cycloplegia
- Anaphylactic/Anaphylactoid
Reactions
- Hypersensitivity
- Pruritus
- Dry Skin
- Post-marketing Experience
- Heart Block
- Prolonged QTc
Interval
|
CONTRAINDICATIONS
Known hypersensitivity
to glycopyrrolate or any of its inactive ingredients.....
WARNINGS
.....In addition,
in the presence of fever, high environmental
temperature and/or during physical exercise,
heat prostration can occur with use of anticholinergic
agents including glycopyrrolate (due to decreased
sweating), particularly in children and the
elderly.
The closure system contains dry natural
rubber that may cause hypersensitivity reactions
when handled by or when the product is injected
in persons with known or possible latex sensitivity.
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Saizen
(somatropin [rDNA origin] for injection)
(click product name to read prescribing
information)
|
CONTRAINDICATIONS
WARNINGS
PRECAUTIONS
- General
- Intracranial hypertension
- Pediatric Patients
- Drug Interactions
ADVERSE REACTIONS
- Growth Hormone Deficient
Pediatric Patients
- Growth Hormone Deficient
Adult Patients
|
CONTRAINDICATIONS
Saizen is
contraindicated in patients with a known hypersensitivity
to somatropin or any of its excipients.....
.....Saizen is contraindicated
in patients with proliferative or preproliferative
diabetic retinopathy.....
....Growth
hormone is contraindicated in patients with
Prader-Willi syndrome who are severely obese
or have severe respiratory impairment. Unless
patients with Prader-Willi syndrome also have
a diagnosis of growth hormone deficiency, Saizen
is not indicated for the long term treatment
of pediatric patients who have growth failure
due to genetically confirmed Prader-Willi syndrome.
WARNINGS
.....There
have been reports of fatalities after initiating
therapy with growth hormone in pediatric patients
with Prader-Willi syndrome who had one or more
of the following risk factors: severe obesity,
history of upper airway obstruction or sleep
apnea, or unidentified respiratory infection.
Male patients with one or more of these factors
may be at greater risk than females ........
(See prescribing information.)
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Striant
(testosterone buccal system) mucoadhesive
(click product
name to read prescribing information)
|
CONTRAINDICATIONS |
Androgens are contraindicated in men with carcinoma of the
breast or known or suspected carcinoma of the prostate..... |
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| Tracleer (bosentan) Tablets
Please contact Actelion
Pharmaceuticals US, Inc. at 1-650-624-6900 for
prescribing information.
|
CONTRAINDICATIONS
- Pregnancy
- Pregnancy Category X
PRECAUTIONS
-
Drug Interactions/ Hormonal Contraceptives,
Including Oral, Injectable, Transdermal,
and Implantable Contraceptives
ADVERSE REACTIONS
|
CONTRAINDICATIONS
Hormonal contraceptives,
including oral, injectable, transdermal, and
implantable contraceptives should not be used
as the sole means of contraception because
these may not be effective in patients receiving
Tracleer.
It has been
demonstrated that hormonal contraceptives,
including oral, injectable, transdermal, and
implantable contraceptives may not be reliable
in the presence of Tracleer and should not
be used as the sole contraceptive method in
patients receiving Tracleer.
PRECAUTIONS
An interaction study
demonstrated that co-administration of bosentan
and the oral hormonal contraceptive Ortho-Novum
produced average decreases of norethindrone
and ethinyl estradiol levels of 14% and 31%,
respectively. However decreases in exposure
were as much as 56% and 66%, respectively,
in individual subjects. Therefore, hormonal
contraceptives, including oral, injectable,
transdermal, and implantable forms, may not
be reliable when Tracleer is co-administered.
Women should practice additional methods of
contraception and not rely on hormonal contraception
alone when taking Tracleer.
ADVERSE REACTIONS
New subsection added: Post-marketing
Experience: Hypersensitivity, Rash
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^Top^
| Brand
(Generic) Name |
Sections Modified
|
|
Arava
(leflunomide) Tablets
(click product name to read prescribing
information)
|
PRECAUTIONS
- Respiratory
- Interstitial
Lung Disease
- Geriatric Use
ADVERSE REACTIONS
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Augmentin
ES-600 (amoxicillin/clavulanate potassium)
Powder for Oral Suspension
(click product name to read prescribing information)
|
SYSTEMIC ANTIBACTERIAL
DRUG PRODUCTS STATEMENT to reduce the development
of drug-resistant bacteria.
PRECAUTIONS
- General
- Information for the Patient
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| Elidel
(pimecrolimus) Cream 1%
(click product name to read prescribing information)
|
PRECAUTIONS
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|
Iressa (gefitinib
tablets)
(click product name to read prescribing
information)
|
PRECAUTIONS
ADVERSE REACTIONS
- Interstitial Lung
Disease
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Keflex (cephalexin,
USP) Pulvules
(click product
name to read prescribing information)
|
PRECAUTIONS
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Lexiva
(fosamprenavir calcium) Tablets
(click product
name to read prescribing information)
|
PRECAUTIONS
- Hepatic Impairment and Toxicity
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Miostat
(carbachol intraocular solution, USP) 0.01%
(click product
name to read prescribing information)
|
PRECAUTIONS
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| Protonix (pantoprazole)
Delayed-Release Tablets
(click product name
to read prescribing information)
|
PRECAUTIONS
ADVERSE REACTIONS
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| Rifampin
Capsules
(click product name
to read prescribing information)
|
SYSTEMIC ANTIBACTERIAL
DRUG PRODUCTS STATEMENT to reduce the development
of drug-resistant bacteria.
PRECAUTIONS
- General
- Information for Patients
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| Slow-K
(potassium chloride) Extended-Release Tablets
(click product name
to read prescribing information)
|
PRECAUTIONS
- Nursing Mothers
- Geriatric Use
ADVERSE REACTIONS
|
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Timentin
(sterile ticarcillin disodium/clavulanate potassium)
for Intravenous Administration
(click product name to
read prescribing information)
|
SYSTEMIC ANTIBACTERIAL
DRUG PRODUCTS STATEMENT to reduce the development
of drug-resistant bacteria.
PRECAUTIONS
- General
- Information for Patients
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| Zofran
(ondansetron hydrochloride) Injection
Zofran (ondansetron hydrochloride) Injection, Premixed
(click product name
to read prescribing information)
|
PRECAUTIONS
- Drug Interactions
- CYP3A4, CYP2D6, CYP1A2
- Phenytoin, Carbamazepine,
and Rifampicin
- Tramadol
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Zofran
(ondansetron hydrochloride) Tablets and Oral
Solution
Zofran ODT (ondansetron hydrochloride) Orally Disintegrating
Tablets
(click product
name to read prescribing information)
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PRECAUTIONS
- Drug Interactions
- CYP3A4, CYP2D6, CYP1A2
- Phenytoin, Carbamazepine,
and Rifampicin
- Tramadol
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FDA Mail Order Warning
1. From the FDA...Beware of mail order prescriptions,
especially from overseas or other "non-certified" sources.
A web site from India was recently shut down after selling
fake Ortho Evra birth control patches as pictured below:
Authentic and Counterfeit Contraceptive Patches
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Authentic Ortho Evra Transdermal
Patch |
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Counterfeit Contraceptive Patches |
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Packaging for Authentic Ortho
Evra Transdermal Patch |
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Counterfeit Contraceptive Patch |
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Packaging for Authentic Ortho
Evra Transdermal Patch |
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Packaging for Authentic Ortho
Evra TransdermalPatch |
They have no medication in them and are useless, and possibly
dangerous. Any prescription drug ordered by mail should
have all the appropriate packaging, enclosures, expiration
dates, etc.
We believe that there is reliable prescription drug availability
in Canada, and Western Europe. Please be cautious and use
common sense.
2. A recent article in the Journal
of the AMA reported that a number of the popular calcium
supplements on the
market have significant problems. First and foremost is
an unusually high lead content. Also, many were found to
dissolve poorly in the digestive system, be poorly absorbed
by the intestinal lining and/or to have no magnesium and
other trace minerals to assist the body in "bioavailability"-
making the calcium useful for body functions and bone building.
We have changed our recommendations based on this. If you
cannot get your calcium requirement through proper diet,
then please find a HIGH QUALITY calcium supplement, or
don't take one at all.
The best lead-free, dissolvable,
absorbable, bioavailable calcium supplement (with Magnesium
and D and trace minerals
is...Osteoguard by Clinician's Choice. This is available
through our office here at Swor Women's Care or online at www.medeonhealth.com
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