Gonak

Generic Name: hypromellose (Ophthalmic route)

hye-PROE-me-lose

Commonly used brand name(s)

In the U.S.

• Genteal


• Genteal Mild


• Gonak


• Goniosoft


• Goniovisc


• Isopto Tears


• Nature's Tears


• Tearisol


• Tears Again Mc

Available Dosage Forms:

• Solution


• Gel/Jelly

Therapeutic Class: Surgical Aid, Ocular

Uses For Gonak

Hydroxypropyl methylcellulose belongs to the group of medicines known as artificial tears. It is used to relieve dryness and irritation caused by reduced tear flow. It helps prevent damage to the eye in certain eye diseases. Hydroxypropyl methylcellulose may also be used to moisten hard contact lenses and artificial eyes. In addition, it may be used in certain eye examinations.

Some of these preparations are available only with your doctor's prescription.

Before Using Gonak

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Although there is no specific information comparing use of hydroxypropyl methylcellulose in children with use in other age groups, this medicine is not expected to cause different side effects or problems in children than it does in adults.

Geriatric

Many medicine have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of hydroxypropyl methylcellulose in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use of hypromellose

This section provides information on the proper use of a number of products that contain hypromellose. It may not be specific to Gonak. Please read with care.

To use:

• First, wash your hands. Then tilt the head back and pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close the eyes. Do not blink. Keep the eyes closed for 1 or 2 minutes to allow the medicine to be absorbed.


• To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Also, keep the container tightly closed.

For patients wearing hard contact lenses:

• Take care not to float the lens from your eye when applying this medicine. If you have any questions about this, check with your health care professional.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For dry eyes:
  
  • For ophthalmic solution (eye drops) dosage form:
    
    • Adults and children—Use 1 drop three or four times a day.
    
    
  
  

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using Gonak

If you experience eye pain, changes in vision, continued redness or irritation of the eye, or if your symptoms continue for more than 3 days or become worse, check with your doctor.

Gonak Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• Eye irritation not present before use of this medicine

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common - more common with 1% solution

• Blurred vision


• matting or stickiness of eyelashes

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

Calcichew Forte Chewable Tablets

1. Name Of The Medicinal Product

Calcichew Forte Chewable Tablets

2. Qualitative And Quantitative Composition

Per tablet: Calcium carbonate 2500mg equivalent to 1g of elemental calcium.

Contains sorbitol, 780mg; isomalt, 124mg; and aspartame, 2mg.

For a full list of excipients see Section 6.1.

3. Pharmaceutical Form

Chewable tablet.

Round, white, uncoated and convex tablets. May have small specks.

4. Clinical Particulars

4.1 Therapeutic Indications

Calcichew Forte Chewable Tablets are to be chewed as a supplemental source of calcium in the correction of dietary deficiencies or when normal requirements are high.

Calcichew Forte Chewable Tablets may be used as an adjunct to conventional therapy in the prevention and treatment of osteoporosis. They may be used as a phosphate binding agent in the management of renal failure in patients on renal dialysis.

4.2 Posology And Method Of Administration

Oral.

Adults and elderly:

Adjunct to osteoporosis therapy	One tablet to be chewed daily.
Dietary deficiency	One tablet to be chewed daily.
Osteomalacia	1-3 tablets daily is recommended.

Children:

Dietary deficiency	One tablet to be chewed daily.
Phosphate Binder:
Adults, children and elderly:	Dose as required by the individual patient depending on serum phosphate level.

The tablets should be taken just before, during or just after each meal.

The tablets may be chewed or sucked.

Dosage in hepatic impairment:

No dose adjustment is required.

Dosage in renal impairment:

In patients with severe renal failure having a creatinine clearance of less than 25 ml/minute, dosage adjustments may be necessary dependent on serum calcium levels. See section 4.4.

4.3 Contraindications

• Severe hypercalcaemia and hypercalciuria, for example in hyperparathyroidism, vitamin D overdosage, decalcifying tumours such as plasmacytoma and skeletal metastases, in severe renal failure untreated by renal dialysis and in osteoporosis due to immobilisation.

• Nephrolithiasis

• Hypersensitivity to the active substance or to any of the excipients.

4.4 Special Warnings And Precautions For Use

Calcichew Forte chewable tablets contain aspartame (a source of phenylalanine) and should be avoided by patients with phenylketonuria.

Calcichew 500 mg Chewable Tablets contain sorbitol (E420) and isomalt (E953). Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine.

In renal insufficiency the tablets should be given only under controlled conditions for hyperphosphataemia. Caution should be exercised in patients with a history of renal calculi.

During high dose therapy and especially during concomitant treatment with vitamin D or nutrients (such as milk), there is a risk of hypercalcaemia with subsequent kidney function impairment and milk-alkali syndrome. In these patients, serum calcium levels should be followed and renal function should be monitored.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

Thiazide diuretics reduce the urinary excretion of calcium. Due to increased risk of hypercalcaemia, serum calcium should be regularly monitored during concomitant use of thiazide diuretics.

Systemic corticosteroids reduce calcium absorption. During concomitant use, it may be necessary to increase the dose of Calcichew Forte Chewable Tablets.

Calcium carbonate may interfere with the absorption of concomitantly administered tetracycline preparations. For this reason, tetracycline preparations should be administered at least two hours before, or four to six hours after, oral intake of calcium.

Hypercalcaemia may increase the toxicity of cardiac glycosides during treatment with calcium. Patients should be monitored with regard to electrocardiogram (ECG) and serum calcium levels.

The efficacy of levothyroxine can be reduced by the concurrent use of calcium, due to decreased levothyroxine absorption. Administration of calcium and levothyroxine should be separated by at least four hours.

The absorption of quinolone antibiotics may be impaired if administered concomitantly with calcium. Quinolone antibiotics should be taken two hours before or after intake of calcium.

If a bisphosphonate or sodium fluoride is used concomitantly, this preparation should be administered at least three hours before the intake of Calcichew Forte Chewable Tablets since gastrointestinal absorption may be reduced.

Oxalic acid (found in spinach and rhubarb) and phytic acid (found in whole cereals) may inhibit calcium absorption through formation of insoluble calcium salts. The patient should not take calcium products within two hours of eating foods high in oxalic acid and phytic acid.

4.6 Pregnancy And Lactation

The adequate daily intake (including food and supplementation) for normal pregnant and lactating women is 1000-1300 mg calcium. During pregnancy, the daily intake of calcium should not exceed 1500 mg. Significant amounts of calcium are secreted in milk during lactation. Calcichew Forte Chewable Tablets can be used during pregnancy in case of a calcium deficiency.

4.7 Effects On Ability To Drive And Use Machines

There are no data about the effect of this product on driving capacity. An effect is, however, unlikely.

4.8 Undesirable Effects

Adverse reactions are listed below, by system organ class and frequency. Frequencies are defined as: uncommon (

Metabolism and nutrition disorders

Uncommon: Hypercalcaemia and hypercalciuria.

Very rare: Seen usually only in overdose, see 4.9: Milk-alkali syndrome

Gastrointestinal disorders

Rare: Constipation, dyspepsia, flatulence, nausea, abdominal pain and diarrhoea.

Skin and subcutaneous disorders

Rare: Pruritus, rash and urticaria.

4.9 Overdose

Overdose can lead to hypercalcaemia. Symptoms of hypercalcaemia may include anorexia, thirst, nausea, vomiting, constipation, abdominal pain, muscle weakness, fatigue, mental disturbances, polydipsia, polyuria, bone pain, nephrocalcinosis, nephrolithiasis and in severe cases, cardiac arrhythmias. Extreme hypercalcaemia may result in coma and death. Persistently high calcium levels may lead to irreversible renal damage and soft tissue calcification.

Milk-alkali syndrome (frequent urge to urinate; continuing headache; continuing loss of appetite; nausea or vomiting; unusual tiredness or weakness; hypercalcaemia, alkalosis and renal impairment). The milk-alkali syndrome of hypercalcaemia, alkalosis and renal impairment still occur in patients who ingest large amounts of calcium and absorbable alkali; it is not uncommon as a cause of hypercalcaemia requiring hospitalisation. The syndrome has also been reported in a patient taking recommended doses of antacids containing calcium carbonate for chronic epigastric discomfort, and in a pregnant woman taking high, but not grossly excessive, doses of calcium (about 3 g of elemental calcium daily). Metastatic calcification can develop.

Treatment of hypercalcaemia: The treatment with calcium must be discontinued. Treatment with thiazide diuretics, lithium, vitamin A, vitamin D and cardiac glycosides must also be discontinued. Treatment: rehydration, and, according to severity of hypercalcaemia, isolated or combined treatment with loop diuretics, bisphosphonates, calcitonin and corticosteroids should be considered. Serum electrolytes, renal function and diuresis must be monitored. In severe cases, ECG and CVP should be followed.

5. Pharmacological Properties

5.1 Pharmacodynamic Properties

Pharmacotherapeutic group: Calcium

ATC-code: A12A A04

An adequate intake of calcium is of importance during growth, pregnancy and breastfeeding.

5.2 Pharmacokinetic Properties

Absorption: The amount of calcium absorbed through the gastrointestinal tract is approximately 30% of the swallowed dose.

Distribution and metabolism: 99% of the calcium in the body is concentrated in the hard structure of bones and teeth. The remaining 1% is present in the intra- and extracellular fluids. About 50% of the total blood-calcium content is in the physiologically active ionised form with approximately 10% being complexed to citrate, phosphate or other anions, the remaining 40% being bound to proteins, principally albumin.

Elimination: Calcium is eliminated through faeces, urine and sweat. Renal excretion depends on glomerular filtration and calcium tubular reabsorption.

5.3 Preclinical Safety Data

There is no information of relevance to the safety assessment in addition to what is stated in other parts of the SmPC.

6. Pharmaceutical Particulars

6.1 List Of Excipients

Sorbitol (E420)

Povidone

Magnesium stearate

Aspartame (E951)

Orange flavour:

Isomalt (E953)

Flavouring (orange)

Mono, di-fatty acid glycerides

6.2 Incompatibilities

Not applicable.

6.3 Shelf Life

3 years.

6.4 Special Precautions For Storage

Do not store above 30ºC.

Keep the container tightly closed to protect from moisture.

6.5 Nature And Contents Of Container

WiMo Box of 28, 30, 56, 60, 90 and 100 tablets. Not all pack sizes may be marketed.

It is a high density polyethylene cylindrical bottle with high density polyethylene screw cap and medium density polyethylene tamper-evident liner.

6.6 Special Precautions For Disposal And Other Handling

No special requirements.

7. Marketing Authorisation Holder

Shire Pharmaceuticals Limited

Hampshire International Business Park

Chineham

Basingstoke

Hampshire RG24 8EP

United Kingdom

8. Marketing Authorisation Number(S)

PL 08557/0022

9. Date Of First Authorisation/Renewal Of The Authorisation

2 January 1992

10. Date Of Revision Of The Text

09-Jun-2010

Ganite

Generic Name: gallium nitrate (Intravenous route)

GAL-ee-um NYE-trate

Intravenous route(Solution)

Concurrent use with other potentially nephrotoxic drugs may increase the risk for developing severe renal insufficiency in patients with cancer-related hypercalcemia. If use of another potentially nephrotoxic drug is indicated during gallium nitrate therapy, discontinue gallium nitrate and continue hydration for several days after administration of the potentially nephrotoxic drug. Monitor renal function during and subsequent to this period. Discontinue gallium nitrate therapy if the serum creatinine level exceeds 2.5 mg/dL.

Commonly used brand name(s)

In the U.S.

• Ganite

Available Dosage Forms:

• Solution

Therapeutic Class: Calcium Regulator

Uses For Ganite

Gallium nitrate is used to treat hypercalcemia (too much calcium in the blood) that may occur with some types of cancer.

This medicine is available only with your doctor's prescription.

Before Using Ganite

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of gallium nitrate in children with use in other age groups.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of gallium nitrate in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Rotavirus Vaccine, Live

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Adenovirus Vaccine Type 4, Live


• Adenovirus Vaccine Type 7, Live


• Bacillus of Calmette and Guerin Vaccine, Live


• Influenza Virus Vaccine, Live


• Measles Virus Vaccine, Live


• Mumps Virus Vaccine, Live


• Rotavirus Vaccine, Live


• Rubella Virus Vaccine, Live


• Smallpox Vaccine


• Typhoid Vaccine


• Varicella Virus Vaccine


• Yellow Fever Vaccine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Gallium Citrate Ga 67

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Kidney disease—Gallium nitrate may make this condition worse

Proper Use of Ganite

Make certain your health care professional knows if your diet includes large amounts of calcium-containing foods and/or vitamin D, such as milk or other dairy products. Also let your health care professional know if you are on any special diet, such as a low-sodium or a low-sugar diet.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For injection dosage form:
  
  • For treatment of too much calcium in the blood:
    
    • Adults and teenagers—The dose is based on body size and must be determined by your doctor. Gallium nitrate is injected slowly into a vein over 24 hours, for five days. The dose may be repeated in two to four weeks.
    
    
    • Children up to 12 years of age—Use and dose must be determined by your doctor.
    
    
  
  

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using Ganite

It is important that your doctor check your progress at regular visits while you are receiving this medicine. If your condition has improved and you are no longer receiving gallium nitrate, your progress must still be checked. The results of laboratory tests or the occurrence of certain symptoms will tell your doctor if your condition is coming back.

Ganite Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

More common

• Blood in urine


• bone pain


• greatly increased or decreased frequency of urination or amount of urine


• increased thirst


• loss of appetite


• muscle weakness


• nausea or vomiting

Less common

• Abdominal cramps


• confusion


• muscle spasms

Rare

• Unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Diarrhea


• metallic taste

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Ganite side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Ganite resources

• Ganite Side Effects (in more detail)
• Ganite Use in Pregnancy & Breastfeeding
• Ganite Drug Interactions
• Ganite Support Group
• 0 Reviews for Ganite - Add your own review/rating

• Ganite Prescribing Information (FDA)


• Ganite MedFacts Consumer Leaflet (Wolters Kluwer)


• Ganite Concise Consumer Information (Cerner Multum)


• Ganite Monograph (AHFS DI)


• Gallium Nitrate Professional Patient Advice (Wolters Kluwer)

Compare Ganite with other medications

• Hypercalcemia
• Hypercalcemia of Malignancy

acetaminophen/chlorpheniramine/phenylephrine

Generic Name: acetaminophen, chlorpheniramine, and phenylephrine (a SEET a MIN oh fen, KLOR fen EER a meen, FEN ill EFF rin)

Brand names: Alka-Seltzer Plus Cold, Allergy Relief Multi-Symptom, Comtrex Flu Therapy, Comtrex Severe Cold & Sinus, Dristan Cold Multi Symptom Formula, Dryphen, Protid, Sinus Congestion & Pain Nighttime, Tylenol Allergy Multi-Symptom, Tylenol Children's Plus Cold, Tylenol Sinus Congestion Nighttime, ...show all 17 brand names.Gendecon, Comtrex Severe Cold & Sinus, Sinus Congestion & Pain Nighttime, Tylenol Sinus Congestion and Pain Cool Burst Day Night, Robitussin Nighttime Nasal Relief, Contac Cold+Flu

What is acetaminophen, chlorpheniramine, and phenylephrine?

Acetaminophen is a pain reliever and fever reducer.

Chlorpheniramine is an antihistamine that reduces the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

The combination of acetaminophen, chlorpheniramine, and phenylephrine is used to treat runny or stuffy nose, sinus congestion, sneezing, and pain or fever caused by allergies or the common cold.

Acetaminophen, chlorpheniramine, and phenylephrine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about acetaminophen, chlorpheniramine, and phenylephrine?

There are many brands and forms of this medication available and not all brands are listed on this leaflet.

Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children. Do not use this medication if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Do not take more of this medication than is recommended. An overdose of acetaminophen can cause damage to your liver. Do not use any other cough, cold, allergy, or pain medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of a certain drug. Read the label of any other medicine you are using to see if it contains acetaminophen (sometimes abbreviated as "APAP"), chlorpheniramine, or phenylephrine. Avoid drinking alcohol. It can increase the risk of liver damage while you are taking acetaminophen. If you drink more than three alcoholic beverages per day, do not take acetaminophen without your doctor's advice, and never take more than 2 grams (2000 mg) per day.

What should I discuss with my healthcare provider before taking acetaminophen, chlorpheniramine, and phenylephrine?

Do not use this medication if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take a decongestant before the MAO inhibitor has cleared from your body. Do not take this medication if you are allergic to acetaminophen, chlorpheniramine, or phenylephrine, or to other antihistamines or decongestants, diet pills, stimulants, or ADHD medications.

Ask a doctor or pharmacist about using acetaminophen, chlorpheniramine, and phenylephrine if you have:

• 
  

  heart disease or high blood pressure;

  
  


• 
  

  liver disease, alcoholism, or cirrhosis of the liver;

  
  


• 
  

  glaucoma;

  
  


• 
  

  kidney disease;

  
  


• 
  

  diabetes;

  
  


• 
  

  a thyroid disorder;

  
  


• 
  

  an enlarged prostate; or

  
  


• 
  

  problems with urination.

  
  

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. This medication may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Artificially-sweetened liquid forms of cold medicine may contain phenylalanine. This would be important to know if you have phenylketonuria (PKU). Check the ingredients and warnings on the medication label if you are concerned about phenylalanine.

How should I take acetaminophen, chlorpheniramine, and phenylephrine?

Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended. Cold medicine should be taken only for a short time until your symptoms clear up.

An overdose of acetaminophen can cause serious harm. The maximum amount of acetaminophen for adults is 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day. Taking more acetaminophen could cause damage to your liver. One acetaminophen, chlorpheniramine, and phenylephrine tablet may contain up to 500 mg of acetaminophen. Know the amount of acetaminophen in the specific product you are taking. Always ask a doctor before giving cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children. Take this medication with food or milk if it upsets your stomach. Drink extra fluids while you are taking acetaminophen, chlorpheniramine, and phenylephrine.

Measure the liquid form of this medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash.

This medication can cause you to have unusual results with allergy skin tests. Tell any doctor who treats you that you are taking an antihistamine.

If you need to have any type of surgery, tell the surgeon ahead of time if you have taken a cold medicine within the past few days.

Store this medication at room temperature, away from heat, light, and moisture.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.

Overdose symptoms may also include feeling restless or nervous, dizziness, drowsiness, dry mouth, warmth or tingly feeling, or seizure (convulsions).

What should I avoid while taking acetaminophen, chlorpheniramine, and phenylephrine?

Avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice. Taking a stimulant together with a decongestant can increase your risk of unpleasant side effects.

Do not use any other cough, cold, allergy, or pain medication without first asking your doctor or pharmacist. Acetaminophen (sometimes abbreviated as "APAP"), chlorpheniramine, and phenylephrine are contained in many cold and pain medicines available over the counter. If you take certain products together you may accidentally take too much of a certain drug. Read the label of any other medicine you are using to see if it contains acetaminophen, APAP, chlorpheniramine, or phenylephrine. Avoid drinking alcohol. It can increase the risk of liver damage while you are taking acetaminophen. If you drink more than three alcoholic beverages per day, do not take acetaminophen without your doctor's advice, and never take more than 2 grams (2000 mg) per day. This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid becoming overheated or dehydrated during exercise and in hot weather.

Acetaminophen, chlorpheniramine, and phenylephrine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have any of these serious side effects:

• 
  

  fast, pounding, or uneven heartbeat;

  
  


• 
  

  confusion, hallucinations, unusual thoughts or behavior;

  
  


• 
  

  severe dizziness, anxiety, restless feeling, or nervousness;

  
  


• 
  

  increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);

  
  


• 
  

  urinating less than usual or not at all;

  
  


• 
  

  easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms; or

  
  


• 
  

  nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

  
  

Less serious side effects may include:

• 
  

  blurred vision;

  
  


• 
  

  dry mouth;

  
  


• 
  

  mild loss of appetite;

  
  


• 
  

  nausea, stomach pain, constipation;

  
  


• 
  

  dizziness, drowsiness;

  
  


• 
  

  problems with memory or concentration;

  
  


• 
  

  ringing in your ears;

  
  


• 
  

  restless or excitability (especially in children);

  
  


• 
  

  sleep problems (insomnia);

  
  


• 
  

  skin rash, redness, or itching; or

  
  


• 
  

  warmth, tingling, or redness under your skin.

  
  

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Acetaminophen/chlorpheniramine/phenylephrine Dosing Information

Usual Adult Dose for Cold Symptoms:

acetaminophen/chlorpheniramine/phenylephrine varying strength oral kit:
Day time tablets (without chlorpheniramine): 2 tablets every 4 hours not to exceed 8 tablets daily.
Night time tablets: 2 tablets every 4 hours no sooner than 4 hours after the last day time dose not to exceed 4 tablets daily.

Usual Adult Dose for Sinus Symptoms:

acetaminophen/chlorpheniramine/phenylephrine varying strength oral kit:
Day time tablets (without chlorpheniramine): 2 tablets every 4 hours not to exceed 8 tablets daily.
Night time tablets: 2 tablets every 4 hours no sooner than 4 hours after the last day time dose not to exceed 4 tablets daily.

Usual Pediatric Dose for Cold Symptoms:

acetaminophen/chlorpheniramine/phenylephrine varying strength oral kit:
12 years or older: Day time tablets (without chlorpheniramine): 2 tablets every 4 hours not to exceed 8 tablets daily. Night time tablets: 2 tablets every 4 hours no sooner than 4 hours after the last day time dose not to exceed 4 tablets daily.

acetaminophen/chlorpheniramine/phenylephrine 160 mg-1 mg-2.5 mg/5 mL oral liquid:
6 to 11 years or 22 to 43 kg: 10 mL orally every 4 hours not to exceed 5 doses.

Usual Pediatric Dose for Sinus Symptoms:

acetaminophen/chlorpheniramine/phenylephrine varying strength oral kit:
12 years or older: Day time tablets (without chlorpheniramine): 2 tablets every 4 hours not to exceed 8 tablets daily. Night time tablets: 2 tablets every 4 hours no sooner than 4 hours after the last day time dose not to exceed 4 tablets daily.

acetaminophen/chlorpheniramine/phenylephrine 160 mg-1 mg-2.5 mg/5 mL oral liquid:
6 to 11 years or 22 to 43 kg: 10 mL orally every 4 hours not to exceed 5 doses.

What other drugs will affect acetaminophen, chlorpheniramine, and phenylephrine?

Before taking this medication, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by chlorpheniramine.

Also tell your doctor if you are using any of the following drugs:

• 
  

  an antidepressant;

  
  


• 
  

  a bronchodilator;

  
  


• 
  

  a diuretic (water pill);

  
  


• 
  

  gout medications;

  
  


• 
  

  blood pressure medication;

  
  


• 
  

  medication to treat irritable bowel syndrome;

  
  


• 
  

  bladder or urinary medications such as oxybutynin (Ditropan, Oxytrol) or tolterodine (Detrol);

  
  


• 
  

  seizure medication;

  
  


• 
  

  isoniazid;

  
  


• 
  

  zidovudine (Retrovir, AZT);

  
  


• 
  

  aspirin or salicylates (such as Disalcid, Doan's Pills, Dolobid, Salflex, Tricosal, and others); or

  
  


• 
  

  a beta-blocker such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others.

  
  

This list is not complete and there may be other drugs that can interact with acetaminophen, chlorpheniramine, and phenylephrine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

More acetaminophen/chlorpheniramine/phenylephrine resources

• Acetaminophen/chlorpheniramine/phenylephrine Side Effects (in more detail)
• Acetaminophen/chlorpheniramine/phenylephrine Use in Pregnancy & Breastfeeding
• Acetaminophen/chlorpheniramine/phenylephrine Drug Interactions
• Acetaminophen/chlorpheniramine/phenylephrine Support Group
• 3 Reviews for Acetaminophen/chlorpheniramine/phenylephrine - Add your own review/rating

Compare acetaminophen/chlorpheniramine/phenylephrine with other medications

• Cold Symptoms
• Sinus Symptoms

Where can I get more information?

• Your pharmacist can provide more information about acetaminophen, chlorpheniramine, and phenylephrine.

See also: acetaminophen/chlorpheniramine/phenylephrine side effects (in more detail)

Valium

Pronunciation: dye-AZ-e-pam
Generic Name: Diazepam
Brand Name: Valium

Valium is used for:

Treating anxiety disorders or for the short-term relief of the symptoms of anxiety. It is also used to relieve certain types of muscle spasms and to treat symptoms of alcohol withdrawal (eg, agitation, tremor, hallucinations). Valium is also used with other medicines to treat certain types of seizure disorders. It may also be used for other conditions as determined by your doctor.

Valium is a benzodiazepine. It works by increasing the action of a certain chemical (gamma-aminobutyric acid [GABA]) in the brain and nervous system. This helps to reduce anxiety. It also helps to reduce seizure activity in the brain and to reduce muscle spasms.

Do NOT use Valium if:

• you are allergic to any ingredient in Valium


• you have acute narrow-angle glaucoma or untreated open-angle glaucoma, certain muscle problems (eg, myasthenia gravis), severe liver problems, severe breathing problems, or sleep apnea


• you are taking an HIV protease inhibitor (eg, ritonavir) or sodium oxybate (GHB)

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

Video: Treatment for Depression

Treatments for depression are getting better everyday and there are things you can start doing right away.

Before using Valium:

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

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have glaucoma or increased pressure in the eye, liver or kidney problems, muscle problems or weakness, or a blood disorder (eg, porphyria)


• if you have a history of lung or breathing problems (eg, asthma, chronic obstructive pulmonary disease [COPD]), seizures, mood or mental problems (eg, depression, psychosis), or suicidal thoughts or actions


• if you have a history of alcohol or other substance abuse or dependence

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

• Rifamycins (eg, rifampin) or St. John's wort because they may decrease Valium's effectiveness


• Azole antifungals (eg, ketoconazole), barbiturates (eg, phenobarbital), cimetidine, clozapine, diltiazem, HIV protease inhibitors (eg, ritonavir), macrolide antibiotics (eg, erythromycin), methadone, nefazodone, omeprazole, selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine, fluvoxamine), sodium oxybate (GHB), or telithromycin because side effects, such as increased sedation and confusion, may occur


• Disulfiram, hormonal contraceptives (eg, birth control pills), monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), narcotic pain medicines (eg, morphine, codeine), or phenothiazines (eg, thioridazine), or other medicines for mood or mental problems (eg, olanzapine) because they may increase the risk of Valium's side effects


• Hydantoins (eg, phenytoin) because the risk of their side effects may be increased by Valium

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

How to use Valium:

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

• Take Valium by mouth with or without food.


• Check with your doctor before you eat grapefruit or drink grapefruit juice while you use Valium.


• If you miss a dose of Valium and you are taking it regularly, take it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up, unless advised by your health care provider. Do not take 2 doses at once.

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

Important safety information:

• Valium may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Valium with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Valium; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.


• Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.


• If you take Valium regularly over a long period of time (eg, several months), do not suddenly stop taking it without first talking with your doctor. You may have an increased risk of side effects (eg, mood changes, trouble sleeping). If you need to stop Valium or add a new medicine, your doctor may need to gradually lower your dose.


• If you are taking Valium for seizures, carry an ID card at all times that says you have a seizure disorder and you take Valium.


• Tell your doctor or dentist that you take Valium before you receive any medical or dental care, emergency care, or surgery.


• Lab tests, including liver function and complete blood cell counts, may be performed while you use Valium. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Use Valium with caution in the ELDERLY; they may be more sensitive to its effects, especially drowsiness, incoordination, and mental or mood changes.


• Caution is advised when using Valium in CHILDREN; they may be more sensitive to its effects, especially mental or mood changes.


• Valium should not be used in CHILDREN younger than 6 months old; safety and effectiveness in these children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: Valium may cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Valium while you are pregnant. Valium is found in breast milk. Do not breast-feed while using Valium.

When used for long periods of time or at high doses, Valium may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Valium stops working well. Do not take more than prescribed.

Some people who use Valium for a long time may develop a need to continue taking it. People who take high doses are also at risk. This is known as DEPENDENCE or addiction. If you stop taking Valium suddenly, you may have WITHDRAWAL symptoms. These may include convulsions, tremor, stomach and muscle cramps, vomiting, or sweating. Do not suddenly stop taking Valium without first checking with your doctor.

Possible side effects of Valium:

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

Drowsiness; incoordination; muscle weakness; tiredness.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; difficulty breathing; fainting; fever, chills, or persistent sore throat; hallucinations; inability to control urination or difficulty urinating; memory problems or memory loss; new or worsening mental or mood changes (eg, agitation, aggressiveness, behavior changes, depression, irritability, rage, restlessness); severe or persistent dizziness or lightheadedness; slurred speech; tremor; trouble sleeping; vision changes (eg, blurred vision, double vision); yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Valium side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include clumsiness; coma; confusion; deep sleep; fainting; loss of consciousness; severe drowsiness; slow or shallow breathing; slow reflexes.

Proper storage of Valium:

Store Valium at room temperature, between 59 and 86 degrees F (15 and 30 degrees C), in a tight, light-resistant container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Valium out of the reach of children and away from pets.

General information:

• If you have any questions about Valium, please talk with your doctor, pharmacist, or other health care provider.


• Valium is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Valium. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Valium resources

• Valium Side Effects (in more detail)
• Valium Dosage
• Valium Use in Pregnancy & Breastfeeding
• Drug Images
• Valium Drug Interactions
• Valium Support Group
• 81 Reviews for Valium - Add your own review/rating

• Valium Consumer Overview


• Valium Advanced Consumer (Micromedex) - Includes Dosage Information


• Valium Prescribing Information (FDA)


• Diazepam Professional Patient Advice (Wolters Kluwer)


• Diazepam Monograph (AHFS DI)


• Diastat Advanced Consumer (Micromedex) - Includes Dosage Information


• Diastat Prescribing Information (FDA)

Compare Valium with other medications

• Alcohol Withdrawal
• Anxiety
• Endoscopy or Radiology Premedication
• Hyperekplexia
• ICU Agitation
• Light Anesthesia
• Light Sedation
• Meniere's Disease
• Muscle Spasm
• Night Terrors
• Seizure Prevention
• Seizures
• Status Epilepticus
• Temporomandibular Joint Disorder
• Tetanus

Kerol Emulsion

Pronunciation: ue-REE-a/zink/LACK-tik AS-id
Generic Name: Urea in Zinc/Lactic Acid
Brand Name: Examples include Kerol and Latrix XM

Kerol Emulsion is used for:

Aiding in the healing of certain skin conditions (eg, calluses; corns; dermatitis; dry, rough skin; eczema; hyperkeratotic sores; psoriasis). It may also be used for other conditions as determined by your doctor.

Kerol Emulsion is a debriding agent. It works by helping the breakdown of dead skin and pus, which helps to loosen and shed hard and scaly skin.

Do NOT use Kerol Emulsion if:

• you are allergic to any ingredient in Kerol Emulsion

Contact your doctor or health care provider right away if this applies to you.

Before using Kerol Emulsion:

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

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have a history of blood circulation problems or diabetes

Some MEDICINES MAY INTERACT with Kerol Emulsion. Because little, if any, of Kerol Emulsion is absorbed into the blood, the risk of it interacting with another medicine is low.

Ask your health care provider if Kerol Emulsion may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Kerol Emulsion:

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

• Apply Kerol Emulsion to the affected area as directed by your doctor. Gently rub it in until it is evenly distributed.


• Wash your hands right away after using Kerol Emulsion, unless your hands are part of the treated area.


• If you miss a dose of Kerol Emulsion, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

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

Important safety information:

• Kerol Emulsion is for external use only. Do not get it in your eyes, nose, or mouth. If you get it in any of these areas, rinse right away with cool tap water.


• Do not use more than the recommended dose or use for longer than prescribed without checking with your doctor.


• Do not use Kerol Emulsion for other skin conditions without checking with your doctor.


• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Kerol Emulsion while you are pregnant. It is not known if Kerol Emulsion is found in breast milk after topical use. If you are or will be breast-feeding while you use Kerol Emulsion, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Kerol Emulsion:

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

Mild skin irritation; temporary burning, stinging, or itching.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); severe or persistent skin irritation, burning, stinging, or itching.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Kerol side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Kerol Emulsion:

Store Kerol Emulsion at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Protect from freezing. Store away from heat, moisture, and light. Keep Kerol Emulsion out of the reach of children and away from pets.

General information:

• If you have any questions about Kerol Emulsion, please talk with your doctor, pharmacist, or other health care provider.


• Kerol Emulsion is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Kerol Emulsion. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Kerol resources

• Kerol Side Effects (in more detail)
• Kerol Use in Pregnancy & Breastfeeding
• Kerol Support Group
• 0 Reviews for Kerol - Add your own review/rating

Compare Kerol with other medications

• Dermatological Disorders
• Dry Skin
• Pityriasis rubra pilaris

AK-Nefrin

Generic Name: phenylephrine ophthalmic (fen ill EFF rin)

Brand Names: AK-Dilate, AK-Nefrin, Isopto Frin, Mydfrin, Neo-Synephrine Ophthalmic, Neofrin

What is AK-Nefrin (phenylephrine ophthalmic)?

Phenylephrine ophthalmic causes constriction of blood vessels in the eyes. It also enlarges the pupils, reduces the production of fluid in the eyes, and increases the amount of fluid that drains from the eyes.

Phenylephrine ophthalmic available over-the-counter is used to relieve redness, burning, irritation, and dryness of the eye caused by wind, sun, and other minor irritants. Prescription-strength phenylephrine ophthalmic is used to constrict blood vessels in the eye and to dilate (make bigger) the pupil for conditions such as glaucoma, before surgery, and before eye examinations.

Phenylephrine ophthalmic may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about AK-Nefrin (phenylephrine ophthalmic)?

Do not touch the dropper to any surface, including the eyes or hands. The dropper is sterile. If it becomes contaminated, it could cause an infection in the eye.

If you wear contact lenses, remove them before applying phenylephrine ophthalmic. Ask your doctor if contact lenses can be reinserted after application of the medication. Phenylephrine ophthalmic may contains preservative (benzalkonium chloride), which may cause discoloration of contact lenses.

Do not use phenylephrine ophthalmic more often or continuously for longer than 48 to 72 hours without consulting a doctor. Chronic use of this medication may damage the blood vessels (veins and arteries) in the eyes. Consult a doctor if your symptoms do not improve or appear to worsen. Use caution when driving, operating machinery, or performing other hazardous activities. Phenylephrine ophthalmic may cause blurred vision. If you experience blurred vision, avoid these activities.

What should I discuss with my healthcare provider before using AK-Nefrin (phenylephrine ophthalmic)?

Do not use phenylephrine ophthalmic if you have glaucoma, except under the supervision of your doctor.

Do not use phenylephrine ophthalmic after eye surgery, if you have an eye infection, if you have an eye injury, or if you have a problem with the normal tearing of your eyes without the approval and direction of your doctor. Using phenylephrine ophthalmic under these circumstances could lead to absorption of the drug by the body, and side effects could affect the heart.

Before using this medication, tell your doctor if you

• 
  

  have any type of heart condition, including high blood pressure;

  
  


• 
  

  take any medicines to treat a heart condition;

  
  


• 
  

  have asthma;

  
  


• 
  

  have diabetes; or

  
  


• 
  

  have thyroid problems.

  
  

You may not be able to use phenylephrine ophthalmic, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Phenylephrine ophthalmic is in the FDA pregnancy category C. This means that it is not known whether phenylephrine ophthalmic will be harmful to an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether phenylephrine ophthalmic passes into breast milk. Do not use phenylephrine ophthalmic without first talking to your doctor if you are breast-feeding a baby.

How should I use AK-Nefrin (phenylephrine ophthalmic)?

Use phenylephrine eyedrops exactly as directed by your doctor, or follow the directions that accompany the package. If you do not understand these instructions, ask your doctor, pharmacist, or nurse to explain them to you.

Wash your hands before and after using the eyedrops.

If you wear contact lenses, remove them before applying phenylephrine ophthalmic. Ask your doctor if contact lenses can be reinserted after application of the medication. Phenylephrine ophthalmic may contain a preservative (benzalkonium chloride), which may cause discoloration of contact lenses.

To apply the eyedrops:

• 
  

  Tilt the head back slightly and pull down on the lower eyelid. Position the dropper above the eye. Look up and away from the dropper. Squeeze out a drop and close the eye. Apply gentle pressure to the inside corner of the eye (near the nose) for about 1 minute to prevent the liquid from draining down the tear duct. Repeat the process in the other eye if needed.

  
  

Do not use phenylephrine ophthalmic more often or continuously for longer than 48 to 72 hours without consulting a doctor. Chronic use of this medication may damage the blood vessels (veins and arteries) in the eyes. Consult a doctor if your symptoms do not improve or appear to worsen. Do not touch the dropper to any surface, including the eyes or hands. The dropper is sterile. If it becomes contaminated, it could cause an infection in the eye. Do not use any eyedrop that is discolored or has particles in it. Store phenylephrine ophthalmic at room temperature away from moisture and heat. Keep the bottle properly capped.

What happens if I miss a dose?

Apply the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and apply the next one as directed. Do not use a double dose of this medication.

What happens if I overdose?

An overdose of this medication is unlikely to be harmful. If you do suspect an overdose, or if the drops have been ingested (taken by mouth), contact an emergency room or poison control center for advice.

What should I avoid while using AK-Nefrin (phenylephrine ophthalmic)?

Use caution when driving, operating machinery, or performing other hazardous activities. Phenylephrine ophthalmic may cause blurred vision. If you experience blurred vision, avoid these activities. Do not touch the dropper to any surface, including the eyes or hands. The dropper is sterile. If it becomes contaminated, it could cause an infection in the eye.

If you wear contact lenses, remove them before applying phenylephrine ophthalmic. Ask your doctor if contact lenses can be reinserted after application of the medication. Phenylephrine ophthalmic may contain a preservative (benzalkonium chloride), which may cause discoloration of contact lenses.

Do not use phenylephrine ophthalmic more often or continuously for longer than 48 to 72 hours without consulting a doctor. Chronic use of this medication may damage the blood vessels (veins and arteries) in the eyes. Consult a doctor if your symptoms do not improve or appear to worsen.

AK-Nefrin (phenylephrine ophthalmic) side effects

If you experience any of the following serious side effects, stop using phenylephrine ophthalmic and seek emergency medical attention or contact your doctor immediately:

• 
  

  an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, face, or tongue; or hives);

  
  


• 
  

  an irregular or fast heart rate; or

  
  


• 
  

  high blood pressure (severe headache, blurred vision, or flushed skin).

  
  

Other, less serious side effects may be more likely to occur. Continue to use phenylephrine ophthalmic and talk to your doctor if you experience

• 
  

  burning, stinging, pain, or increased redness of the eye;

  
  


• 
  

  tearing or blurred vision;

  
  


• 
  

  headache;

  
  


• 
  

  tremor;

  
  


• 
  

  nausea;

  
  


• 
  

  sweating;

  
  


• 
  

  nervousness;

  
  


• 
  

  dizziness; or

  
  


• 
  

  drowsiness.

  
  

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect AK-Nefrin (phenylephrine ophthalmic)?

Do not use other eye medications during treatment with phenylephrine ophthalmic except under the direction of your doctor.

Although drug interactions between phenylephrine ophthalmic and drugs taken by mouth are not expected, they can occur. Before using this medication, tell your doctor if you are taking any of the following medicines:

• 
  

  a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil); or

  
  


• 
  

  a beta-blocker such as propranolol (Inderal), metoprolol (Lopressor, Toprol XL), or labetalol (Normodyne, Trandate).

  
  

You may not be able to use phenylephrine ophthalmic, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with phenylephrine ophthalmic. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

More AK-Nefrin resources

• AK-Nefrin Use in Pregnancy & Breastfeeding
• AK-Nefrin Drug Interactions
• AK-Nefrin Support Group
• 0 Reviews for AK-Nefrin - Add your own review/rating

• AK-Dilate Ophthalmic Advanced Consumer (Micromedex) - Includes Dosage Information


• AK-Dilate Drops MedFacts Consumer Leaflet (Wolters Kluwer)


• Ak-Dilate Ophthalmic Advanced Consumer (Micromedex) - Includes Dosage Information


• Altafrin Drops MedFacts Consumer Leaflet (Wolters Kluwer)

Compare AK-Nefrin with other medications

• Eye Dryness/Redness
• Eye Redness/Itching
• Pupillary Dilation

Where can I get more information?

• Your pharmacist has additional information about phenylephrine ophthalmic written for health professionals that you may read.