Dexbrompheniramine/Pseudoephedrine Solution

Pronunciation: DEX-brome-fen-IR-a-meen/SOO-doe-e-FED-rin
Generic Name: Dexbrompheniramine/Pseudoephedrine
Brand Name: Conex

Dexbrompheniramine/Pseudoephedrine Solution is used for:

Relieving symptoms of sinus congestion, pressure, runny nose, and sneezing due to colds, upper respiratory infections, and allergies. It may also be used for other conditions as determined by your doctor.

Dexbrompheniramine/Pseudoephedrine Solution is an antihistamine and decongestant combination. The antihistamine works by blocking the action of histamine, which helps reduce symptoms such as watery eyes and sneezing. The decongestant promotes sinus and nasal drainage, which relieves congestion and pressure.

Do NOT use Dexbrompheniramine/Pseudoephedrine Solution if:

• you are allergic to any ingredient in Dexbrompheniramine/Pseudoephedrine Solution


• you have severe high blood pressure, severe heart blood vessel disease, rapid heartbeat, or severe heart problems


• you are taking sodium oxybate (GHB) or you have taken furazolidone or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days

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

Before using Dexbrompheniramine/Pseudoephedrine Solution:

Some medical conditions may interact with Dexbrompheniramine/Pseudoephedrine Solution. 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 fast, slow, or irregular heartbeat


• if you have a history of asthma; lung problems (eg, emphysema); sleep apnea; adrenal gland problems (eg, adrenal gland tumor); heart problems; high blood pressure; diabetes; blood vessel problems; stroke; glaucoma or increased pressure in the eye; a blockage of your bladder, stomach, or intestines; ulcers; trouble sleeping; trouble urinating; an enlarged prostate or other prostate problems; seizures; thyroid problems; or phenylketonuria

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

• Digoxin or droxidopa because the risk of irregular heartbeat or heart attack may be increased


• Beta-blockers (eg, propranolol), catechol-O-methyltransferase (COMT) inhibitors (eg, tolcapone), furazolidone, indomethacin, MAOIs (eg, phenelzine), sodium oxybate (GHB), or tricyclic antidepressants (eg, amitriptyline) because they may increase the risk of Dexbrompheniramine/Pseudoephedrine Solution's side effects


• Bromocriptine or hydantoins (eg, phenytoin) because the risk of their side effects may be increased by Dexbrompheniramine/Pseudoephedrine Solution


• Guanadrel, guanethidine, mecamylamine, methyldopa, or reserpine because their effectiveness may be decreased by Dexbrompheniramine/Pseudoephedrine Solution

This may not be a complete list of all interactions that may occur. Ask your health care provider if Dexbrompheniramine/Pseudoephedrine Solution 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 Dexbrompheniramine/Pseudoephedrine Solution:

Use Dexbrompheniramine/Pseudoephedrine Solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Dexbrompheniramine/Pseudoephedrine Solution by mouth with or without food.


• Use a measuring device marked for medicine dosing.


• If you miss a dose of Dexbrompheniramine/Pseudoephedrine Solution, take it as soon as you remember. Continue to take it as directed by your doctor or on the package label.

Ask your health care provider any questions you may have about how to use Dexbrompheniramine/Pseudoephedrine Solution.

Important safety information:

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


• Check with your doctor before you drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Dexbrompheniramine/Pseudoephedrine Solution; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.


• Do not take diet or appetite control medicines while you are taking Dexbrompheniramine/Pseudoephedrine Solution without checking with your doctor.


• Dexbrompheniramine/Pseudoephedrine Solution has dexbrompheniramine and pseudoephedrine in it. Before you start any new medicine, check the label to see if it has an antihistamine or decongestant in it too. If it does or if you are not sure, check with your doctor or pharmacist.


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


• If your symptoms do not get better within 5 to 7 days, if they get worse, or if they occur with a fever, check with your doctor.


• Dexbrompheniramine/Pseudoephedrine Solution may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Dexbrompheniramine/Pseudoephedrine Solution. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.


• Dexbrompheniramine/Pseudoephedrine Solution may interfere with skin allergy tests. If you are scheduled for a skin test, talk to your doctor. You may need to stop taking Dexbrompheniramine/Pseudoephedrine Solution for a few days before the tests.


• Some of these products contain phenylalanine. If you must have a diet that is low in phenylalanine, ask your pharmacist if it is in your product.


• Tell your doctor or dentist that you take Dexbrompheniramine/Pseudoephedrine Solution before you receive any medical or dental care, emergency care, or surgery.


• Use Dexbrompheniramine/Pseudoephedrine Solution with caution in the ELDERLY; they may be more sensitive to its effects, especially confusion, dizziness, drowsiness, dry mouth, excitability, low blood pressure, and trouble urinating.


• Caution is advised when using Dexbrompheniramine/Pseudoephedrine Solution in CHILDREN; they may be more sensitive to its effects, especially excitability.


• Dexbrompheniramine/Pseudoephedrine Solution should not be used in CHILDREN younger than 6 years old without first checking with the child's doctor; safety and effectiveness in these children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Dexbrompheniramine/Pseudoephedrine Solution while you are pregnant. Do not take Dexbrompheniramine/Pseudoephedrine Solution in the third trimester of pregnancy. Dexbrompheniramine/Pseudoephedrine Solution is found in breast milk. Do not breast-feed while taking Dexbrompheniramine/Pseudoephedrine Solution.

Possible side effects of Dexbrompheniramine/Pseudoephedrine Solution:

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

Constipation; diarrhea; dizziness; drowsiness; dry mouth; excitability; headache; loss of appetite; nausea; nervousness or anxiety; trouble sleeping; upset stomach; vomiting; weakness.

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); blurred vision or other vision changes; difficulty urinating or inability to urinate; fast or irregular heartbeat; hallucinations; mood or mental changes; persistent trouble sleeping; restlessness; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; tremor.

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: Dexbrompheniramine/Pseudoephedrine 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 blurred vision; confusion; hallucinations; ringing in the ears; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; unusually fast, slow, or irregular breathing; unusually fast, slow, or irregular heartbeat.

Proper storage of Dexbrompheniramine/Pseudoephedrine Solution:

Store Dexbrompheniramine/Pseudoephedrine Solution at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Dexbrompheniramine/Pseudoephedrine Solution out of the reach of children and away from pets.

General information:

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


• Dexbrompheniramine/Pseudoephedrine Solution 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 Dexbrompheniramine/Pseudoephedrine Solution. 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 Dexbrompheniramine/Pseudoephedrine resources

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

Compare Dexbrompheniramine/Pseudoephedrine with other medications

• Cold Symptoms
• Hay Fever
• Nasal Congestion
• Sinus Symptoms

Doxycycline

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Doxycycline capsules and other antibacterial drugs, Doxycycline capsules should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.

Doxycycline Description

Doxycycline is a broad-spectrum antibiotic synthetically derived from oxytetracycline. Doxycycline 150 mg, 100 mg and 50 mg capsules contain Doxycycline monohydrate equivalent to 150 mg, 100 mg or 50 mg of Doxycycline for oral administration. Inactive ingredients include colloidal silicon dioxide, gelatin, magnesium stearate, microcrystalline cellulose, sodium starch glycolate and titanium dioxide. In addition, the 50 mg strength contains D&C Yellow #6 and D&C Yellow #10. The 100 mg strength also contains black iron oxide, red iron oxide and yellow iron oxide. The 150 mg strength includes FD&C Red #40 and FD&C Yellow #6. Its molecular weight is 462.46. The chemical designation of the light-yellow crystalline powder is alpha-6-deoxy-5-oxytetracycline.

Structural formula:

C22H24N2O8•H20

Doxycycline has a high degree of lipid solubility and a low affinity for calcium binding. It is highly stable in normal human serum. Doxycycline will not degrade into an epianhydro form.

Doxycycline - Clinical Pharmacology

Tetracyclines are readily absorbed and are bound to plasma proteins in varying degrees. They are concentrated by the liver in the bile and excreted in the urine and feces at high concentrations in a biologically active form. Doxycycline is virtually completely absorbed after oral administration.

Following a 200 mg dose of Doxycycline monohydrate, 24 normal adult volunteers averaged the following serum concentration values:

Time (hr):	0.5	1.0	1.5	2.0	3.0	4.0	8.0	12.0	24.0	48.0	72.0
Conc. (mcg/mL):	1.02	2.26	2.67	3.01	3.16	3.03	2.03	1.62	0.95	0.37	0.15

Average Observed Values
Maximum Concentration	3.61 mcg/mL (± 0.9 sd)
Time of Maximum Concentration	2.60 hr (± 1.10 sd)
Elimination Rate Constant	0.049 per hr (± 0.030 sd)
Half-Life	16.33 hr (± 4.53 sd)

Excretion of Doxycycline by the kidney is about 40%/72 hours in individuals with normal function (creatinine clearance about 75 mL/min). This percentage excretion may fall as low as 1 to 5%/72 hours in individuals with severe renal insufficiency (creatinine clearance below 10 mL/ min). Studies have shown no significant difference in serum half-life of Doxycycline (range 18 to 22 hours) in individuals with normal and severely impaired renal function. Hemodialysis does not alter serum half-life.

Microbiology: The tetracyclines are primarily bacteriostatic and are thought to exert their antimicrobial effect by the inhibition of protein synthesis. The tetracyclines, including Doxycycline, have a similar antimicrobial spectrum of activity against a wide range of gram-positive and gram-negative microorganisms. Cross-resistance of these microorganisms to tetracyclines is common.

Doxycycline has been shown to be active against most strains of the following microorganisms, both in vitro and in clinical infections as described in the INDICATIONS AND USAGE section.

Aerobic Gram-Positive Microorganisms:

Because many strains of the following groups of gram-positive microorganisms have been shown to be resistant to tetracyclines, culture and susceptibility testing are recommended:

Bacillus anthracis

Listeria monocytogenes

Staphylococcus aureus*

*Doxycycline is not the drug of choice in the treatment of any type of staphylococcal infection.

Up to 44 percent of strains of Streptococcus pyogenes and 74 percent of Streptococcus faecalis have been found to be resistant to tetracycline drugs. Therefore, tetracyclines should not be used to treat streptococcal infections unless the microorganism has been demonstrated to be susceptible.

Streptococcus pneumoniae

Aerobic Gram-Negative Microorganisms:

Bartonella bacilliformis	Brucella species
Calymmatobacterium granulomatis	Campylobacter fetus
Francisella tularensis	Haemophilus ducreyi
Haemophilus influenzae	Neisseria gonorrhoeae
Vibrio cholerae	Yersinia pestis

Because many strains of the following groups of gram-negative microorganisms have been shown to be resistant to tetracyclines, culture and susceptibility testing are recommended:

Acinetobacter species	Enterobacter aerogenes
Escherichia coli	Klebsiella species
Shigella species
Anaerobic Microorganisms:
Actinomyces israelii	Clostridium species
Fusobacterium fusiforme
Other Microorganisms:
Borrelia recurrentis	Chlamydia psittaci
Chlamydia trachomatis	Mycoplasma pneumoniae
Rickettsiae
Treponema pallidum	Treponema pertenue

Susceptibility Tests:

Dilution techniques:

Quantitative methods are used to determine antimicrobial minimum inhibitory concentrations (MIC’s). These MIC’s provide estimates of the susceptibility of bacteria to antimicrobial compounds. The MIC’s should be determined using a standardized procedure. Standardized procedures are based on a dilution method 1,3 (broth or agar) or equivalent with standardized inoculum concentrations and standardized concentrations of tetracycline powder. The MIC values should be interpreted according to the following criteria for indicated aerobic microorganisms other than Haemophilus species, Neisseria gonorrhoeae, and Streptococcus pneumoniae:

a. Interpretative criteria applicable only to tests performed by broth microdilution method using Haemophilus Test Medium (HTM). 1,3 b. Interpretative criteria applicable only to tests performed by agar dilution method using GC agar base with 1% defined growth supplement. 1,3 c. Interpretative criteria applicable only to tests performed by broth microdilution method using cation-adjusted Mueller-Hinton broth with 2 to 5% lysed horse blood. 1,3
	MIC (mcg/mL)	Interpretation
	≤4	Susceptible (S)
	8	Intermediate (I)
	≥16	Resistant (R)
When testing Haemophilus spp.a
	MIC (mcg/mL)	Interpretation
	≤2	Susceptible (S)
	4	Intermediate (I)
	≥8	Resistant (R)
When testing Neisseria gonorrhoeae b
	MIC (mcg/mL)	Interpretation
	≤0.25	Susceptible (S)
	0.5-1	Intermediate (I)
	≥2	Resistant (R)
When testing Streptococcus pneumoniae c
	MIC (mcg/mL)	Interpretation
	≤2	Susceptible (S)
	4	Intermediate (I)
	≥8	Resistant (R)

A report of “Susceptible” indicates that the pathogen is likely to be inhibited if the antimicrobial compound in the blood reaches the concentrations usually achievable. A report of “Intermediate” indicates that the result should be considered equivocal, and, if the microorganism is not fully susceptible to alternative, clinically feasible drugs, the test should be repeated. This category implies possible clinical applicability in body sites where the drug is physiologically concentrated or in situations where high dosage of drug can be used. This category also provides a buffer zone which prevents small uncontrolled technical factors from causing major discrepancies in interpretation. A report of “Resistant” indicates that the pathogen is not likely to be inhibited if the antimicrobial compound in the blood reaches the concentrations usually achievable; other therapy should be selected.

Standardized susceptibility test procedures require the use of laboratory control microorganisms to control the technical aspects of the laboratory procedures. Standard tetracycline powder should provide the following MIC values:

a. Range applicable only to tests performed by broth microdilution method using Haemophilus Test Medium (HTM). 1,3 b. Range applicable only to tests performed by agar dilution method using CG agar base with 1% defined growth supplement. 1,3 c. Range applicable only to tests performed by broth microdilution method using cation-adjusted Mueller-Hinton broth with 2 to 5% lysed horse blood. 1,3
Microorganism		MIC (mcg/mL)
Enterococcus faecalis	ATCC 29212	8-32
Escherichia coli	ATCC 25922	0.5-2
Haemophilus influenzaea	ATCC 49247	4-32
Neisseria gonorrhoeaeb	ATCC 49226	0.25-1
Pseudomonas aeruginosa	ATCC 27853	8-32
Staphylococcus aureus	ATCC 29213	0.12-1
Streptococcus pneumoniaec	ATCC 49619	0.12-0.5

Quantitative methods that require measurement of zone diameters also provide reproducible estimates of the susceptibility of bacteria to antimicrobial compounds. One such standardized procedure 2,3 requires the use of standardized inoculum concentrations. This procedure uses paper disks impregnated with 30 mcg tetracycline or 30 mcg Doxycycline to test the susceptibility of microorganisms to Doxycycline.

Reports from the laboratory providing results of the standard single-disk susceptibility test with 30-µg tetracycline-class disk or the 30 mcg Doxycycline disk should be interpreted according to the following criteria for indicated aerobic microorganisms other than Haemophilus species, Neisseria gonorrhoeae, and Streptococcus pneumoniae:

Zone Diameter (mm)			Interpretation
tetracycline	Doxycycline
≥19	≥16		Susceptible (S)
15-18	13-15		Intermediate (I)
≤14	≤12		Resistant (R)
When testing Haemophilus spp.a
Zone Diameter (mm)			Interpretation
tetracycline
≥29			Susceptible (S)
26-28			Intermediate (I)
≤25			Resistant (R)
When testing Neisseria gonorrhoeaeb
Zone Diameter (mm)			Interpretation
tetracycline
≥38			Susceptible (S)
31-37			Intermediate (I)
≤30			Resistant R)

Zone diameters ≤ 19 mm may indicate a plasmid-mediated tetracycline-resistant Neisseria gonorrhoeae (TRNG) isolate. These TRNG strains should be confirmed by the dilution test (MIC ≥16 µg/mL).

a. Interpretative criteria applicable only to tests performed by disk diffusion method using a 30-µg tetracycline-class disk and using Haemophilus Test Medium (HTM). 2,3 b. Interpretative criteria applicable only to tests performed by disk diffusion method using a 30-µg tetracycline-class disk and using GC agar base with 1% defined growth supplement. 2,3 c. Interpretative criteria applicable only to tests performed by disk diffusion method using a 30-µg tetracycline-class disk and using Mueller-Hinton agar with 5% defibrinated sheep blood and incubated in 5% CO 2.2,3
When testing Streptococcus pneumoniaec
Zone Diameter (mm)	Interpretation
tetracycline
≥23	Susceptible (S)
19-22	Intermediate (I)
≤18	Resistant (R)

Interpretation should be as stated above for results using dilution techniques. Interpretation involves correlation of the diameter obtained in the disk test with the MIC for tetracycline or Doxycycline, respectively.

As with standardized dilution techniques, diffusion methods require the use of laboratory control microorganisms that are used to control the technical aspects of the laboratory procedures. For the diffusion technique, the 30 mcg tetracycline-class disk or the 30 mcg Doxycycline disk should provide the following zone diameters in these laboratory test quality control strains:

a. Range applicable only to tests performed by disk diffusion method using a 30 mcg tetracycline-class disk and using Haemophilus Test Medium (HTM). 2,3 b. Range applicable only to tests performed by disk diffusion method using a 30 mcg tetracycline-class disk and using GC agar base with 1% defined growth supplement. 2,3 c. Range applicable only to tests performed by disk diffusion method using a 30 mcg tetracycline-class disk and using Mueller-Hinton agar with 5% defibrinated sheep blood and incubated in 5% CO 2.2,3
Microorganisms		Zone Diameter (mm)
		tetracycline	Doxycycline
Escherichia coli	ATCC 25922	18-25	18-24
Haemophilus influenzaea	ATCC 49247	14-22	--
Neisseria gonorrhoeaeb	ATCC 49226	30-42	--
Staphylococcus aureus	ATCC 25923	24-30	23-29
Streptococcus pneumoniaec	ATCC 49619	27-31	--

Anaerobic techniques:

For anaerobic bacteria, the susceptibility to tetracycline as MIC’s can be determined by standardized test methods. 4 The MIC values obtained should be interpreted according to the following criteria:

MIC (mcg/mL)	Interpretation
≤4	Susceptible (S)
8	Intermediate (I)
≥16	Resistant (R)

Interpretation is identical to that stated above for results using dilution techniques.

As with other susceptibility techniques, the use of laboratory control microorganisms is required to control the technical aspects of the laboratory standardized procedures. Standardized tetracycline powder should provide the following MIC values:

a. Range applicable only to tests performed by the reference agar dilution method.
Microorganism		MIC (mcg/mL)
Bacteroides fragilisa	ATCC 25285	0.12-0.5
Bacteroides thetaiotaomicrona	ATCC 29741	8-32

Indications and Usage for Doxycycline

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Doxycycline capsules and other antibacterial drugs, Doxycycline capsules should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to empiric selection of therapy.

Doxycycline is indicated for the treatment of the following infections:

Rocky mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers caused by Rickettsiae.

Respiratory tract infections caused by Mycoplasma pneumoniae.

Lymphogranuloma venereum caused by Chlamydia trachomatis.

Psittacosis (omithosis) caused by Chlamydia psittaci.

Trachoma caused by Chlamydia trachomatis, although the infectious agent is not always eliminated as judged by immunofluorescence.

Inclusion conjunctivitis caused by Chlamydia trachomatis.

Uncomplicated urethral, endocervical or rectal infections in adults caused by Chlamydia trachomatis.

Nongonococcal urethritis caused by Ureaplasma urealyticum.

Relapsing fever due to Borrelia recurrentis.

Doxycycline is also indicated for the treatment of infections caused by the following gram-negative microorganisms:

Chancroid caused by Haemophilus ducreyi.

Plague due to Yersinia pestis (formerly Pasteurella pestis).

Tularemia due to Francisella tularensis (formerly Pasteurella tularensis).

Cholera caused by Vibrio cholerae (formerly Vibrio comma).

Campylobacter fetus infections caused by Campylobacter fetus (formerly Vibrio fetus).

Brucellosis due to Brucella species (in conjunction with streptomycin).

Bartonellosis due to Bartonella bacilliformis.

Granuloma inguinale caused by Calymmatobacterium granulomatis.

Because many strains of the following groups of microorganisms have been shown to be resistant to Doxycycline, culture and susceptibility testing are recommended.

Doxycycline is indicated for treatment of infections caused by the following gram-negative microorganisms, when bacteriologic testing indicates appropriate susceptibility to the drug:

Escherichia coli

Enterobacter aerogenes (formerly Aerobacter aerogenes )

Shigella species

Acinetobacter species (formerly Mima species and Herellea species)

Respiratory tract infections caused by Haemophilus influenzae.

Respiratory tract and urinary infections caused by Klebsiella species.

Doxycycline is indicated for treatment of infections caused by the following gram-positive microorganisms, when bacteriologic testing indicates appropriate susceptibility to the drug:

Upper respiratory infections caused by Streptococcus pneumoniae (formerly Diplococcus pneumoniae).

Skin and skin structure infections caused by Staphylococcus aureus.

Anthrax due to Bacillus anthracis, including inhalational anthrax (post-exposure): to reduce the incidence or progression of disease following exposure to aerosolized Bacillus anthracis.

Doxycycline is not the drug of choice in the treatment of any type of staphylococcal infections.

When penicillin is contraindicated, Doxycycline is an alternative drug in the treatment of the following infections:

Uncomplicated gonorrhea caused by Neisseria gonorrhoeae.

Syphilis caused by Treponema pallidum.

Yaws caused by Treponema pertenue.

Listeriosis due to Listeria monocytogenes.

Vincent’s infection caused by Fusobacterium fusiforme.

Actinomycosis caused by Actinomyces israelii.

Infections caused by Clostridium species.

In acute intestinal amebiasis, Doxycycline may be a useful adjunct to amebicides.

In severe acne, Doxycycline may be useful adjunctive therapy.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Doxycycline capsules and other antibacterial drugs, Doxycycline capsules should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to empiric selection of therapy.

Doxycycline is indicated for the treatment of the following infections:

Rocky mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers caused by Rickettsiae.

Respiratory tract infections caused by Mycoplasma pneumoniae.

Lymphogranuloma venereum caused by Chlamydia trachomatis.

Psittacosis (omithosis) caused by Chlamydia psittaci.

Trachoma caused by Chlamydia trachomatis, although the infectious agent is not always eliminated as judged by immunofluorescence.

Inclusion conjunctivitis caused by Chlamydia trachomatis.

Uncomplicated urethral, endocervical or rectal infections in adults caused by Chlamydia trachomatis.

Nongonococcal urethritis caused by Ureaplasma urealyticum.

Relapsing fever due to Borrelia recurrentis.

Doxycycline is also indicated for the treatment of infections caused by the following gram-negative microorganisms:

Chancroid caused by Haemophilus ducreyi.

Plague due to Yersinia pestis (formerly Pasteurella pestis).

Tularemia due to Francisella tularensis (formerly Pasteurella tularensis).

Cholera caused by Vibrio cholerae (formerly Vibrio comma).

Campylobacter fetus infections caused by Campylobacter fetus (formerly Vibrio fetus).

Brucellosis due to Brucella species (in conjunction with streptomycin).

Bartonellosis due to Bartonella bacilliformis.

Granuloma inguinale caused by Calymmatobacterium granulomatis.

Because many strains of the following groups of microorganisms have been shown to be resistant to Doxycycline, culture and susceptibility testing are recommended.

Doxycycline is indicated for treatment of infections caused by the following gram-negative microorganisms, when bacteriologic testing indicates appropriate susceptibility to the drug:

Escherichia coli

Enterobacter aerogenes (formerly Aerobacter aerogenes )

Shigella species

Acinetobacter species (formerly Mima species and Herellea species)

Respiratory tract infections caused by Haemophilus influenzae.

Respiratory tract and urinary infections caused by Klebsiella species.

Doxycycline is indicated for treatment of infections caused by the following gram-positive microorganisms, when bacteriologic testing indicates appropriate susceptibility to the drug:

Upper respiratory infections caused by Streptococcus pneumoniae (formerly Diplococcus pneumoniae).

Skin and skin structure infections caused by Staphylococcus aureus.

Anthrax due to Bacillus anthracis, including inhalational anthrax (post-exposure): to reduce the incidence or progression of disease following exposure to aerosolized Bacillus anthracis.

Doxycycline is not the drug of choice in the treatment of any type of staphylococcal infections.

When penicillin is contraindicated, Doxycycline is an alternative drug in the treatment of the following infections:

Uncomplicated gonorrhea caused by Neisseria gonorrhoeae.

Syphilis caused by Treponema pallidum.

Yaws caused by Treponema pertenue.

Listeriosis due to Listeria monocytogenes.

Vincent’s infection caused by Fusobacterium fusiforme.

Actinomycosis caused by Actinomyces israelii.

Infections caused by Clostridium species.

In acute intestinal amebiasis, Doxycycline may be a useful adjunct to amebicides.

In severe acne, Doxycycline may be useful adjunctive therapy.

Contraindications

This drug is contraindicated in persons who have shown hypersensitivity to any of the tetracyclines.

Warnings

THE USE OF DRUGS OF THE TETRACYCLINE CLASS DURING TOOTH DEVELOPMENT (LAST HALF OF PREGNANCY, INFANCY, AND CHILDHOOD TO THE AGE OF 8 YEARS) MAY CAUSE PERMANENT DISCOLORATION OF THE TEETH (YELLOW-GRAY-BROWN). This adverse reaction is more common during long-term use of the drugs but has been observed following repeated short-term courses. Enamel hypoplasia has also been reported. TETRACYCLINE DRUGS, THEREFORE, SHOULD NOT BE USED IN THIS AGE GROUP, EXCEPT FOR ANTHRAX, INCLUDING INHALATIONAL ANTHRAX (POST-EXPOSURE), UNLESS OTHER DRUGS ARE NOT LIKELY TO BE EFFECTIVE OR ARE CONTRAINDICATED.

Clostridiumdifficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including Doxycycline monohydrate capsules, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.

C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.

If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.

All tetracyclines form a stable calcium complex in any bone-forming tissue. A decrease in the fibula growth rate has been observed in prematures given oral tetracycline in doses of 25 mg/kg every six hours. This reaction was shown to be reversible when the drug was discontinued.

Results of animal studies indicate that tetracyclines cross the placenta, are found in fetal tissues, and can have toxic effects on the developing fetus (often related to retardation of skeletal development). Evidence of embryo toxicity has been noted in animals treated early in pregnancy. If any tetracycline is used during pregnancy or if the patient becomes pregnant while taking these drugs, the patient should be apprised of the potential hazard to the fetus.

The antianabolic action of the tetracyclines may cause an increase in BUN. Studies to date indicate that this does not occur with the use of Doxycycline in patients with impaired renal function.

Photosensitivity manifested by an exaggerated sunburn reaction has been observed in some individuals taking tetracyclines. Patients apt to be exposed to direct sunlight or ultraviolet light should be advised that this reaction can occur with tetracycline drugs, and treatment should be discontinued at the first evidence of skin erythema.

Precautions

General: As with other antibiotic preparations, use of this drug may result in overgrowth of non-susceptible organisms, including fungi. If superinfection occurs, the antibiotic should be discontinued and appropriate therapy instituted.

Bulging fontanels in infants and benign intracranial hypertension in adults have been reported in individuals receiving tetracyclines. These conditions disappeared when the drug was discontinued.

Incision and drainage or other surgical procedures should be performed in conjunction with antibiotic therapy when indicated.

Prescribing Doxycycline monohydrate capsules in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.

Information for Patients

dobutamine

Generic Name: dobutamine (doe BUE ta meen)

Brand Names: Dobutrex

What is dobutamine?

Dobutamine is a direct-acting inotropic agent.

Dobutamine is used for short term treatment of patients with cardiac decompensation.

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

What is the most important information I should know about dobutamine?

Dobutamine should be administered by a healthcare provider. It is typically administered in a clinical setting where a healthcare provider can monitor vital signs (blood pressure, heart rates) and where an emergency situation can be handled properly.

Other drugs can interact with dobutamine resulting in dangerous side effects and/or decreased effectiveness. Tell your doctor about any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products, you are taking.

Dobutamine use has been associated with increased blood pressure, allergic reactions and other serious side effects. Talk to your doctor if you have questions regarding the potential side effects associated with dobutamine use.

What should I discuss with my healthcare provider before using dobutamine?

Tell your doctor about all prescription or over-the-counter medicines including vitamins, minerals, and herbal products that your are taking.

Dobutamine is in the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Do not take dobutamine without first talking to your doctor if you are pregnant or could become pregnant during treatment. Do not use dobutamine without first talking to your doctor if you are breast-feeding a baby.

How should I use dobutamine?

Dobutamine should be administered by a healthcare provider. It is typically administered in a clinical setting where a healthcare provider can monitor vital signs (blood pressure, heart rates) and where an emergency situation can be handled properly.

Your healthcare provider will store dobutamine as directed by the manufacturer.

What happens if I miss a dose?

Since the medication will be administered by a healthcare provider, missing a dose should not occur.

What happens if I overdose?

Dobutamine is typically administered by a healthcare provider in a clinical setting where an emergency situation or overdose can be handled properly.

What should I avoid while using dobutamine?

Other drugs can interact with dobutamine resulting in dangerous side effects and/or decreased effectiveness. Tell your doctor about any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products, you are taking.

Dobutamine side effects

Dobutamine use has been associated with increased blood pressure, allergic reactions and other serious side effects.

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.

Dobutamine Dosing Information

Usual Adult Dose for Congestive Heart Failure:

The rate of infusion needed to increase cardiac output usually ranges from 2.5 to 15 mcg/kg/min. The initial dosage may be titrated upward by 2.5 mcg per kg per minute as tolerated to maintain systemic blood pressure and urine output. Administration rates greater than 40 mcg per kg per min may be necessary in serious situations.

Usual Adult Dose for Shock:

The rate of infusion needed to increase cardiac output usually ranges from 2.5 to 15 mcg/kg/min. The initial dosage may be titrated upward by 2.5 mcg per kg per minute as tolerated to maintain systemic blood pressure and urine output. Administration rates greater than 40 mcg per kg per min may be necessary in serious situations.

What other drugs will affect dobutamine?

Other drugs can interact with dobutamine resulting in dangerous side effects and/or decreased effectiveness. Tell your doctor about any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products, you are taking.

More dobutamine resources

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

• Dobutamine Professional Patient Advice (Wolters Kluwer)


• Dobutamine MedFacts Consumer Leaflet (Wolters Kluwer)


• Dobutamine Prescribing Information (FDA)


• Dobutamine Hydrochloride Monograph (AHFS DI)

Compare dobutamine with other medications

• Heart Failure
• Shock

Where can I get more information?

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

See also: dobutamine side effects (in more detail)

Doans PM

Generic Name: diphenhydramine and magnesium salicylate (DYE fen HYE dra meen and mag NEE ze um sa LIS a late)

Brand Names: Doans PM

What is Doans PM (diphenhydramine and magnesium salicylate)?

Diphenhydramine is an antihistamine that reduces the natural chemical histamine in the body. It is often used as a sleep aid due to its common side effect of drowsiness.

Magnesium salicylate is in a class of drugs called salicylates (sa-LIS-il-ates). It works by reducing substances in the body that cause pain and inflammation.

The combination of diphenhydramine and magnesium salicylate is used to treat back pain that keeps you awake during your normal sleeping hours.

Diphenhydramine and magnesium salicylate may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Doans PM (diphenhydramine and magnesium salicylate)?

This medication should not be given to a child or teenager who has a fever, especially if the child also has flu symptoms or chicken pox. Magnesium salicylate can cause a serious and sometimes fatal condition called Reye's syndrome in children. You should not use this medication if you are allergic to diphenhydramine or magnesium salicylate.

Before taking this medication, tell your doctor if you have a breathing disorder, heart disease, high blood pressure, kidney or liver disease, diabetes, a thyroid disorder, glaucoma, stomach ulcer, hemophilia or other bleeding disorder, anemia, gout, enlarged prostate, urination problems, nasal polyps, or an allergy to an NSAID (non-steroidal anti-inflammatory drug) such as Advil, Motrin, Aleve, Indocin, Relafen, Feldene, and others.

Drinking alcohol may increase your risk of stomach bleeding while taking magnesium salicylate. 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. Do not use an over-the-counter cough, cold, allergy, or sleep medication without first asking your doctor or pharmacist. Read the label of any other medicine you are using to see if it contains diphenhydramine or another antihistamine. There are many other medicines that can interact with diphenhydramine and magnesium salicylate. 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. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

What should I discuss with my healthcare provider before taking Doans PM (diphenhydramine and magnesium salicylate)?

You should not use this medication if you are allergic to diphenhydramine or magnesium salicylate.

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

• 
  

  asthma, emphysema, or chronic bronchitis;

  
  


• 
  

  heart disease or high blood pressure;

  
  


• 
  

  kidney or liver disease;

  
  


• 
  

  diabetes;

  
  


• 
  

  a thyroid disorder;

  
  


• 
  

  glaucoma;

  
  


• 
  

  stomach ulcer or GERD (gastroesophageal reflux disease);

  
  


• 
  

  a bleeding disorder such as hemophilia;

  
  


• 
  

  anemia (lack of red blood cells);

  
  


• 
  

  gout;

  
  


• 
  

  an enlarged prostate or problems with urination;

  
  


• 
  

  nasal polyps caused by asthma or aspirin allergy; or

  
  


• 
  

  an allergy to an NSAID (non-steroidal anti-inflammatory drug) such as Advil, Motrin, Aleve, Orudis, Indocin, Lodine, Voltaren, Toradol, Mobic, Relafen, Feldene, and others.

  
  

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

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. Older adults may be more likely to have side effects from this medication. This medication should not be given to a child or teenager who has a fever, especially if the child also has flu symptoms or chicken pox. Magnesium salicylate can cause a serious and sometimes fatal condition called Reye's syndrome in children.

How should I take Doans PM (diphenhydramine and magnesium salicylate)?

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.

Take diphenhydramine and magnesium salicylate 15 to 30 minutes before bedtime with a full glass of water. Avoid lying down for at least 15 minutes after taking the medicine.

You may take the medicine with food or milk if it upsets your stomach.

Talk with your doctor if your symptoms do not improve after 10 days of using this product, or 3 days if you also have a fever.

Diphenhydramine and magnesium salicylate can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are taking diphenhydramine and magnesium salicylate.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking diphenhydramine and magnesium salicylate. You may need to stop using the medicine for a short time. Store this medicine at room temperature, away from heat, light, and moisture.

What happens if I miss a dose?

Since this medication is usually taken only at bedtime as needed, you are not likely to be on a daily dosing schedule. If you miss a dose or forget to take your medicine, wait until you are ready for sleep to take the medication. 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.

Overdose symptoms may include stomach pain, diarrhea, blood in your urine, thirst, headache, buzzing in your ears, gasping for breath, confusion, hallucinations, blurred vision, or seizure (convulsions).

What should I avoid while taking Doans PM (diphenhydramine and magnesium salicylate)?

Avoid drinking alcohol while you are taking diphenhydramine and magnesium salicylate. Alcohol may increase your risk of stomach bleeding. 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.

Do not use an over-the-counter cough, cold, allergy, or sleep medication without first asking your doctor or pharmacist. Diphenhydramine is contained in many medicines available over the counter. If you take certain products together you may accidentally take too diphenhydramine. Read the label of any other medicine you are using to see if it contains diphenhydramine or another antihistamine.

Doans PM (diphenhydramine and magnesium salicylate) 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:

• 
  

  black, bloody, or tarry stools;

  
  


• 
  

  coughing up blood or vomit that looks like coffee grounds;

  
  


• 
  

  decreased hearing;

  
  


• 
  

  wheezing or trouble breathing;

  
  


• 
  

  seizure (convulsions);

  
  


• 
  

  urinating less than usual or not at all; 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:

• 
  

  dry mouth;

  
  


• 
  

  mild nausea, indigestion, heartburn;

  
  


• 
  

  ringing in your ears;

  
  


• 
  

  skin rash or itching.

  
  

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Doans PM (diphenhydramine and magnesium salicylate)?

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

Many drugs can interact with diphenhydramine and magnesium. Below is just a partial list. Tell your doctor if you are using:

• 
  

  methotrexate (Rheumatrex, Trexall);

  
  


• 
  

  antacids, or sodium bicarbonate (including baking soda);

  
  


• 
  

  a blood thinner such as warfarin (Coumadin);

  
  


• 
  

  gout medication such as probenecid (Benemid) or sulfinpyrazone (Anturane);

  
  


• 
  

  medication used to prevent blood clots, such as alteplase (Activase), clopidogrel (Plavix), dipyridamole (Persantine), urokinase (Abbokinase), and others.

  
  


• 
  

  pain medications such as acetaminophen (Tylenol), ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Cataflam, Voltaren), etodolac (Lodine), indomethacin (Indocin), and others;

  
  


• 
  

  seizure medication such as phenytoin (Dilantin) or valproic acid (Depakene);

  
  


• 
  

  insulin or diabetes medications you take by mouth; or

  
  


• 
  

  an antibiotic such as ciprofloxacin (Cipro), enoxacin (Penetrex), itraconazole (Sporanox), ketoconazole (Nizoral), norfloxacin (Noroxin), ofloxacin (Floxin), plicamycin (Mithracin), tetracycline (Ala-Tet, Sumycin), or vancomycin (Vancocin);

  
  

There are many other medicines that can interact with diphenhydramine and magnesium salicylate. 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. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

More Doans PM resources

• Doans PM Drug Interactions
• Doans PM Support Group
• 0 Reviews for Doans PM - Add your own review/rating

Compare Doans PM with other medications

• Insomnia
• Pain

Where can I get more information?

• Your pharmacist can provide more information about diphenhydramine and magnesium salicylate.

Dura-Tap/PD

Generic Name: chlorpheniramine and pseudoephedrine (klor fen EER a meen and soo doe e FED rin)

Brand Names: AccuHist Drops, Allerest Maximum Strength, Brexin L.A., Colfed-A, D-Amine-SR, Dayquil Allergy, Deconamine, Dicel, Dicel Chewables, Dura-Tap/PD, Durafed, Duratuss DA, Dynahist-ER Pediatric, Genaphed Plus, Histade, Histex, Kronofed-A, Kronofed-A-Jr, LoHist-D, Mintex, Neutrahist Drops, Re2+30, Rescon-Ed, Suclor, SudaHist, Sudal-12 Chewable, Sudal-12 Tannate, Sudogest Cold & Allergy, SudoGest Sinus & Allergy, Tavist-DA, Triaminic Cold and Allergy, Triaminic Softchew Cold and Allergy, Triaminic Softchews Allergy Runny Nose and Congestion

What is Dura-Tap/PD (chlorpheniramine and pseudoephedrine)?

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.

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

The combination of chlorpheniramine and pseudoephedrine is used to treat symptoms of the common cold or seasonal allergies, including sneezing, runny or stuffy nose, and itchy, watery eyes.

Chlorpheniramine and pseudoephedrine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Dura-Tap/PD (chlorpheniramine and pseudoephedrine)?

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

Do not use chlorpheniramine and pseudoephedrine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects. You should not use this medication if you are allergic to chlorpheniramine or pseudoephedrine, or if you have severe high blood pressure or coronary artery disease, narrow-angle glaucoma, a stomach ulcer, or if you are unable to urinate.

Do not use this medication during an asthma attack.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Drinking alcohol can increase certain side effects of chlorpheniramine and pseudoephedrine. Older adults may be more likely to have side effects from this medicine. Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children.

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.

What should I discuss with my healthcare provider before taking Dura-Tap/PD (chlorpheniramine and pseudoephedrine)?

Do not use chlorpheniramine and pseudoephedrine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects. You should not use this medication if you are allergic to chlorpheniramine or pseudoephedrine, or if you have:

• 
  

  severe or uncontrolled high blood pressure;

  
  


• 
  

  severe coronary artery disease;

  
  


• 
  

  narrow angle glaucoma;

  
  


• 
  

  a stomach ulcer;

  
  


• 
  

  if you are unable to urinate; or

  
  


• 
  

  if you are having an asthma attack.

  
  

Ask a doctor or pharmacist if it is safe for you to take this medication if you have:

• kidney disease;


• liver disease;


• 
  

  diabetes;

  
  


• 
  

  glaucoma;

  
  


• 
  

  circulation problems;

  
  


• 
  

  heart disease or high blood pressure;

  
  


• 
  

  overactive thyroid;

  
  


• 
  

  a seizure disorder such as epilepsy;

  
  


• 
  

  asthma, emphysema or chronic bronchitis; or

  
  


• 
  

  urination problems or an enlarged prostate.

  
  

FDA pregnancy category C. It is not known whether chlorpheniramine and pseudoephedrine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether chlorpheniramine and pseudoephedrine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medicine.

Artificially sweetened liquid cold medicine may contain phenylalanine. If you have phenylketonuria (PKU), check the medication label to see if the product contains phenylalanine.

How should I take Dura-Tap/PD (chlorpheniramine and pseudoephedrine)?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Cold medicine is usually taken only for a short time until your symptoms clear up.

Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time.

The chewable tablet must be chewed before swallowing.

Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with 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 unusual results with allergy skin tests. Tell any doctor who treats you that you are taking an antihistamine.

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

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Since cold medicine is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include some of the serious side effects listed in this medication guide.

What should I avoid while taking Dura-Tap/PD (chlorpheniramine and pseudoephedrine)?

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Drinking alcohol can increase certain side effects of chlorpheniramine and pseudoephedrine. Ask a doctor or pharmacist before using any other cold, allergy, or sleep medicine. Chlorpheniramine and pseudoephedrine are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains an antihistamine or decongestant.

Avoid taking this medication if you also take diet pills, caffeine pills, or other stimulants (such as ADHD medications). Taking a stimulant together with a decongestant can increase your risk of unpleasant side effects.

Dura-Tap/PD (chlorpheniramine and pseudoephedrine) 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 a serious side effect such as:

• 
  

  fast or pounding heartbeats;

  
  


• 
  

  confusion, hallucinations, unusual thoughts or behavior;

  
  


• 
  

  severe dizziness, anxiety, restless feeling, nervousness;

  
  


• 
  

  urinating less than usual or not at all;

  
  


• 
  

  easy bruising or bleeding, unusual weakness; or

  
  


• 
  

  seizure (black-out or convulsions).

  
  

Less serious side effects may include:

• 
  

  blurred vision;

  
  


• 
  

  dry nose or mouth;

  
  


• 
  

  nausea, stomach pain, constipation, loss of appetite;

  
  


• 
  

  dizziness, drowsiness;

  
  


• 
  

  problems with memory or concentration;

  
  


• 
  

  ringing in your ears; or

  
  


• 
  

  feeling restless or excited (especially in children).

  
  

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.

What other drugs will affect Dura-Tap/PD (chlorpheniramine and pseudoephedrine)?

Before using this medication, tell your doctor if you regularly use other medicines that make you sleepy (such as other 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.

Tell your doctor about all other medications you use, especially:

• 
  

  mecamylamine (Inversine);

  
  


• 
  

  methyldopa (Aldomet);

  
  


• 
  

  reserpine;

  
  


• 
  

  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;

  
  


• 
  

  a barbiturate such as butabarbital (Butisol), secobarbital (Seconal), pentobarbital (Nembutal), or phenobarbital (Solfoton); or

  
  


• 
  

  an antidepressant such as amitriptyline (Elavil, Vanatrip), doxepin (Sinequan), nortriptyline (Pamelor), and others.

  
  

This list is not complete and other drugs may interact with chlorpheniramine and pseudoephedrine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More Dura-Tap/PD resources

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

• AccuHist Drops Prescribing Information (FDA)


• Biohist LA Sustained-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)


• Deconamine MedFacts Consumer Leaflet (Wolters Kluwer)


• Deconamine SR Controlled-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)


• Duotan Suspension MedFacts Consumer Leaflet (Wolters Kluwer)


• QDALL 24-Hour Sustained-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Dura-Tap/PD with other medications

• Hay Fever
• Sinusitis

Where can I get more information?

• Your pharmacist can provide more information about chlorpheniramine and pseudoephedrine.

Duac CS Kit Gel

Pronunciation: KLIN-da-MYE-sin/BEN-zoe-il per-OX-ide
Generic Name: Clindamycin/Benzoyl Peroxide
Brand Name: Duac CS Kit

Duac CS Kit Gel is used for:

Treating severe acne.

Duac CS Kit Gel is an antibiotic and drying agent combination. It works by killing the bacteria associated with acne.

Do NOT use Duac CS Kit Gel if:

• you are allergic to any ingredient in Duac CS Kit Gel or to lincomycin


• you have a history of Crohn disease, severe stomach or bowel problems (eg, ulcerative colitis, regional enteritis, pseudomembranous colitis), or stomach or bowel inflammation caused by antibiotic use


• you are using products that contain erythromycin

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

Before using Duac CS Kit Gel:

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

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


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


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


• if you have stomach or bowel problems


• if you are using other medicines on the skin

Some MEDICINES MAY INTERACT with Duac CS Kit Gel. Because little, if any, of Duac CS Kit Gel is absorbed into the blood, the risk of it interacting with another medicine is low.

Ask your health care provider if Duac CS Kit Gel 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 Duac CS Kit Gel:

Use Duac CS Kit Gel as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Use Duac CS Kit Gel on a regular schedule to get the most benefit from it.


• Before applying Duac CS Kit Gel to the affected areas, gently wash the skin with the soap-free cleanser lotion. Rinse with warm water and pat dry. Apply a thin film of medicine to the affected skin and rub in as directed by your doctor.


• Wash your hands immediately after using Duac CS Kit Gel.


• Continue to use Duac CS Kit Gel even if your condition improves. Do not miss any doses.


• If you miss a dose of Duac CS Kit Gel, 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 Duac CS Kit Gel.

Important safety information:

• Duac CS Kit Gel is for external use only. Avoid contact with the eyes, nose, mouth, and other mucous membranes. If you get Duac CS Kit Gel in your eyes, rinse them right away with cool water.


• Duac CS Kit Gel may bleach hair or colored fabric. Avoid getting Duac CS Kit Gel in your hair or on your clothes.


• Duac CS Kit Gel may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Duac CS Kit Gel. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.


• If your symptoms do not get better or if they get worse, check with your doctor.


• Talk with your doctor before you use any other topical acne medicines or cleansers on your skin.


• Do not use Duac CS Kit Gel for other conditions at a later time.


• Tell your doctor or dentist that you take Duac CS Kit Gel before you receive any medical or dental care, emergency care, or surgery.


• Long-term or repeated use of Duac CS Kit Gel may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.


• Be sure to use Duac CS Kit Gel for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.


• If severe diarrhea, stomach pain or cramping, or bloody stools develop during treatment or within several months after treatment with Duac CS Kit Gel, check with your doctor or pharmacist right away. Do not treat it without first checking with your doctor.


• Duac CS Kit Gel should be used with extreme caution in CHILDREN younger than 12 years old; safety and effectiveness in these children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Duac CS Kit Gel while you are pregnant. It is not known if Duac CS Kit Gel is found in breast milk after topical use. Do not breast-feed while using Duac CS Kit Gel.

Possible side effects of Duac CS Kit Gel:

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:

Burning, dryness, or peeling of the skin.

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); bloody stools; severe burning, dryness, or peeling of the skin; severe or persistent diarrhea; stomach cramps or pain.

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: Duac CS 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. Duac CS Kit Gel may be harmful if swallowed.

Proper storage of Duac CS Kit Gel:

Store Duac CS Kit Gel at 77 degrees F (25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep tightly closed. Throw away any unused portion after 2 months. Keep Duac CS Kit Gel out of the reach of children and away from pets.

General information:

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


• Duac CS Kit Gel 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 Duac CS Kit Gel. 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 Duac CS Kit resources

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

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