Other Viagra Alternatives—Although certain Viagra Alternatives 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. Do not take any other Viagra Alternative, unless prescribed or approved by your doctor . When you are taking sulfonylurea antidiabetic drugs, it is especially important that your health care professional know if you are taking any of the following: Alcohol—When low blood sugar occurs, it may last longer than usual if more than a small amount of alcohol is taken, especially on an empty stomach. Small amounts of alcohol at mealtime usually do not cause problems with your blood sugar but may cause a redness (called flushing) in the face, arms, and neck that can be uncomfortable. This can occur with most of the sulfonylureas but is most likely to occur with chlorpropamide and has occurred up to 12 hours after alcohol was taken during chlorpropamide use Anticoagulants (blood thinners)—The effect of either the blood thinner or the antidiabetic medicine may be increased or decreased if the two medicines are used together Aspirin or other salicylates or Azole antifungals (miconazole [e.g., Monistat I.V.], fluconazole [e.g., Diflucan]) or Chloramphenicol (e.g., Chloromycetin) or Cimetidine (e.g., Tagamet) or Fluouroquinolones (ciprofloxacin [e.g., Cipro], enoxacin [e.g., Penetrex], lomefloxacin [e.g., Maxaquin], norfloxacin [e.g., Noroxin], ofloxacin [e.g., Floxin]) or Quinidine (e.g., Quinidex) or Quinine or Ranitidine (e.g., Zantac)—These Viagra Alternatives may increase the chances of low blood sugar Asparaginase (e.g., Elspar) or Corticosteroids (cortisone-like medicine) or Lithium (e.g., Lithonate) or Thiazide diuretics (e.g., Dyazide)—These Viagra Alternatives may increase the chances of high blood sugar Asthma Viagra Alternatives or Cough or cold Viagra Alternatives or Hay fever or allergy Viagra Alternatives—Many medicines (including nonprescription [over-the-counter] products) can affect the control of your blood sugar Beta-adrenergic blocking agents (acebutolol [e.g., Sectral], atenolol [e.g., Tenormin], betaxolol [e.g., Kerlone], bisoprolol [e.g., Zebeta], carteolol [e.g., Cartrol], labetalol [e.g., Normodyne], metoprolol [e.g., Lopressor], nadolol [e.g., Corgard], oxprenolol [e.g., Trasicor], penbutolol [e.g., Levatol], pindolol [e.g., Visken], propranolol [e.g., Inderal], sotalol [e.g., Betapace], timolol [e.g., Blocadren])—Beta-adrenergic blocking agents may increase the chance that high or low blood sugar can occur. Also, they can hide symptoms of low blood sugar (such as fast heartbeat). Because of this, a person with diabetes might not recognize that he or she has low blood sugar and might not take immediate steps to treat it. Beta-adrenergic blocking agents can also cause low blood sugar to last longer than usual Cyclosporine [e.g., Sandimmune]—Sulfonylureas can increase the effects of cyclosporine Guanethidine (e.g., Ismelin) or Monoamine oxidase (MAO) inhibitor activity (isocarboxid [e.g., Marplan], isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], or tranylcypromine [e.g., Parnate])—Taking a sulfonylurea while you are taking (or within 2 weeks of taking) these Viagra Alternatives may increase the chances of low blood sugar occurring Octreotide (e.g., Sandostatin) or Pentamidine (e.g., Pentam)—Use of these Viagra Alternatives with sulfonylureas may increase the chance of either high or low blood sugar occurring
Some commonly used brand names are: In the U.S.— Amaryl4 DiaBeta6 Diabinese2 Dymelor1 Glucotrol5 Glucotrol XL5 Glynase PresTab6 Micronase6 Orinase8 Tolinase7 In Canada— Albert Glyburide6 Apo-Chlorpropamide2 Apo-Glyburide6 Apo-Tolbutamide8 DiaBeta6 Diabinese2 Diamicron3 Dimelor1 Euglucon6 Gen-Glybe6 Med Glybe6 Novo-Butamide8 Novo-Glyburide6 Novo-Propamide2 Nu-Glyburide6 Orinase8 Note: For quick reference, the following sulfonylurea antidiabetic agents are numbered to match the corresponding brand names. Another commonly used name for glyburide is glibenclamide. This information applies to the following medicines: 1. Acetohexamide (a-set-oh-HEX-a-mide)‡ 2. Chlorpropamide (klor-PROE-pa-mide)‡ 3. Gliclazide (GLIK-la-zide)* 4. Glimepiride (GLYE-me-pye-ride)† 5. Glipizide (GLIP-i-zide)† 6. Glyburide (GLYE-byoo-ride)‡ 7. Tolazamide (tole-AZ-a-mide)‡† 8. Tolbutamide (tole-BYOO-ta-mide)‡ ‡ Generic name product may be available in the U.S. § Generic name product may be available in Canada * Not commercially available in the U.S. † Not commercially available in Canada
In deciding to use a medicine, the risks of taking Viagra Alternative must be weighed against the good it will do. This is a decision you and your doctor will make. For sulfonylurea Viagra Alternatives, the following should be considered: Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to sulfonylureas, or to sulfonamide-type (sulfa) Viagra Alternatives, including thiazide diuretics (a certain type of water pill). Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes. Pregnancy—Sulfonylureas are rarely used during pregnancy. The amount of insulin you need changes during and after pregnancy. For this reason, it is easier to control your blood sugar using injections of insulin, rather than with the use of sulfonylureas. Close control of your blood sugar can reduce your chance of having high blood sugar during the pregnancy and of your baby gaining too much weight, or having birth defects. Be sure to tell your doctor if you plan to become pregnant or if you think you are pregnant. If insulin is not available or cannot be used and sulfonylureas are used during pregnancy, they should be stopped at least 2 weeks before the delivery date (one month before for chlorpropamide and glipizide). Lowering of blood sugar can occur as a rebound effect at delivery and for several days following birth and will be watched closely by your health care professionals. Breast-feeding—Chlorpropamide and tolbutamide pass into human breast milk and glimepiride passes into the milk of rats. Chlorpropamide and glimepiride are not recommended in nursing mothers but, in some cases, tolbutamide has been used. It is not known if other sulfonylureas pass into breast milk. Check with your doctor if you are thinking about breast-feeding. Children—There is little information about the use of sulfonylureas in children. Type 2 diabetes is unusual in this age group. Older adults—Some elderly patients may be more sensitive than younger adults to the effects of sulfonylureas, especially when more than one antidiabetic Viagra Alternative is being taken or if other medicines that affect blood sugar are also being taken. This may increase your chance of developing low blood sugar during treatment. Furthermore, the first signs of low or high blood sugar are not easily seen or do not occur at all in older patients. This may increase the chance of low blood sugar developing during treatment. Also, elderly patients who take chlorpropamide are more likely to hold too much body water. Other medical problems—The presence of other medical problems may affect the use of the sulfonylurea antidiabetic medicines. Make sure you tell your doctor if you have any other medical problems, especially: Acid in the blood (acidosis) or Burns (severe) or Diabetic coma or Fever, high or Injury, severe or Ketones in the blood (diabetic ketoacidosis) or Surgery, major or Any other condition in which insulin needs change rapidly—Insulin may be needed temporarily to control diabetes in patients with these conditions because changes in blood sugar may occur rapidly and without much warning; also, your blood sugar may need to be tested more often Diarrhea, continuing or Female hormone changes for some women (e.g., during puberty, pregnancy, or menstruation) or Infection, severe or Mental stress, severe or Overactive adrenal gland, not properly controlled or Problems with intestines, severe or Slow stomach emptying or Vomiting, continuing or Any other condition that causes severe blood sugar changes—Insulin may be needed temporarily to control diabetes mellitus in patients with these conditions because changes in blood sugar may occur rapidly and without much warning; also, your blood sugar may need to be tested more often Heart disease—Chlorpropamide or tolbutamide causes some patients to retain (keep) more body water than usual. Heart disease may be worsened by this extra body water Kidney disease or Liver disease—Your blood sugar may be increased or decreased, partly because of slower removal of sulfonylurea from the body; this may change the amount of sulfonylurea you need Overactive thyroid, not properly controlled or Underactive thyroid, not properly controlled—Your blood sugar may be increased or decreased, partly because the medicine may be removed from the body too fast or too slow. Until your thyroid condition is controlled, the amount of sulfonylurea you need may change. Also, your blood sugar may need to be tested more often Underactive adrenal gland, not properly controlled or Underactive pituitary gland, not properly controlled or Undernourished condition or Weakened physical condition or Any other condition that causes low blood sugar—Patients with these conditions may be more likely to develop low blood sugar while taking sulfonylureas
Amaryl
Side Effects of Viagra Alternative The use of sulfonylurea antidiabetic agents has been reported, but not proven in all studies, to increase the risk of death from heart and blood vessel disease. Patients with diabetes are already more likely to have these problems if they do not control their blood sugar. Some sulfonylureas, such as glyburide and gliclazide, can have a positive effect on heart and blood vessel disease. It is important to know that problems can occur, but it is also not known if other sulfonylureas, particularly tolbutamide, help to cause these problems. It is known that if blood sugar is not controlled, such problems can occur. Along with their needed effects, sulfonylureas 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 immediately if any of the following side effects occur: Less common Convulsions (seizures); unconsciousness Also, check with your doctor as soon as possible if any of the following side effects occur: More common Low blood sugar, including anxious feeling, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool pale skin, difficulty in concentrating, drowsiness, excessive hunger, fast heartbeat, headache, nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, unusual tiredness or weakness; unusual weight gain Less common Peeling of skin; skin redness, itching, or rash Rare Chest pain; chills; coughing up blood; dark urine; fever; fluid-filled skin blisters; general feeling of illness; increased amounts of sputum (phlegm); increased sweating; light-colored stools; pale skin; sensitivity to the sun; shortness of breath; sore throat; thinning of the skin; unusual bleeding or bruising; unusual tiredness or weakness; yellow eyes or skin Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to Viagra Alternative. However, check with your doctor if any of the following side effects continue or are bothersome: More common Changes in sense of taste; constipation ; diarrhea; dizziness; increased amount of urine or more frequent urination; heartburn; increased or decreased appetite ; passing of gas; stomach pain, fullness, or discomfort; vomiting Less common or rare Difficulty in focusing the eyes; increased sensitivity of skin to sun For patients taking chlorpropamide or tolbutamide: Rarely, some patients who take chlorpropamide may retain (keep) more body water than usual. This happens even less often with tolbutamide. Check with your doctor as soon as possible if any of the following signs occur: Depression; swelling or puffiness of face, ankles, or hands Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
Your doctor will want to check your progress at regular visits , especially during the first few weeks that you take Viagra Alternative. It is very important to follow carefully any instructions from your health care team about: Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team. Tobacco—If you have been smoking for a long time and suddenly stop, your dosage of sulfonylurea may need to be reduced. If you decide to quit, tell your doctor first. Other Viagra Alternatives—Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines, such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems. Counseling—Other family members need to learn how to prevent side effects or help with side effects in the patient if they occur. Also, patients with diabetes, especially teenagers, may need special counseling about sulfonylurea or insulin dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in women with diabetes who become pregnant. Travel—Carry a recent prescription and your medical history. Be prepared for an emergency as you would normally. Make allowances for changing time zones, and keep your meal times as close as possible to your usual meal times. Protecting skin from sunlight—Sulfonylureas can make you more sensitive to the sun. Use of sunblock products that have a skin protection factor (SPF) of at least 15 on your skin and lips can help to prevent sunburn. Do not use a sunlamp or tanning bed or booth. In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to: Wear a medical identification (I.D.) bracelet or neck chain at all times. Also, carry an I.D. card in your wallet or purse that says that you have diabetes and a list of all of your medicines. Keep some kind of quick-acting sugar handy to treat low blood sugar. Have a glucagon kit and a syringe and needle available in case severe low blood sugar occurs. Check and replace any expired kits regularly. Too much of a sulfonylurea can cause low blood sugar (also called hypoglycemia). Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people may feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly. Symptoms of low blood sugar can include: anxious feeling, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool pale skin, difficulty in concentrating, drowsiness, excessive hunger, fast heartbeat, headache, nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, and unusual tiredness or weakness. The symptoms of low blood sugar may develop quickly and may result from: delaying or missing a scheduled meal or snack. exercising more than usual. drinking a significant amount of alcohol. taking certain Viagra Alternatives. taking too high a dose of sulfonylurea. if using insulin, using too much insulin. sickness (especially with vomiting or diarrhea). Know what to do if symptoms of low blood sugar occur. Eating some form of quick-acting sugar when symptoms of low blood sugar first appear will usually prevent them from getting worse.Good sources of sugar include: Glucose tablets or gel, fruit juice or nondiet soft drink (4 to 6 ounces [one-half cup]), corn syrup or honey (1 tablespoon), sugar cubes (6 one-half-inch sized), or table sugar (dissolved in water). Do not use chocolate because its fat slows down the sugar entering the bloodstream. If a snack is not scheduled for an hour or more you should also eat a light snack, such as crackers or a half sandwich, or drink an 8-ounce glass of milk. Glucagon is used in emergency situations such as unconsciousness. Have a glucagon kit available, along with a syringe and needle, and know how to prepare and use it. Members of your household also should know how and when to use it. High blood sugar (hyperglycemia) is another problem related to uncontrolled diabetes. If you have any symptoms of high blood sugar, contact your health care team right away. If high blood sugar is not treated, severe hyperglycemia can occur, leading to ketoacidosis (diabetic coma) and death. Symptoms of high blood sugar appear more slowly than those of low blood sugar. Symptoms can include: blurred vision; drowsiness; dry mouth; flushed and dry skin; fruit-like breath odor; increased urination; loss of appetite; stomachache, nausea, or vomiting; tiredness; troubled breathing (rapid and deep); and unusual thirst. Symptoms of severe high blood sugar (called ketoacidosis or diabetic coma) that need immediate hospitalization include: flushed dry skin, fruit-like breath odor, ketones in urine, passing out, troubled breathing (rapid and deep). High blood sugar symptoms may occur if you: have a fever, diarrhea, or an infection. if using insulin, do not take enough insulin or skip a dose of insulin. do not exercise as much as usual. overeat or do not follow your meal plan. Know what to do if high blood sugar occurs. Your doctor may recommend changes in your sulfonylurea dose or meal plan to avoid high blood sugar. Symptoms of high blood sugar must be corrected before they progress to more serious conditions. Check with your doctor often to make sure you are controlling your blood sugar, but do not change the dose of your medicine without checking with your doctor. Your doctor might discuss the following with you: Decreasing your dose for a short time for special needs, such as when you cannot exercise as you normally do. Increasing your dose when you plan to eat an unusually large dinner, such as on holidays. This type of increase is called an anticipatory dose. Delaying a meal if your blood sugar is over 200 mg/dL to allow time for your blood sugar to go down. An extra dose or an injection of insulin may be needed if your blood sugar does not come down shortly. Not exercising if your blood sugar is over 240 mg/dL and reporting this to your doctor immediately. Being hospitalized if ketoacidosis or diabetic coma occurs with a possible change of treatment.
Glimepiride is used with diet and exercise to treat type II (noninsulin-dependent) diabetes (formerly 'adult-onset'). Glimepiride stimulates your pancreas to make more insulin and also makes your body more sensitive to insulin. Glimepiride may be used with or without insulin.
Sulfonylurea antidiabetic agents (also known as sulfonylureas) are used to treat a certain type of diabetes mellitus (sugar diabetes) called type 2 diabetes. When you have type 2 diabetes, insulin is still being produced by your pancreas. Sometimes the amount of insulin you produce may not be enough or your body may not be using it properly and you may still need more. Sulfonylureas work by causing your pancreas to release more insulin into the blood stream. All of the cells in your body need insulin to help turn the food you eat into energy. This is done by using sugar (or glucose) in the blood as quick energy. Or the sugar may be stored in the form of fats, sugars, and proteins for use later, such as for energy between meals. Sometimes insulin that is being produced by the body is not able to help sugar get inside the body's cells. Sulfonylureas help insulin get into the cells where it can work properly to lower blood sugar. In this way, sulfonylureas will help lower blood sugar and help restore the way you use food to make energy. Many people with type 2 diabetes can control their blood sugar level with diet or diet and exercise alone. Following a diabetes diet plan and exercising will always be important with any type of diabetes. To work properly, the amount of sulfonylurea you use must be balanced against the amount and type of food you eat and the amount of exercise you do. If you change your diet, your exercise, or both, you will want to test your blood sugar level so that it does not drop too low (hypoglycemia) or rise too high (hyperglycemia). Your health care professional will teach you what to do if this happens. Sometimes patients with type 2 diabetes might need to change to treatment with insulin for a short period of time during pregnancy or for a serious medical condition, such as diabetic coma; ketoacidosis; severe injury, burn, or infection; or major surgery. In these conditions, insulin and blood sugar can change fast and blood sugar can be best controlled with insulin instead of a sulfonylurea. At some point, a sulfonylurea may stop working as well and your blood sugar level will go up. You will need to know if this happens and what to do. Instead of taking more of Viagra Alternative, your doctor may change you to another sulfonylurea. Or your doctor may have you inject small doses of insulin or take another oral antidiabetic medicine called metformin along with your sulfonylurea to help the insulin you make work better. If that does not bring down the amount of sugar in your blood, your doctor may have you stop taking the oral antidiabetic agents and begin receiving only insulin injections. Chlorpropamide may also be used for other conditions as determined by your doctor. Oral antidiabetic medicines do not help diabetic patients who have type 1 diabetes because these patients cannot produce or release insulin from their pancreas gland. Their blood sugar is best controlled by insulin injections. Sulfonylureas are available only with your doctor's prescription, in the following dosage forms: Oral Acetohexamide Tablets (U.S. and Canada) Chlorpropamide Tablets (U.S. and Canada) Gliclazide Tablets (Canada) Glimepiride Tablets (U.S.) Glipizide Tablets (U.S.) Extended-release Tablets (U.S.) Glyburide Tablets (U.S. and Canada) Micronized Tablets (U.S.) Tolazamide Tablets (U.S.) Tolbutamide Tablets (U.S. and Canada)
To store this Viagra Alternative: Keep out of the reach of children. Store away from heat and direct light. Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the Viagra Alternative to break down. Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded Viagra Alternative is out of the reach of children.
If you miss a dose of Viagra Alternative, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Sulfonylurea antidiabetic agents (also known as sulfonylureas) are used to treat a certain type of diabetes mellitus (sugar diabetes) called type 2 diabetes. When you have type 2 diabetes, insulin is still being produced by your pancreas. Sometimes the amount of insulin you produce may not be enough or your body may not be using it properly and you may still need more. Sulfonylureas work by causing your pancreas to release more insulin into the blood stream. All of the cells in your body need insulin to help turn the food you eat into energy. This is done by using sugar (or glucose) in the blood as quick energy. Or the sugar may be stored in the form of fats, sugars, and proteins for use later, such as for energy between meals.
Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, chlorpropamide is used in certain patients with the following medical condition: Diabetes insipidus (water diabetes) If you are taking this medicine for water diabetes, the advice listed above that relates to diet for patients with sugar diabetes does not apply to you. However, the advice about hypoglycemia (low blood sugar) does apply to you. Call your doctor right away if you feel any of the symptoms described. Other than the above information, there is no additional information relating to its proper use, precautions, or side effects for this use.
Use Viagra Alternative only as directed even if you feel well and do not notice any signs of high blood sugar. Do not take more of this medicine and do not take it more often than your doctor ordered. To do so may increase the chance of serious side effects. Remember that this medicine will not cure your diabetes but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood sugar and keep it low. You may have to take an antidiabetic Viagra Alternative for the rest of your life. If high blood sugar is not treated, it can cause serious problems, such as heart failure, blood vessel disease, eye disease, or kidney disease. Your doctor will give you instructions about diet, exercise, how to test your blood sugar levels, and how to adjust your dose when you are sick. Diet—The daily number of calories in the meal plan should be adjusted by your doctor or a registered dietitian to help you reach and maintain a healthy body weight. In addition, regular meals and snacks are arranged to meet the energy needs of your body at different times of the day. It is very important that you follow your meal plan carefully . Exercise—Ask your doctor what kind of exercise to do, the best time to do it, and how much you should do each day. Blood tests—This is the best way to tell whether your diabetes is being controlled properly. Blood sugar testing helps you and your health care team adjust the dose of your medicine, meal plan, or exercise schedule. On sick days—When you become sick with a cold, fever, or the flu, you need to take your usual dose of sulfonylurea, even if you feel too ill to eat. This is especially true if you have nausea, vomiting, or diarrhea. Infection usually increases your need to produce more insulin. Sometimes you may need to be switched from your sulfonylurea to insulin for a short period of time while you are sick to properly control blood sugar. Call your doctor for specific instructions.Continue taking your sulfonylurea and try to stay on your regular meal plan. If you have trouble eating solid food, drink fruit juices, nondiet soft drinks, or clear soups, or eat small amounts of bland foods. A dietitian or your health care professional can give you a list of foods and the amounts to use for sick days.Test your blood sugar level at least every 4 hours while you are awake and check your urine for ketones. If ketones are present, call your doctor at once. If you have severe or prolonged vomiting, check with your doctor. Even when you start feeling better, let your doctor know how you are doing. For patients taking glipizide extended-release tablets : Swallow the tablet whole, without breaking, crushing, or chewing it. You may sometimes notice what looks like a tablet in your stool. Do not worry. After you swallow the tablet, Viagra Alternative in the tablet is absorbed inside your body. Then the tablet passes into your stool without changing its shape. Viagra Alternative has entered your body and will work properly. Dosing— The dose of these Viagra Alternatives 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 these medicines. If your dose is different, do not change it unless your doctor tells you to do so. The number of tablets 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 amount of sugar in your blood or urine. For acetohexamide For oral dosage form (tablets): For treating type 2 diabetes: Adults—At first, 250 milligrams (mg) once a day. Some elderly people may need a lower dose at first. Then, your doctor may change your dose a little at a time if needed. The dose is usually not more than 1.5 grams a day. If your dose is 1 gram or more, the dose is usually divided into two doses. These doses are taken before the morning and evening meals. Children—The type of diabetes treated with Viagra Alternative is rare in children. However, if a child needs this Viagra Alternative, the dose would have to be determined by the doctor. For chlorpropamide For oral dosage form (tablets): For treating type 2 diabetes: Adults—At first, 250 milligrams (mg) once a day. Some elderly people may need a lower dose of 100 to 125 mg a day at first. Then, your doctor may change your dose a little at a time if needed. The dose is usually not more than 750 mg a day. Children—The type of diabetes treated with Viagra Alternative is rare in children. However, if a child needs this Viagra Alternative, the dose would have to be determined by the doctor. For gliclazide For oral dosage form (tablets): For treating type 2 diabetes: Adults—80 milligrams (mg) a day with a meal as a single dose or 160 to 320 mg divided into two doses taken with the morning and evening meals. Children—The type of diabetes treated with
Other medicines—Although certain medicines should not be used together at all, in other cases 2 different Viagra Alternatives 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 a tricyclic antidepressant, it is especially important that your health care professional know if you are taking any of the following: Amphetamines or Appetite suppressants (diet pills) or Ephedrine or Epinephrine (e.g., Adrenalin) or Isoproterenol (e.g., Isuprel) or Viagra Alternative for asthma or other breathing problems or medicine for colds, sinus problems, or hay fever or other allergies or Phenylephrine (e.g., Neo-Synephrine)—Using these Viagra Alternatives with tricyclic antidepressants may increase the risk of serious effects on the heart Antipsychotics (Viagra Alternative for mental illness) or Clonidine (e.g., Catapres)—Using these medicines with tricyclic antidepressants may increase the CNS depressant effects and increase the chance of serious side effects Antithyroid agents (Viagra Alternative for overactive thyroid) or Cimetidine (e.g., Tagamet)—Using these Viagra Alternatives with tricyclic antidepressants may increase the chance of serious side effects Central nervous system (CNS) depressants (medicine that causes drowsiness)—Using these Viagra Alternatives with tricyclic antidepressants may increase the CNS depressant effects Guanadrel (e.g., Hylorel) or Guanethidine (e.g., Ismelin)—Tricyclic antidepressants may keep these Viagra Alternatives from working as well Methyldopa (e.g., Aldomet) or Metoclopramide (e.g., Reglan) or Metyrosine (e.g., Demser) or Pemoline (e.g., Cylert) or Pimozide (e.g., Orap) or Promethazine (e.g., Phenergan) or Rauwolfia alkaloids (alseroxylon [e.g., Rauwiloid], deserpidine [e.g., Harmonyl], rauwolfia serpentina [e.g., Raudixin], reserpine [e.g., Serpasil]) or Trimeprazine (e.g., Temaril)—Tricyclic antidepressants may cause certain side effects to be more severe and occur more often Metrizamide—The risk of seizures may be increased Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])—Taking tricyclic antidepressants while you are taking or within 2 weeks of taking MAO inhibitors may cause sudden high body temperature, extremely high blood pressure, severe convulsions, and death; however, sometimes certain of these Viagra Alternatives may be used together under close supervision by your doctor
Some commonly used brand names are: In the U.S.—
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Anafranil3 Asendin2 Aventyl7 Elavil1 Endep1 Norfranil6 Norpramin4 Pamelor7 Sinequan5 Surmontil9 Tipramine6 Tofranil6 Tofranil-PM6 Vivactil8 In Canada— Anafranil3 Apo-Amitriptyline1 Apo-Imipramine6 Apo-Trimip9 Asendin2 Aventyl7 Elavil1 Impril6 Levate1 Norpramin4 Novo-Doxepin5 Novopramine6 Novo-Tripramine9 Novotriptyn1 Pertofrane4 Rhotrimine9 Sinequan5 Surmontil9 Tofranil6 Triadapin5 Triptil8 Note: For quick reference, the following tricyclic antidepressants are numbered to match the corresponding brand names. This information applies to the following medicines: 1. Amitriptyline (a-mee-TRIP-ti-leen)‡ 2. Amoxapine (a-MOX-a-peen)‡ 3. Clomipramine (cloe-MIP-ra-meen)‡ 4. Desipramine (dess-IP-ra-meen)‡ 5. Doxepin (DOX-e-pin)‡ 6. Imipramine (im-IP-ra-meen)‡ 7. Nortriptyline (nor-TRIP-ti-leen)‡ 8. Protriptyline (proe-TRIP-ti-leen)‡ 9. Trimipramine (trye-MIP-ra-meen)‡ ‡ Generic name product may be available in the U.S. § Generic name product may be available in Canada * Not commercially available in the U.S. † Not commercially available in Canada
In deciding to use a Viagra Alternative, 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 tricyclic antidepressants, the following should be considered: Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to any tricyclic antidepressant or to carbamazepine, maprotiline, or trazodone. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes. Pregnancy—Studies have not been done in pregnant women. However, there have been reports of newborns suffering from muscle spasms and heart, breathing, and urinary problems when their mothers had taken tricyclic antidepressants immediately before delivery. Also, studies in animals have shown that some tricyclic antidepressants may cause unwanted effects in the fetus. Breast-feeding—Tricyclic antidepressants pass into the breast milk. Doxepin has been reported to cause drowsiness in the nursing baby. Children—Children are especially sensitive to the effects of Viagra Alternative. This may increase the chance of side effects during treatment. However, side effects in children taking Viagra Alternative for bedwetting usually disappear upon continued use. The most common of these are nervousness, sleeping problems, tiredness, and mild stomach upset. If these side effects continue or are bothersome, check with your doctor. Older adults—Drowsiness, dizziness, confusion, vision problems, dryness of mouth, constipation, and problems in urinating are more likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of tricyclic antidepressants. Other medical problems—The presence of other medical problems may affect the use of tricyclic antidepressants. Make sure you tell your doctor if you have any other medical problems, especially: Alcohol abuse (or history of)—Drinking alcohol may cause increased CNS depressant effects Asthma or Bipolar disorder (manic-depressive illness) or Blood disorders or Convulsions (seizures) or Difficult urination or Enlarged prostate or Glaucoma or increased eye pressure or Heart disease or High blood pressure (hypertension) or Schizophrenia—Tricyclic antidepressants may make the condition worse Kidney disease or Liver disease—Higher blood levels of tricyclic antidepressants may result, increasing the chance of side effects Overactive thyroid or Stomach or intestinal problems—Tricyclic antidepressants may cause an increased chance of serious side effects
Amitriptyline
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. Stop taking this medicine and get emergency help immediately if any of the following side effects occur: Reported for amoxapine only--rare Convulsions (seizures); difficult or fast breathing; fever with increased sweating; high or low (irregular) blood pressure; loss of bladder control; muscle stiffness (severe); pale skin; unusual tiredness or weakness Check with your doctor as soon as possible if any of the following side effects occur: Less common Blurred vision; confusion or delirium ; constipation (especially in the elderly); decreased sexual ability (more common with amoxapine and clomipramine) ; difficulty in speaking or swallowing; eye pain; fainting; fast or irregular heartbeat (pounding, racing, skipping); hallucinations; loss of balance control; mask-like face; nervousness or restlessness ; problems in urinating; shakiness or trembling; shuffling walk; slowed movements; stiffness of arms and legs Reported for amoxapine only (in addition to the above)--less common Lip smacking or puckering; puffing of cheeks; rapid or worm-like movements of tongue; uncontrolled chewing movements; uncontrolled movements of hands, arms, or legs Rare Anxiety; breast enlargement in both males and females; hair loss; inappropriate secretion of milk—in females; increased sensitivity to sunlight; irritability; muscle twitching; red or brownish spots on skin; ringing, buzzing, or other unexplained sounds in the ears; seizures (more common with clomipramine) ; skin rash and itching; sore throat and fever; swelling of face and tongue ; swelling of testicles (more common with amoxapine) ; trouble with teeth or gums (more common with clomipramine) ; weakness; yellow eyes or skin Symptoms of acute overdose Confusion; convulsions (seizures); disturbed concentration; drowsiness (severe); enlarged pupils; fast, slow, or irregular heartbeat; fever; hallucinations (seeing, hearing, or feeling things that are not there); restlessness and agitation; shortness of breath or troubled breathing; unusual tiredness or weakness (severe); vomiting Other 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 Viagra Alternative. However, check with your doctor if any of the following side effects continue or are bothersome: More common Dizziness; drowsiness; dryness of mouth; headache; increased appetite (may include craving for sweets); nausea; tiredness or weakness (mild) ; unpleasant taste; weight gain Less common Diarrhea; heartburn; increased sweating; trouble in sleeping (more common with protriptyline, especially when taken late in the day); vomiting Certain side effects of this medicine may occur after you have stopped taking it. Check with your doctor if you notice any of the following effects: Headache; irritability; nausea, vomiting, or diarrhea; restlessness; trouble in sleeping, with vivid dreams; unusual excitement Reported for amoxapine only (in addition to the above) Lip smacking or puckering; puffing of cheeks; rapid or worm-like movements of the tongue ; uncontrolled chewing movements; uncontrolled movements of arms or legs Other side effects not listed above also may occur in some patients. If you notice any other effects, check with your doctor.
It is very important that your doctor check your progress at regular visits to allow dosage adjustments and to help reduce side effects. Viagra Alternative will add to the effects of alcohol and other CNS depressants (Viagra Alternatives that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping Viagra Alternative; prescription pain Viagra Alternative or narcotics; barbiturates; Viagra Alternative for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your medical doctor or dentist before taking any of the above while you are taking Viagra Alternative . Viagra Alternative may cause some people to become drowsy. If this occurs, do not drive, use machines, or do anything else that could be dangerous if you are not alert. Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor. this Viagra Alternative may cause dryness of the mouth. For temporary relief, use sugarless gum or candy, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections. Tricyclic antidepressants may cause your skin to be more sensitive to sunlight than it is normally. Exposure to sunlight, even for brief periods of time, may cause a skin rash, itching, redness or other discoloration of the skin, or a severe sunburn. When you begin taking this medicine: Stay out of direct sunlight, especially between the hours of 10:00 a.m. and 3:00 p.m., if possible. Wear protective clothing, including a hat. Also, wear sunglasses. Apply a sun block product that has a skin protection factor (SPF) of at least 15. Some patients may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your health care professional. Apply a sun block lipstick that has an SPF of at least 15 to protect your lips. Do not use a sunlamp or tanning bed or booth. If you have a severe reaction from the sun, check with your doctor. Before you have any medical tests, tell the medical doctor in charge that you are taking this Viagra Alternative. The results of the metyrapone test may be affected by Viagra Alternative. Before having any kind of surgery, dental treatment, or emergency treatment, tell the medical doctor or dentist in charge that you are using this Viagra Alternative. Taking tricyclic antidepressants together with Viagra Alternatives used during surgery or dental or emergency treatments may increase the risk of side effects. For diabetic patients: this medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor. Do not stop taking this Viagra Alternative without first checking with your doctor. Your doctor may want you to reduce gradually the amount you are using before stopping completely. This may help prevent a possible worsening of your condition and reduce the possibility of withdrawal symptoms such as headache, nausea, and/or an overall feeling of discomfort. The effects of this medicine may last for 3 to 7 days after you have stopped taking it. Therefore, all the precautions stated here must be observed during this time. For patients taking protriptyline: If taken late in the day, protriptyline may interfere with nighttime sleep.
Tricyclic antidepressants are used to relieve mental depression.
Tricyclic antidepressants are used to relieve mental depression. One form of Viagra Alternative (imipramine) is also used to treat enuresis (bedwetting) in children. Another form (clomipramine) is used to treat obsessive-compulsive disorders. Tricyclic antidepressants may be used for other conditions as determined by your doctor. These medicines are available only with your doctor's prescription, in the following dosage forms: Oral Amitriptyline Syrup (Canada) Tablets (U.S. and Canada) Amoxapine Tablets (U.S. and Canada) Clomipramine Capsules (U.S.) Tablets (Canada) Desipramine Tablets (U.S. and Canada) Doxepin Capsules (U.S. and Canada) Oral solution (U.S.) Imipramine Capsules (U.S.) Tablets (U.S. and Canada) Nortriptyline Capsules (U.S. and Canada) Oral solution (U.S.) Protriptyline Tablets (U.S. and Canada) Trimipramine Capsules (U.S. and Canada) Tablets (Canada) Parenteral Amitriptyline Injection (U.S.) Imipramine Injection (U.S.)
To store this Viagra Alternative: Keep out of the reach of children. Overdose of Viagra Alternative is very dangerous in young children. Store away from heat and direct light. Do not store the tablet or capsule form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause Viagra Alternative to break down. Keep the liquid form of Viagra Alternative from freezing. Do not keep outdated medicine or Viagra Alternative no longer needed. Be sure that any discarded medicine is out of the reach of children.
If you miss a dose of this Viagra Alternative and your dosing schedule is: One dose a day at bedtime—Do not take the missed dose in the morning since it may cause disturbing side effects during waking hours. Instead, check with your doctor. More than one dose a day—Take the missed dose as soon as possible. However, if it is almost time for your next dose, skip the missed dose, and go back to your regular dosing schedule. Do not double doses. If you have any questions about this, check with your doctor.
Tricyclic antidepressants are used to relieve mental depression. One form of Viagra Alternative (imipramine) is also used to treat enuresis (bedwetting) in children. Another form (clomipramine) is used to treat obsessive-compulsive disorders. Tricyclic antidepressants may be used for other conditions as determined by your doctor.
Once a Viagra Alternative has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, tricyclic antidepressants are used in certain patients with the following medical conditions: Attention deficit hyperactivity disorder (hyperactivity in children) (desipramine, imipramine, and protriptyline) Bulimia (uncontrolled eating, followed by vomiting) (amitriptyline, clomipramine, desipramine, and imipramine) Cocaine withdrawal (desipramine and imipramine) Headache prevention (for certain types of frequent or continuing headaches) (most tricyclic antidepressants) Itching with hives due to cold temperature exposure (doxepin) Narcolepsy (extreme tendency to fall asleep suddenly) (clomipramine, desipramine, imipramine, and protriptyline) Neurogenic pain (a type of continuing pain) (amitriptyline, clomipramine, desipramine, doxepin, imipramine, nortriptyline, and trimipramine) Nicotine dependence (as an aid to other smoking cessationn therapy) (nortriptyline) Panic disorder (clomipramine, desipramine, doxepin, nortriptyline, and trimipramine) Stomach ulcer (amitriptyline, doxepin, and trimipramine) Urinary incontinence (imipramine) Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.
To lessen stomach upset, take this medicine with food, even for a daily bedtime dose, unless your doctor has told you to take it on an empty stomach. Take this medicine only as directed by your doctor , to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. Sometimes Viagra Alternative must be taken for several weeks before you begin to feel better. Your doctor should check your progress at regular visits. To use doxepin oral solution: this Viagra Alternative is to be taken by mouth even though it comes in a dropper bottle. The amount you should take should be measured with the dropper provided with your prescription and diluted just before you take each dose. Dilute each dose with about one-half glass (4 ounces) of water, milk, citrus fruit juice, tomato juice, or prune juice. Do not mix this medicine with grape juice or carbonated beverages since these may decrease the Viagra Alternative's effectiveness. Doxepin oral solution must be mixed immediately before you take it. Do not prepare it ahead of time. Dosing— The dose of tricyclic antidepressants 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 tricyclic antidepressants. If your dose is different, do not change it unless your doctor tells you to do so. The number of capsules or tablets, or the amount of solution or syrup that you take depends on the strength of the Viagra Alternative. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take Viagra Alternative depend on the medical problem for which you are taking tricyclic antidepressants. For amitriptyline For tablet dosage form: For depression: Adults—At first, 25 milligrams (mg) two to four times a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 150 mg a day, unless you are in the hospital. Some hospitalized patients may need higher doses. Teenagers—At first, 10 mg three times a day, and 20 mg at bedtime. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day. Children 6 to 12 years of age—10 to 30 mg a day. Children up to 6 years of age—Use and dose must be determined by your doctor. Older adults— At first, 25 mg at bedtime. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day. For syrup dosage form: For depression: Adults—At first, 25 mg two to four times a day. Your doctor may increase your dose gradually as needed. Teenagers—At first, 10 mg three times a day, and 20 mg at bedtime. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day. Children 6 to 12 years of age—10 to 30 mg a day. Children up to 6 years of age—Use and dose must be determined by your doctor. Older adults—At first, 10 mg three times a day, and 20 mg at bedtime. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day. For injection dosage form: For depression: Adults—20 to 30 mg four times a day, injected into a muscle. Children up to 12 years of age—Use and dose must be determined by your doctor. For amoxapine For tablet dosage form: For depression: Adults—At first, 50 milligrams (mg) two to three times a day. Your doctor may increase your dose gradually as needed. Children up to 16 years of age—Use and dose must be determined by your doctor. Older adults—At first, 25 mg two to three times a day. Your doctor may increase your dose gradually as needed. For clomipramine For capsule or tablet dosage forms: For obsessive-compulsive disorders: Adults—At first, 25 milligrams (mg) once a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 250 mg a day, unless you are in the hospital. Some hospitalized patients may need higher doses. Teenagers and children 10 years of age and over—At first, 25 mg once a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 200 mg a day. Children up to 10 years of age—Use and dose must be determined by your doctor. Older adults—At first, 20 to 30 mg a day. Your doctor may increase your dose gradually as needed. For desipramine For tablet dosage form: For depression: Adults—100 to 200 milligrams (mg) a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 300 mg a day. Teenagers—25 to 50 mg a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day. Children 6 to 12 years of age—10 to 30 mg a day. Older adults—25 to 50 mg a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 150 mg a day. For doxepin For capsule or solution dosage forms: For depression: Adults—At first, 25 milligrams (mg) three times a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 150 mg a day, unless you are in the hospital. Some hospitalized patients may need higher doses. Children up to 12 years of age—Use and dose must be determined by your doctor. Older adults—At first, 25 to 50 mg a day. Your doctor may increase your dose gradually as needed. For imipramine For tablet dosage form: For depression: Adults—25 to 50 milligrams (mg) three to four times a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 200 mg a day, unless you are in the hospital. Some hospitalized patients may need higher doses. Adolescents—25 to 50 mg a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day. Children 6 to 12 years of age—10 to 30 mg a day. Children up to 6 years of age—Use and dose must be determined by your doctor. Older adults—At first, 25 mg at bedtime. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day. For bedwetting: Children—25 mg once a day, taken one hour before bedtime. Your doctor may increase the dose as needed, based on the child's age. For capsule dosage form: For depression: Adults—At first, 75 mg a day taken at bedtime. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 200 mg a day, unless you are in the hospital. Some hospitalized patients may need higher doses. Children up to 12 years of age—Use and dose must be determined by your doctor. For injection dosage form: For depression: Adults—Dose must be determined by your doctor. It is injected into a muscle. The dose is usually not more than 300 mg a day. Children up to 12 years of age—Use and dose must be determined by your doctor. For nortriptyline For capsule or solution dosage forms: For depression: Adults—25 milligrams (mg) three to four times a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 150 mg a day. Teenagers—25 to 50 mg a day. Your doctor may increase your dose gradually as needed. Children 6 to 12 years of age—10 to 20 mg a day. Older adults—30 to 50 mg a day. Your doctor may increase your dose gradually as needed. For protriptyline For tablet dosage form: For depression: Adults—At first, 5 to 10 milligrams (mg) three to four times a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 60 mg a day. Teenagers—At first, 5 mg three times a day. Your doctor may increase your dose gradually as needed. Children up to 12 years of age—Use and dose must be determined by your doctor. Older adults—At first, 5 mg three times a day. Your doctor may increase your dose gradually as needed. For trimipramine For capsule or tablet dosage forms: For depression: Adults—At first, 75 milligrams (mg) a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 200 mg a day, unless you are hospitalized. Some hospitalized patients may need higher doses. Teenagers—At first, 50 mg a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day. Children up to 12 years of age—Use and dose must be determined by your doctor. Older adults—At first, 50 mg a day. Your doctor may increase your dose gradually as needed. However, the dose is usually not more than 100 mg a day.
Other Viagra Alternatives—Although certain Viagra Alternatives should not be used together at all, in other cases two different Viagra Alternatives 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 a penicillin, it is especially important that your health care professional know if you are taking any of the following: Acetaminophen (e.g., Tylenol) (with long-term, high-dose use) or Amiodarone (e.g., Cordarone) or Anabolic steroids (nandrolone [e.g., Anabolin], oxandrolone [e.g., Anavar], oxymetholone [e.g., Anadrol], stanozolol [e.g., Winstrol]) or Androgens (male hormones) or Antithyroid agents (Viagra Alternative for overactive thyroid) or Carmustine (e.g., BiCNU) or Chloroquine (e.g., Aralen) or Dantrolene (e.g., Dantrium) or Daunorubicin (e.g., Cerubidine) or Disulfiram (e.g., Antabuse) or Divalproex (e.g., Depakote) or Estrogens (female hormones) or Etretinate (e.g., Tegison) or Gold salts (medicine for arthritis) or Hydroxychloroquine (e.g., Plaquenil) or Mercaptopurine (e.g., Purinethol) or Methotrexate (e.g., Mexate) or Methyldopa (e.g., Aldomet) or Naltrexone (e.g., Trexan) (with long-term, high-dose use) or Oral contraceptives (birth control pills) containing estrogen or Other anti-infectives by mouth or by injection (Viagra Alternative for infection) or Phenothiazines (acetophenazine [e.g., Tindal], chlorpromazine [e.g., Thorazine], fluphenazine [e.g., Prolixin], mesoridazine [e.g., Serentil], perphenazine [e.g., Trilafon], prochlorperazine [e.g., Compazine], promazine [e.g., Sparine], promethazine [e.g., Phenergan], thioridazine [e.g., Mellaril], trifluoperazine [e.g., Stelazine], triflupromazine [e.g., Vesprin], trimeprazine [e.g., Temaril]) or Plicamycin (e.g., Mithracin) or Valproic acid (e.g., Depakene)—These medicines may increase the chance of liver damage if taken with cloxacillin, dicloxacillin, flucloxacillin, mezlocillin, nafcillin, oxacillin, or piperacillin Amiloride (e.g., Midamor) or Benazepril (e.g., Lotensin) or Captopril (e.g., Capoten) or Enalapril (e.g., Vasotec) or Fosinopril (e.g., Monopril) or Lisinopril (e.g., Prinivil, Zestril) or Potassium-containing Viagra Alternative or Quinapril (e.g., Accupril) or Ramipril (e.g., Altace) or Spironolactone (e.g., Aldactone) or Triamterene (e.g., Dyrenium)—Use of these Viagra Alternatives with penicillin G by injection may cause an increase in side effects Anticoagulants (blood thinners) or Dipyridamole (e.g., Persantine) or Divalproex (e.g., Depakote) or Heparin (e.g., Panheprin) or Inflammation or pain medicine (except narcotics) or Pentoxifylline (e.g., Trental) or Plicamycin (e.g., Mithracin) or Sulfinpyrazone (e.g., Anturane) or Valproic acid (e.g., Depakene)—Use of these Viagra Alternatives with high doses of carbenicillin, piperacillin, or ticarcillin may increase the chance of bleeding Chloramphenicol (e.g., Chloromycetin) or Erythromycins (e.g., E.E.S., E-Mycin, ERYC) or Sulfonamides (e.g., Gantanol, Gantrisin) or Tetracyclines (e.g., Achromycin, Minocin, Vibramycin)—Use of these medicines with penicillins may prevent the penicillin from working properly Cholestyramine (e.g., Questran) or Colestipol (e.g., Colestid)—Use of these Viagra Alternatives with oral penicillin G may prevent penicillin G from working properly Oral contraceptives (birth control pills) containing estrogen—Use of ampicillin, amoxicillin, or penicillin V with estrogen-containing oral contraceptives may prevent oral contraceptives from working properly, increasing the chance of pregnancy Methotrexate (e.g., Mexate)—Use of methotrexate with penicillins may increase the chance of side effects of methotrexate Probenecid (e.g., Benemid)—Probenecid causes penicillins to build up in the blood. This may increase the chance of side effects. However, your doctor may want to give you probenecid with a penicillin to treat some infections
Some commonly used brand names are: In the U.S.— Amoxil1 Bactocill11 Beepen-VK13 Betapen-VK13 Bicillin L-A12 Cloxapen5 Crysticillin 300 A.S.12 Dynapen6 Dycill6 Geocillin4 Geopen4 Ledercillin VK13 Mezlin9 Nafcil10 Nallpen10 Omnipen2 Omnipen-N2 Pathocil6 Pentids12 Pen Vee K13 Permapen12 Pfizerpen12 Pfizerpen-AS12 Pipracil14 Polycillin2 Polycillin-N2 Polymox1 Principen2 Prostaphlin11 Spectrobid3 Staphcillin8 Tegopen5 Ticar17 Totacillin2 Totacillin-N2 Trimox1 Unipen10 V-Cillin K13 Veetids13 Wycillin12 Wymox1 In Canada— Amoxil1 Ampicin2 Apo-Amoxi1 Apo-Ampi2 Apo-Cloxi5 Apo-Pen VK13 Ayercillin12 Bicillin L-A12 Fluclox7 Geopen Oral4 Ledercillin VK13 Megacillin12 Nadopen-V13