Viagra Collection

For flurbiprofen For oral tablet dosage form: For menstrual cramps: Adults—50 milligrams (mg) four times a day. Children—Use and dose must be determined by your doctor. For bursitis, tendinitis, or athletic injuries: Adults—50 mg every four to six hours as needed. Children—Use and dose must be determined by your doctor. For rheumatoid arthritis or osteoarthritis: Adults—At first, 200 to 300 mg a day, divided into smaller amounts that are taken two to four times a day. Usually, no more than a total of 300 mg a day should be taken. After your condition improves your doctor may direct you to take a lower dose. Children—Use and dose must be determined by your doctor. For spondylitis (lower back pain): Adults—At first, 50 mg four times a day. Your doctor may increase the dose, if necessary, up to a total of 300 mg a day. After your condition improves your doctor may direct you to take a lower dose. Children—Use and dose must be determined by your doctor. For extended-release capsule dosage form: For arthritis: Adults—200 mg once a day, in the evening. Take Viagra Collection at the same time every day. Children—Use and dose must be determined by your doctor. For ibuprofen For oral dosage forms (oral suspension, tablets, chewable tablets): For pain or menstrual cramps: Adults and teenagers—200 to 400 milligrams (mg) every four to six hours as needed. If you are taking Viagra Collection without a prescription from your health care professional, do not take more than a total of 1200 mg (six 200-mg tablets) a day. Children up to 12 years of age—Use and dose must be determined by your doctor. For fever: Adults and teenagers—200 to 400 mg every four to six hours as needed. If you are taking Viagra Collection without a prescription from your health care professional, do not take more than a total of 1200 mg (six 200-mg tablets) a day. Children 6 months to 12 years of age—Viagra Collection should be used only with a prescription from your doctor. The dose is based on body weight and on the body temperature. For fevers lower than 102.5 °F (39.2 °C) the dose is 5 mg per kilogram (kg) (about 2.2 mg per pound) of body weight. For higher fevers the dose is 10 mg per kg (about 4.5 mg per pound) of body weight. Infants younger than 6 months of age—Use and dose must be determined by your doctor. For arthritis: Adults and teenagers—At first, a total of 1200 to 3200 mg a day, divided into smaller amounts that are taken three or four times a day. After your condition improves your doctor may direct you to take a lower dose. Children 6 months to 12 years of age—The dose is based on body weight. At first, a total of 30 to 40 mg per kg (about 13.6 to 18 mg per pound) of body weight a day, divided into smaller amounts that are taken three or four times a day. Your doctor may increase the dose, if necessary, up to a total of 50 mg per kg (about 21 mg per pound) of body weight a day. After your condition improves your doctor may direct you to take a lower dose. Infants younger than 6 months of age—Use and dose must be determined by your doctor. For indomethacin For capsule or oral suspension dosage forms: For arthritis: Adults—At first, 25 or 50 milligrams (mg) two to four times a day. Your doctor may increase the dose, if necessary, up to a total of 200 mg a day. After your condition improves your doctor may direct you to take a lower dose. Children—The dose is based on body weight. At first, 1.5 to 2.5 mg per kilogram (kg) (about 0.7 to 1.1 mg per pound) of body weight a day, divided into smaller amounts that are taken three or four times a day. Your doctor may increase the dose, if necessary, up to a total of 4 mg per kg (about 1.8 mg per pound) of body weight or 200 mg a day, whichever is less. After your condition improves your doctor may direct you to take a lower dose. For gout: Adults—100 mg for the first dose, then 50 mg three times a day. After the pain is relieved, your doctor may direct you to take a lower dose for a while before stopping treatment completely. Children—Use and dose must be determined by your doctor. For bursitis or tendinitis: Adults—25 mg three or four times a day or 50 mg three times a day. Children—Use and dose must be determined by your doctor. For extended-release capsule dosage form: For arthritis: Adults—75 mg once a day, in the morning or evening. Some people may need to take 75 mg twice a day, in the morning and evening. Take the Viagra Collection at the same time each day. Children—Dose must be determined by your doctor. For rectal suppository dosage form: For arthritis, bursitis, tendinitis, or gout: Adults—One 50-mg suppository, inserted into the rectum up to four times a day. Children—One 50-mg suppository, inserted into the rectum up to four times a day. The suppository dosage form is too strong for small children. However, the suppositories may be used for large or heavy children if they need doses as large as 50 mg. For ketoprofen For capsule, tablet, or delayed-release tablet dosage forms: For pain or menstrual cramps: Adults—25 to 50 milligrams (mg) every six to eight hours as needed. Some people may need to take as much as 75 mg every six to eight hours. Doses larger than 75 mg are not likely to give better relief. Over-the-counter Viagra Collection—12.5 mg every 4 to 6 hours. Children—Use and dose must be determined by your doctor. For arthritis: Adults—At first, 50 mg four times a day or 75 mg three times a day. Your doctor may increase the dose, if necessary, up to a total of 300 mg a day. After your condition improves your doctor may direct you to take a lower dose. Children—Use and dose must be determined by your doctor. For extended-release capsule or extended-release tablet dosage forms: For arthritis: Adults—150 or 200 mg once a day, in the morning or evening. Take the medicine at the same time every day. Children—Use and dose must be determined by your doctor. For rectal suppository dosage form: For arthritis: Adults—50 or 100 mg twice a day, inserted into the rectum, in the morning and evening. Sometimes, the suppository is used only at night by people who take an oral dosage form (capsules or delayed-release tablets) during the day. Usually, no more than a total of 300 mg of ketoprofen should be used in a day from all dosage forms combined. Children—Use and dose must be determined by your doctor. For meclofenamate For oral dosage form (capsules): For arthritis: Adults and teenagers 14 years of age and older—At first, 50 milligrams (mg) four times a day. Your doctor may increase the dose, if necessary, up to a total of 400 mg a day. After your condition improves your doctor may direct you to take a lower dose. Children up to 14 years of age—Use and dose must be determined by your doctor. For pain: Adults and teenagers 14 years of age and older—50 mg every four to six hours. Some people may need as much as 100 mg every four to six hours. Children up to 14 years of age—Use and dose must be determined by your doctor. For menstrual cramps and heavy menstrual bleeding: Adults and teenagers 14 years of age and older—100 mg three times a day for up to six days. Children up to 14 years of age—Use and dose must be determined by your doctor. For mefenamic acid For oral dosage form (capsules): For pain and for menstrual cramps: Adults and teenagers 14 years of age and older—500 milligrams (mg) for the first dose, then 250 mg every six hours as needed for up to seven days. Children up to 14 years of age—Use and dose must be determined by your doctor. For meloxicam For oraldosage form (tablets): For osteoarthritis: Adults—7.5 milligrams (mg) daily in a single dose. For nabumetone For oral dosage form (tablets): For arthritis: Adults—At first, 1000 milligrams (mg) once a day, in the morning or evening, or 500 mg twice a day, in the morning and evening. Your doctor may increase the dose, if necessary, up to a total of 2000 mg a day. After your condition improves your doctor may direct you to take a lower dose. Children—Use and dose must be determined by your doctor. For naproxen For naproxen (e.g., Naprosyn) tablet, oral suspension, and delayed-release tablet dosage forms: For arthritis: Adults—At first, 250, 375, or 500 milligrams (mg) two times a day, in the morning and evening. Your doctor may increase the dose, if necessary, up to a total of 1500 mg a day. After your condition improves your doctor may direct you to take a lower dose. Children—The dose is based on body weight. At first, 5 mg per kilogram (kg) (about 2.25 mg per pound) of body weight twice a day. After your condition improves your doctor may direct you to take a lower dose. For bursitis, tendinitis, menstrual cramps, and other kinds of pain: Adults—500 mg for the first dose, then 250 mg every six to eight hours as needed. Children—Use and dose must be determined by your doctor. For gout: Adults—750 mg for the first dose, then 250 mg every eight hours until the attack is relieved. Children—Use and dose must be determined by your doctor. For naproxen extended-release tablet (e.g., Naprelan) dosage form: For arthritis and pain: Adults—750 to 1000 mg once a day, in the morning or evening. Children—The extended-release tablets are too strong for use in children. For naproxen (e.g., Naprosyn) rectal suppository dosage form: For arthritis: Adults—One 500-mg suppository, inserted into the rectum at bedtime. The suppository is usually used only at night by people who take an oral dosage form (tablets, oral suspension, or delayed-release tablets) during the day. Usually, no more than a total of 1500 mg of naproxen should be used in a day from all dosage forms combined. Children—The suppositories are too strong for use in children. For naproxen sodium (e.g., Aleve, Anaprox) tablet dosage form: For arthritis: Adults—At first, 275 or 550 mg two times a day, in the morning and evening, or 275 mg in the morning and 550 mg in the evening. Your doctor may increase the dose, if necessary, up to a total of 1650 mg a day. After your condition improves your doctor may direct you to take a lower dose. Children—Naproxen sodium tablets are too strong for most children. Naproxen (e.g., Naprosyn) tablets or oral suspension are usually used for children. For bursitis and tendinitis: Adults—550 mg for the first dose, then 275 mg every six to eight hours as needed. Children—Use and dose must be determined by your doctor. Naproxen sodium tablets are too strong for most children. For gout: Adults—825 mg for the first dose, then 275 mg every eight hours until the attack is relieved. Children—Use and dose must be determined by your doctor. Naproxen sodium tablets are too strong for most children. For pain, fever, and menstrual cramps: Adults and children 12 years of age or older—For nonprescription (over-the-counter [OTC]) use: 220 mg (one tablet) every eight to twelve hours as needed. Some people may get better relief if they take 440 mg (two tablets) for the first dose, then 220 mg twelve hours later on the first day only. If you are taking
Viagra Collection
without a prescription from your health care professional, do not take more than three 220-mg tablets a day. If you are older than 65 years of age, do not take more than two 220-mg tablets a day. Your health care professional may direct you to take larger doses. Children up to 12 years of age—Use and dose must be determined by your doctor. For oxaprozin For oral dosage form (tablets): For arthritis: Adults—At first, 600 milligrams (mg) once or twice a day, or 1200 mg once a day. Some people may need a larger amount for the first dose only. Your doctor may increase the dose, if necessary, up to 1800 mg a day. This large dose should always be divided into smaller amounts that are taken two or three times a day. After your condition improves your doctor may direct you to take a lower dose. Children—Use and dose must be determined by your doctor. For phenylbutazone For oral dosage forms (capsules, tablets, and buffered tablets): For severe arthritis: Adults and teenagers 15 years of age and older—At first, 100 milligrams (mg) three or four times a day. Some people may need a higher dose of 200 mg three times a day. After your condition improves your doctor may direct you to take a lower dose for a while before stopping treatment completely. Viagra Collection should not be taken for longer than a few weeks. Children up to 15 years of age—Use is not recommended. For gout: Adults—400 mg for the first dose, then 100 mg every four hours for one week or less. Children up to 15 years of age—Use is not recommended. For piroxicam For oral dosage form (capsules): For arthritis: Adults—20 milligrams (mg) once a day or 10 mg twice a day. Children—Dose must be determined by your doctor. For menstrual cramps: Adults—40 mg once a day for one day only, then 20 mg once a day if needed. Children—Dose must be determined by your doctor. For rectal dosage form (suppositories): For arthritis: Adults—20 mg once a day or 10 mg twice a day. Children—Dose must be determined by your doctor. For sulindac For oral dosage form (tablets): For arthritis: Adults—At first, 150 or 200 milligrams (mg) twice a day. After your condition improves, your doctor may direct you to take a lower dose. Children—Use and dose must be determined by your doctor. For gout, bursitis, or tendinitis: Adults—At first, 200 mg twice a day. After the pain is relieved, your doctor may direct you to take a lower dose for a while before treatment is stopped completely. Children—Use and dose must be determined by your doctor. For tenoxicam For oral dosage form (tablets): For arthritis: Adults and teenagers 16 years of age and older—At first, 20 milligrams (mg) once a day, at the same time each day. For some people, a smaller dose of 10 mg (one-half tablet) a day may be enough. Children and teenagers up to 16 years of age—Dose must be determined by your doctor. For tiaprofenic acid For oral tablet dosage form: For arthritis: Adults—At first, 200 milligrams (mg) three times a day or 300 mg twice a day. After your condition improves, your doctor may direct you to take a lower dose. Children—Use and dose must be determined by your doctor. For extended-release capsule dosage form: For arthritis: Adults—600 mg (two capsules) once a day, at the same time each day. Children—Use and dose must be determined by your doctor. For tolmetin For oral dosage forms (capsules or tablets): For arthritis: Adults—At first, 400 milligrams (mg) three times a day. Your doctor may increase the dose, if necessary, up to a total of 1800 mg a day. After your condition improves, your doctor may direct you to take a lower dose. Children 2 years of age and older—The dose is based on body weight. At first, 20 mg per kilogram (kg) (about 9 mg per pound) of body weight a day, divided into smaller amounts that are taken three or four times a day. Your doctor may increase the dose, if necessary, up to 30 mg per kg (about 13.5 mg per pound) of body weight a day. After your condition improves, your doctor may direct you to take a lower dose. Children up to 2 years of age—Dose must be determined by your doctor

Drug Interactions

Other medicines—Although certain Viagra Collections should not be used together at all, in other cases two different Viagra Collections 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 taking calcium channel blocking agents it is especially important that your health care professional know if you are taking any of the following: Acetazolamide (e.g., Diamox) or Amphotericin B by injection (e.g., Fungizone) or Corticosteroids (cortisone-like Viagra Collection) or Dichlorphenamide (e.g., Daranide) or Diuretics (water pills) or Methazolamide (e.g., Naptazane)—These Viagra Collections can cause hypokalemia (low levels of potassium in the body), which can increase the unwanted effects of bepridil Beta-adrenergic blocking agents (acebutolol [e.g., Sectral], atenolol [e.g., Tenormin], betaxolol [e.g., Kerlone], 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., Sotacor], timolol [e.g., Blocadren])—Effects of both may be increased. In addition, unwanted effects may occur if a calcium channel blocking agent or a beta-blocking agent is stopped suddenly after both have been used together Carbamazepine (e.g., Tegretol) or Cyclosporine (e.g., Sandimmune) or Procainamide (e.g., Pronestyl) or Quinidine (e.g., Quinidex)—Effects of these Viagra Collections may be increased if they are used with some calcium channel blocking agents Digitalis glycosides (heart medicine)—Effects of these Viagra Collections may be increased if they are used with some calcium channel blocking agents Disopyramide (e.g., Norpace)—Effects of some calcium channel blocking agents on the heart may be increased Grapefruit juice—Effects of felodipine may be increased. No effects on amlodipine. Also, tell your health care professional if you are using any of the following medicines in the eye: Betaxolol (e.g., Betoptic) or Levobunolol (e.g., Betagan) or Metipranolol (e.g., OptiPranolol) or Timolol (e.g., Timoptic)—Effects on the heart and blood pressure may be increased

Common Brand Names

Some commonly used brand names are: In the U.S.— Adalat7 Adalat CC7 Calan9 Calan SR9 Cardene6 Cardizem2 Cardizem CD2 Cardizem SR2 Dilacor-XR2 DynaCirc5 Isoptin9 Isoptin SR9 Nimotop8 Norvasc10 Plendil3 Procardia7 Procardia XL7 Vascor1 Verelan9 In Canada— Adalat7 Adalat PA7 Adalat XL7 Apo-Diltiaz2 Apo-Nifed7 Apo-Verap9 Cardizem2 Cardizem SR2 Isoptin9 Isoptin SR9 Nimotop8 Norvasc10 Novo-Diltazem2 Novo-Nifedin7 Novo-Veramil9 Nu-Diltiaz2 Nu-Nifed7 Nu-Verap9 Plendil3 Renedil3 Sibelium4 Verelan9 Note: For quick reference, the following calcium channel blocking agents are numbered to match the corresponding brand names. This information applies to the following medicines: 1. Bepridil (BE-pri-dil)† 2. Diltiazem (dil-TYE-a-zem)‡ 3. Felodipine (fe-LOE-di-peen) 4. Flunarizine (floo-NAR-i-zeen)* 5. Isradipine (is-RA-di-peen)† 6. Nicardipine (nye-KAR-de-peen)‡† 7. Nifedipine (nye-FED-i-peen)‡ 8. Nimodipine (nye-MOE-di-peen) 9. Verapamil (ver-AP-a-mil)‡ 10. Amlodipine (am-LOE-di-peen)‡ ‡ 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

Contraindications

In deciding to use a medicine, the risks of taking Viagra Collection must be weighed against the good it will do. This is a decision you and your doctor will make. For the calcium channel blocking agents, the following should be considered: Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to amlodipine, bepridil, diltiazem, felodipine, flunarizine, isradipine, nicardipine, nifedipine, nimodipine, or verapamil. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes. Pregnancy—Calcium channel blocking agents have not been studied in pregnant women. However, studies in animals have shown that large doses of calcium channel blocking agents cause birth defects, prolonged pregnancy, poor bone development in the offspring, and stillbirth. Breast-feeding—Although bepridil, diltiazem, nifedipine, verapamil, and possibly other calcium channel blocking agents, pass into breast milk, they have not been reported to cause problems in nursing babies. Children—Although there is no specific information comparing use of Viagra Collection in children with use in other age groups, it is not expected to cause different side effects or problems in children than it does in adults. Older adults—Elderly people may be especially sensitive to the effects of calcium channel blocking agents. This may increase the chance of side effects during treatment. A lower starting dose may be required. Other medical problems—The presence of other medical problems may affect the use of the calcium channel blocking agents. Make sure you tell your doctor if you have any other medical problems, especially: Congestive heart failure—Calcium channel blocking agents may make this condition worse Heart rhythm problems (history of)—Bepridil can cause serious heart rhythm problems Kidney disease or Liver disease—Effects of the calcium channel blocking agent may be increased Mental depression (history of)—Flunarizine may cause mental depression Parkinson's disease or similar problems—Flunarizine can cause parkinsonian-like effects Other heart or blood vessel disorders—Calcium channel blocking agents may make some heart conditions worse

Drug

Nifedipine

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Not all of the side effects listed below have been reported for each of these Viagra Collections, but they have been reported for at least one of them. Since many of the effects of calcium channel blocking agents are similar, some of these side effects may occur with any of these Viagra Collections. However, they may be more common with some of these medicines than with others. Check with your doctor as soon as possible if any of the following side effects occur: Less common Breathing difficulty, coughing, or wheezing; irregular or fast, pounding heartbeat; skin rash ; slow heartbeat (less than 50 beats per minute—bepridil, diltiazem, and verapamil only); swelling of ankles, feet, or lower legs (more common with amlodipine, felodipine and nifedipine) For flunarizine only--less common Loss of balance control; mask-like face; mental depression; shuffling walk; stiffness of arms or legs; trembling and shaking of hands and fingers; trouble in speaking or swallowing Rare Bleeding, tender, or swollen gums; chest pain (may appear about 30 minutes after medicine is taken); fainting; painful, swollen joints (for nifedipine only); trouble in seeing (for nifedipine only) For flunarizine and verapamil only--rare Unusual secretion of milk 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 medicine. However, check with your doctor if any of the following side effects continue or are bothersome: More common Drowsiness (for flunarizine only); increased appetite and/or weight gain (for flunarizine only) Less common Constipation; diarrhea; dizziness or lightheadedness (more common with bepridil and nifedipine) ; dryness of mouth (for amlodipine and flunarizine only); flushing and feeling of warmth (more common with nicardipine and nifedipine); headache (more common with amlodipine, felodipine, isradipine, and nifedipine); nausea (more common with bepridil and nifedipine); unusual tiredness or weakness Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Precautions

It is important that your doctor check your progress at regular visits. This will allow your doctor to make sure the Viagra Collection is working properly and to change the dosage if needed. If you have been using Viagra Collection regularly for several weeks, do not suddenly stop using it. Stopping suddenly may bring on your previous problem. Check with your doctor for the best way to reduce gradually the amount you are taking before stopping completely. Chest pain resulting from exercise or physical exertion is usually reduced or prevented by this medicine. This may tempt you to be overly active. Make sure you discuss with your doctor a safe amount of exercise for your medical problem. After taking a dose of this medicine you may get a headache that lasts for a short time. This effect is more common if you are taking felodipine, isradipine, or nifedipine. This should become less noticeable after you have taken Viagra Collection for a while. If this effect continues or if the headaches are severe, check with your doctor. In some patients, tenderness, swelling, or bleeding of the gums may appear soon after treatment with Viagra Collection is started. Brushing and flossing your teeth carefully and regularly and massaging your gums may help prevent this. See your dentist regularly to have your teeth cleaned. Check with your medical doctor or dentist if you have any questions about how to take care of your teeth and gums, or if you notice any tenderness, swelling, or bleeding of your gums. For patients taking bepridil, diltiazem, or verapamil: Ask your doctor how to count your pulse rate. Then, while you are taking this medicine, check your pulse regularly. If it is much slower than your usual rate, or less than 50 beats per minute, check with your doctor. A pulse rate that is too slow may cause circulation problems. For patients taking flunarizine: Viagra Collection may cause some people to become drowsy or less alert than they are normally. This is more likely to happen when you begin to take it or when you increase the amount of medicine you are taking. Make sure you know how you react to Viagra Collection before you drive, use machines, or do anything else that could be dangerous if you are not alert. For patients taking this Viagra Collection for high blood pressure : Do not take other Viagra Collections unless they have been discussed with your doctor. This especially includes over-the-counter (nonprescription) Viagra Collections for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

Notes

Amlodipine, bepridil, diltiazem, felodipine, flunarizine, isradipine, nicardipine, nifedipine, nimodipine, and verapamil belong to the group of Viagra Collections called calcium channel blocking agents. Calcium channel blocking agents affect the movement of calcium into the cells of the heart and blood vessels. As a result, they relax blood vessels and increase the supply of blood and oxygen to the heart while reducing its workload. Some of the calcium channel blocking agents are used to relieve and control angina pectoris (chest pain). Some are also used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled. Flunarizine is used to prevent migraine headaches. Nimodipine is used to prevent and treat problems caused by a burst blood vessel around the brain (also known as a ruptured aneurysm or subarachnoid hemorrhage). Other calcium channel blocking agents may also be used for these and other conditions as determined by your doctor. These medicines are available only with your doctor's prescription, in the following dosage forms: Oral Amlodipine Tablets (U.S. and Canada) Bepridil Tablets (U.S.) Diltiazem Extended-release capsules (U.S. and Canada) Tablets (U.S. and Canada) Felodipine Extended-release tablets (U.S. and Canada) Flunarizine Capsules (Canada) Isradipine Capsules (U.S.) Nicardipine Capsules (U.S.) Nifedipine Capsules (U.S. and Canada) Extended-release tablets (U.S. and Canada) Nimodipine Capsules (U.S. and Canada) Verapamil Extended-release capsules (U.S. and Canada) Tablets (U.S. and Canada) Extended-release tablets (U.S. and Canada) Parenteral Diltiazem Injection (U.S. and Canada) Verapamil Injection (U.S. and Canada)

Storage

To store this Viagra Collection: 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 Viagra Collection to break down. Do not keep outdated Viagra Collection or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Missed Dose

If you miss a dose of this Viagra Collection, 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.

Monograph

Amlodipine, bepridil, diltiazem, felodipine, flunarizine, isradipine, nicardipine, nifedipine, nimodipine, and verapamil belong to the group of medicines called calcium channel blocking agents. Calcium channel blocking agents affect the movement of calcium into the cells of the heart and blood vessels. As a result, they relax blood vessels and increase the supply of blood and oxygen to the heart while reducing its workload. Some of the calcium channel blocking agents are used to relieve and control angina pectoris (chest pain). Some are also used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled. Flunarizine is used to prevent migraine headaches. Nimodipine is used to prevent and treat problems caused by a burst blood vessel around the brain (also known as a ruptured aneurysm or subarachnoid hemorrhage). Other calcium channel blocking agents may also be used for these and other conditions as determined by your doctor.

Other Uses

Once a

Viagra Collection

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, calcium channel blocking agents are used in certain patients with the following medical conditions: Hypertrophic cardiomyopathy (a heart condition) (verapamil) Raynaud's phenomenon (circulation problems) (nicardipine and nifedipine) Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.

How To Use

Take Viagra Collection exactly as directed even if you feel well and do not notice any signs of chest pain. Do not take more of Viagra Collection and do not take it more often than your doctor ordered. Do not miss any doses. For patients taking amlodipine: Your doctor may suggest that you change your diet and eat foods that are low in salt and fat. Losing weight will help your blood pressure along with your medicine. Talk to your doctor about the best diet for you. For patients taking bepridil: If this medicine causes upset stomach, it can be taken with meals or at bedtime. For patients taking diltiazem extended-release capsules : Swallow the capsule whole, without crushing or chewing it. Do not change to another brand without checking with your physician. Different brands have different doses. If you refill your

Viagra Collection

and it looks different, check with your pharmacist. For patients taking felodipine: Do not take Viagra Collection with grapefruit juice. For patients taking verapamil extended-release capsules : Swallow the capsule whole, without crushing or chewing it. For patients taking felodipine or nifedipine extended-release tablets: Swallow the tablet whole, without breaking, crushing, or chewing it. If you are taking Adalat XL or Procardia XL, you may sometimes notice what looks like a tablet in your stool. That is just the empty shell that is left after Viagra Collection has been absorbed into your body. If you are taking Adalat CC, take Viagra Collection on an empty stomach For patients taking verapamil extended-release tablets : Swallow the tablet whole, without crushing or chewing it. However, if your doctor tells you to, you may break the tablet in half. Take Viagra Collection with food or milk. For patients taking this medicine for high blood pressure : In addition to the use of the Viagra Collection your doctor has prescribed, appropriate treatment for your high blood pressure may include weight control and care in the types of food you eat, especially foods high in sodium (salt). Your doctor will tell you which factors are most important for you. You should check with your doctor before changing your diet. Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your Viagra Collection exactly as directed and that you keep your appointments with your doctor even if you feel well. Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure Viagra Collection for the rest of your life . If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease. Dosing— The dose of these medicines 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 capsules or tablets that you take depends on the strength of the Viagra Collection. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take Viagra Collection depend on the medical problem for which you are taking calcium channel blocking agents. For amlodipine For oral dosage form (tablets): For angina (chest pain): Adults—5 to 10 milligrams (mg) once a day. Children—Use must be determined by your doctor.

Viagra Collection
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Note: Elderly patients or patients determined by your health care professional may be started on a lower dose. For high blood pressure: Adults—5 to 10 mg once a day. Children—Use must be determined by your doctor. Note: Elderly patients or patients determined by your health care professional may be started on 2.5 mg once a day. For bepridil For oral dosage form (tablets): For angina (chest pain): Adults—200 to 300 milligrams (mg) once a day. Children—Use and dose must be determined by your doctor. For diltiazem For long-acting oral dosage form (extended-release capsules): For high blood pressure: Adults and teenagers: For Cardizem CD or Dilacor-XR: 180 to 240 milligrams (mg) once a day. For Cardizem SR: 60 to 120 mg two times a day. Children—Dose must be determined by your doctor. For regular (short-acting) oral dosage form (tablets): For angina (chest pain): Adults and teenagers—30 mg three or four times a day. Your doctor may gradually increase your dose as needed. Children—Dose must be determined by your doctor. For injection dosage form: For arrhythmias (irregular heartbeat): Adults and teenagers—Dose is based on body weight and must be determined by your doctor. Children—Use and dose must be determined by your doctor. For felodipine For long-acting oral dosage form (extended-release tablets): For high blood pressure: Adults—5 to 10 milligrams (mg) once a day. Children—Use and dose must be determined by your doctor. For angina (chest pain): Adults—10 mg once a day. Children—Use and dose must be determined by your doctor. For flunarizine For oral dosage form (capsules): To prevent headaches: Adults—10 milligrams (mg) once a day in the evening. Children—Dose must be determined by your doctor. For isradipine For oral dosage form (capsules): For high blood pressure: Adults—2.5 milligrams (mg) two times a day. Your doctor may increase your dose as needed. Children—Use and dose must be determined by your doctor. For nicardipine For oral dosage form (capsules): For high blood pressure or angina (chest pain): Adults and teenagers—20 milligrams (mg) three times a day. Children—Dose must be determined by your doctor. For nifedipine For regular (short-acting) oral dosage form (capsules): For high blood pressure or angina (chest pain): Adults and teenagers—10 milligrams (mg) three times a day. Your doctor may increase your dose as needed. Children—Dose must be determined by your doctor. For long-acting oral dosage form (extended-release tablets): For high blood pressure or angina (chest pain): Adults and teenagers: For Adalat CC, Adalat XL or Procardia XL: 30 or 60 mg once a day. Your doctor may increase your dose as needed. For Adalat PA: 10 or 20 mg two times a day. Your doctor may increase your dose as needed. Children—Dose must be determined by your doctor. For nimodipine For oral dosage form (capsules): To treat a burst blood vessel around the brain: Adults—60 milligrams (mg) every four hours. Children—Dose must be determined by your doctor. For verapamil For regular (short-acting) oral dosage form (tablets): For angina (chest pain), arrhythmias (irregular heartbeat), or high blood pressure: Adults and teenagers—40 to 120 milligrams (mg) three times a day. Your doctor may increase your dose as needed. Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 4 to 8 mg per kilogram (kg) (1.82 to 3.64 mg per pound) of body weight a day. This is divided into smaller doses. For long-acting oral dosage form (extended-release capsules): For high blood pressure: Adults and teenagers—240 to 480 mg once a day. Children—Dose must be determined by your doctor. For long-acting oral dosage form (extended-release tablets): For high blood pressure: Adults and teenagers—120 mg once a day to 240 mg every twelve hours. Children—Dose must be determined by your doctor. For injection dosage form: For arrhythmias (irregular heartbeat): Adults—5 to 10 mg slowly injected into a vein. The dose may be repeated after thirty minutes. Children—Dose is based on body weight and must be determined by your doctor. Infants up to 1 year of age: 100 to 200 micrograms (mcg) per kg (45.5 to 90.9 mcg per pound) of body weight injected slowly into a vein. The dose may be repeated after thirty minutes. Children 1 to 15 years of age: 100 to 300 mcg per kg (45.5 to 136.4 mcg per pound) of body weight injected slowly into a vein. The dose may be repeated after thirty minutes.

Drug Interactions

Other Viagra Collections—Although certain Viagra Collections should not be used together at all, in other cases 2 different Viagra Collections 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 medicine 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 medicines with tricyclic antidepressants may increase the risk of serious effects on the heart Antipsychotics (medicine for mental illness) or Clonidine (e.g., Catapres)—Using these Viagra Collections with tricyclic antidepressants may increase the CNS depressant effects and increase the chance of serious side effects Antithyroid agents (Viagra Collection for overactive thyroid) or Cimetidine (e.g., Tagamet)—Using these Viagra Collections with tricyclic antidepressants may increase the chance of serious side effects Central nervous system (CNS) depressants (medicine that causes drowsiness)—Using these medicines with tricyclic antidepressants may increase the CNS depressant effects Guanadrel (e.g., Hylorel) or Guanethidine (e.g., Ismelin)—Tricyclic antidepressants may keep these medicines 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 Collections may be used together under close supervision by your doctor

Common Brand Names

Some commonly used brand names are: In the U.S.— 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 Viagra Collections: 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

Contraindications

In deciding to use a Viagra Collection, the risks of taking Viagra Collection 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 Collection. This may increase the chance of side effects during treatment. However, side effects in children taking this Viagra Collection 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

Drug

Nortriptyline

Side Effects

Along with its needed effects, a Viagra Collection 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

Viagra Collection

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 Viagra Collection. 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 Viagra Collection 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.

Precautions

It is very important that your doctor check your progress at regular visits to allow dosage adjustments and to help reduce side effects. this medicine will add to the effects of alcohol and other CNS depressants (Viagra Collections that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or Viagra Collection for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping Viagra Collection; prescription pain Viagra Collection or narcotics; barbiturates; Viagra Collection 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 this Viagra Collection . this Viagra Collection 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 Collection 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 Viagra Collection: 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 Viagra Collection. The results of the metyrapone test may be affected by Viagra Collection. Before having any kind of surgery, dental treatment, or emergency treatment, tell the medical doctor or dentist in charge that you are using Viagra Collection. Taking tricyclic antidepressants together with medicines used during surgery or dental or emergency treatments may increase the risk of side effects. For diabetic patients: this Viagra Collection 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 Viagra Collection 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 Viagra Collection 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.

Notes

Tricyclic antidepressants are used to relieve mental depression. One form of Viagra Collection (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 Viagra Collections 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.)

Storage

To store this Viagra Collection: Keep out of the reach of children. Overdose of this medicine is very dangerous in young children. Store away from heat and direct light. Do not store the tablet or capsule form of this Viagra Collection in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause

Viagra Collection

to break down. Keep the liquid form of this Viagra Collection from freezing. Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded Viagra Collection is out of the reach of children.

Missed Dose

If you miss a dose of Viagra Collection 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.

Monograph

Other Uses

Once a Viagra Collection 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.

How To Use

To lessen stomach upset, take Viagra Collection with food, even for a daily bedtime dose, unless your doctor has told you to take it on an empty stomach. Take Viagra Collection 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 this medicine 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 Collection 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 Viagra Collection with grape juice or carbonated beverages since these may decrease the Viagra Collection'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 Viagra Collection. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are 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.