Nexium is a trade name for esomeprazole, a proton pump inhibitor used in the treatment of dyspepsia, peptic ulcers, acid reflux and Zollinger-Ellison syndrome.

How does Nexium work?

Nexium is a proton pump inhibitor which acts by inhibiting the enzyme ATPase in the gut thus preventing the production of gastric acid.

What does Nexium look like?

Nexium is available as a purple capsule in strengths of 20 or 40 mg imprinted with two gold bands and 20 mg, and three gold bands and 40 mg respectively.

Nexium dosing and administration

The standard dosage of Nexium for the treatment of gastroesophageal reflux is 20 mg once a day for between four and eight weeks. If the condition has caused erosive esophagitis, the initial dose may be increased to 40 mg one daily for between four to eight weeks followed by 20 mg daily. Nexium may be given as prophylaxis to reduce the risk of gastric ulcers in patients being treated with NSAIDs. The dosage for this purpose is 20 mg or 40 mg once daily for up to six months. Nexium may be used as part of a triple therapy to combat helicobacter pylori. The dosage for this triple therapy is Nexium 40 mg once per day, amoxicillin 1000 mg twice per day and clarithromycin 500 mg twice daily for ten days. For Zollinger-Ellison syndromes and other conditions involving excessive secretion of gastric acid, the dosage is 40 mg twice per day.

Common adverse effects from Nexium

Common side effects of Nexium may include headache, diarrhea, nausea, flatulence, abdominal pain, constipation and dry mouth. Less common side effects may include allergic reaction, flushing, tachycardia, hypertension, back or chest pain, flushing, indigestion, dysphagia, earache or tinnitus, nosebleed, weigh fluctuations, fibromyalgia, acne, angioedema, rash, taste disturbances, depression, otitis media, blurred vision, pancreatitis or hypomagnesaemia.

Interactions with Nexium

Nexium may interact with a number of other drugs including certain antifungals, cilostazol, clopidogrel (Plavix), dasatnib, diazepam (Valium), digoxin, certain diuretics, erlotinib, iron supplements, mesalamine, some protease inhibitors and warfarin.

Nexium warnings and precautions

Nexium should be taken with caution by people who have any kind of liver disease or liver failure, suffer from allergies or hypomagnesaemia. Although animal trials have not demonstrated any negative fetal effects caused by Nexium, it should be used with caution by pregnant women. Because it has not been established whether Nexium is present in milk, it is recommended that nursing be discontinued while taking Nexium. You should inform your doctor of any other medications your taking including any herbal supplements.

What if I take an accidental overdose of Nexium?

Symptoms of a Nexium overdose may include dry mouth, nausea, headache, vision defects, drowsiness, confusion, and tachycardia. In animal experiments, death has resulted from a dosage equivalent to 103 times the normal dose. There is no effective antidote to Nexium overdose, so treatment should consist of dealing with the symptoms. If you suspect that you or anyone else has taken an overdose of Nexium you should seek immediate medical attention.

Motrin is a proprietary name for ibuprofen, a non-steroid anti-inflammatory drug (NSAID) used for pain relief in a wide range of conditions, particularly where there is inflammation present, as well as for the symptomatic relief of various forms of arthritis, fever and dysmenorrhea. It is also marketed as Brufen, Nurofen, Advil and Nuprin. The World Health Organization has included ibuprofen in its list of essential medications for any basic healthcare system.

How does Motrin work?

Motrin blocks the effects of certain pain transmitting hormones and so can relieve mild and moderate pain. It is also a vasodilator which dilates coronary arteries and certain other blood vessels. It also has an antiplatelet effect but this is less efficient than aspirin or other blood thinning drugs.

What does Motrin look like?

Motrin is available in a large number of proprietary and generic presentations with strength ranging from 50 to 600 mg.

Motrin dosing and administration

The standard self-medication dosage for adults and children older than twelve is 200 mg every four to six hours as needed to relieve pain or reduce fever. This dose may be doubled if the lower dose does not provide relief. No more than 1200 mg of Motrin should be taken in any 24 hours unless prescribed by your doctor. Motrin should not be used for self-medication for more than ten days without medical consultation. You should consult your doctor or pharmacist before giving Motrin to children under twelve years of age. For moderate pain or painful menstruation the standard starting dose is 400 mg every four to six hours, but this level of dosage should only be taken with prior medical advice. For relief of rheumatoid arthritis or osteoarthritis pain the usual dosage is between 1200 and 3200 mg daily divided into several smaller doses. It is important not to take a higher dose of Motrin than is necessary for pain relief in order to avoid the risk of side effects.

Common adverse effects from Motrin

The most common side effects of Motrin are nausea, stomach pain, dyspepsia, vertigo, rash, diarrhea, vomiting, constipation, abdominal cramping, bloating, gas, headache, agitation, tinnitus, anorexia and swelling. More serious side effects are an elevated risk of heart attack or cerebrovascular accident and this risk may increase with long-term Motrin therapy. You should seek urgent medical assistance if you experience chest pain, shortness of breath, isolated physical weakness or slurred speech. Other serious side effects of Motrin may include allergic reactions, perforated ulcer, liver or kidney damage, fluid retention or congestive heart failure. You should seek immediate medical attention if you have a nosebleed, melena, blood in the urine, bloody vomit or reddish-purple spots appear on the skin.

Interactions with Motrin

Motrin may have dangerous interaction with warfarin, other NSAIDs, aspirin, lithium, diuretics, ACE inhibitors, methotrexate, beta blockers, corticosteroids, and a number of herbal supplements including dong quai, garlic, ginkgo biloba, ginseng, feverfew, ginger and St John’s wart. Preparations containing fish oil may also interact with Motrin.

Meridia is a trade name used by Abbott Laboratories for Sibutramine, an appetite suppressant used in the treatment of obesity caused by overeating. The drug was originally marketed by Knoll Pharmaceuticals. Although successful in promoting weight loss in conjunction with a low-calorie diet and exercise, it has been associated with an increased risk of heart attack and cerebrovascular incident and was withdrawn in late 2010 from a number of major markets, including the US, the UK , the European Union, China, Australia, Canada and India.

How does Meridia work?

Meridia is a systemic serotonin-norepinephrine reuptake inhibitor (SNRI) which is chemically related to amphetamines, although it has a different mode of action. It reaches peak blood level after one hour and has a short half life of about one hour. The main activity is caused by active metabolites with half lives of around 15 hours. Meridia works by increasing the levels of the neurotransmitters serotonin, norepinephrine and dopamine in the synaptic gap to promote a sense of fullness, which signals the brain to stop eating. It does not suppress the signal to begin eating.

What does Meridia look like?

Meridia is sold in capsules with 10 or 15 mg strength. The 10 mg capsule is dark blue and white with the imprint “Meridia 10” and the 15 mg capsule is yellow and white with the imprint “15 Meridia”.

Meridia dosing and administration

The standard dose of Meridia for weight loss is 10 mg once daily. Your doctor may increase this to 15 mg once daily if there has been no appreciable weight loss after four weeks of Meridia therapy and calorie restricted diet. If the drug is not well tolerated, your doctor may reduce the dosage to 5 mg once daily. Meridia may be taken with or without food.

Common adverse effects from Meridia

In clinical studies, the most common side effects reported for Meridia included headaches, dry mouth, loss of appetite, constipation, insomnia, nasal congestion and sore throat. These side effects occurred in between 10 and 30 percent of subjects. Other side effects noted in between two and nine percent of people included back pain, fever, chills, muscle ache, weakness, abdominal pain, flushing, migraine, increased appetite, nausea, dyspepsia, joint pain, vertigo, agitation, sinus infections, coughing, sweating, taste changes and other unusual sensations, painful menstrual periods and urinary tract infections. Rare but serious side effects of meridian include hypertension, tachycardia, palpitations, seizures, serotonin syndrome, depression or anxiety and allergic reactions. If you experience any of these while taking Meridia you should seek urgent medical attention.

Meridia warnings and precautions

You should tell your doctor before taking Meridia if you suffer from hypertension or heart problems, if you have had a stroke, kidney or liver disease, glaucoma, epilepsy depression, anorexia nervosa or bulimia. You should also inform your doctor if you have any history of substance abuse including alcohol, if you are pregnant or may become pregnant or are breastfeeding or if you suffer from any allergies.

Interactions with Meridia

Meridia may interact with a wide range of other medications and you should tell your doctor if you are taking any other medications including herbal supplements.

Lexapro is a trade name for escitalopram, a selective serotonin reuptake inhibitor used to treat clinical depression, generalized anxiety disorder and a number of brain conditions. It is a highly selective inhibitor of serotonin reuptake.

How does Lexapro work?

Like all SSRI antidepressants, Lexapro blocks the reuptake of serotonin in the synaptic gap, making increased serotonin available and thus elevating mood.

What does Lexapro look like?

Lexapro is presented as a round white pill in strengths of 5, 10 and 20 mg. They are imprinted with FL 5, FL 10 and FL 20 respectively.

Lexapro dosing and administration

The standard initial dosage of Lexapro for adults or adolescents (from 12 upwards) for the treatment of depression, or for adults with generalized anxiety disorder is 10 mg once a day. If symptomatic relief is not obtained at this level, your doctor may increase your dose. If you no not tolerate the drug well, the dosage may be decreased. Lexapro is intended for long term use. Individual doses can range from 10 to 20 mg once a day. Elderly patients or those with impaired livers should not take more than 10 mg per day. It may take several weeks for the effect of Lexapro to appear, so it is important to be patient when beginning the drug. Lexapro may be taken with or without food, but should be taken at the same time each day to ensure a steady blood plasma level.

Common adverse effects from Lexapro

The most common side effects of Lexapro reported in clinical trials are headache, nausea, delayed ejaculation, lethargy, insomnia, dry mouth, fatigue, abnormal sweating, diarrhea, decreased libido, difficulty reaching orgasm and dizziness. Less common side effects are dyspepsia, anorexia, vomiting, bizarre dreams, weight gain and erectile dysfunction. More serious side effects which should be reported to your doctor without delay include suicidal ideation, anxiety, agitation, panic attacks, hostility or rage, risk-taking or unusual behavior, restlessness, mood swings, serotonin syndrome, palpitations, insomnia or allergic reactions.

Lexapro warnings and precautions

You should inform your doctor before taking Lexapro if you have any history or family history of bipolar disorder or any history of suicidal ideation or suicidal gestures, or if you have had a recent heart attack or have any unstable heart condition, diabetes, epilepsy, liver disease or any allergies. You should also tell your doctor if you are pregnant or may become pregnant or if you are breastfeeding. You should also report any other medications you are taking, including herbal supplements and whether you drink alcohol regularly. Lexapro may increase the risk of suicidal ideation or behavior in adults and teenagers. Because of this, any changes in symptoms or behavior should be discussed with your doctor immediately.

Interactions with Lexapro

Lexapro may interact with alcohol, aspirin, cimetidine, ketoconazole, linezolid, lithium, metoprolol, certain antidepressants such as bupropion, mirtazapine, nefazodone, trazodone and vilazodone, monoamine oxidase inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, celecoxib, diclofenac and oxaprozin, pimozide, other SSRI or SNRI medications, St John’s wort, tramadol, tricyclic antidepressants, triptans, tryptophan and warfarin.

What is Levitra?

Levitra is Bayer’s trade name for vardenafil, a PDE5 inhibitor used for treating erectile dysfunction. It begins working within an hour in most cases and in clinical studies as many as 80 percent of men reported that they experienced improved erections while using it. Levitra has proved suitable for men with a variety of health problems and medical conditions. The effect of Levitra lasts about four hours but its effectiveness begins to diminish after the first two hours.

How does Levitra work?

Levitra works by blocking an enzyme which allows blood to flow out of the penis. Thus the penis retains more blood and this means a more rigid erection.

What does Levitra look like?

Levitra is sold as a round orange pill in strengths of 2.5, 5, 10 and 20 mg. These are imprinted with Bayer 2.5, Bayer 5, Bayer 10 and Bayer 20 respectively.

Levitra dosing and administration

The usual starting dose for Levitra is 10 mg one hour before any planned sexual activity. Depending on how effective it is and how well you tolerate the side effects, your doctor may adjust this dose. In men who are over 65 or who have liver disease, the recommended starting dose is 2.5 mg.

Common adverse effects from Levitra

The most common side effects of Levitra are headache, flushing, dyspepsia, nasal or sinus congestion, nausea, dizziness and back pain. Less common but possibly serious side effects include allergic reaction, angina pectoris, arthritis, vision disturbances, diarrhea, hypertension, insomnia, myalgia sudden hearing loss and priapism. If you experience any of these you should inform your doctor immediately.

Does Levitra affect cardiovascular function?

Levitra is a vasodilator and as such will result in transient decreases in blood pressure in healthy patients. Because of this it should be used with care in patients with cardiovascular disease. It can be a particular problem in patients with aortic stenosis or idiopathic hypertrophic subaortic stenosis.

When should you not take Levitra?

If you are taking any nitrates or nitric oxide donors such as nitroglycerine, it is recommended that you do not take Levitra at the same time, as the combined vasodilatory effect of both drugs could lead to severe hypotension or heart failure. Levitra is not recommended for patients with severe renal impairment or severe hepatic insufficiency.

How long does Levitra last?

The terminal half life of vardenafil and its primary metabolite is somewhere between four and five hours. Thus its practical time of action is somewhat longer than that of sildenafil (Viagra) but considerably less than that of Tadalafil (Cialis).

What does Levitra not do?

Levitra does not provide a permanent cure for erectile dysfunction but only gives temporary symptomatic relief. It does not have any effect on male libido. Levitra does not provide any protection against sexually transmitted diseases and does not serve as a contraceptive. Levitra has not been recommended for any use in women or in children under the age of eighteen.

How effective is Levitra?

In clinical trials, Levitra has been shown to be effective in approximately 50% of men over the age of eighteen who have erectile dysfunction from all causes, including diabetes and prostatectomy.

Lasix is the brand name of Sanofi-Aventis for the diuretic furosemide. This loop diuretic is used mainly in the treatment of high blood pressure and edema. It is commonly used to combat fluid retention caused by congestive heart failure, cirrhosis and kidney failure.

How does Lasix work?

Lasix works by increasing the amount of salt and water removed from the blood by the kidneys and excreted in the urine. This causes a decrease in overall blood volume which in turn lowers blood pressure.

What does Lasix look like?

Lasix is presented as an elliptical white tablet of 20 mg strength and round white tablets of 40 and 80 mg strength.

Lasix dosing and administration

The recommended starting dose of Lasix for high blood pressure is 40 mg twice daily. Depending on how your respond to this and how you tolerate Lasix, your doctor may adjust this dose. The full effect of Lasix in lowering blood pressure may not be apparent for several weeks. The dosage for edema ranges from 20 mg to 600 mg daily. It may be prescribed as a regular medication or the doctor may recommend taking it only when required for fluid retention. The standard initial dosage for Lasix for children is 2 mg per day. This may be increased by the doctor up to 6 mg for each kilogram of body weight.

How should I take Lasix?

Lasix should be taken exactly as prescribed and the dosage should not be increased without consultation with your doctor. Because Lasix will make you urinate more frequently you may experience dehydration. Your doctor may advise you to use a potassium supplement. It is important to have regular blood tests and sometimes kidney and liver function tests to check that there are no adverse effects from Lasix.

What are the possible adverse effects of Lasix?

The most common side effects of Lasix may include constipation of diarrhea, vision disturbances, headache, vertigo, anemia, fever and hypersensitivity to the sun. More serious effects may include dizziness or fainting, dehydration, jaundice, tinnitus, hyperglycemia, or allergic reactions. If you experience any of these problems you should consult your doctor immediately.

Contraindications for Lasix

The use of Lasix may be contraindicated if you have any drug or chemical allergies, fluid or electrolyte problems, lupus, diabetes, liver or kidney disease or difficulty passing urine. If you are or may become pregnant or are breastfeeding you should discuss this with your doctor before taking Lasix.

What if I miss a dose of Lasix?

If you have been prescribed a regular dose of Lasix and you miss a dose, you should take that dose when you remember. However, if it is near to the time your next dose is due, you should skip the first dose. Under no circumstances should you take a double dose of Lasix.

What if I take an accidental overdose of Lasix?

Symptoms of Lasix overdose included tinnitus, anorexia, weakness, vertigo, confusion and fainting. If you think you or someone else may have taken an overdose of Lasix, you should seek emergency medical attention.

What is Klonopin?

Klonopin is Roche’s trade name for Clonazepam, a benzodiazepine used as an anticonvulsant, muscle relaxant and anxiolytic. Because it is a high potency benzodiazepine and has fast onset of effects, it is often used in the treatment of epilepsy, particularly those associated with Lennox-Gastaut syndrome, atonic seizures, myoclonic seizures and absence seizures. It is not suitable for long-term treatment of seizures because tolerance is developed to its anticonvulsant effects. Klonopin is also used for panic disorder. It is one of the longest-acting benzodiazepines with a half life of up to 50 hours.

How does Klonopin work?

Like all benzodiazepines, Klonopin works by enhancing the natural calming effect of the neurotransmitter GABA through modulation of GABA receptors.

What does Klonopin look like?

Klonopin is sold as a round orange pill with 0.5 mg strength and an imprint of “Roche ½ Klopin”, a round blue pill with 1 mg strength and the imprint “Roche 1 Klonopin” and a round white pill of 2 mg strength with the imprint “Roche 2 Klonopin”. All three pills have a perforation in the shape of “K”. Klonopin is also available in disintegrating oral wafers with a strength of 0.125 0.25, 0.5 and 1 mg, imprinted with ?, ¼, ½ and 1 respectively. The wafers are particularly useful for children who may have difficulty in swallowing tablets.

Klonopin dosing and administration

The standard initial dose for epilepsy in adults is 0.5 mg or less, three times a day. Your doctor may increase the dose incrementally as necessary in order to control your seizures. The maximum total daily dose should not exceed 20 mg. The starting dose for panic disorder is 0.25 mg twice daily. You doctor may increase this if necessary.

Common adverse effects from Klonopin

The most common side effects of Klonopin include drowsiness which may occur in as many as fifty percent of patients, coordination problems and behavioral problems which may effect between 25 and 30 percent of people, dizziness and upper respiratory tract infections. Less common adverse effects are aphasia, loss of libido, confusion, sinus infection, irritated or runny nose, coughing, sore throat, fatigue, painful menstrual cramps and sexual problems including erectile dysfunction and delayed ejaculation. Serious side effects which may occur occasionally are depression, balance problems, suicidal thoughts, memory problems, anxiety or agitation, hostility or rage, insomnia and hallucinations.

Klonopin warnings and precautions

Combining alcohol with Klonopin may increase your risk of side effects, particularly respiratory depression which may be life threatening. It is best to avoid alcohol while taking Klonopin. You should tell your doctor before taking Klonopin if you have glaucoma, a history of substance abuse including alcohol, depression, respiratory problems, liver or kidney disease, or any allergies. You should also inform your doctor if you are pregnant or may become pregnant or if you are breastfeeding. You should also report any other medications you are currently taking, including herbal supplements.

Interactions with Klonopin

Klonopin may interact with alcohol, anesthetics, antidepressants, antipsychotics, barbiturates and narcotics, some antibiotics and antifungals, other benzodiazepines, protease inhibitors, seizure medications and sleep medications.

Keflex is the proprietary name of Eli Lilly and Company for cephalexin, a cephalosporin antibiotic used to treat respiratory tract infections, sinus infections and skin infections and as prophylaxis for heart infections. It is the antibiotic of choice for cellulitis and is often used as an alterative to penicillin antibiotics in patients who are allergic to these.

What does Keflex look like?

Keflex is available as a green and white capsule of 250 mg strength and the imprint “Dista H69 Keflex 250 mg”, a dark green and light green capsule of 500 mg strength and the imprint “Dista H71 Keflex 500 mg” and a dark green capsule of 750 mg strength and the imprint “Keflex 750 mg”. It is also available in a large number of generic presentations. In addition it is available in an oral suspension.

Keflex dosing and administration

The standard dose for most bacterial infections is between 250 mg and 1 gram, four times a day for between 7 and 14 days. Your doctor may continue Keflex treatment beyond 14 days for more serious infections. The standard dose for children is between 25 and 100 mg per kilogram of body weight per day. This dose should be divided into three of four doses for the day and taken for between 7 and 14 days. Children should not take more than 4 grams of Keflex in one day. It is important to take Keflex for the full length of time prescribed by your doctor, even if your symptoms have improved.

Common adverse effects from Keflex

Common side effects of Keflex which have emerged in clinical investigations include diarrhea, headache, dyspepsia, nausea, confusion, dizziness, rash and yeast infection. Some side effects may be serious and should be reported immediately to your doctor. These may include hives, extreme diarrhea, melena, throat or mouth ulceration, bleeding or bruising, severe rash, itching, respiratory difficulty, difficulty swallowing, swelling of the throat, skin peeling. More rare side effects of Keflex may include hallucinations, fatigue, joint pain, bloody diarrhea, vomiting, anemia, thrombocytopenia, vaginal discharge, confusion, seizures and enterocolitis.

Keflex warnings and precautions

You should tell your doctor before taking Keflex if you have any kidney disease, are planning to have any surgery, or have any allergies, particularly to other cephalosporins, penicillin or other antibiotics. You should also inform your doctor if you are or may become pregnant or are breastfeeding. It is also important to report any medicines you are taking, including herbal supplements.

Interactions with Keflex

Keflex may interact with probenecid, metformin and fortamet. If you are vaccinated with live typhoid vaccine while taking Keflex, the vaccine may be ineffective and you may not be protected against typhoid. If Keflex is taken together with an aminoglycoside antibiotic such as amikacin, gentamicin, kanamycin, neomycin, streptomycin and tobramycin, there may be an increased risk of kidney damage.

What if I miss a dose of Keflex?

If you miss a dose of Keflex you should take it as soon as you remember. If you are close to the time for the next dose, skip the first one. You should not take a double dose.

What is Kamagra?

Kamagra is a trade name for sildenafil citrate, which is sold by Pfizer under the name Viagra. It is a symptomatic treatment for erectile dysfunction.

Kamagra warnings and precautions

If sildenafil is taken at the same time as a high-fat meal, there is a slowing of the absorption of the drug. Maximum plasma concentration is delayed by up to an hour and the maximum concentration reached may be as much as a third lower. Sildenafil may increase blood flow in the eye. If there is a sudden loss of vision, urgent medial care should be sought. You should inform your doctor if you have a recent history of heart disease or arrhythmia, heart attack, stroke or congestive heart failure, or if you have abnormal blood pressure, coronary artery disease, liver or kidney disease, any blood cell disorder, hemophilia, a stomach ulcer or any anatomical deformity of the penis such as Peyronie’s disease. Nitric oxide donors, including organic nitrites and nitrates such as nitroglycerin, sodium nitroprusside and amyl nitrite and its analogues (poppers) taken together with sildenafil may lead to a dangerous drop in blood pressure. Grapefruit of grapefruit juice should be avoided because it may potentiate the dosage of sildenafil leading to symptoms of overdose.

Contraindications for Kamagra

Sildenafil should not be used by patients with severe liver or renal impairment, low blood pressure, a recent history of stroke or heart attack or genetic degenerative retinal disorders.

What if I take an accidental overdose of Kamagra?

Symptoms of a Kamagra overdose include lightheadedness, sudden indigestion, nausea and vomiting, vision and hearing impairment, irregular heartbeat, tachycardia, myocardial infarct or priapism. If any of these conditions becomes painful, emergency medical care should be sought.

When should you not take Kamagra?

Kamagra should not be used when taking glyceryl trinitrate (nitroglycerin) or other vasodilators which release nitric oxide, including sodium nitroprusside and amyl nitrite (known recreationally as “poppers”). Severely decreased liver function or renal function is also a contraindication. Kamagra should not be taken by patients with low blood pressure or who have recently suffered a stroke or heart attack. Use of the drug should also be avoided by patients with genetic retinal disorders.

Abuse of Kamagra for recreational use

Sildenafil is increasingly popular as a sexual heightener even among people who do not need it for erectile dysfunction. A number of popular myths have grown up including those that the drug increases penis size and libido. Because dance drugs such as amphetamine and MDMA or ecstasy are known to inhibit erections, Sildenafil is often taken in combination with those to overcome that effect.

History of Kamagra

Sildenafil was synthesized in Pfizer’s research center in England as a potential treatment for high blood pressure and angina pectoris. In clinical trials it was noted that the drug was not effective for angina, but that it tended to induce erections among male subjects. It was patented for this use in 1996 and approved in the US by the FDA in March 1988. Pfizer’s patent on Viagra is set to expire in the US in March, 2012, however Pfizer continues to hold a monopoly on manufacturing the drug in Britain.

Ismo is a trade name for isosorbide mononitrate, a vasodilator used to treat angina pectoris due to coronary artery disease as a prophylactic treatment. It is not sufficiently fast acting to stop an acute episode of angina. It has also been used as a cervical dilator to speed delivery in obstetric hospitals

How does Ismo work?

Like all nitrates, Ismo works by dilating blood vessels to reduce the workload on the heart.

What does Ismo look like?

Ismo is supplied as a round orange pill with a strength of 20 mg and imprinted with “Ismo 20 W”.

Ismo dosing and administration

The standard dosage of Ismo is 20 mg three times a day.

Common adverse effects from Ismo

The most common side effect, occurring in more than thirty percent of patients is headache. This tends to occur only in the early stages of treatment. Other common side effects are fatigue, sleep disturbance, gastrointestinal upset, hypotension, loss of appetite and nausea. Hypotension with dizziness and nausea have been reported but generally disappear as treatment continues. Infrequently reported side effects have included tachycardia, vomiting, diarrhea, vertigo and dyspepsia. This last group of side effects have been linked to extended release forms of the drug. Other side effects which have been reported included dysuria, erectile dysfunction, neck stiffness, arthralgia, respiratory problems including bronchitis and pneumonia.

Ismo warnings and precautions

Ismo treatment may occasionally need to be discontinued because of serious side effects including dizziness, headaches and nausea. Severe postural hypotension may occur even when only low doses of Ismo are being used. This may be accompanied by bradycardia and an exacerbation of angina pectoris. Angina resulting from hypertrophic cardiomyopathy may be exacerbated by nitrate therapy. Industrial workers who have had extensive exposure to organic nitrates have shown tolerance to nitrates and the unaccustomed withdrawal of nitrates from these workers have resulted in chest pain, severe heart attacks and death. This indicates a physical dependence associated with nitrates, but this has not yet been directly linked to normal clinical treatment with Ismo. Ismo has been linked to stillbirths and neonatal death in rats exposed to high doses of Ismo. Although there have been no clinical studies on human subjects, Ismo should only be used in pregnancy if there is a compelling potential benefit to the mother. Whether or not Ismo is present in human milk has not been definitely established, but caution should be used in prescribing this drug to nursing mothers. There has been no difference in response noted in elderly patients, but caution should be shown in prescribing to this age group and it is recommended that the starting dosage should be at the lower end of the scale. The safety of Ismo for pediatric use has not been established.

Interactions with Ismo

Drugs with which ismo has serious interactions may include sildenafil (Viagra) which may potentiate the vasodilatory action of Ismo and lead to serious side effects including syncope and heart attack. Calcium channel blockers and organic nitrates may cause severe hypotension in combination with Ismo.