Ramipril

Pronunciation: RA-mi-pril
Generic Name: Ramipril
Brand Name: Altace

Ramipril may cause injury or death to the fetus if taken after the third month of pregnancy. If you think you may be pregnant, contact your doctor right away.

Ramipril is used for:

Treating high blood pressure or decreasing the risk of heart attack, stroke, and death in certain patients. It may be used alone or with other medicines. It is used along with other medicines to manage heart failure and improve survival after a heart attack. It may also be used for other conditions as determined by your doctor.

Ramipril is an angiotensin-converting enzyme (ACE) inhibitor. It works by relaxing blood vessels. This helps to lower blood pressure.

Do NOT use Ramipril if:

• you are allergic to any ingredient in Ramipril or to another ACE inhibitor (eg, lisinopril)


• you have a history of angioedema (swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness) caused by treatment with an ACE inhibitor


• you are in your second or third trimester of pregnancy


• you are taking telmisartan

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

Before using Ramipril:

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

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


• if you are able to become pregnant


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


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


• if you have a history of heart problems (eg, aortic stenosis, heart failure), blood vessel problems, blood flow problems, bone marrow problems, kidney problems (eg, renal artery stenosis), certain liver problems (eg, ascites, cirrhosis), or diabetes


• if you have a history of angioedema, a stroke, or a recent heart attack, or you have had a kidney transplant


• if you have an autoimmune disease (eg, lupus, rheumatoid arthritis, scleroderma)


• if you are dehydrated or have low blood volume, high blood potassium levels, or low blood sodium levels, or if you are on a low-salt (sodium) diet


• if you are receiving treatments to reduce sensitivity to bee stings


• if you are on dialysis or are scheduled to have surgery or undergo anesthesia

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

• Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood pressure may be increased


• Aldosterone blockers (eg, eplerenone), nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), potassium-sparing diuretics (eg, spironolactone, triamterene), potassium supplements, or trimethoprim because the risk of high blood potassium levels may be increased


• Telmisartan because the risk of kidney problems may be increased


• Certain gold-containing medicines (eg, sodium aurothiomalate) because flushing, nausea, vomiting, and low blood pressure may occur


• Lithium or thiopurines (eg, azathioprine) because the risk of their side effects may be increased by Ramipril

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

How to use Ramipril:

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

• Take Ramipril by mouth with or without food.


• Swallow this tablet whole unless your doctor tells you otherwise.


• Continue to take Ramipril even if you feel well. Do not miss any doses.


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

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

Important safety information:

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


• Ramipril may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.


• Ramipril may cause a serious side effect called angioedema. Contact your doctor at once if you develop swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness.


• Ramipril may not work as well in black patients. They may also be at greater risk of side effects. Contact your doctor if your symptoms do not improve or if they become worse.


• Dehydration, excessive sweating, vomiting, or diarrhea may increase the risk of low blood pressure. Contact your health care provider at once if any of these occur.


• Rarely, Ramipril may lower the ability of your body to fight infection. This risk may be greater if you have certain other health problems (eg, kidney problems, collagen vascular disease). Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.


• Check with your doctor before you use a salt substitute or a product that has potassium in it.


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


• Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.


• If you have high blood pressure, do not use nonprescription products that contain stimulants. These products may include diet pills or cold medicines. Contact your doctor if you have any questions or concerns.


• Diabetes patients - Ramipril may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.


• Lab tests, including blood pressure, blood electrolyte levels, heart function, or kidney or liver function, may be performed while you use Ramipril. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Use Ramipril with caution in the ELDERLY; they may be more sensitive to its effects.


• Ramipril should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.


• PREGNANCY AND BREAST-FEEDING: Ramipril may cause birth defects or fetal death if you take it while you are pregnant. If you think you may be pregnant, contact your doctor right away. It is not known if Ramipril is found in breast milk. Do not breast-feed while taking Ramipril.

Possible side effects of Ramipril:

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

Cough; dizziness; headache; tiredness.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the hands, eyes, mouth, face, lips, throat, or tongue; hoarseness); chest pain; dark urine; decreased urination; difficulty swallowing; infection (eg, fever, chills, persistent sore throat); irregular heartbeat; loss of appetite; pale stools; red, swollen, blistered, or peeling skin; seizures; stomach pain (with or without nausea or vomiting); symptoms of low blood pressure (eg, fainting, severe dizziness, lightheadedness); yellowing of the skin or eyes.

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

See also: Ramipril side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fainting; severe dizziness or lightheadedness; weakness.

Proper storage of Ramipril:

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

General information:

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


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


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


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

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

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Ramipril resources

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

• Ramipril Prescribing Information (FDA)


• Ramipril Professional Patient Advice (Wolters Kluwer)


• Ramipril Monograph (AHFS DI)


• ramipril Advanced Consumer (Micromedex) - Includes Dosage Information


• Altace Prescribing Information (FDA)


• Altace Consumer Overview

Compare Ramipril with other medications

• Diabetic Kidney Disease
• Heart Attack
• Heart Failure
• High Blood Pressure
• Left Ventricular Dysfunction

rabies vaccine Intramuscular

RAY-beez VAX-een

Commonly used brand name(s)

In the U.S.

• Imovax Rabies


• Rabavert

Available Dosage Forms:

• Injectable


• Powder for Solution


• Powder for Suspension

Therapeutic Class: Vaccine

Uses For rabies vaccine

Rabies vaccine is an active immunizing agent used to prevent infection caused by the rabies virus. The vaccine works by causing your body to produce its own protection (antibodies) against the rabies virus.

Rabies vaccine is used in two ways. Rabies vaccine is given to persons who have been exposed (e.g., by a bite, scratch, or lick) to an animal that is known, or thought, to have rabies. This is called post-exposure prophylaxis. Rabies vaccine may also be given ahead of time to persons who have a high risk of getting infected with rabies virus. These persons include veterinarians, animal handlers, or travelers who will spend more than 1 month in countries having a high rate of rabies infection, and persons who live, work, or take vacations in wild areas of the country where they are likely to come into contact with wild animals. This is called pre-exposure prophylaxis.

Rabies infection is a serious, and often fatal, infection. In the U.S., rabies in wild animals, especially raccoons, skunks, and bats, accounts for most cases of rabies passed on to humans, pets, and other domestic animals. In Canada, the animals most often infected with rabies are foxes, skunks, bats, dogs, and cats. Horses, swine, and cattle also have been known to become infected with rabies. In much of the rest of the world, including Latin America, Africa, and Asia, dogs account for most cases of rabies passed on to humans.

If you are being (or will be) treated for a possible rabies infection while traveling outside of the U.S. or Canada, contact your doctor as soon as you return to the U.S. or Canada, since it may be necessary for you to have additional treatment.

This vaccine is to be administered only by or under the supervision of your doctor or other health care professional.

Before Using rabies vaccine

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

Allergies

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

Pediatric

This vaccine is not expected to cause different side effects or problems in children than it does in adults.

Geriatric

Many vaccines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of rabies vaccine in the elderly with use in other age groups.

Pregnancy

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

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

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

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

• Chloroquine

Interactions with Food/Tobacco/Alcohol

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

Other Medical Problems

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

• Illness, severe, with fever—The symptoms of the condition may be confused with the possible side effects of the vaccine.

• Immune deficiency condition, or family history of—May decrease the useful effects of the vaccine.

Proper Use of rabies vaccine

You will receive this vaccine while you are in a hospital or clinic. A nurse or other trained health professional will give you this vaccine. The vaccine is injected into the upper arm muscle (deltoid). Very young or small children may have the vaccine injected into the upper leg (thigh) muscle.

In order for the rabies vaccine to work properly, it is very important that you do not miss any doses. Keep your appointments with your doctor.

Dosing

The dose of rabies vaccine 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 rabies vaccine. If your dose is different, do not change it unless your doctor tells you to do so.

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

• For injection dosage form:
  
  • For post-exposure prophylaxis if you have never received rabies vaccine before:
    
    • Adults and children—One dose on the first day after rabies exposure (day 0), then one dose three, seven, and fourteen days later for a total of four doses. On the first day, you will also receive an injection of the rabies immune globulin.
    
    
    • Adults and children with an immune system problem will need five doses of the vaccine. The last dose is given twenty-eight days after the first dose.
    
    
  
  
  • For post-exposure prophylaxis if you have received rabies vaccine before:
    
    • Adults and children—One dose on the first day, then one dose three days later for a total of two doses.
    
    
  
  
  • For pre-exposure prophylaxis if you have never received rabies vaccine before:
    
    • Adults and children—One dose on the first day, then one dose seven and twenty-one or twenty-eight days later for a total of three doses. The vaccine is injected into, or under the skin of, the muscle (deltoid) in the upper arm. Very young or small children may have the vaccine injected into the upper leg (thigh) muscle.
    
    
  
  
  • For pre-exposure prophylaxis if you have received rabies vaccine before (also known as a booster dose):
    
    • Adults and children—One dose injected into, or under the skin of, the muscle (deltoid) in the upper arm. Very young or small children may have the vaccine injected into the upper leg (thigh) muscle.
    
    
  
  

Missed Dose

Call your doctor or pharmacist for instructions.

Precautions While Using rabies vaccine

It is very important that your doctor check your progress at regular visits to make sure that this vaccine is working properly.

This vaccine may cause some people to become dizzy. Make sure you know how you react to this vaccine before you drive, use machines, or do anything else that could be dangerous if you are dizzy.

rabies vaccine Side Effects

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

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

Rare

• Hives or skin rash

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

More common

• Chills


• dizziness


• fever


• general feeling of discomfort or illness


• headache


• itching, pain, redness, or swelling at the place of injection


• muscle or joint aches


• nausea


• stomach or abdominal pain


• tiredness or weakness

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

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

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

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

radiopharmaceutical

Class Name: radiopharmaceutical (Oral route)

Commonly used brand name(s)

In the U.S.

• Iodotope

Available Dosage Forms:

• Kit

Uses For This Medicine

Radiopharmaceuticals are agents used to diagnose certain medical problems or treat certain diseases. They may be given to the patient in several different ways. For example, they may be given by mouth, given by injection, or placed into the eye or into the bladder.

These radiopharmaceuticals are used in the diagnosis of:

• Abscess and infection—Gallium Citrate Ga 67, Indium In 111 Oxyquinoline


• Biliary tract blockage—Technetium Tc 99m Disofenin, Technetium Tc 99m Lidofenin, Technetium Tc 99m Mebrofenin


• Blood volume studies—Radioiodinated Albumin, Sodium Chromate Cr 51


• Blood vessel diseases—Sodium Pertechnetate Tc 99m


• Blood vessel diseases of the brain—Ammonia N 13, Iofetamine I 123, Technetium Tc 99m Bicisate, Technetium Tc 99m Exametazime, Xenon Xe 133


• Bone diseases—Sodium Fluoride F 18, Technetium Tc 99m Medronate, Technetium Tc 99m Oxidronate, Technetium Tc 99m Pyrophosphate, Technetium Tc 99m (Pyro- and trimeta-) Phosphates


• Bone marrow diseases—Sodium Chromate Cr 51, Technetium Tc 99m Albumin Colloid, Technetium Tc 99m Sulfur Colloid


• Brain diseases and tumors—Fludeoxyglucose F 18, Indium In 111 Pentetreotide, Iofetamine I 123, Sodium Pertechnetate Tc 99m, Technetium Tc 99m Exametazime, Technetium Tc 99m Gluceptate, Technetium Tc 99m Pentetate


• Cancer; tumors—Fludeoxyglucose F 18, Gallium Citrate Ga 67, Indium In 111 Pentetreotide, Methionine C 11, Radioiodinated Iobenguane, Sodium Fluoride F 18, Technetium Tc 99m Arcitumomab, Technetium Tc 99m Nofetumomab Merpentan


• Colorectal disease—Technetium Tc 99m Arcitumomab


• Disorders of iron metabolism and absorption—Ferrous Citrate Fe 59


• Heart disease—Ammonia N 13, Fludeoxyglucose F 18, Rubidium Rb 82, Sodium Pertechnetate Tc 99m, Technetium Tc 99m Albumin, Technetium Tc 99m Sestamibi, Technetium Tc 99m Teboroxime, Technetium Tc 99m Tetrofosmin, Thallous Chloride Tl 201


• Heart muscle damage (infarct)—Ammonia N 13, Fludeoxyglucose F 18, Rubidium Rb 82, Technetium Tc 99m Pyrophosphate, Technetium Tc 99m (Pyro- and trimeta-) Phosphates, Technetium Tc 99m Sestamibi, Technetium Tc 99m Teboroxime, Technetium Tc 99m Tetrofosmin, Thallous Chloride Tl 201


• Impaired flow of cerebrospinal fluid in brain—Indium In 111 Pentetate


• Kidney diseases—Iodohippurate Sodium I 123, Iodohippurate Sodium I 131, Iothalamate Sodium I 125, Technetium Tc 99m Gluceptate, Technetium Tc 99m Mertiatide, Technetium Tc 99m Pentetate, Technetium Tc 99m Succimer


• Liver diseases—Ammonia N 13, Fludeoxyglucose F 18, Technetium Tc 99m Albumin Colloid, Technetium Tc 99m Disofenin, Technetium Tc 99m Lidofenin, Technetium Tc 99m Mebrofenin, Technetium Tc 99m Sulfur Colloid


• Lung diseases—Krypton Kr 81m, Technetium Tc 99m Albumin Aggregated, Technetium Tc 99m Pentetate, Xenon Xe 127, Xenon Xe 133


• Parathyroid diseases; parathyroid cancer—Technetium Tc 99m Sestamibi, Thallous Chloride Tl 201


• Pernicious anemia; improper absorption of vitamin B12 from intestines—Cyanocobalamin Co 57


• Red blood cell diseases—Sodium Chromate Cr 51


• Salivary gland diseases—Sodium Pertechnetate Tc 99m


• Spleen diseases—Sodium Chromate Cr 51, Technetium Tc 99m Albumin Colloid, Technetium Tc 99m Sulfur Colloid


• Stomach and intestinal bleeding—Sodium Chromate Cr 51, Sodium Pertechnetate Tc 99m, Technetium Tc 99m (Pyro- and trimeta-) Phosphates, Technetium Tc 99m Sulfur Colloid


• Stomach problems—Technetium Tc 99m Sulfur Colloid


• Tear duct blockage—Sodium Pertechnetate Tc 99m


• Thyroid diseases; thyroid cancer—Fludeoxyglucose F 18, Indium In 111 Pentetreotide, Radioiodinated Iobenguane, Sodium Iodide I 123, Sodium Iodide I 131, Sodium Pertechnetate Tc 99m, Technetium Tc 99m Sestamibi


• Urinary bladder diseases—Sodium Pertechnetate Tc 99m

Radiopharmaceuticals are radioactive agents. However, when small amounts are used, the radiation your body receives from them is very low and is considered safe. When larger amounts of these agents are given to treat disease, there may be different effects on the body.

When radiopharmaceuticals are used to help diagnose medical problems, only small amounts are given to the patient. The radiopharmaceutical then passes through, or is taken up by, an organ of the body (which organ depends on what radiopharmaceutical is used and how it has been given). Then the radioactivity is detected, and pictures are produced, by special imaging equipment. These pictures allow the nuclear medicine doctor to study how the organ is working and to detect cancer or tumors that may be present in the organ.

Some radiopharmaceuticals are used in larger amounts to treat certain kinds of cancer and other diseases. In those cases, the radioactive agent is taken up in the cancerous area and destroys the affected tissue. The information that follows applies only to radiopharmaceuticals when used in small amounts to diagnose medical problems.

The dosages of radiopharmaceuticals that are used to diagnose medical problems will be different for different patients and depend on the type of test. The amount of radioactivity of a radiopharmaceutical is expressed in units called becquerels or curies. Radiopharmaceutical dosages given may be as small as 0.185 megabecquerels (5 microcuries) or as high as 1295 megabecquerels (35 millicuries). The radiation received from these dosages may be about the same as, or even less than, the radiation received from an x-ray study of the same organ.

Radiopharmaceuticals are to be given only by or under the direct supervision of a doctor with specialized training in nuclear medicine.

OncoScint(R) CR/CV (satumomab pendetide) was discontinued in the United States on December 26, 2002.

Marketing of NeutroSpec (technetium 99m TC fanolesomab) was discontinued by Palatin Technologies, their marketing partner, Mallinckrodt, and the FDA. The risk of severe and fatal allergic-type reactions outweigh its benefit.

Before Using This Medicine

In deciding to receive a diagnostic test, the risks of taking the test must be weighed against the good it will do. This is a decision you and your doctor will make. For these tests, the following should be considered:

Allergies

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

Pediatric

For most radiopharmaceuticals, the amount of radiation used for a diagnostic test is very low and considered safe. However, be sure you have discussed with your doctor the benefit versus the risk of exposing your child to radiation.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. Although there is no specific information comparing use of most radiopharmaceuticals in the elderly with use in other age groups, problems would not be expected to occur. However, it is a good idea to check with your doctor if you notice any unusual effects after receiving a radiopharmaceutical.

Pregnancy

Radiopharmaceuticals usually are not recommended for use during pregnancy. This is to avoid exposing the fetus to radiation. Some radiopharmaceuticals may be used for diagnostic tests in pregnant women, but it is necessary to inform your doctor if you are pregnant so the doctor may reduce the radiation dose to the baby. This is especially important with radiopharmaceuticals that contain radioactive iodine, which can go to the baby's thyroid gland and, in high enough amounts, may cause thyroid damage. Be sure you have discussed this with your doctor.

Breast Feeding

Some radiopharmaceuticals pass into the breast milk and may expose the baby to radiation. If you must receive a radiopharmaceutical, it may be necessary for you to stop breast-feeding for some time after receiving it. Be sure you have discussed this with your doctor.

Interactions with Medicines

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

Interactions with Food/Tobacco/Alcohol

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

Proper Use of This Medicine

The nuclear medicine doctor may have special instructions for you in preparation for your test. For example, before some tests you must fast for several hours, or the results of the test may be affected. For other tests you should drink plenty of liquids. If you do not understand the instructions you receive or if you have not received any instructions, check with the nuclear medicine doctor in advance.

Precautions While Using This Medicine

There are usually no special precautions to observe for radiopharmaceuticals when they are used in small amounts for diagnosis.

Some radiopharmaceuticals may accumulate in your bladder. Therefore, to increase the flow of urine and lessen the amount of radiation to your bladder, your doctor may instruct you to drink plenty of liquids and urinate often after certain tests.

For patients receiving radioactive iodine (iodohippurate sodium I 123, iodohippurate sodium I 131, iofetamine I 123, iothalamate I 125, radioiodinated albumin, or radioiodinated iobenguane):

• Make sure your doctor knows if you are planning to have any future thyroid tests. Even after several weeks, the results of the thyroid test may be affected by the iodine solution that may be given before the radiopharmaceutical.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. When radiopharmaceuticals are used in very small doses to study an organ of the body, side effects are rare and usually involve an allergic reaction. These effects may occur almost immediately or a few minutes after the radiopharmaceutical is given. It may be helpful to note the time when you first notice any side effect. Your doctor, nuclear medicine physician and/or technologist, or nurse will be prepared to give you immediate medical attention if needed.

Check with your doctor or nurse immediately if any of the following side effects occur:

Rare

• Chills


• difficulty breathing


• drowsiness (severe)


• fainting


• fast heartbeat


• fever


• flushing or redness of skin


• headache (severe)


• nausea or vomiting


• skin rash, hives, or itching


• stomach pain


• swelling of throat, hands, or feet

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

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

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

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Rabies Vaccine (obsolete)

Generic Name: rabies vaccine (ray BEES vack seen)

Brand Names: Imovax Rabies (obsolete), Imovax Rabies I.D. (obsolete), RabAvert (obsolete), Rabies Vaccine (obsolete)

What is Rabies Vaccine (obsolete) (rabies vaccine)?

Rabies is a serious disease caused by a virus. Rabies is mainly a disease of animals. Humans get rabies when they are bitten by an infected animal. There may be no symptoms at first, but weeks or even years after a bite from an infected animal, rabies can cause pain, fatigue, headaches, irritability, fever, seizures, hallucinations, and paralysis. Rabies can be fatal.

What is the most important information I should know about Rabies Vaccine (obsolete) (rabies vaccine)?

People with minor illnesses, such as a cold, may be vaccinated. Those who are moderately or severely ill should usually wait until they recover before getting rabies vaccine. However, if you have been exposed to the rabies virus, you should get the vaccine regardless of any other illnesses you may have.

What should I discuss with my healthcare provider before receiving Rabies Vaccine (obsolete) (rabies vaccine)?

Tell your doctor if you have had a life-threatening allergic reaction to the rabies vaccine or a component of the vaccine.

People at high risk of exposure to rabies include veterinarians, animal handlers, rabies laboratory workers, spelunkers, rabies biologics production workers, or anyone who is likely to come in contact with infected animals or the virus itself. These people should be offered rabies vaccine.

Before receiving rabies vaccine, talk to your doctor if you:

• 
  

  have HIV or AIDS or another disease that affects the immune system;

  
  


• 
  

  are taking an antimalarial drug;

  
  


• 
  

  are taking a medication that affects the immune system (e.g. steroids, anti-rejection medications);

  
  


• 
  

  have cancer; or

  
  


• 
  

  are receiving cancer treatment with x-rays, radiation, or medication.

  
  

Ask your healthcare provider for more information. Rabies vaccine may not be recommended in some cases.

People with minor illnesses, such as a cold, may be vaccinated. Those who are moderately or severely ill should usually wait until they recover before getting rabies vaccine. However, if you have been exposed to the rabies virus, you should get the vaccine regardless of any other illnesses you may have.

Talk to your doctor before receiving rabies vaccine if you are pregnant or breast-feeding a baby.

How is rabies vaccine administered?

Your doctor, nurse, or other healthcare provider will administer the rabies vaccine as an injection.

What happens if I miss a dose?

Talk to your doctor if you miss a dose.

What happens if I overdose?

An overdose of rabies vaccine is unlikely to occur.

What should I avoid before or after getting Rabies Vaccine (obsolete) (rabies vaccine)?

There are no restrictions on food, beverages, or activity before or after receiving rabies vaccine.

Rabies Vaccine (obsolete) (rabies vaccine) side effects

Getting rabies disease is much riskier than getting rabies vaccine. However, a vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of rabies vaccine causing serious harm, or death, is extremely small.

Seek emergency medical attention or contact your doctor immediately if any of the following rare but serious side effects from rabies vaccine are experienced:

• 
  

  a serious allergic reaction including swelling of the lips, tongue, or face; difficulty breathing; closing of the throat; hives; paleness; weakness; dizziness; or a fast heart beat within a few minutes to a few hours after the shot;

  
  


• 
  

  high fever; or

  
  


• 
  

  behavior changes.

  
  

Some people who get rabies vaccine get a sore spot where the shot was given.

Side effects other than those listed here may also occur. Contact your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Rabies Vaccine (obsolete) (rabies vaccine)?

Talk to your doctor before receiving rabies vaccine if you are taking any of the following medications that may affect the immune system:

• 
  

  an oral or injectable steroid medication such as betamethasone (Celestone), cortisone (Cortone), dexamethasone (Decadron, Dexone), hydrocortisone (Cortef, Hydrocortone), methylprednisolone (Medrol), prednisolone (Prelone, Pediapred), prednisone (Orasone, Deltasone, others), or triamcinolone (Aristocort);

  
  


• 
  

  an inhaled or nasal steroid such as beclomethasone (Qvar, Beclovent, Beconase, Vanceril, Vancenase), budesonide (Pulmicort, Rhinocort), flunisolide (Aerobid, Nasalide, Nasarel), fluticasone (Flovent, Flonase), mometasone (Nasonex), or triamcinolone (Azmacort, Nasacort);

  
  


• 
  

  treatment for cancer with chemotherapy (medication), radiation, or x-rays;

  
  


• 
  

  azathioprine (Imuran);

  
  


• 
  

  basiliximab (Simulect);

  
  


• 
  

  cyclosporine (Sandimmune, Neoral, Gengraf);

  
  


• 
  

  etanercept (Enbrel);

  
  


• 
  

  leflunomide (Arava);

  
  


• 
  

  muromonab-CD3 (Orthoclone);

  
  


• 
  

  mycophenolate mofetil (CellCept);

  
  


• 
  

  sirolimus (Rapamune); or

  
  


• 
  

  tacrolimus (Prograf).

  
  

Other drugs may affect rabies vaccine, talk to your doctor about any medications you are taking.

Where can I get more information?

• Your doctor or pharmacist may have additional information or suggest additional resources regarding rabies vaccine.

Robitussin-DM

Generic Name: dextromethorphan and guaifenesin (DEX troe me THOR fan and gwye FEN e sin)

Brand Names: Allfen DM, Altarussin DM, Aquatab DM, Benylin Expectorant, Drituss DM, Extuss LA, Fenesin DM IR, Glycotuss-DM, Guaifen DM, Mucinex Children's Cough, Mucinex DM, MucusRelief DM, Naldecon DX Liquigel, Relacon LAX, Respa-DM, Robitussin Cough & Congestion, Tussi-Bid, Tussi-Organidin DM NR, Vicks 44E

What is Robitussin-DM (dextromethorphan and guaifenesin)?

Dextromethorphan is a cough suppressant. It affects the signals in the brain that trigger cough reflex.

Guaifenesin is an expectorant. It helps loosen congestion in your chest and throat, making it easier to cough out through your mouth.

The combination of dextromethorphan and guaifenesin is used to treat cough and chest congestion caused by the common cold, infections, or allergies.

Dextromethorphan will not treat a cough that is caused by smoking, asthma, or emphysema.

Dextromethorphan and guaifenesin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Robitussin-DM (dextromethorphan and guaifenesin)?

Do not give this medication to a child younger than 2 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. Do not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cough or cold medicine before the MAO inhibitor has cleared from your body. Do not use any other over-the-counter cough or cold medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains dextromethorphan or guaifenesin. Dextromethorphan will not treat a cough that is caused by smoking, asthma, or emphysema.

What should I discuss with my healthcare provider before taking Robitussin-DM (dextromethorphan and guaifenesin)?

Do not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cough or cold medicine before the MAO inhibitor has cleared from your body.

Ask a doctor or pharmacist if it is safe for you to take this medication if you have emphysema or chronic bronchitis.

FDA pregnancy category C. It is not known whether dextromethorphan and guaifenesin is harmful to an unborn baby. Before you take this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether this medication passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

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

How should I take Robitussin-DM (dextromethorphan and guaifenesin)?

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

Do not give this medication to a child younger than 2 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children.

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

Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.

Dextromethorphan and guaifenesin granules should be sprinkled directly onto the tongue and swallowed right away.

Drink extra fluids to help loosen the congestion and lubricate your throat while you are taking this medication. Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash.

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

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

What happens if I miss a dose?

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

What happens if I overdose?

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

Overdose symptoms may include feeling restless or nervous.

What should I avoid while taking Robitussin-DM (dextromethorphan and guaifenesin)?

This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can increase some of the side effects of this medication.

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

Do not use any other over-the-counter cough or cold medication without first asking your doctor or pharmacist. Dextromethorphan and guaifenesin are contained in many medicines available over the counter. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains dextromethorphan or guaifenesin.

Robitussin-DM (dextromethorphan and guaifenesin) side effects

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

• 
  

  severe dizziness, anxiety, restless feeling, or nervousness;

  
  


• 
  

  confusion, hallucinations; or

  
  


• 
  

  slow, shallow breathing.

  
  

Less serious side effects may include:

• 
  

  dizziness;

  
  


• 
  

  headache;

  
  


• 
  

  skin rash or itching; or

  
  


• 
  

  nausea, vomiting, or stomach upset.

  
  

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

What other drugs will affect Robitussin-DM (dextromethorphan and guaifenesin)?

Before taking this medication, tell your doctor if you are using any of the following drugs:

• 
  

  celecoxib (Celebrex);

  
  


• 
  

  cinacalcet (Sensipar);

  
  


• 
  

  darifenacin (Enablex);

  
  


• 
  

  imatinib (Gleevec);

  
  


• 
  

  quinidine (Quinaglute, Quinidex);

  
  


• 
  

  ranolazine (Ranexa);

  
  


• 
  

  ritonavir (Norvir);

  
  


• 
  

  sibutramine (Meridia);

  
  


• 
  

  terbinafine (Lamisil);

  
  


• 
  

  medicines to treat high blood pressure; or

  
  


• 
  

  an antidepressant such as amitriptyline (Elavil, Etrafon), bupropion (Wellbutrin, Zyban), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Janimine, Tofranil), paroxetine (Paxil), sertraline (Zoloft), and others.

  
  

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

More Robitussin-DM resources

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

Compare Robitussin-DM with other medications

• Cough
• Expectoration

Where can I get more information?

• Your pharmacist can provide more information about dextromethorphan and guaifenesin.

See also: Robitussin-DM side effects (in more detail)

Ranitidine Effervescent Tablets

Pronunciation: ra-NI-ti-deen
Generic Name: Ranitidine
Brand Name: Zantac 25 mg EFFERdose

Ranitidine Effervescent Tablets are used for:

Treating heartburn or irritation of the esophagus caused by gastroesophageal reflux disease (GERD). It may be used to treat severe irritation of the esophagus (erosive esophagitis) and to maintain healing of erosive esophagitis. It may be used for short-term treatment of stomach or small intestinal ulcers. It may be used to treat conditions that cause your body to make too much stomach acid (eg, Zollinger-Ellison syndrome). It may also be used for other conditions as determined by your doctor.

Ranitidine Effervescent Tablets are an H₂-receptor blocker. It works by blocking the action of histamine in the stomach. This reduces the amount of acid the stomach makes. Reducing stomach acid helps to reduce heartburn, heal irritation of the esophagus, and heal ulcers of the stomach or intestines.

Do NOT use Ranitidine Effervescent Tablets if:

• you are allergic to any ingredient in Ranitidine Effervescent Tablets


• you have a history of the blood disease porphyria


• you are taking dasatinib

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

Before using Ranitidine Effervescent Tablets:

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

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


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


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


• if you have a history of kidney or liver problems


• if you have phenylketonuria

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

• Certain benzodiazepines (eg, midazolam, triazolam), glipizide, procainamide, or warfarin because the risk of their side effects may be increased by Ranitidine Effervescent Tablets


• Anticoagulants (eg, warfarin) because the risk of their side effects may be increased or their effectiveness may be decreased by Ranitidine Effervescent Tablets


• Dasatinib, delavirdine, gefitinib, certain HIV protease inhibitors (eg, atazanavir), itraconazole, or ketoconazole because their effectiveness may be decreased by Ranitidine Effervescent Tablets

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

How to use Ranitidine Effervescent Tablets:

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

• Take Ranitidine Effervescent Tablets by mouth with or without food.


• Do not chew or swallow the tablet or dissolve it on the tongue. Place the tablet in a glass and add at least 5 mL (1 teaspoonful) of water, as directed by your doctor. Allow the tablet to dissolve completely, then drink all of the liquid. Rinse the container with an additional small amount of water and drink the contents to ensure the entire dose is taken. You may use a dropper or oral syringe to give Ranitidine Effervescent Tablets. Ask your pharmacist for help if you are unsure of how to prepare or use Ranitidine Effervescent Tablets.


• If you also take itraconazole or ketoconazole, ask your doctor or pharmacist how to take it with Ranitidine Effervescent Tablets.


• You may take antacids while you are using Ranitidine Effervescent Tablets if you are directed to do so by your doctor.


• Continue to take Ranitidine Effervescent Tablets even if you feel well. Do not miss any doses.


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

Ask your health care provider any questions you may have about how to use Ranitidine Effervescent Tablets.

Important safety information:

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


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


• Ranitidine Effervescent Tablets may interfere with certain lab tests, including urine protein tests. Be sure your doctor and lab personnel know you are taking Ranitidine Effervescent Tablets.


• Ranitidine Effervescent Tablets should not be used in CHILDREN younger than 1 month old; safety and effectiveness in these children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Ranitidine Effervescent Tablets while you are pregnant. Ranitidine Effervescent Tablets are found in breast milk. If you are or will be breast-feeding while you use Ranitidine Effervescent Tablets, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Ranitidine Effervescent Tablets:

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

Constipation; diarrhea; headache; nausea; stomach upset.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); change in the amount of urine produced; confusion; dark urine; depression; fast, slow, or irregular heartbeat; fever, chills, or sore throat; hallucinations; severe or persistent headache or stomach pain; unusual bruising or bleeding; yellowing of the eyes or skin.

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

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include dizziness; trouble walking.

Proper storage of Ranitidine Effervescent Tablets:

Store Ranitidine Effervescent Tablets between 36 and 86 degrees F (2 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Ranitidine Effervescent Tablets out of the reach of children and away from pets.

General information:

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


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


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


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

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

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Ranitidine resources

• Ranitidine Use in Pregnancy & Breastfeeding
• Drug Images
• Ranitidine Drug Interactions
• Ranitidine Support Group
• 32 Reviews for Ranitidine - Add your own review/rating

Compare Ranitidine with other medications

• Duodenal Ulcer
• Duodenal Ulcer Prophylaxis
• Erosive Esophagitis
• Gastric Ulcer Maintenance Treatment
• Gastrointestinal Hemorrhage
• GERD
• Indigestion
• Pathological Hypersecretory Conditions
• Stomach Ulcer
• Stress Ulcer Prophylaxis
• Surgical Prophylaxis
• Zollinger-Ellison Syndrome

Rituxan

Pronunciation: ri-TUX-i-mab
Generic Name: Rituximab
Brand Name: Rituxan

Severe and sometimes fatal infusion reactions may occur with Rituxan. These reactions may occur while you receive Rituxan or within 24 hours after you receive it. Tell your doctor right away if you develop blurred vision, chest pain, cough, dizziness, drowsiness, fainting, headache, hives, irregular heartbeat, itching, numbness of an arm or leg, swelling, trouble breathing, or wheezing while you receive or after you receive Rituxan.

Severe and sometimes fatal kidney problems and skin reactions may also occur during treatment with Rituxan. Tell your doctor right away if you experience decreased urination; red, swollen, peeling, or blistered skin; or skin or mouth sores or ulcers.

Rarely, a severe and sometimes fatal viral infection of the brain (progressive multifocal leukoencephalopathy [PML]) has been reported with the use of Rituxan in certain patients. Tell your doctor right away if you notice new or worsening medical problems, such as confusion, disorientation, or problems thinking; decreased strength or weakness; unusual vision problems (eg, blurred vision, loss of vision); trouble walking or talking; or loss of balance or coordination.

Rituxan is used for:

Treating patients who have certain types of non-Hodgkin lymphoma. It may be used alone or in combination with other medicines. It is also used along with another medicine (methotrexate) to treat certain patients who have rheumatoid arthritis (RA). It is used along with other medicines (fludarabine and cyclophosphamide) to treat a certain type of chronic lymphocytic leukemia (CLL). It is also used along with corticosteroids (eg, methylprednisolone) to treat certain blood vessel disorders (Wegener granulomatosis [WG], microscopic polyangiitis [MPA]). It may also be used for other conditions as determined by your doctor.

Rituxan is a monoclonal antibody. It works by lowering the number of certain types of white blood cells (B cells) in the body. This helps to treat the non-Hodgkin lymphoma. This also helps to decrease pain, swelling, and inflammation in certain patients with RA.

Do NOT use Rituxan if:

• you are allergic to any ingredient in Rituxan or to mouse or rat protein


• you have RA, unless you have tried certain other medicines (tumor necrosis factor [TNF] antagonists [eg, infliximab]) and they did not work well enough


• you currently have a severe infection

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

Before using Rituxan:

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

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


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


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


• if you have symptoms of an infection (eg, chills, fever, persistent sore throat), an infection that will not go away or keeps coming back, a history of frequent infections, or a weakened immune system


• if you have a history of hepatitis B, hepatitis C, or other viral infections (eg, chickenpox, cytomegalovirus, herpes, Jamestown Canyon virus [JCV], parvovirus, shingles, West Nile virus); an autoimmune disorder (eg, lupus); other cancers; or if you are receiving chemotherapy or immunosuppressants (eg, cyclosporine)


• if you have a history of kidney, liver, lung, or blood problems; heart problems (eg, irregular heartbeat, chest pain); bowel problems; or electrolyte problems


• if you are scheduled to have surgery


• if you have had a recent vaccination or are scheduled to receive vaccination


• if you have developed an infusion reaction, heart or lung problems, or serious skin problems from a previous dose of Rituxan


• if you take medicine for high blood pressure


• if you have RA and are taking or have taken a TNF inhibitor or a disease-modifying antirheumatic drug (DMARD)


• if you have taken Rituxan for WG or MPA in the past

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

• Cisplatin because serious kidney toxicity or kidney failure may occur


• Medicines for high blood pressure because they may increase the risk of low blood pressure when you receive Rituxan

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

How to use Rituxan:

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

• Rituxan comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Rituxan refilled.


• Rituxan is usually given as an injection at your doctor's office, hospital, or clinic.


• Do not use Rituxan if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.


• You may receive other medicines before your dose of Rituxan. This is to decrease the chance of an infusion reaction. Discuss any questions with your doctor.


• Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.


• If you miss a dose of Rituxan, contact your doctor right away.

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

Important safety information:

• Rituxan may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Rituxan with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Rituxan may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.


• The risk of serious and sometimes fatal bacterial, fungal, or viral infections may be greater while you use Rituxan and for up to 1 year after you stop using it. JCV infection may cause a serious and sometimes fatal condition called PML. Signs of PML may include confusion, disorientation, or trouble thinking; decreased strength or weakness; unusual vision problems (eg, blurred vision, loss of vision); trouble walking or talking; or loss of balance or coordination. Tell your doctor right away if you notice any of these effects or other signs or symptoms of infection.


• Serious liver problems may develop with the use of Rituxan in patients who have hepatitis B infection or who carry the hepatitis B virus. Tell your doctor right away if you develop signs of liver problems, including dark urine, pale stools, severe stomach pain, or yellowing of the eyes or skin.


• Do not receive a live vaccine (eg, measles, mumps) while you are taking Rituxan. Talk with your doctor before you receive any vaccine.


• Rituxan may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.


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


• Women who may become pregnant must use effective birth control while they use Rituxan and for 12 months after they stop using it. Check with your doctor if you have questions about effective birth control.


• Lab tests, including kidney and liver function, complete blood cell counts, and blood electrolytes, may be performed while you use Rituxan and for several months after you stop using it. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Use Rituxan with caution in the ELDERLY; they may be more sensitive to its effects, especially irregular heartbeat, breathing problems, and lung infection.


• Rituxan should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: It is not known if Rituxan can cause harm to the fetus. Do not become pregnant while you use Rituxan and for 12 months after you stop using it. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Rituxan while you are pregnant. It is not known if Rituxan is found in breast milk. If you are or will be breast-feeding while you use Rituxan, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Rituxan:

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

Diarrhea; flushing; headache; indigestion; light-headedness; mild fever and chills, especially with the first dose; mild muscle or joint pain; muscle spasms; nausea; night sweats; runny nose; sneezing; throat irritation; trouble sleeping; vomiting; weakness.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest or throat; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness); blurred vision or other vision changes; changes in thinking or strength; chest pain; confusion; decreased amount of urine or dark urine; decreased balance or coordination; disorientation; dizziness; drowsiness; fainting; fast or irregular heartbeat; fever, chills, cough, or persistent sore throat; headache; numbness of an arm or leg; painful urination; persistent muscle, back, or joint pain; red, swollen, peeling, or blistered skin; severe or persistent stomach pain; severe weakness or fatigue; shortness of breath; skin or mouth sores or ulcers; sudden leg pain; swelling of the hands, legs, or feet; trouble walking or talking; unusual bleeding or bruising; wheezing; white patches in the mouth or throat.

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

See also: Rituxan side effects (in more detail)

If OVERDOSE is suspected:

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

Proper storage of Rituxan:

Rituxan is usually handled and stored by a health care provider. If you are using Rituxan at home, store Rituxan as directed by your pharmacist or health care provider. Do not freeze or shake Rituxan. Keep Rituxan out of the reach of children and away from pets.

General information:

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


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


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


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

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

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Rituxan resources

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

• Rituxan Prescribing Information (FDA)


• Rituxan Consumer Overview


• Rituxan Monograph (AHFS DI)


• Rituxan Advanced Consumer (Micromedex) - Includes Dosage Information


• Rituximab Professional Patient Advice (Wolters Kluwer)

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