Bystolic

nebivolol
Pronunciation: ne BIV oh lol Brand: Bystolic What is the most important information I should know about nebivolol? • Do not skip doses or stop taking nebivolol without first talking to your doctor. Stopping suddenly may make your condition worse or cause other serious heart problems such as severe chest pain or heart attack. You may need to use less and less before you stop the medication completely. • If you need to have any type of surgery, tell the surgeon ahead of time that you are using nebivolol. You may need to stop using the medicine for a short time. • Nebivolol 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. • Nebivolol is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension. • Hypertension often has no symptoms, so you may not even feel that you have high blood pressure. Continue using this medicine as directed, even if you feel well. You may need to use blood pressure medication for the rest of your life. What is nebivolol? • Nebivolol is in a group of drugs called beta-blockers. Beta-blockers affect the heart and circulation (blood flow through arteries and veins). • Nebivolol is used to treat hypertension (high blood pressure). • Nebivolol may also be used for other purposes not listed in this medication guide. What should I discuss with my healthcare provider before taking nebivolol? • Do not use this medication if you are allergic to nebivolol or if you have: · severe liver disease; or · a heart problem such as heart block, sick sinus syndrome, slow heart rate, or heart failure. • Before taking nebivolol, tell your doctor if you are allergic to any drugs, or if you have: · asthma, bronchitis, emphysema; · liver or kidney disease; · diabetes; · a thyroid disorder; · problems with circulation (such as Raynaud's syndrome); · pheochromocytoma; or · if you have recently had a heart attack. • If you have any of these conditions, you may not be able to use nebivolol, or you may need a dose adjustment or special tests during treatment. • FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. • It is not known whether nebivolol 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. How should I take nebivolol? • Take nebivolol exactly as it was prescribed for you. Do not take the medication in larger amounts or for longer than recommended by your doctor. Follow the directions on your prescription label. • Take nebivolol at the same time every day. You may take the medication with or without food. • Do not skip doses or stop taking nebivolol without first talking to your doctor. Stopping suddenly may make your condition worse or cause other serious heart problems such as severe chest pain or heart attack. You may need to use less and less before you stop the medication completely. • To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. Do not miss any scheduled appointments. • If you need to have any type of surgery, tell the surgeon ahead of time that you are using nebivolol. You may need to stop using the medicine for a short time. • Nebivolol is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension. • Hypertension often has no symptoms, so you may not even feel that you have high blood pressure. Keep using this medicine as directed, even if you feel well. You may need to use blood pressure medication for the rest of your life. • Store nebivolol at room temperature away from moisture and heat. What happens if I miss a dose? • 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 the 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 slow heart rate, dizziness, vomiting, trouble breathing, or feeling like you might pass out. What should I avoid while taking nebivolol? • Nebivolol 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. What are the possible side effects of nebivolol? • 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. • Call your doctor at once if you have any of these serious side effects: · feeling short of breath, even with mild exertion; · swelling of your ankles or feet; · slow or uneven heartbeats; or · numbness or cold feeling in your hands and feet. • Less serious side effects may include: · headache; · tired feeling; · nausea, stomach pain; · diarrhea; or · sleep problems (insomnia). • This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. What other drugs will affect nebivolol? • Before taking nebivolol, tell your doctor if you are using: · digitalis (digoxin, Lanoxin); · clonidine (Catapres); · reserpine; · guanethidine (Ismelin); · a heart medication such as nifedipine (Procardia, Adalat), reserpine (Serpasil), verapamil (Calan, Verelan, Isoptin), diltiazem (Cartia, Cardizem); · heart rhythm medicine such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), procainamide (Procan, Pronestyl), propafenone (Rythmol), quinidine (Quinidex, Quin-Release Quin-G), and others; · an antidepressant such as fluoxetine (Prozac), paroxetine (Paxil), and others; or · another beta-blocker such as atenolol (Tenormin), bisoprolol (Zebeta), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), propranolol (Inderal, InnoPran), sotalol (Betapace), or timolol (Blocadren), and others. • This list is not complete and there may be other drugs that can interact with nebivolol. 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. Where can I get more information? • Your pharmacist can provide more information about nebivolol.

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Byetta

exenatide
Pronunciation: ex EN a tide Brand: Byetta What is the most important information I should know about exenatide? • Do not use exenatide to treat type 1 (insulin-dependent) diabetes, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin). • You must use this medication within 60 minutes (1 hour) before eating a meal. If you miss a dose, use the medication as soon as you remember, but only if you have not yet eaten a meal. If you have already eaten a meal, wait until your next scheduled dose (1 hour before a meal) to use the medicine. Do not use exenatide after eating a meal. • It is important to use exenatide regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. • To be sure this medication is helping your condition, you will need to check your blood sugar at home. Your blood will also need to be tested by your doctor on a regular basis. Do not miss any scheduled appointments. • Use the exenatide pen for only 30 days and then throw it away, even if it still has medicine in it. Do not use the medicine after the expiration date on the label has passed. • Before using exenatide, tell your doctor if you use any of these oral diabetes medications: acetohexamide (Dymelor), chlorpropamide (Diabinese), glimepiride (Amaryl), glipizide (Glucotrol), glyburide (DiaBeta), tolazamide (Tolinase), tolbutamide (Orinase). • If you are using any type of antibiotic or birth control pill, take these medicines at least 1 hour before you use exenatide. What is exenatide? • Exenatide is an injectable diabetes medicine that helps control blood sugar levels. This medication helps your pancreas produce insulin more efficiently. • Exenatide is used to treat type 2 (non-insulin dependent) diabetes. Other diabetes medicines are sometimes used in combination with exenatide if needed. • Exenatide may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking exenatide? • Do not use exenatide to treat type 1 (insulin-dependent) diabetes, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin). • Before taking exenatide, tell your doctor if you have: · kidney disease (or if you are on dialysis); · problems with digestion; or · severe stomach disorders (gastroparesis). • If you have any of these conditions, you may need a dose adjustment or special tests to safely use exenatide. • FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or if you become pregnant during treatment. • It is not known whether exenatide passes into breast milk or if it could be harmful to a nursing baby. Do not take exenatide without telling your doctor if you are breast-feeding a baby. How should I take exenatide? • Use exenatide exactly as it was prescribed for you. Do not use the medication in larger or smaller amounts, or use it for longer than recommended by your doctor. • Your doctor may occasionally change your dose to make sure you get the best results from this medication. Your dose needs may change if you are ill, if you have a fever or infection, or if you have surgery or a medical emergency. Do not change your dose of exenatide without first talking to your doctor. Use only the diabetes medications prescribed for you. • Exenatide is given as an injection under the skin, usually in the upper thigh, stomach area, or upper arm. Your doctor, nurse, or pharmacist will give you specific instructions on how and where to inject this medicine. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes. • You must use this medication within 60 minutes (1 hour) before eating a meal. Exenatide is usually injected twice a day, before the morning and evening meal. Do not use exenatide after eating a meal. • It is important to use exenatide regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. • Exenatide comes in a prefilled pen with a "Pen User Manual" showing instructions for using the pen and injecting the medicine. You must do a "New Pen Set-Up" one time only, when starting a new prefilled exenatide Pen. If you do this "New Pen Set-Up" before each injection, you will run out of medicine before 30 days. • Pen needles are not included with this medicine. Ask your doctor, diabetes counselor, or pharmacist which needle size is best for you. • To be sure this medication is helping your condition, you will need to check your blood sugar at home. Your blood will also need to be tested by your doctor on a regular basis. Do not miss any scheduled appointments. • Store unused exenatide injection pens in the refrigerator, protected from light. Do not freeze them, and throw away any exenatide pen that has become frozen. After your first use of a pen, it may then be stored at room temperature, away from heat and bright light. • Use the exenatide pen for only 30 days and then throw it away, even if it still has medicine in it. Do not use the medicine after the expiration date on the label has passed. Do not store the exenatide pen with the needle attached. • If the needle is left on, medicine may leak from the pen or air bubbles may form in the cartridge. Keep your exenatide pen, pen needles, and all medicines out of the reach of children. What happens if I miss a dose? • Use the missed dose as soon as you remember, but only if you have not yet eaten a meal. If you have already eaten a meal, wait until your next scheduled dose (1 hour before a meal) to use the medicine. Do not use 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 severe nausea and vomiting, or signs of low blood sugar (headache, weakness, dizziness, confusion, irritability, hunger, fast heartbeat, sweating, and tremor). What should I avoid while taking exenatide? • Avoid drinking alcohol. It lowers blood sugar and may interfere with your diabetes treatment. • If you are using any type of antibiotic or birth control pill, take these medicines at least 1 hour before you use exenatide. What are the possible side effects of exenatide? • 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. • Call your doctor at once if you have severe pain in your upper stomach spreading to your back, with nausea, vomiting, and a fast heart rate. These could be symptoms of pancreatitis. • Less serious side effects may include: · nausea, vomiting, heartburn, diarrhea; · loss of appetite; · weight loss; or · dizziness, headache, or feeling jittery. • This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. • Know the signs of low blood sugar (hypoglycemia) and how to recognize them: · hunger, headache, confusion, irritability; · drowsiness, weakness, dizziness, tremors; · sweating, fast heartbeat; · seizure (convulsions); or · fainting, coma (severe hypoglycemia can be fatal). • Always keep a source of sugar available in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection. What other drugs will affect exenatide? • Before using exenatide, tell your doctor if you use any oral (taken by mouth) diabetes medications. You may need a dose adjustment: · acetohexamide (Dymelor); · chlorpropamide (Diabinese); · glimepiride (Amaryl); · glipizide (Glucotrol); · glyburide (DiaBeta); · tolazamide (Tolinase); or · tolbutamide (Orinase). • Your doctor will tell you if any of your medication doses need to be changed. • There may be other drugs that can interact with exenatide. 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. Where can I get more information? • Your pharmacist can provide more information about exenatide.

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Bydramine

diphenhydramine
Pronunciation: dye fen HYE dra meen Brand: 40 Winks, Aler-Dryl, Banophen, Benadryl, Calm-Aid, Compoz Nighttime Sleep Aid, Diphedryl, Diphen, Genahist, Hydramine, Nu-Med, Nytol Caplet, Quenalin, Scot-Tussin Allergy Relief Formula, Sleep, Sleepinal, Sominex, Twilite, Unisom Sleepgels Maximum Strength What is the most important information I should know about diphenhydramine? • Use caution when driving, operating machinery, or performing other hazardous activities. Diphenhydramine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking diphenhydramine. What is diphenhydramine? • Diphenhydramine is an antihistamine. Diphenhydramine blocks the effects of the naturally occurring chemical histamine in the body. • Diphenhydramine is used to treat sneezing; runny nose; itching, watery eyes; hives; rashes; itching; and other symptoms of allergies and the common cold. • Diphenhydramine is also used to suppress coughs, to treat motion sickness, to induce sleep, and to treat mild forms of Parkinson's disease. • Diphenhydramine may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking diphenhydramine? • Do not take diphenhydramine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A very dangerous drug interaction could occur, leading to serious side effects. • Before taking this medication, tell your doctor if you have · glaucoma or increased pressure in the eye; · a stomach ulcer; · an enlarged prostate, bladder problems or difficulty urinating; · an overactive thyroid (hyperthyroidism); · hypertension or any type of heart problems; or · asthma. • You may not be able to take diphenhydramine, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above. • Diphenhydramine is in the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Do not take diphenhydramine without first talking to your doctor if you are pregnant. • Infants are especially sensitive to the effects of antihistamines, and side effects could occur in a breast-feeding baby. Do not take diphenhydramine without first talking to your doctor if you are nursing a baby. • If you are over 60 years of age, you may be more likely to experience side effects from diphenhydramine. You may require a lower dose of this medication. How should I take diphenhydramine? • Take diphenhydramine exactly as directed on the package or as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you. • Take each dose with a full glass of water. • Diphenhydramine can be taken with or without food. • For motion sickness, a dose is usually taken 30 minutes before motion, then with meals and at bedtime for the duration of exposure. • As a sleep aid, diphenhydramine should be taken approximately 30 minutes before bedtime. • To ensure that you get a correct dose, measure the liquid forms of diphenhydramine with a special dose-measuring spoon or cup, not with a regular tablespoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. • Never take more of this medication than is prescribed for you. The maximum amount of diphenhydramine that you should take in any 24-hour period is 300 mg. • Store diphenhydramine at room temperature away from moisture and heat. What happens if I miss a dose? • Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor. What happens if I overdose? • Seek emergency medical attention if an overdose is suspected. • Symptoms of a diphenhydramine overdose include extreme sleepiness, confusion, weakness, ringing in the ears, blurred vision, large pupils, dry mouth, flushing, fever, shaking, insomnia, hallucinations, and possibly seizures. What should I avoid while taking diphenhydramine? • Use caution when driving, operating machinery, or performing other hazardous activities. Diphenhydramine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking diphenhydramine. What are the possible side effects of diphenhydramine? • Stop taking diphenhydramine and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives). • Other, less serious side effects may be more likely to occur. Continue to take diphenhydramine and talk to your doctor if you experience · sleepiness, fatigue, or dizziness; · headache; · dry mouth; or · difficulty urinating or an enlarged prostate. • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect diphenhydramine? • Do not take diphenhydramine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A very dangerous drug interaction could occur, leading to serious side effects. • Talk to your pharmacist before taking other over-the-counter cough, cold, allergy, or insomnia medications. These products may contain medicines similar to diphenhydramine, which could lead to an antihistamine overdose. • Before taking this medication, tell your doctor if you are taking any of the following medicines: · anxiety or sleep medicines such as alprazolam (Xanax), diazepam (Valium), chlordiazepoxide (Librium), temazepam (Restoril), or triazolam (Halcion); · medications for depression such as amitriptyline (Elavil), doxepin (Sinequan), nortriptyline (Pamelor), fluoxetine (Prozac), sertraline (Zoloft), or paroxetine (Paxil); or · any other medications that make you feel drowsy, sleepy, or relaxed. • Drugs other than those listed here may also interact with diphenhydramine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products. Where can I get more information? • Your pharmacist has more information about diphenhydramine written for health professionals that you may read.

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Bydol

acetaminophen (oral/ rectal)
Pronunciation: a see ta MIH no fen Brand: Anacin-3 Maximum Strength, Childrens Tylenol, Tylenol, Tylenol Caplet, Tylenol Caplet Extra Strength, Tylenol Extended Release, Tylenol Extra Strength, Tylenol Gelcap Extra Strength, Tylenol Suspension What is the most important information I should know about acetaminophen? • Use acetaminophen for up to 3 days for fever or up to 10 days for pain (or up to 5 days to treat a child's pain). If the symptoms do not improve, or if they get worse, stop using acetaminophen and see a doctor. • Avoid alcohol during treatment with acetaminophen. Together, alcohol and acetaminophen can be damaging to the liver. • Be aware of the acetaminophen content of other over-the-counter and prescription products. Care should be taken to avoid taking more than the recommended amount of acetaminophen per dose or per day. What is acetaminophen? • Acetaminophen is a pain reliever and a fever reducer. • Acetaminophen is used to treat many conditions such as headache, muscle aches, arthritis, backache, toothaches, colds, and fevers. • Acetaminophen may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking acetaminophen? • Do not take acetaminophen without first talking to your doctor if you drink more than three alcoholic beverages per day or if you have had alcoholic liver disease. You may not be able to take acetaminophen, or you may require a lower dose or special monitoring. • Before taking acetaminophen, tell your doctor if you have kidney or liver disease. You may not be able to take acetaminophen, or you may require a dosage adjustment or special monitoring during treatment if you have either of these conditions. • Acetaminophen has not been formally assigned to a pregnancy category by the FDA. It is routinely used for short term pain relief and fever in all stages of pregnancy. Acetaminophen is believed to be safe in pregnancy when used intermittently for short durations. Acetaminophen should only be given during pregnancy when need has been clearly established. • Acetaminophen passes into breast milk. It appears to be safe for use during breast-feeding but should be avoided if possible. Talk to your doctor before taking acetaminophen if you are breast-feeding a baby. • If you are treating a child, read the package carefully and use a pediatric form of the medication if possible. Talk to a doctor first if the child is younger than 2 years of age. How should I take acetaminophen? • Take acetaminophen exactly as directed by your doctor or follow the instructions on the package. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you. • Take each oral dose with a full glass of water. • Acetaminophen can be taken with or without food. • Wash your hands before and after using the rectal suppositories. Run the suppository under cold water or put it in the refrigerator for a few minutes before using it. Remove any wrapping from the suppository and moisten the suppository with cold water. Squat, stand, or lie down with one leg straight and the other bent, in a comfortable position that allows access to the rectal area. Use your finger, or the applicator if one is provided, to deposit the suppository as far as it will comfortably go into the rectum. Insert the narrow end first. Close your legs and lie still for a few minutes. If the applicator will be reused, take it apart and wash it with warm water and mild soap, then dry it completely. Avoid having a bowel movement for at least 1 hour after inserting the suppository. • To ensure that you get a correct dose, measure the liquid forms of acetaminophen with a special dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. Shake the liquid well before measuring. • Never take more acetaminophen than is directed. The maximum amounts for adults are 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day. Taking more acetaminophen could be damaging to the liver. If you drink more than three alcoholic beverages per day, talk to your doctor before taking acetaminophen. • Use acetaminophen for up to 3 days for fever or up to 10 days for pain (or up to 5 days to treat a child's pain). If the symptoms do not improve, or if they get worse, stop using acetaminophen and see a doctor. • If you are treating a child, read the package carefully and use a pediatric form of the medication if possible. Talk to a doctor first if the child is younger than 2 years of age. • Store acetaminophen at room temperature away from heat, moisture, and the reach of children. The rectal suppositories can be stored at room temperature or in the refrigerator. What happens if I miss a dose? • If you are taking acetaminophen on a regular schedule, take the missed dose as soon as you remember. Wait the prescribed amount of time or as directed in the package labeling before taking another dose. Do not take a double dose. • If you are taking acetaminophen on an as-needed basis, missing a dose is not usually a problem. Take the dose as soon as you remember, and do not take another dose for the amount of time prescribed or as directed in the package labeling. What happens if I overdose? • Seek emergency medical attention. • Symptoms of an acetaminophen overdose include nausea, vomiting, diarrhea, abdominal pain, sweating, seizures, confusion, and an irregular heartbeat. What should I avoid while taking acetaminophen? • Avoid alcohol during treatment with acetaminophen. Together, alcohol and acetaminophen can be damaging to the liver. • Be aware of the acetaminophen content of other over-the-counter and prescription products. Care should be taken to avoid taking more than the recommended amount of acetaminophen per dose or per day. What are the possible side effects of acetaminophen? • If you experience any of the following rare but serious side effects, stop taking acetaminophen and seek emergency medical attention or contact your doctor immediately: · an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); · liver damage (yellowing of the skin or eyes, nausea, abdominal pain or discomfort, unusual bleeding or bruising, severe fatigue); · blood problems (easy or unusual bleeding or bruising). • Other, less serious side effects are not known to occur. • Side effects other than those listed here may occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect acetaminophen? • Be aware of the acetaminophen content of other over-the-counter and prescription products. Care should be taken to avoid taking more than the recommended amount of acetaminophen per dose or per day. • Acetaminophen may cause false urine glucose test results. Talk to your doctor if you have diabetes and you notice changes in your glucose levels while taking acetaminophen. • Other medications may interact with acetaminophen. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products while taking acetaminophen. Where can I get more information? • Your pharmacist has additional information about acetaminophen written for health professionals that you may read.

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butorphanol

butorphanol (nasal)
Pronunciation: byoo TOR fa nole Brand: Stadol NS What is the most important information I should know about butorphanol nasal? • You should not use butorphanol if you have recently used narcotic medications and have become dependent on them. • Butorphanol may be habit-forming and should be used only by the person it was prescribed for. Butorphanol should never be given to another person, especially someone with a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. • Do not drink alcohol while you are using butorphanol. Dangerous side effects or death can occur when alcohol is combined with a narcotic pain medicine. Check your food and medicine labels to be sure these products do not contain alcohol. • Butorphanol 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. • Never use more than your prescribed dose of butorphanol. Tell your doctor if the medicine seems to stop working as well in relieving your pain. • Do not stop using butorphanol suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication. What is butorphanol nasal? • Butorphanol is in a group of drugs called narcotic pain relievers. It is similar to morphine. • Butorphanol is used to treat moderate to severe pain. • Butorphanol may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before using butorphanol nasal? • Do not use this medication if you have ever had an allergic reaction to a narcotic medicine. • You should not use butorphanol if you have recently used narcotic medications and have become dependent on them. • Butorphanol may be habit-forming and should be used only by the person it was prescribed for. Butorphanol should never be shared with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. • Before using this medication, tell your doctor if you have · asthma, COPD, sleep apnea, or other breathing disorders; · liver or kidney disease; · a history of head injury or brain tumor; · heart disease, high blood pressure, recent heart attack; · mental illness; or · a history of drug or alcohol addiction. • If you have any of these conditions, you may not be able to use butorphanol or you may require a dose adjustment or special tests during treatment. • FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. • Butorphanol passes into breast milk and may harm a nursing baby. Do not use butorphanol without telling your doctor if you are breast-feeding a baby. • Older adults may be more sensitive to the effects of this medication. How should I use butorphanol nasal? • Use this medication exactly as it was prescribed for you. Never use butorphanol in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain. • This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions. • The usual dose of butorphanol nasal for pain is 1 spray into one nostril every 3 to 4 hours. Your dose may be different. Follow your doctor's instructions carefully. • For best results, blow your nose before using the nasal spray. • Before using the spray for the first time, you must prime the spray pump. Remove the protective clip and pump 7 or 8 times into the air until a fine mist appears. Prime the spray pump any time you have not used your nasal spray for longer than 48 hours. • Do not stop using butorphanol suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication. • Store butorphanol at room temperature away from moisture and heat. • After you are finished using this medication, remove the cap and rinse out the bottle under running water. Throw away the bottle and cap where children or pets cannot get to them. What happens if I miss a dose? • Since butorphanol is used as needed, you are not likely to be on a dosing schedule. If you are using the medication regularly, use the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use 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. An overdose of butorphanol can be fatal. Overdose symptoms may include extreme drowsiness, pinpoint pupils, confusion, cold and clammy skin, weak pulse, shallow breathing, fainting, or breathing that stops. What should I avoid while using butorphanol nasal? • Do not drink alcohol while you are using this medication. Dangerous side effects or death can occur when alcohol is combined with butorphanol. Check your food and medicine labels to be sure these products do not contain alcohol. • 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. • If your prescribed dose is more than 1 spray at a time, you may have severe dizziness. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall. What are the possible side effects of butorphanol nasal? • 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. • Tell your caregivers at once if you have any of these serious side effects: · pounding, or uneven heartbeats; · increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure); · shallow breathing, slow heartbeat; · cold, clammy skin; · problems with urination; · tremors, numbness or tingling; · confusion, feeling like you are floating; or · feeling light-headed, fainting. • Less serious side effects include: · drowsiness, dizziness; · nosebleed, stuffy nose, cough; · sleep problems (insomnia); · constipation; · nausea, vomiting, loss of appetite; · warmth or redness under the skin; · dry mouth, unpleasant taste; or · ringing in your ear. • This list is not complete and other side effects may occur. Tell your doctor about any unusual or bothersome side effect. What other drugs will affect butorphanol nasal? • You should not use butorphanol with other narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result. Tell your doctor if you need to use any of these other medicines while you are using butorphanol. • There may be other drugs that can interact with butorphanol. 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. Where can I get more information? • Your pharmacist has additional information about butorphanol written for health professionals that you may read.

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