Endep is used to treat symptoms of depression. Endep may also be used for purposes other than those listed in this medication guide.

How Taken

Take Endep exactly as it was prescribed for you. Do not take Endep in larger amounts, or take 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. Follow the directions on your prescription label.

Drug Class and Mechanism

Endep is in a group of drugs called tricyclic antidepressants. Endep affects chemicals in the brain that may become unbalanced.

Missed Dose

If you miss a dose of this medicine and you are using it regularly, take it as soon as possible. If you do not remember until later, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Storage

Store at the room temperature away from moisture and sunlight. Keep out of the reach of children.

Warnings Precautions

Avoid drinking alcohol. It can cause dangerous side effects when taken together with Endep.

Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, medicine for seizures, or other antidepressants). They can add to sleepiness caused by Endep.

Grapefruit and grapefruit juice may interact with Endep. Discuss the use of grapefruit products with your doctor before increasing or decreasing the amount of grapefruit products in your diet.

Endep 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 exposure to sunlight or artificial UV rays (sunlamps or tanning beds).

Endep can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.

Possible 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.

Call your doctor at once if you have any of these serious side effects:

• fast, pounding, or uneven heart rate;
• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
• sudden numbness or weakness, especially on one side of the body;
• sudden headache, confusion, problems with vision, speech, or balance;
• confusion, hallucinations, or seizures (convulsions);
• restless muscle movements in your eyes, tongue, jaw, or neck;
• uncontrollable shaking or tremor;
• skin rash, severe tingling, numbness, pain, muscle weakness;
• easy bruising or bleeding;
• extreme thirst with headache, nausea, vomiting, and weakness;
• feeling light-headed, fainting; orurinating less than usual or not at all.

Less serious side effects may be more likely to occur, such as:

• nausea, vomiting, constipation, diarrhea, loss of appetite;
• dry mouth, unpleasant taste;
• numbness or tingly feeling;
• lack of coordination;
• feeling anxious, dizzy, drowsy, or tired;
• trouble concentrating;
• sleep problems (insomnia), nightmares;
• blurred vision, headache, ringing in your ears; mild skin rash;
• breast swelling (in men or women); or decreased sex drive, impotence, or difficulty having an orgasm.

More Information

Before taking Endep, tell your doctor if you are allergic to any drugs, or if you have:

• heart disease;
• a history of heart attack, stroke, or seizures;
• bipolar disorder (manic-depression);
• schizophrenia or other mental illness;
• diabetes (Endep may raise or lower blood sugar);
• overactive thyroid;
• glaucoma; or problems with urination.

Endep

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Vitamin A & D prevent fracture and osteoporotic bone loss:

• Vitamin A combinations are used to prevent or to treat a calcium deficiency;
• Vitamin D combinations are responsible for cell division and bone growth.

How Taken

Use Vitamin A & D as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Vitamin A & D by mouth with or without food.
• Swallow Vitamin A & D whole. Do not break, crush, or chew before swallowing.
• Several days may pass before your symptoms improve. Do not stop taking Vitamin A & D without checking with your doctor.
• Take your doses at the same times each day.
• Continue to take Vitamin A & D even if you feel well. Do not miss any doses.

Drug Class and Mechanism

• Vitamin A is found in food from animal sources and needed for cell division, growth of bones, skin, and male and female reproductive organs night vision and. In pregnant women vitamin A is necessary for the growth of a healthy fetus.
• Vitamin D is important for the absorption of calcium from the stomach and for the functioning of calcium in the body.

Missed Dose

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medicine unless your doctor directs otherwise.

Storage

Store Vitamin A & D at 77 degrees F (25 degrees C). Brief storage 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 Vitamin A & D out of the reach of children and away from pets.

Warnings Precautions

Do not use Vitamin A & D if:

• If you take other medicines, do not take Vitamin A & D combination without first talking to your doctor;
• you are allergic to Vitamin A & D;

Possible Side Effects

Check with your doctor if any of these most common side effects persist or become bothersome:

• tiredness; nausea, vomiting, or decreased appetite; irritability; headache; dryness or cracking of the lips or skin; hair loss.

More Information

Additionally, Vitamin A & D is required by the body for growth, good vision and healthy skin.

Vitamin A & D

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Rocaltrol is a synthetic form of vitamin D used to treat people on dialysis who have hypocalcemia (abnormally low blood calcium levels) and resulting bone damage. Rocaltrol is also prescribed to treat low blood calcium levels in people who have hypoparathyroidism (decreased functioning of the parathyroid glands). When functioning correctly, these glands help control the level of calcium in the blood.

Rocaltrol is also prescribed for hyperparathyroidism (increased functioning of the parathyroid glands) and resulting bone disorders in people with kidney disease who are not yet on dialysis.

Most important fact about Rocaltrol

While you are taking Rocaltrol, your doctor may want you to follow a special diet or take calcium supplements. This is an important part of your therapy. On the other hand, too high a calcium level can be harmful. If you are already taking any medications containing calcium or calcium supplements, make sure you doctor knows about it.

How should you take Rocaltrol?

Be sure to get enough fluids and avoid dehydration while taking Rocaltrol.

• If you miss a dose…
  If you take 1 dose every other day, and you remember before the next day, take the forgotten dose immediately, then go back to your regular schedule. If you do not remember until the next day, take the dose immediately, skip a day, then go back to your regular schedule.

If you take 1 dose every day, take it as soon as you remember. Then go back to your regular schedule. If you do not remember until the next day, skip the dose you missed and go back to your regular schedule.

If you take Rocaltrol more than once a day, take the forgotten dose as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule.

Do not take 2 doses at once.

• Storage instructions…
  Keep capsules and oral solution away from heat and light.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Rocaltrol.

• Side effects occurring early may include:
  Bone pain, constipation, dry mouth, extreme sleepiness, headache, loss of appetite, metallic taste, muscle pain, nausea, vomiting, weakness

• Side effects occurring later may include:
  Abnormal thirst, apathy, arrested growth, decreased sex drive, dehydration, elevated blood cholesterol levels, excessive urination, extremely high body temperature, high blood pressure, inflamed eyes, intolerance to light, irregular heartbeat, itchy skin, kidney problems, loss of appetite, nighttime urination, runny nose, sensory disturbances, urinary tract infections, wasting of muscles or other tissues, weight loss, yellowish skin

Excessive amounts of vitamin D may cause abnormally high calcium levels in the blood.

Why should Rocaltrol not be prescribed?

You should not use Rocaltrol if you have high blood levels of calcium, or if you have vitamin D poisoning. You should also avoid Rocaltrol if it, or any similar drug, has given you an allergic reaction in the past.

Special warnings about Rocaltrol

You should not take additional doses of vitamin D while taking Rocaltrol. People who are on dialysis should not take antacids containing magnesium while taking Rocaltrol.

Your doctor will monitor your calcium levels while you are taking Rocaltrol because excessive calcium levels can be very dangerous. If this problem develops, your doctor will need to stop Rocaltrol therapy temporarily and prescribe a lower dose when treatment resumes.

While taking Rocaltrol, you should have an adequate daily intake of calcium (at least 600 milligrams a day), either from foods (such as milk and dairy products) or from a calcium supplement. Your doctor will estimate your daily calcium intake before you take this drug to see if you will require more calcium.

Possible food and drug interactions when taking Rocaltrol

If Rocaltrol is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Rocaltrol with the following:

Antacids containing magnesiumCalcium supplementsCholestyramineDigitalisKetoconazolePhenobarbitalPhenytoinSteroid medications such as prednisoneThiazide diuretics such as hydrothiazdieVitamin D supplements

Special information if you are pregnant or breastfeeding

The effects of Rocaltrol during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Pregnant women should use Rocaltrol only if the possible benefit outweighs any possible risk to the unborn baby.

Rocaltrol may appear in breast milk. Because it may affect a nursing infant, you should not use Rocaltrol while you are breastfeeding.

Rocaltrol

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