Hyzaar is a combination medication used in the treatment of high blood pressure. One component, losartan, belongs to a new class of blood pressure medications that work by preventing the hormone angiotensin II from constricting the blood vessels, thus allowing blood to flow more freely and keeping the blood pressure down. The other component, hydrochlorothiazide, is a diuretic that increases the output of urine, removing excess fluid from the body and thus lowering blood pressure.

Most important fact about Losartan potassium and Hydrochlorothiazide

 You must take Hyzaar regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Hyzaar, and you must continue taking it even if you are feeling well. Hyzaar does not cure high blood pressure; it merely keeps it under control.

How should you take Losartan potassium and Hydrochlorothiazide?

Hyzaar may be taken with or without food. Take Hyzaar exactly as directed. Try to take it at the same time each day so that it is easier to remember.

–If you miss a dose…

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.

–Storage instructions…

Keep in a tightly closed container at room temperature. Protect from 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 Hyzaar.

• Side effects include:
  Dizziness, upper respiratory infection

Why should Losartan potassium and Hydrochlorothiazide not be prescribed?

If you have ever had an allergic reaction to losartan, hydrochlorothiazide, or sulfa drugs, you should not take Losartan potassium and Hydrochlorothiazide. If you are unable to urinate, do not take Hyzaar.

Possible food and drug interactions when taking Losartan potassium and Hydrochlorothiazide

Hyzaar may increase the effects of alcohol. Avoid alcohol while taking Losartan potassium and Hydrochlorothiazide.

If Hyzaar 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 taking Hyzaar with the following:

Barbiturates such as phenobarbital and Seconal
Cholestyramine (Questran)
Colestipol (Colestid)
Corticosteroids (Prednisone)
Diuretics that leave potassium in the body, such as Aldactone, triamterene, and amiloride
Indomethacin (Indocin)
Insulin
Ketoconazole (Nizoral)
Lithium (Eskalith, Lithobid)
Narcotic painkillers such as Demerol, Tylenol with Codeine, and Percocet
Nonsteroidal anti-inflammatory drugs such as Aleve, Anaprox, and Motrin
Other blood pressure-lowering drugs such as Procardia XL and Tenormin
Oral diabetes drugs such as Diabinese, DiaBeta, and Glucotrol
Potassium supplements such as Slow-K
Salt substitutes containing potassium
Sulfaphenazole
Troleandomycin (Tao)

Special information if you are pregnant or breastfeeding

When used in the second or third trimester of pregnancy, Hyzaar can cause injury or even death to the unborn child. Stop taking Hyzaar as soon as you know you are pregnant. If you are pregnant or plan to become pregnant, tell your doctor immediately. Hyzaar appears in breast milk and can affect the nursing infant. If Losartan potassium and Hydrochlorothiazide is essential to your health, your doctor may advise you to stop breastfeeding while you are taking Hyzaar.

Recommended dosage

ADULTS

Hyzaar comes in two strengths, 50-12.5 (50 milligrams of losartan and 12.5 milligrams of hydrochlorothiazide) and 100-25 (a double dose of each component). The usual starting dose is one 50-12.5 tablet per day.

If your blood pressure does not respond to this dose, after about 3 weeks the doctor may increase the dose to two 50-12.5 tablets once daily, or one 100-25 tablet a day.

CHILDREN

The safety and effectiveness of Hyzaar in children have not been studied.

Overdosage

Any medication taken in excess can have serious consequences. Information concerning Hyzaar overdosage is limited. However, extremely low blood pressure and abnormally rapid or slow heartbeat may be signs of an overdose. Other signs may include dryness and thirst, overall weakness and tiredness, restlessness and confusion, muscle pains, nausea, and vomiting.

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Lisinopril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme.

Lisinopril is used to treat high blood pressure (hypertension), congestive heart failure, and to improve survival after a heart attack.

Lisinopril may also be used for purposes other than those listed in this medication guide.

How should I take Prinivil (Lisinopril)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Take each dose with a full glass of water.

Lisinopril can be taken with or without food.

Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking lisinopril. Drink 6 to 8 full glasses of water daily while you are taking this medication.

To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. Your kidney or liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking lisinopril. You may need to stop using the medicine for a short time.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

Store lisinopril at room temperature away from moisture and heat.

What are the possible side effects of Prinivil (Lisinopril)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; severe stomach pain; 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 light-headed, fainting
• urinating more or less than usual, or not at all
• fever, chills, body aches, flu symptoms
• tired feeling, muscle weakness, and pounding or uneven heartbeats
• chest pain; or
• swelling, rapid weight gain

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

• cough
• dizziness, drowsiness, headache
• nausea, vomiting, diarrhea, upset stomach; or
• mild skin itching or rash

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 affect Prinivil (Lisinopril)?

Before taking lisinopril, tell your doctor if you are taking any of the following drugs:

• lithium (Lithobid, Eskalith)
• a potassium supplement such as K-Dur, Klor-Con
• salt substitutes that contain potassium
• insulin or diabetes medication you take by mouth
• aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), piroxicam (Feldene); or
• a diuretic (water pill) such as amiloride (Midamor), bumetanide (Bumex), chlorthalidone (Hygroton, Thalitone), ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril), indapamide (Lozol), metolazone (Mykrox, Zarxolyn), spironolactone (Aldactone), triamterene (Dyrenium, Maxzide, Dyazide), torsemide (Demadex)

If you are using any of these drugs, you may not be able to use lisinopril or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect lisinopril. 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.

What should I avoid while taking Prinivil (Lisinopril)?

Lisinopril 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 further lower your blood pressure and may increase some of the side effects of lisinopril.

Do not use salt substitutes or potassium supplements while taking lisinopril, unless your doctor has told you to.

What happens if I overdose on Prinivil (Lisinopril)?

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

Symptoms of a lisinopril overdose may include feeling extremely dizzy or light-headed, or fainting.

What happens if I miss a dose of Prinivil (Lisinopril)?

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 is the most important information I should know about Prinivil (Lisinopril)?

Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Lisinopril could cause birth defects in the baby if you take the medication during pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment.

Lisinopril 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.

Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking lisinopril. Drink 6 to 8 full glasses of water daily while you are taking this medication.

What should I discuss with my healthcare provider before taking Prinivil (Lisinopril)?

Do not use this medication if you are allergic to lisinopril or to any other ACE inhibitor, such as benazopril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

Before using lisinopril, tell your doctor if you are allergic to any drugs, or if you have:

• kidney disease (or if you are on dialysis)
• liver disease
• heart disease or congestive heart failure
• diabetes; or
• a connective tissue disease such as Marfan syndrome, Sjogren’s syndrome, lupus, scleroderma, or rheumatoid arthritis

If you have any of these conditions, you may not be able to use lisinopril, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category D. Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Lisinopril could cause birth defects in the baby if you take the medication during pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment.

It is not known whether lisinopril 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.

What warnings do you have for Prinivil (Lisinopril)?

The following warnings are available for this medication:

• Be careful if taking OTCs.
• Do not take if pregnant.
• Take as directed.

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Zestril is used in the treatment of high blood pressure. It is effective when used alone or when combined with other high blood pressure medications. It may also be used with other medications in the treatment of heart failure, and may be given within 24 hours of a heart attack to improve chances of survival.

Zestril is a type of drug called an ACE inhibitor. It works by reducing production of a substance that increases salt and water retention in your body.

Most important fact about Zestril

If you have high blood pressure, you must take Zestril regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Zestril; and you must continue taking it even if you are feeling well. Zestril does not cure high blood pressure; it merely keeps it under control.

How should you take Zestril?

Zestril can be taken with or without food. Take it exactly as prescribed. Stopping Zestril suddenly could cause your blood pressure to rise.

–If you miss a dose…

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. Never take 2 doses at the same time.

–Storage instructions…

Store at room temperature, with the container sealed and dry. Avoid excessive heat or freezing cold.

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 Zestril.

• More common side effects may include:
  Chest pain, cough, diarrhea, dizziness, headache, low blood pressure

Why should Zestril not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Zestril or other ACE inhibitors such as Capoten, you should not take this medication. You should also avoid this drug if you suffered angioedema (swelling of the face, lips, tongue, throat, arms, or legs) during previous treatment with an ACE inhibitor, or have a tendency to develop the condition for any other reason. Make sure your doctor is aware of any drug reactions you have experienced.

Possible food and drug interactions when taking Zestril

If Zestril 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 Zestril with any of the following:

Nonsteroidal anti-inflammatory drugs such as indomethacin (Indocin)
Lithium (Lithonate, Eskalith)
Potassium preparations such as K-Phos and Micro-K
Water pills such as HydroDIURIL and Lasix, and others that leave potassium in the body, such as Aldactone and Midamor

Special information if you are pregnant or breastfeeding

If it is taken during the final 6 months of pregnancy, Zestril can cause birth defects, prematurity, and death in the fetus and newborn. If you are pregnant or plan to become pregnant and are taking Zestril, contact your doctor immediately to discuss the potential hazard to your unborn child. Zestril may appear in breast milk and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with this medication is finished.

Recommended dosage

ADULTS

High Blood Pressure

For people not on water pills (diuretics), the initial starting dose is usually 10 milligrams, taken 1 time a day. Your doctor will increase the dosage until your blood pressure is under control. The long-term dosage usually ranges from 20 to 40 milligrams a day, taken in a single dose.

Diuretic use should, if possible, be stopped before using Zestril. If not, your physician may give an initial dose of 5 milligrams under supervision before any further medication is prescribed.

People with kidney disorders must be carefully monitored, and dosages will be adjusted to the individual’s needs, depending on kidney function.

Heart Failure

For this condition, Zestril is usually prescribed along with diuretics and digitalis. The recommended starting dose is 5 milligrams once a day, with the first dose taken under your doctor’s supervision. The doctor may increase the dose by up to 10 milligrams at intervals of no less than 2 weeks. Typical long-term dosages range from 5 to 40 milligrams taken once a day.

Heart Attack

The usual dose is 5 milligrams within the first 24 hours after a heart attack, then 5 milligrams 24 hours later, 10 milligrams 48 hours later, and, finally, 10 milligrams once a day for 6 weeks. If low blood pressure is a problem, the doctor may recommend a lower dosage.

CHILDREN 6 YEARS OR OLDER

High Blood Pressure

The usual starting dose is 0.07 milligrams per day up to a total of 5 milligrams per day.

Zestril is not recommended in children younger than 6 years old or in children with poor kidney function.

OLDER ADULTS

The physician will adjust the dosage carefully, according to the individual’s needs.

Overdosage

Any medication taken in excess can cause symptoms of overdose. If you suspect an overdose, seek medical attention immediately.

A severe drop in blood pressure is the primary sign of a Zestril overdose.

Zestril

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Isosorbide-5-mononitrate belongs to the family of medications known as anti-anginals. This medication is used to prevent angina attacks associated with coronary artery disease. It is not useful for quick relief of an attack.

It acts by opening up the blood vessels that supply the heart, increasing the blood and oxygen supply to the heart. Isosorbide-5-mononitrate may reduce the number, length, and severity of angina attacks. Tolerance to exercise may be increased and the need for fast-acting nitroglycerin (tablets and spray) may be reduced.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

Is there any reason not to take this drug?

Isosorbide-5-mononitrate should not be taken by anyone who:

• is allergic to isosorbide-5-mononitrate, other nitrates or nitrites, or any of the ingredients of the medication
• is in a state of acute circulatory failure associated with extremely low blood pressure (e.g., states of shock or collapse)
• taking sildenafil
• experiences dizziness, blurred vision, or loss of consciousness when rising from a sitting or lying position
• has increased pressure inside the head
• has myocardial insufficiency due to obstruction
• has severe anemia

What about possible side effects?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

More common:

• dizziness or lightheadedness, especially when rising from a lying or sitting position
• fast pulse
• flushing of face and neck
• headache
• nausea or vomiting
• restlessness

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

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

Rare:

• blurred vision
• dryness of mouth
• headache (severe or prolonged)
• skin rash

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

What if I am taking other drugs?

There may be an interaction between isosorbide-5-mononitrate and any of the following:

• alcohol
• ergot alkaloids
• heparin
• medications that reduce blood pressure
• sildenafil
• tranquilizers
• tricyclic antidepressants (e.g., amitriptyline, desipramine)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Other information:

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Drowsiness/reduced alertness: Because this medication may cause faintness or dizziness, use caution when driving or operating machinery, especially at the start of treatment.

Low blood pressure: Symptoms of severe lowering of blood pressure, such as weakness or dizziness, particularly when rising suddenly from a sitting or lying position, may occur. People who are prone to low blood pressure (e.g., those taking diuretics) should be cautious when using this medication.

Tolerance: With continued use, isosorbide-5-mononitrate may stop having beneficial effects because the body gets used to it (i.e., develops a tolerance). Call your doctor if at any time you feel that your angina attacks are getting worse or happening more often.

Withdrawal: Stopping this medication suddenly may occasionally aggravate chest pain or other symptoms of angina. To avoid possible withdrawal effects, this medication should be gradually reduced and not stopped suddenly.

Pregnancy: If you are or may be pregnant, talk to your doctor about the benefits and risks of taking this medication.

Breast-feeding: It is not known is isosorbide-5-mononitrate passes into breast milk. Speak with your doctor about the risks and benefits of using this medication while breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children. Its use by this age group is not recommended.

Seniors: Seniors may be more likely to experience dizziness or lightheadedness while taking this medication.

Special Instructions:

The recommended adult dose of isosorbide-5-mononitrate is 1 tablet (60 mg) taken once daily in the morning after getting up. Your doctor may increase the dose to 2 tablets (120 mg) once daily in the morning if necessary. To reduce the risk of headache, your doctor may suggest starting with one-half tablet (30 mg) once daily each morning for the first 2 to 4 days.

The tablets should not be chewed or crushed, and should be swallowed together with half a glass of water. You may sometimes find whole tablets in the stool. These are only the shell of the tablet, and you can be sure that the medication has been released.

The tablets are available in a 30-day package that is designed to make it easy to keep track of your medication. 28 tablets are labeled with a day of the week. To start, take a tablet in the first row that matches the day you begin this pack. Then take a tablet on each of the following days to complete the 28 labelled tablets. The 2 extra non-labelled tablets should be taken after all the other tablets are gone.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that you take this medication exactly as prescribed by your doctor. Isosorbide-5-mononitrate should be taken at about the same time every day. If you miss a dose and remember within 6 hours, take your usual dose as soon as possible. Then go back to your regular schedule. If it has been more than 6 hours when you remember, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

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We are decreasing the packages for some items from 120 pills to 90 pills:

Corticyn Trimplex
PyruVitol
RiboCREE
Cree-1200
Creatine-1200
Ribose-ATP
GABA (HGH Booster)
BCAA
Vanadyl
ZMA-Power
L-Arginine
Gluta-PEP
L-Glutamine

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Monoket is used to prevent angina (chest pain) caused by heart disease.

How Taken

Use Monoket as directed by your doctor.

• Take Monoket by mouth with or without food.
• This medication should be taken twice daily, with the doses 7 hours apart. The first dose should preferably be taken in the morning upon waking up, unless directed otherwise by your doctor.
• Do not suddenly stop taking Monoket . You may have an increased risk of side effects (eg, angina attacks). If you need to stop Monoket or add a new medicine, your doctor will gradually lower your dose.

Drug Class and Mechanism

Monoket is is a nitrate vasodilator. It works by widening the blood vessels in the body. This reduces the workload of the heart and helps to relieve chest pain.

Missed Dose

If you miss a dose of Monoket, 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.

Storage

Store Monoket at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Monoket out of the reach of children and away from pets.

Warnings Precautions

Do not use Monoket if:

• you are allergic to any ingredient in Monoket or to other nitrate medicines;
• you are also taking a phosphodiesterase type 5 inhibitor (eg, sildenafil, tadalafil, vardenafil);
• you drink alcohol.

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

Important:

• Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Monoket 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.
• Do not drink alcohol while you are taking Monoket.
• When you begin taking Monoket, headaches are likely to occur. Ask your doctor for instructions on ways to reduce this side effect.
• Monoket should not be used to stop an attack of angina; it is intended only for prevention of an attack.
• Monoket may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Monoket.
• Monoket should not be used in children; safety and effectiveness in children have not been confirmed.
• If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Monoket while you are pregnant. It is not known if Monoket is found in breast milk. If you are or will be breast-feeding while you use Monoket, check with your doctor. Discuss any possible risks to your baby.

Possible Side Effects

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

• dizziness; headache; nausea.

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); changes in vision; fainting; numbness of an arm or leg; severe stomach pain; sharp or crushing chest pain; sudden leg pain; sudden, severe headache; sudden shortness of breath; vomiting.

More Information

Monoket 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.

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Ismo is used to prevent angina (chest pain) caused by heart disease.

How Taken

Use Ismo as directed by your doctor.

• Take Ismo by mouth with or without food.
• This medication should be taken twice daily, with the doses 7 hours apart. The first dose should preferably be taken in the morning upon waking up, unless directed otherwise by your doctor.
• Do not suddenly stop taking Ismo . You may have an increased risk of side effects (eg, angina attacks). If you need to stop ISMO or add a new medicine, your doctor will gradually lower your dose.

Drug Class and Mechanism

Ismo is is a nitrate vasodilator. It works by widening the blood vessels in the body. This reduces the workload of the heart and helps to relieve chest pain.

Missed Dose

If you miss a dose of Ismo, 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.

Storage

Store Ismo at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Ismo out of the reach of children and away from pets.

Warnings Precautions

Do not use Ismo if:

• you are allergic to any ingredient in Ismo or to other nitrate medicines;
• you are also taking a phosphodiesterase type 5 inhibitor (eg, sildenafil, tadalafil, vardenafil);
• you drink alcohol.

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

Important:

• Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Ismo 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.
• Do not drink alcohol while you are taking Ismo.
• When you begin taking Ismo, headaches are likely to occur. Ask your doctor for instructions on ways to reduce this side effect.
• Ismo should not be used to stop an attack of angina; it is intended only for prevention of an attack.
• Ismo may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Ismo.
• Ismo should not be used in children; safety and effectiveness in children have not been confirmed.
• If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Ismo while you are pregnant. It is not known if Ismo is found in breast milk. If you are or will be breast-feeding while you use Ismo, check with your doctor. Discuss any possible risks to your baby.

Possible Side Effects

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:

• dizziness; headache; nausea.

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); changes in vision; fainting; numbness of an arm or leg; severe stomach pain; sharp or crushing chest pain; sudden leg pain; sudden, severe headache; sudden shortness of breath; vomiting.

More Information

Ismo 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.

Ismo

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Avapro is used to treat high blood pressure. A member of the new family of drugs called angiotensin II receptor antagonists, it works by preventing the hormone angiotensin II from narrowing the blood vessels, an action that tends to raise blood pressure. Avapro may be prescribed alone or with other blood pressure medications.

In people with type 2 diabetes and high blood pressure, Avapro is also prescribed to stave off damage to the kidneys, often delaying the need for dialysis and a kidney transplant.

Most important fact about Avapro

You must take Avapro regularly for it to be effective. Since blood pressure declines gradually, it may be a couple of weeks before you get the full benefit of Avapro, and you must continue taking it even if you are feeling well. Avapro does not cure high blood pressure, it merely keeps it under control.

How should you take Avapro?

Take your dose of Avapro around the same time every day, with or without food.

–If you miss a dose…

Take it 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 the same time.

–Storage instructions…

Store at room temperature.

What side effects may occur?

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

• More common side effects may include:
  Diarrhea, fatigue, respiratory tract infection

In people taking Avapro for diabetic kidney disease, the most common side effects are dizziness, dizziness when standing up, or low blood pressure when standing up.

Special warnings about Avapro

In rare cases, Avapro can cause a severe drop in blood pressure. The problem is more likely if your body’s supply of water has been depleted by dialysis treatments or high doses of diuretics. Symptoms include light-headedness, dizziness, and faintness, and are more likely when you first start taking the drug. Call your doctor if they occur. You may need to have your dose adjusted.

If you have kidney disease, Avapro must be used with caution.

Possible food and drug interactions when taking Avapro

The chances of an interaction with Avapro are low. Check with your doctor, however, before combining it with tolbutamide (Orinase).

Special information if you are pregnant or breastfeeding

Avapro can cause injury or even death to the unborn child when used during the last 6 months of pregnancy. As soon as you learn you’re pregnant, stop taking Avapro and call your doctor.

It is not known whether Avapro appears in breast milk, but because of potential risks to the newborn, it’s considered best to avoid using the drug while breastfeeding. You and your doctor should decide whether to give up nursing or discontinue Avapro.

Recommended dosage

ADULTS

High Blood Pressure

The recommended starting dose of Avapro is 150 milligrams once a day. If your blood pressure remains elevated, your dose will be gradually increased to 300 milligrams once a day.

If you are being treated with hemodialysis or high doses of diuretics, you’ll be started at a lower dose of 75 milligrams once a day.

Kidney Damage from Type 2 Diabetes

The usual dose is 300 milligrams once a day.

 CHILDREN

For children under 6, safety and effectiveness have not been established. For children 6 to 12 years old, the typical starting dose is 75 milligrams once a day. If blood pressure is still too high, the dose may be increased to 150 milligrams once a day. Children 13 to 16 years old are usually given the adult dosage.

Overdosage

There has been little experience with overdosage of drugs such as Avapro. However, the most likely results would be low blood pressure and an abnormally slow or rapid heartbeat. If you suspect an overdose, seek medical attention immediately.

 Avapro

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We changed the following package:
Quibron-T 300mg we are changed to Quibron-T 400mg (the prices are the same)

And we are decreasing the prices for following items:

Accutane
Aciphex
Aricept
Aceon
Augmentin
Celebrex
Cephalexin
Cipro
Remeron
Sarafem
Zyloprim
Oxytrol
Danazol
Depakote
Desyrel
Diovan
Hyzaar
Prevacid
Mysoline
Zebeta
Zerit
Acomplia
Zimulti
Rimonabant

Drugstore 

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Guggul is one of the oldest and most famous herbs in ayurvedic medicine. It possesses strong purifying and rejuvenating properties and its lipid regulating and immunomodulating properties are especially beneficial.

Who can take Guggul?

Because herbal medicines are relatively mild and gentle on the human body, Guggul can be taken by practically everyone, regardless of age and gender. Guggul can be taken by people for:
- Weight Management
- Lowering Cholesterol
- Improving Circulation
- Relief from Arthritis pain
- Treating Boils
- Eczema
- Menstrual Pain (Relieves it)
- Dermatitis
- Psoriasis
- Skin rashes

Is Guggul addictive?

Guggul made by Himalaya Healthcare does not contain any addictive components. It is safe to use Guggul for extended periods of time without fear of addiction.

Are there any side effects to taking Guggul?

There are no known serious side effects to taking Guggul. It is non-toxic and well-tolerated. However, prolonged use may be associated with mild stomach upset. It may stimulate the thyroid and uterus, so it is best to avoid in cases of hyperthyroidism and pregnancy.

Can Guggul be taken along with other pharmaceutical medication?

It is not advisable to combine guggul with cholesterol-lowering pharmaceutical medication, although the interaction with such drugs has not been studied in detail.

What kind of action does Guggul have on the body?

Guggul has traditionally been used in Ayurvedic medicine to treat obesity, lipid disorders, and rheumatoid arthritis. It is useful in the treatment of arteriosclerosis, while reducing existing plaque in arteries. In terms of obesity, Guggul increases body’s metabolic rate, improves thyroid function, increases fat-burning activity of the body, and increases thermogenesis or heat production. Guggul helps to lower cholesterol and triglycerides. It has been shown to reduce total cholesterol up to 30% in 3 months. Guggul’s cholesterol regulating properties are especially important in reducing LDL by 35% and increasing HDL by 20% in 12 weeks. Guggul decreases platelet stickiness and reduces risk of heart disease and stroke.

What are the benefits of taking Guggul?

- Guggul increased HDL cholesterol, which is needed by the body and lowers LDL cholesterol.
- It lowers triglyceride levels.
- It relaxes the muscles which helps relieve menstrual pain.
- It acts as a blood detoxifier which breaks up stagnation in the body.
- It is a heart tonic that strengthens the heart.

How long do I have take Guggul before I see any results?

Herbal medicines provide progressive, long-term benefits. Certain classes of herbs work well in acute conditions to provide quick relief, however herbs like Guggul usually take 3-4 weeks before you can experience the full benefits of taking it. Individual results can vary, depending on the nature and seriousness of the condition for which Guggul is being consumed.

Have any studies been done on Guggul?

One 12-week study demonstrated that 1500 milligrams of guggulipid had average reduction in serum cholesterol of nearly 22%, while triglycerides were reduced about 25% in people who took it regularly. Another study showed that guggulipid works best for people who have high cholesterol reading of the type IIb (increased LDL, VLDL, and triglycerides) and type IV (increased VLDL and triglycerides). A third study involving 233 people with elevated cholesterol or triglycerides levels (or both) showed that guggulipid worked better than the cholesterol-lowering drug Clofibrate. People taking guggul had the added benefit of seeing some improvements in HDL, the “good cholesterol” - an effect that was not in evidence with the pharmaceutical.

Is Guggul a standardized herbal medicine?

Himalaya Healthcare Company has solved the riddle of ensuring consistency of performance for herbal remedies through full control of all stages of production from growing the herbs on their own farms to adhering to pharma Good Manufacturing Practices (GMP) and stringent quality controls. Every Himalaya Pure Herb, including Guggul, is fingerprinted using the most sophisticated chromatographic techniques to consistently maintain the highest quality.

What is the difference between the pure herb, Guggul, and herbal blends that contain Guggul as a primary ingredient?

Himalaya Pure Herbs is a line of clinically proven traditional herbs from The Himalaya Drug Company. The Himalaya Pure Herbs range delivers to you the best of a rich Indian pharmacopoeia in a convenient capsule form. Each Pure Herb capsule contains the goodness of the entire Guggul plant and all its attendant benefits. On the other hand, herbal blends, like HeartCare and GlucoCare, that contain Guggul as the primary ingredient fulfill essentially all of the functions that Guggul individually does, but include other herbs that address different aspects of cholesterol and glucose metabolism respectively. For most consumers, it is often a matter of choice when deciding between Pure Herbs and Herbal blends.

Which is more important when shopping for herbal medicines - safety, effectiveness, or bioequivalence?

We recognize that, for most consumers, the real issue is less one of safety and effectiveness of herbal remedies in general and more one of the quality of the specified product. The real issue for the consumer is the question of bioequivalence: is the product in front of me going to be bioequivalent to the one I have been reading about and deliver the results I expect?

Why buy Himalaya Guggul when there are countless other brands available on the market?

It is important that you, as a consumer, look for products that have not only been researched clinically but are also “fingerprinted” to guarantee that “the science is in the pill”. Himalaya, in fact, pioneered “fingerprinting” as the way to achieve consistency of performance of herbal remedies. Fingerprinting refers to perfectly matching the entire phytoconstituent profile of the plant between the product on the market and the reference or standard on which the science has been generated. In other words, “fingerprinting” the entire make-up of the herbal product is the only way to verify bioequivalence. Most companies that manufacture herbal medicines are not equipped nor care to perform such fingerprinting. Consequently for the consumer, most products on the market cannot truly make the claims they make because the bioequivalence of their herbal products has not been conclusively established through a match of their phytoconstituent profiles with the reference.

SCIENTIFIC VALIDATION

Guggul has been scientifically validated by many clinical studies. Its formula has been subjected to the modern scrutiny of clinical testing to prove its benefits in gently addressing your health concerns, and its quality is controlled by the most sophisticated chromatographic “fingerprinting” techniques.

Shuddha Guggul

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