Atrovent is used to prevent bronchospasm, or narrowing airways in the lungs, in people with bronchitis, emphysema, or COPD (chronic obstructive pulmonary disease).

Atrovent may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Atrovent (Ipratropium)?

Before using this medication, tell your doctor if you have narrow-angle glaucoma, or an enlarged prostate or bladder obstruction. If you have any of these conditions, you may need a dose adjustment or special tests to safely use Atrovent.

Atrovent is used to prevent bronchospasm attacks. Atrovent will not treat bronchospasm while it is happening. You may still have difficulty breathing and may need to use one of your other medicines to treat the attack. To best control your condition, use Atrovent regularly, and continue using all your other medicines as directed by your doctor.

Use this medication exactly as it was prescribed for you. Do not use it in larger doses or for longer than recommended by your doctor.

Call your doctor right away if you feel that this medicine is not working as well as usual, or if it makes your condition worse. If it seems like you need to use more of any of your medications in a 24-hour period, talk with your doctor.

Extreme heat can cause the Atrovent canister to burst. Do not store your inhaler in your car on hot days. Do not throw an empty canister into open flame.

Keep track of the number of sprays you have used and throw away the inhaler canister after 200 sprays, even if it feels like there is still medicine in it.

What should I discuss with my healthcare provider before using Atrovent (Ipratropium)?

Atrovent is used to prevent bronchospasm attacks. This medication will not treat bronchospasm while it is happening. You may still have difficulty breathing and may need to use one of your other medicines to treat the attack. To best control your condition, use Atrovent regularly, and continue using all your other medicines as directed by your doctor.

Before using Atrovent, tell your doctor if you have:

• narrow-angle glaucoma; or
• an enlarged prostate or a bladder obstruction.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use this medication.

FDA pregnancy category B: This medication is not expected to be harmful to an unborn baby. Do not use Atrovent without telling your doctor if you are pregnant or plan to become pregnant during treatment. It is not known if ipratropium passes into breast milk or if it could harm a nursing baby. Do not use Atrovent without telling your doctor if you are breast-feeding a baby. Atrovent should not be used by a child younger than 12 years of age.

How should I use Atrovent (Ipratropium)?

Use this medication exactly as it was prescribed for you. Do not use it in larger doses or for longer than recommended by your doctor.

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.

When using the inhaler device for the first time, prime it by spraying 2 test sprays into the air, away from your face. Also prime the inhaler if you have not used it for 3 days or longer.

The instructions below are for standard use of the inhaler and nebulizer devices. Your doctor may want you to use your device differently. Be sure you understand all instructions that are specific to your use of Atrovent.

To use the inhaler:

• Uncap the mouthpiece of the inhaler. Breathe out fully. Put the mouthpiece into your mouth and close your lips. Keep your eyes closed to prevent spraying any medicine into your eyes. Breathe in slowly while pushing down on the canister. Hold your breath for 10 seconds, then breathe out slowly.
• If you use more than one inhalation at a time, wait at least 15 seconds before using the second inhalation.
• Keep your inhaler clean and dry, and store it with the cap on the mouthpiece. Clean your inhaler once a week by removing the canister and placing the mouthpiece under warm running water for at least 30 seconds. Allow the parts to dry before putting the inhaler back together.

To use the solution with a nebulizer:

• Measure the correct amount of medicine using the dropper provided, or use the proper number of ampules. Place the liquid into the medication chamber of the nebulizer. If using a medicine dropper, do not allow the dropper to touch any surface including your hands or the nebulizer.
• Attach the mouthpiece or face mask to the drug chamber. Then, attach the drug chamber to the compressor. Sit upright in a comfortable position. Place the mouthpiece into your mouth or put the face mask on, covering your nose and mouth. Breathe in slowly and evenly until you have inhaled all of the medicine (usually 5 to 15 minutes). The treatment is complete when no more mist is formed by the nebulizer and the drug chamber is empty.
• Clean the nebulizer after each use. Follow the cleaning directions that came with your nebulizer.

Call your doctor right away if you feel that this medicine is not working as well as usual, or if it makes your condition worse. If it seems like you need to use more of any of your medications in a 24-hour period, talk with your doctor.

To be sure this medication is helping your condition, your lung function will need to be tested on a regular basis. It is important that you not miss any scheduled visits to your doctor.

Store Atrovent at room temperature away from moisture and heat. Extreme heat can cause the canister to burst. Do not store it in your car on hot days. Do not throw an empty canister into open flame.

Keep track of the number of sprays you have used and throw away the inhaler canister after 200 sprays, even if it feels like there is still medicine in it.

What happens if I miss a dose?

Use the medication 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. Atrovent is not expected to cause overdose symptoms.

Atrovent (Ipratropium) side effects

Stop using Atrovent and 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 a fast, pounding heartbeat.

Other less serious side effects are more likely to occur, such as:

• headache, dizziness;
• dry mouth, cough, hoarseness;
• nausea, upset stomach; or
• blurred vision.

If you switch from Atrovent to Atrovent HFA, you may notice a slightly different taste or feel after inhaling the medication.

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 Atrovent (Ipratropium)?

Before using Atrovent, tell your doctor if you are using any of the following medicines:

• atropine (Donnatal, and others),
• belladonna,
• clidinium (Quarzan),
• dicyclomine (Bentyl),
• glycopyrrolate (Robinul),
• hyoscyamine (Anaspaz, Cystospaz, Levsin, and others)
• mepenzolate (Cantil),
• methantheline (Provocholine),
• methscopolamine (Pamine), and
• propantheline (Pro-Banthine), or
• scopolamine (Transderm-Scop).

This list is not complete and there may be other drugs not listed that can affect Atrovent. 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.

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Topiramate is a seizure medication, also called an anticonvulsant.

Topiramate is used alone or in combination with other medications to prevent seizures in adults and children who are at least 2 years old.

Topiramate is also used to prevent migraine headaches. Topiramate will only prevent migraine headaches or reduce the number of attacks. It will not treat a headache that has already begun.

Topiramate may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Topamax (Topiramate)?

Seek emergency medical attention if you have a sudden change in vision and pain around or behind the eyes. These may be early signs of a serious side effect of topiramate. Do not stop taking topiramate without first talking to your doctor, even if you feel better. You may have increased seizures if you stop taking topiramate suddenly. You will need to use less and less before you stop the medication completely. Contact your doctor if your seizures get worse or you have them more often while taking topiramate.

You may have thoughts about suicide while taking this medication. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself. Carry an ID card or wear a medical alert bracelet stating that you are taking topiramate, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are taking a seizure medication. Topiramate can cause side effects that may impair your vision or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly. Avoid drinking alcohol. It can increase some of the side effects of topiramate, and can also increase the risk of a seizure.

Ketogenic or “ketosis” diets that are high in protein and low in carbohydrates can increase the risk of kidney stones. Avoid the use of such diets while you are taking topiramate.

What should I discuss with my healthcare provider before taking Topamax (Topiramate)?

Do not use this medication if you are allergic to topiramate.

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

• kidney disease or a history of kidney stones;
• liver disease;
• glaucoma;
• asthma, emphysema, or bronchitis; or
• if you have recently had surgery.

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.

You may have thoughts about suicide while taking this medication. Tell your doctor if you have new or worsening depression or suicidal thoughts during the first several months of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

Topiramate can make birth control pills less effective. Talk with your doctor about other forms of birth control if you are trying to prevent pregnancy while taking topiramate. It is not known whether topiramate 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 Topamax (Topiramate)?

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.

Topiramate can be taken with or without food.

Take the medicine with a full glass of water.

The topiramate tablet should be swallowed whole. It has a bitter taste when chewed or broken.

To make the topiramate capsule easier to swallow, you may open the capsule and sprinkle the medicine into a spoonful of applesauce, custard, ice cream, oatmeal, pudding, or yogurt. Swallow this mixture right away without chewing. Do not save the mixture for later use.

To be sure this medication is not causing harmful effects, your blood will need to be tested 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 using topiramate. You may need to stop using the medicine for a short time.

Do not stop taking topiramate without first talking to your doctor, even if you feel better. You may have increased seizures if you stop taking topiramate suddenly. You will need to use less and less before you stop the medication completely. Contact your doctor if your seizures get worse or you have them more often while taking topiramate. Carry an ID card or wear a medical alert bracelet stating that you are taking topiramate, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are taking a seizure medication. Drink extra fluids each day while you are taking topiramate. This will lower your risk of having kidney stones or an electrolyte imbalance. Vomiting or diarrhea can lead to dehydration and cause an electrolyte imbalance. Call your doctor if you have ongoing vomiting or diarrhea while taking topiramate. Store topiramate 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 your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

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

Overdose symptoms may include drowsiness, dizziness, agitation or depression, blurred vision, problems with speech or balance, stomach pain, chest pain, fast or pounding heartbeats, feeling light-headed, fainting, and seizure (convulsions).

Topamax (Topiramate) 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 new or worsening symptoms such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Stop taking topiramate and call your doctor at once if you have any of these serious side effects:

• sudden vision loss, pain around or behind your eyes;
• dry mouth, increased thirst, confusion, drowsiness, decreased sweating, increased body temperature, and hot, dry skin,
• nausea, vomiting, increased urination, muscle pain or weakness, fast heart rate, feeling light-headed, fainting, or seizure (convulsions); or
• severe pain in your side or lower back, painful or difficult urination.

Less serious side effects may include:

• slowed thinking, memory problems, trouble concentrating;
• problems with speech or balance;
• numbness or tingling;
• sleep problems (insomnia);
• tired feeling;
• headache, dizziness; or
• loss of appetite, weight loss.

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 Topamax (Topiramate)?

Before taking topiramate, tell your doctor if you are taking any of the following medicines:

• amitriptyline (Elavil, Etrafon);
• atropine (Donnatal, and others);
• benztropine (Cogentin);
• glycopyrrolate (Robinul);
• hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor, Vasoretic, Zestoretic);
• methscopolamine (Pamine) or scopolamine (Transderm-Scop);
• risperidone (Risperdal);
• bladder or urinary medications such as darifenacin (Enablex), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);
• bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);
• diabetes medicine you take by mouth, such as pioglitazone (Actos) or metformin (Actoplus Met, Avandamet, Glucophage, Fortamet);
• glaucoma medications such as acetazolamide (Diamox), methazolamide (Neptazane), or dichlorphenamide (Daranide);
• irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin, and others), propantheline (Pro-Banthine); or
• other seizure medications such as carbamazepine (Carbatrol, Tegretol), lamotrigine (Lamictal), phenytoin (Dilantin), or valproic acid (Depakote, Depakene).

This list is not complete and there may be other drugs that can interact with topiramate. 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.

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Oxybutynin reduces muscle spasms of the bladder and urinary tract.

Oxytrol is used to treat symptoms of overactive bladder, such as frequent or urgent urination, incontinence (urine leakage), and increased nighttime urination.

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

What is the most important information I should know about Oxytrol?

Do not use Oxytrol if you are allergic to oxybutynin, or if you have uncontrolled glaucoma, a blockage in your stomach or intestines, or if you are unable to urinate. Oxybutynin can cause blurred vision, drowsiness, or dizziness. Be careful if you drive or do anything that requires you to be alert and able to see clearly. Avoid drinking alcohol. It can increase some of the side effects of oxybutynin.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Drink plenty of fluids to keep yourself hydrated while you are using oxybutynin.

Do not expose the Oxytrol patch to sunlight. It should be worn under clothing.

What should I discuss with my healthcare provider before using Oxytrol?

Do not use Oxytrol if you are allergic to oxybutynin, or if you have:

• untreated or uncontrolled glaucoma;
• a blockage in your digestive tract (stomach or intestines); or
• if you have decreased urination or are unable to urinate.

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

• glaucoma;
• liver disease;
• kidney disease;
• myasthenia gravis;
• an enlarged prostate;
• an intestinal disorder, such as ulcerative colitis; or
• a stomach disorder such as gastroesophageal reflux disease (GERD) or slow digestion.

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

FDA pregnancy category B. Oxytrol is not expected to 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 Oxytrol passes into breast milk or if it could harm a nursing baby. Do not use Oxytrol without telling your doctor if you are breast-feeding a baby.

How should I use Oxytrol?

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

Oxytrol comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

To use the Oxytrol patch, open the sealed pouch and remove the protective liner. Apply the Oxytrol transdermal patch to a clean, dry area on your stomach, hip or buttock. Avoid skin that is oily, irritated, or damaged. Avoid placing the Oxytrol patch on a skin area that will be rubbed by a waistband or tight clothing.

Press the Oxytrol patch onto the skin and press it down firmly with your fingers. Make sure the patch is well sealed around the edges. When properly applied, the patch should stay on while swimming or bathing.

Leave the Oxytrol patch in place and wear it for 3 to 4 days. You should change the patch twice per week. Each time you apply a new patch, choose a different skin area on your stomach, hip, or buttock. Do not apply a patch to the same skin twice within one week.

Try to change your Oxytrol patch on the same two days each week (such as every Sunday and Thursday). There is a calendar printed on the package of Oxytrol to help you establish a steady patch-changing schedule.

If the patch falls off, try sticking it back on. If it does not stay on, replace it with a new one and wear it until your next regular patch-changing day. Do not change your schedule, even if you apply a new Oxytrol patch to replace one that has fallen off.

After removing a patch, fold it in half so it sticks together and flush it down the toilet or place it in a waste can with a lid.

Use baby oil or mild soap and water to remove any adhesive residue that stays on your skin. Avoid using harsh soaps, alcohol, nail polish remover, or other solvents that could irritate your skin.

Keep the Oxytrol patch in its sealed pouch until you are ready to use it. Store the pouches at room temperature away from heat and moisture.

What happens if I miss a dose?

If you forget to change a patch on your scheduled day, remove and replace the Oxytrol patch as soon as you remember. Wear the patch until your next regular patch-changing day. Do not change your schedule, even if you wear the new patch for less that 3 days.

Do not apply two patches at the same time 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. Symptoms of an Oxytrol overdose may include restlessness, tingly feeling, fever, uneven heart rate, vomiting, and urinating less than usual or not at all.

Oxytrol side effects

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

• fever with hot, dry skin;

• uneven heart rate;
• pain, burning, or other difficulty when urinating; or
• severe itching, burning, or blistering that does not clear up within several hours after removing the skin patch.

Continue using Oxytrol and talk to your doctor if you have any of these less serious side effects:

• mild skin itching, burning, redness, or discoloration where a patch was worn;
• dizziness, drowsiness, weakness;
• blurred vision;
• dry mouth;
• warmth, tingling, or redness under your skin;
• nausea, vomiting, stomach pain;
• constipation or diarrhea;
• dry eyes;
• stuffy nose;
• back pain;
• feeling restless; or
• sleep problems (insomnia).

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 Oxytrol?

Before using Oxytrol, tell your doctor if you are using any of the following drugs:

• atropine (Donnatal, and others);
• belladonna;
• clidinium (Quarzan);
• dicyclomine (Bentyl);
• glycopyrrolate (Robinul);
• hyoscyamine (Anaspaz, Cystospaz, Levsin, and others);
• mepenzolate (Cantil);
• methantheline (Provocholine);
• methscopolamine (Pamine);
• propantheline (Pro-Banthine);
• scopolamine (Transderm-Scop);
• antibiotics such as clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Ery-Tab, Erythrocin), itraconazole (Sporanox), or ketoconazole (Nizoral).

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

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

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