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п»їSulfamethoxazole and Trimethoprim tablet
What is this medicine?

SULFAMETHOXAZOLE; TRIMETHOPRIM or SMX-TMP is a combination of a sulfonamide antibiotic and a second antibiotic, trimethoprim. It is used to treat bacterial infections. It is also used to prevent infections in people who are at risk. It will not work for colds, flu, or other viral infections.
What should my health care professional know before I take this medicine?

They need to know if you have any of these conditions:
anemia
asthma
being treated with anticonvulsants
if you frequently drink alcohol containing drinks
kidney disease
liver disease
low level of folic acid or glucose-6-phosphate dehydrogenase
poor nutrition or malabsorption
porphyria
severe allergies
thyroid disorder
an unusual or allergic reaction to sulfamethoxazole, trimethoprim, sulfa drugs, other medicines, foods, dyes, or preservatives
pregnant or trying to get pregnant
breast-feeding
How should I take this medicine?

Take this medicine by mouth with a full glass of water. Take your medicine at regular intervals. Do not take it more often than directed. Do not skip doses or stop your medicine early.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed. This medicine has been used in children as young as 2 months of age.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.
What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.
What may interact with this medicine?

Do not take this medicine with any of the following:
aminobenzoate potassium
dofetilide
metronidazole

This medicine may also interact with the following:
ACE inhibitors like benazepril, enalapril, lisinopril, and ramipril
cyclosporine
digoxin
diuretics
indomethacin
medicines for diabetes
methenamine
methotrexate
phenytoin
potassium supplements
pyrimethamine
sulfinpyrazone
tricyclic antidepressants
warfarin

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
What should I watch for while using this medicine?

Tell your doctor or health care professional if your symptoms do not improve. Drink several glasses of water a day to reduce the risk of kidney problems.

Do not treat diarrhea with over the counter products. Contact your doctor if you have diarrhea that lasts more than 2 days or if it is severe and watery.

This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use a sunscreen. Do not use sun lamps or tanning beds/booths.
What side effects may I notice from this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
allergic reactions like skin rash or hives, swelling of the face, lips, or tongue
breathing problems
fever or chills, sore throat
irregular heartbeat, chest pain
joint or muscle pain
pain or difficulty passing urine
red pinpoint spots on skin
redness, blistering, peeling or loosening of the skin, including inside the mouth
unusual bleeding or bruising
unusually weak or tired
yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
diarrhea
dizziness
headache
loss of appetite
nausea, vomiting
nervousness

This list may not describe all possible side effects.
Where can I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 20 to 25 degrees C (68 to 77 degrees F). Protect from light. Throw away any unused medicine after the expiration date.
What is the shelf life of the pills?
The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.


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Generic Name: quinapril hydrochloride
Dosage Form: tablet, film coated
USE IN PREGNANCY


When used in pregnancy during the second and third trimesters, ACE inhibitors can cause injury and even death to the developing fetus. When pregnancy is detected, Accupril should be discontinued as soon as possible. See WARNINGS, Fetal/Neonatal Morbidity and Mortality.
Accupril Description

Accupril® (quinapril hydrochloride) is the hydrochloride salt of quinapril, the ethyl ester of a non-sulfhydryl, angiotensin-converting enzyme (ACE) inhibitor, quinaprilat.

Quinapril hydrochloride is chemically described as [3S-[2[R*(R*)], 3R*]] - 2 - [2 - [[1 - (ethoxycarbonyl) - 3 - phenylpropyl]amino] - 1 - oxopropyl] - 1,2,3,4 - tetrahydro - 3 - isoquinolinecarboxylic acid, monohydrochloride. Its empirical formula is C25H30N2O5•HCl and its structural formula is:


Quinapril hydrochloride is a white to off-white amorphous powder that is freely soluble in aqueous solvents.

Accupril tablets contain 5 mg, 10 mg, 20 mg, or 40 mg of quinapril for oral administration. Each tablet also contains candelilla wax, crospovidone, gelatin, lactose, magnesium carbonate, magnesium stearate, synthetic red iron oxide, and titanium dioxide.
Accupril - Clinical Pharmacology
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Quinapril is deesterified to the principal metabolite, quinaprilat, which is an inhibitor of ACE activity in human subjects and animals. ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor, angiotensin II. The effect of quinapril in hypertension and in congestive heart failure (CHF) appears to result primarily from the inhibition of circulating and tissue ACE activity, thereby reducing angiotensin II formation. Quinapril inhibits the elevation in blood pressure caused by intravenously administered angiotensin I, but has no effect on the pressor response to angiotensin II, norepinephrine or epinephrine. Angiotensin II also stimulates the secretion of aldosterone from the adrenal cortex, thereby facilitating renal sodium and fluid reabsorption. Reduced aldosterone secretion by quinapril may result in a small increase in serum potassium. In controlled hypertension trials, treatment with Accupril alone resulted in mean increases in potassium of 0.07 mmol/L (see PRECAUTIONS). Removal of angiotensin II negative feedback on renin secretion leads to increased plasma renin activity (PRA).

While the principal mechanism of antihypertensive effect is thought to be through the renin-angiotensin-aldosterone system, quinapril exerts antihypertensive actions even in patients with low renin hypertension. Accupril was an effective antihypertensive in all races studied, although it was somewhat less effective in blacks (usually a predominantly low renin group) than in nonblacks. ACE is identical to kininase II, an enzyme that degrades bradykinin, a potent peptide vasodilator; whether increased levels of bradykinin play a role in the therapeutic effect of quinapril remains to be elucidated.

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If Accutane gives you an allergic reaction, you will not be able to use it.

If you are a woman of childbearing age, you should not take Accutane if you are pregnant, if you think there is a possibility you might get pregnant during the treatment, or if you are unable to keep coming back to the doctor for monthly checkups, including pregnancy testing.


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Stop taking Accutane and notify your doctor immediately at the first sign of a skin rash or any other allergic reaction. Although they are rare, serious and even fatal allergic reactions have been known to occur.

When you first start taking Accutane, it is possible that your acne will get worse before it starts to get better.

Accutane may cause depression or other mental problems such as: mood swings, aggression, sadness, hopelessness, loss of pleasure, fatigue, difficulty concentrating, change in sleep patterns, restlessness, and irritability. In rare cases, it has prompted thoughts of suicide. If you begin to feel depressed or become troubled by suicidal thoughts, contact your doctor immediately.

Before starting Accutane therapy, all patients must sign a consent form noting that they are aware of the possibility of mental side effects, the danger of birth defects, and the need for certain other precautions.

If you are a woman of childbearing age and you are considering taking Accutane, you will be given both spoken and written warnings (the iPLEDGE program) about the importance of avoiding pregnancy during the treatment. You will also be asked to sign a second consent form noting that:
You must not take Accutane if you are pregnant, may become pregnant during treatment, or are breastfeeding;
If you get pregnant while taking Accutane, your baby will be at high risk for birth defects;
If you take Accutane, you must use 2 effective forms of birth control from 1 month before the start of treatment through 1 month after the end of treatment;
You must have 2 negative pregnancy tests (one just before starting Accutane therapy), and must be tested every month during therapy;
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If you become pregnant, you must immediately stop taking Accutane and see your doctor;
You have read and understood the Accutane patient brochure and asked your doctor any questions you had;
You have been invited to participate in a survey of women being treated with Accutane.

Some people taking Accutane, including some who simultaneously took tetracycline, have experienced headache, nausea, and visual disturbances caused by increased pressure within the skull. Avoid taking tetracycline while using Accutane. See a doctor immediately if you have these symptoms; if the doctor finds swelling of the optic nerve at the back of your eye, you must stop taking Accutane at once and see a neurologist for further care.

Be careful driving at night. Some people have experienced a sudden decrease in night vision.

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You may not be able to tolerate your contact lenses during and after your therapy with Accutane.

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