Medication effects and side effects. Many side effects of medications may not be reported. Always consult your doctor or healthcare specialist for medical advice.
Here information of medicine.
Atenolol is used with or without other medications to treat high
blood pressure (hypertension). Lowering high blood pressure helps
prevent strokes, heart attacks, and kidney problems. This medication is
also used to treat chest pain (angina) and to improve survival after a
heart attack.
Atenolol belongs to a class of drugs known as beta
blockers. It works by blocking the action of certain natural chemicals
in your body, such as epinephrine, on the heart and blood vessels. This
effect lowers the heart rate, blood pressure, and strain on the heart.
OTHER
USES: This section contains uses of this drug that are not listed in
the approved professional labeling for the drug but that may be
prescribed by your health care professional. Use this drug for a
condition that is listed in this section only
Aspirin, or acetylsalicylic acid (ASA), is a common drug that
is generally used as a pain reliever for minor aches and pains, to
reduce fever, and also as an anti-inflammatory drug.
Aspirin has also become increasingly popular as a drug to prevent clot-forming; it is used long-term in low doses to prevent heart attacks and strokes in high-risk patients.
Nowadays, aspirin is often given to patients immediately after a heart attack to prevent recurrence or cardiac tissue death.
This article will explain what aspirin is and what it is used for; we will also cover precautions, side effects, and any risks.
Apollo Moon astronauts had Aspirin included in their self-medication kits
Aspirin interacts with a number of other drugs, including warfarin and methotrexate
What is aspirin?
Aspirin is commonly used to relieve pain, inflammation, and fever and prevent clot formation.
Aspirin is a non-steroidal anti-inflammatory drug (NSAID). NSAIDs are medications with the following effects:
Analgesic - pain relief without anesthesia or loss of consciousness
Antipyretic - reduces a fever
Anti-inflammatory - in higher doses
Non-steroidal simply means they are not steroids, which often have similar effects.
As analgesics, NSAIDs are generally non-narcotic (do not cause
insensibility or stupor). Aspirin was the first NSAID to be discovered.
Aspirin in its present form has been around for over 100 years and is
still one of the most widely used medications in the world. It is
estimated that approximately 35,000 metric tons
of aspirin is consumed annually.
Aspirin is a trademark owned by German pharmaceutical company - Bayer;
the generic term for aspirin is acetylsalicylic acid (ASA).
Therapeutic uses of aspirin
Aspirin is one of the most commonly used drugs for the treatment of mild to moderate pain, as well as migraines and fever. For the treatment of moderate to severe pain, it is frequently used along with other opioid analgesic and NSAIDs.
Below are some of the therapeutic uses of aspirin:
Mild to moderate pain
Moderate to severe pain combined with other medications
Rheumatic fever (in higher doses)
Rheumatic arthritis (in higher doses)
Many other inflammatory joint conditions (in higher doses)
To inhibit platelet aggregations (blood clot formations) to reduce risk of transient ischemic attacks and unstable angina (in lower doses)
For the prevention of myocardial infarction in patients with cardiovascular disease
In the treatment of pericarditis
In the treatment of coronary artery disease
In the treatment of myocardial infarction
Aspirin and children
Acetaminophen (paracetamol, Tylenol) and ibuprofen are generally used
for children; not aspirin. Aspirin and salicylate NSAID usage in
children raise the risk of developing Reye's Syndrome. In some countries, such as the United Kingdom, aspirin is only occasionally used in children under specialist supervision for Kawasaki disease and to prevent blood clot formation after heart surgery.
Low-dose aspirin
Low-dose aspirin (75 milligrams per day) is used as an antiplatelet medication - to prevent the formation of clots in the blood.
Low-dose aspirin may be given to patients who had:
Anyone planning to have a surgical operation should tell their doctor if
they are taking regular aspirin. In many cases, patients will be asked
to stop taking the aspirin for 7 days before the operation.
Pregnant or breast-feeding patients may take low-dose aspirin, but only
under their doctor's supervision. High-dose aspirin is not recommended.
Drug interactions with aspirin
If
taken alongside anti-inflammatory painkillers such as ibuprofen and
diclofenac, aspirin can increase the risk of stomach bleeding.
Sometimes, one medication can undermine the efficacy of another
medication - this is called a drug interaction. Below is a list of the
most common drugs that aspirin interacts with (there are more):
Anti-inflammatory painkillers - such as diclofenac, ibuprofen,
indomethacin, and naproxen increase the risk of stomach bleeding if
taken in combination with aspirin.
Methotrexate - used in the treatment of cancer
and some autoimmune diseases. Aspirin can make it harder for the body
to eliminate methotrexate, resulting in high and potentially dangerous
levels of methotrexate in the body.
SSRI (selective serotonin reuptake inhibitors) antidepressants -
drugs, such as citalopram, fluoxetine, paroxetine, venlafaxine, and
sertraline, taken with aspirin can increase the risk of bleeding.
Warfarin - this is an anticoagulant drug (a blood thinner); it stops
the blood from clotting. Aspirin taken with warfarin can reduce the
drug's anticoagulant effects, increasing the risk of bleeding. In some
situations, however, a doctor may prescribe aspirin together with
warfarin.
Doxycycline is a tetracycline antibiotic that fights bacteria in the body.
Doxycycline is used to treat many different bacterial infections, such as acne, urinary tract infections, intestinal infections, eye infections, gonorrhea, chlamydia, periodontitis (gum disease), and others.
Doxycycline is also used to treat blemishes, bumps, and acne-like lesions caused by rosacea. It will not treat facial redness caused by rosacea.
Some forms of doxycycline are used to prevent malaria, to treat anthrax, or to treat infections caused by mites, ticks, or lice.
Important information
You should not take doxycycline if you are allergic to any tetracycline antibiotic.
Children younger than 8 years old should use doxycycline only in
cases of severe or life-threatening conditions. This medicine can cause
permanent yellowing or graying of the teeth in children.
Using doxycycline during pregnancy could harm the unborn baby or cause permanent tooth discoloration later in the baby's life.
Before taking this medicine
You should not take this medicine if you are allergic to doxycycline
or other tetracycline antibiotics such as demeclocycline, minocycline,
tetracycline, or tigecycline.
To make sure doxycycline is safe for you, tell your doctor if you have:
liver disease;
kidney disease;
asthma or sulfite allergy;
a history of increased pressure inside your skull;
if you also take isotretinoin (Amnesteem, Claravis, Sotret); or
if you take seizure medicine (carbamazepine, phenobarbital, phenytoin), or a blood thinner (warfarin, Coumadin, Jantoven).
If you are using doxycycline to treat gonorrhea, your doctor may test
you to make sure you do not also have syphilis, another sexually
transmitted disease.
Taking this medicine during pregnancy may affect tooth and bone
development in the unborn baby. Taking doxycycline during the last half
of pregnancy can cause permanent tooth discoloration later in the baby's
life. Tell your doctor if you are pregnant or if you become pregnant
while using this medicine.
Doxycycline can make birth control pills less effective. Ask your
doctor about using a non-hormonal birth control (condom, diaphragm with
spermicide) to prevent pregnancy.
Doxycycline can pass into breast milk and may affect bone and tooth development in a nursing infant. Do not breast-feed while you are taking this medicine.
Children should not use this medicine. Doxycycline can cause
permanent yellowing or graying of the teeth in children younger than 8
years old.
Children should use doxycycline only in cases of severe or
life-threatening conditions such as anthrax or Rocky Mountain spotted
fever. The benefit of treating a serious condition may outweigh any
risks to the child's tooth development.
How should I take doxycycline?
Take doxycycline exactly as prescribed by your doctor. Follow all
directions on your prescription label. Do not take this medicine in
larger or smaller amounts or for longer than recommended.
Take doxycycline with a full glass of water. Drink plenty of liquids while you are taking this medicine.
Most brands of doxycyline may be taken with food or milk if the medicine upsets your stomach. Different brands of doxycycline may have different instructions about taking them with or without food.
Take Oracea on an empty stomach, at least 1 hour before or 2 hours after a meal.
You may open a Doryx capsule or break up a Doryx tablet and sprinkle
the medicine into a spoonful of applesauce to make swallowing easier.
Swallow right away without chewing. Do not save the mixture for later
use. Drink a full glass (8 ounces) of cool water right away.
Do not crush, break, or open a delayed-release capsule or tablet. Swallow the pill whole.
You may need to split the Acticlate tablet to get the correct dose. The tablet is scored so you can break it apart easily.
Measure liquid medicine with the dosing syringe provided, or with a
special dose-measuring spoon or medicine cup. If you do not have a
dose-measuring device, ask your pharmacist for one.
If you take doxycycline to prevent malaria: Start taking the medicine
1 or 2 days before entering an area where malaria is common. Continue
taking the medicine every day during your stay and for at least 4 weeks
after you leave the area. Use protective clothing, insect repellents,
and mosquito netting around your bed to further prevent mosquito bites
that could cause malaria.
Use this medicine for the full prescribed length of time. Your
symptoms may improve before the infection is completely cleared.
Skipping doses may also increase your risk of further infection that is
resistant to antibiotics. Doxycycline will not treat a viral infection
such as the flu or a common cold.
If you need surgery, tell the surgeon ahead of time that you are
using doxycycline. You may need to stop using the medicine for a short
time.
Store at room temperature away from moisture and heat.
Throw away any unused medicine after the expiration date on the label has passed. Using expired doxycycline can cause damage to your kidneys. See also:Dosage Information (in more detail)
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if
it is almost time for your next scheduled dose. Do not take extra
medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking doxycycline?
Do not take iron supplements, multivitamins, calcium supplements,
antacids, or laxatives within 2 hours before or after taking
doxycycline.
Avoid taking any other antibiotics with doxycycline unless your doctor has told you to.
Avoid exposure to sunlight or tanning beds. Doxycycline can make you
sunburn more easily. Wear protective clothing and use sunscreen (SPF 30
or higher) when you are outdoors.
Antibiotic medicines can cause diarrhea, which may be a sign of a new
infection. If you have diarrhea that is watery or bloody, stop taking
this medicine and call your doctor. Do not use anti-diarrhea medicine
unless your doctor tells you to.
Doxycycline side effects
Get emergency medical help if you have any signs of an allergic reaction to doxycycline: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
changes in your vision;
severe stomach pain, diarrhea that is watery or bloody;
fever, swollen glands, body aches, flu symptoms, weakness;
skin rash, pale skin, easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness;
upper stomach pain (may spread to your back), loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);
chest pain, irregular heart rhythm, feeling short of breath;
confusion, nausea and vomiting, swelling, rapid weight gain, little or no urinating;
new or worsening cough with fever, trouble breathing;
increased pressure inside the skull--severe headaches, ringing in
your ears, dizziness, nausea, vision problems, pain behind your eyes; or
severe skin reaction--fever, sore throat, swelling in your face or
tongue, burning in your eyes, skin pain, followed by a red or purple
skin rash that spreads (especially in the face or upper body) and causes
blistering and peeling.
Common doxycycline side effects may include:
nausea, vomiting, upset stomach;
mild diarrhea;
skin rash or itching; or
vaginal itching or discharge.
This is not a complete list of side effects and others may occur.
Call your doctor for medical advice about side effects. You may report
side effects to FDA at 1-800-FDA-1088. See also:Side effects (in more detail)
What other drugs will affect doxycycline?
Other drugs may interact with doxycycline, including prescription and
over-the-counter medicines, vitamins, and herbal products. Tell each of
your health care providers about all medicines you use now and any
medicine you start or stop using.
Your pharmacist can provide more information about doxycycline.
Remember, keep this and all other medicines out of the reach of
children, never share your medicines with others, and use this
medication only for the indication prescribed.
Disclaimer: Every effort has been made to ensure that the
information provided by Cerner Multum, Inc. ('Multum') is accurate,
up-to-date, and complete, but no guarantee is made to that effect. Drug
information contained herein may be time sensitive. Multum information
has been compiled for use by healthcare practitioners and consumers in
the United States and therefore Multum does not warrant that uses
outside of the United States are appropriate, unless specifically
indicated otherwise. Multum's drug information does not endorse drugs,
diagnose patients or recommend therapy. Multum's drug information is an
informational resource designed to assist licensed healthcare
practitioners in caring for their patients and/or to serve consumers
viewing this service as a supplement to, and not a substitute for, the
expertise, skill, knowledge and judgment of healthcare practitioners.
The absence of a warning for a given drug or drug combination in no way
should be construed to indicate that the drug or drug combination is
safe, effective or appropriate for any given patient. Multum does not
assume any responsibility for any aspect of healthcare administered with
the aid of information Multum provides. The information contained
herein is not intended to cover all possible uses, directions,
precautions, warnings, drug interactions, allergic reactions, or adverse
effects. If you have questions about the drugs you are taking, check
with your doctor, nurse or pharmacist.
Commonly reported side effects of metoprolol include: cardiac failure, bradycardia, and hypotension. Other side effects include: bradycardia. See below for a comprehensive list of adverse effects.
For the Consumer
Applies to metoprolol: oral tablet, oral tablet extended release
In addition to its needed effects, some unwanted effects may be
caused by metoprolol. In the event that any of these side effects do
occur, they may require medical attention.
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Major Side Effects
You should check with your doctor immediately if any of these side effects occur when taking metoprolol: More common:
Blurred vision
chest pain or discomfort
confusion
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
shortness of breath
slow or irregular heartbeat
sweating
unusual tiredness or weakness
Less common:
Bloating or swelling of the face, arms, hands, lower legs, or feet
cough
decreased urine output
difficult or labored breathing
difficulty with speaking
dilated neck veins
disturbed color perception
double vision
extreme fatigue
fast, pounding, or racing heartbeat or pulse
halos around lights
headache
inability to move the arms, legs, or facial muscles
inability to speak
irregular breathing
loss of vision
night blindness
noisy breathing
overbright appearance of lights
pain, tension, and weakness upon walking that subsides during periods of rest
paleness or cold feeling in the fingertips and toes
rapid weight gain
seeing, hearing, or feeling things that are not there
short-term memory loss
slow speech
swelling of the face, fingers, feet, or lower legs
tightness in the chest
tingling of the hands or feet
tingling or pain in the fingers or toes when exposed to cold
troubled breathing
tunnel vision
unusual weight gain or loss
Rare
Bluish color skin of the fingers or toes
chills
clay-colored stools
continuing loss of appetite
continuing or severe abdominal or stomach pain
continuing or severe nausea and vomiting
dark urine
difficulty with moving
fever
general tiredness and weakness
hoarseness
increased frequency of urination
itching skin
light-colored stools
lower back or side pain
muscle pain or stiffness
numbness of the fingers or toes
pain, swelling, or redness in the joints
rash
sore throat
sores, ulcers, or white spots on the lips or in the mouth
unpleasant breath odor
unusual bleeding or bruising
upper right abdominal or stomach pain
vomiting of blood
weakness
yellow eyes and skin
Incidence not known:
Black, tarry stools
bleeding gums
blood in the urine or stools
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
cool, sweaty skin
pinpoint red spots on the skin
If any of the following symptoms of overdose occur while taking metoprolol, get emergency help immediately: Symptoms of overdose:
Bluish color of the fingernails, lips, skin, palms, or nail beds
change in consciousness
loss of consciousness
no blood pressure or pulse
stopping of heart
unconsciousness
very drowsy or sleepy
Minor Side Effects
Some of the side effects that can occur
with metoprolol may not need medical attention. As your body adjusts to
the medicine during treatment these side effects may go away. Your
health care professional may also be able to tell you about ways to
reduce or prevent some of these side effects. If any of the following
side effects continue, are bothersome or if you have any questions about
them, check with your health care professional: Less common:
Belching
bloated
decreased interest in sexual intercourse
difficulty having a bowel movement (stool)
discouragement
dry mouth
excess air or gas in stomach or intestines
feeling of constant movement of self or surroundings
feeling of indigestion
feeling sad or empty
full feeling
inability to have or keep an erection
irritability
loss in sexual ability, desire, drive, or performance
loss of interest or pleasure
nightmares
pain in the chest below the breastbone
passing gas
redness or other discoloration of the skin
runny nose
sensation of spinning
sneezing
stuffy nose
tiredness
trouble concentrating
trouble sleeping
Rare
Bone pain
continuing ringing or buzzing or other unexplained noise in the ears
dry eyes
hair loss or thinning of the hair
hearing loss
increased sensitivity of the skin to sunlight
pain of penis on erection
severe sunburn
Incidence not known:
Change in taste or bad, unusual, or unpleasant (after) taste
The
most common adverse reactions were tiredness, dizziness, depression,
shortness of breath, bradycardia, hypotension, diarrhea, pruritus, and
rash.[Ref]
Cardiovascular
Very
common (10% or more): Heart failure (up to 27.5%), hypotension
(systolic blood pressure less than 90 mmHg) (up to 27.4%), bradycardia
(heart rate less than 40 beats per minute) (up to 15.9%), Common (1%
to 10%): Cold extremities, arterial insufficiency, palpitation, first
degree heart block (P-R interval 0.26 seconds or greater), second or
third degree heart block, postural disorders Uncommon (0.1% to 1%): Cardiogenic shock in patients with acute myocardial infarction Rare (0.01% to 0.1%): Disturbances of cardiac conduction, cardiac arrhythmia Very rare (less than 0.01%): Intermittent claudication increased Frequency not reported: Claudication[Ref]
Gastrointestinal
Common (1% to 10%): Diarrhea, nausea, dry mouth, gastric pain, constipation, flatulence, heartburn, abdominal pain, vomiting Frequency not reported: Retroperitoneal fibrosis[Ref]
Other
Common (1% to 10%): Tiredness, peripheral edema, accident and/or injury, death, fatigue Uncommon (0.1% to 1%): Edema, precordial pain Frequency not reported: Lactic dehydrogenase elevated Postmarketing reports: Chest pain[Ref]
Nervous system
Common (1% to 10%): Dizziness, vertigo, stroke, headache Uncommon (0.1% to 1%): Paresthesia, somnolence, impaired concentration Rare (0.01% to 0.1%): Alertness decreased Very rare (less than 0.01%): Amnesia/memory impairment, tinnitus, taste disturbance Frequency not reported: Short-term memory loss Postmarketing reports: Syncope[Ref]
Respiratory
Common (1% to 10%): Shortness of breath, wheezing, dyspnea Rare (less than 0.1%): Rhinitis[Ref]
Dermatologic
Common (1% to 10%): Pruritus, rash Uncommon (0.1% to 1%): Sweating increased Rare (0.01% to 0.1%): Loss of hair Very
rare (less than 0.01%): Photosensitivity reactions, psoriasis
aggravated, gangrene in patients with preexisting severe peripheral
circulatory disorders, hyperhidrosis, alopecia[Ref]
Psychiatric
Common (1% to 10%): Depression Uncommon (0.1% to 1%): Insomnia, nightmare Rare (0.01% to 0.1%): Nervousness, anxiety Very rare (less than 0.01%): Confusion, hallucination, personality disorder, disturbances of libido Frequency not reported: Sleep disturbance[Ref]
Musculoskeletal
Uncommon (0.1% to 1%): Muscle cramps Very rare (less than 0.01%): Arthralgia, arthritis Frequency not reported: Musculoskeletal pain[Ref]
Metabolic
Uncommon (0.1% to 1%): Weight gain Frequency not reported: Unstable diabetes Postmarketing reports: Blood triglycerides increased, high density lipoprotein (HDL) decreased[Ref]
Ocular
Rare (less than 0.1%): Visual disturbance, dry and/or irritated eyes, conjunctivitis Frequency not reported: Blurred vision[Ref]
Hepatic
Rare (0.01% to 0.1%): Liver function test abnormalities Very rare (less than 0.01%): Hepatitis Frequency not reported: Transaminase elevated, alkaline phosphatase elevated Postmarketing reports: Jaundice, non-specific hepatic dysfunction[Ref]
Genitourinary
Rare (0.01% to 0.1%): Impotence/sexual dysfunction Very rare (less than 0.01%): Peyronie's disease[Ref]
Immunologic
Rare (less than 0.1%): Positive antinuclear antibodies[Ref]
Hematologic
Very rare (less than 0.01%): Thrombocytopenia Frequency not reported: Agranulocytosis[Ref]
References
1. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.
2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
3. Cerner Multum, Inc. "Australian Product Information." O 0
Not
all side effects for metoprolol may be reported. You should always
consult a doctor or healthcare professional for medical advice. Side
effects can be reported to the FDA here.
Disclaimer: Every effort has been made to
ensure that the information provided is accurate, up-to-date and
complete, but no guarantee is made to that effect. In addition, the drug
information contained herein may be time sensitive and should not be
utilized as a reference resource beyond the date hereof. This material
does not endorse drugs, diagnose patients, or recommend therapy. This
information is a reference resource designed as supplement to, and not a
substitute for, the expertise, skill , knowledge, and judgement of
healthcare practitioners in patient care. The absence of a warning for a
given drug or combination thereof in no way should be construed to
indicate safety, effectiveness, or appropriateness for any given
patient. Drugs.com does not assume any responsibility for any aspect of
healthcare administered with the aid of materials provided. The
information contained herein is not intended to cover all possible uses,
directions, precautions, warnings, drug interactions, allergic
reactions, or adverse effects. If you have questions about the
substances you are taking, check with your doctor, nurse, or pharmacist.
Metoprolol is a beta-blocker that affects the heart and circulation (blood flow through arteries and veins).
Metoprolol is used to treat angina (chest pain) and hypertension
(high blood pressure). It is also used to treat or prevent heart attack.
Metoprolol may also be used for other purposes not listed in this medication guide.
Important information
You should not use metoprolol if you have a serious heart problem
(heart block, sick sinus syndrome, slow heart rate), severe circulation
problems, severe heart failure, or a history of slow heart beats that
caused fainting.
You should not use this medication if you are allergic to metoprolol,
or other beta-blockers (atenolol, carvedilol, labetalol, nadolol,
nebivolol, propranolol, sotalol, and others), or if you have:
a serious heart problem such as heart block, sick sinus syndrome, or slow heart rate;
severe circulation problems;
severe heart failure (that required you to be in the hospital); or
history of slow heart beats that have caused you to faint.
To make sure metoprolol is safe for you, tell your doctor if you have:
asthma, chronic obstructive pulmonary disease (COPD), sleep apnea, or other breathing disorder;
diabetes (taking metoprolol may make it harder for you to tell when you have low blood sugar);
liver disease;
congestive heart failure;
problems with circulation (such as Raynaud's syndrome);
a thyroid disorder; or
pheochromocytoma (tumor of the adrenal gland).
FDA pregnancy category C. It is not known whether metoprolol will
harm an unborn baby. Tell your doctor right away if you become pregnant
while using this medication. See also:Pregnancy and breastfeeding warnings (in more detail)
Metoprolol can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Metoprolol is not approved for use by anyone younger than 18 years old.
How should I take metoprolol?
Take metoprolol exactly as prescribed by your doctor. Follow all
directions on your prescription label. Your doctor may occasionally
change your dose to make sure you get the best results. Do not take this
medicine in larger or smaller amounts or for longer than recommended.
Take the medicine at the same time each day.
Metoprolol should be taken with a meal or just after a meal.
A Toprol XL tablet can be divided in half if your doctor has told you
to do so. The half tablet should be swallowed whole, without chewing or
crushing.
While using metoprolol, you may need frequent blood tests at your
doctor's office. Your blood pressure will need to be checked often.
If you need surgery, tell the surgeon ahead of time that you are using metoprolol.
You should not stop using metoprolol suddenly. Stopping suddenly may make your condition worse.
If you are being treated for high blood pressure, keep using this
medication even if you feel well. High blood pressure often has no
symptoms. You may need to use blood pressure medication for the rest of
your life.
Store metoprolol at room temperature away from moisture and heat. See also:Dosage Information (in more detail)
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if
it is almost time for your next scheduled dose. Do not take extra
medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid?
Metoprolol may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Drinking alcohol can increase certain side effects of metoprolol.
Metoprolol side effects
Get emergency medical help if you have any signs of an allergic
reaction to metoprolol: hives; difficulty breathing; swelling of your
face, lips, tongue, or throat.
Call your doctor at once if you have:
very slow heartbeats;
a light-headed feeling, like you might pass out;
shortness of breath (even with mild exertion), swelling, rapid weight gain; or
cold feeling in your hands and feet.
Common metoprolol side effects may include:
dizziness, tired feeling;
confusion, memory problems;
nightmares, trouble sleeping;
diarrhea; or
mild itching or rash.
This is not a complete list of side effects and others may occur.
Call your doctor for medical advice about side effects. You may report
side effects to FDA at 1-800-FDA-1088. See also:Side effects (in more detail)
Metoprolol dosing information
Usual Adult Dose of Metoprolol for Angina Pectoris Prophylaxis:
Initial dose: 100 mg orally in 1 or 2 divided doses.
Maintenance dose: 100 to 450 mg/day.
Extended release may be used at the same total daily dose given once a day. Usual Adult Dose for Hypertension:
Initial dose: 100 mg orally in 1 or 2 divided doses.
Maintenance dose: 100 to 450 mg/day.
Extended release may be used at the same total daily dose given once a day. Usual Adult Dose for Supraventricular Tachycardia:
Initial dose: 100 mg orally in 1 or 2 divided doses.
Maintenance dose: 100 to 450 mg/day.
Extended release may be used at the same total daily dose given once a day. Usual Adult Dose of Metoprolol for Angina Pectoris:
Initial dose: 100 mg orally in 1 or 2 divided doses.
Maintenance dose: 100 to 400 mg/day.
Extended release may be used at the same total daily dose given once a day. Usual Adult Dose for Myocardial Infarction:
Early treatment:
IV: 3 bolus injections of 5 mg given at 2 minute intervals.
Oral: In patients who tolerate the full IV dose (15 mg), metoprolol
tablets, 50 mg every 6 hours, should be initiated 15 minutes after the
last IV dose and continued for 48 hours. Maintenance dose: 100 mg orally
twice a day.
Patients who appear not to tolerate the full IV dose should be started
on metoprolol tablets at 25 mg or 50 mg every 6 hours 15 minutes after
the last intravenous dose or as soon as their clinical condition allows.
Late treatment:
Oral: 100 mg orally twice a day.
Patients with contraindications to treatment during the early phase of
suspected or definite myocardial infarction, patients who appear not to
tolerate the full early treatment, and patients in whom the physician
wishes to delay therapy for any other reason should be started on
metoprolol tablets as soon as their clinical condition allows. Usual Adult Dose for Congestive Heart Failure:
Initial dose: 25 mg once daily (of the XL formulation) for two weeks
in patients with NYHA class II heart failure and 12.5 mg once daily (of
the XL formulation) in patients with more severe heart failure.
Maintenance dose: This dosage should then be doubled every two weeks to the highest dosage level tolerated or up to 200 mg.
If transient worsening of heart failure occurs, it may be treated with
increased doses of diuretics, and it may also be necessary to lower the
dose or temporarily discontinue treatment. The dose should not be
increased until symptoms of worsening heart failure stabilize.
Initial difficulty with titration should not preclude later attempts to
institute therapy. If heart failure patients experience symptomatic
bradycardia, the dose should be reduced. Usual Pediatric Dose of Metoprolol for Hypertension:
Immediate release:
1 to 17 years:
Initial dose: 1 to 2 mg/kg/day, administered in 2 divided doses. Dosage should be adjusted based on patient response.
Maximum dose: 6 mg/kg/day (less than or equal to 200 mg/day)
Extended release:
6 to 16 years:
Initial dose: 1 mg/kg orally once daily (not to exceed 50 mg once
daily). The minimum available dose is one half of the 25 mg tablet.
Maintenance dose: Dosage should be adjusted according to blood pressure
response. Doses above 2 mg/kg (or in excess of 200 mg) once daily have
not been studied.
What other drugs will affect metoprolol?
Tell your doctor about all medicines you use, and those you start or
stop using during your treatment with metoprolol, especially:
an ergot medicine - dihydroergotamine, ergonovine, ergotamine, methylergonovine;
heart or blood pressure medications - amlodipine, clonidine,
digoxin, diltiazem, dipyridamole, hydralazine, methyldopa, nifedipine,
quinidine, reserpine, verapamil, and others;
a MAO inhibitor - isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine; or
medicine to treat mental illness - chlorpromazine, fluphenazine haloperidol, thioridazine.
This list is not complete. Other drugs may interact with metoprolol,
including prescription and over-the-counter medicines, vitamins, and
herbal products. Not all possible interactions are listed in this
medication guide.
Cetirizine is an antihistamine
that reduces the natural chemical histamine in the body. Histamine can
produce symptoms of sneezing, itching, watery eyes, and runny nose. It
is used to treat cold or allergy symptoms such as sneezing, itching, watery eyes, or runny nose.
Cetirizine is also used to treat itching and swelling caused by hives.
Cetirizine may also be used for other purposes not listed in this medication guide.
Important information
Cetirizine 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 increase some of the
side effects of cetirizine. Tell your doctor if you regularly use other
medicines that make you sleepy (such as other cold or allergy medicine,
narcotic pain medicine, sleeping pills, muscle relaxers, and medicine
for seizures, depression, or anxiety). They can add to sleepiness caused
by cetirizine. Call your doctor if your symptoms do not improve, if
they get worse, or if you also have a fever.
Before taking this medicine
You should not use this medication if you are allergic to cetirizine.
Before taking cetirizine, tell your doctor about all of your medical conditions.
FDA pregnancy category B. This medication is not expected to be harmful
to an unborn baby. Tell your doctor if you are pregnant or plan to
become pregnant during treatment. Cetirizine can pass into breast milk
and may harm a nursing baby. Do not use cetirizine without telling your
doctor if you are breast-feeding a baby.
Older adults may need to take a lower than normal dose. Follow your doctor's instructions.
How should I take cetirizine?
Take cetirizine exactly as directed on the label, or as prescribed by
your doctor. Do not use it in larger amounts or for longer than
recommended.
You may take cetirizine with or without food.
The chewable tablet must be chewed before you swallow it.
Measure liquid medicine with a special dose-measuring spoon or cup,
not a regular table spoon. If you do not have a dose-measuring device,
ask your pharmacist for one.
Call your doctor if your symptoms do not improve, if they get worse, or
if you also have a fever. Store cetirizine at room temperature away from
moisture and heat.
See also:Dosage Information (in more detail)
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, wait until then to take the medicine and skip the
missed dose. 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 feeling restless or nervous, and then feeling drowsy.
What should I avoid?
Tell your doctor if you regularly use other medicines that make you
sleepy (such as other cold or allergy medicine, narcotic pain medicine,
sleeping pills, muscle relaxers, and medicine for seizures, depression,
or anxiety). They can add to sleepiness caused by cetirizine. Cetirizine
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 increase some of the side effects
of cetirizine.
Cetirizine 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 cetirizine and call your doctor at once if
you have any of these serious side effects:
fast, pounding, or uneven heartbeat;
weakness, tremors (uncontrolled shaking), or sleep problems (insomnia);
severe restless feeling, hyperactivity;
confusion;
problems with vision; or
urinating less than usual or not at all.
Less serious side effects may include:
dizziness, drowsiness;
tired feeling;
dry mouth;
sore throat, cough;
nausea, constipation; or
headache.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. See also:Side effects (in more detail)
What other drugs will affect cetirizine?
There may be other drugs that can interact with cetirizine. Tell your
doctor about all your prescription and over-the-counter medications,
vitamins, minerals, herbal products, and drugs prescribed by other
doctors. Do not start a new medication without telling your doctor. More frequently reported side effects include: abdominal pain, drowsiness, and fatigue. See below for a comprehensive list of adverse effects.
For the Consumer
Applies to cetirizine: oral solution, oral tablets and chewable tablets
Side effects include:
Adults and children ≥12 years of age: Somnolence, fatigue, dry mouth.
Insomnia reported with cetirizine hydrochloride-pseudoephedrine
hydrochloride fixed combination.
Children 2–11 years of age: Headache, pharyngitis, abdominal pain.
Children 6 months to 2 years of age: Irritability, fussiness, insomnia, fatigue, malaise.
Nervous system side effects have
included headache (16%), fatigue (5.6%), and somnolence (5% to 20%).
Somnolence tends to be dose-related and generally occurs more frequently
with doses higher than 10 mg per day. Other nervous system side
effects include dizziness (1.8%), insomnia (1.5%), and nervousness
(1.1%). Post marketing reports have included aggression reaction and
convulsions.[Ref]
Cetirizine appears to be more sedating than loratadine.[Ref]
Gastrointestinal
Gastrointestinal
side effects have included dry mouth (5.7%) and nausea or vomiting
(2.2%). Pharyngitis, dyspepsia, and increased appetite have
occasionally been reported.[Ref]
Hepatic
Hepatic
side effects have included rare liver function test abnormalities which
resolved spontaneously following discontinuation of cetirizine therapy.
At least one case of recurrent acute hepatitis has also been
associated with cetirizine use.[Ref]
Respiratory
Respiratory side effects have included relatively rare reports of wheezing, coughing, bronchitis, sinusitis, and asthma.[Ref]
Dermatologic
Dermatologic
side effects have included reports of maculopapular and urticarial
eruptions. Fixed drug eruptions have also been associated with
cetirizine.[Ref]
General
General side effects have included epistaxis (1.1%) and accidental injury (1.1%).[Ref]
Hypersensitivity
Hypersensitivity side effects have included a case report of an anaphylactic reaction.[Ref]
Psychiatric
Delusional
thinking and depression has been reported in an 18-year-old woman
started on cetirizine; the symptoms resolved once cetirizine was
discontinued.[Ref]
Postmarketing
psychiatric side effects have included reports of aggressive reaction,
hallucinations, suicidal ideation and suicide.[Ref]
References
1.
Barnes CL, McKenzie CA, Webster KD, Poinsett-Holmes K "Cetirizine: a
new, nonsedating antihistamine." Ann Pharmacother 27 (1993): 464-70
2.
Spencer CM, Faulds D, Peters DH "Cetirizine. A reappraisal of its
pharmacological properties and therapeutic use in selected allergic
disorders." Drugs 46 (1993): 1055-80
3.
Lockey RF, Widlitz MD, Mitchell DQ, Lumry W, Dockhorn R, Woehler T,
Grossman J "Comparative study of cetirizine and terfenadine versus
placebo in the symptomatic management of seasonal allergic rhinitis."
Ann Allergy Asthma Immunol 76 (1996): 448-54
4.
Salmun LM, Gates D, Scharf M, Greiding L, Ramon F, Heithoff K
"Loratadine versus cetirizine: Assessment of somnolence and motivation
during the workday." Clin Ther 22 (2000): 573-82
5.
Takahashi H, Ishida-Yamamoto A, Iizuka H "Effects of bepotastine,
cetirizine, fexofenadine, and olopatadine on histamine-induced wheal-and
flare-response, sedation, and psychomotor performance." Clin Exp
Dermatol 29 (2004): 526-32
6. Adelsberg BR "Sedation and performance issues in the treatment of allergic conditions." Arch Intern Med 157 (1997): 494-500
7.
Campoli-Richards DM, Buckley MM, Fitton A "Cetirizine. A review of its
pharmacological properties and clinical potential in allergic rhinitis,
pollen-induced asthma, and chronic urticaria." Drugs 40 (1990): 762-81
8.
Shamsi Z, Kimber S, Hindmarch I "An investigation into the effects of
cetirizine on cognitive function and psychomotor performance in healthy
volunteers." Eur J Clin Pharmacol 56 (2001): 865-71
9.
Hannuksela M, Kalimo K, Lammintausta K, Mattila T, Turjanmaa K,
Varjonen E, Coulie PJ "Dose ranging study: cetirizine in the treatment
of atopic dermatitis in adults." Ann Allergy 70 (1993): 127-33
10.
Breneman D, Bronsky EA, Bruce S, Kalivas JT, Klein GL, Roth HL, Tharp
MD, Treger C, Soter N "Cetirizine and astemizole therapy for chronic
idiopathic urticaria: a double-blind, placebo-controlled, comparative
trial." J Am Acad Dermatol 33 (1995): 192-8
11. "Product Information. Zyrtec (cetirizine)." Pfizer US Pharmaceuticals, New York, NY.
12.
Desager JP, Horsmans Y "Pharmacokinetic pharmacodynamic relationships
of h-1-antihistamines." Clin Pharmacokinet 28 (1995): 419-32
13.
Sannita WG, Crimi E, Riela S, Rosadini G, Brusasco V "Cutaneous
antihistaminic action of cetirizine and dose-related EEG concomitants of
sedation in man." Eur J Pharmacol 300 (1996): 33-41
14.
Rihoux JP, Mariz S "Cetirizine. An updated review of its
pharmacological properties and therapeutic efficacy." Clin Rev Allergy
11 (1993): 65-88
15. Simons FER,
Fraser TG, Reggin JD, Simons KJ "Comparison of the central nervous
system effects produced by six h-1-receptor antagonists." Clin Exp
Allergy 26 (1996): 1092-7
16. Breneman DL "Cetirizine versus hydroxyzine and placebo in chronic idiopathic urticaria." Ann Pharmacother 30 (1996): 1075-9
17.
Spector SL, Nicodemus CF, Corren J, Schanker HM, Rachelefsky GS, Katz
RM, Siegel SC "Comparison of the bronchodilatory effects of cetirizine,
albuterol, and both together versus placebo in patients with
mild-to-moderate asthma." J Allergy Clin Immunol 96 (1995): 174-81
18.
Reunala T, Brummer-Korvenkontio H, Karppinen A, Coulie P, Palosuo T
"Treatment of mosquito bites with cetirizine." Clin Exp Allergy 23
(1993): 72-5
19. Grant JA,
Nicodemus CF, Findlay SR, Glovsky MM, Grossman J, Kaiser H, Meltzer EO,
Mitchell DQ, Pearlman D, Selner J, Settipa "Cetirizine in patients with
seasonal rhinitis and concomitant asthma: prospective, randomized,
placebo-controlled trial." J Allergy Clin Immunol 95 (1995): 923-32
20.
Pompili M, Basso M, Grieco A, Vecchio FM, Gasbarrini G, Rapaccini
GL "Recurrent acute hepatitis associated with use of cetirizine." Ann
Pharmacother 38 (2004): 1844-7
21. Calista D, Schianchi S, Morri M "Urticaria induced by cetirizine." Br J Dermatol 144 (2001): 196
22.
Stingeni L, Caraffini S, Agostinelli D, Ricci F, Lisi P "Maculopapular
and urticarial eruption from cetirizine." Contact Dermatitis 37 (1997):
249-50
23. Mahajan VK, Sharma NL,
Sharma VC "Fixed drug eruption: a novel side-effect of levocetirizine."
Int J Dermatol 44 (2005): 796-8
24. Kranke B, Kern T "Multilocalized fixed drug eruption to the antihistamine cetirizine." J Allerg Clin Immunol 106 (2001): 988
25. Karamfilov T, Wilmer A, Hipler UC, Wollina U "Cetirizine-induced urticarial reaction." Br J Dermatol 140 (1999): 979-80
26.
Afonso N, Shetgaonkar P, Dang A, Rataboli PV "Cetirizine-induced
anaphylaxis: a rare adverse drug reaction." Br J Clin Pharmacol 67
(2009): 577-8
27. Garden BC,
Francois D "Cetirizine-associated delusions and depression in an
18-year-old woman." Clin Neuropharmacol 36 (2013): 96-7
Not
all side effects for cetirizine may be reported. You should always
consult a doctor or healthcare professional for medical advice. Side
effects can be reported to the FDA here.
Belsomra (suvorexant) is a sleep medicine that helps regulate your sleep and wake cycle.
Belsomra is used to treat insomnia (trouble falling asleep or staying asleep).
Belsomra may also be used for purposes not listed in this medication guide.
Important information
You should not use Belsomra if you have narcolepsy.
Before taking this medicine
You should not use Belsomra if you are allergic to suvorexant, or if you have narcolepsy.
Belsomra may be habit-forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.
To make sure Belsomra is safe for you, tell your doctor if you have:
a history of depression or thoughts about suicide;
sleep apnea (breathing stops during sleep); or
chronic obstructive pulmonary disease (COPD) or other breathing disorder.
It is not known whether suvorexant will harm an unborn baby. Tell
your doctor if you are pregnant or plan to become pregnant while using
this medicine.
It is not known whether suvorexant passes into breast milk or if it
could harm a nursing baby. Tell your doctor if you are breast-feeding a
baby.
Belsomra is not approved for use by anyone younger than 18 years old.
How should I take Belsomra?
Take Belsomra exactly as prescribed by your doctor. Follow all
directions on your prescription label. Your doctor may occasionally
change your dose to make sure you get the best results. Never use this
medicine in larger amounts, or for longer than prescribed.
Belsomra should be taken only once per night. Take this medicine at bedtime or within 30 minutes before you go to bed. Belsomra will make you fall asleep. Never take this medicine
during your normal waking hours, unless you have at least 7 hours to
dedicate to sleeping.
Avoid taking Belsomra shortly after eating a meal. The medicine may not work as well during this time.
Some people using this medicine have engaged in activity such as
driving, eating, or making phone calls and later having no memory of the
activity. If this happens, stop taking Belsomra and talk with your
doctor about another treatment for your sleep disorder.
It may take longer for you to wake up, speak, or move around the
morning after taking this medicine. You may have hallucinations or feel
like you are still dreaming for a several minutes after you wake up.
Call your doctor if your insomnia symptoms do not improve, or if they
get worse after using Belsomra for 7 to 10 nights in a row.
Store at room temperature away from moisture, heat, and light.
Keep track of the amount of medicine used from each new bottle.
Belsomra is a drug of abuse and you should be aware if anyone is using
your medicine improperly or without a prescription.
Belsomra dosing information
Usual Adult Dose for Insomnia:
10 mg orally once a day at bedtime
Maximum dose: 20 mg once a day
Comments:
-Take within 30 minutes of going to bed, with at least 7 hours remaining before the planned time of awakening.
-If 10 mg is well-tolerated but not effective, the dose can be increased.
-Time to effect may be delayed if taken with or soon after a meal.
Since Belsomra is taken only at bedtime, you will not be on a frequent dosing schedule.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking Belsomra?
Do not drive or do anything that requires you to be alert if it has been less than 8 hours since you took Belsomra.
Belsomra can cause side effects that may impair your thinking or reactions. You may still feel sleepy the morning after taking this medicine.
Until you know how this medicine will affect you during waking hours,
be careful if you drive, operate machinery or do anything that requires
you to be awake and alert.
Do not drink alcohol while you are taking suvorexant. Alcohol can
increase some of the side effects of this medicine, including
drowsiness. Do not take other medicines that make you sleepy (such as cold
medicine, pain medication, muscle relaxants, and medicine for
depression or anxiety).
Follow your doctor's instructions about any restrictions on food, beverages, or activity.
Belsomra side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Belsomra: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Stop using Belsomra and call your doctor at once if you have:
unusual thoughts or behavior;
hallucinations; or
thoughts about hurting yourself.
You may be more likely to have side effects if you are overweight.
Common Belsomra side effects may include:
daytime drowsiness, dizziness, weakness, feeling "drugged" or light-headed;
amnesia or forgetfulness;
a weak feeling in your legs; or
strange dreams.
This is not a complete list of side effects and others may occur.
Call your doctor for medical advice about side effects. You may report
side effects to FDA at 1-800-FDA-1088. See also:Side effects (in more detail)
What other drugs will affect Belsomra?
Taking Belsomra with other drugs that make you sleepy or slow your
breathing can cause dangerous or life-threatening side effects. Ask
your doctor before taking a sleeping pill, narcotic pain medicine,
prescription cough medicine, a muscle relaxer, or medicine for anxiety,
depression, or seizures.
Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Belsomra, especially:
digoxin;
imatinib;
nefazodone;
St. John's wort;
verapamil;
an antibiotic - ciprofloxacin, clarithromycin, rifampin, telithromycin;
antifungal medicine - itraconazole, ketoconazole, posaconazole, voriconazole;
This list is not complete. Other drugs may interact with suvorexant,
including prescription and over-the-counter medicines, vitamins, and
herbal products. Not all possible interactions are listed in this
medication guide.
In Summary
Common side effects of Belsomra include: drowsiness. See below for a comprehensive list of adverse effects.
For the Consumer
Applies to suvorexant: oral tablet
In addition to its needed effects, some unwanted effects may be
caused by suvorexant (the active ingredient contained in Belsomra). In
the event that any of these side effects do occur, they may require
medical attention.
Major Side Effects
You should check with your doctor immediately if any of these side effects occur when taking suvorexant: More common:
Sleepiness or unusual drowsiness
Less common:
Unusual or abnormal dreams
Incidence not known:
Changes in behavior
discouragement
fear or nervousness
feeling sad or empty
irritability
lack of appetite
loss of interest or pleasure
loss of memory
problems with memory
seeing, hearing, or feeling things that are not there
temporary inability to move or talk for up to several minutes while you are going to sleep or wake up
temporary weakness in your legs
thoughts of killing oneself
tiredness
trouble concentrating
Minor Side Effects
Some of the side effects that can occur
with suvorexant may not need medical attention. As your body adjusts to
the medicine during treatment these side effects may go away. Your
health care professional may also be able to tell you about ways to
reduce or prevent some of these side effects. If any of the following
side effects continue, are bothersome or if you have any questions about
them, check with your health care professional: More common:
Headache
Less common:
Body aches or pain
chills
cough
diarrhea
difficulty with breathing
dizziness
dry mouth
ear congestion
fever
loss of voice
nasal congestion
runny nose
sneezing
sore throat
unusual tiredness or weakness
For Healthcare Professionals
Applies to suvorexant: oral tablet
General
The most common adverse reaction was somnolence.[Ref]
Commonly reported side effects of tramadol include: pruritus, agitation, anxiety, constipation, diarrhea, hallucination, nausea, tremor, vomiting, and diaphoresis. Other side effects include: insomnia, pruritus, and diaphoresis. See below for a comprehensive list of adverse effects.
For the Consumer
Applies
to tramadol: oral capsule extended release, oral suspension, oral
tablet, oral tablet disintegrating, oral tablet extended release
As well as its needed effects, tramadol may cause unwanted side effects that require medical attention.
Major Side Effects
If any of the following side effects occur while taking tramadol, check with your doctor immediately: Less common or rare:
Abdominal or stomach fullness
abnormal or decreased touch sensation
blisters under the skin
bloating
blood in the urine
blood pressure increased
blurred vision
change in walking and balance
chest pain or discomfort
chills
convulsions (seizures)
darkened urine
difficult urination
dizziness or lightheadedness when getting up from a lying or sitting position
fainting
fast heartbeat
frequent urge to urinate
gaseous abdominal or stomach pain
heart rate increased
indigestion
irregular heartbeat
loss of memory
numbness and tingling of the face, fingers, or toes
numbness, tingling, pain, or weakness in the hands or feet
pain in the arms, legs, or lower back, especially pain in the calves or heels upon exertion
pain or discomfort in the arms, jaw, back, or neck
pains in the stomach, side, or abdomen, possibly radiating to the back
pale bluish-colored or cold hands or feet
recurrent fever
seeing, hearing, or feeling things that are not there
severe cramping
severe nausea
severe redness, swelling, and itching of the skin
shortness of breath
sweats
trembling and shaking of the hands or feet
trouble performing routine tasks
weak or absent pulses in the legs
yellow eyes or skin
If any of the following symptoms of overdose occur while taking tramadol, get emergency help immediately: Symptoms of overdose:
Change in consciousness
decreased awareness or responsiveness
difficulty with breathing
lack of muscle tone
lightheadedness
loss of consciousness
pinpointed pupils of the eyes
severe sleepiness
shortness of breath
slow or irregular heartbeat
unusual tiredness
Minor Side Effects
Some tramadol side effects may not need
any medical attention. As your body gets used to the medicine these side
effects may disappear. Your health care professional may be able to
help you prevent or reduce these side effects, but do check with them if
any of the following side effects continue, or if you are concerned
about them: More common:
Abdominal or stomach pain
agitation
anxiety
constipation
cough
diarrhea
discouragement
drowsiness
dry mouth
feeling of warmth
feeling sad or empty
feeling unusually cold
fever
general feeling of discomfort or illness
headache
heartburn
irritability
itching of the skin
joint pain
loss of appetite
loss of interest or pleasure
loss of strength or weakness
muscle aches and pains
nausea
nervousness
redness of the face, neck, arms, and occasionally, upper chest
restlessness
runny nose
shivering
skin rash
sleepiness or unusual drowsiness
sore throat
stuffy nose
sweating
tiredness
trouble concentrating
unusual feeling of excitement
weakness
Less common or rare:
Abnormal dreams
appetite decreased
back pain
bladder pain
blistering, crusting, irritation, itching, or reddening of the skin
bloody or cloudy urine
body aches or pain
change in hearing
clamminess
cold flu-like symptoms
confusion
cough producing mucus
cracked, dry, or scaly skin
decreased interest in sexual intercourse
difficult, burning, or painful urination
difficulty with moving
disturbance in attention
ear congestion
ear drainage
earache or pain in ear
excessive gas
fall
false or unusual sense of well-being
feeling hot
feeling jittery
flushing or redness of the skin
general feeling of bodily discomfort
goosebumps
headache, severe and throbbing
hoarseness
hot flashes
inability to have or keep an erection
itching, pain, redness, swelling, tenderness, or warmth on the skin
joint sprain
joint stiffness
joint swelling
loss in sexual ability, desire, drive, or performance
loss of voice
lower back or side pain
muscle aching or cramping
muscle injury
muscle pain or stiffness
muscle spasms or twitching
nasal congestion
neck pain
night sweats
pain
pain in the limbs
pain or tenderness around the eyes and cheekbones
pain, swelling, or redness in the joints
skin discoloration
swelling
swelling of the hands, ankles, feet, or lower legs
tightness of the chest
trouble in holding or releasing urine
trouble with sleeping
troubled breathing
weight increased or decreased
Side Effects: Post Treatment
After you stop taking
this drug, it is possible that you may still experience side effects
that need medical attention. If you notice any of the following side
effects check with your doctor immediately:
The most common adverse reactions include nausea, constipation, dry mouth, somnolence, dizziness, and vomiting.[Ref]
Psychiatric
CNS
stimulation has been reported as a composite of nervousness, anxiety,
agitation, tremor, spasticity, euphoria, emotional lability, and
hallucinations. During clinical trials, tolerance development was mild
and the reports of a withdrawal syndrome were rare. Symptoms of a
withdrawal syndrome have included: panic attacks, severe anxiety,
hallucinations, paraesthesias, tinnitus and unusual CNS symptoms (i.e.
confusion, delusions, personalization, derealization, and paranoia).[Ref]
Very common (10% or more): CNS stimulation (up to 14%) Common (1% to 10%): Anxiety, euphoria, nervousness, sleep disorder, insomnia, depression, agitation, apathy, depersonalization Uncommon (0.1% to 1%): Emotional lability Rare (less than 0.1%): Hallucinations, nightmares, dependency Very rare (less than 0.01%): Withdrawal syndrome[Ref]
Hypersensitivity
Rare
(less than 0.1%): Anaphylaxis, allergic reactions such as dyspnea,
bronchospasm, wheezing, angioneurotic edema, swollen skin[Ref]
Gastrointestinal
Very common (10% or more): Nausea (up to 40%), constipation (up to 46%), vomiting (up to 17%), dyspepsia (up to 13%) Common (1% to 10%): Dry mouth, diarrhea, abdominal pain, flatulence, sore throat, gastroenteritis viral Uncommon (0.1% to 1%): Toothache, appendicitis, pancreatitis[Ref]
Nervous system
Very common (10% or more): Dizziness (up to 28%), somnolence (up to 25%), headache (up to 32%), Common (1% to 10%): Confusion, coordination disturbance, tremor, paresthesia, hypoesthesia Uncommon (0.1% to 1%): Migraine, sedation, syncope, disturbance in attention Rare (less than 0.1%): Epileptiform seizures Postmarketing reports: Seizures[Ref]
Epileptiform
seizures primarily occurred following administration of high doses or
following concomitant treatment with drugs that lower the seizure
threshold or trigger seizures.[Ref]
Dermatologic
Very common (10% or more): Pruritus (up to 11%) Common (1% to 10%): Sweating, rash, dermatitis Uncommon
(0.1% to 1%): Cellulitis, piloerection, clamminess, urticaria, toxic
epidermal necrolysis, Stevens Johnson-syndrome, hair disorder, skin
disorder[Ref]
Genitourinary
Common (1% to 10%): Menopausal symptoms, urinary frequency, urinary retention, urinary tract infection Uncommon (0.1% to 1%): Difficulty in micturition, hematuria, dysuria, cystitis, sexual function abnormality[Ref]
Cardiovascular
Very common (10% or more): Flushing (up to 15.8%) Common (1% to 10%): Vasodilation, postural hypotension, chest pain Uncommon
(0.1% to 1%): Palpitations, myocardial infarction, lower limb edema,
peripheral swelling, hypertension, increased heart rate, peripheral
ischemia, EKG abnormality, hypotension, tachycardia Rare (less than 0.1%): Bradycardia[Ref]
Other
Very common (10% or more): Asthenia (up to 12%) Common (1% to 10%): Malaise, weakness, pain, feeling hot, influenza like illness, rigors, lethargy, pyrexia Uncommon (0.1% to 1%): Tinnitus, vertigo, ear infection[Ref]
Metabolic
Common (1% to 10%): Anorexia, decreased weight, increased blood glucose Uncommon (0.1% to 1%): Gout Rare (less than 0.1%): Changes in appetite[Ref]
Endocrine
Very rare (less than 0.01%): Syndrome of inappropriate antidiuretic hormone secretion[Ref]
