Actiq--types of drugs

What is Actiq?

Actiq is a narcotic pain medicine.

Actiq treats "breakthrough" cancer pain that is not controlled by other medicines. This medication is not for short-term pain relief.

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

Important information about Actiq

Do not use Actiq if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects could occur.

You should not use Actiq unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant.

Keep both the used and the unused Actiq units out of the reach of children. The amount of fentanyl in the Actiq unit can be fatal to a child who accidentally sucks on or swallows the unit.

Seek emergency medical attention if you think you have used too much Actiq or if anyone else has accidentally swallowed it. An overdose of this medication can be fatal. Overdose symptoms may include weak pulse, fainting, shallow breathing, or breathing that stops.

Actiq may be habit-forming and should be used only by the person it was prescribed for. Actiq should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Keep track of how many Actiq units have been used from each new supply of this medicine. Fentanyl is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription. Do not use more than four Actiq units per day.

Before taking Actiq

You should not use Actiq unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Opioid medicines include fentanyl (Actiq, Duragesic), hydrocodone (Lortab, Vicodin), hydromorphone (Dilaudid, Palladone), morphine (Kadian, MS Contin, Oramorph, and others), oxycodone (Oxycontin), oxymorphone (Numorphan, Opana), and others. Talk with your doctor if you are not sure you are opioid-tolerant.

Do not use Actiq if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you use fentanyl before the MAO inhibitor has cleared from your body.

You should not use this medication if you have had an allergic reaction or severe side effects when using any narcotic pain medicine.

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

· a breathing disorder such as asthma or chronic obstructive pulmonary disease (COPD);

· a seizure disorder;

· a history of head injury or brain tumor;

· liver or kidney disease;

· low blood pressure, heart disease;

· a history of depression or other mental illness; or

· a history of drug or alcohol addiction.

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

FDA pregnancy category C. It is not known whether Actiq is harmful to an unborn baby. It could cause addiction or withdrawal symptoms in newborn if the mother uses fentanyl citrate during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Tell your doctor if you are pregnant or plan to become pregnant during treatment. This medication can pass into breast milk and may cause sleepiness or breathing problems in a nursing baby. Actiq may also cause addiction and withdrawal symptoms in a nursing infant. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more sensitive to the effects of this medicine.

See also: Actiq pregnancy and breastfeeding warnings (in more detail)

If you are diabetic, you should know that each Actiq lozenge contains 2 grams (one-half teaspoon) of sugar.

How should I take Actiq?

Actiq (fentanyl citrate oral transmucosal) comes with a kit and instructions for storing and disposing of the Actiq units. It is very important to keep both the used and the unused Actiq units out of the reach of children. The amount of fentanyl citrate in the Actiq unit can be fatal to a child who accidentally sucks on or swallows the unit.

You will also receive instructions for using the medicine. Follow these instructions carefully. Do not use the medication in larger amounts or for longer than prescribed by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication.

The Actiq transmucosal unit is a fentanyl citrate lozenge attached to a plastic handle. Each unit is wrapped in a child-proof blister pack. Cut the blister pack open with scissors when you are ready to use the unit.

Place the medicine in your mouth between your cheek and gum, and hold the handle with your fingers. Twirl the handle to move the medicine around in your mouth while sucking on it.

Allow the medicine to dissolve in your mouth for 15 minutes. Swallow when needed. Do not bite or chew the lozenge. Do not eat or drink anything while the unit is in your mouth. If you need to use a second unit, wait at least 15 minutes after you have finished the first unit.

Do not use more than four Actiq units per day.

If you feel dizzy or sick to your stomach before the medicine has completely dissolved, stop using the unit and call your doctor.

If you switch from using Actiq to using other forms of fentanyl, you will not use the same dose. Many forms of fentanyl are given at lower doses than Actiq. If you use the same dose of each medication, you may have life-threatening overdose symptoms.

Do not stop using any other pain medicines your doctor has prescribed for you. Call your doctor if this medication does not relieve your pain.

Actiq may be habit-forming and should be used only by the person it was prescribed for. Never share Actiq with another person, especially someone with a history of drug abuse or addiction. Keep this medicine in a place where others cannot get to it.

Keep track of how many Actiq units have been used from each new supply of this medicine. Fentanyl is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Do not stop using Actiq suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using fentanyl citrate.

Store Actiq at room temperature away from moisture and heat. Leave each unit in its child-proof blister pack until you are ready to use it.

Pay special attention to your dental hygiene. Actiq can cause dry mouth leading to tooth decay.

What happens if I miss a dose?

Since Actiq is used as needed, you may not be on a dosing schedule. If you are using the medication regularly, use the missed dose 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.

Do not use more than four (4) Actiq units per day.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. The amount of fentanyl citrate in the Actiq unit can be fatal to a child who accidentally sucks on or swallows the unit.

Symptoms of a Actiq overdose may include weak pulse, fainting, shallow breathing, or breathing that stops.

What should I avoid while taking Actiq?

Grapefruit and grapefruit juice may interact with fentanyl and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

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

· shallow breathing, slow heart rate;

· extreme sleepiness; or

· feeling light-headed, fainting.

Less serious Actiq side effects may include:

· dry mouth;

· headache, dizziness, weakness, anxiety; or

· nausea, vomiting, or constipation.

Side effects other than those listed here may also occur. Call your doctor for medical advice about side effects.You may report side effects to FDA at 1-800-FDA-1088.

See also: Actiq side effects (in more detail)

What other drugs will affect Actiq?

Cold or allergy medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by Actiq. Tell your doctor if you regularly use any of these medicines, or any other narcotic pain medicine.

There are many other medicines that can cause serious medical problems if you take them together with Actiq, especially:

· aprepitant (Emend);

· diltiazem (Cardizem, Cartia, Dilacor, Tiazac);

· verapamil (Calan, Covera, Isoptin, Verelan);

· an antibiotic such as clarithromycin (Biaxin) or erythromycin (E-Mycin, Ery-Tab, E.E.S.);

· an antifungal medication such as fluconazole (Diflucan), ketoconazole (Nizoral), or itraconazole (Sporanox); or

· HIV medicines such as indinavir (Crixivan), fosamprenavir (Lexiva), nelfinavir (Viracept), or ritonavir (Norvir).

This list is not complete and other drugs may interact with Actiq. Tell your doctor about all medications you use. This includes prescription, over the counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Accutane--types of drugs

What is Accutane?

Accutane is a form of vitamin A. It reduces the amount of oil released by oil glands in your skin, and helps your skin renew itself more quickly.

Accutane is used to treat severe nodular acne. It is usually given after other acne medicines or antibiotics have been tried without successful treatment of symptoms.

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

Important information about Accutane

Accutane can cause severe, life-threatening birth defects. Never use Accutane if you are pregnant.

Women of child-bearing potential must agree in writing to use two specific forms of birth control and have regular pregnancy tests before, during, and after taking isotretinoin.

Accutane is available only under a special program called iPLEDGE. It is dangerous to try and purchase Accutane on the Internet or from vendors outside of the United States.

Do not take vitamin supplements containing vitamin A while you are taking isotretinoin. Do not donate blood while taking Accutane and for at least 30 days after you stop taking it.

What should I discuss with my healthcare provider before taking Accutane?

Accutane is available only under a special program called iPLEDGE. You must be registered in the program and sign documents stating that you understand the dangers of this medication and that you agree to use birth control as required by the program. Ask your doctor or call the drug maker if you have questions about the program or the written requirements.

It is dangerous to try and purchase Accutane on the Internet or from vendors outside of the United States. The sale and distribution of Accutane outside of the iPLEDGE program violates the regulations of the U.S. Food and Drug Administration for the safe use of this medication.

Do not use this medication if you are allergic to isotretinoin or to parabens, or if you are pregnant or may become pregnant.

To make sure you can safely take Accutane, tell your doctor if you have any of these other conditions:

· a personal or family history of depression or mental illness;

· heart disease, high cholesterol or triglycerides;

· osteoporosis or other bone disorders;

· an intestinal disorder such as inflammatory bowel disease, ulcerative colitis, or Crohn's disease;

· diabetes;

· asthma;

· an eating disorder (anorexia nervosa); or

· liver disease.

Accutane can cause severe, life-threatening birth defects if the mother takes the medication during pregnancy. Even one dose of Accutane can cause major birth defects of the baby's ears, eyes, face, skull, heart, and brain. Never use Accutane if you are pregnant.

For Women: Unless you have had your uterus and ovaries removed (total hysterectomy with oophorectomy) or have been in menopause for at least 12 months in a row, you are considered to be of child-bearing potential.

Even women who have had their tubes tied are required to use birth control while taking Accutane.

You must have a negative pregnancy test 30 days before you start taking Accutane. A pregnancy test is also required before each prescription is refilled, right after you take your last dose of Accutane, and again 30 days later. All pregnancy testing is required by the iPLEDGE program.

You must agree in writing to use two specific forms of birth control beginning 30 days before you start taking Accutane and ending 30 days after you stop taking it. Both a primary and a secondary form of birth control must be used together.

Primary forms of birth control include:

· tubal ligation (tubes tied);

· vasectomy of the male sexual partner;

· an IUD (intrauterine device);

· estrogen-containing birth control pills (not mini-pills); and

· hormonal birth control patches, implants, injections, or vaginal ring.

Secondary forms of birth control include:

· a male latex condom plus spermicidal foam or gel;

· a diaphragm plus spermicidal foam or gel;

· a cervical cap plus spermicidal foam or gel; and

· a vaginal sponge containing spermicide.

Stop using Accutane and call your doctor at once if you have unprotected sex, if you quit using birth control, if your period is late, or if you think you might be pregnant. If you get pregnant while taking Accutane, call the iPLEDGE pregnancy registry at 1-866-495-0654.

It is not known whether isotretinoin passes into breast milk. Do not take Accutane without first talking to your doctor if you are breast-feeding a baby.

How should I take Accutane?

Take Accutane exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Each prescription of Accutane must be filled within 7 days of the date it was prescribed by your doctor. You will receive no more than a 30-day supply of Accutane at one time.

Always take Accutane with a full glass of water to prevent the capsule from melting in your esophagus (food pipe), causing irritation. Do not chew or suck on the capsule. Swallow it as quickly as possible. Take Accutane with food or milk. Take this medication for the entire length of time prescribed by your doctor. Your acne may seem to get worse at first, but should then begin to improve.

To be sure this medication is not causing harmful effects, your blood may need to be tested often. Your liver function may also need to be tested. Visit your doctor regularly.

Never share this medicine with another person, even if they have the same symptoms you have. Store Accutane at room temperature away from moisture, heat, and light.

What happens if I miss a 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 attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include headache, dizziness, vomiting, stomach pain, warmth or tingling under the skin, swelling of the lips, and loss of balance or coordination.

What should I avoid while taking Accutane?

Do not take vitamin supplements containing vitamin A while you are taking Accutane.

Do not donate blood while taking Accutane and for at least 30 days after you stop taking it. Donated blood that is later given to pregnant woman could lead to birth defects in her baby if the blood contains any level of Accutane.

Do not use wax hair removers or have dermabrasion or laser skin treatments while you are taking Accutane and for at least 6 months after you stop taking it. Scarring may result.

Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Accutane can make your skin more sensitive to sunlight and sunburn may result. Accutane may impair your vision, especially at night. Be careful if you drive or do anything that requires you to see clearly.

Accutane side effects

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

· depressed mood, trouble concentrating, sleep problems, crying spells, aggression or agitation, changes in behavior, hallucinations, thoughts of suicide or hurting yourself;

· sudden numbness or weakness, especially on one side of the body;

· blurred vision, sudden and severe headache or pain behind your eyes, sometimes with vomiting;

· hearing problems, hearing loss, or ringing in your ears;

· seizure (convulsions);

· severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;

· loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

· severe diarrhea, rectal bleeding, black, bloody, or tarry stools;

· fever, chills, body aches, flu symptoms, purple spots under your skin, easy bruising or bleeding;

· severe blistering, peeling, and red skin rash; or

· joint stiffness, bone pain or fracture.

Less serious Accutane side effects may include:

· joint pain, back pain;

· feeling dizzy, drowsy, or nervous;

· dryness of the lips, mouth, nose, or skin; or

· cracking or peeling skin, itching, rash, changes in your fingernails or toenails.

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: Accutane side effects (in more detail)

What other drugs will affect Accutane?

Before taking Accutane, tell your doctor if you are also taking:

· steroids (prednisone and others);

· seizure medication such as phenytoin (Dilantin); or

· a tetracycline antibiotic such as demeclocycline (Declomycin), doxycycline (Doryx, Vibramycin), minocycline (Minocin), or tetracycline (Brodspec, Sumycin, Tetracap).

This list is not complete and other drugs may interact with Accutane. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.