Drug Information: Rabeprazole

Drug Information: Rabeprazole
(ra be' pray zole)
Why is this medication prescribed?
Rabeprazole is used to treat conditions where the stomach produces too much acid, including
ulcers, gastroesophageal reflux disease (GERD), and Zollinger-Ellison syndrome.
Rabeprazole is used in combination with other medications to eliminate H. pylori, a bacteria
that causes ulcers. Rabeprazole is in a class of medications called proton-pump inhibitors. It
works by decreasing the amount of acid made in the stomach.
How should this medicine be used?
Rabeprazole comes as a delayed-release (long-acting) tablet to take by mouth. It is usually

taken once a day for 4 to 8 weeks, but it is sometimes taken for a longer time. When taken for
ulcers, rabeprazole should be taken after the morning meal. When taken in combination with
other medications to eliminate H. pylori, rabeprazole is taken twice a day, with the morning
and evening meals, for 7 days. Follow the directions on your prescription label carefully, and
ask your doctor or pharmacist to explain any part you do not understand. Take rabeprazole
exactly as directed. Do not take more or less of it or take it more often than prescribed by your
doctor.
Swallow the tablets whole; do not split, chew, or crush them.
Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more
information.
What special precautions should I follow?
Before taking rabeprazole,
 tell your doctor and pharmacist if you are allergic to rabeprazole, lansoprazole
(Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), or any other medications.
 tell your doctor and pharmacist what prescription and nonprescription medications,
vitamins, nutritional supplements, and herbal products you are taking. Be sure to
mention any of the following: cyclosporine (Neoral, Sandimmune), digoxin (Lanoxin),
and ketoconazole (Nizoral). Your doctor may need to change the doses of your
medications or monitor you carefully for side effects.
 tell your doctor if you have or have ever had liver disease.
 tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If
you become pregnant while taking rabeprazole, call your doctor.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next
dose, skip the missed dose and continue your regular dosing schedule. Do not take a double
dose to make up for a missed one.
What side effects can this medication cause?

Rabeprazole may cause side effects. Tell your doctor if these symptoms are severe or do not
go away:
 headache
 upset stomach
 diarrhea
 stomach pain
 vomiting
 constipation
 dry mouth
 increased or decreased appetite
 muscle or bone pain
 drowsiness
 dizziness
 difficulty falling asleep or staying asleep
There may be other side effects from rabeprazole. Call your doctor if you have any unusual
problems while taking this medication.
What storage conditions are needed for this medicine?
Keep this medication in the container it came in, tightly closed, and out of reach of children.
Store it at room temperature and away from excess heat and moisture (not in the bathroom).
Throw away any medication that is outdated or no longer needed. Talk to your pharmacist
about the proper disposal of your medication.
In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has
collapsed or is not breathing, call local emergency services at 911.
What other information should I know?
Keep all appointments with your doctor and the laboratory.
Do not let anyone else take your medication. Ask your pharmacist any questions you have
about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription
(over-the-counter) medicines you are taking, as well as any products such as vitamins,
minerals, or other dietary supplements. You should bring this list with you each time you visit
a doctor or if you are admitted to a hospital. It is also important information to carry with you
in case of emergencies.
Brand names
 AcipHex®
Last Revised - 07/01/2003

Last Reviewed - 08/01/2007
Rabies Vaccine
What is rabies?
Rabies is a serious disease. It is caused by a virus. Rabies is mainly a disease of animals.

Humans get rabies when they are bitten by infected animals.
At first there might not be any symptoms. But weeks, or even years after a bite, rabies can
cause pain, fatigue, headaches, fever, and irritability. These are followed by seizures,
hallucinations, and paralysis. Rabies is almost always fatal.
Wild animals, especially bats, are the most common source of human rabies infection in the
United States. Skunks, raccoons, dogs, and cats can also transmit the disease.
Human rabies is rare in the United States. There have been only 39 cases diagnosed since
1990. However, between 16,000 and 39,000 people are treated each year for possible
exposure to rabies after animal bites. Also, rabies is far more common in other parts of the
world, with about 40,000 to 70,000 rabies-related deaths each year. Bites from unvaccinated
dogs cause most of these cases. Rabies vaccine can prevent rabies.
Rabies vaccine
Rabies vaccine is given to people at high risk of rabies to protect them if they are exposed. It
can also prevent the disease if it is given to a person after they have been exposed.
Rabies vaccine is made from killed rabies virus. It cannot cause rabies.
Who should get rabies vaccine and when?
Preventive Vaccination (No Exposure):
 People at high risk of exposure to rabies, such as veterinarians, animal handlers, rabies
laboratory workers, spelunkers, and rabies biologics production workers should be
offered rabies vaccine.
 The vaccine should also be considered for: (1) people whose activities bring them into
frequent contact with rabies virus or with possibly rabid animals, and (2) international
travelers who are likely to come in contact with animals in parts of the world where
rabies is common.
 The pre-exposure schedule for rabies vaccination is 3 doses, given at the following
times: (1) Dose 1: As appropriate, (2) Dose 2: 7 days after Dose 1, and (3) Dose 3: 21
days or 28 days after Dose 1.
 For laboratory workers and others who may be repeatedly exposed to rabies virus,
periodic testing for immunity is recommended, and booster doses should be given as
needed. (Testing or booster doses are not recommended for travelers.) Ask your doctor
for details.
Vaccination After an Exposure:
 Anyone who has been bitten by an animal, or who otherwise may have been exposed
to rabies, should see a doctor immediately.
 A person who is exposed and has never been vaccinated against rabies should get 5
doses of rabies vaccine - one dose right away, and additional doses on the 3rd, 7th,
14th, and 28th days. They should also get a shot of Rabies Immune Globulin at the
same time as the first dose. This gives immediate protection.
 A person who has been previously vaccinated should get 2 doses of rabies vaccine -
one right away and another on the 3rd day. Rabies Immune Globulin is not needed.
Tell your doctor if ...

Talk with a doctor before getting rabies vaccine if you:
 ever had a serious (life-threatening) allergic reaction to a previous dose of rabies

vaccine, or to any component of the vaccine,
 have a weakened immune system because of: HIV/AIDS or another disease that
affects the immune system; treatment with drugs that affect the immune system, such
as steroids; cancer, or cancer treatment with radiation or drugs.
If you have a minor illness, such as a cold, you can be vaccinated. If you are moderately or
severely ill, you should probably wait until you recover before getting a routine (non-
exposure) dose of rabies vaccine. If you have been exposed to rabies virus, you should get
the vaccine regardless of any other illnesses you may have.
What are the risks from rabies vaccine?
A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic
reactions. The risk of a vaccine causing serious harm, or death, is extremely small. Serious
problems from rabies vaccine are very rare.
Mild Problems:
 soreness, redness, swelling, or itching where the shot was given (30% - 74%)
 headache, nausea, abdominal pain, muscle aches, dizziness (5% - 40%)
Moderate Problems:
 hives, pain in the joints, fever (about 6% of booster doses)

 illness resembling Guillain-Barré Syndrome (GBS), with complete recovery (very
rare)
Other nervous system disorders have been reported after rabies vaccine, but this happens so
rarely that it is not known whether they are related to the vaccine.
NOTE: Several brands of rabies vaccine are available in the United States, and reactions may
vary between brands. Your provider can give you more information about a particular brand.
What if there is a moderate or severe reaction?
What should I look for?
 Any unusual condition, such as a high fever or behavior changes. Signs of a serious
allergic reaction can include difficulty breathing, hoarseness or wheezing, hives,
paleness, weakness, a fast heart beat or dizziness.
What should I do?
 Call a doctor, or get the person to a doctor right away.

 Tell your doctor what happened, the date and time it happened, and when the
vaccination was given.
 Ask your health care provider to file a Vaccine Adverse Event Reporting System
(VAERS) form if you have any reaction to the vaccine. Or call VAERS yourself at 1-
800-822-7967, or visit their website at http://vaers.hhs.gov.
The National Vaccine Injury Compensation Program

In the rare event that you or your child has a serious reaction to a vaccine, a federal program
has been created to help pay for the care of those who have been harmed.
For details about the National Vaccine Injury Compensation Program, call 1-800-338-2382 or
visit the program's website at http://www.hrsa.gov/vaccinecompensation.
How can I learn more?
 Ask your doctor or other health care provider. They can give you the vaccine package
insert or suggest other sources of information.
 Call your local or state health department's immunization program.
 Contact the Centers for Disease Control and Prevention (CDC): call 1-800-232-4636
(1-800-CDC-INFO) or visit the National Immunization Program's website at
http://www.cdc.gov/vaccines
Rabies Vaccine Information Statement. U.S. Department of Health and Human

Services/Centers for Disease Control and Prevention National Immunization Program.
1/12/2006.
Brand names of combination products
 Imovax®  containing
Drug Information: Ramipril

(ra mi' pril)
IMPORTANT WARNING:
Do not take ramipril if you are pregnant. If you become pregnant while taking ramipril, call
your doctor immediately. Ramipril may harm the fetus.
Ramipril is used alone or in combination with other medications to treat high blood pressure.
It is also used to reduce the risk of heart attack and stroke in patients at risk for these problems
and to improve survival in patients with heart failure after a heart attack. Ramipril is in a class
of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by
decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly and
the heart can pump blood more efficiently.
Ramipril comes as a capsule to take by mouth. It is usually taken once or twice a day with or
without food. To help you remember to take ramipril, take it around the same time every day.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist
to explain any part you do not understand. Take ramipril exactly as directed. Do not take more
or less of it or take it more often than prescribed by your doctor.
Swallow the capsule whole, or open the capsule and sprinkle the contents on a small amount
of applesauce (about 4 oz.) or in 4 oz. of water or apple juice. Eat or drink the entire mixture.
This mixture can be prepared in advance and stored for 24 hours at room temperature or 48
hours in the refrigerator.
Your doctor will probably start you on a low dose of ramipril and gradually increase your
dose.
Ramipril controls high blood pressure and heart failure but does not cure them. Continue to
take ramipril even if you feel well. Do not stop taking ramipril without talking to your doctor.
information.
Before taking ramipril,
 tell your doctor and pharmacist if you are allergic to ramipril, benazepril (Lotensin),
captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil,
Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), trandolapril
(Mavik), or any other medications.
mention any of the following: aspirin and other nonsteroidal anti-inflammatory
medications (NSAIDs) such as indomethacin (Indocin); diuretics ('water pills');
lithium (Eskalith, Lithobid); and potassium supplements. Your doctor may need to
change the doses of your medications or monitor you carefully for side effects.
 tell your doctor if you have or have ever had heart, liver, or kidney disease; lupus;
scleroderma; diabetes; or angioedema, a condition that causes difficulty swallowing or
breathing and painful swelling of the the face, throat, tongue, lips, eyes, hands, feet,
ankles, or lower legs.
 tell your doctor if you plan to become pregnant or are breast-feeding.
 if you are having surgery, including dental surgery, tell the doctor or dentist that you
are taking ramipril.
 you should know that diarrhea, vomiting, not drinking enough fluids, and sweating a
lot can cause a drop in blood pressure, which may cause lightheadedness and fainting.
Talk to your doctor before using salt substitutes containing potassium. If your doctor
prescribes a low-salt or low-sodium diet, follow these directions carefully.
dose, skip the missed dose and continue your regular regular dosing schedule. Do not take a
double dose to make up for a missed one.
Ramipril may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 headache
 dizziness
 cough
 upset stomach
 vomiting
 excessive tiredness
 weakness
Some side effects can be serious. The following symptoms are uncommon, but if you
experience any of them, call your doctor immediately:
 swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
 hoarseness
 difficulty breathing or swallowing
 yellowing of the skin or eyes
 fever, sore throat, chills, and other signs of infection
 lightheadedness
 fainting
Ramipril may cause other side effects. Call your doctor if you have any unusual problems
while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and
Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at
http://www.fda.gov/MedWatch/index.html] or by phone [1-800-332-1088].
Symptoms of overdose may include:
 lightheadedness
 fainting
Keep all appointments with your doctor and the laboratory. Your blood pressure should be
checked regularly to determine your response to ramipril. Your doctor may order certain lab
tests to check your body's response to ramipril.
Brand names
 Altace®

Drug Information: Ranibizumab Injection

(ra'' ni biz' oo mab)
Ranibizumab is used to treat wet age-related macular degeneration (AMD; an ongoing disease
of the eye that causes loss of the ability to see straight ahead and may make it more difficult to
read, drive, or perform other daily activities). Ranibizumab is in a class of medications called
vascular endothelial growth factor A (VEGF-A) antagonists. It works by blocking abnormal
blood vessel growth and leakage in the eye(s) that may cause vision loss in people with wet
AMD.
Ranibizumab comes as a solution (liquid) to be injected into the eye by a doctor. It is usually
given in a doctor's office every month. Your doctor may give you injections on a different
schedule if that is best for you.
Before you receive a ranibizumab injection, your doctor will clean your eye to prevent
infection and numb your eye to reduce discomfort during the injection. You may feel pressure
in your eye when the medication is injected. After your injection, your doctor will need to
examine your eyes before you leave the office.
Ranibizumab controls wet AMD, but does not cure it. Your doctor will watch you carefully to
see how well ranibizumab works for you. Talk to your doctor about how long you should
continue treatment with ranibizumab.
information.
Before receiving ranibizumab injection,
 tell your doctor and pharmacist if you are allergic to ranibizumab or any other
medications.
 tell your doctor and pharmacist what other prescription and nonprescription
medications, vitamins, nutritional supplements, and herbal products you are taking or
plan to take. Be sure to mention if you have received verteporfin (Visudyne) recently.
 tell your doctor if you have or have ever had glaucoma (an eye disease) or an infection
in or around your eyes.
you become pregnant while taking ranibizumab, call your doctor.
 your doctor may prescribe antibiotic eye drops for you to use for a few days after you
receive each injection. Talk to your doctor about how to use these eye drops.
 ask your doctor if there are any activities you should avoid during your treatment with
ranibizumab injection.
 you should know that your eyes will be dilated (treated with eye drops that widen the
pupils) before you receive each ranibizumab injection. This may make your eyes
sensitive to bright light and may make it difficult for you to drive. Bring a hat or
sunglasses to your appointment and plan to have someone drive you home after your
treatment.
 talk to your doctor about testing your vision at home during your treatment. Check
your vision in both eyes as directed by your doctor, and call your doctor if there are
any changes in your vision.

If you miss an appointment to receive ranibizumab, call your doctor as soon as possible.
Ranibizumab may cause side effects. Tell your doctor if any of these symptoms are severe or
do not go away:
 headache
 dry or itchy eyes
 teary eyes
 feeling that something is in your eye
 nausea
 back pain
Some side effects can be serious. If you experience any of these symptoms, call your doctor
immediately:
 reddening of eye
 eye sensitivity to light
 eye pain
 decrease or changes in vision
 bleeding in or around the eye
 swelling of the eye or eyelid
 seeing ''floaters'' or small specks
 seeing flashing lights
 chest pain
 shortness of breath
 sweating
 slow or difficult speech
 dizziness or faintness
 weakness or numbness of an arm or leg
Ranibizumab may cause other side effects. Call your doctor if you have any unusual problems
while receiving this medication.
Keep all appointments with your doctor. Your doctor will need to examine your eyes to see if
you are developing serious side effects within 2 to 7 days after you receive each ranibizumab
injection.
Brand names
 Lucentis®
Drug Information: Ranitidine Hydrochloride Injection

(ra ni' ti deen)
About your treatment
Your doctor has ordered ranitidine hydrochloride to decrease the acid produced by your
stomach.
Ranitidine may be added to an intravenous fluid that will drip through a needle or catheter
placed in your vein for 15-20 minutes, one to four times a day. It also may be added to your
total parenteral nutrition (TPN) solution.
Ranitidine decreases acid in your stomach to help treat an ulcer or prevent one from
developing. Ranitidine helps to decrease the stomach pain, diarrhea, and loss of appetite that
ulcers can cause. This medication is sometimes prescribed for other uses; ask your doctor or
pharmacist for more information.
Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and
side effects of your treatment using laboratory tests and physical examinations. It is important
to keep all appointments with your doctor and the laboratory. The length of treatment depends
on how you respond to the medication.
Precautions
Before administering ranitidine,
 tell your doctor and pharmacist if you are allergic to ranitidine or any other drugs.
 tell your doctor and pharmacist what prescription and nonprescription medications you
are taking, especially acetaminophen (Tylenol), anticoagulants ('blood thinners') such
as warfarin (Coumadin), propantheline, and vitamins.
 tell your doctor if you have or have ever had kidney or liver disease or acute
porphyria.
you become pregnant while taking ranitidine, call your doctor.
Administering your medication
Before you administer ranitidine, look at the solution closely. It should be clear and free of
floating material. Gently squeeze the bag or observe the solution container to make sure there
are no leaks. Do not use the solution if it is discolored, if it contains particles, or if the bag or
container leaks. Use a new solution, but show the damaged one to your health care provider.
It is important that you use your medication exactly as directed. Do not change your dosing
schedule without talking to your health care provider. Your health care provider may tell you
to stop your infusion if you have a mechanical problem (such as a blockage in the tubing,
needle, or catheter); if you have to stop an infusion, call your health care provider
immediately so your therapy can continue.
Side effects
Ranitidine may cause side effects. Tell your health care provider if any of these symptoms are
severe or do not go away:
 headache
 dizziness
 constipation
 diarrhea
 stomach pain
 upset stomach
Storing your medication
 Your health care provider probably will give you a several-day supply of ranitidine at
a time. If you are receiving ranitidine intravenously (in your vein), you probably will
be told to store it in the refrigerator or freezer.
 Take your next dose from the refrigerator 1 hour before using it; place it in a clean, dry
area to allow it to warm to room temperature.
 If you are told to store additional ranitidine in the freezer, always move a 24-hour
supply to the refrigerator for the next day's use.
 Do not refreeze medications.
If you are receiving ranitidine mixed with TPN, you may be directed to keep it in a clean, dry
area away from heat.
Store your medication only as directed. Make sure you understand what you need to store
your medication properly.
Keep your supplies in a clean, dry place when you are not using them, and keep all
medications and supplies out of reach of children. Your health care provider will tell you how
to throw away used needles, syringes, tubing, and containers to avoid accidental injury.
Signs of infection
If you are receiving ranitidine in your vein or under your skin, you need to know the
symptoms of a catheter-related infection (an infection where the needle enters your vein or
skin). If you experience any of these effects near your intravenous catheter, tell your health
care provider as soon as possible:
 tenderness
 warmth
 irritation
 drainage
 redness
 swelling
 pain
Brand names
 Zantac®  Zantac® Premixed

Drug Information: Ranitidine

(ra nye' te deen)
Ranitidine is used to treat ulcers; gastroesophageal reflux disease (GERD), a condition in

which backward flow of acid from the stomach causes heartburn and injury of the food pipe
(esophagus); and conditions where the stomach produces too much acid, such as Zollinger-
Ellison syndrome. Over-the-counter ranitidine is used to prevent and treat symptoms of
heartburn associated with acid indigestion and sour stomach. Ranitidine is in a class of
medications called H2 blockers. It decreases the amount of acid made in the stomach.
Ranitidine comes as a tablet, an effervescent tablet, effervescent granules, and a syrup to take
by mouth. It is usually taken once a day at bedtime or two to four times a day. Over-the-
counter ranitidine comes as a tablet to take by mouth. It is usually taken once or twice a day.
To prevent symptoms, it is taken 30-60 minutes before eating or drinking foods that cause
heartburn. Follow the directions on your prescription or the package label carefully, and ask
your doctor or pharmacist to explain any part you do not understand. Take ranitidine exactly
as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Dissolve ranitidine effervescent tablets and granules in a full glass (6-8 ounces) of water
before drinking.
Do not take over-the-counter ranitidine for longer than 2 weeks unless your doctor tells you
to. If symptoms of heartburn, acid indigestion, or sour stomach last longer than 2 weeks, stop
taking ranitidine and call your doctor.
Ranitidine is also used sometimes to treat upper gastrointestinal bleeding and to prevent stress
ulcers, stomach damage from use of nonsteroidal anti-inflammatory medications (NSAIDs),
and aspiration of stomach acid during anesthesia. Talk to your doctor about the risks of using
this medication for your condition.
information.
Before taking ranitidine,
 tell your doctor and pharmacist if you are allergic to ranitidine or any other
medications.
mention either of the following: anticoagulants ('blood thinners') such as warfarin
(Coumadin); and triazolam (Halcion). Your doctor may need to change the doses of
your medications or monitor you carefully for side effects.
 tell your doctor if you have or have ever had porphyria, phenylketonuria, or kidney or
liver disease.
you become pregnant while taking ranitidine, call your doctor.

Ranitidine may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 headache
 constipation
 diarrhea
 upset stomach
 vomiting
 stomach pain
Ranitidine may cause other side effects. Call your doctor if you have any unusual problems
Keep all appointments with your doctor.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are
taking ranitidine.
Do not let anyone else take your medicine. Ask your pharmacist any questions you have about
refilling your prescription.
Brand names
 Tritec®  Zantac® 75  Zantac® Premixed
 Zantac®  Zantac® EFFERdose®  Zantac® Syrup

Drug Information: Repaglinide

(re pag' lin ide)
Repaglinide is used to treat type 2 diabetes (condition in which the body does not use insulin
normally and, therefore, cannot control the amount of sugar in the blood). Repaglinide helps
your body regulate the amount of glucose (sugar) in your blood. It decreases the amount of
glucose by stimulating the pancreas to release insulin.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for
more information.
Repaglinide comes as a tablet to take by mouth. The tablets are taken before meals, any time
from 30 minutes before a meal to just before the meal. If you skip a meal, you need to skip the
dose of repaglinide. If you add an extra meal, you need to take an extra dose of repaglinide.
Your doctor may gradually increase your dose, depending on your response to repaglinide.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist
to explain any part you do not understand. Take repaglinide exactly as directed. Do not take
more or less of it or take it more often than directed by the package label or prescribed by
your doctor.
Continue to take repaglinide even if you feel well. Do not stop taking repaglinide without
talking to your doctor.
Before taking repaglinide,
 tell your doctor and pharmacist if you are allergic to repaglinide or any other drugs.
are taking, especially acetophenazine (Tindal), aspirin, blood pressure medicines,
carbamazepine (Tegretol), chloramphenicol (Chloromycetin), chlorpromazine
(Thorazine), corticosteroids, diuretics ('water pills'), drugs for arthritis, erythromycin,
troglitazone (Rezulin), estrogens, fluphenazine (Prolixin), isoniazid (Rifamate),
ketoconazole (Nizoral), mesoridazine (Serentil), oral contraceptives, perphenazine
(Trilafon), phenelzine (Nardil), phenobarbital (Luminal), phenytoin (Dilantin),
probenecid (Benemid), prochlorperazine (Compazine), promazine (Sparine),
promethazine (Phenergan), rifampin (Rifadin, Rimactane), thioridazine (Mellaril),
tranylcypromine (Parnate), trifluoperazine (Stelazine), triflupromazine (Vesprin),
trimeprazine (Temaril), vitamins, or warfarin (Coumadin).
 tell your doctor if you have or have ever had liver or kidney disease or if you have
been told you have type I diabetes mellitus.
you become pregnant while taking repaglinide, call your doctor.
are taking repaglinide.
Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian.
It is important to eat a healthful diet.
Alcohol may cause a decrease in blood sugar. Ask your doctor about the use of alcoholic
beverages while you are taking repaglinide.

If you have just begun to eat a meal, take the missed dose as soon as you remember it.
However, if you have finished eating, skip the missed dose and continue your regular dosing
schedule. Do not take a double dose to make up for a missed one.
This medication may cause changes in your blood sugar. You should know the symptoms of
low and high blood sugar and what to do if you have these symptoms.
You may experience hypoglycemia (low blood sugar) while you are taking this medication.
Your doctor will tell you what you should do if you develop hypoglycemia. He or she may tell
you to check your blood sugar, eat or drink a food or beverage that contains sugar, such as
hard candy or fruit juice, or get medical care. Follow these directions carefully if you have
any of the following symptoms of hypoglycemia:
 shakiness
 dizziness or lightheadedness
 sweating
 nervousness or irritability
 sudden changes in behavior or mood
 headache
 numbness or tingling around the mouth
 weakness
 pale skin
 hunger
 clumsy or jerky movements
If hypoglycemia is not treated, severe symptoms may develop. Be sure that your family,
friends, and other people who spend time with you know that if you have any of the following
symptoms, they should get medical treatment for you immediately.
 confusion
 seizures
 loss of consciousness
Call your doctor immediately if you have any of the following symptoms of hyperglycemia
(high blood sugar):
 extreme thirst
 frequent urination
 extreme hunger
 weakness
 blurred vision
If high blood sugar is not treated, a serious, life-threatening condition called diabetic
ketoacidosis could develop. Call your doctor immediately if you have any of these symptoms:
 dry mouth
 upset stomach and vomiting
 shortness of breath
 breath that smells fruity
 decreased consciousness
Repaglinide may cause side effects. Tell your doctor if any of these symptoms are severe or
do not go away:
 headache
 nasal congestion
 joint aches
 back pain
 constipation
 diarrhea
Keep this medication in the container it came in, tightly closed and out of reach of children.
Keep all appointments with your doctor and the laboratory. Your blood sugar and glycosylated
hemoglobin (HbA1c) should be checked regularly to determine your response to repaglinide.
Your doctor will also tell you how to check your response to this medication by measuring
your blood or urine sugar levels at home. Follow these instructions carefully.
You should always wear a diabetic identification bracelet to be sure you get proper treatment
in an emergency.
Brand names
 Prandin®

Drug Information: Reserpine
(re ser' peen)

Reserpine is used to treat high blood pressure. It works by decreasing your heart rate and
relaxing the blood vessels so that blood can flow more easily through the body. It also is used
to treat severe agitation in patients with mental disorders.
more information.
Reserpine comes as a tablet to take by mouth. It usually is taken once daily. Follow the
directions on your prescription label carefully, and ask your doctor or pharmacist to explain
any part you do not understand. Take reserpine exactly as directed. Do not take more or less
of it or take it more often than prescribed by your doctor.
Reserpine controls high blood pressure or symptoms of agitation, but does not cure them.
Continue to take reserpine even if you feel well. Do not stop taking reserpine without talking
to your doctor. Abruptly stopping reserpine may increase blood pressure and cause unwanted
side effects.
Before taking reserpine,
 tell your doctor and pharmacist if you are allergic to reserpine, aspirin, tartrazine (a
yellow dye in some processed foods and medications), or any other drugs.
are taking, especially amitriptyline (Elavil), clomipramine (Anafranil), desipramine
(Norpramin), digoxin (Lanoxin), doxepin (Adepin, Sinequan), ephedrine, epinephrine,
imipramine (Tofranil), MAO inhibitors [phenelzine (Nardil) and tranylcypromine
(Parnate)], methylphenidate (Ritalin), nortriptyline (Aventyl, Pamelor), phenylephrine,
protriptyline (Vivactil), quinidine (Quinaglute), trimipramine (Surmontil), and
vitamins.
 tell your doctor if you have or have ever had kidney disease, gallstones, ulcers,
ulcerative colitis, a history of depression, or electric shock therapy.
you become pregnant while taking reserpine, call your doctor.
are taking reserpine.
 you should know that this drug may make you drowsy or dizzy. Do not drive a car or
operate machinery until you know how it affects you.
 ask your doctor about the safe use of alcohol while you are taking reserpine. Alcohol
can make the side effects from reserpine worse.
Your doctor may prescribe a low-salt or low-sodium diet. Follow these directions carefully.
Do not take the missed dose when you remember it; skip the missed dose and continue your
regular dosing schedule. Do not take a double dose to make up for a missed one.

Reserpine may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 dizziness
 loss of appetite
 diarrhea
 upset stomach
 vomiting
 stuffy nose
 headache
 dry mouth
 decreased sexual ability
If you experience any of the following symptoms, call your doctor immediately:
 depression
 nightmares
 fainting
 slow heartbeat
 chest pain
 swollen ankles or feet
Store at room temperature and away from excess heat and moisture (not in the bathroom).
Keep all appointments with your doctor and the laboratory. Your blood pressure should be
checked regularly to determine your response to reserpine.
Your doctor may ask you to check your pulse (heart rate) daily and will tell you how rapid it
should be. Ask your doctor or pharmacist to teach you how to take your pulse. If your pulse is
slower than it should be, call your doctor before taking reserpine that day.
Weigh yourself every day. Call your doctor if you experience rapid weight gain.
Brand names
 Serpalan®  Serpasil®

Drug Information: Ribavirin

(rye ba vye' rin)
IMPORTANT WARNING:
Ribavirin will not treat hepatitis C (a virus that infects the liver and may cause severe liver
damage or liver cancer) unless it is taken with another medication. If you have hepatitis C,
your doctor will prescribe another medication to take with ribavirin. Take both medications
exactly as directed.
Ribavirin may cause anemia (condition in which there is a decrease in the number of red blood
cells). Tell your doctor if you have ever had a heart attack and if you have or have ever had
high blood pressure, breathing problems, any condition that affects your blood such as sickle
cell anemia (inherited condition in which the red blood cells are abnormally shaped and cannot
bring oxygen to all parts of the body) or thalassemia (Mediterranean anemia; a condition in
which the red blood cells do not contain enough of the substance needed to carry oxygen), or
heart disease. If you experience any of the following symptoms, call your doctor immediately:
excessive tiredness, pale skin, headache, dizziness, confusion, fast heartbeat, weakness,
shortness of breath, or chest pain.
Keep all appointments with your doctor and the laboratory. Your doctor will order blood tests
before you start taking ribavirin and often during the first 4 weeks of your treatment.
Your doctor or pharmacist will give you the manufacturer's patient information sheet
(Medication Guide) when you begin treatment with ribavirin and each time you refill your
prescription. Read the information carefully and ask your doctor or pharmacist if you have any
questions. You also can obtain the Medication Guide from the FDA website:
http://www.fda.gov/cder/foi/label/2002/21511_Copegus_lbl.pdf.
Talk to your doctor about the risks of taking ribavirin.
For female patients:
Do not take ribavirin if you are pregnant or plan to become pregnant. You should not start
taking ribavirin until a pregnancy test has shown that you are not pregnant. You must use two
forms of birth control and be tested for pregnancy every month during your treatment and for 6
months afterward. Call your doctor immediately if you become pregnant during this time.
Ribavirin may cause harm or death to the fetus.
For male patients:
Do not take ribavirin if your partner is pregnant or plans to become pregnant. If you have a
partner who can become pregnant, you should not start taking ribavirin until a pregnancy test
shows that she is not pregnant. You must use two forms of birth control, including a condom
with spermicide during your treatment and for 6 months afterward. Your partner must be tested
for pregnancy every month during this time. Call your doctor immediately if your partner
becomes pregnant. Ribavirin may cause harm or death to the fetus.
Ribavirin is used with another medication called an interferon to treat hepatitis C. Ribavirin is
in a class of antiviral medications called nucleoside analogues. It works by stopping the virus
that causes hepatitis C from spreading inside the body. It is not known if treatment that
includes ribavirin and another medication cures hepatitis C infection, prevents liver damage
that may be caused by hepatitis C, or prevents the spread of hepatitis C to other people.

Ribavirin comes as a tablet, a capsule and an oral solution (liquid) to take by mouth. It is
usually taken twice a day, in the morning and the evening, for 24-48 weeks or longer. Take
ribavirin tablets with food. Take ribavirin capsules and oral solution with food, unless your
doctor tells you that you may take ribavirin with or without food. In that case, be sure to take
the medication the same way every day. It is best to take ribavirin at around the same times
every day. Follow the directions on your prescription label carefully, and ask your doctor or
pharmacist to explain any part you do not understand. Take ribavirin exactly as directed. Do
not take more or less of it or take it more often than prescribed by your doctor.
Shake the liquid well before each use to mix the medication evenly. Be sure to wash the
measuring spoon or cup after use each time you measure the liquid.
Your doctor may decrease your dose or tell you to stop taking ribavirin for a short time if you
develop side effects of the medication. Call your doctor if you are bothered by side effects of
ribavirin. Do not decrease your dose or stop taking ribavirin unless your doctor tells you that
you should.
Ribavirin is also sometimes used to treat viral hemorrhagic fevers (viruses that can cause
bleeding inside and outside of the body, problems with many organs, and death). In the event
of biological warfare, ribavirin may be used to treat viral hemorrhagic fever that has been
spread deliberately. Ribavirin is also sometimes used to treat severe acute respiratory
syndrome (SARS; a virus that may cause breathing problems, pneumonia, and death). Talk to
your doctor about the possible risks of using this drug for your condition.
information.
Before taking ribavirin,
 tell your doctor and pharmacist if you are allergic to ribavirin or any other
medications. If you are taking ribavirin tablets, tell your doctor if you are allergic to
corn.
 tell your doctor and pharmacist what other prescription and nonprescription
medications, vitamins, nutritional supplements, and herbal products you are taking. Be
sure to mention the medications listed in the IMPORTANT WARNING section and
any of the following: medications for anxiety, depression,or any other mental illness;
medications for human immunodeficiency virus (HIV) or acquired immunodeficiency
syndrome (AIDS) such as didanosine (Videx), stavudine (Zerit), and zidovudine
(Retrovir); and medications that supress the immune system such as cancer
chemotherapy, cyclosporine (Neoral, Sandimmune), sirolimus (Rapamune), and
tacrolimus (Prograf). If you are taking ribavirin capsules, tell your doctor if you are
taking antacids. Your doctor may need to change the doses of your medications or
monitor you carefully for side effects.
 tell your doctor if you drink or have ever drunk large amounts of alcohol, if you use or
have ever used street drugs, if you have ever thought about killing yourself or planned
or tried to do so, and if you have ever had an organ transplant. Also tell your doctor if
you have or have ever had a mental illness such as depression, anxiety, or psychosis
(loss of contact with reality); cancer; psoriasis (an inherited skin condition); HIV or
AIDS; diabetes; sarcoidosis (a condition in which abnormal tissue grows in parts of
the body such as the lungs); Gilbert's syndrome (a mild liver condition that may cause
yellowing of the skin or eyes); gout (a type of arthritis caused by crystals deposited in
the joints); any type of liver disease other than hepatitis C;or thyroid, kidney,
pancreas,eye, or lung disease.
 tell your doctor if you have ever taken any medication to treat hepatitis C. Be sure that
your doctor has your complete medical records and knows how well you responded to
other treatments for hepatitis C.
 tell your doctor if you are breast-feeding. You should not breastfeed while you are
taking ribavirin.
 you should know that ribavirin may make you drowsy, dizzy, or confused. Do not
drive a car or operate machinery until you know how this medication affects you.
 do not drink alcoholic beverages while you are taking ribavirin. Alcohol can make
your liver disease worse.
Be sure to drink plenty of fluids while you are taking ribavirin.
If you remember the missed dose that same day, take the medication right away. However, if
you do not remember the missed dose until the next day, call your doctor to find out what to
do. Do not take a double dose to make up for a missed one.
Ribavirin may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 cough
 upset stomach
 vomiting
 diarrhea
 constipation
 heartburn
 weight loss
 changes in ability to taste food
 dry mouth
 difficulty concentrating
 memory loss
 rash
 dry, irritated, or itchy skin
 sweating
 painful or irregular menstruation (period)
 muscle or bone pain
 hair loss
Some side effects can be serious. The following symptoms are uncommon, but if you
experience any of them, or those listed in the IMPORTANT WARNING section, call your
doctor immediately:
 hives
 swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
 hoarseness
 difficulty swallowing or breathing
 pain in the stomach or lower back
 bloody diarrhea
 bright red blood in stools
 black, tarry stools
 unusual bleeding or bruising
 vision changes
 fever, chills, and other signs of infection
 depression
 thinking about hurting or killing yourself
 mood changes
 excessive worry
 irritability
 starting to use street drugs or alcohol again if you used these substances in the past
 worsening of psoriasis that you had before you started to take ribavirin
 intolerance to cold
Ribavirin may slow growth and weight gain in children. Talk to your child's doctor about the
risks of giving this medication to your child.
Ribavirin may cause other side effects. Call your doctor if you have any unusual problems
Store ribavirin tablets and capsules at room temperature and away from excess heat and
moisture (not in the bathroom). Store ribavirin oral solution in the refrigerator or at room
temperature. Throw away any medication that is outdated or no longer needed. Talk to your
pharmacist about the proper disposal of your medication.
Brand names
 Copegus®  Rebetol®
Other names
 tribavirin  RTCA
Drug Information: Rifampin

(rif' am pin)
Rifampin eliminates bacteria that cause tuberculosis (TB). It is generally used with other
drugs to treat tuberculosis or to eliminate Neisseria meningitidis (a bacteria) and to prevent
you from giving these infections to others. However, rifampin is not used to treat Neisseria
meningitidis infection.
more information.
Rifampin comes as a capsule to take by mouth. It usually is taken once a day. You will
probably be taking it for at least 3 months and possibly for up to 2 years. Rifampin works best
on an empty stomach; take it 1 hour before or at least 2 hours after a meal. If you have
difficulty swallowing the capsule, you may empty its contents into applesauce or jelly. Follow
the directions on your prescription label carefully, and ask your doctor or pharmacist to
explain any part you do not understand. Take rifampin exactly as directed. Do not take more
or less of it or take it more often than prescribed by your doctor.
Before taking rifampin,
 tell your doctor and pharmacist if you are allergic to rifampin or any other drugs.
are taking, especially anticoagulants ('blood thinners') such as warfarin (Coumadin),
cyclosporine (Neoral, Sandimmune), estrogen, hydrocortisone (Hydrocortone),
medications for heart disease or diabetes, methadone, prednisone (Deltasone),
theophylline (Theo-Dur), verapamil (Calan, Isoptin), and vitamins. Rifampin alters the
effectiveness of oral contraceptives; use another method of birth control while taking
this medication. Ask your doctor or pharmacist for advice.
 tell your doctor if you have or have ever had liver disease.
you become pregnant while taking rifampin, call your doctor.
 you should know that this drug may make you drowsy. Do not drive a car or operate
machinery until you know how this drug affects you.
 remember that alcohol can add to the drowsiness caused by this drug.
Rifampin may cause side effects. Your urine, stools, saliva, sputum, sweat, and tears may turn
red-orange; this effect is harmless. Tell your doctor if any of these symptoms are severe or do
not go away:
 headache
 muscle pain
 bone pain
 heartburn
 upset stomach
 vomiting
 stomach cramps
 chills
 diarrhea
 skin rash (hives)

 sores on skin or in the mouth
 fever
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab
tests to check your response to rifampin.
Brand names
 Rifadin®  Rimactane®
 Rifamate® containing Rifampin and  Rifater® containing Rifampin,

Isoniazid Isoniazid, and Pyrazinamide

Drug Information: Risperidone
(ris per' i done)

IMPORTANT WARNING:
Studies have shown that older adults with dementia (a brain disorder that affects the ability to
remember, think clearly, communicate, and perform daily activities and that may cause
changes in mood and personality) who take antipsychotics (medications for mental illness)
such as risperidone have an increased risk of death during treatment. Older adults with
dementia may also have a greater chance of having a stroke or mini-stroke during treatment.
Tell your doctor and pharmacist if you are taking furosemide (Lasix). If you experience any of
the following symptoms, call your doctor immediately: slow or difficult speech, sudden
dizziness or faintness, or weakness or numbness of an arm or leg.
Risperidone is not approved by the Food and Drug Administration (FDA) for the treatment of
behavior problems in older adults with dementia. Talk to the doctor who prescribed this
medication if you, a family member, or someone you care for has dementia and is taking
risperidone. For more information visit the FDA website: http://www.fda.gov/cder
Risperidone is used to treat the symptoms of schizophrenia (a mental illness that causes
disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions) in
adults and teenagers 13 years of age and older. It is also used to treat episodes of mania
(frenzied, abnormally excited, or irritated mood) or mixed episodes (symptoms of mania and
depression that happen together) in adults and in teenagers and children 10 years of age and
older with bipolar disorder (manic depressive disorder; a disease that causes episodes of
depression, episodes of mania, and other abnormal moods). Risperidone is also used to treat
behavior problems such as aggression, self-injury, and sudden mood changes in teenagers and
children 5-16 years of age who have autism (a condition that causes repetitive behavior,
difficulty interacting with others, and problems with communication). Risperidone is in a
class of medications called atypical antipsychotics. It works by changing the activity of
certain natural substances in the brain.
Risperidone comes as a tablet, a solution (liquid), and an orally disintegrating tablet (tablet
that dissolves quickly in the mouth) to take by mouth. It is usually taken once or twice a day
with or without food. Take risperidone at around the same time(s) every day. Follow the
directions on your prescription label carefully, and ask your doctor or pharmacist to explain
any part you do not understand. Take risperidone exactly as directed. Do not take more or less
of it or take it more often than prescribed by your doctor.
Use the dropper provided to measure your dose of risperidone oral solution. You can take the
oral solution with water, orange juice, coffee, or low-fat milk. Do not take the solution with
tea or cola.
Do not try to push the orally disintegrating tablet through the foil. Instead, use dry hands to
peel back the foil packaging. Immediately take out the tablet and place it on your tongue. The
tablet will quickly dissolve and can be swallowed with or without liquid. Do not chew or
crush the tablet.
Your doctor will probably start you on a low dose of risperidone and gradually increase your
dose to allow your body to adjust to the medication.
Risperidone may help control your symptoms but will not cure your condition. It may take
several weeks or longer before you feel the full benefit of risperidone. Continue to take
risperidone even if you feel well. Do not stop taking risperidone without talking to your
doctor. If you suddenly stop taking risperidone, your symptoms may return and your illness
may become harder to treat.
information.
Before taking risperidone,
 tell your doctor and pharmacist if you are allergic to risperidone or any other
medications.
vitamins, nutritional supplements and herbal products you are taking or plan to take.
Be sure to mention any of the following: antidepressants; carbamazepine (Tegretol);
cimetidine (Tagamet); clozapine (Clozaril); dopamine agonists such as bromocriptine
(Parlodel), cabergoline (Dostinex), levodopa (Dopar, Larodopa), pergolide (Permax),
and ropinirole (Requip); medications for anxiety, high blood pressure, or seizures;
other medications for mental illness; paroxetine (Paxil); phenobarbital (Luminal,
Solfoton); phenytoin (Dilantin); quinidine (Quinaglute, Quinidex); ranitidine (Zantac);
rifampin (Rifadin, Rimactane); sedatives; sleeping pills; tranquilizers; and valproic
acid (Depakote, Depakene). Your doctor may need to change the doses of your
medications or monitor you carefully for side effects.
 tell your doctor if you use or have ever used street drugs or large amounts of alcohol;
if you have ever overused prescription medications; if you have or have ever had
Parkinson's disease (PD; a disorder of the nervous system that causes difficulties with
movement, muscle control, and balance); difficulty swallowing; breast cancer; angina
(chest pain); irregular heartbeat; high or low blood pressure; heart failure; a heart
attack; a stroke; seizures; heart, kidney or liver disease; or if you or anyone in your
family has or has ever had diabetes. Also tell your doctor if you have ever had to stop
taking a medication for mental illness because of severe side effects.
 tell your doctor if you are pregnant or plan to become pregnant. If you become
pregnant while taking risperidone, call your doctor. Do not breast-feed while taking
risperidone.
are taking risperidone.
 you should know that risperidone may make you drowsy. Do not drive a car or operate
machinery until you know how this medication affects you.
 you should know that alcohol can add to the drowsiness caused by this medication. Do
not drink alcohol while taking risperidone.
 you should know that you may experience hyperglycemia (increases in your blood
sugar) while you are taking this medication, even if you do not already have diabetes.
If you have schizophrenia, you are more likely to develop diabetes than people who do
not have schizophrenia, and taking risperidone or similar medications may increase
this risk. Tell your doctor immediately if you have any of the following symptoms
while you are taking risperidone: extreme thirst, frequent urination, extreme hunger,
blurred vision, or weakness. It is very important to call your doctor as soon as you
have any of these symptoms, because high blood sugar that is not treated can cause a
serious condition called ketoacidosis. Ketoacidosis may become life-threatening if it is
not treated at an early stage. Symptoms of ketoacidosis include: dry mouth, upset
stomach and vomiting, shortness of breath, breath that smells fruity, and decreased
consciousness.
 you should know that risperidone may make it harder for your body to cool down
when it gets very hot or warm up when it gets very cold. Tell your doctor if you plan
to do vigorous exercise or be exposed to extremely high or low temperatures.
 you should know that risperidone may cause dizziness, lightheadedness, and fainting
when you get up too quickly from a lying position. This is more common when you
first start taking risperidone. To avoid this problem, get out of bed slowly, resting your
feet on the floor for a few minutes before standing up.
 if you have phenylketonuria (PKU, an inherited condition in which a special diet must
be followed to prevent mental retardation), you should know that the orally
disintegrating tablets contain phenylalanine.
Risperidone may cause side effects. Tell your doctor if any of these symptoms are severe or
do not go away:
 drowsiness
 dizziness
 nausea
 vomiting
 diarrhea
 constipation
 heartburn
 dry mouth
 increased saliva
 increased appetite
 weight gain
 stomach pain
 anxiety
 agitation
 restlessness
 dreaming more than usual
 decreased sexual interest or ability
 breastmilk production
 vision problems
 muscle or joint pain
 dry or discolored skin
 difficulty urinating
Some side effects can be serious. If you experience any of the following symptoms or those
listed in the IMPORTANT WARNING section or the SPECIAL PRECAUTIONS section, call
your doctor immediately:
 fever
 muscle stiffness
 confusion
 fast or irregular pulse
 sweating
 unusual movements of your face or body that you cannot control
 faintness
 seizures
 slow movements or shuffling walk
 rash
 hives
 itching
 difficulty breathing or swallowing
 painful erection of the penis that lasts for hours
Risperidone may cause children to gain more weight than expected and for boys and male
adolescents to have an increase in the size of their breasts. Talk to your doctor about the risks
of giving this medication to your child.
Risperidone may cause other side effects. Call your doctor if you have any unusual problems
Always store the orally disintegrating tablets in their sealed package, and use them
immediately after opening the package. Throw away any medication that is outdated or no
longer needed. Talk to your pharmacist about the proper disposal of your medication.
Symptoms of overdose may include:
 drowsiness
 fast, pounding, or irregular heartbeat
 upset stomach
 blurred vision
 fainting
 dizziness
 seizures
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab
tests to check your body's response to risperidone.
Brand names
 Risperdal®  Risperdal® M-TAB®

Drug Information: Ritonavir
(ri toe' na veer)
IMPORTANT WARNING:
[Posted 03/12/2008] FDA and Tibotec Therapeutics notified healthcare professionals of
changes to the WARNINGS section of the prescribing information for darunavir (Prezista)
tablets regarding the risk of hepatotoxicity. In clinical trials and postmarketing experience,
drug induced hepatitis has been reported in patients receiving combination therapy with
darunavir/ritonavir. Appropriate laboratory testing should be conducted prior to initiating
therapy with darunavir/ritonavir and patients should be monitored during treatment. Increased
AST/ALT monitoring should be considered in patients with underlying chronic hepatitis,
cirrhosis, or in patients who have pretreatment elevations of transaminases, especially during
the first several months of darunavir/ritonavir treatment. For more information visit the FDA
website at: http://www.fda.gov/medwatch/safety/2008/safety08.htm#Prezista,
http://www.fda.gov/medwatch/safety/2008/prezista_DHCP.pdf and
http://www.fda.gov/cder/foi/label/2008/021976s003s004lbl.pdf.
IMPORTANT WARNING:
Serious or potentially life-threatening reactions can occur when ritonavir is taken along with
certain drugs. Therefore, do not take ritonavir with alprazolam (Xanax); amiodarone
(Cordarone); astemizole (Hismanal); belladonna, phenobarbital, and ergotamine tartrate
(Bellergal-S, Bel-Phen-Ergot S, Phenerbel-S); bepridil (Vascor); bromocriptine (Parlodel);
bupropion (Wellbutrin); cabergoline (Dostinex); cisapride (Propulsid); clorazepate (Tranxene);
clozapine (Clozaril); diazepam (Valium); dihydroergotamine (D.H.E. 45, Migranal);
disopyramide (Norpace); encainide (Enkaid); ergoloid mesylates (Germinal, Hydergine);
ergonovine (Ergotrate Maleate); ergotamine (Cafatine, Cafergot, Cafetrate, others); estazolam
(ProSom); flecainide (Tambocor); fluoxetine (Prozac, Sarafem); flurazepam (Dalmane);
meperidine (Demerol); methylergonovine (Methergine); methysergide (Sansert); mexiletine
(Mexitil); midazolam (Versed); nefazadone (Serzone); pergolide (Permax); pimozide (Orap);
piroxicam (Feldene); propafenone (Rythmol); propoxyphene (Darvon); quinidine; rifabutin
(Mycobutin); terfenadine (Seldane); triazolam (Halcion); or zolpidem (Ambien).
Pending revision, the material in this section should be considered in light of more recently
available information in the MedWatch notification at the beginning of this monograph.
Ritonavir is used to treat human immunodeficiency virus (HIV) infection. It belongs to a class
of drugs called protease (pro' tee ace) inhibitors, which slow the spread of HIV infection in
the body. It is usually taken with other antiviral medications. Ritonavir is not a cure and may
not decrease the number of HIV-related illnesses. Ritonavir does not prevent the spread of
HIV to other people.
more information.
Ritonavir comes as a capsule and liquid to take by mouth. It is usually taken every 12 hours
(twice a day). Follow the directions on your prescription label carefully, and ask your doctor
or pharmacist to explain any part you do not understand. Take ritonavir exactly as directed.
Do not take more or less of it or take it more often than prescribed by your doctor.
Mix just one dose at a time and take the whole dose within 1 hour of mixing. Rinse the cup
after each dose.
Continue to take ritonavir even if you feel well. Do not stop taking ritonavir without talking to
your doctor.
Before taking ritonavir,
 tell your doctor and pharmacist if you are allergic to ritonavir or any other drugs.
 in addition to the drugs listed in the IMPORTANT WARNING section, also tell your
doctor and pharmacist what other prescription and nonprescription medications you
are taking, especially anticoagulants ('blood thinners') such as warfarin (Coumadin),
cholesterol-lowering medications such as lovastatin (Mevacor) and simvastatin
(Zocor), clarithromycin (Biaxin), desipramine (Norpramin), didanosine (Videx),
disulfiram (Antabuse), heart medications, indinavir (Crixivan), ketoconazole
(Nizoral), medications for depression and seizures, medications that suppress the
immune system such as cyclosporine (Neoral, Sandimmune) and tacrolimus (Prograf),
meperidine (Demerol), Methadone (Dolobid), metronidazole (Flagyl), oral
contraceptives (birth control pills), pain relievers, rifabutin (Mycobutin), rifampin
(Rifadin, Rimactane), saquinavir (Invirase), sildenafil (Viagra), theophylline (Theo-
Dur), vitamins, and nutritional supplements.
 tell your doctor and pharmacist what herbal products you are taking, especially St.
John's wort and products containing St. John's wort.
 tell your doctor if you have or have ever had liver disease, diabetes, hemophilia, or a
history of alcohol abuse.
you become pregnant while taking ritonavir, call your doctor immediately.
 tell your doctor if you drink alcohol.
Take ritonavir with food. Ritonavir liquid may be taken alone or mixed with chocolate milk or
the food supplements Ensure or Advera. Do not mix it with any other fluids.
Side effects from ritonavir may occur. Tell your doctor if any of these symptoms are severe or
do not go away:
 loss of strength or weakness

 upset stomach
 vomiting
 diarrhea or loose stools
 headache
 dizziness
 shift in body fat
 rash
 hives
 difficulty breathing
 swelling of the tongue or lips
 tingling sensation or numbness in the hands, feet, or around the lips
 excessive tiredness
 lack of energy
 pain in the upper right part of the stomach
Ritonavir may increase the sugar level in your blood. If you experience any of the following
symptoms, call your doctor immediately:
 frequent urination
 increased thirst
 weakness
 dizziness
 headache
Keep retonavir capsules and liquid in the refrigerator; do not freeze. The liquid bottle in use
can be stored in a cool area for up to 30 days. Throw away any medication that is outdated or
no longer needed. Talk to your pharmacist about the proper disposal of your medication.
tests to check your response to ritonavir.
Brand names
 Norvir®  Norvir® Softgel

Drug Information: Rituximab Injection
(ri tux' i mab)
IMPORTANT WARNING:
Some people who received rituximab experienced severe reactions to the medication. Some of
these people died within 24 hours after they received a dose of rituximab. Most of these deaths
happened after the first dose of rituximab. Tell your doctor if you have or have ever had
chronic lymphocytic leukemia (CLL; a type of cancer that begins in the white blood cells),
mantle cell lymphoma (a fast-growing cancer that begins in the cells of the immune system),
an irregular heartbeat, or heart or lung disease. If you have any of these conditions, or if you
are female, there is a greater chance that you will experience a serious reaction to rituximab. If
you experience any of the following symptoms, tell your doctor or other health care provider
immediately: hives; swelling of the lips, tongue, or throat; difficulty breathing or swallowing;
dizziness; fainting; shortness of breath, wheezing; blurred vision; headache; pounding or
irregular heartbeat; fast or weak pulse; loss of consciousness, fast breathing; pale or bluish
skin; pain in the chest that may spread to other parts of the upper body; weakness; excessive
tiredness; sweating; or anxiety.
When rituximab is used to treat non-Hodgkin's lymphoma (NHL; a type of cancer that begins
in a type of white blood cells that normally fight infection) it may cause a condition called
tumor lysis syndrome (TLS; a group of symptoms caused by the fast breakdown of cancer
cells). TLS may cause kidney failure and the need for dialysis treatment. Tell your doctor if
you are also receiving cisplatin (Platinol). If you notice that you need to urinate less often than
usual or that you produce less urine than usual, tell your doctor immediately.
Rituximab has caused severe skin reactions. These reactions have caused death. If you
experience any of the following symptoms, tell your doctor immediately: painful sores, ulcers,
blisters, rash, or peeling skin.
Some people who received rituximab developed progressive multifocal leukoencephalopathy

(PML; a rare infection of the brain that cannot be treated, prevented, or cured and that usually
causes death or severe disability) during or after their treatment. If you experience any of the
following symptoms, call your doctor immediately: difficulty thinking clearly or walking, loss
of strength, vision problems, or any other unusual symptoms that develop suddenly.
Talk to your doctor about the risks of using rituximab.
Rituximab is used alone or with other medications to treat certain types of non-Hodgkin's
lymphoma (NHL; a type of cancer that begins in a type of white blood cells that normally
fights infection). Rituximab is also used with another medication to treat the symptoms of
rheumatoid arthritis (RA; a condition in which the body attacks its own joints, causing pain,
swelling, and loss of function) in people who have already been treated with a certain type of
medication called a tumor necrosis factor (TNF) inhibitor. Rituximab is in a class of
medications called biologic antineoplastic agents. It treats NHL by causing the death of blood
cells that have multiplied abnormally. It treats rheumatoid arthritis by causing the death of
certain blood cells that may cause the immune system to attack the joints.
Rituximab comes as a solution (liquid) to be injected into a vein. Rituximab is administered

by a doctor or nurse in a medical office or infusion center. When rituximab is used to treat
rheumatoid arthritis, it is usually given as 2 doses spaced 2 weeks apart. When rituximab is
used to treat NHL it is either given once a week for 4-8 weeks or on the first day of each
chemotherapy cycle. Your dosing schedule will depend on the condition that you have, the
other medications you are using, and how well your body responds to treatment.
Rituximab must be given slowly. It may take several hours or longer to receive your first dose
of rituximab, so you should plan to spend most of the day at the medical office or infusion
center. After the first dose, you may receive your medication more quickly, depending on how
you respond to treatment.
You may experience symptoms such as fever, shaking chills, tiredness, headache, or nausea
while you are receiving a dose of rituximab, especially the first dose. Tell your doctor or other
healthcare provider if you experience these symptoms while you are receiving your
medication. Your doctor may prescribe other medications to help prevent or relieve these
symptoms. Your doctor may tell you to take these medications before you receive each dose
of rituximab.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.
information.
Before using rituximab,
 tell your doctor and pharmacist if you are allergic to rituximab or any other
medications.
vitamins, nutritional supplements, and herbal products you are taking or plan to take.
Be sure to mention the medication in the IMPORTANT WARNING section and either
of the following: medications for high blood pressure and other medications for
rheumatoid arthritis. Your doctor may need to change the doses of your medications or
monitor you carefully for side effects.
 tell your doctor if you have any of the conditions mentioned in the IMPORTANT
WARNING section and if you have or have ever had hepatitis B or other viruses such
as chicken pox, herpes (a virus that may cause cold sores or outbreaks of blisters in the
genital area), West Nile virus (a virus that is spread through mosquito bites and may
cause serious symptoms), or cytomegalovirus (a common virus that usually only
causes serious symptoms in people who have weakend immune systems or who are
infected at birth). Also tell your doctor if you have any type of infection now or if you
have or have ever had an infection that would not go away or an infection that comes
and goes.
 tell your doctor if you are pregnant or plan to become pregnant. Rituximab may harm
the fetus. You should use birth control to prevent pregnancy during your treatment
with rituximab and for up to 12 months after your treatment. Talk to your doctor about
types of birth control that will work for you. If you become pregnant while using
rituximab, call your doctor.
 tell your doctor if you are breast-feeding. You should not breast-feed during your
treatment with rituximab or for some time after your treatment.
are using rituximab.
 you should know that you may be drowsy or dizzy after you receive a dose of
rituximab. Do not drive a car or operate machinery until you know how this
medication affects you. Plan to have someone else drive you home from the medical
office or infusion center after you receive your treatment.
 ask your doctor whether you should receive any vaccinations before you begin your
treatment with rituximab. Do not have any vaccinations during your treatment without
talking to your doctor.
If you miss an appointment to receive rituximab, call your doctor right away.
Rituximab may cause side effects. Tell your doctor if any of these symptoms are severe or do
not go away:
 nausea
 vomiting
 diarrhea
 heartburn
 weight gain
 muscle or back pain
 flushing
 night sweats
 tiredness
 weakness
 numbness, burning or tingling in the hands or feet
 runny nose
Some side effects can be serious. If you experience any of these symptoms or those listed in
the IMPORTANT WARNING section, call your doctor immediately:
 stomach area pain

 unusual bruising or bleeding
 sore throat, fever, chills, or other signs of infection
 chest tightness
 joint pain or soreness
Rituximab may cause other side effects. Call your doctor if you have any unusual problems
while using this medication.
tests to check your body's response to rituximab.
Brand names
 Rituxan®
Drug Information: Rotavirus Vaccine
What is rotavirus?
Rotavirus is a virus that causes severe diarrhea, mostly in babies and young children. It is
often accompanied by vomiting and fever. Rotavirus is not the only cause of severe diarrhea,
but it is one of the most serious. Each year in the United States rotavirus is responsible for:
 more than 400,000 doctor visits

 more than 200,000 emergency room visits
 55,000 to 70,000 hospitalizations
 20-60 deaths
Almost all children in the U.S. are infected with rotavirus before their 5th birthday. Children
are most likely to get rotavirus disease between November and May, depending on the part of
the country. Your child can get rotavirus infection by being around other children who are
already infected.
Rotavirus vaccine
Better hygiene and sanitation have not been very good at reducing rotavirus disease.
Rotavirus vaccine is the best way to protect children against rotavirus disease.
Rotavirus vaccine is an oral (swallowed) vaccine; it is not given by injection.
Rotavirus vaccine will not prevent diarrhea or vomiting caused by other germs, but it is very
good at preventing diarrhea and vomiting caused by rotavirus. About 98% of children who get
the vaccine are protected from severe rotavirus diarrhea, and about 74% do not get rotavirus
diarrhea at all.
Children who get the vaccine are also much less likely to be hospitalized or to see a doctor
because of rotavirus infection.
Who should get rotavirus vaccine and when?
 Children should get 3 doses of rotavirus vaccine. They are recommended at these
ages: 2 months of age, 4 months of age, and 6 months of age.
 The first dose should be given between 6 and 12 weeks of age. The vaccine has not
been studied when started among children outside that age range.
 Children should have gotten all 3 doses by 32 weeks of age.
 Rotavirus vaccine may be given at the same time as other childhood vaccines.
Children who get the vaccine may be fed normally afterward.
Who should not get rotavirus vaccine or should wait?
 A child who has had a severe (life-threatening) allergic reaction to a dose of rotavirus
vaccine should not get another dose. A child who has a severe (life threatening) allergy
to any component of rotavirus vaccine should not get the vaccine. Tell your doctor if
your child has any severe allergies that you know of.
 Children who are moderately or severely ill at the time the vaccination is scheduled
should probably wait until they recover. This includes children who have diarrhea or
vomiting. Ask your doctor or nurse. Children with mild illnesses should usually get
the vaccine.
 Check with your doctor if your child has any ongoing digestive problems.
 Check with your doctor if your child's immune system is weakened because of:
HIV/AIDS, or any other disease that affects the immune system; treatment with drugs
such as long-term steroids; cancer, or cancer treatment with x-rays or drugs.
 Check with your doctor if your child recently had a blood transfusion or received any
other blood product (such as immune globulin).
 In the late 1990s a different type of rotavirus vaccine was used. This vaccine was
found to be associated with an uncommon type of bowel obstruction called
“intussusception,” and was taken off the market. The new rotavirus vaccine has been
tested with more than 70,000 children and has not been associated with
intussusception. However, once a person has had intussusception, from any cause,
they are at higher risk for getting it again. So as a precaution, it is suggested that if a
child has had intussusception they should not get rotavirus vaccine.
What are the risks from rotavirus vaccine?
A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic
reactions. The risk of rotavirus vaccine causing serious harm, or death, is extremely small.
Getting rotavirus vaccine is much safer than getting the disease.
Mild Problems:
 Children are slightly (1-3%) more likely to have mild, temporary diarrhea or vomiting
within 7 days after getting a dose of rotavirus vaccine than children who have not
gotten the vaccine.
Moderate or Severe Problems:
 Moderate or severe problems have not been associated with this vaccine.
 If rare reactions occur with any new product, they may not be identified until
thousands, or millions, of people have used it. Like all vaccines, rotavirus vaccine will
continue to be monitored for unusual or severe problems.
What if there is a moderate or severe reaction?
What should I look for?
 Any unusual condition, such as a high fever or behavior changes. Signs of a serious
allergic reaction can include difficulty breathing, hoarseness or wheezing, hives,
paleness, weakness, a fast heart beat or dizziness.
What should I do?
 Call a doctor, or get the person to a doctor right away.

 Tell your doctor what happened, the date and time it happened, and when the
vaccination was given.
 Ask your health care provider to file a Vaccine Adverse Event Reporting System
(VAERS) form if you have any reaction to the vaccine. Or call VAERS yourself at 1-
800-822-7967, or visit their website at http://vaers.hhs.gov.
The National Vaccine Injury Compensation Program
In the rare event that you or your child has a serious reaction to a vaccine, a federal program
has been created to help pay for the care of those who have been harmed.
For details about the National Vaccine Injury Compensation Program, call 1-800-338-2382 or
visit the program's website at http://www.hrsa.gov/vaccinecompensation.
How can I learn more?
 Ask your doctor or other health care provider. They can give you the vaccine package
insert or suggest other sources of information.
 Call your local or state health department's immunization program.
 Contact the Centers for Disease Control and Prevention (CDC): call 1-800-232-4636
(1-800-CDC-INFO) or visit the National Immunization Program's website at
http://www.cdc.gov/vaccines
Rotavirus Vaccine Information Statement. U.S. Department of Health and Human
Services/Centers for Disease Control and Prevention National Immunization Program.
4/12/2006.
 RotaTeq®

Drug Information: Rabeprazole

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Drug Information: Rabeprazole

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Drug Information: Rabeprazole

(ra be' pray zole)

Why is this medication prescribed?

How should this medicine be used?

Rabeprazole comes as a delayed-release (long-acting) tablet to take by mouth. It is usually

Swallow the tablets whole; do not split, chew, or crush them.

Other uses for this medicine

What special precautions should I follow?

Before taking rabeprazole,

What special dietary instructions should I follow?

What should I do if I forget a dose?

What side effects can this medication cause?

What storage conditions are needed for this medicine?

What other information should I know?

Keep all appointments with your doctor and the laboratory.

Last Revised - 07/01/2003

Rabies is a serious disease. It is caused by a virus. Rabies is mainly a disease of animals.

Who should get rabies vaccine and when?

Preventive Vaccination (No Exposure):

Vaccination After an Exposure:

Tell your doctor if ...

 ever had a serious (life-threatening) allergic reaction to a previous dose of rabies

What are the risks from rabies vaccine?

 hives, pain in the joints, fever (about 6% of booster doses)

What if there is a moderate or severe reaction?

What should I look for?

What should I do?

 Call a doctor, or get the person to a doctor right away.

The National Vaccine Injury Compensation Program

How can I learn more?

Rabies Vaccine Information Statement. U.S. Department of Health and Human

Brand names of combination products

Last Revised - 04/01/2007

Drug Information: Ramipril

Why is this medication prescribed?

How should this medicine be used?

Other uses for this medicine

What special precautions should I follow?

Before taking ramipril,

What special dietary instructions should I follow?

What should I do if I forget a dose?

What side effects can this medication cause?

What storage conditions are needed for this medicine?

Symptoms of overdose may include:

What other information should I know?

Last Revised - 07/01/2003

Drug Information: Ranibizumab Injection

Why is this medication prescribed?

How should this medicine be used?

Other uses for this medicine

What special precautions should I follow?

Before receiving ranibizumab injection,

What special dietary instructions should I follow?

What should I do if I forget a dose?

What side effects can this medication cause?

What other information should I know?

Last Revised - 06/01/2007

Drug Information: Ranitidine Hydrochloride Injection