DRUG / MEDICAL INDICATION SIDE EFFECTS PERTINENT COUNSELING POINTS

DEVICES
1. SALBUTAMOL  asthma attack  Headache  Shake the inhaler. Remove the mouthpiece cover.
METERED DOSE-  COPD  Tremors  Breathe in and breathe out as completely as possible.
INHALER  Tachycardia Place the lips tightly around the mouthpiece. Inhale
 Hyperglycemia deeply while activating the inhaler. Hold your breath
 Hypokalaemia 10 seconds before exhaling.
 If you need a second puff, wait about 1 minute before
you take your next puff. Put the cap back on the
inhaler and make sure it is firmly closed. After using
your inhaler, gargle and rinse your mouth with water.
 2 to 4 puffs (200 to 400 micrograms) every 4 to 6
hours for 24 to 48 hours
 Below 25 °C
 This is so that any medicine that is stuck in your
mouth or throat is cleaned away. This will prevent
side effects such as oral thrush
2. FLUTICASONE +  COPD,  Hoarseness  Never breathe out into the inhaler.
SALMETEROL  chronic bronchitis  Throat irritation  Never try to take the inhaler apart.
(ADVAIR DISKUS)  Headache  Always use the inhaler in a level, horizontal position.
 Stomach upset  Never wash the mouthpiece or any part of the inhaler
– keep it dry.
 Always store the Diskus® in a dry place.
 Open – When the inhaler is removed from the box, it
will be "closed." To open it, hold the outer case in one
hand and put the thumb of your other hand on the
thumb grip. Push your thumb away from you as far as
it will go.
 Slide – Hold the inhaler with the mouthpiece facing
you. Slide the lever away from you as far as it will go
until you hear and/or feel a click. The inhaler is now
ready to use.
 Inhale – Hold the inhaler away from your mouth.
Breathe out as far as is comfortable. Never breathe
into your Diskus®.

1
  Put the mouthpiece to your lips. Breathe in steadily
and deeply – through the inhaler, not through your
nose.
 Remove the inhaler from your mouth.
 Hold your breath for about ten seconds, or for as long
as is comfortable.
 Breathe out slowly.
 Check the dose indicator – The dose indicator on top
of the inhaler tells you how many doses are left.
 Close – To close the inhaler, put your thumb in the
thumbgrip, and slide the thumbgrip back towards
you, as far as it will go. When you close the inhaler, it
clicks shut. The lever automatically goes back to its
starting position and is reset. It is now ready to be
used again.
 Store – Store your Diskus® at room temperature, 68°
to 77° F, in a dry place away from direct heat or
sunlight. Keep out of reach of children. The inhaler
should be thrown away one month after it is taken
from the foil pouch, or after every medication blister
has been used (when the dose indicator reads "0"),
whichever comes first.
 Inhale one puff into the lungs twice a day, rinse your
mouth after use
3. SALBUTAMOL  acute severe  trembling,  2.5 mg to 5 mg salbutamol up to four times a day. Up
SOLUTION FOR  asthma particularly in the to 40 mg per day can be given under strict medical
NEBULIZER  chronic bronchospasm hands. supervision in hospital.
 nervous tension.  Wash your hands.
 headaches.  Connect the hose to an air compressor.
 suddenly  Fill the medicine cup with your medicine. To avoid
noticeable spills, close the medicine cup tightly and always hold
heartbeats the mouthpiece straight up and down.
(palpitations)  Attach the other end of the hose to the mouthpiece
 muscle cramps. and medicine cup.
 Turn on the nebulizer machine.
 Place the mouthpiece in your mouth. Keep your lips
firmly around the mouth piece so that all of the
medicine goes into your lungs. If using a facemask,
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 place it over the mouth and nose. Small children
usually do better if they wear a mask.
 Breathe through your mouth until all the medicine is
used. This takes 5 to 20 minutes, depending on the
device and medicine used. If needed, use a nose clip
so that you breathe only through your mouth.
 Turn off the machine when done.
 Wash the medicine cup and mouthpiece with water
and air dry until your next treatment.
4. BETAMETHASONE  Psoriasis  itchiness  Wash your hands with soap and water before and
OINTMENT  eczema  blistering of the after using this medicine.
skin  Apply a thin layer of this medicine to the affected area
 redness of the skin of the skin. Rub it in gently.
 inflammation of the  Adults and children 13 years of age and older—Apply
hair follicles to the affected area of the skin 1 or 2 times a day.
 Shave it if its hairy
 Cover it with band-aid or a gauze
 Avoid touching your eyes cuz it can cause glaucoma
 Store the medicine in a closed container at room
temperature, away from heat, moisture, and direct
light. Keep from freezing.

5. KETOCONAZOLE  athlete's foot  itching or redness  Wash and dry the infected area of skin. If you're
CREAM  sweat rash (intertrigo), a  a burning feeling on treating your feet, make sure you dry between your
rash that usually appears your skin toes.
in folds of skin  Use your towel or flannel. This stops you from passing
the infection on to anyone else.
 Gently rub the cream into the infected area and
surrounding skin. You'll usually need a small amount,
depending on the size of the area you're treating. Be
careful not to let the cream get into your eyes or
mouth. If it does get into your eyes or mouth, rinse
them with water.
 Wash your hands afterward. This stops you from
spreading the infection to other parts of your body or
other people.
 REMINDER: If you're using any other creams,
ointments or lotions on the same area of skin, do not
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 put them on at the same time as ketoconazole cream.
After putting on the ketoconazole cream, wait 30
minutes before you use different products on the
same area. This gives the ketoconazole time to be
absorbed into your skin.
 Shave the hairy part where your going to apply the
cream
6. PND OTIC DROPS  superficial bacterial  burning or stinging  Hold the bottle in your hand for 1 or 2 minutes to
infections after instilling the warm the solution.
 infections of medication  If you are using the suspension, shake the bottle well.
mastoidectomy and  skin thinning  Clean and dry the affected ear canal thoroughly with
fenestration cavities  small white or red a sterile cotton applicator.
caused by organisms bumps on the skin  Lie down with the affected ear upward.
susceptible to the  acne  Place the prescribed number of drops into your ear.
antibiotics.  unwanted hair  Be careful not to touch the dropper tip to your ear,
growth fingers, or any other surface.
 skin color changes  Remain lying down with the affected ear upward for 5
minutes.
 Repeat steps 1-6 for the opposite ear if necessary. If
you prefer, you may place a cotton wick into the ear
canal, and then the cotton may be saturated with the
ear drops. The wick should be replaced at least once
every 24 hours.
 Use 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 use extra ear drops to make up for a
missed dose.
 Store the medicine in a closed container at room
temperature, away from heat, moisture, and direct
light. Keep from freezing.
 REMINDER: It is usually used in the affected ear(s)
three to four times a day for up to 10 days. To help
clear up your infection completely, keep using this
medicine for the full time of treatment, even if your
symptoms have disappeared. If your symptoms do

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 not improve after one week or get worse, call your
doctor.
 Avoid using earphones or headset for a while until the
infection is not subsides

7. TOBRAMYCIN  Eye infection  eye tearing  Wash your hands thoroughly with soap and water.
OPHTHALMIC DROPS  itching, stinging, or  Check the dropper tip to make sure that it is not
burning of the eye chipped or cracked.
 swelling of the eye  Avoid touching the dropper tip against your eye or
anything else; eye drops and droppers must be kept
clean.
 While tilting your head back, pull down the lower lid
of your eye with your index finger to form a pocket.
 Hold the dropper (tip down) with the other hand, as
close to the eye as possible without touching it.
 Brace the remaining fingers of that hand against your
face.
 While looking up, gently squeeze the dropper so that
a single drop falls into the pocket made by the lower
eyelid. Remove your index finger from the lower
eyelid.
 Close your eye for 2 to 3 minutes and tip your head
down as though looking at the floor. Try not to blink
or squeeze your eyelids.
 Place a finger on the tear duct and apply gentle
pressure.
 Wipe any excess liquid from your face with a tissue.
 If you are to use more than one drop in the same eye,
wait at least 5 minutes before instilling the next drop.
 Replace and tighten the cap on the dropper bottle. Do
not wipe or rinse the dropper tip.
 Wash your hands to remove any medication.
 REMINDER: In mild to moderate disease, instill 1 or 2
drops into the affected eye(s) every 4 hours. In severe
infections, instill 2 drops into the eye(s) hourly until
improvement, following which treatment should be
reduced prior to discontinuation.

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  Lessen of use of gadget to avoid radiation and hot
compress
8. TERRAMYCIN  Bacterial eye infections  Eye irritation  TERRAMYCIN with Polymyxin B Ophthalmic Ointment
OPHTHALMIC  Burning sensation is administered as a small quantity (approximately 1
OINTMENT cm) of the ointment which should be applied into the
conjunctival sac of the lower lid 4 to 6 times daily until
the infection is cleared and healing is complete.
 Hold the tube close to the eye without touching it.
Gently squeeze the tube and place the medicine
inside the lower eyelid.
 Hold the lower lid of the eye and try looking at left to
right to help it spread the ointment in the eyes better
if you also massage it.
 Do not skip any doses and finish the full course of
treatment even if you feel better.
 Apply pressure on the corner of the eye (close to the
nose) for about 1 minute, immediately after instilling
the medication.
 Do not touch the tip to any surface, or to your eye, to
avoid contamination.
 Wait for at least 5-10 minutes before delivering the
next medication in the same eye to avoid dilution.
 Do not wear contact lenses until your infection clears
up.
 Make sure to use within 4 weeks of opening the
bottle.
 REMINDER: Remove your contact lens before applying
the ointment. You can put them on 30 minutes after
applying the eye ointment. Applying eye ointments
may cause your vision to become blurry for a short
period of time. You should avoid driving, operating
machinery, or doing things in places with poor lighting
until your vision clears.
Lessen of use of gadget to avoid radiation and hot
compress
9. SALINASE NASAL  To relieve nasal congestion  they can cause a  Sit or stand in an upright position. You do not need to
SPRAY caused by colds and runny nose if you tilt your head back.
allergies
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  sinus infection use too much at  Gently blow your nose to clear any debris from your
one time. nostrils.
 Close one nostril by pressing your finger against it.
 Place the tip of the spray bottle into the open nostril.
 Close your mouth.
 Inhale slightly as you simultaneously squeeze the
spray bottle.
 Repeat as per the instructions. Most saline nasal
sprays recommend two squeezes per nostril.
 REMINDER: try not to sneeze or blow your nose after
use for atlease 2-5 mins because it can clog your nose
again
10. Symdex tablet  allergic rhinitis, and  Drowsiness  All doses to be taken every 6 hours
(Paracetamol 325 mg sinusitis.  decreased mental  Take it at night
+ alertness  Do not take more than the recommended dose.
Phenylpropanolamine  dizziness  Avoid alcohol intake while using this product. Because
HCl 25 mg + (CPM)  headache, it can cause liver damage when taken at large doses/
Chlorphenamine  blurred vision long duration or used with other paracetamol-
maleate 2 mg)  fatigue containing medicines.
Nasal Decongestants/  weakness  If you are taking this product on a regular schedule
Antihistamines/  dry mouth and miss a dose, take it as soon as you remember. If it
Antipyretic  increased blood is near the time of the next dose, skip the missed
pressure dose. Take your next dose at the regular time. Do not
double the dose to catch up
 Store it at room temperature like cabinet or in a
medicine kit
 Administer with or without food. But if the patient
experiencing an upset stomach it is recommended to
take it with food
11. Colchicine tablet  gouty arthritis  Diarrhea, nausea,  Take this medication by mouth with or without food
cramping,  This medication works best if you take it at the first
abdominal pain, sign of an attack.
and vomiting  The recommended dose is 1.2 milligrams at the first
sign of an attack, followed by 0.6 milligrams one hour
later. The maximum recommended dose is 1.8
milligrams taken over a 1-hour period.

7
  Taking more than the recommended dose may not
increase this drug's effectiveness and may increase
your risk for side effects.
 If you are taking colchicine regularly and miss a dose,
take it as soon as you remember. If it is near the time
of the next dose, skip the missed dose. Take your next
dose at the regular time. Do not double the dose to
catch up.
 Store at room temperature away from light and
moisture. Do not store in the bathroom.
 Do not flush medications down the toilet or pour
them into a drain unless instructed to do so. Properly
discard this product when it is expired or no longer
needed. Pack this medication into a black trash bag
and seal it tightly before throwing into the rubbish
chute or bin. Because It is considered a high-risk
medicine because it is associated with significant
toxicity when not used correctly. Hazardous medicine.
 Avoid taking grapefruit or grapefruit juice while you
are taking this medication as grapefruit might cause
the amount of colchicine to increase in your body.
Large amounts of colchicine can cause serious side
effects. Avoid Alcohol can decrease this drug's
effectiveness. Limit alcohol while taking this drug.
12. Ibuprofen 400mg  dental pain  Upset stomach,  Take this medication by mouth, usually every 4 to 6
tablet  muscle aches nausea, vomiting, hours with a full glass of water (8 ounces/240
headache, diarrhea, milliliters)
constipation,  Do not lie down for at least 10 minutes after taking
dizziness, or this drug. If you have stomach upset while taking this
drowsiness medication, take it with food, milk, or an antacid.
 Stop taking ibuprofen and get medical help right away
if you notice any of these rare but serious side effects:
stomach/abdominal pain that doesn't go away,
black/tarry stools, vomit that looks like coffee
grounds, chest/jaw/left arm pain, shortness of breath,
unusual sweating, confusion, weakness on one side of
the body, trouble speaking, sudden vision change

8
  This medication may make you more sensitive to the
sun. Limit your time in the sun. Avoid tanning booths
and sunlamps. Use sunscreen and wear protective
clothing when outdoors.
 Store at room temperature away from light and
moisture.
 If you are taking this drug on a regular schedule (not
just "as needed") and you miss a dose, take it as soon
as you remember. If it is near the time of the next
dose, skip the missed dose. Take your next dose at the
regular time. Do not double the dose to catch up.
 Alcohol or marijuana (cannabis) can make you more
dizzy or drowsy. Do not drive, use machinery, or do
anything that needs alertness until you can do it
safely.
13. Paracetamol syrup  headache, migraine, nerve  Nausea and  Shake the bottle well before measuring the dose.
pain, toothache, sore Vomiting  Excessive use of Paracetamol can lead to paracetamol
throat  Stomach pain poisoning. It results in liver damage
 Diarrhoea  Paracetamol is normally taken on a needed basis. If
 Indigestion you miss a scheduled dose take it as soon as possible
 Skin Rash but do not double the dose to make up for the missed
one
 It can be taken with or without food. Never take more
than the prescribed dose. Paracetamol maximum
dose per day is 4 grams
 Take it every 4-6 hours
 Store below 25°C. Protect from light. Store in the
original package
 Consumption of alcohol is not recommended during
treatment with Paracetamol 125 MG Syrup as it may
cause liver damage. Consult your doctor immediately
if you experience any signs and symptoms of liver
injury like fever, rash, nausea, vomiting, fatigue, dark
urine, jaundice
14. Colchicine tablet  gouty arthritis  Diarrhea, nausea,  Take this medication by mouth with or without food
cramping,  This medication works best if you take it at the first
abdominal pain, sign of an attack.
and vomiting
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  The recommended dose is 1.2 milligrams at the first
sign of an attack, followed by 0.6 milligrams one hour
later. The maximum recommended dose is 1.8
milligrams taken over a 1-hour period.
 Taking more than the recommended dose may not
increase this drug's effectiveness and may increase
your risk for side effects.
 If you are taking colchicine regularly and miss a dose,
take it as soon as you remember. If it is near the time
of the next dose, skip the missed dose. Take your next
dose at the regular time. Do not double the dose to
catch up.
 Store at room temperature away from light and
moisture. Do not store in the bathroom.
 Do not flush medications down the toilet or pour
them into a drain unless instructed to do so. Properly
discard this product when it is expired or no longer
needed. Pack this medication into a black trash bag
and seal it tightly before throwing into the rubbish
chute or bin. Because It is considered a high-risk
medicine because it is associated with significant
toxicity when not used correctly. Hazardous medicine.
 Avoid taking grapefruit or grapefruit juice while you
are taking this medication as grapefruit might cause
the amount of colchicine to increase in your body.
Large amounts of colchicine can cause serious side
effects. Avoid Alcohol can decrease this drug's
effectiveness. Limit alcohol while taking this drug.
15. Acetylceistein  cystic fibrosis  Shortness of  Melt the tablet(s) in water as you have been told by
efferscent tablet  bronchitis breath. the doctor. Do not swallow the tablet(s) whole.
 Black, tarry, or  Dissolve the effervescent tablet in half a glass of
bloody stools. water.
 Throwing up blood  Wait for 2-3 minutes before the tablet dissolves
or throw up that  Drink the solution immediately.
looks like coffee  Drink within 2 hours of mixing.
grounds.  If you throw up within 1 hour of taking this medicine
(acetylcysteine effervescent tablets), take 1 more
dose.
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  Take a missed dose as soon as you think about it.
 If it is close to the time for your next dose, skip the
missed dose and go back to your normal time.
 Paracetamol Effervescent tablet could be taken with
or without food and drinks.
 Do not to break the effervescent tablet and swallow it
directly like other common oral medications.
 Do not take 2 doses at the same time or extra doses.
 Store in the original container at room temperature.
16. Nystatin oral  thrush, a fungal or yeast  mouth irritation,  It's best to take nystatin liquid after a meal or some
suspension infection in the mouth.  diarrhea, food. However, do not mix it with food or water or
 nausea, any other drink.
 vomiting,  1ml, taken 4 times a day. Leave at least 3 hours
between doses. If your doctor gives you different
instructions, follow their advice
 Shake the bottle well.
 Take the lid off and measure out the right amount
using an oral syringe, medicine spoon or dropper. Do
not use a kitchen teaspoon as it will not measure the
right amount.
 Put the medicine in your mouth.
 Keep it in your mouth for at least 30 seconds if
possible, swilling it around your mouth like a
mouthwash before you swallow it.
 Do not eat or drink anything for 30 minutes after
taking it. This stops you from washing the medicine
out of your mouth too soon.
 It usually takes nystatin liquid around a week to treat
oral thrush, but you'll need to continue taking it for 2
days after this to make sure all the fungus has been
killed.
 Store at 20° to 25°C

17. Azithromycin tablet  Pneumonia  Stomach upset,  Take this medication by mouth as directed by your
 ear, nose and throat and diarrhea/loose doctor, usually once daily with or without food
nose infections such as stools, nausea,  Continue to take this medication until the full
sinus infection (sinusitis) vomiting, or prescribed amount is finished, even if symptoms
abdominal pain
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 disappear after a few days. Stopping the medication
too early may result in a return of the infection.
 If you have these symptoms, do not use anti-diarrhea
or opioid products because they may make symptoms
worse.
 Use of this medication for prolonged or repeated
periods may result in oral thrush or a new yeast
infection. Contact your doctor if you notice white
patches in your mouth, a change in vaginal discharge,
or other new symptoms.
 If you miss a dose, take it as soon as you remember. If
it is near the time of the next dose, skip the missed
dose. Take your next dose at the regular time. Do not
double the dose to catch up.
 Store at room temperature away from light and
moisture.
18. Cefuroxime tablet  Gonorrhea  Nausea, vomiting,  Take this medication by mouth as directed by your
 Haemophilus influenzae diarrhea, or doctor, usually twice daily (every 12 hours). Take
stomach pain cefuroxime with food to increase absorption and
reduce stomach upset.
 Swallow the tablets whole. Do not crush or chew
because the tablets have a strong bitter taste. Use the
liquid suspension form of this medication if it is
difficult to swallow the tablets.
 Continue to take this medication until the full
prescribed amount is finished, even if symptoms
disappear after a few days. Stopping the medication
too early may result in a return of the infection
 If you have these symptoms, do not use anti-diarrhea
or opioid products because they may make symptoms
worse. Use of this medication for prolonged or
repeated periods may result in oral thrush or a new
vaginal yeast infection (oral or vaginal fungal
infection)
 If you miss a dose, take it as soon as you remember. If
it is near the time of the next dose, skip the missed
dose. Take your next dose at the regular time. Do not
double the dose to catch up.
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  Store at room temperature away from light and
moisture.
19. Clotrimazole vaginal  vaginal thrush  local irritation;  Wash your hands before and after inserting the
tablet allergic reactions. vaginal tablet
 Remove the applicator from the packaging
 Remove the tablet from the aluminium package and
place it firmly into the open end of the disposable
applicator “B” (Diagram 1)
 To fit the tablet into the applicator, squeeze the
applicator lightly on both sides, whilst pushing the
tablet far enough into the holder (about 1cm) to be
held in place during insertion one vaginal tablet single
dose, at bedtime, preferably lying down
 Place the tablet on the applicator. Insert the
applicator high into the vagina. Push the plunger then
remove the applicator.
 Also comes in 100 mg vaginal tablets, applied once
daily at bedtime for 6 days. Do not interrupt
treatment during menstruation. Clean the applicator
with water after each use.
 Carefully insert the applicator into the vagina as
deeply as is comfortable. This is easiest when
 lying Holding the applicator “B” in place, slowly and
carefully push the inner plunger “A” as far as it will go
so the tablet is deposited into the vagina on your back
with your legs slightly bent
 Remove the disposable applicator from the vagina
and dispose of it safely, out of the reach of
 children. The applicator cannot be flushed down the
toilet.
 Since the tablet dissolves in the vagina, it is quite
common to notice a white chalky residue after
 using. This does not mean that the treatment has not
worked. However, if you notice pieces of
 undissolved tablet, speak to your doctor or a
pharmacist, as the treatment may not have worked
properly

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  The symptoms of thrush should disappear within 3
days of treatment.
 If no improvement is seen after 7 days you must tell
your doctor.
 If the infection returns after 7 days you may use one
further treatment.
 If you have more than 2 infections within 6 months,
you should see your doctor
 After using Clotrimazole vaginal tablet, you might
experience:
 Vaginal peeling
 Severe itching (pruritus)
 Redness, rashes (erythema)
 Swelling of parts of the body (oedema)
 Discomfort, burning sensation, irritation or
vulvovaginal pain
 Vaginal discharge or bleeding
 Stomach pain
 REMINDER: This product may reduce the
effectiveness of rubber contraceptives, such as
condoms or diaphragms.
 Consequently, you should use alternative precautions
for at least 5 days after using this product
 Do not use tampons, intravaginal douches (vaginal
washes/cleansers), spermicides or other vaginal
products while using this product.
 Avoid vaginal intercourse while you have thrush and
during use of this product because your partner could
become infected.
 Below 25 °C Store in the original package in order to
protect from moisture
20. Metronidazole tablet  rosacea and mouth  Dizziness,  Take this medication by mouth as directed by your
infections headache, stomach doctor. To prevent stomach upset, take this
upset, nausea, medication with food or a full glass of water or milk.
vomiting, loss of  This medication may cause your urine to turn darker
appetite, diarrhea, in color. This effect is harmless and will disappear
constipation, or when the medication is stopped.

14
 metallic taste in  Avoid alcoholic beverages and products containing
your mouth propylene glycol while taking this medication and for
at least 3 days after finishing this medicine because
severe stomach upset/cramps, nausea, vomiting,
headache, and flushing may occur.
 This drug may make you dizzy. Alcohol or marijuana
(cannabis) can make you more dizzy. Do not drive, use
machinery, or do anything that needs alertness until
you can do it safely. Talk to your doctor if you are
using marijuana (cannabis).
 If you are being treated for a certain infection
(trichomoniasis), all sexual partners may also need to
be treated to avoid re-infection. During treatment,
avoid sexual intercourse, or always use a latex or
polyurethane condom.
21. Faktu ointment  hemorrhoids and other  irritation, redness,  before starting: if possible empty your bowel and
anorectal disorders itchiness, or bladder
burning sensation  clean the area where your going to apply it
 1st wash your handwith mild soap with warm water.
Then dry
 2nd open the tube by puncturing the foils sealed with
the pointed end of the cap. The applicator is enclose
to help dispense ointment into recturm directly.
 3rd attach the applicator to the tube and remove the
protective cover. Test the applicator by squeezing the
tube gently to see how much ointment comes out the
amount you want is the length of the tip of your index
finger to lubricate the applicator squeeze some
ointment to the tip of your finger and put it on the
end of the applicator.
 4th lie on your side in comfortable spot with your
bottom leg straighten out and your top leg will bend
toward your stomach lift up your top cheek of your
buttocks
 5th insert the applicator either from the front or
behind until it passes the sphincter muscle. The
sphincter muscle is about one inch in to find it.
Imagine the muscle you tighten to hold in bowel
15
 movement don’t insert pass the base of the
applicator.
 6th squeeze the tube using the same amount of
pressure as when you tested the applicator
 7th hold your buttocks together for five seconds for
best results remain still for 5 mins if you feel you need
extra relief you can apply little more cream to the
external anus area with your finger
 8th clean the applicator with warm water and gentle
soap thoroughly rinse it with water and replace the
protective cover
 9th wash your hand with mild soap and warm water
 It is suggested to wait for 1 hour before using the
bathroom. It could use up until 4 times a day
including night time, morning or after each bowel
 REMINDERS: Apart from using Faktu Ointment, you
can indulge in warm baths. It may help soothe the
area, thus easing the pain.
 Don't ignore the feeling of needing to pass stools.
Some people suppress this feeling and put off going
to the toilet until later. This may result in bigger and
harder stools forming that are more difficult to pass
later.
 The ointment is applied 2-3 times daily to the affected
area. Rectal insertion of ointment requires prior
evacuation of bowel. Use enclosed applicator for
introduction.
22. Al(OH)3 + Mg(OH)2  heartburn, acid  Nausea,  Take this medication by mouth, usually after meals
chewable tablet indigestion, and upset constipation, and at bedtime as needed
stomach diarrhea, or  If you are taking the chewable tablets, chew
headache thoroughly before swallowing, then drink a full glass
of water (8 ounces or 240 milliliters).
 To minimize constipation, drink plenty of fluids and
exercise. Diarrhea is more common with this product
than constipation.
 Lifestyle changes such as stress reduction programs,
stopping smoking, limiting alcohol, and diet changes

16
 (such as avoiding caffeine, fatty foods, certain spices)
may increase the effectiveness of this medication.
 If you are taking this product on a regular schedule
and miss a dose, take it as soon as you remember. If it
is near the time of the next dose, skip the missed
dose. Take your next dose at the regular time. Do not
double the dose to catch up.
 Store at room temperature away from light and
moisture
23. Loperamide tablet  diarrhea  Dizziness,  Take this medication by mouth, usually after each
drowsiness, loose stool
tiredness, or  Drink plenty of fluids and minerals (electrolytes) to
constipation replace what is lost.
 Improper use of this medication (overuse or abuse)
may cause serious harm, such as fast/irregular
heartbeat or death. Do not increase your dose, take it
more often, or take it for longer than directed. Taking
loperamide with certain other medications may also
cause harm.
 If you are taking this drug on a regular schedule (not
"as needed") and you miss a dose, take it as soon as
you remember. If it is near the time of the next dose,
skip the missed dose. Take your next dose at the
regular time. Do not double the dose to catch up.
 Store at room temperature away from light and
moisture.
24. Senokot tablet  constipation  stomach pain,  Avoid taking this product within 2 hours before or
discomfort, or after you take other medicines. Senna can make it
cramps; harder for your body to absorb certain medicines you
 diarrhea, or an take by mouth.
urgent need to  Swallow the tablet whole with a full glass of water
have a bowel and do not crush, chew, or break it.
movement;  Senna should produce a bowel movement within 6 to
 nausea, gas; or 12 hours after you take it.
 discoloration of  Store at room temperature away from moisture, heat,
your urine. and light.

17
  This medicine is for short-term use only. You shouldn’t
take it for longer than a week without first checking
with your doctor.
25. Bisacodyl suppository  constipation  Abdominal  Wash your hands before and after use.
cramping  Use suppository rectally.
 Electrolyte and fluid  Take off foil wrapper.
imbalance  Put suppository into the rectum with gentle pressure,
 Excessive diarrhea pointed end first. Do not handle too much.
 Nausea  If you take this medicine (bisacodyl suppositories) on
 Rectal burning a regular basis, take a missed dose as soon as you
think about it.
 If it is close to the time for your next dose, skip the
missed dose and go back to your normal time.
 Do not take 2 doses at the same time or extra doses.
 Many times this medicine (bisacodyl suppositories) is
taken on an as needed basis. Do not take more often
than told by the doctor.
 Store at room temperature.
26. Aspirin 80mg  muscle aches, toothaches  Upset stomach and  Take this medication by mouth. Drink a full glass of
arthritis. heartburn water (8 ounces/240 milliliters)
 Do not lie down for at least 10 minutes after you have
taken this drug. If stomach upset occurs while you are
taking this medication, you may take it with food or
milk.
 Do not crush or chew extended-release tablets or
capsules. Doing so can release all of the drug at once,
increasing the risk of side effects. Also, do not split
extended-release tablets unless they have a score line
and your doctor or pharmacist tells you to do so.
Swallow the whole or split tablet without crushing or
chewing.
 You should not take this medication for self-treatment
of pain for longer than 10 days. You should not use
this drug to self-treat a fever that lasts longer than 3
days.
 Daily use of alcohol and tobacco, especially when
combined with this product, may increase your risk

18
 for this side effect. Limit alcoholic beverages, and stop
smoking. This medicine may cause stomach bleeding
 If your doctor directs you to take this drug on a
regular schedule (not just "as needed") and you miss
a dose, take it as soon as you remember. If it is near
the time of the next dose, skip the missed dose. Take
your next dose at the regular time. Do not double the
dose to catch up.
 Store at room temperature away from moisture and
light. Different brands of this medication may have
different storage needs.
27. Warfarin tablet  deep vein thrombosis-DVT  Nausea, loss of  Do not drink cranberry or grapefruit juice while you're
or pulmonary embolus-PE appetite, or taking warfarin. It can increase the effect of your
stomach/abdominal medicine and put you at higher risk of bleeding.
pain  Take this medication by mouth with or without food
as directed by your doctor or other health care
professional, usually once a day. It is very important
to take it exactly as directed. Do not increase the
dose, take it more often, or stop using it unless
directed by your doctor.
 It is important to eat a balanced, consistent diet while
taking warfarin. Some foods can affect how warfarin
works in your body and may affect your treatment
and dose. Avoid sudden large increases or decreases
in your intake of foods high in vitamin K (such as
broccoli, cauliflower, cabbage, brussels sprouts, kale,
spinach, and other green leafy vegetables, liver, green
tea, certain vitamin supplements).
 For the best possible benefit, do not miss any doses. If
you do miss a dose and remember on the same day,
take it as soon as you remember. If you remember on
the next day, skip the missed dose. Take your next
dose at the regular time. Do not double the dose to
catch up because this could increase your risk for
bleeding.
 Maximal effect of Warfarin is not observed until 3 to 5
days after therapy has started.

19
  all existing activated factors II, VII, IX, and X are
depleted from the circulation.
 Store at room temperature away from light and
moisture
28. Losartan tablet  hypertension, diabetic  Dizziness or  Take this medication by mouth with or without food
nephropathy. lightheadedness as directed by your doctor, usually once daily. The
dosage is based on your medical condition and
response to treatment.
 To reduce the risk of dizziness and lightheadedness,
get up slowly when rising from a sitting or lying
position.
 This drug can cause serious (possibly fatal) harm to an
unborn baby if used during pregnancy. It is important
to prevent pregnancy while taking this medication
 This drug may make you dizzy. Alcohol or marijuana
(cannabis) can make you more dizzy. Do not drive, use
machinery, or do anything that needs alertness until
you can do it safely. Limit alcoholic beverages
 If you miss a dose, take it as soon as you remember. If
it is near the time of the next dose, skip the missed
dose. Take your next dose at the regular time. Do not
double the dose to catch up.
 Store tablets at room temperature away from light
and moisture
29. Metoprolol tablet  Hypertension  Drowsiness,  Take this medication by mouth with or right after a
 Angina dizziness, tiredness, meal as directed by your doctor, usually 1 to 3 times a
diarrhea, and slow day. The dosage is based on your medical condition
heartbeat and response to treatment.
 To reduce your risk of side effects, your doctor may
direct you to start this medication at a low dose and
gradually increase your dose.
 . Do not suddenly stop taking this medication without
consulting your doctor. Your condition may become
worse when the drug is suddenly stopped.
 For the treatment of high blood pressure, it may take
several weeks before you get the full benefit of this
drug. Keep taking this medication even if you feel

20
 well. Most people with high blood pressure do not
feel sick.
 To prevent chest pain, a second heart attack, or
migraine headaches, it is very important to take this
medication regularly as prescribed. This drug should
not be used to treat chest pain or migraines when
they occur. Use other medications to relieve sudden
attacks as directed by your doctor (for example,
nitroglycerin tablets placed under the tongue for
chest pain, "triptan" drugs such as sumatriptan for
migraines). Consult your doctor or pharmacist for
details.
 To reduce the risk of dizziness and lightheadedness,
get up slowly when rising from a sitting or lying
position.
 This drug may reduce blood flow to your hands and
feet, causing them to feel cold. Smoking may worsen
this effect. Dress warmly and avoid tobacco use. Do
not stop taking this medication without consulting
your doctor. Some conditions may become worse
when you suddenly stop this drug. Some people who
have suddenly stopped taking similar drugs have had
chest pain, heart attack, and irregular heartbeat.
 Alcohol or marijuana (cannabis) can make you more
dizzy or drowsy. Do not drive, use machinery, or do
anything that needs alertness until you can do it
safely. Limit alcoholic beverages
 If you miss a dose, take it as soon as you remember. If
it is near the time of the next dose, skip the missed
dose. Take your next dose at the regular time. Do not
double the dose to catch up.

 Storage
 Store at room temperature away from light and
moisture
30. Amlodipine tablet  Hypertension  Dizziness,  Take this medication by mouth with or without food
 angina lightheadedness, as directed by your doctor, usually once daily.
swelling
21
 ankles/feet, or  This drug may make you dizzy. Alcohol or marijuana
flushing (cannabis) can make you more dizzy. Do not drive, use
machinery, or do anything that needs alertness until
you can do it safely. Limit alcoholic beverages. Talk to
your doctor if you are using marijuana (cannabis).
 Do not start, stop, or change the dosage of any
medicines without your doctor's approval.
 Lifestyle changes that may help this medication work
better include exercising, stopping smoking, reducing
stress, and eating a low-cholesterol/low-fat diet.
Consult your doctor for more details
 If you miss a dose, take it as soon as you remember. If
it is near the time of the next dose, skip the missed
dose. Take your next dose at the regular time. Do not
double the dose to catch up.
 Store the tablets at room temperature away from
light and moisture
31. Hydrochlorothiazide  Hypertension  Upset stomach,  Take this medication by mouth as directed by your
tablet  Edema dizziness, or doctor, usually once daily in the morning with or
headache without food. If you take this drug too close to
bedtime, you may need to wake up to urinate. It is
best to take this medication at least 4 hours before
your bedtime
 To reduce the risk of dizziness and lightheadedness,
get up slowly when rising from a sitting or lying
position.
 This medication may cause dehydration and
electrolyte imbalance. Tell your doctor right away if
you have any symptoms of dehydration or electrolyte
imbalance, including unusual dry mouth/thirst,
muscle cramps/weakness, slow/fast/irregular
heartbeat, or confusion.
 This drug may make you dizzy. Alcohol or marijuana
(cannabis) can make you more dizzy. Do not drive, use
machinery, or do anything that needs alertness until
you can do it safely. Limit alcoholic beverages. Talk to
your doctor if you are using marijuana (cannabis).

22
  Severe sweating, diarrhea, or vomiting may cause
dehydration and cause you to feel lightheaded. Tell
your doctor if you have severe diarrhea or vomiting.
To prevent dehydration, drink plenty of fluids unless
your doctor tells you not to.
 This medication may make you more sensitive to the
sun. It may also increase your risk for skin cancer,
especially if you take it for a long time. Limit your time
in the sun. Avoid tanning booths and sunlamps. Use
sunscreen and wear protective clothing when
outdoors. Tell your doctor right away if you get
sunburned, have skin blisters/redness, or notice new
or changed moles/skin lesions.
 If you miss a dose, take it as soon as you remember. If
it is near the time of the next dose, skip the missed
dose. Take your next dose at the regular time. Do not
double the dose to catch up
 Store at room temperature away from light and
moisture
32. NTG sublingual tablet  coronary artery disease  Headache,  Sit down before using this medication. Place 1 tablet
 angina dizziness, under the tongue and allow it to dissolve as directed
lightheadedness, by your doctor. Do not chew or swallow the tablet.
nausea, flushing, The dosage is based on your medical condition and
and response to treatment.
burning/tingling  If you are using this medication to prevent chest pain
under the tongue before physical activities, use it 5 to 10 minutes
before the activity.
 If you are using this medication to relieve chest pain
once it occurs, use it as soon as possible. If your chest
pain has not improved or if it has worsened 5 minutes
after you use this drug, call emergency medical help
(911). After calling the emergency number, use
another dose. Five minutes after the second dose, if
you still have chest pain and the ambulance has not
arrived, use a third dose. If your chest pain is not gone
after 15 minutes and 3 doses of nitroglycerin, call
emergency medical help (911) if you have not called

23
 already. Do not use more than 3 doses during an
attack unless directed by your doctor.
 To reduce the risk of dizziness and lightheadedness,
get up slowly when rising from a sitting or lying
position.
 Store at room temperature away from light, heat, and
moisture. Do not store in the bathroom. Keep in the
original glass bottle with the cap tightly closed
33. Fluoxetine tablet  major depressive disorder  Nausea,  Take this medication by mouth as directed by your
 obsessive-compulsive drowsiness, doctor, usually once daily in the morning. If you are
disorder, dizziness, anxiety, taking this medication twice a day, your doctor may
 panic disorder, trouble sleeping, direct you to take it in the morning and at noon.
loss of appetite,  The dosage is based on your medical condition and
tiredness, sweating, response to treatment. To reduce your risk of side
or yawning effects, your doctor may direct you to start this
medication at a low dose and gradually increase your
dose. Follow your doctor's instructions carefully. Take
this medication regularly to get the most benefit from
it. To help you remember, take it at the same time
each day.
 Keep taking this medication even if you feel well. Do
not stop taking this medication without first
consulting your doctor. Some conditions may become
worse when the drug is abruptly stopped. Your dose
may need to be gradually decreased.
 You should see some improvement in 1 to 2 weeks. It
may take 4 to 5 weeks before you feel the full benefit.
 This drug may make you dizzy or drowsy. Alcohol. Do
not drive when taking this medication
 If you miss a dose, take it as soon as you remember. If
it is near the time of the next dose, skip the missed
dose. Take your next dose at the regular time. Do not
double the dose to catch up
 Store at room temperature away from light and
moisture.
34. Haloperidol tablet  schizophrenia, Tourette  Dizziness,  Take this medication by mouth with or without food
syndrome lightheadedness, as directed by your doctor.
drowsiness,
24
 difficulty urinating,  Do not stop taking this medication without consulting
sleep disturbances, your doctor. Some conditions may become worse
headache, or when the drug is suddenly stopped. Your dose may
anxiety need to be gradually reduced.
 Dizziness and lightheadedness can increase the risk of
falling. Get up slowly when rising from a sitting or
lying position.
 This drug may make you dizzy or drowsy. Alcohol or
marijuana (cannabis) can make you more dizzy or
drowsy. Do not drive, use machinery, or do anything
that needs alertness until you can do it safely. Limit
alcoholic beverages
 This medication may make you sweat less, making you
more likely to get heat stroke. Avoid doing things that
may cause you to overheat, such as hard work or
exercise in hot weather, or using hot tubs. When the
weather is hot, drink a lot of fluids and dress lightly. If
you overheat, quickly look for a place to cool down
and rest. Get medical help right away if you have a
fever that does not go away, mental/mood changes,
headache, or dizziness.
 If you miss a dose, take it as soon as you remember. If
it is near the time of the next dose, skip the missed
dose. Take your next dose at the regular time. Do not
double the dose to catch up.
 Store at room temperature away from light and
moisture.
35. Phenytoin capsule  Epilepsy  Difficulty with  Take this medication by mouth with water. Take it as
 Seizures paying attention, directed on the prescription label at the same time
memory, or speech every day. Do not cut, crush or chew this medication.
 Dizziness Swallow the capsules whole. You can take it with or
 Drowsiness without food. You should always take it the same way.
 Headache Keep taking it unless your care team tells you to stop.
 If you miss a dose, take it as soon as you can. If it is
almost time for your next dose, take only that dose.
Do not take double or extra doses.
 You may get drowsy or dizzy. Do not drive, use
machinery, or do anything that needs mental
25
 alertness until you know how this medication affects
you. Do not stand or sit up quickly, especially if you
are an older patient. This reduces the risk of dizzy or
fainting spells. Alcohol may interfere with the effect of
this medication. Avoid alcoholic drinks.
 Birth control pills may not work properly while you
are taking this medication.
 This medication may cause a decrease in vitamin D
and folic acid. You should make sure that you get
enough vitamins while you are taking this medication.
 Take phenytoin two hours apart from a high-protein
meal (eg. with milk or meat)
 You can take it with or without food.
 Store at room temperature between 15 and 30
degrees C
36. Zolpidem tablet  Insomnia  Dizziness  Take this medication by mouth on an empty stomach
 Daytime drowsiness as directed by your doctor, usually once a night. Since
 Weakness, zolpidem works quickly, take it right before you get
 Lightheadedness, into bed. Do not take it with or after a meal because it
 "Drugged" feeling, will not work as quickly.
 Tiredness,  Do not take a dose of this drug unless you have time
 Loss of for a full night's sleep of at least 7 to 8 hours. If you
coordination, have to wake up before that, you may have some
 Stuffy nose, memory loss and may have trouble safely doing any
activity that requires alertness, such as driving or
operating machinery
 If you suddenly stop using this medication, you may
have withdrawal symptoms (such as nausea,
vomiting, flushing, stomach cramps, nervousness,
shakiness). To help prevent withdrawal, your doctor
may lower your dose slowly. Withdrawal is more likely
if you have used zolpidem for a long time or in high
doses.
 Though it helps many people, this medication may
sometimes cause addiction. This risk may be higher if
you have a substance use disorder (such as overuse of
or addiction to drugs/alcohol). Take this medication
exactly as prescribed to lower the risk of addiction.
26
  You may have trouble sleeping the first few nights
after you stop taking this medication. This is called
rebound insomnia and is normal. It will usually go
away after 1-2 nights. If this effect continues, contact
your doctor.
 The effects of this drug can last even after you wake
up the next day. If you did not get 7 to 8 hours of
sleep or took other medications that made you sleepy
or are more sensitive to this drug, you may feel alert
but not think clearly enough to drive. You may also
experience dizziness or blurred/double vision. Alcohol
or marijuana (cannabis) can make you more dizzy.
Wait at least 8 hours after taking this drug before
driving, and do not drive, use machinery, or do
anything that needs alertness until you can do it
safely. This medication may also increase the risk of
falls. Avoid alcoholic beverages. Talk to your doctor if
you are using marijuana (cannabis).
 If you miss a dose, do not take it unless you have time
to sleep for 7 to 8 hours afterwards.
 Store at room temperature away from light and
moisture
37. Diazepam tablet  anxiety, alcohol  drowsiness  Take this medication by mouth with a glass of water.
withdrawal, and seizures  tiredness or fatigue Follow the directions on the prescription label. If this
 muscle weakness medication upsets your stomach, take it with food or
 inability to control milk. Take your doses at regular intervals. Do not take
muscle movements your medication more often than directed. If you have
(ataxia) been taking this medication regularly for some time,
 headache do not suddenly stop taking it. You must gradually
 tremor reduce the dose, or you may get severe side effects.
 dizziness Ask your care team for advice. Even after you stop
 dry mouth or taking this medication it can still affect your body for
excessive saliva several days.
 nausea  You may get drowsy or dizzy. Do not drive, use
 constipation machinery, or do anything that needs mental
alertness until you know how this medication affects
you. To reduce the risk of dizzy and fainting spells, do
not stand or sit up quickly, especially if you are an
27
 older patient. Alcohol may increase dizziness and
drowsiness. Avoid alcoholic drinks.
 If you miss a dose, take it as soon as you can. If it is
almost time for your next dose, take only that dose.
Do not take double or extra doses
 Store at room temperature between 15 and 30
degrees C
38. Nalbuphine tablet  pain, for pre and  drowsiness;  Do not drink alcohol. Dangerous side effects or death
postoperative analgesia  dizziness, spinning could occur.
sensation;  Avoid driving or hazardous activity until you know
 dry mouth; how this medicine will affect you. Dizziness or
 headache; drowsiness can cause falls, accidents, or severe
 sweating; injuries.
 cold, clammy skin;  This drug may cause drowsiness and dizziness, if
or affected, do not drive or operate machinery.
 nausea, vomiting.  Avoid consuming alcohol when taking the
Nalbuphine, as it may cause excessive sleepiness or
drowsiness.
 This medicine has the potential to cause drug
dependence and abuse. This risk is especially higher if
the medicine is used for a prolonged period of time.
Patients should be monitored closely for any change
in mood and behavior during treatment with this
medicine. Abrupt discontinuation is not
recommended since it may cause withdrawal
symptoms. Withdrawal of therapy should be done
gradually with close monitoring of the patient.
 nalbuphine is usually given every 3 to 6 hours as
needed. Tell your doctor if the medicine seems to
stop working as well in relieving your pain. If you stop
using nalbuphine suddenly after long-term use, you
could have unpleasant withdrawal symptoms.
 This medicine may cause sleep-related breathing
problems (eg, sleep apnea, sleep-related hypoxemia).
Your doctor may decrease your dose if you have sleep
apnea (stop breathing for short periods during sleep)
while using this medicine.

28
39. Diphenhydramine  Common colds  Drowsiness,  Take the tablet, capsule, or liquid form by mouth with
tablet  Allergy dizziness, or without food.
 Hay fever constipation,  To prevent motion sickness, take your dose 30
stomach upset, minutes before starting an activity such as travel. To
blurred vision, or help you sleep, take your dose about 30 minutes
dry before bedtime. If you continue to have difficulty
mouth/nose/throat sleeping for longer than 2 weeks, contact your doctor.
 This drug may make you dizzy or drowsy or blur your
vision. Alcohol or marijuana (cannabis) can make you
more dizzy or drowsy. Do not drive, use machinery, or
do anything that needs alertness or clear vision until
you can do it safely. Avoid alcoholic beverages. Talk to
your doctor if you are using marijuana (cannabis).
 If you miss a dose, take it as soon as you remember. If
it is near the time of your next dose, skip the missed
dose. Take your next dose at the regular time. Do not
double the dose to catch up.
 Store at room temperature away from moisture and
light.
40. Methylprednisolone  arthritis, blood disorders,  Nausea, vomiting,  Take this medication by mouth as directed by your
tablet severe allergic reactions, heartburn, doctor, usually with food or milk. Follow your dosing
certain cancers, eye headache, instructions carefully. The dosage and length of
conditions, dizziness, trouble treatment are based on your medical condition and
skin/kidney/intestinal/lung sleeping, appetite response to treatment. Different dosing schedules
diseases, and immune changes, increased exist for this medication. If you are not taking the
system disorders sweating, or acne same dose each day or if you take this medication
every other day, it may help to mark your calendar
with a reminder.
 Do not increase your dose or use this drug more often
or for longer than prescribed. Your condition will not
improve any faster, and your risk of side effects will
increase.
 Do not stop taking this medication without consulting
your doctor. Some conditions may become worse
when this drug is suddenly stopped. Your dose may
need to be gradually decreased.
 If you suddenly stop using this medication, you may
have withdrawal symptoms (such as weakness, weight
29
 loss, nausea, muscle pain, headache, tiredness,
dizziness). To help prevent withdrawal, your doctor
may lower your dose slowly. Withdrawal is more likely
if you have used methylprednisolone for a long time
or in high doses. Tell your doctor or pharmacist right
away if you have withdrawal.
 This medication may make your blood sugar rise,
which can cause or worsen diabetes.
 This drug may make you dizzy. Alcohol or marijuana
(cannabis) can make you more dizzy. Do not drive, use
machinery, or do anything that needs alertness until
you can do it safely. Talk to your doctor if you are
using marijuana (cannabis).
 This medicine may cause stomach bleeding. Daily use
of alcohol while using this medicine may increase
your risk for stomach bleeding. Limit alcoholic
beverages
 If you are taking this medication once daily and miss a
dose, take it as soon as you remember. If it is near the
time of the next dose, skip the missed dose. Take your
next dose at the regular time. Do not double the dose
to catch up.
 Store at room temperature away from light and
moisture.
41. Insulin glargine  adults and children with  such as pain,  Do not inject cold insulin because this can be painful.
type 1 diabetes and adults redness, irritation) The insulin container you are currently using can be
with type 2 diabetes to or weight gain kept at room temperature (see also Storage section).
improve and maintain Wash your hands before measuring and injecting
glycemic control insulin. Before using, check the product visually for
particles, thickening, or clumps. If any are present,
discard that container. Insulin glargine should be clear
and colorless. To avoid damaging the insulin, do not
shake the container.
 You may inject insulin glargine once daily at any time
during the day (such as before breakfast or at
bedtime) but you should inject at the same time each
day.

30
 Before injecting each dose, make sure the injection
site is clean and dry. Inject this medication under the
skin of the abdomen, upper arms, or thighs as
directed by your doctor, usually once daily. Do not rub
the injection site. Do not inject into a vein or muscle.
Change where you inject each time to lessen the risk
of problems or damage under the skin (for example,
pits/lumps or thickened skin). Do not inject into skin
that is red, swollen, itchy, or damaged.
 This medication can cause low blood sugar
(hypoglycemia). This may occur if you do not consume
enough calories from food or if you do unusually
heavy exercise. Symptoms of low blood sugar include
sudden sweating, shaking, fast heartbeat, hunger,
blurred vision, dizziness, or tingling hands/feet. It is a
good habit to carry glucose tablets or gel to treat low
blood sugar. If you don't have these reliable forms of
glucose, rapidly raise your blood sugar by eating a
quick source of sugar such as table sugar, honey, or
candy, or drink fruit juice or non-diet soda. Tell your
doctor right away about the reaction and the use of
this product. To help prevent low blood sugar, eat
meals on a regular schedule, and do not skip meals.
 You may experience blurred vision, dizziness, or
drowsiness due to extremely low or high blood sugar.
Do not drive, use machinery, or do any activity that
requires alertness or clear vision until you are sure
you can perform such activities safely.
 Limit alcohol while taking this medication because it
can increase the risk of developing low blood sugar.
 Store all unopened insulin containers in the
refrigerator. Do not freeze, and do not use insulin that
has been frozen. If you are using the vials, store open
vials in the refrigerator or at room temperature. Store
vials and pens away from direct heat and light. Store
in the carton to protect from light. Do not refrigerate
cartridges or pens that are currently in use. Discard all
containers in use after 28 days, even if there is insulin
31
 left. Also discard all insulin products after the
expiration date on the package.
42. Insulin aspart  treatment of type-1 and  such as pain,  Before injecting each dose, clean the injection site
type-2 diabetes mellitus redness, irritation) with rubbing alcohol. Change where you inject each
or weight gain time to lessen the risk of problems or damage under
the skin (for example, pits/lumps or thickened skin).
Insulin aspart may be injected in the stomach area,
the thigh, the buttocks, or the back of the upper arm.
Do not inject into skin that is red, swollen, itchy, or
damaged. Do not inject cold insulin because this can
be painful. The insulin container you are currently
using can be kept at room temperature.
 Inject this medication under the skin as directed by
your doctor, usually 5 to 10 minutes before meals. Do
not inject into a vein or muscle because very low
blood sugar (hypoglycemia) may occur. Because this
insulin is fast-acting, do not use insulin aspart if you
are unable to eat right after the injection or if you
have low blood sugar. Not eating right after a dose of
this insulin may lead to low blood sugar
(hypoglycemia). Do not rub the area after the
injection.
 You may experience blurred vision, dizziness, or
drowsiness due to extremely low or high blood sugar.
Do not drive, use machinery, or do any activity that
requires alertness or clear vision until you are sure
you can perform such activities safely.
 Limit alcohol while taking this medication because it
can increase your risk of developing low blood sugar.
 It is very important to follow your insulin regimen
exactly. Ask your doctor ahead of time what you
should do if you miss a dose of insulin.
 Different brands of this medication have different
storage needs. Check the product package for
instructions on how to store your brand, or ask your
pharmacist. Protect insulin from light and heat. Do
not store in the bathroom. Do not freeze, and do not
use insulin that has been frozen. Throw away all
32
 insulin aspart in use after 28 days, even if there is
insulin left. Also throw away all insulin products after
the expiration date on the package.
43. Glibenclamide tablet  Second-line treatment of  nausea, vomiting,  Glibenclamide is used orally. Patients should take a
type 2 diabetes, in diarrhea and single dose at breakfast or the first main meal. During
patients under 60 years constipation. treatment, patients need to coordinate with diet and
physical activity, exercise and sports.
 The dose of Glibenclamide depends on the patient's
blood glucose level. Before each course of treatment,
it is necessary to check the blood sugar level of each
patient.
 This drug should be taken orally once daily after
breakfast or after the first meal of the day.
 Alcohol intake should be stopped while taking this
drug since the combination can result in an
unpleasant reaction called disulfiram-type reaction.
 Also, alcohol can also cause additional reduction in
blood glucose levels.
 In case the patient forgets a dose of Glibenclamide bp
5mg, it should be taken as soon as he remembers. If it
is almost time for your next dose, skip the missed
dose and take your next dose as scheduled. Do not
take twice the prescribed dose of Glibenclamide.
 Should be stored at room temperature, keep it away
from heat
44. Metformin tablet  type 2 diabetes  Nausea, vomiting,  Take this medication by mouth as directed by your
 PCOS stomach upset, doctor, usually 1 to 3 times a day with meals. Drink
diarrhea, weakness, plenty of fluids while taking this medication unless
or a metallic taste otherwise directed by your doctor.
in the mouth  Take this medication regularly in order to get the most
benefit from it. Remember to use it at the same times
each day.
 Metformin does not usually cause low blood sugar
(hypoglycemia). Low blood sugar may occur if this
drug is prescribed with other diabetes medications.
 Rarely, too much metformin can build up in the body
and cause a serious (sometimes fatal) condition called
lactic acidosis. Lactic acidosis is more likely if you are
33
 an older adult, if you have kidney or liver disease,
dehydration, heart failure, heavy alcohol use, if you
have surgery, if you have X-ray or scanning procedures
that use iodinated contrast, or if you are using certain
drugs.
 You may experience blurred vision, dizziness, or
drowsiness due to extremely low or high blood sugar.
Do not drive, use machinery, or do any activity that
requires alertness or clear vision until you are sure
you can perform such activities safely.
 Limit alcohol while using this medication because it
can increase your risk of lactic acidosis and
developing low blood sugar.
 If you miss a dose, take it as soon as you remember
with food. If it is near the time of the next dose, skip
the missed dose. Take your next dose at the regular
time. Do not double the dose to catch up.
 Store at room temperature away from light and
moisture.
45. Vitamin B complex  sleep disturbances,  Mild upset stomach  Take this medication by mouth, usually once daily or
irritability, fatigue, anemia, or flushing as directed. Follow all directions on the product
mental health symptoms, package. If you have any questions, ask your doctor or
and dermatitis, pharmacist.
 If you are taking a brand that contains vitamin C, take
this medication by mouth with a full glass of water (8
ounces/240 milliliters) unless your doctor directs you
otherwise.
 If you are taking chewable tablets, chew the tablet
thoroughly before swallowing.
 If you are taking extended-release capsules, swallow
them whole. Do not crush or chew extended-release
capsules or tablets. Doing so can release all of the
drug at once, increasing the risk of side effects.
Swallow the whole tablet without crushing or
chewing.
 If you are taking this product on a regular schedule
and miss a dose, take it as soon as you remember. If it
is near the time of the next dose, skip the missed
34
 dose. Take your next dose at the regular time. Do not
double the dose to catch up.
 You can take it in an empty stomach but if it vit b12 its
more better to take it with food as it absorbed better
46. Ferrous sulfate tablet  Anemia  Constipation,  Iron is best absorbed on an empty stomach (usually if
diarrhea, stomach taken 1 hour before or 2 hours after meals). If
cramps, or upset stomach upset occurs, you may take this medication
stomach with food. See the instructions below for the liquid
drops for infants/children. Avoid taking antacids, dairy
products, tea, or coffee within 2 hours before or after
this medication because they will decrease its
effectiveness.
 Take tablets or capsules with a full glass of water (8
ounces or 240 milliliters) unless otherwise directed by
your doctor. Do not lie down for at least 10 minutes
after taking your tablet or capsule dose.
 Swallow extended-release capsules whole. Do not
crush or chew extended-release capsules or tablets.
Doing so can release all of the drug at once,
increasing the risk of side effects. Also, do not split
extended-release tablets unless they have a score line
and your doctor or pharmacist tells you to do so.
Swallow the whole or split tablet without crushing or
chewing.
 Avoid taking this medication at the same time as
antacids. Wait at least 2 hours between taking this
medication and an antacid.
 If you are taking this product on a prescribed schedule
and miss a dose, take it as soon as you remember. If it
is near the time for the next dose, skip the missed
dose. Take your next dose at the regular time. Do not
double the dose to catch up.
 Store at room temperature away from light and
moisture.
47. POPs  Preventing pregnancy  acne  These pills should be taken at the same time each day.
 breast tenderness Choose a time when you are most likely to remember
and breast to take the pill daily. You can fall pregnant if you take
enlargement your pill more than 3 hours late. It can be helpfull to
35
 an increased or set a reminder on your phone or put your pill pack
decreased sex drive next to your toothbrush.
 mood changes  POPs are immediately effective if started during the
 headache and first five days of your menstrual cycle, which start
migraine with the first day of bleeding. If you start at any other
 nausea or vomiting time during your menstrual cycle, these pills will start
to work after you taken the first 3 pills correctly. Other
contraceptive measures such as condoms should be
used during these days, while you are waiting for the
POP to start working.
 If you are more than 3 hours late taking the mini-pill
(also known as Microlut or Noriday), it will not be
effective at preventing pregnancy.
 If this happens, you should:
 take one pill as soon as possible and take the next pill
at the usual time
 continue taking your pills as usual (it will start to work
again after you have taken 3 pills correctly)
 use condoms or don't have sex until you have taken 3
pills correctly
 If you had sex while you weren't protected and did
not use any other contraception, you may be at risk of
pregnancy.
 You should consider using the emergency
contraceptive pill, available from a pharmacy without
a prescription.
 There are 28 pills in a pack of progestogen-only pills.
You need to take 1 pill every day within either 3 or 12
hours of the same time each day, depending on which
type you're taking.
 There's no break between packs of pills – when you
finish a pack, you start the next one the next day.
 If you've just had a baby, you can start the
progestogen-only pill any time between day 1 and day
21 after the birth. You'll be protected against
pregnancy straight away.

36
 If you start the progestogen-only pill more than 21
days after giving birth, use additional contraception
such as condoms until you've taken the pill for 2 days.
 If you've had a miscarriage or abortion, you can start
the progestogen-only pill up to 5 days afterward and
you'll be protected from pregnancy straight away.
 If you start the pill more than 5 days after a
miscarriage or abortion, use additional contraception
until you've taken the pill for 2 days.
 What to do if you miss a pill
 If you forget to take a progestogen-only pill, what
you should do depends on:
 the type of pill you're taking
 how long ago you missed the pill
 how many pills you've forgotten to take
 whether you've had sex without using another type
of contraception in the previous 7 days
 If you're less than 3 or less than 12 hours late taking
the pill
 If you're taking a 3-hour progestogen-only pill and are
less than 3 hours late taking it, or if you're taking the
12-hour progestogen-only pill and are less than 12
hours late:
 take the late pill as soon as you remember, and
 take the remaining pills as normal, even if that means
taking 2 pills on the same day
 The pill will still work, and you'll be protected against
pregnancy – you do not need to use additional
contraception.
 Do not worry if you've had sex without using another
form of contraception. You do not need emergency
contraception.
 If you're more than 3 or more than 12 hours late
taking the pill
 If you're taking a 3-hour progestogen-only pill and are
more than 3 hours late taking it, or you're taking the
12-hour progestogen-only pill and are more than 12

37
 hours late, you will not be protected against
pregnancy.
 What you should do:
 take a pill as soon as you remember – only take 1,
even if you've missed more than 1 pill
 take the next pill at the usual time – this may mean
taking 2 pills on the same day (1 when you remember
and 1 at the usual time); this is not harmful
 carry on taking your remaining pills each day at the
usual time
 use extra contraception such as condoms for the next
2 days (48 hours) after you remember to take your
missed pill, or do not have sex
 if you have unprotected sex from the time that you
miss your pill until 2 days after you start taking it
reliably again, you may need emergency
contraception – get advice from your contraception
clinic or GP
 tell them that you've been taking the progestogen-
only pill as this can affect which emergency
contraception is best for you to take
 It takes 2 days for the progestogen-only pill to thicken
cervical mucus so sperm cannot get through or
survive.
 The Faculty of Sexual Health and Reproductive
Healthcare recommends using extra contraception for
2 days after you remember to take your pill.
 The patient information leaflet that comes with your
pill might say to use condoms for the next 7 days after
you remember to take your pill. This is because it
takes 7 days for the pill to stop you ovulating.
48. COPs  PMS (premenstrual   The standard way to take the pill is to take 1 every day
syndrome) or for 21 days, then have a break for 7 days, and during
endometriosis this week you have a bleed like a period. You start
taking the pill again after 7 days.
 You may be able to take some types of pill with no or
shorter breaks (a tailored regime), which may reduce

38
 some side effects. Speak to a doctor or nurse about
your options.
 You need to take the pill at around the same time
every day. You could get pregnant if you do not do
this, or if you miss a pill, or vomit or have severe
diarrhoea.
 Some medicines may make the pill less effective.
Check with your doctor if you're taking any other
tablets.
 How it prevents pregnancy
 The pill prevents the ovaries from releasing an egg
each month (ovulation). It also:
 thickens the mucus in the neck of the womb, so it is
harder for sperm to penetrate the womb and reach
an egg
 thins the lining of the womb, so there is less chance of
a fertilised egg implanting into the womb and being
able to grow
 Monophasic 21-day pills
 This is the most common type. Each pill has the same
amount of hormone in it. One pill is taken each day
for 21 days and then no pills are taken for the next 7
days. Microgynon, Marvelon and Yasmin are examples
of this type of pill.
 Phasic 21-day pills
 Phasic pills contain 2 or 3 sections of different
coloured pills in a pack. Each section contains a
different amount of hormones. One pill is taken each
day for 21 days and then no pills are taken for the
next 7 days. Phasic pills need to be taken in the right
order. Logynon is an example of this type of pill.
 Every day (ED) pills
 There are 21 active pills and 7 inactive (dummy) pills
in a pack. The two types of pill look different. One pill
is taken each day for 28 days with no break between
packets of pills. Every day pills need to be taken in the
right order. Microgynon ED is an example of this type
of pill.
39
 Follow the instructions that come with your packet. If
you have any questions, ask a doctor, nurse or
pharmacist.
 It's important to take the pills as instructed, because
missing pills or taking them at the same time as
certain medicines may make them less effective.
 How to take 21-day pills - standard regime
 Take your 1st pill from the packet marked with the
correct day of the week, or the 1st pill of the 1st
colour (phasic pills).
 Continue to take a pill at the same time each day until
the pack is finished.
 Stop taking pills for 7 days (during these 7 days you
will get a bleed).
 Start your next pack of pills on the 8th day, whether
you are still bleeding or not. This should be the same
day of the week as when you took your 1st pill.
 How to take every day pills
 Take the 1st pill from the section of the packet
marked "start". This will be an active pill.
 Continue to take a pill every day, in the correct order
and preferably at the same time each day, until the
pack is finished (28 days).
 During the 7 days of taking the inactive pills, you will
get a bleed.
 Start your next pack of pills after you have finished
the 1st pack, whether you are still bleeding or not.
 Tailored regimes
 You can also take the combined pill as a tailored
regime. This may include taking the pill for 21 days
and stopping for 4, or taking the pill continuously
without a break. For more information speak to a
doctor or nurse.
 Starting the combined pill
 You can normally start taking the pill at any point in
your menstrual cycle. There is special guidance if you
have just had a baby, abortion or miscarriage. The
guidance may also be different if you have a short
40
 menstrual cycle. Get advice from a doctor or nurse if
you need it. You may need to use additional
contraception during your 1st days on the pill – this
depends on when in your menstrual cycle you start
taking it.
 Starting on the 1st day of your period
 If you start the combined pill on the 1st day of your
period (day 1 of your menstrual cycle) you will be
protected from pregnancy straight away. You will not
need additional contraception.
 Starting on the 5th day of your cycle or before
 If you start the pill on the 5th day of your period or
before, you will still be protected from pregnancy
straight away.
 Starting after the 5th day of your cycle
 You will not be protected from pregnancy straight
away and will need additional contraception until you
have taken the pill for 7 days.
 If you start the pill after the 5th day of your cycle,
make sure you have not put yourself at risk of
pregnancy since your last period. If you're worried
you're pregnant when you start the pill, take a
pregnancy test 3 weeks after the last time you had
unprotected sex.
 What if I have missed 1 pill?
 If you have missed 1 pill anywhere in the pack or
started a new pack 1 day late, you're still protected
against pregnancy.
 You should:
 take the last pill you missed now, even if this means
taking 2 pills in 1 day
 carry on taking the rest of the pack as normal
 take your 7-day pill-free break as normal, or if you're
on an everyday (ED) pill, take your dummy (inactive)
pills
 You do not need to use extra contraception.
 What if I have missed 2 or more pills?

41
 If you have missed 2 to 7 pills anywhere in the pack or
started a new pack 2 or more days late (48 hours or
more), your protection against pregnancy may be
affected.
 What you need to do next depends on how far into
the pack you are.
 Week 1 (days 1 to 7)
 If you’ve missed 2 to 7 pills in the first week of a pack,
or you’ve started a new pack 2 or more days late, you
may need emergency contraception if you’ve had
unprotected sex. Contact a sexual health clinic,
doctor, nurse, or pharmacist urgently.
 Take the last pill you missed, even if that means taking
2 in a day, and leave any earlier missed pills. Use extra
contraception, such as condoms, for the next 7 days.
 Then take the rest of the pills in your pack as normal.
Take your 7-day pill-free break or dummy pills as
normal too before you begin your next pack.
 Week 2 (days 8 to 14)
 If you’ve missed 2 to 7 pills in week 2 of a pack, take
the last pill you missed even if that means taking 2
pills in a day and leave any earlier missed pills.
 You do not need emergency contraception, but use
extra contraception, such as condoms, for the next 7
days.
 Then take the rest of the pills in your pack as normal.
Take your 7-day pill break or dummy pills as normal
too before you begin your next pack.
 Week 3 (days 15 to 21)
 If you’ve missed 2 to 7 pills in week 3 of a pack, take
the last pill you missed even if that means taking 2
pills in a day and leave any earlier missed pills.
 You do not need emergency contraception, but use
extra contraception, such as condoms, for the next 7
days.
 If your pack usually has 21 pills in it, take the rest of
the pills in your pack as normal and start a new pack
the next day.
42
  If your pack usually has 28 pills in it, take the rest of
the active pills (the first 21 pills in the pack) as usual.
When you have taken the last of the active pills, start
a new pack the next day.
 This means you do not have your pill-free break or
your dummy pills.
 You may not have a withdrawal bleed like you are
used to.
 More than 7 pills missed
 If you've missed 8 or more pills straight after each
other, you will not be protected against pregnancy. If
you have had unprotected sex, you may need to do a
pregnancy test or take emergency contraception.
 Contact a sexual health clinic, doctor, nurse or
pharmacist urgently.
49. Nicotine patch  Quit smoking  Mild itching,
redness, burning,  Put patch on clean, dry, healthy skin on the chest,
and stinging back, belly, or upper arm. Move the site with each
new patch.
 Put patch on a site without hair.
 Wash your hands after use.
 Each patch can stay on for 16 to 24 hours. If you crave
cigarettes when you wake up, wear the patch for 24
hours.
 Do not leave on the skin for more than 24 hours.
 Do not put on more than 1 patch at a time.
 Do not use patches that are cut or do not look right.
 What do I do if I miss a dose?
 Use a missed dose as soon as you think about it.
 If it is close to the time for your next dose, skip the
missed dose and go back to your normal time.
 Do not use 2 doses at the same time or extra doses.
 The patch comes in 3 doses. If you smoke 11 or more
cigarettes a day start with the 21 mg patch (step 1). If
you smoke 10 or less cigarettes a day start with the 14
mg patch (step 2).

43
 Put patch on clean, dry, healthy skin on the chest,
back, belly, or upper arm. Move the site with each
new patch.
 Put patch on a site without hair.
 Wash your hands after use.
 Each patch can stay on for 16 to 24 hours. If you crave
cigarettes when you wake up, wear the patch for 24
hours.
 Do not leave on the skin for more than 24 hours.
 Do not put on more than 1 patch at a time.
 Do not use patches that are cut or do not look right.
 What do I do if I miss a dose?
 Use a missed dose as soon as you think about it.
 If it is close to the time for your next dose, skip the
missed dose and go back to your normal time.
 Do not use 2 doses at the same time or extra doses.

 The patch should be applied to a clean, dry, non-hairy
area on the trunk or upper arm. Check the
manufacturer's instruction sheet for recommended
areas to place the patch. If necessary, clip hair from
the site before applying the patch. Do not shave the
area. Remove the patch from the package, peel off
the protective strip, and immediately apply the patch
to the skin. Press firmly for 10 to 20 seconds to make
sure the patch stays in place. Be sure the edges are
held firmly to the skin. Wash your hands with plain
water after applying the patch. Do not use soap.

The best dose for you is the dose that decreases the
urge to smoke without side effects from too much
nicotine. If your doctor has prescribed this
medication, follow your doctor's orders carefully. Your
dose will need to be adjusted to your needs, including
smoking history and medical condition.

Different brands of nicotine patches have different

amounts of nicotine and different instructions for how
44
long to leave the patch on the skin (such as for 24
hours or only while awake). Consult your doctor or
pharmacist about which brand of patch to use. If you
wake up craving cigarettes, the 24-hour patch may be
best. If the patch causes vivid dreams or interferes
with sleep, you may need to wear the patch only
while awake (16 hours each day).

Do not apply the patch to red/cut/irritated skin or

over other skin products (such as makeup, lotions,
powders). Do not use the patch if the individual
pouch is open or damaged or if the patch is cut, torn,
or damaged. Apply the patch to a different area on
your body each time to avoid irritation. Wait at least a
week before using the same application site. Apply a
new patch if your patch falls off.

Do not wear a patch for more than 24 hours. Do not

wear more than 1 patch at a time. After removing
each patch, fold it in half so it sticks to itself, and
discard in the trash away from children and pets.

Use a new patch each day, applying it at the same

time each day to help you remember, usually when
you wake up. After several weeks, you will gradually
lower your dose (strength of patch) until you no
longer need nicotine replacement. It is important to
complete the treatment with this medication (8 to 10
weeks). If after the treatment period, you still feel the
need to use this medication to prevent you from
smoking, talk to your doctor.

If you suddenly stop using this medication, you may

have withdrawal symptoms (such as tobacco cravings,
nervousness, irritability, headache). To help prevent
withdrawal, your doctor may lower your dose slowly.
Withdrawal is more likely if you have used nicotine for

45
 a long time or in high doses. Tell your doctor or
pharmacist right away if you have withdrawal.

If you forget to change your patch on time, change it

as soon as you remember. You can change your next
patch 24 hours later or go back to your usual dosing
schedule. Do not double the dose to catch up.

Storage
Store in original packaging at room temperature away
from light and moisture. Do not store in the
bathroom. Keep patches in the sealed protective
pouch until ready to use. Apply patch immediately
after removing from pouch. Do not use if the pouch is
damaged, cut, or opened ahead of time.

Strenuous exercise may raise your skin temperature

and increase the amount of nicotine absorbed
through the skin. Talk with your doctor about the
effects of exercise on this medication.

Avoid exposing the skin under the patch to direct heat

sources such as heating pads, electric blankets, heat
lamps, saunas, hot tubs, heated water beds, or
prolonged direct sunlight while wearing your patch.
Heat sources may cause more drug to be released
into your body, increasing the chance of side effects.
50. Nicotine gum  Quit smoking   Recommended dose:
 First cigarette within 30 minutes of waking up: 4 mg
 First cigarette more than 30 minutes after waking up:
2 mg
Recommended regimen:
 Weeks 1 to 6: 1 piece of gum orally every 1 to 2 hours
 Weeks 7 to 9: 1 piece of gum orally every 2 to 4 hours
 Weeks 10 to 12: 1 piece of gum orally every 4 to 8
hours
 Maximum dose: 24 pieces/day

46
 The patch comes in 3 doses. If you smoke 11 or more
cigarettes a day start with the 21 mg patch (step 1). If
you smoke 10 or less cigarettes a day start with the 14
mg patch (step 2).
 Put patch on clean, dry, healthy skin on the chest,
back, belly, or upper arm. Move the site with each
new patch.
 Put patch on a site without hair.
 Wash your hands after use.
 Each patch can stay on for 16 to 24 hours. If you crave
cigarettes when you wake up, wear the patch for 24
hours.
 Do not leave on the skin for more than 24 hours.
 Do not put on more than 1 patch at a time.
 Do not use patches that are cut or do not look right.
 What do I do if I miss a dose?
 Use a missed dose as soon as you think about it.
 If it is close to the time for your next dose, skip the
missed dose and go back to your normal time.
 Do not use 2 doses at the same time or extra doses.

 Do not eat or drink anything for 15 minutes before or
during use of the gum. Do not use if the individual
wrapper is open or damaged.
 Start this medication on your quit (smoking) day.
Chew a piece of gum when you feel the urge to
smoke. Chew the gum very slowly until it tingles, then
move it to the space between your cheek and gum.
Keep it there until it stops tingling. When the tingle is
gone, begin chewing again until the tingle returns.
Most of the nicotine will be gone after 30 minutes. Do
not use more than 1 piece of gum at a time. You may
also use this product on a regular schedule as well as
at times when you have the urge to smoke. The best
dose for you is the dose that decreases the urge to
smoke without side effects from too much nicotine.
Your dose will need to be adjusted to your needs,
including your smoking history and medical condition.
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 For the first 6 weeks, use at least 9 pieces each day. If
you still have a strong urge to smoke, you can use a
second piece of gum within 1 hour. Do not
continuously use 1 piece right after another. Doing so
will increase side effects such as hiccups, nausea, or
heartburn. Most people use about 9 to 12 pieces of
gum per day during the first month of treatment. Do
not chew more than 24 pieces of gum a day.
 After you have stopped smoking and you have
reached the best dose and schedule for you, continue
at that dose. Start to lower your dose after 6 weeks or
as directed by your doctor until you are no longer
smoking and no longer need nicotine replacement. It
is important to complete the treatment with this
medication (12 weeks). If after the treatment period,
you still feel the need to use this medication to
prevent you from smoking, talk to your doctor.
 If you suddenly stop using this medication, you may
have withdrawal symptoms (such as tobacco cravings,
nervousness, irritability, headache). To help prevent
withdrawal, your doctor may lower your dose slowly.
Withdrawal is more likely if you have used nicotine for
a long time or in high doses. Tell your doctor or
pharmacist right away if you have withdrawal.
 Some smokers are unsuccessful the first time they try
to quit. You may need to stop using this product and
try again later. Many people who cannot quit the first
time are successful the next time.
 Mouth/teeth/jaw problems, headache, heartburn,
sweating, or diarrhea
 Chewing the gum too fast can cause lightheadedness,
dizziness, hiccups, nausea, vomiting, or trouble
sleeping. If these effects occur, chew the gum more
slowly.
 If you are using this on a regular schedule and you
miss a dose, use it as soon as you remember. If it is
near the time of the next dose, skip the missed dose.

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 Use your next dose at the regular time. Do not double
the dose to catch up.

 Storage
 Store at room temperature away from light and
moisture. Do not store in the bathroom. Wrap the
used piece of gum in a piece of paper and discard in
the trash away from children and pets. Keep all
medications away from children and pets.
51. Male condom  prevent pregnancy by  irritation  DO use a condom every time you have sex.
stopping sperm from  DO put on a condom before having sex.
meeting an egg  DO read the package and check the expiration date.
 DO make sure there are no tears or defects.
 DO store condoms in a cool, dry place.
 DO use latex or polyurethane condoms.
 DO use water-based or silicone-based lubricant to
prevent breakage.
 DON’T store condoms in your wallet as heat and
friction can damage them.
 DON’T use nonoxynol-9 (a spermicide), as this can
cause irritation.
 DON’T use oil-based products like baby oil, lotion,
petroleum jelly, or cooking oil because they will cause
the condom to break.
 DON’T use more than one condom at a time.
 DON’T reuse a condom.
 STEPS:
 Carefully open and remove condom from wrapper.
 Place condom on the head of the erect, hard penis. If
uncircumcised, pull back the foreskin first.
 Pinch air out of the tip of the condom
 Unroll condom all the way down the penis.
 After sex but before pulling out, hold the condom at
the base. Then pull out, while holding the condom in
place.
 Carefully remove the condom and throw it in the
trash.

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 Make sure the condom is in good condition and not
torn or expired (check the date on the package).
 Carefully open the wrapper and take out the condom.
 Place it on the tip of your fully erect penis. The rolled
side should be facing out. If you’re uncircumcised, pull
back the foreskin first.
 Leave a half-inch of space at the tip where the semen
can collect when you ejaculate. This helps prevent the
condom from breaking. Some condoms have reservoir
tips that leave the space for you.
 Pinch the air out of the tip of the condom.
 Unroll it all the way down your penis.
 Use enough lubrication so the condom doesn't break.
You can use a water-based lubricant, such as K-Y Jelly
or Astroglide. Don't use an oil-based lubricant such as
Vaseline, body lotion, baby oil, or massage oil because
it can weaken the latex and cause the condom to
break.
 When sex is finished, but before your penis gets soft,
grab the rim of the condom to hold it in place while
you pull out. Gently pull out from your partner. Slide
the condom off your penis, making sure you don't
spill any semen.
 Wrap the condom in a tissue and throw it away in a
place where other people won't touch it.

 Make sure you don’t tear the condom when you open
the package.
 Throw it out if it’s brittle, stiff, sticky, or expired.
 Put it on after your penis is erect and before it
touches any part of your partner.
 Keep it on the entire time, from start to finish.
 Use a new one every time. That means for every
erection.
 If the condom doesn’t have a reservoir tip, pinch the
end to leave about a half inch of space to collect the
semen when you ejaculate.
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 If you feel it break or tear during sex, stop right away,
pull out, and put on a new condom.
 When you remove it, make sure the semen doesn’t
spill out.

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