Public Health Articles

Finasteride (Propecia)

CheTeam — Fri, 04 Mar 2011 00:18:37 +0000

Finasteride (marketed as Proscar, Propecia, Fincar, Finpecia, Finax, Finast, Finara, Prosteride) is an antiandrogen which acts by inhibiting 5-alpha reductase, the enzyme that converts testosterone to dihydrotestosterone. It is used in benign prostatic hyperplasia (BPH) in low doses, and in prostate cancer in higher doses. It is also indicated for use in combination with doxazosin therapy to reduce the risk for symptomatic progression of BPH. Additionally, it is registered in many countries for male-pattern baldness.
Finasteride was approved initially in 1992 as Proscar, a treatment for prostate enlargement, but the sponsor had studied 1 mg of finasteride and demonstrated hair growth in male pattern hair loss. In December 22, 1997, FDA approved finasteride to treat male pattern hair loss.
The Prostate Cancer Prevention Trial (PCPT) showed at a dosage of 5mg per day, as is commonly prescribed for BPH, though much higher than the 1mg generally prescribed for hair loss, participants taking finasteride were 25% less likely to have developed prostate cancer at the end of the trial compared to those taking a placebo. However, the cancers that developed in the men taking finasteride looked like they were more likely to grow and spread. The reason for this is not known. The study researchers are continuing to watch these men to see if these cancers truly are more aggressive. At lower doses, this effect is less well-defined.
Recognised side-effects, experienced by around 6%-19% of users, include erectile dysfunction, and less often gynecomastia (breast gland enlargement). In trial studies, side effects ceased after dosage was discontinued.
Drug trade names include Propecia and Proscar, both products of Merck & Co. (the former is marketed for hair loss in male pattern baldness, and the latter for BPH). There is 1 mg of finasteride in Propecia and 5 mg in Proscar
Cipla is also manufacturing finasteride (trade names Fincar and Finpecia), as is Dr. Reddy’s (trade names Finax and Finast), Ranbaxy (trade name Finara), and Aleppo Pharmaceutical (trade name Prosteride).
On June 19, 2006, Merck’s patents on Proscar and Propecia expired and the FDA approved a first-time generic formulation for finasteride 5 mg tablets.
Finasteride is not indicated for use by women. Do not take or handle this medication if you are pregnant or could become pregnant during treatment. Finasteride is in the FDA pregnancy category X. This means that it is known to cause birth defects in an unborn baby. Women who are or who may become pregnant must not handle crushed or broken Finasteride tablets. The medication could be absorbed through the skin. Propecia is known to cause birth defects in a developing male baby. Exposure to whole tablets should be avoided whenever possible, however exposure to whole tablets is not expected to be harmful as long as the tablets are not swallowed. It is not known whether Finasteride passes into breast milk. Finasteride is not intended for use by women and this medication should not be taken if you are breast-feeding a baby. It appears that Finasteride can pass into the semen of men, thus, at certain dosages, caution should be used to avoid ingestion of semen during oral sex if a woman is pregnant or may become pregnant.
Finasteride can also be used to mask steroid abuse, and many professional sports have banned finasteride use for this reason.
Finasteride is taken orally and has a reported 29-68% success rate (vs 17-45% in patients receiving a placebo). It is effective only for as long as it is taken; the hair gained or maintained is lost within 6-12 months of ceasing therapy (Rossi, 2004). In clinical studies, Propecia, like Minoxodil, was shown to work on both the crown area and the hairline, but is most successful in the crown area.
Some users, in an effort to save money, buy Proscar instead of Propecia, and split the Proscar pills to approximate the Propecia dosage.
Propecia has been shown to be ineffective for treating hair loss in women. However, Propecia’s supporters respond that the study was on post-menopausal women whose hairloss was more likely related to the loss of estrogen versus a sensitivity to testosterone. Other studies have shown that Propecia is effective for many women with follicular sensitivity to androgens. Many doctors do prescribe it for women, but not without either careful birth control measures or assurance that the woman cannot become pregnant.
The UC Berkeley Wellness Letter expressed concern in March 2003 about the unproven long-term safety of Propecia and recommended cutting a standard 1 milligram dose into quarters to reduce the cost without reducing its effectiveness.. This claim appears to be supported by clinical pharmacological data reviewed by the FDA during Propecia’s approval process that suggested that the advantage of taking 1 mg per day over 0.2 mg per day is statisticially small. Some people have unsuccessfully petitioned the FDA to re-examine the approved dosage in light of the statistical evidence and unknown long-term risks. The FDA responded and said that just because the level of DHT found in the scalp was not signifigantly different does not mean there is a correlation with hair loss. A study would have to show that the benefits of using 0.2 mg and 1 mg were not statistically different. According to the FDA such a study has been performed and a 1 mg dose has a greater benefit.
Supporters of Propecia respond that while the drug must be taken for a lifetime in order to avoid losing hair, future treatments are widely expected by baldness specialists to replace Propecia, which would end the need for continued use. In addition, Propecia is widely considered safe enough to prescribe by health professionals, and is one of the only two FDA-approved baldness treatment products on the market.
DHT is a derivative hormone (metabolite) of testosterone that has been shown to be critical to the initiation and progression of follicular miniaturization and eventual destruction of hair follicles in male pattern baldness. DHT is a steroid hormone just like testosterone but with greater affinity for the androgen receptor. Converting Testosterone to DHT thus increases many of its effects.
While the mechanism by which DHT is involved in hair loss is not confirmed, many dermatologists and research scientists specializing in hair loss believe DHT molecules may diffuse into the interior of hair follicle cells (the cytoplasm or cytosol) and bind with androgen receptors. This complex, both the receptor and the DHT molecule, then enters the nucleus of the cell. In the nucleus of the hair follicle cell this complex could then alter the rate of protein synthesis in men who are genetically predisposed to baldness.
However, DHT also plays an important role in the functioning of the central nervous system (the brain), the testicles and prostate, and almost everything but muscle tissue. In muscle tissue testosterone is the dominant hormone, which is why some bodybuilders inject testosterone derivatives to aid in muscular development.
Propecia (and other products containing finasteride) cause a rise in testosterone levels because testosterone that would normally be converted into DHT remains testosterone. Continual high levels of testosterone in the body could possibly have negative side effects.
Artificially low levels of DHT in the body could cause some unwanted conditions. DHT is an antagonist of estrogen. Men’s bodies also produce the female hormone estrogen in the adrenal glands, although this is just one-tenth of the estrogen that premenopausal women produce in their ovaries. By reducing DHT with drugs, a man’s protection from the effects of estrogen may also be reduced. This could result in gynecomastia.
Even though both finasteride and dutasteride were developed to combat benign prostatic hyperplasia by reducing DHT in prostate tissue, some scientists question the wisdom of using these 5-alpha reductase inhibitors in younger men who have no problem with their prostates. A research chemist, Pat Arnold, says “Evidence is mounting that the existence of a high estrogen/androgen ratio – a condition common in older men – is highly correlated with the development of benign prostatic hyperplasia.”
^ Layden, J., Dunlap F, Miller B, Winters P, Lebwohl M, Hecker D, et al. (in press). “Finasteride in the treatment of men with frontal male pattern hair loss”. J Am Acad Dermatol.
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Tadalafil (Cialis)

CheTeam — Thu, 03 Mar 2011 15:11:55 +0000

treat male erectile dysfunction (impotence), developed by the biotech firm ICOS and marketed worldwide by Eli Lilly. Cialis has FDA approval and appeared in
U.S. stores in December, 2003. Cialis has a multiyear promotional deal with professional golf ‘s PGA TOUR. The tablets are yellow and oval-shaped.
Cialis’s main selling points are that it works for up to 36 hours after being swallowed and that it can be taken with or
without food (Viagra works for some 4 hours). It has the same mode of action as sildenafil (Viagra), and vardenafil (Levitra).
12–24 hours after taking the drug. These side effects usually go away after a few hours, though back pain and muscle aches
Men taking nitrates or alpha blockers should not take Cialis because it could cause blood pressure problems. Some of the side
effects of the drug include back ache, stomach ache, muscle aches, or headaches. The company advises that in the rare event that

Tadalafil (Forzest)

CheTeam — Wed, 01 Sep 2010 15:23:32 +0000

Tadalafil is a drug used to treat male erectile dysfunction (impotence). It was developed by the biotechnology firm ICOS and marketed worldwide by Eli Lilly and Company under the brand name Cialis. It works by inhibiting an enzyme known as PDE5. Due to its 36-hour effect it is also known as the “Weekend Pill”. In the United States, tadalafil has Food and Drug Administration approval and became available in December, 2003.
The empirical formula for tadalafil is C 22 H 19 N 3 O 4, and its official organic name is (6R,12aR)-6-(1,3-benzodioxol-5-yl)-2,3,6,7,12,12a- hexahydro-2-methyl-pyrazinopyridoindole-1,4-dione. The molecular weight is 389.41. The tablets are yellow, film-coated, and almond-shaped, and are produced in 5, 10, or 20mg doses. A 20mg dose of Tadalafil is comparable to a 100mg dose of sildenafil (Viagra).
The most common side effects when using tadalafil are headache, indigestion, back pain, muscle aches, flushing, and stuffy or runny nose. These side effects usually go away after a few hours. Patients who get back pain and muscle aches usually get it 12 to 24 hours after taking the drug, and the symptom usually goes away after 48 hours.
In May 2005, the U.S. Food and Drug Administration found that tadalafil (along with other PDE5 inhibitors) could lead to vision impairment in certain patient groups, e.g. diabetics. An investigation is currently ongoing.
In the United States, Eli Lily has a multiyear agreement to promote tadalafil (Cialis) with professional golf ‘s PGA TOUR.

Tadalafil (Tadacip)

CheTeam — Wed, 01 Sep 2010 15:20:04 +0000

Tadalafil is a drug used to treat male erectile dysfunction (impotence). It was developed by the biotechnology firm ICOS and marketed worldwide by Eli Lilly and Company under the brand name Cialis.
In the United States, tadalafil has Food and Drug Administration approval and became available in December, 2003 as the third impotence pill after sildenafil (Viagra) and vardenafil (Levitra). Due to its 36-hour effect it is also known as the weekend pill. It should be noted that the drug has not been formally studied in regard to multiple sexual attempts during a 36 hour period.
The history of Cialis cannot be discussed without mentioning Pfizer’s drug, Viagra. The FDA’s approval on March 27, 1998, led this prescription drug, Viagra, to a ground breaking success in just the first year of introduction as Pfizer sold drugs worth over a billion dollars. However, things changed considerably for the giant of erectile dysfunction drugs when the FDA also approved Levitra on August 19, 2003, and Cialis on November 21, 2003. In 1993 the drug company Icos began studying IC351, which is a PDE5 enzyme inhibitor, and this is basically the process through which the erectile dysfunction drugs work. In 1994, Pfizer scientists discovered that sildenafil citrate, which is a white crystalline powder that temporarily normalizes erectile function of the penis by blocking an enzyme known to inhibit the production of a chemical that causes erections, caused the heart patients that were participating in a clinical study of a heart medicine to have erections. Although the scientists were not testing the chemical compound IC351 for erectile dysfunction, the compound seemed to have a side effect which could potentially be worth millions, if not billions of dollars. Soon Icos received its very first patent in 1994 on IC351, and the clinical trials of phase 1 took place in 1995. In 1997, phase 2 clinical studies began and Icos performed its first study on patients with erectile dysfunction. Phase 2 lasted about two years, and after that phase 3 began.
In 1998, ICOS Corporation, and Eli Lilly and Company, commercialized the drug for erectile dysfunction, and two years later they filed a new drug application with the U.S. Food and Drug Administration for IC351; the only difference was that this time they decided to call the drug Cialis. In May of 2002, Icos and Eli Lilly and Company reported to the American Urological Association that the phase 3 tests show that Cialis works for up to 36 hours, and one year later Icos and Eli Lilly and Company received the U.S. FDA’s approval for Cialis. One advantage that Cialis has over Viagra is that tadalafil has a half-life of 17.5 hours (and thus Cialis is advertised to work for up to 36 hours, after which time there is still about one quarter of the absorbed dose in the body) as compared to 4 hours half-life for sildenafil (Viagra).
The empirical formula for tadalafil is C 22 H 19 N 3 O 4, and its official organic name is (6R,12aR)-6-(1,3-benzodioxol-5-yl)-2,3,6,7,12,12a- hexahydro-2-methyl-pyrazinopyridoindole-1,4-dione. The molecular weight is 389.41. Tadalafil tablets are yellow, film-coated, and almond-shaped, and are produced in 5, 10, or 20 mg doses.
Tadalafil works by inhibiting PDE5, an enzyme found primarily in the arterial wall smooth muscle tissue of the penis and the lungs. A 20 mg dose of tadalafil is comparable to a 100 mg dose of sildenafil (Viagra). By inhibiting PDE5, tadalafil relaxes blood vessels in the penis, thereby increasing blood flow and aiding in erection.
Part of the physiological process of erection involves the parasympathetic nervous system causing the release of nitric oxide (NO) in the corpus cavernosum of the penis. NO binds to the receptors of the enzyme guanylate cyclase which results in increased levels of cyclic guanosine monophosphate (cGMP), leading to smooth muscle relaxation (vasodilation) in the corpus cavernosum, resulting in increased inflow of blood and an erection.
Tadalafil is a potent and selective inhibitor of cGMP specific phosphodiesterase type 5 (PDE5) which is responsible for degradation of cGMP in the corpus cavernosum. The molecular structure of tadalafil is similar to that of cGMP and acts as a competitive binding agent of PDE5 in the corpus cavernosum, resulting in more cGMP and better erections. Without sexual stimulation, and therefore lack of activation of the NO/cGMP system, tadalafil should not cause an erection. Other drugs that operate by the same mechanism include sildenafil (Viagra®) and vardenafil (Levitra®).
Tadalafil is currently undergoing clinical trials for the treatment of pulmonary hypertension. The clinical trials are based on tadalafil’s inhibitiong of PDE5. It is hoped that by inhibiting this enzyme, tadalafil will prove effective in opening up blood vessels in the lungs, lowering pulmonary arterial resistance and pressure, and thus reducing the workload of the right ventricle of the heart.
The most common side effects when using tadalafil are headache, indigestion, back pain, muscle aches, flushing, and stuffy or runny nose. These side effects usually go away after a few hours. Back pain and muscle aches can occur 12 to 24 hours after taking the drug, and the symptom usually disappears after 48 hours.
In May 2005, the U.S. Food and Drug Administration found that tadalafil (along with other PDE5 inhibitors) could lead to vision impairment in certain patient groups, including diabetics. An investigation is currently ongoing.
Since PDE5 inhibitors such as tadalafil may cause transiently low blood pressure (hypotension), organic nitrates should not be taken for at least 48 hours after taking the last dose of tadalafil. Using organic nitrates (such as the sex drug amyl nitrite) within this timeframe may increase the risk of life-threatening hypotension.
Since people who have taken tadalafil within the past 48 hours cannot take organic nitrates to relieve angina (such as glyceryl trinitrate spray), these patients should seek immediate medical attention if they experience anginal chest pain. In the event of a medical emergency, paramedics and medical personnel should be notified of any recent doses of tadalafil.
In the United States, Eli Lilly has a multiyear agreement to promote tadalafil (Cialis) with professional golf ‘s PGA Tour.
Some individuals with the surname of “Cialis” objected to Lilly’s naming of the drug, but the company insists that the drug’s trade name has nothing to do with the surname.
^ Cialis – Safety Monitoring(s). Epocrates Rx software, produced by Epocrates, Inc.. Information also available online. Retrieved on 2007 – 04-06.
^ Viagra – Safety Monitoring(s). Epocrates Rx software, produced by Epocrates, Inc.. Information also available online. Retrieved on 2007 – 04-06.
^ Revill, Jo. ” Drugs giant says its new pill will pack more punch than rival Viagra “, The Observer, February 2, 2003. Retrieved on 2007 – 04-06.
Categories : Cleanup from September 2007 | All pages needing cleanup | All articles with unsourced statements | Articles with unsourced statements since February 2007 | PDE5 inhibitors | Lilly

Alprazolam (Xanax)

CheTeam — Wed, 01 Sep 2010 15:13:29 +0000

Alprazolam, also known under the trade names Xanax and Niravam, is a short-acting drug in the benzodiazepine class used to treat severe anxiety disorders and as an adjunctive treatment for anxiety associated with clinical depression.
Alprazolam was first synthesized by Upjohn (now a part of Pfizer). Its patent (#3,987,052) was filed on October 29, 1969, granted on October 19, 1976 and expired in September 1993.
Alprazolam is a triazolobenzodiazepine, that is, a benzodiazepine with a triazolo-ring attached to its structure. Benzodiazepines produce a variety of effects by modulating the GABA A subtype of the GABA receptor, the most prolific inhibitory receptor within the brain. The GABA A receptor is made up from 5 subunits out of a possible 19, and GABA A receptors made up of different combinations of subunits have different properties, different locations within the brain and importantly, different activities in regards to benzodiazepines.
In order for GABA A receptors to be sensitive to the action of benzodiazepines they need to contain an α and a γ subunit, where the benzodiazepine binds. Once bound, the benzodiazepine locks the GABA A receptor into a conformation where the neurotransmitter GABA has much higher affinity for the GABA A receptor, increasing the frequency of opening of the associated Chloride ion channel and hyperpolarising the membrane. This potentiates the inhibitory effect of the available GABA leading to sedatory and anxiolytic effects. As mentioned, different benzodiazepines can have different affinities for GABA A receptors made up of different collection of subunits. For instance, benzodiazepines with high activity at the α1 are associated with sedation whereas those with higher affinity for GABA A receptors containing α2 and/or α3 subunits have greater anxiolytic activity.
The binding site for benzodiazepines is distinct from the binding site for barbiturates and GABA on the GABA receptor.
There is some evidence for antidepressant treatment of clinical depression in out patient settings, evidence for inpatients is lacking; other benzodiazepines are not known to have antidepressant activity.
Alprazolam is readily absorbed from the gastrointestinal tract. The peak plasma concentration is achieved in 1-2 hours. Most of the drug is bound to plasma protein, mainly serum albumin. Alprazolam is hydroxylated in the liver to α-hydroxyalprazolam, which is also pharmacologically active. This and other metabolites are later excreted in urine as glucuronides. Some of the drug is also excreted in unchanged form.
Alprazolam is FDA licensed for the short term treatment (up to 8 weeks) of panic disorder, with or without agoraphobia. Alprazolam is very effective in preventing moderate to severe anxiety, essential tremor, panic attacks and other types of convulsive behaviors. Physicians who elect to prescribe alprazolam for longer than 8 weeks should be aware that continued efficacy has not been systematically demonstrated beyond 8 weeks use as tolerance to alprazolam’s effects may occur after 8 weeks.
Alprazolam is recommended for the short-term treatment (2-4 weeks) of severe acute anxiety. Alprazolam should not generally be used for longer periods because the body becomes rapidly tolerant to the drug’s effects with the risk of withdrawal symptoms when discontinuing the drug.
Xanax is the main and most commonly known brand name for alprazolam. There is a large variety of generic brand names for Alprazolam in use throughout the world. In English-speaking countries, alprazolam is sold under the following brand names: Alprax, Alprox, Alzam, Anxirid, Apo-Alpraz, Azor, Calmax, Gerax, Helex, Kalma, Novo-Alprazol, Nu-Alpraz, Restyl, Xanax, Xanor, Zopax.
The inscriptions on tablets vary depending on manufacturer and on the country where it is marketed. Appearance is generally as follows in the United States.
0.5 mg peach oval or round tablet scored (0.5 mg Alprazolam may also be found in white round tablet scored)(Equivalent to 10 mg diazepam and 0.5 mg clonazepam)
Side effects of alprazolam may occur in patients and are more likely the higher the dosage taken. If signs of an allergic reaction occur such as hives, difficulty breathing, swelling of face, lips, tongue or throat occur medical attention should be sought immediately. Medical attention should also be sought immediately if signs of jaundice appear such as yellowing of the skin or eyes. Other side effects which may occur are as follows:
There is now a general consensus among psychiatrists that alprazolam and other benzodiazepines can cause withdrawal symptoms after long-term treatment and should be done slowly over a period of months (or even up to a year) to avoid serious withdrawal symptoms such as agitation, panic attacks, rebound anxiety, muscle cramps and seizures. Some patients may benefit from a substitution with diazepam or clonazepam as these drugs remain in the bloodstream longer and therefore have less potential for abuse and dependence.
Patients taking a dosing regimen larger than 4 mg per day have an increased potential for dependence. This medication may cause withdrawal symptoms, which in some cases have been known to cause seizures. The discontinuation of this medication may also cause a reaction called rebound anxiety. Other withdrawal effects reported from discontinuing alprazolam therapy include homicidal ideation, rage reactions, hyperalertness, increased nightmares, and intrusive thoughts.
When a patient discontinues use, they may experience the symptoms they had before taking medication. Symptoms may also be accompanied by other reactions including changes in mood, anxiety, or sleep. Rebound anxiety is usually a result of abrupt discontinuation of this medication; patients who taper off are less likely to experience these symptoms.
Alprazolam has an exceptional history insofar soon after its introduction a large number of case reports were published in the medical literature of severe withdrawal symptoms related case reports of withdrawal psychoses, seizures and intense rebound anxiety upon discontinuation of alprazolam. In the United States a survey of physicians showed that 84% of physicians reported alprazolam as being extremely problematic in terms of the severity and prolonged nature of the benzodiazepine withdrawal syndrome after discontinuation. The benzodiazepines diazepam (Valium) and oxazepam were found to produce less severe withdrawal symptoms than alprazolam (Xanax) or lorazepam (Ativan).
Alprazolam should never be abruptly discontinued if taken regularly for any length of time because severe withdrawal symptoms may occur. Severe psychosis has been reported in the medical literature from abrupt alprazolam withdrawal and death occurred from withdrawal-related seizures after gradual dose reduction, which suggests that alprazolam when being discontinued should be done so very slowly over a prolonged period of time to avoid severe withdrawal symptoms.
Nonteratogenic Effects: It should be considered that the child born of a mother who is receiving benzodiazepines may be at risk of developing withdrawal symptoms from the drug during the postnatal period. Also, neonatal flaccidity and respiratory problems have been reported in children born of mothers who have been receiving benzodiazepines.
Benzodiazepines, including alprazolam are known to be excreted in human milk. Chronic administration of diazepam to nursing mothers has been reported to cause their infants to become lethargic and to lose weight. As a general rule, nursing should not be undertaken by mothers who use alprazolam.
Children of mothers who are taking alprazolam are considered at risk for withdrawal symptoms during the postnatal period. Some children born under these conditions have been reported to have neonatal flaccidity and respiratory problems. Likewise, nursing mothers should avoid alprazolam due to the fact that benzodiazepines are known to be passed into breast milk. This can cause infants to become lethargic and lose weight.
Elderly individuals should be cautious in the use of alprazolam due to the possibility of increased sensitivity to side effects, especially loss of coordination and drowsiness.
In fact, any drug that inhibits CYP3A4, for which alprazolam is a substrate, will increase serum concentrations of alprazolam significantly if administered prior or concurrently. Tagamet (cimetidine) is a widely used H2 blocker antacid that inhibits numerous cytochrome P450 enzymes.
Oral contraceptive pills, reduce the clearance of alprazolam which may lead to increased plasma levels of alprazolam and accumulation.
Alprazolam in doses of 0.5 mg or more causes significant deterioration in vigilance performance combined with increased feelings of sleepiness. Therefore, people driving or conducting activities which require vigilance should exercise caution in using alprazolam or possibly avoid it all together.
Alprazolam, like all benzodiazepines, has the potential for abuse. Although it is not manufactured illegally, it is often diverted to the black market. The state of relaxation, anxiolysis, and disinhibition induced by benzodiazepines is the main reason for their illicit use.
Improper injection of alprazolam is considered especially dangerous by medical professionals due to the fact that, when crushed in water it will not fully dissolve (40µg/ml of H 2 O at pH 7, and 12 mg/mL at pH 1.2 per 1mg of alprazolam,) potentially causing severe damage to arteries if not filtered properly. While it is somewhat soluble in alcohol, the combination of the two, particularly when injected, has the potential to cause a serious, and potentially fatal overdose. Alprazolam may also be insufflated ; clinical testing dispels the rumor about less activity via insufflation.
Alprazolam is sometimes used with other recreational drugs to relieve the panic or distress of dysphoric reactions to psychedelics such as LSD and also to promote sleep in the “come-down” period following use of recreational drugs with stimulant or insomniac properties (such as LSD, cocaine, amphetamines, DXM, and MDMA along with the related amphetamines). It is also often used in conjunction with marijuana or heroin to potentiate the relaxing effect.
Alprazolam is also used in recreation due to its “blackout” effects. On many accounts, alprazolam has been found to induce complete memory loss, leading the user into a ‘zombie state.’ In some cases people have been found to take more alprazolam during the aforementioned ‘zombie state.’
Patients from the aforementioned group should be monitored very closely during therapy for signs of abuse and development of dependence. Discontinue therapy if any of these signs are noted. Long-term therapy in these patients is not recommended.
In the United States, alprazolam is a prescription drug and is assigned to Schedule IV of the Controlled Substances Act by the Drug Enforcement Administration. Under the UK drug misuse classification system benzodiazepines are class C drugs. Internationally, alprazolam is included under the United Nations Convention on Psychotropic Substances as Schedule IV.
^ FDA (23rd). FDA APPROVED LABELING FOR XANAX XR (pdf) 4. Federal Drug Administration. Retrieved on 2nd Aug 2007. “The longer-term efficacy of XANAX XR has not been systematically evaluated. Thus, the physician who elects to use this drug for periods longer than 8 weeks should periodically reassess the usefulness of the drug for the individual patient.”
^ Alprazolam – Complete medical information regarding this treatment of anxiety disorders on MedicineNet.com. medicinenet.com. Retrieved on 2nd Aug 2007.
^ Risse SC; Whitters A, Burke J, Chen S, Scurfield RM, Raskind MA. (1990). “Severe withdrawal symptoms after discontinuation of alprazolam in eight patients with combat-induced posttraumatic stress disorder.”. The Journal of clinical psychiatry. 51 (5): 206-9. PMID 2335496.
^ a b Wolf B; Griffiths RR. (1991). “Physical dependence on benzodiazepines: differences within the class.”. Drug and alcohol dependence. 29 (2): 153-6. PMID 1686752.
^ Haque W; Watson DJ, Bryant SG. (Jan 1990). “Death following suspected alprazolam withdrawal seizures: a case report.”. Texas medicine. 86 (1): 44-7. PMID 2300914.
^ Hori A. (Feb 1998). “Pharmacotherapy for personality disorders.”. Psychiatry and clinical neurosciences. 52 (1): 13-9. PMID 9682928.
^ García-Algar O; López-Vílchez MA, Martín I, Mur A, Pellegrini M, Pacifici R, Rossi S, Pichini S. (2007). “Confirmation of gestational exposure to alprazolam by analysis of biological matrices in a newborn with neonatal sepsis.”. Clinical toxicology (Philadelphia, Pa.). 45 (3): 295-8. PMID 17453885.
^ Oo CY; Kuhn RJ, Desai N, Wright CE, McNamara PJ. (Sep 1995). “Pharmacokinetics in lactating women: prediction of alprazolam transfer into milk.”. British journal of clinical pharmacology. 40 (3): 231-6. PMID 8527284.
^ Back DJ; Orme ML. (Jun 1990). “Pharmacokinetic drug interactions with oral contraceptives.”. Clin Pharmacokinet. 18 (6): 472-84. PMID 2191822.
^ Kozená L; Frantik E, Horváth M. (May 1995). “Vigilance impairment after a single dose of benzodiazepines.”. Psychopharmacology (Berl). 119 (1): 39-45. PMID 7675948.
^ Eric C; Wang, Felix S, Chew. (2006). ” MR Findings of Alprazolam Injection into the Femoral Artery with Microembolization and Rhabdomyolysis ” (pdf). Radiology Case Reports 1 (3).

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History of Viagra(Sildenafil Citrate)

admin — Fri, 13 Aug 2010 16:09:29 +0000

Viagra was initially developed to treat heart disease (angina). In trial studies, the penile erection enhancing effects were noticed. The drug was patented in 1996, approved by the FDA on March 27, 1998 (becoming the first pill approved to treat erectile dysfunction in the United States) and offered for sale in the United States later that year. It soon became a smashing success. Even though Viagra is only available by prescription from a doctor, it was advertised directly to consumers on TV (famously being endorsed by Bob Dole). Numerous sites on the Internet offer Viagra for sale after an “online consultation”, a mere web questionnaire. It is likely that many men (and some women) experiment with the drug to increase sexual prowess or pleasure. Annual sales of Viagra in the period 1999 – 2001 exceeded $1 billion.

It has been suggested that Viagra would lead to a marked drop in the demand for certain traditional remedies, such as tiger penises and rhinoceros horns and that the drug may therefore help to preserve these endangered species. However, this is unlikely in that these parts of endangered species are not only used to treat impotence. Rhinoceros horns, for example, are used as a treatment for high fever. Further, since Viagra has not been shown to possess aphrodisiac properties, it is unclear that the natural remedies would compete with this new clinical drug.

The “Viagra” name has become so well known that many fake aphrodisiacs now call themselves “herbal Viagra” or are presented as blue tablets imitating the shape and colour of Pfizer’s product.

Pfizer’s worldwide patents on sildenafil citrate will expire in 2011 – 2013. The UK patent held by Pfizer on the use of PDE5 inhibitors (see below) as treatment of impotence has been invalidated in 2000 because of obviousness; this decision was upheld on appeal in 2002.

A mixture of Viagra and ecstasy, called sextasy, has become popular among rave partygoers.

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Sildenafil Description

admin — Tue, 11 May 2010 18:53:05 +0000

Sildenafil (sil-DEN-a-fil) belongs to a group of medicines that delay the enzymes called phosphodiesterases from working too quickly. The penis is one of the areas where these enzymes work. Sildenafil is used to treat men who have erectile dysfunction (also called sexual impotence).

By controlling the enzyme phosphodiesterase, sildenafil helps to maintain an erection that is produced when the penis is stroked. Without physical action to the penis, such as that occurring during sexual intercourse, sildenafil will not work to cause an erection.

This medicine is available only with your doctor’s prescription, in the following dosage form(s):

Allegra Product Information

admin — Wed, 14 Apr 2010 17:39:09 +0000

Seasonal allergies can make it difficult for you to enjoy what you’re doing. Allegra can help you feel better by relieving allergy symptoms in patients 12 and over, so you can more fully enjoy your world.^TM

Visit our PRODUCT INFORMATION section to learn about:

Once-daily Allegra^® (fexofenadine HCI) 180-mg tablets for seasonal allergic rhinitis in patients 12 and older. NOW AVAILABLE
Allegra^® (fexofenadine HCI) 60-mg tablets & capsules for seasonal allergic rhinitis and chronic idiopathic urticaria hives in patients 12 and older.
Allegra^® (fexofenadine HCI) a pediatric formulation of 30-mg tablets for seasonal allergies and hives for pediatric patients 6-11 years.
Allegra-D^® (fexofenadine HCI 60-mg/pseudoephedrine HCI 120 mg) extended-release tablets for seasonal allergies with nasal congestion in patients 12 and older.

Don’t miss these sections here on our Allegra web site to help you discover the allergy relief you’ve been looking for:

LEARN ABOUT ALLERGIES – find in-depth articles about seasonal allergies, a Glossary of common allergy terminology, Inside Allergies, a cellular animation of what happens in your body during an allergic reaction, and more.
POLLEN FORECAST – Is it an allergy day? Before you go out check for a daily update on pollen counts for your local area.
WHY ALLEGRA? – Claritin^® and Zyrtec^® users will want to check out this section.

Now Allegra^® is Available in 180 mg tablets
Take just one tablet once daily
for 24-hour seasonal allergy relief in patients 12 and older!

Now, Allegra introduces the convenience of long lasting, once-daily seasonal allergy relief with Allegra 180 mg tablets. Imagine the freedom: you take just one Allegra 180 mg tablet once daily for 24-hour seasonal allergy relief!

Allegra is an effective antihistamine that contains fexofenadine—a unique ingredient that combats your seasonal allergy symptoms: itchy, watery eyes. Plus sneezing and runny nose. But unlike some allergy medications, Allegra won’t make you drowsy. In fact, in clinical studies, drowsiness in people who took Allegra 180 mg tablets was similar to placebo (sugar pill), 0.4% vs. 0.0%.

The other formulations of Allegra are also similar to placebo: 60-mg capsules ( 1.3% vs. 0.9%), and 30-mg tablets (0.5% vs. 0.9%).

Claritin, is a registered trademarks of Schering Corporation. Zyrtec is a registered trademark of UCB, Societe Anonyme.

IMPORTANT SAFETY INFORMATION

The most commonly reported adverse events with once-daily Allegra 180-mg tablets and placebo in seasonal allergy patients 12 and older are headache (10.6% vs. 7.5%), upper respiratory tract infection (3.2% vs. 3.1%), and back pain (2.8% vs. 1.4%).

The most commonly reported adverse experiences for Allegra 60-mg capsules and tablets and placebo in seasonal allergy patients 12 and older are cold, flu (2.5% vs. 1.5%), nausea (1.6% vs. 1.5%), and menstrual pain (1.5% vs. 0.3%).

The most commonly reported adverse events with Allegra 30-mg twice daily and placebo in seasonal allergy patients 6-11 years are headache (7.2% vs. 6.6%), upper respiratory tract infection (4.3 % vs. 1.7%), coughing (3.8% vs. 1.3%), and accidental injury (2.9% vs. 1.3%).

Because Allegra-D (fexofenadine HCl 60mg/pseudoephedrine HCl 120mg) extended-release tablets contain pseudoephedrine (the decongestant in most over-the-counter allergy medicines), Allegra-D must not be taken if you are also taking MAO inhibitors (medicines that treat depression) or if you retain urine or have glaucoma, severe high blood pressure, or severe heart disease. Also, let your doctor know before you take Allegra-D if you have high blood pressure, diabetes, heart disease, glaucoma, thyroid disease, impaired kidney function, or symptoms of an enlarged prostate such as difficulty urinating. The most commonly reported adverse experiences with twice-daily Allegra-D extended release tablets compared to pseudoephedrine alone in seasonal allergic rhinitis with nasal congestion in patients 12 and older were headache (13.0% vs. 17.4%), insomnia (12.6% vs. 13.3%), and nausea (7.4% vs. 5.0%).

What is Finasteride?

admin — Tue, 12 Jan 2010 14:46:55 +0000

Finasteride (PROSCAR): U.S. FDA (United States Food and Drug Administration) approved as a prostate gland shrinking medication. Finasteride effectively blocks the enzyme that converts testosterone into a form that enlarges the prostate gland. It is sold as a prescription medication as a 5-milligram tablet under the brand name Proscar.

Merck & Co manufactures Proscar tablets.
Patient Information for Proscar is available in PDF format.

A lower dosage of Finasteride may reduce male baldness.

It was discovered that the same hormone responsible for some prostate gland enlargement plays an important role in signaling certain genetically predisposed hair follicle cells to miniaturize, eventually leading to hair loss.

Finasteride (PROPECIA): U.S. FDA (United States Food and Drug Administration) approved for the treatment of male pattern hair loss on the vertex (top of head) and the anterior mid-scalp area. When prescribed as an anti-baldness medication, Finasteride may be taken orally, or applied topically onto the scalp. The dosage necessary to produce significant hair restoration benefits is much less than the dosage typically prescribed for treating enlarged prostate glands. It is sold as a prescription medication as a 1-milligram tablet under the brand name PROPECIA.

Merck & Co manufactures PROPECIA tablets.

Maximizing success with LEVITRA

admin — Tue, 12 Jan 2010 14:22:54 +0000

Here is a list of tips to help you have a successful experience from the very first try:

LEVITRA should be taken approximately 60 minutes prior to sexual activity. In clinical trials, most patients were able to begin sexual activity before that time.
LEVITRA can be taken with or without food.
If it has been a long time since your partner has had an erection that was hard enough for penetration, don’t give up. Talk to your doctor. LEVITRA may help men with erectile dysfunction (ED) get and keep an erection satisfactory for sexual activity.
Remember to let him know how you feel about him and are ready to explore treatment options together.
Open communication between partners may increase sexual success. The most effective approach is to focus on improving the quality of your sexual life together.
Have fun. Relax. Enjoy.