Can mucinex raise your blood pressure. Safe Cold Medicine for High Blood Pressure: A Comprehensive Guide

08.10.202001.06.2021 by alexxlab

Can Mucinex raise your blood pressure. Is it safe to take Mucinex DM with high blood pressure. Which cold medicines are safe for people with hypertension. How do decongestants affect blood pressure.

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Understanding the Link Between Cold Medicine and Blood Pressure

When you’re battling a cold or allergies, finding relief becomes a top priority. However, if you have high blood pressure, it’s crucial to choose your medications wisely. Some common cold and allergy medicines can potentially raise blood pressure, making it essential to understand which ingredients to look out for and what alternatives are available.

The Pseudoephedrine Effect

Pseudoephedrine, a decongestant found in many over-the-counter cold medications, is known to affect blood pressure. This ingredient, marketed under brand names like Sudafed, works by constricting blood vessels to reduce nasal congestion. However, this same mechanism can lead to increased blood pressure and heart rate.

How does pseudoephedrine impact blood pressure? Pharmacist Kayla Ryan explains, “Pseudoephedrine is chemically similar to adrenaline, so the body recognizes it as such, causing blood pressure and heart rate to increase.” A 2005 study found that pseudoephedrine raised systolic blood pressure by an average of one point and increased heart rate by about three beats per minute.

Identifying Cold Medicines Containing Pseudoephedrine

Due to the Combat Methamphetamine Act of 2005, medications containing pseudoephedrine are now sold behind the pharmacy counter. You’ll often find these products with brand names ending in “D,” such as Mucinex-D or Claritin-D. To purchase these medications, you’ll need to present a valid ID to the pharmacist.

Other Blood Pressure-Raising Cold Medicines

Besides pseudoephedrine, individuals with hypertension should be cautious of:

Afrin nasal spray (containing oxymetazoline)
Multi-symptom cold products with NSAIDs (non-steroidal anti-inflammatory drugs like ibuprofen or naproxen)

Oxymetazoline can potentially increase blood pressure, especially when combined with other medications that have a similar effect. NSAIDs can cause fluid retention and affect kidney function, which may lead to elevated blood pressure.

Safe Alternatives for High Blood Pressure Sufferers

If you have high blood pressure, don’t despair. There are several safer alternatives available for managing cold and allergy symptoms without risking a spike in your blood pressure.

Phenylephrine: A Gentler Decongestant

Phenylephrine is an alternative to pseudoephedrine that can be purchased over the counter. While there haven’t been extensive studies on its effects on blood pressure, experts believe it has less impact than pseudoephedrine. This makes it a potentially safer option for those with hypertension.

Coricidin: Designed for High Blood Pressure Patients

Coricidin is a brand of over-the-counter cold and allergy medicine specifically formulated for people with high blood pressure. It comes in various formulations targeting different symptoms such as cough, cold, chest congestion, and allergies. The active ingredients in Coricidin products are chosen to avoid significant impacts on blood pressure.

Antihistamines: Managing Allergy Symptoms Safely

For allergy symptoms or runny nose, antihistamines like diphenhydramine (Benadryl) can be effective without affecting blood pressure. However, be aware that drowsiness is a common side effect. For non-drowsy options, consider newer antihistamines like Zyrtec, Claritin, or Allegra.

Guaifenesin: Safe Expectorant for Congestion

Guaifenesin, the active ingredient in Mucinex, is an expectorant that helps loosen and thin mucus, making it easier to cough up. This medication is generally considered safe for people with high blood pressure.

Can Mucinex Raise Your Blood Pressure?

The question “Can Mucinex raise your blood pressure?” is a common concern for those with hypertension. The answer depends on the specific Mucinex product in question. Regular Mucinex, which contains only guaifenesin, is unlikely to raise blood pressure significantly. However, Mucinex DM (which contains dextromethorphan, a cough suppressant) and Mucinex D (which contains pseudoephedrine) may have more potential to affect blood pressure.

Is it safe to take Mucinex DM with high blood pressure? While the dextromethorphan in Mucinex DM is not typically associated with blood pressure increases, it’s always best to consult with your healthcare provider before taking any new medication, especially if you have hypertension.

The Importance of Reading Labels and Consulting Healthcare Providers

When shopping for cold and allergy medicines, it’s crucial to read the labels carefully. Look for the active ingredients list, which is typically found on the back of the packaging. If you’re unsure about a medication’s safety, don’t hesitate to ask your pharmacist or healthcare provider.

Questions to Ask Your Healthcare Provider

Are there any cold medicines I should avoid with my current blood pressure medication?
What symptoms should I watch for when taking cold medicine that might indicate a problem with my blood pressure?
Are there any natural remedies you recommend for managing cold symptoms that won’t affect my blood pressure?

Managing Cold Symptoms Naturally with High Blood Pressure

While medication can provide relief, there are also natural ways to manage cold symptoms that may be safer for those with high blood pressure:

Stay hydrated: Drinking plenty of water and clear fluids can help thin mucus and relieve congestion.
Use a saline nasal spray: This can help moisturize nasal passages and clear congestion without medication.
Try a neti pot: Nasal irrigation can help flush out allergens and thin mucus.
Use a humidifier: Adding moisture to the air can help relieve congestion and coughing.
Rest: Adequate sleep and rest can help your body fight off the cold more effectively.

The Role of Diet in Managing Colds and Blood Pressure

Your diet can play a significant role in managing both cold symptoms and blood pressure. Certain foods may help boost your immune system and reduce inflammation, potentially easing cold symptoms without the need for medication.

Immune-Boosting Foods

Citrus fruits: High in vitamin C, which may help shorten the duration of colds.
Garlic: Contains compounds that may help the immune system fight germs.
Ginger: Can help reduce inflammation and ease nausea.
Yogurt: Contains probiotics that may boost immune function.
Chicken soup: The warm liquid can help relieve congestion, and the nutrients may have anti-inflammatory effects.

Foods to Support Healthy Blood Pressure

While managing your cold symptoms, it’s also important to maintain a diet that supports healthy blood pressure. Consider incorporating these foods:

Leafy greens: Rich in potassium, which helps the body get rid of sodium.
Berries: Contain antioxidants that can help reduce blood pressure.
Beets: Contain nitrates that can help lower blood pressure.
Fatty fish: Rich in omega-3 fatty acids, which can help reduce blood pressure.
Whole grains: Can help reduce blood pressure and risk of heart disease.

The Importance of Monitoring Blood Pressure During Illness

When you’re dealing with a cold or flu, it’s especially important to keep an eye on your blood pressure if you have hypertension. Illness can cause fluctuations in blood pressure, and some cold remedies may exacerbate these changes.

Tips for Monitoring Blood Pressure at Home

Use a reliable home blood pressure monitor.
Take readings at the same time each day, preferably in the morning before taking medications and in the evening.
Take multiple readings and record the average.
Avoid caffeine, exercise, and smoking for 30 minutes before measuring.
Sit quietly for 5 minutes before taking a reading.

If you notice significant changes in your blood pressure while ill or taking cold medication, contact your healthcare provider for guidance.

Understanding Drug Interactions: Cold Medicine and Blood Pressure Medication

If you’re taking medication for high blood pressure, it’s crucial to be aware of potential interactions with cold and allergy medicines. Some combinations can lead to dangerously high blood pressure or reduce the effectiveness of your blood pressure medication.

Common Blood Pressure Medications and Their Interactions

ACE inhibitors (e.g., lisinopril, enalapril): May interact with NSAIDs, potentially reducing their blood pressure-lowering effect.
Beta-blockers (e.g., metoprolol, atenolol): Can interact with decongestants, potentially causing a rapid heart rate.
Calcium channel blockers (e.g., amlodipine, diltiazem): May interact with certain antihistamines, potentially increasing the risk of side effects.
Diuretics (e.g., hydrochlorothiazide, furosemide): Can interact with NSAIDs, potentially reducing their effectiveness and increasing the risk of kidney problems.

Always inform your healthcare provider about all medications you’re taking, including over-the-counter drugs and supplements, to avoid potential interactions.

The Future of Cold Medicine for High Blood Pressure Patients

Research continues in the field of cold and allergy medicine, with a focus on developing treatments that are safe and effective for people with various health conditions, including high blood pressure. Some promising areas of research include:

Development of new decongestants with fewer cardiovascular side effects
Exploration of natural compounds with decongestant properties
Advancements in targeted drug delivery to reduce systemic effects
Personalized medicine approaches to tailor treatments based on individual health profiles

As research progresses, we may see more options becoming available for those with high blood pressure seeking safe and effective cold and allergy relief.

Proper Disposal of Old Cold Medicines

As you update your medicine cabinet with safer options for your high blood pressure, you may find yourself with old or unused cold medications. It’s important to dispose of these properly to protect both the environment and public health.

Safe Disposal Methods

Drug take-back programs: Many pharmacies and law enforcement agencies offer these programs for safe disposal of medications.
FDA-recommended household disposal: If take-back programs aren’t available, follow FDA guidelines for disposing of medications in household trash.
Flushing: Only flush medications if they are on the FDA flush list and no take-back programs are available.

Remember, never give your unused medications to others, even if they have the same condition. Medications should only be taken under the guidance of a healthcare professional.

Managing cold and allergy symptoms with high blood pressure requires careful consideration and often consultation with healthcare providers. By understanding the potential risks of certain cold medicines and exploring safer alternatives, you can find relief from your symptoms while keeping your blood pressure under control. Always prioritize your overall health and don’t hesitate to seek professional medical advice when in doubt.

Which Cold Medicine for High Blood Pressure? A Shopper’s Guide

Check for these active ingredients in your decongestant, especially if you have high blood pressure.

Has it ever felt like your cold medicine is increasing your heart rate?

This could be caused by an active ingredient commonly found in over-the-counter cold medications — also known to affect blood pressure.

The ingredient is pseudoephedrine, a decongestant marketed under the brand name Sudafed.

When suffering from a cold or allergies, it’s tempting to grab the first medication you see in the pharmacy aisle. Especially when the packaging lists all your symptoms in big, bold letters.

But be sure to read the list of active ingredients on the back of the packaging. They may be in smaller print, but they can come with unexpected side effects.

The Science Behind Pseudoephedrine

When you have a cold or an allergy attack, your white blood cells gather in your nasal passages and sinuses. This causes nasal membranes to swell and increases mucus production. Pseudoephedrine constricts these blood vessels, which decreases drainage.

But those same constricted vessels might also increase your blood pressure and heart rate.

Pharmacist Kayla Ryan explains the mechanism of pseudoephedrine. “Pseudoephedrine is chemically similar to adrenaline, so the body recognizes it as adrenaline, causing the blood pressure and heart rate to increase.”

She refers to one of the last major studies of the effects of pseudoephedrine on blood pressure, which took place in 2005. This study found that pseudoephedrine increased systolic blood pressure (the top number) by one point on average, while heart rate increased by an average of three beats per minute.

Ryan adds that the immediate-release products had a greater impact on heart rate and blood pressure than their 12 hour or 24 hour extended-release counterparts, which showed a smaller increase in blood pressure.

In 2005, the FDA passed the Combat Methamphetamine Act, which requires pharmacies to sell all medications containing pseudoephedrine behind the counter. At your local drugstore, you’ll find cards in the cold and flu aisle with information for these medications. You can take the card to the pharmacist, who is required to scan your driver’s license before purchase.

You may recognize many of the brand names of products containing pseudoephedrine as ending with a “D,” such as Mucinex-D or Claritin-D.

More Meds that can Raise Blood Pressure

Besides pseudoephedrine, cold and allergy sufferers with hypertension should be wary of:

Afrin nasal spray (which contains oxymetazoline)
Multi-symptom cold products with NSAIDs (non-steroidal anti-inflammatory drugs, such as ibuprofen or naproxen)

If you take prescription medications that increase your blood pressure, such as Adderall or albuterol inhalers, the oxymetazoline in Afrin can also increase your blood pressure through a combined effect.

NSAIDs cause the body to retain fluid and may affect kidney function, which may increase blood pressure.

Fortunately, if you have high blood pressure, there are safer alternatives when cold and allergy season come around.

Phenylephrine

For those with high blood pressure, phenylephrine is an alternative to pseudoephedrine. They are in the same drug class known as nasal decongestants, which help relieve sinus congestion and pressure. You can buy products containing phenylephrine right off the shelf at the pharmacy.

Although there haven’t been studies measuring the effects of phenylephrine on blood pressure, experts believe it has less of an impact than pseudoephedrine.

Coricidin and Benadryl: Alternatives that Won’t Affect Blood Pressure

If you’re looking for a safe cold medicine for high blood pressure, consider Coricidin. Coricidin is an over-the-counter multi-symptom product marketed specifically for patients with high blood pressure. It comes in many varieties and contains different active ingredients that target coughs, colds, chest congestion and allergies.

For runny nose, drainage, or allergy symptoms, you may want to consider diphenhydramine, marketed under the brand name Benadryl. Diphenhydramine is an antihistamine that will help keep your sinuses clear. Drowsiness is a common side effect of this medication, so it is best taken at bedtime. For non-drowsy antihistamines, consider Zyrtec, Claritin, and Allegra.

Guaifenesin, the active ingredient in Mucinex, is an expectorant that helps you cough up mucus when congested. This medication is also safe to use if you have high blood pressure.

Old Cold Meds?
Putting drugs in the garbage or flushing them down the toilet has risks. With the drug take-back program, you can deposit expired or unwanted medication.

Shopping Smart for the Heart

The next time you’re staring down the long shelves of the cough and cold aisle, look past the list of symptoms in bold letters and make sure you consider the active ingredients in the smaller print.

If you suffer from hypertension, your heart will thank you.

And don’t forget, there’s more to decongesting than taking medication: drink more liquids, try using a humidifier, consider rinsing your sinuses with a saline solution and get lots of rest.

Uses, Side Effects, Interactions & Pill Images

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

This combination medication is used to temporarily treat cough and runny/stuffy nose (nasal congestion) caused by infections (such as the common cold), allergies (such as hay fever), and other breathing illnesses. This product is usually not used for ongoing cough from smoking or long-term breathing problems (such as chronic bronchitis, emphysema) unless directed by your doctor. Guaifenesin is an expectorant. It works by thinning and loosening mucus in the airways, clearing congestion, and making breathing easier. Phenylephrine is a decongestant (sympathomimetic). It reduces nasal congestion by narrowing the blood vessels in the nose.If you are self-treating with this medication, it is important to read the package instructions carefully before you start using this product to be sure it is right for you.

Why High Blood Pressure and Cold Meds Don’t Mix

Cold medicines are not off-limits if you have heart disease, but patients with high blood pressure, or hypertension, should check the label carefully when choosing a cold or allergy medicine.

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That’s because decongestants such as pseudoephedrine, ephedrine, phenylephrine, naphazoline and oxymetazoline can increase your blood pressure and heart rate. Make sure the cold or allergy medication you plan to take is free of those ingredients.

Decongestants can also prevent your blood pressure medication from working properly. And always check the active and inactive ingredient lists, because many medications are high in sodium, which also raises blood pressure.

For allergy sufferers with heart disease, medicines such as Allegra, Zyrtec or Claritin should be safe. However, medicines containing decongestants — including Allegra-D, Zyrtec-D and Claritin-D — could increase your blood pressure and heart rate or interfere with your heart medication.

Managing a cold with hypertension

If you can’t take a decongestant because of high blood pressure, there are other ways to reduce your cold or allergy symptoms:

Take Coricidin HBP, which is free of decongestants
Drink plenty of fluids — including water, juice, tea and soup — to prevent dehydration and clear mucus from your lungs
Take a pain reliever such as Tylenol or Motrin for fever, sore throat, body aches and headache
Flush your sinuses with a saline spray to relieve nasal congestion
Soothe a sore or scratchy throat with lozenges
Use a vaporizer or humidifier if necessary to boost humidity
Get plenty of rest
Return to your doctor after five to seven days to make sure you’re on the road to recovery

Before taking any new medication

Always check with your pharmacist before you take a new medication, whether it’s for a cold, allergies or something else, to find out if it is compatible with certain medical conditions and your current drug therapy.

SEE ALSO: Millions More People Now Have High Blood Pressure. Why That’s a Good Thing

If you have a heart condition, be sure to discuss all medication choices with your cardiologist before taking anything.

Medications to Avoid if You Have High Blood Pressure

Blood pressure is best understood as the force of blood pressing against the walls of your arteries. A person can be diagnosed with high blood pressure, also called hypertension, when their blood pressure is consistently greater than 140/90 mm Hg.

When a person’s blood pressure is too high, their hearts need to work harder which can cause serious damage to the arteries. Over time, uncontrolled high blood pressure increases the risk of heart disease, stroke and kidney disease.

Some medications can increase your blood pressure, so it’s important to be aware of which medications to avoid if your blood pressure is already elevated. If you are unsure of whether a medication might impact your current blood pressure state, your physician or pharmacist are the first resources you should consult. Often, they will be able to recommend an alternative product that will not affect your blood pressure.

Oral Nasal Decongestants

Oral nasal decongestants like Sudafed (pseudoephedrine) and Sudafed PE (phenylephedrine) can increase blood pressure by elevating your heart rate and causing blood vessels to narrow, also known as vasoconstriction. Pseudoephedrine and phenylephedrine can also be found in many cold, cough and flu combination products. If you suffer from cold, cough or flu symptoms, try Coricidin HBP products.

Topical Nasal Decongestants

Topical nasal decongestants such as Afrin (oxymetazoline), Neo-Synephrine (phenylephrine), Privine (naphazoline), and Vicks VapoRub Inhaler (l-desoxyephedrine/levmetamfetamine) can also cause an increase in blood pressure. Safer options for people with high blood pressure are Breathe Right strips and saline products such as Ocean Saline Nasal Spray and Neti pots. Neti pots are a great way to irrigate nasal passages, however, if you choose to use one DO NOT USE tap water. It is essential to always use sterile or distilled water.

Topical Hemorrhoid Products

Topical hemorrhoid products such as PREPARATION H Hemorrhoidal Ointment contain phenylephrine, the same active ingredient in Sudafed PE. Phenylephrine causes vasoconstriction, or the constriction of blood vessels, to help decrease swelling. Patients can try Preparation H Anti-Itch Cream with Hydrocortisone or Tucks Hemorrhoidal Ointment.

Asthma Products

Asthma products such as Primatene and Bronkaid tablets contain ephedrine, which can cause an increase in blood pressure. There are no over the counter medications that are appropriate for asthma, and patients with asthma should be seen on a regular basis by their primary care physician.

Aspirin and Non-steroidal Anti-Inflammatory Drugs (NSAIDs)

Aspirin, Advil (ibuprofen) and Aleve (naproxen) are used for inflammation and pain. These medications can cause your body to retain fluid and decrease your kidney function, causing your heart and kidneys to work harder and increasing your blood pressure. For those with hypertension who require non-steroidal anti-inflammatory drugs, it is recommended to use the lowest effective dose for the shortest time possible.

Nicotine Cessation Products,

Products that reduce the urge to smoke including Nicorette gum, NicoDerm patches, and Commit lozenges all warn patients to speak to their physician before use if they have high blood pressure. Kicking a smoking habit may not be easy, but it is worthwhile! The benefits of quitting include improved tolerance for exercise, and a reduction in the risk of developing lung cancer, bladder cancer and heart disease.

Herbal Remedies

This one may come as a surprise to some patients. Herbal remedies that contain ephedra, which can be found in some weight-loss supplements, are dangerous to those with high blood pressure. Weight loss medications or appetite suppressants increase your heart rate and blood pressure. Additionally, patients with high blood pressure should avoid taking gingko, which is an herbal remedy sometimes used for memory problems, and St. John’s Wort, which is commonly used for mood and depression.

Other Medications:

Other medications that can cause an increase in blood pressure are: eye medications, migraine medications, steroids, birth control and hormone replacement pills, tricyclic antidepressants, asthma medications, and stimulants.

If you have been diagnosed with high blood pressure, consult your physician before taking any new medications. Always bring a complete and updated list of your prescription medications, over-the-counter medications, and herbal supplements to every doctor’s appointments.

Mucinex Uses and Side Effects

Mucinex is a brand name for a medication called guaifenesin. In the United States, guaifenesin is sold over-the-counter expectorant that can be used to treat congestion by breaking up and thinning mucus in the chest and throat. Mucus that is closer to a liquid than a solid is easier to cough out and expel. Mucinex is typically used by individuals who are congested because they are suffering from a common cold, the flu, or allergies but it can be prescribed by a doctor for other reasons. Guaifenesin works to relieve the symptoms of these conditions but is not a treatment for the root cause of congestion or decrease the overall time of these illnesses. Guaifenesin is safe to use in both adults and children.

IAN HOOTON / SPL / Getty Images

Aside from being used as an expectorant, guaifenesin is a centrally-acting muscle relaxant and is sometimes used in veterinary medicine for this purpose. There is also an off-label treatment known as the fibromyalgia guaifenesin protocol that is sometimes used, however, there is very little evidence to support the use of guaifenesin in this manner.

Guaifenesin is sold by itself or as one of the several ingredients in many cough and cold preparations. Some of the different medications containing guaifenesin include:

Mucinex
Mucinex DM—contains dextromethorphan as a cough suppressant
Mucinex D—contains pseudoephedrine as sinus and nasal decongestant
Mucinex Fast-Max—contains Tylenol for pain and fever, phenylephrine as a decongestant, and dextromethorphan
Children’s Mucinex Multi-Symptom—different combinations as listed above

Dosage

Mucinex comes in a variety of forms including tablets and liquids and even dissolving granules. You should follow the directions on the package carefully regardless of which form of the medication you are using. Consult your doctor or pharmacist and inform them of any medications you are currently taking as well as any allergies to medications you have before trying Mucinex. If you are using an extended-release preparation the tablets should not be cut, crushed, or chewed but taken whole. You should drink plenty of water with this medication. This medication can typically be taken with or without food.

A typical adult dose of Mucinex is 1 to 2 600mg tablets every 12 hours, or 1 maximum strength tablet (1200mg) every 12 hours. The package directions should be followed very closely when giving Mucinex to children since the dose will vary based on the child’s age and weight as well as the preparation used. Mucinex should not be given to children under the age of 4 years.

You should talk to your doctor before taking this medication if you are pregnant or breastfeeding, have kidney or liver disease, or if your cough may be caused by illness other than an upper respiratory infection or allergies such as emphysema or COPD.

Side Effects

Guaifenesin is generally well tolerated and considered safe to use, but like all medication may cause side effects. The most common side effects associated with this medication are:

Less common side effects of this medication include but are not limited to:

Drowsiness
Skin rash
Headache

You should discontinue this medication and seek emergency medical attention if you experience symptoms of a severe allergic reaction to this medication which could include:

Swelling, itching, or redness of the face
Tongue swelling
Difficulty talking or breathing
Skin rash or hives

You should also contact your doctor if your cough persists longer than 7 days or if it is accompanied by a fever that does not go away.

Alternatives

Mucinex has little evidence to suggest that it has a strong effect to help you clear secretions. Some of the combinations listed above also are counter-intuitive. For instance, Mucinex DM has a cough suppressant, when you should be trying to thin your secretions and get rid of the excess mucus by coughing. Caution should always be used when taking combinations of medications that may reduce the efficacy of the other medication.

Staying properly hydrated with water is an important factor in helping to reduce the frequency of having thick secretions which are then difficult to cough up. If you have difficulty coughing up your thick secretions, your doctor may prescribe hypertonic saline (7%) or a bronchodilator (like Atrovent). There are many other medications that can help, but they are typically reserved for chronic issues related to cystic fibrosis, chronic COPD, and other respiratory conditions.

Dextromethorphan; Guaifenesin; Phenylephrine oral suspension

What is this medicine?

DEXTROMETHORPHAN; GUAIFENESIN; PHENYLEPHRINE (dex troe meth OR fan; gwye FEN e sin; fen il EF rin) is a combination of a cough suppressant, an expectorant, and a decongestant. It is used to treat cough and congestion. This medicine will not treat an infection.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Tusso-XR

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

diabetes
enlarged prostrate
glaucoma
heart disease
high blood pressure
if you have taken an MAOI like Carbex, Eldepryl, Marplan, Nardil, or Parnate in last 14 days
lung or breathing disease, like asthma
thyroid disease
an unusual or allergic reaction to dextromethorphan, guaifenesin, phenylephrine, other medicines, foods, dyes, or preservatives
pregnant or trying to get pregnant
breast-feeding

How should I use this medicine?

Take this medicine by mouth. Follow the directions on the prescription label. Shake well before using. Take with food or milk. Use a specially marked spoon or container to measure your dose. Household spoons are not accurate. Take your medicine at regular intervals. Do not take it more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 6 years old for selected conditions, precautions do apply.

Patients over 60 years old may have a stronger reaction and need a smaller dose.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

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.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

ergot alkaloids like dihydroergotamine
MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
stimulant medicines for attention disorders, weight loss, or to stay awake

This medicine may also interact with the following medications:

alcohol
barbiturates like phenobarbital
certain heart medicines like metoprolol, digoxin, and methyldopa
diuretics
doxazosin
medicines for depression, anxiety, or psychotic disturbances
medicines for sleep
medicines to treat blood pressure
muscle relaxers
other medicines for cold, cough, or allergy
some medicines used for sleep during surgery
tamsulosin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Talk to your doctor if your cough lasts for more than 1 week. If you have a high fever, skin rash, lasting headache, or sore throat, see your doctor.

Drink several glasses of water each day. This will help loosen mucus.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine 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 medicine. Avoid alcoholic drinks.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
anxiety, irritable, or excited
breathing problems
confusion
fast, irregular heartbeat
seizures
tremor
unusually weak or tired

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

diarrhea
dizziness
headache
nausea, vomiting
stomach upset
tiredness
trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Keep bottle tightly closed. Protect from light. Throw away any unused medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

Making Wise Choices When Selecting OTC Medications

To effectively manage hypertension, the more than 75 million adults in the United States with the condition should be compliant with their prescribed drug therapies, change their diets, avoid stress when possible, and use caution when taking other medications, including OTC ones, and supplements to avoid drug—drug interactions.¹ It is particularly important for those with hypertension to be cautious when selecting OTC medications for cough, cold, and flu because the use of decongestants can exacerbate hypertension. Decongestants are indicated for the temporary relief of nasal and eustachian tube congestion and for coughs associated with postnasal drip.² This class of drugs stimulates the alpha-adrenergic receptors, constricting blood vessels and thereby decreasing sinusoid vessel enlargement and edema of the mucosal areas.²Because 1 of the adverse effects associated with the use of decongestants is cardiovascular stimulation, including elevated blood pressure (BP), tachycardia, palpitations, and arrhythmia, the use of this class of agents to relieve nasal congestion may exacerbate conditions that are sensitive to adrenergic stimulation, such as hypertension, ischemic heart disease, and coronary artery disease; the agents may also interact with several other medications.² Individuals with cardiovascular disease, including hypertension, should use decongestants only under the direction of their primary health care provider.^2,3 Individuals with hypertension should be aware that the use of decongestants may increase BP or hinder or interfere with the effectiveness of some antihypertensives, according to the American Heart Association (AHA). ³The AHA also recommends that those with hypertension avoid medications that are high in sodium.³

Results from a 2005 meta-analysis showed that the decongestant pseudoephedrine, which is found in more than 135 medications, modestly increased systolic BP and heart rate.⁴ The study results also showed that pseudoephedrine did not affect diastolic BP and the readings of greater BP were observed with higher doses and in those formulations that were immediate release.⁴ The study concluded that clinicians should consider the “risk-benefit ratio before using sympathomimetic agents in those considered to be high risks.” ⁴ It is important to note that there are a lack of data regarding the safety and efficacy of the decongestant phenylephrine in those with hypertension.⁵

Additionally, the FDA requires that the following warning be included on the label of all products that contain oral or topical decongestants: “Do not use this product if you have heart disease, high blood pressure, thyroid disease, diabetes, or difficulty in urination due to enlargement of the prostate gland, unless directed by a doctor. ”⁶

Pharmacists are in a pivotal position to educate and guide patients who have hypertension in the proper selection and use of OTC cough, cold, and flu products (Table). Patients with hypertension who are seeking advice on the available products that are safe to use should be steered toward products that do not contain decongestants and be directed to use products such as Coricidin HBP from Bayer Consumer Health, which is a product line marketed specifically to patients with hypertension. There is also a product line marketed by Procter & Gamble, including DayQuil HBP Cold & Flu and NyQuil HBP Cold & Flu, for those with hypertension, and these are decongestant free as well.

For patients who have hypertension when no other contraindications are present, such as an allergy to product ingredients, pharmacists may recommend the nasal decongestant propylhexedrine, marketed as Benzedrex from B.F. Ascher & Company, Inc, which is not required to carry the warning against use in patients with hypertension.⁷ Additionally, inhalers that contain the decongestant levmetamfetamine also do not contain the FDA warning.⁸Pharmacists can also recommend the non-medicated nasal strips marketed as Breathe Right from GlaxoSmithKline for relief from nasal congestion. Non-medicated inhalers such as Non-Medicated Vicks VapoInhalers from Procter & Gamble that contain menthol are also available. Additionally, for temporary relief of nasal congestion, pharmacists can recommend nasal steam inhalation, which can be very effective. There is also a variety of personal steam inhalation machines on the market, as well as a host of essential oil diffusers that emit the aromas of essential oils, such as peppermint and eucalyptus, throughout a room, which may provide temporary relief from nasal congestion. Patients should be advised to discuss any concerns with their primary health care provider prior to using any of these therapies.

Conclusion

During counseling, pharmacists should remind patients who have hypertension to always seek medical counsel when in doubt about the use of any OTC product to avoid potential drug—drug interactions or contraindications. Patients should be encouraged to always read the labels of medications prior to use and to adhere to the recommended directions. Pharmacists can also suggest various nonpharmacological measures that patients may employ to relieve cough, cold, and flu symptoms, such as congestion, including vaporizers, humidifiers, rest, and adequate hydration. Counseling provides pharmacists an opportunity to increase awareness and educate patients with hypertension about other OTC medications that they should avoid or use with caution. They can remind patients with hypertension about the critical nature of self-monitoring BP routinely, remaining compliant with prescribed therapy, adhering to low-sodium diets, and routinely following up with their primary health care providers. Pharmacists can be instrumental in recommending appropriate measures to treat congestion in those with hypertension without negatively affecting their BP.

Yvette C. Terrie is a clinical pharmacist and medical writer based in Haymarket, Virginia.

References

High blood pressure. CDC website. cdc.gov/bloodpressure/index.htm. Updated September 5, 2017. Accessed October 28, 2017.
Scolaro KL. Colds and allergy. In: Krinsky DL, Ferreri Stefanie P, Hemstreet B, et al, eds. Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care. 18th ed. Washington, DC: American Pharmacists Association; 2015.
Understanding over-the-counter (OTC) medications and high blood pressure. American Heart Association website. heart.org/HEARTORG/Conditions/HighBloodPressure/MakeChangesThatMatter/Understanding-Over-the-Counter-OTC-Medications-and-High-Blood-Pressure_UCM_303245_Article.jsp#.WfdUa2hSw2x. Updated October 2016. Accessed October 28, 2017.
Salerno SM, Jackson JL, Berbano EP. Effect of oral pseudoephedrine on blood pressure and heart rate: a meta-analysis. Arch Intern Med. 2005;165(15):1686-1694. doi: 10.1001/archinte.165.15.1686 .
Hatton RC, Winterstein AG, McKelvey RP, Shuster J, Hendeles L. Efficacy and safety of oral phenylephrine: systematic review and meta-analysis. Ann Pharmacother. 2007;41(3):381-390. doi: 10.1345/aph.1H679.
US Food and Drug Administration. CFR – code of federal regulations title 21. www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=341.80. Updated April 1, 2017. Accessed October 28, 2017.
Benzedrex FAQ. B.F. Ascher & Co, Inc, website. bfascher.com/questions/benzedrex-faq/. Accessed October 30, 2017.
Vapor Inhaler (levmetamfetamine) [package insert]. Deerfield, IL: Walgreens; 2016. dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=77924474-ccc7-497b-9168-91490bcfadfc. Accessed November 1, 2017.

Memorial Sloan Kettering Cancer Center

This document, provided by Lexicomp ^®, contains all the information you need to know about the drug, including the indications, route of administration, side effects and when you should contact your healthcare provider.

Trade names: USA

Kapspargo Sprinkle; Lopressor; Toprol XL

Trade names: Canada

AG-Metoprolol-L; APO-Metoprolol; APO-Metoprolol SR; APO-Metoprolol Type L; DOM-Metoprolol; DOM-Metoprolol-L; JAMP-Metoprolol-L; Lopresor SR; Lopresor [DSC]; Metoprolol-100; Metoprolol-25; Metoprolol-50; Metoprolol-L; PMS-Metoprolol-B; PMS-Metoprolol-L; RIVA-Metoprolol-L; SANDOZ Metoprolol (Type L) [DSC]; Sandoz Metoprolol SR; TEVA-Metoprolol

Warning

Do not stop taking this drug suddenly.If you stop taking this drug abruptly, your chest pain may worsen and, in some cases, even a heart attack. The risk may be increased with certain types of heart disease. To avoid side effects, this drug should be stopped gradually as directed by your doctor. Call your doctor right away if you experience or worsen chest pain or other heart problems.

What is this drug used for?

Used to treat high blood pressure.
Used to treat chest pain and chest pressure.
Used to treat heart failure (weakened heart).
It is used to prevent the development of repeated myocardial infarction and to prolong life.
This medicinal product can be used for other indications. Consult your doctor.

What should I tell my doctor BEFORE taking this drug?

If you are allergic to this drug, any of its ingredients, other drugs, foods or substances.Tell your doctor about your allergy and how it manifested itself.
If you have any of the following health problems: certain types of heart rhythm disturbances called heart block or weak sinus syndrome, heart failure (weakened heart), low blood pressure, poor blood flow to the upper or lower extremities, shock caused by disturbances from the side of the heart, or bradycardia.
If you have any of the following health problems: asthma or other breathing problems such as COPD (chronic obstructive pulmonary disease).

This list of drugs and diseases that may be adversely associated with this drug is not exhaustive.

Tell your doctor and pharmacist about all medicines you take (both prescription and over-the-counter, natural products and vitamins) and your health problems. You need to make sure that this drug is safe for your medical condition and in combination with other drugs you are already taking.Do not start or stop taking any drug or change the dosage without your doctor’s approval.

What do I need to know or do while taking this drug?

Tell all healthcare providers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
Avoid driving or other activities that require increased attention until you see how this drug affects you.
To reduce the risk of dizziness or loss of consciousness, get up slowly from a lying or sitting position. Use caution when climbing and descending stairs.
Measure blood pressure and heart rate as directed by your doctor.
Perform blood tests as directed by your doctor. Please consult your doctor.
This drug may interfere with some laboratory tests.Tell all healthcare providers and lab staff that you are taking this drug.
This drug may mask signs of low blood sugar. Consult your doctor.
If you have high blood sugar (diabetes), your blood sugar should be checked regularly.
If you are taking this drug and have high blood pressure, talk to your doctor before taking any over-the-counter drugs that can raise blood pressure.These drugs include medicines for coughs and colds, diet pills, stimulants, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, and some naturally occurring drugs.
You may need to refrain from consuming alcoholic beverages with certain medications. Ask your doctor or pharmacist to see if you should refrain from drinking alcoholic beverages with this drug.
This drug may increase the severity of these conditions if you have signs of an overactive thyroid gland, such as tachycardia. If you have an overactive thyroid and suddenly stop taking this drug, your condition may worsen and be life threatening. Please consult your doctor.
If you have had a very severe allergic reaction, consult your doctor. If you come into contact with the agent that caused the allergy, there is a risk of an even more severe reaction.Talk to your doctor if you are using epinephrine to treat very severe allergic reactions. Epinephrine may not work well while you are taking this drug.
Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding. The benefits and risks for you and your child will need to be discussed.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, some people with this drug can cause serious and sometimes deadly side effects. Call your healthcare professional or get medical attention right away if you have any of the following signs or symptoms, which may be associated with serious side effects:

Signs of an allergic reaction such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.
Depression.
Severe dizziness or fainting.
When chest pain occurs or worsens.
The appearance or aggravation of cardiac arrhythmias.
Bradycardia.
Shortness of breath, sudden weight gain, or swelling of the arms or legs.

What are some other side effects of this drug?

Any medicine can have side effects. However, many people have little or no side effects.Call your doctor or get medical help if these or any other side effects bother you or do not go away:

Feeling dizzy, tired, or weak.
Diarrhea, indigestion or vomiting.

This list of potential side effects is not exhaustive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

You can report side effects to the National Health Office.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your healthcare practitioner. Read all the information provided to you. Follow all instructions strictly.

Immediate-release tablets of active ingredient:

Take with or immediately after meals.
Swallow whole with a full glass of water.
Continue taking this drug as directed by your doctor or other healthcare professional, even if you feel well.

Extended-release tablets:

Take with or immediately after meals.
Swallow whole. Do not chew or crumble.
You can break a tablet in half. Do not chew or grind.
Continue taking this drug as directed by your doctor or other healthcare professional, even if you feel well.

Sustained-release capsules:

Take this medication with or without food.
Swallow whole. Do not chew or crumble.
If you cannot swallow this drug whole, pour the contents into applesauce, pudding, yogurt, or other soft foods.Then swallow the mixture without chewing within 60 minutes after mixing. Do not store for future use.
Continue taking this drug as directed by your doctor or other healthcare professional, even if you feel well.
Patients with feeding tubes may use this medication. Apply as directed. Flush the feeding tube after using this drug.

Injection:

For intravenous injection.

What to do if a dose of a drug is missed?

All oral preparations:

Skip the forgotten dose and return to your normal schedule.
Do not take 2 doses at the same time or an additional dose.

Injection:

Call your doctor for further instructions.

How do I store and / or discard this drug?

All oral preparations:

Store at room temperature in a dry place.Do not store in the bathroom.
Protect from heat.

Injection:

If you need to store this drug at home, ask your doctor, nurse, or pharmacist for information about how it is stored.

All forms of issue:

Store all medicines in a safe place. Keep all medicines out of the reach of children and pets.
Dispose of unused or expired drugs.Do not empty into toilet or drain unless directed to do so. If you have any questions about the disposal of your medicinal products, consult your pharmacist. Your area may have drug recycling programs.

General information on medicinal products

If your health does not improve or even worsens, see your doctor.
You should not give your medicine to anyone and take other people’s medicines.
Some medicines may have different patient information sheets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
Some medicines may have different patient information sheets. Check with your pharmacist. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
If you think there has been an overdose of a drug, call a Poison Control Center immediately or seek medical attention. Be prepared to tell or show which drug you took, how much and when it happened.

Use of information by consumer and limitation of liability

This information should not be used to make decisions about taking this or any other drug. Only the attending physician has the necessary knowledge and experience to make decisions about which drugs are appropriate for a particular patient.This information does not guarantee that the drug is safe, effective, or approved for the treatment of any disease or specific patient. Here are only brief general information about this drug. It does NOT contain all available information on the possible use of the drug with instructions for use, warnings, precautions, information about interactions, side effects and risks that may be associated with this drug. This information should not be construed as a treatment guide and does not replace information provided to you by your healthcare professional.For complete information on the possible risks and benefits of taking this drug, consult your doctor.

Copyright

Memorial Sloan Kettering Cancer Center

Trade names: USA

Imitrex; Imitrex STATdose Refill; Imitrex STATdose System; Onzetra Xsail; Sumavel DosePro; Tosymra; Zembrace SymTouch

Trade names: Canada

ACT SUMAtriptan; APO-SUMAtriptan; DOM-SUMAtriptan; Imitrex; Imitrex DF; MYLAN-SUMAtriptan; PMS-SUMAtriptan; RATIO-SUMAtriptan; SANDOZ SUMAtriptan; SUMAtriptan DF; TARO-SUMAtriptan; TEVA-SUMAtriptan; TEVA-SUMAtriptan DF

What is this drug used for?

Used to treat migraines.
Used to treat cluster headache.

What should I tell my doctor BEFORE taking this drug?

If you are allergic to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergy and how it manifested itself.
If you have any of the following health problems: high blood pressure or liver disease.
If you have ever had any of the following health conditions: chest pain or angina, arterial disease of the lower or upper extremities, myocardial infarction or other heart disease, poor circulation in the heart, brain, intestines or kidneys, stroke or transient ischemic attack (TIA), some types of migraine, such as hemiplegic or basilar migraine, or an abnormal heart rhythm, such as Wolff-Parkinson-White syndrome.
If you have taken a drug for depression or Parkinson’s disease in the past 14 days. These include isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. An episode of very high blood pressure may occur.
If you are taking another drug that contains the same drug.
If you have taken the following drugs in the past 24 hours: almotriptan, eletriptan, frovatriptan, naratriptan, risatriptan, sumatriptan, or zolmitriptan.
If you have taken ergotamine, methysergide, dihydroergotamine or similar medications within the past 24 hours.

This list of drugs and diseases that may be adversely associated with this drug is not exhaustive.

Tell your doctor and pharmacist about all medicines you take (both prescription and over-the-counter, natural products and vitamins) and your health problems.You need to make sure that this drug is safe for your medical condition and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor’s approval.

What do I need to know or do while taking this drug?

For all patients taking this drug:

Tell all healthcare providers that you are taking this drug.These are doctors, nurses, pharmacists and dentists.
Avoid driving or other activities that require increased attention until you see how this drug affects you.
High blood pressure has happened with this drug. Monitor your blood pressure as directed by your doctor.
This medication is not intended to prevent or reduce the incidence of migraine headaches.
If you have a headache that is not like your usual migraine headache, talk with your doctor before using this drug.
Taking too much of this drug (higher doses, more frequent use) than what your doctor tells you to do may make your headaches worse.
Be careful if you have risk factors for heart disease (high blood pressure, high cholesterol, being overweight, high blood sugar or diabetes, cigarette smoking, male and over 40 years of age, early heart disease in other members families, postmenopausal women).Please consult your doctor.
Very bad and sometimes life-threatening heart problems, such as a heart attack or an irregular heartbeat, have rarely happened within hours after taking this drug. See your doctor right away if you have a feeling of tightness, pain, pressure, or heaviness in your chest, throat, neck or jaw, if you have a cold sweat, if you have shortness of breath, rapid heartbeat, irregular heartbeat, or very severe dizziness or fainting …
Very bad and sometimes deadly brain damage, such as a stroke, has rarely happened with this drug. If you have weakness on 1 side of your body, difficulty speaking or thinking, imbalance, drooping of 1 side of your face, or impaired vision, see your doctor immediately.
If you are allergic to latex, consult your doctor. Some products contain latex.
If you are 65 years of age or older, use this drug with caution.You may have more side effects.
Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding. The benefits and risks for you and your child will need to be discussed.

Children:

This drug is not approved for use in children. However, your doctor may decide that the benefits of using this drug outweigh the risks associated with it. If your child has received this drug, ask your doctor about the benefits and risks.Talk to your doctor if you have any questions about how your child is using this drug.

What side effects should I report to my doctor immediately?

Signs of an allergic reaction such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.In rare cases, certain allergic reactions have resulted in death.
Signs of high blood pressure, such as very severe headache, or dizziness, or loss of consciousness, or blurred vision.
Convulsions.
Loss of vision. Can persist for a long time.
Unusual burning, numbness, or tingling sensations.
Changing the color of the skin to a bluish tint in the lips, nail bed, fingers and toes.
Diarrhea or constipation.
Severe abdominal pain or diarrhea with bloody stools.
Abdominal pain after eating.
High temperature.
Weight loss.
Cramps and pains in the legs or pelvis.
Feeling of heaviness or tension in the muscles of the legs.
Chills.
Burning or aching pain in feet or toes.
A serious and sometimes fatal complication called serotonin syndrome can occur.This risk may increase with the concomitant use of certain other drugs. Call your doctor right away if you have anxiety, imbalance, confusion, hallucinations, fever, tachycardia or irregular heartbeat, flushing, muscle twitching or stiffness, seizures, tremors or tremors, excessive sweating, severe diarrhea, nausea or vomiting , very severe headache.

What are some other side effects of this drug?

Any medicine can have side effects.However, many people have little or no side effects. Call your doctor or get medical help if these or any other side effects bother you or do not go away:

All forms of issue:

Feeling dizzy, sleepy, tired, or weak.
Hyperemia (blush).
Sensation of warmth.
Nausea or vomiting.

Nasal spray:

Changes in the ability to perceive taste.
Burn.
Nose or throat irritation.

Nasal Powder:

Changes in the ability to perceive taste.
Nose or throat irritation.
Runny or stuffy nose.

Injection:

Injection site irritation.

This list of potential side effects is not exhaustive. If you have any questions about side effects, please contact your doctor.Talk to your doctor about side effects.

You can report side effects to the National Health Office.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your healthcare practitioner. Read all the information provided to you.Follow all instructions strictly.

All forms of issue:

If your headache persists after the first dose, consult your doctor. If your headache comes back or you only feel some relief, you can take 1 more dose as directed by your doctor. You should know exactly how long after you can take another dose. This also applies to those cases when the first dose of the drug was in a different form of release.

Tablets:

Take this medication with or without food.
Swallow whole. Do not chew, break, or crush.
Take with liquids as early as possible after the onset of an attack.

Injection:

The injection is given subcutaneously as soon as possible after the onset of the attack.
If you give yourself injections, your doctor or nurse will teach you how to inject.
Make sure you know exactly where to inject. If you are not sure where to get the injection, consult your doctor.
Wash hands before and after use.
Do not use if solution is cloudy, leaking, or contains particles.
Do not use if solution changes color.
Dispose of needles in the sharps / needles container. Needles and other items cannot be reused. When the container is full, dispose of it according to local regulations.If you have questions, ask your doctor or pharmacist.

Nasal spray:

Not for oral administration. For nasal use only. Avoid contact with mouth and eyes (possible burns).
Take this drug as soon as possible after the onset of an attack.
Sit down before taking.
Clean nose before use.

Nasal Powder:

For nose only.
Take this drug as soon as possible after the onset of an attack.
Use the nosepiece immediately after removing it from the foil bag.
Use only the device sold with this drug. Do not use other devices.
Make sure you know exactly how to use this drug. Read the instructions that came with this drug. Talk to your doctor or pharmacist if you have any questions about the use of this drug.

What to do if a dose of a drug is missed?

This drug should be taken as needed. Do not take this medicine more often than prescribed by your doctor.

How do I store and / or discard this drug?

All forms of issue:

Store at room temperature. Do not place in refrigerator or freezer.
Store in a dry place.Do not store in the bathroom.
Protect from light.
Store all medicines in a safe place. Keep all medicines out of the reach of children and pets.
Dispose of unused or expired drugs. Do not empty into toilet or drain unless directed to do so. If you have any questions about the disposal of your medicinal products, consult your pharmacist.Your area may have drug recycling programs.

Injection:

If you have been given a storage case, store in this case.

General information on medicinal products

If your health does not improve or even worsens, see your doctor.
You should not give your medicine to anyone and take other people’s medicines.
Some medicines may have different patient information sheets.If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
Some medicines may have different patient information sheets. Check with your pharmacist. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
If you think there has been an overdose of a drug, call a Poison Control Center immediately or seek medical attention.Be prepared to tell or show which drug you took, how much and when it happened.

Use of information by consumer and limitation of liability

This information should not be used to make decisions about taking this or any other drug. Only the attending physician has the necessary knowledge and experience to make decisions about which drugs are appropriate for a particular patient. This information does not guarantee that the drug is safe, effective, or approved for the treatment of any disease or specific patient.Here are only brief general information about this drug. It does NOT contain all available information on the possible use of the drug with instructions for use, warnings, precautions, information about interactions, side effects and risks that may be associated with this drug. This information should not be construed as a treatment guide and does not replace information provided to you by your healthcare professional. For complete information on the possible risks and benefits of taking this drug, consult your doctor.

Copyright

Arpimed

Method of application

Swallow the tablet with a glass of water.
Try to take your tablets at the same time every day. It doesn’t matter if you take Lisinopril before or after meals.
Continue taking Lisinopril until your doctor allows you to stop taking it, the treatment is long.It is important to take Lisinopril every day.

First dose

Take special care after taking the first dose of Lisinopril or when increasing the dose. This can lead to a sharp drop in blood pressure than subsequent doses.
Taking the first dose may make you dizzy. If this is observed, you should lie down. If you are concerned about this, please see a doctor as soon as possible.

Adults

Your dose depends on your health condition and on whether you are taking any other medicines in parallel.Your doctor will recommend how many tablets to take each day. If you are unsure of something, check with your doctor or pharmacist.

Treatment of high blood pressure

The recommended starting dose is 10 mg once daily.
The usual dose for long-term use is 20 mg once daily.

Heart failure treatment

The recommended starting dose is 2.5 mg once a day.
The usual dose for long-term use is 5 to 35 mg once daily.

Post-heart attack treatment

The recommended starting dose is 5 mg within 24 hours after a heart attack and 5 mg every other day.
The usual dose for long-term use is 10 mg once daily.

For the treatment of kidney diseases caused by diabetes mellitus

The recommended dose is 10 mg or 20 mg once daily.

If you are an elderly person, have kidney problems, or are taking diuretics, your doctor may prescribe a lower dose than your usual dose.

Use in children and adolescents (aged 6-16 years) with high blood pressure

It is not recommended to use Lisinopril in children under 6 years of age or in children with severe renal impairment.
The doctor will find the right dose for your child.The dose depends on the child’s body weight.
The recommended starting dose for children weighing 20 to 50 kg is 2.5 mg once a day.
The recommended starting dose for children weighing more than 50 kg is 5 mg once a day.

If you took more Lisinopril than recommended

If you have taken more Lisinopril than prescribed by your doctor, you should contact your doctor or the nearest hospital.

Symptoms of the following are most likely: dizziness, heart palpitations.

If you forget to take Lisinopril

If you forget to take Lisinopril, take it as soon as you remember, but if it’s time for your next dose, do not take the missed dose.
Do not take a double dose of the drug to compensate for the missed dose.

If you stop taking Lisinopril

Do not stop taking the tablets without consulting your doctor, even if you feel well.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Tell your doctor right away if you notice any of the effects listed below.

Severe allergic reactions (rare, occurs in 1-10 out of 10,000 people).

Symptoms may include sudden onset:

Swelling of the face, lips, tongue, or throat. This can make it difficult to swallow.
Severe or sudden swelling of the hands, feet and ankles.
Shortness of breath
Severe itching of the skin (with blisters).

Severe skin lesions, such as a sudden, unexpected rash or burning, redness or flaking of the skin (very rare, affects less than 1 in 10 people.000).
Infection with symptoms such as fever and severe worsening of general condition, or fever with local symptoms of infection such as sore throat / pharynx / mouth or urinary problems (very rare, affects less than 1 in 10,000 people).

Other side effects:

Often (observed in 1-10 out of 100 people)

Headache
Feeling dizzy, especially when standing up suddenly.
Diarrhea
Dry cough that does not go away.
Vomiting
Kidney problems (confirmed by a blood test)

Uncommon (observed in 1-10 out of 1000 people)

Mood Changes
Discoloration of fingers or toes (pale blue accompanied by redness) or numbness or tingling in fingers or toes.
Change in taste
Drowsiness
Dizziness (vertigo)
Sleep problems
Stroke
Rapid heartbeat
Runny nose
Nausea
Abdominal pain or indigestion
Skin rash or itching
Lack of erection (impotence)
Feeling tired or weak (loss of strength)
An excessive decrease in blood pressure can occur in people with the following conditions: coronary artery disease, narrowing of the aorta (artery of the heart), renal artery, or heart valves; an increase in the thickness of the heart muscle.If this happens to you, you may feel dizzy, especially when standing up suddenly.
Changes in blood test values that show the functional state of the liver and kidneys.
Heart attack
Visual and auditory hallucinations

Rarely (observed in 1-10 out of 10,000 people)

Confusion
Skin rash (urticaria)
Dry mouth
Hair loss
Psoriasis (skin problem)
Smell impaired
Breast augmentation in men
Changes in some cells or other blood elements.Your doctor will need to take blood samples periodically to check if Lisinopril has any effect on blood composition. Signs of an impact may include feeling tired, pale skin, sore throat, high fever (fever), joint and muscle pain, swelling of the joints or glands, or sensitivity to sunlight.
Low blood sodium levels (symptoms may include fatigue, headache, nausea, vomiting).
Sudden renal failure.

Very rare (occurs in less than 1 person in 10,000)

Sinusitis (feeling of pain and stuffiness behind the cheek and eyes).
Wheezing
Low blood sugar (hypoglycemia). Symptoms include hunger or weakness, sweating, and heart palpitations.
Inflammation of the lungs. Symptoms: cough, feeling short of breath and high temperature (fever)
Yellowing of the skin or whites of the eyes (jaundice)
Inflammation of the liver.May cause loss of appetite, yellowing of the skin and eyes, and darkening of urine
Inflammation of the pancreas. It causes moderate to severe stomach pain
Severe skin lesions. Symptoms include: redness, blistering, and peeling
Sweating
Oliguria or anuria
Liver failure
Swelling
Intestinal inflammation

Unknown (frequency cannot be estimated from available data)

Depression symptoms
Fainting

Side effects in children were found to be comparable to those in adults.

If you have any side effects, talk to your doctor or pharmacist. This includes any side effects not listed in this leaflet.

Reporting side effects

If you notice any side effects, tell your doctor, pharmacist or pharmacist about it, including any side effects not listed in this leaflet. You can also report side effects of Arpimed LLC by going to the website www.arpimed.com and fill out the appropriate form “Report side effects or ineffectiveness of the drug” and to the Scientific Center for the Expertise of Drugs and Medical Technologies. Academician E. Gabrielyan by going to the website www.pharm.am in the section “Report a side effect of the drug” and fill out the form “Card of messages about the side effect of the drug”. Scientific center hotline: +37410200505; +37496220505 By reporting side effects you are helping to gather more information on the safety of this medicine.

How to store Lisinopril

Lisinopril , 5 mg tablet.

The drug should be stored out of the reach of children, protected from moisture and light at a temperature of 15 ⁰ C -25 ⁰ C.

Shelf life – 3 years. Do not take lisinopril after the expiry date printed on the drug packaging. The expiry date refers to the last day of the specified month.
Do not dispose of medicines into waste water or sewage system. Ask your pharmacist how to dispose of the drug that you no longer need. These measures are aimed at protecting the environment.

Contents of the box and additional information

One Lisinopril 5 mg tablet contains:

active substance: lisinopril (in dihydrate format) – 5 mg

excipients: sodium starch glycolate, microcrystalline cellulose, magnesium stearate.

What Lisinopril looks like and contents of the pack:

Lisinopril 5 mg tablets: Round flat tablets of white or almost white color with a score on one side and bevel on both sides, odorless.

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What is this medicine?

What should I tell my health care provider before I take this medicine?

How should I use this medicine?

What if I miss a dose?

What may interact with this medicine?

What should I watch for while using this medicine?

What side effects may I notice from receiving this medicine?

Where should I keep my medicine?

Making Wise Choices When Selecting OTC Medications

Memorial Sloan Kettering Cancer Center

Trade names: USA

Trade names: Canada

Warning

What is this drug used for?

What should I tell my doctor BEFORE taking this drug?

What do I need to know or do while taking this drug?

What side effects should I report to my doctor immediately?

What are some other side effects of this drug?

What is the best way to take this drug?

What to do if a dose of a drug is missed?

How do I store and / or discard this drug?

General information on medicinal products

Use of information by consumer and limitation of liability

Copyright

Memorial Sloan Kettering Cancer Center

Trade names: USA

Trade names: Canada

What is this drug used for?

What should I tell my doctor BEFORE taking this drug?

What do I need to know or do while taking this drug?

What side effects should I report to my doctor immediately?

What are some other side effects of this drug?

What is the best way to take this drug?

What to do if a dose of a drug is missed?

How do I store and / or discard this drug?

General information on medicinal products

Use of information by consumer and limitation of liability

Copyright

Arpimed

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