Acetaminophen and Codeine Uses,Images & Side effects

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Acetaminophen-codeine 300 mg-15 mg 131070058

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Acetaminophen-Codeine 300 mg-30 mg-MAL

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Acetaminophen-Codeine 300 mg-30 mg-RAN

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Acetaminophen-codeine 300 mg-60 mg 131070060

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Acetaminophen-Codeine 300 mg-60 mg-MAL

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APAP 2-BAR

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APAP 3-QUA

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APAP 4-BAR

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APAP 4-TEV

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Tylenol 3

Tylenol 3

round, white, imprinted with TYLENOL CODEINE 3, McNEIL

Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

Tylenol #3 (acetaminophen/codeine) and Percocet (acetaminophen/oxycodone) are two different opioid pain relievers. Both prescription drugs contain a combination of acetaminophen and an opioid medication. Acetaminophen is a non-opioid analgesic that’s commonly found as an over-the-counter pain reliever. The addition of an opioid makes Tylenol #3 and Percocet potent pain medicines.

Opioids like codeine and oxycodone work by binding to mu-opioid receptors in the brain, which play a role in the sensation of pain throughout the body. In addition, by binding to these receptors, opioids block pain signals throughout the central nervous system (CNS). Tylenol #3 and Percocet come in pill forms, and they are meant to be used for short-term pain because of their potential for abuse and dependence.

While these opioid pain relievers have similar ingredients and purposes, there are some differences to note between the two.

What are the main differences between Tylenol 3 vs. Percocet?

The main difference between Tylenol #3 and Percocet is that Percocet is a more potent prescription opioid. Tylenol #3 contains codeine, which is weaker than the benchmark opioid, morphine. In contrast, Percocet contains oxycodone, an opioid that’s almost two times more potent than morphine.

Tylenol #3 (Tylenol #3 details) is a Schedule III or V drug with a lower potential for abuse than other opioids. Low doses of codeine can sometimes be purchased over the counter for mild pain or cough. However, there is still a risk of overdose if it is not taken as prescribed. Tylenol #3 comes in 300-30 mg tablets.

Because (Percocet details) it is a Schedule II drug, Percocet has a higher potential for abuse compared to Tylenol #3. Percocet should only be taken when other pain relief options have failed. Otherwise, it is often prescribed at low doses for pain. Percocet comes in 325-2.5 mg, 325-5 mg, 325-7.5 mg, 325-10 mg tablets.

Main differences between Tylenol 3 vs. Percocet
Drug class	Opioids Opioid and analgesic combination	Opioids Opioid and analgesic combination
Brand/generic status	Brand and generic version available	Brand and generic version available
What is the generic name?	Acetaminophen/Codeine	Acetaminophen/Oxycodone
What form(s) does the drug come in?	Oral tablet	Oral tablet
What is the standard dosage?	One tablet (300 mg acetaminophen/30 mg codeine) every four hours as needed. Maximum of 4000 mg of acetaminophen per day. Dosage is individualized based on severity of pain.	One to two tablets (2.5 to 10 mg of oxycodone) every four to six hours as needed. Maximum of 4000 mg of acetaminophen per day. Dosage is individualized based on severity of pain.
How long is the typical treatment?	Short-term treatment, as directed by a healthcare provider	Short-term treatment, as directed by a healthcare provider
Who typically uses the medication?	Adults	Adults

Conditions treated by Tylenol 3 vs. Percocet

Tylenol #3 is FDA-approved to treat mild to moderate pain. It is often prescribed to relieve pain after certain injuries or dental procedures. For example, after a wisdom tooth extraction, Tylenol #3 may be given for pain management.

Percocet is FDA approved to treat moderate to severe pain. Like Tylenol #3, it can also be used to relieve pain after injuries and surgeries. Another common use for opioids like Percocet includes cancer and chronic pain relief.

Is Tylenol 3 vs. Percocet more effective?

Tylenol #3 and Percocet are often prescribed for pain that is not controlled with over-the-counter pain relievers like non-steroidal anti-inflammatory drugs (NSAIDs). They’re both effective treatment options depending on the type and severity of pain being treated. Professional medical advice should be consulted on the best opioid analgesic for specific situations.

In one systematic review of opioids for chronic noncancer pain, codeine was classified as a weak opioid, and oxycodone was classified as a strong opioid. Oxycodone, found in Percocet, was found to be significantly more effective than other drugs, such as naproxen, for chronic pain relief. On the other hand, codeine was found to be as effective as NSAIDs for chronic pain relief.

One clinical trial comparing Tylenol #3 and Percocet found that both opioid drugs are similar in effectiveness. The study, which included 240 subjects, concluded that Tylenol #3 may be a reasonable alternative to “stronger” opioids for acute pain in the arms or legs. Side effects and patient-reported satisfaction were similar in both study groups.

The effectiveness of an opioid analgesic may depend on the severity of pain, dosing, and other treatments being used. This comparison is for informational purposes only. Always seek professional medical advice for the most effective treatment options for pain.

Coverage and cost comparison of Tylenol 3 vs. Percocet

Tylenol #3 is available as a generic drug that’s covered by most Medicare and insurance plans. For 20 generic Tylenol #3 tablets, the average cash price is around $18. With a SingleCare Tylenol #3 coupon, the price may be lowered to around $8. Compare the cash price of this medication with your insurance copay and your price with a discount card.

Percocet is widely available as a generic medication. Generic Percocet is often covered by Medicare and insurance plans. The typical cash price of Percocet tablets is around $22. However, this price can be reduced by using a SingleCare Percocet card, which may bring the cost down to $9.

Get the SingleCare prescription discount card

Common side effects of Tylenol 3 vs.

Percocet

The most common side effects of Tylenol #3 and Percocet are drowsiness, lightheadedness, dizziness, and sedation. Both opioid medications can also cause nausea, vomiting, dry mouth, and headache. Another common side effect is opioid-induced constipation.

Serious side effects may include respiratory depression and hypersensitivity reactions. Consult medical attention if you experience shallow breathing, severe rash, or swelling of the face.

*not reported

Frequency is not based on data from a head-to-head trial. This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more.

Source: DailyMed (Tylenol 3), DailyMed (Percocet)

Drug interactions of Tylenol 3 vs. Percocet

Tylenol #3 and Percocet are both metabolized, or processed, in the body by liver enzymes. Certain drugs can interfere with how these enzymes work. For example, drugs that act as CYP3A4 inhibitors, such as erythromycin and ketoconazole, can increase opioid levels in the body. This can lead to serious side effects, such as respiratory depression.

Tylenol #3 and Percocet should be avoided or monitored while taking other drugs like benzodiazepines, antipsychotics, antidepressants, and anticonvulsants. These drugs can have effects on the central nervous system (CNS). Taking these drugs together can increase the risk of side effects such as drowsiness and dizziness.

The combined use of opioids and serotonergic drugs, like antidepressants, can increase the risk of serotonin syndrome, a potentially life-threatening condition.

Taking opioid analgesics with diuretics can decrease the effectiveness of the diuretics. Dosage may need to be adjusted and blood pressure may need to be monitored while taking both an opioid and diuretic.

Opioids can increase the risk of urinary retention and constipation when taken with anticholinergic drugs.

Consult a healthcare professional for other possible drug interactions

Warnings of Tylenol 3 vs. Percocet

Tylenol #3 and Percocet are controlled substances with a high potential for abuse, addiction, and misuse. However, because of its potency, Percocet has a higher potential of abuse than Tylenol #3. These opioid medications should be taken under the guidance of a healthcare provider after a complete medical evaluation.

Abuse and dependence on these opioids can increase the risk of overdose. High doses of opioids can lead to shallow breathing (respiratory depression), confusion, loss of consciousness, and even death. A prescribing doctor may recommend a naloxone reversal kit for certain patients at risk of an opioid overdose.

Opioid medications should be tapered, or discontinued gradually. Otherwise, there is a risk of withdrawal symptoms after long-term use. Withdrawal symptoms may include anxiety, fatigue, sweating, and seizures.

Consult a healthcare provider for other possible warnings and precautions associated with these prescription drugs.

Frequently asked questions about Tylenol 3 vs. Percocet

What is Tylenol 3?

Tylenol #3, also known as the combination of acetaminophen and codeine, is an opioid pain reliever. It is FDA approved for mild to moderate pain. Tylenol #3 is often prescribed after an injury or dental procedure. It is available in oral tablets with a strength of 300 mg of acetaminophen and 30 mg of codeine.

What is Percocet?

Percocet is the brand name for the combination of acetaminophen and oxycodone. It is an opioid pain reliever FDA approved to treat moderate to severe pain. It can be prescribed for acute and chronic pain. Percocet is available as an oral tablet.

Are Tylenol 3 and Percocet the same?

Tylenol #3 and Percocet are both opioid painkillers, but they are not the same. Although they both contain acetaminophen, they contain different opioid ingredients; Tylenol #3 contains codeine while Percocet contains oxycodone.

Is Tylenol 3 or Percocet better?

Percocet contains a stronger opioid ingredient than Tylenol #3. Compared to Tylenol #3, Percocet may be prescribed more often for severe pain. However, the effectiveness of either opioid medication ultimately depends on the dosage used, the severity of pain being treated, and other pain relief therapies being used.

Can I use Tylenol 3 or Percocet while pregnant?

Opioid painkillers are not generally recommended for use while pregnant. There is a potential for these opioids to cause birth defects. However, few studies have been conducted on the safety of opioids during pregnancy. Opioid use during pregnancy can lead to respiratory depression or withdrawal symptoms in the baby. Opioids should only be used if the potential benefits outweigh the risks during pregnancy.

Can I use Tylenol 3 or Percocet with alcohol?

It is not recommended to consume alcohol while taking Tylenol #3 or Percocet. Doing so can increase the risk of side effects, such as drowsiness, dizziness, loss of coordination, and confusion. Drinking alcohol may also increase the risk of opioid overdose, coma, or even death in certain people, especially if there’s a history of abuse, addiction, and dependence on the drug.  

Pill Identifier, Uses, High & Effects

If you take codeine, it is important to know the effects and risks of the medication. This is true if you have a prescription for the drug or whether you take codeine illicitly. Knowing how the medication works, as well as its risks, can help you and your loved ones stay safe.

Codeine Pill Identifier

Codeine pills are available in immediate-release oral tablets. They come in 15 mg, 30 mg, and 60 mg strengths.

How Should Codeine Be Used?

Codeine should only ever be taken as prescribed by your doctor. It should not be taken more often or in greater quantities than your doctor instructs.

Codeine is a prescription narcotic pain reliever that’s classified as an opioid. Codeine is a comparatively weak opioid and is the active ingredient in many combination medications used to treat mild-to-moderate pain and coughing. Some of these combination prescriptions include promethazine with codeine and acetaminophen with codeine. Codeine is also available as a single agent in pill form.

Codeine-containing products are all controlled substances and can range from Schedule II (most addictive) to Schedule V (least addictive) depending on the product. Codeine pills are listed as a Schedule II substance.

As with other opioids, codeine pain pills and syrup work by blocking pain responses and, as a result, it also suppresses cough reflexes. Codeine is converted to morphine by the liver.

Can You Get High From Codeine?

Codeine pills can cause a person to get high. When someone takes an opioid such as codeine, the drug binds to mu-opioid receptors in their brain, triggering the brain’s reward circuit through the central nervous system and eliciting feelings of euphoria and a positive rush.

Unfortunately, getting high on codeine can come with serious consequences. People who use codeine to get high can become addicted to the drug. In some cases, they may end up moving on to stronger prescription opioids or illicit street drugs like heroin to continue getting the effects they desire.

How Much Codeine Does It Take To Get High?

How much codeine it takes to get high depends on many factors, including the person’s genetic makeup.

Codeine is broken down into morphine in the liver thanks to an enzyme called CYP2D6. However, due to genetics, this enzyme does not work equally in different people. Some may have more active CYP2D6 than other people, meaning that they are very sensitive to codeine and are therefore at a high risk of overdose even at normal doses of the drug.

Conversely, other people have less active CYP2D6, meaning that codeine does not break down easily in their bodies and they might not get high at all. For this reason, it is hard to predict how codeine will affect you, especially if you have not taken the drug before.

What Are the Side Effects of Codeine Pills?

Codeine has similar side effects to many other opioids. Its side effects include:

• Dizziness
• Drowsiness
• Slow heartbeat
• Itching
• Constipation
• Nausea and vomiting
• Blurred vision
• Slowed breathing

Slowed breathing from too much codeine can be particularly dangerous. Slowed breathing, in addition, to pinpoint pupils and clammy skin, are signs that a codeine overdose may be occurring. If you suspect someone is overdosing on codeine, you should immediately give the opioid reversal agent naloxone (Narcan) if it is available and call 911. You will not get in trouble for saving someone’s life by seeking help.

Codeine combination products can pose an additional overdose risk, so consider if there are any other ingredients in the codeine product. For example, codeine is often combined with acetaminophen. Acetaminophen is a pain reliever available over-the-counter, and it is generally considered safe unless taken in large doses. In large doses, acetaminophen can cause liver damage, which can be fatal.

• Sources

  Drugs.com. “Promethazine VC with Codeine.” March 1, 2021. Accessed May 8, 2021.

  Drugs.com. “Tylenol with Codeine #3.” February 5, 2021. Accessed May 8, 2021.

  Drugs.com. “Codeine.” October 30, 2020. Accessed May 8, 2021.

  National Institute of Diabetes and Digestive and Kidney Diseases. “Acetaminophen.” January 28, 2016. Accessed May 8, 2021.

  Drug Enforcement Administration. “Controlled Substances.” April 2, 2020. Accessed May 8, 2021.

  American Academy of Family Physicians. “Opioid Conversion Table.” Accessed May 8, 2021.

  Pratt, VM; Scott, SA; Pirmohamed, M.; et al. “Codeine Therapy and CYP2D6 Genotype.” March 30, 2021. Accessed May 8, 2021.

• Medical Disclaimer

  The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

  View our editorial policy or view our research.

What Is Your Round White Pill? 21 Possibilities

Have a round white pill in a baggie or pillbox and you aren’t sure what it is? Trying to figure out what the loose white round pill with a numbered imprint in the bottom of your medicine drawer is?

In this guide to identifying your white round pill, we’ll go over how to identify an unknown white round pill and include some common round white pills with different imprints to help you identify your mysterious medication!

Identifying Your Round White Pill: Safety Note

Before we describe how to identify your round white pill, here are a couple of important safety notes on unidentified pills:

#1: Don’t Take a Pill If You Aren’t Sure What It Is

Unless you are absolutely, positively, 100% sure that you’ve successfully identified your white round pill, don’t take it. Taking medication when you aren’t 100% sure what you’re taking is incredibly dangerous and could even lead to death depending on what the pill is and what else you’re taking.

#2: Don’t Take Pills That Weren’t Prescribed to You

Even if you successfully identify the pill in question, what should you do if it’s not something that’s been prescribed to you? If you identify a prescription medication that wasn’t prescribed to you, don’t take it. It’s very dangerous to take pills that weren’t prescribed to you because a doctor has not assessed whether that medication is safe for you to take.

Also, it’s best to keep pills in their original bottles as much as possible so that you don’t end up with unidentified little white round pills floating around. But if you’re reading this article, it’s too late for that! Just something to keep in mind for the future.

This doesn’t look like the original bottle!

3 Steps to Identifying Your Round White Pill

Here is our 3-step process to identifying your white round pill:

Step 1: Check Imprint/Pill Code

Many pills have some kind of number or letter combination imprinted on one or both sides. This is known as the imprint or the pill code.

The first thing to do is check whether there’s any kind of stamp on either side of your white round pill. If yes, note down what it is. A white round pill with an imprint will be much easier to identify than a circle white pill without one.

Step 2: Measure Pill Size

Are you dealing with a small round white pill? A medium-sized one? A big one? Measuring your pill’s exact length in millimeters will help you identify it, especially if your pill has an imprint that other, different medications also have.

Step 3: Look Up Pill

We have some common imprints (with sizes) listed in the next section of this article. (You can ctrl+F to try to find the imprint/pill code you are looking for). If the pill you’re looking for isn’t listed below, you can look up pills by size, shape, color, and imprint on the National Library of Medicine’s Pillbox site.

Note that some pills share an imprint. For example, a small round white pill with an imprint of 10 could be hyoscyamine sulfate, iloperidone, alendronate sodium, or one of several other drugs.

Knowing the size might help you narrow it down, but then again, maybe not: both hyoscyamine sulfate and alendronate sodium come in 5 mm pills. The pictures of the pills are slightly different, but not all the pills in Pillbox have pictures.

If you can’t determine definitively what the pill is, don’t take it, and follow safe disposal practices per the FDA.

Get out that ruler and get ready to measure!

Common Round White Pills

In this section, we’ll go over common white round pills by imprint or pill code. We’ll also give a size, identify the drug and what it’s for, and list what else the medication is sold as. We’ve included an image of the pill from Pillbox when an image is available.

Pill codes that identify the same or similar drugs are grouped together.

Round White Pill AN 627

Tramadol hydrochloride. Source: Pillbox.

Size: 9 mm

What it is: Tramadol hydrochloride 50 mg

What it’s for: Prescription-only opioid pain reliever for moderate to severe pain

Also sold as: Ultram

Round White Pill 319

Size: 9 mm

What it is: Tramadol hydrochloride 50 mg

What it’s for: Prescription-only opioid pain reliever for moderate to severe pain

Also sold as: Ultram

Round White Pill 512

Oxycodone and acetaminophen. Source: Pillbox.

Size: 12 mm

What it is: Oxycodone 5 mg / Acetaminophen 325 mg

What it’s for: Prescription-only opioid/narcotic pain reliever for moderate to severe pain

Also sold as: Percocet, Endocet, Roxicet

Round White Pill A349

Size: 12 mm

What it is: Oxycodone 5 mg / Acetaminophen 325 mg

What it’s for: Prescription-only opioid/narcotic pain reliever for moderate to severe pain

Also sold as: Percocet, Endocet, Roxicet

Round White Pill 54 543

Roxicet oxycodone and acetaminophen. Source: Pillbox.

Size: 11 mm

What it is: Oxycodone 5 mg / Acetaminophen 325 mg; this particular imprint is the brand-name Roxicet

What it’s for: Prescription-only opioid/narcotic pain reliever for moderate to severe pain

Also sold as: Percocet, Endocet

Round White Pill IP 203

Size: 11 mm capsule

What it is: Oxycodone 5 mg / Acetaminophen 325 mg

What it’s for: Prescription-only opioid/narcotic pain reliever for moderate to severe pain

Also sold as: Percocet, Endocet, Roxicet

Round White Pill K 18

Size: 6 mm

What it is: Oxycodone hydrochloride 5 mg

What it’s for: A prescription-only opioid/narcotic pain reliever for moderate to severe pain

Also sold as: Roxicodone, Endocodone, Percolone, Oxaydo

Round White Pill 4810 V

Oxycodone hydrochloride. Source: Pillbox.

Size: 6 mm

What it is: Oxycodone hydrochloride 5 mg

What it’s for: A prescription-only opioid/narcotic pain reliever for moderate to severe pain

Also sold as: Roxicodone, Endocodone, Percolone, Oxaydo

Round White Pill OP 10

OxyContin 10 mg oxycodone. Source: Pillbox.

Size: 7 mm

What it is: 10 mg extended-release oxycodone hydrochloride; this imprint in particular is OxyContin

What it’s for: Prescription-only opioid/narcotic pain reliever for moderate to severe pain

Also sold as: Authorized generic Oxycodone ER.

Round White Pill 44 159

Size: 13 mm

What it is: Acetaminophen 250 MG / Aspirin 250 MG / Caffeine 65 MG

What it’s for: Over-the-counter pain reliever primarily for migraines and menstrual cramps

Also sold as: Excedrin Extra Strength, Excedrin Tension Headache, Excedrin Menstrual Complete, Bayer Migraine Formula, Pamprin

Round White Pill PLIVA 433

Trazodone hydrochloride. Source: Pillbox.

Size: 9 mm

What it is: Trazodone hydrochloride 50 mg

What it’s for: A prescription-only serotonin modulator and stimulator (SMS) antidepressant; also prescribed for insomnia

Also sold as: Desyrel

Round White Pill M 4

Hydromorphone hydrochloride. Source: Pillbox.

Size: 7 mm

What it is: Hydromorphone hydrochloride 4 mg

What it’s for: Prescription-only opioid/narcotic painkiller

Also sold as: Dilaudid

Round White Pill APO TI-4

Tizanidine hydrochloride. Source: Pillbox.

Size: 8 mm.

What it is: Tizanidine hydrochloride 4 mg

What it’s for: Prescription-only muscle relaxant; also prescribed for migraines, as a sleep aid, and as an anticonvulsant

Also sold as: Zanaflex, Sirdalud

Round White Pill G 2011

Orphenadrine Citrate. Source: Pillbox.

Size: 9 mm

What it is: Orphenadrine citrate 100 mg

What it’s for: Extended-release prescription-only muscle relaxant used to treat muscle spasms and pain

Also sold as: Norflex Extended-Release

Round White Pill GPI A325

Acetaminophen. Source: Pillbox.

Size: 10 mm

What it is: Acetaminophen 325 mg

What it’s for: Over-the-counter painkiller

Also sold as: Tylenol

Round White Pill 10 M

Size: 7 mm

What it is: Methylphenidate hydrochloride 10 mg

What it’s for: A prescription-only stimulant used to treat ADHD and sometimes narcolepsy

Also sold as: Ritalin

Round White Pill Watson 241 1

Lorazepam. Source: Pillbox.

Size: 7 mm

What it is: Lorazepam 1 mg

What it’s for: Prescription-only anti-anxiety medication of the benzodiazepine class.

Also sold as: Ativan, Temesta

Round White Pill M 15

Diphenoxylate hydrochloride and atropine sulfate. Source: Pillbox.

Size: 6 mm

What it is: Diphenoxylate hydrochloride 2.5 mg / Atropine sulfate 0.025 mg

What it’s for: Prescription-only opioid used to treat diarrhea; atropine is included to discourage misuse

Also sold as: Lomotil

Round White Pill G 4

Ondansetron. Source: Pillbox.

Size: 7 mm

What it is: Ondansetron 4 mg

What it’s for: Prescription-only nausea/vomiting treatment, primarily prescribed for chemotherapy or post-surgery

Also sold as: Zofran

Round White Pill W 921

Cefuroxime axetil. Source: Pillbox.

Size: 11 mm

What it is: Cefuroxime axetil 250 mg

What it’s for: Prescription-only antibiotic used to treat a variety of bacterial infections.

Also sold as: Ceftin

Round White Pill W 929

Lisinopril. Source: Pillbox.

Size: 8 mm

What it is: Lisinopril 10 mg

What it’s for: Prescription-only ACE inhibitor used to treat high blood pressure.

Also sold as: Zestril, Prinivil

Identifying Your Round White Pill: The Bottom Line

Is your unidentified white pill round? In this article, we went over how to identify a white round pill with an imprint or pill code.

First it’s important to note that if you can’t identify what your small round white pill is definitively, you shouldn’t take it. You also shouldn’t take a circle white pill if it’s prescription-only and something that wasn’t prescribed to you.

Here’s our three-step process to identifying your little round white pill:

#1: Check the imprint/code (the combination of letters and numbers found on one or both sides of the pill).
#2: Measure the pill’s size in mm.
#3: Check the rest of the article for common pill codes and imprints, or look on Pillbox if it’s not listed. Note that multiple medicines may share the same pill code and even the same size. If you can’t definitively identify your pill, don’t take it.

What’s Next?

Want more in-depth info about other pills? We can tell you about M366 pills and and white 377 pills.

Wondering whether supplements work? We can give you the scoop on booty pop, cebria, and virectin—do they work? Are they safe?

Curious about designer drugs? We can tell you all about 4-ho-met and 4-fa.

How To Spot Fake Green Xanax Bars [S 90 3 Fake]

Fake drugs, also referred to as counterfeit drugs can be defined as  illegally produced drugs or pharmaceutical preparations  that may be contaminated or contain the wrong or no active ingredient at all. They sometimes have the right active ingredient but at the wrong dose. Fake drugs are illegal and may be harmful to your health. Each year, fake or substandard medications kill more than 300000 people worldwide. Xanax is one of the brand names for Alprazolam, a class of medications called benzodiazepines which act on the brain and nerves (central nervous system) to produce a calming effect. It is used to treat anxiety and panic disorders. The rectangular green Xanax Pill with imprint S 90 3  has been identified as Alprazolam 2 mg. It is supplied by Dava Pharmaceuticals Inc. Xanax  belongs to a class of medications called benzodiazepines which act on the brain and nerves (central nervous system) to produce a calming effect. It works by enhancing the effects of a certain natural chemical in the body (GABA). It is considered a mild tranquilizer.

A  new report says Xanax pills laced with the potent pain drug fentanyl were to blame for overdoses and  the increasing number of drug related  deaths. Fentanyl is a dangerous and sometimes deadly drug that is 50 times more potent than morphine sold by neighborhood dealers. According to a former drug investigator for the Cincinnati Police department who is now president of the International Health Facility Diversion Association, “Dealers brag about the potency of their products, and even brag when someone overdoses or even dies as proof of the superiority  of their product. Screwed up thought process, but nevertheless that’s the world of illicit drug dealing.” See :The 7 Severe Meth Withdrawal Symptoms That Can Kill

Short-Term Effects of S 90 3

When users get high on s 90 3 green xanax , the short-term effects can cause them to feel completely calm, euphoric, and free from worry. This drug works for people suffering from anxiety and panic disorders because it begins to relieve their anxious feelings and settle their minds almost immediately after taking the medication, usually Its effects may be felt within 30 minutes and can last for around 6 hours. When compared to other similar medications, alprazolam is known for its quick action but If taken in large doses, the depressant effects are stronger and may cause lapses in memory. Read: U03 Pill: Everything You Should Know

Side Effects

Using S 90 3 bars can bring about a variety of side effects. Most side effects may be life-threatening especially when counterfeit products are used. The common side effects of s 903 Xanax include:

• Somnolence.
• Dyspnea or shortness of breath.
• Nausea.
• Dry mouth.
• Hypersalivation.
• Constipation 
• Excessive talking.
• Decreased motivation.
• Irritability.
• Decreased libido.

More Serious Side Effects

• Difficulty concentrating.
• Memory problems.
• Confusion.
• Slurred speech.
• Paranoia.
• Depression.
• Strange dreams.
• Hallucinations.
• Seizures.

Read 44 175 White Pill: Everything You Should Know

What are the withdrawal symptoms of S 90 3 Xanax?

Withdrawal syndrome is a set of symptoms occurring in discontinuation or dosage reduction of some types of medications and recreational drugs. Withdrawal is more likely to occur when given at high doses over prolonged period. It should be noted that symptoms such as seizures can occur in more severe cases of withdrawal. Consequently, patients on this medication for extended periods of time should slowly taper the medication under a doctor’s supervision rather than abruptly stopping the medication. Sudden discontinuation of s 90 3 bars after prolonged use can lead to symptoms of withdrawal such as:

• Insomnia
• Headaches
• Nausea
• Vomiting
• Lightheadedness
• Sweating
• Anxiety
• Fatigue

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How To Spot fake Green Xanax Bars [S 90 3 fake]

Fake drug manufacturers are acquiring new technologies, making it easier to make fake pills look very much like the real thing. Sometimes it is difficult to tell fake S 90 3 bar from an original. Here is how to detect fake green Xanax bars:

• Visual inspection as stated by World Health Organization (WHO) (1999) still remains the first step in identifying potential fake drug irrespective of the analytical methods used. Look at the fonts in the imprints on the pills and the pack for inconsistencies.
• An S 90 3 fake will most times taste differently and have excessive powder and/or pieces of tablets at the bottom of the container (from abraded, crushed or broken bars).
• An S 90 3 fake will easily crack, check for discoloration and fusion of bars. Rectangular pills breaks into three parts instead of four with chalky odor, indicating filler is present.
• If the price of an S 90 3 fake you are being offered is far cheaper than what is expected, then you have to think twice, the product might be fake or counterfeit. However, this may not always be true especially for some products (fake innovator/generic brands) which may be sold at the same price as the genuine one. See Fake Xanax Side Effects

Many communities are saturated with counterfeit, gray and substandard drugs and the attendant negative impacts of these drugs know no bound. Drugs are poisons and adequate care should always be taken to avoid the consequences and side effects of a fake. The tips outlined in this article will not only help reduce your chances of purchasing, using and suffering the untoward effects of a fake S 90 3, but will also help you save money. You can contribute your own quota to fight against fake and counterfeit drugs by sharing this information. You can also let us know your thoughts in the comment section. See How To Spot An R039 yellow pill fake

READ: Green Football Xanax S 902 Pill

Low-Dose ‘Triple Pill’ Lowers Blood Pressure More Than Usual Care

Contact: Nicole Napoli, nnapoli@acc. org, 202-669-1465

ORLANDO (Mar 12, 2018) –

A pill combining low doses of three blood pressure-lowering medications significantly increased the number of patients reaching blood pressure targets compared with usual care, researchers reported at the American College of Cardiology’s 67th Annual Scientific Session. There was also no significant increase in adverse effects with the “Triple Pill.”

“Most people—70 percent—reached blood pressure targets with the Triple Pill. The benefits were seen straight away and maintained until six months, whereas with usual care control rates were 55 percent at six months and even lower earlier in the trial,” said Ruth Webster, MBBS, of The George Institute for Global Health at the University of New South Wales in Sydney, Australia, and lead author of the study. “Based on our findings, we conclude that this new method of using blood pressure-lowering drugs was more effective and just as safe as current approaches. “

Despite the availability of effective blood pressure-lowering drugs, high blood pressure remains a major problem around the world, Webster said. Effectively treating high blood pressure can help to prevent heart attacks, strokes and kidney problems. Globally, however, many people with high blood pressure receive no treatment, and only about a third of those who are treated achieve recommended reductions in blood pressure. Achieving desired reductions in blood pressure often requires treatment with more than one medication, which increases the complexity of treatment, and patients often have difficulty adhering to regimens that involve taking multiple pills every day.

This study was the first large trial designed to test the theory that starting treatment with low doses of three drugs could achieve better blood pressure control compared with usual care and that combining these drugs in a single pill would make it easier both for doctors to prescribe treatment and for patients to adhere to it, Webster said.

The TRIUMPH trial, which was conducted in Sri Lanka, enrolled 700 patients whose average age was 56 years, 58 percent of whom were women. Trial participants had an average blood pressure of 154/90 mm Hg. Over half (59 percent) were receiving no treatment for high blood pressure before they enrolled in the trial. In addition to high blood pressure, 32 percent of participants had diabetes or chronic kidney disease.

Patients were randomly assigned to receive either the combination pill or usual care. The combination pill, or Triple Pill, consisted of the blood pressure medications telmisartan (20 mg), amlodipine (2.5 mg) and chlorthalidone (12.5 mg). These medications use different mechanisms to reduce blood pressure by relaxing the blood vessels, so the heart does not need to pump as hard to send blood throughout the body. Usual care meant that patients received their doctor’s choice of blood pressure¬-lowering medication.

The trial’s primary endpoint was the proportion of patients who achieved a blood pressure target of 140/90 mm Hg or less (130/80 mm Hg or less in those with diabetes or chronic kidney disease) at six months.

Compared with patients receiving usual care, a significantly higher proportion of patients receiving the Triple Pill achieved their target blood pressure at six months. The average reduction in blood pressure was 8.7 mm Hg for participants receiving the Triple Pill and 4.5 mm Hg for those receiving usual care. At six months, 83 percent of participants in the Triple Pill group were still receiving the combination pill and one-third of those in the usual-care group were receiving at least two blood pressure-lowering drugs.

The maximum difference between the two groups of patients was observed at six weeks after starting treatment, when 68 percent of those receiving the Triple Pill had achieved a blood pressure within their target range, compared with 44 percent of those receiving usual care. This represented a 53 percent reduction in the risk for high blood pressure for patients receiving the Triple Pill, Webster said.

Rates of participants having to change treatment due to side effects were not significantly different in the two groups (6.6 percent for the Triple Pill, 6.8 percent for usual care). This should allay concerns that use of the three-drug combination pill could lead to an unacceptable increase in adverse medication side effects, Webster said.
Each of the drugs used in the Triple Pill has been shown to be highly effective in reducing blood pressure and preventing deaths and illness due to heart disease and strokes, she said. Each drug represents a different class of blood pressure medication and previous studies have shown that combining such drugs results in synergistic effects.

“The most urgent need for innovative strategies to control blood pressure is in low- and middle-income countries,” Webster said. “The Triple Pill approach is an opportunity to ‘leap frog’ over traditional approaches to care and adopt an innovative approach that has been shown to be effective.”

The study’s findings are also important for high-income countries, she said.
“A control rate of 70 percent would be a considerable improvement even in high-income settings. Most hypertension guidelines in these countries do not recommend combination blood pressure-lowering therapy for initial treatment in all people,” she said. “Our findings should prompt reconsideration of recommendations around the use of combination therapy.”

An inevitable consequence of a necessarily unblinded study (where both participants and their doctors know whether participants are assigned to the Triple Pill or usual care) is that doctors might manage patients differently depending on the assigned treatment. However, it is important to note this trial was designed to evaluate a new strategy of care in a real-world setting, Webster said.

To minimize the risk of bias in measuring the main outcomes, the number of patient visits was identical in both groups and all outcomes were standardized and objectively documented, she said.

The researchers are now conducting a follow-up qualitative study to find out what participants and their doctors thought about using the Triple Pill. And they are conducting a cost effectiveness evaluation to determine whether the Triple Pill is a cost-effective solution for blood pressure control.

Recommended targets for blood pressure control vary by country. In the U.S., guidance released in 2017 by the ACC and the American Heart Association recommends initiating treatment if blood pressure exceeds 130/80 mm Hg. European guidelines recommend that treatment should aim to achieve a blood pressure level of 140/90 mm Hg or less.
The study was funded by the National Health and Medical Research Council of Australia as part of the Global Alliance for Chronic Disease.

###

Webster will be available to the media in a press conference on Monday, March 12 at 9:30 a.m. EDT / 1:30 p.m. UTC in Room 224 ABC.

Webster will present the study, “A Pragmatic Trial of a Low-dose Triple-Combination Blood Pressure Lowering Pill for Initial Treatment of Hypertension,” on Monday, March 12 at 8:45 a.m. EDT / 12:45 p.m. UTC in Main Tent, Hall C.

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Preventing HIV by Taking One Pill Once a Day: Pre-exposure Prophylaxis (PrEP)

Frequently Asked Questions

1. Is it true that there is a medication that can prevent someone from getting HIV?
2. How often do I take the PrEP medication?
3. Is it OK to switch between daily PrEP and on-demand PrEP?
4. How often are medical appointments for PrEP?
5. When I first start taking the medication, how many days do I have to take the medication in order for it to protect me from an HIV exposure?
6. How well does PrEP work?
7. How would I know if PrEP is right for me?
8. Can adolescents consent to PrEP on their own? Does a healthcare provider need the consent of a parent or guardian in order to prescribe PrEP to an adolescent?
9. I prefer sex without a condom so I don’t always use them. Would PrEP still work to prevent HIV if I don’t use condoms?
10. I have sex partners who are living with HIV and have an undetectable viral load because they are on HIV treatment. Do I still need to take PrEP?
11. How would I pay for PrEP?
12. Can I get the PrEP medication from my regular healthcare provider or do I have to go to a special doctor?
13. What are the side effects of the PrEP medications?
14. Would I have to take PrEP for the rest of my life? What if I want to stop?
15. If I drink alcohol and/or use recreational drugs, is it safe to take PrEP?
16. Is the PrEP medication effective for treating HIV infection?
17. Since PrEP medication alone is not effective at treating HIV, is it possible that taking PrEP coud lead to my developing drug resistant HIV if I become infected? Could it lead to higher levels of drug resistant virus in the community?

1. Is it true that there is a medication that can actually

prevent someone from getting HIV?

Yes. PrEP (short for HIV Pre Exposure Prophylaxis) involves working with a healthcare provider to make an individualized plan to take medication to prevent HIV. Clinical trials have shown that PrEP is 99% effective at reducing sexual transmission of HIV. As of January 2019, the U.S. Food and Drug Administration (FDA) has approved two medications as PrEP for HIV: Truvada (tenofovir disoproxil fumarate 300 mg/emtricitabine 200 mg), and Descovy (tenofovir alafenamide 25 mg/emtricitabine 200 mg).  Note: Descovy is not approved for use by cis-gender women.

Key Points About PrEP:

• PrEP medication is prescribed by a healthcare provider. People interested in PrEP can work with a healthcare provider to determine how PrEP can be tailored to their individual needs and circumstances.
• PrEP is only for people who are not living with HIV. HIV testing should be conducted before starting PrEP and repeated every three months to make sure the person is not living with HIV. Testing may be done by the healthcare provider or at a conveniently located community-based organization (CBO), healthcare facility or lab. 
• Some people benefit from counseling and support for taking the medication regularly. If this is needed, the person can talk with the healthcare provider, a trusted CBO, a peer worker, or other provider.
• People at risk for HIV are also at risk for sexually transmitted infections (STIs). Counseling about using condoms to prevent STIs and periodic screening for STIs is important and may be provided by the healthcare provider, a trusted CBO, or other provider.

2. How often do I take the PrEP medication?

You and your healthcare provider can work together to decide the best way for you to use PrEP.  There are two different ways that people take PrEP:

Daily PrEP:  Daily PrEP involves people of any gender identity (cis-gender man, cis-gender woman or transgender man or woman) taking 1 pill once a day, every day. With daily PrEP, a person can feel protected from HIV whenever they have sex or inject substances. It is for people who have possible exposure to HIV on a frequent basis, or an unpredictable basis. An important benefit of daily PrEP is that the person is always protected and can establish a daily habit of taking the medication. Daily PrEP with Truvada is the only method proven to be effective for cis-gender women and transgender men who have vaginal intercourse.

On-Demand PrEP:  On-demand PrEP is only for cis-gender men who have sex with men (MSM).  On-demand PrEP involves taking 2 pills, 2-24 hours before a possible sexual exposure to HIV and then continuing to take 1 pill each day until 2 days after their last possible sexual exposure. The only PrEP medication approved for on-demand use is Truvada. If a cis-gender MSM has a single possible exposure, they would take 2 pills, 2-24 hours before having sex and then would take 1 pill each day for 2 additional days.  If a person had several possible exposures over the course of 2 or more days, the person would take 2 pills, 2-24 hours before the possible exposure, then 1 pill for each day they are having sex, and then 1 pill each day for 2 days after the last possible exposure. On-demand PrEP is for cis-gender MSM who have occasional risk for HIV that can be predicted at least 2 hours in advance. Cis-gender women, cis-gender men who have sex with women, people of trans experience, and people who share injection equipment should choose daily PrEP, not on-demand PrEP.

It is important to talk with your healthcare provider about whether daily PrEP or on-demand PrEP is right for you.

3. Is it OK to switch between daily PrEP and on-demand PrEP?

On-demand PrEP is only for cis-gender MSM.  Other individuals are not eligible for on-demand PrEP because studies have not demonstrated that it is effective for other populations.  Before switching from daily PrEP to on-demand PrEP, or vice versa, a cis-gender MSM should consult with their healthcare provider. 

4. How often are medical appointments for PrEP?

People who want to take PrEP to prevent HIV can work with their healthcare provider to determine the schedule of medical appointments that best meets their needs. Here is a general description of the schedule of medical appointments for PrEP.

• Initial Medical Appointment:  This first appointment includes education about PrEP, a discussion about readiness to take PrEP, a review of daily versus on-demand PrEP, HIV testing, and other lab work. If the person is ready to start PrEP, the medication can be started right after the initial medical appointment.




• First Follow-Up Contact: The healthcare provider and person should make a plan for a follow-up appointment or call at a convenient time, usually within 2-4 weeks, to:
• Check in on how things are going, including side effects;
• Troubleshoot any problems with payment or access to support services.

• HIV testing: The person should have an HIV test every three months to make sure they have not acquired HIV. The healthcare provider can order the testing which can be done at their office, a conveniently located CBO, health facility or lab. It is important that the results of the test are provided to the healthcare provider who prescribed PrEP.




• Follow-Up Appointments and Prescription Refills: The frequency of follow-up appointment is established jointly by the healthcare provider and the person.

5. When I first start taking the medication, how many days do I have to take the medication in order for it to protect me from an HIV exposure?

The PrEP medication must reach and maintain a certain level in the blood and the body’s mucus membranes to provide protection. The amount of time it takes may vary from person to person. For people taking daily PrEP who engage in anal intercourse, the medication must be taken each day for 7 days to reach the level needed for full protection. Cis-gender MSM who are taking on-demand PrEP, must take two pills, 2-24 hours before having sex. For the receptive partner in vaginal intercourse, it takes approximately 20 days of taking the medication consistently to reach the level of full protection in the female genital tract. This is why cis-gender women and transgender men who have receptive vaginal intercourse should not take on-demand PrEP. People of transgender experience should talk with their healthcare provider about their specific sexual practices to best determine the length of time it will take to be fully protected.

6. How well does PrEP work?

The PrEP medication works very well at preventing a person from getting HIV. Everyone taking PrEP should be sure to take the medication as agreed upon with the healthcare provider, but it is especially important for cis-gender women and transgender men who engage in vaginal intercourse to take it consistently each day to be fully protected during receptive vaginal intercourse. The more days a person misses a dose, the less protective the medication will be for any exposures that occur during that time period. If you are interested in more specific data regarding how well PrEP works, below is a list of links to the major clinical trials.

• iPrEX: Grant RM, Lama JR, Anderson PL, et al; iPrEx Study Team https://www.nejm.org/doi/full/10.1056/NEJMoa1011205
• Fonner VA, Dalglish SL, Kennedy CE, et al. Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. AIDS. 2016;30(12):1973-1983. https://www.ncbi.nlm.nih.gov/pubmed/27149090/
• Chou R, Evans C, Hoverman A, et al. Pre-Exposure Prophylaxis for the Prevention of HIV Infection: A Systematic Review for the U.S. Preventive Services Task Force: Evidence Synthesis No. 178. Rockville, MD: Agency for Healthcare Research and Quality; 2018. AHRQ publication 18-05247-EF-1. https://www.ncbi.nlm.nih.gov/pubmed/27149090/
• Molina JM, Capitant C, Spire B, et al; ANRS IPERGAY Study Group. On-demand preexposure prophylaxis in men at high risk for HIV-1 infection. N Engl J Med. 2015;373(23):2237-2246.  https://www.nejm.org/doi/full/10.1056/NEJMoa1506273
• Grant RM, Mannheimer S, Hughes JP, et al. Daily and nondaily oral preexposure prophylaxis in men and transgender women who have sex with men: the Human Immunodeficiency Virus Prevention Trials Network 067/ADAPT study. Clin Infect Dis. 2018;66(11):1712-1721. https://www.ncbi.nlm.nih.gov/pubmed/29420695
• USPSTF Recommendation Statement on Preexposure Prophylaxis:https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/prevention-of-human-immunodeficiency-virus-hiv-infection-pre-exposure-prophylaxis

7. How would I know if PrEP is right for me?

PrEP is one of many options for preventing HIV. HIV is passed from one person to another through sharing injection drug equipment or through anal or vaginal sexual intercourse. People can avoid getting HIV by: 1) not sharing drug injection equipment (needle, syringe, cooker, cotton, etc.), 2) avoiding anal or vaginal intercourse; 3) having only one monogamous sex partner whose HIV status is known to be negative: 4) having only one partner who is living with HIV and has an undetectable viral load.  It is important to be aware that a person living with HIV who is on HIV treatment and is virally suppressed for six months or longer cannot pass HIV to a partner through sex. If you have sex with more than one partner, taking PrEP or consistent and correct use of condoms each time you have sex, can prevent you from getting HIV.

New York HIV State Clinical Guidelines indicate that healthcare providers should discuss PrEP as an HIV/STD prevention option for adults or adolescents who:

• Have unprotected anal or vaginal intercourse with: 1) a partner whose HIV status is unknown; 2) a partner who is living with HIV but not on HIV treatment; or 3) a partner who is living with HIV but not does not have an undetectable viral load;
• Have unprotected anal or vaginal intercourse with a partner who is living with HIV, on treatment and virally suppressed but wishes to be on PrEP for additional protection;
• Are attempting to conceive with a partner who is living with HIV;
• Have multiple or anonymous sex partners or, have partners who have multiple or anonymous sex partners;
• Participate in sex parties or have partners who do this;
• Are involved in transactional sex, such as sex for money, drugs, or housing, including commercial sex workers and their clients, or have partners who do this;
• Have been diagnosed with at least one STI in the previous 12 months;

• Use of mood-altering substances during sex, such as alcohol, methamphetamine, cocaine, and ecstasy;
• Inject substances, or have partners who inject substances, including illicit drugs and hormones;
• Are receiving post-exposure prophylaxis (PEP) and have ongoing high-risk behavior or have used multiple courses of PEP.
• Request the protection of PrEP even if their sex partners have an undetectable HIV viral load (see the discussion of U=U, below).
• Self-identify as being at risk without disclosing specific risk behaviors.
• Acknowledge the possibility of, or anticipates risk behaviors in the near future.

It is important to weigh the pros and cons and have an open and honest conversation about PrEP with your healthcare provider before beginning PrEP. PrEP is always voluntary and only you can determine if PrEP is right for you. 

8.Can adolescents consent to PrEP on their own? Does a healthcare provider need the consent of a parent or guardian in order to prescribe PrEP to an adolescent?

2017 amendments to NYSDOH regulations allow minors to consent to their own HIV treatment and HIV preventive services, such as PrEP and PEP, without parental/guardian involvement (10 NYCRR Part 23).  The FDA has approved the use of Truvada for adolescents regardless of gender, and Descovy for adolescent cis-gender males. These developments, along with updated New York State Clinical Guidelines, mean that adolescents who are at risk for HIV may consent to PrEP without the involvement of the young person’s parent or guardian. 

9. I prefer sex without a condom so I don’t always use them. Would PrEP still work to prevent HIV if I don’t use condoms?

If a person takes the PrEP medication consistently as directed, it provides a high level of protection against HIV. Condoms provide protection against sexually transmitted infections (STIs). People who are on the PrEP medication but are not using condoms may be exposed to an STI. It is important to be aware that having an STI can increase a person’s chance of getting HIV if exposed to the virus. Some STIs don’t have symptoms or symptoms may disappear on their own for periods of time. If you are not using condoms regularly, it would be especially important to have regular testing for STIs and to get treated as soon as possible if you have an STI. Screening for chlamydia and gonorrhea should include swabs of a person’s genitals, rectum and mouth. Learning about the signs and symptoms of STIs is helpful in identifying whether you or one of your partners has an STI.  Condom use is recommended but choosing to not use condoms routinely should not prevent you from being prescribed PrEP.

10. I have sex partners who are living with HIV and have an undetectable viral load because they are on HIV treatment. Do I still need to take PrEP?

Individuals living with HIV who are taking HIV treatment consistently and have an undetectable viral load for at least 6 months cannot transmit the virus to an HIV-negative partner through sexual activity. In sero-discordant or magnetic couples (one person is living with HIV and the other not living with HIV), PrEP may be used by the HIV-negative partner for additional protection.

11. How would I pay for PrEP?

Medicaid will cover the cost of PrEP without co-pays. This includes the medication, medical appointments and lab tests associated with PrEP. Many health insurance plans with prescription drug coverage also cover all costs associated with PrEP without co-pays. For people without access to health insurance with prescription drug coverage, a number of options for financial assistance are available. If you need information about financial assistance options for PrEP, visit the NYSDOH website.

12. Can I get the PrEP medication from my regular healthcare provider or do I have to go to a special doctor?

It depends on your doctor. Any physician, nurse practitioner or physician assistant can prescribe PrEP. It is important to have a healthcare provider who you can work with to individualize PrEP to your needs and circumstances. The New York State Department of Health has prepared a directory of healthcare providers that prescribe PrEP that can be found online.

13. What are the side effects of the PrEP medications?

Truvada and Descovy are both recognized as well-tolerated medications with few side effects.

In clinical trials, only a small number of people found the side effects serious enough to stop taking the medication. People taking PrEP should discuss any side effects they experience with their healthcare provider. In many cases, side effects are only short term and can be managed. Two important health issues related to taking PrEP include kidney function and bone density. Your healthcare provider will ask if you have a history of kidney disease and will periodically order lab work to monitor your kidney function. Bone density will be monitored as needed. The NYSDOH is aware that there are lawsuits that claim harm to individuals taking Truvada. However, scientific evidence shows that when taken as directed, Truvada is safe and effective. Since there are risks to taking any medication, individuals should speak with their healthcare provider about the benefits, risks (side effects), and possible alternatives for every medication they choose to take in order to understand the best choices for their specific situation.

14. Would I have to take PrEP for the rest of my life? What if I want to stop?

PrEP is not intended to be a life-long program. Rather, it is a program where the healthcare provider works with you to develop an individualized plan with as many renewals of the prescription as you and the healthcare provider agree to. For many people, life circumstances change over time and the risk for HIV may be reduced or eliminated. You should discuss the issue of how long you want to take the PrEP medication with your provider. If for any reason you want to stop taking the PrEP medication, consult with the healthcare provider who prescribed it, or another provider who is familiar with PrEP. Generally speaking, cis-gender men taking on-demand PrEP should continue taking the PrEP medication for at least 2 days after any possible exposure. Anyone taking daily PrEP should continue taking the medication for 28 days after the last possible exposure.

15. If I drink alcohol and/or use recreational drugs, is it safe to take PrEP?

Alcohol and recreational drugs are not known to interact with PrEP medications. It is safe to take PrEP before, after and on days when you are “partying.” In fact, it is important to take extra steps to make sure you take PrEP according to the healthcare provider’s directions when you are “partying.”

16. Is the PrEP medication effective for treating HIV infection?

PrEP medications are not effective alone for treating HIV infection. If you acquire HIV infection while taking PrEP, the provider who conducted the HIV test should either provide HIV medical care or refer you to a healthcare provider who can provide HIV care. The HIV care provider will conduct lab tests and determine the most effective regimen to treat your HIV infection. There is no evidence that having taken PrEP will impact the effectiveness of your HIV treatment. People who acquire HIV while on PrEP can be successfully treated with HIV medications.

17. Since PrEP medication alone is not effective at treating HIV, is it possible that taking PrEP could lead to my developing drug resistant HIV if I become infected? Could it lead to higher levels of drug resistant virus in the community?

HIV testing is a critical component when using PrEP for HIV prevention. HIV testing is done before a person begins PrEP to ensure that only HIV negative people are prescribed PrEP. Periodic HIV testing for everyone taking PrEP ensures that anyone who gets HIV will be identified quickly so they can be put on an effective treatment regimen. If a person on PrEP gets HIV, drug resistance testing is done to determine an effective treatment regimen. There is no evidence that PrEP can lead to higher rates of drug resistant virus in the community.

90,000 Emergency contraception: “I got pregnant in spite of the pill”

• Natasha Presky
• BBC Three

November 10, 2019

Photo author, BBC THREE / ISTOCK

Warning: This article contains references to sexual abuse that can be upsetting.

“It didn’t even occur to me that the emergency contraceptive pill would be ineffective.”

Rachel (not her real name) became pregnant after being raped in Canada after leaving school.She was given an emergency contraceptive pill that evening, as part of the medical care she received after the attack.

“When I found out two months later that I was pregnant, it was a complete shock for me,” she recalls. “It never even occurred to me that it could have happened at all.”

Rachel, now 34 years old, says she was not told that she could still get pregnant after emergency contraception: “I don’t remember at all that it was (pill. – Red .) may not work. “

An estimated 0.6-2.6% of women who take emergency contraceptive pills after unprotected sex still get pregnant.

What people know – and don’t know – about emergency contraception started to discuss after the author of Refinery29 described how she got pregnant despite taking the pill

The article went viral, and there were calls for more active dissemination of information that emergency contraceptive pills do not guarantee protection against unwanted pregnancies.

How do emergency contraceptive pills work?

• Synthetic hormones prevent or delay ovulation (release of an egg from the ovary)
• If you ovulated before you took the pill and you were fertile during unprotected sex, it will not protect you from pregnancy
• This means the pill emergency contraception can be ineffective even if you take it correctly – it all depends on the menstrual cycle
• Ovulation usually occurs in the middle of the cycle (about two weeks before your period)
• There are two types of emergency contraception pills: levonorgestrel and ulipristal acetate
• Levonorgestrel should be taken within 72 hours (three days) after unprotected sex
• Ulipristal acetate must be taken within 120 hours (five days)

Photo by BBC THREE / ISTOCK

Some medications can also affect the effectiveness of the pills, says the doctor Caroline Cooper, specialist in reproductive and sexual health surveys.

“These are medications that can interfere with the way your liver processes medications,” she explains. These include some medicines for HIV, epilepsy, and the over-the-counter herbal remedy St. John’s wort, which is sometimes taken to treat mild mood disorders.

Another reason emergency contraceptive pills may not work is the woman’s weight, explains Dr. Cooper. Women who are overweight have a higher risk of getting pregnant after taking them, she says.”And it’s not even about being overweight,” adds Dr. Cooper.

The risk of ineffectiveness for levonorgestrel is much higher if a woman weighs more than 70 kg or has a body mass index greater than 26, she says (the ideal BMI for most adults is between 18.5 and 24.9, according to the British Health Service).

“Complete surprise”

But how many women know about all this? Although the instructions for the emergency contraceptive pills contain information that the drug’s action is based on delayed ovulation, it, like everything written in small print, is easy to ignore.The instruction also does not directly say that the effectiveness of the tablets depends on the day of the menstrual cycle. So why, along with the emergency contraceptive pills, women are not provided with all the information they need?

“I didn’t expect this to work,” Harriet, 26, told me. During sex, their condom broke, and she resorted to emergency contraception – but still got pregnant, although she took the pill right away and did everything according to the instructions.

Harriet adds that she was told that the pills sometimes do not work, but the only risk factor mentioned was that the pill was taken too late.Since she did it within 24 hours, she was not worried. About a week later, she found out that she was pregnant.

For Rachel, not knowing that the pill might be ineffective made her situation even more difficult. “I would not change anything – my son is 15, it is very difficult with him, but I would not want his mother,” she tells me. “But then … I think that such an unexpected pregnancy was very traumatic for me.”

I ask Dr. Cooper if women at the pharmacy or sexual health clinic are always told that their menstrual cycle affects the effectiveness of the emergency contraceptive pill.

“I think this should be done,” she says and adds that while pharmacists are usually well aware of how emergency contraception works, “if they are very busy, they may not go into all these details.”

Photo Credit, BBC THREE

Gold Standard

Another available method of emergency contraception is a copper IUD (intrauterine device) inserted within the first five days after unprotected sex. oocyte on the lining of the uterus and has an efficiency of 99%.

An estimated two out of every 100 women who use ulipristal acetate become pregnant and 0.6–2.6% of women who use levonorgestrel.

Neither Harriet nor Rachel offered IUDs as an alternative to pills.

Rebecca Pickerill, a sexual health nurse at a clinic run by Brook, a youth sexual health charity, says their workers always offer the IUD as the “gold standard.”

“We find out when they last had unprotected sex, when they had their last period, the length of the cycle, the estimated date of ovulation, which, of course, is only an approximation – usually ovulation occurs in the middle of the cycle, but obviously this does not happen with everyone, “she says.

“We then discuss with them which of the two types of oral contraceptive would work best for them … but we always emphasize that the IUD is most effective.”

Dr. Cooper says she has never seen an IUD ineffective as an emergency contraception. “But of course I saw women who took emergency contraceptive pills, got pregnant, had an abortion, and then came to me to set the spiral, and were furious that no one offered them this option right away,” she adds.

“Men Should Know It Too”

Sexual and Reproductive Health Specialist Dr. Jane Kavanagh believes emergency contraception is worth talking about in school.

“It is outrageous that every child is not told about contraception and what to do if they have sex and there is a risk of pregnancy,” she says. “This should be a basic rule in every school.”

“I did a small focus group with my teenage daughter’s friends a few years ago, aged 14-15,” she continues.“There were about six girls in the room, and I just asked them,“ Who knows you can use an IUD for emergency contraception? ”And she was the only one who knew.”

Harriet adds that more Contraception isn’t just for women. “I think men should know more about it as well,” she says. She says that among her partners there were some who told her that in the morning she could just go to the doctor for pills.

“It’s great that you have the choice to take them,” says Rachel.“But you don’t really make an informed choice if at the moment you decide to take them, you don’t have all the information.”

What to do if you missed a pill

Doctors prescribe drugs with a mandate: to drink strictly in such a dosage, at such a time and with such an interval. With respect to the doctor and our health, sometimes we forget about it. What to do if I miss a medication? Drink a handful at once? And if you didn’t remember all week? Understanding.

Tablet tablet discord

Actions depend on how quickly the drug is excreted from the body.Most drugs that help to cope with chronic conditions – high blood pressure, cardiovascular diseases, diabetes, require daily use. But their elimination period is long, so if a person misses an appointment from time to time, it’s okay, the main thing is to continue on.

General rules

In general, if you accidentally forget to drink almost any oral medication, you can catch up within two hours of your usual dosing time.But if it’s time to drink the next pill (less than 2-4 hours before it), it’s better to just skip the previous one. Carefully consider the course of the following pills.

How to deal with COCs and other hormonal drugs

Hormonal pills. First, it is worth referring to the instructions: different drugs – different advice. Skipping hormonal contraceptives or not following a schedule is dangerous due to the risk of pregnancy. The missed COC pill (containing both estrogen and progesterone) should be taken as soon as you remember, even if there are two pills a day.Then they should be taken as usual.

If 48 hours have passed since the last appointment, the girl is not protected from pregnancy. Then it is worth using condoms or abstaining from sex for a week until daily use resumes.

Progesterone-only pills need to be monitored more closely – they usually need to be drunk every day at the same time (maximum three hours later). If more than three hours have passed, you need to take it as soon as you remember, and then – as usual.The next two days recommend using condoms just in case. If you have had unprotected sex 3-5 days before, you should consult a gynecologist – you may need emergency contraception.

Doctors-gynecologists of the “Scandinavia” clinic will help you to choose the means of contraception.

How to deal with antibiotics

Antibiotics They pass quickly from the body, and a missed dose can slow down recovery. But I really want to put aside the pills when it’s better! Do not do this – the disease can return, and the “unfinished” bacteria will get used to the antibiotic, and the next time they will be more resistant.The UK Department of Health does not recommend taking a double dose if the previous one is forgotten. I had to take it in the morning, but they remembered a couple of hours later – everything is fine. Remembered in the evening – it is better to skip and continue to drink, as usual.

Take caution with anticonvulsants and antidepressants

Do not take a double dose of anticonvulsants or antidepressants to catch up. This can lead to side effects.Typically, these medications are taken 1-3 times a day. If the morning pill is missed, it should be taken as soon as you remember it. But if before the next appointment is less than four hours, you should forget about the missed one and take the course further.

In any case, you cannot prescribe antidepressants yourself, for this you need to contact a psychiatrist or psychotherapist. Your doctor will also tell you what to do if you miss a pill.

Don’t panic

The main thing is that if you missed a dose, you do not need to panic and quit treatment.Better make sure that this does not happen again. An alarm clock, a reminder or a special application will help you remember to take your pills on time. You can combine the reception with a daily habit: placing them near a toothbrush or next to a coffee mug. There are also pill boxes – containers where you can put all the medicines for a week, and track their intake.

You can make an appointment with any specialist by phone or online.

BISOPROLOL AVEXIMA | JSC “Avexima”

Indications for use

• Arterial hypertension.
• Ischemic heart disease (CHD): prevention of attacks of stable angina pectoris.
• Chronic heart failure (CHF).

Method of administration and dosage

Bisoprolol tablets should be taken once a day in the morning with a small amount of liquid, regardless of the meal time. The tablets should not be chewed or powdered.

Arterial hypertension and stable angina pectoris

In all cases, the regimen and dose are selected by the doctor for each patient individually, in particular, taking into account the heart rate and the patient’s condition.

The usual starting dose is 5 mg once a day. If necessary, the dose can be increased to 10 mg once a day.

In the treatment of arterial hypertension and stable angina pectoris, the maximum recommended dose is 20 mg 1 time / day.

Chronic heart failure

The standard treatment regimen for CHF includes the use of angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor antagonists (in case of intolerance to ACE inhibitors), beta-blockers, diuretics and, optionally, cardiac glycosides.The beginning of treatment of CHF with bisoprolol requires a special titration phase and regular medical supervision.

A precondition for treatment with bisoprolol is stable chronic heart failure without signs of exacerbation.

Treatment of CHF with bisoprolol begins in accordance with the following titration scheme. In this case, individual adaptation may be required depending on how well the patient tolerates the prescribed dose, i.e.e. the dose can be increased only if the previous dose was well tolerated. To ensure an appropriate titration process at the initial stages of treatment, it is recommended to use bisoprolol in a dosage form: 2.5 mg tablets. The recommended starting dose is 1.25 mg once daily. Depending on individual tolerance, the dose should be gradually increased to 2.5 mg, 3.75 mg, 5 mg, 7.5 mg and 10 mg once a day. Each subsequent dose increase should be carried out at least two weeks later.

If an increase in the dose of the drug is poorly tolerated by the patient, a dose reduction is possible.

The maximum recommended dose for CHF is 10 mg of bisoprolol once a day.

During titration, regular monitoring of blood pressure, heart rate and the severity of CHF symptoms is recommended. Aggravation of the symptoms of CHF is possible from the first day of using the drug.

If the patient does not tolerate the maximum recommended dose of the drug, a gradual dose reduction is possible.

During the titration phase or after it, a temporary deterioration in the course of CHF, arterial hypotension or bradycardia may occur. In this case, it is recommended, first of all, to adjust the doses of concomitant therapy drugs. You may also need to temporarily reduce the dose of bisoprolol or cancel it.

After stabilization of the patient’s condition, the dose should be titrated again, or treatment should be continued.

Duration of treatment for all indications for the use of bisoprolol

Treatment with bisoprolol is usually a long-term therapy.

Special patient groups

Renal or hepatic impairment:

• Mild to moderate hepatic or renal impairment usually does not require dose adjustment.

• In severe renal impairment (CC less than 20 ml / min.) And in patients with severe liver disease, the maximum daily dose is 10 mg. Increasing the dose in such patients should be done with extreme caution.

Elderly patients:

No dose adjustment required.

Children:

Since there is not enough data on the use of bisoprolol in children, it is not recommended to prescribe the drug to children under 18 years of age.

To date, there is insufficient data on the use of bisoprolol in patients with CHF in combination with type 1 diabetes mellitus, severe renal and / or liver dysfunction, restrictive cardiomyopathy, congenital heart defects or heart valve disease with severe hemodynamic disturbances.Also, until now, sufficient data have not been obtained regarding patients with CHF with myocardial infarction during the last 3 months.

90,000 Common misconceptions about sore throat

For centuries, people have suffered from sore throats. During all this time, countless fictions have been created about why a sore throat occurs and how to cope with it.

In our article, we want to establish once and for all which of them is true and which is myth.

# 1: Antibiotics are the most effective remedy for sore throat

Myth! In most cases (up to 95% in adults ¹ ), sore throat is caused by a viral infection, against which antibiotics are powerless. It is only when bacteria or fungi are the cause of a sore throat that antibiotic therapy takes place. But is it obligatory? Antibiotics are “strong” medicines that, if misused, can do more harm than good, not to mention antibiotic resistance2.Why, with a sore throat, “stuff” yourself with antibiotics, if there are safer methods. For example, you can use Strepsils® lozenges with honey and lemon flavor, which acts regardless of the cause of the sore throat, be it bacteria, viruses or fungus. However, if you are concerned about the condition of your throat, we advise you to see a doctor.

# 2: Sore throat is not a reason to visit the doctor

Myth! Ignoring the treatment of a cold can lead to the disease going down into the lungs, and this in turn can lead to even greater complications: bronchitis, lymphadenitis and other diseases.It is important to note that an untimely reaction to a cold can delay your recovery by several weeks. If within three days the pain in the throat does not go away, but continues to intensify, it is advisable for you to seek help from a doctor. He will be able to determine the cause of the disease and prescribe a complete course of treatment to help you feel better.

# 3: All throat pills work the same

Myth! In fact, despite the external resemblance to lollipops, they are very different in their action, since they have a different composition and purpose.It’s all about the active substance. There are substances that only alleviate the symptoms, and there are those that act on the cause. An example of a drug whose action is directed specifically at the cause of pain is Strepsils Intensive. Its active ingredient – Flurbiprofen – fights inflammation (the cause of pain) and thus relieves pain. Thus, it is possible to get rid of a sore throat in a short time and forget about this trouble. Moreover, the tablets have a pleasant taste.

# 4: Cold air may sore throat

Myth! The cause of colds and inflammation in the throat are viruses, bacteria and fungi.Once in our body, they cause disease. This happens more often in winter or autumn, so the disease automatically begins to be associated with cold. However, cold air is not good for the throat: it “dries out” the mucous membrane of the pharynx, which makes it easier for germs to enter the throat and spread there, which leads to painful sensations. Therefore, cold air can contribute to inflammation, but it is not the main cause.

To get rid of a sore throat, you first need to understand the myths regarding its treatment.Forget about prejudice, choose the right product, for example, Strepsils® lozenges Softening effect with honey and lemon – with vitamin C, with menthol and eucalyptus, with a warming effect or without sugar. They contain a combination of two antiseptic components – dichlorobenzyl alcohol and amylmetacresol, which means they kill the germs that cause sore throat and help the body resist disease. Take one tablet every 2-3 hours as needed. Read the instructions carefully before using the drug.

If your sore throat persists or continues to get worse, be sure to see a doctor.

How to properly take medications before meals, after meals: rules for taking medications

author: DOC.UA

[[doctor text = “Make an appointment with a doctor”]]

[[blockquote text = “Remember that if you take any medication on your own, try to keep at least half an hour between taking them. “]]

[[blockquote text =” Failure to follow doctor’s prescriptions can lead to poor health, longer recovery, unwanted side effects, psychoactive use disorders substances and other serious health conditions requiring intensive treatment.”]]

[[doctor text =” Make an appointment with a doctor “]]

If you are sick, medication can help you feel better and recover. However, if you do not follow the instructions, medication can By carefully adhering to the instructions in the medication instructions or the prescription, which was prescribed by the doctor, you can avoid side effects and other negative consequences. is described in the article.

Basic rules for taking pills

How to take pills correctly?

1. Consult a doctor before taking this medicine.
2. Follow your medication schedule.
3. Read the instructions carefully.
4. Take medicines with water only.
5. Take the medicine in the amount indicated in the prescription.
6. Store medicines correctly.

Before, during and after meals – how’s that?

Before or after meals – is there a difference?

Medicines can be taken before, after, during food or independently of it.Some people do not understand, how is it while eating? Indeed, if in the understanding of the majority, food is porridge with a cutlet and compote, then for a doctor and our body, daily snacks in the form of a banana, apple or snack are also a full-fledged meal. Indeed, when they are consumed, the stomach secretes enzymes and hydrochloric acid, and all digestion processes occur in the same way as when digesting more “serious” food.

4.9

Krushenitskaya Olga Yurievna

Doctor of the second category

6 years of experience

Adults

Olga Yurievna has high qualifications and experience in clinical practice as a family doctor, so the doctor successfully copes with the therapy of pathologies and disorders in the activity of the heart and blood vessels, bronchopulmonary system, digestive organs, etc.d.

Vera Nadezhda Lyubov

Consultation of a family doctor with a certificate for the pool 200 UAH