What are the primary uses of prescription strength Pepcid. How should patients take this medication. What are the potential side effects and interactions of famotidine. What precautions should be taken when using prescription strength Pepcid.

Understanding Prescription Strength Pepcid: An Overview

Prescription strength Pepcid, also known by its generic name famotidine, is a powerful medication used to treat various gastrointestinal conditions. As a histamine-2 (H2) blocker, it works by reducing the amount of acid produced in the stomach. This article delves into the intricacies of this medication, providing valuable information for patients and healthcare professionals alike.

The Medical Applications of Famotidine

Famotidine is prescribed for several conditions related to excess stomach acid. These include:

• Prevention of ulcer recurrence
• Treatment of erosive esophagitis (heartburn)
• Management of gastroesophageal reflux disease (GERD)
• Treatment of stomach ulcers
• Control of excessive stomach acid production in Zollinger-Ellison syndrome

Each of these conditions requires specific dosing regimens, which we will explore in detail.

Proper Usage and Dosage Guidelines

Adhering to the prescribed dosage is crucial for the effectiveness and safety of famotidine. How should patients take this medication? The dosage varies depending on the condition being treated and the patient’s age and weight.

General Dosage Instructions

Famotidine can be taken with or without food. For liquid formulations, it’s essential to use a marked measuring spoon or medicine cup to ensure accurate dosing. The medication should be taken exactly as directed by a healthcare provider or as indicated on the package.

Dosage for Specific Conditions

1. Ulcer Prevention: Adults typically take 20 mg once daily.
2. Erosive Esophagitis: Adults and children weighing 40 kg or more usually take 20 mg once or twice daily, or 40 mg once daily at bedtime for up to 12 weeks.
3. GERD Treatment: The standard dose for adults and children over 40 kg is 20 mg twice daily for up to 6 weeks.
4. Stomach Ulcers: Treatment often involves 20 mg twice daily or 40 mg once daily at bedtime for up to 8 weeks.
5. Zollinger-Ellison Syndrome: Adults may be prescribed 20 mg every 6 hours, with dosage adjustments as needed.

For children weighing less than 40 kg, dosages must be determined by a healthcare professional.

Potential Side Effects and Adverse Reactions

While famotidine is generally well-tolerated, it’s important to be aware of potential side effects. What are the most common adverse reactions associated with prescription strength Pepcid?

• Headache
• Dizziness
• Constipation or diarrhea
• Nausea and vomiting
• Dry mouth
• Fatigue

In rare cases, more serious side effects may occur, such as irregular heartbeat, confusion, or signs of liver problems. Patients should seek immediate medical attention if they experience any severe or unusual symptoms.

Drug Interactions: What to Watch Out For

Famotidine can interact with various medications, potentially altering their effectiveness or increasing the risk of side effects. Which drugs are known to interact with prescription strength Pepcid?

Notable Drug Interactions

• Acalabrutinib: Famotidine may decrease the levels of this cancer medication by increasing gastric pH.
• Atazanavir: H2-receptor antagonists like famotidine can significantly reduce the effectiveness of this HIV medication.
• Alendronate: Famotidine might increase levels of this osteoporosis drug, potentially enhancing its side effects.
• Aripiprazole: The antipsychotic’s levels may be decreased when taken with famotidine.

It’s crucial for patients to inform their healthcare providers about all medications, supplements, and herbal products they are taking to avoid potential interactions.

Storage and Handling Precautions

Proper storage and handling of famotidine are essential to maintain its effectiveness and safety. How should prescription strength Pepcid be stored?

• Keep the medication in a closed container at room temperature.
• Protect it from heat, moisture, and direct light.
• Do not freeze the medication.
• Keep out of reach of children.
• Dispose of any unused oral liquid after 30 days.

Patients should consult their healthcare provider or pharmacist for proper disposal methods for unused or expired medication.

Special Considerations and Warnings

While famotidine is generally safe when used as directed, there are certain precautions and warnings to keep in mind:

• Patients with kidney problems may require dose adjustments.
• Elderly patients may be more sensitive to side effects.
• Pregnant or breastfeeding women should consult their healthcare provider before using famotidine.
• Long-term use of H2 blockers may increase the risk of certain infections or nutritional deficiencies.

It’s important for patients to discuss their complete medical history with their healthcare provider before starting treatment with prescription strength Pepcid.

Maximizing the Benefits of Famotidine Therapy

To get the most out of famotidine treatment, patients should follow these guidelines:

1. Take the medication consistently as prescribed, even if symptoms improve.
2. Do not abruptly stop taking famotidine without consulting a healthcare provider.
3. Avoid alcohol and tobacco, which can exacerbate acid-related conditions.
4. Make dietary and lifestyle changes as recommended by a healthcare provider to support treatment.
5. Keep all follow-up appointments to monitor progress and adjust treatment as needed.

By adhering to these recommendations, patients can optimize the effectiveness of their famotidine therapy and improve their overall gastrointestinal health.

Prescription strength Pepcid (famotidine) is a valuable medication for managing various acid-related gastrointestinal conditions. Its effectiveness, coupled with a generally favorable safety profile, makes it a common choice for many patients. However, as with any prescription medication, it’s crucial to use famotidine under the guidance of a healthcare professional, adhering to prescribed dosages and being vigilant for potential side effects or interactions. By understanding the proper use, potential risks, and important precautions associated with famotidine, patients can safely and effectively manage their gastrointestinal health.

As medical knowledge continues to evolve, it’s important for both healthcare providers and patients to stay informed about the latest research and guidelines regarding famotidine use. Regular check-ups and open communication with healthcare providers can ensure that treatment remains optimized and tailored to each individual’s needs. With proper use and monitoring, prescription strength Pepcid can significantly improve quality of life for those suffering from acid-related gastrointestinal disorders.

Famotidine (Oral Route) Proper Use

Proper Use

Drug information provided by: IBM Micromedex

Take this medicine exactly as directed by your doctor or as directed on the package. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

Keep using this medicine for the full time of treatment, even if you begin to feel better.

You may take this medicine with or without food.

Measure the oral liquid with a marked measuring spoon or medicine cup. The average household teaspoon may not hold the right amount of liquid.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• 
  For oral dosage forms (suspension, tablets):
  • 
    To prevent an ulcer from coming back:
    • 
      Adults—20 milligrams (mg) once a day.
    • 
      Children—Use and dose must be determined by your doctor.

  • 
    To treat erosive esophagitis (heartburn):
    • 
      Adults and children weighing 40 kilograms (kg) or more—20 milligrams (mg) 1 or 2 times per day, at the morning and at bedtime, or 40 mg once a day at bedtime for up to 12 weeks.
    • 
      Children weighing less than 40 kg—Use and dose be determined by your doctor.

  • 
    To treat gastroesophageal reflux disease (GERD):
    • 
      Adults and children weighing 40 kilograms (kg) or more—20 milligrams (mg) 2 times per day, in the morning and at bedtime for up to 6 weeks.
    • 
      Children weighing less than 40 kg—Use and dose be determined by your doctor.

  • 
    To treat stomach ulcers:
    • 
      Adults and children weighing 40 kilograms (kg) or more—20 milligrams (mg) 2 times per day, at the morning and at bedtime, or 40 mg once a day at bedtime for up to 8 weeks.
    • 
      Children weighing less than 40 kg—Use and dose be determined by your doctor.

  • 
    To treat too much stomach acid (Zollinger-Ellison syndrome):
    • 
      Adults—20 milligrams (mg) every 6 hours. Your doctor may adjust your dose as needed.
    • 
      Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Throw away any unused oral liquid after 30 days.

Portions of this document last updated: Aug. 01, 2021

Copyright © 2021 IBM Watson Health. All rights reserved. Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes.

.

Pepcid AC, Zantac 360 (famotidine) dosing, indications, interactions, adverse effects, and more

Amazon.com: Pepcid AC, Maximum Strength 20mg Famotidine, 50 ct : Everything Else

Safety Information

Allergy alert: Do not use if you are allergic to famotidine or other acid reducers.Do not use

• if you have trouble or pain swallowing food, vomiting with blood, or bloody or black stools. These may be signs of a serious condition. See your doctor.
• if you have kidney disease, except under the advice and supervision of a doctor
• with other acid reducers

Ask a doctor before use if you have

• had heartburn over 3 months. This may be a sign of a more serious condition.
• heartburn with lightheadedness, sweating, or dizziness
• chest pain or shoulder pain with shortness of breath; sweating; pain spreading to arms, neck, or shoulders; or lightheadedness
• frequent chest pain
• frequent wheezing, particularly with heartburn
• unexplained weight loss
• nausea or vomiting
• stomach pain

Stop use and ask a doctor if

• your heartburn continues or worsens
• you need to take this product for more than 14 days

If pregnant or breast-feeding, ask a health professional before use. Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center right away.

Ingredients

Active: Famotidine 20 Mg. Inactive: Carnauba Wax, Hydroxypropyl Cellulose, Hypromellose, Magnesium Stearate, Microcrystalline Cellulose, Pregelatinized Starch, Talc, Titanium Dioxide.

Directions

Read the directions and warnings before use. Keep the carton. It contains important information. Store at 2030c (6886f). Protect from moisture. Adults and children 12 years and over: to relieve symptoms, swallow 1 tablet with a glass of water. Do not chew. To prevent symptoms, swallow 1 tablet with a glass of water at any time from 10 to 60 minutes before eating food or drinking beverages that cause heartburn. Do not use more than 2 tablets in 24 hours. Children under 12 years: ask a doctor.

Legal Disclaimer

Statements regarding dietary supplements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease or health condition.

Pepcid AC – Uses, Side Effects, Interactions

How does this medication work? What will it do for me?

Famotidine belongs to a class of medications called h3 antagonists. It is used to treat stomach and duodenal (intestinal) ulcers, gastroesophageal reflux disease (GERD), and conditions where too much stomach acid is secreted, such as Zollinger-Ellison syndrome. It is also used to prevent duodenal ulcers and prevent GERD symptoms from coming back. It works by reducing the amount of acid secreted by the stomach.

The over-the-counter form of famotidine is used to treat conditions where a reduction of stomach acid is needed, such as acid indigestion, heartburn, or sour or upset stomach. It can also be used to prevent these symptoms when they are associated with eating food or drinking beverages, including nighttime symptoms.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Pepcid AC
Each rounded-square, pale rose (pink) coloured, film-coated tablet, with “Pepcid AC” embossed on one side contains 10 mg of famotidine. Nonmedicinal ingredients: hydroxypropyl cellulose, hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, red ferric oxide, starch, talc, and titanium dioxide.

Pepcid AC, Maximum Strength
Each white, “D” shaped, film-coated tablet, with “PAC20” debossed on one side and blank on the other, contains 20 mg of famotidine. Nonmedicinal ingredients: carnauba wax, hydroxypropyl cellulose, hypromellose, magnesium stearate, microcrystalline cellulose, starch, talc, and titanium dioxide.

How should I use this medication?

Tablets: The usual adult dose of famotidine tablets ranges from 20 mg or 40 mg at bedtime to 20 mg or 40 mg twice daily, depending on the condition being treated. This medication can be taken with or without food. Seniors and those with decreased kidney function may require lower doses or longer intervals between doses.

• The dose of famotidine for treatment of duodenal ulcer is 40 mg at bedtime for 4 to 8 weeks, or less if healing occurs. Therapy is often continued after healing of the ulcer at a dose of 20 mg once daily for up to 6 to 12 months.
• The usual dose for treatment of benign stomach ulcer is 40 mg once a day at bedtime for 4 to 8 weeks, or less if healing occurs.
• For Zollinger-Ellison syndrome and similar conditions, the dose varies with the individual patient, but often starts with 20 mg every 6 hours.
• When used to relieve the symptoms of GERD or prevent GERD from returning, the usual dose is 20 mg twice daily. When used to treat esophageal damage related to GERD, the usual dose is 40 mg twice daily.

When used over-the-counter to treat acid indigestion, heartburn, or sour or upset stomach, the usual dose for adults and children 12 years of age or older is 10 mg to 20 mg when symptoms are experienced. To prevent symptoms brought on by consuming food or beverages, take the dose 10 to 15 minutes before eating food or drinking beverages that are expected to cause symptoms. The maximum dose is 40 mg every 24 hours. Do not take this medication every day for more than 2 weeks without seeking medical advice.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

• are allergic to famotidine or any ingredients of the medication
• are allergic to other acid-reducing agents known as h3-receptor antagonists (e.g., ranitidine, cimetidine, nizatidine)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• constipation
• diarrhea
• dizziness
• dry mouth
• headache
• nausea
• tiredness
• vomiting

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Stop taking the medication and seek immediate medical attention if any of the following occur:

• symptoms of an allergic reaction (e.g., difficulty breathing or swallowing; swelling of the hands, feet, ankles, face, lips, mouth, or throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Kidney disease: Famotidine is removed from the body mostly by the kidneys. Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Lower doses or longer intervals between doses may be needed.

Severe stomach problems: Although common, heartburn and acid indigestion can sometimes be a warning sign for more serious stomach problems. If you are over the age of 40 and are experiencing heartburn for the first time, you should check with your health care professional before starting this medication. If you have recurrent vomiting, difficulty swallowing, blood in the stool, significant unintentional weight loss, fatigue (anemia), or are coughing up blood, check with your doctor right away. If you have heartburn that continues, worsens, or returns after using this medication continuously for 2 weeks, check with your doctor. If you frequently need to use this medication for heartburn for 14 days in a row, you should see your doctor.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking famotidine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children. For the over-the-counter form, the safety and effectiveness of using this medication have not been established for children less than 12 years of age.

Seniors: Seniors are at an increased likelihood of having decreased kidney function and therefore may be more likely to experience side effects. If you are a senior, your doctor should closely monitor your condition while you are taking famotidine.

What other drugs could interact with this medication?

There may be an interaction between famotidine and any of the following:

• “azole” antifungals (itraconazole, ketoconazole, posaconazole)
• cefuroxime
• certain protein kinase inhibitors (e.g., bosutinib, dabrafenib, dasatinib, nilotinib, pazotinib)
• cyclosporine
• dexmethylphenidate
• indinavir
• iron supplements (e.g., ferrous fumarate, ferrous gluconate, ferrous sulfate)
• ledipasvir
• mesalamine
• multiple vitamin supplements with iron
• rilpivirine
• risedronate (delayed-release)
• tizanidine
• varenicline
• velpatasvir

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Pepcid-AC

Pepcid AC Maximum Strength Tablets for Heartburn Prevention & Relief

Pepcid AC Maximum Strength Tablets for Heartburn Prevention & Relief – 8 ct

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From the Manufacturer

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PRODUCT DETAILS

Item No. 0385281

Maximum Strength Pepcid AC Indigestion Relief Tablets with famotidine provide fast-acting prevention and relief of heartburn associated with acid indigestion and sour stomach. Each acid controlling tablet contains 20 mg of famotidine, a known acid reducer that helps relieve heartburn brought on by eating or drinking certain food and beverages. Keep a package in your bag or at your desk for easy-access to treat heartburn on-the-go. You can take Maximum Strength Pepcid AC as little as 10 minutes before eating, and know you have strength on your side all day or all night.Prevents heartburn if taken 10 to 60 minutes before a meal. Based on 9-hour acid control studies during the day and 12-hour acid control studies during the night. Acid control does not imply symptom relief.

• Maximum Strength Pepcid AC Heartburn Relief Tablets with famotidine help prevent & relieve heartburn
• These acid controlling tablets relieve heartburn due to acid indigestion & sour stomach
• 1 tablet controls acid all day or night based on results of 9-hr daytime & 12-hr nighttime studies
• Each tablet contains 20 mg of famotidine, a known acid reducer, for heartburn relief & acid control
• Can prevent heartburn if taken up to 10-60 minutes prior to consuming food or beverage

• Over-the-counter digestive aids are now available for FSA and HSA reimbursement without a prescription. For any questions you may have regarding FSAs or HSAs, please browse our FAQ.

HOW TO USE

Adults and children 12 years and over to relieve symptoms, swallow 1 tablet with a glass of water. Do not chew. to prevent symptoms, swallow 1 tablet with a glass of water at any time from 10 to 60 minutes before eating food or drinking beverages that cause heartburn do not use more than 2 tablets in 24 hours Children under 12 years ask a doctor read the directions and warnings before use keep the carton. It contains important information Other information read the directions and warnings before use keep the carton. It contains important information. store at 20-25C (68-77F) protect from moisture Questions or comments 1-800-755-4008 (toll-free) or 215-273-8755 (collect)

INGREDIENTS

Active Ingredient (in each tablet): Famotidine 20 mg (Acid reducer) Inactive Ingredients: Carnauba wax, hydroxypropyl cellulose, hypromellose, magnesium stearate, microcrystalline cellulose, pregelatinized starch, talc, titanium dioxide.

SAFETY

Allergy alert: Do not use if you are allergic to famotidine or other acid reducers. Do not use if you have trouble or pain swallowing food, vomiting with blood, or bloody or black stools. These may be signs of a serious condition. See your doctor. i f you have kidney disease, except under the advice and supervision of a doctor with other acid reducers Ask a doctor before use if you have had heartburn over 3 months. This may be a sign of a more serious condition. heartburn with lightheadedness, sweating, or dizziness chest pain or shoulder pain with shortness of breath; sweating; pain spreading to arms, neck, or shoulders; or lightheadedness frequent chest pain frequent wheezing, particularly with heartburn unexplained weight loss nausea or vomiting stomach pain Stop use and ask a doctor if your heartburn continues or worsens you need to take this product for more than 14 days If pregnant or breast-feeding, ask a health professional before use. Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center right away.

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PEPCID AC Maximum Strength | Healthgrades

Brand Name: PEPCID AC Maximum Strength

Generic Name: FAMOTIDINE

Drug Type: HUMAN OTC DRUG

Route: ORAL

Dosage Form: TABLET, FILM COATED

Data Current As Of: 2020-03-23

Drug Facts

active ingredient (in each tablet)

Famotidine 20 mg

Acid reducer

• relieves heartburn associated with acid indigestion and sour stomach
• prevents heartburn associated with acid indigestion and sour stomach brought on by eating or drinking certain food and beverages

Do not use if you are allergic to famotidine or other acid reducers

• if you have trouble or pain swallowing food, vomiting with blood, or bloody or black stools. These may be signs of a serious condition. See your doctor.
• with other acid reducers

ask a doctor before use if you have

Ask a doctor or pharmacist before use if you are taking a prescription drug. Acid reducers may interact with certain prescription drugs.

stop use & ask a doctor if

• your heartburn continues or worsens
• you need to take this product for more than 14 days

If pregnant or breast-feeding, ask a health professional before use.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center right away. (1-800-222-1222)

• adults and children 12 years and over:
  • to relieve symptoms, swallow 1 tablet with a glass of water. Do not chew.
  • to prevent symptoms, swallow 1 tablet with a glass of water at any time from 10 to 60 minutes before eating food or drinking beverages that cause heartburn
  • do not use more than 2 tablets in 24 hours
• children under 12 years: ask a doctor

• read the directions and warnings before use
• keep the carton. It contains important information.
• store at 20°-25°C (68°-77°F)
• protect from moisture

carnauba wax, hydroxypropyl cellulose, hypromellose, magnesium stearate, microcrystalline cellulose, pregelatinized starch, talc, titanium dioxide

1-800-755-4008 (toll-free) or 215-273-8755 (collect)

Pepcid vs Zantac: What’s the difference?

An estimated 15 to 30 percent of Americans have gastroesophageal reflux disease (GERD),  meaning they experience heartburn or indigestion at least twice per week. A number of factors has contributed to the skyrocketing rates of GERD in the United States over the past several decades, including the rising obesity epidemic, as people who are overweight or obese are more likely to suffer from the condition. Over the counter (otc) medications like Pepcid and Zantac offer relief of mild to moderate occasional symptoms of GERD for some people, while others require prescription medications to help control their symptoms. Regardless of the type of medication used to treat GERD, the condition usually does not resolve without substantial lifestyle changes and dietary changes as well. Pepcid and Zantac both offer relief from GERD symptoms, but there are differences between the two medications.

Drug Class

Pepcid, sold under the generic name famotidine, and Zantac, sold under the generic name ranitidine hydrochloride, both belong to a class of medications called Histamine-2 receptor blockers, or H-2 blockers. Both medications are available over the counter and prescription forms. H-2 blockers (sometimes called H-2 antagonists) were the original form of treatment for ulcers and were the most popular form of treatment for ulcers and GERD in the 1980s.

Conditions Treated

Pepcid and Zantac both treat similar conditions, including GERD, Zollinger-Ellison Syndrome, stomach ulcers, esophagitis, and other digestive conditions. 

Gastroesophageal Reflux Disease 

Gastroesophageal reflux disease, also known as GERD or heartburn, is a condition in which stomach acid and digestive enzymes flow backward from the stomach into the esophagus. Most people occasionally experience symptoms of heartburn or acid reflux, but people with gastroesophageal reflux disease experience these symptoms multiple times per week over a long period of time. Often, the condition results from dysfunction in the esophageal sphincter. The muscular ring, or sphincter, that seals off the esophagus from the stomach is designed to prevent food and any amount of acid from coming back up into the esophagus, but people with GERD often have an esophageal sphincter that does not function properly and does not seal tightly enough. When this happens, the sphincter remains relaxed between swallows, allowing food and digestive juices to enter the esophagus. Stomach acid is dangerous to the esophagus, so over time, the condition can cause damage, inflammation, narrowing, development of open sores, or a condition called Barrett’s esophagus, which increases the risk of esophageal cancer. People with GERD often experience some or all of the following symptoms:

• Nausea
• A repeated sour or bitter taste in the mouth
• Sharp or burning pain behind the breast bone
• Tightness in the chest or upper abdomen
• Regurgitation
• Difficulty swallowing
• Hoarseness
• Sore throat
• Coughing, wheezing or needing to clear your throat

Zollinger-Ellison Syndrome

Zollinger-Ellison syndrome is a rare condition that causes tumors to form in your pancreas or upper small intestines. Tumors associated with Zollinger-Ellison syndrome secrete large amounts of a hormone called gastrin, which causes overproduction of acid in the stomach. The extra acid eventually leads to peptic ulcers, diarrhea, and other symptoms. While the majority of diagnoses are made between the ages of 20 and 50, the disease may present at any time in life. Symptoms associated with Zollinger-Ellison syndrome include:

• Abdominal pain
• Burning, aching, or discomfort in the upper abdomen
• Nausea and vomiting
• Diarrhea
• Acid reflux and heartburn
• Bleeding in the digestive tract
• Decreased appetite

How it Works

H-2 blockers like Pepcid and Zantac act on histamine receptors in the body. Histamine is a chemical in the body that directs the stomach lining to produce hydrochloric acid; it is also responsible for producing allergic reactions to allergens in certain individuals. The H-2 blockers work by binding to the H-2 receptors within the stomach, preventing histamine from binding and directing the production of hydrochloric acid. With the production of hydrochloric acid diminished, peptic ulcers are given time to heal, and excess acid is not produced, helping to prevent heartburn and GERD.

Dosing

Pepcid

Pepcid comes in oral tablets with strengths of 10 mg, 20 mg, and 40 mg. Doses depend on the condition being treated, with ulcers typically treated by a 40 mg oral tablet taken once daily or 20 mg taken twice daily for up to eight weeks and GERD being treated with 20 mg taken twice daily for up to six weeks. Patients with Zollinger-Ellison syndrome generally take an initial dose of 20 mg taken every six hours, with a maximum dosage of 160 mg every six hours.

Zantac

Zantac comes in oral tablets with strengths of 75 mg, 150 mg, and 300 mg. The standard dose of Zantac for treatment of an ulcer is 150 mg taken twice daily, although some patients may be able to receive effective treatment from one 300 mg dose taken after dinner or at bedtime. Patients being treated for Zollinger-Ellison syndrome and GERD are recommended to take 150 mg twice daily.

Benefits

H-2 blockers like Zantac and Pepcid are considered effective at lowering acidity and relieving heartburn symptoms for patients with mild to moderate symptoms that occur less than twice a week. The medications can (and should) be taken on an empty stomach to allow them to work their best. Compared to Pepcid, Zantac has been shown to be more effective at lowering acidity and relieving symptoms associated with heartburn; it also works faster. However, H-2 blockers only work effectively for two to six weeks before the stomach adjusts to the medication and begins working around it, so it is important that these medications only be taken for short term use.

Side Effects

The side effects for Pepcid and Zantac are similar to most other H-2 blockers, although there are some key difficulties between the two. Common side effects associated with Pepcid include:

• Constipation
• Fatigue
• Weakness
• Headache
• Muscle pain or cramps
• Dry mouth
• Vomiting
• Diarrhea
• Dizziness
• Mood changes
• Insomnia
• Joint pain
• Nausea

Common side effects associated with Zantac include:

• Decreased sex drive
• Impotence
• Difficulty having an orgasm
• Swollen or tender breasts (in men)
• Constipation
• Diarrhea
• Fatigue
• Headache (sometimes severe)
• Insomnia
• Drowsiness
• Dizziness
• Muscle pain
• Stomach pain
• Vomiting
• Nausea

Drug Interactions

Drug interactions for both Pepcid and Zantac are relatively minimal, but patients should still make sure to discuss all medications and supplements taken with their health care professional, as some drug interactions may occur. Drug interactions associated with Pepcid include:

• Atazanavir
• Ketoconazole
• Itraconazole
• Aspirin
• Nonsteroidal anti-inflammatory drugs (NSAIDs) like Aleve and ibuprofen

Drugs that may interact with Zantac include:

• Ketoconazole
• Atazanavir
• Triazolam
• Riazolam
• Midazolam
• Procainamide
• Glipizide
• Delavirdine
• Getfitinib
• Blood thinners, such as warfarin

Use in Pregnant and Breastfeeding Women

Pepcid

Pepcid is considered a FDA Class B medication for pregnant women, meaning that no harm has been shown to occur to an unborn child when taken during pregnancy. However, the manufacturer advises that each woman speak with their healthcare provider  or pharmd before taking any new medications during pregnancy. Pepcid ac has been found to pass through breast milk to nursing infants, but no problems have been reported to occur in infants whose mothers nursed while taking Pepcid.

Zantac

Like Pepcid, Zantac is also considered an FDA Class B medication for pregnant women, as no harm has been shown to occur to unborn children when taken during pregnancy. However, the manufacturer advises that each woman speak with their doctor for medical advice before taking any new medications during pregnancy. Zantac has been found to pass through breastmilk to nursing infants, but no problems have been reported to occur in infants whose mothers nursed while taking Zantac. Some infants suffer from acid reflux and receive a small dose of Zantac as treatment for the condition; the dose given to infants is less than the amount that passes through breast milk.

Recall of Zantac

It should be noted that Zantac and all other ranitidine products were recalled by the U.S. Food and Drug Administration (FDA) in April 2020 due to the presence of a nitrosamine impurity called N-nitrosodimethylamine (NDMA) in some ranitidine products. NDMA levels were found to increase over time in normal storage conditions and increase at a higher rate when the medication is stored at high temperatures. Nitrosamine impurities, like NDMA, may increase the risk of cancer in people who are exposed to them at levels above what is recommended and over long periods of time. NDMA is considered safe at or below the recommended daily intake level, which would allow a patient to intake the acceptable amount of NDMA every day for 70 years without an increased risk of cancer. However, NDMA levels were found to be unacceptably high in some ranitidine products, prompting a total recall of all ranitidine products by the FDA. 

Alternatives to Zantac include other h3 blocker heartburn medications, such as Pepcid and Tagamet. Antacids like Tums, Mylanta, and Rolaids can provide fast-acting relief for indigestion and heartburn on a temporary basis; however, these medications work temporarily and may only offer relief for 30 to 60 minutes at a time. For more persistent cases of GERD, proton pump inhibitors (PPIs) like Nexium, Prevacid, and Prilosec are also an option, although long term use of PPIs is not without risks. It’s recommended that you talk to a healthcare professional about alternatives of Zantac that might be able to help provide relief from your symptoms. 
 

90,000 Treatment and prevention of gastroesophageal reflux disease

Treatment and prevention of gastroesophageal reflux disease (GERD)

Gastroesophageal reflux disease (GERD) is common but rarely detected and therefore untreated or treated on its own and incorrectly, which is undesirable since GERD usually responds well to treatment.

GERD is treated gradually. The doctor will help you choose the right course of treatment.If the disease is mild, the patient will need to follow a certain diet, give up certain activities, and sometimes take over-the-counter medications.

In cases where symptoms are more persistent (daily heartburn, symptoms that appear at night), prescription drugs may be required. Surgery is a reasonable alternative to continuous medication, especially if the disease is acquired at an early age.

Surgery is also recommended if medications do not help. However, today there is a new generation of drugs that can effectively control gastroesophageal reflux.

If symptoms are still uncomfortable after taking strong drugs, it is most likely not caused by GERD. Most gastroenterologists and surgeons do not recommend surgery in such cases, since after it the symptoms still continue to bother.

Lifestyle changes

Treatment of gastroesophageal reflux begins with lifestyle changes. First you need to understand what affects the onset of symptoms.

If you have symptoms of GERD, use the following tips:

• Avoid foods and drinks that stimulate the relaxation of the lower esophageal sphincter, such as mint flavored foods, chocolate and alcohol.

• Lose weight if you are overweight. Being overweight and obese contributes to GERD, as being overweight increases pressure on the stomach and lower esophageal sphincter, which causes acidic gastric juice to flow into the esophagus and irritate the lining of the esophagus.

• Avoid lying down for at least two or three hours after eating. It’s good to take a walk after eating.This not only prevents the onset of GERD symptoms, but also burns excess calories.

• Avoid foods that trigger GERD symptoms in your diet. Don’t eat fatty or fried foods, creamy sauces, mayonnaise, or ice cream. Other foods that can worsen symptoms include coffee, tea, sodas, tomatoes, and citrus fruits.

• Stop smoking.Smoking disrupts the digestive system and, according to some studies, relaxes the lower esophageal sphincter. Smoking also decreases saliva’s bicarbonate content and decreases its ability to protect the esophagus from stomach acid. Certain types of nicotine replacement therapy (nicotine patch, nicotine gum) can cause indigestion, abdominal pain, and vomiting. Discuss the possible side effects of these products with your doctor before use.

• Do not wear clothing that puts pressure on the abdomen, such as tight belts, skinny jeans, and elastic waistbands that increase pressure on the stomach and lower esophageal sphincter.

• Raise the head of the bed 15-20 cm, or use a wedge-shaped pillow to allow the acid to enter the stomach by gravity.

• Do not bend over after eating.If you need to lift something from the floor, it is better to sit down on bent knees and try not to bend at the waist. Do not exercise or physical labor after meals.

• Check the drugs you are taking. Due to the use of certain medications, symptoms may worsen. These drugs include theophylline, calcium channel blockers, alpha-blockers and beta-blockers, anticholinergics that may be present in drugs used to treat Parkinson’s disease, asthma, and some over-the-counter cold and cough remedies.If you think the drug you are taking is affecting your symptoms, talk to your doctor about how you can substitute it. Do not interrupt the prescribed treatment without consulting your doctor.

Drug treatment of gastroesophageal reflux

The attending physician may prescribe medication for GERD. Because GERD is often a chronic condition, you will have to take medications for your entire life. In some cases, long-term treatment is not required.

Be patient, it takes time to find the right drug and dosage. If symptoms persist even after taking medications, or if they recur immediately after completing the course, consult your doctor. If symptoms of GERD occur during pregnancy, contact your obstetrician before starting medication.

The following is information about the drugs that are commonly prescribed to treat GERD:

OTC antacids

These remedies help with mild and rare symptoms.Their action is to neutralize acidic gastric juice. Usually, antacids work quickly and can be taken as needed. Since they do not last long, they do not prevent heartburn and are less effective for symptoms that often appear.

Most antacids contain calcium carbonate (Maalox) or magnesium hydroxide. Sodium bicarbonate, or baking soda, helps with heartburn and indigestion. It should be mixed with at least 120 ml of water and taken one to two hours after a meal, so as not to overload a full stomach.Talk to your healthcare provider about the need for this treatment. Do not use this method for more than two weeks and only use it in extreme cases, as baking soda can lead to metabolic disorders (pH) and the formation of erosions in the esophagus and stomach. Consult your doctor before using it on children under 12 years of age.

Another type of antacid contains alginate or alginic acid (eg Gaviscon Gaviscon). The advantage of this antacid is that it prevents fluid from seeping back into the esophagus.

Antacids can interfere with the body’s ability to absorb other drugs, so if you are taking other drugs, consult your doctor before using antacids.

Ideally, you should take antacids at least 2-4 hours after taking other drugs to minimize the chances of non-absorption. People with high blood pressure are advised to refrain from taking high sodium antacids (Gaviscon Gaviscon).

Finally, antacids are not a reliable treatment for erosive esophagitis, a disease that must be treated with other drugs.

Preparations suppressing the production of hydrochloric acid

These drugs reduce the amount of acid produced by the stomach and are available with or without a prescription. Usually, the same drugs are available on prescription, but at a higher dosage. They can help those who are not helped by antacids.Most patients feel better if they take hydrochloric acid suppressants and make lifestyle changes.

According to the mechanism of action, two groups of such drugs are distinguished:

– Blockers H ₂ – histamine receptors

– Proton pump inhibitors

Most likely, the doctor first recommends taking the drug in a standard dose for several weeks, and then, if the desired effect is not achieved, he will prescribe a drug with a higher dosage.

Traditional h3 blockers include:

– nizatidine (“Axid AR” Axid AR)

– famotidine (“Pepsid AC” Pepcid AC)

– cimetidine (“Tagamet HB” Tagamet HB)

– ranitidine (“Zantac 75” Zantac 75)

Pepcid Complete is a combination of famotidine, calcium carbonate and magnesium hydroxide contained in antacids.

Traditional proton pump inhibitors include:

– lansoprazole (“Prevacid”, Prevacid)

– omeprazole (“Prilosec”, Prilosec)

– rabeprazole (AcipHex, AcipHex, Pariet)

– pantoprazole (Protonix Protonix, Nolpaza Nolpaza)

– esomeprazole (“Nexium”, Nexium)

– omeprazole + sodium bicarbonate (Zegerid Zegerid)

– dexlansoprazole (“Dexilant” Dexilant)

Proton pump inhibitors (PPIs) also lower acidity, but are more potent than h3 blockers.Proton pump inhibitors are most commonly prescribed to treat heartburn and acid reflux.

These agents block the secretion of acid by the cells of the gastric mucosa, and significantly reduce the amount of stomach acid. They do not work as quickly as antacids, but can relieve reflux symptoms for hours.

PPIs are also used to treat esophageal inflammation (esophagitis) and esophageal erosions. Studies have shown that most patients with esophagitis who took such drugs recovered after 6-8 weeks.Most likely, your doctor will reevaluate your health after 8 weeks of taking proton pump inhibitors and, according to the results obtained, will reduce the dosage or stop the treatment. If symptoms do not return within three months, you will only need to take medication from time to time. People with liver disease should consult their doctor before taking these drugs.

Prokinetics

Prokinetics, for example, metoclopramide (Cerucal, Raglan, Metosolv), increase the tone of the lower esophageal sphincter, so that acid does not enter the esophagus.They also reinforce the contractions of the esophagus and stomach to some extent, so that the stomach empties faster. These drugs can be used as an adjunct treatment for people with GERD.

Surgical treatment of GERD

The operation is an alternative to the conservative treatment of GERD. The operation is most often prescribed for young patients (because otherwise they will need long-term treatment) with typical GERD symptoms (heartburn and belching), who are helped by drug treatment, but they are looking for an alternative to daily medication.

Patients with atypical symptoms or patients who are unresponsive to medical treatment are only prescribed surgery if there is no doubt about the diagnosis of GERD and the relationship between symptoms and reflux is supported by research results.

Fundoplication is used in most cases. During this operation, the upper part of the stomach is wrapped around the lower esophageal sphincter, thereby increasing its tone.Today, instead of the traditional “open” surgery, minimally invasive (laparoscopic) technologies are usually used. One of the benefits of fundoplication is that the hiatal hernia can also be removed during surgery.

The operation is not always effective, and after it, some patients still have to take medications. The results of this surgery are usually positive, but complications can nevertheless occur, such as difficulty swallowing, bloating and gas, a difficult recovery from surgery, and diarrhea that occurs due to damage to the nerve endings that adjoin the stomach and intestines.

Prevention of GERD

First of all, it is necessary to pay attention to lifestyle and avoid situations that can provoke the onset of the disease.

Remember that GERD occurs when stomach acid is pumped into the esophagus, which connects the pharynx to the stomach.

To keep the lower esophageal sphincter functioning properly, follow these guidelines:

Avoid bending or other physical exercises that increase pressure on the abdomen.Do not exercise on a full stomach.

Do not wear clothing that fits tightly around the waist, such as elastic waistbands and belts, which can increase pressure on the stomach.

Do not lie down on the food field. If you lie on your back after a heavy meal, it will be easier for stomach contents to enter the esophagus. For a similar reason, do not eat before bed. The head of the bed should rise 15-20cm so that gravity stays acid in the stomach, where it should be while you sleep.

Don’t overeat. Due to the fact that there is a large amount of food in the stomach, the pressure on the lower esophageal sphincter increases, as a result of which it opens.

To keep your lower esophageal sphincter and esophagus functioning properly, follow these guidelines:

Stop smoking and do not use products containing tobacco. Smoking relaxes the lower esophageal sphincter, reducing the amount of saliva in the mouth and pharynx, which neutralizes the acid, and damage to the esophagus.

Avoid foods that aggravate symptoms, such as tomato sauces, mints, citrus fruits, onions, coffee, fried and sodas.

Do not drink alcoholic beverages. Due to alcohol, the lower esophageal sphincter relaxes, and the esophagus may begin to contract unevenly, as a result of which acid reflux into the esophagus will occur and heartburn will begin.

Check the drugs you are taking.Due to the use of certain medications, symptoms may worsen. Do not interrupt the prescribed treatment without consulting your doctor. Drugs that have this effect include drugs for asthma and emphysema (such as theophylline), anticholinergics for Parkinson’s disease and asthma sometimes found in over-the-counter drugs, some calcium channel blockers, alpha blockers, etc. beta blockers for the treatment of heart disease or high blood pressure, certain medications that affect the nervous system, iron supplements.

Although some drugs exacerbate the symptoms of GERD, other drugs can cause drug-induced esophagitis, which causes the same symptoms as in GERD, but not due to reflux. Medicinal esophagitis occurs when the pill is swallowed but does not reach the stomach as it sticks to the wall of the esophagus. This erodes the lining of the esophagus, causing chest pain, esophageal ulcers and painful sensations during swallowing.

Drugs that provoke medicinal esophagitis include aspirin, non-hormonal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Mortin Motrin, Aleve Aleve), alendronate (Fosamax Fosamax), potassium and some antibiotics (especially tetracycline and doxycycline ).

For more information on the symptoms of gastroesophageal reflux disease, please contact the gastroenterologists of the Zdorovye 365 clinic in Yekaterinburg.

Related articles:

Abdominal pain

Ultrasound of the abdominal cavity

Gastroscopy (FGS)

Colonoscopy

Sigmoidoscopy

Major misconceptions about capsule endoscopy, FGS and colonoscopy

Preparation for endoscopic examination

Stomach ulcer

Gastritis

Pancreatitis

Pancreas

Irritable bowel syndrome (IBS)

Ulcerative colitis

Cholecystitis

Crohn’s disease

Gastroenteritis

Semax instructions for use: indications, contraindications, side effects – description of Semax nasal drops 0.1%: fl. 3 ml with cap with attached pipette with cap, fl. 3 ml with dropper cap (28676)

The method of application and dosage regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly observe the compliance of the used dosage form of a particular drug with the indications for use and the dosage regimen.

Applied intranasally.

1 drop of a standard solution contains 50 μg of active substance.A solution of the drug is injected with a pipette into each nasal passage in an amount of no more than 2-3 drops. If it is necessary to increase the dose, the administration is carried out in several doses at intervals of 10-15 minutes.

For intellectual-mnestic disorders with vascular lesions of the brain, discirculatory encephalopathy, transient cerebrovascular accidents single dose is 200-2000 mcg (based on 3-30 mcg / kg). The daily dose is 800-8000 mcg (at the rate of 7-70 mcg / kg).The drug is prescribed 2-3 drops in each nasal passage 4 times / day for 10-14 days, if necessary, the course of treatment is repeated.

After traumatic brain injury, neurosurgical operations and anesthesia single dose is 1400-3500 mcg (40-50 mcg / kg) 3 times / day for 3-5 days. If necessary, the course of treatment is extended to 14 days.

For increasing the adaptive capabilities of the body and preventing mental fatigue – 2-3 drops in each nasal passage 2-3 times in the morning for 3-5 days.The daily dose is 400-900 mcg. If necessary, repeat the course of treatment.

For diseases of the optic nerve , the drug is instilled 2-3 drops into each nasal passage 2-3 times / day. The daily dose is 600-900 mcg. The course of treatment is 7-10 days. In addition, the drug can be administered by endonasal electrophoresis: the drug is administered from the anode; current strength – 1 mA; the duration of exposure is 8-12-15 minutes. The daily dose is 400-600 mcg. The course of treatment is 7-10 days.

Children aged 7 years with minimal cerebral dysfunctions are prescribed 1-2 drops in each nasal passage (at the rate of 5-6 μg / kg) 2 times / day (morning and afternoon).The daily dose is 200-400 mcg. The course of treatment is 30 days.

What they are treating us with: Saxenda – Indicator

But scientists doubt the possibility of preventing type II diabetes in such drugs. The effect of liraglutide on the risk of developing non-insulin dependent diabetes has not yet been proved, despite a number of studies in which it lowers the blood levels of certain substances that are precursors of the disease. The long-term effects of the drug on blood pressure in obese patients are also poorly understood.

Indicator.Ru recommends: to be taken under medical supervision

The drug is a prescription, so self-medication is unlikely to be a problem. And rightly so: with an increased dosage, you can lower your blood sugar levels to dangerous levels (this is called hypoglycemia), getting fainting as a reward or worse. And no one canceled the risks due to improper injection of injections. Most patients are unlikely to face something serious: the most common side effects, which occur in about 5% of patients, will not be dangerous, but rather unpleasant, like nausea or constipation.

The drug is recommended for patients with a body mass index above 30 (or above 27, but with complications). Taking it for the sake of wanting to lose a couple of kilos from your 60, and even without type 2 diabetes, will be dangerous, but, for example, if your body weight is 90 kg with a height of 165 cm, such indicators can already be considered justified. The medicine will indeed be effective and will help you lose about 6% of body weight, which is more than a number of other weight loss drugs.

There are suspicions that the drug increases the risk of thyroid and pancreatic cancer, as well as pancreatitis and heart problems, but they are only indirectly confirmed.If such a danger exists, then it occurs infrequently.

But who better not to use Saxenda is for patients with impaired kidney and liver function, pancreatitis, gallbladder diseases, as well as (not fully proven effect, but better beware) people with suicidal tendencies. It is not recommended for patients with heart palpitations at rest. During pregnancy and breastfeeding, the safety for the baby has not been proven, so it is better not to risk it.

The combination of the drug with other drugs for diabetes should be very thoughtful: the effect of some it can intensify many times, others will interfere, so consult your doctor.Warfarin and other coumarin derivatives should be used with caution.

In addition, do not forget about a healthy lifestyle: the drug can be a good addition to a diet with a calorie deficit and physical activity, but without them the results are unlikely to impress you.

Our advice cannot be equated with a doctor’s prescription. Before you start taking this or that drug, be sure to consult with a specialist.

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Potency Erection Means

Potency Erection Means

It is important to distinguish between the types of reviews – true from those who actually used the drug from the potency of the Power of Suleiman, ordered from competitors. There is another type of such posts – from people who bought, drank pills, but did not follow the instructions for use and did not accept the manufacturer’s warnings regarding contraindications.

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Erection pills from the PDE ס inhibitor group (Viagra, Cialis, Levitra) are the first choice for any form of organic ED. They are prescribed immediately before intercourse in the interval from 30 minutes to 1 hour before the planned sex.In some cases, drugs are prescribed regularly before each intercourse, sometimes they are recommended to be taken only in cases where, in the patient’s opinion, there is the greatest chance of failure. Potency regulators are a group of drugs that include various drugs used to treat erectile dysfunction. The effect of VIP (vasointestinal peptide), a neurotransmitter that ensures vasodilation, continues to be studied. When administered intracavernously, it affects tumescence, therefore it should be used only in combination with phentolamine.Methods and means to improve erection. The development of medicine is currently going in many directions, including science does not ignore such an important problem as a bad erection or its absence and its effective treatment. All specialists in this field are in solidarity in the opinion that it is important for a man at any age to manage his sex life. Sexual health. Under the term drugs for men, drugs that affect potency are most often considered. After all, having full sex that brings pleasure is very important for a man’s normal life.Sexual problems cause feelings of inferiority, lower self-esteem, cause neuroses, and lead to family troubles. Impotence in men – signs and how to treat at home. Useful and relevant articles on the website of the Elamed company. Apparatus and devices for home and medical institutions. Consultation by phone: 8 (800) 350-04-13. What are the drugs for potency. Preparations for the complex treatment of erectile dysfunction. Tablets and capsules for one-time potency improvement. Recommendations of doctors to improve potency.What are the drugs for potency. Conventionally, all drugs can be divided into two types – tablets and other dosage forms that affect the cause of dysfunction, and types of drugs that contribute to a short-term improvement in potency. Erectile mediators act by decreasing it, while their antagonists, on the contrary, cause it to increase. The main pro-erectile mediator is nitric oxide (NO), the effect of which is mediated by the guanylate cyclase-cGMP system. Oral medications can have central and peripheral effects.Medications for treatment should be taken only as directed by a doctor. Self-medication can cause ill health. Contraindications The catalog contains both Russian and foreign drugs. Here you can find analogues for the active substance from another manufacturer, which will help you find a better quality product. The pharmacy has products from: Spain, Belgium Preparations for potency. Erection and ejaculation under control. Preparations: (table) Total. What drugs are there for potency? What were we guided by when distributing places in the TOP? 5th place – Viagra (Sildenafil) Cheap analogues of Viagra 4th place – Levitra (Vardenafil) Cheap analogues of Levitra 3rd place – Zydena (Udenafil) Cheap analogues of Zidena 2nd place – Stendra (Avanafil) Cheap analogues of Stendra 1st place – Cialis (Tadalafil) Cheap analogues of Cialis …

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Suleiman’s Power Capsules are admired, some remain dissatisfied with them, but definitely not indifferent.The problem of inadequate sex, dissatisfaction in sexual relations is so acute among the representatives of the strong half of humanity that it will not be difficult to figure out whether the comments are truthful on the Internet or if this is all a divorce. Suleiman’s strength has one of the most effective formulations among analogues. Therefore, it works in 95% of cases, provides good arousal and a stable erection lasting up to 5 hours. The effect persists even if the man uses alcohol or a number of sedatives.An erection after taking the capsule comes almost instantly and lasts a very long time. Even after intercourse is over, the penis does not become too flaccid. Remains full of blood and excitability. Sexual intercourse when using the product lasts a very long time, a man can control ejaculation and delay this moment as much as possible. The composition of a natural preparation was first used in ancient Turkey. It has remained practically unchanged to this day. Capsules have a powerful restorative effect on the entire body, raise testosterone, regulate sex drive, heal internal organs.Herbal and plant extracts allow you to get new sensations from sex, as well as satisfy even the most demanding partner. The product has been tested on humans and guarantees real results after just a few days of use.

90,000 Feta cheese at home

Feta cheese is a good option to try your hand at cheese making. It turns out to be quite recognizable, fits perfectly into a Greek salad or other snacks, and at the same time is quite simple to make.Connoisseurs, of course, will object – real feta cheese can only be produced in Greece. This is so, but our cheese will turn out to be much better than much of what is sold outside this sunny country, and most importantly – it is made in your kitchen, and you can be absolutely sure of the quality of the ingredients included in it.

Homemade feta cheese

250 g.cheese

1 l. milk
2 tbsp. yoghurt
2 tab. acidin-pepsin (or rennet)

Pour milk into a saucepan and, stirring occasionally, bring it to a temperature of 31 degrees. Add yogurt, stir well, cover and leave at room temperature. Pound acidin-pepsin into powder, pour a couple of tablespoons of cold water and stir.

After 1 hour, pour water with acidin-pepsin into a saucepan, stir and leave overnight. During this time, the milk will curdle and the whey will separate from the curd mass (if it has not separated or is not completely separated, leave it for a few more hours).Using a knife, carefully cut this mass on the surface of the whey into squares with a side of about 1 cm, and stir several times at intervals of five minutes, being careful not to disturb the structure of the cubes from the curd mass. Then carefully pour the contents of the pan into a colander lined with folded gauze and leave for several hours to drain all the liquid.

Mix 1/4 tsp into the curd mass. salt, put the cheese in a mold and leave it at room temperature for another 12-24 hours – the cheese will finally “grab” and the consistency will be like real feta.

If you don’t have a cheese pan, you can quickly make one from scrap materials – for example, from a juice box. Cut the bottom of the box and make small holes on the sides and bottom, and cut a square from the top so that it fits into the box with a minimum gap. Put the curd mass in a mold (if it does not grasp enough, wrap it in one or two layers of gauze), tamp, level, cover with a square-lid, and press down with something heavy on top: being under pressure, the curd mass will “squeeze” out of itself whey that will flow out through the holes, while the cheese will retain its shape.

Prepare brine: 200 ml. whey (you didn’t pour it out, did you?) Stir with 1.5 tbsp. salt, cut the cheese into cubes, cover with brine and refrigerate. This, firstly, will “pull” the liquid out of feta even more, and, secondly, will allow it to be stored almost forever – however, you are sure to eat it earlier.

Note from 08/17/2014: I am writing this note a few years after writing the recipe for those commentators who are failing feta or not doing well enough.This is how I made feta a couple of days ago.

I took a liter of Ruzskoye milk with a fat content of 3.2% -4% – it is quite expensive, but of high quality, so that in case of problems in preparing feta, you can be sure that it is not milk. He warmed up to 31 degrees and even overheated a little, then added 2 tablespoons of yogurt (homemade, so just in case he took 2 spoons, not one), mixed, measured the temperature – now it turned out exactly 31 degrees. I covered it with a lid. An hour later, there was a detached cloudy whey and a “fringe” of the curd mass along the edges of the milk – a sign that the acidity of the milk had increased.I added 2 tablets of acidin-pepsin, ground in a mortar, mixed with a couple of tablespoons of water, mixed, covered with a lid again and left overnight. After 8 hours, the curd mass distinctly separated from the yellowish-transparent whey. I cut the curdled mass into squares – it turned out to be quite fragile, jelly-like, so it was decided to leave it for a few more hours. Then he mixed the curdled mass with a slotted spoon – despite my accuracy, the cubes of the mass broke, so I carefully poured the mass together with the whey into a colander lined with three layers of gauze and left to drain for several hours.I put the mass in a bowl, straightened the cheesecloth, laid out the bottom and sides of the mold, put the mass in the mold, tamped it, covered it with gauze and put the load. I decided not to add salt at this stage. Serum has begun to stand out – clear, not whitish, a sure sign that things are going according to plan. The first few hours periodically increased the load, then put the weight in the refrigerator. In total, the mass was pressed for about a day. After this time, he carefully took the cheese out of the mold, unwrapped the cheesecloth and removed it, transferred the feta layer to the serum with salt mixed in it.The result is a soft, tender, slightly salty feta, which, with strict adherence to the recipe, turned out without problems:

What advice can I give to those who are going to cook feta for the first time? Focus not on time, but on the external signs of making cheese. The milk is not completely curdled – do not rush to pour it into a colander. Do not glass the serum – do not rush to transfer the mass to the mold. Let it compress properly, take your time – and everything will work out.

Author: Alexey Onegin

Who is this ?….

Widelash Peptide

Widelash Peptide

Serum “Activator of eyelash growth”, 50 ml

Serum promotes the growth of eyelashes, regular application stimulates the growth of the bulb, thickens the hairs and makes them elastic. A great way to take care of your eyelashes at night.
How to use: After make-up removal, apply to eyelashes.
– purified water – 47 ml,
– aristolex – 0.4 g,
– vitamin AEF complex – 0.5 ml,
– rice protein hydrolyzate – 1 ml,
– Widelash peptide – 1 ml,
– phenoxyethanol preservative – 0.25 ml.
In warm water, gel the aristophlex, whisk with a mixer until smooth. Enter assets in turn and mothball.