Information for Patients-Medications

Bay Area Urology
50 So. San Mateo Drive #120
San Mateo, Ca 94401
tel: 650-348-7770 fax: 650-348-0166

	BCG
	This medicine contains live, attenuated mycobacteria, and is used in the treatment of superficial bladder cancer. It helps to reduce the frequency of recurrent tumors and may also reduce the risk of disease progression. Who can benefit from this treatment? The most common type of bladder cancer is called transitional cell carcinoma. Most patients will present with superficial tumors, which involve only the innermost lining of the bladder wall, as opposed to muscle-invasive tumors. High-grade tumors and carcinoma in-situ are two main indications for BCG treatment after undergoing initial surgery (transurethral resection) to remove the tumors. Other indications include cases involving multiple tumors (>2), large tumors, and in those patients who have history of frequent recurrences. When and How is BCG given? BCG treatment usually starts no earlier than 2 weeks after the initial transurethral resection. The medicine is instilled into the bladder by gravity through a catheter, a procedure done in the doctor's office. The initial course is usually once a week for 6 weeks. Patients are often reevaluated after this initial course to determine response, which may involve repeat biopsy of the bladder, especially the area(s) of the original tumor(s). Additional courses or doses may be recommended depending on the particular circumstances of your case. For each weekly dose, patients are asked to retain the medicine in the bladder for about 2 hours and then voided. In order to achieve maximum time of bladder surface contact with the medicine, the bladder is emptied before instillation, and patients are asked to avoid drinking fluids during this 2-hour period to avoid the need to urinate. What special handling is required for proper disposal of this medicine? Since this medicine contains live bacteria, it must be properly disinfected. Patients should void while seated in order to avoid splashing of urine. For the 6 hours after treatment, urine voided should be disinfected for 15 minutes with an equal volume of household bleach before flushing the toilet. Patient should also increase fluid intake to "flush" the bladder during this time. What can I expect to feel during treatment? You may experience burning with first few voids after treatment. The more common symptoms are low-grade fever, headache, malaise, and mild flu-like symptoms. Relief can be obtained with over the counter medications such as Tylenol. If you are having high, persistent fever, chills, visible blood in the urine, or other symptoms such as joint pain, cough, or skin rash, please contact your doctor immediately. Special Precautions Females of childbearing are: Tell your doctor if you are pregnant or breast-feeding. Tell your doctors if you are an organ-transplant recipient and taking immunosuppressive drugs or taking similar drugs (chemotherapy drugs, steroids) for other illnesses. Betamethasone - Clotrimazole This is medicated ointment, lotion, or cream used externally to treat fungus infection of the skin. It also contains a steroid (Betamethasone) to help reduce inflammation of the involved area. How is it used in Urology? It is used in patients with fungal infection involving the areas of the genitalia. This is a particularly common problem in persons with diabetes, especially in those who have poor control of their condition. Patients with urinary incontinence may also experience similar problem. Proper Use Use this medicine only for the condition for which it was prescribed. Using your fingers apply a thin layer on the affected area. DO NOT GET THIS MEDICINE IN YOUR EYES OR IN OPEN WOUNDS. Do not cover the area with a bandage unless instructed by your doctor. This medicine is not recommended for treating diaper rash in babies or small children. Possible Side Effects Report to your doctor if you have worsening redness, irritation, swelling, or pain. Possible Drug Interactions Do not use with any other medicated cream, lotion, or ointment. Do not use with strong soap, medicated cosmetics, or products containing alcohol. Bethanechol (Urecholine® 25mg) This medicine is used to improve urination and bladder emptying in patients whose bladder muscle has weakened. Proper Use This medicine works best when taken on an empty stomach, 1 hour before or 2 hours after meals, unless your doctor tells you otherwise. Take this medicine as directed by your doctor. Typical starting dose is 25 mg three times a day. Do not take double dose even if you had missed a dose. To avoid interrupting your sleep at night, take the last dose of the day before 6 PM. What are the more common side effects? Side-effects occur in varying degree and include dizziness, lightheadedness, diarrhea, headache, nausea, and vomiting. By taking the medication as directed above, nausea and vomiting can be avoided. Notify your doctor immediately if you are experiencing trouble breathing, chest tightness, or severe stomach cramp or ache. Possible Drug Interactions Talk to your doctor if your are taking any of these medicines: Quinidine (Quinora, Quinaglute, Quinalan, Cardioquin) Procainamide (Pronestyl) Nitrates (Isordil) and nitroglycerin (Nirostat, Nitrolingual, Nitrong, Nitro-Dur, Nitrol) Ganglionic blocking agents Bicalutamide In urology, this is an anti-androgen medicine used in the treatment of advanced prostate cancer. How and When is it used? It is more commonly used along with another class of medication called LHRH agonists (Lupron, Zoladex). In most cases it is used to block the testosterone flare which is seen during the first few weeks of starting a LHRH agonist. In certain patients, long -term use is indicated. You may take this pill with or without food. What are the side effects? The most common side effect of hormonal treatment for prostate cancer is hot flashes (redness and warm feeling of your face and neck areas). Some men will also notice gradual breast enlargement (gynecomastia) when taking anti-androgens. Others may experience nausea, vomiting, abdominal pain, loss of appetite, constipation and diarrhea. Your liver function is regularly monitored to detect any potential effects on its function since this medicine is metabolized through the liver. Notify your doctor immediately if you see dark color urine, or yellowing of your skin or eyes. Possible Drug Interactions Medications metabolized by the liver may be affected by concurrent use of anti-androgens. This would include blood thinners such as warfarin (Coumadin) and closer monitoring of its effect is needed. Ciprofloxacin (Cipro®) This is a fluoroquinolone antibiotic commonly used in bacterial urinary tract infections. It is also used for other conditions. Proper Use For outpatient therapy, this antibiotic is taken by mouth twice a day. It is best to take this medicine 2 hours after a meal unless otherwise directed by your doctor. Avoid taking it along with other medications especially iron, antacids containing aluminum or magnesium, multivitamins, sucrafate (Carafate), and didanosine (Videx). Please Note - Side Effects -Tell your doctor if you have ever had seizures. If you have a seizure while taking this medicine, stop taking it and contact your doctor. -If you are a diabetic using insulin or taking diabetes medicine by mouth and you have symptoms of low blood sugar, immediately contact your doctor. Symptoms include confusion, shaking, weakness, strong hunger, cold sweats, headache, nausea, vision problems, and feeling faint. -Allergic reaction to this medicine presents as hives, itching, tightness in your chest, or trouble breathing. Contact your doctor immediately or get emergency medical care. -This medicine may cause drowsiness. Do not drive or operate machinery unless you are fully alert. -This medicine may increase the effects of caffeine in coffee, black tea, and colas. You may feel shaky and have trouble sleeping. -This medicine may make your skin more sensitive to the sun, even when you use sunscreen. While you taking this medicine, avoid long exposure to the sun. Do not use a sunlamp. -Women of childbearing age: this medicine is not usually given during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Do not breast-feed while taking this medicine. Possible Drug Interactions Talk to your doctor if you are taking any of the following medicines: - amiodarone (Cordarone) - antacids (Maalox, Mylanta) - cimetidine (Tagamet) - cyclosporine (Sandimmune, Neoral) - didanosine (Videx) - digoxin (Lanoxin) - disopyramide (Norpace) - erythromycin (Erythrocin, EES, EryPed) - glyburide (DiaBeta, Glynase) - medicines with caffeine - multivitamins with iron or zinc - nitrofurantoin (Macrodantin) - Pepto-Bismol - phenytoin (Dilantin) - probenecid (Benemid) - procainamide (Pronestyl, Procan) - quinidine (Quinora, Quinidex, Quinaglute, Cardioquin) - sotalol (Betapace) - sucrafate (Carafate) - theophylline (Theo-Dur, Slo-Bid) - thioridazine (Mellaril) -tricyclic antidepressants such as amitriptyline (Elavil), desipramine (Norpramin), nortriptyline (Aventyl, Pamelor), imipramine (Tofranil), and doxepin (Sinequan) - warfarin (Coumadin) or other blood thinners. Cranberry Cranberry plants grow as small, trailing evergreen shrubs. Their flowers range from pink to purple, and bloom from May to August, depending on the type. The berries are harvested in the fall. Common names are small cranberry, southern mountain cranberry, lowbush cranberry, and highbush cranberry. How is cranberry used in urology? Cranberries and their juice have been used for treating and preventing urinary tract infections. Its juice has a promising use as a urinary deodorant. The bad odor of fermenting urine from people who have lost bladder control is a common problem in hospitals and long-term care facilities. Drinking cranberry juice helps stop the odor by slowing down the bacteria that ferment the urine. How are cranberries taken? You can eat the fruit or drink the juice. There has been some recent scientific proof of benefit for prevention of urinary tract infections. Cranberry is also available in capsules. What are the side effects? Extremely large amounts of cranberry juice can produce stomach pain and diarrhea. Rarely, people are allergic to cranberries. Cranberry is considered a natural remedy. Unfortunately, "natural" does not always mean safe. Natural remedies and prescription medicines may interact. Lack of standardization may result in products with different strengths and effects. Lack of quality control may allow contamination of products. If you are pregnant or breast-feeding, you should ask your obstetrician before taking any natural remedy. Long-term use and increasing dosages are not recommended. Infants, young children and the elderly should also not use natural remedies without seeking professional advice. Doxazosin (Cardura®) This medicine was originally used to treat and control high blood pressure. Many men who were taking it also reported improvement of the urinary voiding symptoms. As such, it is also currently used for men with bothersome voiding symptoms secondary to prostate enlargement (BPH). Proper Use This medicine is taken by mouth, usually in the evening hours. Do not take double doses at one time. If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. Dose can be adjusted to achieve maximum potential benefit, however, the risk of side effects may also increase. Please Note You may feel dizzy, lightheaded or faint when you get up quickly after sitting or lying down. Getting up slowly may help. If you are consistently feeling dizzy, contact your doctor. Alcohol, exercise, and hot weather may also make you feel dizzy, lightheaded, or drowsy. Avoiding these factors is important, especially after you take the first few doses, after your dosage is increased, and when you start taking the medicine again after some time without it. Rarely, this medicine may cause a painful erection of the penis that will not go down. If this occurs, contact your doctor immediately. Other problems include nausea, weakness, fatigue, drowsiness, stomach pain, nervousness, headache, vomiting, and vision problems. Contact your doctor immediately for irregular or fast heartbeat, fainting, chest pain, trouble breathing, swelling in your hands or feet, loss of feeling in your hands or feet, and severe or constant headache. Estradiol Cream (Estrace®) Estrogens have important benefits but also some risks. This medicated cream is used to treat thinning of the vaginal lining caused by the lack of estrogen. Since it is applied directly to the affected area, less medication is needed and its absorption into the blood stream is minimized thereby reducing the risk of systemic side effects. Proper Use This is a vaginal cream, which can be applied with a fingertip. Do not use more of it or use it longer than prescribed. Wearing sanitary pads while you are using this cream will help protect your clothing. Please Note Exposure to the sun and sunlamps while you are using this medicine may cause dark spots to appear on your skin. This problem is usually self-limiting. Contact lenses may feel uncomfortable while you are using this medicine. Do not use this medicine if you are pregnant or plans to become pregnant while using this cream. Smoking while using this medicine increases the risk of side effects. Common side effects include nausea, swollen/tender breasts, cramps, and bloating. Notify your doctor if you are experiencing swollen ankles or feet, changes in menstrual periods, breast discharge, or vaginal irritation. Possible Drug Interactions Talk to your doctor if you are taking any of the following medicines: - blood thinners (warfarin) - carbamazepine (Tegretol) - cortinsone-like drugs such as cortisone (Cortone), dexamethasone (Decadron, Hexadrol) hydrocortisone (Hydrocortone, Cortef), prednisone (Meticorten, Deltasone) - dantrolene (Dantrium) - Phenobarbital - phenytoin (Dilantin) - primidone (Mysoline) - rifampin (Rifadin, Rimactane) - tricyclic antidepressants such as amitriptyline (Elavil), nortriptyline (Aventyl, Pamelor), imipramine (Tofranil), and doxepin (Sinequan). Finasteride (Proscar®) This medicine is taken by mouth to (1) shrink an enlarged prostate gland that may be causing your symptoms and voiding difficulties, (2) reduce the risk of inability to pass urine (urinary retention), and (3) reduce the chance you will need prostate surgery. This is only effective in a limited group of patients. Your urologist can determine its potential benefit to you. Proper Use This medicine is usually taken once a day (5 mg), with or without food. The potential shrinking effect of the prostate gland generally takes several months. Please Note This medicine is usually given to men only. Women and children should not take this medicine. Women who are pregnant or may become pregnant should not take this medicine. This medicine can affect a blood test called PSA, which is used to screen men for prostate cancer. Inform your doctor of your taking this medicine for proper interpretation of your PSA result. This medicine may cause impotence (trouble having and keeping an erection), decrease your sex drive, or reduce the amount of semen released during sexual intercourse. These effects are mild and temporary when they occur. Do not expose your partner to your semen if she is pregnant or can become pregnant. Use a condom under these circumstances. Possible Drug Interactions Tell your doctor if you are taking theophylline, a medication used to treat asthma and other breathing problems. Possible Food Interactions The effects of this medicine may be increased if you take it with grapefruit juice. Tell your doctor about all medicines you are taking, including over the counter products, vitamins, and natural remedies. Goserelin Acetate Implant (Zoladex®) The medicine is an implant placed just under the skin to treat advanced prostate cancer. It produces an effect of castration as it shuts down testosterone production from the testicles. In women, it is sometimes used for breast cancer and endometriosis. How is it given? This medicine comes either as a one-month formula or multi-month formula (3 or 4 months). The implants are designed to allow slow release of the drug into your body. It is commonly implanted under the skin over the abdominal area, an office procedure performed with minimal local anesthesia. Please Note Diabetics: This medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Closer monitoring may be required and your dosing may need to be adjusted. When you first start this particular treatment, there is usually a surge in your blood testosterone level. As such, some of your voiding symptoms or pain may worsen. To blunt this effect, another medicine (an anti-androgen) is often given concurrently for the first two weeks. Other side-effects may occur after long term use of this medicine and may include elevation of total blood cholesterol and triglycerides, osteoporosis, anemia (low red cell blood count), hot flashes, sexual problems, decreased erections, loss of appetite, and fatigue. No significant drug interactions have been reported to date. However, be sure to update your doctors about all medicines you are taking, including over the counter medications, vitamins, and natural supplements. Hyoscyamine (Levsin®, Cystospaz®) This medicine is in a class of drugs called belladonna alkaloids, and is used to relieve symptoms of bladder spasm, by relaxing the smooth muscles of the bladder. Since other systems or organs (stomach and intestines) also contain similar smooth muscles, it is also commonly used for certain gastrointestinal conditions. Proper Use This medicine works best when taken 30 minutes to 1 hour before meals. If you are taking antacids, take them 2 hours before or after you take this medicine. There is also a faster onset formulation, which is taken sublingually (under the tongue) and avoids stomach absorption problems. Do not take more than directed. Do not take double doses. If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Please Note Common side effects include dry mouth, constipation, and decreased sweating. It may also cause blurred vision, dizziness, or drowsiness. Due to these potential side effects, do not drive or operate machinery unless you are full alert and can see clearly. Also be careful when you exercise, especially in hot weather. Serious side effects include severely impaired vision, confusion, clumsiness, seizures, trouble breathing, fast heartbeat, chest pain, and slurred speech. Contact your doctor immediately or seek emergency medical care. Possible Drug Interactions - amantadine (Symmetrel) - atenolol (Ternormin) - antacids (Maalox, Mylanta, TUMS) - digoxin (Lanoxin) - anti-diarrhea (Kaopectate, Pepto-Bismol, Amphogel) - phenothiazines (Thorazine, Compazine, Prolixin, Mellaril) - tricyclic anti-depressants (Elavil, Aventyl, Pamelor, Tofranil, Sinequan) Leuprolide Acetate (Lupron®) This medicine is given by injection to treat advanced prostate cancer. It produces an effect of castration as it shuts down testosterone production from the testicles. As other hormonal treatment of prostate cancer, it helps lessen the symptoms of this disease, but it is not a cure. Women may be prescribed this medicine for several gynecological conditions. How is it given? The injection (shots) is given deep into a muscle (usually the buttock or thigh). Several formulations are available including one-month and multi-month (usually 3 months) dosing, with the drug slowly released over these time periods. When starting this medicine, there is usually a testosterone surge, which can worsen any voiding symptoms or bony pain. This effect is blunted by using another medicine (an anti-androgen) for the first few weeks of treatment. Please Note Common side effects include hot flashes, night sweating, fatigue or loss of stamina, sexual problems, decreased or loss of erections, and loss of appetite. Long-term use of this medicine is associated with anemia (low red blood cell count), osteoporosis, and elevation of total blood cholesterol and triglycerides. If you are experiencing severe problem with urination or bladder emptying, intractable bony pain, loss of strength in your arms or legs, immediately contact your doctor or seek emergency care. No significant drug interactions have been reported. Be sure that you tell your doctors about all medicines you are taking, including over the counter drugs and natural remedies.This medicine is a fluoroquinolone antibiotic used to treat urinary tract infections. It may also be used by other physicians to treat other bacterial infections in other parts of the body. Proper Use This medicine may be taken by mouth (a pill) or given by injection (intravenous). When given orally, it can be taken with or without food. Avoid taking this medicine around the time (usually 2 hours) of other drugs, especially iron medicine, antacids containing aluminum or magnesium, multivitamins, sucrafate (Carafate), and didanosine (Videx). A typical dose is once a day. Please Note Do not take with antacids. If you are a diabetic using insulin or taking diabetes medicines by mouth and you have symptoms of low blood sugar, contact your doctor right away. Symptoms of low blood sugar include confusion, shaking, weakness, strong hunger, cold sweats, headache, nausea, vision problems, and feeling faint. Tell your doctor if you have a seizure condition. If you have a seizure while taking this medicine, stop taking it and contact your doctor or seek emergency medical attention. Allergic reactions can present in varying degree. Serious reactions include hives, severe itching, tightness in your chest, and trouble breathing. Contact your doctor right away or seek emergency medical care. This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert. Your skin may have increase sensitivity to the sun while taking this medicine. Use sunscreen and avoid long exposure to the sun. You may also feel increase effects of caffeine in coffee, black tea, and colas. Women should not take this medicine during pregnancy or when breast feeding. Possible Drug Interactions - antacids containing aluminum or magnesium - didanosine (Videx) - insulin and other oral diabetes drugs - multivitamins or supplements containing iron or zinc - nonsteroidal anti-inflammatory drugs (NSAIDS): ibuprofen, Motrin, Advil, Naproxyn, Orudis, Relafen, Indocin - sucrafate (Carafate) - theophylline (Theo-Dur, Slo-Bid) - warfarin (Coumadin) or other blood thinners Nitrofurantoin (Macrobid®, Macrodantin®, Furadantin®) This is antibiotic used to treat bacterial infections of the urinary tract. Proper Use Take this medicine with food or milk to lessen stomach upset and to increase absorption. Depending on the specific clinical situation, dosing may vary from once daily up to multiple times per day. Always take the medicine as prescribed by your doctor. Please Note Common side effects include diarrhea, stomach upset, nausea, and vomiting. Serious side effects are fever, chest pain, trouble breathing, hives, generalized rash, yellowing of eyes or skin, and numbness or pain in your hands or feet. Contact your doctor right away or seek emergency medical attention. This medicine may darken the color of your urine from yellow-brown to brown. It may also cause a false urine sugar test. Check with your doctor before making any changes in your diet or medication. Women: Breast-feeding is not recommended while you are taking this medicine. Possible Drug Interactions - antacids containing magnesium - probenecid (Benemid) - sulfinpyrazone (Anturane) Saw Palmetto (Natural Remedy) What is it? It is a member of the fan palm family. It grows to about 10 feet tall, with leaf clusters that can reach a length of 2 feet or more. The plant grows in many areas across southern United States, and is actually the "state plant" of South Carolina. Saw palmetto produces a brownish-black berry. The ripe fruit of the plant is in medicines. The scientific names are Serenoa repens, Serenoa serrulata, and Serenoa serrulatum. The common names include saw palmetto, sabal, American dwarf palm tree, and cabbage palm. How is saw palmetto used in urology? Be aware that medical indications of natural remedies are not approved by the Food and Drug Administration (FDA). They are classified as dietary supplements, and are not subject to the same scrutiny and regulations as prescription medicines. Saw palmetto has been reported to be used for the relief of voiding symptoms secondary to prostate gland enlargement, irritable bladder (causing pelvic pain and frequent urination), and to increase sperm production. How is saw palmetto taken? It is taken by mouth as a tea, capsule, tablet, or liquid. What are the side effects? No serious side effects have been reported. However, there have been reports of headaches and diarrhea if taken in large amounts. What special precautions are there? - If you are pregnant, trying to become pregnant, or breast-feeding you should not take saw palmetto. - Some natural remedies may have the same effects as prescription drugs. If you have any unusual effects while taking any natural remedy, stop and get advice from your doctor. - "natural" does not always mean safe. Report any unusual reactions. - Lack of standardization may result in products with different strengths and effects. - Lack of quality control may allow contamination of products. - Infants, children, and the elderly should not use natural remedies without advice from a doctor. - Follow dosage recommendations on the package. Do not increase dosages. Sildenafil Citrate (Viagra®) This medicine is taken by men for the treatment of impotence (erectile dysfunction). Proper Use Take the dosage exactly as prescribed for you by your doctor. Do not increase dosage without your doctor's advice. Do not take this medicine more than once a day. The recommended dosage is one 50-mg tablet. However, you may need to take as little as 25 mg or as much as 100mg. An adequate trial is needed before consideration of dosage increase. This medicine is best taken on an empty stomach, usually about 1 hour before expectation of sexual activity. Please Note Elderly men who have not had sexual intercourse for a long time should be cautious when they begin to have sex again, especially if they have heart problems. In these particular cases, an evaluation with your primary care doctor or your heart doctor is advised. This medicine is approved for men only. Do not take this drug (1) if you are taking any nitrate products (nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate) for the treatment of angina or chest pain or to control your high blood pressure, and (2) if you have any heart disease. Sexual activity is considered strenuous activity, particularly in elderly men with heart problems who are at risk of heart attacks that may be fatal. You should discuss your situation with your primary care physician or heart physician before taking this medicine. Common side effects include headache, facial flushing, stomach upset, stuffy nose, and abnormal vision (light sensitivity or blurred vision). Possible Drug Interactions - cimetidine (Tagamet) - erythromycin (Erythrocin, EES) - itraconazole (Sporanox) - ketoconazole (Nizoral) - mibefradil (Posicor) - nitrates (nitroglycerin, Imdur, Isordil) - protease inhibitors (Novir, Fortovase, Invirase, Crixivan, Viracept, Agenerase) - rifampin (Rifadin, Rimactane) Be sure to inform all your physicians about all medicines you are taking, including over the counter products, vitamins, and natural remedies. Soybean (Natural Remedy) The soybean plant grows 1 to 5 feet tall, with bean pods containing up to 4 oval seeds, which are yellow to brownish in color. This plant was cultivated in China as far back as the 11th century BC. Current U.S. production is about 49% of the world's supply. The scientific name is Glycine max. Common names are soy, soybean, and soya. How has soybean been used? Remember that natural remedies are classified as dietary supplements by the FDA, and are not subjected to the same scrutiny and regulations as prescription drugs. Food use: Soy is an important food source that is nutritious and low cost. Examples are soybean milk, soybean flour, soybean curd, tofu, fermented soybean paste, soybean sprouts, soy sauce, soybean oil, soy protein drinks, and livestock feeds. Soy is used to make some infant formulas, especially for babies who are allergic to milk. Hormonal effects: Soybeans contain a substance that is similar to the female hormone, estrogen. As such, it has been used to help with symptoms of menopause (hot flashes), and possibly may be used to help reduce osteoporosis. Anticancer effects???: In certain parts of the world in which there is a high intake of soy products, there is a lower prevalence of breast cancer, endometrial cancer and prostate cancer. Cardiovascular disease: Asian countries with higher soy intake appear to have lower rates of heart disease. Gastrointestinal effect: Soybean fiber can prevent constipation, and possibly reducing the incidence of bowel diseases. Possible Side Effects Most people have no problems with soy. Infants with a cow's milk allergy may have a reaction to soy milk products as well. There is also some concern about the phytoestrogens in soy-based infant formulas. Discuss your concern with your pediatrician. Large amounts of soybean oil may increase bilirubin in your blood. See your doctor if your skin or eyes look yellow (jaundice). Sulfamethoxazole-Trimethoprim (Bactrim®, Septra®, Sulfatrim®, SMZ/TMP) This is an antibiotic used to treat bacterial urinary tract infections. Proper Use This medicine comes in liquid and pill forms, and works best when taken with a full glass of water 1hour before or 2 hours after meals. There is also an intravenous preparation. Dosing may vary for different clinical indications. Take as directed by your physician. Please Note Allergy to sulfa drugs is common. Serious allergic reaction includes hives, rash, bloody urine, yellowing of your eyes and skin, tightness in your chest, and trouble breathing. Contact your doctor right away or seek emergency medical care. This medicine may make your skin more sensitive to the sun. While you are taking this medicine, avoid long exposure to the sun. While you are in the sun, wear protective clothing and sunscreen lotion. Do not use a sunlamp. Women who are pregnant or breast-feeding, please inform your doctor. Other milder side effects include headache, dizziness, nausea, vomiting, and diarrhea. Possible Drug Interactions Talk to your doctor is you are taking any of these medicines: - cyclosporine (Sanimmune, Neoral) - indomethacin (Indocin) - methotrexate - phenytoin (Dilantin) - probenecid (Benemid) - salicylates (aspirin) - thiazide diuretics - tolbutamide (Orinase) - warfarin (Coumadin) Birth control pills may be less effective while you are taking this medicine. Talk to your doctor if you need birth control. Tamsulosin Hydrochloride (Flomax®) This medicine is the first medicine developed to relieve the symptoms of an enlarged prostate. It does this be relaxing the smooth muscle in the prostate and around the bladder neck. Proper Use Take your dose one-half hour after the same meal each day. If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. Do not chew, crush, or open the capsules. Swallow them whole. Please Note This medicine may make you dizzy or feel like you may faint. Do not drive or operate machinery unless you are fully alert and clearheaded. This medicine is not intended for any use in women or children. Some abnormal ejaculation (less volume) may occur. Ask your doctor about this. Other side effects include headache, weakness, drowsiness, runny nose, diarrhea, and nausea. Contact your doctor for worsening dizziness or fainting. Possible Drug Interactions - blood pressure medicines (prazosin, doxazosin, terzosin). Do not take concurrently. - cimetidine (Tagamet) - warfarin (Coumadin) Tolterodine Tartrate (Detrol LA®) This medicine is being used to treat a variety of lower urinary tract disorders, most commonly for women (some men) with overactive urinary bladders. Proper Use Take this medicine exactly as directed by your doctor. Do not take more or less, or take it longer than prescribed. With the new long-acting formula, dosing is now once a day. If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. Please Note Do not take this medicine if you are not able to urinate. If you have closed-angle glaucoma, inform your doctor of this condition. This medicine may cause blurred vision. Do not drive or operate machinery unless your vision is perfectly clear. Women: Tell your doctor if you are pregnant or breast-feeding. Do not breast-feed while you are taking this medicine. Side effects include dry mouth, blurred vision, upset stomach, headache, constipation, dizziness, confusion, fatigue, and nausea. If you cannot urinate, contact your doctor immediately. Possible Drug Interactions - clarithromycin (Biaxin) - erythromycin (Erythrocin, EES, Eryped) - itraconazole (Sporanox) - ketoconazole (Nizoral) - miconazole (Monistat) Be sure to inform all your doctors about all medicines you are taking, including over the counter products, vitamins, and natural remedies. * This advisory includes selected information only and may not include all the side effects of this medicine or interactions with other medicines. Ask your doctor or pharmacist for more information or if you have any questions. Keep all medicines out of the reach of children. Do not share medicines with other people. This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate, and is not a replacement for medical evaluation, advice, diagnosis or treatment by a licensed physician. * This information is not intended to substitute for a consultation with a urologist. It is offered to educate patients on the basis of urological conditions in order to get the most out of their office visits and consultations. Please see our web page disclaimer for addition information.
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