MIGRAMAX 900MG/10MG POWDER FOR ORAL SOLUTION
Active substance: METOCLOPRAMIDE HYDROCHLORIDE
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*256661* *256661*
PACKAGE LEAFLET: INFORMATION FOR THE USER
MigraMax 900mg/10mg, Powder for oral solution
Acetylsalicylic acid (as DL-lysine acetylsalicylate) Metoclopramide hydrochloride
Read all of this leaflet carefully before you start taking this medicine Keep this leaflet. You may need to read it again. If you have any further questions, ask your doctor or pharmacist. This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours. If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist. In this leaflet: 1.What MigraMax is and what it is used for 2.Before you take MigraMax 3.How to take MigraMax 4.Possible side effects 5.How to store MigraMax 6.Further information 1. What MigraMax is and what it is used for The name of your medicine is MigraMax 900mg/10mg Powder for oral solution (called MigraMax in this leaflet). What MigraMax contains MigraMax contains two different medicines. These are called: Metoclopramide hydrochloride: This belongs to a group of medicines called antiemetics. It works on muscles in the upper part of the digestive system causing your stomach to empty. It also works on a part of your brain that prevents you from feeling sick (nausea) or being sick (vomiting). DL-lysine acetylsalicylate: This belongs to a group of medicines called painkillers (analgesics). DL-lysine acetylsalicylate is broken down in your body to aspirin (acetylsalicylic acid). This works by blocking a substance that naturally occurs in your body called cyclo-oxygenase. Cyclo-oxygenase makes some of the chemicals that cause pain. If it is blocked, pain is relieved. What MigraMax is used for MigraMax is used to treat the signs of migraine, such as headache, feeling sick (nausea) or being sick (vomiting) in adults 18 years and over. 2. Before you take MigraMax Do not take this medicine and tell your doctor if: x You are allergic (hypersensitive) to: - Metoclopramide hydrochloride - DL-lysine acetylsalicylate (aspirin) - Other salicylates or non-steroidal antiinflammatory medicines (NSAIDs) - Any of the other ingredients of MigraMax (listed in Section 6 below) Signs of an allergic reaction can include: rash, swallowing or breathing problems, swelling of your lips, face, throat or tongue x You under the age of 18 x You have haemophilia or any other blood clotting or bleeding problems x You have a blockage or bleeding in your stomach or intestine x You have an ulcer in your stomach or gut. Signs include burning or aching pain in your stomach, with an empty feeling and hunger x You have had an operation on your stomach or intestine (gut). Do not take during the first 3 to 4 days after your operation. x You have a tumour on the adrenal gland (called phaeochromocytoma) x You are pregnant. This is especially important during the third trimester (week 26 to delivery). See Pregnancy and breast feeding section below. x You are breast feeding (see Pregnancy and breast feeding section below) Do not take this medicine if any of the above applies to you. If you are not sure, talk to your doctor or pharmacist before taking MigraMax. Take special care with MigraMax. Check with your doctor or pharmacist before taking your medicine if: pYou have ever had an ulcer in your stomach or gut. Signs include burning or aching pain in your stomach with an empty feeling and hunger pYou have asthma pYou have a runny nose, itching, sneezing and stuffy nose (called rhinitis) pYou have growths inside your nose causing an obstruction (called nasal polyps) pYou have liver problems
pYou have gout pYou have ever had any bleeding in the stomach or intestine pYou have menstrual periods which are heavier or last longer than usual pYou use an intrauterine contraceptive device (IDU) pYou have epilepsy. This is because MigraMax may increase the chances of you having a fit pYou drink a lot of alcohol pYou have kidney problems If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before taking MigraMax Taking other medicines Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines you buy without prescription, including herbal medicines. This is because MigraMax can affect the way some other medicines work. Also some medicines can affect the way MigraMax works. In particular tell your doctor if you are taking any of the following: MigraMax may increase the effects of the following medicines: Medicines for mental illness known as antipsychotics Medicines to calm or reduce anxiety (hypnotics, anxiolytics) Medicines to help you sleep (sedatives, barbiturates) Medicines used for epilepsy such as phenytoin or sodium valproate Some medicines used for depression such as mirtazapine or venlafaxine Medicines to prevent blood clotting (anticoagulants) such as warfarin Ciclosporin used to help prevent rejection of transplants. Your doctor may change your dose of ciclosporin Clonidine used for high blood pressure, migraine or hot flushes in the menopause Medicines used to treat muscle spasms (anticholinergics) for irritable bowel syndrome (IBS) such as mebeverine or hyoscine Medicines used to treat incontinence such as oxybutynin, propiverine or tolterodine Some medicines for moderate to severe pain (morphine products) such as codeine, dihydrocodeine or dextropropxyphene Oral medicines used for diabetes (sulphonylureas) such as gliclazide Medicines that can make your sleepy that are used for hay fever, rashes or other allergies called sedative antihistamines such as chlorphenamine or promethazine Methotrexate used to treat rheumatoid arthritis, cancer and some other conditions Zafirlukast used for asthma MigraMax can make the following medicines work less well: Medicines used to lower the amount of uric acid in your body (uricosurics) such as probenecid or sulfinpyrazone Digoxin used for heart problems. Your doctor may change your dose of digoxin Interferon alpha used to treat certain types of infections and certain forms of cancer Mifepristone usually given in hospital for termination of a pregnancy Water tablets (diuretics) such as spironolactone, triamterene or amiloride The following medicines can increase the chance of you getting side effects, when taken with MigraMax: Other related painkillers that lower inflammation (Non-steriodal antiinflammatory medicines NSAIDs), such as ibuprofen Medicines used to prevent blood clots such as clopidogrel, ticlopidine or dipyridamole Medicines for indigestion and heartburn (antacids) Steroid medicines used for lots of different illnesses such as inflammation, allergy or immune system problems Levodopa used for Parkinsons disease Taking MigraMax with food and drink Drinking alcohol while taking MigraMax may make you feel sleepy Pregnancy and breast feeding Do not take this medicine if: You are pregnant, might become pregnant or think you may be pregnant. This is especially important during the third trimester, week 26 to delivery You are breast feeding or planning to breast feed. This is because small amounts may pass into mothers milk Ask your doctor or pharmacist for advice before taking any medicine if you are pregnant or breast feeding. 1
Driving and using machines You may feel sleepy after taking this medicine. This is more likely if you have drunk alcohol or taking other medicines that cause drowsiness. If this happens do not drive or use any tools or machines. Important information about some of the ingredients of Migramax This medicine contains aspartame. This is a source of phenylalanine. It may be harmful for people with phenylketonuria. 3. How to take MigraMax Always take MigraMax exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. Taking this medicine Take this medicine by mouth Pour the contents of one sachet into some water, mix well and drink straight away If you feel the effect of your medicine is too weak or too strong, do not change the dose yourself, but ask your doctor How much to take Adults (18 years and older) and the elderly: Take one sachet when you have the first warning of a migraine attack If you do not feel better, you may take a second sachet 2 hours later Do not take more than three sachets in a 24 hour period Children Do not take if you are under 18 years old If you take more MigraMax than you should If you take more MigraMax than you should, tell a doctor or go to a hospital casualty department straight away. Take the medicine pack with you. This is so the doctor knows what you have taken. The following effects may happen: Being sick (vomiting); feeling thirsty (dehydration); ringing in the ears (tinnitus); balance problems, dizziness (vertigo); loss of hearing (deafness); sweating, feeling of warmth in the hands, feet or lips with a strong and forceful pulse; increased or heavy breathing In some cases vomiting blood; very high body temperature; a sense of nervousness, shaky or sweaty (hypokalaemia); tiredness or weakness and muscle cramps (hypokalaemia): you may also feel that your limbs are swollen (fluid retention) this is a sign of changes in the way your kidneys are working Extreme shortness of breath or difficulty breathing and a feeling of suffocating or drowning. These are signs of something called non-cardiac pulmonary oedema You may also bleed easily or have unusual bruising or bleeding these are signs of blood problems such as thrombocytopenia. Other effects such as lack of awareness (disorientation), confusion, loss of consciousness (coma) and rapid uncontrollable shaking (convulsion) may also occur If you have any further questions on the use of this medicine, ask your doctor or pharmacist 4.Possible side effects Like all medicines, MigraMax can cause side effects, although not everybody gets them. Stop taking MigraMax and see a doctor or go to a hospital straight away if: You have an allergic reaction. Severe allergic reactions can occur very rarely and usually happen soon after taking MigraMax. These can involve difficulty breathing, tightness in the throat, rapidly spreading rashes, dizziness, very fast heartbeat or even loss of consciousness You have difficulty breathing, wheezing or tightness in the chest (called bronchospasm) You develop an itchy, lumpy rash sometimes called hives (urticaria) You are short of breath, have bluish skin colouration, headache, tiredness, dizziness and loss of consciousness. These could be signs of a very rare but serious side effect called methaemoglobinaemia You are paler than normal, are sweating, have a high temperature, fast heartbeat, stiff muscles, fast breathing and feel confused, drowsy or agitated. These could be signs of a serious side effect called neuroleptic malignant syndrome You have a fit You notice that you have black tarry stools (faeces) or blood in the stools You notice any blood or dark particles (coffee ground colour) when you are being sick You have a burning, aching pain in your stomach, with an empty feeling and hunger. You may have an ulcer in your stomach or gut
Tell a doctor straight away if you notice any of the following serious side effects: Problems controlling certain muscles of the body or you have muscle spasms or jerks. The affected muscles may include your tongue, mouth, jaw, arms and legs. The spasms may cause unusual movements of the face, tongue, eyes, neck and affect speech, expression and/ or lead to unnatural positioning of the head and shoulders Decreased level of consciousness, confusion, hallucination Rigid or stiff muscles, trembling or shaking or difficulty moving You bruise more easily than usual. This could be because of a blood disorder (thrombocytopenia) You get infections more often and easier than normal. This could be because you have a low number of white blood cells (agranulocytosis) Shortness of breath, fast heartbeat and chest pain Depression Tell your doctor as soon as possible if you have any of the following side effects: Diarrhoea You bleed more easily than usual. You may have something called hypothrombinaemia Feeling tired, faint, dizzy or having pale skin. These could be signs of anaemia You have pain when passing urine with lower back pain, sometimes radiating to the sides and/or groin. These could be signs of kidney stones Tell your doctor or pharmacist if any of the following side effects get serious or lasts longer than a few days: Abnormal production of breast milk in men and women Breast enlargement in men Loss of menstrual periods Feeling nervous (anxious), restless or confused Difficulty sleeping, feeling drowsy or tired Feeling dizzy or having ringing in your ears (tinnitus) Lack or loss of strength (weakness) Wind (flatulence) Talk to your doctor or pharmacist if any of the side effects get serious or lasts longer than a few days, or if you notice side effects not listed in this leaflet 5. How to store MigraMax Keep this medicine in a safe place where children cannot see or reach it Do not use MigraMax after the expiry date which is stated on the label and carton after EXP. The expiry date refers to the last day of that month. Store below 25C. Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment. 6. Further information What MigraMax contains Each sachet contains 1620mg DL-lysine acetylsalicylate equivalent to 900mg acetylsalicylic acid (the same amount that is in three 300mg aspirin tablets) and 10mg metoclopramide hydrochloride (as anhydrous) as the active ingredients MigraMax sachets also contain aspartame, glycine and lemon flavour What MigraMax looks like and contents of the pack MigraMax is a white powder with a lemon odour and is soluble in water. MigraMax is available in cartons containing 2, 6 or 20 sachets. Not all pack sizes may be marketed. Marketing Authorisation Holder and Manufacturer Marketing Authorisation Holder Zentiva, One Onslow Street, Guildford, Surrey, GU1 4YS, UK. Manufacturer Sanofi Winthrop Industrie, 196 avenue du Marchal Juin, 45200 Amilly, France This leaflet does not contain all the information about your medicine. If you have any questions or are not sure about anything, ask your doctor or pharmacist. This leaflet was last revised in November 2011. Zentiva is a registered trademark
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256661
PACKAGE LEAFLET: INFORMATION FOR THE USER
MigraMax 900mg/10mg, Powder for oral solution
Acetylsalicylic acid (as DL-lysine acetylsalicylate) Metoclopramide hydrochloride
Read all of this leaflet carefully before you start taking this medicine Keep this leaflet. You may need to read it again. If you have any further questions, ask your doctor or pharmacist. This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours. If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist. In this leaflet: 1.What MigraMax is and what it is used for 2.Before you take MigraMax 3.How to take MigraMax 4.Possible side effects 5.How to store MigraMax 6.Further information 1. What MigraMax is and what it is used for The name of your medicine is MigraMax 900mg/10mg Powder for oral solution (called MigraMax in this leaflet). What MigraMax contains MigraMax contains two different medicines. These are called: Metoclopramide hydrochloride: This belongs to a group of medicines called antiemetics. It works on muscles in the upper part of the digestive system causing your stomach to empty. It also works on a part of your brain that prevents you from feeling sick (nausea) or being sick (vomiting). DL-lysine acetylsalicylate: This belongs to a group of medicines called painkillers (analgesics). DL-lysine acetylsalicylate is broken down in your body to aspirin (acetylsalicylic acid). This works by blocking a substance that naturally occurs in your body called cyclo-oxygenase. Cyclo-oxygenase makes some of the chemicals that cause pain. If it is blocked, pain is relieved. What MigraMax is used for MigraMax is used to treat the signs of migraine, such as headache, feeling sick (nausea) or being sick (vomiting) in adults 18 years and over. 2. Before you take MigraMax Do not take this medicine and tell your doctor if: x You are allergic (hypersensitive) to: - Metoclopramide hydrochloride - DL-lysine acetylsalicylate (aspirin) - Other salicylates or non-steroidal antiinflammatory medicines (NSAIDs) - Any of the other ingredients of MigraMax (listed in Section 6 below) Signs of an allergic reaction can include: rash, swallowing or breathing problems, swelling of your lips, face, throat or tongue x You under the age of 18 x You have haemophilia or any other blood clotting or bleeding problems x You have a blockage or bleeding in your stomach or intestine x You have an ulcer in your stomach or gut. Signs include burning or aching pain in your stomach, with an empty feeling and hunger x You have had an operation on your stomach or intestine (gut). Do not take during the first 3 to 4 days after your operation. x You have a tumour on the adrenal gland (called phaeochromocytoma) x You are pregnant. This is especially important during the third trimester (week 26 to delivery). See Pregnancy and breast feeding section below. x You are breast feeding (see Pregnancy and breast feeding section below) Do not take this medicine if any of the above applies to you. If you are not sure, talk to your doctor or pharmacist before taking MigraMax. Take special care with MigraMax. Check with your doctor or pharmacist before taking your medicine if: pYou have ever had an ulcer in your stomach or gut. Signs include burning or aching pain in your stomach with an empty feeling and hunger pYou have asthma pYou have a runny nose, itching, sneezing and stuffy nose (called rhinitis) pYou have growths inside your nose causing an obstruction (called nasal polyps) pYou have liver problems
pYou have gout pYou have ever had any bleeding in the stomach or intestine pYou have menstrual periods which are heavier or last longer than usual pYou use an intrauterine contraceptive device (IDU) pYou have epilepsy. This is because MigraMax may increase the chances of you having a fit pYou drink a lot of alcohol pYou have kidney problems If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before taking MigraMax Taking other medicines Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines you buy without prescription, including herbal medicines. This is because MigraMax can affect the way some other medicines work. Also some medicines can affect the way MigraMax works. In particular tell your doctor if you are taking any of the following: MigraMax may increase the effects of the following medicines: Medicines for mental illness known as antipsychotics Medicines to calm or reduce anxiety (hypnotics, anxiolytics) Medicines to help you sleep (sedatives, barbiturates) Medicines used for epilepsy such as phenytoin or sodium valproate Some medicines used for depression such as mirtazapine or venlafaxine Medicines to prevent blood clotting (anticoagulants) such as warfarin Ciclosporin used to help prevent rejection of transplants. Your doctor may change your dose of ciclosporin Clonidine used for high blood pressure, migraine or hot flushes in the menopause Medicines used to treat muscle spasms (anticholinergics) for irritable bowel syndrome (IBS) such as mebeverine or hyoscine Medicines used to treat incontinence such as oxybutynin, propiverine or tolterodine Some medicines for moderate to severe pain (morphine products) such as codeine, dihydrocodeine or dextropropxyphene Oral medicines used for diabetes (sulphonylureas) such as gliclazide Medicines that can make your sleepy that are used for hay fever, rashes or other allergies called sedative antihistamines such as chlorphenamine or promethazine Methotrexate used to treat rheumatoid arthritis, cancer and some other conditions Zafirlukast used for asthma MigraMax can make the following medicines work less well: Medicines used to lower the amount of uric acid in your body (uricosurics) such as probenecid or sulfinpyrazone Digoxin used for heart problems. Your doctor may change your dose of digoxin Interferon alpha used to treat certain types of infections and certain forms of cancer Mifepristone usually given in hospital for termination of a pregnancy Water tablets (diuretics) such as spironolactone, triamterene or amiloride The following medicines can increase the chance of you getting side effects, when taken with MigraMax: Other related painkillers that lower inflammation (Non-steriodal antiinflammatory medicines NSAIDs), such as ibuprofen Medicines used to prevent blood clots such as clopidogrel, ticlopidine or dipyridamole Medicines for indigestion and heartburn (antacids) Steroid medicines used for lots of different illnesses such as inflammation, allergy or immune system problems Levodopa used for Parkinsons disease Taking MigraMax with food and drink Drinking alcohol while taking MigraMax may make you feel sleepy Pregnancy and breast feeding Do not take this medicine if: You are pregnant, might become pregnant or think you may be pregnant. This is especially important during the third trimester, week 26 to delivery You are breast feeding or planning to breast feed. This is because small amounts may pass into mothers milk Ask your doctor or pharmacist for advice before taking any medicine if you are pregnant or breast feeding. 1
Driving and using machines You may feel sleepy after taking this medicine. This is more likely if you have drunk alcohol or taking other medicines that cause drowsiness. If this happens do not drive or use any tools or machines. Important information about some of the ingredients of Migramax This medicine contains aspartame. This is a source of phenylalanine. It may be harmful for people with phenylketonuria. 3. How to take MigraMax Always take MigraMax exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. Taking this medicine Take this medicine by mouth Pour the contents of one sachet into some water, mix well and drink straight away If you feel the effect of your medicine is too weak or too strong, do not change the dose yourself, but ask your doctor How much to take Adults (18 years and older) and the elderly: Take one sachet when you have the first warning of a migraine attack If you do not feel better, you may take a second sachet 2 hours later Do not take more than three sachets in a 24 hour period Children Do not take if you are under 18 years old If you take more MigraMax than you should If you take more MigraMax than you should, tell a doctor or go to a hospital casualty department straight away. Take the medicine pack with you. This is so the doctor knows what you have taken. The following effects may happen: Being sick (vomiting); feeling thirsty (dehydration); ringing in the ears (tinnitus); balance problems, dizziness (vertigo); loss of hearing (deafness); sweating, feeling of warmth in the hands, feet or lips with a strong and forceful pulse; increased or heavy breathing In some cases vomiting blood; very high body temperature; a sense of nervousness, shaky or sweaty (hypokalaemia); tiredness or weakness and muscle cramps (hypokalaemia): you may also feel that your limbs are swollen (fluid retention) this is a sign of changes in the way your kidneys are working Extreme shortness of breath or difficulty breathing and a feeling of suffocating or drowning. These are signs of something called non-cardiac pulmonary oedema You may also bleed easily or have unusual bruising or bleeding these are signs of blood problems such as thrombocytopenia. Other effects such as lack of awareness (disorientation), confusion, loss of consciousness (coma) and rapid uncontrollable shaking (convulsion) may also occur If you have any further questions on the use of this medicine, ask your doctor or pharmacist 4.Possible side effects Like all medicines, MigraMax can cause side effects, although not everybody gets them. Stop taking MigraMax and see a doctor or go to a hospital straight away if: You have an allergic reaction. Severe allergic reactions can occur very rarely and usually happen soon after taking MigraMax. These can involve difficulty breathing, tightness in the throat, rapidly spreading rashes, dizziness, very fast heartbeat or even loss of consciousness You have difficulty breathing, wheezing or tightness in the chest (called bronchospasm) You develop an itchy, lumpy rash sometimes called hives (urticaria) You are short of breath, have bluish skin colouration, headache, tiredness, dizziness and loss of consciousness. These could be signs of a very rare but serious side effect called methaemoglobinaemia You are paler than normal, are sweating, have a high temperature, fast heartbeat, stiff muscles, fast breathing and feel confused, drowsy or agitated. These could be signs of a serious side effect called neuroleptic malignant syndrome You have a fit You notice that you have black tarry stools (faeces) or blood in the stools You notice any blood or dark particles (coffee ground colour) when you are being sick You have a burning, aching pain in your stomach, with an empty feeling and hunger. You may have an ulcer in your stomach or gut
Tell a doctor straight away if you notice any of the following serious side effects: Problems controlling certain muscles of the body or you have muscle spasms or jerks. The affected muscles may include your tongue, mouth, jaw, arms and legs. The spasms may cause unusual movements of the face, tongue, eyes, neck and affect speech, expression and/ or lead to unnatural positioning of the head and shoulders Decreased level of consciousness, confusion, hallucination Rigid or stiff muscles, trembling or shaking or difficulty moving You bruise more easily than usual. This could be because of a blood disorder (thrombocytopenia) You get infections more often and easier than normal. This could be because you have a low number of white blood cells (agranulocytosis) Shortness of breath, fast heartbeat and chest pain Depression Tell your doctor as soon as possible if you have any of the following side effects: Diarrhoea You bleed more easily than usual. You may have something called hypothrombinaemia Feeling tired, faint, dizzy or having pale skin. These could be signs of anaemia You have pain when passing urine with lower back pain, sometimes radiating to the sides and/or groin. These could be signs of kidney stones Tell your doctor or pharmacist if any of the following side effects get serious or lasts longer than a few days: Abnormal production of breast milk in men and women Breast enlargement in men Loss of menstrual periods Feeling nervous (anxious), restless or confused Difficulty sleeping, feeling drowsy or tired Feeling dizzy or having ringing in your ears (tinnitus) Lack or loss of strength (weakness) Wind (flatulence) Talk to your doctor or pharmacist if any of the side effects get serious or lasts longer than a few days, or if you notice side effects not listed in this leaflet 5. How to store MigraMax Keep this medicine in a safe place where children cannot see or reach it Do not use MigraMax after the expiry date which is stated on the label and carton after EXP. The expiry date refers to the last day of that month. Store below 25C. Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment. 6. Further information What MigraMax contains Each sachet contains 1620mg DL-lysine acetylsalicylate equivalent to 900mg acetylsalicylic acid (the same amount that is in three 300mg aspirin tablets) and 10mg metoclopramide hydrochloride (as anhydrous) as the active ingredients MigraMax sachets also contain aspartame, glycine and lemon flavour What MigraMax looks like and contents of the pack MigraMax is a white powder with a lemon odour and is soluble in water. MigraMax is available in cartons containing 2, 6 or 20 sachets. Not all pack sizes may be marketed. Marketing Authorisation Holder and Manufacturer Marketing Authorisation Holder Zentiva, One Onslow Street, Guildford, Surrey, GU1 4YS, UK. Manufacturer Sanofi Winthrop Industrie, 196 avenue du Marchal Juin, 45200 Amilly, France This leaflet does not contain all the information about your medicine. If you have any questions or are not sure about anything, ask your doctor or pharmacist. This leaflet was last revised in November 2011. Zentiva is a registered trademark
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256661
Source: Medicines and Healthcare Products Regulatory Agency
Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
