Chemical Name Bisacodyl bisaoedill

Brand Name: Dulcolax—tablet or suppository (U.S.); Bisacolax—tablet or suppository (Canada)

Generic Available: Yes (U.S. and Canada)

Description: Bisacodyl is an over-the-counter stimulant laxative that can be used in either oral or suppository form. Stimulant laxatives encourage bowel movements by increasing the muscle contractions in the intestinal wall that propel the stool mass. Although stimulant laxatives are popular for self-treatment, they are more likely to cause side effects than other types of laxatives.

Proper Usage

• Laxatives are to be used to provide short-term relief only, unless otherwise directed by the nurse or physician who is helping you to manage your bowel symptoms. A regimen that includes a healthy diet containing roughage (whole grain breads and cereals, bran, fruit, and green, leafy vegetables), six to eight full glasses of liquids each day, and some form of daily exercise is most important in stimulating healthy bowel function.

• If your physician has recommended this laxative for management of constipation, follow his or her recommendations for its use. If you are treating yourself for constipation, follow the directions on the package insert.

• The tablet form of this laxative is usually taken on an empty stomach to speed results. The tablets are coated to allow them to work properly without causing stomach irritation or upset. Do not chew or crush the tablets or take them within an hour of drinking milk or taking an antacid.

• A bedtime dose usually produces results the following morning. Be sure to consult your physician if you experience problems or do not get relief within a week.

Precautions

• Do not take any laxative if you have signs of appendicitis or inflamed bowel (e.g., stomach or lower abdominal pain, cramping, bloating, soreness, nausea, or vomiting). Check with your physician as soon as possible.

• Do not take any laxative for more than 1 week unless you have been told to do so by your physician. Many people tend to overuse laxatives, which often leads to dependence on the laxative action to produce a bowel movement. Discuss the use of laxatives with your healthcare professional to ensure that the laxative is used effectively as part of a comprehensive, healthy bowel management regimen.

• Do not take any laxative within 2 hours of taking other medication because the desired effectiveness of the other medication may be reduced.

• If you are pregnant, discuss with your physician the most appropriate type of laxative for you to use.

• Some laxatives pass into breast milk. Although it is unlikely to cause problems for a nursing infant, be sure to let your physician know if you are using a laxative and breast-feeding at the same time.

Possible Side Effects

• Side effects that may go away as your body adjusts to the medication and do not require medical attention unless they persist or are bothersome: belching; cramping; diarrhea; nausea.

• Unusual side effects that should be reported to your physician as soon as possible: confusion; irregular heartbeat; muscle cramps; skin rash; unusual tiredness or weakness.

Chemical Name: Carbamazepine (kar-ba-maz-e-peen)

Brand Name: Tegretol (U.S. and Canada)

Generic Available: Yes (U.S.)

Description: Carbamazepine is used to relieve shock-like pain, such as the facial pain caused by trigeminal neuralgia (tic douloureux).

Proper Usage

• It is very important that you take this medicine exactly as directed by your physician in order to obtain the best results and lessen the chance of serious side effects.

• Carbamazepine is not an ordinary pain reliever. It should be used only when your physician prescribes it for certain types of pain. Do not take this medication for other aches or pains.

• If you miss a dose of this medication, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double dose. If you miss more than one dose in a day, check with your physician.

• It is very important that your physician check your progress at regular intervals. Your physician may want to have certain tests done to see if you are receiving the correct amount of medication or to check for certain side effects of which you might be unaware.

Precautions

• Carbamazepine adds to the effects of alcohol and other central nervous system depressants that may cause drowsiness (e.g., antihistamines, sedatives, tranquilizers, prescription pain medications, seizure medications, muscle relaxants). Be sure that your physician knows if you are taking these or other medications.

• Some people who take carbamazepine may become more sensitive to sunlight than they are normally. Exposure to sunlight, even for brief periods of time, may cause a skin rash, itching, redness or other discoloration of the skin, or severe sunburn.

• Oral contraceptives (birth control pills) that contain estrogen may not work properly while you are taking carba-mazepine. You should use an additional or alternative form of birth control while taking this drug.

• Carbamazepine affects the urine sugar levels of diabetic patients. If you notice a change in the results of your urine sugar tests, check with your physician.

• Before having any medical tests or any kind of surgical, dental, or emergency treatment, be sure to let the healthcare professional know that you are taking this medication.

• Carbamazepine has not been studied in pregnant women. There have been reports of babies having low birth weight, small head size, skull and facial defects, underdeveloped fingernails, and delays in growth when their mothers had taken carbamazepine in high doses during pregnancy. Studies in animals have shown that carbamazepine causes birth defects when given in large doses.

• Carbamazepine passes into breast milk, and the baby may receive enough of it to cause unwanted effects. In animal studies, carbamazepine has affected the growth and appearance of nursing babies.

Possible Side Effects

• Side effects that typically go away as your body adjusts to the medication and do not require medical attention unless they continue for several weeks or are bothersome: clumsiness or unsteadiness*; mild dizziness*; mild drowsiness*; lightheadedness; mild nausea or vomiting; aching joints or muscles; constipa tion*; diarrhea; dryness of mouth; skin sensitivity to sunlight; irritation of mouth or tongue; loss or appetite; loss of hair; muscle or abdominal cramps; sexual problems in males*.

• Check with your physician as soon as possible if any of the following side effects occur: blurred or double vision*; confusion; agitation; severe diarrhea, nausea, or vomiting; skin rash or hives; unusual drowsiness; chest pain; difficulty speaking or slurred speech*; fainting; frequent urination*; unusual heartbeat; mental depression or other mood or emotional changes; unusual numbness, tingling, pain, or weakness in hands or feet*; ringing or buzzing in ears; sudden decrease in urination; swelling of face, hands, feet, or lower legs; trembling; uncontrolled body movements; visual hallucinations.

• Check with your physician immediately if any of the following occur: black tarry stools or blood in urine or stools; bone or joint pain; cough or hoarseness; darkening of urine; nosebleeds or other unusual bleeding or bruising; painful or difficult urination; tenderness, swelling, or bluish color in leg or foot; pale stools; pinpoint red spots on skin; shortness of breath or cough; sores, ulcers, or white spots on lips or in the mouth; sore throat, chills, and fever; swollen glands; unusual tiredness or weakness*; wheezing, tightness in chest; yellow eyes or skin.

• Symptoms of overdose that require immediate attention: unusual clumsiness or unsteadiness*; severe dizziness or fainting; fast or irregular heartbeat; unusually high or low blood pressure; irregular or shallow breathing; severe nausea or vomiting; trembling, twitching, and abnormal body movements.

*Since it may be difficult to distinguish between certain common symptoms of MS

and some side effects of carbamazepine, be sure to consult your healthcare professional if an abrupt change of this type occurs.

Chemical Name: Ciprofloxacin (sip-roe-fox-a-sin) combination

Brand Name: Cipro (U.S. and Canada)

Generic Available: No

Description: Ciprofloxacin is one of a group of antibiotics (fluoroquinolones) used to kill bacterial infection in many parts of the body. It is used in multiple sclerosis primarily to treat urinary tract infections.

Proper Usage

• This medication is best taken with a full glass (8 ounces) of water. Additional water should be taken each day to help prevent some unwanted effects.

• Ciprofloxacin may be taken with meals or on an empty stomach.

• Finish the full course of treatment prescribed by your physician. Even if your symptoms disappear after a few days, stopping this medication prematurely may result in a return of the symptoms.

• This medication works most effectively when it is maintained at a constant level in your blood or urine. To help keep the amount constant, do not miss a dose. It is best to take the doses at evenly spaced times during the day and night.

Precautions

• This medication may cause some people to become dizzy, lightheaded, drowsy, or less alert.

• If you are taking antacids that contain aluminum or magnesium, be sure to take them at least 2 hours before or after you take ciprofloxacin. These antacids may prevent the ciprofloxacin from working properly.

• This medication may cause your skin to become more sensitive to sunlight. stay out of direct sunlight during the midday hours, wear protective clothing, and apply a sun block product that has a skin protection factor (SPF) of at least 15.

• Studies of birth defects have not been done in humans. This medication is not recommended during pregnancy since antibiotics of this type have been reported to cause bone development problems in young animals.

• Some of the antibiotics in this group are known to pass into human breast milk. Since they have been reported to cause bone development problems in young animals, breast-feeding is not recommended during treatment with this medication.

Possible Side Effects

• Side effects that may go away as your body adjusts to the medication and do not require medical attention unless they continue or are bothersome: abdominal or stomach pain; diarrhea; dizziness; drowsiness*; headache; lightheadedness; nausea or vomiting; nervousness; trouble sleeping.

• Rare side effects that should be reported to your physician immediately: agitation; confusion; fever; hallucinations; peeling of the skin; shakiness or tremors*; shortness of breath; skin rash; itching; swelling of face or neck.

*Since it may be difficult to distinguish between certain common symptoms of MS and some side effects of ciprofloxacin, be sure to consult your healthcare professional if an abrupt change of this type occurs.

Chemical Name: Clonazepam (kloe-na-ze-pam)

Brand Name: Klonopin (U.S.); Rivotril; Syn-Clonazepam (Canada)

Generic Available: No

Description: Clonazepam is a benzodi-azepine that belongs to the group of med ications called central nervous system depressants, which slow down the nervous system. Although clonazepam is used for a variety of medical conditions, it is used in multiple sclerosis primarily for the treatment of tremor, pain, and spasticity.

Proper Usage

• Keep this medication out of the reach of children. An overdose of this medication may be especially dangerous for children.

Precautions

• During the first few months taking clon-azepam, your physician should check your progress at regular visits to make sure that this medicine does not cause unwanted effects.

• Take this medication only as directed by your physician; do not increase the dose without a prescription to do so.

• Clonazepam adds to the effects of alcohol and other central nervous system depressants (e.g., antihistamines, sedatives, tranquilizers, prescription pain medications, seizure medications, muscle relaxants, sleeping medications). Consult your physician before taking any of these CNS depressants while you are taking clonazepam. Taking an overdose of this medication or taking it with alcohol or other CNS depressants may lead to unconsciousness and possibly death.

• Stopping this medication suddenly may cause withdrawal side effects. Reduce the amount gradually before stopping completely.

• Clonazepam frequently causes people to become drowsy, dizzy, lightheaded, clumsy, or unsteady. Even if taken at bedtime, it may cause some people to feel drowsy or less alert on awakening.

• Studies in animals have shown that clon-azepam can cause birth defects or other problems, including death of the animal fetus.

• Overuse of clonazepam during pregnancy may cause the baby to become dependent on it, leading to withdrawal side effects after birth. The use of clon-azepam, especially during the last weeks of pregnancy, may cause breathing problems, muscle weakness, difficulty in feeding, and body temperature problems in the newborn infant.

• Clonazepam may pass into breast milk and cause drowsiness, slow heartbeat, shortness of breath, or troubled breathing in nursing babies.

Possible Side Effects

• Side effects that may go away during treatment as your body adjusts to the medication and do not require medical attention unless they continue for several weeks or are bothersome: drowsiness or tiredness; clumsiness or unsteadiness*; dizziness or lightheadedness; slurred speech*; abdominal cramps or pain; blurred vision or other changes in vision*; changes in sexual drive or performance*; gastrointestinal changes, including constipation* or diarrhea; dry-ness of mouth; fast or pounding heartbeat; muscle spasm*; trouble with urination*; trembling.

• Unusual side effects that should be discussed as soon as possible with your physician: behavior problems, including difficulty concentrating and outbursts of anger; confusion or mental depression; convulsions; hallucinations; low blood pressure; muscle weakness; skin rash or itching; sore throat, fever, chills; unusual bleeding or bruising; unusual excitement or irritability.

• Symptoms of overdose that require immediate emergency help: continuing confusion; severe drowsiness; shakiness; slowed heartbeat; shortness of breath;

slow reflexes; continuing slurred speech*; staggering*; unusual severe weakness*.

*Since it may be difficult to distinguish between certain common symptoms of MS and some side effects of clonazepam, be sure to consult your healthcare professional if an abrupt change of this type occurs.

Chemical Name: Desmopressin acetate (des-moe-press-in)

Brand Name: DDAVP Tablets (U.S. and Canada)

Generic Available: No

Description: Desmopressin is a synthetic analogue of the natural pituitary hormone 8-arginine vasopression (ADH), that works on the kidneys to control urination. It is used in MS to block the kidney's production of urine for brief periods of time, e.g., to treat nocturia by reducing nighttime awakening to urinate.

Proper Usage

• Keep this medication in the refrigerator but do not allow it to freeze.

Precautions

• Let your physician know if you have heart disease, blood vessel disease, or high blood pressure. Desmopressin can cause an increase in blood pressure.

• Studies have not been done in pregnant women. It has been used before and during pregnancy to treat diabetes melli-tus and has not been shown to cause birth defects.

• It is not known whether desmopressin passes into breast milk and should therefore be used with caution by women who are breastfeeding.

Possible Side Effects

• Side effects that typically go away as your body adjusts to the medication and do not require medical attention unless they continue for several weeks or are bothersome: runny or stuffy nose; abdominal or stomach cramps; flushing of the skin; headache; nausea; pain in the vulva.

• Unusual side effects that require immediate medical attention: confusion; convulsions; unusual drowsiness*; continuing headache; rapid weight gain; markedly decreased urination.

*Since it may be difficult to distinguish between certain common symptoms of MS and some side effects of desmopressin, be sure to consult your healthcare professional if an abrupt change of this type occurs.

Chemical Name: Desmopressin acetate (des-moe-press-in)

Brand Name: DDAVP Nasal Spray (U.S. and Canada)

Generic Available: No

Description: Desmopressin is a synthetic analogue of the natural pituitary hormone 8-argi-nine vasopression (ADH), that works on the kidneys to control urination. It is used in MS to block the kidney's production of urine for brief periods of time, e.g., to treat nocturia by reducing nighttime awakening to urinate.

Proper Usage

• Keep this medication in the refrigerator but do not allow it to freeze.

Precautions

• Let your physician know if you have heart disease, blood vessel disease, or high blood pressure. Desmopressin can cause an increase in blood pressure.

• Studies have not been done in pregnant women. it has been used before and during pregnancy to treat diabetes melli-tus and has not been shown to cause birth defects.

• Desmopressin passes into breast milk but has not been reported to cause problems in nursing infants.

Possible Side Effects

• Side effects that typically go away as your body adjusts to the medication and do not require medical attention unless they continue for several weeks or are bothersome: runny or stuffy nose; abdominal or stomach cramps; flushing of the skin; headache; nausea; pain in the vulva.

• Unusual side effects that require immediate medical attention: confusion; convulsions; unusual drowsiness*; continuing headache; rapid weight gain; markedly decreased urination.

*Since it may be difficult to distinguish between certain common symptoms of MS and some side effects of desmopressin, be sure to consult your healthcare professional if an abrupt change of this type occurs.

Chemical Name: Dexamethasone (dex-a-meth-oh-zone)

Brand Name: Decadron (U.S. and Canada)

Generic Available: Yes (U.S. and Canada)

Description: Dexamethasone is one of a group of corticosteroids (cortisone-like medicines) that are used to relieve inflammation in different parts of the body. Corticosteroids are used in MS for the management of acute exacerbations because they have the capacity to close the damaged blood-brain barrier and reduce inflammation in the central nervous system. Although dexamethasone is among the most commonly used corticosteroids in MS, it is only one of several possibilities. other commonly used corticosteroids include prednisone, betamethasone, and methylprednisolone. The following information pertains to all the various corticosteroids.

Proper Usage

• Most neurologists treating MS believe that high-dose corticosteroids given intravenously are the most effective treatment for an MS exacerbation, although the exact protocol for the drug's use may differ somewhat from one treating physician to another. Patients generally receive a 4-day course of treatment (either in the hospital or as an outpatient), with doses of the medication spread throughout the day (see Methylprednisolone). The high-dose, intravenous dose is typically followed by a gradually tapering dose of an oral cor-ticosteroid (usually ranging in length from 10 days to 5 or 6 weeks). Dexamethasone is commonly used for this oral taper. Oral dexamethasone may also be used instead of the high-dose, intravenous treatment if the intravenous treatment is not desired or is medically contraindicated.

Precautions

• This medication can cause indigestion and stomach discomfort. Always take it with a meal and/or a glass or milk. Your physician may prescribe an antacid for you to take with this medication.

• Take this medication exactly as prescribed by your physician. Do not stop taking it abruptly; your physician will give you a schedule that gradually tapers the dose before you stop it completely.

• Since corticosteroids can stimulate the appetite and increase water retention, it is advisable to follow a low-salt and/or a potassium-rich diet and watch your caloric intake.

• corticosteroids can lower your resistance to infection and make any infection that you get more difficult to treat. contact your physician if you notice any sign of infection, such as sore throat, fever, coughing, or sneezing.

• Avoid close contact with anyone who has chicken pox or measles. Tell your physician immediately if you think you have been exposed to either of these illnesses. Do not have any immunizations after you stop taking this medication until you have consulted your physician. People living in your home should not have the oral polio vaccine while you are being treated with corticosteroids since they might pass the polio virus on to you.

• Corticosteroids may affect the blood sugar levels of diabetic patients. If you notice a change in your blood or urine sugar tests, be sure to discuss it with your physician.

• The risk of birth defects in women taking corticosteroids during pregnancy has not been studied. Overuse of corticos-teroids during pregnancy may slow the growth of the infant after birth. Animal studies have demonstrated that corticos-teroids cause birth defects.

• Corticosteroids pass into breast milk and may slow the infant's growth. If you are nursing or plan to nurse, be sure to discuss this with your physician. It may be necessary for you to stop nursing while taking this medication.

• Corticosteroids can produce mood changes and/or mood swings of varying intensity. These mood alterations can vary from relatively mild to extremely intense, and can vary in a single individual from one course of treatment to another. Neither the patient nor the physician can predict with any certainty whether the corticosteroids are likely to precipitate these mood alterations. If you have a history of mood disorders (depression or bipolar disorder, for example), be sure to share this information with your physician. If you begin to experience unmanageable mood changes or swings while taking corticosteroids, contact your physician so that a decision can be made whether or not you need an additional medication to help you until the mood alterations subside.

Possible Side Effects

• Side effects that may go away as your body adjusts to the medication and do not require medical attention unless they continue or are bothersome: increased appetite; indigestion; nervousness or restlessness; trouble sleeping; headache; increased sweating; unusual increase in hair growth on body or face.

• Less common side effects that should be reported as soon as possible to your physician: severe mood changes or mood swings; decreased or blurred vision*; frequent urination*.

• Additional side effects that can result from the prolonged use of corticos-teroids and should be reported to your physician: acne or other skin problems; swelling of the face; swelling of the feet or lower legs; rapid weight gain; pain in the hips or other joints (caused by bone cell degeneration); bloody or black, tarry stools; elevated blood pressure; markedly increased thirst (with increased urination indicative of diabetes mellitus); menstrual irregularities; unusual bruising of the skin; thin, shiny skin; hair loss; muscle cramps or pain. Once you stop this medication after taking it for a long period of time, it may take several months for your body to readjust.

*Since it may be difficult to distinguish between certain common symptoms of MS and some side effects of dexamethasone, be sure to consult your healthcare professional if an abrupt change of this type occurs.

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Responses

  • aleisha
    Can bisacodyl flush out dexathamasone from system?
    3 years ago

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