Archive for May, 2017

Cefdinir: Uses, Side Effects, Dosage and Reviews

May 16 2017 Published by under Medicines

What is Cefdinir?

Cefdinir is an advanced semi-synthetic (when an original drug chemically modified to isolate the active ingredient), antimicrobial drug i.e. third generation cephalosporin drug which is isolated from the plant, bacterial sources (Cephalosporium acremonium).

It will kill the bacteria and is so called bactericidal and relieve us from bacterial infections.  It is available in the market as Omnicef and Cefzon. It was first introduced in 1991 by Fujisawa pharmaceutical Co., Ltd. It was approved on December 4, 1998, by Food and Drug Administration (FDA). As of 2008, it was top selling cephalosporin antibiotic in the United States.

cefdinir for baby's ear infection, UTI, strep, acne, sinus infection

What is Cefdinir molecular formula and weight?

Cefdinir molecular formula: C14H13N5O5S2.

Cefdinir molecular formula: C14H13N5O5S2

Cefdinir belongs to the class of organic compounds known as cephalosporins. These are compounds containing a 1,2-thiazine fused to a 2-azetidinone to for a oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid moiety or a derivative thereof.

Cefdinir molecular weight: 395.416 g/mol.

Cefdinir Drug Class

Cefdinir belongs to cephalosporin antibiotics drug class. They are generally classified under third generation broad-spectrum antibiotics, which mean they are resistance to most gram positive and gram negative aerobic microorganisms. First and second generation antibiotics are known to have less antimicrobial properties.

These extended-spectrum antibiotics are kept under the third generation and it is Cefdinir. They are also identified to be stable against beta-lactamases. All antibiotics, in general, contain beta-lactam ring in their molecular structures. This works by inhibiting the bacterial cell wall growth.

Nowadays many bacteria are developing resistance against this class of antibiotics by producing special enzyme beta-lactamase.  To avoid this bacterial growth, the doctor may prescribe beta-lactamase inhibitors (clavulanic acid) along with antibiotics.

Third generation cephalosporins characteristics are:

  • Broad coverage for gram-positive and gram-negative
  • Broad spectrum against antipseudomonal.
  • Long half life, so best effect can be achieved in taking a single
  • The best therapy for community-acquired diseases (bacterial pneumonia, Lyme disease, and sexually transmitted diseases).
  • Most third generation antibiotics penetrate cerebrospinal fluid and act against bacterial meningitis.
  • Less adverse effects compared to other generation of the drug.

How does Cefdinir work in the body?

There are different classes of antibiotics doing a different function. The specialty of antibiotics lies in differentiating from the bacterial and human cell and targeting bacterial cell. The beta- lactam antibiotic kills the cell wall surrounding bacteria.

Bacteria build their cell wall by joining molecules together and beta-lactam blocks this initial process. Without a cell wall, the pressure inside the cell exceeds maximum level and cell bursts. Cefdinir class of antibiotics used to treat only bacterial infections, not fungus or protists.

Taking antibiotics may kill healthy (friendly) bacteria which help you stay healthy. Studies show that people taking antibiotics less frequently will recover soon. Taking antibiotics for viral infections is an utter waste it may kill resident bacteria from your system.

Cefdinir brand names

Cefdinir is avaialble in different brand names. Most common with their manufacturers are following:

  • Adcef – Torrent pharmaceuticals
  • Adinir -Vensat Bio
  • Bacirom – Aristo pharmaceuticals
  • Cednir – Nicholas Piramal Ltd.
  • Cefcas – Casca Remedies Ltd
  • Cefdiel – Ranbaxy Diagnostics
  • Cefditis – Scortis Labs Ltd
  • Cefedeal – Talent healthcare
  • Cefrine – Macleods
  • Idinir – Invision
  • Kefdure – Sanat products Ltd.
  • Kefnir – Glenmark
  • Rtist – Lupin laboratories
  • Sefdin – Unichem
  • Vignir LB – Madhav Biotech Ltd.
  • Zefdinir – Zydus
  • Zinir – FDC (proxima).
  • Omnicef – Abbott Laboratories.

What is Cefdinir 300 mg capsule used for?

What is Cefdinir used for?

Cefdinir is an antibiotic which is prescribed for any infections caused by bacteria. Proven to be active against community-acquired pneumonia, chronic bronchitis at acute stage, maxillary sinusitis, pharyngitis/ tonsillitis, acute bacterial otitis media, complex skin related infections. Cefdinir is recommended for children with ear infections if they are allergic to amoxicillin class of antibiotics.

Beta- lactam class of antibiotics is known to have a broad range of activity against these species Haemophilus influenza, Haemophilus parainfluenzae, Streptococcus pneumoniae and Moraxella catarrhalis which are the ultimate cause of these bacterial infections.

Cefdinir dosage form and strength

These dosage form and strengths are given by manufacturers (pharmaceutical companies). It is not encouraged to use more quantity of drug without a proper prescription. Different dosage forms and strengths of different Brand names are shown in table below:

Brand NameCapsule SuspensionTabletSyrupInjection
Adcef300 mg125 mg/5ml125mg--
Adinir300 mg125 mg/5ml---
Bacirom O---125mg-
Cednir300 mg----
Cefdiel300 mg--125mg1 g and 500 mg
Cefditis--300mg--
Cefedeal300 mg----
Idinir
--300mg125mg-
Kefdure300 mg---
Kefnir300 mg125 mg/5ml-125mg-
Rtist300 mg125 mg/5ml100 mg
150 mg
--
Vignir LB300 mg----
Zefdinir300 mg125mg/5ml---
Zinir--100 mg,
150 mg,
300 mg
125mg-

Cefdinir dosage for different indications

Dosage is very important and it is determined by your health problem and doctors choice. Dosage is different for a different medication and it depends on a number of doses you take per day, the time interval between each dose, how long you continuing the medication.

The data is available for following strengths: 300mg for capsule or tablet form; 125mg/5mL and 250mg/5mL for oral suspension. The oral suspension should be shaken well before usage, add water and keep the container at room temperature. It can be used for 10 days and 11th day the remaining unused should be discarded.

Adults and teenagers dosage:

  • For infections: maximum of 600mg only should be taken per day. 300mg can be taken every twelve hours (twice a day). Dosage period is 5 to 10 days. If the infection persists, consult a nearby pharmacist or health advisor.
  • Pneumonia: 300mg orally for every twelve-hour time gap. Taken for 10 to 14 days.
  • Acute Bronchitis: 300mg for every twelve hours or 600mg for twenty-four hours for 10 days.
  • Sinusitis: 300mg twice a day or 600mg every 24 hours. Should take a minimum of 12 days medication.
  • Skin infection (soft tissue): 300mg orally every twelve hours. It is not prescribed to take once a day as 600mg.
  • Tonsillitis/ pharyngitis: 300mg every 12 hours for 10days. 600mg every 24 hours for 10days.

Pediatric dosage:

  • Bacterial infections or for acute otitis media: Children 6 months up to 12 years the dosage is based on body weight and it should be determined by the doctor. Usual dosage is 7mg/ kg of body weight for 12 hours time interval or 14mg/kg taken per day for 5 to 10 days. The maximum dose should not exceed 600mg/day.
  • Infants: baby up to 6 months of age is not advisable to take any kind of medication without prior notification to doctor.
  • Pneumonia: Children >13 years can take 300mg every 12 hours for 10 to 14 days.
  • Bronchitis: Children >13 years can take 300mg orally every 12 hours or 6oomg orally every 24 hours for 10days.
  • Tonsillitis / pharyngitis:
  • 6months to 12 years: 7mg/kg orally for 5 to 10 days every 12 hours. Or 14 mg/kg orally for 10days every 24 hours.
  • >13 years: 300mg orally for 5 to 10 days every 12 hours or 600mg/day for 10days.
  • Acute Sinusitis: dosage is same as tonsillitis and maximum dosage should be maintained as 600mg/day it should not be exceeded.
  • Complex skin infection:
  • 6months to 12 years: 7mg/kg every 12 hours for 10 days.
  • >13 years: 300mg every 12hours for 10days.

Patients with Renal Problems:

It is based on creatine clearance rate (crcl). Creatine is a waste produced by our muscle tissue. In healthy (normal) individual it gets filtered in kidney and excreted wholly through urine. In the case of people with kidney problems, it gets accumulated and it needs to be tested frequently to find the glomerular filtration rate (GFR).

  • Adults:

Crcl <30mL/min: 300mg dose should be taken every 24 hours.

Maximum dosage: 300mg.

  • Infants:

Crcl< 30mL/min: 7mg/kg dose should be taken every 24 hours.

Maximum dose: 300mg.

Patients undergoing diabetes: It is studied that Cefdinir antibiotic contains sucrose amount of 2.86 g/ teaspoon.

So they are advised to take 300mg or 7mg/kg of the dose given after completing diabetes and routine starts after 48 hours of completion.

Cefdinir Highest Dose

The maximum dose for Adults and teenagers for all complication was 600mg/day.

The maximum dosage for infants is determined by the doctor. As by body weight, the dosage varies for each baby. 7mg/kg twice a day or 14mg/kg per day is generally prescribed dosage.

Cefdinir Side Effects

Every medicine had both advantage and disadvantage (side effects). The antibiotic common side effect is killing resident bacteria. So need to take a live supplement like probiotics (yogurt) to maintain the microbial inhabitant. It is known to decrease diarrhea. These side effects need immediate medical treatment:

  • diarrhoea
  • stomach cramps
  • cough
  • chest pain
  • bloating
  • red spots on the skin
  • constipation
  • loss of strength
  • unable to sleep
  • bleeding gums
  • bloody stool and urine
  • skin turning blue
  • blue fingernails
  • confusion
  • dizziness
  • hives
  • high fever
  • weak pulse
  • heavier menstrual periods
  • swelling of face and lips
  • itching
  • Nosebleeds
  • eye irritation
  • seizures
  • swollen lymph nodes
  • weight gain
  • Eyes and skin turning yellow.

If the following side effects continue, check with a nearby health care professional for a quick remedy. They are a vaginal yeast infection, red colored stool, drowsiness, abnormal stools, vomiting, rashes, pruritus, insomnia, increased lymphocytes, white blood cells (WBC), platelets, breathing problems etc.

How to take Cefdinir?

Take Cefdinir as prescribed by your health care specialist. It should be taken in less or more quantity and no longer than recommended. Study the label information before using any medication.

You can take Cefdinir along with food or without food. But antibiotics are generally risky to take with food. Milk contains divalent ions like calcium and magnesium this lessens the absorption of Cefdinir. Before taking any dairy products consult a doctor about the various interaction of food with a specific antibiotic. If the medicine upsets your stomach, try taking it with food.

Tablets and capsules form can be taken along with water. Capsules should not be broken or chewed. It should be swallowed with a cup of water.

Shake the oral suspension well before you use. Try avoiding handy-silver spoon for dose measurement. This may slightly increase or decrease the dose level. Ask the doctor for medicine cup for measurement.

Intravenous mode of administration should be handled only by health care professionals. To get rid of injection soon, try taking medication at a full stretch. Even if you begin to feel better, complete full amount of dose because it may revert your infection.

To better working of medicine try not to avoid any doses. If you missed any dose don’t rush it with your next dose because it may cause overdosage symptoms.

The best result is obtained if cefdinir is taken at the same time each day.

Cefdinir withdrawal symptoms

Recent studies show that out of 2000 people only 1 experienced withdrawal symptoms taking Cefdinir. People with 60+ age group known to have withdrawal symptom and they all are female. “Withdrawal syndrome” is occurring due to discontinuation of any medication.

Here it has been reported in people with depression, pain, anxiety, stress, back pain and fibromyalgia. Taking other drugs like Percocet, marcaine, kenalog and fentanyl are also known to exacerbate this situation. This withdrawal syndrome is also observed in patients with withdrawing alcohol, narcotics, tranquilizers etc.

So it is better to consult doctor taking multiple drugs at a time. Seeking health care specialist advice will lighten you from confusion.

Precautions and Warnings for using Cefdinir

Precaution needs to be taken when your symptom is getting worse day by day. Then there is need to consult the doctor.

  • Patients with diabetes: This medication may cause negative results for urine sugar tests. So, better check with your doctor before changing your medicine pattern for diabetes.
  • Severe diarrhea may be another serious effect of Cefdinir. It may be due to antibiotic action towards bacteria. It will change the bacterial microflora. Do not take any medicine for diarrhea without asking a doctor. It may worsen the situation more or it will make it lasts long.
  • Tell your doctor about your health issues and medication you have been following (prescribed, herbs, vitamins). Your doctor may change certain dosages and evaluate side effects to you after using this medicine.
  • Antacids should be taken 2 hours before or after Cefdinir. Because it contains iron supplement it affects Cefdinir absorption.
  • Inform your doctor if you have or ever had gastrointestinal problems especially colitis, infection related to swelling of large intestine and kidney problems.
  • Diabetes patient should be cautious while taking Cefdinir because it suspension form contains sucrose.
  • Tell your doctor if you are allergic to any of the active ingredient of Cefdinir. Even allergic to a penicillin
  • It has interactions with some medicines so inform your doctor if you are undergoing these medications: probenecid, which increases uric acid secretion in the urine. Once if administered with cefdinir it causes adverse side effects. BCG vaccine or live typhoid vaccine effectiveness may get decreased by cefdinir.

Warnings:

  • The conversation needs to be made whether the patient has had hypersensitivity reactions to cefdinir before.
  • Clostridium difficile associated diarrhea (CDAD) is observed in some patients with nearly all antimicrobial agents, especially cefdinir. This is occurring by altering the normal flora of the large intestine species leading to overgrowth of difficile.
  • This secretes toxins A and B when these toxins increased in large amount it may lead to morbidity and mortality.
  • Cefdinir should not be prescribed when other antibiotic medication you are undergoing.
  • Patients with renal problems, the amount of cefdinir should be reduced based on creatine clearance rate.
  • Safety and efficacy in babies under 6 months have not been established.

How long does cefdinir take to work?

  • Cefdinir is just a broad spectrum antibiotics acting against bacterial infections. So it should work within 24-48 hours to get rid of fever.
  • For bronchial infection, it takes 48 hours to work but mucous may persist for 3-4 days.
  • For a sinus infection, it takes 1 week for the cefdinir to act. Nasal mucous may persist for another week.

Cefdinir During Pregnancy

Cefdinir is classified under the FDA category B list of drugs during pregnancy. Animal studies have revealed evidence of maternal toxicity (decreased body weight gain) and decreased fetal body weight. There are no controlled data in human pregnancy. Cefdinir should be given during pregnancy only if need is clearly established.

However, there are was no teratogenic effect in rats and rabbits have been reported. When in higher dose (10mg/kg/day) it causes miscarriages in some rabbits and other problems like sudden weight loss. Before taking cefdinir make sure your up to date with your medical reports to your doctor. We cannot predict much with animal studies, it may cause an adverse effect in humans. So taking antibiotics only when needed is encouraged.

Cefdinir During Breastfeeding

Following administration of single 600 mg doses, cefdinir has not been detected in human breast milk. Other cephalosporins have been classified as compatible with breast-feeding by the American Academy of Pediatrics. It is not said to be harmless, but doctor prescription is needed for any drug uptake during nursing.

Cefdinir Overdosage

Overdosage in the case of humans is not available. In the case of rodents, it doesn’t show adverse effect till 5600mg/kg of a single dose. When this level increased, toxic effects were observed and it shows nausea, vomiting, diarrhea, convulsions, epigastric distress, seizures etc. If overdosing causes any sudden effect then doctor consultation is a must.

Remedy: hemodialysis is known to remove cefdinir from the body. So it can be a useful way in the removal of toxicity from the body.

Cefdinir absorption and elimination

Absorption:

Cefdinir is rapidly absorbed from the gastrointestinal tract and it is distributed throughout the body. A drug which reaches the maximum peak in the plasma with the minimal time is the drug which is having good bioavailability. Bioavailability is the amount of drug which is present in the general circulatory system. Cefdinir maximum plasma concentration by capsule and suspension occurs 2 to 4 hours before administering the second dose.

Bioavailability:

  • 300mg capsule dose -21%
  • 600mg capsule dose-16%
  • Suspension dose-25%

Absorption is reduced to 15% late by taking high-fat meal and dairy products.

Elimination:

It is a process through which drug or its metabolites leave the body. Excretion primarily in urine, bile, breast milk, sweat, feces, saliva, tears, exhaled air, renal excretion. Since cefdinir is not metabolized completely its mode of elimination is kidney (renal mode), urine (12% to 18% as unchanged drug). They are excreted with a half-life of 1.1 hours or 2.3 hours.  I.e. plus or minus 1.7

Is cefdinir a strong antibiotic?

Not all the antibiotics, when taken against viral infection, causes a side effect. This cephalosporin class of antibiotic, cefdinir if used an overdose or used against bacterial infection it causes the growth of antibiotic resistant bacteria called as “superbugs”.

When comparing cefdinir and penicillin dosage for streptococcal pharyngitis, the eradication rates at the completion of the therapy were 91.7% in case of cefdinir and 82% in the penicillin group. Thus cefdinir is considered to be strong and broad antibiotic class against Streptococcus pyogenes.

From the recent studies of cefdinir and amoxicillin-clavulanate in the treatment of acute community-acquired bacterial sinusitis, 300mg twice a day and 600mg/day was given to patients using cefdinir and 500mg three times a day was given using amoxicillin. Cefdinir shows 90% cure rates and cefdinir causes fewer side effects compared to amoxicillin treatment.

It is also considered to be the safe class of drugs because it doesn’t belong to the sulfur group of antibiotic.

Is cefdinir a form of penicillin?

Penicillin and cefdinir both belong to beta-lactam class of antibiotics, which inhibits the bacteria by building cell wall using cross-linking. But they should not be mixed together because if you are allergic to cefdinir since it is a close cousin to penicillin family, you will be allergic to penicillin antibiotic also. These antibiotics are known as bactericidal, which kills the bacteria.

Is cefdinir a fluoroquinolone?

Cefdinir and fluoroquinolone (fluorine atom attached to the ring structure) are different classes of antibiotics. Fluoroquinolone belongs to quinolone drug class. It is also a broad spectrum antibiotic isolated from a plant or bacterial sources but they are classified under bacteriostatic which mean it will cleverly stop the bacterial growth and replication.

Infectious disease society of America advised not to use Fluoroquinolones because it encourages the spread of multidrug-resistant strains of clostridium difficult infections. It is not observed much in other antibiotics so all other antibiotics are safe to use. It should be used only if there are no alternative treatment methods.

Is cefdinir a cephalosporin?

Yes, cefdinir belongs to the cephalosporin drug class. It is an orally administering third generation class of antibiotic with more advanced version than a first and second generation. As increasing generations, activity against gram-negative organisms is high but lower gram-positive activity.

Is cefdinir a generic drug?

Yes, cefdinir is manufactured as generic drug earlier by 28 companies and recently by February 2017, there are 56 brands of generics of cefdinir are available.

Is cefdinir a sulfa drug?

Sulfa drugs were no way related to cefdinir. Sulfa drugs were the earliest drug developed in the 1930s for bacterial infections and it worked as “miracle drug” for soldiers in Second World War. Sulfa drugs were effective for pneumonia, leprosy and blood poisoning. Later from the studies, it is clearly shown that too much sulfa use may damage the kidney.

Later penicillin came into play with fewer side effects and people opted for it. If you are allergic to sulfa drugs don’t use cefdinir because it may exacerbate the infection. Doctor advice is important before taking any antibiotics.

Can I take cefdinir for an ear infection?

Yes, it was the first recommended antibiotic for children with an ear infection. Generally, the doctor prescribes cefdinir if your child is allergic to amoxicillin. This can be taken twice or in a single dose. A single dose will be effective but taking twice will be gentler on the stomach. Doctor prescription is essential for using any drugs.

Is cefdinir safe for toddlers?

Newborn of <36 months baby immune system will be prone to bacterial infections caused by Haemophilus species and streptococcus species. A blood test will reveal whether the infection is caused by virus or bacteria and proper antibiotic will be prescribed by the doctor.

From the journal of the American board of family medicine report in 2008, it shows that cefdinir causes red stools in infants taking antibiotic along with iron supplements or iron-fortified formula (breast milk). So the safety of cefdinir in infants is not known. Parents should report

Cefdinir Half Life? How long Cefdinir stay in your system?

The half-life of a drug is the time taken for the drug to reduce to half its original value. Here cefdinir has a half-life of 1.1 hours or 2.3 hours (plus or minus 1.7). Let us consider 2.3 hours if a person consuming 10mg of medicine at 8 pm then by 10 pm there will be 5mg and by 12 pm they will be 2.5mg remaining in your system.

Half life is dependent on how fast the drug is eliminated from the body. Before elimination, the drug can be translocated to the different fluid compartment or it may get destroyed in the blood.

Is it safe to take cefdinir with alcohol?

  • Since cefdinir causes dizziness and drowsiness this effect may get worse taking alcohol along with it. People should avoid using sharp motor tools or driving.
  • The sensitivity of cefdinir can cause some gastrointestinal problems like vomiting, stomach upset etc. this is because some cells in the gastrointestinal tissue may get replicated by the action of this drug and the bacterial community gets affected. Here alcohol can irritate the GI tract causing the release of stomach acid thereby affecting GI tract.
  • It may increase side effects like difficulty in passing urine, fever, some allergic reactions.
  • Certain cephalosporin antibiotics may cause breakdown of alcohol in the liver. It simultaneously causes nausea, flushing, and vomiting.
  • Cefdinir sometimes loses its function of fighting against bacteria in the presence of alcohol. So the bacteria get resistant to the drug making infection lasts longer with more side effects.

Is it safe to take cefdinir along multivitamins with minerals?

It is not advisable to take cefdinir with iron supplements because iron can bind with cefdinir in your stomach or intestines decreasing the efficacy ( the ability of a drug to initiate cellular effect) of the drug. It also affects the absorption capacity of the drug making the drug less effective.

Take cefdinir 2 hours before or 2 hours after taking multivitamins with minerals. Consult your pediatrician before changing dosage level or discontinuing any medicines.

Is it safe to take cefdinir and Motrin, Advil together?

Both these drugs belong to same drug classification. They are the generic forms of ibuprofen. There are no specific interactions or there are minor interactions between these classes of drugs. Motrin and Advil belong to the nonsteroidal anti-inflammatory agents (NSAID) drug class. It works by reducing hormones which cause fever, pain, and inflammation in the body. It is proven to be used by the infants above 6 months.

Can I use cefdinir if I have renal impairment?

After administering cefdinir, it gets excreted in few hours in patients with kidney problems and it shows the beta-lactam antibiotics are showing less effect. From the studies, it also shows that serum concentrations of antibiotics are increased and there is prolonged half-life in some patients.

It may delay the curing period of kidney problem. Renal function tests should be taken regularly when every side effect appears and when changing dosage chart. Nephrotoxicity was not observed in cefdinir usage.

Can I use cefdinir if I have renal disease?

Jaundice and elevated liver enzymes level (Hepatotoxicity) was well recognized in a patient after administering cefdinir for streptococcal It may be due to the overdosage of cefdinir because the patient was advised to take cefdinir 300mg for 10days.

He completed the dosage 5 days prior to presentation. The sudden rise in alkaline phosphatase level was observed. So precaution is necessary while administering cefdinir in patients with liver disorders.

Can I use cefdinir if I have seizure disorders?

Several cephalosporin drugs known to enhance seizures (sudden attack), especially in patients with renal dysfunction. It is observed when the dosage was not maintained properly (overdose). If seizure appears, with doctor advice cefdinir should be discontinued.

Can I use cefdinir if I have colitis?

Pseudomembranous colitis is observed in patients using broad spectrum antibiotics (cefdinir) because it may alter normal microbial flora and causes overgrowth of Clostridium difficult. So caution should be handled in patients with gastrointestinal disorders while administering cefdinir.

Can I take cefdinir with cholera vaccine?

Live vaccines are generally defined as using weakened form of the virus but still keeping it effective (viable). Avoid using antibiotics with the vaccine because it will decrease the therapeutic effect of vaccination. The doctor will give you an idea on how to alternatively use antibiotics when taking vaccine treatment.

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Prenatal vitamins and minerals

May 15 2017 Published by under Vitamins

What are prenatal vitamins?

Can you take prenatal vitamins if you are not pregnant?

The word prenatal itself denotes anything relating to pregnant women and their unborn child. Prenatal vitamins are important part of prenatal healthcare. These basically consist of range of vitamins and minerals that are vital for the healthy development of the baby. These are similar to other multivitamins that are usually available in market but the composition is different.

Why prenatal vitamins are important?

According to American Dietetic Association, prenatal vitamins have been recognized for the healthy pregnancy outcome. These vitamins should be an important part of the child bearing women, not only to have a safe pregnancy but also these help to cover any nutritional gaps in the mother’s diet. It also aids in filling up the deficiencies of mother’s body.

The fetus during this time period, if supplied with the required nutrients in sufficient amount, will lead to the healthy proper development of the organs and body parts.

Those mothers who are going through a complicated pregnancy or suffering from other health issues concomitantly are often prescribed to take these vitamins on a regular basis.

Many women, start taking these vitamins just before conceiving as it makes easier for the woman to conceive when her body is sufficient in nutrients. Neural tube defects such as Spina Bifida can develop in an embryo even before a woman comes to know about her pregnancy.

What’s in a prenatal supplement that I can’t get from food?

Prenatal vitamin combinations that are available in market are variable, each depending on the nutritional focus. For instance, one manufacturing company have prepared the combination focusing on the anemic pregnant women thus keeping the iron content in the combination a slightly higher in amount than other minerals and vitamins.

Obtaining nutrients from food should be the first priority, but because nowadays food that is available is processed. During the processing of food, certain important vitamins and minerals are removed and if the expecting mother constantly consumes processed food, she might get deficient in vitamins. However, certain important compounds needed by the body are not available in these multivitamin supplements, such as fiber.

These are available only through food. It is important to bring this in the knowledge of child bearing mothers that these prenatal vitamins are not used to correct a poor diet; instead it supplements a good one.

Folic Acid use during Pregnancy

Folic acid is a synthetic derivative of a B vitamin, folate. Folate helps in the production of red blood cells and helps in the development of the spinal cord and brain of the fetus. Birth defects especially due to folate deficiency occur within the first 3-4 weeks of pregnancy, thus making it necessary to have enough folate in body before this phase to prevent any defects.

Pregnant women are at increased risk for folate deficiency due to too little stores, increase maternal, fetal demand on folate stores and inadequate dietary sources. During pregnancy, the daily requirement for folate increases from 100-150µg to 200-400µg.  The CDC recommends that the woman should start taking folic acid every day a month before getting pregnant and on a daily basis during pregnancy.

During the forth – ninth month of pregnancy the recommended dose is increased up to 600 µg. Good sources of folate are green vegetables. Folic acid itself helps the body with production and maintenance of new cells and helps to prevent any possible changes in DNA that would lead to cancer. Folic acid has been consigned in A pregnancy category by FDA.

It is also used to treat megaloblastic anemia. Studies have failed to reveal any harm caused by Folic acid to the mother or child when the dose is increased. However if the mother is deficient in folic acid, it may lead to problems of brain (anencephaly) and spinal cord (spina bifida). Folic acid is actively excreted and colostrum and breast milk but no adverse effects have been observed in infants feeding on mothers’ milk.

Iron use during Pregnancy

In those who have reached puberty, gradually the iron stores become depleted and reach on the lower end of the margin. This is due to the loss of iron from the body due to menstrual cycle. According to the survey conducted by WHO, an estimated 35-75% of women in developing countries and 15% in industrialized nation get anemic during their pregnancies.

The requirement of iron in body increases during pregnancy by almost 1g, over the normal body store of 2- 2.5g in adult women. Iron is needed most during the early second trimester and peaks in the second half of pregnancy. Fetal and placental requirement for iron stores are met according to the need, even if the mother is anemic the fetus will not suffer.

If iron stores are depleted or very low, then iron is not available for the synthesis of red blood cells (RBCs), the maternal RBCs won’t increase, hence decreasing the hemoglobin. During pregnancy, dietary sources and maternal stores alone are not sufficient to meet the pregnancy demands. In later pregnancy, stores are exhausted. It becomes a necessity for the mothers to be to take supplemental iron too.

For a pregnant woman, 27mg of iron are required per day. Iron has been categorized under the pregnancy category C, which means that it should only be administered when benefits dominate over risks. Use is contraindicated in the first trimester of pregnancy.

Moreover, if the daily intake is more 45mg, it will cause the blood levels of iron to rise increasing the chances of bringing harm to the mother or child or even both. According to studies, increase in serum iron levels has caused gestational diabetes or oxidative stress that has thought to play an important role towards the infertility, preeclampsia and even miscarriage.

Calcium use during pregnancy

Calcium is the most abundant mineral present in the body which is necessary for various functions such as bone formation, muscle contraction, enzyme and hormone functioning. Calcium absorption is maximum during the period of pregnancy. A dietary intake for calcium of 1200mg/day is recommended by WHO and FAO.

Inadequate consumption will cause the calcium stores to deplete over time when the demand increases. As a result of depletion of Calcium, severe adverse effects are observed on mother and fetus. These effects include osteopenia, tremor, muscle cramping, paresthesia, delayed fetal growth, poor fetal mineralization and low birth weight.

Calcium also reduces the risk of hypertension and preeclampsia. If the intake of calcium mineral is not available then the babies will take it from mother’s bones leading to the impairment in mother’s bones. In babies, it helps to develop a normal heart rhythm and blood clotting abilities. Supplemental calcium should not increase more than 500mg.

It comes in different salt combinations such as Ca citrate, lactate, gluconate etc. All pregnant women, particularly those having hypertension and osteopenia in their family histories should take these supplements daily, esp. from 20th week of pregnancy till the end.

However, like iron, Calcium is also assigned under pregnancy category C, only prescribed when benefits are more as compared to risks. A total intake of calcium from food, supplements and even water should never exceed 2500mg per day otherwise it will cause constipation, iron and zinc absorption is hindered and increases the chance of formation of kidney stones in mother.

Vitamin D use during pregnancy

Vitamin D is a steroid vitamin and derived from water soluble, pro-hormone. The most important subtypes of vitamin for the development of human are vitamin D2 and D3. Vitamin D2 is responsible for the absorption of mineral including Calcium, iron and zinc from the stomach, whereas vitamin D3 is commonly present as supplements. Vitamin D is a vital component in the prenatal vitamins.

Women bearing child should be given these supplements not only for their own well being but also for the complete development of baby’s organs and body parts. According to the studies, vitamin D has proved to be beneficial in immune system, healthy cell division and better bone formation. It is usually given along with Calcium supplements to enhance their absorption and metabolism. Most prenatal vitamins contain about 400IU.

High risk women are advised to take at least 1000 units each day. High risk population includes those which have increased skin pigmentation, are minimally exposed to sunlight or are obese. Deficiencies of vitamin D have been recently contributed towards preeclampsia, gestational diabetes, preterm birth, and low birth weight. Sunlight is the major source for vitamin D.

According to FDA, it has been allotted under category C, limiting its ucalcse only when there is deficiency and according to the case of the patients, benefits outweigh risks. Babies born with vitamin D deficiency develop rickets gradually if no measures are taken to fill the gaps. Low maternal vitamin D levels have also caused fetal lung development failure and childhood immune disorders such as asthma.

Hypovitaminosis D is also associated with impaired glucose tolerance and has caused diabetes in general population. Studies have reveled fetal abnormalities when vitamin is taken in excess.

Abnormalities similar to supravalvular aortic stenosis syndrome are developed in babies. A major drawback is that the precise amount of ingested vitamin D and time of exposure to sunlight that will cause hypervitaminosis D is not known to any degree of certainty. So when the diet is balanced, supplementation is not required. How does vitamin D aid in calcium absorption?

Vitamin E use during pregnancy

Vitamin E is an anti-oxidant which means that it slows down the processes that damages the cells of our body. This allows for the proper function of many organs in the body.

Vitamin E usage in pregnancy helps avoid gestational diabetes and preeclampsia in the mother. In the fetus, it helps maintain cellular structure and this is vital since at that stage the cells are dividing very rapidly. There is also decreased incidence of low birth weight babies with vitamin E usage. It also promotes eye development.

Recommended dose in pregnancy is 400 IU with vitamin C 1000 mg daily. Taking excess vitamin E may cause harm to the mother and fetus. Similarly since it is excreted in human breast milk, it should not be taken when breastfeeding premature babies.

Vitamin E shows interactions with the following drugs

  • Warfarin, heparin, anti-platelets such as clopidogrel and NSAIDs such as aspirin: Vitamin E may increase the risk of bleeding when taken with these drugs
  • Cyclosporine: Vitamin E increases the absorption of cyclosporine. This will cause increased side effects of cyclosporine on the body
  • Medications metabolized by the: Vitamin E increases metabolism of these drugs, as a result more drug will now be required for achieving the same effect.
  • Medications for cancer (Chemotherapy): Vitamin E decreases their effect on the body as it is an anti-oxidant.
  • Medications used for lowering cholesterol (Statins and niacin): Exact cause is unknown

Thiamine use during pregnancy

Thiamine or vitamin B1 is a water soluble vitamin which combines with adenosine triphosphate (ATP) to form a coenzyme, thiamine pyrophosphate, which is required by our bodies to properly use carbohydrates

During pregnancy, it plays an important role in the development of fetus, particularly the development of nervous system. It is also given during the management of hyperemesis gravidarum (uncontrolled, intractable vomiting during pregnancy).

Thiamine has been put into pregnancy category A by FDA i.e.it should only be used during pregnancy when benefit outweighs risk. The recommended daily allowance (RDA) for thiamine during pregnancy is 1.4 mg/day (regardless of a woman’s age).

Women carrying twins or more fetuses need to take more. Thiamine is not excreted in breast milk so it may be taken in lactation without fear of harming the baby. Natural food sources of vitamin B-1 include pork, peas, pastas, yeast, and even some dairy products.

Vitamin B1 shows interactions with antihypertensive and antidiabetic drugs. In both cases the effect of these drugs is enhanced which will result in hypotension and hypoglycemia respectively. Minor interactions may be seen with P450 inhibitors since thiamine is metabolized by liver.

Riboflavin use during pregnancy

Riboflavin, or vitamin B2, functions as a coenzyme, meaning that it is required for enzymes of our body produce energy.

It is a water-soluble vitamin that promotes your baby’s vision, growth, and healthy skin. It is also needed for the muscle, bone, and nerve development of the fetus.

Usually you can get all the vitamin B2 you need through your diet as it can be found in certain foods such as milk, meat, eggs, nuts, enriched flour, and green vegetables. Riboflavin is LIKELY SAFE for mother and baby when taken in the amounts recommended.

The recommended daily dose for pregnant women is 1.4 mg per day and 1.6 mg per day for breast-feeding women. When taken by mouth in larger doses and for short-term only, riboflavin is POSSIBLY SAFE. Some studies argue that riboflavin is safe when taken at a dose of 15 mg once every 2 weeks for 10 weeks.

Vitamin B2 shows interactions with the following drugs

  • Drying medications (Anticholinergic drugs): These drugs increase the time riboflavin stays in the intestine increasing its absorption.
  • Medications for depression (Tricyclic antidepressants): After chronic use of these drugs, they decrease the amount of riboflavin in the body.
  • Phenobarbital: It increase how quickly riboflavinis broken down in the body
  • Probenecid: It increases absorption of riboflavin in the body

Niacin use during pregnancy

Vitamin B3, also called niacin, is present in two forms – nicotinamide and nicotinic acid. Both compounds are precursors of the coenzymes  NAD and NADP. NAD is important in catabolism of carbohydrate, protein, fat, and alcohol, as well as cell signaling and DNA repair, and NADP is important in anabolism reactions such as fatty acid and cholesterol synthesis.

During pregnancy niacin helps ease nausea, subside a painful migraine and improves digestion. It is also beneficial for the fetus as it helps to keep the skin, nervous system and mucous membrane healthy and is critical for brain development.

The recommended amount of vitamin B3 during pregnancy is 18mg per day but you can take up to 35mg per day. Intake of more than 35mg has not been studied in pregnant women, therefore it is not recommended.

The U.S. Food and Drug Administration (FDA) assigns oral niacin Pregnancy Category C meaning that it has not been fully studied on pregnant humans and animals.

Niacin shows drug interactions with the following drugs:

  • Alcohol
  • Allopurinol
  • Carbamazepine
  • Clonidine
  • Antidiabetic drugs
  • Medications used for lowering cholesterol such as Statins, ezetimibe, and bile acid sequestrants such as colestipol
  • Primidone
  • Probenecid
  • Aspirin

Vitamin B12 use during pregnancy

Vitamin B12, also called Cobalamin, also functions as a coenzyme, meaning that its presence is required for enzyme-catalyzed reactions.

Vitamin B12 has several functions when given to a pregnant mother. In the mother, it is essential for the synthesis of fatty acids and myelin, which help in maintaining the normal neurological function and central nervous system (CNS). It aids in harvesting energy from food substances by metabolizing carbohydrates, proteins, and fats and thus improves your mood, energy levels and stress levels when you are expecting.

In the growing fetus, it aids in functioning and development of red blood cells, brain, and nerves and at micro level plays role in DNA synthesis. It also plays a major role in fetus brain development and neural tube formation

The recommended daily dose of vitamin B12 is 2.6 mg during pregnancy and taking vitamin B12 along with folic acid is effective. Natural food sources for vitamin B12 include milk, eggs, meat, fish, poultry and shellfish.

The only major drug interaction of vitamin B12 is with chloramphenicol. Vitamin B12 is needed for producing new blood cells whereas chloramphenicol might decrease new blood cells. So taking chloramphenicol for a long time might decrease the effects of vitamin B12 on new blood cells.

Zinc use during pregnancy

Zinc is another trace mineral present in many foods. It is required by over 200 metalloenzymes, including carboxypeptidase A, carbonic anhydrase, alkaline phosphatase, alcohol dehydrogenase and RNA polymerase.

It is also required to maintain structure in cell membranes, proteins, and nucleic acids.  Physiological functions that are dependent on zinc include cell growth and division wound-healing, host immunity, sexual maturation and reproduction, dark adaptation and night vision, taste acuity, and possibly olfactory acuity

The recommended daily allowance of zinc during pregnancy is 11 mg; although the upper intake limit is 40 mg. Red meat and fortified cereals are good sources of this nutrient. Shellfish, poultry, beans, nuts, whole grains, and dairy products are also other natural sources for zinc.

Zinc interacts with the following drugs:

  • Tetracycline and Quinolone antibiotics: Zinc might decrease how much antibiotic the body absorbs. If you’re taking zinc, take antibiotics at least 1 hour after.
  • Cisplatin: It is a chemotherapeutic drug- zinc increases the effects and side effects of cisplatin
  • Penicillamine: Penicillamine is used for rheumatoid arthritis and Wilson’s disease. Zinc decreases the amount of penicillamine your body absorbs and decrease the effectiveness of penicillamine.
  • Amiloride: It is a diuretic. It increases the amount of zinc that is present in the body.

Iodine use during pregnancy

Iodine is used by the thyroid gland for iodination of thyroglobulin molecule, which is then broken down by enzymes to release thyroid hormones. These hormones play an essential role in the development of CNS, skeletal system and muscles. These hormones also play a vital role in metabolism. So deficiency of iodine will result in hypothyroidism, short stature and course facial features.

The recommended daily allowance of zinc in pregnancy is 220 mg and 290 mg for lactating/breastfeeding women.  Iodine is LIKELY SAFE when it is taken in recommended amounts by the oral route; however Iodine is POSSIBLY UNSAFE when taken by mouth in high doses.

prenatal vitamins and minerals in pregnancy

Iodine interacts with the following drugs:

  • Antithyroid drugs: Taking iodine along with antithyroid might decrease the thyroid too much
  • Amiodarone: It contains iodine so taking iodine supplements along with amiodarone might cause excess iodine in the blood.
  • Lithium: Lithium causes hypothyroidism. Simultaneous use of lithium with iodine may have synergistic hypothyroid effects.
  • ACE inhibitors, Angiotensin receptor blockers (ARBs) and potassium sparing diuretics: These classes of drugs cause potassium retention. Most iodine supplements contain potassium therefore concomitant use of potassium iodide along with these drugs might cause hyperkalemia.

Essential fatty acids use during pregnancy

Essential fatty acids are those fatty acids that cannot be produced by the body so they must come from your diet. The two primary EFAs alpha-linolenic acid (omega-3) and are linoleic acid (omega-6).

Omega-3 fatty acids are essential for fetal CNS and PNS development, the timing of gestation and birth weight of the baby.  Omega-3 fatty acid eicosapentaenoic acid (EPA) may play an important role in DHA transplacental transport and intracellular absorption

Docosahexaenoic acid (DHA), an omega-3 fatty acid is a major structural fat in the human brain and eyes. About 93% of all omega-3 fats in the retina and 97% of all omega-3 fats in the brain are DHA.

It is particularly important during the third trimester of gestation and up to 18 months of life.

Another thing to keep in mind is that the balance between omega-3 fatty acids and omega-6 acids is important too.

Pregnant women likely have an increased need for essential omega-3 fatty acids compared with women who are not pregnant. Fish is an excellent source of both EPA and DHA, but its serving is restricted to 2 per week due to risks of mercury poisoning. Each serving should not exceed 6 ounces and may contain shrimp, salmon, pollock, catfish, scallops, or sardines.

A good alternative are the fish oil supplements, which contain either both EPA and DHA, or DHA alone. Algae-derived DHA-only oils are good, mercury-safe means of supplementing the diet of a pregnant woman.

When should I start taking prenatal vitamins?

It is recommended that you should start taking prenatal vitamins even before you are pregnant. This ensures that the health of the mother is at an optimum level even before she conceives. Taking them while you’re trying to conceive is always great and has proven to decrease the prevalence of congenital anomalies. Usually mothers are already taking one of the many multivitamins available OTC.

Although this too is sufficient before pregnancy, but once pregnancy is confirmed, you should switch to pregnancy-specific vitamins since they contain the right amount of each vitamin unlike the other multivitamins which are known to have decreased amount of folic acid.

However, if you’re pregnant, and have not started taking your vitamins, and are now panicking by reading the above paragraph, then please don’t. All is not lost- there are a number of people who are not taking prenatal vitamins when they find out that they are pregnant. The best course of action is that you should just start immediately.

Do prenatal vitamins have any side effects?

All medicines may cause side effects, but majority of mothers who are taking prenatal vitamins have no, or just minor side effects. Consult your doctor if any of these most common side effects persist or become bothersome:

  • Constipation
  • dark or green stools
  • diarrhea
  • loss of appetite
  • nausea
  • vomiting
  • stomach cramp
  • pain
  • GI upset

Serious side effects with these vitamins which are reported by less than 5% of all mothers taking these vitamins:

  • Severe allergic reactions characterized by any of the following: rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue
  • black, tarry stools
  • blood or streaks of blood in the stools
  • fever
  • severe or persistent nausea
  • stomach pain
  • Vomiting; vomit that looks like blood or coffee grounds.

Please note that this not a complete list of all side effects that may occur. Therefore it is recommended that you report your doctor or midwife any of the side effects which you feel are due to these vitamins.

Can prenatal vitamins upset my stomach?

Prenatal vitamins, particularly iron may cause GI disturbances in some mothers. These disturbances vary in intensity. Common disturbances include diarrhea, flatulence, bloating, dyspepsia or nausea. However due to the immense importance of these vitamins for the fetus, it is never recommended to leave your prenatal vitamins to stop these side effects. The recommendations which are given in such a case are as follows:

  • Change your brand.
  • Try taking them after a meal rather than on an empty stomach.
  • Dairy products interfere with the absorption of vitamins and minerals; therefore avoid taking your vitamins with milk.
  • Smoothies made without dairy or Juices with no added sugar maybe used more often. The juice, a liquid can help reduce constipation the prenatal vitamins may cause. Similarly, smoothies made with fruit add fiber, which also help relieve constipation.
  • Iron is the most offensive agent out of all the prenatal vitamins. Anemic women do not need more than 30mg of iron per day. So reducing the amount of iron in a non-anemic patient is also desirable.

What if my Prenatal Vitamin Makes me Nauseous?

The common nausea causing ingredients in prenatal vitamins are iron and folic acid.

During pregnancy, your blood volume increases by about one third so extra iron is need for extra blood production. Without it you will face symptoms of anemia such as fatigue and lethargy. The folic acid is included to reduce the risk of birth defects of the brain and spinal cord. So it is essential to take your vitamins, but to reduce the feeling of nausea following can be done.

  • If you are not anemic and your vitamin contains extra iron, switch to one with less
  • Break the tablet in half and take it in divided doses
  • New studies indicate that vitamin B6 helps relieve nausea in some women during pregnancy so make sure that your prenatal vitamin contains vitamin B6.
  • Finally, if you just can’t stomach prenatal vitamins, try to make sure you at least get you take 400 micrograms (mcg) of folic acid daily if you’re trying to get pregnant, and 600 mcg when you are pregnant. Use various calculators present on the internet to calculate whether you are taking sufficient iron and folic acid in your diet.

Prenatal vitamins interactions with other drugs

A list individualized of drug interactions is given in the description of the various vitamins and mineral above, however for convenience purposes we have made a list of drugs which will cause interactions with your prenatal vitamins.

Known drug interactions of prenatal vitamins exist with methyldopa, chloramphenicol and other vitamin/nutritional supplements. It decreases the absorption of other drugs such as penicillamine, levodopa, bisphosphonates (for example, alendronate), quinolone antibiotics (for example, ciprofloxacin, levofloxacin), thyroid medications (for example, levothyroxine), and tetracycline antibiotics (for example, doxycycline, minocycline).

If your multivitamin also contains folic acid, inform your health care provider if you take anti-seizure drugs.

Contraindications during prenatal vitamins and minerals use

Prenatal vitamins are contraindicated when mother has any of the following conditions:

  • Diverticular Disease
  • Ulcer from Stomach Acid
  • Ulcerated Colon
  • Inflammation of the Lining of the Stomach and Intestines
  • Several Blood Transfusions,
  • Iron Metabolism Disorder causing Increased Iron Storage
  • Increased Bodily Iron from High Red Blood Cell Destruction, Hemolytic Anemia
  • Known allergic to iron supplements

Why is vitamin A harmful for the baby? Are there any other vitamins that can harm my baby?

Vitamin A is needed for epithelial growth. Its deficiency leads to xeropthalmia of eyes, anemia, and lowered immunity. In children it causes growth retardation and development. However a problem arises when vitamin A is consumed too much.

Studies have shown that taking an excess amount of vitamin A in pregnancy may cause congenital anomalies that include deformities of the skull, eyes, heart, and lungs. These studies were performed using very high amounts of water-soluble, synthetic forms of vitamin A which is from non-food sources

A number of food products are fortified with preformed vitamin A, therefore pregnant women should avoid so the best way to avoid this teratogenic effect is avoid synthetic forms and take it from food sources (A number of food products are fortified with vitamin A). If vitamin A is present in other multivitamins or prenatal supplements that contain more than 1,500 mg (5,000 IU) of vitamin A, then those supplements should be replaced with other supplements immediately.

Apart from vitamin A, no other vitamin is known to cause fetal anomalies.

Is beta carotene during pregnancy safe?

Vitamin A exists in two forms. Preformed vitamin A and provitamin A carotenoid.

Performed vitamin A, also called retinol or retinoids, are found in animal products, such as milk, eggs, liver, fortified food products and vitamin supplements, including prenatal vitamins.

Caroteniods are found in carrots, cantaloupes, spinach, kale and sweet potatoes. Beta-carotene, alpha-carotene and beta-cryptoxanthin are the caroteniods that can be converted to vitamin A in the body include. Beta-carotene is generally the preferred carotenoid for vitamin A consumption, because it is converted to vitamin A more efficiently than the other carotenoids and hence the most safe for use in pregnancy.

Is Vitamin A Dangerous for My Pregnancy and Baby

What if I accidentally take two prenatal vitamins on the same day?

Accidentally taking two prenatal vitamins in a day is actually not that uncommon. A number of women do that. The good news is that doing so is pretty harmless as long as you don’t make it a habit. Even vitamin A is harmless if this accident happens 1, 2, or 3 times in a pregnancy, and that is one vitamin that is actually teratogenic when taken in excess.

Our bodies are designed to absorb only a fixed amount of nutrients that we eat. The rest is defecated. And even if an excess is absorbed, then our kidneys filter out the blood of those nutrients, so all that extra vitamin is excreted as urine. Therefore two vitamin pills for one day have no effect on either the mother’s body or on the fetus.

An easy way to overcome this problem is to buying a small 7 day pill-case. Each case has about 7 compartments, one for each day. Fill up that case every 7 days, and if you see that the compartment is empty for a particular day, it would mean that you have already taken your vitamin for that day.

Which brands of prenatal vitamins are best?

A physician will usually make a recommendation on this regard and write a prescription for you. On the other hand, over-the-counter vitamins are also available at the pharmacy.

While there are many brands available, a good multivitamin will contain all the vitamins in appropriate quantity, choose a prenatal vitamin that includes:

  • folic acid
  • iron
  • calcium
  • vitamins D, C, A, and E
  • zinc
  • copper

Other criterion on which to base your choice should include:

  • raw ingredient quality: is it food-based, organic or synthetic
  • Manufacturing protocols: does the company employ FDA approved methods in manufacturing.
  • Value for money: it shouldn’t be very expensive
  • Lab test results and rating: what do independent labs say about them
  • Customer feedback

Some of the top rated and hence most commonly used prenatal vitamins are:

  • Baby and me by MegaFood
  • Baby and me 2 by MegaFood
  • Zahler prenatal vitamin + DHA
  • Perfect prenatal vitamin by new chapter
  • Vitamin Code Raw Prenatal by Garden of Life
  • Thorne Research Basic Prenatal Multivitamin
  • Maxi Pre-Natal by Country Life
  • Pre-Natal Care Multivitamins by TwinLab
  • Prenatal One Multivitamin by Rainbow Light
  • Prenatal Multivitamin by Nature Made
  • Gummy Prenatals by Vita Fusion
  • Once Daily Prenatal Multivitamin by Solaray
  • Prenatal Multivitamins by Spring Valley
  • Complete Prenatal System by rainbow light

Top Prenatal Vitamins

Best over the counter prenatal vitamins vs prescription

MegaFood Baby And Me Prenatal Multivitamin

Baby And Me by MegaFood is a food based an organic vitamin. A lot of people avoid taking synthetic vitamins in their pregnancy, so this is ideal for them. Since it is organic, there is a less chance of getting nauseas or other GI disturbances after their consumption. Customers have reported a number of advantages of using this vitamin.

The most common positive comment about this brand was how mothers feel more safe in using an organic vitamin brand, which contains folate instead of folic acid (folic acid is more spurious for your stomach than folate). Some users also reported a significant difference in growth patterns of their nails and hair.

On the other hand, there was also a lot of critique present for this vitamin. The pill is very large and hence difficult to swallow for some. It has a bad smell, and may also cause your urine smell. The dosage is 4 pills daily, so overall it may become expensive to use. There is also the fact that the idea of taking 4 pills a day could be real bummer for some mothers.

MegaFood has also introduced Baby and Me 2, whose dosage is only 2 pills per day it is expensive than its predecessor.

Garden Of Life Vitamin Code Raw Prenatal Multivitamin

Vitamin code has one of the best customer feedbacks on the internet. Amazon customers give it a rating of 4.5 out of 5 stars and lab-door scores it at 86 out of 100.

The fact that the ingredients are comprised of raw whole-foods makes digestion and absorption much easier. It is classified as an organic and non-GMO vitamin.  So you should give this vitamin a try if you’re having dyspepsia with your current vitamin.

Extracts of dozens of different fruits, vegetables, and sprouted seeds are also included to cover up any deficiencies in dietary intake of nutrients present in these fruits and vegetables..There is also addition of ginger root and active bacterial culture to reduce the incidence of morning sickness and stomach troubles that sometimes accompany pregnancy.

Users complaining of constipation with this vitamin are common because it contains iron (though it’s the amount recommended by WHO). There are complaints about its taste as well.

Zahler Prenatal Vitamin + DHA

Zahler’s prenatal vitamin formulation is another highly rated prenatal vitamin. Amazon users give it 4 stars and labdoor scores it at 82.6. It contains a concentrated dose of many of the critical vitamins and minerals for pregnant women. The various forms of vitamin B are present at anywhere from eight to sixteen times the recommended daily dosage for pregnant women.

Apart from vitamin B complex other essential vitamins and minerals are also provided at 200% of their daily intake or more. So while the recommended dosage is 2 softgels a day, there is no reason you can’t go with only one softgel and fulfill your daily needs.

Almost all of the minerals are present as easily absorbed salts amino acid chelates, therefore the bioavailability of the ingredients is very high.

The capsule is made from gelatin, two oils, and natural coloring. This simple and natural formulation results in fewer side effects than a number of other multivitamins.

The inclusion of omega 3 fatty acid DHA in an amount of 250 mg is an unusual aspect of the formulation.  However it must be noted that while all other vitamins are present above the level of recommended daily intake values, the 250mg amount of DHA is lower than recommended and therefore must be taken in diet.

Thorne Research Basic Prenatal Multivitamin

Basic prenatal vitamin from Thorne Reseach is another top selling prenatal vitamin formulation. Amazon users give it 4.2 stars and labdoor scores it 81.8.

A unique point about its formulation is that vitamin B12 levels are through the roof at 3,333% of your recommended daily intake.

Vitamin B12 is one of the essential vitamins for preventing neural tube defects, a very serious birth defect that can occur when intake of these vitamins is low so it’s likely their intent is to increase blood levels of vitamin B12 as rapidly as possible during pregnancy, especially since neural tube defects can occur within the first few weeks of conception.

Another possible reason for such high levels could be that recent scientific research has questioned the levels of the recommended daily intakes for vitamin B12. New studies have found that there is still an increased risk occurs with the current recommended levels of vitamin B12 intake   and hence there should be an increase in the recommended dose.

Other essential vitamins and minerals are present in the expected 100-250% of the recommended daily intake. However metal mineral content is pretty high: 45 mg of iron (on the high end), 200 mg of calcium (could inhibit iron absorption somewhat), and moderate amounts of other minerals.

New Chapter Perfect Prenatal

New Chapter’s Perfect Prenatal multivitamins is another top of the line formualtion. Customer feedback on amazon gives it a whopping 4.5 stars.

The vitamins are fermented with amino acids, live probiotics, and other co-factors. The net effect of their presence is that they enhance the absorption of the vitamins. These prenatals come with enzymes which aid the digestive process. The multivitamins are certified by NSF International depicting a high quality production method.

New Chapter flagship vitamins are not derived from real. Their method of production simply involves converting conventional vitamins into a more “natural” form through a culturing process involving yeast. Furthermore, although the company claims that the formulation contains organic fruits and vegetables, the truth is that organic bled is no more than 5% of the total capsule volume. 95% of the ingredients are non-organic ingredients.

This formulation is missing some key ingredients like calcium and Omega-3 fatty acids, so their supplementation is needed through another source to prevent congenital anomalies in the baby.

Prenatal vitamins overdose

An overdose on prenatal vitamins is a rather uncommon presentation in the emergency room. However, it is a real possibility and hence here we discuss the possible causes of overdose. It is important here to mention that almost all cases of overdose are accidental, and so they may happen to anyone if care is not taken. Also note that it is usually a chronic case, rather than acute poisoning.

Perhaps the most common cause of overdose is when you choose to supplement your diet with synthetic nutrients and are not keeping track of the daily amounts you take. Therefore it is important to let your health care provider know about your diet so that he can prescribe you that vitamin which is suitable for you.

Another cause of overdose is forgetfulness, the mother forgets that she has already taken her dose for the day and takes another. When this happens for more than a couple of weeks, signs of toxicity will start to appear.

Toxicity of vitamin A is particularly harmful for the fetus.

How much b12 can you take in a day? when is the best time to take vitamin b12?
Can you take probiotics and prenatal vitamins together?

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Phenobarbital – Uses, Dosage, Side effects and Interactions

May 13 2017 Published by under Medicines

What is Phenobarbital?

Phenobarbital is a Generic name for an anti-seizure drug. It is recommended  from World Health Organization (WHO) for the treatment of epilepsy. It is also used to treat insomnia, and as a sedative to treat tension or anxiety.

In recent times, the usage of this medicine has evolved to cure certain types of seizures in young children and to control bilirubin level in the body of a newly born infant. It is also known as phenobarbitone or phenobarb and has antipsychotic property.

What is Phenobarbital molecular formula and weight?

phenobarbital chemical formula

Phenobarbital belongs to the class of organic compounds known as barbituric acid derivatives. These are compounds containing a perhydropyrimidine ring substituted at C-2, -4 and -6 by oxo groups.

IUPAC name – 5-ethyl-5-phenyl-1,3-diazinane-2,4,6-trione

Molecular formula – C12H12N2O3

Molecular weight – 232.239 g/mol

Phenobarbital 3D fmolecular formula:

phenobarbital solubility in water

Phenobarbital drug class

Phenobarbital is a barbiturate, usually used as antiepileptic drugs.

How does Phenobarbital work in the body?

Phenobarbital is a derivative of barbituric acid and works by slowing down the brain and nervous system. It activates the gamma-antibutyric acid (GABA) A-receptor by binding with them, thereby mimicking the inhibitory actions of GABA in the brain.

The activation effect is associated with the rapid influx of chloride ions in nerve, membrane hyperpolarization leading to synaptic inhibition and decreased neural excitability, thus reducing tension and anxiety. Direct blockage of excitatory glutamate also contributes to the anticonvulsant/hypnotic effect.

phenobarbital mechanism of action gaba

Phenobarbital brand names

There are 48 brand names for Phenobarbital in the market. Some of the trusted ones are listed below:

  • Barbinol (tablet) – Human Antibiotic pharmaceuticals Pvt Ltd.
  • Barbinol 100, 200 (injection) – Human Antibiotic pharmaceuticals Pvt Ltd.
  • Epitan (tablet) – Reliance Formulation Pvt. Ltd.
  • Gardenal (tablet) – Piramal Healthcare
  • Gardenal (syrup) – Piramal Healthcare
  • Phenetone 60 mg (tablet) – Cipla Healthcare
  • Phenobarbitone sodium (injection) – Nicholas Piramal India Ltd.

What is Phenobarbital used for?

  • Phenobarbital is used for treating certain types of epilepsy.
  • It is the first-line drug for status epilepticus.
  • It is also first-line drug choice for the treatment of neonatal seizures.
  • It is used to treat all types of seizures except absence seizure.
  • It is often used to treat insomnia (difficulty in sleeping).
  • It is also used as a sedative to treat the symptoms of anxiety and tension.
  • One major use of Phenobarbital is in the removal of bilirubin from a newly born infant’s body. Bilirubin is removed by liver however sometimes, the liver of a newly born takes the time to start working efficiently. In such cases, phenobarbital is administered to remove the bilirubin produced by the body.

Why Phenobarbital can’t be used for absence seizure?

Phenobarbitals may prove effective in controlling AAS, but the risk of sedation and dependence limits their use. A large Canadian study evaluating retrospectively CLB efficacy in the management of various epileptic syndromes involved 139 AAS patients.

The majority of these patients were reported to be responders. In a recent randomized, placebo-controlled trial evaluating CLB efficacy in LGS, the treatment outcome on AAS was not reported. It must be noted that benzodiazepine administration might aggravate tonic seizures in Lennox-Gastaut syndrome patients, especially when administered via an intravenous route.

A certain degree of efficacy was observed with LTG in retrospective studies. However, in a randomized, placebo-controlled study of 16-week duration involving 169 patients with LGS, there was no statistically significant difference between groups with regard to AAS: a 13% decrease in atypical absence frequency was reported for the LTG group versus 38% for the placebo group.

In Dravet syndrome, atypical absences were not influenced by LTG treatment, but the aggravation of other seizure types was reported in 80% of cases.

Phenobarbital dosage for different indications

Adults

  • Seizure dosage – 30 mg to 250 mg of Phenobarbital in single or divided doses is recommended to prevent seizure.
  • Treatment of insomnia – For insomnia, recommended dosage for an adult ranges from 100mg to 200mg during bedtime. For sedation purpose, 30 to 90mg is recommended in 2-3 doses daily.

Children

  • Seizure – For treatment of seizure in children, the recommended dosage ranges from 1mg to 6mg per kilogram in divided doses.
  • Sedative – For the sedative purpose, the recommended dosage in children below 12 years of age is 2mg per kilogram of weight, taken 3 times daily.

Many things can affect the dosage of medication such as other continued medications, medical conditions of the body etc. Consult a doctor before starting your medication. Once started, it is strictly advised not to discontinue the medication abruptly or without consulting a doctor.

It can cause adverse effects on your body. Also, Phenobarbital has an addictive effect, when used in long term. It should be kept out of range of children and drug addicts. The drug dosage much is reduced periodically instead of just stopping it suddenly to reduce its withdrawal effects on the body.

Phenobarbital highest dose

The maximum dose for Phenobarbital is 600mg daily. This dosage is to be taken in most adverse conditions, with the consultation of a doctor. Also, chances are high that your body will show withdrawal effects when you return to normal medication from such high dosage administration.

Phenobarbital side effects

A side effect of any medication is the unwanted response of the drug over the body on its normal dosage. Any medication can have side effects. It can be mild or severe, short-term or permanent. And it is also not necessary that everyone show the side effects. The internal build up of everybody is slightly different from other, therefore, not everyone shows the same response to the administration of any drug over their body.

Therefore, it is always advised to contact a doctor as soon as you notice any unwanted or diverted response of drug on your body. Side effects of Phenobarbital are listed below. Almost 1% of the users have reported these side effects.

  • Nervousness or anxiety
  • Sedation
  • Hypnosis
  • Nystagmus
  • Ataxia
  • Dizziness
  • Drowsiness
  • Clumsiness or uneasiness
  • Facial swelling
  • Lightheaded or feeling faint
  • Headache
  • Hangover effect
  • Trouble sleeping or nightmares
  • Irritability
  • Nausea
  • Vomiting

In elder patients, excitement and confusion are the most prominent side effects. On children, its usage may cause paradoxical hyperactivity.

Listed below side effects don’t happen usually but can lead to serious problems if not given immediate medical attention

  • Confusion
  • Unusual excitement
  • Hallucinations
  • Signs of anemia (low blood cells) i.e. pale skin, dizziness, unusual tiredness or weakness, shortness of breath.
  • Signs of depression e.g. change in weight, poor concentration, decreased interest in activities, changes in sleep patterns, and thoughts of suicide.
  • Signs of clotting problems e.g. unusual nose bleeding, coughing blood, blood in urine, bleeding gums, bruising, cuts that don’t stop bleeding.
  • Signs of liver problems i.e. nausea, vomiting, loss of appetite, diarrhea, yellowing of the skin or white part of the eyes, weight loss, dark urine, pale stools.

Apart from the above side effects, there are some severe signs when you should stop Phenobarbital usage immediately after consulting a doctor.

  • Signs of serious allergic reactions i.e. abdominal cramps, difficulty breathing, swelling of the face and throat, vomiting and nausea.
  • Signs of severe skin reactions i.e. peeling, blistering, rashes covering a large area of the body, rashes with fever or discomfort or rashes that spread quickly.

Sometimes, the patient may also experience side effects not listed here. Seek immediate medical attention if you notice any unexpected response of the medication on your body.

How to take Phenobarbital?

Phenobarbital can be taken orally as well as through parenteral. Orally, it can be taken by following dosage forms and strengths:

  • Elixir– 20mg/5ml

Each ml of red liquid contains 15mg Phenobarbital.

Tablets

  • 15mg – pink, round scored tablet contain USP 15mg Phenobarbital
  • 30mg – Yellow, round scored tablet contain USP 30mg Phenobarbital
  • 60mg – Green, round scored tablet contain USP 60mg Phenobarbital
  • 100mg – Blue, round scored tablet contain USP 100mg Phenobarbital

Tablets are also available in the market for 16mg, 32mg, 65mg content of Phenobarbital.

For parenteral route, injections are available in the market.

  • 30mg/ml – Phenobarbital sodium injection
  • 60mg/ml – Phenobarbital sodium injection
  • 65mg/ml – Phenobarbital sodium injection
  • 130mg/ml – Luminal sodium (Sanofi-aventis)

Is Phenobarbital addictive?

Yes, Phenobarbital is addictive. The body can adapt to the long-term use of Phenobarbital, causing severe uneasiness, anxiety if stopped abruptly. Either, it should be used for short-term use or should be stopped over a specified period of time with periodically, reducing dosage (when used in long term) as per the advice of the doctor. Phenobarbital must not be given to drug addicts and should be kept out of reach of children.

Can Phenobarbital make you high?

Yes, Phenobarbital can make you high. It mainly affects central and peripheral nervous system, slowing down the body functions. Sometimes, its normal administration leads to reduced consciousness.

Can I abrupt Phenobarbital suddenly?

No, you can’t abrupt Phenobarbital suddenly. It has habit-forming characteristics and causes serious withdrawal effects when stopped suddenly. Therefore, it is strictly advised to consult a doctor before stopping the medication.

Can Phenobarbital cause withdrawal effects?

Yes, Phenobarbital can cause withdrawal effects. Barbiturates cause physical and psychological dependence when used in long term. It is better to gradually reduce its dosage over a period of time to manage withdrawal effects. It is often considered under narcotic medication and has a direct effect on slowing down central and peripheral nervous system. Its withdrawal effects are listed below:

  • Muscle twitching
  • Anxiety
  • Uncontrollable shaking of body
  • Insomnia
  • Dizziness
  • Loss of appetite
  • Weight loss

Precautions and warnings during Phenobarbital use

Before starting any drug, it is better to share all your medical history with doctor including currently continued medications, if any, whether you are pregnant or breastfeeding, or any other facts about your health. These factors may affect how if you should start the medication or not:

  • Breathing – Phenobarbital can suppress breathing. You should always tell your doctor if suffering from any breathing problems such as asthma or breathing difficulties so that doctor can prescribe an appropriate effective dosage of medication and also if any special attention is needed or not, during medication.
  • Liver function – Liver disease can interfere with the effectiveness of Phenobarbital use and also may cause more harm to the body itself. Discuss with doctor – your medical condition, the appropriate dosage with that condition and if it will be equally effective or not. Also know, if any special monitoring is needed. Regular blood tests may be conducted by a doctor to keep a check on your medical condition.
  • Skin rash – It is rare that people on the medication of Phenobarbital develop any life-threatening skin rash. Always seek immediate medical attention if you notice a rash that gets worse and develops into blisters, sores over eyes or lips, or rashes that cover a large part of your body.

Apart from the warnings, there are certain precautions of when one should not use Phenobarbital. Do not use the drug if you:

  • Allergic to Phenobarbital or any ingredients.
  • An alcohol addict.
  • Are drug dependent.
  • Have kidney impairment
  • Are an old aged person, suffering from confusion or restless from sedative medication.
  • Have liver impairment
  • Have kidney impairment
  • Have reduced lung function
  • Have porphyria
  • Have suicidal tendencies
  • Have sleep apnea
  • Have suicidal tendencies
  • Have severe respiratory depression

How long does Phenobarbital stay in your system, urine, blood, saliva?

Phenobarbital can be visible for a shorter time in some tests while in other it can detect even after 2-3 weeks. The time span for which it can be visible in tests also varies individually, depending on the rate of metabolism, body mass index, hydration level, age, and other health conditions.

  • In urine, it can be detected up to 2-3 weeks.
  • Blood tests for Phenobarbital can detect the drug for up to 5-10 days.
  • It is visible in salivary tests for up to 1-10 days.
  • In hair, it is present up to 90 days.

Can Phenobarbital affect a drug test?

Phenobarbital is visible in a drug test and can be detected up to 4 weeks.

Phenobarbital use during pregnancy

The choice of use of Phenobarbital during pregnancy should be left with the patient. Phenobarbital has a history of causing potential abnormalities to the fetus. However, if the overall benefits of using it weigh more than the potential risks, then one should not stop the medication. However, if the medication is continued it should be accompanied by following supplements:

  • Supplementation with folic acid before conception and during pregnancy
  • Supplementation of Vitamin K in both women and neonates.

If Phenobarbital is used during labor, fetus’ respiratory depression should be monitored. If it is used during pregnancy, check the newborn fetus for withdrawal syndrome symptoms for up to 14 days.

Phenobarbital use during breastfeeding

Phenobarbital is not recommended during breastfeeding as it easily passes into newborn infant through breast milk. If medication is continued, the infant should be regularly monitored for unusual weight gain, sedation or any developmental milestones.

Infant serum concentration for this drug should be obtained if drug toxicity of Phenobarbital in infants is a concern. Methemoglobinemia is another potential risk since it is excreted in breast milk.

Can geriatric patients use Phenobarbital safely?

No, geriatric patients cannot use Phenobarbital as they have impaired overall function. Geriatric patients have a dysfunctional central nervous system and Phenobarbital has a direct sedative effect on CNS. Therefore, it’s use should strictly be avoided in geriatric patients.

Phenobarbital overdosage

It has a depressing effect on the central nervous system and peripheral nervous system. Thus, an even slight overdose of the drug results in slow body functions, decreased consciousness (can also go into a coma), bradypnea, bradycardia, hypothermia, and hypotension. Massive overdose may lead to acute renal failure and pulmonary edema as a result of shock and can result in death.

The electroencephalogram of the overdosed patient can show decreased electrical activity of CNS and PNS to the extent of mimicking brain death but it is usually reversible and patient recovers back to the normal from that state.

Phenobarbital absorption, metabolism, and elimination

Phenobarbital is a weak acid that is rapidly absorbed and transferred to all fluids and tissues with a high concentration in brain, kidney, and liver. It penetrates the tissues more efficiently if the drug is more lipids soluble. However, Phenobarbital has lowest lipid solubility, lowest brain protein binding, lowest plasma day, longest onset time span for effective activity and longest usage period among the barbiturates class.

As far as excretion is concerned, roughly 25 to 50 percent of a dose of the drug gets eliminated in an unchanged form in the urine, whereas a number of other barbiturates excreted without being changed, in the urine is negligible.

The excretion of unmetabolized barbiturate is one feature that tells apart, the long-acting class from those belonging to other types which are almost exclusively metabolized. The inactive metabolites of the barbiturates are excreted as conjugates of glucuronic acid.

Can I drink alcohol while taking Phenobarbital?

Phenobarbital itself is a sedative and brain depressant drug, therefore; it is strictly advised not to take alcohol with the drug. The combination will increase the depressant and sedative effect on the central nervous system and peripheral nervous system, leading to the symptoms of a drug overdose.

Can patients with liver disease take Phenobarbital safely?

Phenobarbital is known to cause liver problems in long term use. Therefore, it is recommended to avoid the drug with liver disease. However, it can be used with the prescription of doctor – the dosage, its effect and any special monitoring, if needed. Regular blood tests may be advised by a doctor to check how your liver is responding to the drug in the blood.

Can patients with renal disease take Phenobarbital safely?

Be it liver or kidney, the long term effects are similar on both as it is distributed in high concentration to both the organs after dissolving in a body. And as far as its safe use with a patient of renal diseases is concerned, it is not advised.

Discuss the medical condition with a doctor to check if it can be administered in your body – the dosage, its effect, the time period for which medication will continue and any special monitoring if needed. The doctor will advise regular blood tests to keep a close look on your medical condition.

Difference between Phenobarbital and Carbamazepine

According to a study by the pharmaceutical giant, the Cochrane group, 13 clinical trials were conducted to compare phenobarbitone with carbamazepine based on how effective the drugs were at controlling seizures and how tolerable any related side-effects of the drugs were.

We were able to combine data for 836 people from six of the 13 trials; for the remaining 619 people from seven trials, data were not available to use in this review.

It was suggested by the results that people usually tend to withdraw from phenobarbitone treatment earlier compared to the carbamazepine treatment. This is probably due to the fact that seizures recur, or there are numerous side effects of the drug or both.

It has also been shown by the results that recurrence of seizures after starting treatment with phenobarbitone may happen earlier than treatment with carbamazepine for people with generalized seizures, but vice-versa for people with partial onset seizures. As far as achieving long periods of seizure freedom is concerned, no difference has been found between carbamazepine and phenobarbitone for people (six- or 12-month remission of seizures).

Difference between Phenobarbital and Phenytoin

Phenobarbital and Phenytoin are commonly used antiepileptic drugs throughout the world. And due to the fact that they are inexpensive, their use is more in developing countries than developed countries. Multiple studies have been conducted to compare the effects of Phenobarbital and Phenytoin on the body and which one is safer for use.

To date, data have been obtained for four of ten studies meeting the inclusion criteria, amounting to 599 patients, or approximately 65% of the potential data. The main overall results (HR, 95% CI) were: a) time to treatment withdrawal 1.62 (1.22 to 2.14), b) time to 12 month remission 0.93 (0.70 to 1.23), c) time to first seizure 0.84 (0.68 to 1.05).

These results indicate a statistically significant clinical advantage for Phenytoin in terms of treatment withdrawal and a non-significant advantage in terms of 12-month remission. Results for time to first seizure suggest a non-significant clinical advantage for Phenobarbital.

The studies favor Phenytoin over Phenobarbital. Although there is no significant difference for seizure outcomes, the more withdrawal rates of Phenobarbital may be due to its side-effects.

Can I use Phenobarbital for alcohol detoxification?

Phenobarbital has been put to use for alcohol detoxification in recent times. Alcohol suppresses the human brain by enhancing inhibitory GABA receptors and suppressing excitatory glutaminergic receptors. The human brain adapts to chronic alcoholism. This allows alcoholics to survive even with high blood alcohol levels who would have died otherwise.

But, the high alcohol blood levels also lead to withdrawal resulting in low inhibitory GABA receptors and up-regulation of glutaminergic receptors. Phenobarbital administration, in this case, results in simultaneously enhancing GABA activity and suppressing glutaminergic receptors. Thus, Phenobarbital is used medically to restore normal blood pressure and neural activity in alcoholics.

Can I use Phenobarbital for benzodiazepine detoxification?

Benzodiazepine withdrawal often leads to withdrawal effects. Also, the body adapts to regular use of benzodiazepine, in long term leading to its addiction. Studies have shown that its abuse is common among persons suffering from co-occurring severe mental illness and substance abuse. The people who abused were scored high on anxiety and depression. Thus, Phenobarbital is used to slow down brain activity as counteract for benzodiazepine withdrawal.

Phenobarbital as aid in the conjugation of bilirubin in people with Crigler-Najjar syndrome

Crigler-Najjar syndrome is a rare CNS disorder which results in high level of bilirubin which often leads to brain damage. Often found in infants, Phenobarbital is used as the first-line drug for the treatment. As liver takes some time to work efficiently, the drug is used to reduce the bilirubin level in blood, which otherwise leads to hemolytic jaundice.

Phenobarbital medication of 5 mg/day twice orally decreases serum bilirubin concentrations approximately threefold over a period of 30 days. The drug is efficiently capable of hepatic enzyme induction thus, most effective in the treatment of bilirubin disorder in people.

Can Phenobarbital be used by patients with Gilbert syndrome?

Gilbert syndrome is a genetic liver disorder. It produces a high level of bilirubin in the blood. Jaundice may occur in rare cases. The cause of hyperbilirubin is due to reduced activity of enzyme glucuronyltransferase which conjugates bilirubin. Phenobarbital reduces unconjugated bilirubin levels and can also relieve other symptoms of Gilbert’s syndrome. Thus, Phenobarbital is an effective drug in the treatment of Gilbert syndrome.

Can I use Phenobarbital for cyclic vomiting syndrome?

Cyclic vomiting is an uncommon disorder, described as recurrent, self-limiting, fairly uniform episodes of vomiting and intractable nausea usually without any identifiable organic cause. It is separated by symptom-free intervals. Phenobarbital is often used for the treatment. The dose usually ranges from 30 to 120 mg/daily. The average dose of 60mg/day is used in most cases.

What is Ataxia? Can Phenobarbital cause ataxia?

Ataxia is a lack of muscle coordination which may affect speech, eye movements, the ability to swallow, walking, picking up objects, and other voluntary movements. Causes include muscular sclerosis, alcohol abuse, cerebral palsy, head trauma, stroke, or tumor. Ataxia is of three types:

  • Cerebellar ataxia
  • Sensory ataxia
  • Vestibular ataxia

Phenobarbital can cause ataxia. And if the drug is accompanied with potassium medications, it can cause increased ataxia.

What is Nystagmus? Can Phenobarbital cause nystagmus?

Nystagmus is eye disorder for involuntary eye movements or rapid voluntary eye movement in rare cases. It may result in reduced or limited vision. There are two forms of ataxia – psychological and pathological with variants in each type. The causes of this disease may be idiopathic, congenital or secondary to pre-existing neural disorder. Alcohol addiction is also one of the major causes of nystagmus.

Phenobarbital affects CNS and brain, which is responsible for involuntary movements of the body. Thus, Phenobarbital can cause nystagmus as its withdrawal effects.

May phenobarbital cause paradoxical hyperactivity in children?

Yes, Phenobarbital may cause paradoxical hyperactivity in children.

What is amelogenesis imperfecta? Can Phenobarbital cause amelogenesis imperfecta?

Yes, Phenobarbital can cause amelogenesis imperfecta.

A rare abnormal function of the external layers of the crown of teeth or the enamel is presented by Amelogenesis imperfecta (AI). The compositions of enamel are mostly dominated by minerals which are formed as well as regulated by the present proteins, The malfunction of proteins in the enamel causes Amelogenesis imperfect: amelogenin, tufted in, enamelin, and ameloblastin.

People afflicted with amelogenesis imperfecta have teeth with abnormal color: yellow, brown or gray; this disorder can afflict any number of teeth of both dentitions. A higher risk of developing hypersensitivity to changes in temperature, dental cavities, gingival hyperplasia, excessive calculus deposition, as well as rapid attrition is developed by the affected individuals.

Is phenobarbital controlled substance?

Yes, Phenobarbital is a controlled substance. It is highly recommended to start the drug only after a prescription from a doctor. The dosage should be taken in a regulated way. The human body adapts quickly to the drug. After long term use, abrupt stoppage of the medication can cause withdrawal effects. Therefore, the dosage should be reduced evenly for a set period of time.

Is Phenobarbital considered as a narcotic?

Phenobarbital is a controlled substance. Narcotics are usually used for opioids. Therefore, Phenobarbital cannot be considered under narcotics as it is a barbiturate. However, it is an addictive substance. It has withdrawal effects and should strictly be avoided from drug addicts, alcoholics and children.

Is Phenobarbital for dogs safe?

Phenobarbital is medication, used to treat seizures in dogs because it is relatively inexpensive, easy to use and effective in 60 to 80% of dogs with idiopathic epilepsy. It is first line drug for the treatment of seizures. The usual dosage of Phenobarbital to treat seizures in dogs is around 1 – 1.8 mg/lb every 12 hours, but it depends on how bad the seizures are.

If seizures are severe, a “loading dose” may be required where a larger amount of around 9 mg/lb is injected intravenously (at a maximum rate of 60 mg per minute). The half-life of the drug after oral administration in dogs is 37-89 hours.

Can I take Phenobarbital and warfarin together?

Consult a doctor before starting the combination of Phenobarbital and warfarin. Studies have shown that the interaction between both did not produce appreciable changes in the prothrombin time until 1 week after starting Phenobarbital. Also, the cytochrome enzyme induction effect due to Phenobarbital lasted 3-4 weeks after discontinuation.

Can I take Phenobarbital and Xanax together?

Phenobarbital and Xanax cannot be taken together. It increases the side effects such as dizziness, confusion, drowsiness and difficult concentration. In elderly people, it can cause impairment in judgment, thinking and motor coordination. Avoid alcohol when using the combination, if prescribed by a doctor.

What is the drug hyoscyamine used for? How do you take hyoscyamine?

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Curcumin (Turmeric) benefits

May 12 2017 Published by under Medicinal Herb

What is Turmeric? What is curcumin?

Turmeric (Curcuma longa) is a plant of the ginger family. Its root has been used as a seasoning and natural remedy in the Indian and Chinese cuisine and medicine for more than 4,000  years. Turmeric is traditionally called  “Indian saffron”, because of its deep yellow-orange color. It is known that turmeric is one of the main ingredients of curry, and it is curcumin that gives curry its color.

what is turmeric curcumin

The most beneficial medical properties Turmeric comes from from its active ingredient called curcumin, which is the best to known due to its antioxidant properties. Other substances in this herb have also antioxidant properties as well. The roots, or rhizomes and bulbs, are used in medicine and food. They are boiled and then dried, turning into the familiar yellow powder.

Curcumin is available as a dietery supplement in the following forms: capsules powder, fluid extract and tincture – alcoholic extract of a herb. Despite its traditional use, medical properties of curcumin are uncertain, since there are no adequate studies conducted on humans that will confirm it benefits.

Curcumin anticancer acitivity

Curcuminc has been most widely investigated for its anticancer activity. In rodents, curcuminc has been shown to have protective and therapeutic properties against cancers of the blood, skin, oral cavity, lung, breast, pancreas, and intestinal tract, and to suppress angiogenesis  (physiological process through which new blood vessels form from pre-existing vessels) and metastasis (spread of a cancer from one organ or part to another organ not directly connected with it).

Laboratory and animal research suggests that curcumin may also prevent cancer, make chemotherapy more effective and protect healthy cells from damage by radiation therapy. Several recent studies have found that curcumin can induce process that triggers the self-destruction and elimination of damaged (cancerous) cells. Researchers at UCLA have even found that curcumin is able to inhibit cancer growth.

Curcumin has been found to possess properties that reduce the expression of deadly molecules within cancer cells, and can potentially slow down the spreading of a breast cancer. A recent study shows that a combination of curucmin and piperine can limit the growth of stem cells for breast cancer.

A 2007 American study that combined curcumin with chemotherapy to treat bowel cancer cells in  a laboratory showed that the combined treatment killed more cancer cells than chemotherapy alone. A recent study published in the Asian Pacific Journal of Cancer Prevention, for instance, found that a dose-dependent administration of curcumin effectively induces death of the liver cancer cells.

A study published in “Brain Research” in 2009 reported that curcumin prevents brain tumor formation and kills brain tumor cells. More research is needed to confirm these effects in live patients.

But, studies of curcumin in people are still in the early stages. Clinical trials are underway to investigate curcumin as a way to prevent cancer in people with precancerous conditions, as a cancer treatment, and as a remedy for signs and symptoms caused by cancer treatments.

In an open clinical trial a curcumin 0.5% was tested in 62 patients with skin and mucous membrane cancers. The ointment was applied three times daily for a minimum of four weeks. A total of 68% of the patients responded (reduction in exudates 70%, lesion smell 90%, and pain 50%).

Research is ongoing, and there isn’t enough evidence to recommend curcumin at this time. As always, talk with your doctor before using any herbal supplement. It’s unclear how curcumin may interact with medications.

However, it has to be known that in populations where turmeric is broadly used like India and the Middle East, cancer rates are lower. As you can see it in the picture below:

does turmeric help with cancer

Curcumin for Alzheimer disease

Alzheimer’s  disease (AD) is a progressive neurodegenerative disease. It is characterized by progressive cognitive  deterioration together with declining activities of daily living and behavioral changes. It is the most common type of pre-senile and senile dementia. For now, there is no cure for Alzheimer‟s disease.

Various studies and research results indicate a lower incidence and prevalence of AD in India. The prevalence of AD among adults aged 70-79 years in India is 4.4 times less than that of adults aged 70-79 years in the United States. Researchers investigated the association between the curry consumption and cognitive level in 1010 Asians between 60 and 93 years of age.

The study found that those who occasionally ate curry (less than once a month) and often (more than once a month) performed better on a standard test (MMSE) of cognitive function than those who ate curry never or rarely.

Alzheimer patients’ brains  contain  some strange proteins,  which are bad for brain functon. They are called beta-amyloid that forms amyloid plaques, and they are crucially involved in Alzheimer disease. Curcumin is able to inhibit aggregation of beta-amyloid proteins in the brain, and thus prevent neural inflammation  which  would  normally  be  downstream  from  said  aggregation.

Studies in animal models indicate a direct  effect in decreasing the amyloid pathology of AD. The bad things are, that the limited clinical trials conducted do not support the findings of the lab-based studies, and that curucmin is not easily absorbed in the human body, and also there is no real evidence that supports curcumin being used as a treatment for Alzheimer’s disease.

But, the specific effects by curcumin on amyloid-beta plaques could be a useful  target for future investigations into potential treatments.

Curcumin and cardiovascular health

High cholesterol levels can cause various health problems like atherosclerosis, cardiovascular diseases, peripheral heart disease, strokes and so on.

According to studies, turmeric helps in maintaining heart and blood vessels health by – reducing bad LDL-cholesterol (It is good to know that there is also a good type of cholesterol  called HDL-cholesterol),  reducing  cholesterol  oxidation (oxidized  form of cholesterol is the main cardiovascular risk factor  for atherosclerosis), reducing plaque build-up, clot formation, and by reducing pro-inflammatory response which are also risks factors for atherosclerosis and strokes. The study,  published  in the journal Atherosclerosis  in 2004,  found  turmerics cardio-protective properties are most beneficial at a lower rather than a higher dose.

Studies have found that turmeric could reduce the adhesive abilities of blood platelets, thereby preventing them from forming clots. It can also relax blood vessels and minimize heart damage after suffering a heart attack.

The endothelium is the thin layer that lines the interior surface of blood vessels and lymphatic vessels, forming an interface between circulating blood or lymph in the lumen and the rest of the vessel wall.

It is well known that endothelial dysfunction is a major driver of heart disease and involves an inability of the endothelium to regulate blood pressure, blood clotting and various other factors. Several studies suggest that curcumin leads to improvements in endothelial function. One study shows that is as effective as exercise, another shows that it works as well as the drug Atorvastatin.

A new research suggests that turmeric may help in protection against heart attacks in patients who‟ve had recent bypass surgery. For this research, Dr. Wanwarang Wongcharoen and his team from Thailand studied  121 patients who had non-emergency bypass surgery at their hospital from 2009 to 2011. Half of the patients were given pills containing curcumin and the other half was given curcumin-free placebo-inactive pills.

Just 13% of the group taking curcumin had a heart attack during the course of their post-surgery hospital stay, compared with 30% of the placebo-control group. the team calculated that the patients who took curcumin had a 65% lower chance of a heart attack, compared with those who did not.

The scientists at the Peter Munk Cardiac Centre of the Toronto General Hospital tested the effects of curcumin in mice with enlarged hearts  (hypertrophy) and found it could prevent and reverse the condition, restore heart function, and reduce scar formation. You should know that whether you are young or old, male or female, the larger your heart is, the higher your risk is for developing heart attacks or heart failure in the future.

So, If human clinical trials support these findings, curcumin-based treatments may provide a safe and inexpensive new option for patients with heart enlargement. Anti-oxidant  properties  of  curcumin  may  also  help  prevent cardiovascular
complications among diabetics.

Curcumin for the prevention of type 2 diabetes

Diabetes is better known as a group metabolic disease, which disturbs the sugar or glucose levels in the blood. The main cause is insufficient production of insulin in the beta cells of pancreas or the body‟s irresponsiveness toward insulin.

Several animal studies have shown that curcumin may delay the development of diabetes in animals, improve the function of the pancreas‟ insulin-producing beta cells and reduce insulin resistance, the precursor to diabetes.

In one the study, in Thailand, more than 200 prediabetic patients were randomly assigned to receive either curcumin extract  (750 mg twice a day) or placebo-inactive pills for a nine-month period. At the end of the trial, not one of the curcumin extract takers had developed clear-cut diabetes, however, 16% of the placebo group did.

The curcumin extract group, moreover, had improved beta cell function, which the researchers attributed to the anti-inflammatory activity of curcumin. In the other study, the 100 patients were given either 300 mg per day of curcumin or placebo for three months.

At the end, the patients in the curcumin group, experienced a significant decline in blood glucose levels, insulin resistance, free fatty acids, and Hemoglobin A1c (as a person’s blood sugar becomes higher, more of the person’s hemoglobin becomes glycosylated, and it is a bad prognostic parameter for diabetics).

Type 2 diabetes melitus patients can develop foot ulcers if their blood glucose has not been controlled for a long term. H.M. Maier from the Florida State University in Tallahassee, and colleagues, reviewed studies and found evidence from animal studies, indicating that curcumin, amino acid L-arginine and vitamin E as dietery supplements can help wound healing in people with type 2 diabetes.

Curcumin for liver health and obesity

The liver is a vital organ that has a wide range of functions, including detoxification of various metabolites, protein synthesis, and the production of biochemicals necessary for digestion. A recent study published in the journal BMC Complementary and Alternative Medicine, highlights turmerics protective effect on the liver. The participants liver enzyme, alanine aminotransferase (ALT) was mildly to moderately high before study.

This study showed that turmeric not only lowered levels of ALT, but also reduced levels of two other liver enzymes. Fetuin-A is protein, synthesized in the liver and is secreted into the bloodstream. Clinical studies suggest involvement of fetuin-A in metabolic disorders such as visceral obesity, insulin resistance, diabetes, and fatty liver. One study found that curcumin appeared to be effective in reducing liver triglycerides and serum fetuin-A levels.

These findings suggest that the reduction of fetuin-A may contribute to the beneficial effects of curcumin in the pathogenesis of obesity. New science shows that curcumin is yet another nutrient that helps regulate the formation of fat cells within white adipose tissue, helping lower their activity, and thereby helping lower the production of leptin- a hormone made by fat cells that helps to regulate energy balance by inhibiting hunger.

Furthermore, excessive leptin  also  activates genes within your liver that  promote  the  improper accumulation of fat within liver cells, leading to fatty liver a consequent liver malfunction (including type 2 diabetes). Curcumin has been shown to help protect your liver from such leptin induced problems.

Curcumin and pain relief

Curcumin is a rich source of salicylic acid, found in aspirin, but the Rowett Research  Institute,  found  the  constituent  in  turmeric  doesn‟t  cause  ulcers  or bleeding like acetylsalicilic acid in aspirin does. Eating curry spice foods that include cumin, turmeric and paprika, such as vindaloo, with a high level of spices, might help cure a headache.

Curcumin at  400mg in persons with acute algesic episodes appears to have a potency comparable to 1,000mg acetominophen and 100mg nimesulide (trending to be more potent than acetominophen yet less potent than nimesulide). It appeared to start working within two hours (slower than nimesulide) with maximal efficacy at 3-4 hours and a loss of efficacy but not yet normalized within 12 hours.

Traditionally, turmeric is specifically recommended as an herbal pain reliever for chest, abdominal, and menstrual cramps. It is reported to relieve pain associated with eye inflammation and scorpion bites as well. Turmeric compounds may also be able to reduce chronic nerve pain associated with some diseases (a condition called neuropathy).

Curcumin anti-inflammatory benefits

A number of studies support the use of curcumin in relieving associated with rheumatoid arthritis (RA). The Journal of Clinical Immunology recently reported on a study that curcumin has the ability to suppress production of a specific B cell-activating factor involved in rheumatoid arthritis and to relieve RA symptoms.

One study showed that curcumin is more effective and safer than the common anti-inflammatory medication diclofenac for the pain associated with mild, active RA. In the study, RA patients taking curcumin for eight weeks had a 44 percent reduction in pain symptoms, while those taking diclofenac had a 42 percent reduction.

Interestingly, the curcumin group also had a greater reduction in overall inflammation compared to the diclofenac group. There also were no adverse events with curcumin. This was an initial study, but was well controlled and randomized. It is a good study and the results cannot be dismissed. Larger clinical trials are needed to confirm these results.

The results of a recently concluded study indicated that the use of a compound containing extracts of turmeric was beneficial to patients affected by osteoarthritis.

The study was conducted by researchers in Italy, and it found that the use of a particular turmeric formulation, known as Meriva, resulted in a significant decrease in pain, joint stiffness and inflammation in patients, who were able to reduce their dependence on pain killers and anti-inflammatory drugs as a direct result of the use of Meriva.

Curcumin for skin care

There is a long list of skin care benefits associated with turmeric, including the treatment of acne blemishes, blackheads, dark spots and hyperpigmentation. Turmeric, with its anti-inflammatory and redness reducing properties, can be used to treat a variety of skin conditions including eczema, allergic hives, and even chicken pox!

The juice of fresh turmeric is prized as a cure/soother for many skin conditions, including eczema, chicken pox, shingles, poison oak/ivy, and scabies. Turmeric paste makes quite a satisfactory substitute! You can apply the paste directly to the affected area, cover lightly with gauze or loose cotton clothing (that will likely be ruined with stain). This is known to help dry the blisters up and accelerate the healing process.

It also helps heal and prevent dry skin, and to slow the skin aging process, and is used to diminish wrinkles, keep skin supple and improve skins elasticity. This sunny bright spice is also being used as an ingredient in sunscreens. It is used daily by East Indian women as a facial cleanser and exfoliant.

However, there are two potential problems with topical-skin approach. First, optimal use of topical curcumin has not been researched. A few skin creams with various forms of curcumin are available on the market, but optimal concentrations, remain unclear. Second, sufficiently concentrated curcumin may give your skin a yellowish tint that you may not like.

The tint can be avoided by using a colorless curcumin that is called tetrahydrocucumin, instead of curcumin itself. Notably, tetrahydrocucumin has been found to inhibit the synthesis of the skin pigment melanin and, therefore, may have skin-lightening effect. Unfortunately, good skin care products with tetrahydrocucumin are at least as hard to find as those with curcumin.

Curcumin for kidney protection

The renoprotective effect of curcumin has been evaluated in several experimental models including diabetic nephropathy, chronic renal failure, ischemia and reperfusion and toxicity induced by many nephrotoxic compounds. It has been shown recently in a model of chronic renal failure that curcumin also exerts a nephro-therapeutic effect.

This common Indian spice has also been used to lessen the chance of rejection after kidney transplant surgery. Researchers are continuing to determine its value and effectiveness in kidney disorders including kidney stones and inflammation of the kidneys. Its anti-inflammatory characteristics make it a natural pain reliever as well as reducing swelling.

Curcumin has been shown in clinical tests to help reduce cyst formation in the kidneys or elsewhere in the body. Researchers at Peking University conducted studies on curcumin’s effect on the development of kidney cysts and concluded that curcumin slowed the growth of kidney cysts by 62%. The herb also showed promising results in the treatment of polycystic kidney disease (enlarged fluidfilled cysts) that could cause kidney failure.

Curcumin for Inflammatory bowel disease

Crohn’s disease and ulcerative colitis are the principal types of inflammatory bowel disease. Crohn’s disease illness that causes the intestines, or other parts of the digestive tract (the parts of the body food goes through), to become swollen, and sometimes develop ulcers (holes). People with Crohn’s disease often have pain in the gut, diarrhea, vomiting, and weight loss.

Crohn’s can also cause skin rashes, arthritis, and swollen eyes. Ulcerative colitis is a form of colitis, a disease of the colon (the largest portion of the large intestine), that includes characteristic ulcers, or open sores. The main symptom of active disease is usually constant diarrhea mixed with blood. Turmeric shows anti-inflammatory properties that can benefit those with Crohn‟s and Colitis.

But as with most herbal / natural remedies further research is required to prove it with scientific rigor. A pilot study conducted in 2005. showed participants in the investigation taking turmeric  capsules  had  fewer  symptoms  including  improved  stool  formation, decreased muscle soreness after exercise, less abdominal pain and cramping and fewer bowel movements.

Lab testing also showed decreased inflammation related to several blood biomarkers. Studies have found that curcumin‟s anti-inflammatory benefits are on par with corticosteroids and phenylbutazone and other anti-inflammatory drugs. Since it does not produce side effects like reduced blood count, ulcers or intestinal bleeding like these drugs, it could be used as a safe alternative in treating inflammatory bowel disease.

In research carried out on mice, scientists found that mice fed on a diet rich in curcumin experienced less intestinal inflammation when exposed to irritants. A problem with understanding how it works, what dose is most effective and other details is that more human studies are needed.

Curcumin and cataract prevention

A cataract is when the lens of the eye gets cloudy. Cataracts can cause short-sightedness (myopia), which means you cannot see things in the distance but can see things up close. If left untreated, some types of cataracts will cause blindness. Curcumin‟s antioxidant powers appear to help reduce oxidative stress in the eye, which could prevent cataract development, according to researchers from the University of Madras.

The team examined whether curcumin at a dose of 75 mg/kg body weight could affect cataractogenesis induced by selenite. Treatment with curcumin, whether before, during or after selenite  administration,  significantly  decreased  levels  of  lipid  peroxidation (chemical  reaction  that  can  cause  cataract)  and  cataract  formation.  The team concluded natural consumption of curcumin in food could help protect against the onset of cataract.

Curcumin use for depression

Curcumin inhibits the production of monoamine oxidase, an enzyme that at high levels is linked to depression. In a recent study published in Phytotherapy Research, 1,000 mg daily of curcumin proved to be just as effective at treating depression as fluoxetine, the antidepressant better known as Prozac.

After six weeks, curcumin relieved symptoms of depression as effectively as Prozac. It’s possible it may help alleviate short-term mood issues, too. The big difference is that Prozac often comes with possible negative side effects, ranging from suicidal thoughts to digestive problems.

So far, no similar side effects of curcumin have been discovered. The researchers used a very specific form of curcumin called BCM95, which has been shown to be more absorptive than generic forms of the compound. People can experience the benefits of curcumin by eating turmeric, but a person would have to eat it several times a day to get the antidepressive effects.

how turmeric changed my life

All treatments worked equally well as the figure above shows. The results actually seem too good to be true. Anti-depressants usually require a few weeks for effects to start showing, and if they work they tend only to slightly reduce feelings of depression. Anti-depressants enable patients to start functioning again so that they can embark on recovery.

To actually cure severe depression in scores of people within  six  weeks,  as  seems  to  be  the  case  in  the  figure  above,  is  virtually impossible. In addition, given the efficacy of curcumin treatment by itself, this study highlights the need for future large-scale clinical trials evaluating the use of this safe and natural dietary botanical as a possible mono-therapy in patients with depressive disorders.

Curcumin for Parkinson’s disease

Parkinson’s disease is a slow damaging disease of the central nervous system in which a substance in the brain called dopamine is lost. It hurts the patient’s movement  skills  and  their  speech,  but  the  former  is  much  more  specific. Sometimes it can also affect their mood, behavior, and thinking. Curcumin showed neuroprotective properties in an animal model of Parkinson‟s disease.

The beneficial effect was thought to be related to its antioxidant capabilities and the ability to easily penetrate the brain. Curcumin prevents dopaminergic neuronal death through inhibition of the one neural pathway, and thereby offers a neuroprotective effect that may be beneficial for Parkinson‟s.

At Michigan State University, a group of researchers discovered that curcumin can help prevent proteins called alpha synuclein from clumping. The process of clumping is the first step in Parkinsons and other debilitating diseases.

Curcumins usefulness as an actual drug may be pretty limited since it doesn‟t go into the brain easily where this misfolding is taking place. These discoveries about curcumin and alpha-synuclein may lead scientists to identify drugs that can treat Parkinson‟s and other diseases.

Curucmin as a natural antibioitc

A new study published in the journal Molecule indicates that the ancient Indian spice turmeric may help to countermand the growing threat of bacteria that have become completely resistant to conventional antibiotics (MRSA – Methicillin-resistant Staphylococcus aureus).

Electronic microscope images of MRSA showed damage  of  the  cell  wall, disruption of the cytoplasmic contents, broken cell membrane and cell lysis after the treatment of curcumin. These data indicate a remarkable antibacterial effect of curcumin.

Briefly, curcumin (and related turmeric compounds) has been found to kill and/or inhibit the following bacteria: Bacillus Subtilis (bacteria is only known to cause disease in severely immunocompromised patients, and can conversely be used as a probiotic in healthy individuals), Escherichia Coli (Some strains of E. coli can cause sickness in people), Helicobacter Pylori (bacteria that causes more than 90 percent of ulcers, which are sores in the lining of the stomach or the the first part of the small intestine), Vibrio Vulnificus (Infection with V. vulnificus leads to rapidly expanding cellulitis or septicemia)

Curcumin benefits for dyspepsia and gastroesophageal reflux disease

Dyspepsia is a condition of impaired digestion.  It is a medical condition characterized by chronic or recurrent pain in the upper abdomen, upper abdominal fullness and feeling full earlier than expected when eating. One study in Thailand compared the effects of 500 mg curcumin 4 times daily against inactive placebo, as well as against a locally popular over-the-counter treatment.

A total of 116 people were enrolled in the study. After 7 days, 87% percent of the curcumin group experienced full or partial symptom relief from dyspepsia as compared to 53% of the placebo group, and this difference was statistically significant.

Gastroesophageal reflux disease – GERD, occurs when stomach acid or bile flows back up into the esophagus, irritating the lining and causing a burning sensation in the chest, difficulty swallowing, hoarseness, sore throat, a lump in the throat, regurgitation and even a dry cough.

Curcumin,  may  help  the  occasional  bout  of  indigestion  by  stimulating  the gallbladder to produce bile, which some think aids digestion. However, studies have shown that curcumin and turmeric interfere with acid-reducing medications such as omeprazole, cimetidine, ranitidine, lansoprazole and famotidine, increasing stomach acid production and potentially making the condition worse, according to the University of Maryland Medical Center.  So, you should always discuss turmeric with your physician before use for GERD or any other condition.

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Hyoscyamine

May 12 2017 Published by under Medicines

What is Hyoscyamine?

Hyoscyamine is a Generic name for a drug that contains tropane ring in its chemical structure so it is sometimes called as tropane alkaloid. It is a secondary metabolite from plants of family Solanaceae (Deadly nightshade family). This family also includes certain plants like tomato (Solanum Lycopersicum), Jimsonweed (Datura Stramonium) etc.

Datura Stramonium is a common plant which is generally found in roadside. This drug is also known as the levo-atropine because it is the levorotatory isomer of atropine (used in the treatment of irregular heartbeat, snake poisonings). Levorotation is based on the direction of plane polarized light. If the light rotates in an anticlockwise direction, then it is levorotatory.

hyoscyamine reviews

What is Hyoscyamine molecular formula and weight?

Hyoscyamine belongs to the class of chemical entities known as tropane alkaloids. These are organic compounds containing the nitrogenous bicyclic alkaloid parent N-Methyl-8-azabicyclo[3.2.1]octane.

Molecular formula: C17H23NO3.

Hyoscyamine molecular formula

Weight: 289.375 g/mol.

Hyoscyamine 3D formula

Hyoscyamine molecular weight

Hyoscyamine drug class

It belongs to the anticholinergics drug class. These classes of drugs have a broad range of medications. They are generally used in treating muscle-related problems, urinary incontinence, certain types of poisoning, breathing problems, diarrhea, gastrointestinal problems etc.

They work by blocking the action of acetylcholine, they are the chemicals made and released by nerves that travel to nearby muscles and glands and they get attached to the receptors of the nerve, glandular cells. This attachment can inhibit the activity of the receptor-containing cells.

Anticholinergic drugs act by preventing the acetylcholine from binding to its receptors. They decrease the muscles activity in the gut and reduce the level of production of sweat, saliva, urine, tears etc. So they are widely used in the surgical purpose to decrease the level of urine.

They are also known as antispasmodic drugs, which help to maintain the neurotransmitter named dopamine which plays an important role in maintaining mood, problem solving and motivation.

How does Hyoscyamine work in the body?      

Hyoscyamine acts as an antagonist of acetylcholine receptors. It blocks the action of acetylcholine at the muscarinic receptors in the salivary, sweat, bronchial, eye, heart and gastrointestinal tract. As a result sweat, saliva, urine, acid in the stomach, mydriasis, and changes in heart rate is secreted in lower amounts. Heart rate is increased, lowers blood pressure.

Hyoscyamine Brand names

These brands are distinguished based on the route of administrations and manufacturers.

  • Anaspaz
  • Cystospaz
  • Donnamar
  • Ed-spaz
  • Hyoscyamine
  • Hyoscyamine ER
  • Hyoscyamine SI
  • Hyoscyamine sulphate
  • Hyoscyamine sulfate Extended- release
  • Hyoscyamine ODT
  • Hyosyne
  • Levbid
  • Levsin
  • Levsin SI
  • Nulev
  • Oscimin
  • Symax duotab
  • Symax fastab
  • Symax SI
  • Symax SR
  • Antispas
  • Atrohist plus
  • Atrosept
  • Barbidonna
  • Barophen
  • Bellalphen
  • Bellatal
  • Colidrops
  • D-Tal
  • Darpaz
  • Digex
  • Elixiral
  • Hyomax
  • Hyophen
  • Liqui-sooth
  • Malatal
  • Neosol
  • Q-Tuss
  • Ru-Tab
  • Uaa
  • Urella
  • Uribel
  • Utrona-C
  • Utira.

What is Hyoscyamine used for?

It is used to control the motion of the stomach and intestines and the secretion of stomach fluids including acid. It is also used to treat bladder related problems, peptic ulcers, irritable bowel syndrome (IBS), cystitis, pancreatitis, colic, to treat heart conditions to decrease the symptoms of Parkinson’s disease, control of respiratory symptoms (hyper-mucous secretions). It also helps in clinical procedures to reduce the excess urine production before surgery.

FDA approved indications for hyoscyamine are following:

  • Biliary Colic
  • Colic
  • Cystitis
  • Diverticulitis
  • Heart Block
  • Irritable Bowel Syndrome (IBS)
  • Neurogenic Bladder
  • Neurogenic Bowel Dysfunction
  • Pancreatitis
  • Parkinsonism
  • Peptic Ulcers
  • Poisoning caused by anticholinesterases
  • Pylorospasm
  • Renal Colic
  • Spastic bladder
  • Acute Enterocolitis
  • Acute Rhinitis
  • Gastric secretions
  • Hypermotility disorders of the lower urinary tract
  • Mild Dysentery
  • Pharyngeal secretions
  • Salivary secretions
  • Spastic colitis
  • Tracheobronchial secretions

Hyoscyamine dosage form and strength

Hyosciamine is available in following dosage forms and strengths: Immediate release Tablet 0.125mg/1, Extended release Tablet, 0.375 mg/1, liquid,  0.125 mg/5mL, Solution/drops, 0.125 mg/mL, Injection, 0.5mg/mL, Elixir, 0.125mg/5ml.

Hyoscyamine dosage for different indications

Irritable Bowel Syndrome

Immediate release: 0.125 to 0.25 mg every 4 hours. Not more than 12 tablets in 24 hours.

Extended release: 0.375 to 0.75 mg every 12 hours. No more than 4 tablets in 24 hours.

Elixir: 5 to 10 mL every 4 hours (0.125 to 0.25 mg). no more than 12 teaspoons in 24 hours.

Oral drops: 1 to 2 mL (0.125 to 0.25) every 4 hours. No more than 12 mL in 24 hours.

Anesthesia:

5mcg/kg given 30 to 60 minutes prior to the time of anesthesia or narcotic or sedative administration.

Hypermotility of Lower Urinary Tract:

Primary treatment was given (adjunctive treatment)

Immediate release: 0.15-0.3 mg. It is given in a time interval of 6 hours.

Extended release: 0.375 mg. given in 12 hours time gap.

Gastrointestinal Disorders:

Immediate release: 0.125-0.25 mg. 4 hours time interval. Should not be given more than 1.5mg/day.

Extended release: 0.375-0.75 mg. 12 hours time interval. Not more than 4 times a day.

Pediatric doses:

Urinary incontinence:

>2years or less than 12 years:

Immediate release: tablets 0.0625 to 0.125 mg.

Elixir: 1.25 to 5mL

Drops: 0.25 to 1 mL

Anesthesia:

5mcg/kg administered before 30 minutes of anesthesia administration.

Gastrointestinal Disorders:

<2 years (oral drops)

5kg: 5drops no more than 30drops/day.

7kg: 6drops no more than 36 drops/day

10kg: 8 drops no more than 48 drops/day

>15kg: 11 drops no more than 66 drops/day.

2-12 years (tablet)

Immediate release: 0.0625-0.125 mg. No more than 0.75mg/day.

Extended release: 0.375. No more than 0.75 mg/day.

2-12 years (elixir)

10-19 kg: ¼ tsp (1.25ml)

20-39 kg: ½ tsp (2.5ml)

40-49 kg: ¾ tsp (3.75ml)

50kg: 1tsp (5ml).

Geriatric doses:

Hyper motility of lower urinary tract:

Immediate release: 0.125-0.25 mg

Extended release: 0.375 mg.

Hyoscyamine highest dose

Adults and children with 12 years or older should not take more than 1.5 grams per day. Children with 2 to 12 years should not take more than 0.75 grams in 24 hours.

Hyoscyamine side effects

Hyoscyamine causes adverse side effects because it is inhibiting a chemical which is related to the brain to show its effect. Side effects includes

  • Dry mouth
  • No frequent urination
  • Blurred vision
  • Loss of taste
  • Weakness
  • Fatigue
  • Drowsiness
  • Constipation
  • Vomiting
  • Nausea
  • Impotence
  • Dermal problems
  • Mental confusion
  • Short term memory loss
  • Loss of fluids from body

How to take Hyoscyamine?

Use Hyoscyamine as prescribed by your doctor. Dosage level depends on your medication and overdosage leads to severe effect. Check the label for exact dosing instructions.

Route of administration for Hyoscyamine is the mouth. It should be taken 30-60 minutes before food intake as directed by the doctor. Injection should be used only at the hospital or by a pharmacist. Without doctor permission, one should not use intravenous mode of administration. Water should be taken in high amount because this drug causes loss of fluid from the body.

The extended release capsule should not exceed twice a day. The capsules should not be broken, cut or divide. It should be taken as a whole capsule.

The sublingual tablet should not be swallowed. It should be kept under the tongue and wait until it gets dissolved. Do not wash it off with water.

Hyoscyamine oral spray should be tested in common place before usage. It should be sprayed twice away from your face and in the air. You should use it only after mist appears. Do not use it more than 30 sprays even there is left out medicine in the bottle.

Is Hyoscyamine addictive?

This class of drug rarely cause abnormal drug-seeking syndrome (addiction). This may increase the risk of alcohol addiction or drug addiction if you are using it in past. Any drug which is taken on a long term basis should be discussed with the health advisor.

Hyoscyamine abuse

From the reports, it is found that this class of drug causes “true hallucinations” effect. From the patient point of view, they said that hallucinations can only be achieved by smoking cigarette. But they are getting it using hyoscyamine, a triggering neurotransmitter drug.

Can I abrupt Hyoscyamine therapy suddenly?

Can I stop taking hyoscyamine? Some people use Hyoscyamine drug even after getting rid of the disease. This is termed as a dependency. It will cause withdrawal symptoms after abruption of this drug. Doctor advice is necessary for the withdrawal of any drug suddenly. Medication should not be withdrawn before dosage gets over.

Hyoscyamine withdrawal effects

All will experience withdrawal symptoms after a sudden change to the other medication. The withdrawal effect of hyoscyamine lasts for 6 weeks. Symptoms include severe anxiety, Body doing continuous work, vomiting, intestinal and stomach cramping, losing mind, restless leg syndrome, jaw clenching, trouble in sleep etc. consult a doctor for any severe effect even after 6 weeks of withdrawal. Don’t withdraw any drug without seeking permission from health advisor or before dosage getting over.

Precautions and warnings for using Hyoscyamine

  • If you have any allergies to any food substances, medicines inform the health advisor clearly
  • If you are pregnant or planning to get pregnant inform previously.
  • Kindly consult a doctor about your diet intake or any prescription or non-prescription medicine usage, herbal treatment etc.
  • If you have taken any medicines for bowel problems or heart problems etc.
  • If you are constantly ill for long period or if you have any other serious health issues.
  • If you have nerve problems, kidney problems, paralysis, brain damage stomach problems, coronary heart disease, urinary problems and myasthenia gravis.
  • This drug may increase the risk of heart stroke because it causes heart rate problems and decreased sweat. Avoid doing heavy exercise, try to avoid going out in the hot sun because it causes dehydration.
  • Older adults will have an adverse effect during this medication period. Confusion and drowsiness may cause them to lose consciousness.
  • Try to keep away from children.
  • Nursing women should not use this drug without doctor prescription because it will pass into breast milk.
  • Caution should be taken in patients with a hiatal hernia associated with reflux esophagitis.
  • This drug will increase heart rate as a result tachycardia should be closely checked for every instance.

Warnings:

From the evaluated reports the drug is showing these problems

  • IBS (irritable bowel syndrome) – 50%
  • Bowel irritability –  70%
  • Abdominal pain –  75%
  • Diarrhea –  85%
  • Stomach pain – 20%
  • Diverticulosis –  80%
  • Urinary incontinence – 100%
  • Blurred vision –  75%

Psychosis is observed in some sensitive individuals. The central nervous system signs (CNS) observed to get resolved after 48 hours of drug withdrawal.

How long does Hyoscyamine take to work?

It is generally made of an equal mixture of atropine and has much higher potency than atropine. When taking 4x times daily it will start its action in 15-30 minutes. It is also observed that patients using sublingual ( a drug taken below tongue) form recovered or responded much faster than oral form.

How long does Hyoscyamine stay in your system – urine, blood, saliva?

The half-life of Hyoscyamine is 3.5 hours. The ability of the drug to stay in our system depends on the strength of the drug i.e. we are taking a long-acting drug or short-acting drug. The half-life for the short-acting drug is 15-25 hours and for the long-acting drug is 38 hours. The action capacity will last until 10-21 hours. Generally, a drug can stay in 12 hours and its effect lasts for 4 hours and for extended release tablet it will be up to 12 hours.

Hyoscyamine absorption and elimination

It is absorbed totally by the gastrointestinal tract and distributed to blood. The majority of the drug is converted to tropic acid or tropine and part of the drug are excreted through urine. Traces of this drug are found in breast milk. It passes the blood-brain barrier and the placental barrier.

Elimination: efficient drug should be excreted in large amount. After administration drug is distributed ant it gets excreted through various ways like urine, bile, breast milk, tears etc. Hyoscyamine is excreted 50% through urine. Feces excretion is considered in fewer amounts.

Hyoscyamine during pregnancy

Hyoscyamine is assigned as category ‘C’ in pregnancy. It shows adverse effect shows in animal studies and it affects the fetus. There is no effective result for human studies. If there is no effective alternative for this medicine then it can be taken with doctor prescription.

Hyoscyamine during breastfeeding

It is categorized under L3. It shows moderately safe and there are no controlled studies towards it. It is causing no effect to feeding mother. But this class of drug is known to pass into breast milk and it will cause highly damage to the fetus. Consult a doctor before using this medication.

Hyoscyamine Storage

  • Hyoscyamine should be stored under room temperature.
  • Should not store excess heat or excess cold condition
  • Expired medicine should be thrown immediately.
  • Keep medicine out of the reach of children.

What is Hyoscyamine sulfate?

It is one of the major components of belladonna alkaloids. It belongs to anticholinergics drug class. It has both inactive and active ingredients. Each tablet is made up of active ingredients like methenamine, monobasic sodium phosphate, methylene blue, hyoscyamine sulfate.

hyoscyamine vs hyoscyamine sulfate

Appearance:

  • Hyoscyamine sulfate: exists in white powder form. Should be kept away from light (loses its activity). It is considered to be soluble in water and alcohol but insoluble in ether.
  • Methenamine: exists in colorless, crystalline form. Freely soluble in alcohol, chloroform and in water.
  • Methylene blue: dark green crystal appearance. Soluble in water and chloroform, partially soluble in alcohol.

It is available in the market as urogesic blue.

Elimination:

  • Hyoscyamine: It is freely absorbed by the gastrointestinal tract and distributed throughout the body. Elimination is through urine within 12 hours. 50% is remaining in the body.
  • Methenamine: It is absorbed by the gastrointestinal tract. Excreted up to 90% through urine in 24 hours.
  • Methylene blue: while absorption in gastrointestinal tract it is reduced to leukomethylene blue (blood) and excreted in some form of urine (75%).

Patients should not be worried about urine discoloration. It will get released in blue or blue-green combination. This is due to the excretion of methylene blue.

They are available in the market in both oral form and sublingual form. Once they are administered, they rapidly distributed to entire system from the blood.

It is also available in brand named Levsin SL. It is used to relieve muscle spasms, reduces fluid secretions, it is used as an effective agent to treat intestinal disorders, control irritable bowel syndrome, it is used as a drying agent to control salivation for surgical purpose etc.

Hyoscyamine and food interactions

Every drug interacts with food and it may decrease the absorption capacity or efficacy of the drug. Grape juice is considered to be avoidable food item when taking medications like antibiotics, antihistamines, antacids etc.

Seek your doctor advice for taking any certain food items along with your medication. In the case of hyoscyamine, there is no specific food that you must avoid and there are no well-developed studies on food-drug interactions.

Hyoscyamine use for neuropathic pain

It is very useful for controlling pain when it acts together with opioids. By this mixture, it will increase the activity of analgesia obtained.

Hyoscyamine use for Parkinson’s disease

It has been shown that hyosciamine can be efficient in decreasing rigidity and tremors associated with parkinsonism and may control related sialorrhea and hyperhidrosis due to its anticholinergic effects.

Hyoscyamine and dementia

It is defined as memory loss. From the recently published studies, it shows that 75% people using anticholinergics are subjected to dementia. An anticholinergic drug that causes dementia includes antidepressants, antihistamines, and overactive bladder drugs. Sample from adults shows that long-term use of this class of medications had led to dementia. It also leads to brain atrophy with these individuals.

Can Hyosciamine cause weight loss?

It is not a weight loss medication. But it causes appetite problem because of that you won’t feel hungry and it automatically lead to weight loss. This drug is suitable for treating irritable bowel syndrome and diarrhea. It will automatically lose water from the body as a result, there may be weight loss.

Can I use hyoscyamine if I have neurophaty?

Autonomic neuropathy is a condition which is raised when there is a problem with the nerves which handles blood pressure, sweating, digestion etc. This anticholinergic agent (hyoscyamine) will make the autonomic neuropathy symptoms worse than before.

These include tachycardia, dry mouth, and eyes, vision problems, impotence in males. Thus a person should cautiously administer drugs with anticholinergic agents. Higher doses are not encouraged.

Can I take Hyoscyamine if I have Gastrointestinal obstruction?

This bowel obstruction occurs when your small or large intestine is completely blocked. This affects food movements and intestine functions. Taking hyoscyamine is known to aggregate the gastrointestinal obstructive diseases like achalasia, esophageal stenosis, and paralytic ileus. Patients with these disorders should avoid anticholinergic drugs

Can I take Hyoscyamine if I have Glaucoma?

It is related to eye’s optical damage. It is mostly caused by pressure build-up in your eyes. This has relation to hyoscyamine drug. Patients with glaucoma should avoid anticholinergic drug class drugs. Since this class of drug causes mydriasis, it may worsen the situation.

Can I use Hyoscyamine if I have Obstructive Uropathy?

It is avoided in patients with urinary retention and neck obstruction. Hyoscyamine may aggravate obstructive Uropathy. Caution is taken in elderly patients even with a minimum dose of hyoscyamine.

Can I use Hyoscyamine if I have Respiratory tract diseases?

Hyoscyamine is restricted in patients with low respiratory tract infections like asthma. This class of drug causes a reduction in the fluid secretion and it increases the thickening because of accumulation.

Can I use Hyoscyamine if I have Myasthenia gravis?

It is a neuromuscular disease related to muscle weakness. Eyelid of the person will be affected. Anticholinergic agents are avoided in patients with myasthenia gravis.

Can I use Hyoscyamine if I have Infectious diarrhea?

Drugs with antiperistaltic activity are inhibited in patients with diarrhea because of enterotoxin-producing bacteria. These drugs may exacerbate diarrhea associated with bacteria that invades intestinal cells.

Anticholinergic agents may decrease the motility of gastrointestinal tract so it will delay the secretion of fluid or toxicity. Even cough and cold products may include antimuscarinic agents so it is necessary to consult a doctor before making a selection.

Can I use Hyoscyamine if I have Cardiac disease?

Anticholinergic agents may block the function of sinoatrial nodal (SA) pacemaker. So drug should be administered carefully to cardiac disease patients.

Can I use Hyoscyamine if I have Gastric Ulcer?

Hyoscyamine may cause a delay in gastric secretion and also causes antral stasis in patients with gastric ulcer. So caution is taken in patients with gastric ulcer.

Can I use Hyoscyamine if I have Ulcerative colitis?

Antimuscarinic agents may decrease motility of intestine with the release of megacolon (toxic). It causes paralytic ileus because of this situation. So proper precaution is taken with patients having ulcerative colitis.

Can I use Hyoscyamine if I have Liver disease?

Anticholinergic agents undergo relatively fast liver metabolism. So this drug should not be mixed with liver disease patients.

Can I use Hyoscyamine if I have renal disease?

Hyoscyamine drug elimination is mainly by the kidney. So the drug should not be mixed with renal failure patients.

Can I use Hyoscyamine if I have hypertension?

Anticholinergic has severe cardiovascular activities. So patients with hypertension should avoid this class of drugs.

Can I use Hyoscyamine if I have Hyperthyroidism?

There is no mode of action. In general, this class of drug may increase thyroid. So hyoscyamine should be administered cautiously in patients with hyperthyroidism.

Can I use hyosciamine if I have fever?

Anticholinergic agents may cause hyperthermia by producing anhidrosis. The administration is restricted in persons with fever.

Hyoscyamine with antihypertensive drugs?

Anticholinergic agents are known to cause cardiovascular effects. This, in turn, causes problems in patients taking hypertension medication. It is not advisable to mix these drugs.

Hyoscyamine for prostatitis

Anticholinergic agents have both advantage and disadvantage over men’s problem of prostatitis. Some patients may urinate without any reason. This problem is treated using anticholinergics but they show negative impact over them.

Detrol and Ditropan are prescribed the antimuscarinic drugs for prostatitis treatment. They will help to relieve from frequent urination and relax muscles in the bladder to control urinary urgency.

Can I take Hyoscyamine and Benadryl together?

Interactions are adverse in the case of hyoscyamine and Benadryl. Using Benadryl along with this medication may increase the chance of blurred vision, irregular heartbeat, decreased sweating, irregular urination, constipation and memory loss.

These symptoms are more likely to affect elderly persons. Since it causes drowsiness, it is better to avoid driving jobs and machinery works. Consult with your doctor about your other medication including vitamins and herbs. Try not withdrawing any drugs before talking to your doctor.

Can I take Hyoscyamine and Flexeril together?

Usage of hyoscyamine and Flexeril together causes side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, confusion, and memory problems.

This is likely to affect elderly and people with less immunity condition. It is important to tell your doctor about all your medications used regularly. Do not stop using any medications without first talking to your doctor.

Can I take Hyoscyamine and Norco together?

Using Norco (hydrocodone) together with hyoscyamine increases the effect in persons. Side effects include dizziness, abdominal cramping, difficulty urination and problem in thinking and judgment. Consult a doctor before using these medications.

Can I take Hyoscyamine and Nitroglycerin together?

Anticholinergic agents such as hyoscyamine may decrease the absorption of Nitroglycerin. Specifically, anticholinergic drugs may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption.

Can I take Hyoscyamine and Tramadol together?

Tramadol is a narcotic analgesics drug class. They are used to treat back pain, chronic pain, depression etc. Till now there is no interaction between hyoscyamine and tramadol and consult a doctor before proceeding your medication.

Can I take Hyoscyamine and Potassium chloride together?

You should be cautious when using potassium in a solid form of drug i.e. tablets, capsules. Overdosage and mixing cause irritable effects of potassium in upper intestine and stomach. Consult a doctor if you experience these effect and don’t stop taking any drugs without a prior reminder to doctor.

Can I take Hyoscyamine and Topiramate together?

Topiramate belongs to an anticonvulsant class of drug and can be useful for the treatment of severe migraine headaches. It causes an increase in body temperature and decreased sweating as hyoscyamine.

When taking Topiramate along with hyoscyamine leads to heat stroke and fatal for some patients. It is caused mostly in hot summer or after severe exercise (dehydration). Drinking plenty of water during warmth whether can tackle this side effect.

Can I take Hyoscyamine and Xanax together?

Xanax belongs to the benzodiazepines drug class. They are used in anxiety, depression and panic disorder treatment. They are nothing to do with the anticholinergic class of drug (hyoscyamine). Seek permission from a doctor before taking this medication together.

Can I take Hyoscyamine and Tylenol together?

When these two drugs consumed together there are only minor effects and it shows there is no alteration or medication for this therapy. Health specialist will give any pieces of advice before taking these drugs together.

What is Hyoscyamine atropine?

It is generally made of several combinations of drugs namely belladonna alkaloids (hyoscyamine, atropine, scopolamine) and Phenobarbital. This medication is helpful in the treatment of cramps in intestines and stomach.

Mode of action: They work by relaxing the muscles in the stomach and intestines and slowing the natural movement of the gut.  In this, each component belongs to different drug class but they will provide the same function without causing side effects.

Drug classes:

  • Belladonna alkaloids belonging to antispasmodics/ anticholinergics. It does the function of hyoscyamine.
  • Phenobarbital belongs to barbiturate sedatives they help in reducing anxiety.

This drug is known to reduce irritable bowel syndrome (IBS).

Usage:

  • If you are taking extended-release tablets take 3 to 4 times a day as prescribed by your doctor. Take usually every 12 hour time interval.
  • Liquid form in 3 to 4 times a day. They should be measured with the proper measuring device not using a household spoon. The liquid form is dangerous since it contains little amount of sugar and alcohol it may raise the risk in persons with diabetes, alcohol dependence, liver damage etc. use this medicine as prescribed by the doctor.
  • Taking along with antacids may reduce the working and absorption of this drug.

Can I take Hyoscyamine and Adderall together?

Adderall is the combination of the two stimulant drugs namely amphetamine and dextroamphetamine. Amphetamine is derived from Alpha-Methyl Phenyl amine. It is a powerful drug for the treatment of attention deficit hyperactivity disorder (ADHD), obesity. They have divided into two enantiomers, levoamphetamine, and dextroamphetamine.

  • Amphetamine interaction with hyoscyamine:

It shows only minor interactions i.e. less risk when consumed together. The studies do not show clinically significant results in all patients. This minor interaction does not harm any patients and there is no need of alternative for this medication.

  • Dextroamphetamine interaction with hyoscyamine:

It also shows a minor interaction between these drugs. Seeking doctor advice for the medication will be the better option.

Can I take Hyoscyamine and Zofran together?

Zofran belongs to the 5HT3 receptor antagonists drug class. This class of drug does its function by reducing vomiting sensation by inhibiting receptors present in vomiting center at the small intestine. They are also useful in treating nausea.

They relieve us from alcohol addiction, obsessive compulsive disorder, and pruritus. Hyoscyamine class of drug does opposite functions and they both are different in their own way. There are no interactions between these two classes of drugs (medications).

Can I take Hyoscyamine and morphine together?

Using morphine together with hyoscyamine increases the effect of drowsiness, dizziness, dry mouth, abdominal cramping, constipation, and difficulty in concentration, thinking, and judgment. Avoid working in machinery and driving after uptake of hyoscyamine and morphine. Do not stop your medicine without prior information to the doctor.

Can I take Hyoscyamine and Haldol together?

Haldol is an antipsychotic agent. It is used to treat mental stress and problems caused by the brain. It is not advisable to treat during dementia, it leads to death.

When it is used together with hyoscyamine may increase the side effects of anticholinergic drugs like blurred vision, memory loss, sweating, difficulty urination, abdominal cramping, inconsistent heartbeat, confusion etc. The effect may be severe in the case of elderly persons or people with weak immune system. Doctor prescription is needed for buying these drugs in the pharmacy.

Can I take Hyoscyamine and Promethazine together?

Promethazine belongs to the antihistamine class of drugs. They act by modifying some chemicals in the brain. When this interacts with hyoscyamine it increases the risk of side effects caused by hyoscyamine. Doctor guidance is needed if any problem occurs. The prescription is necessary for drug usage.

Can I take Hyoscyamine and with OTC fixed combination drugs?

Antihistamine, anticholinergic, and decongestant used to treat stuffy nose, runny nose caused by dust infection or common cold as a combo. Antihistamine inhibits a natural substance called histamine in the body. It generally causes itching, cold etc. decongestant clears the nasal route.

Anticholinergics produce drying effect in the chest. These medicines are available as Over the counter (OTC) drug. It should not be used for baby or child under 4 years of age as OTC. Doctor prescribed medicine is efficient in all ways against fighting infections.

Avoid this combination:

Antacids and hyoscyamine: when administered together, antacids decrease the effect of hyoscyamine absorption. No positive result is obtained when these two drugs are taken together.

Antihistamines and anticholinergics: Antihistamines increases side effects in the person taking anticholinergic.

Corticosteroids: It increases intraocular pressure.

Hyoscyamine effects on blood pressure

Hyoscyamine generally works by increasing cardiac rate and decreasing blood pressure. So before using hyoscyamine, it is advised to meet the doctor to know the risk of taking this drug in person with blood pressure problems. Since it lowers the blood pressure, people with already low blood pressure will need to be more cautious. They should add some more medication to tackle this situation.

Can Hyoscyamine cause blurred vision?

Common side effects of hyoscyamine include blurred vision and it is reported in 60% of the patients taking this drug. It is considered to be major side effect after using this drug. Immediately after taking a tablet, dizziness and blurred vision appear.

It is advised not to do any work after using this medication. Driving is strictly not allowed. The patient should seek advice from health specialist for his use of other drugs related to optical problems. Overdosage or withdrawal of medication is not encouraged.

Hyoscyamine use before or after meals

  • Many anticholinergic agents are recommended to be taken along with food (may be before or after meals). Any medication which is not advised with food, then it may not have an effect. Here hyoscyamine is advised to be taken before food.
  • The absorption capacity of the drug from the gut:
  • Food intake increases the action of gut like blood flow rate, changes in pH and movement of the gut. When taking medication after food can increase the absorption capacity of the drug. It is observed in some drugs for fungal infections (Itraconazole).
  • In the case of antibiotics, it is recommended to take in an empty stomach because the drug can act well under acidic conditions.
  • The size of food:
  • There are no exact studies related to food size. It is observed in some medicines that eating fiber rich food known to increase drug absorption capacity.
  • Patients using a drug which causes weight loss should be taking full food before taking a tablet.
  • Labeled information:
  • If the label states “takes with or without food” it means the medicine should be taken during a meal or half an hour after a meal.
  • Check the label for detailed information before using any medication

Does hyoscyamine cause constipation?

Side effects are general for every drug. Hyoscyamine has a number of side effects and yes constipation is one among them. Constipation is occurring when large intestine is absorbing too much water and it makes a stool to move slowly by making it hard. Hyoscyamine is related to the motion of stomach and intestines. So it causes constipation.

Does hyoscyamine cause diarrhea?

Hyoscyamine causes diarrhea as a major side effect. So patients with diarrhea are advised not to take any medication along with hyoscyamine. It will aggravate the situation and lead to chronic.

Hyoscyamine or Dicyclomine – which is better?

  • Both belong to the same drug class anticholinergics. But hyoscyamine is known to reduce more problems than Dicyclomine. Dicyclomine is known to act against stomach and intestinal cramping. They slow the movement of the gut and relax it.
  • Dicyclomine is known to cause fewer side effects compared to hyoscyamine. “Dry mouth” is the only complaint from the consumer using hyoscyamine. Early morning the tongue is very dry to suspect thirst. Dicyclomine is not known to cause dry mouth.
  • Cramps works well with Dicyclomine. It has immediate action and fewer doses can relieve one from pain. Patients using hyoscyamine is known to use it on a long-term basis to get expected results. So it causes addiction.
  • Dicyclomine is known to act faster by reaching gastrointestinal tract and distribution is also ultra fast. The elimination is through urine (79.5%). Through feces, the only lesser amount (8.4%). It is not showing any toxicity effects.
  • Hyoscyamine is known to act much slower than Dicyclomine. Absorption is ultra fast by both sublingual and oral form. It is known to cause toxicity symptoms like dizziness, headache, blurred vision, hot dry skin etc.
  • From a consumer point of view, Dicyclomine is known to be effective and better by all means.

May hyoscyamine cause erectile dysfunction?

Erectile dysfunction is also known as “impotence”. It is one of the side effects of using an anticholinergic class of drugs (hyoscyamine). Many men with diabetes known to develop erectile dysfunction during young and mid stages. Other causes for ED are kidney disease, multiple sclerosis, and vascular disease. Studies reveal that drugs taken for these conditions known to decrease sexual functioning:

  • High blood pressure
  • Irritable bowel disease
  • Anxiety
  • Depression
  • Alcoholism
  • Glaucoma
  • Obesity
  • Heroin addiction etc.

Alcohol addiction: You may think drinking alcohol makes you “high”. It is not practically. Drinking excess amount may reduce the ability to have an erection. Nicotine can directly reach the nervous system and maintains and produce an erection. If taken in large amount it leads to erectile dysfunction.

Hyoscyamine use for nausea

Hyoscyamine is used to treat nausea in a better way. When anticholinergic agent used along with antacids can be treated peptic ulcers, nausea, vomiting and motion sickness.

Hyoscyamine for hospice

Hospice deals with counseling chronically ill, terminally ill patients and hearing about their emotional and spiritual needs. For century’s back, they are using only counseling methods to hear their need. Nowadays they are using medications.

Hyoscyamine is used to treat excessive wet tongue of some patients. This tablet is easily dissolvable in patients with wet tongue ant it will be easy medication method.

Hyoscyamine for anxiety

Anxiety and irritable bowel syndrome are related. When there are gut irritations, it will make us “high” and it will cause anxiety. Some said that hyoscyamine is not working well for anxiety as IBS.

Hyoscyamine overdose

Hyoscyamine causes overdosage symptoms like other drugs. It includes a headache, dizziness, CNS stimulation, difficulty in swallowing etc. Missing dose is one of the overdosage early signs. If you have missed a dose try to take it as soon as possible. Do not take along with the second set of dosage it will lead to overdosage. If you experience these signs contact your health care advisor or nearby pharmacy for alternatives.

Measures to be taken are immediate lavage of the stomach and injection of physostigmine 0.5 to 2 mg intravenously and repeated as necessary up to a total of 5 mg. Fever may be treated symptomatically (tepid water sponge baths, hypothermic blanket).

Excitement to a degree which demands attention may be managed with sodium thiopental 2% solution given slowly intravenously or chloral hydrate (100-200 mL of a 2% solution) by rectal infusion. In the event of progression of the curare-like effect to paralysis of the respiratory muscles, artificial respiration should be instituted and maintained until effective respiratory action returns

Hyoscyamine use with gluten free diets

Gluten is a protein component found in wheat, barley, rye etc. It has two main component namely gliadin and glutenin. Gliadin is found to cause harmful effect to people.

When this gluten reaches the digestive tract, it is unknowingly considered as a foreign invader by our immune cells and it causes bad effects like nutrient deficiencies, anemia, fatigue, digestive problems etc.

Hyoscyamine and gluten diets

An experiment did by people with irritable bowel syndrome with gluten containing or gluten free diet.

People with gluten-containing diet found to have more pain, bloating, stool inconsistency compared to another group of people. Gluten is known to cause inflammation in colon and leakage in the lining. Thus taking hyoscyamine along gluten diets is not advisable without doctor prescription.

Can I take hyoscyamine with alcohol?

Alcohol generally causes dizziness when taken individually. Taking along with hyoscyamine may increase drowsiness and dizziness and leads to falling. Avoid going for the excessive dosage of both drug and alcohol. It is important to tell your doctor about all your medications even about herbal diet.

Is Hyoscyamine a narcotic?

It is not considered to be narcotic. Taking on a long term basis leads to abuse. It is prescribed along with morphine (narcotic) to relieve from dryness. Hyoscyamine is considered to be uncontrolled substance under controlled substance act (CSA).

Does Hyoscyamine belong to FDA-approved category or not?

It is not considered to be safe drug by Food and Drug administration department. It is not available in the market nowadays as hyoscyamine. They are available as Hyomax SR and Levbid/ Levsin. These drugs are not giving effective results as hyoscyamine gave.

Can elderly safely take Hyosciamine?

Reported clinical experience has not identified differences in safety between patients aged 65 and over and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function

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Hematochezia Rectal Bleeding : Causes, Symptoms, Treatment and Prevention

May 11 2017 Published by under Diseases

What is hematochezia?

Hematochezia is a medical term for rectal bleeding. It refers to the passage of bright red blood from the rectum which is often mixed with stool or blood cloths. Hematochezia is most commonly associated with lower GIT bleeding (cecum to anus) usually from the rectum, colon, or hemorrhoids, but rarely it can be also occur as a brisk of upper gastrointestinal (stomach to ileum) bleeding or if there is an excessive bleeding.

Rectal bleeding is most usually associated with diarrhea. As a medical term hematochezia is in general population often confused and mixed up with melena and rectorrhagia, so the easiest and the most appropriate term for all may be bright red blood per rectum (BRBPR).

Hematochezia severity depends mainly on the amount and duration of bleeding. Severe cases need urgent treatment and hospitalization. In such cases the patient may be given blood transfusion in order to retain the blood volume.

Mild cases can be easily managed in the doctor office without need for hospitalization. Most cases have mild hematochezia with small blood quantities, usually occurring on the toilet papers. The main purpose in managing rectal bleeding is to support the patient circulation and then to diagnose and manage the underlying cause.

Hematochezia or Blood in Stool- Causes, Symptoms, Treatment

Difference between hematochezia and melena, hematemesis, rectorrhagia and hematopapyrus

As described, hematochezia is rectal bleeding most commonly associated with lower GIT bleeding (cecum to anus) and it represent as bright red sometimes fresh blood. On the other hand melena usually signifies bleeding that comes from the upper gastrointestinal tract (e.g bleeding from stomach ulcers, duodenum or from the small intestine). Bleeding in the case of melena is: black, “tarry” (sticky) and smelling because the blood stays in the gastrointestinal tract for a longer period of time before defecation.

The main difference between rectorrhagia and hematochezia is that, in the latter phase, rectorrhagia is not associated only with defecation; instead, it is also related with expulsion of fresh bright red blood without stools. However, the phrase bright red blood per rectum (BRBPR) is related with both hematochezia and rectorrhagia.

Hematopapyrus is blood on the toilet paper noticed when wiping, usually caused by hemorrhoids. It comes mostly from rectum. Blood on toilet paper may or may not be present in the case of hematochezia.

Hematemesis is a medical term for the blood vomiting, which may be noticeably red or have an look similar to coffee grounds.

How the stool look and color may indicate where bleeding came from?

Blood in the stool may be bright red, black and tarry, maroon in color or occult (not visible to the naked eye). Causes of blood in the stool may be different from harmless GIT conditions such as hemorrhoids or anal fissures and straining because of hard stools correlated with constipation to serious conditions such as cancer. If duration and amount of blood in stool is severe, it should be evaluated by a health care professional.

The color of the blood that may show up after defecation or without defecation may represent the location of the bleeding in the gastrointestinal tract. General rule is that, the closer the bleeding site is to the anus, the blood will be fresher and brighter red. Thus, bleeding from the anus, rectal region and the sigmoid colon tend to be bright red, while bleeding from the transverse colon and the right colon tend to be dark red or maroon in color.

The color of the blood in stool can also be black, smelly, and tarry and as described above it is called melena. It occurs when the blood stays enough in the colon giving the time for the bacteria to breakdown the blood into hematin chemicals which are black.

Thus, melena signifies bleeding is from the upper gastrointestinal tract. In some cases melena may also occur with bleeding localized in the right colon. Bleeding from the sigmoid colon and the rectum usually does not stay quite enough for the bacteria to turn it into black.

In some not so common cases caused by substantial bleeding from the right colon, and upper parts of the GIT such as gastric or duodenal ulcers may cause fast passage of the blood in the GIT and result with bright red rectal bleeding. This may happen because the blood is moving so rapidly that there is not enough time for the bacteria to breakdown it and to turn the blood in black.

Occasionally, GIT bleeding can be so slow to cause either melena or rectal bleeding. In such cases, bleeding is most commonly occult and is not visible to the naked eye. Blood can be only found by laboratory testing the stool for blood. Occult bleeding is in many ways as similar as rectal bleeding and may have the same symptoms as rectal bleeding. Results commonly show that occult bleeding is often associated with anemia because of the iron loss – iron deficiency anemia.

What are the causes of hematochezia?

In nearly 90% cases of hematochezia, the bleeding source lies in the colon. The amount and severity of bleeding is however variable. Hemorrhoids are known to cause only minor bleeding, whereas the conditions such as diverticular disease and vascular malformations may provoke severe and life-threatening bleeding. The other 10% of bleeding cases may be caused from location in the GIT which are above from colon.

If the bleeding is considerable from upper GI blood may be also bright and red and this may happen in cases of peptic ulcer disease, Mallory-Weiss syndrome, arteriovenous malformations, gastroesophageal varices, duodenitis, gastritis, and esophagitis.

The most common causes of hematochezia are following:

  • Hemorrhoids
  • Anal fissure
  • Proctitis
  • Polyps – Abnormal tissue growth. Bleeding can also occur after surgical resection of polyps
  • Condyloma acuminata
  • Diverticular Disease – blood comes from colon because of the defects in the external muscle layers
  • Crohn’s disease
  • Ulcerative colitis
  • Ischemic colitis – Colon Inflammation caused by inadequate blood supply
  • Rectal ulcer
  • Rectal prolapse
  • Angiodysplasia – Vascular malformations or blood vessels dialtation in the walls of intestines.
  • Rectal trauma
  • Anal cancer
  • Colon cancer – uncommon, but very important cause
  • Radiation therapy
  • Idiopathic – In nearly 1/4 of cases, the source of bleeding can be identified

lower gastrointestinal bleeding causes

What are the signs and symptoms of rectal bleeding and hematochezia?

Rectal bleeding with or without hematochezia can be present with following signs and symptoms:

  • Passing fresh blood
  • Fresh blood on the surface of stools
  • Fresh blood mixed with stool
  • Fresh blood on the toilet paper
  • Pink coloration of the toilet paper
  • Dark colored stools; tarry stools or maroon stools
  • Blood on the underwear

Various other symptoms may be related with rectal bleeding such as:

  • Pain when passing blood, typically if anal fissures are present
  • Sensation of bulge from the anus
  • Tearing sensations before passing stools
  • Cramping
  • Pain in the abdomen
  • Constipation
  • Unintentional loss of weight
  • Long straining
  • Loss of appetite
  • Unexplained fatigue
  • Anemia

What happens when you poop out blood?

Hemorrhoids and hematochezia

Hemorrhoidal hematochezia is most usually painless, despite bleeding caused by fissures tends to be painful. Hemorrhoids are also present with strangulation and pruritus. Typically, hemorrhoids may result with red-bright blood coats in the stool at the end of defecation or blood may stay on the toilet paper. In very rare cases bleeding may be massive, distressing the patient.

Anal fissures and hematochezia

Anal fissure is painful condition where the lining of the anal canal is torn. It is usually caused by physical trauma due to constipation or because of intensive bowel movement through tight muscles of the rectum.

The bleeding amount and hematochezia that may occur with an anal fissure is mostly small and noticeable on bowl or on the toilet paper as bright red in color. The anal fissure symptoms are commonly mistaken for hemorrhoids, but it can be differentiate, because hemorrhoids generally do not cause pain with bowel movements.

Polyps and hematochezia

Polyps are irregular tissue growth on the colon wall. Polyps can cause lower GIT bleeding and hematochezia, but more frequently, bleeding will occur when polyps are surgically removed.

Diverticulosis and hematochezia

Diverticulosis develops when pouches form in the wall of the colon. About 1/3 of the patients with hematochezia have diverticular diseases. However, only 3-15% of them will have present blood in stool. Diverticular disease can be diagnosed by a colonoscopy.

There are different treatment options for this disease. If colonoscopy is able to find the bleeding site, local injection of epinephrine or electrocautery can be used for bleeding control. If these methods fail to stop bleeding or if bleeding reoccurs, surgical resection of the colon can be performed.

Inflammatory bowel disease (IBD) and hematochezia

Colon inflammation can be caused by various conditions such as: infections, ischemia, radiotherapy, and inflammatory bowel diseases including Ulcerative colitis and Crohn’s Disease. Amongst IBD, Ulcerative Colitis is known to be more commonly present with observable hematochezia than Crohn’s disease. Crohn’s disease rarely causes hematochezia visible to the naked eye; however laboratory results may represent occult blood in patients suffering from this condition.

Infectious colitis and hematochezia

Infectious colitis commonly causes bloody diarrhea. Bacteria including Escherichia coli, Shigella, Salmonella, Clostridium difficile, Campylobacter can cause infectious colitis. Cytomegalovirus can also cause blood mixed diarrhea in patients with low immunity, especially in those with AIDS. Antibiotics use during long-term period may provoke Clostridium difficile colitis.

Radiotherapy for different abdominal and pelvic cancers can commonly cause colitis with lower GI bleeding resulting with blood in the stool. Mesenteric artery ischemia may also result in colitis, in which patient has bloody diarrhea and abdominal pain. This may require urgent surgical intervention.

Cancers and hematochezia

Patients who have colorectal cancers don’t necessarily have blood in their stools. Actually, hematochezia is rare symptom in such patients, but it is very significant as it might be the reason of poor prognosis.

Hematochezia might be the earliest and sometime the only symptom of colon cancer in its initial stages. It occurs rarely and gradually and is not usually related with pain. A colonoscopy is used as a major diagnostic procedure to rule out colorectal carcinomas. It should be known that massive bleeding can also occur in patients with colorectal cancers.

Angiodysplasia and hematochezia

Angiodysplasias is degenerative condition characterized by blood vessels dilation in the intestinal walls. This condition may cause massive bleeding occasionally with heamtochezija, which in some cases may be life threatening.

May hematochezia have no cause?

Yes, hematochezia may occur with no evident cause, and this is called idiopathic heamtochezia. In nearly 25% of the patients with blood in the stool, there is no known cause to be found. Most commonly in such cases, hematochezia is resolved spontaneously.

Hematochezia importance for the diagnosis of underlying conditions

During physical examination it is very important to mention if hematochezia is present, because in some cases this may be very important symptom for diagnosing underlying condition. Some of the following guidelines may be useful for diagnosis:

  • Taking detail anamnesis including: related symptoms, onset, duration and blood amount, previous history, and family history.
  • Full physical examination, especially if anemia is suspected, abdomen signs and symptoms, and rectal examination.
  • Anoscopy is endoscopic procedure that can be used for the visualization of the anus and rectum. Sigmoidoscopy or colonoscopy can be also used especially if colonic abnormalities are suspected.
  • Radionuclide scans may be also helpful to determine the location of the site of bleeding
  • Complete blood count can be also done in order to determine the severity of anemia caused by the rectal bleeding. Serum electrolytes levelsshould be also checked.
  • Coagulation profile is also recommended, including aPTT – activated partial thromboplastin time PT – prothrombin time, platelet count, and bleeding time.
  • Abdomen and pelvis helical CT scanning can be used when a routine tests fails to determine the cause of active GI bleeding. This procedure is able to diagnose following: vascular extravasation of the contrast medium, thickening of the bowel wall, contrast enhancement of the bowel wall, vascular dilatations.

Patients who have experienced multiple episodes of hematochezia without a known source or diagnosis should be examined with some of following procedures:

  • Elective mesenteric angiography
  • Upper and lower endoscopy
  • Meckel scanning
  • Upper GI series with small bowel assessment
  • Enteroclysis

Rare causes of lower GI bleeding that may need to be considered include the following:

  • Chronic radiation enteritis/proctitis
  • Small bowel diverticulosis
  • Meckel diverticulum
  • Ischemic colitis/mesenteric vascular insufficiency
  • Colonic/rectal varices
  • Portal colopathy
  • Solitary rectal ulcer syndrome
  • Diversion colitis
  • Dieulafoy lesion of colon
  • Dieulafoy lesion of small bowel
  • Vasculitides
  • Small bowel ulceration
  • Intussusception
  • Endometriosis
  • GI bleeding in runners

Hematochezia and lower GIT bleeding management

The management hematochezia and lower GIT bleeding has 3 principles, as follows:

  • Resuscitation and initial assessment
  • Localization of the bleeding site
  • Therapeutic intervention to stop bleeding at the site

Progresses in diagnostic and therapeutic angiography and endoscopy, the capability to localize and effectively treat lower GIT bleeding and hematochezia have resulted in improved patient outcomes and reduced healthcare costs. The requirement for surgery has also been meaningfully reduced.

What shall be done in the case of massive lower GIT bleeding?

Massive lower GIT bleeding can be a life-threatening condition. Initial resuscitation is one of the most important components in the management of massive bleeding. 2 large-bore intravenous (IV) catheters and isotonic crystalloid infusions should be administered in such cases.

Vital signs assessment, including monitoring of heart rate, pulse pressure, systolic blood pressure, and urine output, should be also achieved. Orthostatic hypotension treatment is also needed when blood loss is more than 1L.

Initial resuscitation and assessment for hematochezia

Initial resuscitation includes establishing large-bore IV access and management with normal saline. Besides ordering routine laboratory tests, blood should be typed and cross-matched. The volume of patient’s blood loss and hemodynamic status need to be determined and when severe bleeding is present, the patient may need invasive hemodynamic monitoring to direct therapy.

Hematochezia and localization of bleeding site

If it is not determined that bleeding comes from lower GIT, it should be considered that bleeding comes from the upper GIT. This may happen in about 10% of cases.  To be sure that bleeding actually comes from lower GIT; some patients should have a nasogastric tube placed, and if the lavage or aspirate do not have any blood or coffee ground material but do have bile, then bleeding that comes from the upper GIT is unlikely. Esophagogastroduodenoscopy (EGD) should be performed in the case of further suspicion.

Initial hemostasis for hematochezia

In hemodynamically stable patients with mild to moderate bleeding colonoscopy should be initially performed. When the bleeding site is localized, therapeutic options are injection with vasoconstrictors or sclerosing agents and coagulation.

If the bleeding is caused by diverticulosis, coagulation, epinephrine injection, and metallic clips may be used.

In the case of recurrent bleeding, the affected bowel segment should be resected.

In patients with angiodysplasia, thermal therapy including electrocoagulation or argon plasma coagulation is effective.

Vasoconstrictive therapy for hematochezia

Vasoconstrictive drugs such as vasopressin (Pitressin) are commonly used in situations with lower GIT bleeding. Vasopressin is a pituitary hormone which causes intense vasoconstriction in the splanchnic circulation reducing the blood flow and facilitates hemostatic plug formation in the bleeding vessel.

Vasopressin infusions are very effective in the case of diverticular bleeding, which is arterial. However, the efficacy is very low in patients with severe atherosclerosis and coagulopathy.

The use of epinephrine with propranolol and vasopressin has been also studied. Although epinephrine and propranolol significantly reduced mesenteric blood flow, they also produced a rebound effect increasing in blood flow and recurrent bleeding.

Therapeutic colonoscopy for hematochezia

Therapeutic colonoscopy has been proved useful in GIT bleeding induced by the radiation and in the treatment of polyp lesions. Colonoscopy treatment of radiation-induced bleeding includes topical application of formalin, laser therapy, and argon plasma coagulation. Neoplastic bleeding caused by polyps needs polypectomy. Patients diagnosed with colonic tumors may also need surgical resection.

Superselective embolization for hematochezia

The alternative for vasoconstrictive therapy is embolization with following agents: coil springs, gelatin sponge, polyvinyl alcohol, and oxidized cellulose. Embolization includes superselective catheterization of the bleeding vessel in order to minimize necrosis. It is indicated for the cases when vasopressin is unsuccessful or contraindicated.

When the bleeding location is recognized, microcoils can be used to occlude the broken vessel and to achieve hemostasis. Polyvinyl alcohol and Gelfoam can be also used alone or in combination with microcoils. In cases when terminal mural branches of the bleeding vessel cannot be catheterized, the procedure should be aborted and surgery should be performed.

Endoscopic therapy for hematochezia

Endoscopic regulation of bleeding can be attained using thermal modalities or sclerosing agents. Absolute alcohol, sodium tetradecyl sulfate and morrhuate sodium can be used for sclerotherapy of both upper and lower GIT bleeding.

Endoscopic thermal modalities including electrocoagulation, laser photocoagulation, and heater probe can also be used to stop bleeding. Endoscopic control of bleeding is appropriate for GIT polyps and cancers, endometriosis, mucosal lesions, arteriovenous malformations, postpolypectomy hemorrhage, and colonic and rectal varices. Postpolypectomy bleeding can be managed by polypectomy electrocoagulation with either snare or hot biopsy forceps or by epinephrine injection.

Surgery for massive lower GIT bleeding

Emergency surgery is needed in about 10-25% of patients with lower GIT bleeding in whom no surgical treatment was unsuccessful or unavailable. Embolization failure usually warrants surgical intervention.

Indications for surgery are:

  • Persistent hemodynamic instability with active bleeding
  • Persistent, recurrent bleeding
  • Transfusion of more than 4 units packed red bloods cells in a 24-hour period, with active or recurrent bleeding

Factors such as comorbidity disease and individual surgical practices play an important role in deciding which patient need surgery.

Segmental bowel resection with precise localization of the place of bleeding is a well-accepted surgical procedure in hemodynamically stable patients. Subtotal colectomy is another procedure of choice in individuals who are persistently bleeding from an unknown cause. 2008 SIGN guideline recommends subtotal colectomy for the management of colonic bleeding that is uncontrolled by other procedures.

Intraoperative esophagogastroduodenoscopy, colonoscopy and surgeon-guided enteroscopy can be helpful in diagnosing undiagnosed massive GI bleeding. Depending on the patient’s condition and availability of recourses, it may be in some cases be better to perform subtotal colectomy with distal ileal inspection.

Hemodynamically stable patients need preoperative localization of the hemorrhage site, while hemodynamically unstable patients with active bleeding may undergo emergency laparotomy with intraoperative endoscopy. Once the bleeding site is preoperatively localized, vasopressin infusion should be used as a temporizing measure to reduce the bleeding before patients undergo segmental colectomy.

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Methylphenidate

May 10 2017 Published by under Medicines

What is methylphenidate?

Methylphenidate is a Generic name for a special type of medication which is well known as a central nervous system stimulant. This medication normally affects chemicals in nerves and the brain which contributes to impulse control and hyperactivity. This medicine normally uses for the treatment of attention deficit disorder, narcolepsy and attention deficit hyperactivity disorder.

First, this medication was licensed by the FDA of USA in the year 1995 for the treatment which is now known as hyperactivity. This medication is sold under many trade names but the most common and famous trade name is known as Ritalin.

This medication began to medical use in 1960 and after 1990s this medication has prescribed vastly when the ADHD diagnosis became accepted. The prescription of this medication increased 50 % in between the year 2007 to 2012.

What are methylphenidate molecular formula, drug class and weight?

Chemical name: a-Phenyl-2-piperidineacetic Acid Methyl Ester

Methylphenidate belongs to the class of chemical entities known as aralkylamines. These are alkylamines in which the alkyl group is substituted at one carbon atom by an aromatic hydrocarbyl group.

Molecular Formula: C14H19NO2

methylphenidate molecular formula

Weight: 233.311g/mol

3D molecular formula of Methylphenidate

(3D molecular formula of Methylphenidate)

Methylphenidate is a class of drug which is specially used for stimulate the CNS which is known as central nervous system. This medication is similar to amphetamines but it has mild actions than the amphetamines. It treats attention deficit disorder, narcolepsy and attention deficit hyperactivity disorder.

What is methylphenidate used for?

Methylphenidate is a special kind of drug which specially uses for the treatment of attention deficit disorder, narcolepsy and attention deficit hyperactivity disorder. This medication normally affects chemicals in nerves and the brain which contributes to impulse control and hyper activity. It is a very useful and popular medication for ADD (attention deficit disorder) and ADHD (attention deficit hyperactivity disorder).

How methylphenidate works in the body?

As all of you known brain is the most vital organ of a human and it controls the nerves system. When you are taking methylphenidate this medication affects chemicals in your nerves and brain and contributes to impulse control and hyperactivity as a result, it helps a lot to the attention deficit disorder patient. Most of the doctor recommends this medicine for the treatment of ADHD, ADD and narcolepsy.

Methylphenidate brand names

Methylphenidate medication is well available with various brand names. That’s the main reason behind the medication you are taking might be called differently like:

  • Ritalin
  • Concerta
  • Metadate CD
  • Quillivant XR

You will get methylphenidate each of these above medications but the only difference is the brand name which is different from each other and it is because this medication is manufacturing by several companies so never get confused with names only always try to understand the composition or ingredient of the medication. If you have any doubt then strictly consult your doctor.

Methylphenidate brand name = Ritalin

 What is FDA approved indications for methylphenidate?

Methylphenidate is known as CNS stimulant which normally affects chemicals in nerve and brain which helps for the impulse control and hyper activity. This medication specially uses for the treatment of ADHD, ADD and narcolepsy.

Methylphenidate dosage forms and strengths

Methylphenidate is well available in three forms like

  • Oral
  • Tablets
  • Extended-release tablets

This is a good medication which usually uses for the treatment of narcolepsy, ADD and ADHD. Methylphenidate medications are well available in various strengths like 5mg, 10 mg and 20 mg and slow release forms containing 20 mg.

The dosage always depends on your health condition so never take medication as per your calculation always consult your doctor and take medicine according to the prescription of the doctor for the better result. If you see any type of side effects then immediately consult your doctor because you may be any dose adjustment.

Methylphenidate dosage for different indications

For attention-deficit hyperactivity disorder:

For short-acting oral dosage form (tablets)

  • For teenagers and adults: You need to take 5 to 20 milligrams two or three times per day. You can take it with or after your meal.
  • Children 6 years or over: you need to take 5 mg two times per day, take it with or after breakfast or lunch. Your doctor may increase the dose to 5 to 10 mg in a week but it totally depends on your health condition or a maximum dose is reached.
  • Children up to 6 years of age: doctor will decide the dose

For long-acting oral dosage form (extended-release tablets)

  • Teenagers and adults: You need to take 20 mg medication once or up to three times per day within eight hours of the gap.
  • Children 6 years of age and more: You need to take 20 mg one to three times per day with eight hours apart.
  • Children up to 6 years of age: For this age group, the doctor will decide the dose.

 For narcolepsy:

For short-acting oral dose form (tablets):

  • Adults and teenagers: you need to take 5 to 20 mg two or three times in a day with or after meals.

For long acting oral dosage:

  • Teenagers and adult: you need to take 20 mg one or three times a day and remember the dosage gap should be 8 hours.

Methylphenidate highest dose

60 mg is the highest dose of methylphenidate but you need to consult your doctor for the best dose for your body. Never take any extra dose or never take the double dose if you miss it because it can cause overdose and can lead many side effects. So always take medication according to your doctor’s prescription.

Methylphenidate overdose

In case of methylphenidate overdose, you need to call your nearest poison help center or emergency medical attention. An overdose of methylphenidate is always fatal and can seriously damage your body. So never take any extra dose without the permission of your doctor. Even after the dose suggested by the doctor, if you mark any side effects then consult your doctor immediately because you may need dose adjustment.

how much ritalin is too much

Methylphenidate side effects

Methylphenidate may lead many side effects so if you ever mark any side effects after taking your dose then immediately consult your doctor and discuss all your problems with your doctor for better dose adjustment. If your children are using methylphenidate and they are not growing properly then immediately consult your doctor. Stop taking methylphenidate and just consult your physician if you have:

  • Hallucinations problems
  • Chest pain, breathing problem
  • Cold feeling, skin color changes
  • Muscle twitches
  • Vision changes
  • Muscle pain, weakness, tenderness

Common methylphenidate side effects:

  • Headache
  • Loss of appetite
  • Sleep problems nervousness

Major side effects:

Consult your doctor immediately if you mark these side effects:

More Common:

  • Fast heart rate

Less common:

  • Fever
  • Chest pain
  • Joint pain
  • Skin rash

Rare:

  • Unusual bleeding
  • Muscle cramps
  • Convulsions
  • Blurred vision
  • Black or tarry stools

Incident not known:

  • Sudden headache
  • Numbness
  • Depression
  • Pale skin
  • Scaly skin
  • Difficulty in urination
  • Confusion
  • Unusual behavior
  • Weight loss
  • Yellow eyes or skin
  • Sudden coordination loss

Minor side effects:

Sometimes use of methylphenidate may occurs minor side effects at the initial intake of medication but later it will adjust on your body. So in such case, there is no need of any type of medication but never forget to consult your doctor because you may need any dose adjustment.

More common:

  • Nervousness
  • Sleeping trouble
  • Unusual warm skin
  • Loss of appetite
  • Stuffy nose
  • Headache

Less common:

  • Fear
  • Anger
  • Drowsiness
  • Irritability
  • Vomiting
  • Muscle aches
  • Scalp hair loss
  • Nausea
  • Runny nose

In all such side effects always consult your doctor for the best suggestion and treatment never neglect to any side effects.

How to take methylphenidate?

It’s quite important to take methylphenidate according to your doctor’s suggestion. Never take any extra dose without the permission of your doctor because medicine improperly or overdose can cause serious side effects and sometimes death. This drug may be habit-forming so don’t share this medication with other people special to the person who has drug abuse.

If you need any dose adjustment then it should be decided by your doctor according to your health condition for the best result. Never take medicines larger or smaller amount as per your own decision. You may feel sleepy after taking this medication so to avoid it always takes this medicine in the morning.

You should be taken some brands of methylphenidate at least 30 minutes before a meal but you can take the methylphenidate with or without food. Always try to follow the directions which normally stay on your medicine label.

Never chew, crush or break the extended-release tablets. Always swallow it whole in case you break or crush the medication then pill may cause too much of the drug to be released at a time. Always try to swallow in a perfect way without chewing the medicine. Never save the mixture for later use if you open the capsule and sprinkle the medication into a spoonful of applesauce.

If you are using oral suspension then shake it well before use it. During your methylphenidate medication, you need regular check up of your health especially your blood pressure, heart rate, weight and height.

If you need any type of surgery then always say your doctor that you are using methylphenidate because the doctor may advise you to stop this medication for short period of time. Always store your methylphenidate at room temperature try to avoid moisture and heat.

You should never take this medication if you have these listed problems like

  • High blood pressure
  • Glaucoma
  • Allergy to methylphenidate
  • Depression or mental illness
  • Abnormal brain wave test
  • Tourette’s syndrome

This medication is not approved for less than 6 year age group. If you are pregnant then your doctor will decide whether you will take this medication or not and it totally depends on your health condition. The doctor always suggest you after your complete check up so never take this medication according to your own decision because it can be dangerous.

Is methylphenidate detectable on a drug test?

If you are going for the standard NIDA-5 drug test then it is not but you can test it if you have any doubt. Methylphenidate always stays in the urine for around 1 to 2 days before fully excreted.

Methylphenidate for arrhythmias

According to the medical report use of methylphenidate medication can increase the risk for arrhythmias particularly in the case of young people or children those who have congenital heart disease. According to the research, the risk factor increases almost 60% for the arrhythmias.

In such case, a regular health monitoring required and you need to consult your doctor for the best dose adjustment and best treatment or medication therapy. Never take the decision on your own regarding the medication intake because it can be harmful to you.  

Methylphenidate for pheochromocytoma

Till the date, there is no pheochromocytoma reported by patients those who are taking methylphenidate. But it’s always better and safe to consult your doctor before taking this medication for the best dose and medication.

Don’t take any medication without the suggestion of your doctor. If you mark any type of side effects then immediately discuss your problems with your doctor because you may need any dose adjustment or other medication.

Methylphenidate for hypertension and angina pectoris

If you have hypertension and angina, then methylphenidate is always risky for you. So in such case always consult your doctor for the best treatment and dose adjustment. Never take or abrupt any medication without the suggestion of your doctor because if you are doing so then it may put a bad effect on your health condition.

Methylphenidate for heart failure

If you have serious heart disease or heart failure then there is always a risk factor on your methylphenidate. If you have such problem then consults your doctor and take proper advice regarding the dose and medication for the best result. Most of the doctor never recommend methylphenidate if you have the serious heart problem or heart failure because it always increases the risk factor.

Methylphenidate for hyperthyroidism

According to the medical report, people those who are using methylphenidate mostly female above the age group of 60 have Hyperthyroidism problem.

So if you are one of them then don’t suddenly abrupt your medication, first of all, consult your doctor and check up your health condition after that take medication according to your doctor’s suggestion. Never take any medications without the permission of your doctor because it may lead serious health issues.

Methylphenidate for anxiety

According to medical study, methylphenidate can increase the anxiety so if you have anxiety problem then just consult your doctor if your doctor is suggesting then you can take according to the prescription. If you mark any type of side effects after taking medicines then immediately consult your doctor and discuss in details because there may be dose adjustment require for you.

How long does it take for methylphenidate to work?

Methylphenidate normally works within an hour but people react differently to medications. It will not take several days to work perfectly like other drugs so for the better information you can consult with your doctor.

What happens if I miss a methylphenidate dose?

If you miss a dose then take it immediately as soon as you remember but if the time is later than 6.00 pm then just miss the dose and take care for the future dose. Never try to take the extra dose for the adjustment because it can cause serious damage to your body. But if you have already taken overdose then immediately call to nearest health care center for emergency treatment.

Can methylphenidate cause a heart attack?

Yes, methylphenidate can cause or increase the risk of heart attack especially in the case of children so always consult your doctor for the better treatment and best dose. Never take any medication without the permission of your physician. If you mark any side effects then just discuss with your doctor in details because you may need dose adjustment for the better result.

Can methylphenidate cause low blood pressure?

Yes, according to the medical report it is found that those people who take methylphenidate most probably who are female and above 60 years age group are facing low blood pressure problem. So there is always a possibility of low blood pressure with methylphenidate medication intake. In such case, always consult your doctor for the best treatments don’t stop the medication immediately without consulting your physician.

Can diabetics take methylphenidate?

Yes, diabetics can take methylphenidate but you need to take extra attention to your blood sugar level as stimulants will raise the sugar level so if you are unable to monitor your blood sugar level then never take methylphenidate.

So if you are a diabetic patient then consult your doctor and regular check up your sugar level and take medication according to the doctor prescription. After that, if you mark any uncertain side effects then immediately consult your doctor for the best solution sometimes patients need the dose adjustment to avoid side effects.

Methylphenidate and asthma

It is found that people who are female and age group in between 20 to 29 years old are affected with asthma those have been taking this drug for even less than 1 month. So if you have asthma problem then you need to consult your doctor before taking this medication don’t stop this medication immediately. Just discuss your problem with your physician and take medication according to the prescription.

If any side effects occur then says your doctor because you may need a dose adjustment or any other treatment for the best result. Never neglect to any type of side effects because it can be dangerous for your health.

Can I abrupt methylphenidate therapy suddenly?

No, you can’t abrupt methylphenidate therapy suddenly without consulting your doctor. If you do so then you may mark various side effects like withdrawals and much more it also put bad effects on your body so always consult your doctor and say him about your problems and take the suggestion for the best result and medication.

If you suddenly abrupt you may also feel more depression and other mental problems so consult your doctor because you may need dose adjustment for better improvement of your health condition.

Can methylphenidate cause withdrawal effects?

No, methylphenidate never causes withdrawal effects but yes if you abrupt discontinuation of methylphenidate then it can cause withdrawal effects so never abrupt your medication without consulting your doctor. If you mark any side effects then immediately consult your doctor because you may need any dose adjustment.

Precautions and warnings during methylphenidate use

If you have used a MAO inhibitor in the last 14 days then don’t take methylphenidate because it can occur dangerous drug interaction. Never take methylphenidate if you have an allergy to it, tension, severe anxiety, muscle twitches. So if you have this type of problems then discuss with your doctor in details and follow their suggestion and medication. This medication is not suitable for use by anyone who is younger than 6 years of old.

How long does methylphenidate work?

Methylphenidate drug effect or working time on your body always depends on which type of medication you are taking. If you are using immediate release formulation then it lasts around 8 hours. If you are using sustained release formulation then it lasts about 8 hours at last if you are using extended release formulation then it will work around 24 hours.

How long does methylphenidate stay in your system, urine, blood, saliva?

According to the medical science research report, methylphenidate stays at least 2 to 3 days in the human body like in blood, saliva and blood.

Methylphenidate during pregnancy

FDA has been assigned methylphenidate to pregnancy category C. there is no such controlled date in human pregnancy. Methylphenidate is only recommended by the doctor during pregnancy when there is any benefit outweighs the risk. But it’s always better to consult your doctor before using this medication during your pregnancy.    

Methylphenidate during breastfeeding

There is no such perfect report on this matter so always discuss with your doctor for the best suggestion. As per the report a maternal 5mg of dose in the morning and 10mg immediate- release formulation at noon, you can find the milk/serum concentration ratio is 1.1. There are no such effects were observed in the infant but it’s always better to take the suggestion from your doctor.

Can patients with renal disease take methylphenidate safely?

There is no such clear evidence or report on this matter so always consult your doctor before taking methylphenidate if you have renal disease. Don’t take this medication without the permission of your physician because it can cause serious damage to your body.

Can patients with liver disease take methylphenidate safely?

No, you can’t take methylphenidate if you have liver disease because according to medical report it can lead serious liver damage so it’s always better to consult your doctor and discuss regarding this for the best medication and result.  

Methylphenidate absorption, metabolism and elimination

Absorption:

Methylphenidate produces a bi-modal plasma concentration- time profile which is around four hours apart. When orally administered to children diagnosed with ADHD and to the healthy adults then the initial rate of absorption are quite same for both Ritalin LA and Ritalin tablets which are around one to three hours. The absorption time is quite different according to the form of medication but the average time of absorption is around 8 hours.

Metabolism:

In the case of children, the absolute oral bioavailability of methylphenidate was 22±8% for d-methylphenidate and 5±3% for l-methylphenidate. Very small amount of hydroxylated metabolites is detectable in plasma. Metabolized is normally by de-esterification by carboxyl esterase 1A1 to form d-ritalinic acid, which has very less or no pharmacologic activity.

Elimination:

According to the medical study, if an adult is taking methylphenidate then the medication elimination from plasma will occur with an average half-life period of around 3.5 hours. In the case of children, the half life will about 2.5 hours which is around 1.5 to 5.0 hours.

The whole system clearance is 0.40±0.12 L/h/kg for d-methylphenidate and 0.73±0.28 L/h/kg for methylphenidate. After taking immediate release formulation of methylphenidate 78 to 97% of the medication dose is exerted in the urine.

Can I drink alcohol while taking methylphenidate?

No, you can’t take alcohol while taking methylphenidate especially if you are using extended-release methylphenidate. Drinking alcohol with methylphenidate can change the way of the drug works in real. So always try to avoid alcohol during your methylphenidate medication.

Can I take methylphenidate and aspirin together?

Yes, you can take methylphenidate and aspirin together because there were no such interactions found between these two medications according to the medical science till now that doesn’t mean that there is no interaction exist so always consult your doctor before taking this medication. If you feel or mark any kind of side effects then just check up your body and consult your doctor you may need dose adjustment.

Can I take methylphenidate and amlodipine together?

No, you can’t take methylphenidate and amlodipine together because as per the medical report there are drug interactions between these two medications so always consult your doctor before taking any medications if after the suggestion of doctor you mark any type of side effects then discuss with your doctor because you may need a dose adjustment. 

Can I take methylphenidate and Viagra together?

No, you can’t take methylphenidate and Viagra together because there are drug interactions between these two medications. So always consult your doctor to get the best and accurate suggestion. Don’t take any medication without the prescription of your doctor.

 Can I take methylphenidate and advil together?

There is no such known interaction between advil and methylphenidate in medical records but that doesn’t mean that there is no such interaction exist so always it’s better to consult your doctor before taking these medications for the safety purpose and the better result.

Can patients with congestive heart failure take methylphenidate?

No, if you have a serious heart problem or congestive heart failure then it’s too risky for you to take methylphenidate and can be a cause of sudden death so never take this medication without the permission of your doctor.

Can I take methylphenidate and digoxin together?

No, you can’t take digoxin and methylphenidate medications together because there are drug interactions found in between them and can cause serious damage to human body. Always consult your doctor and make clear about these two medications for you.

Can I take methylphenidate and hydralazine together?

Yes, you can take hydralazine and methylphenidate together because according to medical science there are no such interactions found between these two medications. That doesn’t mean that there is no interaction exists so for the safety purpose always discuss with your doctor regarding these two medications intake and after the doctor’s suggestion if you mark any side effects then immediately consult your doctor because there may be any dose adjustment required for you.

Can I take methylphenidate and metformin together?

Till the date, there are no such drug interactions found as per the medical record between these two medications but that doesn’t mean that no interaction exists in between them so before taking these two medications together its always better to consult with your physician for the best suggestion.

If you are taking these two medications and mark any type of side effects then never neglect to them just consult your doctor immediately and go for the solution or you may need any dose adjustment for the better result.

All about storage and disposal of methylphenidate medication

This medicine normally comes with a tightly closed container so always keep your medicine in it and make sure that the cover is tight enough so that the air could not pass through it. Always keep this medicine out of the reach of the children.

Always store this medicine at room temperature and away from excess moisture and heat. Never keep any medicine which is outdated just threw it away. Consult your physician to know the proper way of disposal of your medication.

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Is it fine to be fat?

May 10 2017 Published by under Common Health Questions

What is Body mass index (BMI)?

The body mass index (BMI), also known as Quetelet index, is a parameter indicating whether someone is at a normal weight, overweight, or has obesity. It measures weight in relation to height of individual and gives a certain score. In dependence of this score, it classified a person in the one of three category of weight:

  1. normal weight: BMI of 18.5 to 24.9
  2. overweight: BMI of 25 to 29.9
  3. obesity: BMI of 30 or higher

BMI formula:

What is a good body mass index?

Excess BMI and health problems

Excess BMI may increase the risk for many health problems, such as: diabetes mellitus type 2, hypertension, angina pectoris, heart disease, heart and brain strokes, certain types of cancer, sleep apnea, kidney disease, osteoarthritis, fatty liver disease, pregnancy problems such as pregnancy hypertension and diabetes, and increased risk for cesarean delivery.

Is being slightly overweight actually good for health?

However, recent studies have revealed that being slightly overweight may, in fact, improve a person’s health and even lower a risk of mortality. Researchers discovered, that an enzyme called Nicotinamide phosphoribosyltransferase (NAMPT), secreted by the body’s fat tissue controls energy levels in the brain and its response to a lack of food, and they also concluded that there may be an optimal amount of body fat for maximizing health and longevity. But, scientists still do not know what amount of fat is needed, and how it might vary from person to person.

Many studies reported that as we are getting older, people who are slightly overweight tend to have fewer health problems, especially lower number of cases with dementia, and also lower mortality rate.

Mechanism of overweight benefits

Studies conducted by professor Imai and his colleagues indicate the importance of an enzyme NAMPT in producing a vital cellular fuel called Nicotinamide adenine dinucleotide – NAD, and in controlling metabolism and ageing processes. It was known that NAMPT have essential rule in producing energy inside cell, but Imai’s study suggests that this enzyme have important activities outside the cells, during circulation through the bloodstream, and that this is actually highly active and regulated enzyme.

Their studies on mice have shown surprising results. Mice were raised with a deficit of NAMPT, and as it was expected, the energy levels in fat tissue was reduced. Effects on other tissues like liver and muscle were no significant, but there was a significant effect on the hypothalamus, an important part of the brain, with important roles including regulating body temperature, sleep cycles, heart rate, blood pressure, thirst and appetite.

Low levels of NAMPT in fat tissue of mice resulted with low energy levels in the hypothalamus, and lower physical activity compared to mice without this defect. The team has also performed and opposite experiment with mice that produce higher levels of NAMPT in fat tissue than normal, and those mice was much more physically active, especially after fasting, than control normal mice.

Researchers also found that physical activity in mice with low levels of NAMPT in fat tissue can be improved with NMN injection (NMN – nicotinamide mononucleotide), which is an enzyme product of NAMPT. According to professor Imai, ”NAMPT signal from the fat tissue, especially in response to fasting, may serve as a survival mechanism”, and ”therapy with NMN might be a possible treatment of diseases which are associated with aging.”

Reasons Why Being 'Fat' Is Pretty Awesome

Obesity and mortality rates

One big study conducted in United States and published in JAMA – Journal of the American Medical Association, investigated relative risks of mortality associated with underweight, overweight, and obesity according to BMI. Obesity category (BMI > 30) was associated with 111,909 excess deaths while underweight (BMI < 18.5) with 33,746 excess deaths.

Overweight (BMI 25-30) was not associated with excess mortality. Underweight and obesity, particularly higher levels of obesity, were associated with increased mortality relative to the normal weight category. Because of improvements in public health and medical care, the impact of obesity on mortality may have decreased over time.

May obesity reduce the risk of dementia?

Recent cohort study suggests that overweight people are less likely to develop dementia. The researchers analyzed the medical records of nearly 2 million people (aged 40 years or older) in whom BMI was recorded between 1992 and 2007. Results showed that underweight people (BMI <20) had a 34% higher risk of dementia, compared with normal weight people.

The incidence of dementia continued to fall for every increasing BMI category. Overweight people with a BMI of 25 to 29) had an 18 % lower risk of dementia, and very obese people (BMI >40) had a 29% lower dementia risk than people of a normal weight.

Being underweight in middle age and old age carries an increased risk of dementia over two decades. Results contradict the theory that obesity in middle age could increase the risk of dementia in old age. However this finding needs further investigation.

May obesity improve life-span?

There are also statistical findings which show that those who are overweight or moderately obese better tolerate the same health problems. Some of them are that diabetes patients with normal weight are twice as likely to die as those who are overweight or obese, heavier dialysis patients have a lower chance of dying than those who are of normal weight or underweight, mild to moderate obesity poses no additional mortality risks to those already suffering from heart disease, and obesity can help people with certain cancers live longer.

The explanation for that may be that fat cells are not equal and could have different characteristics, also, some types of fats and fatty acids can promote illness and dysfunction in the human body, or they can prevent the body from diseases. For example, belly fat tissue can release fatty acids and inflammatory compounds into the bloodstream leading to higher LDL – bad cholesterol, blood glucose and blood pressure.

There is no doubt that becoming heavier and heavier must, at some point, damage health and reduce life expectancy. However, the critical point is certainly not anywhere between 25 and 30 of BMI, and it could be even higher.

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Does coconut oil expire? Can you freeze coconut oil? How do you store coconut oil?

May 09 2017 Published by under Common Health Questions

Coconut oil and its properties

Extracted from kernel or flesh of fully grown coconuts, Coconut Oil is edible oil and a healthy fat that is made up of 50% essential fatty acid (lauric acid) that is beneficial in enhancing immunity. Coconut oil contains high saturated fat content, therefore, it is slow to oxidize and less prone to rancidification.

Though there are countless benefits of Coconut Oil but the medicinal tool, moisturizer, cosmetic base, cooking oil are some common uses that everybody enjoys. Coconut oil has a huge number of health benefits that it is used as a medicine at many places. Some studies show that the people who use to have high coconut oil rich diet, do not suffer from many of modern diseases and stay generally good in health.

There are two types of Coconut Oil that are:

  1. Virgin Oil or Extra-Virgin Oil: Highly Nutritious
  2. Refined Oil: Expeller pressed and refined with the help of steam

does coconut oil go bad if not refrigerated

Coconut oil medical use

Coconut oil is commonly used as a moisturizer and a cosmetic base due to its extremely safe and stable properties. Coconut oil used as a medicinal aid in many conditions such as itching, burning, rashes, lesions, injuries very frequently. Its antimicrobial properties make it safest for medicinal use. Coconut oil is frequently used as cooking oil and considered as safe and healthier for use as compared to other cooking oils. Coconut oil contains healthier fatty acids that help in strengthen the weaker immune system.

Can I freeze Coconut Oil?

Coconut Oil is highly shelf stable oil that you do not need to store it in the fridge. Due to its longer shelf life than any other oil, Coconut oil does not require any special treatment for storage and it remains fresh for up to 2 years. It has a high melting point that is 76 degrees due to which it frequently changes its state, with temperature fluctuation throughout the year.

Normally Coconut Oil needs not to store in the fridge, but in the summer season when the temperature is extremely high, it may need to get stored in the fridge, for making it better for future use.

For personal use, one can store the coconut oil in the fridge in the form of frozen cubes..

Procedure: you can store coconut oil in the fridge by melting the coconut oil and then pour them into the heat resistant or silicon molds. Measure the quantity of coconut oil at the time of pouring oil, as it will help you to identify the right quantity of coconut oil per frozen cube.

Place them in the freezer for few hours, then after passing few hours, take them out of the freezer and then from molds and place them in a freezer-safe bag. You can mention the quantity of coconut oil in each frozen cube.

Here are some uses of frozen oil cubes:

  1. Lotion Bar: Used as Skin Moisturiser
  2. Cooking: Used for perfect measure of oil
  3. Oil pulling: Used as a little section of cube and placed in mouth
  4. Baking: Used for appropriate portions of oil
  5. Coconut oil coffee: Used as half cube to make coconut oil coffee
  6. Moisturising Bath: Used as a moisturiser in a hot bath.

How long Coconut Oil can last?

Where a refined coconut oil lasts up to 18 months, before getting spoiled, a virgin or a pure coconut oil has a shelf life of 3 years. Because the virgin oil is produced by a wet milling method, which makes virgin coconut oil filled with antioxidants that help to prevent rancidity of oil. The oil produced by this method lasts for several years without getting rancid.

Coconut oil has effective antimicrobial properties and it doesn’t oxidize easily. Just like every other product in the market, Coconut Oil also has a “best before” date that indicates the stability of coconut oil before a specific expiry date.

Coconut oil itself has amazing properties that make it last longer than other oils, so you can check your coconut oil, for this “until you find your coconut oil is bad (with a bad smell or any mold/bacteria growth), it is fine and safe for use”.

Coconut oil lasts at for 3 years at least, if you have a coconut oil from past 8 years than just throw it out. Coconut oil lasts so long due to some great properties, such as:

  1. It has a melting point of 24 degree Celsius (75 F) which makes it super stable due to changing its state (solid or liquid) as per temperature fluctuations in its surroundings.
  2. It has antibacterial and anti-fungal properties that prevent it from getting rancid.
  3. It reduces contamination from microbes due to its natural antimicrobial activity.
  4. It has a highly stable chemical structure that makes it most stable under any kind of temperature conditions.
  5. It contains higher lauric acid (saturated fat) content that enhances its stability even more.

Does Coconut Oil Expire?

Due to higher saturated fatty acid content and stable chemical structure, coconut oil resists any kind of spoilage or rancidity. Coconut Oil lasts more than any other cooking oil due to its resistance to oxidisation process and rancidity. Although coconut oil contains great antibacterial properties, but still it can get rancid if stored under inappropriate temperature conditions.

Of course, coconut oil also get expires but only if it is placed under improper storage conditions. Although all manufacturing companies provide a best before the date on containers of coconut oil, making it suitable for use it expires. Here are some signs that will help you to know if your coconut oil is expired or not:

Use your senses:

  • In order to prevent any kind of food-born illness, one should maintain proper hygiene conditions and practice appropriate food safety techniques.
  • Smell the oil container to check the spoilage of coconut oil if you sense any foul smell or bad odour than your coconut oil become rancid and its time to throw it out.
  • Coconut oil mainly comes as White soft solid and it turns slightly yellow if spoiled, so check out if it discoloured or not.
  • Food safety measures are most recommended techniques to prevent any kind of oil to prevent them from rancidity.

Extend the shelf life of your coconut oil

You can extend the shelf life of your coconut oil by storing it in the best-suited conditions. To enhance the shelf life:

  • Coconut oil should be stored in the pantry. Here it can store in liquid (above 75F) form as well as in the solid form (below 75F) without any risk of getting rancid.
  • Avoid storing your coconut oil in the fridge, as it gets very hard in the fridge and making it difficult to use.

Your Coconut Oil can go bad also:

  • If you are using the coconut oil in a bakery food product, It can go bad. All food products expire soon along with quickest expiring ingredient in the dish and so do the coconut oil.

Coconut oil proved beneficial even under storing conditions. Some uses of food storage are healthier eating; lesser food costs and avoid wastage thereby saving the environment.

How to identify rancid Coconut Oil?

An expired product is never fit for use. A rancid coconut oil can produce bumps and fungal lesions on the skin. If you are using a product for the very first time, you can not identify the rancidity or rotten condition of any product here it becomes necessary to know your coconut oil before using. If you are using a coconut oil for the first time, you can check its rancidity with some common signs. You can identify your oil by:

  1. If it is yellow in color in the liquid state.
  2. If it tastes bitter and smells very bad.
  3. If it has non-smoothed consistency
  4. If it too hard to clean from the skin surface (try a little patch first)
  5. If you find any kind of impurities at the bottom of the container, It can be some growth of bacteria.

There are two types of coconut oil, Virgin oil, and refined oil. One can identify the virgin coconut oil by checking the final product. Virgin coconut oil is not processed and you can identify it from copra derived cooking oil by checking its colour. The Copra derived coconut oil is yellow in colour which is created by molds. These molds can be destroyed during the refining process and these molds are not harmful for human consumption.

Coconut oils also available in the market under multiple brands with different qualities. Always use a good quality coconut oil and it should be sealed and closed properly after every usage in order to prevent entry of any kind of moisture. Because moisture can enhance the growth of mold inside the container and oil can get rancid.

Avoid doing the double dip in the same container and avoid using dirty cutlery while taking the coconut oil out from the container because these are some prime causes of spreading the bacteria. Fresh coconut oil is white solid and becomes transparent when melted. It becomes naturally cloudy or semi-solid in between states.

What can I do with expired / rancid Coconut Oil?

An expired coconut oil becomes rancid over the time. If you notice any kind of dark spots or foul smell than of course, it is of no use. But if it still smells nice,

  1. You can use it to oil a lamp by mixing with some other flammable oil.
  2. You can make some candles out of it, by mixing with some beeswax or essential oils.

If you spot any kind of mold or growth on the surface of the coconut oil, you can scoop off the mold and contaminated area with the clean cutlery and now you can use rest of it. but if it developed a foul smell or bitter taste, discard it right away.

Can Expired Oil cause side effects?

Coconut oil is better known for its health benefits and nutritional data, but it need the lower temperature in cooking and it should be used in low heat or no heat dishes.

Every oil has a particular smoke point, the temperature at which the nutritional content of the oil starts degrading rapidly. At this temperature, oil starts emitting smoke and become rancid which is more harmful than destroyed oil.  Refined coconut oil has a smoke point of 450’F, whereas virgin coconut oil has a smoke point of 350’F.

There are some free fatty acids released at the time of rancidity process that is responsible for producing unpleasant smell. Although, these fatty acid are not dangerous for your health but at the time of oxidative rancidity, oxygenated aldehydes are produced, which are responsible for oxidative stress in your body and are responsible for developing the risk of atherosclerotic and degenerative diseases.

How can I store Coconut Oil?

  • Coconut oil can be stored at different temperatures for desired consistency. For example, Coconut oil will turn liquid when the temperature rises above 75’F, and when room temperature is less than 75’F or 24’C, Coconut oil will changes its state from liquid to solid. Coconut oil can also achieve a Jelly like a state, when stored at a temperature little less than 24’C. Coconut Oil can be stored as frozen cubes, where it turns very solid and used for purposes of cooking and much more.
  • Coconut Oil should be stored away from direct sunlight. Direct sunlight can spoil the coconut oil soon and make it rancid before its expiry date. Under tropical climate or summer season, the extremely hot temperature can make coconut oil go bad and not suitable for use, so in such conditions, one should store the coconut oil in fridge or cool areas.
  • Coconut oil should not be stored in Bathroom, where temperature changes frequently. Ideally, it should be stored in the counter, and then shift it to the fridge, if needed.
  • Coconut oil becomes rancid, if it produces a bad odor or it if shows the growth of bacteria on its surface. So, whenever in use, you should use very clean utensils or cutlery to scoop out the coconut oil from the container, because dirty cutlery can lead to spoilage of coconut oil.

Commercially (in bulk quantities) coconut oil is sold in 5-pound bulk increments and these large containers quantities are also stored after making small portions. For this, One has to melt all the oil in a very large container where mixing of fiber and oil takes place. Then you can transfer the coconut oil into smaller parts and store them in small food safe containers. The most common sizes of stored coconut oil are considered as quartz and pints.

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Plantar Fasciitis – definition, symptoms, causes, treatment, home remedies

May 08 2017 Published by under Diseases

What is Plantar Fasciitis?

Plantar Fasciitis is a commonly occurring condition in which the plantar fascia ligament is inflamed. This ligament is attached at the heel bone and has the unique feature of being the largest ligament in human body

Plantar Fasciitis signs and symptoms

The most common symptom of Plantar Fasciitis is pain and tenderness that can be felt at either a specific point or the whole sole of the foot. This pain last throughout the day.

The pain is very severe on the initial few steps after prolonged period of rest or inactivity of the foot and is continued throughout the day. Heel spurs are also commonly seen in patients with this condition. The heel spurs are basically hard bands of connective tissue on the bony prominence on the underside of the foot.

Plantar Fasciitis is basically an inflammatory condition due which it holds the benefit of not spreading to other areas in the body or even from one person to another. Keeping aside the fact that in plantar fasciitis, sometimes the calf muscle of the leg is also stretched but this inflammation stay limited to fascia ligament.

plantar fasciitis pain area

Causes and risk factors for Plantar Fasciitis

The precise cause of Plantar Fasciitis is not known but it occurs possibly due to repeated small injuries of the fascia. These small injuries lead to degeneration of collagen fibers which make up the ligament.  On extreme running and walking, jumping and other activities the fascia ligament is subjected to repetitive tearing and stretching which can irritate the cause its inflammation.

Besides these activity based factors, changing footwear style or wearing uneven footwear can also exacerbate the injuries and irritation will lead to inflammation.  However, it may also occur due to underlying diseases such as reactive arthritis and ankylosing spondylitis.

However, there are certain factors that can make a person more prone to suffer from this condition. These factors are enlisted below:

  • Age: middle aged people between 40-50 are more likely to suffer.
  • Exercise: certain exercises can contribute to an early onset of plantar fasciitis- such as aerobic dance
  • Obesity: more body mass, more stress on the ligament
  • Occupations: people who stay on their feet throughout their working hours can injure their ligament – such as factory workers
  • Foot mechanics: certain foot movements or positions such as having an irregular pattern of walking (cat walking for female models), wearing high uncomfortable heels giving a high arch to the ligament and walking on rough surfaces with flat shoes for long time can also damage the fascia.

Plantar Fasciitis complications

Usually during this condition, complications don’t occur but in rare cases due to consistent aggressiveness, or pressure on the ligament, it may be ruptured. This rupturing lead to further complications which include the flattening and weakening of the longitudinal arch and heel hypoesthesia. The rupture of the fascia ligament may also occur during the treatment with steroids.

Plantar Fasciitis diagnosis and tests

A complete case history is required in the diagnosis of plantar fasciitis. When the physical examination of Plantar Fasciitis done, the primary finding is the reproducing pain when plantar medial calcaneal is palpated at the site the fascial insertion to the heel bone. Pain is increased by dorsiflexion of the toes. There might a pain in the plantar fascia ligament as it moves anteriorly.

Tightening of Achilles tendon secondary and occasionally contributes to pathological findings. The pathological findings in these patients are reproduction of tenderness and inflammation of the collagen fibers. A strong grip on the knowledge of local anatomy is needed for the differential diagnosis of Plantar Fasciitis as many of the signs and symptoms are similar to those experienced in Baxter Nerve Syndrome.

Furthermore, a full musculoskeletal examination helps is diagnosing this condition. This examination includes range of movements of the hind-foot joints. A vascular examination also aids the physician in the diagnosis.

Laboratory tests are not required in the workup of Plantar Fasciitis but they can be used to rule out other suspected diseases. Basically because this is an inflammatory condition, there would be a rise in Leukocytes/WBCs when complete blood count CBC is carried out and there might be disruption in erythrocyte sedimentation rate ESR, but they won’t be used for differential diagnosis of Plantar Fasciitis.

Radiological techniques such as X-rays are only recommended when there is a doubt in identifying the heel spur and a bony tumor located on the heel of the foot, but this must be done before the treatment with steroids (injection) that is given for pain. However, imaging studies such as ultrasound are useful to monitor the treatment response in chronic cases.

This can also be used in determining the extent of the condition. MRI can be reserved for rare cases such as partial or complete rupture of the ligament. Edema in the surroundings and thickening of ligament can also be identified in a MRI report. Ultrasonography is used to examine hypoechogenicity.

Plantar Fasciitis treatments

Once a complete case history has been taken and a differential diagnosis is made, a proper stepwise, organized treatment should be directed. Basically Plantar Fasciitis is a self limiting condition; first approach like other conditions should be to perform noninvasive procedures.

Non-surgical treatment for Plantar Fasciitis

Empirically, it is observed that most cases of Plantar Fasciitis will respond to multi-therapy approach and the suffering will become bearable within 1-2months and full recovery can be made in 6-9 months.

The irritation and inflammation in Plantar Fasciitis contributes the most to discomfort of the patient. For this discomfort non-steroidal anti-inflammatory drugs (NSAID’s) are given initially. They work by blocking the synthesis of prostaglandins and producing an analgesic effect and reducing the inflammation.

Side by side, remedial actions are taken to provide symptomatic relief to the patient such as icing the ligament on the underside of the foot. Complete rest to the foot is not possible for an ambulant patient, therefore certain types of cushions and pads are now available to reduce symptoms associated with this condition. Night splints are commonly advised to reduce the intensity of the morning pain.

These are rigid, casted ankle-foot orthosis manufactured to hold the ankle in 10° of dorsiflexion. A walking cast on the lower leg will help to restore strength and motion.

Furthermore, exercises like toe stretches, calf stretches and towel stretches done all through the day especially before getting up from bed in the morning. These help to improve the flexibility of the ligament.  Physical therapists are available to provide their services to such patients. Tapping practice is also another way to provide transitory relief but frequent re-taping is required for prolonged relief.

If no improvements are seen in a period of 6 weeks or if the suffering becomes worse, the doctor moves up to give corticosteroids. Though these are potent drugs to provide relief from pain but the relief is only short term. Instead the injections of these corticosteroids are themselves painful, and repeated injections can damage the fascia. Extracorpeal shock wave therapy (ESWT) is only considered in refractory cases.

Patients who are having a point tenderness and no associated pathology, are the ones who will respond best to such a therapy. A drawback with this is that not all patients will get relief from pain.

Traditional therapy includes daily icing, stretching exercise, tapping and OTC orthosis are recommended in the initial treatment for planter fasciitis. This can be done in the first 6 weeks of the condition. Counseling is also done to keep the patient aware of all the necessary inputs he has to make in order to not to suffer from the pain of plantar fasciitis. After 6 weeks, additionally a night splint and corticosteroid injection is recommended.

Surgical treatment for Plantar Fasciitis

Surgical treatment is needed for chronic, non-responsive users only which comprise less than 5% of the total cases.  The indications for surgery are:

  • You continue to have loss of foot function despite using all other nonsurgical treatment options
  • You have had symptoms for at least one year.
  • You are an athlete and symptoms and it is severely affecting your performance

The surgery performed is called ‘Plantar fascia release surgery’ and it involves cutting part of the plantar fascia ligament  to release stress and relieve inflammation of the ligament. The surgery can be an open surgery or endoscopic surgery.

The complications of surgery include:

  • Nerve problems, including nerve entrapment or tarsal tunnel syndrome.
  • Recurring heel pain.
  • Neuroma, a benign tumormade of nerve cells and nerve fibers.
  • Delayed wound healing.
  • Risks of anesthesia.
  • Possibility that symptoms could get worse after surgery

Botulinum toxin for Plantar fasciitis

Botulinum toxin or Botox has long been used for aesthetic purposes, but since the turn of century its utility has been expanded to treat spastic conditions. There are now a number of published researches who favor the use of botulinum toxin in the treatment of plantar fasciitis.

One research randomly divided and treated 36 patients with either the traditional steroid injections to the painful area of the plantar fascia or with Botox injections to the gastrocnemius & soleus muscle complex. Both treatment groups were asked to perform stretching exercises.

The results of the study show that the patients who received Botox injections displayed more rapid and sustained improvement over the duration of the study.

Therefore Botox injections could be effective treatment for treatment of plantar fasciitis. This will limit the side effects of corticosteroids on the body. The only drawback to this treatment is the relatively high cost of Botox injections as compared to a steroid injection.

Dry needling for plantar fasciitis

Dry Needling or Percutaneous Ultrasound Guided Approach to Plantar Fasciitis is a fairly new treatment for chronic plantar fasciitis. The advantage of this procedure is that it is a minimally invasive procedure that can be done in the office for patients suffering from chronic plantar fasciitis. It lasts for only 15 to 20 minutes.

The theory of dry needling is that it breaks up scar tissue which is present at the attachment of the heel. This minor trauma serves as a stimulus, allowing the body to recognize the injured tissue as an acute problem area initiating an acute inflammatory and repair reaction. As a result, this area that normally has poor circulation will have increased blood flow.

Initial results are promising and show up to 95% success rate. However more research is required as there is variation in success rate which may be due to faulty technique by some physicians as the exact rigger point for this procedure is still unknown.

is dry needling effective for plantar fasciitis

What is the best pain reliever for plantar fasciitis?

To answer this question one must realize that not everyone has the same response to a drug. So while a drug may completely alleviate pain for some individuals, it might not have the same affect for another individual. Nevertheless the oral pain medications which are recommended in plantar fasciitis are non-steroidal anti-inflammatory drugs (NSAID’s) such as ibuprofen or naproxen.

How long does it take for plantar fasciitis to heal completely?

There is no fixed time for plantar fasciitis to heal because every person’s plantar fasciitis is different, so you may face shorter or longer healing time depending upon the severity of your condition. Generally, pain due to fasciitis can last anywhere from two to three weeks.

However, in some cases pain can last up to six weeks because this is how long it takes for the soft tissue to repair itself. If it lasts for more than 6 weeks without any response to treatment, doctors think about employing invasive procedures.

Another factor that determines the duration of pain is whether you are taking any steps to improve pain and functionality of your foot or not? The worst thing is taking no medication or home remedies. Rest is good, but you should also be actively trying to heal the condition. Taking steps to reduce inflammation can shorten healing time for your Plantar Fasciitis

As a general rule, the earlier you begin treatment for plantar fasciitis, the less time it takes to recover.

Plantar fasciitis socks or shoes. Are they helpful?

Plantar fasciitis patients are advised to massage their heels and feet and to put pressure of their heels several times a day till the pain has completely resolved.

However, since most of us don’t have the time to do the aforementioned treatment aids, socks and compression sleeves along with arch support shoes and/or orthotic support can prove to be extremely valuable in the treatment. They would be beneficial for anyone who sits for long periods of time, or who prefers to use them over a night splint in order to keep the ligament stretched.

There have been limited professional studies proving the benefits of these compressions fasciitis socks in the reduction of pain or as a treatment option at all, however, there are many users in general who feel that it has been a worthwhile investment in their ability to reduce pain.

The benefits of wearing these socks are comfortable and hence can be worn around the clock. Some people might complain that these socks are too tight. It is advised to them that they should change the size of their socks.

plantar fasciitis sock arch support

Plantar Fasciitis prevention

For those of you who have experienced pain of plantar fasciitis would know the amount of limitation it causes to your daily routine. Therefore if you have experienced a previous episode of plantar fasciitis and those who are among the vulnerable population should employ the following techniques.

Take care of your feet like you take care of your face. Only shoes with good arch support and heel cushioning should be used. If your profession demands that you stand on hard surfaces, place a thick rubber mat and stand on that to reduce stress on your feet. Similarly, ask your human resources department for information about different ways of doing your job and employ the method that will not make your heel pain worse.

Exercises to stretch the Achilles tendon at the back of the heel should be done at least two times a day. It is helpful for both athletes and non-athletes. Consult a physiotherapist on guidance about which exercises will suit you the best.

Establish good exercise habits like doing it regularly and increasing your exercise levels gradually and not suddenly. If you are a runner, switch running with other sports that will not cause heel pain. Besides these, consult a sports training specialist for conditioning and training programs to prevent plantar fasciitis from recurring.

Reduce weight if you are obese or overweight. A healthy weight for your height is critical in long term prevention. Wear supportive shoes as soon as you get up. Going barefoot or wearing slippers puts extra stress on your feet which these supportive shoes do not.

Stretching exercises for Plantar Fasciitis

Stretching exercises are one of the best ways to reduce heel pain due to plantar fasciitis as they involve your feet and lower leg muscles. Exercises may also help to reduce inflammation in the calves and other so you can move around comfortably. In the morning, before you get out stretch your feet, calf muscles, lower leg muscles and toes.

Hold onto your stretched feet and gently pull them toward you for 30 seconds, release and repeat 2 more times. This may be helpful to minimize your pain in the morning. You can also roll a frozen water bottle or a little ball under the arch of your foot, beginning from the front and working your way back. Apply a little pressure. Do this for a couple of minutes, once daily.

Do Yoga Toes work for Plantar Fasciitis?

Yoga Toes are rubbery devices. They separate the toes from each other and are designed to affect the muscles of the feet like a workout or massage affects other parts of your body. They are

They extend the shortened Achilles tendon in plantar fasciitis and improve the foot arch, hence reducing the pain associated with plantar fasciitis.  They can’t completely rid a person of a foot ailment; however they can help significantly decrease foot pain.

This device is not useful if the fasciitis is due to any structural deformity, therefore one should go to a podiatrist before using this remedy.

Home remedies for Plantar Fasciitis

There are a number of home remedies available for the treatment of plantar fasciitis. If you resist taking medicine, then the following remedies maybe used by you.

Epsom salt for Plantar Fasciitis

Epsom salt which is basically magnesium sulfate crystals is a common treatment for plantar fasciitis. It has an anti-inflammatory action and hence reduces pain. It also helps in healing muscles and connective tissues of the body. Ideal way of using it is to put 2 to 3 tablespoons of Epsom salt in a small tub of warm water and then soak your foot in this water for 10 to 15 minutes, twice a day. Do this a few times a week for maximum benefits.

Fastest way to heal plantar fasciitis = epsom salt soak

Turmeric for Plantar Fasciitis

Turmeric contains the compound curcumin which works as a strong painkiller. It too is an anti-inflammatory agent. A study by Davis et al., which was published in a June 2007 issue of the American Journal of Physiology found that curcumin can reduce both acute and chronic inflammation.

Method for using it is as follows: Add 1 teaspoon of turmeric powder to a cup of milk and heat it over a low flame. Then add half teaspoon of honey and drink it daily before going to bed. If this doesn’t suit you, you can take curcumin supplements, 400 to 600 milligrams 2 times a day.

Ginger for Plantar Fasciitis

Ginger is a known anti-inflammatory and analgesic spice that can help battle plantar fasciitis.

Mix 1 tablespoon of grated ginger in 1 cup of water and then boil it for a few minutes. Then turn off the heat and wait for 10 minutes. Then pass the mixture through a fine mesh and drink the tea while it is still hot. Drink 2 to 3 cups of this tea daily.

Ginger can also be added in your diet. Another option is that like curcumin, ginger supplements are also available which you can take after consulting your doctor.

Vinegar for Plantar Fasciitis

Apple cider vinegar is a helpful health tonic which can be used for treating plantar fasciitis along with a host other morbidities. It is an analgesic, anti-inflammatory and anti-oxidant liquid. You can use this by adding 1 tablespoon of raw, unfiltered apple cider vinegar and 1 teaspoon of raw honey to a glass of warm water. Drink it a couple of times daily.

Alternatively, you can mix 2 tablespoons of apple cider vinegar in a small tub filled with warm water and soak your feet in the tub for 5 to 10 minutes.

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