The Pill Book (13th Edition)

Book by Silverman Harold M

Abilify see Aripiprazole
Generic Name
Acamprosate (ah·CAM·pro·sate)

Brand Name
Campral

Type of Drug
Synthetic neurochemical similar to the amino acid homotaurine.

Prescribed For
Alcoholism.
General Information

Acamprosate is used to help alcoholic patients stay alcohol·free after they have stopped drinking. Unlike other drugs used to help people stay away from alcohol, it does not cause people to have a physical reaction to alcohol. Acamprosate restores the balance between two chemical systems in the brain, glutamate and GABA, that are known to become unbalanced in alcoholics, but its exact action is not known. It may reduce alcohol craving. Acamprosate should be part of a program that includes counseling and support, and it should be started as soon as possible after alcohol with·drawal and continued even if the patient starts drinking again. This medication has not been proven to help patients if they are still drinking when they start treatment. Acamprosate has not been studied in patients who abuse other substances together with al·cohol. Tolerance or addiction has not developed with acamprosate. It passes out of the body through the kidneys.
Cautions and Warnings

Do not take acamprosate if you are allergic or sensitive to any of its ingredients or if you have severe kidney disease. People with moderate kidney disease require a lower dosage of acamprosate.
Acamprosate does not eliminate or ease alcohol withdrawal symptoms. People taking acamprosate may become depressed or have suicidal thoughts.

Acamprosate can affect your judgment, thinking, or coordina·tion. Do not drive or operate dangerous machinery if you are tak·ing this medicine.
Possible Side Effects

Almost 2 of every 3 people who take this medicine will expe·rience a drug side effect.
·    Most common: diarrhea.

·    Common: headache, weakness, anxiety, depression, and sleep problems.

·    Less common: pain, accidental injuries, nausea, stomach gas, dizziness, dry mouth, tingling in the hands or feet, itch·ing, sweating, chest pain, loss of appetite, weight gain or loss, impotence, abnormal vision, rash, vomiting, and constipation.

·    Rare: heart or kidney failure, psoriasis, hypothyroidism, rheumatoid arthritis, and urinary tract infections. Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions

·    Mixing acamprosate with naltrexone can increase the levels of both drugs in the blood, but no dose adjustments are needed.
Food Interactions
Acamprosate may be taken without regard to food or meals.

Usual Dose
Adult: Two 333·mg tablets 3 times a day. Child: not recommended.
Overdosage

The only symptom associated with acamprosate overdose has been diarrhea. Overdose victims should be taken to a hospital emergency room for observation and treatment. ALWAYS bring the prescription bottle or container.
Special Information

Call your doctor if you are breast·feeding, pregnant, or thinking about becoming pregnant while taking this medicine.

 
Take care while driving a car or performing complex tasks.
If you forget to take a dose, take it as soon as possible. If you do not remember until it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Call your doctor if you forget to take 2 or more doses in a row. Do not take a double dose.
Acamprosate must be part of an ongoing treatment program. Do not stop taking it on your own, even if you start drinking again.

Special Populations
Pregnancy/Breast·feeding: Acamprosate can damage animal fetuses in doses that are approximately equal to those taken by people on this medicine. Women of childbearing age should use an effective contraceptive while taking this drug. The potential benefits of acamprosate must be weighed against its risks if your doctor considers it a crucial treatment during your pregnancy.
Acamprosate passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Dosage reduction may be needed in seniors because of a general decline in kidney function due to age.
Generic Name
Acebutolol (ah·seh·BUTE·uh·lol)
Brand Name
Sectral

Type of Drug
Beta·adrenergic blocking agent.

Prescribed For
High blood pressure and abnormal heart rhythms.
General Information

Acebutolol hydrochloride is one of many beta·adrenergic block·ing drugs, or beta blockers. These drugs interfere with the action of adrenaline and other chemicals in the body that affect many body functions. Individual beta blockers have different character·istics that can make them more suitable for certain conditions or people.
Cautions and Warnings

Do not take acebutolol if you are allergic or sensitive to any of its ingredients or to beta blockers.
You should be cautious about taking acebutolol if you have asthma, severe heart failure, a very slow heart rate, or heart block (disruption of the electrical impulses that control heart rate) because the drug may worsen these conditions.
People with angina taking acebutolol for high blood pressure risk aggravating their angina if they suddenly stop taking the drug. These patients should have their acebutolol dosage reduced grad·ually over 1—2 weeks.
Acebutolol should be used with caution if you have liver or kid·ney disease because your ability to eliminate this drug from your body may be impaired.
Acebutolol reduces the amount of blood pumped by the heart with each beat. This reduction in blood flow may aggravate the condition of people with poor circulation or circulatory disease.
If you are undergoing major surgery, your doctor may want you to stop taking acebutolol at least 2 days before surgery.
People with a history of severe anaphylactic reaction to al·lergens may be unresponsive to usual doses of epinephrine while taking beta blockers.
Possible Side Effects

Side effects are relatively uncommon and usually mild; nor·mally they develop early in the course of treatment and are rarely a reason to stop taking acebutolol.

·    Most Common: fatigue.

·    Common: dizziness and headache.

·    Less Common: chest pain, swelling in the legs or arms, depression, sleeplessness, abnormal dreams, rashes, con·stipation, diarrhea, upset stomach, stomach gas, nausea, frequent urination, back pain, joint and muscle pain, diffi·culty breathing, stuffy nose, and vision changes.

·    Rare: cough, low blood pressure, slow heart beat, anxiety, impotence, changes in response to touch stimulation, itch·ing, vomiting, abdominal pain, painful urination, nighttime urination, liver changes, sore throat, wheezing, eye irrita·tion, pain or dry eye, and lupus erythematosus (extremely rare). Contact your doctor if you experience any side ef·fect not listed above.
ACEBUTOLOL

Drug Interactions

·    Acebutolol may interact with surgical anesthetics to increase the risk of heart problems during surgery. Some anesthesi·ologists recommend gradually stopping the drug by 2 days before surgery.

·    Acebutolol may interfere with the normal signs of low blood sugar and with the action of oral antidiabetes drugs.

·    Acebutolol increases the blood·pressure·lowering effects of other blood·pressure·reducing agents, including clonidine, guanabenz, and reserpine, and calcium channel blockers such as nifedipine.

·    Aspirin·containing drugs, nonsteroidal anti·inflammatory drugs (NSAIDS), and sulfinpyrazone may interfere with the blood·pressure·lowering effect of acebutolol.

·    Cocaine may reduce the effectiveness of all beta blockers.

·    Acebutolol may worsen the problem of cold hands and feet associated with ergot alkaloids, used to treat migraine. Gan·grene is a possibility in people taking both an ergot and acebutolol.

·    Acebutolol will counteract thyroid hormone replacements.

·    Calcium channel blockers, flecainide, hydralazine, contra·ceptive drugs, cimetidine, propafenone, haloperidol, phe·nothiazine sedatives (molindone and others), quinolone antibacterials, and quinidine may increase the amount of ace·butolol in the bloodstream and lead to increased acebutolol effects.

·    Acebutolol should not be taken within 2 weeks of taking a monoamine oxidase inhibitor (MAOI) antidepressant.

·    Acebutolol may interfere with the effects of some antiasthma drugs, including theophylline and aminophylline.

·    Combining acebutolol with digitalis drugs may result in ex·cessive slowing of the heart, possibly causing heart block.

·    If you stop smoking while taking acebutolol, your dose may have to be reduced because your liver will break down the drug more slowly afterward.

·    Aluminum salts, barbiturates, calcium salts, cholestyramine, colestipol, ampicillin, and rifampin may reduce the effective·ness of acebutolol.

·    Beta blockers may block the effects of epinephrine.
Food Interactions

None known.
Usual Dose
High Blood Pressure
Adult: starting dose is...