generic: ursodeoxycholic acid

class: other gastrointestinal drugs

indication: chronic cholestatic liver disease

dose: 10 - 20mg/kg/day in 2-4 divided doses

SIDE EFFECTS

common: diarrhoea

infrequent: increased itch, increased cholestasis, nausea, vomitting, sleep disturbances

generic: pancreatic enzymes

indication: cystic fibrosis, chronic pancreatitis

dose: individualized

SIDE EFFECTS

common: nausea, vomitting, abdominal pain

infrequent: irritation around mouth and anus

COUNSELLING

Take this medicine with food

Swallow capsule whole, or open and spread on soft food and swallow immediately

Avoid taking with hot food or drink

generic: glyceryl trinitrate

indication: anal fissure 

dose: 1 - 1.5cm of ointment into the rectum tds. Continue for 8 weeks 

SIDE EFFECTS 

common: headache (dose related)

infrequent: dizziness, fainting, anal burning and itching, rectal bleeding

xenical

Generic: orlistat

Indication: obesity in adults

Dose: 120mg tds with meals

SIDE EFFECTS:

common: increased fat in stool causes flatus, faecal incontinence/urgency, loose oily stools, headache, fatigue

rare: hepatits, allergic reactions

COUNSELLING

This medication can cause fatty or oily stools.  This is most likelyu to occur when your diet is high in fat.

Take with (or within 1 hour) of meals.  Do not take dose if you miss the meal, or meal does not have fat.

Eat a low caloric diet high in fruit and vegetables

generic: phentermine

class: sympathomimetic

indication: obesity in adults

dose: 15mg - 40 mg daily at breakfast

SIDE EFFECTS

common: overstimulation of CNS (insomnia, nervousness, restlessness, euphoria, agitation, arrythmia, tachycardia, hypertension, vomitting diarrhoea) headache, rash, urinary frequency, facial oedema, unpleasant taste, urticaria, incontinence

rare: primary pulmonary hypertension, psychosis, increased seizure activity in epileptics, withdrawal symptoms on stopping

COUNSELLING

May affect your ability to drive a car or may increase effects of alcohol.

Tell your doctor if you get short of breath, or cannot do as much as before you started this medicine

generic: sibutramine

class: inhibits sertraline and noradrenaline

indication: obesity in adults

dose: 10 - 15mg daily in morning

SIDE EFFECTS

common: increased heart rate, palpitation, raised BP, nausea, constipation, aggravation of haemarhoids, dry mouth, taste disturbances, vasodilation, insomnia, dizziness, parasthesia, sweating, headache, anxiety

rare: depression, urinary retention, vomitting, diarrhoea, sexual dysfunction, menstrual cycle disorders

COUNSELLING:

Eat a low caloric diet high in fruit and vegetables

This medicine may make you a bit light headed

Generic: sulfasalazine

Class: 5-aminosalicylate

Indication: ulcerative colitis, crohn's disease, rheumatoid arthritis

Dose: 0.5 - 4g bd - qid

SIDE EFFECTS:

common: nausea, headache, rash, diarrhoea

infrequent: interstitial nephritis

Counselling:

Take whole, with food

Generic: mesalazine

Class: 5-aminosalicylate

Indication: rheumatoid arthritis, inflammatory bowel disease (crohn's or ulcerative colitis)

Dose: 250 - 1500mg tds

SIDE EFFECTS:

common: nausea, rash, headache, diarrhoea

infrequent: interstitial nephritis

COUNSELLING

Take whole, on an empty stomach (label 3b)

generic: olsalazine

class: 5-aminosalicylate

indication: inflammatory bowel disease, rheumatoid arthritis

dose: 0.5-1g bd

SIDE EFFECTS

common: nausea, rash, headache, diarrhoea

infrequent: interstitial nephritis

COUNSELLING

Take with food to reduce chance of diarrhoea. 

Generic: balsalazide

class: 5-aminosalicylate

indication: rheumatoid arthritis, inflammatory bowel disease

dose: 1.5 - 6g bd or tds

SIDE EFFECTS

common: nausea, diarrhoea, rash, headache

infrequent: interstitial nephritis

COUNSELLING

Swallow whole with food

Generic: diphenoxylate

Class: Opioid antidiarrhoeals

Indication: diarrhoea, interstitial stoma

Dose: 5mg tds or qid prn, max 20mg daily

SIDE EFFECTS:

common: abdominal pain and bloating, nausea, vomitting, constipation

Atropine is added to prevent abuse

COUNSELLING:

This medicine may cause drowsiness or increase effects of alcohol

Label 1 and 13

Generic: loperamide

Class: opioid antidiarrhoeals

Indication: diarrhoea, interstitial stoma

Dose: 2 - 4mg prn, max 16mg daily

SIDE EFFECTS:

COMMON: abdominal pain and bloating, nausea, vomitting, constipation

Generic: lactulose

Class: laxative

Indication: constipation, hepatic encephalopathy

Dose: 15 - 60mg in 1 or 2 divided doses

SIDE EFFECTS:

common: flatulence, abdominal discomfort, cramps

infrequent: diarrhoea, electrolyte disturbances

COUNSELLING:

this medicine tastes very sweet.  It may help to mix it in fruit juice or milk

Generic: senna

Class: laxative

Indication: constipation

Dose: 7.5 - 30mg nocte

SIDE EFFECTS:

infrequent: discoloration or urine (yellowish brown or red), diarrhoea, fluid and electrolyte imbalances, abdominal cramps, nausea

COUNSELLING:

Eat granules plain, or mix with fluid or food

generic: bisacodyl

class:

Generic: docusate

Class: stool softener

Indication: constipation

DOSE: 100 - 480mg daily (1 or 2 doses)

SIDE EFFECTS

Rare: abdominal cramps, diarrhoea, nausea, rash

Counselling:

Take with plenty of fluids

Generic: liquid paraffin

Class: stool softeners

Indication: Constipation

DOSE: 40mL initially daily (adjust in 5mL incriments based on response)

SIDE EFFECTS:

infrequent: anal leakage and rectal irritation

COUNSELLING

Do not take dose immediately before lying down

Generic: poloxamer

Class: stool softener

Indication: constipation in infants

Dose: 10 - 25 drops tds

SIDE EFFECTS:

abdominal discomfort, diarrhoea (with excessive dose)

COUNSELLING: mix with fruit juice or milk

Emend

generic: aprepitant

class:substance P/neurokinin 1 inhibitor

indication: prevention of nausea and vomitting with moderately/highly emetic chemotherapy

dose: 125mg day 1, followed by 80mg on day 2 and 3

SIDE EFFECTS:

common: diarrhoea, headache, fatigue, dizziness, weakness, hiccups,

COUNSELLING

If using OCP, use barrier contraception during three day course and 1 month after last dose of aprepitant

generic: hyoscine

class: anticholinergics

indication: motion sickness

dose: 1 - 2 tablets (0.3mg per tablet) max 4 tablets in 24 hours

generic: dolasetron

class: 5-HT3 antagonists

indication: nausea and vomitting

dose: 50 - 200mg once daily

SIDE EFFECTS:

common: diarrhoea, dyspepsia, dizziness, taste disturbances, constipation, headache

infrequent: abdominal pain, fatigue

PROLONGATION OF QT INTERVAL 

generic: ondansetron

class: 5-HT3 antagonist

indication: nausea and vomitting

dose: 8mg bd or tds prn

SIDE EFFECTS:

common: constipation, headache, transient rise in hepatic enzymes

generic: tropisetron

class: 5HT3 antagonist

indication: nausea and vomitting

dose: 5mg daily

SIDE EFFECTS:

common: headache, transient rise in hepatic enzymes, constipation

generic: granisetron

class: 5-HT3 antagonist

indication: nausea and vomitting

dose: 1mg daily

SIDE EFFECTS:

common: headache, transient rise in hepatic enzymes, constipation

generic: promethazine

class: H1 antagonist

indication: nausea and vomitting, motion sickness

dose: 25mg q4-6h prn, max 100mg daily

SIDE EFFECTS:

common: sedation, dizziness, tinnitus, blurred vision, euphoria, incoordination, anxiety, insomnia, tremor, nausea, vomitting, constipation, diarrhoea, epigastric discomfort, dry mouth, cough

infrequent: urinary retention, palpitations, hypotension, headache, hallucination, psychosis

COUNSELLING

This medicine may make you sleepy, do not drive/operate machinary if this happens

Avoid alcohol and other medication that causes sedation

generic: dimenhydrinate

class: sedating antihistamine

indication: nausea and vomitting associated with menieres disease, motion sickness, labrinthitis

dose: 50 - 100mg q4-6h prn, max 400mg daily

SIDE EFFECTS:

common: sedation, dizziness, tinnitus, blurred vision, euphoria, incoordiation, anxiety, insomnia, tremor, nausea, vomitting, constipation, diarrhoea, epigastric discomfort, dry mouth

COUNSELLING

This medicine may make you sleepy.  Do not drive/operate heavy machinary if it affects you this way.

Avoid alcohol and other mediciation that may make you sleep.

generic: dromperidone

class: dopamine antagonist

indication: nausea and vomitting, gastroparesis, lactation stimulation

dose: 10 - 20mg in 3 or 4 divided doses

SIDE EFFECTS:

common: dry mouth, headache

infrequent: hyperprolactinaemia, rash, insomnia

rare: EPSE and allergic reactions

MAY PROLONG QT INTERVAL

Maxolon

generic: metoclopramide

class: dopamine antagonist

indication: nausea and vomitting

dose: 10 - 40mg 3-4 times daily

SIDE EFFECTS:

common: restlessness, drowsiness, dizziness, headache

COUNSELLING

This medicine may make you drowsy.  Do not drive/operate heavy machinary until you know if it affects you this way

generic: prochlorperazine

class: dopamine antagonist

indication: nausea and vomitting

dose: 5 - 10 mg bd or tds prn

SIDE EFFECTS:

common: constipation, dry mouth, drowsiness, akathisia, parkinsonianism, blurred vision, EPSE, hypotension, hyperprolactinaemia

COUNSELLING

This medicine may make you drowsy and increase the effects of alcohol.  Do not drive/operate machinary if it affects you this way

colese

generic: mebeverine

class: reduces GI motility and spasm

indication: Irritable bowel syndrome

dose: 135mg tds

SIDE EFFECTS:

common: dyspepsia, anorexia, constipation, dizziness, insomnia, headache, decreased heart rate, malaise

COUNSELLING

Take immediately before or with food

generic: misoprostol

class: prostaglandin analogue

indication: peptic ulcer disease, prevention of NSAID-related ulcer

dose: 400 - 800mcg daily in 2 - 4 divided doses

SIDE EFFECTS:

common: diarrhoea, abdominal cramps and pain, flatus, nausea, vomitting

infrequent: rash, headache, dizziness, constipation, menorrhagia, postmenopausal bleeding, intermenstrual bleeding

COUNSELLING

Take with meals to reduce risk of diarrhoea

Tell dr if you have symptoms such as black stools or coffee-grain vomit

generic: lansoprazole

class: PPI

indication: PUD, GORD, dyspepsia, part of H Pylori eradication regime, zollinger-ellison syndrome, prevention/treatment of upper-GI adverse effects from NSAIDS

dose:15 - 30mg once daily

SIDE EFFECTS:

common: headache, nausea, vomitting, diarrhoea, abdominal pain, flatulence, constipation

infrequent: rash, itch, B12 malabsorption, dizziness, fatigue, drowsiness, insomnia, dry mouth

COUNSELLING

Swallow whole, or add granules to fruit juice/puree etc and swallow immediately

generic: esomeprazole

class: PPI

indication: PUD, GORD, zollinger-ellison syndrome, prevention/treatment of NSAID ADR in upper GIT, component of H Pylori eradication regime

dose: 20 - 40mg daily 

SIDE EFFECTS:

common: headache, nausea, vomitting, diarrhoea, abdominal pain, constipation, flatulance

COUNSELLING

Swallow whole or alternatively disperse in food/liquid and consume immediately

generic: rabeprazole

class: PPI

indication: PUD, GORD, zollinger-ellison syndrome, component of H Pylori eradication regimen, prevention/treatment of NSAID ADR in upper GIT

dose: 20mg daily

SIDE EFFECTS:

common: diarrhoea, constipation, flatulence, nausea, vomitting, abdominal pain, headache

infrequent: rash, itch, dizziness, fatigue, B12 malabsorption

COUNSELLING

Swallow whole or disperse in food/fluid and consume immediately

generic: pantoprazole

class: PPI

indication: PUD, GORD, zollinger-ellison syndrome, component of H Pylori eradication routine, prevention/treatment of NSAID-related upper GIT ADR

dose: 20 - 40mg once a day (occassional bd)

SIDE EFFECTS:

common: headache, nausea, vomitting, constipation, diarrhoea, abdominal pain, fatigue

infrequent: rash, itchiness, B12 malabsorption, fatigue

COUNSELLING

swallow whole or disperse in fluid/food and consume immediately

generic: omeprazole

class: PPI

indication: PUD, GORD, zollinger-ellison syndrome, prevention/treatment of NSAID related ADR in upper GIT, component of H Pylori eradication

dose: 10 - 40mg daily

SIDE EFFECTS:

common: headache, nausea, vomitting, abdominal pain, flatulance, diarrhoea, constipation

infrequent: rash, itch, fatigue, B12 malabsorption

COUNSELLING

swallow whole or disperse in food/fluid and consume immediately

generic: ranitidine

class: H2 antagonist

indication: PUD, GORD, dyspepsia, stress ulcer prophylaxis

dose: 150mg once or twice daily, or 300mg daily

SIDE EFFECTS:

infrequent: hypotension

generic: nizatidine

class: H2 antagonist

indication: GORD, PUD, dyspepsia

dose: 150 - 300mg once or twice daily

SIDE EFFECTS:

infrequent: hypotension

generic: cimetidine

class: H2 antagonist

indication: PUD, GORD, dyspepsia

dose: 200 - 800mg in 1 - 4 divided doses

SIDE EFFECTS:

common: headache, tiredness, dizziness, confusion, diarrhoea, constipation rash

generic: sucrulfate

indication: PUD

dose: 1g bd or qid

SIDE EFFECTS:

common: constipation, nausea, dry mouth, headache