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Ethionamide: Side Effects See also Antituberculosis drugs Ethionamide is a synthetic derivative of thio-isonicotinamide. The initial oral dosage for adults is 250 mg/day, slowly increasing up to 15-20 mg/kg/day (maximum 1 g/day). Protionamide is a pyridine derivative of ethionamide. The dosage is 250-300 mg/day. Ethionamide and protionamide have often proved to be effective in non-tuberculous mycobacterial infections. Acute rheumatic symptoms and difficulty in the management of diabetes have been reported. Organs and Systems Nervous system Mental depression, weakness, drowsiness, and hypotension are not rare in patients taking ethionamide or protionamide. Other neurological reactions include diplopia, olfactory disturbances, metallic taste, dizziness, paresthesia, headache, and tremor. Psychological, psychiatric Psychotic reactions have been described […]

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Clofazimine: Side Effects See also Antituberculosis drugs Clofazimine is weakly bactericidal against Mycobacterium leprae. It is active in chronic skin ulcers (Buruli ulcer) and partly against Mycobacterium avium intracellulare. The usual adult dosage is 50-100 mg/day. At higher doses, its anti-inflammatory effect seems to prevent the development of acute reactions, such as erythema nodosum leprosum. Clofazimine is a strongly lipophilic dye and accumulates in tissues, especially fat, bile, macrophages, the reticuloendothelial system, and skin. This is the basis of adverse reactions, including skin discoloration. Lymphedema, diminished sweating, and reduced tearing have been observed. Observational studies In 84 patients with leprosy who took clofazimine, the most common adverse effect was a dark […]

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Nalidixic acid: Side Effects Nalidixic acid, the first quinolone, first introduced in 1962, is now only rarely used and has been supplanted by the fluoroquinolones. It is almost completely absorbed from the gastrointestinal tract and is rapidly eliminated by the kidneys, resulting in urinary concentrations 4-6 times higher than plasma concentrations. There are better drugs to treat urinary tract infections. General adverse effects The adverse effects of nalidixic acid tend to be toxic rather than allergic. Nervous system toxicity is predominant, including disturbances of sensory perception and benign intracranial hypertension, which is nearly exclusively found in babies and young children. Gastrointestinal toxicity and skin reactions also occur. Immunological and hypersensitivity reactions […]

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Griseofulvin: Side Effects Griseofulvin was originally isolated in 1939 as a natural product of Penicillium griseofulvum. It interferes with fungal microtubule formation, disrupting the cell's mitotic spindle formation and arresting the metaphase of cell division. Griseofulvin is a fungistatic compound and is active against Trichophyton, Microsporon, and Epidermophyton species. With the development of newer safer azoles and the introduction of terbinafine, all of which are easy to administer, the indications for griseofulvin have dwindled. Pharmacokinetics Griseofulvin is commercially available for oral administration as griseofulvin microsize (4 |j,m particle size) and griseofulvin ultramicrosize (1 m particle size). The oral availability of the micronized formulation is variable, 25-70%; ultramicronized griseofulvin, in contrast, is […]

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Griseofulvin: Organs and Systems Nervous system Headache is the most common adverse effect of griseofulvin. It occurs in about 50% of patients and can be severe. Drowsiness, dizziness, fatigue, confusion, depression, irritability, and insomnia have also been observed. Impaired co-ordination and unsteadiness while walking have been reported in some cases when there was confusion. Peripheral neuritis has been attributed to griseofulvin, but with little proof of a causal relation. Sensory systems Eyes Blurring of vision has been reported with griseofulvin. Taste Griseofulvin can cause dysgeusia; both taste and smell disturbances may occur more frequently than has been realized. Psychological, psychiatric The psychiatric effects of griseofulvin can be very disturbing and are […]

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Tetracycline: Side Effects See also Individual agents The tetracyclines are a closely related group of antibiotics with comparable pharmacological properties but different pharmacokinetic characteristics. They have both the advantages and disadvantages of broad-spectrum antibiotics. Tetracyclines are effective not only against bacteria and spirochetes, but also against some forms of Mycoplasma, Chlamydia, and Rickettsia, as well as protozoa. They affect multiplying microorganisms by inhibiting ribosomal protein synthesis. Their effect is therefore primarily bacteriostatic rather than bactericidal, depending on the kind of microorganism. Most of the adverse effects of the tetracyclines depend on the concentration of the antibiotic in the affected organ. The more lipophilic drugs are more potent with regard to their […]

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Tetracycline: Drug-Drug Interactions Antacids Co-administration of tetracyclines with antacids or other drugs containing divalent or trivalent cations, such as calcium, magnesium, or iron, is contraindicated. Tetracyclines form complexes with such cations, which are very poorly or not at all absorbed. To avoid this interaction, delay of 2-3 hours between the ingestion of tetracycline and the cation is recommended. Similarly, reduced systemic availability results from simultaneous intake of abundant quantities of milk or milk products. Antidiarrheal drugs Antidiarrheal drugs, such as kaolin-pectin and bismuth products, impair the absorption of tetracyclines by chelation (see the interaction with antacids in this post). Coumarin anticoagulants Although antibiotics can inhibit the production of vitamin K in […]

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Tetracycline: Organs and Systems Cardiovascular Cardiovascular reactions to tetracyclines have often been associated with other symptoms of hypersensitivity, such as urticaria, angioedema, bronchial obstruction, and arterial hypotension. Such reactions occurred in patients who had tolerated tetracyclines previously and were therefore considered as anaphylactic. Respiratory There have been a few cases of acute bronchial obstruction after the administration of a tetracycline. Pneumonitis with eosinophilia has also been described. When pleural tetracycline instillation is used to produce local inflammation for pleurodesis in spontaneous pneumothorax, there are no severe short-term or long-term adverse effects. Nervous system Tetracyclines rarely cause benign intracranial hypertension. This syndrome has primarily involved children, although it has also been observed […]

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Tetracycline: General Adverse Effects Mild gastrointestinal disturbances are common. A common and nearly unique feature of all tetracyclines is the formation of drug-melanin complexes, resulting in pigment deposition at various sites. Except for enamel defects and presumable disturbances of osteogenesis these deposits do not give rise to abnormalities of organ function. In view of tooth discoloration and enamel hypo-plasia, with a tendency to caries formation, tetracyclines should be avoided in children under 8 years of age and in women after the third month of pregnancy. The risk of photosensitivity reactions largely depends on the dose of the drug and the degree of exposure to sunlight. It may be increased in long-term […]

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Ribavirin: Side Effects The synthetic triazole nucleoside, ribavirin (1-beta-D-ribofuranosyl-1,2,4-triazole-3-carboxamide, tribavirin, virazole), has a broad spectrum of antiviral activity, including DNA as well as RNA viruses. Ribavirin closely resembles guanosine and is converted intracellularly to mono-, di-, and triphosphate derivatives, which inhibit the virally induced enzymes involved in viral nucleic acid synthesis by different mechanisms that are not fully understood. Of the DNA viruses, ribavirin is active against Herpes simplex virus and hepatitis B virus; among the RNA viruses, good activity has been observed against hepatitis C virus, orthomyxoviruses, paramyxoviruses, arenaviruses, and bunyaviruses. Although active against HIV in vitro and in vivo, ribavirin is not widely used in the treatment of HIV […]