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The major disadvantages of this use are cocaine’s potential for cardiovascular toxicity, glaucoma, and pupil dilation. Some ENT specialists occasionally use cocaine within the practice when performing procedures such as nasal cauterization.
Even when used this way, some of the used cocaine may be absorbed through the oral or nasal mucosa and give systemic effects.
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Cocaine is a powerful nervous system stimulant. Its effects can last from fifteen or thirty minutes to an hour. The duration of cocaine’s effects depends on the amount taken and the route of administration.  Cocaine can be in the form of fine white powder, bitter to the taste. When inhaled or injected, it causes a numbing effect.
Cocaine use leads to increases in alertness, feelings of well-being and euphoria, increased energy and motor activity, and increased feelings of competence and sexuality
What is Adipex-P?
Adipex-P (phentermine) is a stimulant similar to an amphetamine. Phentermine is an appetite suppressant that affects the central nervous system.
Adipex-P is used together with diet and exercise to treat obesity (overweight) in people with risk factors such as high blood pressure, high cholesterol, or diabetes.
Adipex-P may also be used for purposes not listed in this medication guide.
Do not use Adipex-P if you are pregnant or breast-feeding a baby.
You should not take Adipex-P if you have a history of heart disease (coronary artery disease, heart rhythm problems, congestive heart failure, stroke), severe or uncontrolled high blood pressure, overactive thyroid, glaucoma, a history of pulmonary hypertension, if you are in an agitated state, or if you have a history of drug or alcohol abuse.
Do not use Adipex-P if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.
Before taking this medicine
You should not take Adipex-P if you are allergic to phentermine, or if you have:
- a history of heart disease (coronary artery disease, heart rhythm problems, congestive heart failure, stroke);
- a history of pulmonary hypertension;
- severe or uncontrolled high blood pressure;
- overactive thyroid;
- if you are pregnant or breast-feeding;
- if you are in an agitated state;
- if you have a history of drug or alcohol abuse;
- if you are allergic to other diet pills, amphetamines, stimulants, or cold medications.
Taking Adipex-P together with other diet medications such as fenfluramine (Phen-Fen) or dexfenfluramine (Redux) can cause a rare fatal lung disorder called pulmonary hypertension. Do not take phentermine with any other diet medications without your doctor’s advice.
To make sure you Adipex-P is safe for you, tell your doctor if you have:
- high blood pressure;
- kidney disease;
- a thyroid disorder;
- if you are allergic to aspirin or to yellow food dye (FD & C Yellow No. 5, or tartrazine).
Phentermine may be habit forming. Never share Adipex-P with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.
FDA pregnancy category X. Weight loss during pregnancy can harm an unborn baby, even if you are overweight. Do not use Adipex-P if you are pregnant.
Phentermine can pass into breast milk and may harm a nursing baby. You should not breast-feed while taking Adipex-P.
Do not give this medication to a child younger than 16 years old.
Sibutramine is used for:
Generic Name: sibutramine (si-BUE-tra-meen)
Treating obesity. It should be used with a reduced calorie diet.
Sibutramine is a diet aid. It appears to work by regulating chemicals in the brain that reduce hunger or craving for food.
Do NOT use sibutramine if:
- you are allergic to any ingredient in sibutramine
- you have an eating disorder (eg, anorexia, bulimia), uncontrolled or severe high blood pressure, or increased blood pressure in the lungs
- you have a history of heart or blood vessel problems (eg, chest pain, fast or irregular heartbeat, heart attack, heart failure, hardening of the arteries or blood vessels, poor circulation in the legs), or stroke or transient ischemic attack (TIA) (mini-stroke)
- you have severe liver or kidney problems or you are on dialysis for severe kidney problems
- you are taking a selective serotonin reuptake inhibitor (SSRI) (eg, fluoxetine), another appetite suppressant, or you have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days
- you are over 65 years old
Contact your doctor or health care provider right away if any of these apply to you.
Before using sibutramine:
Some medical conditions may interact with sibutramine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have kidney or liver problems, heart problems, high blood pressure, bleeding problems, narrow-angle glaucoma, gallbladder problems (eg, gallstones), underactive thyroid, or seizures
- if you have a history of mental or mood problems (eg, depression), or suicidal thoughts or actions
Some MEDICINES MAY INTERACT with sibutramine. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Dextromethorphan, dihydroergotamine, imidazole antifungals (eg, itraconazole, ketoconazole), lithium, MAOIs (eg, phenelzine), narcotic analgesics (eg, codeine, fentanyl, meperidine), pentazocine, serotonin 5-HT1 receptor agonists (eg, sumatriptan), SSRIs (eg, fluoxetine), or tryptophan because they may increase the risk of sibutramine’s side effects, including increased risk of restlessness, fever, excessive sweating, twitching, and seizures that can, rarely, be life-threatening
- Ephedrine or pseudoephedrine because they may increase the risk of sibutramine’s side effects, including increased blood pressure and fast or irregular heartbeat
- Anticoagulants (eg, warfarin) because the risk of bleeding may be increased
- Cyclosporine because the risk of its side effects may be increased by sibutramine
This may not be a complete list of all interactions that may occur. Ask your health care provider if sibutramine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use sibutramine:
Use sibutramine as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- An extra patient leaflet is available with sibutramine. Talk to your pharmacist if you have questions about this information.
- Take sibutramine by mouth with or without food.
- Unless otherwise directed by your doctor, sibutramine should be taken in the morning to avoid sleeping problems.
- If you miss a dose of sibutramine, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use sibutramine.
Important safety information:
- Sibutramine may cause dizziness or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use sibutramine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using sibutramine; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
- Changes in dietary habits and increased exercise are important parts of a successful weight loss program. To maintain your ideal weight, these changes should be continued for life. Follow the guidelines given to you by your doctor or diet counselor.
- Serotonin syndrome or neuroleptic malignant syndrome (NMS)-like reactions are possibly fatal syndromes that can be caused by sibutramine. Your risk may be greater if you take sibutramine with certain other medicines (eg, “triptans,” MAOIs, antipsychotics [eg, aripiprazole, risperidone]). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; incoordination; rigid muscles; blood pressure changes; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.
- Sibutramine may increase the risk of stroke, heart attack, or similar problems. The risk may be greater if you have a history of heart problems.
- Lab tests, including blood pressure, pulse, and weight monitoring, may be performed while you use sibutramine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use an effective method of birth control while you are taking sibutramine.
- Do not use sibutramine in ELDERLY patients older than 65 years old; safety and effectiveness in these elderly patients have not been confirmed.
- Sibutramine should not be used in CHILDREN younger than 16 years old; safety and effectiveness in these children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using sibutramine while pregnant. It is not known if this medicine is found in breast milk. Do not breast-feed while taking sibutramine.
When used for long periods of time or at high doses, some people develop a need to continue taking sibutramine. This is known as DEPENDENCE or addiction.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fast or irregular heartbeat; severe or persistent dizziness or headache.
Proper storage of sibutramine:
Store sibutramine at 77 degrees F (25 degrees C) in a tightly closed container. Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep sibutramine out of the reach of children and away from pets.
- If you have any questions about sibutramine, please talk with your doctor, pharmacist, or other health care provider.
- Sibutramine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take sibutramine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about sibutramine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to sibutramine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using sibutramine.
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