Tapentadol is a novel, centrally acting analgesic combining mu-opioid receptor (MOR) agonism and noradrenaline (NA) reuptake inhibition in a single molecule. Many classic opioids form active metabolites that contribute to analgesia and/or side effects, and the involved cytochrome P450 enzyme complex can give rise to pharmacokinetic drug-drug interactions and variability in drug efficacy due to enzyme polymorphisms. Here we report on the relevance of tapentadol metabolites. Nine metabolites, including the major metabolite tapentadol-O-glucuronide, had no analgesic effects in the tail-flick test in mice. In the phenylquinone writhing test in mice, only 5 of these metabolites showed analgesic effects.
Tapentadol is in a class of medications called opiate (narcotic) analgesics. It works by changing the way the brain and nervous system respond to pain.
Is Tapentadol is same as Tramadol?
Both medications are considered opioid agonists, but tramadol is significantly weaker than tapentadol. Tramadol and tapentadol both inhibit reuptake of norepinephrine to roughly the same degree, but tramadol inhibits serotonin reuptake 3 times more than tapentadol.
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This medication is used to treat acne. It may decrease the number and severity of acne pimples and promote quick healing of pimples that do develop. Tretinoin belongs to a class of medications called retinoids. It works by affecting the growth of skin cells.
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Tretinoin is a medication that is prescribed for treating acne. This medicine is prescribed for peeling off the affected skin areas and also for unclogging the pores. Tretinoin is a natural metabolite of retinol and belongs to a class of Retinoids. Tretinoin is available in many other forms apart from capsules, like gel and cream form. This medication is used to minimize the signs and severity of the disease, Acne.
Tretinoin was patented in 1957 and approved for medical use in 1962. It is on the World Health Organization’s List of Essential Medicines, the most effective and safe medicines needed in a health system. Tretinoin is available as a generic medication.
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Tretinoin is most commonly used to treat acne. It is also used off-label to treat and reduce the appearance of stretch marks by increasing collagen production in the dermis.
In topical form, this drug is pregnancy category C and should not be used by pregnant women.
People using the topical form should not also use any cream or lotion that has a strong drying effect, contains alcohol, astringents, spices, lime, sulfur, resorcinol, or aspirin, as these may interact with tretinoin or exacerbate its side effects
Usual Adult Dose for Acne
Apply a thin layer to the entire affected area once a day at bedtime
Usual Adult Dose for Dermatoheliosis
Apply a pea-sized amount to the entire affected area once a day at bedtime
Duration of therapy: 48 weeks (0.05% cream/emollient cream) and 52 weeks (0.02% cream)
A brief sensation of warmth or stinging may occur immediately after applying the medication. Skin redness, dryness, itching, scaling, mild burning, or worsening of acne may occur during the first 2-4 weeks of using the medication. These effects usually decrease with continued use. A daytime moisturizer may be helpful for excessive dry skin (see Notes).
If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Your doctor may want you to decrease how often you use tretinoin, change the strength or type, or have you stop using it.
Each gram of PREMARIN (conjugated estrogens) Vaginal Cream contains 0.625 mg conjugated estrogens, USP in a nonliquefying base containing cetyl esters wax, cetyl alcohol, white wax, glyceryl monostearate, propylene glycol monostearate, methyl stearate, benzyl alcohol, sodium lauryl sulfate, glycerin, and mineral oil. PREMARIN Vaginal Cream is applied intravaginally.
PREMARIN Vaginal Cream contains a mixture of conjugated estrogens obtained exclusively from natural sources, occurring as the sodium salts of water-soluble estrogen sulfates blended to represent the average composition of material derived from pregnant mares’ urine. It is a mixture of sodium estrone sulfate and sodium equilin sulfate. It contains as concomitant components, sodium sulfate conjugates, 17 α-dihydroequilin, 17 α-estradiol, and 17 β-dihydroequilin.
The recommended adult dose of conjugated estrogens vaginal cream ranges from 0.5 g to 2 g of cream daily. Depending on how severe the symptoms are, the cream may be inserted into the vagina using the applicator provided, applied to the outside areas of the vagina, or both. The cream should be used on a regular cycle, with 3 weeks of use followed by 1 week off.
Nausea/vomiting, bloating, breast tenderness, headache, or weight changes may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Estrogen is a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.
Conjugated estrogens are a mixture of estrogen hormones used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Other uses include prevention of osteoporosis in postmenopausal women, and replacement of estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body. Conjugated estrogens are sometimes used as part of cancer treatment in women and men.
Conjugated estrogens may also be used for purposes not listed in this medication guide.
Imiquimod cream is used to treat certain types of actinic keratoses (flat, scaly growths on the skin caused by too much sun exposure) on the face or scalp. Imiquimod cream is also used to treat superficial basal cell carcinoma (a type of skin cancer) on the trunk, neck, arms, hands, legs, or feet and warts on the skin of the genital and anal areas. Imiquimod is in a class of medications called immune response modifiers. It treats genital and anal warts by increasing the activity of the body’s immune system. It is not known exactly how imiquimod cream works to treat actinic keratoses or superficial basal cell carcinoma.
Valacyclovir is used to treat infections caused by certain types of viruses. In children, it is used to treat cold sores around the mouth (caused by herpes simplex) and chickenpox (caused by varicella zoster). In adults, it is used to treat shingles (caused by herpes zoster) and cold sores around the mouth.
Valacyclovir is also used to treat outbreaks of genital herpes. In people with frequent outbreaks, this medication is used to reduce the number of future episodes.
Valacyclovir is an antiviral drug. It stops the growth of certain viruses. However, it is not a cure for these infections. The viruses that cause these infections continue to live in the body even between outbreaks. Valacyclovir decreases the severity and length of these outbreaks. It helps the sores heal faster, keeps new sores from forming, and decreases pain/itching.
is an antiviral medication used to treat cytomegalovirus (CMV) infection in those with HIV/AIDS or following organ transplant. It is often used long term as it only suppresses rather than cures the infection. Valganciclovir is taken by mouth.
Common side effects include abdominal pain, headaches, trouble sleeping, nausea, fever, and low blood cell counts. Other side effects may include infertility and kidney problems. When used during pregnancy, it causes birth defects in some animals. Valganciclovir is the L-valyl ester of ganciclovir and works when broken down into ganciclovir by the intestine and liver.
Usual Adult Dose for CMV Retinitis
Induction dose: 900 mg orally twice a day for 21 days
Maintenance dose: 900 mg orally once a day
-The tablet formulation should be used, not the oral solution.
-The maintenance dose should be used after the induction dose or in patients with inactive CMV retinitis.
Use: For the treatment of CMV retinitis in patients with AIDS
Usual Adult Dose for CMV Prophylaxis
900 mg orally once a day
Duration of therapy:
-Heart or kidney-pancreas transplant patients: Until 100 days posttransplantation.
-Kidney transplant patients: Until 200 days posttransplantation.
-The tablet formulation should be used, not the oral solution.
-Therapy should be started within 10 days of transplantation.
Use: For the prevention of CMV disease in kidney, heart, and kidney-pancreas transplant recipients at high risk (donor CMV seropositive/recipient CMV seronegative)
Valganciclovir is commonly associated with vomiting, abdominal pain, diarrhea, and headache.
Entecavir is mainly used to treat chronic hepatitis B infection in adults and children 2 years and older with active viral replication and evidence of active disease with elevations in liver enzymes. It is also used to prevent HBV reinfection after liver transplant and to treat HIV patients infected with HBV. Entecavir is weakly active against HIV, but is not recommended for use in HIV-HBV co-infected patients without a fully suppressive anti-HIV regimen as it may select for resistance to lamivudine and emtricitabine in HIV.
Usual Adult Dose for Chronic Hepatitis B
Compensated Liver Disease:
-Nucleoside-inhibitor-therapy-naive: 0.5 mg orally once a day
-History of hepatitis B viremia while using lamivudine or known lamivudine or telbivudine resistance substitutions rtM204I/V with or without rtL180M, rtL80I/V, or rtV173L: 1 mg orally once a day
Decompensated Liver Disease: 1 mg orally once a day
Use: For the treatment of chronic HBV infection in patients with evidence of active viral replication and either persistent elevations in serum aminotransferases (ALT or AST) or histologically active disease
The majority of people who use entecavir have little to no side effects. The most common side effects include headache, fatigue, dizziness, and nausea. Less common effects include trouble sleeping and gastrointestinal symptoms such as sour stomach, diarrhea, and vomiting.
Serious side effects from entecavir include lactic acidosis, liver problems, liver enlargement, and fat in the liver.
Laboratory tests may show an increase in alanine transaminase (ALT), hematuria, glycosuria, and an increase in lipase. Periodic monitoring of hepatic function and hematology are recommended.
Daclatasvir is used along with another medication sofosbuvir to treat a certain type of chronic hepatitis C (an ongoing viral infection that damages the liver). Daclatasvir is in a class of antiviral medications called hepatitis C virus (HCV) NS5A inhibitors. It works by stopping the virus that causes hepatitis C from spreading inside the body. It is not known if daclatasvir prevents the spread of hepatitis C to other people.
How should this medicine be used?
Daclatasvir comes as a tablet to take by mouth. It is usually taken with or without food once a day. Daclatasvir must be taken in combination with sofosbuvir, usually for 12 weeks. Take daclatasvir at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take daclatasvir exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Continue to take daclatasvir even if you feel well. Do not stop taking daclatasvir or sofosbuvir without talking to your doctor.
Usual Adult Dose for Chronic Hepatitis C
60 mg orally once a day for 12 weeks
-Sustained virologic response rates reduced in HCV genotype 3-infected patients with cirrhosis using this drug with sofosbuvir for 12 weeks; optimal duration of therapy has not been established for patients with cirrhosis.
-The manufacturer product information for sofosbuvir should be consulted.
Use: In combination with sofosbuvir, for the treatment of patients with chronic HCV genotype 3 infection
Renal Dose Adjustments
No adjustment recommended.
Liver Dose Adjustments
Mild, moderate, or severe liver dysfunction (Child-Pugh A, B, or C): No adjustment recommended.
Decompensated cirrhosis: Data not available
Coadministration with strong CYP450 3A inhibitors: Dose should be reduced to 30 mg orally once a day.
Coadministration with moderate CYP450 3A inducers: Dose should be increased to 90 mg orally once a day.
Coadministration with strong CYP450 3A inducers: Contraindicated
The dose of this drug should not be reduced for side effects.
If sofosbuvir is permanently discontinued, this drug should also be discontinued.
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Any degree of renal dysfunction: No adjustment recommended.
Comments: This drug is highly protein-bound; significant removal via dialysis is not likely.
Daclatasvir may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
Some side effects can be serious. If you are also taking amiodarone and you experience any of these symptoms, call your doctor immediately: