This new and revised 11th edition is the most authoritative, comprehensive, and popular consumer guide to prescription drugs in the United States. It contains information on more than 40 top new drugs and dozens of new brand names. Original.

Dr. Harold M. Silverman, Pharm.D., has been practicing health care public affairs and communications for 15 years. He has written numerous consumer health resources including <b>The Pill Book</b> (Bantam Books ten editions through 2002). <b>The Pill Book</b> was named one of the ten best health reference books by <i>American Health</i> magazine and an "old reliable of book publishing," by <i>The New York Times</i>. The 10th edition of <b>The Pill Book</b> was on the New York Times Advice and How-To best-seller list for more than 6 months after its release. He is also the author of the chapter on generic drugs in the <b>Merck Manual Home Edition</b> (1997, 2003).?

Generic Name
Abacavir (uh-BAK-uh-veer)

Brand Name
Ziagen

Type of Drug
Antiviral.

Prescribed For Human immunodeficiency virus (HIV) infection.

General Information
Abacavir is a man-made nucleoside drug that inhibits the reproduction of the HIV virus. Once inside the HIV-infected cell, abacavir is transformed by enzymes into carbovir triphosphate. Carbovir triphosphate interferes with the activity of HIV reverse transcriptase, an enzyme essential to the virus’ ability to reproduce. Abacavir is always given with another anti-HIV antiviral–such as didanosine, lamivudine, stavudine or zalcitabine–to achieve optimum effectiveness. Some of the drug is broken down in the liver, some passes out of the body unchanged in the urine, and some passes out of the body in the stool.

Cautions and Warnings
Stop taking this drug at the first sign of drug allergy or sensitivity (see “Special Information”). People have died from abacavir sensitivity.

People with liver disease should be cautious about using this drug because of the possibility that it can aggravate the condition. Some people have died from liver damage associated with abacavir.

The use of nucleoside drugs such as abacavir can very rarely cause lactic acidosis, a fatal metabolic disturbance.

Resistance to abacavir has developed in laboratory versions of HIV also resistant to lamivudine, didanosine, and zalcitabine. HIV that is resistant to protease inhibitors is not likely to be resistant to abacavir.

Abacavir cannot be used in infants under age 3 months.

Drug Interactions
• Alcohol interferes with the elimination of abacavir through the liver and can lead to a 40% increase in the amount of drug in the blood.
• Abacavir can increase blood levels of acetaminophen, amitriptyline, bumetanide, chloral hydrate, chlorpheniramine, chlorpromazine, chlorzoxazone, dapsone, doxepin, fluconazole, imipramine, ketoconazole, labetalol, lamotrigine, miconazole, morphine, naloxone, non-steroidal anti-inflammatory drugs (NSAIDs), oxazepam, promethazine, propofol, propranolol, and valproic acid.
• Cigarette smoking and clofibrate may reduce the amount of abacavir in the blood.
• Combining abacavir with isoniazid may decrease abacavir levels and increase isoniazid levels in the blood.
• Abacavir levels in the blood may be decreased if you are also taking phenobarbital, phenytoin, or T3 thyroid hormone replacement.

Food Interactions
None known.

Usual Dose
Adult (age 17 and over): 300 mg 2 times a day.
Child (age 3 months—16 years): 3.6 mg per lb. of body weight twice a day, up to a maximum of 300 mg in each dose.

Overdosage
Little is known about the effects of abacavir overdose. Overdose victims should be taken to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.

Special Information
Stop taking this drug and call your doctor at the first sign of allergy or sensitivity. Symptoms include fever, rash, fatigue, nausea, vomiting, diarrhea, abdominal pain, sore throat, difficulty breathing, and coughing. If you continue to take abacavir and are allergic to it, more severe reactions including a life-threatening drop in blood pressure could develop in hours.
Abacavir is not a cure for HIV. People taking the drug may still develop opportunistic infections and other conditions associated with HIV infection.

People taking abacavir can still be infectious and transmit HIV to others.
The long-term effects of abacavir are not known. Report anything unusual to your doctor.
It is very important for you to take abacavir exactly as prescribed. If you forget to take a dose and remember within 2 to 3 hours, take the medication. If you forget until it is almost time for your next dose, skip the forgotten dose and continue with your regular schedule. Remember, every dose of any HIV medication you forget or skip can make it more difficult for the drugs to do their job and can also lead to the development of HIV resistant to abacavir.

Special Populations
Pregnancy/Breast-feeding
Abacavir passes into the fetal circulation. In animal studies, the drug caused low birth weight and increased the risk of stillbirth. The effect of abacavir in pregnant women is not known. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.

It is not known if abacavir passes into breast milk. Women with HIV are advised to bottle-feed their babies to avoid transmitting the drug.

Seniors
Studies of abacavir did not include many seniors. Seniors should use this drug with caution because of the risk that normal reductions in organ function or drug interactions may affect how abacavir works in the body or increase the likelihood of side effects.



Generic Name
Acarbose (uh-CAR-bose)

Brand Name
Precose

Type of Drug
Antidiabetic.

Prescribed For
Type II (non-insulin-dependent) diabetes mellitus.

General Information
Acarbose works in a different way than other antidiabetes drugs. Acarbose interferes with enzymes in the intestine responsible for breaking down the complex carbohydrates found in starchy foods into simple sugars, including glucose. Acarbose lowers blood sugar by delaying the absorption of glucose into the blood after eating. Because it works against diabetes in this way, the blood-sugar-lowering effect of acarbose adds to that of other antidiabetes drugs. Acarbose may also be used by people who are unable to control their blood sugar by diet alone. Most of acarbose’s side effects are related directly to the fact that it leaves undigested carbohydrates in the lower intestines.

Cautions and Warnings
Acarbose should not be used if you are allergic or sensitive to it.
People should not use acarbose if they have diabetic ketoacidosis, cirrhosis, severe kidney disease, inflammatory bowel disease, ulcers of the colon, intestinal obstruction, severe digestive disease, or absorption diseases, or if intestinal gas will be a severe problem.
Acarbose may lead to liver inflammation.

Drug Interactions
• Acarbose adds to the blood-sugar-lowering effect of sulfonylureas and other antidiabetes drugs and may increase the risk of hypoglycemia (low blood sugar) associated with these drugs.
• Thiazides and other diuretics, corticosteroid anti-inflammatory drugs, phenothiazines, thyroid drugs, estrogens, oral contraceptives (“the pill”), phenytoin, nicotinic acid, stimulants, calcium channel blockers, and isoniazid may increase blood sugar levels. Your dosage of acarbose may need to be increased if you combine it with any of these drugs.
• Activated charcoal and antacids–and other drugs intended to absorb stomach contents–and digestive enzyme preparations may reduce the effectiveness of acarbose. Separate these drugs from acarbose by at least 2 hours.
• Combining acarbose and digoxin may decrease the effects of digoxin.

Food Interactions
Acarbose must be taken with the first bite of each meal.

Usual Dose
Adult: 25—100 mg with breakfast, lunch, and dinner.
Child: not recommended.

Overdosage
Acarbose overdose does not cause low blood sugar, but diarrhea, abdominal pain, and intestinal gas can be expected. Call your local poison control center for more information. If you seek treatment, ALWAYS bring the prescription bottle or container.

Special Information
As with all antidiabetes drugs, people taking acarbose must follow their doctor’s instructions for diet, exercise, and blood sugar testing.

Acarbose prevents the breakdown of table sugar. If you take this drug in combination with insulin or a sulfonylurea drug, be sure to have a quick source of glucose (dextrose) with you to treat hypoglycemia (symptoms include tiredness, increased hunger, increased heart rate, sweating, and numbness in the arms and legs).

Read product labels carefully or check with your pharmacist before buying any nonprescription drug to be sure it is safe for diabetics to take with acarbose.
It is essential to take each dose of acarbose at the beginning of each meal. Since the drug works in the intestines, it has to be there at the same time as the food you are digesting.
If you forget a dose of acarbose, skip it and continue with your regular schedule. Taking a missed dose between meals will not provide any benefit.

Special Populations

Pregnancy/Breast-feeding
Animal studies of acarbose showed no effects on the fetus, but there is no information available on its effect in humans. Blood sugar control is considered essential during pregnancy and insulin is usually prescribed for that purpose. When acarbose is considered crucial by your doctor, its potential benefits must be weighed against its risks.
It is not known if acarbose passes into human breast milk. Nursing mothers who must take this drug should bottle-feed.

Seniors
Blood levels of acarbose are higher in older adults, but this is not considered important. Seniors with severe kidney disease should avoid this medication.

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Excerpted from The Pill Book by Harold M. Silverman
All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.