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preserve (*this news item will not be available after 01/22/2018) By E. J. Mundell Tuesday, October 24, 2017 TUESDAY, Oct. 24, 2017 (HealthDay News) -- While obesity in pregnancy has long been linked to a higher risk for complications during childbirth, there's now another reason to avoid it: a late start to breast milk production. That's the finding from a new study of more than 200 women with newborns who planned to breast-feed. The researchers found that delays in "lactogenesis" -- the production of breast milk within three days of delivery -- "occurred more frequently among women who were obese at the time of delivery." The study highlights an issue many new moms have to deal with, said one pediatrician who reviewed the new study. "Breast-feeding is hard for all mothers," said Dr. Sophia Jan, who directs pediatrics at Cohen Children's Medical Center in New Hyde Park, N.Y. "This study found that breast-feeding is even harder for mothers who were obese prior to pregnancy." There are potential consequences for babies, too, she said. "Newborns of mothers whose breast milk comes in late may lose more weight during those initial days and weeks after birth compared to newborns of mothers whose milk comes in within three days postpartum," Jan noted. These babies also often end up on formula, which cannot match breast milk's nutritional goodness. The new study was led by Diane Spatz, a professor of nutrition at the University of Pennsylvania School of Nursing. She and her colleagues tracked the onset of breast milk production in 216 women who gave birth to single babies. The study found that breast milk production was delayed to beyond three days post-delivery in about 46 percent of non-obese women. However, that rose to almost 58 percent for new moms who were statistically obese. Statistical obesity begins with a body mass index (BMI) of 30 or above -- BMI being a measurement of height versus weight. For example, a 5-foot-5-inch woman weighing 180 pounds has a BMI of 30. "Because nearly 1 in 4 women in the United States begins pregnancy with a body mass index [BMI] equal to or greater than 30, the study underscores the need for targeted interventions and support to help these women achieve their personal breast-feeding goals," Spatz said in a university news release. Dr. Jennifer Wu, an ob-gyn with Lenox Hill Hospital in New York City, agreed. The new findings should at least let obese women understand that their milk may "come in later," she said, and "encourage them to continue to try breast-feeding for longer." According to Wu, "hospitals need to partner with milk banks to help meet the needs of these newborns. Patients should be reminded that there are merits to even small amounts of breast milk for their babies." For her part, Jan said the study raises the question as to why weight gain can slow breast milk production. More studies that try to answer that question would help identify targets for interventions, she said. The study will be published Nov. 1 in the Journal of Human Lactation . SOURCES: Sophia Jan, M.D., director, general pediatrics, Cohen Children's Medical Center, New Hyde Park, N.Y.; Jennifer Wu, M.D., obstetrician-gynecologist, Lenox Hill Hospital, New York City; University of Pennsylvania School of Nursing, news release, Oct. 28, 2017; Journal of Human Lactation , Nov. 1, 2017 HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Breastfeeding Obesity Pregnancy Recent Health News tourists


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you have to be (*this news item will not be available after 01/23/2018) By Robert Preidt Wednesday, October 25, 2017 WEDNESDAY, Oct. 25, 2017 (HealthDay News) -- The U.S.'s leading group of obstetricians and gynecologists is warning against a new trend where babies born by C-section are "seeded" via cotton swabs with vaginal microbes from the mother. "Vaginal seeding" is growing in popularity because it's thought that babies born through Cesarean-section miss out on certain "helpful" vaginal microbes that might shield the infant from asthma, allergies and immune disorders. "Vaginal seeding has become a rising trend for patients," noted Dr. Jennifer Wu, an ob/gyn at Lenox Hill Hospital in New York City. "Patients read about the benefits of a vaginal delivery and hope to replicate these benefits with vaginal seeding." As explained by the American College of Obstetricians and Gynecologists (ACOG), it's thought that contact with healthy vaginal bacteria helps stimulate the infant immune system, prevents the growth of dangerous bacteria and regulates the gut. That contact doesn't happen for babies born via C-section, however, so in vaginal seeding, a cotton swab with vaginal fluids from the mother is used to transfer vaginal bacteria to a newborn. But in a statement issued Oct. 24, ACOG -- the nation's largest ob/gyn organization -- said the procedure is not recommended because the known risks outweigh any potential benefits. "Due to the lack of sufficient data, the very real risks [of vaginal seeding] outweigh the potential benefits," Dr. Christopher Zahn, ACOG's vice president of practice activities, said in a college news release. "By swabbing an infant's mouth, nose or skin with vaginal fluid after birth, the mother could potentially, and unknowingly, pass on disease-causing bacteria or viruses," he explained. Wu agreed. "There are very real risks attached to this practice," she said. "Certain viruses, such as group B strep and herpes, can cause serious illnesses such as meningitis in newborns." And Zahn stressed that there's a much safer way for a new mom to transfer her helpful bacteria to her newborn: Breast-feeding. "Breast-feeding for the first six months is the best way to overcome the lack of exposure to maternal vaginal flora at birth," Zahn said. "The bacteria present in breast milk and on the nipple is sufficient for natural colonization or seeding of the gut. There may be some initial difference in the gut [microbes] of infants based on mode of delivery, but research has shown that difference disappears after about six months," he added. If a woman does insist on vaginal seeding, her ob/gyn needs to make sure the patient understands the potential risks, ACOG said. Dr. Mitchell Kramer is head of obstetrics and gynecology at Huntington Hospital in Huntington, N.Y. He agreed that breast-feeding is a good means of transmitting healthy microbes from a mom to her baby, but that "the jury is still out on [vaginal seeding] and further study is necessary before this is recommended as a routine protocol." SOURCES: Jennifer Wu, M.D., obstetrician/gynecologist, Lenox Hill Hospital, New York City; Mitchell Kramer, M.D., chairman, obstetrician/gynecologist, Huntington Hospital, Huntington, N.Y.; American College of Obstetricians and Gynecologists, news release, Oct. 24, 2017 HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Cesarean Section Childbirth Recent Health News customer support


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committed (*this news item will not be available after 01/23/2018) Wednesday, October 25, 2017 WEDNESDAY, Oct. 25, 2017 (HealthDay News) -- After-effects of a concussion continue to wrack the brains of young hockey players long after they appear ready to return to play, new research finds. MRI scans of concussed teen hockey players revealed brain changes persist for at least three months -- weeks after other symptoms resolve and skaters are cleared to hit the ice, a Canadian research team found. Scores on thinking and memory tests -- two current measures of recovery -- returned to normal about 24 days (on average) following a concussion, the study findings showed. These results indicate that current clinical tests used to judge an athlete's recovery could be improved, said senior researcher Ravi Menon. He's a professor and chair of functional and molecular imaging with the University of Western Ontario's Schulich School of Medicine and Dentistry. "Clearly those tests are not very sensitive," Menon said. "Basically, the standard concussion guidelines would indicate it's OK to go back to play, but the MRI changes show the brain is still damaged and still trying to compensate." The study involved 17 Canadian boys, aged 11 to 14, who sustained a concussion while playing in Bantam hockey leagues. Each player underwent standard thinking, memory and balance testing following his concussion. The boys also had MRI brain scans -- most had one right after the concussion and another three months later. All the players' scores on thinking and memory tests returned to normal before the three-month mark, ranging from 10 to 46 days. But the three-month MRIs showed they still had signs of widespread damage to their white matter. The white matter serves as the wiring that allows different regions of the brain to communicate, Menon noted. "We see damage to the wiring, and as a consequence of that we see a reduction in the communication between the areas that those wires connect," Menon said. The researchers also found other areas of the brain trying to create new connections, apparently in an attempt to re-establish communication impeded by the white matter damage, Menon explained. According to lead researcher Kathryn Manning, a doctoral student at the University of Western Ontario, "Those underlying white matter changes persist." Menon said that the results call for better clinical tests that reveal whether the damaged white matter has fully re-established communications. In the meantime, parents should consider keeping their kid out of play a little longer following a concussion, he suggested. There's some concern that brain damage can stack up in a youngster who receives additional knocks to the head while recovering from concussion. "Probably the more pragmatic approach is to not rush a kid who is 12 years old back into a game the minute their clinical score is normalized," Menon said. "There's no multimillion-dollar athletic contract on the line at this point. Give them a chance to rest and recover, and then ease them back in." That stance is a little too conservative for Dr. Anthony Alessi, a Norwich, Conn., neurologist and fellow of the American Academy of Neurology. "The best clinical tools right now are the tests we have," Alessi said. "If your child feels they're back to normal, they're functioning well at school, neuropsychometric testing is normal, they've seen a physician and all clinical indications are that they're normal, I'd let them go back and play." The best way parents can protect their child is to interview coaches to make sure they can recognize a concussion and place proper concern on removing injured children from play, Alessi said. It also helps if there's medical expertise on site. Studies have shown it's advantageous to have a certified athletic trainer working with the team, Alessi said. "Typically, a concussion will be recognized sooner and there will be intervention sooner," he added. The study was published online Oct. 25 in the journal Neurology . SOURCES: Ravi Menon, Ph.D., professor and chair, functional and molecular imaging, University of Western Ontario Schulich School of Medicine and Dentistry, Ontario, Canada; Kathryn Manning, M.Sc., doctoral student, University of Western Ontario, Ontario, Canada; Anthony Alessi, M.D., Norwich, Conn., neurologist and fellow, American Academy of Neurology; Oct. 25, 2017, Neurology , online HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Children's Health Sports Injuries Sports Safety Recent Health News you have to be


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mesmerizing (*this news item will not be available after 01/23/2018) Wednesday, October 25, 2017 WEDNESDAY, Oct. 25, 2017 (HealthDay News) -- The advent of powerful drugs in the mid-1990s brought remarkable gains in survival for HIV patients who had access to the medications. But a team of experts now warns that the global HIV pandemic continues and is at risk of expanding, given the worrisome global rise of HIV resistance to antiretroviral (ART) medications. "Current trends in HIV drug resistance are very concerning," said Dr. Chris Beyrer, lead author of an overview on the state of global HIV drug resistance. "Resistance levels have been found to be highest in ART-exposed infants and children," he added. "Which is a real concern, since children are already among the least-treated age group in many developing countries." Beyrer is professor of epidemiology with the Johns Hopkins Bloomberg School of Public Health in Baltimore. He and his colleagues noted that roughly 19.5 million HIV patients -- or approximately half the global population of HIV patients -- are now being treated with ART. The United Nations and the World Health Organization aim to eliminate AIDS as a public health threat by the year 2030. On the way to that goal, both organizations want to make sure that 90 percent of all HIV patients gain access to ART by 2020. That will be "enormously difficult," said Beyrer. For one, WHO and experts from the U.S. Centers for Disease Control and Prevention acknowledged that ART effectiveness is increasingly at risk, with HIV drug resistance having shot up from just 11 percent in 2001 to 29 percent today. Why? The review team noted that the "Achilles' heel" is shoddy adherence to ART regimens, mostly because of insufficient education and insufficient access to the medications. Poor adherence allows the HIV virus to mutate and develop drug resistance. To tackle the issue, the research team advocates placing more focus on prevention by hastening the development of an effective vaccine and by ratcheting up the use of Truvada, the HIV prevention regimen also known as PrEP. PrEP combines two ART drugs (tenofovir and emtricitabine), and the CDC says it can curtail HIV infection risk by as much as 90 percent. At the same time, Beyrer said, those already infected but not yet treated should be given access to newer types of ART "cocktails," including drugs such as dolutegravir that have "higher genetic barriers to resistance." That move alone, said Beyrer, would be "likely to have a major impact on resistance levels in the countries which go this route." Drug resistance may ultimately also pose a risk for PrEP, though for the time being Beyrer characterizes PrEP resistance as "very rare." "We need to be vigilant about this from a surveillance perspective," he said, "but PrEP users should adhere to regimens today with confidence." Beyrer and his colleagues highlighted another concern: a looming threat by the U.S. government to sharply curtail global health funding. "The proposed cuts from the Trump administration would have a severe impact on HIV treatment programs," he said, "particularly in the poorest and highest prevalence countries in Africa, and of course in underserved communities in the U.S." "The Congress has so far resisted these cuts," Beyrer added, "and we can only hope they continue to prioritize the support we need to finally control the HIV epidemic." Dr. Annette Sohn, from the global AIDS research advocacy organization amfAR, said she "agrees with the author's [Beyrer's] concerns around the current trends in resistance and their characterization of these as alarming." Sohn is based in Bangkok and serves as vice president of Global Initiatives for amfAR. "To achieve true global success in preventing resistance," she said, "we will need to create access to the best regimens for all people living with HIV. "The proposed cuts to global HIV programs are of primary concern in this regard," said Sohn. By doing so "we risk people losing access to treatment and stopping their medicines, which will lead to treatment failure, more new HIV infections, and increased drug resistance," she added. "Instead of cutting federal funding for HIV research," Sohn said, "we need more support for implementation research to study how to optimally deliver testing and treatment services in cost-effective ways." The review is published in the Oct. 26 issue of the New England Journal of Medicine . SOURCES: Chris Beyrer, M.D., M.P.H., professor, epidemiology, department of epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore; Annette Sohn, M.D., vice president, Global Initiatives, and director, TREAT Asia, amfAR, Bangkok, Thailand; Oct. 26, 2017, New England Journal of Medicine HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on HIV/AIDS Recent Health News yuletide


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always (*this news item will not be available after 01/23/2018) Wednesday, October 25, 2017 WEDNESDAY, Oct. 25, 2017 (HealthDay News) -- It's tough, often thankless work done by millions of Americans every day. And people who tend to a loved one with dementia say they're often overburdened, but the task has its rewards, too. Those are just some of the findings from a new University of Michigan survey, the National Poll on Healthy Aging, which tallied the experiences of dementia caregivers. About 5.5 million Americans are currently living with Alzheimer's disease, according to the Alzheimer's Association. It estimates that the bulk of their care -- 83 percent -- falls on unpaid family members. Alzheimer's is the most common form of dementia. It's no secret that family caregivers face heavy demands. However, the new survey turned up some surprises, said Erica Solway, of the University of Michigan's Institute for Healthcare Policy and Innovation. A striking finding, she said, was that 45 percent of caregivers described their experience as "very rewarding," while just 19 percent called it "very stressful." That illuminates the fact that there are positive aspects to dementia caregiving, Solway said, but she stressed that it should not overshadow the burdens families face. Of the survey respondents, 78 percent said caregiving was at least "somewhat" stressful, and more than a fourth said they'd neglected their own health. Dr. Gisele Wolf-Klein, director of geriatric education for Northwell Health in Great Neck, N.Y., was not surprised by that finding, saying she's witnessed how caregivers put their own health care on the back burner. "They don't go for routine health screenings because they think they don't have time," Wolf-Klein said. "But something as simple as getting your flu shot is important for both you and your loved one -- to help make sure neither of you gets sick." Beyond health care, caregivers often say they have little personal time at all. Of those Solway's team surveyed, two-thirds said their responsibilities interfered with their work, everyday tasks or general ability to take care of themselves. It's crucial, Wolf-Klein said, that family caregivers have time for themselves -- even if that means an afternoon to "just do nothing." She recommended that caregivers ask a trusted relative or friend to take over for the day, or a few hours -- and do so "without guilt." If there's no one who can step in, Wolf-Klein said, "respite" care might be an option. Some assisted-living facilities, for example, offer short-term care when a family member needs to travel or simply needs a break. Those breaks are critical, agreed Ruth Drew, who directs information and support services for the Alzheimer's Association. "No one can do this on their own," she said. "It's not a sign of weakness to ask for help. It's actually a sign of strength." Besides turning to family and friends, Drew said, caregivers can look to resources in their community and online. Those range from support groups and classes on caregiving to adult day centers -- where people with dementia can go for supervised activities, giving their family members time off. But in the survey, only 27 percent of caregivers said they'd used such resources. Families often are unaware that help is out there, Drew said, and by the time caregivers need those resources, they might be so overwhelmed by their responsibilities that they feel they don't have the time -- or energy -- to make it happen. She suggested that families start planning for those needs soon after a loved one is diagnosed with dementia -- before the caregiving becomes too intense. Money, of course, can be another barrier. Medicare does not pay for adult day care, and offers only limited coverage for in-home health care. Some families, though, may be eligible for benefits through the U.S. Department of Veterans Affairs or state assistance programs, for instance, Drew said. Also, the Alzheimer's Association has a 24-hour "helpline" and information on a range of resources for caregivers on its website, she said. "That's a good starting point," Solway agreed. Families can also try their local agency on aging, she said. "We're putting a lot of responsibility on the shoulders of family caregivers," Solway said. "Supporting them is critical." The survey included 148 caregivers, ages 50 to 80. Most -- 62 percent -- were women, and 60 percent were caring for a parent. The others were caring for a spouse, another relative or a friend. SOURCES: Erica Solway, Ph.D., senior project manager, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor; Ruth Drew, M.S., L.P.C., director, information and support services, Alzheimer's Association, Chicago; Gisele Wolf-Klein, M.D., director, geriatric education, Northwell Health, Great Neck, N.Y.; University of Michigan, National Poll on Healthy Aging, Oct. 25, 2017 HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Alzheimer's Disease Recent Health News looking ahead to


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practical (*this news item will not be available after 01/24/2018) Thursday, October 26, 2017 THURSDAY, Oct. 26, 2017 (HealthDay News) -- If you have trouble keeping slim, don't put all the blame on your DNA. People carrying so-called "obesity" genes tend to gain more weight if they don't work out or don't get enough sleep, said Timothy Frayling, a professor with the University of Exeter Medical School in England. "You can't change your genes -- but they only explain part of your weight," Frayling said. This means that even people genetically inclined to pile on pounds can curb it by eating right and exercising. Frayling and his fellow researchers tracked physical activity and sleep patterns for about 85,000 people in England, aged 40 to 70. The participants wore accelerometers that allowed researchers to estimate their amount of exercise and quality of sleep. The team also computed a genetic risk score for each person based on 76 common variants known to be associated with increased risk for obesity. Genetics accounted for some, but not all, of a person's obesity risk, the researchers concluded. For example, a person of average height who had 10 genetic risk factors for obesity gained an average of 8 pounds during the course of their life if they tended to be couch potatoes, but only about 6 pounds if they were more physically active, the study authors said. The results were similar regarding sleeplessness. People with some genetic risk for obesity tended to have a higher body mass index (BMI) if they woke frequently or slept more restlessly, the study findings showed. BMI is a measurement of body fat based on height and weight. "For public health and diet and exercise interventions, our study suggests there will be 'bigger bang for the buck' by focusing limited resources on people who are most susceptible due to their genes and their lifestyles," Frayling said. Obesity experts said the study results make sense, given what's known about the factors that contribute to excess weight. "Obesity is an energy storage disease that is caused by hormonal imbalances," said Dr. Mitchell Roslin, chief of obesity surgery at Lenox Hill Hospital in New York City. "Your genetic makeup plays a role, but your activity and the environment also influence your genetic expression," he explained. "Many believe that obesity is an epigenetic disease, meaning it is not the genes themselves but how the environment changes their shape," Roslin continued. "Think of genes as pieces in a jigsaw puzzle. The environment puts the puzzle together. Our actions matter, and while our genes influence our behavior, our behavior influences how genes work and their effect on the body." Dr. Jamie Kane, chairman of the Center for Weight Management at Northwell Health's Syosset Hospital in Syosset, N.Y., said the study "seems to ring true based on the research that's out there to date, and based on my clinical experience as well." Kane and his staff try "to look at the lifestyle, and work at the most stringent level with patients because we don't know who has what genetics," he said. It might require more dedication, but a person can overcome genetics that might otherwise lead to obesity, Kane concluded. "There are a very small number of people who suffer from morbid obesity where it's purely genetic," he said. "In most of these cases, people might need to exercise way more than the average person, and they might need to change their diet dramatically." Frayling and his colleagues presented their findings this week at the annual meeting of the American Society of Human Genetics, in Orlando, Fla. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed journal. SOURCES: Timothy Frayling, Ph.D., professor, University of Exeter Medical School, Exeter, England; Mitchell Roslin, M.D., chief, obesity surgery, Lenox Hill Hospital, New York City; Jamie Kane, M.D., chairman, Center for Weight Management, Syosset Hospital, Syosset, N.Y.; presentation, Oct. 20, 2017, annual meeting, American Society of Human Genetics, Orlando HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Genes and Gene Therapy Obesity Weight Control Recent Health News and have become


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with a purpose to (*this news item will not be available after 01/24/2018) By Margaret Farley Steele Thursday, October 26, 2017 THURSDAY, Oct. 26, 2017 (HealthDay News) -- More fallout from the U.S. opioid epidemic: Wisconsin has seen a near doubling of women on Medicaid who have the hepatitis C virus (HCV) in pregnancy. In turn, this has fueled a rise in babies born with the dangerous infection. Widespread injection drug use has triggered rapid increases of hepatitis C infections among young adults nationwide, according to a new report from the U.S. Centers for Disease Control and Prevention. Such drug use is seen as fallout from the opioid epidemic, as more people turn to injection drugs after becoming addicted to prescription painkillers. The CDC said most people today get hepatitis C by sharing needles or other injectable drug equipment. This means more babies are exposed to the liver-damaging virus in the womb, with mother-to-child transmission occurring in about 6 percent of cases nationwide, the CDC said. "The study highlights the need to educate mothers about the risk of transmitting hepatitis C to the infant," said Dr. Mariecel Pilapil, an internist and pediatrician at Cohen Children's Medical Center in New Hyde Park, N.Y. Pilapil wasn't involved in the current study. And, that education needs to include teaching women the risk factors for getting hepatitis C themselves, she added. The study came just as President Trump on Thursday declared the opioid epidemic a public health emergency, in his first major speech on the heroin and prescription painkiller crisis. Health care providers can protect babies by testing women of childbearing age for hepatitis C and curing those with the infection, said the research team led by Theresa Watts, of the University of Wisconsin-Madison School of Nursing. Watts and her colleagues wanted to see whether pregnant women and their infants were being tested for hepatitis C. They analyzed 2011-2015 data from Wisconsin's Medicaid program, the publicly funded insurance plan for the poor. Mirroring national findings, the proportion of pregnant women with hepatitis C increased 93 percent during that time, the researchers found. The birth rate for mothers infected with the hepatitis C virus went from 2.7 percent to more than 5 percent. But only about one-third of infants born to infected mothers were tested, with the virus detected in 4 percent of them, according to the study. "I was shocked by the low screening rate of infants born to hepatitis C positive mothers," Pilapil said, adding that there's a need to collaborate with obstetricians to check an expectant mom's hepatitis C status before delivery. The study authors agreed. "As the rate of HCV [hepatitis C] infection among women of childbearing age continues to increase nationally, practices for screening pregnant women for HCV and for monitoring infants born to HCV-infected mothers should be improved," they wrote. Their recommendations: Test all pregnant women with hepatitis C risk factors and provide better monitoring of infants at risk of maternal transmission. Signs of hepatitis C infection in infants often appear slowly. While some cases may be mild, others can be severe and require liver transplantation, the report said. The findings appear in the CDC's Oct. 27 Morbidity and Mortality Weekly Report . SOURCE: Oct. 27, 2017, U.S. Centers for Disease Control and Infection, Morbidity and Mortality Weekly Report HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Infections and Pregnancy Opioid Abuse and Addiction Recent Health News normal


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to collapse (*this news item will not be available after 01/23/2018) Wednesday, October 25, 2017 WEDNESDAY, Oct. 25, 2017 (HealthDay News) -- Nearly 40 percent of indoor tanning facilities ignore state laws that curb teen tanning, a new survey finds. To protect teens, most states have laws that prevent or create obstacles to using tanning salons, but nearly 2 million high school kids still get indoor tans, said the researchers who conducted the survey. "The U.S. Food and Drug Administration has classified tanning beds as cancer causing," said the survey's lead researcher, Dr. Erik Stratman, a dermatologist at the Marshfield Clinic in Marshfield, Wis. Indoor tanning is particularly dangerous for young people, according to the U.S. Centers for Disease Control and Prevention, because it increases their risk for melanoma, a deadly form of skin cancer. Banning indoor tanning for teens might prevent thousands of melanomas and melanoma deaths and the millions spent on treatment, Stratman said. "While no federal ban exists on indoor tanning of minors, there have been over 40 states and the District of Columbia that passed laws limiting the use of tanning beds for minors," he said. However, Stratman said the survey, conducted by telephone, found that many tanning salons ignore state laws restricting access to minors. Responsibility for enforcing these laws varies by state, but in most cases falls to the state's health department, Stratman said, adding that lax enforcement is most likely due to limited resources. For the study, researchers posing as teenagers called 427 tanning facilities in 42 states and the District of Columbia. The callers said they wanted to tan before a family vacation and asked about costs and whether a parent needed to be present to consent to tanning. The researchers found that slightly more than 37 percent of the tanning facilities did not comply with their state's laws. The most common breach was allowing tanning without parental permission, Stratman said. Most of the tanning salons that flouted the laws were in rural areas, the South, in states with laws governing teens 15 or younger and in states with more than one tanning regulation. In addition, independently owned salons were more likely than chain tanning facilities not to follow the laws, the researchers found. The American Suntanning Association represents the tanning salon industry and responded to the study. "This was a telephone survey, and not a single business contacted actually allowed a teenager to use UV tanning services without parental consent or violated any law," said Joseph Levy, director of scientific affairs for the association. "The American Suntanning Association and its members, who operate more than 1,000 professional salons throughout the country, have supported compliance with indoor tanning standards for decades, including those related to tanning by minors," Levy said. However, teens don't know the potential consequences of tanning, said Dr. Michele Green, a dermatologist at Lenox Hill Hospital in New York City. "Indoor tanning is exposing teens to a carcinogen. Kids don't know they are doing something that can hurt them." Green knows the dangers of tanning beds firsthand. "I have a 25-year-old patient who tanned when he was a teen and now has a deep, incisive melanoma and has a 50 percent chance of dying," she said. Stratman said it's his "hope that this study stimulates states to look for opportunities for better enforcement of the laws intended to improve the safety and health of minors." The survey results were published online Oct. 25 in the journal JAMA Dermatology . SOURCES: Erik Stratman, M.D., Marshfield Clinic, Marshfield, Wis.; Michele Green, M.D., dermatologist, Lenox Hill Hospital, New York City; Joseph Levy, scientific adviser, American Suntanning Association; Oct. 25, 2017, JAMA Dermatology , online. HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Skin Cancer Tanning Recent Health News of fashion


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the roles (*this news item will not be available after 01/23/2018) By Robert Preidt Wednesday, October 25, 2017 WEDNESDAY, Oct. 25, 2017 (HealthDay News) -- American teens underestimate their use of amphetamines, likely because many don't know that the attention-deficit/hyperactivity disorder (ADHD) drug Adderall is an amphetamine, a new study suggests. High school and college students sometimes use Adderall, a type of stimulant medication, without a doctor's order because they believe it will boost their mental function and school performance. Use of amphetamines without a doctor's order, known as nonmedical use, carries a high risk of abuse and dependency, as well as potential harmful side effects such as heart problems and seizures. People who use prescription stimulants like amphetamines without a doctor's order also are more likely to engage in other drug use and risky behaviors, the researchers said. The researchers examined the responses of more than 24,000 high school seniors who took part in a national survey between 2010 and 2015. Though nearly 8 percent of the students reported nonmedical amphetamine use and about 7 percent reported nonmedical Adderall use in the past year, about 29 percent of nonmedical Adderall users reported no nonmedical amphetamine use. Students aged 18 and older, black students, and students with parents with lower education levels were more likely than others to report no nonmedical amphetamine use, despite reporting nonmedical Adderall use, the study found. It was conducted by the Center for Drug Use and HIV/HCV Research at New York University's Meyers College of Nursing in New York City. "Over a quarter of teens who reported using Adderall without a doctor telling them to take it contradicted themselves by saying they do not use amphetamine," senior author Joseph Palamar, an associate professor of population health, said in a university news release. "As a result, the estimated prevalence of nonmedical amphetamine use of 7.9 percent may be an underestimate," he said. "It may be as high as 9.8 percent, or one out of 10 high school seniors, when considering the discordant reporting we found." "Our findings suggest that many young people are unaware that Adderall is amphetamine," Palamar said. "In addition, such conflicting reports mean that prescription stimulant misuse may be underestimated." The study was published Oct. 23 in the journal Drug and Alcohol Dependence . "Alarmingly, we had similar findings regarding opioids in another study, with many teens appearing unaware that the Vicodin and OxyContin they took are opioids," Palamar added. "Better drug education is needed to inform the public about common drugs like amphetamines and opioids." He and his colleagues also said their study shows the need to improve how drug use surveys are conducted. For example, surveys could provide images of specific substances to help respondents recognize specific pills. SOURCE: New York University, news release, Oct. 23, 2017 HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Teen Health Recent Health News worthwhile


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component There's a New Shingles Vaccine -- Is It for You? flattening

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assignment (*this news item will not be available after 01/24/2018) Thursday, October 26, 2017 THURSDAY, Oct. 26, 2017 (HealthDay News) -- On the heels of approval of a better vaccine for the painful condition shingles, adults over 50 should plan to roll up their sleeves -- again. The new vaccine, Shingrix, will likely be recommended even for those already inoculated with an older vaccine. An advisory panel of the U.S. Centers for Disease Control and Prevention recommended Wednesday that all adults 50 and older receive the new two-shot vaccine, just days after the U.S. Food and Drug Administration announced its approval of Shingrix. Shingrix, manufactured by GlaxoSmithKline, is more than 90 percent effective in preventing shingles, a painful skin disease that afflicts about one of every three people in the United States during their lifetime. If the CDC adopts the panel's recommendation, Shingrix will supplant the only other shingles vaccine available, the single-dose Merck product Zostavax. "The new shingles vaccine represents a major step forward," said Dr. Amesh Adalja, a senior associate with the Johns Hopkins Center for Health Security in Baltimore. "The efficacy of this vaccine is significantly higher than Zostavax, and those vaccinated with Zostavax should benefit from revaccination with Shingrix." Shingles is a painful itching rash caused by the varicella zoster virus, the same bug behind chickenpox. The virus lies dormant in the nerve tissue of people who've had chickenpox, and years later can reactivate as shingles. Anyone who's had chickenpox can develop shingles, but about half of all cases occur in people 60 and older, according to the CDC. Shingrix is 97 percent effective in preventing shingles in people 50 to 69 years old, and 91 percent effective in those 70 and older, according to a briefing provided to the CDC's Advisory Committee on Immunization Practices prior to its decision Wednesday. By comparison, Zostavax is 70 percent effective in your 50s; 64 percent effective in your 60s; 41 percent effective in your 70s; and 18 percent effective in your 80s, the briefing states. Shingrix is also better than Zostavax in preventing nerve pain that continues after a shingles rash has cleared -- about 90 percent effective versus 65 percent effective, the briefing stated. "The shingle attack itself is severe and painful to most people, and then there's the possibility that the skin lesions clear up but nerve pain continues," said Dr. Len Horovitz, a pulmonologist at Lenox Hill Hospital in New York City. "That can be really chronic, unremitting and difficult to treat." Based on these results, the advisory committee voted 8 to 7 to recommend Shingrix for people 50 and older. It also said people previously inoculated with Zostavax should come back to get the new vaccine. Dr. Talia Swartz is an assistant professor of infectious diseases with the Icahn School of Medicine at Mount Sinai in New York City. Swartz said, "The reason for the close vote is that while Shingrix is much more effective, it is also associated with more reactions. While they are not serious reactions, they may be temporarily inconvenient, including fever and muscle pain." The advisory committee vote closely followed the FDA approval of Shingrix on Monday. It's not clear at this point whether people who've received Zostavax should come back immediately for Shingrix or wait. The point did not come up during the panel's discussion, Glaxo spokesman Sean Clements said. The pharmaceutical company expects the CDC to clarify the timing of re-vaccination with Shingrix if it supports the advisory committee recommendation, Clements said. Horovitz said he also hopes for clarification on whether someone who has received Zostavax will only need a single dose of Shingrix, or the full two-dose regimen. Zostavax patients who wait a bit likely will not have to pay as much for their Shingrix vaccination, Swartz said. Vaccine maker GSK estimates that Shingrix costs about $280 for two doses, according to The New York Times . "Shingrix is more expensive and not yet covered by insurance," Swartz said. "Pending official endorsement from the Centers for Disease Control, insurance companies will likely begin covering Shingrix." Shingrix is a non-live herpes zoster vaccine that contains a booster intended to generate a strong and long-lasting immune response. That booster and the fact that the vaccine is a two-dose series are likely why it has superior protection, Adalja said. SOURCES: Amesh Adalja, M.D, senior associate, Johns Hopkins Center for Health Security, Baltimore; Len Horovitz, M.D., pulmonologist, Lenox Hill Hospital, New York City; Talia Swartz, M.D., Ph.D., assistant professor, infectious diseases, Icahn School of Medicine at Mount Sinai, New York City HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Immunization Seniors' Health Recent Health News in the present day


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continuously Skinny in 20s, Earlier Menopause Later? is generally

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dollars (*this news item will not be available after 01/24/2018) Thursday, October 26, 2017 THURSDAY, Oct. 26, 2017 (HealthDay News) -- Young women who are underweight may have an increased risk of early menopause, potentially jeopardizing their health, a large new study suggests. The study found that those who were underweight in younger adulthood were 30 percent more likely to go through early menopause, compared to normal-weight women. Early menopause -- defined in this study as before age 45 -- is a concern for several reasons. It shortens a woman's reproductive life, and has been tied to heightened risks of heart disease, osteoporosis and memory decline. The new findings don't prove that being underweight directly causes early menopause, said lead researcher Kathleen Szegda, of Partners for a Healthier Community in Springfield, Mass. "This is suggestive, and needs to be followed up with additional studies," she said. Still, there are known links between weight and a woman's menstrual cycle, Szegda noted. Some underweight women, for example, stop getting their periods altogether, in what's called amenorrhea -- though it's not clear if that would contribute to early menopause. One theory, Szegda said, is that some underweight women may have been small at birth, too. That means they could have been born with a smaller "ovarian pool," or number of eggs. The findings, published Oct. 26 in the journal Human Reproduction, are based on nearly 79,000 U.S. nurses taking part in a large health study. They were between the ages 25 and 42 at the study's outset, in 1989. Over the next 22 years, just over 2,800 of those women went through early menopause. And the chances were higher among those who'd been underweight at age 18 or 35 -- the two time points the researchers analyzed. "Underweight" was defined as a body mass index (BMI) below 18.5. BMI is a measure of weight in relation to height, and figures between 18.5 and 24.9 are considered "normal." So, the researchers explained, a woman 5 feet 5 inches tall who weighs 111 pounds or less would be considered underweight. Most of the underweight women did not go through early menopause: For example, of roughly 1,100 women who were underweight at age 35, only 61 went through menopause early. But their risks were higher, even compared with women at the lower end of the normal-weight range: The odds of early menopause were 56 percent higher among women who were underweight at age 35, and 51 percent higher if they were underweight at age 18. "This is more evidence that you really can be too thin," said Dr. Lila Nachtigall, a professor of obstetrics and gynecology at NYU Langone Medical Center in New York City. Nachtigall, who was not involved in the study, did point to some limitations with the research. For one, she said, some underweight women may have mistakenly said they'd gone through menopause when they were really experiencing amenorrhea. Plus, the researchers did not know whether the women were naturally very thin or had an eating disorder. Nachtigall said the potential role of malnutrition is important since that could contribute to "ovarian failure" and menopause. Szegda's team did find some evidence that extreme weight "cycling" was a culprit. The risk of early menopause was highest among underweight women who also reported major weight changes -- losing at least 20 pounds three or more times in young adulthood. But, Szegda said, that was based on a handful of women, so it's not clear what to make of it. Since early menopause is linked to certain diseases, it is a concern beyond fertility, Nachtigall said. Women who do transition early, she said, should pay extra attention to their risk factors for heart disease and osteoporosis -- regardless of their weight. That means being vigilant about diet and exercise, and reining in conditions such as high blood pressure and high cholesterol. Underweight women, Nachtigall added, may need a nutritional evaluation to make sure they are getting enough protein, fat, vitamins and minerals. SOURCES: Kathleen Szegda, Ph.D., M.P.H., director, community research and evaluation, Partners for a Healthier Community, Public Health Institute of Western Massachusetts, Springfield, Mass.; Lila Nachtigall, M.D., professor, obstetrics and gynecology, NYU Langone Medical Center, New York City; Oct. 26, 2017, Human Reproduction , online HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Body Weight Menopause Recent Health News shots


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to confess Many High-Risk Women Skip MRI Breast Cancer Screenings photographs

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most tenacious (*this news item will not be available after 01/24/2018) By Robert Preidt Thursday, October 26, 2017 THURSDAY, Oct. 26, 2017 (HealthDay News) -- Knowing they're at increased risk for breast cancer isn't enough to persuade many women to get MRI screenings -- even if they're free. Researchers studied more than 1,000 women in a U.S. military health system who had a 20 percent or greater lifetime risk of breast cancer due to genetics or personal or family history. Between 2015 and 2016, they were offered free MRI cancer screening at the Madigan Army Medical Center in Tacoma, Wash. (Women with higher than average risk are advised to start annual MRIs and mammograms at age 30, according to the American Cancer Society.) But only 23 percent of the women underwent MRI screening. That included 15 percent of those with a 20 to 24 percent lifetime risk of breast cancer, and only half of those with more than a 40 percent risk. The study was to be presented Wednesday at an American College of Surgeons meeting in San Diego. "The military health system is an equal access, no-cost system. This system allows us to study how well we are doing in terms of truly adhering to the current recommended guidelines for screening of breast cancer," said study lead author Dr. Vance Sohn. He's a surgical oncologist at the Madigan Army Medical Center. "In the interest of helping more women be screened earlier for breast cancer, we were intrigued about what this preliminary study identified -- that 85 percent of women with a 20 to 24 percent lifetime risk still did not pursue high risk surveillance," he said said in a college news release. "Ultimately, the question we are really trying to answer is why women at high risk for breast cancer are declining MRI screening. That issue is the next phase of this study," Sohn added. "The general sense is that patients are just too busy, but discovering the reason will be a very important piece to this puzzle," he added. Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal. SOURCE: American College of Surgeons, news release, Oct. 25, 2017 HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Breast Cancer Health Screening Recent Health News most luxurious


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entering into (*this news item will not be available after 01/24/2018) By Alan Mozes Thursday, October 26, 2017 THURSDAY, Oct. 26, 2017 (HealthDay News) -- After a severe traumatic injury, the composition of a patient's intestinal bacteria quickly changes -- a phenomenon that could affect the patient's prognosis, new research suggests. The finding that the gut's so-called "microbiome" experiences a depletion in the presence of some bacteria and an increase in the presence of others came from a small investigation, involving 12 critically injured adults. The patients were aged 20 to 85. Stool samples were collected from each person three times: when they were admitted to the hospital, and then 24 and 72 hours later. The samples were compared with those from 10 other patients who had not sustained traumatic injury. Samples taken at the time of admission were similar in both groups. But within 24 hours, differences started to show, the investigators found. By 72 hours, three types of bacteria were depleted in the traumatic injury group, relative to the non-injury group, and the levels of two other types of bacteria had risen. "The short time-course in which such alterations occur is also notable -- such relatively rapid alterations in intestinal microbiota represent a critical and previously unrecognized phenomenon that may influence clinical course and outcomes after severe trauma," the study authors wrote in the report. The study was published online Oct. 23 in Trauma Surgery & Acute Care Open . The study team, led by Dr. Benjamin Howard from the department of surgery at San Francisco General Hospital, said more research is needed to further explore the phenomenon. But the researchers added that the findings so far point to the possibility that intestinal bacterial composition could in some way be critical to patient outcomes after a traumatic injury. Theoretically, that could ultimately point the way toward interventions -- such as administering probiotic regimens -- that might help improve patient outcomes after injury, the authors suggested in a journal news release. SOURCE: Trauma Surgery and Acute Care Open , news release, Oct. 23, 2017 HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Wounds and Injuries Recent Health News tremendously


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most room Sitagliptin and Metformin Extended-Release Tablets Generic Name: Sitagliptin and Metformin Extended-Release Tablets (sit a GLIP tin & met FOR min) Brand Name: Janumet XR Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings User Reviews Support Group Q & A Warning Rarely, metformin may cause an acid health problem in the blood (lactic acidosis). The risk of lactic acidosis is higher in people with kidney problems and in people who take certain other drugs like topiramate. The risk is also higher in people with liver problems or heart failure, in older people (65 or older), or with alcohol use. If lactic acidosis happens, it can lead to other health problems and can be deadly. Lab tests to check the kidneys may be done while taking this medicine (sitagliptin and metformin extended-release tablets). Talk with the doctor. Call your doctor right away if you have signs of too much lactic acid in the blood (lactic acidosis) like fast breathing, fast or slow heartbeat, a heartbeat that does not feel normal, very bad upset stomach or throwing up, feeling very sleepy, shortness of breath, feeling very tired or weak, very bad dizziness, feeling cold, or muscle pain or cramps. Do not take this medicine if you have a very bad infection, low oxygen, or a lot of fluid loss (dehydration). If you have liver disease, talk with your doctor. Talk with your doctor before you drink alcohol. If you are having an exam or test with contrast or have had one within the past 48 hours, talk with your doctor. Tell all of your health care providers that you take this medicine (sitagliptin and metformin extended-release tablets). This includes your doctors, nurses, pharmacists, and dentists. Uses of Sitagliptin and Metformin Extended-Release Tablets: It is used to lower blood sugar in patients with high blood sugar (diabetes). Slideshow 14 Essential Health Screenings That All Men Should Consider What do I need to tell my doctor BEFORE I take Sitagliptin and Metformin Extended-Release Tablets? If you have an allergy to sitagliptin, metformin, or any other part of this medicine. If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs. If you have any of these health problems: Acidic blood problem, kidney disease, liver disease, or type 1 diabetes. If you have had a recent heart attack or stroke. If you are not able to eat or drink like normal, including before certain procedures or surgery. This is not a list of all drugs or health problems that interact with this medicine (sitagliptin and metformin extended-release tablets). Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this medicine with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor. What are some things I need to know or do while I take Sitagliptin and Metformin Extended-Release Tablets? Tell all of your health care providers that you take this medicine (sitagliptin and metformin extended-release tablets). This includes your doctors, nurses, pharmacists, and dentists. Do not drive if your blood sugar has been low. There is a greater chance of you having a crash. Check your blood sugar as you have been told by your doctor. Have blood work checked as you have been told by the doctor. Talk with the doctor. Low blood sugar can happen. The chance of low blood sugar may be raised when this medicine is used with other drugs for high blood sugar (diabetes). Signs may be dizziness, headache, feeling sleepy, feeling weak, shaking, a fast heartbeat, confusion, hunger, or sweating. Call your doctor right away if you have any of these signs. Follow what you have been told to do if you get low blood sugar. This may include taking glucose tablets, liquid glucose, or some fruit juices. It may be harder to control your blood sugar during times of stress like when you have a fever, an infection, an injury, or surgery. A change in level of physical activity or exercise and a change in diet may also affect your blood sugar. Talk with your doctor. Be careful in hot weather or while being active. Drink lots of fluids to stop fluid loss. Follow the diet and workout plan that your doctor told you about. If you have been taking this medicine (sitagliptin and metformin extended-release tablets) for a long time or at high doses, it may not work as well and you may need higher doses to get the same effect. This is known as tolerance. Call your doctor if this medicine stops working well. Do not take more than ordered. A skin reaction called bullous pemphigoid has happened with drugs like this one. Sometimes, people have had to go to the hospital. Call your doctor right away if you have blisters or if your skin starts to break down. Heart failure has happened in people taking drugs like this one. Tell your doctor if you have ever had heart failure or kidney problems. Call your doctor right away if you feel very tired or you have shortness of breath, a big weight gain, or swelling in the arms or legs. If you are 65 or older, use this medicine (sitagliptin and metformin extended-release tablets) with care. You could have more side effects. Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using this medicine while you are pregnant. Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby. How is this medicine (Sitagliptin and Metformin Extended-Release Tablets) best taken? Use this medicine (sitagliptin and metformin extended-release tablets) as ordered by your doctor. Read all information given to you. Follow all instructions closely. Take with a meal. Take in the evening, unless your doctor tells you otherwise. Swallow whole. Do not chew, break, or crush. Keep taking this medicine as you have been told by your doctor or other health care provider, even if you feel well. To gain the most benefit, do not miss doses. What do I do if I miss a dose? Take a missed dose as soon as you think about it. If it is close to the time for your next dose, skip the missed dose and go back to your normal time. Do not take 2 doses at the same time or extra doses. Dosage Information (comprehensive) What are some side effects that I need to call my doctor about right away? WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect: Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat. Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain. Chest pain or pressure. Fever or chills. Sore throat. Very bad and sometimes deadly pancreas problems (pancreatitis) have happened with this medicine (sitagliptin and metformin extended-release tablets). This could happen at any time during care. Signs of pancreatitis include very bad stomach pain, very bad back pain, or very upset stomach or throwing up. Call your doctor right away if you have any of these signs. It is common to have stomach problems like upset stomach, throwing up, or loose stools (diarrhea) when you start taking this medicine. If you have stomach problems later during care, call your doctor right away. This may be a sign of an acid health problem in the blood (lactic acidosis). A very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause very bad health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes. Drugs like this one may cause joint pain that can be very bad and disabling. Call your doctor right away if you have very bad joint pain or any joint pain that does not go away. You may see something that looks like the tablet in your stool. If you see tablets in your stool a lot, talk with your doctor. What are some other side effects of Sitagliptin and Metformin Extended-Release Tablets? All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away: Belly pain. Upset stomach or throwing up. Loose stools (diarrhea). Gas. Feeling tired or weak. Headache. Sore throat. Stuffy nose. Runny nose. These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch. Side Effects (complete list) If OVERDOSE is suspected: If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened. How do I store and/or throw out Sitagliptin and Metformin Extended-Release Tablets? Store at room temperature. Store in a dry place. Do not store in a bathroom. Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets. Check with your pharmacist about how to throw out unused drugs. Consumer Information Use and Disclaimer If your symptoms or health problems do not get better or if they become worse, call your doctor. Do not share your drugs with others and do not take anyone else's drugs. Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor. Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins. This medicine comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this medicine (sitagliptin and metformin extended-release tablets) is refilled. If you have any questions about this medicine, please talk with the doctor, pharmacist, or other health care provider. If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened. This information should not be used to decide whether or not to take this medicine (sitagliptin and metformin extended-release tablets) or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. 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 this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine (sitagliptin and metformin extended-release tablets). This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine. Review Date: November 1, 2017 Next Side Effects Print this page Add to My Med List More about metformin/sitagliptin Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Español 47 Reviews Add your own review/rating Drug class: antidiabetic combinations Consumer resources Metformin and sitagliptin Sitagliptin and Metformin Tablets Sitagliptin and metformin (Advanced Reading) Other brands: Janumet , Janumet XR Professional resources Sitagliptin and Metformin (Wolters Kluwer) Related treatment guides Diabetes, Type 2} Drug Status Rx Availability Prescription only B Pregnancy Category No proven risk in humans N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Metformin / sitagliptin Rating 47 User Reviews 6.6 /10 47 User Reviews 6.6 Rate it! Manufacturer Macleods Pharmaceuticals Limited Drug Class Antidiabetic combinations Related Drugs Diabetes, Type 2 metformin , insulin aspart , glipizide , glimepiride , Januvia , pioglitazone , Victoza , Actos , Tradjenta , Glucophage , glyburide , Janumet , Invokana , Amaryl , Welchol , Onglyza , sitagliptin , Trulicity , Jardiance , Lantus , Farxiga , Levemir , Tresiba , Glucotrol , Bydureon , More...} } every body


rear lights Sitagliptin and Metformin Extended-Release Tablets among the best

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Photo :Blood Thinners May Also Protect Brains of A-Fib Patients
all of sudden (*this news item will not be available after 01/24/2018) By Robert Preidt Thursday, October 26, 2017 THURSDAY, Oct. 26, 2017 (HealthDay News) -- Blood thinners may pull double duty for people with the heart rhythm disorder atrial fibrillation: New research suggests they help prevent dementia as well as stroke. Because atrial fibrillation increases the risk for stroke, people with the condition are often prescribed blood thinners (also known as anticoagulants) to prevent blood clots that can cause a stroke. Atrial fibrillation also increases the risk for dementia. During the study, more than 26,000 of the 440,000 participants, all with atrial fibrillation, were diagnosed with dementia. At the time they joined the study, about half of the participants were taking oral anticoagulants, such as warfarin, Eliquis (apixaban), Pradaxa (dabigatran), Savaysa (edoxaban) or Xarelto (rivaroxaban). The researchers found that people taking anticoagulants were 29 percent less likely to develop dementia than were those who were not taking the blood thinners. When the researchers focused on people who continued to take the drugs, they found an even larger reduction (48 percent) in the risk for dementia. They also found that the sooner people started taking blood thinners after their diagnosis of atrial fibrillation, the lower their risk for dementia. Along with not taking blood thinners, the strongest predictors for dementia were age, Parkinson's disease and alcohol abuse, according to the study, published Oct. 25 in the European Heart Journal . The findings strongly suggest that blood thinners reduce the risk for dementia in people with atrial fibrillation, but proving that would not be possible, the Swedish researchers said. "In order to prove this assumption, randomized placebo-controlled trials would be needed, but such studies cannot be done because of ethical reasons," researchers Leif Friberg and Marten Rosenqvist, of the Karolinska Institute in Stockholm, said in a journal news release. "It is not possible to give placebo to [atrial fibrillation] patients and then wait for dementia or stroke to occur." However, the findings show that people with atrial fibrillation should start taking blood thinners as soon as possible after their diagnosis and continue to take the drugs, Friberg noted. "Patients start on oral anticoagulation for stroke prevention but they stop after a few years at an alarmingly high rate," he said. "In the first year, approximately 15 percent stop taking the drugs, then approximately 10 percent each year." "If you know that [atrial fibrillation] eats away your brain at a slow but steady pace and that you can prevent it by staying on treatment, I think most patients would find this a very strong argument for continuing treatment," he said. SOURCE: European Heart Journal , news release, Oct. 24, 2017 HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Atrial Fibrillation Blood Thinners Dementia Recent Health News wonderful


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seems to be sitagliptin and metformin (Oral route) a protracted

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Photo :sitagliptin and metformin (Oral route)
exquisite sitagliptin and metformin (Oral route) met-FOR-min hye-droe-KLOR-ide, sit-a-GLIP-tin FOS-fate Oral route(Tablet;Tablet, Extended Release) Postmarketing cases of metformin-associated lactic acidosis have resulted in death, hypothermia, hypotension, and resistant bradyarrhythmias. Symptoms included malaise, myalgias, respiratory distress, somnolence, and abdominal pain. Laboratory abnormalities included elevated blood lactate levels, anion gap acidosis, an increased lactate/pyruvate ratio, and metformin plasma levels generally greater than 5 mcg/mL. Risk factors include renal impairment, concomitant use of certain drugs (eg, carbonic anhydrase inhibitors), age 65 years old or greater, radiological studies with contrast, surgery and other procedures, hypoxic states, excessive alcohol intake, and hepatic impairment. If lactic acidosis is suspected, immediately discontinue metformin hydrochloride/sitagliptin phosphate and institute general supportive measures in a hospital setting; prompt hemodialysis is recommended . Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings User Reviews Support Group Q & A Commonly used brand name(s) In the U.S. Janumet Janumet XR Available Dosage Forms: Tablet, Extended Release Tablet Therapeutic Class: Antidiabetic Pharmacologic Class: Sitagliptin Chemical Class: Metformin Slideshow Lifestyle Lessons - 9 Tips For Managing Type 2 Diabetes Uses For sitagliptin and metformin Metformin and sitagliptin combination is used to treat high blood sugar levels caused by type 2 diabetes. Metformin reduces the absorption of sugar from the stomach, reduces the release of stored sugar from the liver, and helps your body use sugar better. Sitagliptin helps to control blood sugar levels by increasing substances in the body that make the pancreas release more insulin. It also signals the liver to stop producing sugar (glucose) when there is too much sugar in the blood. sitagliptin and metformin does not help patients who have insulin-dependent or type 1 diabetes. sitagliptin and metformin is available only with your doctor's prescription. Before Using sitagliptin and metformin In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For sitagliptin and metformin, the following should be considered: Allergies Tell your doctor if you have ever had any unusual or allergic reaction to sitagliptin and metformin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Pediatric Appropriate studies have not been performed on the relationship of age to the effects of metformin and sitagliptin combination in the pediatric population. Safety and efficacy have not been established. Geriatric Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of metformin and sitagliptin combination in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require an adjustment in the dose for patients receiving metformin and sitagliptin combination. Pregnancy Pregnancy Category Explanation All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus. Breast Feeding There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Interactions with Medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking sitagliptin and metformin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using sitagliptin and metformin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Acetrizoic Acid Diatrizoate Ethiodized Oil Iobenzamic Acid Iobitridol Iocarmic Acid Iocetamic Acid Iodamide Iodipamide Iodixanol Iodohippuric Acid Iodopyracet Iodoxamic Acid Ioglicic Acid Ioglycamic Acid Iohexol Iomeprol Iopamidol Iopanoic Acid Iopentol Iophendylate Iopromide Iopronic Acid Ioseric Acid Iosimide Iotasul Iothalamate Iotrolan Iotroxic Acid Ioxaglate Ioxitalamic Acid Ipodate Metrizamide Metrizoic Acid Tyropanoate Sodium Using sitagliptin and metformin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Aspirin Balofloxacin Besifloxacin Bupropion Ciprofloxacin Dasabuvir Dofetilide Dolutegravir Eliglustat Enoxacin Fleroxacin Flumequine Gatifloxacin Gemifloxacin Ioversol Lanreotide Levofloxacin Lomefloxacin Moxifloxacin Nadifloxacin Norfloxacin Octreotide Ofloxacin Ombitasvir Paritaprevir Pasireotide Pazufloxacin Pefloxacin Pioglitazone Prulifloxacin Ritonavir Rufloxacin Simeprevir Sparfloxacin Thioctic Acid Tosufloxacin Vandetanib Using sitagliptin and metformin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Acebutolol Atenolol Betaxolol Bisoprolol Bitter Melon Carteolol Carvedilol Celiprolol Esmolol Fenugreek Furazolidone Glucomannan Guar Gum Iproniazid Isocarboxazid Labetalol Levobunolol Linezolid Methylene Blue Metipranolol Metoprolol Moclobemide Nadolol Nebivolol Nialamide Oxprenolol Patiromer Penbutolol Phenelzine Pindolol Practolol Procarbazine Propranolol Psyllium Ranolazine Rasagiline Rifampin Safinamide Selegiline Sotalol Timolol Tranylcypromine Verapamil Interactions with Food/Tobacco/Alcohol Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Other Medical Problems The presence of other medical problems may affect the use of sitagliptin and metformin. Make sure you tell your doctor if you have any other medical problems, especially: Alcohol, excessive use or Congestive heart failure, acute or unstable or Dehydration, severe or Heart attack, acute or Heart or blood vessel problems or Hypoxemia (decreased oxygen in the blood) or Liver disease or Poorly nourished condition or Sepsis (severe infection) or Shock (low blood pressure, blood circulation is poor) or Weakened physical condition Use with caution. May increase risk of serious side effects. Anemia (low blood cells) or Kidney disease or Vitamin B12 deficiency Use with caution. May make these conditions worse. Angioedema (swelling of the face, lips, tongue, throat, arms, or legs), history with this medication or other dipeptidyl peptidase-4 (DPP-4) inhibitors Use with caution. May increase the risk of this condition occurring again. Diabetic ketoacidosis or metabolic acidosis (high ketones and acid in the blood) or Kidney disease, severe or Type 1 diabetes Should not be used in patients with these conditions. Fever or Infection of any type or Surgery (major) or Trauma These conditions may cause temporary problems with blood sugar control and your doctor may want to treat you with insulin. Hypercholesterolemia (high cholesterol in the blood) or Hypertriglyceridemia (high triglycerides and fats in the blood) or Obesity or Pancreas problems, history of Use with caution. May increase risk for pancreatitis (swelling of the pancreas). Radiologic procedures (eg, X-rays, CT scans, and MRIs) that require dyes to be injected in your vein sitagliptin and metformin should be stopped before you have one of these procedures. Proper Use of sitagliptin and metformin Your doctor will tell you how much of sitagliptin and metformin to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to. sitagliptin and metformin should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions. Metformin and sitagliptin combination should be taken with meals to help reduce any stomach upset. Take the extended-release tablets as directed in the evening. Swallow the extended-release tablet or immediate-release tablet whole. Do not crush, break, or chew it. Carefully follow the special meal plan your doctor gave you . This is the most important part of controlling your diabetes, and is necessary if the medicine is to work properly. Exercise regularly and test for sugar in your blood or urine as directed. While taking Janumet XR , you may see tablets in your stools. If you see tablets in your stool several times, tell your doctor right away. Do not stop taking sitagliptin and metformin without checking first with your doctor. Dosing The dose of sitagliptin and metformin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of sitagliptin and metformin. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For type 2 diabetes: For oral dosage form (extended-release tablets): For patients taking metformin alone: Adults At first, 100 milligrams (mg) of sitagliptin, plus the dose of metformin already being taken once a day. Your doctor may gradually increase your dose until your blood sugar is controlled. If you are taking 850 or 1000 mg of immediate-release metformin 2 times per day, you may start with two 50 mg sitagliptin tablets and 1000 mg of metformin taken together once a day. Children Use and dose must be determined by your doctor. For patients taking sitagliptin alone: Adults At first, 100 milligrams (mg) of sitagliptin and 1000 mg of metformin once a day. Your doctor may gradually increase your dose until your blood sugar is controlled. However, the dose is usually not more than 100 mg of sitagliptin and 2000 mg of metformin once a day. Children Use and dose must be determined by your doctor. For patients using Janumet immediate-release tablets: Adults The dose is the same as the dose you are already taking. Your doctor may gradually increase your dose until your blood sugar is controlled. However, the dose is usually not more than 100 mg of sitagliptin and 2000 mg of metformin once a day. Children Use and dose must be determined by your doctor. For oral dosage form (immediate-release tablets): For patients taking metformin alone: Adults At first, 50 milligrams (mg) of sitagliptin, plus the dose of metformin already being taken, 2 times per day. Your doctor may gradually increase your dose until your blood sugar is controlled. If you are taking 850 mg of metformin 2 times per day, you may start with 50 mg of sitagliptin and 1000 mg of metformin 2 times per day. Children Use and dose must be determined by your doctor. For patients taking sitagliptin alone: Adults At first, 50 milligrams (mg) of sitagliptin and 500 mg of metformin two times per day. Your doctor may gradually increase your dose until your blood sugar is controlled. However, the dose is usually not more than 50 mg of sitagliptin and 1000 mg of metformin two times per day. Children Use and dose must be determined by your doctor. For patients using metformin and sitagliptin together as separate tablets: Adults The dose is the same as the dose you are already taking. Your doctor may gradually increase your dose until your blood sugar is controlled. Children Use and dose must be determined by your doctor. Missed Dose If you miss a dose of sitagliptin and metformin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Storage Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use. Precautions While Using sitagliptin and metformin It is very important that your doctor check your progress at regular visits , especially during the first few weeks that you take sitagliptin and metformin. Blood and urine tests may be needed to check for unwanted effects. Under certain conditions, too much metformin can cause lactic acidosis. Symptoms of lactic acidosis include abdominal or stomach discomfort, decreased appetite, diarrhea, fast, shallow breathing, a general feeling of discomfort, muscle pain or cramping, and unusual sleepiness, tiredness, or weakness. If symptoms of lactic acidosis occur, you should get immediate emergency medical help . sitagliptin and metformin may cause hypoglycemia (low blood sugar). This is more common when sitagliptin and metformin is taken together with certain medicines. Low blood sugar must be treated before it causes you to pass out (unconsciousness). People feel different symptoms of low blood sugar . It is important that you learn which symptoms you usually have so you can treat it quickly. Talk to your doctor about the best way to treat low blood sugar. Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual. High blood sugar can be very serious and must be treated right away. It is important that you learn which symptoms you have in order to treat it quickly . Talk to your doctor about the best way to treat high blood sugar. There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says you have diabetes and a list of all your medicines. It is important to tell the doctor in charge that you are taking sitagliptin and metformin if you are going to have any medical or surgical procedures. Pancreatitis may occur while you are using sitagliptin and metformin. Check with your doctor right away if you have a sudden and severe stomach pain, chills, constipation, nausea, vomiting, loss of appetite, fever, or lightheadedness. sitagliptin and metformin may cause serious allergic reactions, including anaphylaxis, angioedema, or certain skin conditions (Stevens-Johnson syndrome). These reactions can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, blistering, peeling, or loosening of the skin, fever or chills, trouble breathing or swallowing, or any swelling of your hands, face, mouth, or throat while you are using sitagliptin and metformin. sitagliptin and metformin may cause severe and disabling joint pain. Call your doctor right away if you have severe joint pain while using sitagliptin and metformin. sitagliptin and metformin may cause bullous pemphigoid. Tell your doctor if you have large, hard skin blisters while using sitagliptin and metformin. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. sitagliptin and metformin Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: Less common Anxiety blurred vision chills cold sweats confusion cool, pale skin depression dizziness fast heartbeat headache increased hunger loss of consciousness mental cloudiness nausea nightmares not thinking clearly seizures shakiness slurred speech unusual tiredness or weakness Rare Abdominal or stomach discomfort decreased appetite diarrhea fast, shallow breathing general feeling of discomfort muscle pain or cramping shortness of breath sleepiness Incidence not known Blistering, peeling, or loosening of the skin darkened urine hives or welts, itching, or skin rash large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs loss of appetite pains in the stomach, side, or abdomen, possibly radiating to the back puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue red skin lesions, often with a purple center severe joint pain sores, ulcers, or white spots in the mouth or on the lips vomiting yellow eyes or skin Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Bloated or full feeling excess air or gas in the stomach or intestines indigestion lack or loss of strength muscle aches passing gas sore throat stuffy or runny nose vomiting Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. Side Effects (complete list) The information contained in the Truven Health Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Truven Health does not assume any responsibility or risk for your use of the Truven Health products. Copyright 2017 Truven Health Analytics, Inc. All Rights Reserved. Next Side Effects Print this page Add to My Med List More about metformin/sitagliptin Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Español 47 Reviews Add your own review/rating Drug class: antidiabetic combinations Consumer resources Metformin and sitagliptin Sitagliptin and Metformin Extended-Release Tablets Sitagliptin and Metformin Tablets Other brands: Janumet , Janumet XR Professional resources Sitagliptin and Metformin (Wolters Kluwer) Related treatment guides Diabetes, Type 2} Drug Status Rx Availability Prescription only B Pregnancy Category No proven risk in humans N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Manufacturer Macleods Pharmaceuticals Limited Drug Class Antidiabetic combinations Related Drugs Diabetes, Type 2 metformin , insulin aspart , glipizide , glimepiride , Januvia , pioglitazone , Victoza , Actos , Tradjenta , Glucophage , glyburide , Janumet , Invokana , Amaryl , Welchol , Onglyza , sitagliptin , Trulicity , Jardiance , Lantus , Farxiga , Levemir , Tresiba , Glucotrol , Bydureon , More... Metformin / sitagliptin Rating 47 User Reviews 6.6 /10 47 User Reviews 6.6 Rate it! Related Questions & Answers Metformin/Sitagliptin - Can someone please tell me the names and 800 numbers to the company that? Read more questions} } personalize


combating sitagliptin and metformin (Oral route) in recent times