Comprehensive Medication Information Guide
Jardiance (empagliflozin)
Brand and generic name: Jardiance (empagliflozin)
Dosage forms: Oral tablets: 10 mg, 25 mg 1
Pharmacologic category: Sodium-glucose co-transporter 2 (SGLT2) inhibitor 1
FDA-approved indications:
- As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
- To reduce the risk of cardiovascular death in adult patients with type 2 diabetes mellitus and established cardiovascular disease 1
Dosage and frequency:
- Initial dose: 10 mg once daily, taken in the morning, with or without food
- May be increased to 25 mg once daily if needed for glycemic control
- Do not initiate if eGFR is below 45 mL/min/1.73 m²
- Discontinue if eGFR falls persistently below 45 mL/min/1.73 m² 1
Mechanism of action: Inhibits sodium-glucose co-transporter 2 (SGLT2) in the proximal renal tubules, reducing reabsorption of filtered glucose and lowering the renal threshold for glucose, resulting in increased urinary glucose excretion 2
Contraindications:
- History of serious hypersensitivity reaction to empagliflozin or any excipients
- Severe renal impairment (eGFR <45 mL/min/1.73 m²), end-stage renal disease, or dialysis 1
Adverse effects:
- Urinary tract infections
- Female genital mycotic infections
- Hypotension
- Ketoacidosis
- Acute kidney injury
- Urosepsis and pyelonephritis
- Hypoglycemia (when used with insulin or insulin secretagogues)
- Increased LDL-C 1, 3
Drug interactions:
- Insulin and insulin secretagogues: increased risk of hypoglycemia
- Diuretics: increased risk of volume depletion and hypotension 1, 4
Patient counseling points:
- Take once daily in the morning with or without food
- Monitor for signs of urinary tract infections and genital mycotic infections
- Maintain adequate hydration to prevent hypotension
- Seek medical attention for symptoms of ketoacidosis (nausea, vomiting, abdominal pain, fatigue, difficulty breathing)
- Monitor blood glucose regularly
- May cause modest reduction in blood pressure (5-8 mmHg systolic) 1, 5, 4
Procardia/XL (nifedipine)
Brand and generic name: Procardia/Procardia XL (nifedipine)
Dosage forms: Immediate-release capsules, extended-release tablets (LA formulation) 6
Pharmacologic category: Calcium channel blocker - dihydropyridine 6
FDA-approved indications: Treatment of hypertension 6
Dosage and frequency:
- Immediate-release (IR): 30-90 mg daily in divided doses
- Extended-release (LA): 30-90 mg once daily 6
Mechanism of action: Blocks calcium channels in vascular smooth muscle, causing vasodilation and reducing peripheral resistance 6
Contraindications:
- Hypersensitivity to nifedipine
- Cardiogenic shock 6
Adverse effects:
- Dose-related peripheral edema (more common in women)
- Headache
- Dizziness
- Flushing
- Hypotension 6
Drug interactions:
- CYP3A4 inhibitors may increase nifedipine levels
- CYP3A4 inducers may decrease nifedipine levels 6
Patient counseling points:
- Take extended-release tablets whole; do not crush or chew
- May cause dizziness; use caution when driving or operating machinery
- Report significant swelling in ankles or feet
- Avoid grapefruit juice which may increase drug levels 6
Cardizem/CD/LA (diltiazem)
Brand and generic name: Cardizem/Cardizem CD/Cardizem LA (diltiazem hydrochloride)
Dosage forms: Immediate-release tablets, extended-release capsules (CD), extended-release tablets (LA) 6
Pharmacologic category: Calcium channel blocker - nondihydropyridine 6
FDA-approved indications: Treatment of hypertension, angina pectoris, and certain arrhythmias 6
Dosage and frequency:
- Immediate-release (IR): 120-360 mg daily in divided doses (3 times daily)
- Extended-release (ER): 120-360 mg once daily 6
Mechanism of action: Inhibits calcium influx through slow channels in cardiac and vascular smooth muscle, decreasing myocardial contractility and oxygen demand, and causing vasodilation 6
Contraindications:
- Sick sinus syndrome or second- or third-degree AV block (without pacemaker)
- Hypotension (SBP <90 mmHg)
- Acute myocardial infarction with pulmonary congestion
- Severe heart failure 6
Adverse effects:
- Bradycardia
- AV block
- Hypotension
- Dizziness
- Headache
- Edema
- Abnormal liver function tests (rare) 6
Drug interactions:
- Beta-blockers: increased risk of bradycardia and heart block
- CYP3A4 substrates: diltiazem is a moderate CYP3A4 inhibitor
- Specific interactions with: apixaban, itraconazole, bosutinib, ceritinib, cilostazol, cyclosporine, everolimus, ibrutinib, idelalisib, ivabradine, lomitapide, olaparib, posaconazole, ranolazine, rifampin, simeprevir, voriconazole 6
Patient counseling points:
- Take extended-release formulations whole; do not crush or chew
- Monitor heart rate and blood pressure regularly
- Report unusual fatigue, shortness of breath, or swelling
- Avoid abrupt discontinuation 6
Norvasc (amlodipine)
Brand and generic name: Norvasc (amlodipine besylate)
Dosage forms: Oral tablets: 2.5 mg, 5 mg, 10 mg 6
Pharmacologic category: Calcium channel blocker - dihydropyridine 6
FDA-approved indications: Treatment of hypertension and coronary artery disease 6
Dosage and frequency:
- Initial dose: 2.5-5 mg once daily
- Maximum dose: 10 mg once daily 6
Mechanism of action: Inhibits calcium influx across cell membranes, resulting in peripheral arterial vasodilation 6
Contraindications:
- Hypersensitivity to amlodipine 6
Adverse effects:
- Peripheral edema (dose-related, more common in women)
- Dizziness
- Flushing
- Headache
- Palpitations 6
Drug interactions:
- CYP3A4 inhibitors may increase amlodipine levels
- CYP3A4 inducers may decrease amlodipine levels 6
Patient counseling points:
- Take once daily with or without food
- May cause ankle swelling, especially when starting therapy
- Report significant swelling or shortness of breath
- Full antihypertensive effect may take 7-14 days 6
Fosamax (alendronate)
Brand and generic name: Fosamax (alendronate sodium)
Dosage forms: Oral tablets, oral solution
Pharmacologic category: Bisphosphonate
FDA-approved indications:
- Treatment and prevention of osteoporosis in postmenopausal women
- Treatment of osteoporosis in men
- Treatment of glucocorticoid-induced osteoporosis
- Treatment of Paget's disease
Dosage and frequency:
- Osteoporosis treatment: 10 mg once daily or 70 mg once weekly
- Osteoporosis prevention: 5 mg once daily or 35 mg once weekly
- Paget's disease: 40 mg once daily for 6 months
Mechanism of action: Inhibits osteoclast-mediated bone resorption
Contraindications:
- Abnormalities of the esophagus which delay esophageal emptying
- Inability to stand or sit upright for at least 30 minutes
- Hypocalcemia
- Hypersensitivity to alendronate
Adverse effects:
- Esophageal irritation and ulceration
- Abdominal pain
- Musculoskeletal pain
- Osteonecrosis of the jaw (rare)
- Atypical femur fractures (rare)
Drug interactions:
- Calcium supplements and antacids interfere with absorption
- NSAIDs may increase GI irritation
Patient counseling points:
- Take on an empty stomach with plain water first thing in the morning
- Remain upright (sitting or standing) for at least 30 minutes after taking
- Wait at least 30 minutes before taking other medications, food, or beverages
- Ensure adequate calcium and vitamin D intake
- Report any thigh or groin pain
Boniva (ibandronate)
Brand and generic name: Boniva (ibandronate sodium)
Dosage forms: Oral tablets, intravenous injection 7
Pharmacologic category: Bisphosphonate
FDA-approved indications: Treatment and prevention of osteoporosis in postmenopausal women 7
Dosage and frequency:
- Oral: 150 mg once monthly
- IV: 3 mg every 3 months 7
Mechanism of action: Inhibits osteoclast-mediated bone resorption by binding to bone hydroxyapatite and inhibiting osteoclast activity 7
Contraindications:
- Hypocalcemia
- Hypersensitivity to ibandronate
- Inability to stand or sit upright for at least 60 minutes (oral formulation)
- Creatinine clearance <30 mL/min 7
Adverse effects:
- Hypocalcemia
- Renal impairment
- Osteonecrosis of the jaw
- Musculoskeletal pain
- Atypical femoral fractures
- Gastrointestinal irritation (oral formulation)
- Acute phase reactions (IV formulation) 7
Drug interactions:
- Calcium supplements and antacids interfere with oral absorption
- NSAIDs may increase GI irritation 7
Patient counseling points:
- Take oral tablet on an empty stomach with plain water first thing in the morning
- Remain upright for at least 60 minutes after taking oral tablet
- Ensure adequate calcium and vitamin D intake
- Report any thigh or groin pain
- Report any jaw pain, swelling, or non-healing sores in the mouth 7
Abilify (aripiprazole)
Brand and generic name: Abilify (aripiprazole)
Dosage forms: Oral tablets, orally disintegrating tablets, oral solution, injectable solution
Pharmacologic category: Atypical antipsychotic
FDA-approved indications:
- Schizophrenia
- Acute treatment of manic and mixed episodes associated with bipolar I disorder
- Adjunctive treatment of major depressive disorder
- Treatment of irritability associated with autistic disorder
- Treatment of Tourette's disorder
Dosage and frequency:
- Schizophrenia: 10-15 mg once daily (adults); 2-10 mg once daily (adolescents)
- Bipolar mania: 15 mg once daily (adults); 2-10 mg once daily (pediatrics)
- Major depressive disorder (adjunctive): 2-15 mg once daily
- Irritability with autism: 2-15 mg once daily
- Tourette's disorder: 2-20 mg once daily
Mechanism of action: Partial agonist at dopamine D2 and serotonin 5-HT1A receptors, and antagonist at 5-HT2A receptors
Contraindications:
- Hypersensitivity to aripiprazole
Adverse effects:
- Akathisia
- Extrapyramidal symptoms
- Weight gain (less than other atypical antipsychotics)
- Somnolence
- Headache
- Increased risk of cerebrovascular adverse events in elderly patients with dementia-related psychosis
- Metabolic changes (hyperglycemia, dyslipidemia)
- Orthostatic hypotension
Drug interactions:
- CYP2D6 inhibitors (e.g., quinidine, fluoxetine, paroxetine)
- CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin)
- CYP3A4 inducers (e.g., carbamazepine, rifampin)
Patient counseling points:
- Take as directed, with or without food
- May cause drowsiness; use caution when driving or operating machinery
- Avoid alcohol
- Monitor for unusual changes in behavior or suicidal thoughts
- Rise slowly from sitting or lying position to minimize orthostatic hypotension
- Report any involuntary movements or restlessness
Aricept (donepezil)
Brand and generic name: Aricept (donepezil hydrochloride)
Dosage forms: Oral tablets, orally disintegrating tablets
Pharmacologic category: Acetylcholinesterase inhibitor
FDA-approved indications:
- Treatment of mild, moderate, and severe Alzheimer's disease
Dosage and frequency:
- Initial dose: 5 mg once daily at bedtime
- May increase to 10 mg once daily after 4-6 weeks
- Severe Alzheimer's: May increase to 23 mg once daily after at least 3 months on 10 mg
Mechanism of action: Increases acetylcholine levels in the central nervous system by inhibiting acetylcholinesterase
Contraindications:
- Hypersensitivity to donepezil or piperidine derivatives
Adverse effects:
- Nausea, vomiting, diarrhea
- Insomnia
- Muscle cramps
- Fatigue
- Anorexia
- Bradycardia
- Syncope
Drug interactions:
- Cholinergic agonists and cholinesterase inhibitors
- Anticholinergic medications
- CYP2D6 and CYP3A4 inhibitors
Patient counseling points:
- Take at bedtime
- May cause GI upset; take with food if needed
- Benefits may be modest and related to slowing disease progression rather than improvement
- Continue other prescribed medications
- Report significant GI side effects, dizziness, or fainting
Humalog/Humalog Mix (insulin lispro)
Brand and generic name: Humalog (insulin lispro), Humalog Mix (insulin lispro protamine/insulin lispro)
Dosage forms:
- Solution for injection
- Suspension for injection (Mix formulations)
Pharmacologic category: Rapid-acting insulin analog
FDA-approved indications: Treatment of diabetes mellitus to improve glycemic control
Dosage and frequency:
- Individualized based on patient needs
- Humalog: Given 15 minutes before or immediately after meals
- Humalog Mix: Usually given twice daily, before breakfast and dinner
Mechanism of action: Regulates glucose metabolism by stimulating peripheral glucose uptake by skeletal muscle and fat, and inhibiting hepatic glucose production
Contraindications:
- Hypoglycemia
- Hypersensitivity to insulin lispro or any component
Adverse effects:
- Hypoglycemia
- Injection site reactions
- Lipodystrophy
- Weight gain
- Allergic reactions
- Peripheral edema
Drug interactions:
- Drugs that may increase hypoglycemic effects: oral antidiabetic agents, ACE inhibitors, salicylates, sulfonamide antibiotics
- Drugs that may decrease hypoglycemic effects: corticosteroids, thyroid hormones, sympathomimetics, atypical antipsychotics
Patient counseling points:
- Administer Humalog within 15 minutes before or immediately after meals
- Rotate injection sites to prevent lipodystrophy
- Monitor blood glucose regularly
- Recognize and treat symptoms of hypoglycemia
- Store unopened insulin in refrigerator; opened vials can be kept at room temperature for up to 28 days
Humulin R, N, 70/30 (human insulin)
Brand and generic name: Humulin R (regular insulin), Humulin N (NPH insulin), Humulin 70/30 (70% NPH insulin/30% regular insulin)
Dosage forms: Solution or suspension for injection
Pharmacologic category: Insulin
FDA-approved indications: Treatment of diabetes mellitus to improve glycemic control
Dosage and frequency:
- Individualized based on patient needs
- Humulin R: Usually given 30 minutes before meals
- Humulin N: Usually given once or twice daily
- Humulin 70/30: Usually given twice daily, before breakfast and dinner
Mechanism of action: Regulates glucose metabolism by stimulating peripheral glucose uptake by skeletal muscle and fat, and inhibiting hepatic glucose production
Contraindications:
- Hypoglycemia
- Hypersensitivity to any component
Adverse effects:
- Hypoglycemia
- Injection site reactions
- Lipodystrophy
- Weight gain
- Allergic reactions
- Peripheral edema
Drug interactions:
- Drugs that may increase hypoglycemic effects: oral antidiabetic agents, ACE inhibitors, salicylates, sulfonamide antibiotics
- Drugs that may decrease hypoglycemic effects: corticosteroids, thyroid hormones, sympathomimetics, atypical antipsychotics
Patient counseling points:
- Administer Humulin R 30 minutes before meals
- Rotate injection sites to prevent lipodystrophy
- Monitor blood glucose regularly
- Recognize and treat symptoms of hypoglycemia
- Properly mix suspensions (Humulin N and 70/30) by gently rolling vial
- Store unopened insulin in refrigerator; opened vials can be kept at room temperature for up to 31 days
Armour Thyroid (thyroid desiccated)
Brand and generic name: Armour Thyroid (thyroid desiccated)
Dosage forms: Oral tablets
Pharmacologic category: Thyroid product
FDA-approved indications:
- Hypothyroidism
- Pituitary TSH suppression
Dosage and frequency:
- Initial dose: 15-30 mg daily
- Maintenance dose: Individualized based on clinical response and laboratory parameters
- Usually administered as a single daily dose
Mechanism of action: Replaces or supplements endogenous thyroid hormones
Contraindications:
- Untreated thyrotoxicosis
- Acute myocardial infarction
- Uncorrected adrenal insufficiency
Adverse effects:
- Symptoms of hyperthyroidism with overdose (tachycardia, palpitations, nervousness, insomnia, tremors)
- Weight loss
- Heat intolerance
- Headache
- Menstrual irregularities
Drug interactions:
- Oral anticoagulants: increased anticoagulant effect
- Antidiabetic agents: may increase blood glucose
- Cholestyramine and colestipol: decreased absorption
- Estrogen-containing oral contraceptives: increased thyroid-binding globulin
Patient counseling points:
- Take on an empty stomach, 30-60 minutes before breakfast
- Do not switch brands without consulting healthcare provider
- Regular monitoring of thyroid function tests is necessary
- Report symptoms of hyperthyroidism (rapid heartbeat, nervousness, weight loss)
- May take 4-6 weeks to see full therapeutic effect
Mirapex (pramipexole)
Brand and generic name: Mirapex (pramipexole dihydrochloride)
Dosage forms: Immediate-release tablets, extended-release tablets
Pharmacologic category: Non-ergot dopamine agonist
FDA-approved indications:
- Treatment of Parkinson's disease
- Treatment of moderate-to-severe primary Restless Legs Syndrome
Dosage and frequency:
- Parkinson's disease:
- Initial: 0.125 mg TID (immediate-release) or 0.375 mg once daily (extended-release)
- Gradual titration to effective dose
- Maintenance: 1.5-4.5 mg/day in three divided doses (immediate-release) or once daily (extended-release)
- Restless Legs Syndrome:
- Initial: 0.125 mg once daily 2-3 hours before bedtime
- Maximum: 0.5 mg daily
Mechanism of action: Stimulates dopamine receptors in the striatum
Contraindications:
- Hypersensitivity to pramipexole or any component
Adverse effects:
- Somnolence and sudden sleep onset
- Orthostatic hypotension
- Hallucinations
- Impulse control disorders (pathological gambling, hypersexuality)
- Dyskinesia
- Nausea
- Dizziness
- Edema
Drug interactions:
- Dopamine antagonists (antipsychotics, metoclopramide)
- CNS depressants
- Drugs that increase dopaminergic effects
Patient counseling points:
- May cause drowsiness and sudden sleep onset; use caution when driving
- Rise slowly from sitting or lying position to minimize orthostatic hypotension
- Take extended-release tablets whole; do not crush or chew
- Report any unusual urges or behaviors (gambling, sexual urges)
- Do not discontinue abruptly