What is carisoprodol?

• Carisoprodol is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain.
• Carisoprodol is used, along with rest & physical therapy, to treat injuries & other painful muscular conditions.
• Carisoprodol may also be used for purposes other than those listed in this medication guide.

• Do not take carisoprodol if you have acute intermittent porphyria.
• Before taking carisoprodol, tell your doctor if you have kidney or liver disease. You may need a lower dose or special monitoring during your therapy.
• It is not known whether carisoprodol will harm an unborn baby. Do not take carisoprodol without first talking to your doctor if you are pregnant.
• It is also not known whether carisoprodol passes into breast milk. Do not take carisoprodol without first talking to your doctor if you are breast-feeding a baby.
• Carisoprodol is not approved for use in children younger than 12 years of age.

• Take carisoprodol exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• The maximum amount of carisoprodol you should take in one day is 1,400 mg (4 tablets).
• Store carisoprodol at room temperature away from moisture & heat.

• Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose & take only your next regularly scheduled dose. Do not take a double dose of this medication. Try to keep your doses at least 4 hours apart.

• Seek emergency medical attention.
• Symptoms of a carisoprodol overdose include low blood pressure (weakness, fainting, confusion), decreased breathing, & unconsciousness.

• Use caution when driving, operating machinery, or performing other hazardous activities. Carisoprodol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
• Use alcohol cautiously. Alcohol may increase drowsiness & dizziness while you are taking carisoprodol.

• If you experience any of the following serious side effects, stop taking carisoprodol & seek emergency medical attention:
  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
  • paralysis (loss of feeling) or extreme weakness;
  • vision loss; or
  • agitation or tremor.
• Other, less serious side effects may be more likely to occur. Continue to take carisoprodol & talk to your doctor if you experience
  • drowsiness or dizziness;
  • headache;
  • depression;
  • blurred vision;
  • insomnia; or
  • hiccups.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

• alcohol
• barbiturate medicines for inducing sleep or treating seizures (convulsions), like phenobarbital
• cimetidine
• isoniazid (INH)
• medicines for colds, hay fever or other allergies
• medicines for HIV or AIDS
• medicines for mental depression, anxiety, or emotional disturbances
• medicines for pain
• medicines for seizures (convulsions) or epilepsy
• medicines for sleep
• modafinil
• omeprazole
• other muscle relaxants
• rifampin, rifabutin, or rifapentine
• voriconazole

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture & would differ from batch to batch depending on when they were manufactured.

What is sildenafil?

• Sildenafil relaxes muscles & increases blood flow to particular areas of the body.
• Sildenafil under the name Viagra is used to treat erectile dysfunction (impotence) in men. Another brand of sildenafil is Revatio, which is used to treat pulmonary arterial hypertension & improve exercise capacity in men & women.
• Sildenafil may also be used for purposes other than those listed here.

• Do not take sildenafil if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, & others), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), & isosorbide mononitrate (Imdur, ISMO, Monoket). Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking sildenafil with a nitrate medicine can cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack.
• A small number of patients have had a sudden loss of eyesight after taking sildenafil. This type of vision loss is caused by decreased blood flow to the optic nerve of the eye. It is not clear whether sildenafil is the actual cause of such vision loss. Sudden vision loss with sildenafil use has occurred most often in people with heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, & in those who smoke or are over 50 years old.
• Before taking sildenafil, tell your doctor if you have:
  • heart disease or heart rhythm problems;
  • a recent history (in the past 6 months) of a heart attack, stroke, or heart rhythm disorder;
  • congestive heart failure;
  • high or low blood pressure;
  • coronary artery disease;
  • liver disease;
  • kidney disease;
  • a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;
  • a bleeding disorder such as hemophilia;
  • a stomach ulcer;
  • retinitis pigmentosa (an inherited condition of the eye);
  • a physical deformity of the penis (such as Peyronie's disease); or
  • if you have been told you should not have sexual intercourse for health reasons.
• If you have any of these conditions, you may not be able to use sildenafil or you may need a dosage adjustment or special tests during treatment.
• FDA pregnancy category B: This medication is not expected to be harmful to an unborn baby. Do not use sildenafil without telling your doctor if you are pregnant or plan to become pregnant during treatment.
• It is not known if sildenafil passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

• Take each dose with a full glass of water.
• Avoid taking High-fat food before taking Viagra as it may cause the medicine to take more time to start working.
• Sildenafil is usually taken only when needed, 30 - 90 minutes before sexual activity. The medication can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill.
• Do not take sildenafil more than once a day. Allow 24 hours to pass between doses.
• Store this medication at room temperature away from moisture & heat.

• Viagra is used as needed, so you are not likely to miss a dose.
• If you miss a dose of Revatio, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose & take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

• Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a sildenafil overdose may include chest pain, nausea, irregular heartbeat, & feeling light-headed or fainting.

• Avoid drinking alcohol, which can increase some of the side effects of sildenafil.
• Avoid using other medicines to treat impotence, such as alprostadil (Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others), without first talking to your doctor.

• If you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw during sexual activity, stop & call your doctor right away. You could be having a serious side effect of sildenafil.
• Stop using sildenafil & get emergency medical help if you have sudden vision loss.
• Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
• Stop using sildenafil & call your doctor at once if you have any of these serious side effects:
  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
  • irregular heartbeat;
  • swelling in your hands, ankles, or feet;
  • shortness of breath;
  • vision changes;
  • feeling light-headed, fainting; or
  • penis erection that is painful or lasts 4 hours or longer.
• Continue taking sildenafil & talk with your doctor if you have any of these less serious side effects:
  • warmth or redness in your face, neck, or chest;
  • stuffy nose;
  • headache;
  • upset stomach; or
  • back pain.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Do not take sildenafil if you are taking the following medications:

• nitroglycerin-type drugs for the heart or chest pain such as amyl nitrite, isosorbide dinitrate, isosorbide mononitrate, nitroglycerin, even if these are only taken occasionally

Sildenafil may also interact with the following medications:

• alpha blockers, used for high blood pressure or an enlarged prostate. NOTE: Do not take doses of sildenafil higher than 25 mg within 4 hours of taking alpha blockers, such as alfuzosin (UroXatral®), doxazosin (Cardura®), prazosin (Minipress®), or terazosin (Hytrin®).
• bosentan
• certain drugs used for seizures such as carbamazepine, phenytoin, & phenobarbital
• certain drugs used for fungal or yeast infections, such as fluconazole, ketoconazole, & voriconazole
• certain drugs for the treatment of HIV infection or AIDS
• cimetidine
• cisapride
• clarithromycin
• diltiazem
• erythromycin
• grapefruit juice
• mibefradil
• nitroprusside
• rifabutin
• rifampin
• quinidine
• some drugs for treating depression, anxiety or other mood problems (examples: fluoxetine, fluvoxamine, nefazodone)
• verapamil

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture & would differ from batch to batch depending on when they were manufactured.