What is Advair? What will it do for me?

Advair contains the drugs salmeterol and fluticasone (steroid).  This medication is used to treat COPD (chronic obstructive pulmonary disease) and asthma. Salmeterol is a bronchodilator which prevents the release of substances in the body that cause inflammation. These medications relax the muscles in the walls of the small air passages in the lung keeping the air passage open and making it easier to breathe. Fluticasone belongs to a group of medications known as corticosteroids. Corticosteroids reduce inflammation in the lungs and help reduce the swelling and irritation in the walls of the small air passages in the lungs.

Before using Advair

 The drug salmeterol has been shown to increase the risk of asthma-related death. It is critical that you use only the prescribed dose of this medicine and follow all patient instructions for safe use of the medication.If you have been diagnosed with any of the conditions below, you may need a dose adjustment or take special caution to safely use Advair:

• Food or drug allergies.
• Heart disease or high blood pressure.
• Epilepsy or other seizure disorder.
• An infection of any kind.
•  Weak immune system.
• Diabetes.
• Glaucoma.
• Tuberculosis.
• Osteoporosis.
• Thyroid disorder.
• Liver disease.

Drug interactions

Patients who are allergic to Flonase and Flovent (fluticasone), Serevent (salmeterol) or milk allergies, or if you’ve been diagnosed with severe COPD, or having an asthma attack.  We recommended contacting your medical provider immediately before using Advair. Avoid using a similar inhaled bronchodilator such as Foradil unless your doctor has told you to do so.

Inform your doctor of usage before taking Advair if you are using medications under these categories:

 Cordarone

 Water pill or diuretic

HIV medicines

 MAO inhibitor

Antidepressant

Antibiotics

Antifungal medications

Beta-blocker

Side effects?

 Call your doctor at once if you have any of these serious side effects:

• wheezing, chest tightness, trouble breathing
• white patches or sores inside your mouth or on your lips
• worsening asthma symptoms
• fast or uneven heart beats, restless feeling, tremor
• fever, chills, stabbing chest pain, cough with yellow or green mucus
• blurred vision, eye pain, or seeing halos around lights

       Less serious Advair side effects include

• headache, dizziness
• nausea, vomiting, diarrhea
• dry mouth, nose, or throat
• stuffy nose, sinus pain, cough, sore throat
• hoarseness or deepened voice.

It is not known whether Advair is harmful to an unborn baby. Before using this medication, inform your doctor if you are pregnant during treatment.

 It is not known whether salmeterol and fluticasone can pass into breast milk or if it could harm a nursing baby.

Advair Inhaler (fluticasone, salmeterol) is used to help manage symptoms of asthma or chronic obstructive pulmonary disease (COPD). In both cases the medication should reduce the frequency of attacks and, when they do happen, they should be less severe.

Advair Inhaler is a maintenance inhaler, meaning it should be taken every day regardless of the presence or absence of symptoms; little benefit is to be had if used only sporadically. It is not a rescue inhaler; a fast-acting rescue treatment, such as albuterol, should always be kept on hand for emergencies.

Inhaler versus Diskus

Note that this product is the inhaler; it is distinct from the Advair Diskus. While both contain the same active ingredients, there are some important differences:

• The inhaler delivers aerosol propelled by HFA to administer the medication to the lungs; it relies much less on breathing technique. Some individuals do not react well to HFA.
• The diskus delivers a fine powder and is largely dependent on the patient's ability to breathe it in to disperse it in the lungs. The diskus contains milk proteins, which some patients are allergic to.
• The diskus can be used in patients age 4 and up; the inhaler ages 12 and up.

Both the inhaler and diskus are available in a range of strengths; double-check the prescribed strength is chosen before purchasing.

Other Concerns

Advair Inhaler and Diskus both contain two active ingredients:

• Fluticasone is a corticosteroid that inhibits immune response to allergens and irritants, thus reducing the inflammation that leads to restricted airways.
• Salmeterol is a long-acting beta2-adrenergic receptor agonist (LABA) bronchodilator that relaxes and widens the airways, reducing symptoms of an attack.

Used together---and used as directed---these two ingredients can make a tremendous positive difference for patients. However, the use of Salmeterol---like all LABAs---is a little controversial.

Research suggests that individuals who take a LABA are at increased risk of asthma-related death, as the medication can cause increased bronchial sensitivity and inflammation with very little warning. While some studies suggest this risk is eliminated when a LABA is taken with a corticosteroid like fluticasone, others suggest the risk is not mitigated at all.

Risk of death from asthma or COPD is already very small, and the increased risk of LABA use is likewise very small. Patients with very severe asthma or COPD may want to use caution, and take care to avoid using other LABAs without explicit doctor approval. Patients also may want to avoid using LABAs without a corticosteroid.

Other than salmeterol, other common LABAs are formoterol and bambuterol. Albuterol is a short-acting beta2-adrenergic receptor agonist, not long-acting, and so is not a LABA.

Using Advair Inhaler

Advair Inhaler comes in a metered-dose inhaler, which can be used with or without a spacer. The inhaler should be shaken before each use, and should be primed before first use. To prime, simply actuate the inhaler 4 times before first use.

Use is easy; patients age 12 and up should:

• Administer 2 inhalations twice per day, for a total of 4 inhalations.
• Exhale fully before administering an inhalation; breathe in fully and deeply with each inhalation.
• Wait at least one minute before administering the second inhalation.
• Rinse mouth with water when finished.

Patients should not use more than 4 total daily inhalations. If the medication is not providing sufficient benefit, increasing dosage will be far more beneficial than increasing number of inhalations.

Some patients notice improvements after the first dose, but most will need to wait around one week before significant improvement is seen.

A doctor may advise some patients with mild asthma or COPD to use just 1 inhalation twice per day; this is relatively normal.

Inhalers should not be exposed to extreme heat or cold; this can interfere with its effectiveness. Exposure to extreme heat may cause the canister to explode.

Casodex (bicalutamide) is a hormone therapy, usually used in conjunction with a luteinizing hormone-releasing hormone (LHRH), to combat advance prostate cancer when the cancer has started to spread to other areas of the body.

This medication is an androgen receptor inhibitor, which means, when treating prostate cancer, it inhibits the ability of testosterone receptors found on the cancer to utilize testosterone. Deprived of testosterone, which most prostate cancers thrive on, the cancer will stop growing and may begin to shrink.

Casodex is almost always given along with an LHRH; LHRH medications further reduce the cancer's access to testosterone by telling the body to stop producing the hormone.

Treatment with Casodex

Casodex is typically prescribed for as long as it is effective; treatment may last months or years, either until the cancer is gone or treatment no longer seems to be providing any benefit.

Taking Casodex is fairly straightforward:

• Tablets are taken once daily, usually in the morning but some patients prefer evening.
• The bladder should be emptied before tablets are taken.
• For maximum effectiveness tablets should be taken at the same time each day.
• Casodex may be taken with or without food.
• Staying hydrated is important during treatment.
• Missed doses can be taken as soon as remembered.

LHRH treatments are usually given by a doctor; either as a skin implant which releases medication over time, or as an injection given every 1, 3 or 6 months. LHRH treatment may begin at the same time as Casodex treatment, or it may be delayed for several weeks.

Treatment should not be stopped or interrupted without doctor approval. Stopping treatment may cause symptoms to worsen.

Frequent check-ups and blood tests are typically recommended during treatment, to monitor for developing adverse effects as well as to ensure the medication is working properly. Doses may be adjusted during treatment. If treatment stops being effective, there are numerous other, similar therapies which may be tried. Patients are strongly advised to attend regular check-ups.

Warnings & Side Effects

Some side effects are fairly common, affecting about 30% of men, though it is quite rare for any individual to experience all common side effects. Most side effects are completely reversible when treatment stops, and dangerous adverse reactions are very rare. Alcohol consumption may worsen side effects.

Most common side effects include:

• Hot flashes
• Decreased libido (interest in sex)
• Impotence (inability to achieve an erection)
• Swollen or painful breasts
• Constipation or diarrhea
• Nausea or vomiting
• Infertility

The above side effects can often be minimalized with other treatments; speak to a doctor about options.

More dangerous side effects call for immediate medical attention:

• Difficulty breathing
• Blood in urine
• Chest pain
• Urine retention (unable to urinate for more than 8 hours)
• Excessive vomiting (unable to keep food or medications down)

Very rarely Casodex may be prescribed to women. In general women should avoid use of this medication, and women who are pregnant, trying to become pregnant, or breast feeding should not even handle tablets; the medication can cause severe birth defects and interfere with reproductive development. Likewise, keep this medication out of reach of children and pets; even traces of residue may be absorbed into the skin. 

Certain preexisting conditions, such as diabetes or liver disease, put patients at greater risk of serious adverse effects. Risks should be discussed with a doctor prior to treatment, and alternative therapies may be desirable.

Casodex may interact with numerous other prescription medications, causing unpleasant side effects or reducing effectiveness. Be sure your doctor is aware of all medications being taken before starting treatment.

Ships from the UK with tracking.

Flovent Inhaler (fluticasone) is a corticosteroid medication used to reduce the frequency and severity of asthma attacks. It can be used in patients age 4 and up. It is not a rescue inhaler; a rescue treatment should always be kept on-hand for asthma attacks that do occur.

As a corticosteroid, Flovent Inhaler reduces inflammation in the lungs. While the exact cause of asthma is unknown and the triggers are variable---from exercise to animal dander---the resulting inflammation produces many of the symptoms associated with an asthma attack. Flovent Inhaler keeps this inflammation minimized and may prevent it from developing in the first place.

Patients who use a rescue inhaler more than twice a week may be good candidates for Flovent Inhaler or other inhaled steroids, though results do vary to some degree. Some individuals find inhaled steroids entirely eliminate asthma symptoms, while others find steroids produce no noticeable effect. Most people are somewhere in the middle; the medication is definitely helpful but does not entirely eliminate asthma.

How to Use Flovent Inhaler

Flovent is available in two forms; an HFA inhaler and a diskus. Both of these administer fluticasone powder to the lungs. Inhalers contain the propellant HFA, in use since CFC propellants were banned; some individuals react poorly to HFA propellants. The diskus does not contain HFA but it does contain milk proteins, which can trigger reactions in those who are allergic to milk proteins.

If neither HFA nor milk proteins are a concern, the two products are essentially the same. Some patients find the familiarity of the inhaler a bit easier to use.

Dosage will depend on a number of factors, including age and severity of asthma. Treatment typically looks like:

• Some patients may be started on a relatively high dose, to be lowered after asthma is under control.
• Other patients may be started on a lower dose, increased only if needed.
• The medication is usually taken twice per day, morning and evening.
• Inhalers should be shaken before use. The diskus does not need to be shaken.
• If taking multiple doses at the same time, wait at least 30 seconds between them.
• Rinse the mouth with water after each dose to prevent infection.

Many patients notice a difference about 24 hours after starting treatment, but it will take about two weeks to see full benefit. If there is no significant improvement after two weeks, dosage may be increased.

Duration of treatment is usually indefinite, as long as the medication provides benefit. Patients may need to periodically stop using Flovent Inhaler due to other medications, medical procedures, or infections. Use can generally be resumed after these events are over.

Note that this medication should not be stopped abruptly; doing so can cause worsening of asthma as well as other symptoms of withdrawal. Dosage will ideally be gradually lowered over several weeks, though this is not always possible. A doctor can help determine a discontinuation plan.

Warnings & Side Effects

Some individuals may not be good candidates for Flovent Inhaler use; speak with a doctor if there is a history of:

• Lung or systemic infection, such as tuberculosis
• Cataracts, glaucoma, or eye infections
• Osteoporosis (bone loss)
• Liver impairment

Additionally, long-term use of Flovent Inhaler---or any steroid use---in children may stunt growth. However, this is often preferable to impaired breathing. Stunted growth isn't guaranteed to happen and is more likely to occur if high doses of steroids are given over the long term.

In all ages long-term steroid use can reduce the body's ability to respond to stress. Again this is usually only an issue if using very high doses over the long term, but it is a small risk among other patients as well. Notify all doctors and dentists that Flovent Inhaler---and any other steroids---are being used prior to surgery or emergency treatment. Carrying some sort of medical ID stating the medication is being taken is also a good idea.

In most cases patients can take Flovent Inhaler with no problems, or with only mild side effects. Commonly reported side effects include:

• Throat irritation
• Nausea
• Vomiting
• Persistent cough
• Headache
• Upper respiratory tract irritation or infection

As steroids inhibit the immune system's response, patients using Flovent Inhaler are a bit more susceptible to infection, particularly respiratory infection. Care should be taken to avoid coming into contact with others who have contagious respiratory ailments, and if an infection is suspected, a doctor should be seen so it can be addressed quickly.

Effects on unborn or nursing infants are unclear; speak with a doctor about risks versus benefits.

Tofranil (imipramine) is a tricyclic antidepressant primarily used to treat depression and, in patients at least 6 years of age, bedwetting, which is formally called nocturnal enuresis. Though not particularly common, it is also sometimes used in an assortment of other conditions, including chronic pain, night terrors, panic attacks, and migraines. The exact mechanism by which it works is unclear in all conditions.

The medication is administered by tablets, which may be taken once per day to several times per day, depending on the condition being treated and patient response. Treatment typically lasts at least a few months, sometimes much longer.

This product is also known by the brand name Antidep.

Treating Depression with Tofranil

Like most antidepressants, Tofranil is thought to work by stabilizing substances in the brain, such as serotonin, norepinephrine, dopamine and so forth. It may take about two to four weeks for substantial benefit to be seen, and dosage may be increased at that point if no there are no significant improvements.

Patients taking Tofranil report:

• More stabilized mood
• Fewer and milder mood swings
• Improved focus and control of thoughts
• Less anxiety
• Increased energy

Some patients struggle with the first few months of treatment, especially if it is the first time taking an antidepressant; depression and other symptoms may briefly worsen. This is why antidepressants come with a warning about possibly increasing risk of suicide. Worsening symptoms are more likely to happen with patients who are under age 25, and most likely to happen during the first month of treatment. Younger patients or those with a history of suicide attempts or self-harm should be monitored closely for the first few weeks of treatment with Tofranil or any antidepressant.

Dosage should always be determined by a doctor, particularly in patients under 25. Standard treatment for adults is:

• Start with 75 mg per day, increased up to 200 mg per day after two weeks of treatment if 75 mg proves insufficient.
• Once symptoms are under control, a lower daily maintenance dose of 50 to 150 mg can be established.
• Patients should not exceed 200 mg per outside of hospital settings.
• Smaller doses may be taken once per day. Larger doses are often divided into 2, 3, or 4 smaller doses taken throughout the day.
• Treatment should not end abruptly, especially at higher doses. A doctor can help with a discontinuation plan that gradually reduces dosage.

Treatment typically lasts 6 to 9 months, though this can vary.

Tofranil for Bedwetting

Tofranil can be used in patients age 6 and up for bedwetting when there is no known cause; other causes, such as physical complications or medication side effects should be ruled out first. Dosage should be determined by a doctor according the child's weight.

Treatment typically starts with low doses, increased in weekly increments if improvements are not seen. Tablets are typically administered about an hour prior to bed, though some have better results giving a half-dose in the afternoon and the other half before bed.

Duration of treatment should be established by a doctor.

Potential Complications

Patients with preexisting medical conditions are at increased risk of experiencing serious side effects. Speak with a doctor about risks and warning signs before taking Tofranil if there is any history of:

• Liver or kidney problems
• Heart or cardiovascular issues
• Diabetes

At higher doses Tofranil is associated with a risk of heart problems. Warning signs include:

• Feeling faint and/or dizzy
• Rapid or irregular heartbeat
• Pain or discomfort in chest

Tofranil can interact with a wide range of other medications, particularly other antidepressants. Always check with a doctor or pharmacist before mixing medications.

Natural Plant Peptides and Caffeine help firm and revive tired under eye area.

DIRECTIONS: Apply a small amount to the eye area. Gently pat into skin with fingertips. Use morning and night.

INGREDIENTS: Water (Aqua), Glycerin, Cetearyl Alcohol, Vitis Vinifera (Grape) Seed Oil, Hydroxyethyl Acrylate/Sodium Acryloyldimethyl Taurate Copolymer, Sodium Hyaluronate, Prunus Amygdalus Dulcis (Sweet Almond) Oil, Argania Spinosa (Argan) Kernal Oil, Butyrospermum Parkii (Shea Butter), Sodium Ascorbyl Phosphate, Hydrolysed Hazelnut Protein, Caffeine, Coffee Arabica (Coffee) Seed Extract, Ceramide NP, Ceramide NS, Ceramide EOS, Ceramide EOP, Ceramide AP, Caprool Phytosphingosine, Caprooyl Sphingosine, Cholesterol, Behenic Acid, Ginkgo Biloba (Ginkgo) Leaf Extract, Cucumis Sativus (Cucumber) Fruit Extract, Camellia Sinensis (Green Tea) Leaf Extract, Xanthan Gum, Cetyl Alcohol, Ceteareth-25, Lecithin, Kaolin CI 77891 (Titanium Dioxide) Disodium EDTA, BHT. Caprylyl Glycol, Phenoxyethanol.

Store below 30 degrees celsius. 

A daily serum with Plant Peptides and Ceramides to help firm and repair the skin. Helps reduce the appearance of fine lines, wrinkles and sun damage.

DIRECTIONS: Apply 2-3 drops to cleansed skin and gently massage until absorbed. Follow with moisturiser. Use morning and evening. Avoid eye area.

INGREDIENTS: Water (Aqua), Glycerin, Caprylic/Capric Triglyceride, Hydroxyethyl Acrylate/Sodium, Acryloyldimethyl Taurate Copolymer, Ceramide NP, Cermaide NS, Ceramide EOS, Ceramide EOP, Ceramide AP, Cholesterol, Caprooyl Phytosphingosine, Caprooyl Sphingosine, Ceteareth-25, Cetyl Alcohol, Behenic Acid, Hydrolysed Hazelnut Protein, Tocopheryl Acetate, Disodium EDTA, BHT, Caprylyl Glycol, Phenoxyethanol.

Store below 30 degrees celsius