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CLOSE THIS BOOKWhere Women Have No Doctor - A Health Guide for Women (Hesperian Foundation, 1997, 600 p.)
VIEW THE DOCUMENT(introduction...)
VIEW THE DOCUMENTWomen’s health is in your hands
VIEW THE DOCUMENTThanks
VIEW THE DOCUMENTAbout this Book
VIEW THE DOCUMENTHow to Use this Book
Chapter 1: Women’s Health Is a Community Issue
Chapter 2: Solving Health Problems
Chapter 3: The Medical System
Chapter 4: Understanding Our Bodies
Chapter 5: Health Concerns of Girls
Chapter 6: Pregnancy and Childbirth
Chapter 7: Breastfeeding
Chapter 8: Growing Older
Chapter 9: Women with Disabilities
Chapter 10: Staying Healthy
Chapter 11: Eating for Good Health
Chapter 12: Sexual Health
Chapter 13: Family Planning
Chapter 14: Infertility (When You Are Not Able to Have a Baby)
Chapter 15: Abortion and Complications from Abortion
Chapter 16: Sexually Transmitted Diseases and Other Infections of the Genitals
Chapter 17: AIDS (Acquired Immune Deficiency Syndrome)
Chapter 18: Violence Against Women
Chapter 19: Rape and Sexual Assault
Chapter 20: Sex Workers
Chapter 21: Pain in the Lower Abdomen
Chapter 22: Abnormal Bleeding from the Vagina
Chapter 23: Problems of the Urine System
Chapter 24: Cancer and Growths
Chapter 25: Tuberculosis
Chapter 26: Work
Chapter 27: Mental Health
Chapter 28: Alcohol and Other Drugs
Chapter 29: Refugees and Displaced Women
Chapter 30: Female Circumcision
Chapter 31: Use of Medicines in Women’s Health
VIEW THE DOCUMENTTable of Medicines: Green Pages
Health Care Skills
VIEW THE DOCUMENTVocabulary: List of difficult words
VIEW THE DOCUMENTWhere to get more information
VIEW THE DOCUMENTBack cover

Table of Medicines: Green Pages

HOW TO USE THE GREEN PAGES

This section gives information about the medicines mentioned in this book. For general information about medicines, be sure to read the chapter called “Use of Medicines in Women’s Health”. For specific information about each medicine, you can look it up in these Green Pages. Medicines are listed by their generic (scientific) names, the same names used in the chapters. The medicines are arranged in the order of the alphabet:

a b c d e f g h i j k l m n o p q r s t u v w x y z

For example, if you are looking up hydroxyzine, it comes after doxycycline but before metronidazole.

You can also find a medicine in the Green Pages by using:

· the problem index. This index lists the health problems discussed in this book and medicines used to treat them. The index gives the page number where information about the health problem can be found. Be sure to read about the problem before treating it with medicine. Remember: good health does not depend only on medicines! The most important ‘medicine’ for good health is good health information.

· the medicine index. This index lists the generic names of medicines and some common brand (commercial) names. If there is a medicine you want to use, you can look it up here to find the number of the page where you can learn more about that medicine.

Both the problem and medicine indexes are arranged in the order of the alphabet.

Information about specific medicines

The information about each medicine appears in a box like this:


Figure

Problem Index

This is a list of the health problems discussed in this book that are sometimes treated with medicines. The problems are listed in order of the alphabet in the column on the left. You should read these pages before taking any medicine. The column on the right has medicines that can be used to treat each problem on the left. To learn more about a medicine, look it up in the medicine tables.

Problem

See medicines

arthritis

aspirin, ibuprofen

bleeding from the vagina



after abortion

ergometrine


after childbirth

ergometrine, oxytocin


around menopause

medroxyprogesterone

chancroid

ceftriaxone, ciprofloxacin, erythromycin, co-trimoxazole

chlamydia

co-trimoxazole, doxycycline, erythromycin, tetracycline

cough

codeine

diarrhea

co-trimoxazole, metronidazole, norfloxacin

emergency birth control

low-dose birth control pills (groups 2 and 3)

fever

aspirin, paracetamol, ibuprofen


after abortion

amoxicillin, doxycycline, metronidazole


after childbirth

amoxicillin, metronidazole, procaine penicillin, chloramphenicol


during labor

ampicillin, procaine penicillin

fits during pregnancy

diazepam, magnesium sulfate

fungal infection


mouth (thrush)

Gentian Violet, ketoconazole, nystatin


skin

Gentian Violet, ketoconazole, nystatin


vagina

Gentian Violet, clotrimazole, miconazole, nystatin, vinegar, ketoconazole

gonorrhea

cefixime, ceftriaxone, ciprofloxacin, co-trimoxazole, doxycycline, kanamycin, metronidazole, norfloxacin

herpes sores

acyclovir

infection (prevention)

amoxicillin, doxycycline


in deinfibulation

amoxicillin, erythromycin, tetanus vaccine

infection (treatment)



after abortion

amoxicillin, benzyl penicillin, chloramphenicol, doxycycline, erythromycin, gentamicin, metronidazole, tetanus vaccine


bladder

amoxicillin, co-trimoxazole


breast infection

dicloxacillin, erythromycin


after childbirth

amoxicillin, chloramphenicol, erythromycin, metronidazole, penicillin, procaine penicillin


after circumcision

dicloxacillin, erythromycin, tetanus vaccine


kidney

amoxicillin, co-trimoxazole, ampicillin, gentamicin

itching



of the genitals (see vaginal discharge)



of the skin

diphenhydramine, hydrocortisone, hydroxyzine

nausea

promethazine

newborn eye care

erythromycin eye ointment, tetracycline eye ointment, chloramphenicol eye ointment

pain



mild to moderate

aspirin, paracetamol, ibuprofen


severe

codeine

pelvic inflammatory disease (PID)

doxycycline, metronidazole, norfloxacin

pneumonia for people with AIDS

co-trimoxazole

sores, infected

dicloxacillin, erythromycin, penicillin, potassium permanganate


on the genitals

benzathine penicillin, erythromycin

syphilis

benzathine penicillin, doxycycline, erythromycin, tetracycline

tetanus in newborn

penicillin G

toxemia/fits

magnesium sulfate, diazepam

trichomonas

metronidazole

vaginal discharge (see Chapter 16)



at risk for STD

co-trimoxazole, doxycycline, metronidazole


not at risk for STD

clotrimazole, Gentian Violet, metronidazole

warts on the genitals

podophyllin, trichloroacetic acid

womb infection

amoxicillin, chloramphenicol, metronidazole, penicillin, procaine penicillin

yeast, thrush

Gentian Violet, clotrimazole, miconazole, nystatin, vinegar, ketoconazole

List of Medicines

This list of medicines has two different kinds of names - brand (commercial) names and generic (scientific) names. You can look up the name of a medicine you want to use here to find the page number in the Green Pages where you can learn more about it. Brand names are shown in slanted letters like this. Brand names have the generic name of the medicine next to it.

acetaminophen or paracetamol (APAP, Panadol, Tempra, Tylenol, others)

Acetaminophen and paracetamol are 2 names for the same drug that is used to ease pain and lower fever. It is one of the safest pain killers. It does not cause stomach irritation and can be used instead of aspirin by people with stomach ulcers. It can also be used by pregnant women. See paracetamol.

acyclovir (Zovirax)
CAUTION

Acyclovir is a medicine that kills viruses and is used to fight herpes, which can cause painful blisters on the genitals, and anus, and in the mouth. Acyclovir will not stop herpes from coming back, but it makes it less painful and keeps it from spreading.

In what forms does this medicine come?

Tablets: 200, 400 or 800 mg
Ointment: 5%

How much and when to take

For genital herpes infection: Take 200 mg by mouth 5 times a day for 7 to 10 days.
For cold sores: Apply ointment on sores 6 times a day for 7 days.

Who should not take this medicine?

Someone with kidney damage.

Information you should know

The tablets are much more effective than the ointment. Take with lots of water

Side effects

May sometimes cause headache, dizziness, nausea, vomiting.

Signs taking too much

Headache, loss of memory, nausea, cannot pass urine.

adrenaline or epinephrine (Adrenalin)

Adrenaline and epinephrine are two names for the same drug. It is used for severe allergic reactions or allergic shock, for example, allergic reaction to penicillin. It is also used for severe asthma attacks. See epinephrine.

amoxicillin (Amoxifar, Amoxil, Himox, Megamox, Sumoxil)

Amoxicillin is an antibiotic of the penicillin family used to treat womb infections, urine system infections, pneumonia, and other infections. It is now used instead of ampicillin in many places.

In what forms does this medicine come?

Tablets: 250 and 500 mg
Liquid: 125 or 250 mg per 5 ml

How much and when to take

For chlamydia, PID, or breast infection: 500 mg by mouth 3 times a day for 10 days (for drug combinations to treat vaginal discharge, for PID).

For kidney infection: Take 500 mg by mouth 3 times a day for 14 days.

For infection of the womb after childbirth: Take 1 gram 3 times a day for 10 days (also use other drugs).

To prevent infection after abortion: Take 500 mg by mouth 3 times a day for 5 days.

For bladder infection or infection after abortion: 3 grams by mouth one time only (for drug combinations to treat infection after an abortion).

Who should not take this medicine?

Do not use if allergic to medicines of the penicillin family.

Side effects

May cause diarrhea, rash, nausea or vomiting. May cause yeast infection in women or diaper rash in children.

Information you should know

If you do not start to get better in 3 days, look for medical help; you may need a different medicine.
Take with food.

Other medicines that may work
for bladder or kidney infection: ampicillin, co-trimoxazole, gentamicin, norfloxacin
for breast infection: cephalexin, dicloxacillin, erythromycin
to prevent infection after abortion: doxycycline

amoxicillin with clavulanate potassium (Augmentin)

Amoxicillin with clavulanate potassium (Augmentin) is an antibiotic of the penicillin family used to treat gonorrhea and other infections. In some places, however; gonorrhea is now resistent to this drug. It is much more effective for some infections than amoxicillin alone but is expensive and often hard to find outside of rich countries. Unfortunately, clavulanate potassium cannot be purchased by itself and combined with regular amoxicillin.

In what forms does this medicine come?

Tablets: 125, 200, 250, 400, 500 and 875 mg Liquid: 125, 200, 250, and 400 mg per 5 ml

How much and when to take

For gonorrhea: Take 3 grams of amoxicillin with clavulanate potassium (Augmentin) plus 1 gram of probenecid, 1 time only.

Who should not take this medicine?

Do not use if allergic to medicines of the penicillin family.

Other medicines that may work
for gonorrhea: see drug combinations.

ampicillin (Amcil, Ampicin, Omnipen, Penbritin, Polycillin)

Ampicillin is an antibiotic of the penicillin family used to treat many kinds of infections.

In what forms does this medicine come?

Tablets and Capsules: 250 or 500 mg
Liquid: 125 or 250 mg per 5 ml Powder for mixing injections: 500 mg

How much and when to take

For breast infection or PID: Take 250 to 500 mg by mouth 4 times a day for 7 days.

For bladder infection: Take 3 grams all at once unless you are pregnant. If you are pregnant, take 250 mg by mouth 4 times a day for 7 days.

For kidney infection: Take 500 mg by mouth 4 times a day for 14 days. If vomiting, inject 500 mg into muscle 4 times a day and change to tablets when the vomiting stops.

For fever during pregnancy:
Take 500 mg 4 times a day until you can get medical attention.

Who should not take this medicine?

Do not use ampicillin if you are allergic to medicines of the penicillin family.

Side effects

May cause stomach upset and diarrhea. May cause rash.


If you do not start to get better in 3 days, look for medical help; you may need another medicine.

Information you should know

Take this medicine before eating.

Other medicines that may work
for bladder or kidney infection: amoxicillin, co-trimoxazole, norfloxacin
for breast infection: amoxicillin, cephalexin, dicloxacillin, erythromycin

aspirin (acetylsalicylic acid, ASA, others)
CAUTION

Aspirin works against pain, swelling, and fever.

In what forms does this medicine come?

Tablets: 300, 500 mg and other sizes.

How much and when to take

For pain, swelling or fever:
300 to 600 mg by mouth no more than 6 times a day as needed.

Who should not take this medicine?

Women should not take aspirin during the last 3 months of pregnancy. People with stomach ulcers or bleeding problems should not take aspirin. Do not use before surgery. Do not use if breastfeeding in the first week of the baby’s life. Do not give to children for fever; colds or chicken pox.

Side effects

May cause stomach upset, stomach pain, or bleeding problems.

Information you should know

Aspirin treats some sicknesses like arthritis and heart problems, but is usually used to ease pain and fever. It is important to find the cause of the pain or fever and cure that. If pain lasts more than 10 days or fever more than 3 days, get medical help.

Signs taking too much

Ringing in the ears, headache, dizziness, confusion, fast breathing.

Other medicines that may work
for pain or fever: paracetamol
for pain, fever, or swelling: ibuprofen
for severe pain: codeine

azithromycin (Zithromax)
CAUTION

Azithromycin is an antibiotic of the macrolide family used to treat many STDs. It is expensive and often hard to find, but it works well against STDs when many other antibiotics do not

In what forms does this medicine come?

Capsules: 250 mg

How much and when to take

For women at risk for STDs:
Take 1 gram by mouth 1 time only.

Who should not take this medicine?

People with allergies to erythromycin and other antibiotics of the macrolide family.

Side effects

Diarrhea, nausea, vomiting, abdominal pain.

Information you should know

Take at least 1 hour before eating or at least 2 hours after eating.

Azithromycin is an excellent treatment for most STDs that cause discharge or genital sores. It is good for treating STDs where there is resistance to other medicines.

Other medicines that may work
for vaginal discharge with an STD.
for genital ulcers.

AZT (azidothymidine, Retrovir, zidovudine)

AZT is a medicine used to treat AIDS and to help prevent passing the HIV virus to a baby during pregnancy and birth. It is a difficult drug to use, and should be given in a hospital or under the care of a qualified health worker. Also, it is very expensive and often hard to find in poor countries.

benzathine penicillin (Bicillin L-A, Penadur L-A, Permapen)

Benzathine penicillin is a long-acting antibiotic of the penicillin family used to treat syphilis, genital ulcers, and other infections, including some sore throats. It is always given as an injection into muscle.

In what forms does this medicine come?

Powder for mixing for injection: 1.2 or 2.4 million
Units in a 5 ml vial.

How much and when to take

For genital ulcers, early syphilis or syphilis prevention after sexual assault or exposure: Inject 2.4 million Units into muscle one time only.

For late syphilis: Inject 2.4 million Units into muscle every week for 3 weeks.

Who should not take this medicine?

People who are allergic to medicines of the penicillin family


Have epinephrine on hand whenever you inject penicillin. Watch for allergic reactions and allergic shock which could start within 30 minutes.

Other medicines that may work
for syphilis: doxycycline, tetracycline, erythromycin
also treat for chancroid

benzylpenicillin (Celinex, Hi-Do-Pen, penicillin G potassium or sodium)

Benzylpenicillin is an antibiotic of the penicillin family used to treat many serious infections, including infection after an abortion.

In what forms does this medicine come?

Powder for mixing for injection: 1 or 5 million Units

How much and when to take

For serious infection after an abortion: Inject 5 million Units into muscle 1 time only (also give other medicines).

Who should not take this medicine?

People who are allergic to medicines of the penicillin family.


Watch for allergic reactions and signs of shock.

Other medicines that may work
for serious infection after an abortion: ampicillin, cephalexin, ciprofloxacin, norfloxacin.

cefixime (Suprax)
CAUTION

Cefixime is an antibiotic of the cephalosporin family that is used to treat many infections including gonorrhea, pelvic inflammatory disease, and others.

In what forms does this medicine come?

Tablets: 200 or 400 mg
Liquid: 100 mg in 5 ml

How much and when to take

For gonorrhea or PID: Take 400 mg by mouth one time only

Who should not take this medicine?

Do not use if you are allergic to antibiotics of the cephalosporin family.

Side effects

Nausea, diarrhea, headache.


Watch for allergic reaction. People who have liver problems should be watched carefully when taking cefixime.

Other medicines that may work
for gonorrhea: ceftriaxone, ciprofloxacin, co-trimoxazole kanamicin, norfloxacin
for PID: ceftriaxone, norfloxacin

ceftriaxone (Nitrocephin, Rocephin)
CAUTION

Ceftriaxone is a very strong antibiotic of the cephalosporin family that is injected into muscle. It is used for many infections including gonorrhea, pelvic inflammatory disease (PID), kidney infections, and serious infections after abortion, childbirth, or miscarriage.

In what forms does this medicine come?

In vials for injection: 250, 500 mg and 1 gram, 2 grams and 10 grams

How much and when to take

For severe infections after abortion or childbirth: Inject 1 gram into muscle once a day for 10 days.

For gonorrhea, chancroid, or PID: Inject 250 mg into muscle one time only.

Who should not take this medicine?

Do not use if you are allergic to antibiotics of the cephalosporin family.


Watch for allergic reaction.
Always be prepared to treat for allergic reaction and shock when injecting antibiotics.

Other medicines that may work
for severe infections: amoxicillin with clavulanate potassium (Augmentin),
for gonorrhea, chancroid, or PID: kanamicin

Cephalexin (Ceporex, Keflex, Keftab)

Cephalexin is an antibiotic of the cephalosporin family used to treat breast and bladder infections, bronchitis and some skin infections.

In what forms does this medicine come?

Tablets: 250 or 500 mg
Liquid: 125 or 250 mg per 5 ml

How much and when to take

For breast or bladder infection: 250 mg by mouth 4 times a day for 7 days.

Who should not take this medicine?

Do not take Cephalexin if you are allergic to antibiotics of the cephalosporin family.

Side effects

Nausea, vomiting, and diarrhea. In rare cases, the beginning of bloody diarrhea with fever.


Watch for allergic reaction.

Information you should know

If you start having bloody diarrhea with fever, stop taking cephalexin and treat with metronidazole.

Other medicines that may work
for breast or skin infection: erythromycin, dicloxacillin, amoxicillin
for bladder infection: amoxicillin, co-trimoxazole, erythromycin, norfloxacin

activated charcoal (Activated Carbon, Liquid Antidote)

Activated charcoal is a specially prepared charcoal used to treat some poisonings by drugs like aspirin, acetaminophen, phenobarbitol, or other medicines or chemicals, or poisonous mushrooms. After giving activated charcoal, get medical help immediately.

In what forms does this medicine come?

Liquid: 25 g per 120 ml
Powder: 15 g

How much and when to take

Take 30 to 100 g by mouth all at one time.

Who should not take this medicine?

Do not take if you have swallowed lighter fluid, fuel, kerosene or petroleum products.

Side effects

Black stools, vomiting, diarrhea.


Get medical help immediately. People who take too much of a drug can get very sick and may need much more help than activated charcoal.

chloramphenicol (Chloromycetin, Kemicetine, Mychel, Pharex)

Chloramphenicol is a very strong antibiotic used for serious infections after childbirth, miscarriage, or abortion. It should only be used when less dangerous drugs do not work or are not safe to take. As an ointment, it is also used for baby eye-care if tetracycline or erythromycin ointments are not available.

In what forms does this medicine come?

Capsules: 250 mg
Liquid: 150 mg per 5 ml
Powder for mixing for injection: 1 g
Ointment: 1%
Liquid for eye-care: 0.5%

How much and when to take

For infection after childbirth: Take 1 g by mouth one time only and then 500 mg by mouth 4 times a day for 7 days.

For serious infection after abortion: Inject 1 g into vein (IV) 4 times a day.

For baby eye care: put a little in each eye at birth.

Who should not take this medicine?

Women who are pregnant or breastfeeding.

Side effects

Upset stomach, vision problems.


Use other antibiotics if possible. Risk of permanent harm to the blood or even death in some people.

Information you should know

For serious infections, chloramphenicol should be taken with 10 million Units of benzyl penicillin.

Signs taking too much

Bleeding or bruising easily, vision problems.

Other medicines that may work
for serious infection:
after birth
after abortion
for baby eye core: tetracycline or erythromycin ointments are better.

ciprofloxacin (Ciloxan, Cipro, Ciprobay)

Ciprofloxacin is a strong antibiotic of the quinolone family that is used to treat skin and kidney infections, and some STDs like gonorrhea, chancroid and PID.

In what forms does this medicine come?

Tablets: 250, 500 or 750 mg

How much and when to take

For gonorrhea, PID, or chancroid: 500 mg by mouth one time only

For kidney infection: Take 500 mg by mouth 2 times a day for 10 days.

Who should not take this medicine?

Do not use if you are pregnant, breastfeeding or younger than 16 years old.

Side effects

Nausea, diarrhea, vomiting, headache.


This medicine reacts with caffeine (in coffee, chocolate, cola drinks, etc.), making the caffeine even stronger Do not take with dairy products.

Information you should know

Drink lots of water You can - eat while taking ciprofloxacin, just avoid dairy products.

Other medicines that may work
for chancroid: erythromycin, co-trimoxazole
for PID: norfloxacin, doxycycline, metronidazole
for kidney infection: amoxicillin, co-trimoxazole
for gonorrhea: ceftriaxone, kanamicin, norfloxacin

clotrimazole (Canesten, Fungistin, Gyne-lotrimin, Mycelex-G)

Clotrimazole is used to treat yeast infections of the vagina, mouth and throat.

In what forms does this medicine come?

Inserts: 100 or 500 mg
Cream: 1%
Lozenge: 10 mg

How much and when to take

For vaginal yeast infections: Inserts: Put one 500 mg insert in the vagina at bedtime one time only; on put two 100 mg inserts in the vagina at bedtime every night for 3 nights. Cream: Put 5 g in the vagina each night at bedtime for 7 to 14 days.

For mouth and throat infections: Take a 10 mg lozenge by mouth 5 times a day for 14 days.

Who should not take this medicine?

Do not use if you have had allergic reactions to this drug.

Side effects

Mild burning or itching. Nausea or vomiting if taken by mouth.


If clotrimazole burns the vagina, stop using it. Avoid having sex for 3-4 days so you do not pass the infection to your partner

Information you should know

The single, larger dose works better for pregnant women.

Other medicines that may work
for yeast infections: nystatin, miconazole, Gentian Violet or vinegar.
for AIDS patients: ketaconazole.

Codeine
CAUTION

Codeine is a pain killer of the opiate family that also calms coughs and helps you relax and sleep. Only use codeine to calm very bad coughs after you have treated the cause for the cough. Only use codeine for pain when milder pain medicines do not work.

In what forms does this medicine come?

Liquid: 15 mg per ml
Tablets: 15, 30, or 60 mg
Cough syrup: Different strengths

How much and when to take

For coughs: 7 to 15 mg 4 times a day, only as needed.
For severe pain: 30 to 60 mg 4 to 6 times a day, as needed.

Side effects

Causes constipation (difficulty passing stools) and temporary inability to pass urine. Nausea, vomiting, itching, headaches.

Information you should know

Codeine is habit forming (addictive). If you use it for more than a few - days, you will need more and more of it for the medicine to work.

Signs taking too much

Sleepiness, stupor, coma.

Treatment for taking too much

Naloxone (Narcan) can be given as an injection to someone who has taken too much codeine. Seek medical help.

Other medicines that may work
for pain: acetaminophen, aspirin, ibuprofen.
for severe pain: morphine
for cough: drink plenty of water, use home-made cough syrup

co-trimoxazole = trimethoprim + sulfamethoxazole
(AzoGantanol, Bactrim, Coptin, Gantanol, Pologrim, Septra, Sulfatrim, TMP/SMX, Trimpex, others)
CAUTION

Co-trimoxazole is a combination of 2 antibiotics (one from the sulfa family) that is used to treat bladder and kidney infections, vaginal discharge caused by gonorrhea, and chancroid. It also helps prevent diarrhea and pneumonia for people with AIDS.

In what forms does this medicine come?

Tablets: 120 mg (20 mg trimethoprim + 100 mg sulfamethoxazole)
480 mg (80 mg trimethoprim + 400 mg sulfamethoxazole), and
960 mg (160 mg trimethoprim + 800 mg sulfamethoxazole)
Liquid: 240 mg (40 mg trimethoprim + 200 mg sulfamethoxazole) per 5 ml

How much and when to take

For bladder infection: Take four 480 tablets by mouth one time only.
For kidney infection: Take two 480 tablets by mouth 2 times a day for 10 days.
For vaginal discharges caused by STDs: Take ten 480 tablets once a day for 3 days
For prevention of pneumonia and diarrhea for people with AIDS: Take one 480 tablet every day or two 480 tablets two times a week
For bloody diarrhea, or pneumonia for people with AIDS: Take two 480 tablets by mouth 2 times a day for 10 days.
For PID or chancroid: Take five 480 tablets by mouth 2 times a day for 3 days; or, if this makes you nauseous, take two 480 tablets by mouth 2 times a day for 7 days

Who should not take this medicine?

Women in the last 3 months of pregnancy should not use this medicine. If you are allergic to sulfa antibiotics, do not take this drug.

Side effects

Stop taking it if it causes allergic reactions like itching or skin rashes. Also may cause nausea and vomiting.


Take with lots of water

Signs taking too much

Nausea, vomiting, diarrhea, confusion, sweating.

Other medicines that may work
for bladder and kidney infection: amoxicillin, nitrofurantoin, norfloxacin
for gonorrhea: ceftriaxone, kanamycin, norfloxacin
for chancroid: ciprofloxacin, ceftriaxone, erythromycin, kanamycin
for PID: see drug combinations.
for diarrhea for people with AIDS: norfloxacin, metronidazole

dexamethasone (Decadron, Decilone, Inflam, Maxidex)

Dexamethasone is a steroid medicine used to treat allergic shock.

In what forms does this medicine come?

Tablets: 0.25, 0.5, 0.75, 1, 1.5, 2, or 4 mg
Liquid: 0.5 mg per 5 ml, or 1 mg per 1 ml
For injection: 4, 8, 10, 16, or 20 mg per ml

How much and when to take

For allergic shock: Inject 20 mg into muscle. If signs return, take 20 mg by mouth and repeat once if needed.

Side effects

If the person has diabetes, it could make it worse for a few hours. Also, it might raise blood pressure.

Other medicines that may work
for allergic shock: hydrocortisone

diazepam (Anxionil, Calmpose, Valium)
CAUTION

Diazepam is a tranquilizer used to treat and prevent convulsions and seizures. It also relieves anxiety and helps promote sleep.

In what forms does this medicine come?

Tablets: 5 or 10 mg
For injections: 5 mg per 1 ml or 10 mg per 2 ml

How much and when to take

For convulsions: Use 20 mg of injectable diazepam in the anus using a syringe without a needle. Repeat if needed using 15 mg after every convulsion. Use crushed up tablets in water it you do not have injectable diazepam.
To prevent seizures during alcohol withdrawal: Take 10 to 20 mg by mouth. Repeat after 1 hour if needed. If signs continue, give every 4 to 5 hours while seeking medical help.
For anxiety or sleeplessness: Take 2.5 to 5 mg by mouth.

Who should not take this medicine?

Pregnant or breastfeeding women should only use diazepam in an emergency.

Side effects

Frequent or large doses of diazepam during pregnancy can cause birth defects.


Diazepam is an addictive (habit-forming) drug. Avoid taking with other drugs that will make you sleepy, especially alcohol.

Information you should know

Diazepam does not treat pain. It is very habit-forming.

Signs taking too much

Sleepiness, loss of balance, confusion.

Other medicines that may work
for convulsions: magnesium sulfate
for sleep: diphenhydramine
for anxiety: hydroxyzine

dicloxacillin

Dicloxacillin is an antibiotic of the penicillin family used to treat breast and skin infections.

In what forms does this medicine come?

Capsules: 125, 250 or 500 mg
Liquid: 62.5 mg per 5 ml

How much and when to take

For breast or skin infections: Take 250 mg 4 times a day for 10 days.

Who should not take this medicine?

Do not take this drug if you are allergic to penicillin.

Side effects

Nausea, vomiting, diarrhea.


Watch for allergic reactions or shock.

Other medicines that may work
for breast or skin infections: amoxicillin, cephalexin, erythromycin

diphenhydramine hydrochloride (Bectivo, Benadryl)
CAUTION

Diphenhydramine is an antihistamine that dries up mucus in the nose and also makes you sleepy. It is useful for treating chronic itching and sleep problems for people with AIDS. It is also a treatment for allergic reactions and allergic shock.

In what forms does this medicine come?

Tablets or capsules: 25 or 50 mg
Syrup: 12.5 mg per 5 ml
Ampules for injection: 10, 30 or 50 mg in 1 ml

How much and when to take

For allergies, mild to moderate allergic reaction, or itching: Take 25 mg by mouth 3 or 4 times a day as needed.
For steep: Take 25 to 50 mg at bedtime.
For allergic shock: Inject 50 mg into muscle, repeat in 8 hours or sooner if needed.

Who should not take this medicine?

Pregnant and breastfeeding women should not use this drug as a long-term treatment for allergies. People with asthma should not take it.

Side effects

Sleepiness, dry mouth. Sometimes causes nausea and vomiting. In rare cases can have the opposite effect and excite rather than calm you.


Do not use if you need to be alert. Makes the effects of tranquilizers and alcohol dangerously stronger.

Information you should know

Only inject diphenhydramine for severe allergic reactions or shock.

Other medicines that may work
for allergies: hydroxyzine, promethazine
for sleep: diazepam

doxycycline (Biocolyn, Doryx, Monodox, Vibramycin, Vibra-Tabs)

Doxycycline is an antibiotic of the tetracycline family used to treat many different infections including STDs, pelvic infections, infections after abortions, and others. It is used instead of tetracycline.

In what forms does this medicine come?

Tablets: 50 and 100 mg

How much and when to take

For vaginal discharge from an STD: Take 100 mg by mouth 2 times a day for 7 days.
For syphilis: 100 mg by mouth 2 times a day for 15 days.
For late syphilis: 100 mg by mouth 2 times a day for 28 days.
For PID or infection after female circumcision: Take 100 mg by mouth 2 times a day for 10 days.
For risk of STDs before an abortion or to prevent infection after an abortion: Take 100 mg 2 times a day for 5 days.
For infections after an abortion: Take 100 mg by mouth 2 times a day for 10 days.

Who should not take this medicine?

Pregnant and breastfeeding women and children under 8. Doxycycline can damage a baby’s or child’s teeth and bones.

Side effects

Diarrhea or upset stomach. Some people get a rash after staying a longtime in the sun.


Do not take if pregnant or breastfeeding. Do not use doxycycline that is old or has passed the expiration date. Do not take with dairy products or antacids.

Information you should know

Do not take just before laying down. Sit up while taking pills and drink lots of water to prevent the irritation that swallowing this medicine can cause.

Other medicines that may work
for syphilis: benzathine penicillin
for gonorrhea: co-trimoxazole
for chlamydia: erythromycin to prevent infection after abortion: amoxicillin
for infection after abortion
for infection after circumcision: erythromycin

epinephrine or adrenaline (Adrenalin)

Epinephrine and adrenaline are two names for the same drug. It is used for allergic reactions or allergic shock, for example, allergic shock caused by penicillin. It is also used for severe asthma attacks.

In what forms does this medicine come?

Ampules for injection: 1 mg in 1 ml

How much and when to take

For asthma, moderate allergic reaction or allergic shock: Inject ½ mg (½ ml) just under the skin (not into muscle) of the upper arm. If needed, a second dose can be given after 20-30 minutes, and a third dose after another 20-30 minutes.

Side effects

Fear, restlessness, nervousness, tension, headaches, dizziness, increased heart rate.


Be careful never to give more than the recommended amount. Avoid injecting this into the buttocks, instead use the back of the upper arm.

Information you should know

Take the person’s pulse before injecting. Do not give more than 3 doses. If the pulse goes up by more than 30 beats per minute after the first injection, do not give another dose.

Signs taking too much

High blood pressure, fast heart beat, stroke.

ergometrine maleate, methylergonovine maleate
(Anurhage, Ergonovine, Ergotrate, Methergine)

Ergometrine causes contractions of the womb and its blood vessels and is used to control heavy bleeding after childbirth or an abortion. Ergometrine and methylergonovine are the same drug. After giving this medicine, get help.

In what forms does this medicine come?

Tablets: 0.2 mg
For injection: 0.2, 0.25 and 0.5 mg in 1 ml vial.

How much and when to take

For heavy bleeding after childbirth: After the placenta has come out, inject 0.5 mg into muscle, or give 1 tablet (0.2 mg) by mouth 4 to 6 times a day.
For heavy bleeding due to complications after an abortion: Give an injection of 0.2 mg into muscle, then give a 0.2 mg pill or a 0.1 mg injection every 4 hours for 24 hours.

Side effects

Nausea, vomiting, dizziness, sweating.


Do not use these drugs to start labor or make labor stronger. Never give this medicine before the baby and the placenta have come out.

Information you should know

Do not use this drug to cause an abortion because it could kill the woman before making her abort. (For abortion, see Chapter 15).

Other medicines that may work
oxytocin

erythromycin (E.E.S., E-Mycin, Ery-max, Ethril, Ilosone, Ilotycin)

Erythromycin is an antibiotic of the macrolide family used to treat many infections, including some STDs, respiratory and skin infections. It can be safely used during pregnancy and is widely available.

In what forms does this medicine come?

Tablets or capsules: 250 mg
Ointment: 1%
Powder for solution: 125 mg per 5 ml

How much and when to take

For bladder infections or chlamydia: 500 mg by mouth 4 times a day for 7 days
For breast infection, PID or infection from female circumcision: 500 mg by mouth 4 times a day for 10 days
For chancroid or skin infections: 500 mg by mouth 3 times a day for 7 days
If you are treating genital sores but are allergic to penicillin: 500 mg by mouth 3 times a day.
For early syphilis: 500 mg by mouth 4 times a day for 15 days.
For genital sores caused by chlamydia: 500 mg by mouth 4 times a day for 21 days.
For newborn eye-care: Use 1% ointment one time only.

Who should not take this medicine?

Do not use if you are allergic to antibiotics of the macrolide family.

Side effects

May upset stomach or cause nausea, vomiting, diarrhea.

Information you should know

Erythromycin works best when taken 1 hour before or 2 hours after a meal. If this upsets your stomach too much, take with a little food. Do not break up tablets. Many tablets are coated to prevent strong stomach juices from breaking down the drug before it can begin to work.

Other medicines that may work
for breast infection: amoxicillin, cephalexin, dicloxacillin
for bladder infection: ampicillin, co-trimoxazole
for infection after circumcision: doxycycline
for STDs.
for drug combinations to treat STDs for baby eye-care: tetracycline ointment

estrogen (ethinyl estradiol, mestranol)

Chemical forms of estrogen are used in birth control pills and injections. They are similar to the hormone estrogen made in a woman’s body. Estrogen can also be used to treat abnormal bleeding or problems of menopause (see Chapter 8). For more information, see the section on birth control pills, injections, and emergency family planning (see Chapter 13).

ethambutol (Interbutol, Myambutol, Mycrol, Odetol, Triambutol)

Ethambutol is used to treat tuberculosis (TB) especially where other TB medicines are no longer strong enough. It is used in combination with other drugs. See Chapter 25.

In what forms does this medicine come?

Tablets: 100 or 400 mg

How much and when to take

The doses for tuberculosis medicines differ from region to region. See a health worker.

Who should not take this medicine?

People with serious vision problems, including cataracts, should not take this drug. Neither should people with severe kidney problems.

Side effects

Ethambutol often causes vision changes in one or both eyes. It might make the area of what you can see smaller, or cause patchy dark spots or “holes” in your vision. This usually goes away when you stop taking the drug.

Information you should know

It is very important that you take the entire course of treatment for tuberculosis, even if it lasts for a year If not, you might infect other people.

gentamicin (Bactiderm, Garamycin, Servigenta)
CAUTION

Gentamicin is a very strong antibiotic of the aminoglycoside family that is used to treat gonorrhea, kidney and other serious infections, and for pelvic inflammatory disease in combination with other drugs. You should use this drug only when the woman is vomiting and cannot keep other medicines down or no other antibiotic is available.

In what forms does this medicine come?

In vials for injection: 10 or 40 mg per ml

How much and when to take

For severe infection after an abortion: Give this medicine according to a woman’s weight: inject into muscle 5 mg for every kg of weight, split into 3 doses (morning, afternoon and night) for 5 to 7 days; or you can use the following average dose: Inject 80 mg into muscle, then give 60 mg injections 3 times a day for 5 to 7 days

Who should not take this medicine?

Pregnant women or people with kidney problems should use this drug very carefully. Do not use this drug if you are allergic to other antibiotics of the aminoglycoside family.

Side effects

This drug can damage the kidneys or cause deafness.


Use a different medicine if hearing problems or ringing in the ears start. Give with plenty of fluids.

Information you should know

Because of the serious side effects and the difficulty of calculating the dosage, this drug should only be used when safer antibiotics are not available.

Signs taking too much

Ringing in the ears or worsening of hearing. Kidney problems.

Other medicines that may work
for severe infection: cefixime, ceftriaxone, kanamycin
for kidney infection: amoxicillin, ampicillin, norfloxacin

Gentian Violet (Crystal Violet, methylrosanilinium chloride)

Gentian Violet is a disinfectant used to help fight infections of the skin, mouth, and vagina.

In what forms does this medicine come?

Liquid: 0.5%, 1%, 2%
Tincture: 0.5%
Crystals: 1 teaspoon in ° liter of water makes a 2% liquid.

How much and when to take

For vaginal yeast infections: soak clean cotton with 1% liquid and place high in the vagina overnight for 3 nights. Be sure to remove the cotton every morning.
For yeast infections in the mouth (thrush): Rinse the mouth with 1% liquid for 1 minute 2 times a day, but do not swallow.
For skin infections: First wash with soap and water; and dry. Then paint on skin, mouth, or vulva 3 times a day for 5 days.

Side effects

Long-term use causes irritation. Use on a sore or on broken skin may stain that skin purple when it heals.


Do not have sex while you are using Gentian Violet for a vaginal infection to avoid passing the infection to your partner Stop using Gentian Violet if it starts to irritate you.

Information you should know

After putting this in an infant’s mouth, turn the baby face down so it does not swallow too much. Gentian Violet will stain your skin and clothes purple.

Other medicines that may work
for skin infections: antibiotic ointments, iodine
for thrush in the mouth: lemon (not for babies), nystatin
for vaginal yeast infections: nystatin, miconozole, clotrimazole

hepatitis B vaccine (Engerix-B, Recombivax HB)

This vaccine provides immunity to Hepatitis B.

In what forms does this medicine come?

Liquid for injection: 2.5, 5, 10, or 25 mg per ml

How much and when to take

Always give this vaccine by injection in the upper arm or thigh in 3 doses. Try to give the 2nd dose 1-2 months after the 1st, and the 3rd dose 4-12 months after the 2nd.

Doses for these 2 brands of the vaccine are different:

Engerix-6

Recombivax HB

Adults:

20 mg

10 mg

Children

0 to 11 years

10 mg

2.5 mg

11 to 19 years

20 mg

5 mg


Side effects

Sometimes fever, headache, weakness, tiredness.

Information you should know

This vaccine needs to be stored at 2-8 degrees centigrade or it loses its strength. This vaccine should be injected in the upper arm or thigh.

Other medicines that may work
Hepatitis B immune globulin

hydrocortisone or cortisol
(Eczacort, Hycotil, Solu-Cortef, others)
CAUTION

Hydrocortisone is an anti-swelling and anti-itch skin cream used to treat rashes. It is also useful for treating hemorrhoids (piles). In its injection form and as tablets it is an important drug for treating allergic shock.

In what forms does this medicine come?

Cream or ointment: 1%
Tablets: 5, 10, and 20 mg
Liquid for injection and powder for mixing for injection: various strengths

How much and when to take

For rash, itching or piles: Apply cream directly on skin 3 or 4 times a day.
For allergic shock: Inject 500 mg into muscle, repeat in 4 hours if needed. If signs return later take 500 to 1000 mg by mouth and repeat once if needed.

Side effects

Cream may cause thinning and scarring of skin if used for more than 10 days.


Do not use cream with a bandage covering. Pregnant and breastfeeding women should use tablets with caution, but can safely use cream.

Signs taking too much

High blood pressure, passing more urine than usual.

Other medicines that may work
for allergic shock dexamethasone
for allergies or itching: diphenhydramine

hydroxyzine (Atarax, Iterax, Marax, My-Pam, Vistaril)
CAUTION

Hydroxyzine is an antihistamine used for allergic reactions, to control itching, and sometimes to treat nausea, vomiting, and anxiety.

In what forms does this medicine come?

Tablets: 25, 50 or 100 mg For injection: 25 or 50 mg

How much and when to take

For itching: Take 25 to 50 mg by mouth 3 or 4 times a day.
To relieve anxiety: Take 25 to 50 mg by mouth 4 times a day,
For moderate allergic reactions or allergic shock: Inject into muscle: 25 mg for children, 50 mg.

Who should not take this medicine?

Do not use during first 3 months of pregnancy. In the rest of pregnancy or if breastfeeding, use only if there is no other choice. Do not use this drug if you must stay alert.

Side effects

Causes dry mouth, sleepiness, and may cause loss of appetite.

Signs taking too much

Sleepiness

Other medicines that may work
for itching, allergy or allergic shock: diphenhydramine, promethazine
for anxiety: diazepam

ibuprofen (Actiprofen, Advil, Genpril, Motrin, Nuprin, Rufen, others)
CAUTION

Ibuprofen works against pain, swelling, and fever. It is very useful to relieve discomfort during monthly bleeding and pain from arthritis and AIDS.

In what forms does this medicine come?

Tablets: 200 mg and larger
Liquid: 100 mg per 5 ml

How much and when to take

Take 200 to 400 mg 4 to 6 times a day. Do not take more than 2400 mg daily.

Who should not take this medicine?

People with stomach ulcers. Pregnant women during the last 3 months.

Side effects

May cause stomach irritation or pain.


Avoid taking within a week of surgery.

Information you should know

Works best if taken with food, especially dairy products, at mealtimes.

Other medicines that may work
for pain, swelling and fever: aspirin
for pain and fever: acetaminophen
for severe pain: codeine, morphine

isoniazid (Bisonid, INH, Isoniazdum, isonicotinic acid hydrazide, Odinah, Zidrid)

Isoniazid is used to treat tuberculosis (TB) in combination with other medicines. See Chapter 25.

In what forms does this medicine come?

Tablet: 100 or 300 mg
Syrup: 50 mg per 5 ml

How much and when to take

The doses for tuberculosis medicines differ from region to region. See a health worker.

Who should not take this medicine?

Anyone who has hepatitis, liver disease, or has taken isoniazid before and had liver problems, should not take this drug.

Side effects

May cause pain or numbness in arms and legs. Sometimes isoniazid may cause severe hepatitis with signs like tiredness, loss of appetite, nausea, vomiting, dark urine or yellowing of eyes. If this happens, stop taking this medicine immediately.

Information you should know

Never take more than 300 mg a day. It is important to take the full course of treatment for tuberculosis so you do not infect other people.

Signs taking too much

Nausea, vomiting, dizziness, slurred speech, blurred vision. If you take too much, take 1 g of pyridoxine (vitamin B6).

kanamycin (Kantrex)

Kanamycin is a very strong antibiotic of the aminoglycoside family that is used to treat gonorrhea and other serious infections. Kanamycin should only be used when other, safer antibiotics are not available.

In what forms does this medicine come?

In vials for injection: 75, 500, or 1000 mg
Powder for mixing for injections: 1 g in 2 ml
Tablets: 500 mg

How much and when to take

For severe infection: Give this medicine according to a woman’s weight: inject into muscle 15 mg for every kg of weight, divided into 2 doses (morning and night), for 5 to 7 days; or you can use the following dose: Inject 500 mg into muscle 2 times a day for 5 to 7 days.
For gonorrhea: Inject 2 g into muscle 1 time only.

Who should not take this medicine?

Pregnant women or people with kidney problems should not use this drug. Do not use this drug if you are allergic to other antibiotics of the aminoglycoside family.

Side effects

This drug can damage the kidneys or cause deafness.


Use a different medicine if hearing problems or ringing in the ears start. Give with plenty of fluids.


Information you should know

Because of the serious side effects and the difficulty of calculating the dosage, this drug should only be used when safer antibiotics are not available.

Signs taking too much

Ringing in the ears or worsening of hearing. Kidney problems.

Other medicines that may work
for serious infection or for gonorrhea: cefixime, ceftriaxone, norfloxacin

ketoconazole (Nizoral)
CAUTION

Ketoconazole is a strong anti-fungus medicine that is used to treat thrush and other yeast infections. Use only if you have AIDS and other remedies do not work. It is expensive and sometimes hard to find.

In what forms does this medicine come?

Tablets: 200 mg
Also comes as skin cream and shampoo: 2%

How much and when to take

For fungal infection: Take 200 mg by mouth once a day for 10 days.
For yeast infection inside the mouth (thrush): Take 200 mg by mouth 2 times a day for 14 days.

Side effects

May cause nausea, vomiting.


Use with caution if you are pregnant or breastfeeding. Do not put cream or shampoo in vagina. Take with food. If taken by mouth, it may give you hot flashes if you also drink alcohol.

Information you should know

This medicine works best if taken with orange juice or another citrus fruit.

Other medicines that may work
for yeast infections without STDs: nystatin, clotrimazole.

magnesium sulfate

Magnesium sulfate is the best medicine to prevent convulsions in pregnant women with toxemia.

In what forms does this medicine come?

Injections of 10%, 12.5%, 25%, or 50% solution.

How much and when to take

For convulsions: Inject 10 g into muscle.

Who should not take this medicine?

Women with kidney problems should not be given this drug.


Only use this drug if a woman’s blood pressure is over 160/110, After giving, continue to check her blood pressure. Too much of this medicine can slow down or stop her breathing!

Information you should know

Injecting a large amount needs a big needle and may be uncomfortable. You might want to split the dose in half and give 2 smaller shots, one in each hip.

Signs taking too much

Sweating, low blood pressure, weakness, problems breathing.

Other medicines that may work
For convulsions: diazepam

medroxyprogesterone acetate
(Amen, Curretab, Cycrin, Depo-Provera, Megestron, Provera)
CAUTION

Medroxyprogesterone acetate is a chemical form of progesterone, a hormone produced naturally in a woman’s body. It can be used to treat irregular bleeding caused by changing hormones, especially around the time of menopause. For more information, see Chapter 8 “Older Women.” For family planning, see Chapter 13.

In what forms does this medicine come?

Tablets: 2.5, 5, or 10 mg

How much and when to take

For heavy bleeding: Take 10 mg once a day for 10 days. If bleeding continues, take for 10 more days.

Who should not take this medicine?

Women with hepatitis, or cancer of the breast or cervix should not take this medicine.


If bleeding continues after 20 days of treatment, see a health worker It could be a serious problem.

methyl ergonovine (Methergine)

Methyl ergonovine causes contractions of the womb and its blood vessels and is used to control heavy bleeding after childbirth. It is the same drug as ergometrine and ergonovine. See ergometrine.

metronidazole (Flagyl, Methoprotostat, Metro, Metroxyn, Satric)
CAUTION

Metronidazole is used for vaginal infections caused by yeast and trichomonas. It is also effective against some bacteria and amebic dysentery (also see Where There is No Doctor).

In what forms does this medicine come?

Tablets: 200, 250, 400, or 500 mg
Inserts: 500 mg
For injection into vein: 500 mg in 100 ml

How much and when to take

For PID or infection after childbirth: Take 500 mg by mouth 2 times a day for 10 days
For mild vaginal infections: Put one 500 mg insert in the vagina 2 times a day for 10 days.
For trichomonas, yeast, or bacterial vaginosis: Take 2 grams by mouth 1 time only, but not if you are pregnant. If you are pregnant: Take 400 mg by mouth 2 times a day for 7 days (to treat abnormal discharge with or without an STD, see drug combinations).
For serious infection after abortion: Give 500 mg by mouth 4 times a day or inject 1 g into a vein 2 times a day (see treatment combinations recommended).
For bloody diarrhea with or without fever: 500 mg 3 times a day for 7 days.

Who should not take this medicine?

People with liver problems like jaundice (yellow eyes).

Side effects

Metallic taste in mouth, dark urine, upset stomach or nausea, headache.


Stop taking it if you feel numb. If you are in the first 3 months of pregnancy, try not to use this medicine. If you must, do not take the one large dose during pregnancy. But if you are breastfeeding, the 1 large dose is the safest way to take it.

Information you should know

Your sexual partner should also be treated. Do not drink alcohol, not even 1 been while you are taking metronidazole. It will make you feel very nauseous.

Other medicines that may work
for yeast and trichomonas: tinidazole
for diarrhea for people with AIDS: co-trimoxazole, norfloxacin

miconazole (Daktarin, Fungtopic, Micatin, Monistat)

Miconazole is an anti-fungus medicine used to treat vaginal yeast and other fungus infections.

In what forms does this medicine come?

Cream: 2%
Inserts: 100 mg and 200 mg

How much and when to take

For yeast infections: Cream: put 5 g in the vagina every night for 7 days. 100 mg inserts: put 1 in the vagina every night for 7 days. 200 mg inserts: put 1 in the vagina every night for 3 days.

Who should not take this medicine?

Women in the first 3 months of pregnancy.

Side effects

Irritation


If miconazole irritates you, stop using it. Avoid having sex for 3-4 days so you do not pass it to your partner Keep it out of your eyes.

Other medicines that may work
for yeast infections: nystatin, clotrimazole, Gentian Violet or ketaconazole

mifepristone (RU 486)
CAUTION

Mifepristone, used together with misoprostol or other drugs, can be used for abortion. This drug is available now only through special programs in some countries, and is given in clinics and hospitals where the woman can be watched and treated for complications.

In what forms does this medicine come?

Tablets: 200 mg

How much and when to take

For medical abortion: 600 mg is given 1 time before the woman is 2 months pregnant. After 48 hours, another medicine such as misoprostol (400 mcg) is placed high in the vagina.

Who should not take this medicine?

Women who are more than 9 weeks from their last monthly bleeding.

Information you should know

After cramping and heavy bleeding, the abortion is usually completed within 48 hours after the second medicine is given.

If this medicine fails, an abortion by manual vacuum aspiration (MVA) or dilation and curettage (D and C) may be necessary. (See Chapter 15, “Abortion.”)

Other medicines that may work
misoprostol

misoprostol (Cytotec)
CAUTION

Misoprostol is used for stomach ulcers. It can be used for abortion because it makes the womb contract, bleed, and expel the pregnancy.

In what forms does this medicine come?

Tablets: 100 or 200 mcg

How much and when to take

For medical abortion: Place 400 mcg high in the vagina. If bleeding has not started in 12 hours, repeat. If bleeding still has not started, wait 2 weeks and try again.

Who should not take this medicine?

Women after the third month of pregnancy must not use this medicine. It could cause the womb to split open.

Side effects

May cause nausea, vomiting, diarrhea and headache. If breastfeeding, will cause diarrhea in infants.


Do not use more than 400 mcg at once or take it more often than every 12 hours because it can make the womb split open.

Information you should know

An abortion caused by misoprostol may take several hours to several days to finish. Most of the time, complete abortion does not occur See a health worker after bleeding has begun to have the womb emptied completely.

Signs taking too much

Severe pain in the belly and very heavy bleeding. Get medical help immediately.

nitrofurantoin (Furadantin, Macrobid, Macrodantin)
CAUTION

Nitrofurantoin is an antibiotic used to treat kidney and bladder infections.

In what forms does this medicine come?

Tablets: 25, 50 or 100 mg

How much and when to take

For bladder infections: 50 mg 4 times a day for 7 days.
For kidney infections: 100 mg 4 times a day for 7 days.

Who should not take this medicine?

People with kidneys that did not work well before they got an infection. Women in their last month of pregnancy.

Side effects

Nausea or vomiting, headaches, passing gas.

Signs taking too much

Vomiting, chest pains.

Other medicines that may work
for bladder or kidney infections: ampicillin, amoxicillin, co-trimoxazole, erythromycin, norfloxacin

norfloxacin (Lexinor, Noroxin, Uritracin)

Norfloxacin is an antibiotic of the quinolone family used to treat gonorrhea, bladder and kidney infections, and serious cases of diarrhea.

In what forms does this medicine come?

Tablets: 400 mg

How much and when to take

For bladder infections: Take 1 tablet 2 times a day for 3 days, either 1 hour before eating or 2 hours after eating.
For kidney infections: Take 1 tablet 2 times a day either 1 hour before eating or 2 hours after eating for 10 days.
For PID, gonorrhea, or vaginal discharge with STDs: Take 800 mg one time only
For diarrhea for people with AIDS: Take 400 mg 2 times a day for 5 days.

Who should not take this medicine?

Women who are pregnant, breastfeeding, or under 16 years old should not take norfloxacin. People with allergies to quinolone antibiotics should not take norfloxacin.

Side effects

May cause lightheadedness and increase the effect of caffeine.


Take with lots of water Do not take this drug while using antacids or vitamins that contain iron or zinc. If norfloxacin gives you an allergic reaction, stop using it.

Other medicines that may work
for bladder or kidney infections: ampicillin, amoxicillin, nitrofurantoin, co-trimoxazole, erythromycin
for gonorrhea: ciprofloxacin, ceftriaxone, cefixime, kanamycin
for diarrhea for people with AIDS: metronidazole, co-trimoxazole

nystatin (Dermodex, Mycostatin, Nilstat, Nystat)

Nystatin is an anti-fungus medicine used to treat yeast infections in the mouth (thrush), the vagina, or the skin.

In what forms does this medicine come?

Inserts: 100,000 U
Lozenges for the mouth: 100,000 U
Cream: 100,000 U per gram
Liquid: 100,000 U per ml

How much and when to take

For mouth or throat infections: Three or four times a day put 1 ml of liquid in mouth, swish around both sides of mouth for 1 minute and swallow. Do this for 5 days.
For skin infections: Keep area dry and apply ointment 3 times a day.
For vaginal infections: Put cream inside the vagina twice daily for 10-14 days; or put 100,000 U insert inside the vagina at bedtime for 10-14 days.
For vaginal discharge not caused by STDs: Put 100,000 U insert in the vagina at bedtime for 7 nights.


If nystatin causes you irritation, stop using it. Avoid having sex for 3-4 days so you do not pass the infection to your partner

Information you should know

Nystatin works only against candida yeast infections, while miconazole works against other fungal infections as well. Clotrimazole may be less costly and easier to use.

Other medicines that may work
for yeast infections: miconazole, ketoconazole, clotrimazole, vinegar or Gentian Violet

oxytocin (Oxtimon, Pitocin, Syntocinon, Uteracon)

Oxytocin is used to cause contractions of the womb and its blood vessels to control heavy bleeding after childbirth or if the placenta takes more than 1 hour to come out.

In what forms does this medicine come?

For injection: 10 Units in 1 ml

How much and when to take

Inject 10 Units into muscle after the baby is born. Repeat every 10 minutes if needed.

Side effects

Oxytocin can cause the womb to contract so strongly that it will not relax after and may even tear the womb. Also, oxytocin can cause high blood pressure.


Do not use this drug to cause an abortion, because it could kill the woman before making her abort. (See Chapter 15, “Abortion.”)

Using oxytocin to speed up labor or give strength to the mother in labor can be dangerous to both mother and child. Do not give it before the baby is out.

Other medicines that may work
for heavy bleeding after childbirth: ergometrine

paracetamol, acetaminophen (APAP, Panadol, Tempra, Tylenol, others)

Paracetamol and acetaminophen are 2 names for the same drug that is used to ease pain and lower fever. It is one of the safest pain killers. It does not cause stomach irritation and so it can be used instead of aspirin or ibuprofen by people with stomach ulcers. It can also be used by pregnant women, and is safe at lower doses for children.

In what forms does this medicine come?

Tablets: 100, 325 and 500 mg
Liquid: 120 or 160 mg per 5 ml
Inserts: 300 mg
Drops: 80 mg per 0.8 ml

How much and when to take

500 to 1000 mg by mouth 4 to 6 times a day.

Who should not take this medicine?

Do not take acetaminophen if you have liver or kidney damage.


If your fever or pain lasts for more than 3 days, get medical help. Acetaminophen can cause liver damage if you take too much or if taken with or after drinking alcohol.

Information you should know

Acetominophen does not cure the sickness, it only eases the pain or the fever. It is important to find the cause of the pain or fever and cure that

Signs taking too much

Nausea
Vomiting
Pain in the stomach

Other medicines that may work
for pain, fever, or swelling: aspirin, ibuprofen (do not take either if you are pregnant)
for severe pain: codeine

penicillin (Betapen VK, PenVee K, phenoxymethyl penicillin)

Penicillin is an antibiotic used to treat mouth, tooth, skin, womb and many other infections.

In what forms does this medicine come?

Tablets: 250, 500 mg
Liquid: 125 or 250 mg per 5 ml

How much and when to take

For womb infection after childbirth: 250 mg (which is the same as 400,000 U) by mouth 4 times a day for 7 days
For skin infection: 250 mg by mouth 4 times a day for 10 days.

Who should not take this medicine?

Do not take if you are allergic to any antibiotics of the penicillin family.

Side effects

Rash


Watch for allergic reactions and allergic shock

Other medicines that may work
for skin infection: ampicillin, amoxicillin, erythromycin
for infection after childbirth: procaine penicillin, amoxicillin, metronidazole

podophyllin (Condylox, Podocon-25)

Podophyllin is a liquid that can be put directly on genital warts to shrink them.

In what forms does this medicine come?

Liquid: 10% to 25%

How much and when to take

Apply liquid to warts with a cotton swab or clean cloth rolled to a fine point. Wash it off carefully with soap and water after 4 hours. Use once a week for 4 weeks.

Who should not take this medicine?

Do not use this if you are pregnant or breastfeeding.

Side effects

Podophyllin can be very irritating to skin.


Do not put on bleeding warts. If severe skin irritation occurs, do not use it again.

Information you should know

Podophyllin is very irritating to healthy skin. Protect the area around the wart with petroleum gel before using podophyllin.

Signs taking too much

Nausea, vomiting, belly pain, diarrhea. Too much might cause the skin to thin, break, and bleed.

Other medicines that may work
for genital warts: trichloracetic acid, bichloracetic acid

probenecid (Benemid, Probalan)
CAUTION

Used with some antibiotics of the penicillin family, probenecid increases the amount of penicillin in the blood and makes it last longer, increasing the effectiveness of treatment.

In what forms does this medicine come?

Tablets: 500 mg

How much and when to take

Take 500 mg to 1 gram by mouth each time you use an antibiotic from the penicillin family.

Who should not take this medicine?

Do not give probenecid to children under 2 years old.

Side effects

It sometimes causes headache, nausea, or vomiting.


Use with caution during pregnancy and breastfeeding, and if you have a stomach ulcer.

Signs taking too much

Vomiting

procaine penicillin (Benzylpenicillin Procaine, Bicillin C-R, Crysticillin, Duracillin AS, Penadur, Pfizepen AS, Wycillin)

Procaine penicillin is an antibiotic used to treat womb and other infections.

In what forms does this medicine come?

For injection: vials of 300,000, 400,00 or 600,000 Units
Powder for mixing for injection: 1 gram = 1 million Units

How much and when to take

For womb infection after childbirth: Inject 800,000 Units into muscle 2 times a day for 7 days
For fever during pregnancy: Inject 1.2 million Units every 12 hours while you take the woman for medical treatment.

Who should not take this medicine?

Do not use this drug if you are allergic to antibiotics of the penicillin family.


Use with caution if you have asthma. Do not use with tetracycline. Never inject this into the vein.

Information you should know

When taken with probenecid, the amount of penicillin in the blood increases and lasts longer making the treatment more effective.

Other medicines that may work
for fever during pregnancy: ampicillin
for womb infection after childbirth: amoxicillin, metronidazole, penicillin

progesterone, progestin

Progestin is a chemical found in birth control pills and injections that is similar to the hormone progesterone produced in women’s bodies. It is also used to treat irregular bleeding caused by changing levels of hormones. For information about birth control pills, injections, and emergency pills, see Chapter 13.

promethazine (Mepergan, Phenergan, Thaprozine)
CAUTION

Promethazine is an antihistamine that dries up mucus and makes you drowsy. It is used for allergic reactions, to sleep at night, and to help stop uncontrollable vomiting.

In what forms does this medicine come?

Tablets: 10, 12.5 or 25 mg
Syrup: 5 mg per 5 ml
Injection: ampules of 25 mg in 1 ml
Rectal inserts: 12.5, 25, or 50 mg

How much and when to take

For moderate allergic reaction: Give 25 mg by mouth or injection into muscle. Repeat in 8 hours or sooner if needed.
For allergic shock: Inject 50 mg into muscle. Repeat in 8 hours or sooner if needed.
For vomiting: Inject 25 to 50 mg every 6 hours as needed.
For sleep: Take 25 to 50 mg at bedtime.

Who should not take this medicine?

Pregnant and breastfeeding women should not use this drug for long-term treatment. Do not take this if you need to stay alert.

Side effects

Often causes dry mouth and blurry vision. In rare cases, may cause twitching movements of body, face or eyes.


Pregnant and breastfeeding women should take with caution. Do not drive or use heavy machines if you are taking this medicine.

Signs taking too much

Unconsciousness, seizures.

Other medicines that may work
for allergy or allergic reaction: diphenhydramine, hydroxyzine

pyrazinamide (Isopas, Pyzamed, PZA, Zinamide, Zinastat)

Pyrazinamide is used to treat tuberculosis (TB) (see Chapter 25).

In what forms does this medicine come?

Tablets: 500 mg

How much and when to take

The doses for tuberculosis medicines differ from region to region. See a health worker

Who should not take this medicine?

People with liver damage or hepatitis should not take this medicine.

Side effects

Yellow skin or eyes, fever, loss of appetite, tiredness, liver tenderness, gout or arthritis. If you have any of these problems, get medical help.


Pregnant and breastfeeding women should avoid this drug since its effects on the baby are not known. It is very important that you take the entire course of treatment for tuberculosis. If not, you might infect other people.

rifampicin (Resimin, rifampin, Rifastat)
CAUTION

Rifampicin is an antibiotic used to treat tuberculosis (TB) (see Chapter 25) and other kinds of infections, including leprosy (Hansen’s Disease).

In what forms does this medicine come?

Tablets: 150 or 300 mg
Liquid: 50 mg per 5 ml
Ampules for injection: 600 mg

How much and when to take

Doses for tuberculosis medicines differ from region to region. See a health worker

Who should not take this medicine?

People with liver damage or liver disease should not take this medicine.

Side effects

· Nausea, vomiting, loss of appetite, diarrhea, cramps
· Hot face, itching, rash
· Headaches, fever; chills, bone pain
· Yellow skin or eyes

Except for yellow skin or eyes, these side effects usually happen 2 to 3 hours after taking this medicine and can sometimes be avoided by taking the medicine with food.

Information you should know

May turn your urine, stool, tears, sweat, or spit a red-orange color It is very important that you take the entire course of treatment for tuberculosis so you do not infect others.

streptomycin

Streptomycin is an antibiotic of the aminoglycoside family used to treat tuberculosis (TB). It is given only by injection into muscle. It is used for TB in combination with other medicines. See Chapter 25.

In what forms does this medicine come?

Liquid for injection: 400 mg per ml

How much and when to take

The doses for tuberculosis medicines differ from region to region. See a health worker

Who should not take this medicine?

Pregnant women should not use streptomycin because it can cause deafness in the baby. People with allergies to antibiotics of the aminoglycoside family like gentamicin should not take this drug. People with kidney problems should use with caution.

Side effects

May damage hearing or balance, and can cause a rash.

Information you should know

Wear gloves if you touch this medicine often because it can cause a serious rash.

It is very important that you take the entire course of treatment for tuberculosis. If not, you might infect other people.

sulfisoxazole (Gantrisin)
CAUTION

Sulfisoxazole is an antibiotic of the sulfonamide family used to treat bladder infections.

In what forms does this medicine come?

Tablets: 500 mg
Liquid: 500 mg per 5 ml

How much and when to take

For bladder infections: Take 1,000 mg by mouth 4 times a day for 10 days.

Side effects

Nausea, vomiting, diarrhea, rashes, headaches.

Who should not take this medicine?

Pregnant women should not take this drug in the last 3 months. Do not give Sulfisoxazole to anyone who has allergies to sulfa antibiotics or kidney problems.

Information you should know

Drink at least 2 liters of water every day when you are taking Sulfisoxazole.

Other medicines that may work
for bladder infection: amoxicillin, ampicillin, co-trimoxazole

tetanus toxoid (Tetavax)

Tetanus toxoid is an immunization given to prevent a tetanus infection. It can be given during or after pregnancy, or after an abortion. If a woman gets 2 injections (or better still, 3 injections) when pregnant, it will also prevent this deadly infection in her newborn baby.

In what forms does this medicine come?

Liquid for injection: 4, 5, or 10 U per 0.5 ml

How much and when to take

To be safe from tetanus for your entire life, you must get 5 immunization injections, and then one injection every 10 years.

For each immunization: Give 1 injection of 0.5 ml into the muscle of the upper arm.

Side effects

Pain, redness, warmth, slight swelling.

Information you should know

Tetanus immunizations should be given to everyone, starting in childhood. Tetanus immunization is often given to children as part of a combined immunization called DPT and the three DPT immunizations are equal to the first 2 tetanus toxoid immunizations.

The schedule below gives the minimum time in between injections for adults.

First................................

As soon as possible

Second..........................

4 weeks after the first

Third..............................

6 months after the

Fourth............................

1 year after the third

Fifth................................

1 year after the

tetracycline (Achromycin, Sumycin, Terramycin, Theracine, Unimycin)

Tetracycline is an antibiotic of the tetracycline family. It is used to treat many infections including chlamydia, syphilis, pelvic inflammatory disease, kidney and bladder infections, respiratory infections, diarrhea, and other infections. Doxycycline works for all the same infections, costs less and is easier to take

In what forms does this medicine come?

Capsules: 100, 250, or 500 mg
Ointment: 1%

How much and when to take

For chlamydia: 500 mg 4 times a day for 7 days (also take other medicines).
For syphilis: 500 mg 4 times a day for 15 days (also take other medicines).
For PID: 500 mg 4 times a day for 10 days.
For baby eye-care: a bit of ointment in each eye at birth, one time only.

Who should not take this medicine?

Do not use tetracycline if you are pregnant or breastfeeding. Do not give to children under 9 years old except for baby eye care. Do not take if allergic to antibiotics of the tetracycline family.


Do not take within 1 hour of eating dairy products or antacids. Do not take if past expiration date.

Information you should know

Tetracycline does no good in fighting common colds or preventing STD infections.

Side effects

If you spend a lot of time in the sun it can cause skin rashes. It may cause diarrhea or upset stomach.

Other medicines that may work
for chlamydia: amoxicillin, erythromycin
for syphilis: benzathine penicillin
for PID: amoxicillin
for baby eye-care: erythromycin ointment

thiacetazone
CAUTION

This drug is combined with isoniazid to fight tuberculosis (TB). People who have the HIV virus must not take this drug! See Chapter 25.

In what forms does this medicine come?

Tablets: 50 mg with 100 mg of isoniazid

How much and when to take

The doses for tuberculosis medicines differ from region to region. See a health worker

Who should not take this medicine?

People who have the HIV virus must not take this drug because it can cause severe, even deadly allergic reactions, and can make their skin peel off. People with liver or kidney problems should also not use this drug.

Side effects

Rashes, vomiting, dizziness, loss of appetite. Sometimes causes uncontrollable laughing.

trichloroacetic acid, bichloroacetic acid

Either trichloroacetic acid or bichloroacetic acid can be used to treat genital warts.

In what forms does this medicine come?

Liquids in strengths between 10% and 35%

How much and when to take

Put only on wart once a week for 1 to 3 weeks as needed.

Side effects

Trichloroacetic acid will hurt or destroy normal skin if spilled.


Use very carefully. It can burn normal skin badly enough to cause a scar.

Information you should know

First protect the area around the wart with petroleum gel. Then put on trichloroacetic acid. It will hurt for 15 to 30 minutes. If it spills onto normal skin, wash it off with soap and water You can also put baby powder (talc) or baking soda on spills.

Other medicines that may work
for genital warts: podophyllin

ORAL CONTRACEPTIVES (BIRTH CONTROL PILLS)

Most birth control pills contain 2 hormones similar to those produced in a woman’s body to control her monthly bleeding. These hormones are called estrogen and progesterone (progestin).The pills come under many different brand names with different strengths and combinations for the 2 hormones. A few of the brand names are listed in the groups below.

Usually, brands that contain a smaller amount of both hormones are the safest and work best for most women. These “low dose” pills are found in Groups 1, 2, and 3.

Group 1 - Triphasic pills

These contain low amounts of both estrogen and progestin in a mix that changes throughout the month. Since the amounts change, it is important to take the pills in order.

Brand names:

Logynon
Tricyclen
Trinovum
Triphasil
Synophase
Trinordiol
Triquilar

Group 2 - Low dose pills

These contain low amounts of estrogen (35 mcg of the estrogen “ethinyl estradiol” or 50 mcg of the estrogen “mestranol”) and progestin in a mix that stays the same throughout the month.

Brand names:

Brevicon 1 + 35
Norinyl 1 + 35, 1 + 50
Neocon
Noriday 1 + 50
Ortho-Novum 1/35, 1/50
Ovysmen 1/35
Norimin
Perle

Group 3 - Low dose pills

These pills are high in progestin and low in estrogen (30 or 35 mcg of the estrogen “ethinyl estradiol”).

Brand names:

Lo-Ovral
Microvlar
Lo-Femenal
Microgynon 30
Nordette

To assure effectiveness and minimize spotting (small amounts of bleeding at other times than your normal monthly bleeding), take the pill at the same time each day, especially with pills that have low amounts of hormones. If spotting continues after 3 or 4 months, try one of the brands in Group 3. If there is still spotting after 3 months, try a brand from Group 4 (see the next page).

As a rule, women who take birth control pills have less heavy monthly bleeding. This may be a good thing, especially for women who are anemic. But if a woman misses her monthly bleeding for months or is disturbed by the very light monthly bleeding, she can change to a brand with more estrogen from Group 4.

For a woman who has very heavy monthly bleeding or whose breasts become painful before her monthly bleeding begins, a brand low in estrogen but high in progestin may be better. These pills are found in Group 3.

The higher progestin pills in Group 3 may sometimes cause or increase pimples or hair growth on your arms or upper lip. If this bothers you, you may want to change to a pill that is lower in progestin.

Women who continue to have spotting or miss their monthly bleeding when using a brand from Group 3, or who became pregnant before while using another type of pill, can change to a pill that has a little more estrogen. These “high dose” pills are found in Group 4.

Group 4 - High dose pills

These pills are higher in estrogen (50 mcg of the estrogen “ethinyl estradiol”) and most are also higher in progestin.

Brand names:

Eugynon
Femenal
Minovlar
Neogynon
Nordiol
Norlestrin
Ovcon 50
Ovral
Primovlar

If spotting continues even when taking pills from Group 4, the brands Ovulen and Demulen will often stop it. But these are very strong in estrogen and so are rarely recommended. They are sometimes useful for women with severe acne.

Women who are disturbed by morning sickness or other side effects after 2 or 3 months of taking birth control pills, and women who have a higher risk for blood clots, should try a Triphasic birth control pill, low in both estrogen and progestin, from Group I,

Women who are breastfeeding, or who should not use regular pills because of headaches or mild high blood pressure, may want to use a pill with only progestin. These pills in Group 5 are also called “mini-pills.”

Group 5 - Progestin only pills

These pills, also known as “mini-pills,” contain only progestin.

Brand names:

Femulen
Mocrolut
Micronor
Mocronovum
Nor-Q D
Ovrette

These pills should be taken at the same time every day, even during the monthly bleeding. Menstrual bleeding is often irregular. There is also an increased chance of pregnancy if even a single pill is forgotten.

EMERGENCY FAMILY PLANNING (EMERGENCY PILLS)

Emergency pills are special doses of certain birth control pills for a woman who has had unprotected sex and wants to avoid pregnancy. Using birth control pills this way is safe, even for many women who should not use pills all the time.

Dose:

The sooner you take the pills after unprotected sex, the more likely you will not get pregnant. For emergency family planning, carefully follow these instructions:

Take 2 “high dose” birth control pills from GROUP 4 within 3 days of unprotected sex, followed by 2 more GROUP 4 pills 12 hours later.

or

Take 4 “low dose” birth control pills from GROUP 2 or GROUP 3 within 3 days of unprotected sex, followed by 4 more GROUP 2 or GROUP 3 pills 12 hours later.

or

Take 20 progestin only pills or “mini-pills” from GROUP 5 within 2 days of unprotected sex, followed by 20 more GROUP 5 pills 12 hours later.

New birth control pills have been developed just for emergency family planning and may be available where you live. Some brand names include: PC4, Postinor-2, and Tetragynon. With Postinor-2, for example, which contains only progestin, you take 1 pill within 2 days of unprotected sex, followed by 1 more pill 12 hours later.

Side effects:

More than half of all women who use emergency pills will have nausea and even vomiting. If vomiting occurs within 3 hours after taking the pills, another dose must be taken. If vomiting is a problem for you, you can take 25 mg of promethazine by mouth 2 times a day (see Green Pages). Or, instead of taking the emergency pills by mouth you can place them high in the vagina. This method works just as well to prevent pregnancy. It does not reduce the side effects of nausea or vomiting, but it does prevent you from vomiting the pills.

Progestin only pills cause less nausea and vomiting, but must be taken within 2 days of unprotected sex.

INJECTABLE CONTRACEPTIVES

With this type of family planning, an injection of hormones is given to a woman every 1, 2 or 3 months, depending on the brand. It is very effective.

Two brand names, Depo Provera (DMPA) and Noristerat (Net-En) are progestin only injections. Like the mini-pill and implants, these injections may be a good choice for women who cannot take the regular pill because of medical risks or side effects. The dose for Depo Provera (DMPA) is 150 mg once every 3 months, and the dose for Noristerat (Net-En) is 200 mg once every 2 months.

Sometimes these injections cause sore breasts or nausea, or make women feel tired. This usually goes away after two months. Some women have headaches or feel nervous, depressed or dizzy. Any side effects may last until the injection wears off. While some women can get pregnant 3 or 4 months after their last injection, other women have to wait up to 18 months to get pregnant again.

Do not use injectable contraceptives if you think you might be pregnant, if you have vaginal bleeding and do not know why, if you have liver problems, breast cancer, or blood clots in the legs, lungs, or eyes.

Two other brand names, Cyclofem and Mesigyna, are injections of both progestin and estrogen. These injections do not cause the problems with irregular bleeding that progestin only injections cause, but women who cannot take regular birth control pills because of medical risks or side effects should not use them. The dose for Cyclofem is 25 mg DMPA with 5 mg estradiol cypionate once every month, and the dose for Mesigyna is 50 mg Net-En with 5 mg estradiol valerate once every month.

With all injectable contraceptives, monthly bleeding may be irregular and often becomes very light or stops after the first year. This is not serious, but it worries some women. Older women may mistake this for menopause, stop getting injections and then become pregnant. If very heavy bleeding occurs, seek medical advice.

CONTRACEPTIVE IMPLANT (NORPLANT)

Implants are a very convenient and effective form of birth control. Because they contain only progestin, they can be used by women who should not use regular pills because of headaches or mild high blood pressure.

Six small rubber tubes are put under the skin in a woman’s upper arm by a specially trained health worker. They prevent pregnancy for about 5 years, but can be removed sooner if the woman wants to become pregnant. The tubes should be inserted 5-7 days after the woman starts her monthly bleeding.

SPERMICIDES

Spermicides are foams, jellies, and tablets which are placed in the vagina to kill sperm and prevent pregnancy. Some spermicides contain nonoxynol-9, which may also prevent some STDs, but not all brands have this. Remember, no spermicide can prevent the passing of the HIV virus which can give you AIDS. Use a condom.

Contraceptive foam (Delfen, Emko, Koromex)

Contraceptive foam is put in the vagina with a special applicator. The foam will kill sperm for 1 to 2 hours. You must put in another applicator full of foam every time you have sex. Foam prevents pregnancy better than inserts, jellies, or creams, and is very effective when used together with a condom.

Contraceptive inserts (Encare, Koromex, Neo Sampoon)

This is a tablet containing spermicide that a woman puts deep in her vagina near her cervix. The insert should be put in 10 to 15 minutes before having sex, and works for up to one hour. It is a fairly effective method of birth control alone, and very effective if used with a condom. Use one insert each time you have sex.

Contraceptive jellies and creams (Conceptrol, Koromex, Ortho Gynol)

Jellies and creams work best with a diaphragm. They do not cover the vagina as well as foam or inserts. They are put in the vagina with an applicator and kill sperm for at least 1 hour. Used with a diaphragm, they work for 6 to 8 hours. For even better protection against pregnancy and to prevent STDs or HIV infection, also use a condom.

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