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Clotrimazole balanitis dosage and a possible risk for adverse effects of this drug (see DOSAGE AND ADMINISTRATION). Sudden Death and Suicides In a 4-year placebo-controlled trial of patients with uncomplicated acne, a single dose of topical tetracycline (50 mg/kg) was associated with an estimated 2% excess risk of suicide compared with placebo (RR, 1.2; 95% CI, 0.9-1.6; P<.001). The risk was Indomethacin 25 mg price significantly higher (3.0% [95% CI, 1.5%-6.2%]) in patients with acne who had not been treated with tetracycline before. Sudden Death and Suicides in Patients with a History of Suicide Attempts Suicide risk has been reported in several countries with low tetracycline exposure, such as the Netherlands, England, and United States. It has been estimated that for a population of patients with moderate acne, up to 2% of patients may die by suicide within a few years. In a retrospective study of patients who had attempted suicide, the risk of death by suicide was higher in patients treated with tetracycline the first year of therapy compared with patients treated tetracycline between 3 and 6 years of therapy. Fatalities occurred mostly in patients with severe acne, often evidence of drug toxicity (tetracycline overdose).[Ref] The incidence of TTP in patients with moderate-to-severe acne is approximately 5%, and the most frequent causes of death are drug toxicity and suicide. The rate of TTP in United States is 3%. a retrospective study, approximately 1% of patients experienced a sudden death and about 1% of patients experienced a sudden death due to suicide.[Ref] Tolerance and Addiction In a 12-week study of 1,300 patients at four dermatology centers in the United States, no statistically significant difference was found in the incidence of drug Can you buy imitrex online tolerance and addiction. Other Serious Adverse Effects Anaphylactic reactions, including shock, are rare. Severe dermatological reactions, including anaphylaxis, have occurred in a small number of patients. Common Adverse Reactions In a clinical trial of 500 patients with moderate-to-severe acne, the most frequent adverse reactions in response to tetracycline treatment were the following: Anesthesia, including hyperalgesia Anxiety Agitation Blurred vision Dizziness Dry eyes Dry mouth Eye pain Nausea/vomiting Respiratory problems Vomiting Diarrhea Weight increase Hepatic dysfunction Injection site reactions (e.g., erythema multiforme and Stevens-Johnson syndrome) The most frequent adverse reactions of tetracycline were nausea (8% patients), vomiting (6%), and diarrhea (6%). Drug Interactions Tetracycline is contraindicated with corticosteroids, steroids, other antiemetics, beta-blockers, and antipsychotics. Tetracycline may significantly increase the risk of hepatic enzyme elevation that may be associated with the increased incidence of hepatic encephalopathy and failure, especially in patients with chronic alcoholism or other coexisting hepatic disease. Tetracycline may also increase the risk of severe hyperkalemia and renal failure, there have been reports of rhabdomyolysis and acute renal failure. Other serious drug interactions have been identified during clinical studies of tetracycline. These may include thioridazine (for hypotension), carbamazepine hyperkalemia), and quinidine (for gastrointestinal renal depression). Tetracycline may also inhibit the action of certain oral anticoagulants, including warfarin, warfarin-containing conjunctivitis, and oral contraceptives. Tetracycline treatment should not be discontinued in patients taking warfarin when tetracycline is added to anticoagulant therapy because warfarin is also contraindicated with tetracycline treatment. Tetracycline may increase the risk of bleeding due to increased time, risk associated with decreased serum concentration of heparin with the concomitant use of tetracycline, decreased serum concentration heparin and of blood coagulation factors (e.g., heparin, VII, VIII, and IX) increased risk of bleeding due to decreased clotting time, increased bleeding risk associated with decreased platelet aggregation, and increased risk.

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