The Hays Daily News from Hays, Kansas on September 22, 2002 · Page 61
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The Hays Daily News from Hays, Kansas · Page 61

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Wit0Wisdom FR Ead wor o AME GAMES BY TERRY STICKELS i puzzle stands for a well-known d or phrase. Answers below. SHOHJLDER (g) S.F. TTTT RRRRRRRRR FRAME GAMES BY IHfflV SIKKELS" DONT KNOW MUCH ABOUT* FAMOUS CENTENARIANS A hundred years may seem like a long time, but more of us are living to that ripe old age, a milestone marked this Sunday by National Centenarians Day. In 1983, when v Willard Scott first began announcing centenarians' birthdays on NBC's Today show, he !•••••••• received a trickle of letters; now he's alerted to hundreds of 100+ birthdays every week. The Census Bureau says 76,000 Americans are 100 or older; in 2010, the number is projected to be 129,000.Try a quick quiz by Don't Know Much About History author Kenneth C. Davis: Can you identify these celebrated centenarians (none, alas, still living)? Answers below. 1. What sisters of a certain age (above) wrote a best seller and were the subject of a Broadway play in the '90s? 2. What immigrant, who died at age 101, wrote dozens of the best-loved songs of the 20th century? 3. What cigar-chomping COmiCsaid, "I would go out with women my age, but there are no women my age"? 4. What folk artist illustrated Twos the the Night Before Christmas at age 100? •SQ/ Jaq uj 6u|}UjBd dn >|OO} isjij OUM '(L 961-0981) sasoiAi BtupueJO •* '(9661-9681) swng 96jo39'e '(6861-8881) U!|J3fl 6u|AJ| 'Z •Aosino 6uiADH |B3|u,dej6o|qo}ne aqi ajoiM oq/v\'(S66t-l68L) 3|S»a P"B (6661-6881) ' SIBMSNVZinD '£ 1l e * NOXIUHI (esomeprazole magnesium) 20-MG, 40-MG Delayed-Release Capsules BRIEF SUMMARY Before prescribing NEXIUM. please see full Prescribing Information. INDICATIONS AND USAGE NEXIUM Is Indicated for the short-term treatment H to 6 weeks) in the healing and symptomatic resolution ol diagnostic* confirmed erosive esophagus. CONTRAINDICATIONS NEXIUM Is contraindlcated In patients with known hypersensiMy to any component ol the formulation or to substituted benzimidazoles. PRECAUTIONS Symptomatic response to therapy win NEXIUM does not preclude the presence of gastric malignancy. Atrophic gastritis has been noted occasionally In gastric corpus biopsies from patients treated long-term with omeprazole, of which NEXIUM is an enantlomer. Information for Patients: NEXIUM Delayed-Release Capsules should be taken at least one hour before meals. For patients who have difficulty swallowing capsules, one tablespoon ol applesauce can be added to an empty bowl and the capsule opened, and the pellets carefully emptied onto the applesauce. The pellets should be mixed with the applesauce and then swallowed immediately. The applesauce used should not be hot and should be soft enough to be swallowed without chewing. The pellets should not be chewed or crushed. The pellet/applesauce mixture should not be stored for future use. Antacids may be used while taking NEXIUM. DRUG INTERACTIONS Esomeprazole Is extensively metabolized In the liver by CYP2C19 and CYP3A4. In vitro and In vivo studies have shown that esomeprazole Is not likely to Inhibit CYPs 1A2,2A6,2C9,2D6,2E1 and 3A4. No clinically relevant Interactions with drugs metabolized by these CYP enzymes would be expected. Drug interaction studies have shown that esomeprazote does not have any clinically significant Interactions with phenytoln. warfarin, qulnldine, clarilhromycln or amoxlclllin. Esomeprazole may potentially Interfere with CYP2C19, the major esomeprazole-metabolizing enzyme. Coadministration of esomeprazole 30 mg and diazepam, a CYP2CI9 substrate, resulted in a 45% decrease in clearance of dlazepam. Increased plasma levels of dlazepam were observed 12 hours after dosing and onwards. However, at that time, the plasma levels of diazepam were below the therapeutic interval, and thus this interaction Is unlikely to be of clinical relevance. Coadmlnlstrab'on ol oral contraceptives, dlazepam, phenytoin, or quinldine did not seem to change the pharmaco- kinetic profile of esomeprazole. Esomeprazole Inhibits gastric add secretion, therefore, it is theoretically possible that esomeprazole and omeprazole may Interfere with absorption of drugs where gastric pH is an important determinant ol their bloavaiiability (eg, keto- conazole, amplcillln esters, digoxln, and Iron salts). Carcinogmesls, Mutagenesis, Impairment of Fertility; The carcinogenic potential ol esomeprazole was assessed using omeprazole studies. In two 24-month carcinogenlcity studies in rats, omeprazole al daily doses of 1.7,3.4,13.6,44.0 and 140.8 mg/kg/day (about 0.7 to 57 times the human dose of 20 mo/day expressed on a body surface area basis) produced gastric ECL cell carcinolds In a dose-related manner in both male and female rats; the incidence of this effect was markedly higher In female rats, which had higher blood levels of omeprazole. Gastric carcinolds seldom occur In the untreated rat. In addition, ECL cell hyperplasla was present in all treated groups ol bom sexes. In one of these studies, female rats were treated with 13.8 mg omeprazole/kg/day (about 5.6 limes (tie human dose on a body surface area basis) for 1 year, then followed for an additional year without the drug. No carclnolds were seen In these rats. An Increased Incidence of treatment-related ECL cell hyperplasla was observed al the end of 1 year (94% treated vs 10% controls). By the second year the difference between Healed and control rats was much smaller (46% vs 26%) but still showed more hyperplasia in the treated group. Gastric adenocarclnoma was seen In one rat (2%). No similar tumor was seen In male or female rats treated for 2 years. For this strain ol rat no similar tumor has heen noted historically, but a finding involving only ona tumor Is difficult to interpret. A 78-week mouse carcinogenlcity study of omeprazole did not show Increased tumor occurrence, but the study was not conclusive. Esomeprazole was negative in the Ames mutation test. In the In vivo rat bone marrow cell chromosome aberration test, and the In vivo mouse mlcronucleus test Esomeprazole, however, was positive in the In vitro human lymphocyte chromosome aberration test. Omeprazole was posithre In the in vitro human lymphocyte chromosome aberration test, the In vivo mouse bone marrow cell chromosome aberration test, and the in vivo mouse mlcronucleus test The potential effects of esomeprazole on fertility and reproductive performance were assessed using omeprazole studies. Omeprazole at oral doses up to 138 mg/kg/day in rats (about 56 times the human dose on a body surface area basis) was found to have no effect on reproductive performance of parental animals. Pregnancy: Tinlogenlc Ctlects. Pnrjiamy Category B • Teratology studies have been performed in rals at oral doses up to 260 mg/kg/day (about 57 times the human dose on a body surface area basis) and In rabbits at oral doses up to 86 mg/kg/day (about 35 times the human dose on a body surface area basis) and have revealed no evidence of impaired fertility or harm to the fetus due to esomeprazole. There are, however, no adequate and well-controlled studies In pregnant women. Because animal reproduction studies are not always predictive ol human response, this drug should be used during pregnancy only If clearly needed. Teratology studies conducted with omeprazole In rats at oral doses up to 138 mg/kg/day (about 56 times the human dose on a body surface area basis) and In rabbits at doses up to 69 mg/kg/day (about 56 times the human dose on a body surface area basis) did not disclose any evidence for a teratogenic potential of omeprazole. In rabbits, omeprazole In a dose range of 6.9 to 69.1 mg/kg/day (about 5.5 to 56 times the human dose on a body surface area basis) produced dose-related Increases In embryo-lethality, felal resorptions. and pregnancy disruptions. In rats, dose-related embryo/fetal toxicity and postnatal developmental toxicity were observed in oflspring resulting from parents treated with omeprazole at 13.6 to 138.0 mg/kg/day (about 5.6 to 56 times the human doses on a body surface area basis). There are no adequate and well-controlled studies in pregnant women. Sporadic reports have been received of congenital abnormalities occurring In infants born to women who have received omeprazole during pregnancy. Nursing Mothers: The excretion of esomeprazole in milk has not been studied. However, omeprazole concentrations have been measured in breast milk of a woman following oral administration of 20 mg. Because esomeprazole and omeprazole are likely to be excreted In human milk, and because ol the potential for serious adverse reactions in nursing Infants from esomeprazole and because ol the potential for tumorigenlcity shown for omeprazole In rat carcinogenlcity studies, a decision should be made to discontinue the drug, taking Into account the importance of the drug to the mother. Pedialric Use: Safety and effectiveness in pediatric patients have not been established. Geriatric Use: Of the total number ol patients who received NEXIUM in clinical trials, 776 were 65 to 74 years ol age and 124 patients were s 75 years of age. No overall differences in safety and efficacy were observed between the elderly and younger Individuals, and other reported clinical experience has not Identified differences In responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. ADVERSE REACTIONS The safety of NEXIUM was evaluated in over 10,000 patients (aged 18-84 years) in clinical trials worldwide including over 7,400 patients in the United States and over 2,600 patients in Europe and Canada. Over 2,900 patients were treated in long-term studies for up to 6-12 months. In general, NEXIUM was well tolerated In both short- and long-term clinical trials. The safety in the treatment of healing of erosive esophagitis was assessed in four randomized comparative clinical trials, which Included 1,240 patients on NEXIUM 20 mg, 2 434 patents on NEXIUM 40 mg, and 3,008 patients on omeprazole 20 mg dally. The most frequently occurring adverse events (21 %) in all three groups was headache (5.5,5.0, and 3.8, respectively) and diarrhea (no difference among the three groups). Nausea, flatulence, abdominal pain, constipation, and dry mouth occurred at similar rates among patients taking NEXIUM or omeprazole. Additional adverse events that were reported as possibly or probably related to NEXIUM with an Incidence < 1% are listed below by body system: Body it i Wnili: abdomen enlarged, allergic reaction, asthenia, back pain, chest pain, chest pain substemal, facial edema, peripheral edema hoi flushes, fatigue, fever, flu-like disorder, generalized edema, leg edema, malaise, pain, rigors; Cintlmtuilii: flushing, hypertension, tachycardia; BOmlu: goiter, Gutnlntutlml: bowel Irregularity, constipation aggravated, dyspepsia, dysphagla, dysplasla Gl, epigastric pain, eructation, esophageal disorder, frequent stools, gastroenteritis, Gl hemorrhage, Gl symptoms NOS, hiccup, melena, mouth disorder, pharynx disorder, rectal disorder, serum gastrtn Increased, tongue disorder, tongue edema, uteeratfye stomatitis vomiting; Hnrlni: earache, tinnitus; Hmatoloile: anemia, anemia hypochromic, cervical lympboadenopathy, eplstaxis, leukocytosis, leukopenia, thrombocytopenia; Hipitlc: bilirublnemia, hepatic function abnormal, SGOT increased, SGPT Increased; Mjttio/MWuWtfMi/: gfycosurla, hyperurlcemla, hyponatremla. Increased alkaline phosphatase, thirst, vitamin 812 deficiency, weight Increase, weight decrease; Mioculoiliililil: arthralgia. arthritis aggravated, arthropathy, cramps, fibromyalgia syndrome, hernia, polymyalgla rheumatlca; Himin Srstim/PsyOilitrlK anorexia, apathy, appetite increased, confusion, depression aggravated, dizziness, hypertonia, nervousness, hypoesthesia, Impotence, Insomnia, migraine, migraine aggravated, paresthesla, sleep disorder, somnolence, tremor, vertigo, visual field defect; Rif attain: dysmenonhea, menstrual disorder, vaglnltis; Rurlnl/w asthma aggravated, coughing, dyspnea, larynx edema, pharyngitis, rhinitis, sinusitis; SUn mi tppimtiin: acne, angioedema, dermatitis pruritus, pruritus ani, rash, rash erythematous, rash maculo-papular, skin Inflammation, sweating Increased, urticaria; Snnlil Sinus: oftis media, parosmia, taste loss, taste perversion; Ungmllil: abnormal urine, albumlnuria, cystitis, dysuria, fungal infection, hematuria, micturition frequency, moniliasis, genital monlllasls, polyuria; Iftait- conjunct!*, vision abnormal. Endoscoplc Wings that were reported as adverse events include: duodenitis, esophagrSs, esophageal stricture, esophageal ulcera- lion esophageal varices, gastric ulcer, gastritis, hernia, benign polyps or nodules, Barrett's esophagus, and mucosal discoloration. Other adverse events not observed with NEXIUM, but occurring with omeprazole can be found in the omeprazole package Insert OVERDOSAGE A single oral dose of esomeprazole at 510 nig/Kg (about 103 times the human dose on a body surface area basis), was lethal to rats. The ma|or signs of acute toxicity were reduced motor activity, changes in respiratory frequency, tremor, ataxla, and intermittent clonlc convulsions. There have been no reports of overdose with esomeprazole. Reports have been received of overdosage with omeprazole in humans. Doses ranged up to 2,400 mg (120 times the usual recommended clinical dose). Manifestations were variable, but Included confusion, drowsiness, blurred vision, tachycardia, nausea, diaphoresis, flushing, headache, dry mouth, and other adverse reactions similar to those seen In normal clinical experience (see omeprazole package Insert-ADVERSE REACTIONS). No specific antidote for esomsprazole is known. Since esomeprazole Is extensively protein bound. It Is not expected to be removed by dialysis In the event of ovetdosage. treatment should be symptomatic and supportive. As with the management of any overdose, the • possibility of multiple drug Ingestton should be considered. For current Information on treatment of any drug overdose, a certified Regional Poison Control Center should be contacted. Telephone numbers are listed In the Physicians' Desk Reference (PDR) or local telephone book. (omeprazole) 20-MG Delayed-Release Capsules BRIEF SUMMARY Before presenting PRILOSEC, please see full Prescribing Information. INDICATIONS AND USAGE Srostti Esop/iaoft's: PRILOSEC Oelayed-Release Capsules are indicated for the short-term treatment (4-8 weeks) In the healing ol erosive esophagitis, which has been diagnosed by endoscopy. CONTRAINDICATIONS Omeprazole PRILOSEC Delayed-Release Capsules are contraindicated in patients with known hypersenslthity to any component ol the formulation. PRECAUTIONS Symptomatic response to therapy with omeprazole does not preclude the presence of gastric malignancy. Atrophic gastritis has been noted occasionally In gastric cops biopsies from patents treated long-term with omeprazole. Information tor Patients: PRILOSEC Oelayed-Release Capsules should be taken before eating and should not be opened, chewed or crushed, and should be swallowed whole. For patients who have difficulty swallowing capsules, the contents of a PRILOSEC Delayed-Release Capsule can be added to applesauce. One tablespoon ol applesauce should be added to an empty bowl and the capsule should be opened. All ol the pellets Inside the capsule should be carefully emptied on the applesauce. The pellets should be mixed with the applesauce and then swallowed immediately witii a glass ol cool water to ensure complete swallowing of the pellets. The applesauce used should not be hot and should be soft enough to be swallowed without chewing. The pellets should not be chewed or crushed. The pellets/applesauce mixture should not be stored for future use. DRUG INTERACTIONS Otter Omeprazole can prolong the elimination ol dlazepam, warfarin and phenytoln. drugs that are metabolized by oxidation In the liver. Although In normal subjects no interaction with theophylllne or propranolol was lound, there have been clinical reports of Interaction vrtlh other drugs melabolSed via the cytochrome P-450 system (eg, cyclosportne, dlsul- (iram. and benzodiazeplnes). Patients should be monitored to determine If It Is necessary to adjust the dosage of these drugs when taken concomitanlfy with PRILOSEC. Omeprazole Inhibits gastric acid secretion, therefore, it Is theoretically possible that omeprazole may interfere with absorption of drugs where gastric pH Is an Important determinant of their bloavaiiability (eg, ketoconazole. amplcillln esters, dlgoxln, and iron salts). In clinical trials, antacids were used concomitantly with the administration of PRILOSEC. Carcinogeneili, Mutogenew, Impairment of Fertility: In two 24-month carcinogenlcity studies in rats, omeprazole at daily doses of. 1.7,3.4,13.8,44.0 and 140.8 mg/kgfday (approximately 4 to 352 times the human dose, based on a patient weight of 50 kg and a human dose of 20 mg) produced gastric ECL cell carclnolds In a dose-relaled manner in both male and female rals; the Incidence of this effect was markedly higher In female rats, which had higher blood levels of omeprazole. Gastric carclnoids seldom occur In the untreated rat. In addition, ECL cell hyperplasla was present In all treated groups ol both sexes. In one of these studies, female rats were treated with 13.8 mg omeprazole/kg/day (approximately 35 times Ihe human dose) for one year, then followed for an additional year wtlhout the drug. No carclnolds were seen In these rats. An Increased Incidence of treatment-related ECL cell hyperplasla was observed at the end ol one year (94ft treated vs 10% controls). By the second year the difference between treated and control rals was much smaller (46% vs 26%) but still showed more hyperplasla In the treated group. An unusual primary malignant tumor In the stomach was seen In one rat (2%). No similar tumor was seen in male or female rats treated for two years. For this strain of rat no similar tumor has been noted historically, but a finding involving only one tumor is difficult to interpret A 78-week mouse carcinogenlcity study ol omeprazole did not show increased, tumor occurrence, but the study was not conclusive. Omeprazole was not mutagenlc In an In vitro Ames Safaon* fypWmuram assay; an In vHro mouse fymphoma cell assay and an to vivo rat liver DNA damage assay. A mouse mlcronucleus test al 625 and 6250 times the , human dose gave a borderline resulL as did an In vivo bone marrow chromosome aberration test. A second mouse mictonucleus study at 2000 times the human dose, hut with ditlerent (suboptimal) sampling times, was negative. In a rat fertility and general reproductive ' performance test omeprazole In a dose range ol 13.8 to 138.0 mg/kg/day (approximately 35 to 345 times the human dose) was not toxic or deleterious to the reproductive performance ol parental animals. Pregnancy: Category C • Teratology studies conducted in pregnant rats at doses up to 138 mg/kg/day (approximately 345 times the human dose) and In pregnant rabbits at doses up to 69 mgikg/dey (approximately 172 times the human dose) did not disclose any evidence for a teratogenic potential of omeprazole. In rabbits, omepra- zole in a dose range ol 6.9 to 69.1 mg/kg/day (approximately 17 to 172 times the human dose) produced dose-related Increases In embryo-lethality, fetal resorptions and pregnancy disruptions. In rats, dose-related embryo/fetal toxicity and postnatal developmental toxicity were observed In offspring resulting from parents treated with omeprazole 13.B to 136.0 mg/kg/day (approximately 35 to 345 times the human dose). There are no adequate or well-controlled studies In pregnant women. Sporadic reports have been received of congenital abnormalities occurring in Infants bom to women who have received omeprazole during pregnancy. Omeprazole should be used during pregnancy only If the potential benefit justifies the potential risk to the fetus. Nunlng Mothers: It Is not known whether omeprazole is excreted In human milk. In rats, omeprazole administration during late gestation and lactation at doses of 13.8 to 138 mg/kg/day (35 to 345 times the human dose) resulted in decreased weight gain in pups. Because many drugs are excreted In human milk, because of the potential lor serious adverse reactions in nursing infants from omeprazole, and because of the potential for tumori- genioty shown lor omeprazole In rat carcinogenlcity studies, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the Importance ol the drug to the mother. Pediatric Use: Safety and effectiveness In pediatric patients have not been established. Geriotric Use: No overall differences In safety and efficacy were observed between Ihe elderly and younger individuals, and other reported clinical experience has not Identified differences In responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. ADVERSE REACTIONS In the U.S. clinical trial population ol 465 patients (Including duodenal ulcer, Zollinger-Ellison syndrome and resistant ulcer patients), the following adverse experiences were reported to occur in 1% or more of patients on therapy with PRILOSEC. Numbers in parentheses indicate percentages of the adverse experiences considered by Investigators as possibly, probably or definitely related to the drug: Omeprazole (n=465) Placebo |n.64) Ranitidlne (n.195) Headache Diarrhea Abdominal Pain Nausea URI Dizziness Vomiting Rash Constipation Cough Asthenia ' Back Pain 6.9(2.4) 3.0(1.9) 2.4(0.4) 2.2(0.9) 1.9 1.5(0.6) 1.5(0.4) 1.5(1.1) • 1.1 (0.9) 1.1 1.1 (0.2) 1.1 6.3 3.1 (1.6) 3.1 3.1 1.6 0.0 4.7 0.0 0.0 0.0 1.6(1.6) 0.0 7.7(2.6) 2.1 (0.5) 2.1 4.1 (0.5) 2.6 2.6(1.0) 1.5(0.5) 0.0 0.0 1.5 1.5(1.0) 0.5 z J3p|noi|sp|03'i USA WEEKEND-Sept. 20-22,2002 19 The following adverse reactions which occurred In 1% or more of omeprazole-trealed patients have been reported In International double- blind and open-label, clinical trials In which 2,631 patients and subjects received omeprazole and 120 patients took a placebo. A causal relationship was not assessed. The percentages are given omeprazole then placebo, respectively. Body as i WMi. siti i/nsp«/rM Abdominal Pain 5.2% and 3.3%; Asthenia 1.3% and 0,8%. 0/jeslw System:Constipation 1.5 and.0.8; Diarrhea 3.7 and 2.5; Flatulence 2.7 and 5.8; Nausea 4.0 and 6.7; Vomirjng 3.2 and 10.0; Acid regurgilation 1.9 and 3.3: Herms SystiMPsychiitiic: Headache 2.9 and 2.5. Additional adverse experiences occurring in < 1 % of patients or subjects In domestic and/or International trials, or occurring since the drug was marketed, are shown below within each body system. In many Instances, the relationship to PRIIOSEC was unclear. Body As a mole: Allergic reactions, including, rarely, anaphylaxis (see also SOn below), lever, pain, fatigue, malaise, abdominal swelling Cirtiovascular Chest pain or angina, tachycardia, bradycardia, palpitation, elevated blood pressure, peripheral edema. SasW/ilestat Pancreatitis (some fatal), anorexia, Irritable colon, flatulence, fecal discoloration, esophageal candldlasls, mucosal atrophy of the tongue, dry mouth. During treatment with omeprazole, gastric fundic gland polyps have been noted rarely. These polyps are benign and appear to be reversible when treatment Is discontinued. Gastreduodenal carclnolds have been reported in patients with ZE syndrome on long-term treatment with PRILOSEC. This finding Is believed to be a manifestation of the underlying condition, which Is known to be associated with such tumors, /ftpalfc Mild and, rarely, marked elevations ol liver function tests (ALT (SGPT), AST (SGOT), rglutamyl transpeptldase, alkaline phosphatase, and bilirubin (jaundice)]. In rare Instances, overt liver disease has occurred, Including hepatocellular, cholestalic, or . mixed hepatitis, liver necrosis (some fatal), hepaBc failure (some fatal), and hepafcencephalopathy.MslaioMuW'iirijtHyponatremla, hypogrycemia. weight gain. Musoilostiletal: Muscle cramps, myalgia, muscle weakness, |oint pain, leg pain. Nervous System/ Psychiatric: Psychic disturbances Including depression, aggression, hallucinations, confusion, Insomnia, nervousness, tremors, apathy, somnolence, anxiety, dream abnormalities; vertigo; paresthesla; hemifaclal dyseslhesia. Resplntory: Eplslaxls, pharyngeal pain. S<k Rash and, rarely, cases of severe generalized skin reactions Including toxic epidermal necrolysls (TEN: some fatal), Stevens-Johnson syndrome, and erythema multiforme (some severe); purpnra and/or petechlae (some with rechallenge); skin inflammaf on, urticaria, angioedema pruritus alopecia, dryskin,hyperhldrosis.Specla/Senses:Tlnnitus, taste perversion. 1/rojmiW: Interstitial nephritis (some with positive rechallenge), urinary tract Infection, microscopic pyurla, urinary frequency, elevated serum creab'nlne, protalnutia, hema- turia, glycosuria, testicular pain, gynecomastia. Htmatotojfc Rare Instances of pancytopenla, agranulocytosls (some fatal), thromoocy- lopenia, neutropenia, anemia, leucocytes, and hemolylic anemia have been reported. OVERDOSAGE Reports have been received of overdosage with omeprazole in humans. Doses ranged up to 2400 mg (120 times the usual recommended clinical dose). • Manifestations were variable, but included confusion, drowsiness, blurred vision, tachycardia, nausea, vomiting, diaphoresis, flushing, headache dry mouth, and other adverse reactions similar to those seen In normal clinical experience. (See ADVERSE REACTIONS.) Symptoms were transient, and no serious clinical outcome has been reported when PRILOSEC was taken alone. No specific antidote for omeprazole overdosage Is known. Omeprazole is extensively protein bound and Is, therefore, not readily dlalyzable. In the event of over- dosage, treatment should be symptomatic and supportive. All trademarks are the property of the AstraZeneca group eAstraZeneca2002 206646 1/02 AstraZeneca NOTE: This lumrniry ptoridu Important inlormillon about NEXIUM ind PRILOSEC. II you would liki mori inlormillon, iik your doctor or phirmiciil to lit you teid the prolmlonil lib.ling ind thin dltcun It with Ihim.

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