Hesperian.org

How to use the Green Pages 485
the Green PaGes
The Green Pages gives information about the medicines mentioned in this book. For general information about medicines, and before giving a medicine, be sure to read the chapter called "Use of Medicines in Women's Health," beginning on page 468. For specific information about each medicine, 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: 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:
problem index on page 486. 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. medicine index on page 487. 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.
The information about each medicine appears in a box like this: These pictures appear with the word CAUTION
when pregnant or breastfeeding women need to take special care. If the medicine should not be used by a woman who is pregnant or in heavy letters: in slanted letters: breastfeeding, the picture is crossed out.
the chart { Where Women Have No Doctor 2014 486 Green Pages problem index
This is a list of health problems discussed in this book that can be treated with medicines. The problems are listed in order of the alphabet in the left column. The middle column has the numbers of the pages where you can read about each problem before taking any medicine. The right column 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 that start on page 490. arthritis .133 .aspirin, ibuprofenbleeding from the vagina after abortion .251–253 .ergometrine, misoprostolafter childbirth .92–93 .ergometrine, misoprostol, oxytocinaround menopause .129 .medroxyprogesterone chancroid .271 .azithromycin, ceftriaxone, ciprofloxacin, erythromycinchlamydia .265-268.amoxicillin, azithromycin, doxycycline, erythromycin, cough .303 .codeinediarrhea .296–299 .ciprofloxacin, cotrimoxazole, metronidazoleeclampsia/seizures .87 .diazepam, magnesium sulfateemergency family planning .226, 245, 523–524 .low-dose birth control pills, emergency pillsfever .297 .aspirin, paracetamol, ibuprofen after abortion .255–257 .ampicillin, ceftriaxone, clindamycin, doxycycline, after childbirth .97 .ampicillin, doxycycline, gentamicin, metronidazoleduring labor .86 .ampicillin, gentamicin, metronidazole fungal infection, yeast esophageal thrush .305 .fluconozolemouth (thrush) .117, 305 .gentian violet, ketoconazole, nystatinskin .300 .gentian violet, fluconazole, ketoconazole, nystatinvagina .265–266, 296 .gentian violet, clotrimazole, miconazole, nystatin, vinegar gonorrhea .264–268 .ceftriaxone, spectinomycinherpes sores .272–273, 301 .acyclovir, gentian violetinfection (prevention) for abortion .249 .doxycycline, erythromycinin deinfibulation .465 .doxycycline, erythromycinfor people with HIV .296 .cotrimoxazole infection (treatment) after abortion .255–257 .ampicillin, ceftriaxone, clindamycin, doxycycline, gentamicin, metronidazole, tetanus vaccine bladder .368 .cotrimoxazole, nitrofurantoinbreast infection .116–117 .dicloxacillin, erythromycinafter childbirth .97, 465 .ampicillin, doxycycline, erythromycin, gentamicin, after genital cutting .461–462 .cephalexin, dicloxacillin, erythromycin, tetanus vaccinekidney .368 .ceftriaxone, ciprofloxacin, cotrimoxazole, gentamicinskin .306–307, 539 .cephalexin, dicloxicillin, erythromycin, penicillin of the genitals .(see vaginal discharge)of the skin .301 .diphenhydramine, hydrocortisone, hydroxyzine malaria during the first .74 .clindamycin, quinine 3 months of pregnancy nausea .302 .promethazine Where Women Have No Doctor 2014 List of medicines in the Green Pages 487
newborn eye care .83 .erythromycin eye ointment, tetracycline eye ointmentpain mild to moderate .482 .aspirin, paracetamol, ibuprofensevere .482 .codeine pelvic inflammatory disease (PID) .274–275 .amoxicillin, azithromycin, ceftriaxone, doxycycline, erythromycin, metronidazole, spectinomycin pneumonia for people with HIV .304 .cotrimoxazoleseizures ("fits") during pregnancy .87 .diazepam, magnesium sulfatesores, infected .306–307 .dicloxacillin, erythromycin, gentian violet, penicillin, potassium permanganate on the genitals .270–273 .azithromycin, benzathine penicillin, ceftriaxone, ciprofloxacin, doxycycline, erythromycin, tetracycline syphilis .270–271 .benzathine penicillin, doxycycline, erythromycin, after abortion .257 .tetanus toxoidin newborn.95 .benzylpenicillin trichomonas .267–268 .metronidazole, tinidazolevaginal discharge .(see Chapter 16) at risk for STI .264–268 .amoxicillin, azithromycin, ceftriaxone, doxycycline, erythromycin, metronidazole, spectinomycin, tetracycline, tinidazole not at risk for STI .265–266 .clindamycin, clotrimazole, gentian violet, metronidazole, miconazole, nystatin warts on the genitals .269 .podophyllin, trichloroacetic acidwomb infection .97 .amoxicillin, ampicillin, azithromycin, ceftriaxone doxycycline, erithromycin, gentamicin, metronidazole, spectinomycin 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 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. 3TC lamivudine . 519–520 Amen medroxyprogesterone .506 Bactiderm gentamicin .502 Amoxifar amoxicillin .490 acetaminophen, Bactrim cotrimoxazole .497 see paracetamol .511 Amoxil amoxicillin .490 Bectivo diphenhydramine .499 acetylsalicylic acid, Benadryl diphenhydramine .499 see aspirin .492 Ampicin ampicillin .491 Benemid probenecid .512 Achromycin tetracycline .516 Anurhage ergometrine benzathine penicillin .493 Actiprofen ibuprofen .504 benzylpenicillin .493 Activated Carbon Anxionil diazepam .498 Benzylpenicillin Procaine activated charcoal .495 APAP paracetamol .511 procaine penicillin .513 activated charcoal .495 ASA aspirin .492 Betapen VK penicillin .511 bichloroacetic acid, see adrenaline, see epinephrine .500 Atarax hydroxyzine .504 trichloroacetic acid .516 Adrenalin epinephrine .500 Azidothymidine Bicillin L-A Advil ibuprofen .504 Zidovudine . 519–520 benzathine penicillin .493 Alesse birth control pill .522, 524 azithromycin .492 Bicillin C-R procaine penicillin .513 Amcil ampicillin .491 AzoGantanol cotrimoxazole .497 Biocolyn doxycycline .499 AZT Zidovudine . 519–520 birth control pills . 522–524 Where Women Have No Doctor 2014 488 List of medicines in the Green Pages
Bisonid isoniazid .505 Engerix-B hepatitis B vaccine .503 Brevicon 1 + 35 Keflex cephalexin .495 birth control pill .522 Epivir lamivudine . 519–520 Keftab cephalexin .495 ergometrine maleate .500 Kemicetine chloramphenicol .495 Calmpose diazepam . 498 Ergonovine ketoconazole .505 ergometrine maleate .500 Celinex benzylpenicillin .493 Ergotrate ergometrine maleate .500 lamivudine . 519–520 Ery-max erythromycin .501 Lessina birth control pill .524 Ceporex cephalexin .495 erythromycin .501 Lexinor norfloxacin .509 charcoal, see Liquid Antidote activated charcoal .495 activated charcoal .493 Cilest birth control pill .522 ethinyl estradiol, see estrogen .501 Lo-Femenal Ciloxan ciprofloxacin .496 Ethril erythromycin .501 birth control pill .522, 524 Cipro ciprofloxacin .496 Ciprobay ciprofloxacin .496 Fasigyn tinidazole .516 birth control pill .522, 524 ciprofloxacin .496 Femoden birth control pill .522 Logynon birth control pill .522 Cleocin clindamycin .496 Femulen birth control pill .523 Lutera birth control pill .524 Flagyl metronidazole .507 Condylox podophyllin .512 FTC emtricitabine.519 Macrobid nitrofurantoin .509 Coptin cotrimoxazole .497 Fungtopic miconazole .507 Macrodantin nitrofurantoin .509 cortisol, see hydrocortisone .503 Furadantin nitrofurantoin .509 magnesium sulfate .506 cotrimoxazole .497 Marax hydroxyzine .504 Crystal Violet gentian violet .503 Maxidex dexamethasone .498 Crysticillin procaine penicillin .513 Gantanol cotrimoxazole .497 medroxyprogesterone Curretab Garamycin gentamicin .502 medroxyprogesterone .506 Genpril ibuprofen .504 Megamox amoxicillin .490 Cycrin medroxyprogesterone . 506 Megestron Cytotec misoprostol .508 gentian violet .503 medroxyprogesterone .506 Gynera birth control pill .522 Mepergan promethazine .513 mestranol, see estrogen .501 D4T stavudine . 518–519 Methergine Daktarin miconazole .507 Harmonet birth control pill.522 ergometrine maleate .500 Dalacin clindamycin .496 hepatitis B vaccine .503 methylrosanilinium chloride Decadron dexamethasone .498 Hi-Do-Pen benzylpenicillin .493 gentian violet . 503 Decilone dexamethasone .498 Himox amoxicillin .490 Methoprotostat Dermodex nystatin .510 Hycotil hydrocortisone .503 metronidazole .507 dexamethasone .498 hydrocortisone .503 methylergonovine see Diane birth control pill .522 ergometrine maleate .500 Metro metronidazole .507 dicloxacillin .498 Metroxyn metronidazole .507 Ilosone erythromycin .501 metronidazole .507 diphenhydramine .499 Ilotycin erythromycin .501 Micatin miconazole .507 INH isoniazid .505 Inflam dexamethasone .498 Duracillin AS procaine penicillin . 513 Interbutol ethambutol .501 birth control pill .522, 524 Isoniazdum isoniazid .505 Eczacort hydrocortisone .503 birth control pill .523, 524 E.E.S. erythromycin .501 isonicotinic acid hydrazide Micronor birth control pill .523 Micronovum birth control pill . 523 EFV efavirenz.519 Isopas pyrazinamide .514 Microval birth control pill .523, 524 Ella birth control pill .524 Iterax hydroxyzine .504 Microvlar birth control pill .522 Ella 1 birth control pill .524 mifepristone .508 emtricitabine (FTC).519 E-Mycin erythromycin .501 Monistat miconazole .507 Where Women Have No Doctor 2014 List of medicines in the Green Pages 489
Monodox doxycycline .499 Phenergan promethazine .513 Sustive efavirenz .519 Motrin ibuprofen .504 phenoxymethyl penicillin Synphase birth control pill .522 Myambutol ethambutol .501 Syntocinon oxytocin .510 Mychel chloramphenicol .495 Pitocin oxytocin .510 Mycostatin nystatin .510 Plan B emergency pill .524 Mycrol ethambutol .501 Plan B One-Step Tempra paracetamol .511 My-Pam hydroxyzine .504 emergency pill .524 Terramycin tetracycline .516 Podocon-25 podophyllin .512 tetanus toxoid vaccine .515 Tetavax tetanus toxoid vaccine .515 narcotics, see codeine .497 Pologrim cotrimoxazole .497 tetracycline .516 Neogest birth control pill.523–524 Polycillin ampicillin .491 Tetragynon emergency birth Neogynon birth control pill .524 Postinor emergency birth control pill .524 nevirapine . 519–520 control pill .524 Thaprozine promethazine .513 Postinor-1 emergency birth Theracine tetracycline .516 Nitrocephin ceftriaxone .494 control pill .524 Tindamax tinidazole .516 nitrofurantoin .509 Postinor-2 emergency birth Nizoral ketaconazole .505 control pill .524 TMP/SMX cotrimoxazole .497 Nordette birth control Probalan probenecid .512 Togamycin spectinomycin .514 Triambutol ethambutol .501 Nordiol birth control pill .524 procaine penicillin .513 trichloroacetic acid .516 progesterone .513 trimethoprim, see Norinyl birth control pill .522 progestin, see progesterone.513 cotrimoxazole .497 Norlevo 1.5 emergency pill .524 promethazine .513 Trimpex cotrimoxazole .497 Noroxin norfloxacin .509 Trinordiol birth control pill .522 Nuprin ibuprofen .504 medroxyprogesterone .506 Trinovum birth control pill .522 NVP nevirapine . 519–520 Triphasil birth control pill .522 Nystat nystatin .510 Pyzamed pyrazinamide .514 Triquilar birth control pill .522 PZA pyrazinamide .514 Trobicin spectinomycin .514 Tylenol paracetamol .511 Odetol ethambutol .501 Recombivax HB hepatitis B vaccine .503 Odinah isoniazid .505 Resimin rifampicin .514 Omnipen ampicillin .491 Uritracin norfloxacin .509 Retrovir Zidovudine . 519–521 Optinor emergency pill .524 Uteracon oxytocin .510 rifampicin, rifampin .514 Rifastat rifampicin .514 birth control pill .522 Rocephin ceftriaxone .494 Valium diazepam .498 Ovral birth control pill .524 RU486 mifepristone .508 Vibra-Tabs doxycycline .499 Ovrette birth control pill .523–524 Rufen ibuprofen .504 Vibramycin doxycycline .499 Ovysmen 1/35 Viramune nevirapine . 519–520 birth control pill .522 Vistaril hydroxyzine .504 Oxtimon oxytocin .510 Satric metronidazole .507 SCM spectinomycin .514 Septra cotrimoxazole .497 Wycillin procaine penicillin.513 Servigenta gentamicin .502 Panadol paracetamol .511 Simplotan tinidazole .516 Solu-cortef hydrocortisone .503 ZDV zidovudine . 519–520 Penadur procaine penicillin .513 spectinomycin .514 Zerit stavudine . 518–519 Penadur L-A Stanilo spectinomycin .514 Zidovudine . 519–520 benzathine penicillin .493 stavudine . 518–519 Zidrid isoniazid .505 Penbritin ampicillin .491 streptomycin .514 Zinamide pyrazinamide .514 sulfamethoxazole, see Zinastat pyrazinamide .514 Penicillin G potassium or sodium cotrimoxazole .497 Zithromax azithromycin .492 benzylpenicillin .493 Sulfatrim cotrimoxazole .497 Zovirax acyclovir .490 PenVee K penicillin .511 Suprax cefixime .494 Permapen benzathine penicillin .493 Pfizepen AS Sumoxil amoxicillin .490 procaine penicillin .513 Sumycin tetracycline .516 Where Women Have No Doctor 2014 490 acetaminophen, acyclovir, adrenaline, amoxicillin
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, page 511. acyclovir (Zovirax)
Acyclovir is a medicine that kills viruses and is used to fight herpes, which can cause painful blisters on the genitals, anus, and in the mouth; and shingles, an infection common in people with HIV. Acyclovir will not stop herpes from coming back, but it makes it less painful and keeps it from spreading.
Who should In what forms not take this Someone with kidney damage.
does this medicine come? Information To shorten the duration and you should severity of herpes sores, start taking acyclovir as soon For genital herpes infection or cold as signs start to appear.
and when to sores: Take 200 mg by mouth 5 times a day, or 400 mg by mouth 3 times a day, for 7 days. For cold sores: Apply May sometimes cause headache, ointment on sores 6 times a day for 7 effects dizziness, nausea, vomiting.
days. Wash hands immediately.
Headache, loss of memory, For shingles: Take 800 mg by mouth 5 times a day taking too for 7 to 10 days.
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, page 500. amoxicillin (Amoxifar, Amoxil, Himox, Megamox, Sumoxil)
Amoxicillin is an antibiotic of the penicillin family used to treat some sexually transmitted infections, pneumonia, and other infections. Because of high levels of drug resistance, it is less useful than previously.
In what forms Who should Do not use if allergic to does this Tablets: 250 and 500 mg not take this Liquid: 125 or 250 mg per 5 ml medicines of the penicillin family.
May cause diarrhea, rash, nausea or vomiting. May cause yeast infection in How much and For chlamydia: 500 mg, by women or diaper rash in children.
when to take mouth, 3 times a day for 7 days (for drug combinations Information If you do not start to get better in to treat vaginal discharge, see 3 days, look for medical help; you page 268).
may need a different medicine.
For pelvic inflammatory disease: Take with food.
500 mg, by mouth, 3 times a day for 14 days (for drug for bladder or kidney infection: combinations to treat PID, see medicines ceftrianxone, ciprofloxacin, page 275). cotrimoxazole, gentamicin, nitrofurantoin workfor breast infection: cephalexin, dicloxacillin, erythromycin Where Women Have No Doctor 2014 ampicillin (Amcil, Ampicin, Omnipen, Penbritin, Polycillin)
Ampicillin is an antibiotic of the penicillin family used to treat many kinds of infections. Because of high levels of drug resistance, it is less useful than previously.
Who should Do not use ampicillin if you In what forms Tablets and Capsules: not take this are allergic to medicines of does this medicine the penicillin family.
125 or 250 mg per 5 mlPowder for mixing injections: May cause stomach upset and diarrhea. May cause rash.
How much and when For infection after abortion If you do not start to get (drugs by injection) or womb better in 3 days, look for infection: Inject 2 grams medical help; you may (2000 mg) into muscle or into need another medicine.
vein, then reduce dose to 1 gram 4 times a day. Also take gentamicin or metronidazole Information Take this medicine (see page 256 for drug you should before eating.
combinations to treat infection after abortion and page 97 for womb infection). for womb infection after childbirth: see For fever during childbirth: Take 2 g (2000 mg) medicines drug combinations on page 97.
4 times a day until you can get medical attention. for infection after abortion: see drug combinations on page 256. Where Women Have No Doctor 2014 492 aspirin, azithromycin
(acetylsalicylic acid, ASA, others) Aspirin works against pain, swelling, and fever.
In what forms Tablets: 300, 500 mg May cause stomach upset, stomach does this pain, or bleeding problems.
medicine come? and other sizes.
Aspirin treats some sicknesses How much and For pain, swelling or fever: Information like arthritis and heart problems, 300 to 600 mg by mouth you should but is usually used to ease pain no more than 6 times a and fever. It is important to find day as needed.
the cause of the pain or fever and cure that. If pain lasts more Who should Women should not take than 10 days or fever more than not take this aspirin during the last 3 days, get medical help.
3 months of pregnancy. People with stomach ulcers Ringing in the ears, or bleeding problems should taking too headache, dizziness, not take aspirin. Do not use confusion, fast breathing.
before surgery. Do not use if breastfeeding in the first for pain or fever: paracetamol week of the baby's life. Do medicines for pain, fever, or swelling: ibuprofen not give to children.
for severe pain: codeine Azithromycin is an antibiotic of the macrolide family used to treat many STIs. It may be expensive or hard to find, but it works well against STIs that cause discharge or genital sores where many other antibiotics do not. It can be used during pregnancy and breastfeeding.
In what forms Diarrhea, nausea, vomiting, does this abdominal pain.
medicine come? How much and For chlamydia or chancroid: Take when to take 1 gram (1000 mg) by mouth Information If weekly dose is used, you should 1 time only (also take other take with food.
drugs, see pages 268 and 271). For PID: Take 1 gram (1000 mg) by mouth as a single dose, and a second dose 1 week (7 days) for chlamydia: see drug later (also take other drugs, see page 275). combinations on page 268 medicines for chancroid: see drug People with allergies combinations on page 271 Who should to erythromycin and not take this other antibiotics of the for PID: see drug combinations on macrolide family.
Where Women Have No Doctor 2014 benzathine penicillin, benzylpenicillin 493
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 Who should People who are allergic Powder for mixing for does this not take this to medicines of the injection: 1.2 or 2.4 million penicillin family.
Units in a 5 ml vial.
Have epinephrine on hand whenever you inject penicillin. Watch for How much and For syphilis: If there is a sore, allergic reactions and allergic shock when to take inject 2.4 million Units into muscle one time only. If there which could start within 30 minutes. is a blood test or the sores for syphilis: doxycycline, tetracycline, have already disappeared, then medicines every week for 3 weeks. also treat for chancroid, see page 271 benzylpenicillin (Celinex, Hi-Do-Pen, penicillin G potassium or sodium)
Benzylpenicillin is an antibiotic of the penicillin family used to treat many serious infections.
In what forms Powder for mixing does this Watch for allergic reactions medicine come? 1 or 5 million Units.
and signs of shock.
How much and For tetanus in newborns: Inject when to take 100,000 Units/kg into muscle 4 times a day for 10 days.
for infection after abortion: ampicillin, medicines ceftriaxone, clindamycin, doxycycline, gentamicin, metronidazole (see page Who should People allergic to 256 for medicine combinations). not take this medicines of the penicillin family.
Where Women Have No Doctor 2014 494 ceftriaxone, cephalexin
ceftriaxone
Ceftriaxone is a very strong antibiotic of the cephalosporin family that is injected into muscle or vein. It is used for many infections including gonorrhea, pelvic inflammatory disease (PID), kidney infections, and serious infections after abortion, childbirth, or miscarriage.
Do not use if you are In what forms In vials for injection: Who should does this allergic to antibiotics of the not take this 250, 500 mg, 1 gram, and cephalosporin family, or if you had hives or a severe allergic reaction to penicillin.
For infection after abortion: Inject Watch for allergic reaction.
250 mg into muscle one time How much and Always be prepared to treat for when to take only (see page 256 for drug allergic reaction and shock when combinations to treat infection after For PID: Inject 250 mg into muscle for PID or infection after abortion: medicines ampicillin, amoxicillin, azithromycin, one time only (see page 275 for clindamycin, doxycycline, erythromycin, drug combinations to treat PID). gentamicin, metronidazole, spectinomycin For gonorrhea: Inject 250 mg into muscle one time (see pages 256 and 275) only (see page 268 for drug combinations to treat for gonorrhea: spectinomycin For kidney infection: Inject 1 gram into the vein for kidney infection: ciprofloxacin, cotrimoxazole, For chancroid: Inject 250 mg into muscle one time only (see page 271 for drug combinations). cephalexin (Ceporex, Keflex, Keftab)
Cephalexin is an antibiotic of the cephalosporin family used to treat breast infections, bronchitis and some skin infections.
Tablets: 250 or 500 mg forms does Watch for allergic reaction.
this medicine 125 or 250 mg per 5 ml How much and For breast or skin infection and Information you when to take infection after female genital If you start having bloody should know cutting: 250 mg by mouth 4 diarrhea with fever, stop times a day for 7 days.
taking cephalexin and treat with metronidazole (see page 507). Who should Do not take cephalexin if not take this you are allergic to antibiotics of the cephalosporin family.
for breast or skin infection: dicloxacillin, erythromycin, medicines Nausea, vomiting, and diarrhea. for infection after female In rare cases, the beginning of genital cutting: dicloxacillin, bloody diarrhea with fever.
Where Women Have No Doctor 2014 activated charcoal 495
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 Liquid: 25 grams per does this medicine come? 120 mlPowder: 15 grams vomiting, diarrhea.
Take 30 to 100 g soon as possible.
Get medical help immediately. People who take too much of a drug can get very sick and Do not take if you Who should may need much more help than have swallowed lighter not take this activated charcoal.
fluid, fuel, kerosene or petroleum products.
Where Women Have No Doctor 2014 496 ciprofloxacin, clindamycin
ciprofloxacin (Ciloxan, Cipro, Ciprobay)
Ciprofloxacin is a strong antibiotic of the quinolone family that is used to treat skin and kidney infections, and some STIs like chancroid.
In what forms does this This medicine reacts with caffeine medicine come? (in coffee, chocolate, cola drinks, etc.), making the caffeine even stronger. Do not take with dairy products.
How much and For chancroid or bloody when to take diarrhea with fever: 500 mg, by mouth, 2 times a day for Information you Drink lots of water. You 3 days (see page 271 for drug should know can eat while taking combinations to treat genital ciprofloxacin, just avoid dairy products.
For kidney infection: Take 500 mg, by mouth, 2 times a day for 10 days.
for chancroid: azithromycin, medicines Who should Do not use if you are not take this pregnant, breastfeeding or for kidney infection: ceftriaxone, younger than 16 years old.
Nausea, diarrhea, for bloody diarrhea with fever: vomiting, headache.
clindamycin (Cleocin, Dalacin)
Clindamycin is an antibiotic of the lincosamide family that is used to treat infections of the vagina, pelvis, abdomen, skin, and respiratory tract.
In what forms Nausea, vomiting, and diarrhea does this 25 mg, 75 mg, 150 mg, 300 mg can happen within a few weeks of Liquid for injection:150 mg/ ml using this medicine. If clindamycin gives you a skin rash, stop using it and see your health worker.
How much and For bacterial vaginosis vaginal Using for more than when to take infection: 30 days can lead to thrush and Tablets: Take 300 mg, by mouth, yeast infections, and harm people 2 times a day for 7 days.
with kidney or liver problems. The Cream: Put 5 g high in the vaginal cream can weaken condoms vagina each night at bedtime for up to 3 days after use.
For infection after abortion: Inject 900 mg into vein Using this medicine with Information 3 times a day (see page 256 for drug combinations erythromycin or chloramphenicol you should for post-abortion infections). can make both drugs less effective. If you have your monthly bleeding For malaria in the first 3 months of pregnancy: Take while using the cream, do not use 300 mg by mouth 4 times a day for 7 days. Also a tampon because it will absorb take 600 mg of quinine, 3 times a day for 7 days.
the medicine.
for bacterial vaginosis: metronidazole Who should If you are breastfeeding and medicines for womb infection or infection after not take this this medicine gives your abortion: ampicillin, ceftriaxone, baby diarrhea, stop using it.
doxycycline, erythromycin, gentamicin, Where Women Have No Doctor 2014 codeine, cotrimoxazole 497
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 Liquid: 15 mg per ml does this Tablets: 15, 30, or 60 mg Sleepiness, stupor, coma.
Cough syrup: Different strengths How much and For coughs: 7 to 15 mg Treatment for when to take 4 times a day, only as needed.
taking too much Naloxone (Narcan) can be given as an injection to someone who For severe pain: 30 to 60 mg has taken too much codeine. 4 to 6 times a day, as needed.
Seek medical help.
May cause constipation (difficulty passing stools) and temporary inability to pass urine. Nausea, vomiting, itching, headaches. Other for pain: medicines acetaminophen, aspirin, ibuprofen Information Codeine is habit forming (addictive). for severe pain: morphine If you use it for several days, you will for cough: drink plenty of water, use home-made cough syrup (see page 303). need more for it to keep working.
cotrimoxazole = trimethoprim + sulfamethoxazole
(AzoGantanol, Bactrim, Coptin, Gantanol, Pologrim, Septra, Sulfatrim, TMP/SMX, Trimpex, others) Cotrimoxazole is a combination of 2 antibiotics (one from the sulfa family) that is used to treat bladder and kidney infections. It also helps prevent diarrhea, pneumonia, and other infections for people with HIV.
In what forms does Who should not take Women in the last 3 months this medicine come? 120 mg (20 mg trimethoprim this medicine? of pregnancy should avoid + 100 mg sulfamethoxazole), this medicine. If you are 480 mg (80 mg trimethoprim allergic to sulfa antibiotics, + 400 mg sulfamethoxazole— do not take this drug.
called "single strength"), and 960 mg (160 mg trimethoprim + 800 mg sulfamethoxazole—called "double strength") Stop taking it if it causes allergic Oral suspension: 240 mg (40 mg trimethoprim + reactions like itching or skin rashes. Also may cause nausea and vomiting.
200 mg sulfamethoxazole) per 5 ml How much and For bladder infection: Take two when to take 480 tablets by mouth 2 times a day for 3 days. Take with lots of water.
For kidney infection: Take two 480 tablets by mouth 2 times a day for 10 days. Nausea, vomiting, diarrhea, For prevention of diarrhea, pneumonia and other infections for people with HIV: Take two 480 tablets every day. For bloody diarrhea with fever for people with AIDS: for bladder and kidney infection: Take two 480 tablets by mouth 2 times a day for medicines that ceftriaxone, ciprofloxacin, For pneumonia for people with AIDS: Take four 480 tablets by mouth 3 times a day for 21days. for bloody diarrhea with fever for people with AIDS: ciprofloxacin, For children born to mothers with HIV: Give 120 mg (2.5 ml of liquid by mouth) to babies less than 6 months old; give 240 mg (5 ml of liquid by mouth) to children from 6 months to 6 years old, each day.
Where Women Have No Doctor 2014 498 dexamethasone, diazepam, dicloxacillin
dexamethasone (Decadron, Decilone, Inflam, Maxidex)
Dexamethasone is a steroid medicine used to treat allergic shock (see page 545). Tablets: 0.25, 0.5, 0.75, 1, In what forms does this medicine come? 1.5, 2, 4, or 6 mg If the person has diabetes, Liquid: 0.5 mg per 5 ml, it could make it worse for a few hours. Also, it might For injection: 4, 8, 10, 16, raise blood pressure.
How much and For allergic shock: Inject when to take 20 mg into muscle. If signs for allergic shock: Other medicines return, take 20 mg by mouth that may work and repeat once if needed. diazepam (Anxionil, Calmpose, Valium)
Diazepam is a tranquilizer used to treat and prevent convulsions and seizures. It also relieves anxiety and helps promote sleep.
Tablets: 5 or 10 mg Frequent or large doses of forms does For injections: 5 mg per diazepam during pregnancy this medicine can cause birth defects.
How much and For convulsions: Use 20 mg of Diazepam is an addictive when to take injectable diazepam in the anus (habit-forming) drug. Avoid taking using a syringe without a needle with other drugs that will make (see page 87). Repeat after 30 you sleepy, especially alcohol.
minutes if needed, using 10 mg. Use crushed tablets in water if you do not have Information Diazepam does not injectable diazepam. you should treat pain. It is very For agitation or DTs 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 Sleepiness, loss of while seeking medical help. taking too balance, confusion.
For anxiety or sleeplessness: Take 2.5 to 5 mg by mouth. for convulsions: magnesium sulfate Who should Pregnant or breastfeeding Other medicines for sleep: diphenhydramine not take this women should only use that may work for anxiety: hydroxyzine diazepam to stop seizures.
Dicloxacillin is an antibiotic of the penicillin family used to treat breast and skin infections.
In what forms does this Capsules: 125, 250, or 500 mg Nausea, vomiting, Liquid: 62.5 mg per 5 ml For breast, skin or other Watch for allergic reations infections: Take 500 mg 4 times a day for 7 days.
Who should Do not take this drug if you Other medicines for breast or skin infections: not take this are allergic to penicillin.
that may work cephalexin, erythromycin, penicillin Where Women Have No Doctor 2014 diphenhydramine hydrochloride, doxycycline 499
diphenhydramine hydrochloride
Diphenhydramine is an antihistamine that dries up mucus in the nose and also makes you sleepy. It is useful for treating itching and sleep problems. It is also a treatment for allergic reactions and allergic shock.
In what forms Tablets or capsules: 25 or 50 mg Sleepiness, dry mouth. Sometimes does this causes nausea and vomiting. In rare Syrup: 12.5 mg per 5 ml cases can have the opposite effect Ampules for injection: and excite rather than calm you.
10, 30, or 50 mg in 1 ml For allergies, mild to moderate allergic Do not use if you need to be alert. reaction, or itching: Take 25 mg, by Makes the effects of tranquilizers mouth, 3 or 4 times a day as needed.
and alcohol dangerously stronger.
For sleep: Take 25 to 50 mg at bedtime. Warning For allergic shock: Inject 50 mg into muscle, repeat in 8 hours or sooner if Information you should needed (see page 545). for severe allergic Who should not take reactions or shock.
Pregnant and breastfeeding this medicine? women should not use this drug as a long-term treatment Other medicines for allergies: for allergies. People with that may work asthma should not take it.
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 STIs, pelvic infections, infections after abortions, and others. It is used instead of tetracycline.
In what forms does Tablets: 50 mg and 100 mg Diarrhea or upset stomach. this medicine come? Some people get a rash after staying a long time in the sun.
How much and For vaginal discharge from an when to take STI (chlamydia): Take 100 mg, by Do not take if pregnant and try to mouth, 2 times a day for 7 days avoid if breastfeeding. Do not use (also take other drugs, see page doxycycline that is old or has passed the expiration date. Do not take For early syphilis: 100 mg by with dairy products or antacids.
mouth 2 times a day for 14 days.
Information you For PID: Take 100 mg, by mouth, 2 times a day for Do not take just before should know 14 days (also take other drugs for PID, see page 275).
laying down. Sit up while taking pills and drink lots For infection prevention after an abortion or of water to prevent the deinfibulation: Take 100 mg 2 times a day for 1 day.
irritation that swallowing For infection after abortion: Take 100 mg by mouth this medicine can cause. 2 times a day for 10 days (also take other drugs, see page 256). Other medicines for syphilis: benzathine, that may work erythromycin, penicillin, For infection after childbirth: Take 100 mg by mouth, 2 times a day until fever has been gone for 2 full for gonorrhea: ceftriaxone, spectinomycin days (also use other drugs, see page 97). for chlamydia: amoxicillin, azithromycin, Who should Pregnant women and children under 8. to prevent infection after abortion: erythromycin not take this Doxycycline can damage a baby's or child's teeth and bones. Women who for infection after abortion: see page 256 are breastfeeding can take doxycycline for a short time to treat infections, but should avoid taking it long-term.
Where Women Have No Doctor 2014 500 epinephrine, ergometrine maleate
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 Be careful never to give more than Ampules for injection: does this medicine the recommended amount. Avoid injecting this into the buttocks, instead use the back of the upper arm.
For asthma, moderate allergic reaction or allergic shock: Inject Take the person's pulse ½ mg (½ ml) just under the How much and Information you before injecting. Do not give when to take skin (not into muscle) of the should know more than 3 doses. If the upper arm. If needed, a second pulse goes up by more than dose can be given after 20-30 30 beats per minute after minutes, and a third dose after the first injection, do not another 20-30 minutes (also give another dose.
give other drugs, see page 545). Fear, restlessness, nervousness, High blood pressure, tension, headaches, dizziness, taking too fast heart beat, stroke.
increased heart rate.
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? For injection: 0.2, 0.25 Do not use these drugs to and 0.5 mg in 1 ml vial start labor or make labor stronger. Never give this medicine before the baby and How much and For heavy bleeding after the placenta have come out.
when to take childbirth: After the placenta has come out, inject 0.2 mg into muscle, or give 1 tablet (0.2 mg) by mouth every 2 to 4 hours Information you Do not use this drug for severe bleeding or every should know to cause an abortion 6 to 12 hours for less severe bleeding. Continue because it could kill the to give until bleeding stops and the womb is hard, woman before making about 48 hours.
her abort. (For abortion, For heavy bleeding due to complications after an see Chapter 15). abortion: Give an injection of 0.2 mg into muscle, then give a 0.2 mg pill or an injection every 6 hours for 24 hours.
Other medicines oxytocin, misoprostol Nausea, vomiting, that may work Where Women Have No Doctor 2014 erythromycin, estrogen, ethambutol 501
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 STIs, respiratory and skin infections. It can be safely used during pregancy and is widely available.
In what forms Tablets or capsules: May upset stomach or cause does this medicine 200, 250 or 500 mg nausea, vomiting, diarrhea.
Powder for solution: Erythromycin works best when taken Information 1 hour before or 2 hours after a meal. How much and For chlamydia: 500 mg by you should If this upsets your stomach too much, when to take mouth 4 times a day for take with a little food. 7 days (see page 268 for drug Do not break up tablets. Many tablets combinations to treat vaginal are coated to prevent strong stomach discharge from STIs). juices from breaking down the drug For breast infection, infection after female genital before it can begin to work.
cutting or deinfibulation: 500 mg by mouth 4 times a day for 7 days. Other medicines for breast infection: cephalexin, For chancroid or skin infections: 500 mg by mouth that may work 4 times a day for 7 days (also use other drugs, see page 271). For syphilis: 500 mg by mouth 4 times a for infection after genital cutting: cephalexin, day for 15 days. For newborn eye care: Use 1% ointment one time only. for STIs: see pages 268 and 271 for drug For skin infection: Give 250 mg by mouth, 4 times a day for 7 to 10 days.
for newborn eye care: tetracycline ointment Who should Do not use if you are for skin infection: dicloxacillin not take this allergic to antibiotics of the macrolide family. 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. It should no longer be used for problems of menopause (see Chapter 8). For more information, see the section on birth control pills, injections, and emergency family planning (see Chapter 13 and pages 522 to 524). 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 Tablets: 100 or 400 mg Ethambutol often causes vision changes does this in one or both eyes. It might make medicine come? the area of what you can see smaller, or cause patchy dark spots or "holes" How much and The doses for tuberculosis when to take in your vision. This usually goes away medicines differ from region when you stop taking the drug.
to region. See a health worker. (Take ethambutol in combination It is very important that you with other drugs, see page 389.) Information you take the entire course of should know treatment for tuberculosis, People with serious vision even if it lasts for a year. If not, should not problems, including cataracts, you might infect other people take this should not take this drug. or get sick again with a kind of Neither should people with TB that is very hard to cure.
severe kidney problems.
Where Women Have No Doctor 2014 502 fluconazole, gentamicin
Fluconazole is a strong anti-fungus medicine that is used to treat thrush and other yeast and fungal infections. Use only if you have HIV and other remedies do not work.
Who should not take Do not use during pregnancy this medicine? In what forms Liquid: 50 mg per 5 ml or if breastfeeding. Also, anyone does this who has hepatitis, liver disease, medicine come? Solution for IV injection: 2 mg/ 5 ml in vial or kidney problems should not take this drug.
How much and For yeast infections in the mouth or when to take throat (thrush): Take 400 mg by May cause nausea, vomiting.
mouth once only. Then take 200 mg a day for 14 days. If not better in 3 to 5 days, increase amount to medicines ketoconazole, nystatin For yeast infections of the skin: Take 100 mg to 200 mg by mouth once a day for 7 to 14 days.
gentamicin (Bactiderm, Garamycin, Servigenta)
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 In vials for injection: Use a different medicine does this 10 or 40 mg per ml if hearing problems or medicine come? ringing in the ears start. Give with plenty of fluids.
For kidney infection, womb infection, How much and when to take infection after abortion, or infection Information you Because of the serious side during labor: Give this medicine should know effects and the difficulty of according to a woman's body calculating the dosage, this weight: inject into muscle 1.5 mg drug should only be used for every kg of weight, every 8 when safer antibiotics are not available.
hours, for 5 to 10 days; or you can use the following average dose: Inject 80 mg into muscle every 8 hours for 5 to 10 days (also use other drugs, see pages 97 Ringing in the ears or taking too worsening of hearing. For fever during childbirth: Give 80 mg in the muscle Kidney problems.
or vein, every 8 hours. Also give ampicillin.
for womb or pelvic infection: amoxicillin, ampicillin, azithromycin, Who should not take Pregnant women or people ceftriaxone, doxycycline, erythromycin, this medicine? with kidney problems should medicines use this drug very carefully. Do for infection after abortion: ampicillin, not use this drug if you are allergic to other ceftriaxone, clindamycin, doxycycline, antibiotics of the aminoglycoside family.
metronidazolefor kidney infection: ceftriaxone, This drug can damage the kidneys or cause deafness.
Where Women Have No Doctor 2014 gentian violet, hepatitis B vaccine, hydrocortisone 503
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 Liquid: 0.5%, 1%, 2% Long-term use causes irritation. Use this medicine come? on a sore or on broken skin may stain that skin purple when it heals.
Crystals: 1 teaspoon in ½ liter of water makes a 2% liquid.
Do not have sex while you are using gentian violet for a vaginal infection, to avoid passing the infection to your partner. How much and For vaginal yeast infections: Stop using gentian violet if it starts to when to take Soak clean cotton with irritate you. Keep it away from eyes.
1% liquid and place high in the vagina overnight for Information you After putting this in an infant's 3 nights. Be sure to remove should know mouth, turn the baby face down the cotton every morning.
so it does not swallow too For yeast infections in the mouth (thrush): Rinse much. Gentian violet will stain the mouth with 1% liquid for 1 minute 2 times a your skin and clothes purple.
day, but do not swallow.
For skin infections: First wash with soap and water, for skin infections: and dry. Then paint on skin, mouth, or vulva medicines antibiotic ointments, iodine 3 times a day for 5 days. for thrush in the mouth: For skin infections for people with AIDS: First wash lemon (not for babies), nystatin with soap and water, and dry. Then paint on skin, for vaginal yeast infections: mouth, or vulva 2 times a day until rash is gone.
nystatin, miconozole, clotrimazole hepatitis B vaccine (Engerix-B, Recombivax HB)
This vaccine provides life-long immunity to Hepatitis B. It is given in 3 separate doses: the 2nd dose is given 1 to 2 months after the first dose; and the 3rd dose is given 4 to 12 months after the 2nd dose. Must be stored at 2 to 3° C or it loses its strength. Doses for these 2 brands of the vaccine are different: Engerix-B: children 0 to 11 years, 10 ucg; children 12 to 19 years and adults, 20 ucg Recombivax HB: children 0 to 11 years old, 2.5 ucg; children 12 to 19 years, 5 ucg; adults 10 ucg hydrocortisone or cortisol
(Eczacort, Hycotil, Solu-Cortef, others) Hydrocortisone is an anti-swelling and anti-itch medicine 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 Cream or ointment: in many Do not use cream with a does this strengths, often1% bandage covering it. Tablets: 5, 10, and 20 mg Pregnant and breastfeeding Liquid for injection and women should use tablets powder for mixing for with caution, but can safely injection: various strengths How much and For rash, itching or piles: when to take Apply cream directly on skin 3 or 4 times a day.
High blood pressure, For allergic shock: Inject 500 mg passing more urine into muscle, repeat in 4 hours if needed (also give other drugs, see page 545). If signs return later, take 500 to 1000 mg by mouth and for allergic shock: repeat once if needed.
dexamethasone, diphenhydramine Cream may cause thinning and medicines scarring of skin if used for more for allergies or itching: than 10 days.
Where Women Have No Doctor 2014 504 hydroxyzine, ibuprofen
hydroxyzine (Atarax, Iterax, Marax, My-Pam, Vistaril)
Hydroxyzine is an antihistamine used for allergic reactions, to control itching, and sometimes to treat nausea, vomiting, and anxiety.
In what forms does Tablets: 25, 50, or 100 mg this medicine come? Causes dry mouth, sleepiness, and may Syrup: 10 or 25 mg per 5 ml cause loss of appetite.
How much and For itching: Take 25 to 50 mg when to take 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 for adults (also use other medicines, see page 545). Do not use during first Who should not 3 months of pregnancy. In take this medicine? for itching, allergy or allergic shock: the rest of pregnancy or if medicines breastfeeding, use only if there is no other choice. Do not use for anxiety: diazepam this drug if you must stay alert.
ibuprofen
(Actiprofen, Advil, Genpril, Motrin, Nuprin, Rufen, others) 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? 200 mg and larger Avoid taking within a week of surgery. Take 200 to 400 mg Information you should know Causes less irritation Do not take more if taken with food, than 2400 mg daily.
especially dairy products, at mealtimes.
Who should People with stomach ulcers. not take this Pregnant women during the last 3 months of pregnancy.
for pain, swelling and fever: aspirin medicines for pain and fever: acetaminophen May cause stomach irritation or pain. Take with food.
for severe pain: codeine, morphine Where Women Have No Doctor 2014 isoniazid, ketoconazole 505
isoniazid (Bisonid, INH, Isoniazdum, isonicotinic acid hydrazide, Odinah, Zidrid)
Isoniazid is used to treat tuberculosis (TB) in combination with other medicines. See Chapter 25. People with HIV can use isoniazid to prevent latent TB (TB with no signs) from becoming active TB.
In what forms May cause pain or numbness in arms Tablet: 100 or 300 mg and legs. Sometimes isoniazid may cause medicine come? Syrup: 50 mg per 5ml severe hepatitis with signs like tiredness, loss of appetite, nausea, vomiting, dark urine, or yellowing of eyes. If this happens, The doses for medicines to stop taking this medicine immediately.
How much and treat tuberculosis differ from when to take region to region. See a health Information Never take more than 300 mg worker. (Take isoniazid in you should a day if you take it every day, combination with other drugs, see know or 900 mg if you take it 3 times page 389.) a week. It is important to take For prevention of TB in adults the full course of treatment for with HIV: Take 300 mg by mouth tuberculosis. If not, you can infect every day for 6 months to 3 other people or get sick again with a kind of TB that is very hard Anyone who has hepatitis, should not Signs of taking Nausea, vomiting, dizziness, slurred liver disease, or has taken take this speech, blurred vision. If you take isoniazid before and had too much, take 50 mg pyridoxine liver problems, should not (vitamin B6) 3 times a day.
take this drug.
ketoconazole (Nizoral)
Ketoconazole is a strong anti-fungus medicine that is used to treat thrush and other yeast infections. Use only if you have HIV and other remedies do not work. Do not take if you are pregnant In what forms or breastfeeding. Do not put does this medicine cream or shampoo in vagina. Take with food. If taken by mouth, it may give you hot flashes if you also drink alcohol.
For fungal infection on the skin: Take Information you should This medicine works best if taken with orange juice or another citrus fruit.
For yeast infection inside the mouth (thrush): Take 200 mg by mouth 2 times a day for 14 days.
for yeast infections without May cause nausea, vomiting.
Other medicines STIs: clotrimazole, fluconazole, that may work gentian violet, miconazole, nystatin, vinegar Where Women Have No Doctor 2014 506 magnesium sulfate, medroxyprogesterone acetate, methyl ergonovine
magnesium sulfate
Magnesium sulfate is the best medicine to prevent convulsions in pregnant women with eclampsia.
In what forms does this Injecting a large amount medicine come? Information you or 50% solution.
needs a big needle and should know may be uncomfortable. You might want to split the dose in half and For convulsions: and when to give 2 smaller shots, Inject 10 g into muscle.
one in each hip.
Who should Women with kidney not take this problems should not be given this drug.
Sweating, low blood pressure, weakness, Only use this drug if a woman's problems breathing.
blood pressure is over 160/110. After giving, continue to check her blood pressure. Too much of this medicine Other medicines For convulsions: diazepam can slow down or stop her breathing! that may work (Amen, Curretab, Cycrin, Depo-Provera, Megestron, Provera) 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 "Growing Older." For family planning, see Chapter 13.
In what forms does this Women with hepatitis, medicine come? Who should or cancer of the breast Liquid for injection: not take this or cervix should not 150 or 400 mg per ml take this medicine.
How much and For heavy bleeding: when to take Take 10 mg once a day for If bleeding continues after 20 days 10 days. If bleeding continues, of treatment, see a health worker. take for 10 more days.
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, page 500. Where Women Have No Doctor 2014 metronidazole, miconazole 507
metronidazole (Flagyl, Methoprotostat, Metro, Metroxyn, Satric)
Metronidazole is used for vaginal infections caused by yeast and trichomonas. It is also effective against some bacteria and amebic dysentery (see Where There Is No Doctor). In what forms does this Tablets: 200, 250, 400, or 500 mg Who should People with liver problems Inserts: 375, 500 mg not take this like jaundice (yellow eyes).
For injection into vein: 500 mg Metallic taste in mouth, How much and For PID: Take 400 to 500 mg dark urine, upset stomach when to take by mouth 3 times a day for or nausea, headache.
14 days (take in combination with other drugs, see page 275). Stop taking it if you feel numb. If you are in the first 3 months For mild vaginal infections: Put one 500 mg insert in of pregnancy, try not to use the vagina 2 times a day for 5 days.
this medicine. If you must, do For trichomonas or bacterial vaginosis: Take 2 grams not take the one large dose by mouth 1 time only, but not if you are pregnant. during pregnancy. But if you are If you are pregnant: Take 400 to 500 mg by mouth breastfeeding, the one large dose 2 times a day for 7 days (to treat abnormal is the safest way to take it.
discharge with or without an STI, see drug combinations on pages 266 and 268). Information you Your sexual partner should For womb infection after abortion or childbirth: should know also be treated. Do not Give 500 mg by mouth 3 times a day or inject drink alcohol, not even 1 beer, 500 mg into a vein 3 times a day (see treatment while you are taking combinations recommended on page 256 for abortion metronidazole. It will make and page 97 for childbirth). you feel very nauseous.
For bloody diarrhea without fever: 500 mg 3 times a day for 7 days.
For tetanus: 7.5 mg/kg 4 times a day for 10 days.
For fever during childbirth: Take 400 to 500 mg by for bacterial vaginosis and mouth 3 times a day. Also take ampicillin.
medicines trichomonas: clindamycin, miconazole
(Daktarin, Fungtopic, Micatin, Monistat) Miconazole is an anti-fungus medicine used to treat vaginal yeast and other fungus infections.
forms does Inserts: 100 mg, this medicine 200 mg, and 1200 mg For yeast infections: If miconazole irritates you, How much and Cream: put 5 g in the vagina stop using it. Avoid having when to take every night for 7 days. sex for 3-4 days so you do 100 mg inserts: put 1 in the not pass it to your partner. vagina every night for 7 days.
Keep it out of your eyes.
200 mg inserts: put 1 in the vagina every night for 3 days.
for yeast infections: nystatin, Who should Women in the first Other medicines clotrimazole, fluconazole, not take this that may work 3 months of pregnancy.
gentian violet or ketoconazole Where Women Have No Doctor 2014 508 mifepristone, misoprostol
mifepristone (Mifegyne, Mifeprex) and misoprostol (Cytotec)
Mifepristone is used for medical abortion. It blocks the effects of the hormone that maintains pregnancy. Taken together with misoprostol before 9 weeks of pregnancy, mifepristone is very effective in causing a complete abortion. Misoprostol makes the womb contract and expel the pregnancy.
Taking misoprostol by itself is also effective, but it is more effective when both medicines are used together. Misoprostol can also be used to stop bleeding after childbirth or incomplete abortion, or if the placenta takes more than 1 hour to come out. It is also used for stomach ulcers.
Before taking these medicines, read the chapter "Abortion and Complications from Abortion." In what forms do For incomplete abortion, or if the these medicines placenta takes more than 1 hour mifepristone: Tablets, 200 mg to come out: dissolve 400 mcg misoprostol: Tablets, 100 or misoprostol against the cheek or under the tongue for about 30 minutes, 1 time only. Or swallow 600 mcg misoprostol, 1 time only.
For medical abortion until 9 weeks (63 days) of pregnancy: Swallow It is normal to have painful How to take 200 mg mifepristone. After 2 days cramping and heavy bleeding mifepristone with (48 hours), insert 800 micrograms with clots for 3 to 6 hours after misoprostol: (mcg) misoprostol in the vagina, taking misoprostol. You may also or dissolve 800 mcg misoprostol have nausea, vomiting, diarrhea, inside the mouth, against the cheek headache, and slight fever in the or under the tongue for about 30 first few hours. These signs will minutes. Then swallow what is left. go away on their own. Bleeding Then dissolve 400 mcg misoprostol lasts 2 to 4 weeks but gets in the mouth or insert 400 mcg lighter after 1 to 2 weeks.
misoprostol deep in the vagina every 3 hours up to 5 doses.
Do not take these medicines For medical abortion until 9 weeks if you cannot get to a clinic or (63 days) of pregnancy: Dissolve hospital within one hour, especially How to take 800 mcg inside the mouth, against if more than 9 weeks pregnant, or misoprostol by itself: the cheek or under the tongue, if you think you have a pregancy in for about 30 minutes. Then the tube (see page 73).
swallow what is left. 3 hours later, If you have continued heavy dissolve and swallow another bleeding (soaking more than 800 mcg the same way or insert 2 cloths or large pads in 1 hour for 800 mcg deep in the vagina. If 2 hours in a row) especially with bleeding does not start after 3 dizziness or lightheadedness, get more hours, insert another 800 medical care immediately. You may mcg in the vagina, or dissolve and have an incomplete abortion (see swallow another 800 mcg for a page 251) and need an MVA or total of 2400 mcg.
D and C (see page 244).
For heavy bleeding after giving birth: Dissolve 800 mcg inside the mouth, against the cheek or Information Taking misoprostol with or under the tongue, for about 30 you should without mifepristone is more minutes. Then swallow what is effective the earlier it is taken left. If the woman cannot swallow, in pregnancy. After 9 weeks it insert tablets in her rectum becomes less effective and there where they will dissolve and be are more side effects, especially absorbed. Wear a glove. heavy vaginal bleeding. (continued in next column) Where Women Have No Doctor 2014 nitrofurantoin, norfloxacin 509
nitrofurantoin (Furadantin, Macrobid, Macrodantin)
Nitrofurantoin is an antibiotic used to treat kidney and bladder infections.
In what forms does Nausea or vomiting, this medicine come? headaches, passing gas. To limit Tablets: 25, 50 or 100 mg these, take with milk or food.
Suspension: 25 mg/5 ml If you do not feel better in Information you should know 2 days (48 hours), there may be a resistance to this medicine in For bladder infections: your area. If possible, check with and when to 100 mg 2 times a day a health worker or take other Vomiting, chest pains. Who should not take People with kidneys that taking too Urine may turn dark this medicine? did not work well before yellow or brown.
they got an infection. Women in their last month of pregnancy.
Other medicines for bladder infections: that may work norfloxacin (Lexinor, Noroxin, Uritracin)
Norfloxacin is an antibiotic of the quinolone family used to treat bladder and kidney infections, and serious cases of diarrhea.
Side effects May cause lightheadedness In what forms does this medicine come? and increase the effect of caffeine. To limit these, take either 1 hour before eating For bladder infections: or 2 hours after eating.
and when to Take 1 tablet 2 times a day for 3 days. Take with lots of water. For kidney infections: Take 1 tablet 2 times a day Do not take this drug while either 1 hour before eating or 2 hours after eating using antacids or vitamins that contain iron or zinc. If norfloxacin gives you an allergic reaction, stop using it.
Women who are pregnant, Who should not take breastfeeding, or anyone this medicine? under 16 years old should for bladder or kidney infections: not take norfloxacin. People medicines ceftriaxone, ciprofloxacin, with allergies to quinolone antibiotics should not take Where Women Have No Doctor 2014 510 nystatin, oxytocin
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 Inser ts: 100,000 U medicine come? Lozenges for the mouth: If nystatin causes you Cream: 100,000 U per gram irritation, stop using it. Avoid Liquid: 100,000 U per ml having sex for 3-4 days so you do not pass the infection to your partner.
For mouth or throat infections: How much and when to take Three or four times a day, put 1 ml of liquid in mouth, swish around both sides of mouth for 1 minute and Information you Nystatin works only against swallow. Do this for 5 days.
should know candida yeast infections, while miconazole works For skin infections: Keep area dry and apply cream against other fungal infections 3 times a day until rash is gone. as well. Clotrimazole may be less costly and easier to use.
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 14 nights.
for yeast infections: miconazole, For vaginal discharge not caused by STIs: Other medicines ketoconazole, clotrimazole, Put 100,000 U insert in the vagina at bedtime that may work vinegar or gentian violet for 7 nights.
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 Do not use this drug to does this cause an abortion, because medicine come? it could kill the woman before making her abort. (See Chapter 15, "Abortion.") How much and Inject 10 Units into when to take mother in a large Using oxytocin to speed up muscle after the baby labor or give strength to is born. Repeat after the mother in labor can be 10 minutes if needed.
dangerous to both mother and child. Do not give it before the baby is out.
Side effects Oxytocin can cause the womb to contract so strongly that it will not relax after and may even tear the Other medicines for heavy bleeding after childbirth: womb. Also, oxytocin can that may work ergometrine, misoprostol cause high blood pressure.
Where Women Have No Doctor 2014 paracetamol, penicillin 511
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 Tablets: 100, 325 and 500 mg this medicine come? Liquid: 120 or 160 mg per 5 ml Information you Acetominophen does not Inserts: 80, 120, 300, 325, or should know cure the sickness, it only eases the pain or the fever. Drops: 80 mg per 0.8 ml It is important to find the cause of the pain or fever How much and and cure that.
500 to 1000 mg, by mouth, when to take 4 to 6 times a day as needed, but do not take more than 4,000 mg a day.
taking too Who should Pain in the stomach not take this acetaminophen if you have liver or kidney damage.
If your fever or pain lasts for more for pain, fever, or swelling: than 3 days, get medical help. aspirin, ibuprofen (do not take Acetaminophen can cause liver damage medicines either if you are pregnant) if you take too much or if taken regularly with or after drinking alcohol. for severe pain: codeine Overdoses can be very dangerous.
penicillin (Betapen VK, PenVee K, phenoxymethyl penicillin)
Penicillin is an antibiotic used to treat mouth, tooth, skin and many other infections. Unfortunately a lot of resistance to penicillin has developed and it is less useful than previously.
In what forms Tablets: 250, 500 mg does this Liquid: 125 or 250 mg How much and Watch for allergic when to take reactions and allergic For sores: 500 mg by shock (see page 545). mouth 4 times a day for Who should Do not take if you are medicines for skin infection: not take this allergic to any antibiotics of the penicillin family.
Where Women Have No Doctor 2014 512 podophyllin, probenecid
podophyllin (Condylox, Podocon-25, podophylom resin)
Podophyllin is a liquid that can be put directly on genital warts to shrink them.
Do not put on bleeding warts, In what forms does Liquid: 10% to 25% birthmarks, moles, warts with this medicine come? hair, or in the mouth. If severe skin irritation occurs, do not use it again.
Apply liquid to warts with a How much and cotton swab or clean cloth when to take Podophyllin is very irritating rolled to a fine point. Wash Information you should know to healthy skin. Use only a it off carefully with soap and little bit (.5 ml or less) at a water after 4 hours. Use time. Protect the area around once a week for 4 weeks.
the wart with petroleum gel before using podophyllin.
Who should Do not use this if you are not take this Nausea, vomiting, belly pain, pregnant or breastfeeding.
diarrhea. Too much might taking too cause the skin to thin, break, Podophyllin can be for genital warts: Other medicines that very irritating to skin.
trichloracetic acid, bichloracetic acid probenecid (Benemid, Probalan)
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 It sometimes causes headache, does this medicine nausea, or vomiting.
How much and Take 500 mg to 1 gram when to take Use with caution by mouth each time you during pregnancy and use an antibiotic from the breastfeeding, and if you penicillin family.
have a stomach ulcer.
Who should Do not give probenecid to not take this children under 2 years old.
taking too Where Women Have No Doctor 2014 procaine penicillin, progesterone, promethazine 513
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, 400,000 or 600,000 Units Use with caution if you have asthma. Powder for mixing for injection: Do not use with tetracycline. Never 1 gram = 1 million Units inject this into the vein.
For fever during pregnancy: Inject Information you How much and should know probenecid, the amount 1.2 million Units into muscle when to take of penicillin in the blood every 12 hours while you take increases and lasts longer, the woman for medical treatment. making the treatment To reduce pain, do not inject in more effective.
the same place twice.
Who should Do not use this drug if you not take this are allergic to antibiotics medicines that for fever during pregnancy: ampicillin of the penicillin family.
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 and pages 522 to 524. promethazine (Mepergan, Phenergan, Thaprozine)
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.
Tablets: 10, 12.5, 25, or 50 mg Who should not take In what forms does this medicine? Pregnant and breastfeeding this medicine come? Syrup: 5 mg per 5 ml women should not use this drug regularly. Do not take this Injection: ampules of 25 or if you need to stay alert.
Rectal inserts: 12.5, 25, or 50 mg Often causes dry mouth and blurry vision. Sometimes causes twitching in How much and body, face and especially eyes and neck.
when to take For moderate allergic reaction: Give 25 mg by mouth or injection into muscle. Repeat in Pregnant and breastfeeding women 8 hours or sooner if needed. should take with caution. Do not drive or use heavy machines if you are taking this medicine.
For allergic shock: Inject 50 mg into muscle. Repeat in 8 hours or sooner if needed. (See page 545 for information on treating allergic reactions and shock.) taking too For vomiting: Inject 25 to 50 mg every 6 hours for allergy or allergic reaction: For sleep: Take 25 to 50 mg at bedtime. Other medicines that may work Where Women Have No Doctor 2014 514 pyrazinamide, rifampicin, spectinomycin
pyrazinamide (Isopas, Pyzamed, PZA, Zinamide, Zinastat)
Pyrazinamide is used to treat tuberculosis (TB) (see Chapter 25). Yellow skin or eyes, rash, fever, loss of In what forms does this medicine come? appetite, tiredness, liver tenderness, gout or arthritis. If you have any of these problems, get medical help.
How much and The doses for tuberculosis when to take medicines differ from region to Pregnant and breastfeeding women region. See a health worker. (Take should avoid this drug since its effects pyrazinamide in combination with on the baby are not known. It is very other drugs, see page 389). important that you take the entire course of treatment for tuberculosis. If not, you Who should People with liver damage might infect other people or get sick again not take this or hepatitis should not take this medicine.
with a kind of TB that is very hard to cure.
rifampicin (Resimin, rifampin, Rifastat)
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 Side effects • Nausea, vomiting, loss of appetite, this medicine come? Tablets: 150 or 300 mg Liquid: 20mg/ml and • Hot face, itching, rash • Headaches, fever, chills, bone pain Ampules for injection: 600 mg • Yellow skin or eyes Except for yellow skin or eyes, these side effects usually How much and Doses for tuberculosis medicines happen 2 to 3 hours after taking this medicine and can when to take differ from region to region. See a sometimes be avoided by taking the medicine with food.
health worker. (Take rifampicin in combination with other drugs, see Information May turn urine, stool, tears, sweat, or page 389). Do not take more than you should spit a red-orange. It will stain contact 600 mg a day.
lenses too. Reduces the effectiveness of hormonal contraceptives. Take Who should People with liver damage or the entire course of TB treatment to not take this liver disease should not take prevent drug resistance and infecting this medicine.
spectinomycin (SCM, Stanilo, Togamycin, Trobicin)
Spectinomycin is a strong aminocyclitol antibiotic used to treat most types of gonorrhea, but it does not work for gonorrhea of the throat. It is especially useful for people allergic to penicillin and cephalosporin In what forms does this medicine Chills, pain or redness at Vials for injection: 2 grams injection site, dizziness, nausea.
How much and For gonorrhea or PID: Inject for gonorrhea: ceftriaxone when to take 2g (2000 mg) into muscle one medicines for PID: amoxicillin, azithromycin, time only. (See pages 268 and ceftriaxone, doxycycline, 275 for drug combinations to treat these problems.) Where Women Have No Doctor 2014 streptomycin, tetanus toxoid 515
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 Liquid for injection: May damage hearing or balance, medicine come? and can cause a rash and How much and The doses for tuberculosis when to take medicines differ from region to region. See a health worker. Information Wear gloves if you touch you should this medicine often because (Take streptomycin in combination it can cause a serious rash.
with other drugs, see page 389). It is very important that you Who should Pregnant women should not not take this use streptomycin because it can take the entire course of cause deafness in the baby. People treatment for tuberculosis. If with allergies to antibiotics of the not, you might infect other aminoglycoside family like gentamicin people or get sick again with should not take this drug. People with a kind of TB that is very kidney problems should use with caution.
hard to cure.
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 Tetanus immunizations should Liquid for injection: Information does this you should be given to everyone, starting in medicine come? 4, 5, or 10 U per 0.5 ml childhood. Tetanus immunization is often given to children as part of a combined immunization called DPT, How much and and the three DPT immunizations when to take To be safe from tetanus for are equal to the first 2 tetanus your entire life, you must get toxoid immunizations. Teens and 5 immunization injections, and adults may get the combined Td immunization.
then one injection every 10 years.
The schedule below gives the minimum time in between injections for adults.
For each immunization: Give 1 injection of 0.5 ml into the muscle of the upper arm.
First . As soon as possible Second . 4 weeks after the first Third . 6 months after the second Fourth . 1 year after the third Pain, redness, warmth, slight swelling.
Fifth . 1 year after the fourth Booster . Every 10 years after last injection Where Women Have No Doctor 2014 516 tetracycline, tinidazole, trichloroacetic acid
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, respiratory infections, diarrhea, and other infections. Doxycycline works for all the same infections, costs less and is easier to take (see page 499). In what forms Do not take within 1 hour of does this Capsules: 100, 250, or 500 mg eating dairy products or antacids. Do not take if past expiration date.
How much and For chlamydia: 500 mg 4 times Information Tetracycline does no when to take a day for 7 days (also take you should good in fighting common other medicines, see page 268). know colds or preventing STIs.
For syphilis: 500 mg 4 times a day for 14 days. If you spend a lot of time in the For baby eye care: a bit of sun it can cause skin rashes. It may ointment in each eye at birth, cause diarrhea or upset stomach.
one time only.
for chlamydia: amoxicillin, azithromycin, Who should Do not use tetracycline if you are not take this pregnant or breastfeeding. Do not medicines for PID: ceftriaxone, doxycycline, give to children under 9 years old that may metronidazole, spectinomycin except for baby eye care. Do not for newborn eye care: erythromycin ointment take if allergic to antibiotics of the for syphilis: benzathine penicillin, doxycycline, tinidazole (Fasigyn, Simplotan, Tindamax)
Tinidazole is used for vaginal infections caused by trichomonas. It is also effective against some amoebas, parasites, and giardia. It is similar to metronidazole but you don't have to take it as long.
In what forms Tablets: 250 mg, Your sexual partner should also be treated. does this Do not drink alcohol, not even one beer, while medicine come? you are taking tinidazole or for 3 days after. It will make you feel very nauseous. Avoid this How much and For trichimonas: Take 2 grams medicine in the first 3 months of pregnancy.
when to take by mouth one time only, but not if you are pregnant. If you are pregnant: Take 500 mg by Information Drink a glass of water you should mouth 2 times a day for 5 days. know after taking this medicine.
Metallic taste in mouth, upset Other medicines that stomach or nausea, headache.
for trichimonas: metronidazole trichloroacetic acid, bichloroacetic acid
Either trichloroacetic acid or bichloroacetic acid can be used to treat genital warts.
In what forms Liquids in strengths Use very carefully. It can burn normal does this skin badly enough to cause a scar.
medicine come? between 10% and 35% Information First protect the area around the wart with Put only on wart you should petroleum gel. Then put on trichloroacetic and when to once a week for 1 to acid. It will hurt for 15 to 30 minutes. If 3 weeks as needed.
it spills onto healthy skin, wash it off with soap and water. You can also put baby Trichloroacetic acid will hurt or powder (talc) or baking soda on spills.
destroy normal skin if spilled.
Other medicines that for genital warts: podophyllin Where Women Have No Doctor 2014 Medicines for AIDS 517
Medicines for AIDS – AntiretroviraL TheraPy (ART)
(see also pages 291 and 292) Certain medicines can help people with HIV live longer and healthier lives. Taken daily as a combination of at least 3 medicines, this is called Antiretroviral Therapy, or ART. HIV care and ART programs
HIV is a complicated disease that affects every part of your body. As soon as you have a positive HIV test, try to find an HIV care program that can provide medicines to prevent and treat HIV illnesses, counseling and other support. They can help you start ART and manage any possible side effects. Getting drugs from an ART program is more reliable and less costly than buying them from a private source.
When is ART needed?
People who test positive for HIV and show signs that their immune system is becoming weak need ART. A blood test called a CD4 cell count can measure how well the immune system is working. If your CD4 count is below 350, even if you feel healthy, you should talk to your health worker about starting ART.
If you are pregnant and test positive for HIV, you should start ART even if you do not get a CD4 test.
Before starting ART, it is important to discuss with your health worker: • Have you ever taken any ART before? This may affect what medicines you should • Do you have any illnesses or serious infections such as pneumonia? They may need to be treated first. • Do you know about the benefits, risks, and possible side effects of ART? Try to talk to someone who is already using ART as well as your health worker. • Are you able to take medicines every day, at the correct times? This is necessary for ART to work.
• Is a steady supply of the medicines you need available?• Have you told at least one person that you have HIV? She or he may be able to help if something prevents you from getting or taking your medicines.
• Is there an HIV support group you can turn to for information and help? Do not start taking ART on your own. They may be the wrong medicines for you and can have serious side effects or cause drug resistance.
Do not share ART medicines with anyone. The medicines will not work if you take less than the recommended dose.
Do not buy ART from someone who is not part of an approved HIV care or ART program.
IMPORTANT Once you start taking ART you must continue for the rest of your life, or the virus
will multiply in your body once again and you will become sick. If you do not take ART every day, at the right time, resistance can develop and the drugs will no longer work for you or for others in your Where Women Have No Doctor 2014 518 Medicines for AIDS
How to take ART
ART is effective only in combinations (regimens) of at least 3 medicines. Some medicines are combined into 1 or 2 tablets or capsules so there are fewer pills to take. This makes taking medicines every day easier. The 4 combinations described on the next page are widely available, have fewer side effects, and are safer. Depending on what is available, other combinations of medicines may be used where you live. • Whatever combination you use, take each medicine every day, at the same time of day.
• Twice-a-day medicines should be taken every 12 hours. For example, if you take the first dose at 6:00 in the morning, then the second dose should be taken at 6:00 in the evening. Some medicines need to be taken only once a day (see page 476). Side effects of ART ART can have side effects. Some side effects decrease and go away completely with time. Others appear only after you have taken a medicine for a long time. Some common side effects are bothersome but are not serious, such as diarrhea, tiredness, headaches, and stomach problems. Talk to your health worker about how to handle these problems. But keep taking all your medicines until your health worker tells you to change or stop.
Other side effects can be life-threatening, such as severe liver problems, severe tiredness with shortness of breath, skin allergies and rashes, tingling or burning in the hands and feet, and anemia. If you have serious side effects, see a health worker right away.
Drug resistance – first and second line combinations The ART you start on is called a first line combination, or first line regimen. Over a period of years, HIV can become resistant to ART (see page 481). Many people may need to switch to a second line of drugs. Talk to your health worker about which drugs work in your area and if you need to change. These recommendations for ART are based on the newest information we have as of Changes in drugs: Any of the combinations on page 519 may be available as one pill, taken once daily.
• Combinations with efavirenz (EFV) are now recommended for all women, including women who are pregnant or breastfeeding.
• Emtricitabine (FTC) can substitute for lamivudine (3TC) in combinations that also include tenofovir (TDF). The dose for FTC and 3TC in those combinations is the same.
Changes in when to start: People with HIV should start ART early while they are still healthy to avoid serious illnesses. HIV positive people who are already sick with advanced AIDS should start treatment, even if no CD4 test is available. To start early, they need a CD4 test to see if the count is 350 or less. Changes in who to treat: All pregnant, HIV positive women should start treatment. ART should also be started for anyone with HIV and active TB or hepatitis B infection, no matter what their CD4 count is, or whether they have advanced HIV disease. Where Women Have No Doctor 2014 Medicines for AIDS 519
ART Combinations for adults and adolescents
(not for children under 10 years old)
Warnings and side effects Advantages
• tenofovir (TDF) 300 mg once a day Can cause kidney • Preferred combination for pregnant and breastfeeding women • lamivudine (3TC) 150 mg 2 times a day, • Preferred combination emtricitabine (FTC) 300 mg once a day if taking rifampicin for • Preferred combination • efavirenz (EFV) 600 mg once a day for women with HIV Warnings and side effects Advantages
• zidovudine (AZT) Low white blood count • Preferred combination if taking rifampicin for • lamivudine (3TC) 150 mg 2 times a day, or 300 mg once a day • efavirenz (EFV) 600 mg once a day Warnings and side effects Advantages
• zidovudine (AZT) Low white blood count • lamivudine (3TC) 150 mg 2 times a day, or 300 mg once a day200 mg once a day for • nevirapine (NVP) 14 days, then 200 mg Warnings and side effects Advantages
• tenofovir (TDF) 300 mg once a day Can cause kidney • lamivudine (3TC) 150 mg 2 times a day, emtricitabine (FTC) 300 mg once a day200 mg once a day for • nevirapine (NVP) 14 days, then 200 mg IMPORTANT Many people still take stavudine instead of zidovudine in Combinations 2 and 3.
Most HIV treatment programs are trying not to use combinations that include stavudine, because it can cause severe side effects after long-term use. If you use stavudine, do not take more than 30 mg twice a day. Where Women Have No Doctor 2014 520 Medicines for AIDS
ART for pregnant women
All pregnant women who have HIV should start ART to maintain or improve their health. ART will also help prevent HIV from spreading to the baby. Once a pregnant woman starts an ART combination, she should continue for the rest of her life.
A woman who is already on ART when she becomes pregnant should continue taking it throughout her pregnancy, during the birth, while breastfeeding, and after. When her baby is born, he will also need medicines.
Preventing Mother-to-Child Transmission, or PMTCT
To prevent HIV spreading to her baby, a pregnant woman with HIV needs to take ART medicines during pregnancy, labor, and breastfeeding. The baby will also need medicines. Medicines are only one part of preventing HIV in a baby. Safer sex during pregnancy, safe birth practices, careful feeding of the baby, and treatment of illnesses in both mother and child are also important to prevent babies from getting HIV. ART medicines to prevent HIV in babies (mother-to-child transmission)
If the mother IS already taking ART, she should continue taking her medicines and also give the baby the medicines listed in Option 1.
If the mother IS NOT taking ART, she and her baby should take the medicines listed in Option 1 or in Option 2. Use medicines recommended and available in your country.
Option 1FOR THE MOTHER FOR THE BABYWhether or not the baby is breastfeeding, the baby should be given: Start taking one of the combinations of ART as soon • AZT (ZDV, zidovudine), oral suspension, 4 mg/kg, as possible. You will need to take ART medicines 2 times a day for 6 weeks, OR every day for the rest of your life.
• NVP (nevirapine), oral suspension, 2 mg/kg, once a day for 6 weeks.
Option 2FOR THE MOTHER FOR THE BABY During pregnancy, starting as soon as possible from Immediately after birth, the baby should be given: 14 weeks of becoming pregnant she should take: • NVP (nevirapine), 2 mg/kg oral suspension • AZT (ZDV, zidovudine), 300 mg, 2 times a day. During labor, she should take: If the mother IS TAKING ART, continue giving the • NVP (nevirapine), 200 mg, in a single dose when baby this NVP dose every day for 6 weeks. labor starts, AND If the mother is NOT TAKING ART and is NOT • 3TC (lamivudine), 150 mg, when labor starts, and breastfeeding, continue giving the baby this NVP every 12 hours until the baby is born, AND dose every day for 6 weeks. • continue taking AZT (ZDV, zidovudine), 300 mg, If the mother is NOT TAKING ART and IS breastfeeding, continue giving the baby this NVP After the birth, she should continue taking for 7 days: dose every day until 1 week after she stops breastfeeding.
• 3TC (lamivudine), 150 mg, 2 times a day, AND • AZT (ZDV, zidovudine), 300 mg, 2 times a day.
Where Women Have No Doctor 2014 Medicines for AIDS 521
Preventing HIV right after a woman has been exposed to it
When a woman is exposed to HIV, for example when a health worker is stuck with a needle or a woman is raped by someone who probably has HIV, it is sometimes possible to prevent getting HIV by taking ART medicines for a short time. This is called Post Exposure Prophylaxis, or PEP. If you think you have been exposed to HIV (see page 285 for information about how HIV is spread), talk with a health worker you trust as soon as possible about whether starting PEP is the best decision for you. You should start taking PEP medicines within a few hours, and no later than 3 days after, exposure. Start one of the ART combinations on page 519, preferably Combination 1 or Combination 4. Other combinations may be available and recommended in your area. Whatever combination you use, take the medicines for 28 days. Where Women Have No Doctor 2014 522 Oral contraceptives (birth control pills)
OraL contracePtives (birth controL PiLLs)
Most birth control pills contain 2 hormones similar to the hormones that a woman's body normally makes. These hormones are called estrogen and progestin. Usually, brands that contain a smaller amount of both hormones are the safest and work best Birth control pills come in different strengths of each hormone and are sold under many different brand names. We list only a few brands in the combined pills chart below. Groups 1, 2, and 3 list different types of combined pills.
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: Gracial Group 2 - Low dose pills
These contain low amounts of estrogen and progestin in a mix that stays the same
throughout the month.
Brand names: Alesse Brevicon 1 + 35 Femoden Group 3 - Low dose pills
These pills are high in progestin and low in estrogen.
Brand names: Lo-Femenal
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 2.
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. If spotting continues after 3 or 4 months, try one of the brands in Group 3.
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.
Where Women Have No Doctor 2014 Oral contraceptives (birth control pills) 523
Progestin-only pills should be taken at the same time every day, even during monthly bleeding. Menstrual bleeding is often irregular. There is also an increased chance of pregnancy if a woman forgets to take even one pill.
Group 4 - Progestin-only pills (minipills)
Minipills contain only progestin.
Brand names: Femulen
Emergency family planning
(EC, emergency contraceptive pills)
You can use regular birth control pills or special emergency pills to prevent pregnancy within 5 days after unprotected sex. The number of pills you need to take depends on the amount of estrogen or progestin each pill contains. There are many brands of pills, and some brand names are used for more than one type of pill. The chart on the next page lists only a few common brands for each type of pill. Make sure you know the amount of hormone in the pills before you use them in an emergency.
Where Women Have No Doctor 2014 524 Emergency family planning (emergency pills)
How to take pills for emergency family planning
Pills for emergency family planning
Emergency pills containing 1.5 mg (1500 mcg) Take one pill, one time only levonorgestrel (Norlevo 1.5, Plan B One-Step, Postinor-1) Emergency pills containing 30 mg ulipristal acetate Take one pill, one time only (Ella, Ella One) Emergency pills containing 0.75 mg (750 mcg) levonorgestrel (Norlevo 0.75, Optinor, Postinor, Take 2 pills, one time only Postinor-2, Plan B) Emergency pills containing 50 mcg ethinyl estradiol Take 2 more pills and 250 mcg levonorgestrel (Tetragynon) Combined pills containing 50 mcg ethinyl estradiol Take 2 more pills and 250 mcg levonorgestrel (Neogynon, Nordiol ) or 500 mcg norgestrel (Ovral) Combined pills containing 30 mcg ethinyl estradiol Take 4 more pills and 150 mcg levonorgestrel (Microgynon, Nordette) or Take 4 pills 300 mcg norgestrel (Lo-Femenal, Lo/Ovral) Combined pills containing 20 mcg ethinyl estradiol Take 5 more pills and 100 mcg levonorgestrel (Alesse, Lutera) Progestin-only pills (minipills) containing 75 mcg Take 20 pills one time only Progestin-only pills (minipills) containing 37.5 mcg Take 40 pills one time only Progestin-only pills (mini pills) containing 30 mcg Take 50 pills one time only levonorgestrel (Microlut, Microval) With a pack of 28 pills, use any of the first 21 pills for emergency contraception. Do not use the last 7 pills in a 28-day pack, because these pills do not contain any hormones.
Progestin-only pills and special emergency pills have fewer side effects (headaches and nausea) than combined pills used for emergency family planning.
Where Women Have No Doctor 2014

Source: https://hesperian.org/wp-content/uploads/pdf/en_wwhnd_2014/en_wwhnd_2014_gp.pdf