Hesperian Health Guides

Alphabetical list of medicines

In this chapter:


Contents

activated charcoal

Activated charcoal is a specially prepared charcoal used to treat poisonings by drugs like aspirin, paracetamol, chloroquine, or other medicines or chemicals, by absorbing them in the stomach.

Often comes in:
Liquid: 25 g per 120 ml
Powder: 50 g

How to use:
For treating poisoning, give 50 g by mouth as soon as possible with a full glass of water. Then give 25 g every 4 to 6 hours for 24 hours.

Important
Do not give activated charcoal if the person has swallowed fuel, kerosene, lighter fluid, or other petroleum products.

Side effects
Black stool, vomiting, diarrhea.

Warning
After giving activated charcoal, get medical help immediately. People who take too much of a drug
or chemical can get very sick and need much more
help than activated charcoal.


Pregnant women need to take special care

WARNING!
acyclovir

Acyclovir is a medicine that fights viruses including herpes.

Often comes in:
Tablets: 200 mg
Powder: for mixing injections.

How to use:
For the first outbreak of herpes, give 400 mg by mouth, 3 times a day for 7 to 10 days.

For continuing herpes outbreaks, give 400 mg by mouth, 3 times a day for 5 days.

For a woman with more than 6 herpes outbreaks
a year,
give 400 mg acyclovir by mouth, 2 times every day for 1 year. Then stop and see if the medicine is
still needed.

For a pregnant woman who has a herpes outbreak during her pregnancy, give 400 mg by mouth, 2 times a day during the last month of pregnancy.

Important
Acyclovir can reduce the symptoms of herpes infection — but it will not cure it or prevent it from coming back.
Side effects
headache, dizziness, nausea, vomiting.
Warning
This medicine may have some harmful effects in pregnancy. For pregnant women, it is best only to give this medicine for an initial herpes outbreak, or during the last month to prevent an outbreak during labor.


amoxicillin

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

Often comes in:
Tablets: 250 and 500mg
Powder for mixing injections
Syrup of various strengths.

How to use:
For preventing infection after an invasive procedure, give 1 g (1000 mg) by mouth, 1 time only. Also give metronidazole.
For infection after genital cutting, give 500 mg by mouth 3 times a day for 10 days.

For preventing infection after an invasive procedure, give 1 g by mouth, 1 time only. Also give metronidazole.

For infection in a newborn baby, inject in the thigh muscle for 7-10 days. For a baby that weighs 2 kg or less, use 100 mg, 2 times a day; 3 kg, use 150 mg, 3 times a day; 4 kg or more, use 200 mg, 3 times a day

Important
Take with food. If you do not start to get better in 3 days, get medical help. You may need a different medicine.
Side effects
Diarrhea, rash, nausea, vomiting. May cause yeast infection in women or diaper rash in children.
Other medicines
that may work
Ampicillin can almost always be used instead of amoxicillin. A person who is allergic to penicillins can try erythromycin.

Warning

Do not give amoxicillin to someone who is allergic to drugs in the penicillin family.


amoxicillin with clavulanic acid (Augmentin)

The combination of clavulanic acid and amoxicillin improves the effectiveness of amoxicillin and its ability to fight drug resistance. It is a medicine of the penicillin family used to treat womb infection and urine system infections, among others.

Often comes in:
Tablets: 875 mg amoxicillin + 125 mg clavulanic acid
Tablets: 500 mg amoxicillin + 125 mg clavulanic acid Liquid: 250 mg amoxicillin + 62.5 mg clavulanic acid in 5 ml.

How to use:

For womb infection after birth or abortion,
give 500 mg amoxicillin + 125 mg clavulanic acid by mouth, 3 times a day for 10 days
For kidney infection,
give 500 mg amoxicillin + 125 mg clavulanic acid by mouth, 3 times a day for 10 days
For wound infection from female genital cutting,
give 875 mg amoxicillin + 125 mg clavulanic acid by mouth, 2 times a day for 7 to 10 days.

Important
Take with food.
Side effects
Stomach upset, diarrhea, jaundice.
Other medicines
that may work
doxycycline, metronidazole

Warning

Do not give amoxicillin with clavulanic acid to someone who is allergic to medicines in the penicillin family. Be ready to treat an allergic reaction if someone is allergic to medicines in the cephalosporin family.


ampicillin

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

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



How to use:
For womb infection during labor, after birth or after abortion, inject 2 g (2000 mg) into muscle for the first dose, then inject 1 g (1000 mg) 4 times a day until fever has been gone 48 hours. You must also give other antibiotics.

For infection in a newborn baby, inject in the thigh muscle for 7 to 10 days. For a baby that weighs: 2 kg or less, use 100 mg, 2 times a day; 3 kg, use 150 mg, 3 times a day; 4 kg or more, use 200 mg, 3 times a day.

Important
Take ampicillin before eating.

Side effects
May cause stomach upset, diarrhea, and rash. May cause yeast infection in women or diaper rash in children.

Other medicines
that may work
Amoxicillin can almost always be used instead of ampicillin. A person who is allergic to penicillins can try erythromycin.

Warning
Do not give ampicillin to someone who is allergic to drugs in the penicillin family.

Pregnant women need to take special care

WARNING!
artemisinin-based combination therapy (ACT) (artesunate, artemether, wormwood)

Depending on the region, chloroquine or other malaria medicines may no longer work to against falciparum malaria. Instead, use ACT (Artemisinin-based Combination Therapy) medicines. Find out from local health authorities which of the ACT medicines work in your area.

How to use:
For malaria, ACT comes as 2 medicines combined in 1 or more pills or as 2 medicines in separate pills but packaged together to take at the same time. ACT is always taken for 3 days, either 1 or 2 times a day, depending on the type of ACT.

The different types of ACT that treat malaria include artemether + lumefantrine, artesunate + amodiaquine, and artesunate + sulfadoxine–pyrimethamine (SP).
Important
For women in the first 3 months of pregnancy, avoid ACT and give quinine + clindamycin instead (or only quinine).

Pregnant women need to take special care

WARNING!
aspirin(acetylsalicylic acid, ASA)

Aspirin works against pain, swelling and fever. A low dose can help prevent pre-eclampsia

Often comes in:
Tablets: 300 mg, 500 mg, and other sizes.
Low dose tablets: 81 mg.
How to use:
For pain, swelling or fever: give 300 to 600 mg by mouth, every 4 hours as needed.

For prevention of pre-eclampsia: give 81 mg by mouth, 1 time each day after 12 weeks of pregnancy and until birth.
Important
Breastfeeding women can use aspirin one week after the baby is born, but pregnant women should use paracetamol instead unless they are using a low dose to prevent pre-eclampsia. Aspirin helps reduce signs of illness such as pain and fever, but it is important to find and treat their causes. For pain more than 10 days, or fever more than 3 days, get help.
Side effects
May cause stomach upset, stomach pain, or bleeding problems.
Other medicines
that may work
For pain, swelling or fever: paracetamol (acetaminophen), ibuprofen.


azithromycin

Azithromycin is an antibiotic of the macrolide family used to treat many serious infections and STIs.

Often comes in:
Capsules: 250 mg and 500 mg
How to use:
For chlamydia,pelvic inflammatory disease,chancroid give 1 g (1000 mg) by mouth, 1 time only.

To prevent infection after abortion, give 500 mg by mouth, 1 time only, 1 hour before the procedure.

For a baby with chlamydia or gonorrhea who is 7 days old or older,give 50 mg syrup by mouth, 1 time a day for 3 days. You must also give other antibiotics.

For a person who has had syphilis for less than 2 years, give 2 g (2000 mg) by mouth, 1 time only.
Important
Take with food
Side effects
May cause diarrhea, nausea, vomiting, abdominal pain
Other medicines
that may work
ampicillin or amoxicillin, or doxycycline.


BCG vaccine

The BCG vaccine helps to protect against getting tuberculosis (TB).

Often comes in:
Liquid for injection.

How to use:
Inject 0.1 ml in the skin (intradermal injection), usually on the upper arm.

Important
The BCG vaccine is a live vaccine so it must be kept cold at all times or it will not work.
Side effects
The vaccination usually makes a sore and leaves a scar.


benzathine benzylpenicillin (penicillin G benzathine)

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

Often comes in:
Powder for mixing injections of 1.2 or 2.4 million Units in a 5 ml vial.

How to use:
For a person who has had syphilis for less than 2 years, inject 2.4 million Units into muscle, 1 time only.

For a person who has had syphilis 2 years or more, inject 2.4 million Units into muscle, 1 time a week for 3 weeks.

tetanus in a newborn, inject 100,000 Units into muscle, 1 time only, on the way to the hospital.

Important
May cause yeast infection in women or diaper rash in children. Be ready to treat an allergic reaction.

Other medicines
that may work
erythromycin.

Warning
Do not give benzathine benzylpenicillin to someone who is allergic to medicines in the penicillin family.


cephalexin

Cephalexin is an antibiotic of the cephalosporin family that is used to treat a variety of infections including skin and urinary tract infections.

Often comes in:
Capsules: 250 mg
Liquid: 125 mg in 5 ml; 250 mg in 5 ml

How to use:
For infection from female genital cutting, give 1 g (1000 mg) by mouth, 2 times a day for 7 to 10 days.

Important
Be ready to treat an allergic reaction.
Side effects
diarrhea, headache, rash.

Other medicines
that may work
clindamycin

Warning
Do not give cephalexin to someone who is allergic to medicines in the cephalosporin family. Be ready to treat an allergic reaction if someone is allergic to medicines in the penicillin family.

cefixime

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

Often comes in:
Tablets: tablets of 200 or 400 mg
Liquid: 100 mg in 5 ml

How to use:
For gonorrhea or inflammatory disease , give 400 mg by mouth, 1 time only.

For bladder infection, give 200 mg by mouth, 2 times a day for 5 days.

For kidney infection, give 200 mg by mouth, 2 times a day for 14 days. You must also give other antibiotics.

Important
Be ready to treat an allergic reaction. People who have liver problems should be careful when taking cefixime.
Side effects
Nausea, diarrhea, headache. May cause yeast infection in women or diaper rash in children.

Other medicines
that may work
ceftriaxone, erythromycin.

Warning
Do not give cefixime to someone who is allergic to medicines in the cephalosporin family.



ceftriaxone

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

Often comes in:
Vials for injection: 250 and 500 mg, and 1 gram,
2 grams, and 10 grams.

How to use:
For kidney infection, inject 1 g (1000 mg) into muscle, 1 time only. You must also give other antibiotics.

For chlamydia,pelvic inflammatory disease,chancroid, iinject 250 mg into muscle, 1 time only. In some places, 500 mg may be recommended for gonorrhea or pelvic inflammatory disease.

For a baby with chlamydia or gonorrhea, inject 125 mg into the thigh muscle, 1 time only. For babies 7 days old or older, you must also give another antibiotic.

Important
Be ready to treat an allergic reaction.

Side effects
May cause yeast infection in women or diaper rash in children.

Other medicines
that may work
cefixime, erythromycin.

Warning
Do not give ceftriaxone to someone who is allergic to medicines in the cephalosporin family.


Breastfeeding women need to take special care

WARNING!
clindamycin

Clindamycin is a strong antibiotic used to treat malaria early in pregnancy as well as other infections.

Often comes in:
Capsules: 150 mg
Liquid for injection: 150 mg per ml

How to use:
For malaria in women in the first 3 months of pregnancy, give 600 mg by mouth 2 times a day for 7 days. You must also give quinine.

For bacterial vaginosis, give 300 mg by mouth' 2 times a day for 7 days.

Side effects
Diarrhea, vomiting, rash, metallic taste in the mouth. May cause yeast infection in women or diaper rash in children.

Warning
Clindamycin can cause serious problems with the colon.

It also passes through a breastfeeding mother’s milk to her baby.

Only use this drug when it is truly needed.


cotrimoxazole(trimethoprim + sulfamethoxazole)

Cotrimoxazole is a combination of 2 antibiotics (one from the sulfa family) that is used to treat bladder, kidney, and other infections. It also helps prevent infections for people with HIV.

Often comes in:
Tablets: 120, 480, and 960 mg
Liquid: 240 mg per 5 ml

How to use:
For bladder infections, give 960 mg (160 mg trimethoprim and 800 mg sulfamethoxazole) by mouth, 2 times a day for 3 days.
To prevent infections for adults with HIV, take 960 mg by mouth 1 time each day.
For children of mothers with HIV:
For babies less than 6 months old, give 120 mg of liquid by mouth, 1 time each day.
For children 6 months to 6 years old, give 240 mg of liquid by mouth, 1 time each day

Important
Take with lots of water.
Side effects
Stop taking cotrimoxazole if it causes allergic reactions like itching or rashes. It may also cause nausea or vomiting.
Warning
Do not give cotrimoxazole to someone who is allergic to medicines in the sulfa family.

Do not give cotrimoxazole to someone already taking sulfadoxine-pyrimethamine for malaria.


clotrimazole

Clotrimazole is an anti-fungal medicine used to treat yeast and other fungus infections in the vagina, mouth, and skin.

Often comes in:
Inserts: 100 mg, 500 mg
Cream

How to use:
For yeast infections in the vagina, put one insert high in the vagina every night, including during menstruation. Use one 100 mg insert every night for 6 nights, or one 500 mg insert for 1 night only.

Side effects
Clotrimazole may irritate the skin. Stop using if you get a rash.

Other medicines
that may work
nystatin


Pregnant women need to take special care

Breastfeeding women need to take special care

WARNING!
diazepam

Diazepam is a tranquilizer used to treat and prevent convulsions and seizures.

Often comes in:
Tablets of 5 to 10 mg
Liquid of 5 mg per 1 ml.

How to use:
For syringe without a needle. Repeat with 10 mg if needed, at least 20 minutes after the first dose. Do not give any additional doses after this. If you do not have liquid diazepam, use crushed diazepam tablets mixed with clean water.

Important
Diazepam is a habit-forming (addictive) medicine. Avoid taking with other drugs that will make you sleepy, especially alcohol.
Side effects
Sleepiness, loss of balance, confusion.
Other medicines
that may work
magnesium sulfate.
Warning
Diazepam is an addictive (habit-forming) drug.

Do not use diazepam with alcohol or other drugs that can make you sleepy.

Frequent or large doses of diazepam during pregnancy can cause disabilities in the developing baby.

This medicine also passes through breastmilk, so breastfeeding mothers should avoid it except in emergencies.


dicloxacillin

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

Often comes in:
Capsules of 125, 250, or 500 mg
Liquid of 62.5 mg per 5 ml

How to use:
For breast infection, give 500 mg by mouth 4 times a day for 7 days.

Important
Be ready to treat an allergic reaction.
Side effects
Nausea, vomiting, diarrhea. May cause yeast infection in women or diaper rash in children.
Other medicines
that may work
erythromycin.
Warning
Do not give dicloxacillin to someone who is allergic to medicines in the penicillin family.


Pregnant women need to take special care

Breastfeeding women need to take special care

WARNING!
diphenhydramine

Diphenhydramine is an antihistamine that treats allergic reactions and allergic shock. It is also used for treating chronic itching and sleep problems for people with HIV.

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

How to use:
For mild to moderate allergic reaction, give 25 mg by mouth, every 6 hours until signs go away.

For allergic shock, inject 50 mg into muscle. Repeat in 4 hours if signs do not improve. You must also give other medicines.

Side effects
Sleepiness and dryness in the mouth and nose. May cause nausea and vomiting. Very rarely causes excitement rather than sleepiness.

Other medicines
that may work
promethazine.

Warning
Diphenhydramine is best taken by mouth. Only inject it for severe allergic reactions and shock.

Do not use diphenhydramine with alcohol or tranquilizers. It makes their effects dangerously strong.

This medicine is OK to use in emergencies, but should not be used regularly during pregnancy or breastfeeding.


Pregnant women need to take special care

Breastfeeding women need to take special care

WARNING!
doxycycline

Doxycycline is an antibiotic of the tetracycline family used to treat many different infections.

Often comes in:
Tablets: 50 and 100 mg.

How to use:
For chlamydia, give 100 mg by mouth, 2 times a day for 7 days.

For pelvic inflammatory disease, give 100 mg by mouth, 2 times a day for 14 days. You must also give other antibiotics.

To prevent infection after abortion, give 200 mg by mouth, 1 time only, 1 hour before the procedure.

For womb infection after birth or after abortion give 100 mg by mouth, 2 times a day for 10 days.

Important
Take pills while sitting up and with lots of water. Stay out of the sun or you may get a rash or severe sunburn. Avoid milk, iron pills, and antacids for 2 hours before or after taking doxycycline. They make the medicine less effective.

Side effects
Diarrhea, upset stomach. May cause yeast infection in women or diaper rash in children.

Other medicines
that may work
amoxicillin, metronidazole.

Warning
Women who are pregnant should not take this medicine. Doxycycline can damage a baby's teeth and bones.

Women who are breastfeeding can take doxycycline for a short time to treat infections, but should avoid taking it long term.

Doxycycline may not be safe to use after it has passed its expiration date.



epinephrine (adrenaline)

Epinephrine is used for allergic reactions or shock, for example, allergic shock caused by penicillin. It is also used for severe asthma attacks.

Often comes in:
Ampules for injection: 1 mg in 1 ml (1 mg/ml or 1:1000)

How to use:
For allergic reaction or shock, inject 0.5 ml of 1:1000 (1 mg/ ml) into muscle or under the skin. If needed, a second dose can be given in 5 to 15 minutes, and a third dose after another 5 to 15 minutes. Do not give more than 3 doses. You must also give other medicines.

Important
Inject into muscle, the thigh is best. Take the person's pulse before injecting.
Side effects
Fear, restlessness, nervousness, tension, headaches, dizziness, increased heart rate.


ergometrine (ergonovine, methylergonovine)

Ergometrine causes contractions of the womb and its blood vessels and is used to control heavy bleeding after childbirth or an abortion.

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

How to use:
To stop heavy bleeding after birth, inject 0.2 mg in muscle every 4 hours as needed. Do not give more than 5 doses (1.0 mg total).

Side effects
Nausea, vomiting, dizziness, sweating.

Important
Refrigerate ergometrine so it stays cold (2°C to 8°C or 35°F to 46°F) and keep it away from light. If not it will lose strength over time. If it becomes discolored and does not look like clear water, it probably will not work.
Other medicines
that may work
misoprostol, oxytocin.

Warning
Do not use ergometrine to start or speed up labor or to cause an abortion.

Do not give this drug before the baby and the placenta have come out.

Do not give ergometrine to women with high blood pressure.


erythromycin

Erythromycin is an antibiotic of the macrolide family used to treat many infections. It can be used safely during pregnancy and is often a good choice when a woman is allergic to penicillin family antibiotics.

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

How to use:
For newborn eye care, use 0.5% or 1% ointment 1 time only, within 2 hours of the birth.

For breast infection, give 500 mg by mouth, 2 times a day for 7 days.

For chlamydia or chancroid, give 500 mg by mouth, 4 times a day for 7 days.

For a baby with chlamydia or gonorrhea who is 7 days old or older, give 30 mg syrup by mouth, 4 times a day for 14 days. You must also give other antibiotics.

For pelvic inflammatory disease, give 500 mg by mouth, 4 times a day for 14 days.

For a person who has had syphilis 2 years or more, give 500 mg by mouth, 4 times a day for 30 days.

Important
Erythromycin works best when taken 1 hour before or 2 hours after a meal. If this makes a person nauseated, take with a little food.

Do not break up tablets. Tablets are often coated to prevent strong stomach juices from breaking down the drug before it can begin to work.

Side effects
Upset stomach, nausea, diarrhea. May cause yeast infection in women or diaper rash in children.

Other medicines
that may work
amoxicillin, benzathine benzylpenicillin, ceftriaxone, dicloxicillin, povidone iodine, procaine penicillin, silver nitrate, tetracycline eye ointment.
Warning
Do not give erythromycin to someone who is allergic to drugs in the macrolide family.



ferrous sulfate (iron)

Iron is a mineral that everyone, especially a pregnant woman, needs to have healthy blood and enough energy. It is possible but difficult to get enough iron by eating meat or lots of green leafy vegetables.

Often comes in:
Tablets: of many different strengths.

How to use:
To prevent anemia in pregnancy, give 300 to 325 mg by mouth once a day with meals, throughout pregnancy.

To treat anemia, give 300 to 325 mg by mouth 2 or 3 times a day until the woman no longer has signs of anemia, or throughout pregnancy.

Important
Eating fruits and vegetables high in vitamin C can help the body use iron better.
Side effects
Nausea, diarrhea, constipation. Iron is best taken with food.
Warning
High doses of iron can be poisonous. Keep iron away from children.


folic acid (folate, folacin)

Folic acid is an important vitamin that helps prevent disabilities in the developing baby when the mother takes it early in pregnancy.

Often comes in:
Tablets: 0.4 mg, 1 mg, 5 mg

How to use:
To prevent disabilities in the developing baby , give 0.4 mg by mouth, 1 time each day.



Pregnant women need to take special care

WARNING!
gentamicin

Gentamicin is a very strong antibiotic of the aminoglycoside family that is used to treat serious infections.

Often comes in:
Vials for injection: 10 or 40 mg per ml.

How to use:
For womb infection during labor, after birth, or after abortion, inject 80 mg into muscle, 2 times a day until fever has been gone 48 hours. You must also give other antibiotics.

For infection in a newborn that weighs 2 kg or less, , inject 3 mg per kg of the baby's weight, in the muscle, 1 time each day for 5 days.

For infection in a newborn that weighs more than 2 kg, inject 5 mg per kg of the baby's weight, in the muscle, 1 time each day for 5 days.

Important
Use gentamicin only if the woman cannot take other drugs without vomiting, or if no other antibiotic is available. Give with plenty of fluids.

Side effects
May cause yeast infection in women or diaper rash in children.

Other medicines
that may work
ampicillin, benzylpenicillin, doxycycline, metronidazole
Warning
Gentamicin can damage the kidneys and cause deafness. When it is given in pregnancy, it may cause disabilities in the developing baby. Do not give gentamicin to someone who is allergic to drugs in the aminoglycoside family.



Pregnant women need to take special care

Breastfeeding women need to take special care

WARNING!
hydrocortisone(cortisol)

Hydrocortisone lessens swelling and itching and can be used to treat rashes. It also helps treat allergic shock.

Often comes in:
Creams or ointment: 1%
Tablets: 5, 10, and 20 mg
Liquid for injection
Powder for mixing for injections of various strengths.

How to use:
For allergic shock, inject 500 mg into muscle. Repeat in 4 hours if needed. You must also give other medicines.

Warning
Pregnant and breastfeeding women should not use this medicine regularly — only in emergencies to treat allergic shock.




lidocaine(lignocaine)

Lidocaine is an anesthetic. It blocks pain in the part of the body where it is injected. It can be used to prevent pain while sewing tears or episiotomies, or during a manual vacuum aspiration (MVA).

Often comes in:
Liquid for injection in strengths of 0.5%, 1%, or 2%.

How to use:
For a local anesthetic, inject 15 to 20 ml of 1% solution in the skin. Repeat if necessary. Do not give more than 300 mg (30 ml of 1% solution) of lidocaine.




magnesium sulfate

Magnesium sulfate is used to stop convulsions in pregnant women with eclampsia.

Often comes in:
Liquid for injection: 10%, 12.5%, 25%, or 50%.

How to use:
For convulsions in a woman with eclampsia, inject 10 grams of 50% solution into muscle. Continue injecting 5 g of 50% solution into muscle every 4 hours for 24 hours after the birth or after the last seizure (whichever is later).

Important
Injecting magnesium sulfate requires a big needle and may be uncomfortable. You can split the dose in half and give 2 smaller doses, 1 in each buttock. If you have it, you could also use a little lidocaine to lessen the pain.

Other medicines
that may work
diazepam.
Warning
Only use this drug if a woman’s blood pressure is over 160/110 or if she is having a convulsion. Stop using this drug and get medical help immediately if her breathing slows to less than 12 breaths a minute or if she has not urinated for 4 hours.

Women with kidney problems should not use magnesium sulfate.



metronidazole

Metronidazole is used against some bacteria, amoebic dysentery, trichomonas, and vaginal infections.

Often comes in:
Tablets: 200, 250, 400, and 500 mg
Inserts of 500 mg
Injection of 500 mg in 100 ml vial
Suspension of 200 mg in 5 ml.

How to use:
For womb infection during labor, give 500 mg by mouth, 3 times a day until 24 hours after birth and the mother has no fever.

For womb infection after birth, or abortion, give 500 mg by mouth, 3 times a day until fever has been gone 48 hours. Then give 500 mg by mouth, 3 times a day for 10 more days. You must also give other antibiotics.

To prevent infection in the womb after an invasive procedure, give 1 g (1000 mg) by mouth, 1 time only. Also give amoxicillin.

For bacterial vaginosis or trichomonas, give 500 mg by mouth, 2 times a day for 7 days.

For pelvic inflammatory disease, give 400 to 500 mg by mouth, 3 times a day for 14 days. You must also give other antibiotics

Important
Drinking alcohol while taking metronidazole will cause nausea.
Side effects
Metallic taste in mouth, dark urine, nausea, vomiting, headache.
Other medicines
that may work
amoxicillin, ampicillin, benzylpenicillin, clindamycin, doxycycline, gentamicin
Warning
People with liver problems should not use this drug.



mifepristone

Mifepristone can be used with misoprostol or other medicines to end a pregnancy.

Often comes in:
Tablets: 200 mg.

How to use:
See directions for using with misoprostol below.

Important
It is best to be close to medical help when taking medicines for abortion in case they do not empty the womb completely.
Other medicines
that may work
misoprostol.
Warning
If the combination of mifepristone and misoprostol does not empty the womb completely, it must be emptied by MVA.



misoprostol

Misoprostol can be used to end a pregnancy, empty the womb after an incomplete abortion or miscarriage, or stop heavy bleeding after a birth.

Often comes in:
Tablets: 100 or 200 micrograms.

How to use:
To stop heavy bleeding after a birth, give 800 micrograms by mouth by letting tablets dissolve under the tongue for 30 minutes, then swallowing what is left. If the woman cannot swallow, insert pills in her rectum where they will dissolve and be absorbed. Wear a glove. Either way, you can repeat the dose 24 hours later if necessary.

To end a pregnancy with misoprostol and mifepristone:
For a pregnancy of less than 12 weeks, give 200 mg mifepristone by mouth, 1 time only. After 1 to 2 days, give 800 micrograms (4 pills) misoprostol in the vagina or in the mouth (dissolve between gums and cheeks or under the tongue for about 30 minutes, then swallow what is left). If the abortion is not complete in 3 hours, give another dose of 800 micrograms of misoprostol.

For a pregnancy 12 weeks or more, give 200 mg mifepristone by mouth, 1 time only, and after 1 to 2 days, give 400 micrograms (2 pills) of misoprostol every 3 hours until the abortion is complete. The womb is more sensitive to misoprostol in later weeks, so use this lower dose for later pregnancies. It may take up to 48 hours for the abortion to complete.

OR
If you do not have mifepristone:
For a pregnancy of less than 12 weeks, give 800 micrograms (4 pills) misoprostol in the vagina or in the mouth (dissolve between gums and cheeks or under the tongue for about 30 minutes, then swallow what is left). Repeat this dose of 800 mcg misoprostol every 3 hours until the abortion has completed.
For a pregnancy of 12 weeks or more, give 400 micrograms (2 pills) misoprostol every 3 hours until the abortion is complete. The womb is more sensitive to misoprostol in later weeks, so use this lower dose for later pregnancies. It may take up to 48 hours for the abortion to complete.

Be ready to get medical help if the womb does not empty completely.

Important
Misoprostol can be used alone or with mifepristone to end a pregnancy. An abortion caused by misoprostol may take several hours to several days to finish.

After an incomplete abortion, misoprostol can empty the womb and help save a woman’s life.

Wetting misoprostol tablets before putting them in the vagina may make them more effective
Side effects
Nausea, vomiting, diarrhea, headache. If the woman is breastfeeding, misoprostol will cause diarrhea in infants.
Warning
Never use misoprostol to speed up or start a labor. It could cause the womb to tear.

The uterus is more sensitive to misoprostol starting in later weeks of pregnancy, so a lower dose of misoprostol is used in later pregnancies. A higher dose can harm the uterus.

Where abortion is restricted, serious legal trouble can result if someone suspects a person tried to have an abortion. Because misoprostol usually does not dissolve completely in the vagina, if there is a problem with the abortion and medical help is necessary, undissolved pieces of pills might be found there. Using misoprostol between the cheeks and gums or under the tongue is safer in places where abortion is illegal.



nitrofurantoin

Nitrofurantoin is an antibiotic used to treat infections of the urine system.

Often comes in:
Tablets of 25, 50, and 100 mg
Suspension of 25 mg in 5 ml.

How to use:
For bladder infection, give 100 mg by mouth, 3 times a day for 7 days.

Important
Do not use nitrofurantoin at the same time as antacids. To limit side effects, take with milk or food.
Side effects
Dizziness, dark urine, nausea, vomiting, headache.
Other medicines
that may work
cefixime, cotrimoxazole
Warning
Do not give nitrofurantoin during the last month of pregnancy, or when someone is breastfeeding in the first month after giving birth. It can harm the baby. People with kidney problems should not use nitrofurantoin.


nystatin

Nystatin fights yeast and other fungus infections in the mouth (thrush), the vagina, or the skin.

Often comes in:
Inserts, lozenges for the mouth
Cream: 100,000 Units
Liquid with 100,000 Units per ml.

How to use:
For yeast infections of the mouth (thrush) in babies, give 2 full droppers (0.5 ml each) by mouth, 4 times a day, and continue giving this medicine for 2 days after the patches are gone.

For vaginal infections, put one 100,000 Unit insert or cream high in the vagina every night for 14 nights.

Important
Stop using nystatin if it irritates the skin.

A person with a yeast infection should not have sex while using nystatin to avoid passing the infection to her partner.

Nystatin works only against candida yeast infections, while cotrimazole works against other fungal infections as well.
Side effects
Diarrhea and stomach upset.
Other medicines
that may work
cotrimazole



oxytocin

Oxytocin is used to cause contractions of the womb and its blood vessels to control heavy bleeding after abortion or childbirth.

Often comes in:
10 Units in 1 ml for injection.

How to use:
To help the placenta come out or to stop heavy bleeding after a birth, inject 10 Units in the muscle, 1 time only.

Important
Refrigerate oxytocin so it stays cold (2°C to 8°C, or 35°F to 46°F) or it will lose strength over time.
Other medicines
that may work
ergometrine, misoprostol.
Warning
Do not use oxytocin to start or speed up labor. Oxytocin can make the womb contract so strongly that it will tear.

Do not use this drug to cause an abortion because it could kill the woman before ending the pregnancy.



paracetamol(acetaminophen)

Paracetamol is used to ease pain and lower fever.

Often comes in:
Tablets: 100, 325, and 500 mg.
Liquid: 120 and 160 ml per 5 ml.

How to use:
Take 500 to 1000 mg by mouth every 4 to 6 hours. Do not take more than 4000 mg of paracetamol in 24 hours.

Important
Paracetamol does not cure sickness. It is important to find the cause of the pain and fever and treat that.
Other medicines
that may work
Aspirin or ibuprofen may work, but do not use either during pregnancy.
Warning
Paracetamol should not be used by women with liver or kidney problems. It can damage the liver if used for a long period of time, especially by a person who regularly drinks alcohol.



Pregnant women need to take special care

Breastfeeding women need to take special care

WARNING!
promethazine

Promethazine is an antihistamine used to treat allergic reactions and allergic shock.

Often comes in:
Tablets: 10, 12.5, and 25 mg
Syrup: 5 mg per 5 ml
Ampules for injection: 25 mg in 1ml.

How to use:
For moderate allergic reaction, give 25 mg by mouth. Repeat in 6 hours if needed.

Side effects
Dry mouth and nose, blurry vision. Rarely, twitching of the body, face, or eyes.
Other medicines
that may work
diphenhydramine.
Warning
Promethazine is best taken by mouth. Only inject it for severe allergic reactions.

This medicine is OK to use in emergencies, but should not be used regularly in pregnancy or while breastfeeding.




quinine(quinine sulfate or quinine bisulfate)

Quinine is a medicine used to treat malaria. Do not use it after the first 3 months of pregnancy

Often comes in:
Tablets: 300 or 650 mg.

How to use:
For malaria in women in the first 3 months of pregnancy, give 600 mg by mouth, 3 times a day for 7 days.

Side effects
May cause sweaty skin, ringing of the ears or impaired hearing, blurred vision, dizziness, nausea, vomiting, and diarrhea.



tetanus immune globulin

Tetanus immune globulin (also called anti-tetanus immunoglobulin, or HyperTET) can be given to people who have been exposed to tetanus but have not received tetanus toxoid vaccinations. Do not give tetanus antitoxin made from horse serum to people.

Often comes in:
Vials: 250 Units or 500 Units

How to use:
For someone who has a wound that could cause tetanus (like from an unsafe abortion) and has not been vaccinated against tetanus, inject 250 Units tetanus immune globulin in the muscle, 1 time only.

If a person develops signs of tetanus, inject 500 Units tetanus immune globulin in the muscle, 1 time only.

Important
For people who have not been vaccinated for tetanus, it is OK to give the vaccine on the same day as the tetanus immune globulin. But do not inject tetanus immune globulin into the same spot where you inject tetanus toxoid vaccination — it will stop the vaccination from working.
Side effects
Allergy.
Other medicines
that may work
benzylpenicillin, tetanus toxoid vaccine.
Warning
Tetanus can easily kill a person. Get medical help even after giving tetanus immune globulin.


tetanus toxoid vaccine

This immunization prevents tetanus infection, and can be given during or after pregnancy, or after abortion or female genital cutting. Immunization during pregnancy can also prevent this deadly infection in the newborn baby.

Often comes in:
single dose ampules of 0.5 ml for injection.

Liquid for injection.

How to use:
To give lifetime protection from tetanus, inject 5 immunizations of 0.5 ml into the muscle of the upper arm and then 1 booster injection every 10 years.
Injection 1..........As soon as possible
Injection 2..........4 weeks after injection 1
Injection 3..........6 months after injection 2
Injection 4..........1 year after injection 3
Injection 5..........1 year after injection 4
Booster.............10 years after injection 5

To prevent tetanus infection if a woman may already have been exposed,inject 0.5 ml in the muscle, 1 time only. You must also give 250 Units tetanus immune globulin.

Important
Tetanus immunizations should be given to everyone starting in childhood. They are often given to children as part of a combined immunization (DPT), and the 3 DPT immunizations are equal to the first 2 tetanus toxoid immunizations.
Side effects
Pain, redness, warmth, slight swelling.


Pregnant women need to take special care

Breastfeeding women need to take special care

WARNING!
tetracycline

Tetracycline is an antibiotic of the tetracycline family used to treat many infections. In this book, we recommend it only for blindness prevention for newborns.

Important
Avoid milk, iron pills, and antacids for 2 hours before or after taking tetracycline. They will make the medicine less effective.
Often comes in:
Ointment: 1%.

How to use:
For newborn eye care, use 1% ointment in each eye at birth, 1 time only, within 2 hours of the birth.

Other medicines
that may work
erythromycin eye ointment, povidone iodine, silver nitrate
Warning
Do not take tetracycline by mouth while pregnant or breastfeeding as it can harm a baby's developing teeth.

Do not take tetracycline and penicillins by mouth at the same time. This will make the penicillin less effective.


Pregnant women need to take special care

Breastfeeding women need to take special care

WARNING!
tinidazole

Tinidazole is an antibiotic used to treat infections caused by bacteria and some parasites.

Often comes in:
Tablets of 250 and 500 mg.
Important
To limit side effects, take with food. Drinking alcohol while taking tinidazole will cause nausea.
How to use:
For trichomonas or bacterial vaginosis, give 500 mg by mouth, 2 times a day for 5 day
Other medicines
that may work
metronidazole
Side effects
Metallic taste in mouth, upset stomach or nausea, headache.
Warning
If tinidazole is given during breastfeeding, it may cause diarrhea in the baby. Do not use for long periods of time during pregnancy or breastfeeding.


tricloroacetic acid(bichloroacetic acid)

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

Often comes in:
Liquids of varying strengths from 10% to 90%.

How to use:
To treat genital warts first protect the area around the wart with petroleum jelly. Then put on the trichloroacetic acid and leave on for 30 minutes. Then clean off. Repeat once a week for 4 to 6 weeks. Do not use this more than 1 time each week.

Important
Use very carefully. It can burn normal skin badly enough to cause a scar. If it spills onto healthy skin, wash off with soap and water.
This page was updated:28 Aug 2024