Hesperian Health Guides

Medicines Pages

Contents

The Medicines Pages

The Medicines 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. For specific information about each medicine, find it on this page, below. 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 scroll down the page until you get to Hydroxyzine, or you can click on H in the alphabet list and go directly to the medicines beginning with H, and then scroll down to Hydroxyzine.

To find a medicine by some common brand (commercial) names, use the medicine index.


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.


Pregnant women need to take special care

CAUTION
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.

Often comes in:
Tablets: 200, 400 or 800 mg.
Ointment: 5%

How to use:
For genital herpes infection or cold sores:
Take 200 mg by mouth 5 times a day, or 400 mg by mouth 3 times a day, for 7 to 10 days.

For cold sores: Apply ointment on sores 6 times a day for 7 days.

For shingles:Take 800 mg by mouth 5 times a day for 7 to 10 days.
Wash hands immediately.

Who should not take this medicine?
Someone with kidney damage

Information you
should know
To shorten the duration and severity of herpes sores, start taking acyclovir as soon as signs start to appear.

Side effects

May sometimes cause headache, dizziness, nausea, vomiting, diarrhea.

Signs of taking too much

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

adrenaline or epinephrine (Adrenalin)

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

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

Amoxicillin is an antibiotic of the penicillin family used to treat some sexually transmitted infections, pneumonia, and other infections. Because of high levels of drug resistance, it is less useful than previously.

Often comes in:
Tablets: 250 and 500 mg
Liquid: 125, 200, 250 or 400 mg per 5 ml

How to use:
For chlamydia: 500 mg, by mouth, 3 times a day for 7 days (see drug combinations to treat vaginal discharge)

For Pelvic Inflammatory Disease: 500 mg, by mouth,
3 times a day for 14 days (see drug combinations to
treat PID)

Who should not take this medicine?
Do not use if allergic to medicines of the penicillin family.

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

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

Other medicines
that may work
for bladder or kidney infection: ceftriaxone, ciprofloxacin, cotrimoxazole, gentamicin, nitrofurantoin.

for breast infection: cephalexin, dicloxacillin, erythromycin

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.

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

How to use:
For infection after abortion (drugs by injection) or womb infection: Inject 2 grams (2000 mg) into muscle or into vein, then reduce dose to 1 gram every 6 hours. Also take gentamicin or metronidazole (see drug combinations to treat infection after abortion and drug combinations for womb infection).

For fever during childbirth: Inject 2 grams (2000 mg) into muscle or into vein, then reduce dose to 1 gram every 4 hours until you can get medical attention.

Who should not take this medicine?
Do not use ampicillin if you are allergic to medicines of the penicillin family.

Side effects
May cause stomach upset and diarrhea. May cause rash.

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

Information you
should know
Take this medicine before eating.

Other medicines
that may work
see drug combinations for fever during pregnancy
see drug combinations for infection after abortion

Pregnant women need to take special care

Breastfeeding women need to take special care

CAUTION
aspirin (acetylsalicylic acid, ASA, others)

Aspirin works against pain, swelling, and fever.

Often comes in:
Tablets: 300, 500 mg and other sizes.
Low dose tablets: 81mg

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

To prevent pre-eclampsia: 81 mg by mouth 1 time each day after 12 weeks of pregnancy and until the birth.

Who should not take this medicine?
Women should not take aspirin during the last 3 months of pregnancy.People with stomach ulcers or bleeding problems should not take aspirin. Do not use before surgery. Do not use if breastfeeding in the first week of the baby’s life. Do not give to children.

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

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

Signs of taking too much
Ringing in the ears, headache, dizziness, confusion, fast breathing.

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

azithromycin (Zithromax)

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.

Often comes in:
Capsules: 250 mg

How to use:
For chlamydia or chancroid: Take 1 gram (1000 mg) by mouth 1 time only (also take other drugs for chlamydia or other drugs for chancroid)

For PID: Take 1 gram (1000 mg) by mouth one time each week for 2 weeks. (also take other drugs for PID)

To prevent infection before an abortion: Take 500 mg by mouth 1 time only.

Who should not take this medicine?
People with allergies to erythromycin and other antibiotics of the macrolide family.

Side effects
Diarrhea, nausea, vomiting, abdominal pain.

Information you
should know
If weekly dose is used, take with food.

Other medicines
that may work

See drug combinations for chlamydia
See drug combinations for chancroid
See drug combinations for PID


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.

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

How to use:
For syphilis: If there is a sore, inject 2.4 million Units into muscle one time only. If there is a blood test or the sores have already disappeared, then every week for 3 weeks.

Who should not take this medicine?
People who are allergic to medicines of the penicillin family.

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

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

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

Benzylpenicillin is an antibiotic of the penicillin family used to treat many serious infections.

Often comes in:
Powder for mixing for injection: 1 or 5 million Units

How to use:
For tetanus in newborns: Inject 100,000 Units/kg into muscle 4 times a day for 10 days. Can give with immune globulin therapy.

Who should not take this medicine?
People allergic to medicines of the penicillin family.

Warning
Watch for allergic reactions and signs of shock.

Other medicines
that may work
for serious infection after an abortion: ampicillin, ceftriaxone, clindamycin, doxycycline, gentamicin, metronidazole (see medicine combinations for infection after abortion).


Pregnant women need to take special care

Breastfeeding women need to take special care

CAUTION
ceftriaxone (Nitrocephin, Rocephin)

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.

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

How to use:
For infections after abortion: 1 to 2 g IV or into muscle every 12 to 24 hours for 4 to 7 days. (see drug combinations to treat infections after abortion).

 For PID: Inject 250 mg into muscle one time only (see drug combinations to treat PID).

For gonorrhea: Inject 250 mg into muscle one timeonly (see drug combinations to treat STIs)

 For kidney infection: Inject 1 gram into the vein or muscle once an day for 10 days

For chancroid: Inject 250 mg into muscle one time only (see chancroid for drug combinations).

Who should not take this medicine?
Do not use if you are allergic to antibiotics of the cephalosporin family, or if you had hives or a severe allergic reaction to penicillin.

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

Other medicines
that may work
for PID or infections after abortion: ampicillin, amoxicillin, azithromycin, clindamycin, doxycycline, erythromycin, gentamicin, metronidazole, spectinomycin
 for gonorrhea: spectinomycin
for kidney infection: ciprofloxacin, cotrimoxazole, gentamicin

cephalexin (Ceporex, Keflex, Keftab)

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

Often comes in:
Tablets: 250 or 500 mg
Liquid: 125 or 250 mg per 5 ml

How to use:
For breast or skin infection and infection after female genital cutting: 250 mg by mouth 4 times a day for 7 to 14 days. Serious infections may need higher doses, but use no more than 4 g a day.

Who should not take this medicine?
Do not take cephalexin if you are allergic to antibiotics of the cephalosporin family.

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

Warning
Watch for allergic reaction.

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

Other medicines
that may work
for breast or skin infection: dicloxacillin, erythromycin, penicillin
for infection after female genital cutting: dicloxacillin, erythromycin

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.

Often comes in:
Liquid: 25 g per 120 ml
Powder: 15 g

How to use:
Take 30 to 100 g by mouth all at one time and as soon as possible.

Who should not take this medicine?
Do not take if you have swallowed lighter fluid, fuel, kerosene or petroleum products.

Side effects
Black stools, vomiting, diarrhea.

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

Pregnant women should not take this medicine

Breastfeeding women should not take this medicine

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.

Often comes in:
Tablets: 250, 500, or 750 mg

How to use:
For chancroid or bloody diarrhea with fever: 500 mg, by mouth, 2 times a day for 3 days (see drug combinations to treat genital sores) Give for 7 days if the woman also has HIV.

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

Who should not take this medicine?
Do not use if you are pregnant, breastfeeding or younger than 16 years old.

Side effects
Nausea, diarrhea, vomiting, headache.

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

Information you
should know
Drink lots of water. You can eat while taking ciprofloxacin, just avoid dairy products

Other medicines
that may work
for chancroid: azithromycin, erythromycin, ceftriaxone
for kidney infection: ceftriaxone, cotrimoxazole, gentamicin
for bloody diarrhea with fever: cotrimoxazole, norfloxacin

Breastfeeding women need to take special care

CAUTION
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.

Often comes in:
Capsules: 25 mg, 75 mg, 150 mg, 300 mg
Liquid for injection: 150 mg/ ml
Cream: 2%

How to use:
For bacterial vaginosis vaginal infection: Tablets: Take 300 mg, by mouth, 2 times a day for 7 days. Cream: Put 5 g high in the vagina each night at bedtime for 7 days.

For infection after abortion: Inject 900 mg into vein 3 times a day (see drug combinations for post-abortion infections).

For malaria in the first 3 months of pregnancy: Take 300 mg by mouth 4 times a day for 7 days. Also take 600 mg of quinine, 3 times a day for 7 days.

Who should not take this medicine?
If you are breastfeeding and this medicine gives your baby diarrhea, stop using it.

Side effects
Nausea, vomiting, and diarrhea can happen within a few weeks of using this medicine. If clindamycin gives you a skin rash, stop using it and see your health worker.

Warning
Using for more than 30 days can lead to thrush and yeast infections, and harm people with kidney or liver problems. The vaginal cream can weaken condoms for up to 3 days after use.

Information you
should know
Using this medicine with erythromycin can make both drugs less effective. If you have your monthly bleeding while using the cream, do not use a tampon because it will absorb the medicine.

Other medicines
that may work
for bacterial vaginosis: metronidazole
for womb infection or infection after abortion: ampicillin, ceftriaxone, doxycycline, erythromycin, gentamicin, metronidazole

Pregnant women need to take special care

CAUTION
codeine

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.

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

How to use:
For coughs: 7 to 15 mg 4 times a day, only as needed.

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

Side effects
May cause constipation (difficulty passing stools) and temporary inability to pass urine. Nausea, vomiting, itching, headaches.

Information you
should know
Codeine is habit forming (addictive). If you use it for several days, you will need more for it to keep working.

Signs of taking too much
Sleepiness, stupor, coma.

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

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

Pregnant women need to take special care

CAUTION
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.

Often comes in:
Tablets: 120 mg (20 mg trimethoprim + 100 mg sulfamethoxazole), 480 mg (80 mg trimethoprim + 400 mg sulfamethoxazole—called “single strength”), and 960 mg (160 mg trimethoprim + 800 mg sulfamethoxazole—called “double strength”)
Oral suspension: 240 mg (40 mg trimethoprim +
200 mg sulfamethoxazole) per 5 ml

How to use:
For bladder infection: Take two 480 tablets by mouth 2 times a day for 3 days.

For kidney infection: Take two 480 tablets by mouth 2 times a day for 10 days.

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: Take two 480 tablets by mouth 2 times a day for 7 to 14days.

For pneumonia for people with AIDS: Take four 480 tablets by mouth 3 times a day for 21days.

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.

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

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

Warning
Take with lots of water.

Signs of taking too much
Nausea, vomiting, diarrhea, confusion, sweating

Other medicines
that may work
for bladder and kidney infection: ceftriaxone, ciprofloxacin, nitrofurantoin
for bloody diarrhea with fever for people with AIDS: ciprofloxacin, norfloxacin


dexamethasone (Decadron, Decilone, Inflam, Maxidex)

Dexamethasone is a steroid medicine used to treat allergic shock.

Often comes in:
Tablets: 0.25, 0.5, 0.75, 1, 1.5, 2, 4, or 6 mg
Liquid: 0.5 mg per 5 ml, or 1 mg per 1 ml
For injection: 4, 8, 10, 16, or 20 mg per ml

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

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

Other medicines
that may work
for allergic shock: hydrocortisone

Pregnant women need to take special care

Breastfeeding women need to take special care

CAUTION
diazepam (Anxionil, Calmpose, Valium)

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

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

How to use:
For convulsions: Use 20 mg of injectable diazepam in the anus using a syringe without a needle (see 'How to give diazepam'). Repeat after 30 minutes if needed, using 10 mg.

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 while seeking medical help.

For anxiety or sleeplessness: Take 2.5 to 5 mg by mouth.

Who should not take this medicine?
Pregnant or breastfeeding women should only use diazepam to stop seizures.

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

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

Information you
should know
Diazepam does not treat pain. It is very habit-forming.

Signs of taking too much
Sleepiness, loss of balance, confusion

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

dicloxacillin

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

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

How to use:
For breast, skin, or other infections: Take 500 mg 4 times a day for 7 days.

Who should not take this medicine?
Do not take this drug if you are allergic to penicillin.

Side effects
Nausea, vomiting, diarrhea.

Warning
Watch for allergic reactions or shock.

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

Pregnant women need to take special care

Breastfeeding women need to take special care

CAUTION
diphenhydramine hydrochloride (Bectivo, Benadryl)

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.

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 allergies, mild to moderate allergic reaction, or itching: Take 25 to 50 mg, by mouth, 3 or 4 times a day
as needed.

For sleep: Take 25 to 50 mg at bedtime.

For allergic shock: Inject 50 mg into muscle, repeat in 8 hours or sooner if needed.

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

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

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

Information you
should know
Only inject diphenhydramine for severe allergic reactions or shock.

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

Pregnant women should not take this medicine

Breastfeeding women need to take special care

CAUTION
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.

Often comes in:
Tablets: 50 mg and 100 mg

How to use:
For vaginal discharge from an STI (clamydia): Take 100 mg, by mouth, 2 times a day for 7 days (also take other drugs).

For early syphilis: 100 mg by mouth 2 times a day for 14 days.

For PID: Take 100 mg, by mouth, 2 times a day for 14 days (also take other other drugs for PID)

For infection prevention after an abortion or deinfibulation: Take 100 mg 2 times a day for 5 days.

For infections after an abortion: Take 100 mg by mouth 2 times a day for 10 days(also take other drugs by mouth)

For infections after an abortion (by injection): Inject 100 mg into muscle or into vein 2 times a day (also inject other drugs).

For infections after childbirth: Take 100 mg, by mouth, 2 times a day until fever has been gone for 2 full days (also use other drugs).

Who should not take this medicine?
Pregnant women and children under 8. Doxycycline can damage a baby’s or child’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.

Side effects
Diarrhea or upset stomach. Some people get a rash after staying a long time in the sun.

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

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

Other medicines
that may work
for syphilis: benzathine, erythromycin, penicillin, tetracycline
for gonorrhea: ceftriaxone, spectinomycin
for chlamydia: amoxicillin, azithromycin, erythromycin, tetracycline
to prevent infection after abortion: erythromycin
for infection after abortion: see drug combinations
for infection after genital cutting: erythromycin


epinephrine or adrenaline (Adrenalin)

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

Often comes in:
Ampules for injection: 1 mg in 1 ml

How to use:
For asthma, moderate allergic reaction or allergic shock: Inject ½ mg (½ ml) into the muscle or just under the skin of the upper arm or outer thigh. If needed, a second dose can be given after 20-30 minutes, and a third dose after another 20-30 minutes (also give other drugs for allergic shock).

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

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

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

Signs of taking too much
High blood pressure, fast heart beat, stroke.

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

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

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:
For heavy bleeding after 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 for severe bleeding or every 6 to 12 hours for less severe bleeding. Continue to give until bleeding stops and the womb is hard, about 48 hours.

For heavy bleeding due to complications after an abortion: Give an injection of 0.2 mg into muscle, then give a 0.2 mg pill or an injection every 6 hours for
24 hours.

Side effects
Nausea, vomiting, dizziness, sweating.

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

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

Other medicines
that may work
oxytocin, misoprostol

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.

Often comes in:
Tablets or capsules: 200, 250 or 500 mg
Ointment: 1% Powder for solution: 125 mg per 5 ml

How to use:
For chlamydia: 500 mg by mouth 4 times a day for 7 days (see drug combinations to treat vaginal discharge from STIs).

 For breast infection, infection from female genital cutting or deinfibulation, or infection after abortion: 500 mg by mouth 4 times a day for 7 days.

For chancroid or skin infections: 500 mg by mouth
4 times a day for 7 days (also use other drugs).

For syphilis or PID: 500 mg by mouth 4 times a day for 15 days. (see drug combinations to treat vaginal discharge from STIs)
For newborn eye-care: Use 1% ointment
one time only.

For skin infection: Give 250 mg by mouth, 4 times a day for 7 to 10 days.

Who should not take this medicine?
Do not use if you are allergic to antibiotics of the macrolide family.

Side effects
May upset stomach or cause nausea, vomiting, diarrhea.

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

Other medicines
that may work
for breast infection: cephalexin, dicloxacillin
for infection after genital cutting: cephalexin, doxycycline
for STIs: see drug combinations for STIs
for newborn eye-care: tetracycline ointment
for skin infection: dicloxacillin

Pregnant women should not take this medicine

Breastfeeding women should not take this medicine

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 (also see Chapter 13).

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

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

Often comes in:
Tablets: 100 or 400 mg
Syrup: 25 mg/ml

How to use:
The doses for tuberculosis medicines differ from region to region. See a health worker. (Take ethambutol in combination with other drugs.)

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

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

Information you
should know
It is very important that you take the entire course of treatment for tuberculosis, even if it lasts for a year. If not, you might infect other people or get sick again with a kind of TB that is very hard to cure.


Pregnant women should not take this medicine

Breastfeeding women should not take this medicine

fluconazole (Diflucan)

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.

Often comes in:
Capsule: 50 mg
Liquid: 50 mg per 5 ml
Solution for IV injection: 2 mg/ 5 ml in vial

How to use:
For yeast infections in the mouth or throat (thrush):
Take 800 mg by mouth once only. Then take 400 mg a day for 14 days. If not better in 3 to 5 days, increase amount to 400 mg a day.

For yeast infection of the skin: Take 200 mg to 400 mg by mouth once a day for 7 to 14 days.

Who should not take this medicine?
Do not use during pregnancy or if breastfeeding. Also, anyone who has hepatitis, liver disease, or kidney problems should not take this drug.

Side effects
May cause nausea, vomiting.

Other medicines
that may work
ketoconazole, nystatin


Pregnant women need to take special care

CAUTION
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.

Often comes in:
In vials for injection: 10 or 40 mg per ml

How to use:
For kidney infection, womb infection, infection after an abortion, or infection during labor: Give this medicine according to a woman’s body weight: inject into muscle 1.5 mg for every kg of weight, every 8 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 for womb infection and other medicines for infection after abortion).

For fever during childbirth: Give 80 mg in the muscle or vein, every 8 hours. Also give ampicillin.

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

Side effects
This drug can damage the kidneys or cause deafness.

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

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

Signs of taking too much
Ringing in the ears or worsening of hearing. Kidney problems.

Other medicines
that may work
for womb or pelvic infection: amoxicillin, ampicillin, azithromycin, ceftriaxone, doxycycline, erythromycin, metronidazole, spectinomycin
for infection after abortion: ampicillin, ceftriaxone, clindamycin, doxycycline, metronidazole
for kidney infection: ceftriaxone, ciprofloxacin, cotrimoxazole

gentian violet (Crystal Violet, methylrosanilinium chloride)

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

Often comes in:
Liquid: 0.5%, 1%, 2%
Tincture: 0.5%
Crystals: 1 teaspoon in ½ liter of water makes a 2% liquid.

How to use:
For vaginal yeast infections: Soak clean cotton with 1% liquid and place high in the vagina overnight for 3 nights. Be sure to remove the cotton every morning.

For yeast infections in the mouth (thrush): Rinse the mouth with 1% liquid for 1 minute 2 times a day, but do not swallow.

For skin infections: First wash with soap and water, and dry. Then paint on skin, mouth, or vulva 3 times a day for 5 days.

For skin infections for people with AIDS: First wash with soap and water, and dry. Then paint on skin, mouth, or vulva 3 times a day until rash is gone

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

Warning
Do not have sex while you are using gentian violet for a vaginal infection, to avoid passing the infection to your partner. Stop using gentian violet if it starts to irritate you. Keep it away from eyes.

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

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

Pregnant women need to take special care

Breastfeeding women need to take special care

CAUTION
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.

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

How to use:
For rash, itching or piles: Apply cream directly on skin 3 or 4 times a day.

For allergic shock: Inject 500 mg into muscle, repeat in 4 hours if needed (also give other drugs for allergic shock). If signs return later, take 500 to 1000 mg by mouth and repeat once if needed.

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

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

Signs of taking too much
High blood pressure, passing more urine than usual.

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

Pregnant women need to take special care

Breastfeeding women need to take special care

CAUTION
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.

Often comes in:
Tablets: 25, 50, or 100 mg
For injection: 25 or 50 mg per 5 ml
Syrup: 10 or 25 mg per 5 ml

How to use:
For itching: Take 25 to 50 mg by mouth 3 or 4 times a day.

To relieve anxiety: Take 25 to 50 mg by mouth 4 times a&day.

For moderate allergic reactions or hives: Inject into muscle: 25 mg 3 or 4 times a day.

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

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

Signs of taking too much
Sleepiness

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


Pregnant women need to take special care

CAUTION
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.

Often comes in:
Tablets: 200 mg and larger
Liquid: 100 mg per 5 ml

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

Who should not take this medicine?
People with stomach ulcers. Pregnant women during the last 3 months of pregnancy.

Side effects
May cause stomach irritation or pain. Take with food.

Warning
Avoid taking within a week of surgery.

Information you
should know
Causes less irritation if taken with food, especially dairy products, at mealtimes.

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

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

Isoniazid is used to treat tuberculosis (TB) in combination with other medicines. See Chapter 25. People with HIV can use isoniazid to prevent latent TB (TB with no signs) from becoming active TB.

Often comes in:
Tablet: 100 or 300 mg
Syrup: 50 mg per 5ml

How to use:
The doses for medicines to treat tuberculosis differ from region to region. See a health worker. (Take isoniazid in combination with other drugs for TB).

For prevention of TB in adults with HIV: take 300 mg by mouth every day for 6 months to 3 years.

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

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

Information you
should know
Never take more than 300 mg a day if you take it every day, or 900 mg if you take it 3 times a week. It is important to take the full course of treatment for tuberculosis. If not, you can infect other people or get sick again with a kind of TB that is very hard to cure.

Signs of taking too much
Nausea, vomiting, dizziness, slurred speech, blurred vision. If you take too much, take 50 mg pyridoxine (vitamin B6) 3 times a day.


Pregnant women should not take this medicine

Breastfeeding women should not take this medicine

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.

Often comes in:
Tablets: 200 mg
Also comes as 2% skin cream and 1% shampoo

How to use:
For fungal infection on the skin: Take 200 mg by mouth once a day for 10 days.

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

Side effects
May cause nausea, vomiting.

Warning
Do not take if you are pregnant or breastfeeding. Do not put cream or shampoo in vagina. Take with food. Do not drink alcohol while using this medicine.

Who should not take this medicine?
Anyone who has hepatitis or liver disease should not take this drug.

Information you
should know
This medicine works best if taken with orange juice

Other medicines
that may work
for yeast infections without STIs: clotrimazole, fluconazole, gentian violet, miconazole, nystatin, vinegar


magnesium sulfate

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

Often comes in:
Injections of 10%, 12.5%, 25%, or 50% solution

How to use:
For convulsions: Inject 10 g into muscle. After 4 hours, inject another 4 g if necessary.

Who should not take this medicine?
Women with kidney problems should not be given this drug.

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

Information you
should know
Injecting a large amount needs a big needle and is uncomfortable. You might want to split the dose in half and give 2 smaller shots, one in each hip or buttock.

Signs of taking too much
Sweating, low blood pressure, weakness, problems breathing.

Other medicines
that may work
For convulsions: diazepam

Pregnant women need to take special care

CAUTION
medroxyprogesterone acetate (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.

Often comes in:
Tablets: 2.5, 5, or 10 mg
Liquid for injection: 150 or 400 mg per ml

How to use:
For heavy bleeding: Take 10 mg by mouthonce a day for 10 days. If bleeding continues, take for 10 more days

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

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

methyl ergonovine (Methergine)

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

Pregnant women need to take special care

Breastfeeding women need to take special care

CAUTION
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).

Often comes in:
Tablets: 200, 250, 400, or 500 mg
Inserts: 375, 500 mg
For injection into vein: 500 mg in 100 ml

How to use:
For PID: Take 400 to 500 mg by mouth 3 times a day for 14 days (take in combination with other drugs).

For mild vaginal infections: Put one 500 mg insert in the vagina 2 times a day for 5 days.

For trichomonas or bacterial vaginosis: Take 2 grams by mouth 1 time only, but not if you are pregnant. If you are pregnant: Take 400 to 500 mg by mouth 2 times a day for 7 days (see drug combinations for abnormal discharge with an STI and drug combinations for abnormal discharge without an STI).

For womb infection after abortion or childbirth: Give 500 mg by mouth 3 times a day or inject 400 to 500 mg into a vein 3 times a day (see treatment combinations recommended for abortion and treatment combinations for infection after childbirth).

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 mouth 3 times a day. Also take ampicillin.

Who should not take this medicine?
People with liver problems like jaundice (yellow eyes).

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

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

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

Other medicines
that may work
for bacterial vaginosis and trichomonas: clindamycin, tinidazole

Pregnant women need to take special care

CAUTION
miconazole (Daktarin, Fungtopic, Micatin, Monistat)

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

Often comes in:
Cream: 2%, 4%
Inserts: 100 mg, 200 mg, and 1200 mg

How to use:
For yeast infections:
2% Cream: put 5 g in the vagina every night for 7 days.
4% Cream: put 5 g in the vagina every night for 3 days.
100 mg inserts: put 1 in the vagina every night for 7 days. 200 mg inserts: put 1 in the vagina every night for 3 days.

Who should not take this medicine?
Women in the first 3 months of pregnancy.

Side effects
Irritation

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

Other medicines
that may work
for yeast infections: nystatin, clotrimazole, fluconazole, gentian violet or ketoconazole

mifepristone and misoprostol (Mifegyne, Mifeprex) and (Cytotec)

Mifepristone is used for medical abortion. It blocks the effects of the hormone that maintains pregnancy. Taken together with misoprostol up to 10 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 still very effective but it is more effective when both medicines are used together. Misoprostol can also be used to stop bleeding after childbirth and 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.”

Often comes in:
mifepristone: Tablets, 200 mg
misoprostol: Tablets, 100 or 200 mcg

How to take mifepristone with misoprostol:
For medical abortion until 10 weeks (69 days) of pregnancy: Swallow 200 mg mifepristone. After 24 to 48 hours, insert 800 micrograms (mcg) misoprostol in the vagina, or dissolve 800 mcg misoprostol inside the mouth, against the cheek or under the tongue for about 30 minutes. Then swallow what is left.

How to take misoprostol
by itself
For medical abortion until 10 weeks (69 days) of pregnancy: Dissolve 800 mcg inside the mouth, against the cheek or under the tongue, for about 30 minutes. Then swallow what is left. 3 hours later, dissolve and swallow another 800 mcg the same way or insert 800 mcg deep in the vagina. If bleeding does not star t after 3 more hours, insert another 800 mcg in the vagina, or dissolve and swallow another 800 mcg for a total of 2400 mcg.

For heavy bleeding after giving birth: Dissolve 600 mcg inside the mouth, against the cheek or under the tongue, for about 30 minutes. Then swallow what is left. If the woman cannot swallow, insert tablets in her rectum where they will dissolve and be absorbed. Wear a glove.

For incomplete abortion, or if the placenta takes more than 1 hour to come out: dissolve 400 mcg misoprostol against the cheek or under the tongue for about 30 minutes, 1 time only. Or swallow 600 mcg misoprostol, 1 time only.

Side effects
It is normal to have painful cramping and heavy bleeding with clots for 3 to 6 hours after taking misoprostol. You may also have nausea, vomiting, diarrhea, headache, and slight fever in the first few hours. These signs will go away on their own. Bleeding lasts 2 to 4 weeks but gets lighter after 1 to 2 weeks.

Warning
Do not take these medicines if you cannot get to a clinic or hospital within one hour, especially if more than 10 weeks pregnant, of if you think you have a pregancy in the tube.

If you have continued heavy bleeding (soaking more than 2 cloths or large pads in 1 hour for 2 hours in a row) especially with dizziness or lightheadedness, get medical care immediately. You may have an incomplete abortion and need an MVA or D and C.

Information you
should know
Taking misoprostol, with or without mifepristone, is more effective the earlier it is taken in pregnancy. After 10 weeks it becomes less effective and there are more side effects, especially heavy vaginal bleeding.


Pregnant women need to take special care

CAUTION
nitrofurantoin (Furadantin, Macrobid, Macrodantin)

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

Often comes in:
Tablets: 25, 50 or 100 mg
Suspension: 25 mg/5 ml

How to use:
For bladder infections: 100 mg 2 times a day for 5 days.

Who should not take this medicine?
People with kidneys that did not work well before they got an infection. Women in their last month of pregnancy.

Side effects
Nausea or vomiting, headaches, passing gas. To limit these, take with milk or food.

Information you
should know
If you do not feel better in 2 days (48 hours), there may be a resistance to this medicine in your area. If possible, check with a health worker or take other medicines.

Signs of taking too much
Vomiting, chest pains. Urine may turn dark yellow or brown.

Other medicines
that may work
for bladder infections: cotrimoxazole, norfloxacin

Pregnant women should not take this medicine

Breastfeeding women should not take this medicine

norfloxacin (Lexinor, Noroxin, Uritracin)

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

Often comes in:
Tablets: 400 mg

How to use:
For bladder infections: Take 1 tablet 2 times a day for 3 days.

For kidney infections: Take 1 tablet 2 times a day either 1 hour before eating or 2 hours after eating for 10 days.

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

Side effects
May cause lightheadedness and increase the effect of caffeine. To limit these, take either 1 hour before eating or 2 hours after eating.

Warning
Take with lots of water. Do not take this drug while using antacids or vitamins that contain iron or zinc. If norfloxacin gives you an allergic reaction, stop using it. Other UTI medicines are easier on the body.

Other medicines
that may work
for bladder or kidney infections: ceftriaxone, ciprofloxacin, cotrimoxazole, gentamicin

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.

Often comes in:
Inserts: 100,000 U
Lozenges for the mouth: 200,000 U
Cream: 100,000 U per gram
Liquid: 100,000 U per ml

How to use:
For mouth or throat infections: Three or four times a day, put 1 ml of liquid in mouth, swish around both sides of mouth for several minutes and swallow. Do this for 7 to 14 days.

For skin infections: Keep area dry and apply cream 3 times a day until rash is gone.

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 vaginal discharge not caused by STIs: Put 100,000 U insert in the vagina at bedtime for 7 nights.

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

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

Other medicines
that may work
for yeast infections: miconazole, ketoconazole, clotrimazole, vinegar or gentian violet


oxytocin (Oxtimon, Pitocin, Syntocinon, Uteracon)

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

Often comes in:
For injection: 10 Units in 1 ml

How to use:
Inject 10 Units into mother in a large muscle after the baby is born. Repeat after 10 minutes if needed

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

Warning
Do not use this drug to cause an abortion, because it could kill the woman before making her abort. (See Chapter 15, “Abortion.”)
Using oxytocin to speed up labor or give strength to the mother in labor can be dangerous to both mother and child. Do not give it before the baby is out.

Other medicines
that may work
for heavy bleeding after childbirth: Ergometrine, misoprostol


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.

Often comes in:
Tablets: 100, 325 and 500 mg
Liquid: 120 or 160 mg per 5 ml
Inserts: 80, 120, 300, 325, or 650 mg
Drops: 80 mg per 0.8 ml

How to use:
500 to 1000 mg, by mouth, 4 to 6 times a day as needed, but do not take more than 4,000 mg a day.

Who should not take this medicine?
Do not take acetaminophen if you have liver or kidney damage.

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

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

Signs of taking too much
Nausea
Vomiting
Pain in the stomach

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

penicillin (Betapen VK, PenVee K, phenoxymethyl penicillin)

Penicillin is an antibiotic used to treat mouth, tooth, skin, and many other infections.
Unfortunately a lot of resistance to penicillin has developed and it is less useful than previously.

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

How to use:
For sores: 500 mg by mouth 4 times
a day for 10 days.

Who should not take this medicine?
Do not take if you are allergic to any antibiotics of the penicillin family.

Side effects
Rash

Warning
Watch for allergic reactions and allergic shock.

Other medicines
that may work
for skin infection: dicloxacillin, erythromycin

Pregnant women should not take this medicine

Breastfeeding women should not take this medicine

podofilox (Condylox)

Podofilox is a liquid or gel that can be put directly on genital warts to shrink them. It is safer and easier to use than podophyllin.

Often comes in:
Liquid: 0.5%
Gel: 0.5%

How to use:
Apply liquid to warts with a cotton swab or clean cloth rolled to a fine point. The gel can be applied with a finger. Use 2 times a day for 3 days, then stop using for 4 days. If necessary, repeat this up to 4 times.

Who should not take this medicine?
Do not use this if you are pregnant or breastfeeding.

Side effects
Redness, itching, burning, or pain.

Warning
If there is bleeding, swelling, or severe pain, wash it off with soap and water and stop using it.

Information you
should know
Do not have sex on the days you use podofilox.

Signs of taking too much
Nausea, vomiting, trouble breathing, seizures, coma.

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

Pregnant women need to take special care

Breastfeeding women need to take special care

CAUTION
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.

Often comes in:
Tablets: 500 mg

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

Who should not take this medicine?
Do not give probenecid to children under 2 years old.

Side effects
It sometimes causes headache, nausea, or vomiting.

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

Signs of taking too much
Vomiting

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

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

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

How to use:
For fever during pregnancy: Inject 1.2 million Units into muscle every 12 hours while you take the woman for medical treatment. To reduce pain, do not inject in the same place twice

Who should not take this medicine?
Do not use this drug if you are allergic to antibiotics of the penicillin family.

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

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

Other medicines
that may work
for fever during pregnancy: ampicillin

Pregnant women should not take this medicine

progesterone, progestin

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

Pregnant women need to take special care

Breastfeeding women need to take special care

CAUTION
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

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

How to use:
For moderate allergic reaction: Give 25 mg by mouth or injection into muscle. Repeat in 8 hours or sooner if needed.

For allergic shock: Inject 50 mg into muscle. Repeat in 8 hours or sooner if needed. (See information on treating allergic reactions and shock.)

For vomiting: Insert into rectum or inject 25 to 50 mg into muscle every 6 hours as needed.

For sleep: Take 25 to 50 mg at bedtime.

Who should not take this medicine?
Pregnant and breastfeeding women should not use this drug regularly. Do not take this if you need to stay alert. Do not give to children under 2 years.

Side effects
Often causes dry mouth and blurry vision. Sometimes causes twitching in body, face and especially eyes and neck.

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

Signs of taking too much
Unconsciousness, seizures.

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

Pregnant women should not take this medicine

Breastfeeding women should not take this medicine

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

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

Often comes in:
Tablets: 400 or 500 mg
Liquid: 30 mg/ml

How to use:
The doses for tuberculosis medicines differ from region to region. See a health worker. (Take pyrazinamide in combination with other drugs for TB).

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

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

Warning
Pregnant and breastfeeding women should avoid this drug since its effects on the baby are not known. It is very important that you take the entire course of treatment for tuberculosis. If not, you might infect other people or get sick again with a kind of TB that is very hard to cure.


Pregnant women need to take special care

Breastfeeding women need to take special care

CAUTION
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).

Often comes in:
Tablets: 150 or 300 mg
Liquid: 25 mg/ml and 50 mg per 5 ml
Ampules for injection: 600 mg

How to use:
Doses for tuberculosis medicines differ from region to region. See a health worker. (Take rifampicin in combination with other drugs for TB). Do not take more than 600 mg a day.

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

Side effects
• Nausea, vomiting, loss of appetite, diarrhea, cramps

  • Hot face, itching, rash
  • Headaches, fever, chills, bone pain
  • Yellow skin or eyes

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

Information you
should know
May turn urine, stool, tears, sweat, or spit a red-orange. It will stain contact lenses too. Reduces the effectiveness of hormonal contraceptives. Take the entire course of TB treatment to prevent drug resistance and infecting others.


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 antibiotics.

Often comes in:
Vials for injection: 2 grams

How to use:
For gonorrhea or PID: Inject 2 g (2000 mg) into muscle one time only. (See drug combinations to treat gonorrhea or drug combinations to treat PID.)

Side effects
Chills, pain or redness at injection site, dizziness, nausea.

Other medicines
that may work
for gonorrhea: ceftriaxone
for PID: azithromycin, ceftriaxone, doxycycline, metronidazole, tetracycline

Pregnant women should not take this medicine

streptomycin

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

Often comes in:
Liquid for injection: 500 mg per ml

How to use:
The doses for tuberculosis medicines differ from region to region. See a health worker. (Take streptomycin in combination with other drugs for TB).

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

Side effects
May damage hearing or balance, and can cause a rash and difficulty urinating

Information you
should know
Wear gloves if you touch this medicine often because it can cause a serious rash. It is very important that you take the entire course of treatment for tuberculosis. If not, you might infect other people or get sick again with a kind of TB that is very 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.

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

How to use:
To be safe from tetanus for your entire life, you must get 5 immunization injections, and then one injection every 10 years. For each immunization: Give 1 injection of
0.5 ml into the muscle of the upper arm.

Side effects
Pain, redness, warmth, slight swelling.

Information you
should know

Tetanus immunizations should be given to everyone, starting in childhood. Tetanus immunization is often given to children as part of a combined immunization called DPT, and the three DPT immunizations are equal to the first 2 tetanus toxoid immunizations. Teens and adults may get the combined Td immunization. Every country has its own schedule. The example below shows the minimum time in between injections for adults in one schedule.
First.......................As soon as possible
Second..................4 weeks after the first
Third.................6 months after the second
Fourth...................1 year after the third
Fifth...................1 year after the fourth
Booster.....Every 10 years after last injection

Pregnant women should not take this medicine

Breastfeeding women should not take this medicine

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.

Often comes in:
Capsules: 100, 250, or 500 mg
Ointment: 1%

How to use:
For chlamydia: 500 mg 4 times a day for 7 days (also take other medicines).

For syphilis: 500 mg 4 times a day for 14 days.

For baby eye-care: a bit of ointment in each eye at birth, one time only.

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

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

Information you
should know
Tetracycline does no good in fighting common colds or preventing STIs.

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

Other medicines
that may work
for chlamydia: amoxicillin, azithromycin, doxycycline, erythromycin
for PID: ceftriaxone, doxycycline, metronidazole, spectinomycin
for newborn eye-care: erythromycin ointment
for syphilis: benzathine penicillin, doxycycline, erythromycin

Pregnant women need to take special care

CAUTION
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.

Often comes in:
Tablets: 250 mg, 500 mg

How to use:
For trichomonas: Take 2 grams by mouth one time only, but not if you are pregnant. If you are pregnant: Use metronizadole instead

Side effects
Metallic taste in mouth, upset stomach or nausea, headache.

Warning
Your sexual partner should also be treated. Do not drink alcohol, not even one beer, while you are taking tinidazole or for 3 days after. It will make you feel very nauseous. Avoid thismedicine if you are pregnant.

Information you
should know
Drink a glass of water after taking this medicine.

Other medicines
that may work
for trichomonas: metronidazole

trichloroacetic acid, bichloroacetic acid

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

Often comes in:
Liquids in strengths between 10% and 35%

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

Side effects
Trichloroacetic acid will hurt or destroy normal skin if spilled.

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

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

Other medicines
that may work
for genital warts: podofilox


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This page was updated:24 May 2021
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