Uses and side effects of Tranax

Tranax is a prescription only drug in the benzodiazepine family. It is a brand of Alprazolam manufactured by Cipla pharmaceuticals, India. 

It is commonly prescribed by doctors to treat anxiety, phobias and panic disorders. In addition, some doctors prescribe this medication to alleviate sleep problems in certain patients.

Principal side effects of Tranax are drowsiness, tiredness and dizziness. One of the most important side effect of this medication is addiction. It can become habit forming and in certain individuals it can become a difficult to treat condition.

What are the common uses of this medication?

Panic disorder, Anxiety disorders and phobias are most common indications. It is effective in people who have social anxiety when they face social situations. 

Tranax 1mg tablets 

It is available as 1mg, 0.5mg and 0.25mg tablets.

What are the dangerous and problematic side effects?

One of the main problems with Tranax is dependence, withdrawal symptoms and tolerance. Dependence and withdrawal means getting adverse effects when the drug is stopped. These include sweating, muscle pains, apprehension and fits. Tolerance means requiring increased amount of the drug to achieve same benefit. This feature is also called habit formation.

Addiction is common side effect of Tranax

Allergic reactions to this medication can occur rarely and they can progress into an anaphylactic reaction. So be careful when a patient develops widespread hives, shortness of breath, chest tightness and pallor.

Some patients can become depressed and can get suicidal ideation. In addition, certain patients can get reduced inhibitions and may show increased risk taking behavior.

If taken during the night, drowsiness may continue to the next day. This side effect makes operating machinery and driving dangerous. In addition, taking alcohol with this medication can aggravate the problematic side effects of both alcohol and the drug.

Hangover in next day make operating machinery dangerous

What are the common but less dangerous side effects?

Fatigue and dizziness are quite common. In addition, certain patients may complain reduced muscle strength and co-ordination problems of movements. Other side effects are poor mental concentration, restlessness, confusion and memory loss.

What are the relatively rare side effects?

Rarely patients can get stomach upset including nausea and vomiting. In addition, certain patients may get breathing difficulty. Headache is another rare side effect. Rarely some patients may complain sexual problems with this medication. In addition, very rarely few patients may get urinary problems. Difficulty in speech can occur rarely in some patients.

What the doctor should know before prescribing?

 If the patient has following diseases, they should tell it to the doctor before taking the drug.

* Kidney disease

* Liver disease

* Breathing disorder

* Ataxia (poor control of body movements)

* Clinical depression

* Myasthenia gravis

Other than that, the doctor should know about over the counter medications you are on. If the you are pregnant, then the doctor may not prescribe this medication, especially in the last three months of the pregnancy. In addition, the doctor should know your sober habits before prescribing Tranax.

General advice

 This medication is available as tablets. Tablets should be taken with full glass of water without crushing, to minimize side effects. It can be taken with or without meals. Never share this medication with anybody else.

Finally let us see how this drug acts

Tranax Modulate GABA type A receptors in the brain and increases the inhibitory neurotransmission. This process alleviates anxiety and panic attacks. But the same action causes side effects such as drowsiness.

GABA Type A receptor, where tranax acts

Summary

Tranax or Xanax is a benzodiazepine class medication prescribed for anxiety disorders. Main side effects of this medication are drowsiness that may continue to the next day, increased risk of falls due to incoordination, problems in memory and drug dependence.

Uses and side effects of Anxit tablets

Anxit is an Indian brand name of Generic Alprazolam manufactured by Micro pharmaceuticals. It is prescribed for anxiety disorders and in sleep problems. At lower doses it is helpful in reducing anxiety while causing minimal drowsiness. Most common side effects are drowsiness, fatigue and addiction. This medication can be habit forming in long term use. 

Anxit tablets

Uses of Anxit tablets

This tablet is primarily used to treat anxiety. At 0.25mg thrice a day, it is effective in treating sudden anxiety. It is helpful for people who experience anxiety in social situations such as social phobia. In addition, it is helpful in treating sudden panic attacks. However, it is not recommended to long term use in panic attacks.

In addition to above uses it can be used in treating epilepsy. However, it is rarely used for this purpose. 

This medication is used primarily to reduce anxiety

Dose range and use of Anxit tablets

This medication comes in 0.25mg and 0.5 tablets. Usually it is used thrice a day. It should not be crushed before use as it will increase the side effects. In addition, it should be taken with full glass of water.

This medication should not be used as a long term anti-anxiety medication. It is because it has habit forming properties and it can cause adverse effects upon discontinuation. In addition, in long term use some people may need increasing doses to get the same effect. So it is advisable to take it short term (Usually less than 3 months).

Common side effects

This medication is known to cause sedation and drowsiness. It can interfere with operating machinery and driving. Therefore, it is very important not to operate machinery or drive while on this medication. In addition, please state your occupation before getting the prescription from your doctor.

This medication interfere with normal sleep pattern. Therefore, some people may not experience natural sleep while on this medication. They may not feel refreshed following sleep.

This medication can cause problems with operating machinery

Some people may get suicidal ideation and this medication is known to precipitate depressive episodes. Other common side effects are impairment in memory, confusion, and fatigue. Confusion is much more common among elderly people who takes this medication.

This medication can interfere with driving

List of common side effects of Anxit tablets

1.       Sedation

2.       Drowsiness

3.       Dizziness

4.       Loss of quality sleep

5.       Depression

6.       Disinhibition

7.       Aggression

8.       Memory impairment

9.       Confusion

10.    Fatigue

Rare side effects of Anxit tablets

1.       Sexual difficulties

2.       Allergic reactions

3.       Headache

4.       Difficulty in walking

You need to discuss following information with your doctor before getting prescription

1.       Kidney disease

2.       Pregnancy status

3.       Breastfeeding

4.       Liver disease

5.       Breathing problem such as Asthma

6.       Clinical depression

7.       Myasthenia gravis

Summary

Anxit is a prescription only benzodiazepine class medication. Its generic name is Alprazolam. It is prescribed in Anxiety disorders and prescribed to induce sleep as well. Its main side effects are sedation, drowsiness, confusion and memory impairment.

Petril tablets uses and side effects

Petril ® is a clonazepam (benzodiazepine) brand manufactured in India. It is prescribed in epilepsy, anxiety disorders and in sleep problems. Most commonly reported side effects are drowsiness, dizziness, light headedness and problems in walking (ataxia).

In addition to the side effects mentioned above it has habit forming properties (Needing more dose to get the same effect especially sleep and getting unpleasant withdrawal symptoms when it is stopped) in long term use.

Petril 2mg tablets from MICRO pharma

Uses of Petril ®

This medication is used primarily to treat epilepsy. However, it is used in combination with other types of anti-epileptic medications. In psychiatry practice, it is used to calm down disturbed patients and to treat sleep problems.

In treating sleep problems, it is important to identify the cause for sleep problems and practice sleep hygiene techniques before getting pharmaceutical treatment.

Most common causes for sleep problems are psychiatry and medical problems. Common psychiatry problems are depression and anxiety disorders. Sleep problem settle once the underlying cause is treated.

Sleep hygiene techniques should be tried before taking this medication

Sleep hygiene techniques that could be tried before taking this medication

1. Use the bed only for sleep
2. Do not sleep in the day
3. Do not take alcohol, coffee, coke or chocolate (Caffeine) just before sleep
4. When you are unable to sleep then get up from the bed and do something else for some time
5. Try to make the sleeping environment comfortable, quiet and calm 
6. Overall exercise improves sleep, but try not to do vigorous exercise just before sleep

Dosage and how to take it

Petril ® is prescribed in 0.5mg to 4mg dose range. Most common dose is 1mg and 2mgs. It is taken at night therefore drowsiness would not interfere with day to day activities. Since this medication has long half-life (30 – 40 hrs), it is prescribed once a day.

To minimize side effects do not crush the medication. Take it with a meal and with a full glass of water. Do not exceed the dose prescribed by the doctor. Since it has abuse potential, do not take this without doctor’s prescription.

This medication should be taken long term with close medical supervision. It is because of its habit forming properties and quite severe withdrawal reaction.

Side effects of Petril ®

A list of common side effects

1. Drowsiness
2. Dizziness
3. Unsteady gait (walking)
4. Muscle weakness

It is very important that drowsiness and lightheadedness may persists into next day when you have taken this medication at night. Therefore, it is very important that you need to be very careful when driving or operating machinery.

IMPORTANT ! Operating machinery can become problematic when you are on this medication

IMPORTANT ! You should be careful when driving vehicles while on this medication

Uncommon side effects of Petril ® 

1. Headache
2. Vertigo
3. Slurred speech
4. Low blood pressure or hypotension
5. Tremors of hands and body
6. Urine incontinence and retention: - Common in elderly people
7. Rare side effects 
8. Respiratory depression: - It is important to tell whether you have respiratory problems such as Asthma, before getting the prescription. 
9. Blood disorders
10. Skin reactions
11. Paradoxical excitation: - Can cause disinhibition and increased activity in certain group of people.

What to tell your doctor before getting the prescription?

If you have following problems or medical condition, it is very important that you tell your doctor about them.

1. Liver disease
2. Kidney disease
3. Heart disease
4. Whether you are snoring in the night: - It is an indication that you have obstructive sleep apnea. When this medication is given in obstructive sleep apnea, it can result in dangerous lowering of respiration and blood oxygen levels in sleep that may result in brain damage. People with snoring complaint about poor sleep which make it a dangerous combination. 
5. Your work and occupation
6. Any medications you are on including street drugs
7. Whether you are pregnant or breast feeding

Snoring due to sleep apnea can cause sleep problems and prescribing sleep inducing medications in them can cause serious problems. 

Summary

Petril ® is a benzodiazepine class medication and its generic name is clonazepam. It is prescribed for epilepsy and in sleep problems. Main problems associated with this medication are drowsiness, lightheadedness and habit forming properties. This medication should not be a long term solution for sleep problems.

Pictures  Courtesy : Wikimedia

Side effects of Zolfresh tablets

Zolfresh is an Indian brand of Zolpidem tartrate prescribed for people with sleep problems. It induces sleep and use to treat insomnia. Its brand name used in US is Ambien. Compared to other medications that induces sleep this medication causes less disruption of sleep architecture.

Zolfresh tablets

What are the side effects of Zolfresh?

This medication causes drowsiness within one hour of taking it. The drowsiness effects usually lasts for around six to eight hours. However, some people may experience persistent drowsiness in next day morning. In addition, some may experience impairment in memory, motor coordination and other cognitive deficits.

Prescribed for sleep problems

Therefore, it is sometimes becomes dangerous to drive vehicles or operate machinery next morning when you take this in the night.

Dangerous to operate machinery next morning

It is advised that you should at least leave eight hours between taking Zolfresh and working on a skilled task.   

In addition to that this medication is known to cause nausea, diarrhea, headache and dizziness. Some people may experience hallucinations and clinical depression with this medication.

During sleep induced by this medication, some may experience nightmares. In addition, there are documented cases of sleepwalking associated with this medication.

Nightmares can occur in sleep

Some may get confused while on this medication. It is especially common among elderly people. Some people may experience motor coordination difficulties, muscle weakness, falls and may get double vision. In addition, some may experience tremors of the hands and body.

Taking this medication with alcohol would exacerbate the effects of alcohol and would cause more severe side effects. 

List of common side effects of Zolfresh

1. Drowsiness and sedation
2. Nausea
3. Diarrhea
4. Memory problems
5. Nightmares and sleepwalking
6. Hallucinations and clinical depression
7. Difficulties in motor coordination, muscle weakness and falls
8. Problems in driving and operating machinery

If you have following problems then you cannot take this medication. Therefore, mention it to your doctor. In addition, you need to mention other medications you are on.

1. Myasthenia gravis
2. Obstructive sleep apnea (people with snoring at night tend to have this problem. It is very dangerous to have sedatives such as Zolfresh when you have this problem as it would cause breathing problems at night. Sometimes it could be fatal)
3. Psychotic illness
4. Severe respiratory distress

Pregnancy and breastfeeding

Pregnant women should be careful when taking this medication

Women who are pregnant should be careful when taking this medication. Taking this medication in late pregnancy can cause problems in the new born. In addition, it is safe not to take this medication in first three months of pregnancy.

This medication was found in significant amounts in breast milk. So it is safe to stop it during breast feeding.

Potential for dependence of Zolfresh

This medication is habit forming in some individuals. When this is taken for long duration, some may could not sleep without it. Some may experience calmness, and relief of anxiety therefore tend to abuse it. In addition, this medication should not be used for more than four weeks. If it is taken more than that, it need to be slowly discontinue.

Dependence and abuse of this medication is a problem

Sleep hygiene methods 

It is always better to try sleep hygiene methods before get medications. Common sleep hygiene methods are

1. Use bed only for sleep : - Do not read or watch television on the bed

2. Do not take daytime naps

3. Take a glass of warm milk before bedtime

4. Do not take caffeine containing drinks such as coffee or tea before sleeping

5. Do not take alcohol just before sleep

6. If you are unable to sleep just get up from the bed and do something else such as reading a book.

Following video will illustrate the sleep hygiene methods

If you need to take this medication for more than four weeks then its indicated that there could be a underlying cause for the sleep problem. It need to be found out. Commonest causes for abuse of this medication and continued sleep problems are depression and anxiety disorders.

Uses and side effects of Lonazep tablets

Lonazep is a brand of clonazepam manufactured by Sun pharmaceuticals, India. It is a benzodiazepine class medication prescribed for epilepsy, calm down disturbed patients, and induce sleep and to treat anxiety. Its main side effects are drowsiness, dizziness and unsteadiness or ataxia.

What are the uses of Lonazep?

Lonazep is mainly prescribed to treat epilepsy. It is effective in most types of epilepsies and it is usually prescribed in combination with other anti epileptic medications. It is also prescribed immediately to prevent further seizures when a seizure attack occurs.

In addition, it is prescribed for short term relief of insomnia (poor sleep). However, it should not be used for more than three weeks for the purpose of insomnia, as it is known to cause dependence (habit forming).

It is also used to treat alcohol dependence. In addition, it is helpful for people with poor sleep following discontinuation of alcohol. Medications like Zolfresh would also help people with sleep problems. 

Another brand of clonazepam that is commonly prescribed is Anxit. 

Summary of uses

1.       To induce sleep

2.       To calm down disturbed patients

3.       Epilepsy

4.       To relieve Alcohol withdrawal symptoms

Who should not use this medication?

Lonazep should be used carefully in patients with breathing difficulties. It is known to cause breathing difficulties, especially in higher doses. It should not be used in patients with myasthenia gravis.

In addition, it should not be used in patients with sleep apnea. Therefore, if you have poor sleep associated with snoring at night then you need to inform that to your doctor.

Lonazep should be used cautiously in patients with severe liver and kidney problems.

You should be cautious when you have following problems and inform them to the prescribing doctor.

1.       Breathing difficulties

2.       Snoring at night with poor sleep

3.       Kidney and liver problems

Lonazep 2mg tablets pack.

What are the common side effects of Lonazep?

Drowsiness and light headedness can go on to next day when it is taken in the night. In addition, it can cause unsteadiness or ataxia. It is also dangerous to operate machinery or drive vehicles when its effects are present.

Operating machinery can be dangerous when taking Lonazep tablets

In addition, some patients who were given Lonazep can become more agitated and it is called paradoxical excitation.

In addition, this medication is habit forming in long term use. People can become addicted to this medication and they may find that sleeping is becoming dependent on medication. It is common when this medication is taken more than three weeks.

Summary of common side effects

1.       Drowsiness

2.       Light headed ness

3.       Ataxia

4.       Danger of operating machinery and driving even in next day

5.       Habit forming

6.       Paradoxical excitation

How do you take Lonazep?

This medication is taken as oral tablet. It should be taken without crushing or breaking. It should be taken with a full glass of water. Also it should be taken as prescribed by the doctor. Never adjust dose for yourself or use it for poor sleep for more than three weeks.

This medication is available as 1 - 2mg tablets.

Lonazep mouth dissolving tablets

Mouth dissolving tablets are useful when the patient is violent and refusing medications. In such situations putting the tablets into the mouth causes rapid disintegration and patient cannot spit out the medication.

In addition,  they can be given in covert medication administration. Here the tablets are dissolved into a drink without patient’s knowledge. However, it has associated legal and ethical problems.

Lonazep mouth dissolving tablets

Summary

Lonazep is a benzodiazepine class medication prescribed for epilepsy, poor sleep and to calm down agitated patients. Its main side effect is drowsiness and difficulty in operating machinery and driving. In addition, this medication has abuse potential and can be habit forming.

Uses and side effects of Nitrest

Nitrest is an Indian brand of generic medication called Zolpidem Tartrate. It’s common brand name is Ambien. It is classified as a non-benzodiazepine hypnotic. It is a prescription only medication used to induce sleep or as a temporary treatment for insomnia. However, it has addictive and abuse potential.

Nitrest10mg tablets

Uses of Nitrest

Nitrest helps to induce sleep. You will usually get sleepy usually within 15 minutes of taking Nitrest. Its effects usually lasts for six to seven hours. But some people can get hangovers in the next day.

In addition, it does not change the sleep architecture (Amount of REM and NREM sleep). Therefore, unlike benzodiazepine hypnotics (Valium) you will feel refreshed after the sleep. Due to its sleep inducing properties some people abuse it. In fact Zolpidem (Nitrest) abuse is a recognized phenomenon. 

Another brand of Zolpidem is Zolfresh.

Nitrest is used to help sleep

What are other side effects associated with Nitrest?

This medication can cause diarrhea, nausea, dizziness, headache, hallucinations, agitation, memory problems, nightmares, depression, confusion and problems in walking such as unsteady gait.

Sleep walking is also reported rarely.

However, above side effects are not common and most people tolerate this medication quite well.

Problems associated with Nitrest

This medication should be used only for short term relief of insomnia. It is not recommended to use it for long term. It is not recommended to use it for more than four weeks. It is because long term insomnia would be due to underlying medical or psychiatric condition that need treatment. In addition, due to addictive potential long term use can cause problems.

Nitrest should be used cautiously in depression, psychosis and in patients with history of alcohol and other substance use.

This medication should not be used by patients with myasthenia gravis.

Sometimes drowsiness may persist into next day. This will cause problems with driving and operating machinery.

Inform your doctor whether you have following conditions,

1. Clinical depression or Bipolar disorder
2. Liver and kidney problems
3. Myasthenia gravis
4. Breathing difficulties

Driving can be dangerous if you took Nitrest last night

Nitrest should not be used by people with obstructive sleep apnea. It is common among people who snores at night. Snoring is caused by obstruction in respiratory tract that occurs in deep sleep. Due to this obstruction frequent nighttime awakenings occur and it can be misidentified as insomnia. In addition, taking this class of medications (hypnotics) by such people can cause severe obstruction and in some occasions brain damage.

In addition, this medications should not be used in patients with end stage renal and hepatic disease.

Use in pregnancy can cause problems in muscle tone, delayed crying and reduced body temperature in newborn baby.

Summary

Nitrest is a medication prescribed for short term relief of insomnia. It acts quickly and effects goes off quickly as well. However, it have addictive potential and can cause problems with driving and operating machinery. 

You can get more information about this medication from Medline online medical library

How chronic insomnia is treated with sedative hypnotics–New guidelines

According to the stahl’s essentials of psychopharmacology 3rd edition, There is a place for long term use of sedative hypnotics in chronic insomnia. Sedative hypnotic is a drug that causes depression of central nervous system activity which causes sleep.

The old guidelines recommend short term use of sedative hypnotics, improve sleep hygiene and treat the underlying cause for insomnia. It does not appreciate chronic insomnia as a disease entity on its own.

In addition, most of the older sedative hypnotics such as benzodiazepines (Vallium, Dalmane) and barbiturates are comparatively long acting. These long acting compounds tend to cause sleepiness in the following day and falls/hip fractures in the elderly. In addition, they tend to cause withdrawal symptoms and dependence.

New thinking on insomnia and sedative hypnotic use

Now most experts think chronic insomnia is a disorder by itself and there is a need for long term treatment. In addition, hypnotics such as Zaleplon, Zolpidem and Zopiclone extremely short acting. Therefore they do not show any sleepiness in the following day.

In addition, long term studies conducted on eszopiclone shows little or no tolerance (need to take increasing amount of drug to get the same effect) and withdrawal symptoms (Stahl, 3rd).

Following hypnotics have shown marked promise and have no restrictions in the long term use. However, some of them may cause sleepiness in the next day morning.

1. Zolpidem CR (Ambien continuous release)
2. Trazadone (Desyrel)
3. Quatiapine (Seroquel)

Warning
This drug related blog post is for information only. YOU MUST CONSULT YOUR DOCTOR BEFORE TAKING THESE DRUGS.


Sources
Essential psychopharmacology Stahl, 3rd edition

Use and side effects of Zaleplon(Sonata, Zalep, Zalpilo, Zanlop, Zaplon, Zaso)

Sonata is a prescription only medication used for short term relief of insomnia. Its generic name is Zaleplon. This drug is quite useful for initiation of sleep. However, it is not helpful in maintaining sleep and it usually does not prevent frequent nighttime awakenings.


 Similar to benzodiazepines, Sonata Modulate GABA Type A receptors in the brain and increase their action. This action increases the inhibitory neuro transmission and it ultimately relieves insomnia.


 What the doctor should know before prescribing Sonata?
 If the patient has kidney disease, liver disease, breathing disorder, clinical depression, ataxia (poor control of body movements), or myasthenia gravis then he/she should discuss that with the doctor before taking Sonata. In addition, the doctor should know what the over the counter medications patient is on.


  The doctor may not prescribe this medication to pregnant and nursing mothers. Problematic effects to the new born are reported in regular use, especially in the last three months of the pregnancy.


In addition, this drug increases adverse effects of alcohol and other recreational drugs. Therefore the doctor should know the patients sober habits, before prescribing Sonata.


What should the patient know before taking Sonata?


This medication is available as tablets. Tablets should be taken with full glass of water without crushing, to minimize side effects. It can be taken with or without meals. This is a very short acting drug. Therefore patients should take this medication immediately before sleep.


What are the common side effects?


 If taken in the night drowsiness is usually not continued to the next day. However, operating machinery and driving motor vehicles are not recommended in the following day. 


 Other common side effects are numbness in extremities and menstrual pain. Reduced muscle strength and co-ordination problems of movements are side effects as well. In addition, people can get poor mental concentration, restlessness, confusion and memory loss with this drug.


In addition, one of the main problems associated with Sonata is dependence and withdrawal symptoms like rebound insomnia and fits. Dependence and withdrawal means getting adverse effects when the drug is stopped. However, unlike other hypnotics, tolerance is not reported with regular use. In addition, tolerance means requiring increased amount of the drug to achieve the same benefit.