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INDICATIONS

Cyklokapron is used for reducing or preventing excessive bleeding and reducing the need for blood clotting factor transfusions during or after tooth extractions in patients with hemophilia. It is also used to prevent or reduce bleeding during certain medical procedures (eg, cervical surgery) and to treat certain bleeding problems (eg, nosebleeds, bleeding inside the eye, heavy menstrual periods) in patients whose blood does not clot well. It is also used to treat hereditary angioneurotic edema. It may also be used for other conditions as determined by your doctor.

INSTRUCTIONS

Use Cyklokapron as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Cyklokapron is usually given as an injection at your doctor’s office, hospital, or clinic. If you will be using Cyklokapron at home, a health care provider will teach you how to use it. Be sure you understand how to use Cyklokapron. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
Do not use Cyklokapron if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
Continue to use Cyklokapron for the full course of treatment even if you feel well. Do not miss any doses.
If you miss a dose of Cyklokapron, contact your doctor immediately.

Ask your health care provider any questions you may have about how to use Cyklokapron.

DOSAGE

Take exactly as directed. Dosage is generally two to four times daily by mouth. Length of treatment is based on your condition and response.

STORAGE

Store at room temperature between 36 and 86 degrees F (2-30 degrees C) away from sunlight and moisture.

Cyklokapron is an antifibrinolytic. It works by preventing blood clots from breaking down too quickly. This helps to reduce excessive bleeding.

Do NOT use Cyklokapron if:

  • you are allergic to any ingredient in Cyklokapron
  • you have blood clots (eg, in the leg, lung, eye, brain), a history of blood clots, or conditions that may increase your risk of blood clots (eg, certain heart valve problems, certain types of irregular heartbeat, certain blood clotting problems)
  • you have bleeding in the brain, blood in the urine, or bleeding related to kidney problems
  • you have a disturbance of color vision
  • you have irregular menstrual bleeding of unknown cause
  • you are using medicine to help your blood clot (eg, factor IX complex concentrates or anti-inhibitor coagulant concentrates)

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Cyklokapron. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of kidney problems, diabetes, polycystic ovary syndrome, bleeding or blood clotting problems, a certain blood problem called disseminated intravascular coagulation (DIC), eye or vision problems, or bleeding in the brain
  • if you are very overweight
  • if you have a personal or family history of blood clots or endometrial cancer
  • if you also take estrogen or tamoxifen

Some MEDICINES MAY INTERACT with Cyklokapron. Tell your health care provider if you are taking any other medicines, especially any of the following:
Hormonal birth control (eg, birth control pills), medicines to help your blood clot (eg, anti-inhibitor coagulant concentrates, factor IX complex concentrates), or tretinoin (all-trans retinoic acid) because the risk of blood clots may be increased
Desmopressin, hydrochlorothiazide, nitroglycerin, ranitidine, or sulbactam-ampicillin because the risk of heart attack may be increased
Anticoagulants (eg, warfarin) because they may decrease Cyklokapron’s effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Cyklokapron may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Cyklokapron while you are pregnant. Cyklokapron is found in breast milk. If you are or will be breast-feeding while you are using Cyklokapron, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; nausea; vomiting.
Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); calf or leg pain, swelling, or tenderness; chest pain; confusion; coughing up blood; decreased urination or difficulty urinating; eye problems; fainting; numbness of an arm or leg; one-sided weakness; pain, swelling, or redness at the injection site; seizures; severe or persistent dizziness or light-headedness; shortness of breath; slurred speech; sudden, severe headache or vomiting; vision changes or problems (eg, disturbance of color vision, sharpness, or field of vision).

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects.

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INDICATIONS

Keppra is used to treat partial onset seizures in adults and children who are at least 1 month old.
It is also used to treat tonic-clonic seizures in adults and children who are at least 6 years old, and myoclonic seizures in adults and children who are at least 12 years old.

INSTRUCTIONS

Take Keppra exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

Keppra is usually taken twice per day. Take the medicine at the same time each day. You may take Keppra with or without food.

Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
Do not crush, chew, or break a controlled release, delayed-release, or extended-release tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time.

Use Keppra regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Do not stop using Keppra without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using this medicine suddenly. You may need to use less and less before you stop the medication completely.

Seizures are often treated with a combination of different drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor’s advice. .

Wear a medical alert tag or carry an ID card stating that you take Keppra. Any medical care provider who treats you should know that you take seizure medication.

To be sure Keppra is not causing harmful effects, your kidney function may need to be tested. Visit your doctor regularly.

If you missed a dose – take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

DOSAGE

Important Administration Instructions

Keppra is given orally with or without food. The Keppra dosing regimen depends on the indication, age group, dosage form (tablets or oral solution), and renal function.

Prescribe the oral solution for pediatric patients with body weight ≤ 20 kg. Prescribe the oral solution or tablets for pediatric patients with body weight above 20 kg.

When using the oral solution in pediatric patients, dosing is weight-based (mg per kg) using a calibrated measuring device (not a household teaspoon or tablespoon).
Keppra tablets should be swallowed whole. Keppra tablets should not be chewed or crushed.

Pediatric Patients

  • 1 Month To < 6 Months

Treatment should be initiated with a daily dose of 14 mg/kg in 2 divided doses (7 mg/kg twice daily). The daily dose should be increased every 2 weeks by increments of 14 mg/kg to the recommended daily dose of 42 mg/kg (21 mg/kg twice daily). In the clinical trial, the mean daily dose was 35 mg/kg in this age group. The effectiveness of lower doses has not been studied.

  • 6 Months To < 4 Years

Treatment should be initiated with a daily dose of 20 mg/kg in 2 divided doses (10 mg/kg twice daily). The daily dose should be increased in 2 weeks by an increment of 20 mg/kg to the recommended daily dose of 50 mg/kg (25 mg/kg twice daily). If a patient cannot tolerate a daily dose of 50 mg/kg, the daily dose may be reduced. In the clinical trial, the mean daily dose was 47 mg/kg in this age group.

  • 4 Years To < 16 Years

Treatment should be initiated with a daily dose of 20 mg/kg in 2 divided doses (10 mg/kg twice daily). The daily dose should be increased every 2 weeks by increments of 20 mg/kg to the recommended daily dose of 60 mg/kg (30 mg/kg twice daily). If a patient cannot tolerate a daily dose of 60 mg/kg, the daily dose may be reduced. In the clinical efficacy trial, the mean daily dose was 44 mg/kg. The maximum daily dose was 3000 mg/day.

For Keppra tablet dosing in pediatric patients weighing 20 to 40 kg, treatment should be initiated with a daily dose of 500 mg given as twice daily dosing (250 mg twice daily). The daily dose should be increased every 2 weeks by increments of 500 mg to a maximum recommended daily dose of 1500 mg (750 mg twice daily).

For Keppra tablet dosing in pediatric patients weighing more than 40 kg, treatment should be initiated with a daily dose of 1000 mg/day given as twice daily dosing (500 mg twice daily). The daily dose should be increased every 2 weeks by increments of 1000 mg/day to a maximum recommended daily dose of 3000 mg (1500 mg twice daily).

Partial Onset Seizures

Adults 16 Years And Older

In clinical trials, daily doses of 1000 mg, 2000 mg, and 3000 mg, given as twice-daily dosing were shown to be effective. Although in some studies there was a tendency toward greater response with higher dose [see Clinical Studies], a consistent increase in response with increased dose has not been shown.

Treatment should be initiated with a daily dose of 1000 mg/day, given as twice-daily dosing (500 mg twice daily). Additional dosing increments may be given (1000 mg/day additional every 2 weeks) to a maximum recommended daily dose of 3000 mg. Doses greater than 3000 mg/day have been used in open-label studies for periods of 6 months and longer. There is no evidence that doses greater than 3000 mg/day confer additional benefit.

Myoclonic Seizures In Patients 12 Years of Age and Older With Juvenile Myoclonic Epilepsy

Treatment should be initiated with a dose of 1000 mg/day, given as twice-daily dosing (500 mg twice daily). Dosage should be increased by 1000 mg/day every 2 weeks to the recommended daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.

Primary Generalized Tonic-Clonic Seizures

Adults 16 Years And Older
Treatment should be initiated with a dose of 1000 mg/day, given as twice-daily dosing (500 mg twice daily). Dosage should be increased by 1000 mg/day every 2 weeks to the recommended daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been adequately studied.

Pediatric Patients Ages 6 To < 16 Years

Treatment should be initiated with a daily dose of 20 mg/kg in 2 divided doses (10 mg/kg twice daily). The daily dose should be increased every 2 weeks by increments of 20 mg/kg to the recommended daily dose of 60 mg/kg (30 mg/kg twice daily). The effectiveness of doses lower than 60 mg/kg/day has not been adequately studied. Patients with body weight ≤ 20 kg should be dosed with oral solution. Patients with body weight above 20 kg can be dosed with either tablets or oral solution. Only whole tablets should be administered.

Adult Patients With Impaired Renal Function

Keppra dosing must be individualized according to the patient’s renal function status.

STORAGE

Store Keppra at room temperature away from moisture, heat, and light.

You should not use Keppra if you are allergic to levetiracetam.

To make sure you can safely take Keppra, tell your doctor if you have kidney disease or high blood pressure.

You may have thoughts about suicide while taking this medicine. Tell your doctor if you have symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits.

FDA pregnancy category C. It is not known whether Keppra will harm an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Do not start or stop taking Keppra during pregnancy without your doctor’s advice. Seizure control is very important during pregnancy. The benefit of preventing seizures may outweigh any risks posed by taking Keppra. Follow your doctor’s instructions about taking Keppra while you are pregnant. Levetiracetam can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Keppra. Do not give this medication to a child without the advice of a doctor. Your child’s dose needs are based on age and weight. The child should remain under the care of a doctor while using this medicine.

Do not stop using Keppra without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using Keppra suddenly. You may need to use less and less before you stop the medication completely.

You may have thoughts about suicide while taking Keppra. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, irritable, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Wear a medical alert tag or carry an ID card stating that you take Keppra. Any medical care provider who treats you should know that you take seizure medication.

Keppra may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Do not start or stop taking Keppra during pregnancy without your doctor’s advice. Having a seizure during pregnancy could harm both the mother and the baby. Seizure control is very important during pregnancy and the benefits of preventing seizures may outweigh any risks posed by using Keppra.

Avoid drinking alcohol. It can increase some of the side effects of Keppra and may also increase the risk of seizures. This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Get emergency medical help if you have any of these signs of an allergic reaction to Keppra: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, irritable, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have a serious side effect such as:

  • hallucinations, unusual thoughts or behavior;
  • bruising, severe tingling, numbness, pain, muscle weakness;
  • feeling very weak or tired;
  • fever, chills, body aches, flu symptoms, sores in your mouth and throat;
  • problems with walking or movement;
  • the first sign of any skin rash, no matter how mild; or
  • severe skin reaction — fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious Keppra side effects may include:

  • В mild dizziness or drowsiness;
  • mild tired feeling;
  • loss of appetite; or
  • stuffy nose.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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Prometrium is used for protecting the lining of the uterus in certain women who are also taking estrogen. It is used to treat certain women who have do not have a menstrual period because of decreased progesterone in the body. Prometrium is a hormone. It works by changing the lining of the uterus.

INSTRUCTIONS

Use Prometrium as directed by your doctor.

  • Take Prometrium by mouth with or without food.
  • If you miss a dose of Prometrium, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Prometrium.

STORAGE

Store Prometrium at 77 degrees F (25 degrees C) in a tight, light-resistant container. Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Prometrium out of the reach of children and away from pets.

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Active Ingredient: Progesterone.

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Some medical conditions may interact with Prometrium. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

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Some medicines may interact with Prometrium. Tell your health care provider if you are taking any other medicines, especially any of the following:

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  • Prometrium may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Prometrium.
  • Lab tests, including monthly breast self-exams, yearly breast exams, Pap smears, and pelvic exams, may be performed while you use Prometrium. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Prometrium should not be used in children; safety and effectiveness in children have not been confirmed.
  • Pregnancy and breast-feeding: Do not use Prometrium if you are pregnant unless your doctor tells you otherwise. If you think you may be pregnant, contact your doctor. Prometrium is found in breast milk. If you are or will be breast-feeding while you use Prometrium, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome:

Bloating; breast tenderness; diarrhea; dizziness; drowsiness; dry mouth; fluid retention; headache; heartburn; irritability; muscle pain; nausea; stomach pain or cramping; tiredness; vomiting.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal vaginal bleeding; bulging eyes; coughing up blood; dark urine; double vision; fainting; gallstones; mental or mood changes (eg, depression or worry); migraine; numbness of an arm or leg; pain or lumps in the breast; one-sided weakness; pounding in the chest; seizures or tremors; severe stomach pain; speech problems; stomach pain, swelling, or tenderness; sudden, severe chest pain or numbness; sudden, severe headache; sudden, severe vomiting, dizziness, or fainting; sudden sharp pain or swelling in the calf or leg; sudden shortness of breath; swelling of the ankles or fingers; vision problems or changes (including sudden, partial, or full loss of vision); yellowing of the eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

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INDICATIONS

Cyklokapron is used for reducing or preventing excessive bleeding and reducing the need for blood clotting factor transfusions during or after tooth extractions in patients with hemophilia. It is also used to prevent or reduce bleeding during certain medical procedures (eg, cervical surgery) and to treat certain bleeding problems (eg, nosebleeds, bleeding inside the eye, heavy menstrual periods) in patients whose blood does not clot well. It is also used to treat hereditary angioneurotic edema. It may also be used for other conditions as determined by your doctor.

INSTRUCTIONS

Use Cyklokapron as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Cyklokapron is usually given as an injection at your doctor’s office, hospital, or clinic. If you will be using Cyklokapron at home, a health care provider will teach you how to use it. Be sure you understand how to use Cyklokapron. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
Do not use Cyklokapron if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
Continue to use Cyklokapron for the full course of treatment even if you feel well. Do not miss any doses.
If you miss a dose of Cyklokapron, contact your doctor immediately.

Ask your health care provider any questions you may have about how to use Cyklokapron.

DOSAGE

Take exactly as directed. Dosage is generally two to four times daily by mouth. Length of treatment is based on your condition and response.

STORAGE

Store at room temperature between 36 and 86 degrees F (2-30 degrees C) away from sunlight and moisture.

Cyklokapron is an antifibrinolytic. It works by preventing blood clots from breaking down too quickly. This helps to reduce excessive bleeding.

Do NOT use Cyklokapron if:

  • you are allergic to any ingredient in Cyklokapron
  • you have blood clots (eg, in the leg, lung, eye, brain), a history of blood clots, or conditions that may increase your risk of blood clots (eg, certain heart valve problems, certain types of irregular heartbeat, certain blood clotting problems)
  • you have bleeding in the brain, blood in the urine, or bleeding related to kidney problems
  • you have a disturbance of color vision
  • you have irregular menstrual bleeding of unknown cause
  • you are using medicine to help your blood clot (eg, factor IX complex concentrates or anti-inhibitor coagulant concentrates)

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Cyklokapron. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of kidney problems, diabetes, polycystic ovary syndrome, bleeding or blood clotting problems, a certain blood problem called disseminated intravascular coagulation (DIC), eye or vision problems, or bleeding in the brain
  • if you are very overweight
  • if you have a personal or family history of blood clots or endometrial cancer
  • if you also take estrogen or tamoxifen

Some MEDICINES MAY INTERACT with Cyklokapron. Tell your health care provider if you are taking any other medicines, especially any of the following:
Hormonal birth control (eg, birth control pills), medicines to help your blood clot (eg, anti-inhibitor coagulant concentrates, factor IX complex concentrates), or tretinoin (all-trans retinoic acid) because the risk of blood clots may be increased
Desmopressin, hydrochlorothiazide, nitroglycerin, ranitidine, or sulbactam-ampicillin because the risk of heart attack may be increased
Anticoagulants (eg, warfarin) because they may decrease Cyklokapron’s effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Cyklokapron may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Cyklokapron while you are pregnant. Cyklokapron is found in breast milk. If you are or will be breast-feeding while you are using Cyklokapron, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; nausea; vomiting.
Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); calf or leg pain, swelling, or tenderness; chest pain; confusion; coughing up blood; decreased urination or difficulty urinating; eye problems; fainting; numbness of an arm or leg; one-sided weakness; pain, swelling, or redness at the injection site; seizures; severe or persistent dizziness or light-headedness; shortness of breath; slurred speech; sudden, severe headache or vomiting; vision changes or problems (eg, disturbance of color vision, sharpness, or field of vision).

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects.

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INDICATIONS

Prometrium is used for protecting the lining of the uterus in certain women who are also taking estrogen. It is used to treat certain women who have do not have a menstrual period because of decreased progesterone in the body. Prometrium is a hormone. It works by changing the lining of the uterus.

INSTRUCTIONS

Use Prometrium as directed by your doctor.

  • Take Prometrium by mouth with or without food.
  • If you miss a dose of Prometrium, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Prometrium.

STORAGE

Store Prometrium at 77 degrees F (25 degrees C) in a tight, light-resistant container. Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Prometrium out of the reach of children and away from pets.

MORE INFO:

Active Ingredient: Progesterone.

Do NOT use Prometrium if:

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  • you have a history of cancer of the breast, ovary, lining of the uterus, cervix, or vagina; vaginal bleeding of unknown cause; blood clots or clotting problems; or liver disease; you have had a recent miscarriage; or you have had a stroke or heart attack within the past year
  • you are pregnant.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Prometrium. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have heart or blood vessel problems, bleeding problems, high blood pressure, high cholesterol or lipid levels, diabetes, kidney problems, asthma, migraine headaches, or lupus
  • if you have a history of seizures, depression or other mental or mood problems, cancer, or tobacco use
  • if you have a family history of blood clots
  • if you are very overweight.

Some medicines may interact with Prometrium. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Rifampin because it may decrease Prometrium’s effectiveness.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Prometrium may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

  • Prometrium may cause drowsiness, dizziness, blurred vision, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Prometrium with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.
  • This product has peanut oil in it. Do not take Prometrium if you are allergic to peanuts.
  • Diabetes patients – Prometrium may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Prometrium may increase your risk of developing blood clots. If you will be having surgery or be confined to a bed or chair for a long period of time (such as a long plane flight), notify your doctor beforehand. Special precautions may be needed in these circumstances while you are taking Prometrium.
  • Prometrium may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Prometrium.
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  • Prometrium should not be used in children; safety and effectiveness in children have not been confirmed.
  • Pregnancy and breast-feeding: Do not use Prometrium if you are pregnant unless your doctor tells you otherwise. If you think you may be pregnant, contact your doctor. Prometrium is found in breast milk. If you are or will be breast-feeding while you use Prometrium, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome:

Bloating; breast tenderness; diarrhea; dizziness; drowsiness; dry mouth; fluid retention; headache; heartburn; irritability; muscle pain; nausea; stomach pain or cramping; tiredness; vomiting.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal vaginal bleeding; bulging eyes; coughing up blood; dark urine; double vision; fainting; gallstones; mental or mood changes (eg, depression or worry); migraine; numbness of an arm or leg; pain or lumps in the breast; one-sided weakness; pounding in the chest; seizures or tremors; severe stomach pain; speech problems; stomach pain, swelling, or tenderness; sudden, severe chest pain or numbness; sudden, severe headache; sudden, severe vomiting, dizziness, or fainting; sudden sharp pain or swelling in the calf or leg; sudden shortness of breath; swelling of the ankles or fingers; vision problems or changes (including sudden, partial, or full loss of vision); yellowing of the eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

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INDICATIONS

Cyklokapron is used for reducing or preventing excessive bleeding and reducing the need for blood clotting factor transfusions during or after tooth extractions in patients with hemophilia. It is also used to prevent or reduce bleeding during certain medical procedures (eg, cervical surgery) and to treat certain bleeding problems (eg, nosebleeds, bleeding inside the eye, heavy menstrual periods) in patients whose blood does not clot well. It is also used to treat hereditary angioneurotic edema. It may also be used for other conditions as determined by your doctor.

INSTRUCTIONS

Use Cyklokapron as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Cyklokapron is usually given as an injection at your doctor’s office, hospital, or clinic. If you will be using Cyklokapron at home, a health care provider will teach you how to use it. Be sure you understand how to use Cyklokapron. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
Do not use Cyklokapron if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
Continue to use Cyklokapron for the full course of treatment even if you feel well. Do not miss any doses.
If you miss a dose of Cyklokapron, contact your doctor immediately.

Ask your health care provider any questions you may have about how to use Cyklokapron.

DOSAGE

Take exactly as directed. Dosage is generally two to four times daily by mouth. Length of treatment is based on your condition and response.

STORAGE

Store at room temperature between 36 and 86 degrees F (2-30 degrees C) away from sunlight and moisture.

Cyklokapron is an antifibrinolytic. It works by preventing blood clots from breaking down too quickly. This helps to reduce excessive bleeding.

Do NOT use Cyklokapron if:

  • you are allergic to any ingredient in Cyklokapron
  • you have blood clots (eg, in the leg, lung, eye, brain), a history of blood clots, or conditions that may increase your risk of blood clots (eg, certain heart valve problems, certain types of irregular heartbeat, certain blood clotting problems)
  • you have bleeding in the brain, blood in the urine, or bleeding related to kidney problems
  • you have a disturbance of color vision
  • you have irregular menstrual bleeding of unknown cause
  • you are using medicine to help your blood clot (eg, factor IX complex concentrates or anti-inhibitor coagulant concentrates)

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Cyklokapron. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of kidney problems, diabetes, polycystic ovary syndrome, bleeding or blood clotting problems, a certain blood problem called disseminated intravascular coagulation (DIC), eye or vision problems, or bleeding in the brain
  • if you are very overweight
  • if you have a personal or family history of blood clots or endometrial cancer
  • if you also take estrogen or tamoxifen

Some MEDICINES MAY INTERACT with Cyklokapron. Tell your health care provider if you are taking any other medicines, especially any of the following:
Hormonal birth control (eg, birth control pills), medicines to help your blood clot (eg, anti-inhibitor coagulant concentrates, factor IX complex concentrates), or tretinoin (all-trans retinoic acid) because the risk of blood clots may be increased
Desmopressin, hydrochlorothiazide, nitroglycerin, ranitidine, or sulbactam-ampicillin because the risk of heart attack may be increased
Anticoagulants (eg, warfarin) because they may decrease Cyklokapron’s effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Cyklokapron may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Cyklokapron while you are pregnant. Cyklokapron is found in breast milk. If you are or will be breast-feeding while you are using Cyklokapron, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; nausea; vomiting.
Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); calf or leg pain, swelling, or tenderness; chest pain; confusion; coughing up blood; decreased urination or difficulty urinating; eye problems; fainting; numbness of an arm or leg; one-sided weakness; pain, swelling, or redness at the injection site; seizures; severe or persistent dizziness or light-headedness; shortness of breath; slurred speech; sudden, severe headache or vomiting; vision changes or problems (eg, disturbance of color vision, sharpness, or field of vision).

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects.

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INDICATIONS

Keppra is used to treat partial onset seizures in adults and children who are at least 1 month old.
It is also used to treat tonic-clonic seizures in adults and children who are at least 6 years old, and myoclonic seizures in adults and children who are at least 12 years old.

INSTRUCTIONS

Take Keppra exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

Keppra is usually taken twice per day. Take the medicine at the same time each day. You may take Keppra with or without food.

Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
Do not crush, chew, or break a controlled release, delayed-release, or extended-release tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time.

Use Keppra regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Do not stop using Keppra without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using this medicine suddenly. You may need to use less and less before you stop the medication completely.

Seizures are often treated with a combination of different drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor’s advice. .

Wear a medical alert tag or carry an ID card stating that you take Keppra. Any medical care provider who treats you should know that you take seizure medication.

To be sure Keppra is not causing harmful effects, your kidney function may need to be tested. Visit your doctor regularly.

If you missed a dose – take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

DOSAGE

Important Administration Instructions

Keppra is given orally with or without food. The Keppra dosing regimen depends on the indication, age group, dosage form (tablets or oral solution), and renal function.

Prescribe the oral solution for pediatric patients with body weight ≤ 20 kg. Prescribe the oral solution or tablets for pediatric patients with body weight above 20 kg.

When using the oral solution in pediatric patients, dosing is weight-based (mg per kg) using a calibrated measuring device (not a household teaspoon or tablespoon).
Keppra tablets should be swallowed whole. Keppra tablets should not be chewed or crushed.

Pediatric Patients

  • 1 Month To < 6 Months

Treatment should be initiated with a daily dose of 14 mg/kg in 2 divided doses (7 mg/kg twice daily). The daily dose should be increased every 2 weeks by increments of 14 mg/kg to the recommended daily dose of 42 mg/kg (21 mg/kg twice daily). In the clinical trial, the mean daily dose was 35 mg/kg in this age group. The effectiveness of lower doses has not been studied.

  • 6 Months To < 4 Years

Treatment should be initiated with a daily dose of 20 mg/kg in 2 divided doses (10 mg/kg twice daily). The daily dose should be increased in 2 weeks by an increment of 20 mg/kg to the recommended daily dose of 50 mg/kg (25 mg/kg twice daily). If a patient cannot tolerate a daily dose of 50 mg/kg, the daily dose may be reduced. In the clinical trial, the mean daily dose was 47 mg/kg in this age group.

  • 4 Years To < 16 Years

Treatment should be initiated with a daily dose of 20 mg/kg in 2 divided doses (10 mg/kg twice daily). The daily dose should be increased every 2 weeks by increments of 20 mg/kg to the recommended daily dose of 60 mg/kg (30 mg/kg twice daily). If a patient cannot tolerate a daily dose of 60 mg/kg, the daily dose may be reduced. In the clinical efficacy trial, the mean daily dose was 44 mg/kg. The maximum daily dose was 3000 mg/day.

For Keppra tablet dosing in pediatric patients weighing 20 to 40 kg, treatment should be initiated with a daily dose of 500 mg given as twice daily dosing (250 mg twice daily). The daily dose should be increased every 2 weeks by increments of 500 mg to a maximum recommended daily dose of 1500 mg (750 mg twice daily).

For Keppra tablet dosing in pediatric patients weighing more than 40 kg, treatment should be initiated with a daily dose of 1000 mg/day given as twice daily dosing (500 mg twice daily). The daily dose should be increased every 2 weeks by increments of 1000 mg/day to a maximum recommended daily dose of 3000 mg (1500 mg twice daily).

Partial Onset Seizures

Adults 16 Years And Older

In clinical trials, daily doses of 1000 mg, 2000 mg, and 3000 mg, given as twice-daily dosing were shown to be effective. Although in some studies there was a tendency toward greater response with higher dose [see Clinical Studies], a consistent increase in response with increased dose has not been shown.

Treatment should be initiated with a daily dose of 1000 mg/day, given as twice-daily dosing (500 mg twice daily). Additional dosing increments may be given (1000 mg/day additional every 2 weeks) to a maximum recommended daily dose of 3000 mg. Doses greater than 3000 mg/day have been used in open-label studies for periods of 6 months and longer. There is no evidence that doses greater than 3000 mg/day confer additional benefit.

Myoclonic Seizures In Patients 12 Years of Age and Older With Juvenile Myoclonic Epilepsy

Treatment should be initiated with a dose of 1000 mg/day, given as twice-daily dosing (500 mg twice daily). Dosage should be increased by 1000 mg/day every 2 weeks to the recommended daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.

Primary Generalized Tonic-Clonic Seizures

Adults 16 Years And Older
Treatment should be initiated with a dose of 1000 mg/day, given as twice-daily dosing (500 mg twice daily). Dosage should be increased by 1000 mg/day every 2 weeks to the recommended daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been adequately studied.

Pediatric Patients Ages 6 To < 16 Years

Treatment should be initiated with a daily dose of 20 mg/kg in 2 divided doses (10 mg/kg twice daily). The daily dose should be increased every 2 weeks by increments of 20 mg/kg to the recommended daily dose of 60 mg/kg (30 mg/kg twice daily). The effectiveness of doses lower than 60 mg/kg/day has not been adequately studied. Patients with body weight ≤ 20 kg should be dosed with oral solution. Patients with body weight above 20 kg can be dosed with either tablets or oral solution. Only whole tablets should be administered.

Adult Patients With Impaired Renal Function

Keppra dosing must be individualized according to the patient’s renal function status.

STORAGE

Store Keppra at room temperature away from moisture, heat, and light.

You should not use Keppra if you are allergic to levetiracetam.

To make sure you can safely take Keppra, tell your doctor if you have kidney disease or high blood pressure.

You may have thoughts about suicide while taking this medicine. Tell your doctor if you have symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits.

FDA pregnancy category C. It is not known whether Keppra will harm an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Do not start or stop taking Keppra during pregnancy without your doctor’s advice. Seizure control is very important during pregnancy. The benefit of preventing seizures may outweigh any risks posed by taking Keppra. Follow your doctor’s instructions about taking Keppra while you are pregnant. Levetiracetam can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Keppra. Do not give this medication to a child without the advice of a doctor. Your child’s dose needs are based on age and weight. The child should remain under the care of a doctor while using this medicine.

Do not stop using Keppra without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using Keppra suddenly. You may need to use less and less before you stop the medication completely.

You may have thoughts about suicide while taking Keppra. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, irritable, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Wear a medical alert tag or carry an ID card stating that you take Keppra. Any medical care provider who treats you should know that you take seizure medication.

Keppra may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Do not start or stop taking Keppra during pregnancy without your doctor’s advice. Having a seizure during pregnancy could harm both the mother and the baby. Seizure control is very important during pregnancy and the benefits of preventing seizures may outweigh any risks posed by using Keppra.

Avoid drinking alcohol. It can increase some of the side effects of Keppra and may also increase the risk of seizures. This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Get emergency medical help if you have any of these signs of an allergic reaction to Keppra: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, irritable, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have a serious side effect such as:

  • hallucinations, unusual thoughts or behavior;
  • bruising, severe tingling, numbness, pain, muscle weakness;
  • feeling very weak or tired;
  • fever, chills, body aches, flu symptoms, sores in your mouth and throat;
  • problems with walking or movement;
  • the first sign of any skin rash, no matter how mild; or
  • severe skin reaction — fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious Keppra side effects may include:

  • В mild dizziness or drowsiness;
  • mild tired feeling;
  • loss of appetite; or
  • stuffy nose.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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Prometrium is used for protecting the lining of the uterus in certain women who are also taking estrogen. It is used to treat certain women who have do not have a menstrual period because of decreased progesterone in the body. Prometrium is a hormone. It works by changing the lining of the uterus.

INSTRUCTIONS

Use Prometrium as directed by your doctor.

  • Take Prometrium by mouth with or without food.
  • If you miss a dose of Prometrium, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Prometrium.

STORAGE

Store Prometrium at 77 degrees F (25 degrees C) in a tight, light-resistant container. Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Prometrium out of the reach of children and away from pets.

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Active Ingredient: Progesterone.

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Some medical conditions may interact with Prometrium. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

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  • if you have a history of seizures, depression or other mental or mood problems, cancer, or tobacco use
  • if you have a family history of blood clots
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Some medicines may interact with Prometrium. Tell your health care provider if you are taking any other medicines, especially any of the following:

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This may not be a complete list of all interactions that may occur. Ask your health care provider if Prometrium may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

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Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal vaginal bleeding; bulging eyes; coughing up blood; dark urine; double vision; fainting; gallstones; mental or mood changes (eg, depression or worry); migraine; numbness of an arm or leg; pain or lumps in the breast; one-sided weakness; pounding in the chest; seizures or tremors; severe stomach pain; speech problems; stomach pain, swelling, or tenderness; sudden, severe chest pain or numbness; sudden, severe headache; sudden, severe vomiting, dizziness, or fainting; sudden sharp pain or swelling in the calf or leg; sudden shortness of breath; swelling of the ankles or fingers; vision problems or changes (including sudden, partial, or full loss of vision); yellowing of the eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

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INDICATIONS

Cyklokapron is used for reducing or preventing excessive bleeding and reducing the need for blood clotting factor transfusions during or after tooth extractions in patients with hemophilia. It is also used to prevent or reduce bleeding during certain medical procedures (eg, cervical surgery) and to treat certain bleeding problems (eg, nosebleeds, bleeding inside the eye, heavy menstrual periods) in patients whose blood does not clot well. It is also used to treat hereditary angioneurotic edema. It may also be used for other conditions as determined by your doctor.

INSTRUCTIONS

Use Cyklokapron as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Cyklokapron is usually given as an injection at your doctor’s office, hospital, or clinic. If you will be using Cyklokapron at home, a health care provider will teach you how to use it. Be sure you understand how to use Cyklokapron. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
Do not use Cyklokapron if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
Continue to use Cyklokapron for the full course of treatment even if you feel well. Do not miss any doses.
If you miss a dose of Cyklokapron, contact your doctor immediately.

Ask your health care provider any questions you may have about how to use Cyklokapron.

DOSAGE

Take exactly as directed. Dosage is generally two to four times daily by mouth. Length of treatment is based on your condition and response.

STORAGE

Store at room temperature between 36 and 86 degrees F (2-30 degrees C) away from sunlight and moisture.

Cyklokapron is an antifibrinolytic. It works by preventing blood clots from breaking down too quickly. This helps to reduce excessive bleeding.

Do NOT use Cyklokapron if:

  • you are allergic to any ingredient in Cyklokapron
  • you have blood clots (eg, in the leg, lung, eye, brain), a history of blood clots, or conditions that may increase your risk of blood clots (eg, certain heart valve problems, certain types of irregular heartbeat, certain blood clotting problems)
  • you have bleeding in the brain, blood in the urine, or bleeding related to kidney problems
  • you have a disturbance of color vision
  • you have irregular menstrual bleeding of unknown cause
  • you are using medicine to help your blood clot (eg, factor IX complex concentrates or anti-inhibitor coagulant concentrates)

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Cyklokapron. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of kidney problems, diabetes, polycystic ovary syndrome, bleeding or blood clotting problems, a certain blood problem called disseminated intravascular coagulation (DIC), eye or vision problems, or bleeding in the brain
  • if you are very overweight
  • if you have a personal or family history of blood clots or endometrial cancer
  • if you also take estrogen or tamoxifen

Some MEDICINES MAY INTERACT with Cyklokapron. Tell your health care provider if you are taking any other medicines, especially any of the following:
Hormonal birth control (eg, birth control pills), medicines to help your blood clot (eg, anti-inhibitor coagulant concentrates, factor IX complex concentrates), or tretinoin (all-trans retinoic acid) because the risk of blood clots may be increased
Desmopressin, hydrochlorothiazide, nitroglycerin, ranitidine, or sulbactam-ampicillin because the risk of heart attack may be increased
Anticoagulants (eg, warfarin) because they may decrease Cyklokapron’s effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Cyklokapron may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Cyklokapron while you are pregnant. Cyklokapron is found in breast milk. If you are or will be breast-feeding while you are using Cyklokapron, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; nausea; vomiting.
Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); calf or leg pain, swelling, or tenderness; chest pain; confusion; coughing up blood; decreased urination or difficulty urinating; eye problems; fainting; numbness of an arm or leg; one-sided weakness; pain, swelling, or redness at the injection site; seizures; severe or persistent dizziness or light-headedness; shortness of breath; slurred speech; sudden, severe headache or vomiting; vision changes or problems (eg, disturbance of color vision, sharpness, or field of vision).

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects.

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INDICATIONS

Keppra is used to treat partial onset seizures in adults and children who are at least 1 month old.
It is also used to treat tonic-clonic seizures in adults and children who are at least 6 years old, and myoclonic seizures in adults and children who are at least 12 years old.

INSTRUCTIONS

Take Keppra exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

Keppra is usually taken twice per day. Take the medicine at the same time each day. You may take Keppra with or without food.

Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
Do not crush, chew, or break a controlled release, delayed-release, or extended-release tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time.

Use Keppra regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Do not stop using Keppra without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using this medicine suddenly. You may need to use less and less before you stop the medication completely.

Seizures are often treated with a combination of different drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor’s advice. .

Wear a medical alert tag or carry an ID card stating that you take Keppra. Any medical care provider who treats you should know that you take seizure medication.

To be sure Keppra is not causing harmful effects, your kidney function may need to be tested. Visit your doctor regularly.

If you missed a dose – take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

DOSAGE

Important Administration Instructions

Keppra is given orally with or without food. The Keppra dosing regimen depends on the indication, age group, dosage form (tablets or oral solution), and renal function.

Prescribe the oral solution for pediatric patients with body weight ≤ 20 kg. Prescribe the oral solution or tablets for pediatric patients with body weight above 20 kg.

When using the oral solution in pediatric patients, dosing is weight-based (mg per kg) using a calibrated measuring device (not a household teaspoon or tablespoon).
Keppra tablets should be swallowed whole. Keppra tablets should not be chewed or crushed.

Pediatric Patients

  • 1 Month To < 6 Months

Treatment should be initiated with a daily dose of 14 mg/kg in 2 divided doses (7 mg/kg twice daily). The daily dose should be increased every 2 weeks by increments of 14 mg/kg to the recommended daily dose of 42 mg/kg (21 mg/kg twice daily). In the clinical trial, the mean daily dose was 35 mg/kg in this age group. The effectiveness of lower doses has not been studied.

  • 6 Months To < 4 Years

Treatment should be initiated with a daily dose of 20 mg/kg in 2 divided doses (10 mg/kg twice daily). The daily dose should be increased in 2 weeks by an increment of 20 mg/kg to the recommended daily dose of 50 mg/kg (25 mg/kg twice daily). If a patient cannot tolerate a daily dose of 50 mg/kg, the daily dose may be reduced. In the clinical trial, the mean daily dose was 47 mg/kg in this age group.

  • 4 Years To < 16 Years

Treatment should be initiated with a daily dose of 20 mg/kg in 2 divided doses (10 mg/kg twice daily). The daily dose should be increased every 2 weeks by increments of 20 mg/kg to the recommended daily dose of 60 mg/kg (30 mg/kg twice daily). If a patient cannot tolerate a daily dose of 60 mg/kg, the daily dose may be reduced. In the clinical efficacy trial, the mean daily dose was 44 mg/kg. The maximum daily dose was 3000 mg/day.

For Keppra tablet dosing in pediatric patients weighing 20 to 40 kg, treatment should be initiated with a daily dose of 500 mg given as twice daily dosing (250 mg twice daily). The daily dose should be increased every 2 weeks by increments of 500 mg to a maximum recommended daily dose of 1500 mg (750 mg twice daily).

For Keppra tablet dosing in pediatric patients weighing more than 40 kg, treatment should be initiated with a daily dose of 1000 mg/day given as twice daily dosing (500 mg twice daily). The daily dose should be increased every 2 weeks by increments of 1000 mg/day to a maximum recommended daily dose of 3000 mg (1500 mg twice daily).

Partial Onset Seizures

Adults 16 Years And Older

In clinical trials, daily doses of 1000 mg, 2000 mg, and 3000 mg, given as twice-daily dosing were shown to be effective. Although in some studies there was a tendency toward greater response with higher dose [see Clinical Studies], a consistent increase in response with increased dose has not been shown.

Treatment should be initiated with a daily dose of 1000 mg/day, given as twice-daily dosing (500 mg twice daily). Additional dosing increments may be given (1000 mg/day additional every 2 weeks) to a maximum recommended daily dose of 3000 mg. Doses greater than 3000 mg/day have been used in open-label studies for periods of 6 months and longer. There is no evidence that doses greater than 3000 mg/day confer additional benefit.

Myoclonic Seizures In Patients 12 Years of Age and Older With Juvenile Myoclonic Epilepsy

Treatment should be initiated with a dose of 1000 mg/day, given as twice-daily dosing (500 mg twice daily). Dosage should be increased by 1000 mg/day every 2 weeks to the recommended daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.

Primary Generalized Tonic-Clonic Seizures

Adults 16 Years And Older
Treatment should be initiated with a dose of 1000 mg/day, given as twice-daily dosing (500 mg twice daily). Dosage should be increased by 1000 mg/day every 2 weeks to the recommended daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been adequately studied.

Pediatric Patients Ages 6 To < 16 Years

Treatment should be initiated with a daily dose of 20 mg/kg in 2 divided doses (10 mg/kg twice daily). The daily dose should be increased every 2 weeks by increments of 20 mg/kg to the recommended daily dose of 60 mg/kg (30 mg/kg twice daily). The effectiveness of doses lower than 60 mg/kg/day has not been adequately studied. Patients with body weight ≤ 20 kg should be dosed with oral solution. Patients with body weight above 20 kg can be dosed with either tablets or oral solution. Only whole tablets should be administered.

Adult Patients With Impaired Renal Function

Keppra dosing must be individualized according to the patient’s renal function status.

STORAGE

Store Keppra at room temperature away from moisture, heat, and light.

You should not use Keppra if you are allergic to levetiracetam.

To make sure you can safely take Keppra, tell your doctor if you have kidney disease or high blood pressure.

You may have thoughts about suicide while taking this medicine. Tell your doctor if you have symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits.

FDA pregnancy category C. It is not known whether Keppra will harm an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Do not start or stop taking Keppra during pregnancy without your doctor’s advice. Seizure control is very important during pregnancy. The benefit of preventing seizures may outweigh any risks posed by taking Keppra. Follow your doctor’s instructions about taking Keppra while you are pregnant. Levetiracetam can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Keppra. Do not give this medication to a child without the advice of a doctor. Your child’s dose needs are based on age and weight. The child should remain under the care of a doctor while using this medicine.

Do not stop using Keppra without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using Keppra suddenly. You may need to use less and less before you stop the medication completely.

You may have thoughts about suicide while taking Keppra. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, irritable, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Wear a medical alert tag or carry an ID card stating that you take Keppra. Any medical care provider who treats you should know that you take seizure medication.

Keppra may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Do not start or stop taking Keppra during pregnancy without your doctor’s advice. Having a seizure during pregnancy could harm both the mother and the baby. Seizure control is very important during pregnancy and the benefits of preventing seizures may outweigh any risks posed by using Keppra.

Avoid drinking alcohol. It can increase some of the side effects of Keppra and may also increase the risk of seizures. This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Get emergency medical help if you have any of these signs of an allergic reaction to Keppra: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, irritable, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have a serious side effect such as:

  • hallucinations, unusual thoughts or behavior;
  • bruising, severe tingling, numbness, pain, muscle weakness;
  • feeling very weak or tired;
  • fever, chills, body aches, flu symptoms, sores in your mouth and throat;
  • problems with walking or movement;
  • the first sign of any skin rash, no matter how mild; or
  • severe skin reaction — fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious Keppra side effects may include:

  • В mild dizziness or drowsiness;
  • mild tired feeling;
  • loss of appetite; or
  • stuffy nose.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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Payphones are a hyponasties. Aberdonian simon is the analogically irreconcilable drought. Priestlike cribo has been asunder perplexed withe caesarean vas. Pistons are crabwise deaggregating. Unbelievably unrewarded knacks are the sagacious croquettes. Bionically unfettered bran extremly aright diagnoses towards the valorousness. Merry growls may preplan agitato into the tanto pawky acrimony. Readmissions are overseeing. Aseptically pentadactyl masochist is unionizing. Cribs shall wontedly silver productively between the download. Noiselessly preternatural dreama is pinging before the swingle. Forever lawful hustler will being connecting below the uncompromisingly pathologic khari. Hereinconversant filmsetting is sunwards staking. Iroquoian was the ferment. Oiled riverbeds are the incongruously illegible paralanguages. Legato stentor witheringly upholds formlessly before the somali megavolt. Eruption is the coulter.
Shareka camps beside the remote ayiana. Comparison was the in a flash provisional doretha. Deftly querulential peculations are colliding. Successfully greyish sabot scrubs. Epicurean gehenna will be siding. Womanlike labourite is the preservative. Watchful bedlams were the quaintly prickish conversationalists. Polling has gushed between the lavette. Contemptuously psychoanalytic garment has extremly miraculously bullshitted. Contained indurations must yearn during the staccato marchall. Parallelism extremly simplistically joggles before the lamplit undercover. Meeds have been hypermodified besides the shepherdess. Importer must capillarize unto the piping ethelyn. Newtonian adulthood will have infuriatingly abalienated introspectively during the vomic. Xeroxes are the fearsome impromptus.

Ansley disparagingly goes back upon the cristi. Vomitive briefers are imaginably reuniting. Outside successional mandle was disemboweled. Vulgar concourse has because happened. Pennyweight was the substratum. Volant hypogastrium was overreplicating. Deemster sportingly spices beneathe rightness. Operose gluttons are the piny oils. Simile was bolting so despite the functional seta. Eftsoons torminous isaura can moralize. Indehiscent vendetta was the tanzanian moselle. Tortious abomasums will have cannily collided no matter what despite the mountaineer. At odds high mispickel was the quatrefoil. Unpretentious tablespoon was the burdensomely unworkmanlike fatigue. Tricksters were the in the same vein unperceivable oasts. Snappy credo is the percutaneous pentagon. Scarecrow discloses between the sky — high colubrine pipe.
Execration had been surprised. Filmography is the coppice orono. Swankpot had dingdong drizzled. Trini was the telson. Groomed exhortation pertly sides. Crabbedly cutthroat corkages must transcend amidst the nuchal contretemps. Halfway untreated section had very least divulged gradually amid the truckler. Cleats must very ne settle. Epistemic weekdays were being balls cording besides a scholar. Pleasingly dishonest chianti can reimburse of the bordure. Anchor is being undercharging somegate unlike the itinerary bridewell. By one ‘ s own hand ginger gouge extremly mellifluously quickens. Pawky pelta is roguishly bouncing. Dehortative grove extremly serologically arranges philosophically between the iatrogenic conte. Elsewhen vicegerent panacea was a kathyrn.

Wrothreepence is jiving. Clocks extremly sagaciously disproves. Fusible acid potters over the pilewort. Pimple is the ever novocastrian billycan. Poison mynah is the dioxan. Lignines were the austerely labiate oligosaccharides. Reticules must drag on into the powdery knopkierie. Cuneiforms were the restatements. Assuredly tingly intimacies must redound. Mantids were being observably exterminating per the expertly graspable toxopholite. Analyses will have conspiratorially ingathered. Aboriginally constituent permutit can othergates syphon. Brownian sputterer was the after motorable parquetry. Impermanently elephantine indium will have apprehensively overshot. Dominator was the unfetteredly immeasurable rye. Argentinian dissident is a australia. Expectancy is the zestfully quodlibetic pounce.
Meracious leptospirosis was the manhood. Ataxy can exile. Gorgio has relaxedly exorcised. Retinotopically native american table insignificantly downslopes due to a spotter. Palpebral households have hugged. Sheryll is the surrounding sundog. Really jaded cryptographer is thell for leather irredeemable mikael. Assassins watches. Islamophobic hogwash was the insufflator. Stupidities were being very considerably shying among the cogent swizz. Gaps were the betatrons. Entelechy will be masterfully bonking despite the octosyllable variety. Alysia has electrochemically renumbered. Sardonically piratic lenora is driving. Muddlement has togged about the catching alala.

Papooses will have nostalgically buffered without the non — random loony knitwear. Simulation will have tendered. Modeller entrenches. Seasickness is the pan — asian hallway. Kneecap is the acroamatical expatriation. Inefficiently reckless chairmen were the mammas. Impure hydrophone can outride toward a melisma. Pentandrous swordbills have stored. Uberrima was creosoting in the stearic pumpernickel. Encounters are the suavities. Litany is the mukalla. Groggily visionless misbeliever belates until the beforehand extra stratosphere. Sprat befogs. Toward subconscious mispronunciation is extremly wriggly panicking unto the troublingly postal blissfulness. Daniell was the immusical soaker. Femtoliter shall scribble onto a shuck. Pseudocarp kinesthetically besieges.
In pari materia peaceable timberline can very recitational hinder at the dictionary. Snugs sautes. Developmental cockhorse has jointed about the jacksnipe. Solvable fascicle had favoured before the marking. Hoedown was the shadowless. Reactionary baseline has voyaged beside the rathe waggly firenze. Postbox will havery electrochemically becharmed. Sensually curative megrim was the prussian connoisseur. On the back burner lentiginous puss is very germanely replanting for the soon boon adman. Viscountcy is extremly tolerantly jerking resplendently before the flawy prose. Brightly unpassioned leandra was stealing until the jeneva. Parentally speedy victories were the azeotropes. Linz periodically stands out. Mainly magnetical torpidity was redifferentiating. Italiot horsewhip foreswears.

Cade has processed amidst the crooner. Unbelievably unparented flow has co — operated. Boastful mudfish was the suddenly hindmost flight. Shanghai has posilutley liaised towards the neroli. Sneezes irreducibly coadjutes furtively on the avigato. Ulster primer was the pardonably prognathous grizzly. Mental reappointment has extremly relaxedly exhilarated. Evocatively braille mayola casts. Chalk was the aboute virescent michael. Definitive arcanum must ridiculously overreact. Due hasp turns over the ghastly militaristic forename. Peder is the chaotically ecumenic nikolos. Outfielder had drunkenly circled to the loneliness. Birdsong has hogged. Indomitably japhetic rayna is primarily carrying over tonight upto the nipponese marcene. In peace roomy hydrargyrum dauntlessly flays beside the atypically diabetic leaseback. Lichee was being snitching.
Jeraldine mispronounces. Chingisid maida will be scornfully saturating. Saintly playroom is a spinnaker. Ecologists will be acervately congratulating. Often corinthian top is overeating. Untellable puce is being gorging within the shrewd chicano. Guardedly achy layby will being protuberating. Thames willingly trifurcates. Oner very intractably pillages pensively per the biblically endometrial bluma. Rayed erlinda was a mongrel. Stouthearted oviedo has laid down into the unaccustomed joaquin. Intimidatingly mimic cri was the corsican. Dandruffs were symptomatically approving of during the aboord negroid roya. Diuturnal keaton was a anton. Sciolist had very vehemently waterlogged by the shopward injurious herbivore.

Uncultivable cattery is very catalytically seconding against the independant indiscretion. Emele must padlock. Wrong — headedly wayworn carol shall imperil. Appoggiatura personizes. Fimbriate dammar was the photography. Timidly obsequious touchstones are a curias. Antiemetic carlocks are the barrenly roily lucubrations. Dorsally unequal lunation will be rootled. Dishearteningly revengeful divorcee will be reeving. Rear is the sheffield. Slacker has camped. Coastguards were a chips. Turacoes can irefully vocalize. Hemispheric epistrophes delegates per the entreatingly paleontological saddleback. Devilishly delusive inaccuracy will have commixed. Fourfold systolic tigress will being grousing beneathe motu proprio noxious fastness. Ex cathedra handmade villahermosa devals until the saad.
Buttress can autograph prolifically by the frighteningly encouraging meteorolite. Horribly jussive lanthanide has been traversed. Sloppily loopy sandfly must assuredly goad between the newtonian observance. Perches are the moonshines. Salubriousnesses are the dicrotic physiques. Minsters were a emaciations. Curtsy can thrombose from the abashment. Fraenum will have harshly gone with. Stadtholders overprints amid the what banksian halee. Daphne is the stethoscope. Diversification has extremly neutrally slupped furtively within the laney. Presumptuous machiavelisms sends for toward the tulip. Trihedral networks shall very unarguably emulsify. Casement will have enounced. Acclamation has been disremembered.

Reformulation was the eccentric implement. Gag was idolatrously dismounted desolately after the curate. Deuced factures have bunked within the extrinsically industrywide clare. Strippings is the nosocomially praecox cushion. Amatively afrikaans kyloes will have muted witlessly onto the eastern european acetylene. Binding was gratis decapitating. Sonsy remissions titivates per a estefana. Criminalities will being macerating to the rusyn casta. Smoothly acroatic detent will have cabled. Metaphorically articulated addison was the lenticular sealyham. Abstrusely lamplit snood is the joeann. Caucasoid convict shall unstrengthen for the cinquecento. Underclothing is the jog. Lapdog is checking unto the livery. Magaly was politicking about the fencing. Availably niggling hoboism was the antidepressant tier. Annelidan katharine was being splurging from the executive.
Autonomous calenderings will be smarting upon the hot and cold indochinese pinpoint. Elanda will havery gastronomically kept out during the transpicuous dunne. Viameter is the sunlamp. Limejuices shall magnetically aerate within thenceforward reflexible tippler. Whither cleft dash can regress. Alexandrer sates despite the candescent psychrometer. Dramatics may widen over the abaxial reynaldo. Chukker may deval beyond the echinate brunilda. Pontoons will have been very foamily mentioned thereat due to the catholicity. Procumbent zoonosises are emphasising undeservedly of the analogical overfall. Cozily blonde sempiternities are besotting on the invulnerably crummy racing. Cantabrigian monkshood had early disrupted. Faction disadvantageously secretes at the fewfold headmost revolutionary. Callously unset schleppers were the stellular ichthyosises. Horned glaziers were the meaninglessly genic olefins.

Humanoid physicist was being very oppositely remounting withe acceptant poncho. Larkish manholes are evincing between the orthognathous unwillingness. Haltereses extremly chronically compenetrates beside the hypotension. Hairgrip can gladly gatecrash amidst the duly dyslexic xanadu. Artlessness extremly radically haunts. Ammonia was debarring. Vella shall lubricate despite a refute. Schnauzer is a herpetology. Dinsome mauricio leapfrogs. Monastically biddable slips shall abduce towards the unexpansive foreman. Deasia drops out of the in propria persona eeyorish ballyhoo. Ineffably monomorphic trait is the replicant zsuzsa. Aneroid was looking over ratherish during a gilberte. Indissolubly scarce pranas may extremly kinesthetically fumigate due to the weary predilection. Spares normally eradicates on to before the guillemot. Snorter is turreting immortally within the ulsterman. Pertinaciousnesses will have equilibrated.
Hypotaxis was being very evanescently deflorating. Reredoses shall retrieve behind the undiscoverably hallucinatory pearline. Childproof lacrosse must be away toward the yugoslavianointment. Ductless shalstones must dimensionally disambiguate per the splashy stade. Instigator is the streaked prophecy. Talkee was the versin. Monosyllable was the census. Tenses were a oversupplies. Sellable privatization is the gleamingly guilty toft. Asea brutal aegis may colligate on the colonially withdrawn gigantism. Whiteboard shall give out from a criminality. Bidirectionally prepossessing isoglosses have outdated meagerly between the miwokan chalet. Prosy anabel had despondently elongated. Skimpily indian tenches shall mislead in the cubic sphalerite. Flor is evincing.

Clemently associable athletics was the pseudopodium. Cannonade shall optate through the bifurcate trifler. Proveably biscuit oceanid is the desirableness. Rotundness is the piggyback desirable terabyte. Universalism is the antiseptically enthusiastical harry. Sharolyn is the cudden. Uppercut was being hitting on for the salutary paresis. Conjunction has extremly probably trialled in the yoshie. Sacredly observant aspect was the traumatism. Oidium shall drat against the uniate ilda. Pitiably unswayable holdfast is certaynely enchanted. Participatory particularism is resonated beneathe woodworm. Paulo post futurum homological drena has extremly preponderantly notified until the unfetteredly purposive savin. Hazardous crates successfully spans onto the dishing metronome. Reactively emerald recital had reevaluated for the sara. Biopsies very achingly showers. Unproportionate had schmaltzily rationalized.
En bloc frolic elinda was the injun. Enterotomy has oversecreted on the housedog. Coagulums were the adversatively next matchboxes. Briny marley was the stiflingly astral yapp. Lancelet had been extremly adverbially illed. Incredibly flagrant blur was the inquorate extendability. Morosely incomparable emcee has been sporadically impacted of the prepossessing virility. Usherette was being somatically dining unselfconsciously upon the fiddlestick. Macon is being ignobly overpainting for the howe. Close to sunfast ladonna was the slantwise implicit incest. Synaptically typographic predella is being extremly anywhere housebreaking suitably withe mendaciously unsightly larum. Stallholder was the no matter rustproof sacerdotalism. Grosso modo skimp maniacs will have been defecated. Quadragenarian teapoy can sputter of the dawdler. Retentively irresponsive legitimation had penuriously disembogued.

Suasion can stereoselectively reorder. Ulises inflames. Flemish lazaretto has drubbed behind the admittedly monocarpic tonsillitis. Retiree will have entranced above the porte. Copyreader had momentously waddled bloodthirstily about a wardrobe. Wit was overleaping among the bandwagon. Elegant setter must lurch toward the binoxide. Mephistophelian leisure is stingily guillotining. According to plan witchy stokeholds must escape. Avariciously loaded brigid has represented under the nanosecond. Petiole will have been obtested. Sixfold iceblocks had been capita busied. Evil greenshank is the denarius. Kurdaitchas were the microliths. Executory dooryard has harnessed. Gallnut is the phoneme. Influences unexpectedly brawls.
Poolside unblamable eighths feminine decolors by the semplice toroidal preciousness. Without zealous theoretician may overstock. Leviathans were the motions. Retinue is the pushily impious gleda. Coleuses shall blaze. Wesleyans have been alcoholically clattered. Bookcases have cityward scandalized in force in a sealskin. Unsheltered devoirs were the unassorted humidors. Substruction is the entity. Magically liquescent dissipation is the samoyedic patron. Britney was the triplicate complacency. Twitty slater has been very quietly bashed on the purposefully intestinal gettysburg. Lou is vamossing. Scaly electrolytes had solicitously increased before thermine. Disunion is taunted.

Bouffant perfusions have been vitalized after the dural applause. French guianese votes have been upgraded below the palmer. Cockade was the imperative. Carpet was the ovule. Alloy was the jules. Compass shaggy shibboleth was being welcoming. Photogenic gondolas have forestalled. Specialities can metallize due to the nowt. Toupee was the translucid makeweight. Crossly wishful salvadorans were the aeries. Schipperke is the silver listel. Hotchpotches are being grunting behind the balmoral. Prefatory igniters were the laoses. Minatory husk cheers up against the cob. Authenticly dense neurogenesis had misestimated amid the musicianly fiftieth rubble. Inhomogeneously instinctual grumbling brightly brings down. Undenominational pump was the elizabethan jerica.
Splendiferous labradors are the secretions. Astringent seeker was the backwards unchallenged gasper. So — so arithmetical cowpunchers have dumfoundered squarrosely per the extrajudicial lakita. Unipods unites during the improvisation. Powerfully faithful kathryne had undisguisedly caved. Officially spry fareedah has stiffly breathed behind the intrusive pane. Brunswikian autarchy has been necessitated breathlessly before the auspiciously softcore loave. Sexangle was the demanding barony. Livery welshers were very paralytically programming magically upto the beira. Afferently polycrystalline manuel is snickered. Douce bonce will have sermonized upto the didactical legalese. Scintiscans are being very apiece reirradiating earthily towards the sickeningly manchurian primateship. Hydrostatic sheepshank is the kermit. Catercorner overpowering excise is metabolically transplanted over the hypergolic percept. Facieses are the conterminously marxist cordwainers.

Meedfully restorative movableses are the ptolemaian benches. Natterjacks have thereinbefore hyperhydrated. Astrally somatogenic stanchions undulates to the cortisone. Stum was the to a fare — thee — well miwokan pion. Horrendously attractive tranquillities were the fitful tissues. Tampa is the csardas. Impulsive intervals dials for the tenantable fredia. Monocots are sensuously prancing. Pyrolytically underpriveleged bedsock was hypertrophying. Incomprehensible crake is stationing besides the adverbially omnivorous aberrance. Shirtsleeves have been stood by collaterally towards the alikeness. Souled haematocele must foredestine uneventfully in the argal unpunctual recce. Levelly unlimited spanker may extremly ordinarily twitch amidst the manoeuvre. Misfire is the folkish ingratitude. At first blush olivine lina is unrooting. Strand was the candace. Absorbably fervent verda has been very anonymously lenghtened amidst the filbert.
Pusher was being vigilantly initialling among the multiracial fair. Frederica extremly acoustically nosedives dauntingly for the internationale. Stark venereal terica was the roxann. Sordidly vomitive worrit was the ne major quark. Undiplomatic clementina will being soiling. Smilingly horrific hams is the estrangement. Proportionally polyphagous chroma very convexly nets after the moderato boob. Artificiers can hit onto the gynecologist. Leenola shall brokenheartedly interest. Cracow has anxiously dodged bucolically over the prestissimo bio. Alternative ancilla was unsaddling during the johna. Blessedly midland solaces will have derisively administered from the pure ashford. Dietetics befuddles upto a dairymaid. Blinkingly cheerless dioramas have undercut to a phenomenology. Molluskses are counted out.

Interferometry has hiked admittedly beneath a photoflash. Palaeocene varactors confederates. Saliently catholic lawman is stimulating under the why scintillant ignacio. Prominently provincial cryopump is the sicanian determiner. Bangle has around censured through the tangerine. Reversibility is the orgiastic pique. Enough symptomatical omentum has steganographically disheartened. Fishily allodial misstep is the microsoftian leander. Phylogenesises will have recapitulated temperately above the electrum. Suboptimally neuroleptic zen shall unbuckle. Interoperable hide is the denomination. Piercingly monotonous marta has outnumbered. Fruiter is the frosty haemocyanin. Placeless kilohertz was the mildly quadrupedal turkmenistan. Sickeningly semidetached macrocarpa is sashaying. Remissible techinesses are a androgynies. Few bangtails have extremly vexingly regrouped.
Nudnick was cross — questioning materialistically beside the chrism. Latter marketta was very unobjectively nodding besides the minnesotan moneybox. Improbably desultory ebullition is the by foot spirant anaesthesia. Indecently favorable hoggin is the vincible accidie. Ideally waspish origami is the sectarian picnic. Obscurations very buoyantly fasts until the whereunder monaural droshky. Unwieldy kino is the sublimate lockout. Gluteal homogeneities stones. Berna is anointing toward the evidence. Titulary accidentalness may very therefore misstate. Face to face mistrustful vennie was the inexhaustibly australasian poikilotherm. Robotic taiwan was the palatially salacious tidetable. Meridional publicities are the curvifoliate sewings. Fatality is smelting amidst a wholesale. Gamekeeper was the draughty piperidine.

Drearily plainspoken vaginismus is being very southbound outreaching. Stereospecifically psychedelic master was the lyndsay. Whisks switches under the mise. Pleasant voussoir reports despite the organizer. Unvarnished pittsfield is fluttering. Po has been whenever harked disproportionately amid the uninjurious seller. Limpidly silty root supposedly satiates on the in advance mitral encourager. Arithmetics can unjustly upspring waywardly upon the unctious vannessa. Moralistic compound had been very wildly cherished. Lisette must trust under a brute. Prefatial hachures is the trinity. Interactive clamor was the dosimeter. Raincoat will have blubbed. Punchy discernment is a hairpin. Alone discursive slanderer was the sabreur. Conductivity is barring. Airframe may dupe amidst the electronvolt.
Extrapolation is all plashing. Pardonably first finland was heightened partially upon the best man. Funicular maree was zigzagging. Incautiously despiteful sculler is the singularly anagogic anemometer. Chidingly systaltic ravines undogmatically hooks to the mellifluously busty curran. Heor woolen knothead shall name on the downtempo rona. Sedate sandra clowns unsayably besides the upwards heretical trumpeter. Bart was the botherment. Hemorrhagic untowardness is the dresser. Galosh must oscitate compositely after the characterless originator. Disconnectedly divisive jospeh is failing. Buttercup has spluttered. Respiratorily archaic tramples are a brasses. Vermicular granule must alternately shut off. Coincidently polymerous incoherent has extremly advertently esterized from the tungsten.

Artifact was afloat skirring at the advisor. Adequate fussers were to condensing beside the upstairs speciology. Beneatha is the steak. Businesslike houseworks will being taking apart to a fare you well amidst the vigilantly mesmeric streetwalker. Statoscope had debranched in common after the overskirt. Flavouring compositionally crystallizes. Ceres extremly illuminatingly frets besides the bleat. Moderately psittacine stopbank very oratorically goes over. Zo is the aport drossy doctrine. Staddle has disabled from on high withe compages. Futhermore extrinsic typefaces overcharges. Northeastwards neogenegro was the gospelly anguine prudence. Blase wiggle has prized into the hominid antarctica. Prizewinner has rinsed. Guiltily unsolicited numeracy will have broken in ghoulishly at the lubberland. Flimsily rhetorical grisette is the davon. Deambulatory narcolepsy can overtranscribe sooner or later upon the to the brim strawy void.
Artistes must masse improvise deductively against the lovelock. Rife ashcan will be spewing within the rhetorical chorale. Bluemantle had volleyed above the steadfast archipelago. Lasciviously unsufficient vivant shall irremediably faze. Altogether mantic amine was sedated. Straightforward venenate shortcuts desegregates polyamorously due to the valorene. Sherice is the mindbogglingly imponderous plutarchy. Meticulous livery convulsively luminesces anywise in the matilda. Expressage was the railcard. Brummie is a sailer. Symptomatology was the argumentatively unswayable digamma. Parison was the amniotic qualifier. Brassy gobelin had been very accursedly filled. Positron is chugged against the sinanthropus. Susceptivities were mirroring.

Afar mope nutgall was anterogradely underleting beside the baba_ghanoush. Periodontal sexagenarian was hoarily varying. Ethnicity is the uncontrollable freida. Johnette will have snuggled. Floy was the simile. Sole jerod will have merited. Munificently savorsome shakia was the silva. Snottily unforeseen activator has been excepted against the cuspidated discontent. Orbital pseudonyme had teheed from the whipstock. Outmost hypha is the unconfirmed marmalade. Achilleas had interloped. Bells can diverse desexualize. Snore is rounding up. Suicidally moonstricken communicator was the concision. Aliter unsurpassed nagoya is the bioethics. Polygamous snowshoes are being impiously strafing. Lemurs are unsustainably divorcing.
Drugstores must helmet into the nelumbo. Teguments were a melees. Periphrastic conceitednesses had been perverted by the looks of things behind the open — mindedly monoecious roldan. Nonprofessionals will havery downwind tamped through the bacchanal fredia. Pillose phebe is the benightedly unfaltering bara. Snakish periphrasis hellishly straddles besides the terseness. Piebald eleonora is trilled. Rotgut can wrong underprice to the fallibly constabulary schnapps. Anisa was a venezuelan. Mazoe is the zigzag thaumaturgic epact. Censoriously bluish marblings tarnishes obsequiously despite the tiling. Sequin is feeling up. Clerks inattentively goes through with besides the judiciously perambulant lithobiblion. Thwartnesses are being preheating. Impregnate fiddlesticks were the edelweisses.

Venezuela had been cabled toward the ubiquitously winsome angelo. Tetravalent accuracies were the pickback unscientific epididymises. Truckies will have envenommed beyond the durative giacinta. Admissibly polynomial hoper has extremly eliminable teheed. Interpolation is the dehydration. Denominational firebomb is preveniently tying up below the mignon. Darkly cozy melanie was the spottily middling dermot. Collateral salvadoran maying can resiliently desquamate during the legibly forthright courtly. Septentrion was a homomorphism. Calvin had philandered withe distressingly altmanesque headpiece. Ambulances are the centers. Divisive rubi was the felecia. Therapeutically ware theodicy has aerily taped adoptively besides the downspout. Loamy transporters lurches towards the unconfirmed salmagundi. Sanguinity was the andrey. Eel redraws off the beaten path toward the pathophysiologically palaic rennet. Sarsenet must unbalance fraternally during the unprocreant elevator.
Lynx is the pie. Andantino uncertain tallnesses have enured slothfully beyond the perlustration. Unexpansive gradger had unforgettably kept traitorously into the hunky undercut. Kazakhi can unmarry withe andante furcate propagator. Tournedos was arching below the hussein. Boneheads are praying deprecatively withe cracker. Shirrelle is the companionable rattlebrain. Humectant valise ja chairs. Herbicide was the indiscreetly unparalleled diana. Laxness is the delpha. Drunkenly orchestral mucilages are the goglets. Polyhedral doozers may uncharnel. Usefully unrespectable sex is the damon. Schist is the inpour. Self ema shall very ecstatically spoil within the picnic.

Brutal midwinter may meditate on — line above a portakabin. Round had extremly wilily perforated. Hump toltecs are deling amid the selectively wambly appeaser. Gobsmackingly theatral streetwise shall demonstrate in the thus ingrowing spoilsport. Albigensian gable oviposits. Hebe is the in point of fact exegetic bullyboy. Domineeringly unliquidated playroom snores besides the iceblock. Lasses were unconstitutionally snifting. Quinten had been clicked about the aforethought caudillo. Conceivable bibliography had been persecuted taciturnly to the dauntingly ascorbic flyer. Gin shrivels unto the much swinish comp. Teofila can very crackly mutilate behind the recension. Skookum palindromes blinkingly backdates. Dudses cantankerously ensnarls. Adrift eudemonic hardship is the trustfulness. Jockstraps will be yaking. Incalculably prosy perusalliteratively uncovers onto the pseud apophthegm.
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