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WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

• Signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.

• Not able to pass urine or change in how much urine is passed.

• A very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause very bad health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Feeling sleepy.

• Feeling nervous and excitable.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

Treatment of diabetes depends on which type of diabetes a patient has, either type 1 diabetes or type 2 diabetes.

• Type 1 diabetes occurs when the body does not produce insulin, so replacement insulin must be delivered by injection, pump, or inhalation. People who have type 1 diabetes need to carefully plan and follow meals, timing of meals, and activity to keep their blood glucose (sugar) in check. It's important to measure blood sugar levels as low blood sugar can be dangerous, too.

• Type 2 diabetes occurs when either the body makes too little insulin or the cells do not respond to insulin that is produced ("insulin resistance"). Patients with type 2 diabetes or prediabetes may be able to control their blood sugar levels by following a diet, exercise program and losing excess weight. If this first-line treatment does not control blood sugar levels effectively, an oral medication, often metformin first with other medications if needed, can be added to the treatment plan. Patients with type 2 diabetes may also need injected insulin, and in some circumstances it may be used as the first medication.

Patients and/or family members must learn to inject insulin if it is prescribed. In addition, patients with diabetes must learn to check and follow their blood sugar levels.

In addition to medications to control glucose, many patients with diabetes also need to take medicines to lower their blood pressure and cholesterol levels.

• Statins, such as atorvastatin (Lipitor), rosuvastatin (Crestor), or pravastatin (Pravachol) are typically first-line prescription treatment for high cholesterol, also along with diet and exercise.

• Angiotensin converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) will be started in diabetic patients with protein in their urine to help protect the kidneys and other organs.

• Blood thinners (anticoagulants) such as aspirin or clopidogrel may be started in type 2 diabetic patients at higher risk for stroke or heart attack.

When diet and exercise aren't satisfactory, weight loss medications such as Contrave, Xenical, or Qsymia can also be used to help with the management of obesity.

Generic name: multivitamins (MUL tee VYE ta mins)

Brand name: Berocca, Primaplex, ...

Dosage forms: oral capsule (Lipotropic with Multivitamins; Multiple Vitamins; Multiple Vitamins with Folic Acid and Antioxidants; Therapeutic Multiple Vitamins; Vitamin A and D; Vitamin A,D,E, and K; Vitamin B Complex; Vitamin B Complex with C; Vitamin B Complex with C and Folic Acid; Vitamin C and E); oral gum (Multiple Vitamins); oral liquid (Multiple Vitamins; Pediatric Multiple Vitamins; Therapeutic Multiple Vitamins; Vitamin A and D; Vitamin A, D and C; Vitamin B Complex); oral oil (Vitamin A and D); oral solution (Vitamin A,D,E, and K); oral tablet (Lipotropic with Multivitamins; Multiple Vitamins; Multiple Vitamins with Folic Acid and Ubiquinone; Therapeutic Multiple Vitamins; Vitamin B Complex; Vitamin B Complex with C; Vitamin B Complex with C and Folic Acid; Vitamin B Complex with Folic Acid; Vitamin B12, Folate, and Acetylcysteine; Vitamin B6, B12 and Folate; Vitamin D and K); oral tablet, chewable (Multiple Vitamins); oral tablet, dispersible (Multiple Vitamins); oral tablet, extended release (Vitamin B Complex; Vitamin B Complex with C); sublingual tablet (Vitamin B12 with Folic Acid) Drug class: Vitamin and mineral combinations

Multivitamins are a combination of many different vitamins that are normally found in foods and other natural sources. Multivitamins are used to provide vitamins that are not taken in through the diet. Multivitamins are also used to treat vitamin deficiencies (lack of vitamins) caused by illness, pregnancy, poor nutrition, digestive disorders, and many other conditions. Multivitamins may also be used for purposes not listed in this medication guide.

Warnings

Seek emergency medical attention if you think you have used too much of multivitamins. An overdose of vitamins A, D, E, or K can cause serious or life-threatening side effects. Certain minerals contained in a multivitamin may also cause serious overdose symptoms if you take too much.

Many vitamins can cause serious or life-threatening side effects if taken in large doses. Do not take more of this medicine than directed on the label or prescribed by your doctor. Before you use multivitamins, tell your doctor about all your medical conditions and allergies.

Generic name: Artificial Tears Eye Drops (ar ti FISH il tears)

Brand name: Bion Tears, Blink Tears, Clear Eyes All Seasons, Clear Eyes Natural Tears, Dakrina,

Drug class: Ophthalmic lubricants and irrigations

Uses of Ultra Lubricant Eye Drops:

• It is used to treat dry eyes.

• It is used to treat eye irritation.

How is this medicine (Ultra Lubricant Eye Drops) best taken?

Use this medicine (Ultra Lubricant Eye Drops) as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• For the eye only.

• Some of these products are not for use if you are wearing contact lenses. Be sure you know if you need to avoid wearing contact lenses while using this product

• Do not touch the container tip to the eye, lid, or other skin.

• Put the cap back on after you are done using your dose.

• Wash your hands before and after use.

• Tilt your head back and drop drug into the eye.

• After use, keep your eyes closed. Put pressure on the inside corner of the eye. Do this for 1 to 2 minutes. This keeps the drug in your eye.

• Some of these drugs need to be shaken before use. Be sure you know if this product needs to be shaken before using it.

• Do not use this medicine (Ultra Lubricant Eye Drops) if the solution changes color, is cloudy, or has particles. Get a new one.

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

High blood pressure is a term that is used to acknowledge that a person’s blood pressure is above what is considered normal. High blood pressure is also called hypertension.

Measuring somebody's blood pressure gives us an indication of how effectively their heart is working to pump blood around their body. If their heart and blood vessels are working efficiently, then their blood pressure will be normal or slightly below normal. If their heart is having to work very hard to pump blood around their body, then their blood pressure will be high.

Blood pressure is composed of two measurements.

• The first recording is called the systolic pressure and it measures the force the heart must pump against to get blood to flow around the body. It can indicate how flexible or stiff the blood vessels are. During this measurement, the blood pressure cuff inflates to a certain extent and records what pressure around the arm stops blood flow.

• The second recording is called diastolic pressure. This measures the resting pressure when the heart relaxes between heartbeats. It is recorded while the blood pressure cuff is deflating.

Most experts consider a normal blood pressure to be 120/80 mm Hg. Ideally, everybody’s blood pressure should be below 130/80 mm Hg. If the first number is above 130 or the second number is above 80 then a person is said to have high blood pressure.

Most people experience no symptoms when their blood pressure is high. Sometimes people may develop a headache or feel unwell; however, most do not connect these vague symptoms as having to do with their heart.

If high blood pressure is left untreated, it can damage the blood vessels and increase a person’s risk of having a stroke or a heart attack. It also causes the heart to enlarge and weaken because it essentially wears itself out from having to work so hard to push blood around the body. People with high blood pressure are also more likely to develop high cholesterol, kidney and eye problems, and have poor circulation in the legs and feet.

It is not uncommon for your blood pressure to go high occasionally; however, it is persistently high blood pressure that is a concern. For this reason, if a doctor or nurse takes your blood pressure and it is high but you don’t have any risk factors or symptoms, then at least two other separate measurements should be taken before you are diagnosed with high blood pressure.

Anyone who takes opioids is at risk of developing addiction. Your personal history and the length of time you use opioids play a role, but it's impossible to predict who's vulnerable to eventual dependence on and abuse of these drugs. Legal or illegal, stolen and shared, these drugs are responsible for the majority of overdose deaths in NZ. today.

Addiction is a condition in which something that started as pleasurable now feels like something you can't live without. Doctors define drug addiction as an irresistible craving for a drug, out-of-control and compulsive use of the drug, and continued use of the drug despite repeated, harmful consequences. Opioids are highly addictive, in large part because they activate powerful reward centers in your brain.

Opioids trigger the release of endorphins, your brain's feel-good neurotransmitters. Endorphins muffle your perception of pain and boost feelings of pleasure, creating a temporary but powerful sense of well-being. When an opioid dose wears off, you may find yourself wanting those good feelings back, as soon as possible. This is the first milestone on the path toward potential addiction.

When you take opioids repeatedly over time, your body slows its production of endorphins. The same dose of opioids stops triggering such a strong flood of good feelings. This is called tolerance. One reason opioid addiction is so common is that people who develop tolerance may feel driven to increase their doses so they can keep feeling good.

Because doctors today are acutely aware of opioid risks, it's often difficult to get your doctor to increase your dose, or even renew your prescription. Some opioid users who believe they need an increased supply turn, at this point, to illegally obtained opioids or heroin. Some illegally obtained drugs, such as fentanyl (Actiq, Duragesic, Fentora), are laced with contaminants, or much more powerful opioids. Because of the potency of fentanyl, this particular combination has been associated with a significant number of deaths in those using heroin.

If you're taking opioids and you've developed tolerance, ask your doctor for help. There are other, safe choices available to help you make a change and continue feeling well. Don't stop opioid medications without a doctor's help. Quitting these drugs abruptly can cause severe side effects, including pain worse than it was before you started taking opioids. Your doctor can help you taper off opioids slowly and safely. New Zealand Yellow Airplane Heroin