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Fosamax

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Drug Uses

Fosamax is indicated for treatment and prevention of osteoporosis in postmenopausal women. For the treatment of osteoporosis, Fosamax increases bone mass and reduces the incidence of fractures, including those of the hip and spine. It is also indicated for the prevention of osteoporosis, treatment to increase bone mass in men with osteoporosis, treatment of glucocorticoid. It is used to treat induced osteoporosis in men and women receiving glucocorticoids in a daily dosage equivalent to 7.5 mg or greater of prednisone and who have low bone mineral density, treatment of Paget's disease of bone in men and women.

How Taken

Fosamax comes as a tablet to take by mouth. It should be taken once a day in the morning on an empty stomach. Fosamax should be taken with a full glass (6-8 ounces) of plain water. Wait at least 30 minutes after taking Fosamax before you eat, drink, or take other medications. Do not take Fosamax with mineral water, coffee, orange juice, milk, or other dairy products. Do not suck or chew the tablet; swallow the tablet whole. Do not lie down for at least 30 minutes after taking Fosamax. Standing or sitting upright helps you get the full dose and decreases heartburn or the risk of injury to your esophagus.

Warnings/Precautions

Before taking Fosamax, tell your doctor if you have a problem swallowing, such as a narrowing of the esophagus; have esophageal ulcers or an esophageal disease; have a condition that causes low levels of calcium in the body; have kidney disease; have stomach ulcers or other stomach or digestive problems; or are unable to stand or sit upright for at least 30 minutes. You may not be able to take Fosamax, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. Fosamax is in the FDA pregnancy category C. This means that it is not known whether Fosamax will be harmful to an unborn baby. Do not take Fosamax without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether Fosamax passes into breast milk. Do not take Fosamax without first talking to your doctor if you are breast-feeding a baby.

Missed Dose

If you take Fosamax every day and you miss a dose, skip that dose and take the next regularly scheduled dose the following day. Missing one dose will not affect your treatment. Do not take two tablets at the same time. If you take a Fosamax once a week and you miss a dose, take the missed dose on the morning after you remember. Do not take two tablets on the same day. Return to taking one tablet once a week, as originally scheduled on your chosen day.

Possible Side Effects

Stop taking Fosamax if you experience any of the following serious side effects: an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); Seek emergency or talk to your doctor if you have difficulty or pain when swallowing; chest pain; pain or burning under the ribs or in the back; or new or worsening heartburn. Other, less serious side effects may be more likely to occur. Continue to take Fosamax and talk to your doctor if you experience abdominal discomfort; stomach upset, nausea, vomiting, diarrhea, or constipation; headache; muscle, bone, or joint soreness or aches; eye pain; a rash; or an altered sense of taste. Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Storage

Store in a well-closed container at room temperature, 15-30°C (59-86°F).

Overdose

Hypocalcemia, hypophosphatemia, and upper gastrointestinal adverse events, such as upset stomach, heartburn, esophagitis, gastritis, or ulcer, may result from oral over dosage. If you do think that an overdose has occurred, call an emergency room or poison control center.

More Information

Follow you doctor's recommendations about drinking alcohol and smoking. These activities are related to decreased bone density. Antacids and other medicines taken by mouth may decrease the effects of Fosamax. Do not take any other medicines within 30 minutes after a dose of Fosamax. Talk to your doctor before taking any other medicines during treatment with Fosamax.

Disclaimer

This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information.




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Ovarian Cancer
Ovarian cancer usually happens in women over age 50, but it can also affect younger women. Ovarian cancer causes more deaths than any other cancer of the female reproductive system.
The sooner ovarian cancer is found and treated, the better your chance for recovery. But ovarian cancer is hard to detect early. Many times, women with ovarian cancer have no symptoms or just mild symptoms until the disease is in an advanced stage and hard to treat. Symptoms may include:
* Heavy feeling in pelvis
* Pain in lower abdomen
* Bleeding from the vagina
* Weight gain or loss
* Abnormal periods
* Unexplained back pain that gets worse
* Gas, nausea, vomiting, or loss of appetite
Treatment is usually surgery followed by treatment with medicines called chemotherapy.
Types of Ovarian Tumors
Many types of tumors can start growing in the ovaries. Some are benign (non-cancerous) and never spread beyond the ovary. Women with these types of tumors can be treated successfully by removing one ovary or the part of the ovary that contains the tumor. Other types of ovarian tumors are malignant (cancerous) and can spread to other parts of the body. Their treatment is more complex and is discussed later in this document.
In general, ovarian tumors are named according to the kind of cells the tumor started from and whether the tumor is benign or cancerous. There are 3 main types of ovarian tumors:
* Germ cell tumors start from the cells that produce the ova (eggs).
* Stromal tumors start from connective tissue cells that hold the ovary together and produce the female hormones estrogen and progesterone.
* Epithelial tumors start from the cells that cover the outer surface of the ovary.
Epithelial Ovarian Tumors
Benign epithelial ovarian tumors: Most epithelial ovarian tumors are benign, do not spread, and usually do not lead to serious illness. There are several types of benign epithelial tumors including serous adenomas, mucinous adenomas, and Brenner tumors.
Tumors of low malignant potential: When looked at under the microscope, some ovarian epithelial tumors do not clearly appear to be cancerous. These are called tumors of low malignant potential (LMP tumors). They are also known as borderline epithelial ovarian cancer. These differ from typical ovarian cancers in that they do not grow into the supporting tissue of the ovary (called the ovarian stroma). Likewise, if they spread outside the ovary, for example, into the abdominal cavity, they do not usually grow into the lining of the abdomen.
These cancers affect women at a younger age than the typical ovarian cancers. LMP tumors grow slowly and are also a less life-threatening disease than most ovarian cancers. Although they can be fatal, this is not common.
Epithelial ovarian cancers: Cancerous epithelial tumors are called carcinomas. About 85% to 90% of ovarian cancers are epithelial ovarian carcinomas. Epithelial ovarian carcinoma cells have several features that can be seen under the microscope. These features are used to classify epithelial ovarian carcinomas into serous, mucinous, endometrioid, and clear cell types. The serous type is by far the most common.
Undifferentiated epithelial ovarian carcinomas don't look like any of these 4 subtypes, and they also tend to grow and spread more quickly. Epithelial ovarian carcinomas are classified by cell type and are also given a grade and a stage.
The grade is on a scale of 1, 2, or 3. Grade 1 epithelial ovarian carcinomas look more like normal tissue and tend to have a better prognosis (outlook). Grade 3 epithelial ovarian carcinomas look less like normal tissue and usually have a worse outlook.
The tumor stage describes how far the tumor has spread from where it started in the ovary. Staging is explained in detail in a later section.
Primary Peritoneal Carcinoma
Primary peritoneal carcinoma is a cancer closely related to epithelial ovarian cancer. It is also sometimes called also called extra-ovarian (meaning outside the ovary) primary peritoneal carcinoma (EOPPC) or serous surface papillary carcinoma. It develops in cells from the peritoneum, which is the membrane that lines the walls and organs of the pelvis and abdomen. These cells are very similar to epithelial cells on the surface of the ovaries. Because EOPPC tends to spread along the surfaces of the pelvis and abdomen, it is often difficult to tell exactly where the cancer first started. Under a microscope, EOPPC looks just like epithelial ovarian cancer. Women who have had their ovaries removed can still develop this type of cancer.
Symptoms of EOPPC are similar to those of ovarian cancer, including abdominal pain or bloating, nausea, vomiting, indigestion, and a change in bowel habits. Also, like ovarian cancer, EOPPC may cause an elevation in the amount of CA-125 in the blood. This is a tumor marker for ovarian cancer (discussed later in this document).
Treatment for women with EOPPC usually includes surgery to remove as much of the cancer as possible, followed by chemotherapy like that given for ovarian cancer. Its outlook is similar to widespread ovarian cancer.
Germ Cell Tumors
About 5% of ovarian cancers are germ cell tumors. Germ cells are the cells that usually form the ova or eggs. There are several subtypes of germ cell tumors. Most germ cell tumors are benign, although some are cancerous and may be life threatening. The most common germ cell tumors are teratoma, dysgerminoma, endodermal sinus tumor, and choriocarcinoma.
Teratoma: This germ cell tumor has a benign form called mature teratoma and a cancerous form called immature teratoma. The mature teratoma is by far the most common ovarian germ cell tumor and usually affects women of reproductive age (teens through forties). It is often called a dermoid cyst because its lining resembles skin. These tumors or cysts also contain a variety of other benign tissues that may resemble adult respiratory passages, bone, nervous tissue, teeth, and other tissues. The patient is cured by surgically removing the cyst.
Immature teratomas occur in girls and young women, usually younger than 18. These are rare cancers that resemble embryonic or fetal tissues such as connective tissue, respiratory passages, and brain. Tumors that are not very immature (grade 1 immature teratoma) and have not spread beyond the ovary are cured by surgical removal of the ovary. When they have spread beyond the ovary and/or much of the tumor has a very immature appearance (grade 2 or 3 immature teratomas), chemotherapy is recommended in addition to surgical removal of the ovary.
Dysgerminoma: This is the most common ovarian cancer of germ cells. However, it is a rare cancer. It usually affects women in their teens and twenties. Although dysgerminomas are considered malignant (cancerous), most do not grow or spread very rapidly. When they are limited to the ovary, more than 75% of patients are cured surgically removing the ovary, without any further treatment. Even when the tumor has spread further (or if it recurs, or comes back) surgery and/or chemotherapy is effective in controlling or curing the disease in about 90% of patients.
Endodermal sinus tumor (yolk sac tumor) and choriocarcinoma: These very rare tumors typically affect girls and young women. They tend to grow and spread rapidly but are usually very sensitive to chemotherapy. Choriocarcinomas more commonly start in the placenta (during pregnancy) rather than in the ovary. Placental choriocarcinomas usually respond even more to chemotherapy than ovarian choriocarcinomas.
Stromal Tumors
More than half of stromal tumors are found in women over age 50, but some occur in young girls. Some, but not all, of these tumors produce female hormones or, less often, male hormones. They can cause vaginal bleeding to start again after menopause, or can cause menstrual periods and breast development in young girls. If male hormones are produced, the tumors can disrupt normal periods and cause facial and body hair to grow. Types of malignant (cancerous) stromal tumors include granulosa cell tumors, granulosa-theca tumors, and Sertoli-Leydig cell tumors, which are usually considered low-grade cancers. Thecomas and fibromas are benign stromal tumors.
Ovarian Cysts
An ovarian cyst is a collection of fluid inside an ovary. Many cysts are completely normal. These are called functional cysts and occur as a normal part of ovulation. The fluid will usually be absorbed and over a few months, the cyst will disappear without any treatment. If you develop a cyst, your doctor may want to check it again after a period of time to see if it has gotten smaller. If, however, the mass is large, occurs in childhood or after menopause, or does not go away, your doctor will usually recommend that you have more tests, since a small number of these cysts may be cancer. Benign cysts are treated by observation (follow-up with physical exams and imaging tests), medications, or surgical removal.
Fallopian Tube Cancer
This is an extremely rare cancer. It begins in the fallopian tube, The symptoms are similar to those in women with ovarian cancer, except that there may be more pelvic pain. Treatment and outlook is similar to that for ovarian cancer. There are no reliable statistics for this cancer because it is so rare.

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