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Pharmacology/Questions Answered by Expert Joe Haynes, R.Ph., MBA

SubjectDate Asked
How safe is Ranitidine, long-term?6/8/2010
  Q: I have been taking something for gastric reflux since 1982. Back then it was Tagamet, by ...
  A: Histamine receptor antagonists like Tagamet and Zantac are very safe for long term use. Tagamet did ...
vitamin B125/19/2010
  Q: I am a nurse who was trained that vitamin B-12 (cyanocobalamin) had to be given parenterally or ...
  A: B-12 is a water soluble vitamin and can be given orally. The dosing for all routes is anywhere from ...
sinus infection medicines5/18/2010
  Q: My dr. Gave me calithromyacin 500mg for a bad sinus infection and cough. Also told me to use a ...
  A: Don- Yes, that is a common side effect of Symbicort. It contains a long acting bronchodilator ...
DM ii5/16/2010
  Q: age 50 weight 98 height 5.7 + after failure in alone metformin Dr has prescribed gliclazide 80 mg ...
  A: It is better to take gliclazide/metformin 30 minutes prior to the meal so the medication has time to ...
restoril and ambien4/5/2010
  Q: i read an article on internet by some doctor that high doses of restoril 30mg over long period of ...
  A: Usually not recommended because you could become over sedated. I would only recommend that if your ...
Medicine Doses4/5/2010
  Q: If there are two versions of the same medicine, one is extended release and the other one standard ...
  A: Alfonso- You are correct. Usually a sustained (SR) or extended release (XL or XR) is the equivalent ...
restoril and ambien4/5/2010
  Q: i read an article on internet by some doctor that high doses of restoril 30mg over long period of ...
  A: Howard- I have seen similar things as well. Nothing in the package literature indicates that ...
omeprazole and rantitidine3/9/2010
  Q: I have been diagnosed with the helicobacter bacteria and given the triple therapy. After all this ...
  A: Paul- You can use both together but therapeutically there really is no advantage. It's preferable to ...
Combatting Stimulant-caused insomnia3/8/2010
  Q: I am a college student who takes Focalin (IR) for diagnosed ADHD. Because of night classes, I take ...
  A: Brian- Xyrem is mostly indicated in people who are narcoleptic during the day and then cannot sleep ...
Mixing drugs3/7/2010
  Q: What would happen if someoneone took the following drugs: metoprl/hctz 100/25 zocor 40 augmentin 875 ...
  A: Sam- Question is a little vague. Are you looking for the drug interactions for all of these when ...
Lexapro Insomnia3/2/2010
  Q: I have been treated for RLS for the past nine months with Mirapex .25mg with no problems. I have ...
  A: Brock- Lexapro can cause insomnia in some people because it works by increasing serotonin in the ...
Xanax Testing2/27/2010
  Q: recently my ex and I had to take hair drug test for a custody trial.. I got my results back and I ...
  A: Jennifer- Unless they are testing for benzodiazepines, Xanax will not show up based on the ...
aspirin replacement2/26/2010
  Q: I am 48 years old and very near to 49.............I live a sedentary life and am a little ...
  A: Paul- The next step up from aspirin is called Plavix here in the US (generic name clopidogrel) but ...
Hydroxyzine2/24/2010
  Q: My question is.......can use of Hydroxyzine on a daily basis cause any side effects. I've read this ...
  A: I can sympathize. I encounter sleep issues myself. The only other non-benzo or non-Ambien product ...
pain relievers2/24/2010
  Q: Why do certain pain relievers, like Ibuprofen, help some pain conditions and not others? For ...
  A: Lee- Very good question. It depends on the nature of the pain. Ibuprofen and other non-steroidals ...
Hydroxyzine2/23/2010
  Q: My question is.......can use of Hydroxyzine on a daily basis cause any side effects. I've read this ...
  A: Eileen- Sure- any long term use of any medication can result in chronic side effects. Usually drugs ...
Hydrocodone1/4/2010
  Q: Is it common (or not that uncommon) for Hydrocodone to have reverse sedating effect when it comes to ...
  A: James- I did a couple of quick searches and did find other cases where insomnia was a side effect of ...
sulfa drugs5/3/2009
  Q: A couple years ago I used a dye on my hair that contained PPDA (para-phenylenediamine)and developed ...
  A: Lee- Yes, sulfacetamide is a sulfonamide and can cause the same allergic reactions. Sulfonamides ...
instead of imitrex5/1/2009
  Q: A few times a month I'll get a headache that I'd really rather do without. Fortunately, the ...
  A: Vascular type headaches like yours sometimes respond well to caffeine (either coffee, soda, Excedrin ...
WELLBUTRIN5/1/2009
  Q: I WAS TAKING WELLBUTRIN FOR A LONG TIME 10YRS, I JUST LOVED IT FOR ADD AND MY MOOD. BUT I HAD A ...
  A: Antidepressants work a little differently for everyone. Unfortunately, there is no other drug ...
azithromycin 250 mg tablets3/7/2009
  Q: I was given azithromycin 250m tablets(5 daily dose) on 02/23/2009 for a possible bacterial ...
  A: No not a problem. With antibiotics the thing to watch out for is diarrhea because the bacteria in ...
azithromycin 250 mg tablets3/6/2009
  Q: I was given azithromycin 250m tablets(5 daily dose) on 02/23/2009 for a possible bacterial ...
  A: Sherry- The half life (the time it takes for 1/2 of the drug in your blood to me removed) is 24 ...
please help3/6/2009
  Q: i want to start off by thanking you for taking the time to respond to my question. this is hard for ...
  A: That will be dictated by the laws in your state. As for the doctor, I don't think passing it off ...
vyvance overdose3/5/2009
  Q: will doubling a dose of vyvance 30mg in a child under 50 pounds hurt a child..what are the possible ...
  A: Anna- I'm going to provide you with the following link to help answer this. ...
please help3/5/2009
  Q: i want to start off by thanking you for taking the time to respond to my question. this is hard for ...
  A: Jennifer- Thanks for being willing to share your situation. I cannot imagine what you must be going ...
pharmacology3/3/2009
  Q: I am currently going through a custody battle with my exhusband where we are both guilty of throwing ...
  A: Robbi- The following link opens up a PDF file that describes what a paracervical block is. I had to ...
vitamins1/9/2009
  Q: I have been taking Vitamin B12 pills and Folate pills every day for the past six months. But I would ...
  A: Al- Yes, vitamins can be stopped immediately without any problem. If you were/are using them as a ...
Drug interaction1/5/2009
  Q: Dr. Haynes I am currently taking lamictal for bipolarity and I had taken benadryl for my allergies, ...
  A: I performed an interaction check (http://www.drugs.com/drug_interactions.php) with Lamictal and ...
Levocarnitine1/1/2009
  Q: What is the exact action of levocarnitine(CARNITOR) on human body,which is given especially in some ...
  A: Prajessh- This is kind of a lazy method to answer your questions but here is the link to the ...
drug interactions1/1/2009
  Q: my dads neurolgist prescribed lexapro 10mg but i read of some possible interactions with meds he is ...
  A: Mark- Very good question. Yes, there are interactions between the three that may be cause for ...
orlistat and kidney stones12/31/2008
  Q: Can you tell me if this drug causes kidney stones or not? I have had one kidney stone back in 1999. ...
  A: Alison- Yes, some people do develop high levels of calcium oxalate which is a salt excreted in the ...
chronic nausea12/31/2008
  Q: I have suffered from chronic nausea for 2 years and have been tried on all the anti nausea meds with ...
  A: It seems as if the hernia is independent of the nausea. Do you have any other underlying conditions ...
ZPack12/31/2008
  Q: I have been taking Azithromycin, 250mg for my soar throat and am on the 4th day. I have had a nail ...
  A: Malinda- Zithromax has no antifungal activity- it only treats bacteria. My guess is that due to your ...
Drug test12/31/2008
  Q: I was recently given a urine drug test and it came back as positive. My boss said that the test said ...
  A: Adderall is a mixture of four amphetamine salts (dextroamphetamine sulfate, dextroamphetamine ...
Liver and Kidney test12/29/2008
  Q: Our son is diagnosed as having ADHD, Bipolar and anxiety. He is currently on Vyvance, Lamictal, and ...
  A: Ransom- The only reason those tests may be necessary would be if your son were experiencing reduced ...
Nexium12/26/2008
  Q: When does the license or patent expire on Nexium so that it can go generic?
  A: Judy- Not sure of when the patent is due to expire. Just so you are aware, Prilosec (omeprazole) is ...
Prescription Drugs12/25/2008
  Q: My elder father is in a nursing home and is prescribed numerous drugs. Is there a specialist who ...
  A: Perry- If your father is in a nursing home, a consultant pharmacist (licensed in your state) is ...
taking niacin to lower triglyceride levels12/22/2008
  Q: I am beginning to take niacin at 100 mg dosage and increase up to a level to lower triglycerides. ...
  A: Virginia- Sorry I took so long to answer. For niacin, usual dose is 500mg of a sustained-released ...
depression/anxiety12/21/2008
  Q: my adult son is currently on prozac 20mg per day and perphenazene 2mg bid. He can have klonipin 1mg ...
  A: Shirl- I apologize for the delayed response (mainly due to the holidays). Psychotropic medications ...
Duricef and Cellulitis12/14/2008
  Q: I took a course of Duricef for 14 days for cellulitis in an arm that has lymphedemia. I got an ...
  A: Marge- Simple cuts once they are washed and dressed usually pose no risk of causing systemic ...
safety of nexium's degradation products after expiration date12/14/2008
  Q: Are the degradation products of nexium after expiration date safe?
  A: Sameh- Expiration dates on drugs are intended to prevent drug companies from incurring liability if ...
Please Help!12/11/2008
  Q: Haynes, My name is Amy, I have been suffering from generalized anxiety disorder from the age of 7. ...
  A: The combination is not a problem; however, I cannot recommend the use of someone else's medication ...
Medication dosing schedule6/25/2008
  Q: I have been taking Effexor XR 37.5mg for 2 months and I love it. The only problem is that I take it ...
  A: Beverly- Most antidepressants will cause some sleep disruption because they increase the amount of ...
Toporal Side Effect?6/16/2008
  Q: My mom is 89 years old, and is having a lot of lethargy and dizziness. She has a slight arrythmia, ...
  A: Dory- Usually blood pressure medication is adjusted based on blood pressure more so than body weight ...
Shingles6/16/2008
  Q: My wife suffers from shingles. She’s 57 years old. So far it’s been 8 weeks. What causes it… ...
  A: Larry- My apologies for being tardy in answering your inquiry. Shingles is caused by the same virus ...
Vitamin A5/24/2008
  Q: As an M.D. I have used 50,000 IU vitamin orally for one month in treatment of skin keratosis with ...
  A: Acute toxicity does not manifest itself until approximately 1 million units/dose which you are well ...
Tourette's5/23/2008
  Q: My nine yr old son has Tourette's Syndrome. He is on Prozac, Clonidine and Tenax. Last week he had ...
  A: My only guess would be since opiates are central nervous system depressants (sleep,somnolence, ...
filled prescriptions5/14/2008
  Q: When a doctor writes a paper prescription for someone, is the doctor able to know whether or not the ...
  A: Jenna- Once you leave the doctor's office, there is no way for them to know whether you got it ...
timolol maleate5/12/2008
  Q: Can timolol maleate reduce pressure from 54 hh mg to 15 hh mg in 2.5 days? Thank you! ANSWER: ...
  A: Lauren- That seems reasonable to wait and I agree- why risk the side effects of the drug if there is ...
Allergic to most pain meds5/6/2008
  Q: I will be having oral surgery in a few days and need some advice on pain medications. I am allergic ...
  A: Adrian- Not much left. There is Ultram (tramadol) or Ultracet (tramdol and Tylenol) which may work ...
Taking Zantac in less and more frequent doses?5/5/2008
  Q: Our 7-week old son has been taking Zantac for reflux for two weeks. The prescription from our ped ...
  A: Since the total daily dose you are giving is less than prescribed, there will not be an overdose the ...
Vaccinations and Autism5/1/2008
  Q: The rate of autism 40 years ago was 1 and 10,000. Now it's 1 in 150. Being I just had a son I ...
  A: Having no scientific proof that vaccines do not cause autism does not automatically mean you have ...
insomnia after benzo4/23/2008
  Q: I took clonopin 1-2mg for 4yrs only at night to sleep and 1mg of xanax for 6 months. Of course they ...
  A: You have at least two other drug options. One is Ambien which is a non-benzo but acts at the same ...
Infant Zantac Dosage4/16/2008
  Q: Our pediatrician prescribed Zantac syrup for our nearly 2 month old for reflux. He weighs approx. ...
  A: Chris- Usual dose for Zantac is 2mg/kilogram of weight twice daily. Your baby weighs about 4.4 kilos ...
medication interaction4/14/2008
  Q: My 22-year old son takes a low dose(10mg)of Adderol once a day as needed to function at school. He ...
  A: Donna- Any decongestant is going to work with the Adderall to raise blood pressure because ...
Xanax hair drug test4/10/2008
  Q: I took one .25mg pill of Xanax in early April to help me sleep. It was the first and only time I ...
  A: Most drug tests are for classes of drugs like opiates or benzos in general. Xanax has a half life of ...
Nexium expiration4/10/2008
  Q: I have some nexium with an expiration date of 12/25/07 E/09. My prescription calls for me to take ...
  A: Without seeing the prescription label or the bottle, I'm not sure what E/09 is. But as far as the ...
switching antidepressants3/30/2008
  Q: Dr. Haynes - My mother is 76, she has suffered chronic depression for many years, and has been on ...
  A: Russell- Sorry for the delayed response. I have been on vacation. You are correct, cross tapering ...
azathioprine & prednisolone3/29/2008
  Q: prednisolone and azathioprine have been used for sclerosing peritonitis. Is this a recognised ...
  A: Sorry for the delay in response as I have been on vacation. I am not familiar with this particular ...
drug interactions3/28/2008
  Q: I have been told to avoid Vitamin c supplementation as I take low-dose Vytorin. Is this tru, and if ...
  A: I use www.drugs.com to check for interactions and there were no documented interactions between ...
Xanax Drug testing3/25/2008
  Q: How long does xanax stay in your system for urine testing, I weigh 140 lbs. I am 42 years old, and ...
  A: Larry- Xanax has a half-life of 6.3-27 hours which means it can take that amount of time for one ...
breathing difficulties relating to medication3/23/2008
  Q: Any medication i take appears to depress my respiratory system and gives me very bad breathing ...
  A: David- If you could be more specific regarding the medications you are taking and for what ...
Zovirax 400mg3/16/2008
  Q: I'm Melojane from Philippines. My mother had been exposed to varicella for 3 days now. The doctor ...
  A: There are no cures for viral infections- only treatments that will lessen the symptoms and reduce ...
viagra/cialis3/4/2008
  Q: What are the effects of viagra/cialis on a young healthy male not needing them? Lots of people today ...
  A: Well other than the obvious, most common side effects are lowered blood pressure, painful erections ...
Vyvase2/20/2008
  Q: My 10 year old son has been taking Vyvase for about 3 full months. Aside from appetite suppression ...
  A: It is a possibility as all amphetamines increase the amount of epinephrine in the brain. The package ...
difference?2/13/2008
  Q: What is the difference between Lorazepam and oxazepam?? Thank you very much for your time and help. ...
  A: Keep the questions coming. That's what we are here for. Half-life refers to how long it takes for a ...
difference?2/13/2008
  Q: What is the difference between Lorazepam and oxazepam?? Thank you very much for your time and help. ...
  A: Not a problem. Keep asking until you get the answer you need. You are correct- Serax has a longer ...
difference?2/13/2008
  Q: What is the difference between Lorazepam and oxazepam?? Thank you very much for your time and help. ...
  A: Yona- Both are benzodiazepines use for anxiety or to help facilitate sleep. The main difference ...
zantac overdose2/7/2008
  Q: My daughter who is 7 years old (40 pounds) has been in a steroid therapy. To prevent a side effect ...
  A: JP-- Let's take your concerns in order. I apologize for being long-winded: 1. Pediatric dosing for ...
diaphenhydramine1/28/2008
  Q: A person I love is addicted to diaphenhydramine and has asked me to support her in an effort to ...
  A: Adam- She obviously is not suffering the overt signs of overdose, however, signs like increased ...
Amoxicilin1/28/2008
  Q: How long does this drug stay in the system after completeing a 7 day course? Thank you.
  A: The half-life (the time it takes for your body to eliminate 1/2 of the ingested dose) for ...
Wellbutrin/Paxil.......1/22/2008
  Q: I've been taking Wellbutrin for about 8 years, and my doctor and I have come to the conclusion that ...
  A: Dave- Switching between classes of antidepressants should be done gradually. While tapering off of ...
flexeril vs soma1/22/2008
  Q: Please discuss if you can, known differences between flexeril and soma. when i do a web search on ...
  A: TK- The differences are based on their chemistry and mechanisms of action. Soma (carisoprodol) is ...
Can Kenalog in Orabase c1/21/2008
  Q: "Dear Dr.I am 28 year old, relatively healthy male I recently finished a five day treatment of ...
  A: Eric- Kenalog can cause some localized reactions although they tend to be rare (see table below). It ...
Reaction or all in my head?1/7/2008
  Q: In the past I have had some itching after taking antibiotics so I have stopped them, I was recently ...
  A: It's not uncommon to be confused about potential allergic reactions. Let's start with what a ...
Treatment of prostatitis1/7/2008
  Q: About 1.5 years ago i was treated with 1g IM Ceftriaxone once a day for 4 consective days followed ...
  A: Mike- The use of IV or IM Rocephin (ceftriaxone)for the first 4 days is to achieve rapid prostatic ...
Trileptal1/3/2008
  Q: Happy New Year. I know that Lamictil causes short term memory loss. How does trileptal compare for ...
  A: Just from my brief search on this topic, I gather that memory loss is also a result of the seizure ...
drug interactions12/28/2007
  Q: I have a question about a possible drug interaction between propranolol and fluoxetine. I ...
  A: Sounds like you have a good handle on this one. I cannot find anything specific between fluoxetine ...
diabetic and smoking12/27/2007
  Q: patches gum and everything you can think of I think that smoking increases blood sugar levels can ...
  A: There was a study back in 2002 by the Joslin Diabetes Center (an affiliate of Harvard University) ...
medicine12/16/2007
  Q: I'm 56 years old and have had chronic constipation since about 21. Usually I just ignore it (after ...
  A: Sorry this is late;have been out for a while. Hyperosmolar just means the laxative draws water into ...
medicine12/16/2007
  Q: I'm 56 years old and have had chronic constipation since about 21. Usually I just ignore it (after ...
  A: Miralax is also a bulk forming laxative. Like Citrucel, it requires a lot of water in order to ...
medicine12/15/2007
  Q: I'm 56 years old and have had chronic constipation since about 21. Usually I just ignore it (after ...
  A: Constipation can be a chronic health problem related to possible food allergies, chronic use of ...

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Joe Haynes, R.Ph., MBA

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Expertise

I can answer pharmacy/pharmacology questions as they relate to both pediatric and adult therapies. Please note that since I practice in Florida that I may not be able to answer specific questions regarding pharmacy practice in your state. As a disclaimer, I have no financial interest in recommending or failing to recommend any drug product. My goal is to give you the best answer to your questions regardless of product.

Experience

I have 24 years experience in pharmacy practice including pediatric and adult hospital, home-infusion, and long-term care (nursing home/ALF). I enjoy assisting with pediatric dosing and medication questions since children respond differently and are dosed differently than adults. I can help you determine if the dose you want to administer to your child is appropriate. I am currently director of pharmacy for a small community hospital in St. Petersburg, FL.

Organizations
Florida Society of Health-Systems Pharmacists American Society of Health-Systems Pharmacists Florida Pharmacy Association

Education/Credentials
BS in Microbiology from Auburn University (1989) BS in Pharmacy from Northeastern University (1994) MBA (generalist) from St. Leo University (2005)

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