How to take it

• Advise patient to take with 8 oz of water to ensure passage into stomach.
• Tell patient to take on empty stomach at least 1 hour before meals or 2 hours afterwards.
• Instruct patient to take at least 1 hour before bedtime to prevent esophagitis.
• Tell patient to immediately report painful swallowing, abdominal pain, easy bruising or bleeding, or signs of hypersensitivity such as skin rash
• Advise female patient to tell prescriber if she is pregnant.
• Instruct patient to avoid alcohol use and large amounts of calcium containing foods (such as dairy products and some green leafy vegetables, such as spinach).
• Stress importance of good oral hygiene.
• As appropriate, review all other significant and life threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, and behaviors mentioned above.

 How to take it

• Tell patient she can take with or without food.
• Instruct patient to weigh herself regularly and report significant changes.
• Advise patient and family to watch for signs and symptoms of depression.
• Tell patient to minimize GI upset by eating small, frequent servings of healthy food and drinking plenty of fluids.
• Caution patient to avoid driving and other hazardous activities until she knows how the drug affects concentration and alertness.
• Inform the patient that treatment is long-term. Urge her to keep follow-up appointments with the prescriber.
• Tell the patient to inform the prescriber if she is pregnant or breastfeeding.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests mentioned above.

• Emphasize the importance of continuing to take medication as directed at the same time each day, even if feeling well. Take missed doses as soon as remembered but not if almost time for the next dose. Do not double doses. Warn the patient not to discontinue ACE inhibitor therapy unless directed by a health care professional.
  • Caution patient to avoid salt substitutes containing potassium or foods containing high levels of potassium or sodium unless directed by a health care professional (see ).
  • Caution patient to change positions slowly to minimize orthostatic hypotension. Use of alcohol, standing for long periods, exercising, and hot weather may increase orthostatic hypotension.
  • Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult a health care professional before taking any Rx, OTC, or herbal products, especially cough, cold, or allergy remedies.
  • May cause dizziness. Caution patient to avoid driving and other activities requiring alertness until response to medication is known.
  • Advise patient to inform health care professional of medication regimen prior to treatment or surgery.
  • Instruct patient to notify health care professional if rash; mouth sores; sore throat; fever; swelling of hands or feet; irregular heartbeat; chest pain; dry cough; hoarseness; swelling of face, eyes, lips, or tongue; or if difficulty swallowing or breathing occurs. Persistent dry cough may occur and may not subside until the medication is discontinued. Consult health care professional if cough becomes bothersome. Also notify health care professionals if nausea, vomiting, or diarrhea occurs and continues.
  • Advise women of childbearing age to use contraception and notify health care professionals if pregnancy is planned or suspected, or if breastfeeding.
  • Emphasize the importance of follow-up examinations to evaluate the effectiveness of the medication.
• Hypertension: Encourage the patient to comply with additional interventions for hypertension (weight reduction, low-sodium diet, discontinuation of smoking, moderation of alcohol consumption, regular exercise, and stress management). Medication controls but does not cure hypertension.
  • Instruct patient and family on correct techniques for monitoring BP. Advise them to check BP at least weekly and to report significant changes to health care professionals.

• Advise patient to establish an effective bedtime routine, to minimize insomnia.
• Inform patient that drug may cause psychological and physical dependence and should be used only as prescribed and needed.
• Caution patient to avoid driving and other hazardous activities on day after taking drug, until they know how it affects concentration and alertness.
• Instruct patient not to drink alcohol.
• Advise patient not to smoke or use herbs without consulting prescriber.
• Instruct patient to report suspected pregnancy.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.