Guide

Medications and Recovery An Important Piece of the Puzzle Second Edition

A guide to maintaining sobriety while receiving treatment for other health problems

Renee Enstrom, Pharm.D., R.Ph. Richard Zinni, D.O.

Copyright © 2007, Glenbeigh

2015 All rights reserved. This publication may not be reproduced or quoted in whole or in part by any means whatsoever without written permission from the CEO of: Glenbeigh 2863 St Rt. 45 P.O. Box 298 Rock Creek, Ohio 44084

Table of Contents Table of Contents Introduction to Medications and Recovery ........................................................................................... I Introduction to Medications and Recovery ........................................................................................... I Chapter 1 Chapter 1 Class A (alcohol, anorexiants) .................................................................................................................. 1 (alcohol, anorexiants) .................................................................................................................. Class A (antitussives/antihistamines/decongestants/expectorants/combo products).................................. 12 Class A (ecstasy, (antitussives/antihistamines/decongestants/expectorants/combo products) .................................. 32 gastrointestinal/anti-diarrheal, gastrointestinal/antispasmodic) ...................................... (ecstasy, gastrointestinal/anti-diarrheal, gastrointestinal/antispasmodic) ...................................... 34 Class A (hallucinogens, inhalants) ............................................................................................................ Class A (hallucinogens, inhalants)pain, ............................................................................................................ (marijuana, neuropathic opiates) .......................................................................................... 45 Class A (marijuana, neuropathic pain, opiates) .......................................................................................... 65 (opiates) ....................................................................................................................................... Class A (opiates) ....................................................................................................................................... 67 (opiates) sedatives/analgesic/antimigraine, ....................................................................................................................................... Class A (opiates, sedatives/anti-anxiety) .............................................. 78 Class A (opiates, sedatives/analgesic/antimigraine, sedatives/anti-anxiety) .............................................. 89 (sedatives/barbiturates, sedatives/ benzodiazepines) .................................................................. Class A (sedatives/barbiturates, sedatives/ benzodiazepines) .................................................................. 9 (sedatives/hypnotic/sleep, sedatives/other central nervous system depressants, Class A (sedatives/hypnotic/sleep, central nervous system depressants, skeletal muscle relaxants) sedatives/other ........................................................................................................... 10 skeletal muscle relaxants) ........................................................................................................... 10 Class A (stimulants) .................................................................................................................................. 11 Class A (stimulants) .................................................................................................................................. 11 Chapter 2 Chapter 2 Class B (addiction treatments, anabolic steroids/androgens) .................................................................... 12 (addictionsteroids/androgens, treatments, anabolicantihistamines/sedating, steroids/androgens) .................................................................... 12 Class B (anabolic antitussives/expectorants) ..................... 13 Class B (anabolic steroids/androgens, antihistamines/sedating, antitussives/expectorants) ..................... 13 (antitussives/expectorants, corticosteroids) .................................................................................. 14 Class B (antitussives/expectorants, corticosteroids) .................................................................................. (decongestants/nasal sprays, decongestants/phenylephrine) ...................................................... 14 15 Class B (decongestants/nasal sprays, decongestants/phenylephrine) ...................................................... 16 15 (decongestants/phenylephrine) .................................................................................................... 16 Class B (decongestants/phenylephrine) .................................................................................................... 17 (decongestants/phenylephrine) decongestants/pseudoephedrine, .................................................................................................... 17 Class B (decongestants/phenylephrine, Class B (decongestants/phenylephrine, decongestants/pseudoephedrine, gastrointestinal/constipation) ....................................................................................................... 18 gastrointestinal/constipation) gastrointestinal/nausea/vomiting, ....................................................................................................... 18 Class B (gastrointestinal/constipation, Class B (gastrointestinal/constipation, gastrointestinal/nausea/vomiting, skeletal muscle relaxants, sleep aids) ......................................................................................... 19 skeletalaids, muscle relaxants, sleep aids)other) ......................................................................................... Class B (sleep vertigo/motion sickness, ................................................................................. 19 20 Class B (sleep aids, vertigo/motion sickness, other) ................................................................................. 20 Chapter 3 Chapter 3 Products ............................................................................................................................... 21 Alcohol-Free Alcohol-Free Products ............................................................................................................................... 21 Chapter 4 Chapter 4 Non-Prescription & Prescription Products That Contain Alcohol................................................................. 25 Non-Prescription & Prescription Products That Contain Alcohol ................................................................. 25

Medications and Recovery – Introduction Medications and Recovery – Introduction

I I

There are many types of medications which may present a hazard to a person beginning the journey of recovery chemical include prescription andtoover-the-counter medications. There arefrom many types ofdependency. medications These which may present a hazard a person beginning the journeyThe of danger isfrom not always a recoveringThese addictinclude may develop a new – though medications. this certainly The can recovery chemicalthat dependency. prescription andaddiction over-the-counter happen is– not but always that one be led back into may dependence theiraddiction drug of –choice. Recent scientific danger thatcan a recovering addict develop aonnew though this certainly can research that can all the drugs on act their on thedrug brainofinchoice. the sameRecent way toscientific produce happen –has butproven that one bedependence-producing led back into dependence addiction has – despite effects or a different kindact of on “high” In addition, if urine research provenhaving that alldifferent the dependence-producing drugs the when brain intaken. the same way to produce drug screening is part of the recovering continuing program, many types of addiction – despite having different effectsperson’s or a different kind treatment of “high” when taken.useInofaddition, if urine medications canisresult positive tests for the more highly addictive classesuse of drugs, resulting in drug screening part in of falsely the recovering person’s continuing treatment program, of many types of negative consequences. medications can result in falsely positive tests for the more highly addictive classes of drugs, resulting in negative Therefore,consequences. it is very important for a recovering person to learn about the different types of medications and drugs – and ones present a special risk to continuing recovery and sobriety. The commonly Therefore, it iswhich very important for a recovering person to learn about the different types of medications and available medications and present drugs area divided classes –recovery A, B andand C – sobriety. to indicateThe threecommonly levels of drugs – and which ones special into risk three to continuing risk. available medications and drugs are divided into three classes – A, B and C – to indicate three levels of risk. Class A drugs must be avoided completely, as they are well known to produce addiction and are the most

dangerous of all. under very unusual as conditions Class A drugsaddiction be takenand by aarerecovering Class A drugs mustOnly be avoided completely, they are can well the known to produce the most addict or alcoholic andunder only when by conditions a physiciancan or dentist. These exceptional circumstances can dangerous of all. –Only very given unusual the Class A drugs be taken by a recovering include:or severe including major surgery, car accidents and othercircumstances trauma, testscan or addict alcoholicillness – andand onlyinjuries when given by a physician or dentist. These exceptional procedures whichillness can only be doneincluding under sedation or anesthesia. Medication treatments fortests certain include: severe and injuries major surgery, car accidents and other trauma, or psychiatric conditions thisdone category, are medications used forMedication drug detoxification. “street procedures which canare onlyin be underassedation or anesthesia. treatments The for certain drugs” are also included A. At times, a Class A medication maydrug be necessary for anThe individual psychiatric conditions areininClass this category, as are medications used for detoxification. “street with anare addiction historyintoClass take A.under the supervision of a physician. is recommended that the drugs” also included At times, a Class A medication may beIt necessary for an individual individual be proactive andtohave be responsible for the medication that is needed be with an addiction history take someone under theelse supervision of a physician. It is recommended thatto the given dose dose and at appropriate times. recommendation includes Class B individual be by proactive have someone elseThis be responsible for the also medication thatcertain is needed to be medications. given dose by dose at appropriate times. This recommendation also includes certain Class B medications. The medications in Class B are also potentially very dangerous – especially when taken by recovering persons without the guidance of aalso physician or another healthcare–professional. However, under certain The medications in Class B are potentially very dangerous especially when taken by recovering circumstances, B group be taken a physician’s care. However, under certain persons withoutthe theClass guidance of a can physician or safely anotherunder healthcare professional. circumstances, the Class B group can taken under care. Class C medications are generally safebefrom thesafely point of viewaofphysician’s addiction recovery. However, overuse of

any – even common – can result in unwanted effects. Classmedication C medications arethe generally safeover-the-counter from the point ofremedies view of addiction recovery. However,side overuse of Classmedication C medications arethe left common out of thisover-the-counter pamphlet. any – even remedies – can result in unwanted side effects. Class medications are leftwith out of thisaddiction pamphlet.or alcoholism must remain aware of the tendency to look PeopleCwho have struggled drug

for “external solutions for internal problems” – and should avoid taking ANYaware of these medications People who have struggled with drug addiction or alcoholism must remain of the tendencyon to their look own, in ordersolutions to medicate emotionsproblems” and feelings. toolsavoid of recovery – including participation at 12-Step for “external for internal – andThe should taking ANY of these medications on their fellowship meetings, working the and Steps or talking with ofa recovery sponsor,– including counselor,participation doctor or atindividual own, in order to medicate emotions feelings. The tools 12-Step counseling meetings, - provide safe and healthy waysorto talking deal withwith the astrong feelings that can come any time fellowship working the Steps sponsor, counselor, doctoruporatindividual in early sobriety. counseling - provide safe and healthy ways to deal with the strong feelings that can come up at any time in early sobriety.

II II

Medications and Recovery – Introduction Medications and Recovery – Introduction

Many recovering people also have other chronic illnesses or mental health issues, such as depression, bipolar disorder, diabetes or hypertension, which require prescription andsuch otherastreatments to Many recovering people also have other chronic illnesses or mentalmedications health issues, depression, remain healthy. diabetes Staying clean and sober which from drugs and alcohol often requires and continued use of these bipolar disorder, or hypertension, require prescription medications other treatments to medications. Stopping prescribed treatments without doctor’soften guidance cancontinued result in ause relapse into remain healthy. Stayingtheclean and sober from drugs andaalcohol requires of these active addiction. medications. Stopping the prescribed treatments without a doctor’s guidance can result in a relapse into active addiction. that appear on the following pages include both the BRAND NAME, listed first, (i.e.: The medications “Valium”), followed the GENERIC NAME pages (i.e.: “diazepam”) as listed the majority of The medications thatbyappear on the following include both intheparentheses– BRAND NAME, first, (i.e.: prescriptionfollowed bottles are with the generic For “street drugs”, the COMMON NAME is listed “Valium”), by labeled the GENERIC NAME name. (i.e.: “diazepam”) in parentheses– as the majority of first, and thebottles (chemical “slang” in parentheses. each the drugCOMMON group in Class B, prescription are name labeledor with the name) genericisname. For “streetFor drugs”, NAMEAisand listed there is also a brief explanation of the dangers associated with taking the medication or street drug. first, and the (chemical name or “slang” name) is in parentheses. For each drug group in Class A and B, there alsoofa the briefdocument explanation of the associated withistaking thealcohol-free medication or street drug. At theisend there aredangers two tables. The first a list of products grouped by therapeutic category. The manufacturer listed next each name. The products second isgrouped a table by of At the end of the document there are twoistables. The tofirst is aproduct list of alcohol-free alcohol-containing medications. therapeutic category. The manufacturer is listed next to each product name. The second is a table of alcohol-containing Use of Class A andmedications. certain Class B medications listed should become a rarity for a recovering addict and alcoholic. Use of Class A and certain Class B medications listed should become a rarity for a recovering addict and alcoholic. Please remember, this information does not include all drugs and is only intended as a quick reference becauseremember, manufacturers change product Please this information doesingredients not includeand all brand drugs names and is frequently. only intended as a quick reference because manufacturers change product ingredients brand frequently. This guide is not intended to be a substitute for and advice thatnames only your own personal physician can provide. it is VERY that on thethat basis the information contained in this This guideInisparticular, not intended to be aIMPORTANT substitute for advice onlyofyour own personal physician can guide, youIndo not suddenly discontinue or make of medication that provide. particular, it is VERY IMPORTANT thatany on changes the basisin ofthe thedoses information contained in you this may have Doing so may resultany in changes unexpected problems such as withdrawal guide, you been do notprescribed. suddenly discontinue or make in the doses of- medication that you reactions whichprescribed. in some cases canso be may life-threatening. You MUSTproblems check with your as doctor before may have -been Doing result in unexpected - such withdrawal making ANY medication reactions - which in somechanges. cases can be life-threatening. You MUST check with your doctor before making medication changes. It is alsoANY essential that you inform ALL of your personal physicians, dentists and other health care providers of your chemical dependency so that medications can be prescribed safely care and It is also essential that you inform ALL ofhistory your personal physicians, dentists and other health appropriately whenchemical they are dependency deemed necessary. providers of your history so that medications can be prescribed safely and appropriately they are deemedaddict necessary. The bottom linewhen is that a recovering or alcoholic needs to become a good consumer, and ask a healthcare are questions takingneeds ANY kind of medication BEFORE taking it. a The bottomprofessional line is that ifa there recovering addict orabout alcoholic to become a good– consumer, and ask healthcare professional if there are questions about taking ANY kind of medication – BEFORE taking it. is Remember that “RECOVERY IS ITS OWN REWARD” – being healthy and regaining a happy life YOUR responsibility! Remember that “RECOVERY IS ITS OWN REWARD” – being healthy and regaining a happy life is YOUR responsibility!

Chapter 1 1 Class A –Chapter Avoid Completely Class A – Avoid Completely Alcohol (Ethanol) Sedative Hypnotic: Alcohol (Ethanol) Sedative Hypnotic: Ale Whiskey Ale (including “non-alcoholic” forms) Whiskey Beer Wine Beer (including “non-alcoholic” forms) Brandy Wine Cooler Brandy Wine Cooler Liquor Liquor Alcohol consumption initially reduces social inhibitions and produces pleasure and a sense of well-being Alcohol consumption initially reduces social inhibitions and produces pleasure and the a sense of well-being and relaxation. Those effects are replaced by drowsiness as the alcohol leaves system. Drinking and relaxation. Those effects are replaced by drowsiness as the alcohol leaves thewhich system. Drinking alcohol initially increases the release of dopamine in the reward centers of the brain promotes the alcohol initially increases the release of dopamine in the reward of the brain which experience of pleasure. Alcohol increases the inhibitory activitycenters of GABA receptors whichpromotes is likely the experience pleasure. Alcohol increases the also inhibitory activitytheofexcitatory GABA receptors likely the cause of theofsedating effects of alcohol. Alcohol decreases activity ofwhich NMDAis glutamate cause of the sedating effects of alcohol. decreases the excitatory activity of NMDA glutamate receptors which is responsible for the Alcohol memoryalso deficits experienced after drinking. Chronic alcohol receptors which is responsible for formation, the memory deficits experienced drinking. Chronic alcohol consumption compromises memory abstract thinking, problemafter solving, attention, concentration consumption compromises formation, abstract problem attention,use. concentration and perception of emotion. memory Tolerance, dependence andthinking, withdrawal occursolving, with continued The “nonand perception emotion. Tolerance, and withdrawal use. of Thealcohol “nonalcohol” or “NA”of forms of beer should dependence not be consumed because occur there with is acontinued small amount alcohol” or “NA” formsshows of beerthatshould there is aand small amount of relapse alcohol present and research smell not maybebeconsumed enough tobecause trigger cravings a subsequent present and research shows thatnote smellthat may be isenough to of trigger a subsequent among certain alcoholics. Please there a variety coughcravings and coldand preparations that relapse contain among alcoholics.which Please note is a variety of not cough and cold that contain alcohol certain and medications can be that takenthere in tablet form will contain ethylpreparations alcohol. Certain topical alcohol and medications which can takenethyl in tablet formand willshould not contain ethyl alcohol and are safe to products, soft-gels and capsules thatbe contain alcohol be avoided. use. Certain topical products, soft-gels and capsules that contain ethyl alcohol should be avoided. Anorexiants: Anorexiants: Adipex-P (phentermine tablet & capsule) Qsymia ER (phentermine/ topiramate capsule) Adipex-P tablet & capsule) Qsymia ERstimulant (phentermine/ topiramate capsule) Also CNS(phentermine stimulant Also CNS Also CNS stimulant Also CNS(benzphetamine stimulant Regimex tablet) Belviq (lorcaserin tablet) Regimex tablet) Also CNS(benzphetamine stimulant Belviq (lorcaserin tablet) Also CNS (phentermine stimulant Suprenza tablet orally disintegrating) Bontril PDM ER (phendimetrazine capsule) Suprenza tablet orally disintegrating) Also CNS (phentermine stimulant Bontril PDM ER (phendimetrazine capsule) Also CNS(diethylpropion stimulant Tenuate tablet) Bontril PDM (phendimetrazine tablet) Tenuate tablet) Also CNS(diethylpropion stimulant Bontril PDM (phendimetrazine tablet) Also CNS stimulant Desoxin (methamphetamine tablet) Desoxin tablet) Also CNS(methamphetamine stimulant Also CNS stimulant The mechanism of action in reducing appetite for the stimulants appears to be secondary to the central The mechanism of action All in reducing for the stimulants appears to be secondary to theuse central nervous system effects. of these appetite medications have a high abuse potential and prolonged may nervous system effects. All of theseSee medications have a for high abuse potential and prolonged use may lead to dependency and withdrawal. stimulant section further information. lead to dependency and withdrawal. See stimulant section for further information.

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Antitussives/Antihistamines/Decongestants/Expectorants/Combo Products: Codeine Allfen CD (codeine/guaifenesin tablet) Allfen CDX (codeine/guaifenesin tablet) Cheratussin DAC (codeine/ guaifenesin/pseudoephedrine syrup) Codar AR (codeine/chlorpheniramine liquid) Codar D (codeine/pseudoephedrine liquid) Codar GF (codeine/guaifenesin liquid) Dex-Tuss (codeine/guaifenesin liquid) Guaiatussin AC (codeine/guaifenesin syrup) Iophen C-NR (codeine/guaifenesin liquid) Lexuss 210 (codeine/chlorpheniramine liquid) Lortuss EX (codeine/guaifenesin/pseudoephedrine liquid) M Clear (codeine/guaifenesin capsule) M Clear WC (codeine/guaifenesin liquid) Mar-Cof CG (codeine/guaifenesin solution) Ninjacof-XG (codeine/guaifenesin liquid) Notuss-DC (codeine/pseudoephedrine liquid) Phenergan with Codeine (codeine/promethazine syrup) Phenergan VC with Codeine (codeine/promethazine/phenylephrine syrup)

Codeine, continued Phenylhistine DH (codeine/ chlorpheniramine/pseudoephedrine elixir) Robafen AC (codeine/guaifenesin syrup) Robitussin AC (codeine/guaifenesin liquid) Tricode AR (codeine/chlorpheniramine/pseudoephedrine liquid) Tricode GF (codeine/guaifenesin/pseudoephedrine liquid) Tuzistra XR (codeine/chlorpheniramine suspension) Virtussin DAC (codeine/guaifenesin/pseudoephedrine liquid) Hydrocodone Hycofenix (hydrocodone/guaifenesin/pseudoephedrine solution, oral) Hydromet (hydrocodone/homatropine syrup) Obredon (hydrocodone/guaifenesin solution, oral) Rezira (hydrocodone/pseudoephedrine solution) TussiCaps ER(hydrocodone/ chlorpheniramine capsule) Tussigon (hydrocodone/homatropine tablet) Tussionex PennKinetic ER (hydrocodone/chlorpheniramine suspension) Vituz (hydrocodone/chlorpheniramine solution) Zutripro (hydrocodone/ chlorpheniramine/pseudoephedrine solution)

Any cough medications containing narcotics such as codeine or hydrocodone should not be used. These medications bind to opiate receptors in the central nervous system, altering the perception of and response to pain and produce generalized central nervous system depression and may alter mood or cause sedation.

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Ecstasy: Adam (MDMA) Beans Eve (MDE) Love (MDA) Methylenedioxyamphetamine (MDA) Methylenedioxyethylamphetamine (MDE)

Methylenedioxymethamphetamine (MDMA) Molly Rolls X XTC

MDMA increases dopamine, norepinephrine and to a greater extent, serotonin. With high doses, users can experience jitteriness, teeth clenching, dry mouth, muscle cramping and nausea. MDMA can cause a distorted sense of perception, hallucinogen-like effects and hyperactivity. Overdose can occur leading to increased body temperature, hypertension and kidney failure. Ecstasy is often combined in tablet or powder form with other drugs of abuse such as: methamphetamine, dextromethorphan, ephedrine, pseudoephedrine, caffeine, cocaine, piperazine drugs (mCPP, TFMPP, BZP) and ketamine. This increases the risks of adverse effects. Gastrointestinal (Anti-Diarrheal): Donnatal (phenobarbital/atropine/hyoscyamine/ scopolamine elixir oral, tablet oral) Donnatal Extentabs (phenobarbital/atropine/hyoscyamine/ scopolamine tablet ER oral) Lomotil (atropine/diphenoxylate solution oral, tablet oral) Lonox (atropine/diphenoxylate tablet oral)

Motofen (atropine/difenoxin tablet oral) Opium (morphine tincture oral) Also opiate Paregoric (morphine tincture oral) Also opiate Viberzi (eluxadoline oral)

Diphenoxylate is a member of the opioid class of drugs. Atropine is added to discourage abuse for recreational purposes. At recommended doses, the atropine causes no effects but in larger doses, unpleasant symptoms are experienced. Prolonged use with high doses may cause physical and psychological dependence. Adverse reactions of euphoria and feeling drunk were reported in clinical trials with the use of Viberzi. Paregoric and Opium belong to the opiate class of medications. See opiates section for more information. Gastrointestinal (Antispasmodic): Librax (chlordiazepoxide/clidinium capsule oral) Chlordiazepoxide is also a benzodiazepine Librax can cause drowsiness, ataxia and confusion. Withdrawal can occur after prolonged use. See benzodiazepine section for more information.

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Hallucinogens: 4-bromo-2,5-dimethoxyphenethylamine (2-CB) Ayahuasca (caapi, yage, vegetal) Belladonna Alkaloids (atropine, scopolamine, belladonna, deadly nightshade, Jimsonweed, stink weed, mandrake) Dextromethorphan (CCC, robo, red devils, poor man’s PCP, DXM, Dex) Dimethyltryptamine (DMT, businessman’s special) Ketamine (Special K, K)

Lysergic Acid Diethylamide (acid, blotter, California sunshine, LSD, microdot, paper, trip, yellow sunshine and many others) Mescaline (buttons, mesc, mescal, topi, peyote) Phencyclidine (PCP, angel dust, T, PeaCe pill) Psilocybin (boomers, magic mushroom, shrooms) Salvia Divinorum (ska, Maria, la Maria, ska Pastora)

People using high doses of hallucinogens begin to perceive an experience as actually happening when it is not. Hallucinogen effects include feelings of detachment from one’s surroundings, emotional swings and an altered sense of space and time. Hallucinations and a sense of separation from one’s body can occur. Physical effects include jitteriness, racing or slowed heart rate, chills, nausea, numbness and changes in coordination. Belladonna alkaloids can stimulate the heart and increase body temperature. At the point where hallucinations occur, the user is at or very near a life-threatening level. PCP can cause seizures, coma, or psychosis lasting several days. “Flashbacks” of the original hallucination can occur. Inhalants: Aimes Anesthetics (nitrous oxide, Whippets, halothane, ether) Bolt Bullets Climax Fuels (butane, propane, gasoline) Glues Locker Room

Nitrites (amyl, butyl) Paints Poppers Rush Snappers Solvents (benzene, toluene, methanol, chloroform, freon, coolants) Sprays

Nitrites can cause visual distortions and sedation occurs as the dose increases. Solvent use can cause disorientation and loss of muscle coordination. Long term effects can include depression, hallucinations and damage to the brain, heart, liver, lungs and kidneys. All solvent use can lead to overdose at increased doses.

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Marijuana: Blanche Bhang Charas (extracted plant resin) Dagga Ganga Grass Hash (hash oil) Hashish (tar) Herb

Marinol (dronabinol) Old Man Pot Reefer Sinsemilla Smoke (dried plant material) THC Weed

Drowsiness and sedation follow the initial effects of marijuana. Eating marijuana can lead to hallucinations. Because it takes a long time to eliminate THC from the body, a person’s cognitive function can be affected for a day or more after a single dose. Marijuana can impair judgement and coordination. The effects of marijuana on learning and memory can be long-lasting. Chronic marijuana smoking can lead to lung damage. Chronic usage can also lead to tolerance, dependence and withdrawal if stopped suddenly. Neuropathic Pain: Lyrica (pregabalin capsule oral, solution oral) Lyrica can lead to withdrawal symptoms upon discontinuation. It also produces euphoria, blurred vision, difficulty with attention and concentration and a “drunk or high” feeling in certain individuals. Opiates: Alfenta (alfentanyl solution injection) Belladonna & Opium (suppository rectal) Buprenorphine Bunavail (buprenorphine/naloxone film, buccal) Buprenex (buprenorphine injection solution) Butrans (buprenorphine transdermal patch) Suboxone (buprenorphine/naloxone film, sublingual)

Buprenorphine, Continued Subutex (buprenorphine sublingual tablet) Zubsolv (buprenorphine/naloxone tablet, sublingual) Stadol (butorphanol solution nasal & injection) Codeine Trezix (dihydrocodeine/ acetaminophen/ caffeine capsule oral) Tylenol #2, #3 or #4 (codeine/ acetaminophen tablet oral)

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Opiates, Continued: Codeine, continued Tylenol with Codeine (codeine/ acetaminophen solution & suspension oral) Fentanyl Abstral (fentanyl tablet sublingual) Actiq (fentanyl lozenge, transmucosal) Duragesic (fentanyl patch, transdermal) Fentora (fentanyl tablet buccal) Ionsys (fentanyl iontophoretic transdermal system) Lazanda (fentanyl intranasal spray) Onsolis (fentanyl film, buccal) Sublimaze (fentanyl solution injection) Subsys (fentanyl sublingual spray) Heroin (down, dreck, H, horse, smack, mojo, white lady, brown) Heroin & Cocaine (speedball)

Hydrocodone, continued Zohydro ER (hydrocodone capsule ER oral) Hydromorphone Dilaudid (hydromorphone tablet oral, solution oral & injection, suppository rectal) Exalgo (hydromorphone tablet ER oral) Levo-Dromoran (levorphanol tablet oral) Meperidine Demerol (meperidine tablet oral, solution, injection) Meperitab (meperidine tablet oral) Methadone Dolophine (methadone tablet oral) Methadose (methadone tablet oral) Methadose (methadone solution concentrate oral) Methadone Intensol (methadone solution concentrate oral) Metadol (methadone solution oral)

Hydrocodone Hysingla ER (hydrocodone tablet ER Morphine oral) Hycet (hydrocodone/acetaminophen Astramorph/PF (morphine solution solution oral) injection) Norco (hydrocodone/acetaminophen Avinza (morphine capsule ER oral) tablet oral) Verdrocet (hydrocodone/ Duramorph (morphine solution acetaminophen tablet oral) injection) Vicodin(hydrocodone/acetaminophen Embeda (morphine/naltrexone capsule tablet oral) CR oral) Vicodin ES (hydrocodone/ Infumorph (morphine solution injection) acetaminophen tablet oral) Vicodin HP (hydrocodone/ Kadian (morphine capsule ER oral) acetaminophen tablet oral) Xodol (hydrocodone/acetaminophen Morphine (solution concentrate oral) tablet oral)

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Opiates, Continued: Morphine, continued

Oxymorphone Opana (oxymorphone solution Morphine (solution intramuscular) injection) Morphine (solution intravenous) Opana (oxymorphone tablet oral) MS Contin (morphine tablet ER oral) Opana ER (oxymorphone tablet oral) Oramorph SR (morphine ) Opana ER (oxymorphone tablet oral) RMS (morphine suppository rectal) Pentazocine Talacen (pentazocine/acetaminophen Roxanol (morphine solution oral) tablet oral) Nubain (nalbuphine solution injection) Talwin (pentazocine solution injection) Opium (Chinese molasses, dreams, gong, Talwin NX (pentazocine/naloxone tablet O, skee, toys, zero) oral) Ultiva (remifentanul solution Oxycodone intravenous) Combunox (oxycodone/ibuprofen Sufenta (sufentanil solution intravenous) tablet oral) Endocet(oxycodone/acetaminophen Tapentadol tablet oral) Endodan (oxycodone/aspirin tablet Nucynta (tapentadol tablet) oral) Oxycodone (solution concentrate Nucynta ER (tapentadol tablet) oral) Oxycodone (solution oral) Tramadol Oxycontin (oxycodone ER tablet Active-Tramadol (cream external) oral) OxyIR (oxycodone capsule oral) ConZip (tramadol capsule ER oral) Percocet (oxycodone/ EnovaRX (tramadol cream external) acetaminophen tablet oral) Percodan (oxycodone/aspirin tablet Rybix (tramadol tablet orally oral) disintegrating) Primlev (oxycodone/acetaminophen Synapryn FusePaq (tramadol tablet oral) suspension oral) Roxicet (oxycodone/acetaminophen Ultram (tramadol tablet oral) solution oral) Roxicodone (oxycodone tablet oral) Ultram ER(tramadol tablet oral) Targiniq ER (oxycodone/naloxone tablet oral) Xartemis XR (oxycodone/ acetaminophen tablet oral)

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Opiates, Continued:

Opiate use causes decreased sensitivity to pain as well as slowed breathing, skin flushing, pinpoint pupils, drowsiness, nausea, vomiting and constipation. Overdose can be lethal as the opiate suppresses the respiratory system. Tolerance or drug dependence may result from extended use. Buprenorphine binds to mu receptors in the brain leading to a suppression of withdrawal and cravings and a feeling of euphoria. Opiates have the potential for drug dependency and abrupt cessation may precipitate withdrawal. Sedatives: Increased doses of sedatives can cause dizziness, vertigo, drowsiness, slurred speech and muscle incoordination. Learning is impaired and there is a loss of memory for events occurring while under the influence. Unexpected effects of sedatives include: anxiety, nightmares, hostility and rage. Overdose of sedatives can lead to suppression of breathing, heart failure and death. Tolerance and dependence develop after a few weeks or more of use. Sudden withdrawal can produce seizures. Sedatives: Analgesic, Anti-Migraine: Midrin (acetaminophen/ dichloralphenazone/isometheptene capsule oral) Migragesic (acetaminophen/ dichloralphenazone/ isometheptene capsule oral)

Nodolor (acetaminophen/ dichloralphenazone/ isometheptene capsule oral)

Dichloralphenazone is converted to chloral hydrate which is a sedative. Dependence can occur leading to headaches which occur more frequently and more severe than before. Sedatives: Antianxiety: Equanil (meprobamate tablet oral)

Quaalude, Sopor (methaqualone)

Tolerance, psychological and physical dependence and withdrawal can occur with prolonged use. Central nervous system depression can occur with routine use. Equanil can also cause heart arrhythmias, decreased blood pressure, dizziness and weakness.

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Sedatives: Barbiturates: Alagesic LQ (butalbital/acetaminophen/ caffeine liquid, oral) Ascomp with Codeine (butalbital/codeine/aspirin/caffeine capsule, oral) Brevital (Methohexital solution, reconstituted, injection) Bupap (butalbital/acetaminophen tablet, oral) Butisol (butabarbital elixir & tablet oral) Esgic (butalbital/acetaminophen/caffeine capsule, oral) Fioricet (butalbital/acetaminophen/ caffeine capsule, oral) Fioricet with Codeine (butalbital/codeine/acetaminophen/ caffeine capsule, oral) Margesic (butalbital/acetaminophen/ caffeine capsule, oral) Dolgic Plus (butalbital/acetaminophen/ caffeine tablet, oral)

Amytal (amobarbital solution, reconstituted, injection) Fiorinal (butalbital/aspirin/ caffeine capsule, oral) Fiorinal with Codeine (butalbital/codeine/aspirin/caffeine capsule, oral) Nembutal (pentobarbital solution, injection) Phrenilin Forte (butalbital/acetaminophen capsule, oral) Mysoline (primidone tablet oral) Phenobarbital (elixir oral, solution oral, solution injection, tablet oral) Seconal (secobarbital capsule oral) Zebutal (butalbital/acetaminophen/ caffeine capsule, oral)

Sedatives: Benzodiazepines: Alprazolam Intensol (alprazolam concentrate oral) Ativan (lorazepam solution injection, tablet oral) Dalmane (flurazepam capsule oral) Diazepam Intensol (concentrate oral) Diastat (diazepam gel rectal) Doral (quazepam tablet oral) Halcion (triazolam tablet oral) Klonopin (clonazepam tablet oral & tablet orally disintegrating) Limbitrol (chlordiazepoxide/amitriptyline tablet oral) Lorazepam Intensol (concentrate oral)

Niravam (alprazolam tablet orally disintegrating) Onfi (clobazam suspension oral & tablet oral) ProSom (estazolam tablet oral) Restoril (temazepam capsule oral) Rohypnol (flunitrazepam, roofies) Serax (oxazepam capsule oral) Tranxene-T (clorazepate tablet oral) Valium (diazepam solution injection, solution oral, tablet oral) Xanax (alprazolam tablet oral) Xanax XR (alprazolam tablet oral)

Benzodiazepines can cause amnesia at therapeutic doses.

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 Chapter 1 Class A – Avoid Completely

Chapter 1 Class A – Avoid Completely

10

Sedatives: Hypnotics (Sleep Medications): Ambien (zolpidem tablet oral) Ambien CR (zolpidem tablet CR oral) Belsomra (suvorexant tablet oral) Edular (zolpidem tablet sublingual) Intermezzo (zolpidem tablet sublingual)

Lunesta (eszopiclone tablet oral) Somnote (chloral hydrate capsule oral, syrup oral) Sonata (zaleplon capsule oral) Zolpimist (zolpidem solution oral spray)

Most drugs in this class act on a benzodiazepine receptor that induces sleep. These medications can cause amnesia for activities that occur during the time it is effective. These activities can include: sleep driving, sleep eating, sleep shopping, sleep sex, sleep e-mailing and criminal activity. Daytime drowsiness, dizziness, hallucinations and agitation can occur. Belsomra can cause temporary paralysis during early sleep and early wake cycles. Sedatives: Other Central Nervous System Depressants: GHB (G, gamma-hydroxybutyrate, everclear, Xyre GHB can be added to drinks to cause sedation leading to rape or sexual assault. After ingestion, a person begins to feel weak, dizzy, lightheaded or confused. Abuse is common in teenagers and young adults. Overdose can occur leading to death. Tolerance and withdrawal occur with regular use. Skeletal Muscle Relaxants: Soma (carisoprodol tablet oral) Soma Compound (carisoprodol/aspirin tablet oral)

Soma Compound with Codeine (codeine/carisoprodol/aspirin tablet oral) Also opiate

Soma can impair physical and mental abilities and has been rarely associated with seizures. Tolerance, dependence and withdrawal are common. Withdrawal can include: insomnia, vomiting, abdominal pain, headache, tremors, ataxia, hallucinations or psychosis.

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Chapter 1 Class A – Avoid Completely

Stimulants: Adderall (dextroamphetamine/amphetamine tablet) Adderall XR (dextroamphetamine/amphetamine capsule) Amphetamine (crank, bennies, uppers) Aptensio XR (methylphenidate capsule, oral) Cathinone Cocaine (coke, blow, candy, crack, jack, jimmy, rock, nose candy, whitecoat) Concerta ER (methylphenidate tablet, oral) Daytrana (methylphenidate patch transdermal) Dexedrine ER (dextroamphetamine capsule, oral) Dexedrine (dextroamphetamine tablet, oral) Evekeo (amphetamine table, oral) Focalin (dexmethylphenidate tablet, oral) Focalin XR (dexmethylphenidate capsule, oral) MDPV (bath salts, ivory wave, bliss, bubbles, meow meow, explosion, vanilla sky)

Mephedrone Metadate CD (methylphenidate capsule, oral) Metadate ER (methylphenidate tablet, oral) Methamphetamine (crystal meth, meth, crystal, ice) Methcathinone (cat, Khat, crank, goob) Methylin (methylphenidate solution oral & tablet chewable, oral) Methylone Nuvigil (armodafinil tablet, oral) Provigil (modafinil tablet, oral) Quillivant XR (methylphenidate suspension oral) Ritalin (methylphenidate tablet, oral) Ritalin LA (methylphenidate capsule, oral) Vyvanse (lisdexamfetamine capsule, oral)

Heart rate and blood pressure are increased at therapeutic doses of stimulants. High doses can cause adverse cardiac effects, stroke, hyperthermia, seizures and death. Repeated high doses over days to weeks can cause a state of hostility and paranoia, similar to paranoid schizophrenia. Bizarre, repetitive movements (picking at imaginary insects under the skin leading to wounds, repeated conversations and sexual activity) can become extreme. Long term effects depend on how the drug is administered and include: nasal ulcerations, bleeding in the lungs, stomach ulcers, atherosclerosis, damage to the heart muscle and difficulties with memory and decision making. Tolerance, dependence and withdrawal can occur.

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Chapter 2 Class B – Take Only with Your Doctor’s Chapter 2 Approval or Prescription

Class B – Take Only with Your Doctor’s Approval or Prescription

***NOTE: Read all labels on OTC products. Many come in different dosage forms such as: tablets, capsules, gel capsules, liquids, suspensions and powders. Some stores also carry their own generic formulation of brand name products. Many cough andcome cold in medications containforms more such than one ***NOTE: Read all labels on OTC products. Many different dosage as: product. tablets, Caution be used when more than cough and cold stores medication, changing and capsules,should gel capsules, liquids,taking suspensions andone powders. Some also carry their products own generic taking pain relievers addition to these products thiscold reason. Taking contain more than onethan product can put formulation of brand in name products. Many coughfor and medications more one product. you at risk of receiving recommended dailycough dosesand of medications. Tylenol (acetaminophen) is Caution should be usedhigher whenthan taking more than one cold medication, changing products and ataking common reliever found in tocombination products. pain pain relievers in addition these products for this***reason. Taking more than one product can put you at risk Although of receiving than recommended doses of medications. Tylenol (acetaminophen) is ***NOTE: thehigher medications listed below daily in the “Addiction Treatments” section are specifically aintended commontopain reliever in combination *** be taken forfound prevention of relapseproducts. for dependence upon one or more drugs, none of them are

habit-forming or addictive themselves,listed and should therefore be considered safe for recovering people to ***NOTE: Although the medications below in the “Addiction Treatments” section are specifically take. However, their for proper use in the context for of adependence recovery program requires monitoring by a of health intended to be taken prevention of relapse upon one or more drugs, none themcare are professional, and it is for this reason thatand weshould place them in Class B.*** habit-forming or addictive themselves, therefore be considered safe for recovering people to take. However, their proper use in the context of a recovery program requires monitoring by a health care Addiction Treatments: professional, and it is for this reason that we place them in Class B.*** Antabuse Treatments: (disulfiram) Revia (naltrexone) Addiction Campral (acamprosate) Symmetrel (amantadine) Antabuse (clonidine) (disulfiram) Revia (naltrexone) Catapres Vivitrol (naltrexone ER) Campral(varenicline) (acamprosate) Symmetrel (amantadine) Chantix Zyban (bupropion) Catapres (clonidine) Vivitrol (naltrexone ER) Naltrexone may precipitate intense withdrawal symptoms in patients addicted to opiates. Clonidine acts Chantix (varenicline) Zyban (bupropion) via autoreceptors in the locus coeruleus to suppress adrenergic hyperactivity that is involved in the expression theprecipitate opioid withdrawal syndrome. symptoms Disulfiram in is dangerous if takentowith alcohol.Clonidine Amantadine Naltrexone of may intense withdrawal patients addicted opiates. acts can cause decreased mental or to altered coordination. Chantix and Zyban medications to via autoreceptors in the locusalertness coeruleus suppress adrenergic hyperactivity that are is involved in the help with nicotine cigars,syndrome. chewing tobacco, snuff) addiction. if taken with alcohol. Amantadine expression of the (cigarettes, opioid withdrawal Disulfiram is dangerous can cause decreased mental alertness or altered coordination. Chantix and Zyban are medications to Anabolic Steroids(cigarettes, (Androgens): help with nicotine cigars, chewing tobacco, snuff) addiction. Fluoxymesterone Anabolic Steroids (Androgens): Androxy Fluoxymesterone Methyltestosterone Androxy Android Methyltestosterone Methitest Android Testred Methitest Oxandrolone Testred Oxandrin Oxandrolone Testosterone Oxandrin Androderm Testosterone AndroGel Androderm Aveed AndroGel Aveed

Testosterone, continued Axiron Testosterone, continued Depo-Testosterone Axiron First-Testosterone Depo-TestosteroneMC First-Testosterone First-Testosterone Fortesta First-Testosterone MC Natesto Fortesta Striant Natesto Testim Striant Testopel Testim Vogelxo Testopel Vogelxo

Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription  13 Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription  13

13 Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription 13 Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription Anabolic Steroids (Androgens), Continued: Anabolic Steroids (Androgens), Continued: “Anabolic steroids” is the familiar name for synthetic variants of the male sex hormone testosterone. “Anabolic” to the drugs promote muscle and male “steroid”sex refers to the “Anabolic steroids” is refers the familiar nameability for tosynthetic variantsgrowth of the hormone chemical structure. male hormones. steroids not refers take to effect testosterone. “Anabolic”Androgens refers to thearedrugs ability to promoteAnabolic muscle growth and do “steroid” the immediately. After several weeks ofare use,male some hormones. people experience an chemical structure. Androgens Anaboliceuphoria, steroidsincreased do notenergy take and effect increase in combativeness and competitiveness. Depression, fatigue, loss ofincreased appetite,energy insomnia immediately. After several weeks of use, some people experience euphoria, andand an headachesin can be seen when use of the anabolic steroid stops. High-doses and prolonged use and can increase combativeness andthecompetitiveness. Depression, fatigue, loss of appetite, insomnia lead to an can increase in when lipid levels attack, decreased libido, decreased headaches be seen the useinofthe the blood, anabolicheart steroid stops.stroke, High-doses and prolonged use can spermto production andinbreast men. The of certain anabolic steroidslibido, can lead to liver lead an increase lipid development levels in theinblood, heartuseattack, stroke, decreased decreased disease, liver cancer blood-filled cysts oninthe liver.The Physicians may prescribe anabolic can steroids sperm production andorbreast development men. use of certain anabolic steroids lead to men liver who haveliver inadequate no testosterone production. Anabolic steroids may also be used in women to disease, cancer ororblood-filled cysts on the liver. Physicians may prescribe anabolic steroids to men treat certain breast cancers, fibrocystic breast diseaseAnabolic and endometriosis. may alsoinbe used to in who have inadequate or no testosterone production. steroids may They also be used women certain peoplebreast for weight gainfibrocystic and to treat delayed puberty. All anabolic steroids usedalso as be above treat certain cancers, breast disease and endometriosis. They may usedare in considered Class B. Anabolic steroids be used to increase mass or are to certain people for weight gain and to treatshould delayednotpuberty. All anabolic steroidsmuscle used as above improve performance. There areshould many anabolic thatincrease are illegally produced in bootleg consideredathletic Class B. Anabolic steroids not be steroids used to muscle mass or to labs or underground and are marketed purpose. medications may have different names improve athletic performance. There for arethis many anabolicThese steroids that are illegally produced in bootleg whichorare not included thismarketed list. Anabolic dangerous if used this different way would be labs underground andinare for this steroids purpose. are These medications mayinhave names considered Class A. in this list. Anabolic steroids are dangerous if used in this way would be which are not included Antihistamines (Sedating): considered Class A. Antihistamines (Sedating): Atarax (hydroxyzine hydrochloride) Periactin (cyproheptadine) Benadryl Allergy (diphenhydramine) Polarmine (dexchlorpheniramine) Atarax (hydroxyzine hydrochloride) OTC Periactin (cyproheptadine) Chlorphen-12 (chlorpheniramine) OTCOTC Robitussin Nighttime Cough DM, Maximum Strength Benadryl Allergy (diphenhydramine) Polarmine (dexchlorpheniramine) (dextromethorphan/doxylamine) Chlorphen-12 (chlorpheniramine) OTC Robitussin Nighttime Cough DM,OTC Maximum Strength Chlor-Trimeton (chlorpheniramine) OTC Tavist (clemastine) OTC (dextromethorphan/doxylamine) OTC Coricidin HBP Cold & Flu Vicks Nyquil (dextromethorphan/ Chlor-Trimeton (chlorpheniramine) OTC TavistCough (clemastine) OTC (acetaminophen/chlorpheniramine) OTC doxylamine) Coricidin HBP Cold & Flu Vicks Cough OTC Nyquil (dextromethorphan/ Coricidin HBP Multi-Symptom Cold OTC Night (acetaminophen/chlorpheniramine) doxylamine) OTC (acetaminophen/chlorpheniramine/ Vistaril (hydroxyzine pamoate) Coricidin HBP Multi-Symptom Cold Night dextromethorphan) OTC (acetaminophen/chlorpheniramine/ Vistaril (hydroxyzine pamoate) Karbinal ER (carbinoxamine) dextromethorphan) OTC Karbinal ER (carbinoxamine) Sedating antihistamines should be used with caution because they have the potential to alter judgment and causeantihistamines drowsiness, grogginess, fatigue.because they have the potential to alter judgment Sedating should be dizziness used withorcaution and cause drowsiness, grogginess, dizziness or fatigue. Antitussives/Expectorants: Antitussives/Expectorants: Coricidin HBP Maximum Strength Flu Coricidin HBP Multi-Symptom Cold (acetaminophen/chlorpheniramine/ Nighttime(acetaminophen/ Coricidin HBP Maximum Strength Flu Coricidin HBP Multi-Symptom Cold dextromethorphan) OTC dextromethorphan/doxylamine) OTC (acetaminophen/chlorpheniramine/ Nighttime(acetaminophen/ Coricidin HBP ChestOTC Congestion & Cough Coricidin HBP Cough & Cold OTC dextromethorphan) dextromethorphan/doxylamine) (dextromethorphan/guaifenesin) (chlorpheniramine/dextromethorphan) OTC Coricidin HBP Chest CongestionOTC & Cough Coricidin HBP Cough & Cold (dextromethorphan/guaifenesin) OTC (chlorpheniramine/dextromethorphan) OTC

Coricidin HBP Multi-Symptom Cold Day Delsym Cough (dextromethorphan) OTC (dextromethorphan/guaifenesin) OTC Delsym Cough + Chest Congestion, DM, Max Diabetic Tussin DM 14  Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription Strength (dextromethorphan/guaifenesin) OTC (dextromethorphan/guaifenesin) OTC Mucinex DM & DM ER Vicks Cough DayQuil (dextromethorphan) OTC (dextromethorphan/guaifenesin) OTC Vicks NyQuil Mucinex Fast-Max DM Max,Chapter Cough2 &Class Chest B – Take Only with Your Doctor’s Approval or Prescription (acetaminophen/dextromethorphan/doxylamine) 14 Congestion (dextromethorphan/guaifenesin) OTC OTC Antitussives/Expectorants, Continued: Vicks NyQuil Cold & Flu Phenergan DM (dextromethorphan/promethazine) (acetaminophen/dextromethorphan/doxylamine) Coricidin HBP Multi-Symptom Cold Day OTC Cough (dextromethorphan) OTC Delsym (dextromethorphan/guaifenesin) OTC Robitussin Cough + Chest Congestion DM Vicks NyQuil Delsym Cough + Chest Congestion, DM, Max Diabetic TussinCough DM Regular and Maximum (dextromethorphan/doxylamine)OTC OTC Strength (dextromethorphan/guaifenesin) OTC (dextromethorphan/guaifenesin) Strength(dextromethorphan/guaifenesin) OTC Mucinex DM & DM ER Robitussin DM (dextromethorphan/guaifenesin) Vicks Cough DayQuil (dextromethorphan) OTC (dextromethorphan/guaifenesin) OTC OTC Vicks NyQuil Mucinex Fast-Max DM Max, Cough & Chest (acetaminophen/dextromethorphan/doxylamine) Perceptual distortions and a dissociative state can also be seen in those people taking large doses of Congestion (dextromethorphan/guaifenesin) OTC dextromethorphan, similar to symptoms as seen OTC in PCP and ketamine use. Toxic doses can cause Vicks high NyQuilblood Cold pressure & Flu confusion, disorientation, elevated body temperature, and nausea or vomiting. Phenergan DM (dextromethorphan/promethazine) Dextromethorphan mixed with decongestants can(acetaminophen/dextromethorphan/doxylamine) raise blood pressure. Dextromethorphan combined OTC toxicity. with chlorpheniramine can cause a serotonin syndrome-like Robitussin Cough + Chest Congestion DM Vicks NyQuil Cough Regular and Maximum Corticosteroids: (dextromethorphan/doxylamine) OTC Strength(dextromethorphan/guaifenesin) OTC Robitussin CortisoneDM (dextromethorphan/guaifenesin) Florinef (fludrocortisone) OTC Cortef (hydrocortisone) Medrol (methylprednisolone)

Decadron (dexamethasone) Orapred (prednisolone) Perceptual distortions and a dissociative state can also be seen in those people taking large doses of Deltasone (prednisone) dextromethorphan, similar to symptoms as seen in PCP and ketamine use. Toxic doses can cause confusion, disorientation, elevated body temperature, high blood pressure and nausea or vomiting. It is important to take corticosteroids exactly as directed. Corticosteroids are similar to cortisol, a hormone Dextromethorphan mixed with decongestants can raise blood pressure. Dextromethorphan combined naturally made by the adrenal glands. If corticosteroids are taken for more than a few weeks, cortisol with chlorpheniramine can cause a serotonin syndrome-like toxicity. production is decreased in the adrenal glands. Gradually tapering the dosage of the corticosteroid gives the adrenal glands time to resume normal function. Corticosteroids suppress the immune system and can Corticosteroids: cause insomnia, nervousness, cataracts and bone loss. Cortisone Cortef (hydrocortisone) Decadron (dexamethasone) Deltasone (prednisone)

Florinef (fludrocortisone) Medrol (methylprednisolone) Orapred (prednisolone)

It is important to take corticosteroids exactly as directed. Corticosteroids are similar to cortisol, a hormone naturally made by the adrenal glands. If corticosteroids are taken for more than a few weeks, cortisol production is decreased. Gradually tapering the dosage of the corticosteroid gives the adrenal glands time to resume normal function. Corticosteroids suppress the immune system and can cause insomnia, nervousness, cataracts and bone loss.

Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription  15

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Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription

Decongestants: Nasal Sprays: Neo-Synephrine Cold & Sinus Mild Strength (phenylephrine) OTC Afrin Original, Severe Congestion, Sinus, Extra Neo-Synephrine Cold & Sinus Regular Strength Moisturizing (oxymetazoline) OTC (phenylephrine) OTC Afrin Original, Maximum Strength (oxymetazoline) Neo-Synephrine Extra Strength OTC (phenylephrine) OTC Afrin Nasal Spray, Severe Congestion, Maximum Vicks QlearQuil (oxymetazoline) OTC Strength Plus Menthol (oxymetazoline) OTC Benzedrex Nasal Inhaler (propylhexamine) OTC Vicks Sinex (oxymetazoline) OTC Dristan (oxymetazoline) OTC Vicks Vapoinhaler (levmetamfetamine) OTC Zicam Intense Sinus Relief Nostrilla (oxymetazoline) OTC (oxymetazoline) OTC 4-Way (phenylephrine) OTC

Benzedrex has been used recreationally for its psychostimulant effects. Intranasal decongestants attach to receptors on the blood vessels in the nose. After the decongestant attaches to the receptors, the blood vessels constrict. This reduces inflammation and swelling. After a while, the cells realize the receptors are being overstimulated and remove some receptors to create balance. The decongestant then stops working. If an individual continues to use the decongestant, more is used to overcome this “tolerance”. When the individual stops using the decongestant, the few receptors left on the blood vessels of the nose are not enough and there is a huge rebound in the nasal congestion. For this reason, intranasal decongestants (oxymetazoline, phenylephrine) should be used for a maximum of 3 days. Decongestants (Many are cough, cold & flu combination products): Phenylephrine: Advil Allergy & Congestion Relief Alka Seltzer Plus Night Cold & Flu (acetaminophen/ (chlorpheniramine/ibuprofen/ phenylephrine) OTC dextromethorphan/doxylamine/phenylephrine) OTC Alka Seltzer Plus Severe Sinus Congestion Allergy Advil Sinus Congestion & Pain & Cough (acetaminophen/ dextromethorphan/ (ibuprofen/phenylephrine) OTC doxylamine/phenylephrine) OTC Alka Seltzer Plus Cold & Flu Severe Alka Seltzer Plus Day Multi-Symptom (acetaminophen/ chlorpheniramine/ (acetaminophen/ dextromethorphan/ dextromethorphan/phenylephrine) OTC phenylephrine) OTC Alka Seltzer Plus Severe Sinus Congestion & Alka Seltzer Plus Severe Sinus Congestion & Cough Night (acetaminophen/ dextromethorphan/ Cough Day (acetaminophen/ doxylamine/phenylephrine) OTC dextromethorphan/phenylephrine) OTC

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 Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription

Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription

Decongestants (Many are cough, cold & flu combination products): Phenylephrine, Continued: Alka Seltzer Plus Cold & Cough (aspirin/chlorpheniramine/ dextromethorphan/phenylephrine) OTC Alka Seltzer Plus Cold Night (aspirin/ chlorpheniramine/ doxylamine/phenylephrine) OTC Alka-Seltzer Plus Cold (aspirin/ chlorpheniramine/phenylephrine) OTC Allerest PE (chlorpheniramine/phenylephrine) OTC Benadryl Severe Allergy Plus Sinus Headache (acetaminophen/diphenhydramine/ phenylephrine) OTC Comtrex Cold & Cough Day (acetaminophen/dextromethorphan/ phenylephrine) OTC Comtrex Cold & Cough Night (acetaminophen/ chlorpheniramine/ dextromethorphan/ phenylephrine) OTC Contac Cold + Flu Night Maximum Strength (acetaminophen/chlorpheniramine/ phenylephrine) OTC Contac Cold + Flu Day Maximum Strength (acetaminophen/phenylephrine) OTC Delsym Cough + Cold Day Time (acetaminophen/dextromethorphan/guaifenesin/ phenylephrine) OTC Delsym Cough + Cold Nighttime (acetaminophen/diphenhydramine/ phenylephrine) OTC Dristan Cold (acetaminophen/chlorpheniramine/ phenylephrine) OTC Delsym Cough + Cold Nighttime (acetaminophen/diphenhydramine/ phenylephrine) OTC

Dristan Cold (acetaminophen/ chlorpheniramine/phenylephrine) OTC Mucinex Fast-Max Cold & Sinus (acetaminophen/guaifenesin/phenylephrine) OTC Mucinex Fast-Max Cold, Flu & Sore Throat (acetaminophen/dextromethorphan/ guaifenesin/phenylephrine) OTC Mucinex Fast-Max Day Time Severe Cold (acetaminophen/dextromethorphan/ phenylephrine) OTC Mucinex Sinus-Max Night (acetaminophen/ diphenhydramine/phenylephrine) OTC Mucinex Fast-Max Night Time Cold & Flu (acetaminophen/diphenhydramine/ phenylephrine) OTC Mucinex Fast-Max Severe Congestion & Cold, Multi-Symptom, Maximum Strength (dextromethorphan/guaifenesin/ phenylephrine) OTC Mucinex Fast-Max Severe Cold Multi-Symptom, Maximum Strength (acetaminophen/ dextromethorphan/ guaifenesin/ phenylephrine) OTC Mucinex Sinus-Max Day (acetaminophen/guaifenesin/phenylephrine) OTC Mucinex Sinus-Max Pressure & Pain (acetaminophen/guaifenesin/phenylephrine) OTC Mucinex Sinus-Max Severe Congestion Relief (acetaminophen/guaifenesin/phenylephrine) OTC Robitussin CF (dextromethorphan/ guaifenesin/phenylephrine) OTC Robitussin Peak Cold Multi-Symptom Cold, Maximum Strength, CF Max (dextromethorphan/ guaifenesin/phenylephrine) OTC

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Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription  17

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Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription

Decongestants (Many are cough, cold & flu combination products): Phenylephrine, Continued: Robitussin Peak Cold Multi-Symptom Cold, CF Nighttime (acetaminophen/ diphenhydramine/phenylephrine) OTC Sine Off (acetaminophen/ chlorpheniramine/phenylephrine) OTC Sudafed PE Pressure + Pain + Cold (acetaminophen/ dextromethorphan/ guaifenesin/phenylephrine) OTC Sudafed PE Severe Cold (acetaminophen/diphenhydramine/ phenylephrine) OTC Sudafed PE Sinus & Allergy (chlorpheniramine/phenylephrine) OTC Sudafed PE Cough & Cold (dextromethorphan/guaifenesin/ phenylephrine) OTC Sudafed PE (phenylephrine) OTC Sudafed PE Pressure + Pain + Cough (acetaminophen/dextromethorphan/ phenylephrine) OTC Sudafed PE Pressure + Pain + Mucus (acetaminophen/guaifenesin/phenylephrine) OTC Sudafed PE Triple Action (acetaminophen/guaifenesin/phenylephrine) OTC Sudafed PE Pressure + Pain (acetaminophen/phenylephrine) OTC Sudafed PE Pressure + Pain Maximum Strength (acetaminophen/phenylephrine) OTC Theraflu Multi-Symptom Severe Cold Nighttime (acetaminophen/diphenhydramine/ phenylephrine) OTC

TheraFlu Severe Cold & Cough Nighttime (acetaminophen/diphenhydramine/ phenylephrine) OTC Theraflu Multi-Symptom Severe Cold Nighttime (acetaminophen/diphenhydramine/ phenylephrine) OTC TheraFlu Severe Cold & Cough Nighttime (acetaminophen/diphenhydramine/ phenylephrine) OTC Theraflu Warming Relief Flu & Sore Throat (acetaminophen/diphenhydramine/ phenylephrine) OTC Theraflu Daytime (acetaminophen/dextromethorphan/ phenylephrine) OTC Theraflu ExpressMax Severe Cold & Cough Daytime (acetaminophen/dextromethorphan/ phenylephrine) OTC Theraflu Multi-Symptom Severe Cold (acetaminophen/dextromethorphan/ phenylephrine) OTC TheraFlu Severe Cold & Cough Daytime (acetaminophen/ dextromethorphan/ phenylephrine) OTC Theraflu ExpressMax Flu, Cough, & Sore Throat (acetaminophen/diphenhydramine/ phenylephrine) OTC Theraflu ExpressMax Severe Cold & Cough Nighttime (acetaminophen/diphenhydramine/ phenylephrine) OTC Tylenol Cold Head Congestion Severe (acetaminophen/ dextromethorphan/ guaifenesin/phenylephrine) OTC Tylenol Cold Multi-Symptom Night (acetaminophen/chlorpheniramine/ dextromethorphan/phenylephrine) OTC Tylenol Cold Multi-Symptom Severe (acetaminophen/dextromethorphan/ guaifenesin/phenylephrine) OTC

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 Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription

Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription

18

Decongestants (Many are cough, cold & flu combination products): Phenylephrine, Continued: Tylenol Cold Multi-Symptom Day (acetaminophen/dextromethorphan/ phenylephrine) OTC Tylenol Cold & Flu Severe (acetaminophen/ dextromethorphan/guaifenesin/ phenylephrine) OTC

Tylenol Sinus Congestion & Pain Nighttime (acetaminophen/chlorpheniramine/ phenylephrine) OTC Tylenol Sinus Congestion & Pain Daytime (acetaminophen/phenylephrine) OTC

Decongestants can raise blood pressure and should be used with caution because they are stimulating and can trigger relapse. Decongestants (Many are cough, cold & flu combination products): Pseudoephedrine: Advil Cold & Sinus (ibuprofen/pseudoephedrine) OTC Alavert-D 12 Hour Allergy & Sinus (loratadine/ pseudoephedrine) OTC Advil Allergy Sinus (chlorpheniramine/ibuprofen/pseudoephedrine) OTC Aleve-D Sinus & Cold (naproxen/ pseudoephedrine) OTC Aleve-D Sinus & Headache (naproxen/ pseudoephedrine) OTC Allegra-D 12 Hour Allergy & Congestion (fexofenadine/ pseudoephedrine) OTC Allegra-D 24 Hour Allergy & Congestion (fexofenadine/ pseudoephedrine) OTC Bromfed DM (brompheniramine/pseudoephedrine) OTC Mucinex D Original & Maximum Strength (guaifenesin/ pseudoephedrine) OTC

Nexafed Sinus Pressure + Pain (acetaminophen/pseudoephedrine) OTC Pseudo-Gest (pseudoephedrine) OTC Semprex-D (acrivastine/pseudoephedrine) Silfedrine (pseudoephedrine) OTC Sudafed (pseudoephedrine) OTC Sudafed 12 Hour (pseudoephedrine) OTC Sudafed 12 Hour Pressure + Pain (naproxen/pseudoephedrine) OTC Sudafed 24 Hour (pseudoephedrine) OTC

Gastrointestinal (Constipation): Dulcolax (bisacodyl) OTC Senokot-S (docusate sodium/sennosides) OTC

Senokot (sennosides) OTC

Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription  19

19

Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription

Gastrointestinal (Constipation), Continued: Frequent use of laxatives can cause the body to become deficient in potassium, sodium and magnesium. These deficiencies can result in electrolyte imbalances that can cause muscle pain, spasms, irregular heartbeat and possibly death. Laxative abuse can cause: laxative dependency; long term digestion problems; decreased immune response; dehydration and the inability of the individual to hold their bowels. Gastrointestinal (Nausea/Vomiting): Compazine (prochlorperazine) Phenergan (promethazine) Reglan (metoclopramide)

Tigan (trimethobenzamide) Zofran (ondansetron)

Compazine and Phenergan can cause altered heart rhythm, dystonia, hypotension and sedation. Tigan can cause central nervous system depression, dizziness, drowsiness and blurred vision. Reglan can cause tardive dyskinesia (abnormal muscle movements). These movements happen mostly in the face muscles and are not controllable. The movements may not go away even after stopping Reglan. Zofran can cause an abnormal heart beat and serotonin syndrome in combination with other medications. Skeletal Muscle Relaxants: Dantrolene (dantrium) Flexeril (cyclobenzaprine) Lioresal (baclofen) Norflex (orphenadrine)

Parafon Forte (chlorzoxazone) Robaxin (methocarbamol) Skelaxin (metaxalone) Zanaflex (tizanidine)

Muscle relaxants can cause heart arrhythmias and central nervous system depression (sedation, dizziness) which may impair physical or mental abilities. Serotonin syndrome can occur in combination with other medications. Sleep Aids: Advil PM (diphenhydramine/ibuprofen) OTC Aleve PM (diphenhydramine/naproxen) OTC Excedrin PM Headache (acetaminophen/ aspirin/diphenhydramine) OTC Nytol Quickcaps (diphenhydramine) OTC Simply Sleep (diphenhydramine) OTC

Sominex (diphenhydramine) OTC Tylenol PM Extra Strength (diphenhydramine/acetaminophen) OTC Unisom Sleepgels (diphenhydramine) OTC Unisom Sleeptabs (doxylamine) OTC Vicks ZzzQuil (diphenhydramine) OTC

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 Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription

Chapter 2 Class B – Take Only with Your Doctor’s Approval or Prescription

20

Sleep Aids, Continued: Sleep aids act in the central nervous system and can alter judgment and cause sedation. H1 antagonists suppress the wake promoter pathway and cause the person to become sleepy. After about three days, a person develops a tolerance to the drowsiness, therefore the sleep medication is not effective for more than a few days at a time if used for sleep. Vertigo/Motion Sickness Bonine (meclizine) OTC Dramamine (dimenhydrinate) OTC

Transderm Scop (scopolamine)

These medications affect the central nervous system and can cause dizziness, drowsiness, or blurred vision. Other: Asthmanefrin (racepinephrine) OTC Asthmanefrin in used to treat asthma and can cause nervousness, restlessness, sleeplessness, palpitations, tachycardia, chest pain, muscle tremors, dizziness and flushing.

Chapter 1 and 2 References: Kuhn, C; Swartzwelder, S; Wilson, W. (2014). BUZZED The Straight Facts About the Most Used and Abused Drugs from Alcohol to Ecstasy. New York, NY: W. W. Norton & Company.

 21

Chapter 3 A Partial List of Non-Prescription Chapter 3 and Prescription Alcohol-Free Products A Partial List of Non-Prescription and Prescription Products Alcohol is present in many over theAlcohol-Free counter and prescription liquid medications. Research shows that

even the smell of alcohol may be enough to trigger cravings and a subsequent relapse among certain Alcohol is present in many counter and prescription medications. Research that recovering individuals. Pleaseliquid noteover that the there is a variety of cough and cold preparations thatshows contain even theand smell of alcohol maycan be be enough to tablet triggerform cravings a subsequent relapse among certain alcohol medications which taken in will notand contain ethyl alcohol. When purchasing recovering individuals. When purchasing liquidthemedications the household, the label to be sure liquid medications for the household, check label to beforsure the productcheck is alcohol-free. When the product is alcohol-free. When receiving a prescription for a liquid medication, ask the pharmacist if the receiving a prescription for a liquid medication, ask the pharmacist if the medication is alcohol-free. The medicationlistisisalcohol-free. following list is a selection alcohol-free grouped by therapeutic following a selection ofThe alcohol-free products groupedofby therapeuticproducts category. Manufacturers are category. are listed each name. The list is not comprehensive. listed afterManufacturers each product name. Theafter list is not product comprehensive. Manufacturers change productManufacturers ingredients change product names frequently.are The the listto are and brand namesingredients frequently. and Thebrand following medications safe medications for recoveringonpeople take.safe Thefor cough, coldpeople and to allergy used medications with caution. See recovering take. medications The cough, should cold andbeallergy should be individual used with sections caution. on See antihistamines, antitussives and decongestants forand explanations. individual sections on antihistamines, antitussives decongestants for explanations. Product

Manufacturer

Analgesics Product

Manufacturer

Acetaminophen Infants drops lvax Analgesics Advil Children's suspension Wyeth Consumer Acetaminophen Infants drops lvax APAP elixir Bio-Pharm Advil Children's suspension Wyeth Consumer Genapap Children's elixir lvax APAP elixir Bio-Pharm Genapap Infant's drops lvax Genapap Children's elixir lvax Motrin Children's suspension McNeil Consumer Genapap Infant's drops lvax Motrin Infants' suspension McNeil Consumer Motrin Children's suspension McNeil Consumer Silapap Infant's drops Silarx Motrin suspension McNeil Consumer TylenolInfants' Children's suspension McNeil Consumer Silapap Infant's drops solution McNeil Consumer Silarx Tylenol Extra Strength Tylenol Children's suspension McNeil Consumer Tylenol Infants' suspension McNeil Consumer Tylenol solution McNeil Consumer Cough, Extra cold, Strength and allergy preparations Tylenol suspension AccuhistInfants' PDX Drops solution McNeil Consumer Pediamed Cough, Accuhistcold, PDX and syrupallergy preparations Pediamed Accuhist PDX syrup Drops solution Pediamed Allanhist PDX Allan Accuhist Pediamed AltarussinPDX DM syrup syrup Altaire Allanhist Allan Amerifed PDX liquidsyrup Ambi Altarussin DM syrup Altaire Amerifed DM liquid Ambi Amerifed liquid Ambi Anaplex DM syrup ECR Amerifed DM suspension liquid Ambi Anaplex DMX ECR Anaplex DM syrup ECR Andehist DM NR syrup Cypress Anaplex DMX suspension ECR Andehist DM NR syrup Cypress NR syrup Cypress Andehist NR syrup

Cypress

Product Manufacturer Cough, cold, and allergy preparations, Product Manufacturer continued Cough, cold, and allergy preparations, Aquatab DM syrup Adams continued Banophen elixir Major Aquatab syrup Adams Benadryl DM Allergy solution Pfizer Consumer Banophen Major Benadryl-Delixir Allergy & Sinus Johnson & Benadryl Allergy solution Pfizer Consumer Children's solution Johnson Consumer Benadryl-D Allergy & Sinus Johnson & Bromaline syrup Rugby Children's Johnson Consumer Bromaline solution DM elixir Rugby Bromaline syrup Rugby Bromatan-DM suspension Cypress Bromaline DM elixir Rugby Bromhist Pediatric solution Cypress Bromatan-DM suspension Cypress Bromhist-DM solution Cypress Bromhist Pediatric solution Cypress Bromhist-DM Pediatric syrup Cypress Bromhist-DM solution Cypress Bromhist-NR solution Cypress Bromhist-DM Cypress Bromhist-PDX Pediatric syrup syrup Cypress Bromhist-NR solution Cypress Bromphenex DM solution Breckenridge Bromhist-PDX syrup Cypress Bromplex DM solution Prasco Bromphenex solution Breckenridge Bromtuss DMDM solution Breckenridge Bromplex solution Prasco BroncotronDM liquid Seyer Pharmatec Bromtuss DM solution Breckenridge Broncotron-D suspension Seyer Pharmatec Broncotron liquid Seyer Pharmatec Carbofed DM syrup Hi-Tech Pharmacal Broncotron-D suspension Seyer Pharmatec Cardec solution Qualitest Carbofed DMsolution syrup Hi-Tech Pharmacal Cardec DM Qualitest Cardec solution Qualitest Children's Dimetapp Cold & Cardec DM solution Qualitest Allergy solution Wyeth Consumer Children's Dimetapp Cold & Allergy solution Wyeth Consumer

22

 Chapter 3 – A Partial List of Non-Prescription Alcohol-Free Products

Chapter 3 - A Partial List of Non-Prescription and Prescription Alcohol-Free Products

Product Manufacturer Cough, cold, and allergy preparations, continued Children's Dimetapp DM Cold & Wyeth Cough solution Consumer Children's Dimetapp Long Acting Wyeth Cough Plus Cold solution Consumer Children's Dimetapp Nighttime Wyeth Flu syrup Consumer Children's Mucinex syrup Adams Children's Mucinex Cold solution Adams Children's Mucinex Cough syrup Corfen DM solution Crantex syrup De-Chlor DM solution Dex PC syrup Diabetic Tussin solution

Adams Cypress Breckenridge Cypress Boca Pharmacal

Health Care Products

Diabetic Tussin Allergy Health Care Relief Liquid Products Diabetic Tussin Health Care Cough lozenges Products Diabetic Tussin Health Care DM liquid Products Diabetic Tussin Health Care DM solution Products Diabetic Tussin EX liquid Health Care Products Diabetic Tussin Night Time Health Care Formula solution Products Duratan DM suspension Proethic Duratuss DM solution Duratuss DM12 suspension Endacof DM solution Ganidin NR liquid Gani-Tuss NR liquid Genexpect-DM liquid Genexpect-PE liquid Hydramine elixir

Victory Victory Larken Cypress Cypress Pharm Generic Pharm Generic lvax

22

Product Manufacturer Cough, cold, and allergy preparations, continued Lodrane liquid ECR Lodrane D suspension ECR Lodrane XR suspension Lohist D syrup Lohist DM syrup Lortuss DM solution Motrin Cold Children's Suspension Nasop suspension Neotuss-D liquid A.G. Norel DM liquid Organidin NR liquid PediaCare Children's syrup PediaCare Cough + Cold Children's liquid PediaCare Decongestant & Cough liquid PediaCare Long-Acting Cough solution PediaCare Multi-Symptom Cold liquid Pediahist DM syrup Pedia-Relief liquid Phanatuss syrup Phanatuss DM Diabetic Choice syrup Q-Tussin liquid Q-Tussin PE liquid Quintex syrup Relacon-DM NR solution Rescon-DM liquid Rescon-GG liquid Robitussin Chest Congestion syrup

ECR Larken Larken Proethic McNeil Consumer Hawthorn Marin US Pharmaceutical Medpointe Johnson & Johnson Consumer Johnson & Johnson Consumer Johnson & Johnson Consumer Johnson & Johnson Consumer Johnson & Johnson Consumer Boca Pharmacal Major Pharmakon Pharmakon Qualitest Qualitest Qualitest Cypress Capellon Capellon Wyeth Consumer

Chapter 3 – A Partial List of Non-Prescription Alcohol-Free Products  23

23

Chapter 3 - A Partial List of Non-Prescription and Prescription Alcohol-Free Products

Product Manufacturer Cough, cold, and allergy preparations, continued Robitussin Cough & Allergy solution Wyeth Consumer Robitussin Cough & Cold CF syrup Wyeth Consumer Robitussin Cough & Congestion liquid Wyeth Consumer Robitussin Cough, Cold & Flu Nighttime solution Wyeth Consumer Robitussin Cough DM syrup Wyeth Consumer Robitussin DM syrup Wyeth Consumer Robitussin Head & Chest Congestion PE syrup Wyeth Consumer Robitussin PE syrup Wyeth Consumer Robitussin Pediatric Wyeth Cough syrup Consumer Robitussin Pediatric Cough Wyeth & Cold CF solution Consumer Robitussin Pediatric Cough & Wyeth Cold Long-Acting solution Consumer Robitussin Pediatric Wyeth Night Relief liquid Consumer Rondec solution

Biovail

Rondec DM drops

Biovail

Rondec DM solution

Biovail

Scot-Tussin Diabetes CF liquid

Scot-Tussin

Scot-Tussin DM solution

Scot-Tussin

Scot-Tussin Expectorant solution

Scot-Tussin

Scot-Tussin Original solution Scot-Tussin Scot-Tussin Senior solution Scot-Tussin Siladryl Allergy solution Silarx Sildec-DM syrup Silarx Sildec-PE solution Silarx Sildec PE-DM solution Silarx Simply Cough liquid McNeil Consumer

Product Manufacturer Cough, cold, and allergy preparations, continued Sudafed Children's solution

Pfizer

Sudafed Children's Cold & Cough solution

Pfizer

TriTuss solution

Everett

Tusdec-DM solution

Cypress

Tussi-Organidin DM NR solution Tussi-Organidin NR solution

Wallace Wallace

Tussi-Pres liquid

Kramer-Novis

Tussi-Pres Pediatric solution Tylenol Cold Children's Suspension Tylenol Cold Infants' drops

Kramer-Novis McNeil Consumer McNeil Consumer

Tusdec-DM solution

Cypress

Tussi-Organidin DM NR solution

Wallace

Tylenol Cold Plus Cough Children's suspension Tylenol Flu Children's suspension Tylenol Flu Night Time Max Strength liquid Tylenol Sinus Children's suspension Vazol solution Vicks Dayquil Multi-Symptom liquid Z-Cof 8 DM suspension Z-Cof 12 DM suspension Z-Cof DM solution Z-Cof DMX solution Z-Tuss DM syrup Z-Tuss Expectorant solution

McNeil Consumer McNeil Consumer McNeil Consumer McNeil Consumer Wraser Pharm Gamble Zyber Zyber Zyber Zyber Magna Magna

W

24

 Chapter 3 – A Partial List of Non-Prescription Alcohol-Free Products

Chapter 3 - A Partial List of Non-Prescription and Prescription Alcohol-Free Products

24

Product Manufacturer Product Manufacturer Ear, nose, and throat products Gastrointestinal agents, continued 4-Way Saline BristolLiqui-Doss liquid Ferndale Moisturizing Mist spray Myers Mylicon Infants' Johnson & Ayr Baby Saline spray B.F. Ascher suspension Johnson/Merck Gly-Oxide solution GlaxoSmithKline Topical products Listermint solution Johnson & Aloe Vesta 2-N-1 Johnson Consumer Antifungal ointment Convatec Dermatone Lips 'n Nasal Moist gel Blairex Face Protector ointment Dermatone Dermatone Moisturizing Orajel Baby liquid Del Sunblock cream Dermatone Orajel Baby Day & Night gel Del Dermatone Skin Protector cream Dermatone Orajel Baby Nighttime gel Del HandClens solution Woodward Neutrogena Acne Wash liquid Neutrogena Orajel Baby Nighttime Teething Pain Medicine gel Del Neutrogena Antiseptic liquid Neutrogena Neutrogena Antiseptic solution Neutrogena Orajel Baby Teething Pain Medicine liquid Del Neutrogena Clear Pore gel Neutrogena Tanac liquid Del Neutrogena T/Derm liquid Neutrogena Gastrointestinal agents Neutrogena Toner liquid Neutrogena Baby Gasz drops Lee Neutrogena Toner solution Neutrogena Kaopectate Advanced Pharmacia Sea Breeze Foaming Formula Suspension Consumer Face Wash gel Clairol Tiger Balm Arthritis Prince of Lodrane liquid ECR Rub lotion Peace Enterprises Lodrane D suspension ECR Vitamins, minerals, and supplements Lodrane XR suspension ECR Poly-Vi-Sol drops Mead Johnson

List of Alcohol-Free Products from: Gourley, D: Eoff, J. (2013). The APhA Complete Review for Pharmacy. 10th ed. American Pharmacists Association. Washington, DC: American Pharmacists Association.

 25

Chapter 4 - A Partial List of Non-Prescription and Prescription that Contain Alcohol Chapter 4 - A Partial Products List of Non-Prescription and Prescription Products that Do Contain Alcohol Below is a partial list of alcohol-containing products. All of these products should be avoided. Some nasal sprays used for allergic rhinitis and sinus congestion contain alcohol. Alcohol-containing nasal sprays that Below partial listbyofrecovering alcohol-containing All of these products should be avoided. Some nasal should isbea avoided persons products. include Flonase and Nasonex. The majority of mouthwashes sprays for allergic rhinitis and sinus congestion contain used alcohol. Remember to always check labels forcontain alcohol.alcohol. Alcohol-containing nasal sprays that should be avoided by recovering persons include Flonase and Nasonex. The majority of mouthwashes contain alcohol.Mouthwash Remember to always check labels for alcohol. Act Restoring Cepacol Antibacterial Anticavity, Icy Cool Vanilla McNeil PPC Mouthwash with Ceepryn 14% Combi Act Restoring Mouthwash Mint, Cinnamon and Mint Cepacol Antibacterial Denatured Anticavity, Icy Cool Vanilla 11% Water Alcohol McNeil PPC Mouthwash with Ceepryn 14% Combi Mint, Cinnamon andwith Mint Advanced Listerine Colgate Peroxyl Antiseptic Oral Denatured Colgate Oral 11% Alcohol TartarWater Protection Arctic Pfizer Cleanser Original & Refreshing Pharmaceuticals INC Advanced Listerine with Colgate Peroxyl Antiseptic Oral Mint 21.6% Water Alcohol Cool Mint 6% Ethyl Alcohol Colgate Oral Tartar Protection Arctic Pfizer Cleanser Original & Refreshing Brometane DX Syrup Pharmaceuticals INC Mint 21.6% Water Alcohol Hi Tech Cool Mint 6% Ethyl Alcohol (brompheniramine/ Ferrous Sulfate Elixir 5% Rugby Brometane DX Syrup pseudoephedrine/ Pharmacal (brompheniramine/ Hi Tech dextromethorphan) Ferrous Sulfate Elixir 5% Rugby pseudoephedrine/ Pharmacal Cepacol Antibacterial dextromethorphan) Mouthwash with Ceepryn Combi Hydroxyzine HCI Syrup 0.5% Hi Tech Pharmacal Cepacol Antibacterial 14% Denatured Mouthwash with Ceepryn Combi Hydroxyzine Syrup 0.5% Hi TechConsumer Pharmacal Chlorhexidine Oral Rinse Imodium A-DHCI Liquid McNeil Teva 14% 11.6%Denatured (loperamide) 0.5% Healthcare Chlorhexidine Oral Rinse Imodium A-D Liquid McNeil Consumer Cheracol D Maximum Teva 11.6% (loperamide) 0.5% Healthcare Strength Cough Formula Lee Listerine Whitening Rinse 8% Pfizer Cheracol D Maximum (dextromethorphan/ Pharmaceuticals Water Alcohol Strength Cough Formula Lee Listerine Whitening Rinse 8% guaifenesin) 4.75% Pfizer (dextromethorphan/ Act Restoring Mouthwash Pharmaceuticals Water Alcohol guaifenesin) Anticavity, Icy4.75% Cool Vanilla Listerine Antiseptic Cool Mint or McNeil PPC Pfizer Act Restoring Mouthwash Mint, Cinnamon and Mint Natural Citrus .095% Listerine Antiseptic Cool Mint or Anticavity, Icy Cool Vanilla 11% Water Alcohol Pfizer McNeil PPC Natural Citrus .095% Mint, Cinnamon andwith Mint Advanced Listerine Listerine Antiseptic 26.9% 11% Alcohol TartarWater Protection Arctic Pfizer Pfizer Water Alcohol Advanced Listerine with Mint 21.6% Water Alcohol Listerine Antiseptic 26.9% Pfizer Tartar Protection Arctic Pfizer Brometane DX Syrup Water Alcohol Mint 21.6% Water Alcohol Hi Tech (brompheniramine/ Metoclopramide Solution