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Dermatologists Say These Creams Can Remove Gnarly Fungus
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Athlete's Foot, Jock Itch, Ringworm—fungal infections go by many names but they all boil down to the same thing. Fungus is attracted to moisture, so areas of our bodies that tend to be a little damp are especially susceptible to fungus growth. Generally, our body's microbiome takes care of it, but when fungus gets out of hand, we can develop itchy, hot rashes, flaky, scaly skin and plaque buildup. Let's just say, it's never fun.
The answer, of course, is an anti-fungal cream. They work by attacking the fungus that's proliferating on your skin and thus relieving both the symptoms and cause of your rash. "On a microscopic level, antifungals work by interfering with essential processes needed for fungi to live," says dermatologist Joshua Zeichner, MD, Director of Cosmetic and Clinical Research in Dermatology at Mt. Sinai Hospital in New York City. "For example, some block production of the cell wall of the fungus." There are several different ingredients that different anti-fungal creams will use to treat the fungus, but the common thread is that they all prevent it from developing.
Best Anti-Fungal CreamsDepending on how your fungal infection is presenting itself and where on the body you're seeing it will inform what kind of anti-fungal cream you use. There are plenty out there on the market, so we asked Dr. Zeichner for his expert recommendations and then tested as many as we could get our hands on. These are the best and most effective.
What to Consider Active IngredientsSince anti-fungal creams are considered to be an over-the-counter drug, it's most important that they contain an FDA-approved ingredient for fighting fungus, advises Dr. Zeichner. These ingredients include clioquinol, haloprogin, miconazole nitrate, povidone-iodine, tolnaftate, and clotrimazole. Legally, in order to be considered an anti-fungal cream by the FDA, a product must contain one of these ingredients; if it doesn't, they aren't allowed to make anti-fungal claims. Always check the label—under FDA labeling guidelines, these active ingredients must be listed separately to make them easy to identify.
FormatUsually, you'll see anti-fungal products in cream format, but other things like sprays and powders also exist. Which one you choose is a personal choice and also depends on where you're using it. Often, things like sprays are slightly easier to apply because they are able to reach areas like your feet or back easily and don't need to be rubbed in as much. However, creams are more hydrating to the skin and you often don't need to apply as much to cover an infected area. We say when in doubt, go for a cream, but really, it's your choice.
How We SelectedFirst, we consulted expert dermatologist Joshua Zeichner, MD, Director of Cosmetic and Clinical Research in Dermatology at Mt. Sinai Hospital in New York City. After his expert recommendations, we tested as many anti-fungal creams (and other formats) as we could get our hands on to make sure what is presented on this list is the very best—and actually works.
Athelete's Foot Antifungal CreamThe active ingredient in Lamisil, terbinafine hydrochloride, is generally considered the most effective over-the-counter treatment for fungus issues, says Dr. Zeichner. And in our testing, we found that this easy-to-use, non-greasy cream really did zap our athlete's foot problems quickly. We saw improvement after just a couple of days and it was nearly cleared up entirely in about a week. The cream has nearly no scent to speak of and the small opening of the tube made it easy to apply to our feet without getting our hands too messy (though you still need to rub it in). Compared to other anti-fungal creams we tried, this one cleared up our issues the fastest.
The tube itself is fairly small (only one ounce) but it's okay because really, you don't need to apply much of this stuff to get the effects. In fact, you really want to be sparing. While the cream itself doesn't leave a greasy residue, applying too much can mean it takes a while to dry and you may find yourself rubbing it in for longer than you'd like. Also, whether you're using this on your feet or other areas of your body, you want to make sure it's fully dried before putting on clothes and socks to avoid unwanted moisture in the infected areas (remember, fungus loves moisture).
Read more: Best Foot Creams
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Athelete's Foot Antifungal Cream
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$30.00
Ultra Antifungal Jock Itch CreamWhile all the products on this list can technically treat jock itch (as well as athlete's foot, ringworm and other fungal rashes), we found that this one is especially good at treating jock itch. Not only does it contain the maximum amount of butenafine hydrochloride allowed for an over-the-counter cream, but the cream itself isn't too heavy or greasy. Applying it to the affected areas was easy and foolproof. It is a cream, so it requires a bit of rubbing into the skin, but we found that it sinks in fairly quickly and didn't leave a greasy or moist residue behind, which is especially welcome when treating jock itch, since putting clothes on top of still-wet lotion is not very fun.
Perhaps most important, however, is that it works quickly and effectively. In about the span of a week, we felt that our jock itch was almost completely gone with minimal redness, scaling and pretty much no itchiness. The directions note to apply once a day and while Dr. Zeichner advised to apply a cream twice a day, we stuck to the directions on this one. Even though we applied it once a day (at night, when we could be sure sweating in our groin area could be kept to a minimum), that stuff still worked just as well as other twice-a-day creams.
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Ultra Antifungal Jock Itch Cream
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$18.99
Antifungal CreamCompared to other products on this list, like Lamisil and Lotrimin, this rich cream containing miconazole nitrate immediately relieved itchiness from fungal infections quickest—we're talking almost immediately. But in the long run, those other completely cleared up fungus quicker than this one. That's not necessarily a bad thing, even though, of course, you want to get rid of your fungal infection. Part of what makes fungal infections so annoying is that constant itch, so if you find yourself constantly scratching and being driven crazy by itching, this is a great option for you.
Also, the cream itself is richer and more moisturizing than the other formulas on this list. That doesn't necessarily factor into the effectiveness (though, maybe it has something to do with the itch relief), but it absolutely helps to moisturize skin in addition to helping treat fungus. The base formula contains moisturizing and soothing ingredients like glycerin and aloe vera, which help to keep skin happy regardless of whether you have a rash or not. If you struggle with dry skin or just like a more moisturizing product, this is an ideal option.
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Antifungal Cream
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$21.99
Antifungal CreamThis well-loved anti-fungal cream contains tolnaftate, which attacks not only athlete's foot but other forms of fungal infection like ringworm and jock itch. The cream itself is smooth and easy to apply and dries quickly so it doesn't rub off onto your socks or other clothes. It also helps soothe itching and burning on contact—though not as quickly as McKesson's cream.
Even though this cream doesn't get rid of athlete's foot as quickly as Lamisil, what makes it so good for athlete's foot is the tolnaftate in the formula. Tolnaftate helps to curb fungus development, so it not only gets rid of any fungus that's already there, but it also helps prevent new fungus from growing. That's especially great news if you struggle with regular cases of athlete's foot that keeps coming back. When used regularly and as directed, it can help prevent new cases even after existing athlete's foot has been cleared up. That said, it may not be aggressive enough to treat very extreme cases of fungal infection (if that's the case, head to a dermatologist instead).
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Antifungal Cream
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$13.00
Anti-Fungal SprayThe downfall of many anti-fungal creams is their application. With a classic cream, you have to physically rub it into the affected area—like your feet or groin—with your hands. Hopefully, you're going to wash your hands after you apply it, but still the risk of cross-contamination is pretty high. Not to mention possible dexterity issues if you need to apply it to a hard-to-reach area. That problem is solved with this anti-fungal spray, which has the same active ingredients you find in an anti-fungal cream, but with the added convenience of spray application, so you don't need to use your hands to rub it in.
What we loved most about this spray, as compared to the more traditional anti-fungal creams on this list, is that it not only works—and works quickly—to treat athlete's foot, but it also deodorizes at the same time, leaving your feet smelling fresh even after a sweaty workout or long day on your feet. You really can't argue with the convenience of a spray, especially when treating an area like your feet. A quick spray between your toes is all it takes to squash the fungus that causes athlete's foot. Keep in mind that while you probably could use this on other areas, like your groin, it's really designed for your feet so when in doubt, keep it to that area.
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Anti-Fungal Spray
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$8.77
Why Use An Anti-Fungal Cream?"If you develop an itchy, red rash between the toes or in the groin, your knee-jerk reaction should be to think that it could be caused by a fungus," says Dr. Zeichner. Fungus grows in areas where there are lots of moisture, like your feet and groin, which are common areas for fungal infections—hence the names Athlete's Foot and Jock Itch. "Between the toes, the skin may turn white and soft and fall apart, leading to superficial erosions," he says. "In the groin, you may develop a red plaque with a border of scale (large, dry flakes)." Though these areas are most common, it's also possible to develop fungal infections on other parts of your body, which is called ringworm (not actually a worm). It looks like "a red scaly patch with a ring of scale around the border," he says. Treating these issues requires a product that's designed to attack fungus, which is where anti-fungal creams come in.
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How To Use An Anti-Fungal Cream?Apply the cream to the affected area twice daily, advises Dr. Zeichner. Typically these products work quickly, but "if a rash is not improving after twice-daily use of an antifungal cream for two weeks, you should visit your dermatologist to make sure that you get proper diagnosis and treatment," he says.
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Are Anti-Fungal Creams Safe?"Topical use of anti-fungal creams is very safe and effective," says Dr. Zeichner. They're generally well tolerated by almost everyone and have been shown to have very few adverse reactions. If you do have an adverse reaction, stop using it right away and head to your dermatologist.
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Meet The ExpertsJoshua Zeichner, MD, is a board-certified dermatologist in New York City. He is the associate professor and the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital.
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Go Easy On Medicated Lotions, Creams, Gels
Lidocaine, methyl salicylate, hydrocortisone. You probably don't think twice about using over-the-counter creams with these ingredients when you need to soothe a sore muscle or bug bite, prep your legs before hair removal, or combat that vaginal itch. If the product's available without a prescription, it can't hurt you, right? Wrong.
One study estimates that women apply 175 chemicals a day from cosmetics, creams, and toiletries alone.
Take Arielle Newman, for instance, a New York City-area high school track star who died last year from a sports-cream overdose. She'd used large amounts of popular OTC pain-relieving ointments like Icy Hot and Ben-Gay on her sore muscles. The key ingredient in such products is methyl salicylate, which built up in Newman's body, may have interacted with other aspirin-based meds she was using, and caused her to go into cardiac arrest.
Another case: In 2005, Shiri Berg, 22, of North Carolina died of a lidocaine overdose. Following the instructions she'd been given by the staff at a local hair-removal clinic, she generously applied a numbing gel to her legs, then covered them in plastic wrap. On her way to the clinic to get hair lasered from her legs, Berg passed out. She went into convulsions, then a coma. Eight days later, she was dead.
Women dying in the name of hair removal? Athletes putting themselves at risk by using mentholated muscle soothers? Extreme situations, to be sure. But with all the stuff each of us slathers on our skin (one study estimates that women apply 175 chemicals a day from cosmetics, creams, and toiletries alone), it's no surprise that potential hazards are lurking.
Your skin is designed to protect you from countless insults: from air pollution to murky lake water, from dirty gasoline-pump handles to staph. Skin cells provide a physical barrier, sort of like bricks and mortar, to keep the bad stuff out -- most of the time, says Francesca J. Fusco, M.D., assistant clinical professor of dermatology at the Mount Sinai School of Medicine. "The cells aren't as tightly packed as real bricks, though, which means things can squeeze by and pentrate." That's good news if you want, say, an antiaging wrinkle cream to wage war against your crow's feet or an anti-itch product to tackle that exercise-induced rash on your inner thighs. Bad news when strong chemicals meet sensitive or thin skin, cause an allergic reaction, or dangerously flood your bloodstream.
Here, we investigate 14 ingredients commonly found in products you may be using right now -- and we tell you how to stay safe.
Methyl salicylate
Most OTC muscle creams (including Ben-Gay, Icy Hot, and Tiger Balm) contain one or more of three main ingredients: the cooling agents menthol and camphor, and the pain reliever methyl salicylate. The last one is similar to topical aspirin, says Matt Zirwas, M.D., director of The Ohio State University Medical Center Contact Dermatitis Center. And what happened to track-star Newman is essentially the same thing that could happen with an aspirin overdose, he says.
The safe way to use muscle creams? Rub a small amount (about the size of a quarter) into the painful muscle or joint area not more than three or four times a day to prevent accumulation. If you're applying more than a four-ounce tube a week, that's probably too much, Zirwas says. And watch your aspirin intake -- too much can increase your risk of overdose (in addition to the creams, Newman may have been using a pain-relieving patch and taking aspirin), as can wrapping or using a heating pad on ointment-covered skin.
Rubs with methyl salicylate may also interact with blood-thinning prescription drugs, such as Plavix or Coumadin, used to prevent blood from clotting, says Brian J. Krabak, M.D., sports-medicine physician at the University of Washington's department of rehabilitation medicine. Because of its toxicity, any product containing 5 percent or more of methyl salicylate (also called wintergreen oil) has to carry a warning label stating it must be used as directed and kept out of children's reach.
Lidocaine, benzocaine, tetracaine
If you've ever numbed a mole before the doc removed it or undergone laser hair removal, you've probably used a topical anesthetic that contains one of the "caines" -- lidocaine, benzocaine, or tetracaine -- which are commonly used in various strengths in medical and cosmetic situations. Most OTC types contain small amounts (less than 5 percent) of numbing ingredients and should be safe when used according to package instructions, experts say.
There are dangers, however, if your skin is too numb to detect that it's being harmed. If you have no feeling at all during a bikini wax or hair lasering, for instance, you won't be able to tell whether the wax is too hot or the laser is too strong.
An allergy is also possible, particularly when using vaginal-itch treatments with benzocaine, Zirwas says. A benzocaine product may temporarily help the problem, he says, "but a half-hour or an hour later, the itching will return -- often worse -- so women apply more cream," he says. "Sometimes we see patients who are using these creams 10 times a day." The results can be a severe vaginal rash. Zirwas' advice: "If the itch comes back an hour after you apply the cream or if you develop a rash, suspect that you have a benzocaine allergy and see a doctor."
When topical anesthetics are seriously overused, there can be big trouble. Shiri Berg applied a product called Lasergel Plus 10/10, a powerful anesthetic containing 10 percent lidocaine and 10 percent tetracaine. Experts have said the gel, a prescription-strength compound given to the 22-year-old without a prescription by a hair-removal spa, was too strong and applied over too large an area for Berg's system to handle. After her death, the Food and Drug Administration pointed out that risks rise when a topical anesthetic is left on the skin for extended periods of time or applied to broad portions of the body, especially if a bandage, plastic, or another type of dressing is used as a covering. This is exactly what Berg did, not knowing either the strength of the product she was using or that there was any danger. Even more surprising: Berg was not the first woman to die from the overzealous use of numbing cream. Blanca Bolanos, a 25-year-old from Tucson, Arizona, suffered a similar fate (convulsions, then a two-year coma ending in death) after using a cream of 6 percent each lidocaine and tetracaine prior to laser hair removal.
The safe way to use numbing creams? Apply them sparingly -- use as little as possible, most experts say. And always know the ingredients in and the strength of the product. Click here for tips on correctly applying creams.
Hydrocortisone
An anti-inflammatory topical steroid that shrinks swollen tissue by constricting blood vessels, hydrocortisone is often used to stop the itching caused by chronic skin conditions like eczema and contact dermatitis, and it's also an ingredient in vaginal and hemorrhoidal creams. OTC topical steroids can contain just 1 percent hydrocortisone, which should be safe, says Dina D. Strachan, M.D., a dermatologist in private practice in New York City.
Be careful, though, when applying the creams to sensitive spots such as the eyelids, armpits, and groin (all places where eczema, rashes, and allergic reactions are particularly common). In these locations, skin is thinner and more folds exist, so skin hits skin often, which can cause medications to penetrate more deeply. These areas are also prone to stretch marks, irritation, hypopigmentation (lightening), and "a crinkly, cigarette-paper appearance," Strachan explains -- a good reason to avoid that old beauty-queen trick of using hemorrhoidal cream to de-puff eye bags, experts say. In fact, last year the makers of Preparation H issued a warning cautioning consumers to avoid applying hemorrhoid cream to the face. Health.Com: The year's best beauty products
Overuse of topical steroids containing hydrocortisone can cause the skin to develop a resistance (called tachyplaxis) to the medication, says Daniel Behroozan, M.D., dermatologic surgeon and founder of the Dermatology Institute of Southern California, and clinical instructor at the University of California, Los Angeles, School of Medicine. As a result, "in order to have the desired medical effect, a stronger and more potent steroid may be needed, which may cause more potential side effects."
Estrogen
Women experiencing vaginal itching and irritation due to menopausal changes sometimes turn to OTC products that contain estrogen, a practice that worries Wen Shen, M.D., assistant professor of gynecologic specialties at the Johns Hopkins University School of Medicine. "Such creams get absorbed through the skin and metabolized into estrogens in the body. That means they can cause the same side effects as estrogen pills, such as elevated blood pressure, breast tenderness, increased risk of breast cancer, abnormal vaginal bleeding, and endometrial hyperplasia, which can lead to uterine cancer," she says. "If a woman is thinking about using anything with estrogen, she really needs to get it through her physician."
The same goes for OTC progesterone creams used to treat PMS and menopause symptoms, says Michael Krychman, M.D., medical director of sexual medicine at Hoag Hospital in Newport Beach, California. "You have to be very careful. You don't always know how much you're getting or how much you're absorbing with these products," he says. "That makes it very easy to get too much." A lot of women who are trying these OTC creams on their own may not even have lowered hormone levels, at all, he says. Consult your doctor before using.
Hydroquinone
Want to "fade away" those age spots? Be careful if you're thinking of using hydroquinone, a popular ingredient in products claiming to lighten age spots, melasma (excessive pigmentation usually caused by the sun), or postinflammatory hyperpigmentation (a condition that can afflict darker-skinned women). Such products are often available over the counter but should be used only under a doctor's supervision, Francesca J. Fusco, M.D., says. Ironically, in certain skin types the opposite -- ochronosis, or darkening of the skin -- can occur. In many cases, this happens in darker-skinned individuals, she says, adding that hydroquinone has been under FDA investigation for discontinuation in OTC products because of possible cancer-causing activity in rats exposed to large amounts. Health.Com: How I beat hypochondria
Dihydroxyacetone (DHA)
Wonder why self-tanners have such a distinctive scent? It's the dihydroxyacetone (DHA), a sugar derived from plants like beets and sugarcane, that combines with your body's chemistry to produce a "tan" and the smell. The odor won't hurt you, but the tan might -- if you're thinking of getting hair lasered from your darkened skin.
"Lasers work by detecting pigment," Fusco says. That's why laser hair removal works best on people with a good degree of contrast between their hair and skin, such as fair-skinned women with dark hair. "The stains in self-tanners can throw off the laser, leaving you with first- or second-degree burns or discolored skin," she explains. As a caution, allow self-tanned skin about a week to fade before going in for a laser procedure.
Vitamin A, glycolic acid
Retin-A and other vitamin A-based products (such as glycolic acid) are often used to treat acne, as well as to reduce the appearance of wrinkles by boosting collagen production. The downside: They thin the very top layer of skin, which can make you more sensitive to sunlight and to procedures like chemical peels, phototherapy (light treatments), or even a simple eyebrow waxing. If you're scheduled for, say, a waxing or a peel, it's a good idea to stop using any vitamin A-based products one week prior; and don't resume for another week. Also, avoid blackhead-removing strips, which can remove a top layer of skin more easily while on such medications. And check in with your doctor to be on the safe side.
Neomycin, bacitracin
Strangely, one of the treatments most often recommended to help heal burns, stitches, and other wounds is now thought to cause an allergic reaction in up to 10 percent of users. For those people, neomycin or bacitracin, the active ingredients in products like Neosporin, may cause an inflammatory reaction, angering the wound and making it appear infected. The result: A minor cut can take even longer to heal and have a potentially adverse cosmetic outcome, Behroozan says. "For that reason, most dermatologists are now avoiding products with neomycin and recommending plain Vaseline or Aquaphor Healing Ointment for superficial wounds," he says. "They promote a moist environment for better wound-healing without potentially causing allergic contact dermatitis."
Paraphenylenediamine (PPD)
Ever get a temporary tattoo on a beach vacation? Many of them are made with "black henna," which contains paraphenylenediamine, or PPD, a strong allergen that's also in hair dye. If you've had a product with this chemical applied to your skin directly, as is done with a tattoo, you're at risk of developing a strong allergy later from hair dye. "You can have a horribly intense reaction," Zirwas says. "I've seen people hospitalized for up to a week -- eyes swollen shut, lips swollen, too." Zirwas estimates that just 2 percent of women will develop an allergy to hair dye, but everyone should do a patch test when coloring hair at home and look for PPD-free dyes.
Betaine
Very gentle shampoos often contain a lathering agent called betaine, and they're fine for about 99 percent of the U.S. Population. But for the approximately 1 percent who develop a betaine allergy, even a product created for the most sensitive skins can cause a red rash around the eyes and along the neck, with flaking, peeling, and itching. If you have this kind of contact dermatitis that just won't go away, try betaine-free products such as Free & Clear shampoo, Cetaphil soap, or Head & Shoulders shampoo, Zirwas says. E-mail to a friend
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Copyright Health Magazine 2009
Additional reporting by Allison Avery and Brittani Tingle
Benadryl Dosage
Benadryl (diphenhydramine) is a brand-name drug used for allergies, allergic reactions, and itching. Benadryl comes in several forms that are available over the counter. The dosage can vary depending on your age and the form you use.
Benadryl belongs to a drug class called first-generation antihistamines. Benadryl is available in generic versions.
Keep reading for specific information about the dosage of Benadryl, including its strengths and how to take the medication. For a comprehensive look at Benadryl, see this article.
Note:This article describes typical dosages for Benadryl provided by the drug's manufacturer. When taking Benadryl, always follow the dosage instructions on the product labeling.
The information below describes Benadryl's typical dosages and other details about the drug.
Benadryl formsBenadryl comes in the following oral forms:
Benadryl comes in topical forms that you apply to your skin. These include:
Benadryl strengthsThe chart below lists the available strengths for different forms of Benadryl, all of which contain the active ingredient diphenhydramine:
* Note that this table is not an exhaustive list of Benadryl products or combination products. Besides diphenhydramine, these topical forms of Benadryl also contain a second active ingredient called zinc acetate. It's a skin protectant. Talk with your pharmacist or read the specific product label for more details.
Typical dosagesThe following information describes dosages that are commonly used or recommended. However, be sure to take the dosage recommended by your doctor or as directed on the product label.
Oral forms of Benadryl may be used to treat allergies or allergic reactions.
For adults, the recommended oral dose of Benadryl is 25 to 50 mg. You'll take this dose every 4 to 6 hours. The maximum amount is 6 doses in 24 hours.
Topical forms of Benadryl are used to temporarily relieve skin itching and related discomforts due to rashes or insect bites. You'll apply the product to the affected area(s) of your skin 3 to 4 times per day.
For more information about your specific dosage, talk with your doctor or pharmacist.
Children's dosageOral forms of Benadryl are approved to treat allergies or allergic reactions in kids age 6 years and older.
For children, the recommended oral dose of Benadryl is based on age, as follows:
They'll take this dose every 4 to 6 hours. The maximum amount is 6 doses in 24 hours.
Children age 2 to 5 years old should not be given oral forms of Benadryl unless their doctor specifically recommends it. In this situation, the dosage may be based on your child's weight and is calculated by your child's doctor.
Topical forms of Benadryl are approved for use in children age 2 years and older to temporarily relieve skin itching and related discomforts due to causes such as rashes or insect bites.
If you have questions about the dosage of Benadryl for kids, talk with your pharmacist or your child's doctor.
How to use BenadrylBenadryl is an over-the-counter (OTC) medication. All OTC medications have a product label that includes information on how to take or use the medication. Be sure to read all of the directions before using.
Benadryl comes in several oral forms that you take by mouth. You may take oral forms of Benadryl with or without food. If you or your child has trouble swallowing pills, Benadryl also comes in a chewable tablet and an oral liquid solution. You can also check out this article for tips on how to swallow pills.
Topical forms of Benadryl are applied to the affected area(s) of the skin. They're meant for external use only.
If you have questions about the directions on the product label, ask your doctor or pharmacist.
Long-term treatmentBenadryl may be used as a short-term or long-term treatment. For example, you might use it short term to treat an allergic reaction. Some people use it long term for allergies.
If you have questions about how long you can safely take Benadryl, talk with your doctor or pharmacist.
It's important that you don't take more Benadryl than shown on the product's label directions. For some medications, taking more than the recommended amount may lead to harmful effects or overdose.
If you take more than the recommended amount of BenadrylCall your doctor right away if you believe you've taken too much Benadryl. Another option is to call America's Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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