![]() Talk with your healthcare provider if aspirin is right for you.Īspirin can increase the risk of stomach bleeding.ĭigoxin is used to treat heart failure and irregular heartbeats.If you HAVE had heart problems or stroke, aspirin is usually recommended to prevent future heart problems or strokes.If you have NEVER had heart problems or a stroke, the harms of aspirin can outweigh its benefits.Used to prevent heart attacks and strokes. USE WITH CAUTION Aspirin (For certain people - see below) They can also increase blood pressure, affect your kidneys, and make heart failure worse. Also use special caution if you have kidney problems or heart failure.Those at higher risk include people more than 75 years old, people taking oral steroids, and people taking a blood-thinning medication such as apixaban (Eliquis), aspirin, clopidogrel (Plavix), dabigatran (Pradaxa), edoxaban (Savaysa), rivaroxaban (Xarelto), or warfarin (Coumadin). Use special caution if you are at higher risk of developing bleeding stomach ulcers.When good alternatives are not available and NSAIDs are necessary, use a proton pump inhibitor such as omeprazole (Prilosec) or misoprostol (Cytotec) to reduce bleeding risk.NSAIDs are used to reduce pain and inflammation. USE WITH CAUTION NonSteroidal Anti-Inflammatory Drugs (NSAIDs) ![]() Do not stop taking any medication without first talking to your healthcare provider. (Suvorexant, zaleplon and ramelteon are not currently available in Canada, but zaleplon is available through compounding pharmacies.) Trazodone, melatonin, tryptophan, tiagabine and valerian are not recommended for treating insomnia ( Sateia et al., 2017).Īll of the newest hypnotics (eszopiclone, ramelteon, zaleplon, zolpidem) have been shown to be safe and effective in older adults.If you are taking any of these medications, talk to your healthcare provider or pharmacist. Some sedating agents have the potential for physical or psychological dependence and there are limited studies on the effects of long-term hypnotic use.Īccording to the most recent American Academy of Sleep Medicine clinical practice guidelines, the following medications can be used to treat insomnia: suvorexant, eszopiclone, zaleplon, zolpidem, temazepam, ramelteon and doxepin. Sleep-promoting agents (hypnotics or sedatives) are generally recommended for short-term treatment of insomnia if CBT is not available or accepted by the patient. Use with caution in children and in patients with lung diseaseĬaution with renal impairment and alcohol use Temazepam (Restoril): Benzodiazepine (GABA agonist) Cognitive Behavioural Therapy: An information guide for families.Psychiatry in Primary Care: A Concise Canadian Pocket Guide 2019.The efficacy of hypnotics is comparable to that of CBT-I for the acute treatment of insomnia however, the effects dissipate after the hypnotic is discontinued, whereas improvements made through CBT-I are maintained after the patient completes treatment. Consider pharmacotherapy for chronic insomnia when CBT-I is not available, when treatment was not effective or when the patient prefers pharmacotherapy.Įvidence suggests that insomnia with objective short sleep duration has primarily biological roots (e.g., genetics and physiological hyperarousal) and may respond better to biological treatments, whereas insomnia with objective normal sleep duration has primarily psychological roots and may respond better to psychological interventions alone (CBT techniques). Pharmacotherapyįor pharmacotherapies used in Canada to treat sleep disorders, see table below. Goolam Hussain and Colin Shapiro (CAMH, 2019). ![]() Text adapted from: "The adult patient with a sleep disorder," in Psychiatry in primary care by Dora Zalai, M.R. ![]()
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