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INFORMATION FOR PATIENTS Ambien CR* 6 MpMew tartrate extended-release tablets) iwwiMTiaHHH wmensnimr imunoi Your doctor has prescribed Ambwn CR to help vou sleep The bl owing infor mation is intended to guide vou in the safe use of this medic-ne It is not meant to take the pface of your doctor's instructions. If you have am questions about Ambien CR tablets be sure to ask vour doctor or pharmacist. Ambien CR is used to treat different hues of steep problems, such as. • trouble tailing asleep • waking up often dunng the night Some people may have more than one ol these problems Ambien CR belong, to a group of medicines known as the 'sedative/ hypnotics' or simpK. sleep medicines. There are mam different sleep medicines mailable to help people sleep better Sleep problems are usualh temporary, lequmng treatment for only a short time, usualh 1 or 2 davs up to 1 or 2 weeks Some people have chronic seep problems that mas require more prolonged use of sleep medicine However, you should not use these medicines for long periods without talking with vour doctor about the risks and benefits of prolonged use MXffKCTS Most common side effects: • headache • somnolence sleepiness • dimness You may find that these medicines make vou sleepy dunng the dav How drowsy vou feel depends upon how your bodv reacts to the medicine, whuh sleep medicine you are taking, and how large a dose vour doctor has prescribed Davtime drowsiness is best avoided by taking the lowest dose possible that will still help you sleep at night Your doctor will work with vou to find the dose of Ambien CR that is best for vou. To manage these side effects while vou are taking this medicine: • tt hen vou first start taking Ambien CR or anv other sleep mode me until vou know whether the medicine will still have some carry over ehect in you the nett day. use extreme care while doing anvthmg that requires complete alertness, such as driving a car operating machinery or pilot ng an aircraft • NEVER drink alcohol while you are being treated with Amtnen CR or any sleep medicine Aicoboi can increase the s.de effects of Amijien CR or anv other sleep medicine. • Do not take anv other medicines without asking vour doctor first This includes medicines vou can buy without a prescription Some medicines can cause drowsiness and are best avoided while taking Ambien CR. • Alwavs take the exact dose of Ambien CR prescribed by vour doctor Never change your dose without talking to vour doctor first SfECML CONCERNS There are some special problems that may occur while taking sleep medicines. “Sleep-Onving" and other complex behaviors: "here have been reports of people getting out ol bed after taking a sleep medicine and driving their cars while not fully awake, often with no memory of the event If you experi ence such an event, it should be reported to your doctor immediately, since 'sleep-driving' can be dangerous This behavior is more likely to occur when Ambien CR is taken with alcohol or other drugs such as those for the treatment of depression or anxiety Other complex behaviors such as arepanng and eating food, making phone calls, or having sex have been reported in people who are not fully awake after taking a sleep medicine As with 'sleep-driving', people usually do not remember these events Memory problems: Sleep medicines may cause a special type of memory loss or 'amnesia" When this occurs, a person may not remember what has happened for several hours after taking the medicine This is usually not a problem vnee most people fall asleep after taking the medicine Memory loss can be a problem however, when sleep medicines are taken while traveling, such as during an airplane flight and the pe'son wakes up before the effort of the medicine is gone This has been called 'travelers amnesia' 8c sure to talk to vour doctor if vou think vou are having memory problems Although memory problems are not very common while taking Ambien CR. in most instances, they can be avoided if vou take Ambien CR onh- when you are able to get a full night's sleep 7 to 8 hours before you need to l>e active again Tolerance: When sleep medicines are used every night for more than a few weeks they mav lose tlieir effectiveness to help vou sleep This is known as ‘tolerance' Sleep medic ines should, in most cases, be used only for short periods of time, such as 1 or 2 davs and generally no longer than 1 or 2 weeks. If vour sleep problems continue consult vour doctor who will determine whether other measures are needed to overcome vour sleep problems Dependence: sleep medicines can cause dependence, especially when these medicines arc used regularly for longer than a few weeks ot at high doses Some people develop a need to continue taking their medicines this is known as dependence or 'addiction' When people develop dependence they mav have difficulty stopping the sleep medicine. If the medicine is suddenly stopped, the boev is not able to function normally and unpleasant symptoms mav occur see Withdniwal). Thev mav find that thev have to keep taking the medicine cither at the prescribed dose or at increasing doses )usl to avoid withdrawal symptoms. All people taking sleep medicines have some risk of becoming dependent on the medicine However, people who have been dependent on alcohol or other drugs in the past may have a higher rhance of becoming addicted to sleep med Kines This possibility must be considered before using rbese medicines for more than a few weeks If you have been addicted to alcohol or drugs in the past, it is important to tell your doctor beforp starting Ambien CR or anv skrp medicine Copyright, sanofi-aventrs I S. LIC 2007 AMB-APRO7 IFP-Ab /4MBENCR' RELEASE USfllfn Withdrawal: Withdrawal symptoms mav occur when sleep medicines are stopped suddenly after being used daily for a long time In some cases, these symptoms can occur even if the medicine has been used for only a week or two In mild cases, withdrawal symptoms mav include unpleasant feelings In more severe cases, abdominal and muscle cramps, vomiting, sweating, shakiness, and rareh. seizures mav occur These more severe withdrawal symptoms are very uncommon Another problem that mav occur when sleep medicines are stopped is known as 'rebound insomnia" This means that a person may have more trouble sleeping the first few nights after the medicine is stopped than before starting the medicine !f you should experience rebound insomnia, do not get discouraged This problem usually goes away on its own after 1 or 2 nights If vou have been taking Ambien CR or anv other sleep medicine for more than 1 or 2 weeks, do not stop taking it on your own Always follow vour doctor s directions. Changes in behavior and thinking: Some people using sleep medicines have experienced unusual changes in their thinking and/or behavior these effects arc not common However, thev have included: • more outgoing or aggressive behavior than normal • confusion • strange behavior • agitation • hallucinations • worsening of depression • suicidal thoughts How often these effects occur depends on several factory such as a person s general health, the use of other medicines, and which sleep medicine is being used It is also important to realize that it is rarely clear whether these behavior changes are caused bv the medicine, an illness, or occur on their own In fact, sleep problems that do not improve may be due to illnesses that were present before the medicine was used. If vou or vour family notice any changes in vour behavior, or if you have any unusual or disturbing thoughty cail vour doctor immediately Pregnancy: Sleep medicines may cause sedation of the unborn baby when used dunng the last weeks of pregnancy Be sure to tell vour doctor if vou are pregnant, if you are planning to become pregnant, or if you become pregnant while taking Ambien CR. SAfE USE Of SLEEPIN6 MEDICINES To ensure the safe and effective use of Ambien CR or any other sleep medicine, vou should observe the following cautions: 1 Ambien CR is a prescription medicine and should be used ONLY as directed by vour doctor Follow your doctor s instructions about how to take, when to take, and how long to take Ambien CR Ambien CR tablets should not be divided, crushed, or chewed, and must be swallowed whole 2. Never use Ambien CR or am other sleep medicine for longer than directed by your doctor 3. If vou develop an allergic reaction such as rash, hives, shortness of breath or swelling of vour tongue or throat when using Ambren CR or anv other sleep medicine discontinue Ambien CR or other sleep medicine immedi ateh' and contact your doctor I If vou notice any unusual and'or disturbing thoughts or behavior during treatment with Ambien CR or anv other sleep medicine, contact vour doctor 5. Tell vour doctor about any medicines vou may be taking, including medicines vou mav buy without a prescription. You should also tell your doctor if vou drink alcohol DO NOT use alcohol while taking Ambien C R or any other sleep medicine 6. Do not take Ambien CR unless vou are able to get a full night s sleep before vou must be active again For example. Ambien CR should not be taken on an overnight airplane flight ot less than 7 to 8 hours since 'travelers amnesia' mav occur 7. Do not increase the prescribed dose of Ambien CR or anv other sleep medicine unless instructed bv vour doctor 8 When vou first start taking Ambien CR or any otlier sleep medicine, until vou know whether the medicine will still have some carryover effect in you tfie next dav use extreme care while doing anything that requires complete alertness, such as driving a car. operating machinery , or piloting an aircraft 9 Be aware that you mav have more sleeping problems the first night after stopping Ambien CR or anv other sleep medicine 10 Be sure to tell your doctor if vou are pregnant, if vou are planning to become pregnant, or if vou become pregnant while taking Ambien CR or anv other sleep medicine II As with all prescr'ption medicines, never share Ambien CR or any other sleep medicine with anvonc else Always store Ambien CR or anv other sleep medicine in the original container that you received it in and store it out ol reach of children 12. Ambien CR works very quicklv you should only take Ambien CR right before going to bed and are readv to go to sleep Ambien CR' € /olpidcm tartrate extended release tablets) sanofi-aventis U S LLC Revised April 2007 Bridgewater. NJ 08807 UjilSjlw ggjK Iff ip Ilf §£ lf| TSk Shopping tips from an expert A mall guru shares strategies for your holiday haul. BY NATALIE ERMANN RUSSELL YOU’RE EITHER the type ♦ of person who would call the < frenetic energy at the mall ’ during the holidays “holiday spirit,” or you’d call it “chaos.” Either way, you can streamline the shopping experience to make it low-stress, highly productive and, dare we say, fun. Here, Dan Jasper of Mall of America (aka MOA, the largest retail and entertainment complex in the United States, located just outside of St. Paul and Minneapolis) shares his tips for suc cess at the mall. ■ MAKE A PLAN. A good plan often stalls with a list of who you would like to buy gifts for, what those gifts may be, which stores are likely to carry them and the expected cost. This will help you coordi nate your trip and keep a better handle on your budget. Then, go online to find a map of the mall so you can determine which stores are near each other and in what order you will visit them. ■ FIGURE OUT WHAT DAY AND TIME WOULD BE BEST FORTHEVtSIT. At the MOA, crowds are usually the smallest on Mondays and Tbesdays. The same is probably true at your local mall. ■ DON'T PARK IN THE FIRST SPOT YOU SEE. Instead, (hive to one of the top levels. The upper levels usually fill up last, so you’ll be one of the first cars there, and you can select a space that’s close and convenient to the elevator or stairs. ■ START ON THE MALL'S TOP FLOOR AND WORK YOUR WAY DOWN. Almost everyone else stalls shopping on the first floor, which is usually the most crowded. And 14 USA WEEKEND • Nov. 16-18,2007 AbW/ Qi ra&Pl. ft m \ MESIIX 4SPj; % ■ ♦♦♦ HK 4 ffisSSkfiP’ i * * * MWnrfW mtwrVllr f i♦ ♦ ♦ * ♦ ♦ ♦ mWmW be sure to avoid food courts during the hectic lunch and dinner horn's. Instead, consider making a reservation ahead of time at a restaurant in the mall. ■ ALLOW SOME TIME FOR BROWSING. You might stumble across the perfect gift for someone that you’d never have thought of. Leisurely browsing also gives you an opportunity to reflect on the joy of the season. And who knows—you might find a nice little treat for yourself. ■ TAKE A BREAK. Whether you stop to eat a meal, grab a snack, or simply sit and rest your feet, we all benefit from taking breaks. It’s also a great chance to do some people-watching. ■ BREAK UP YOUR SHOPPING INTO AT LEAST TWO TRIPS. This approach will reduce the stress and help you better enjoy the experience of shopping for loved ones. It also gives you a chance, at home, to assess the gifts you purchased and think about what else might complement them, which you can pick up on your next trip. ■ KEEP PERSONAL SAFETY IN MIND. Always be aware of your surroundings while you’re out shopping. Keep your purse secure, such as by putting a chair leg through the strap when you’re sitting for a meal. And don’t be afraid to ask a mall employee for some assistance if you need it. ca Natalie Ekmann Russell last wrote about holiday entertaining.