INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1189, 1189, '<p>Protamine Crystallised Insulin Aspart is an insulin analog indicated to improve glycemic control in patients with diabetes mellitus.</p>', '<p>The primary activity of Insulin Aspart is the regulation of glucose metabolism. Insulin Aspart bind to the insulin receptors on muscle and fat cells and lower blood glucose by facilitating the cellular uptake of glucose and simultaneously inhibiting the output of glucose from the liver.</p>', '<p>Insulin Aspart has a faster onset and a shorter duration of action than soluble human insulin. Due to the faster onset of action, Insulin Aspart should generally be given immediately before a meal. When necessary Insulin Aspart may be given soon after a meal.<br />\r\n<br />\r\nDosage of Insulin Aspart is individual and determined on the basis of the physician&#39;s advice in accordance with the needs of the patient. It should normally be used in combination with long-acting insulin given at least once a day.<br />\r\n<br />\r\nThe individual insulin requirement is usually between 0.5 and 1.0 IU/kg/day in adults and children over 2 years of age. In a meal-related treatment 50-70% of this requirement may be provided by Insulin Aspart and the remainder by long-acting insulin. Adjustment of dosage may also be necessary if patients undertake increased physical activity or change their usual diet. Exercise taken immediately after a meal may increase the risk of hypoglycaemia.<br />\r\n<br />\r\n<strong>Subcutaneous Injection</strong>: Insulin Aspart should be administered by subcutaneous injection in the abdominal region, buttocks, thigh, or upper arm. Because Insulin Aspart has a more rapid onset and a shorter duration of activity than human regular insulin, it should be injected immediately (within 5-10 minutes) before a meal Continuous Subcutaneous Insulin Infusion (CSII) by External Pump Insulin Aspart can also be infused subcutaneously by an external insulin pump. The initial programming of the external insulin infusion pump should be based on the total daily insulin dose of the previous regimen. Approximately 50% of the total dose is usually given as meal-related boluses of Insulin Aspart and the remainder is given as a basal infusion. When used with an infusion pump Insulin Aspart should not be mixed with any other insulin.<br />\r\n<br />\r\n<strong>Intravenous Use</strong>: Insulin Aspart can be administered intravenously under medical supervision for glycemic control with close monitoring of blood glucose and potassium levels to avoid hypoglycemia and hypokalemia. For intravenous use, Insulin Aspart should be used at concentrations from 0.05 IU/mL to 1.0 IU/mL insulin aspart in infusion systems using polypropylene infusion bags. Insulin Aspart has been shown to be stable in infusion fluids such as 0.9% sodium chloride.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Instructions to be given to the patient before injecting this Insulin:</p>\r\n\r\n<ul>\r\n	<li>According to the instruction given with ConviPen, insert the cartridge into the pen correctly &amp; equip the needle</li>\r\n	<li>Gently turn the pen upside down for 8-10 times until the insulin in the cartridge becomes uniformly mixed suspension</li>\r\n	<li>Remove the needle cap, discharge air bubbles in the catridge</li>\r\n	<li>Adjust the dosage button to get correct dose &amp; inject to the specific site</li>\r\n	<li>In order to avoid cross contamination, do not let the needle touch anything during the process of preparation.</li>\r\n</ul>', '<p>A number of drugs affect glucose metabolism and may require dose adjustment.<br />\r\n<br />\r\nThe following substances may reduce the Insulin as well as Insulin Aspart requirements: Oral anti-diabetic products, angiotensin converting enzyme (ACE) inhibitors, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, propoxyphene, pentoxifylline, salicylates and sulfonamide antibiotics.<br />\r\n<br />\r\nThe following substances may increase the Insulin as well as Insulin Aspart requirements: Thiazides, glucocorticoids, thyroid hormones, beta-sympathomimetics, growth hormone and danazol. Beta-blockers, clonidine, lithium salts, and alcohol may either potentiate or weaken the blood glucose lowering effect of insulin.</p>', NULL, '<p>Side effects of Insulin Aspart are hypoglycemia, allergic reactions, injection site reaction, lipodystrophy, pruritus and rash.</p>', '<p>Pregnancy category B. There are no restrictions on treatment with Protamine Crystallised Insulin Aspart during lactation. Insulin treatment of the nursing mother should not affect the baby. However, dosage may need to be adjusted.</p>', '<p><strong>Dose adjustment and monitoring</strong>: Blood glucose should be monitored in all patients treated with insulin. Insulin regimens should be modified cautiously and only under medical supervision.</p>', '<p>A specific overdose for insulin cannot be defined, however, hypoglycaemia may develop over sequential stages if too high doses relative to the patient&rsquo;s requirement are administered. Mild hypoglycaemic episodes can be treated by oral administration of glucose or sugary products. Severe hypoglycaemic episodes, where the patient has become unconscious, can be treated by glucagon (0.5 to 1 mg) given intramuscularly or subcutaneously. Glucose must also be given intravenously if the patient does not respond to glucagon within 10 to 15 minutes. Upon regaining consciousness administration of oral carbohydrate is recommended for the patient in order to prevent relapse.</p>', '<p>Rapid Acting Insulin.</p>', '<p>Store at 2&deg;C to 8&deg;C in a refrigerator. Do not freeze. Protect from light.</p>', NULL, '2022-03-14 05:00:54', '2022-03-14 05:00:54'),
(1190, 1190, '<p>Protamine Sulfate Injection is indicated in the treatment of&nbsp;heparin&nbsp;overdosage.</p>', '<p>Protamine sulfate is prepared from the sperm or mature testes of salmon or related species and is composed of arginine, proline, serine and valine. It combines with strongly acidic heparin to form a stable complex, neutralising the anticoagulant activity of both drugs.</p>', '<p>Each mg of Protamine Sulfate will neutralize approximately 90 units of heparin activity derived from beef lung tissue or about 115 units of heparin activity derived from&nbsp;porcine&nbsp;intestinal&nbsp;mucosa.<br />\r\n<br />\r\nProtamine Sulfate Injection, should be given by very slow intravenous injection in doses not to exceed 50 mg of Protamine Sulfate in any 10 minute period.<br />\r\n<br />\r\nProtamine Sulfate is intended for injection without further dilution; however,if further dilution is desired, 5% Dextrose Injection,or 0.9% Sodium Chloride Injection may be used. Diluted solutions should not be stored since they contain no preservative.<br />\r\n<br />\r\nProtamine Sulfate should not be mixed with other drugs without knowledge of their compatibility, because Protamine Sulfate has been shown to be incompatible with certain antibiotics,including several of the cephalosporins and penicillins.<br />\r\n<br />\r\nBecause heparin disappears rapidly from the&nbsp;circulation, the dose of Protamine Sulfate required also decreases rapidly with the time elapsed following intravenous injection of heparin.For example, if the Protamine Sulfate is administered 30 minutes after the heparin, one-half the usual dose may be sufficient.<br />\r\n<br />\r\nThe dosage of Protamine Sulfate should be guided by blood coagulation studies.Parenteral&nbsp;drug products should be visually inspected for particulate matter and discolouration prior to administration, whenever solution and container permit.</p>', '<p>Protamine sulfate has been shown to be incompatible with certain antibiotics, including several of the cephalosporins and penicillins.</p>', '<p>Protamine sulfate is contraindicated in patients who have shown previous intolerance to the drug.</p>', '<p>Intravenous&nbsp;injections of Protamine sulfate may cause a sudden fall in&nbsp;blood pressure, bradycardia, pulmonary hypertension,&nbsp;dyspnea, or transitory flushing and a feeling of warmth. There have been reports of&nbsp;anaphylaxis&nbsp;that resulted in respiratory embarrassment. Other reported adverse reactions include systemic hypertension, nausea, vomiting and lassitude.&nbsp;Back pain&nbsp;has been reported rarely in conscious patients undergoing such procedures as&nbsp;cardiaccatheterization. Because fatal reactions often resembling anaphylaxis have been reported after administration of Protamine sulfate, the drug should be given only when&nbsp;resuscitation&nbsp;techniques and treatment of anaphylactoid shock&nbsp;are readily available.</p>', '<p><strong>Usage in Pregnancy</strong>: Animal reproduction studies have not been conducted with Protamine sulfate . It is also not known whether Protamine sulfate can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Protamine sulfate should be given to a pregnant woman only if clearly needed.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Protamine sulfate is administered to a nursing woman.</p>', '<p>Patient at risk of developing hypersensitivity to protamine (e.g. previous history of procedures such as coronary angioplasty or cardiopulmonary bypass surgery where protamine is frequently used, diabetics using protamine insulin, allergy to fish, vasectomised or infertile males who may have antibodies to protamine). Pregnancy and lactation.</p>', '<p>Because of the&nbsp;anticoagulant&nbsp;effect of Protamine sulfate , overdosage of this drug may theoretically result in&nbsp;hemorrhage. However, in one study, overdosage of 600 to 800 mg of&nbsp;intravenous&nbsp;Protamine sulfate had only minimal, transient effects on blood&nbsp;coagulation&nbsp;tests.The patient should be followed with coagulation studies and treated symptomatically. The LD50&nbsp;of Protamine sulfate is 100 mg/kg in mice.</p>', '<p>Antidote preparations.</p>', '<p>Store between 20-25&deg; C. Do not freeze.</p>', '<p><strong>Usage in Children</strong>: Safety and effectiveness in children have not been established.</p>', '2022-03-14 05:02:40', '2022-03-14 05:02:40'),
(1191, 1191, '<p>Total diet replacement or supplement in anorexia, illness, convalescence, pregnancy, lactation, old age, weight loss, fatigue, pre- &amp; post-surgical conditions, oral pathology, cancer, transition from TPN &amp; tube feeding for adults &amp; older persons. Specialized nutrition with fiber for diabetic patients.</p>', '<p>No data has found</p>', '<p>To prepare a 250 ml feeding, put 200 ml of cold water in a glass. Gradually add 6 level scoops (enclosed) of powder while stirring and mix until dissolved. When mixed as directed powder provides approx. 1 k.cal. per ml.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity to any of the ingredient of this product.</p>', NULL, '<p>Pregnancy Category: Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', NULL, NULL, '<p>Oral nutritional preparations.</p>', NULL, NULL, '2022-03-14 05:03:58', '2022-03-14 05:03:58'),
(1192, 1192, '<p>Prucalopride is indicated for symptomatic treatment of chronic constipation in adults in whom laxatives fail to provide adequate relief.</p>', '<p>Prucalopride acts as a selective stimulator of the 5-HT4 receptors while having no interaction with hERG channel or 5-HT1 receptors which reduces significantly the cardiovascular risk found in other similar drugs. 5-HT4 receptors can be found throughout the gastrointestinal tract primarily in smooth muscle cells, enterochromaffin cells, and myenteric plexus. Its activation produces the release of acetylcholine which is the major excitatory neurotransmitter in the GI tract. Hence, prucalopride stimulates motility by interacting specifically with 5-HT4 receptors in the GI tract which causes a release of acetylcholine and further contraction of the muscle layer of the colon and relaxation of the circular muscle layer leading to the propulsion of luminal content.</p>', '<p><strong>Adults</strong>: 2 mg once daily with or without food, at any time of the day. Due to the specific mode of action of prucalopride (stimulation of propulsive motility), exceeding the daily dose of 2 mg is not expected to increase efficacy.<br />\r\n<br />\r\n<strong>Older people</strong>: Start with 1 mg once daily; if needed the dose can be increased to 2 mg once daily.<br />\r\n<br />\r\n<strong>Children</strong>: Prucalopride should not be used in children and adolescents younger than 18 years</p>', '<p>In-vitro data indicate that, Prucalopride has a low interaction potential and therapeutic concentrations of Prucalopride are not expected to affect the CYP-mediated metabolism of co medicated medicinal products. Although Prucalopride may be a weak substrate for P-glycoprotein (P-gp), it is not an inhibitor of P-gp at clinically relevant concentrations.<br />\r\n<br />\r\nKetoconazole (200 mg b.i.d.), a potent inhibitor of CYP3A4 and of P-gp, increased the systemic exposure to prucalopride by approximately 40%. This effect is too small to be clinically relevant. Interactions of similar magnitude may be expected with other potent inhibitors of P-gp such as verapamil, cyclosporine A and quinidine.<br />\r\n<br />\r\nStudies in healthy subjects showed that, there were no clinically relevant effects of Prucalopride on the pharmacokinetics of warfarin, digoxin, alcohol, paroxetine or oral contraceptives.</p>', '<p>Prucalopride is contraindicated in those people who are hypersensitive to the active substance or to any of the excipients and people with renal impairment requiring dialysis.</p>', '<p>The most frequently reported adverse reactions associated with Prucalopride therapy are headache (17.8%) and gastrointestinal symptoms (abdominal pain), nausea and diarrhoea. The adverse reactions occur predominantly at the start of therapy and usually disappear within a few days with continued treatment. Other adverse reactions have been reported occasionally. The majority of adverse events were mild to moderate in intensity.</p>', '<p>Prucalopride is not recommended during pregnancy and women of childbearing potential should use effective contraception during treatment. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy, embryonal/fetal development, parturition, or postnatal development. In the absence of human data, it is not recommended to use Prucalopride during breastfeeding.</p>', '<ul>\r\n	<li>Renal excretion is the main route of elimination of prucalopride. A dose of 1 mg is recommended in subjects with severe renal impairment.</li>\r\n	<li>Caution should be exercised when prescribing Prucalopride to patients with severe hepatic impairment (Child-Pugh class C) due to limited data in patients with severe hepatic impairment.</li>\r\n	<li>In case of severe diarrhoea, the efficacy of oral contraceptives may be reduced and the use of an additional contraceptive method is recommended to prevent possible failure of oral contraception.</li>\r\n	<li>The tablets contain lactose. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicinal product.</li>\r\n</ul>', '<p>An overdose may result in symptoms resulting from an exaggeration of prucalopride&#39;s known pharmacodynamic effects and include headache, nausea and diarrhoea. Specific treatment is not available for Prucalopride overdose. Should an overdose occur, the patient should be treated symptomatically and supportive measures instituted, as required. Extensive fluid loss by diarrhoea or vomiting may require correction of electrolyte disturbances.</p>', '<p>Osmotic purgatives</p>', '<p>Store at room temperature, below 30&deg;C. Do not remove desiccant. Dispense in original bottle.</p>', '<p><strong>Renal Impairment</strong>: The dose for patients with severe renal impairment (GFR &lt;30 ml/min/1.73 m2) is 1 mg once daily. No dose adjustment is required for patients with mild to moderate renal impairment.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Patients with severe hepatic impairment (Child-Pugh class C) start with 1 mg once daily which may be increased to 2 mg if required to improve efficacy and if the 1 mg dose is well tolerated. No dose adjustment is required for patients with mild to moderate hepatic impairment.</p>', '2022-03-14 05:05:58', '2022-03-14 05:05:58'),
(1193, 1193, '<p>This&nbsp;is indicated for the symptomatic relief of upper respiratory tract disorders accompanied by productive cough which benefits from the administration of a nasal decongestant, a histamine H1 receptor antagonist and an expectorant combination.</p>', '<p><strong>Pseudoephedrine</strong>&nbsp;is a decongestant as well as a bronchodilator for the upper respiratory tract, which gives symptomatic relief of nasal congestion. Pseudoephedrine is both an &alpha;-and &beta;-adrenergic receptor agonist. It causes vasoconstriction via direct stimulation of &alpha;-adrenergic receptors of the respiratory mucosa. It also directly stimulates &beta;-adrenergic receptors causing bronchial relaxation, increased heart rate and contractility.<br />\r\n<br />\r\nLike ephedrine, pseudoephedrine releasing norepinephrine from its storage sites, an indirect effect. This is its main and direct mechanism of action. The displaced noradrenaline is released into the neuronal synapse where it is free to activate the postsynaptic adrenergic receptors.<br />\r\n<br />\r\n<strong>Guaifenesin</strong>&nbsp;reduces the viscosity of tenacious sputum and is used as an expectorant. It increases the hydration of respiratory tract, thereby increasing the volume and reducing the viscosity of bronchial secretions.<br />\r\n<br />\r\n<strong>Triprolidine</strong>&nbsp;is an antihistamine; it is used for the symptomatic relief of hypersensitivity reactions including rhinitis, conjunctivitis and urticaria.</p>', '<p><strong>Adult and Children over 12 years</strong>: 10 ml (2 teaspoonful) three times a day.<br />\r\n<strong>Children 6-12 years</strong>: 5 ml (1 teaspoonful) three times a day.<br />\r\n<strong>Children 2-5 years</strong>: 2.5 ml (1/2 teaspoonful) three times a day.<br />\r\n&nbsp;</p>', '<p>Concomitant use of Pseudoephedrine, guaiphenasine &amp; triprolidine with sympathomimetic agents such as decongestants, tricyclic antidepressants, appetite suppressants and amphetamine-like psychostimulants or with monoamine oxidase inhibitors which interfere with the catabolism of sympathomimetic amines may occasionally cause a rise in blood pressure. Because of its pseudoephedrine content, Pseudoephedrine, guaiphenasine &amp; triprolidine partially reverse the hypotensive action of drugs which interfere with sympathetic activity including guanethidine, methyldopa, alpha-adrenergic blocking agents.</p>', '<p>This is contraindicated in the cases of known hypersensitivity to any of its constituents, cardiovascular disease including hypertension, lower respiratory symptoms including asthma, monoamine oxidase inhibitor (MAOI) therapy.</p>', '<p>CNS depression or excitation, drowsiness (reported most frequently), sleep disturbances, hallucinations (rarely reported), skin rashes with or without irritation, tachycardia, dryness of mouth, nose and throat have occasionally been reported.</p>', '<p>Although pseudoephedrine, triprolidine and guaiphenesin have been in widespread use of many years without apparent ill consequence, there are no specific data on their use during pregnancy. Caution should therefore be exercised by balancing the potential benefits of treatment of the mother against any possible hazards to the developing fetus.</p>', '<p>As with any other antihistamine therapy, Pseudoephedrine, guaiphenasine &amp; triprolidine may cause drowsiness. If affected, patients should be advised not to drive or operate machinery. Concomitant administration of alcohol or other centrally acting sedatives should be avoided. Although Pseudoephedrine has no pressor effects in normotensive patients but Pseudoephedrine, guaiphenasine &amp; triprolidine should be used with caution to patients suffering from mild to moderate hypertension. Moreover, caution should also be exercised in the following disease conditions - hypertension and heart disease, diabetes, hyperthyroidism, elevated intra-ocular pressure, prostatic enlargement, severe renal and hepatic impairment. This preparation should not be used for persistent or chronic cough, which occurs with smoking, asthma or emphysema or where excessive secretions accompany cough, unless directed by a physician.</p>', '<p>The effects of acute toxicity from Pseudoephedrine, guaiphenasine &amp; triprolidine may include drowsiness, irritability, restlessness, lethargy, dizziness, gastrointestinal discomfort, respiratory depression, convulsion, tremor, tachycardia and hypertension. Incase of overdose, necessary measures should be taken to maintain and support respiration and control convulsion. Gastric lavage may be undertaken if indicated. Catheterization of bladder may be necessary.</p>', '<p>Combined cough expectorants.</p>', '<p>Store below 25&deg; C. Protect from light. Do not refrigerate.</p>', NULL, '2022-03-14 05:07:55', '2022-03-14 05:07:55'),
(1194, 1194, '<p>Pseudoephedrine is a decongestant of the mucous membranes of the upper respiratory tract, especially the nasal mucosa, sinuses and eustachian tube. It is indicated for the symptomatic relief of allergic rhinitis (hay fever), vasomotor rhinitis, the common cold, influenza (flu) and ear congestion caused by ear inflammation or infection. Pseudoephedrine can also be used as a bronchodilator.</p>', '<p>Pseudoephedrine is both an &alpha;-and &beta;-adrenergic receptor agonist. It causes vasoconstriction via direct stimulation of &alpha;-adrenergic receptors of the respiratory mucosa. It also directly stimulates &beta;-adrenergic receptors causing bronchial relaxation, increased heart rate and contractility.<br />\r\n<br />\r\nLike ephedrine, pseudoephedrine releasing norepinephrine from its storage sites, an indirect effect. This is its main and direct mechanism of action. The displaced noradrenaline is released into the neuronal synapse where it is free to activate the postsynaptic adrenergic receptors.</p>', '<p>As a decongestant and symptomatic treatment for upper respiratory tract infections the recommended dose is:<br />\r\n<br />\r\n<strong>Adults</strong>: 1 tablet every 4 to 6 hours, up to maximum of 240 mg in 24 hours<br />\r\n<br />\r\nChildren:</p>\r\n\r\n<ul>\r\n	<li><strong>6-12 years of age</strong>: 1/2 tablet every 4 to 6 hours daily</li>\r\n	<li><strong>2-5 years of age</strong>: 1/4 tablet every 4 to 6 hours daily</li>\r\n	<li><strong>Less than 2 years of age:</strong>&nbsp;This drug is not advised unless specifically recommended by a physician.</li>\r\n</ul>', NULL, '<p>Pseudoephedrine is contraindicated in-</p>\r\n\r\n<ul>\r\n	<li>Hypersensitivity of individuals to this drug</li>\r\n	<li>Severe hypertension and coronary artery disease</li>\r\n	<li>Concurrent use of Mono Amine Oxidase Inhibitor (MAOI) drugs</li>\r\n</ul>', '<p>Serious adverse effects associated with the use of Pseudoephedrine are rare. Symptoms of central nervous system excitation may occur, including sleep disturbances and, rarely, hallucinations have been reported. Skin rashes, with or without irritation, have occasionally been reported.</p>', '<p>Although Pseudoephedrine has been in widespread use for many years without apparent ill consequence, there are no specific data on its use during pregnancy. Caution should therefore be exercised by balancing the potential benefit of treatment to the mother against any possible hazards to the developing foetus. Pseudoephedrine is excreted in breast milk in small amounts but the effect of this on breast-fed infants is not known.</p>', '<p>Although Pseudoephedrine has virtually no pressor effects in normotensive patients, it should be used with caution in patients suffering mild to moderate hypertension. As with other sympathomimetic agents, Pseudoephedrine should be used with caution in patients with hypertension, heart disease, diabetes, hyperthyroidism, elevated intraocular pressure and prostatic enlargement. Caution should be exercised when using the product in the presence of severe hepatic impairment or moderate to severe renal impairment.</p>', '<p>As with other sympathomimetic agents, symptoms of overdosage include irritability, restlessness, tremor, convulsions, palpitations, hypertension and difficulty in micturition. Necessary measures should be taken to maintain and support respiration and control convulsions. Gastric lavage should be performed if indicated. If desired, the elimination of Pseudoephedrine can be accelerated by acid diuresis or by dialysis.</p>', '<p>Decongestant.</p>', NULL, NULL, '2022-03-14 05:10:09', '2022-03-14 05:10:09'),
(1195, 1195, '<p>Psyllium Husk is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Constipation</li>\r\n	<li>Raised levels of cholesterol</li>\r\n	<li>Hemorrhoids or piles</li>\r\n	<li>Irritable bowel syndrome (IBS)</li>\r\n	<li>Reduces blood glucose level</li>\r\n</ul>\r\n\r\n<p>Psyllium also provides easy bowel movement with smooth stool. So, it is desirable in patients with anal fissures, colon cancer, post anal &amp; rectal surgery and during pregnancy.</p>', NULL, '<p><strong>Usual dose</strong>: 1 spoonful 1-3 times daily or as per doctor&#39;s advice.<br />\r\n<br />\r\n<strong>Adults and children over 12 years</strong>: 1 spoonful with water 2 times daily or as per doctor&#39;s advice.<br />\r\n<br />\r\n<strong>Children 6 to 12 years</strong>: &frac12; to 1 spoonful with water depending on age and size, in the morning and at bedtime or as per doctor&#39;s advice.<br />\r\n<br />\r\n<strong>Children below 6 years</strong>: Not recommended except as directed by the physician.<br />\r\n<br />\r\nAn additional glass of water is helpful after taking this gel.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Take one spoonful with the provided spoon.</li>\r\n	<li>Put this husk into an empty glass.</li>\r\n	<li>Fill glass with water (150 ml or 2/3 of the glass) stir &amp; drink immediately.</li>\r\n</ul>', '<p>No significant interaction has been observed with other medicine.</p>', '<p>Contraindicated in patients with gastrointestinal tract obstruction or threatening obstruction of the bowel.</p>', '<p>Common side effects are flatulence, abdominal distension, gastro-intestinal obstruction.</p>', NULL, NULL, NULL, '<p>Bulk-forming laxatives</p>', '<p>Store in a cool and dry place. Keep out of reach of children.</p>', NULL, '2022-03-14 05:12:08', '2022-03-14 05:12:08'),
(1196, 1196, '<p>This&nbsp;medication&nbsp;is used to treat intestinal worm infections such as&nbsp;pinworm, roundworm, and hookworm. Pyrantel belongs to a class of drugs known as anthelmintics. It works by making the worms unable to move (paralyzed) so that the body can remove them naturally in the stool.<br />\r\n<br />\r\nPyrantel Pamoate is specifically indicated for the treatment of infestations caused by Ascaris lumbricoides, Enterobius vermicularis, Ancylostoma duodenale/Necator americanus and Trichostrongylus.&nbsp;<br />\r\n<br />\r\nThis medication may be used to self-treat pinworm infections. For other types of worm infections (such as roundworm, hookworm), use this product only as directed by your doctor. Do not use this medication in children younger than 2 years unless directed by the doctor.</p>', '<p>Pyrantel pamoate acts as a depolarizing neuromuscular blocking agent, thereby causing sudden contraction, followed by paralysis, of the helminths. This has the result of causing the worm to &quot;lose its grip&quot; on the intestinal wall and be passed out of the system by natural process. Since Pyrantel is poorly absorbed by the host&#39;s intestine, the host is unaffected by the small dosage of medication used. Spastic (tetanic) paralyzing agents, in particular pyrantel pamoate, may induce complete intestinal obstruction in a heavy worm load. This obstruction is usually in the form of a worm impaction and happens when a very small, but heavily parasitized animal is treated and tries to pass a large number of dislodged worms at once. Worms usually pass in normal stool or with diarrhea, straining, and occasional vomiting.</p>', '<p>Pyrantel Pamoate is given orally at anytime without regard to ingestion of food or beverages. A single dose of 11 mg/kg body weight, to a maximum of 1 gm, should be given to treat infestations caused by the parasites mentioned above. In the case of Pinworm, it is often wise to repeat the dose after an interval of 2 weeks.</p>', NULL, '<p>Known hypersensitivity to pyrantel or any ingredient in the formulation.</p>', '<p>Pyrantel Pamoate is well tolerated in recommended dosage. When given in large dosage, Pyrantel Pamoate may cause gastrointestinal upset such as anorexia, nausea, vomiting and diarrhoea. Other side effects that may occur in rare occasions are headache, dizziness and rash.</p>', '<p><strong>Pregnancy:</strong>&nbsp;Since Pyrantel Pamoate has not been studied in pregnant women, use of Pyrantel Pamoate in such patients is normally contraindicated. Pyrantel Pamoate is not recommended for children below 1 year of age.</p>', '<p>Since Pyrantel Pamoate and Piperazine appear to be mutually antagonistic, Pyrantel Pamoate should not be given together with Piperazine. Pyrantel Pamoate should be kept out of the reach of children.</p>', NULL, '<p>Anthelmintic</p>', NULL, '<p><strong>Pediatric Use</strong>: Safety and efficacy not established in children &lt;2 years of age;a&nbsp;use in this age group only when potential benefits justify possible risks.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Use with caution in patients with preexisting liver dysfunction.</p>', '2022-03-14 05:13:40', '2022-03-14 05:13:40'),
(1197, 1197, '<p>Pyrazinamide is indicated for the initial treatment of active tuberculosis in adults and children when combined with other antituberculous agents.</p>\r\n\r\n<ul>\r\n	<li>The current recommendation of the CDC for drug-susceptible disease is to use a six-month regimen for initial treatment of active tuberculosis, consisting of isoniazid, rifampin and Pyrazinamide given for 2 months, followed by isoniazid and rifampin for 4 months</li>\r\n	<li>Patients with drug-resistant disease should be treated with regimens individualized to their situation. Pyrazinamide frequently will be an important component of such therapy.</li>\r\n	<li>In patients with concomitant HIV infection, the physician should be aware of current recommendation of CDC. It is possible these patients may require a longer course of treatment</li>\r\n</ul>\r\n\r\n<p>It is also indicated after treatment failure with other primary drugs in any form of active tuberculosis.<br />\r\n<br />\r\nPyrazinamide should only be used in conjunction with other effective antituberculous agents.</p>', '<p>Pyrazinamide may be bacteriostatic or bactericidal in action, depending on the concentration of the drug attained at the site of the infection and the susceptibility of the infecting organism. Its activity appears to partly depend on conversion of the drug to pyrazinoic acid (POA), which lowers the pH of the environment below that which is necessary for growth of Mycobacterium tuberculosis. Susceptible strains of M. tuberculosis produce pyrazinamidase, an enzyme that deaminates pyrazinamide to POA, and the in vitro susceptibility of a given strain of the organism appears to correspond to its pyrazinamidase activity.</p>', '<p>Usual Adult Dose for Tuberculosis: Active:</p>\r\n\r\n<p>15 to 30 mg/kg (up to 2 g) orally once a day in combination with three other antituberculous drugs for the initial 2 months of a 6-month or 9-month treatment regimen, until drug susceptibility tests are known. An alternate dosing regimen of 50 to 75 mg/kg (up to 3 g) orally twice a week may be used after 2 weeks of daily therapy to increase patient compliance.<br />\r\n<br />\r\nAlternatively, the CDC, The American Thoracic Society, and the Infectious Diseases Society of America suggest the following dosing based on estimated lean body weight:<br />\r\n<br />\r\nDaily dosing:</p>\r\n\r\n<ul>\r\n	<li><strong>40 to 45 kg</strong>: 1000 mg</li>\r\n	<li><strong>56 to 75 kg</strong>: 1500 mg</li>\r\n	<li><strong>76 to 90 kg</strong>: 2000 mg</li>\r\n</ul>\r\n\r\n<p>Twice weekly dosing:</p>\r\n\r\n<ul>\r\n	<li><strong>40 to 55 kg</strong>: 2000 mg</li>\r\n	<li><strong>56 to 75 kg</strong>: 3000 mg</li>\r\n	<li><strong>76 to 90 kg</strong>: 4000 mg</li>\r\n</ul>\r\n\r\n<p>Thrice weekly dosing:</p>\r\n\r\n<ul>\r\n	<li><strong>40 to 55 kg</strong>: 1500 mg</li>\r\n	<li><strong>56 to 75 kg</strong>: 2500 mg</li>\r\n	<li><strong>76 to 90 kg</strong>: 3000 mg</li>\r\n</ul>\r\n\r\n<p><br />\r\nUsual Adult Dose for Tuberculosis: Latent:&nbsp;</p>\r\n\r\n<p>A public health expert should be consulted prior to the use of the combination regimen with rifampin.<br />\r\n<br />\r\n15 to 20 mg/kg, based on actual body weight (lean), orally once daily (maximum 2 g) for 2 months. Alternatively, a dosage of 50 mg/kg may be administered orally twice-weekly (maximum 4 g).</p>\r\n\r\n<p><br />\r\nUsual Pediatric Dose for Tuberculosis: Active:</p>\r\n\r\n<p>(Used as part of a multidrug regimen. Treatment regimens consist of an initial 2-month phase, followed by a continuation phase of 4 or 7 additional months. Frequency of dosing may differ depending on phase of therapy)<br />\r\n<br />\r\nInfants, Children less than 40 kg and Adolescents 14 years and younger and less than 40 kg:<br />\r\nNon-HIV patients:</p>\r\n\r\n<ul>\r\n	<li><strong>Daily therapy</strong>: 15 to 30 mg/kg/dose (maximum: 2 g/dose) once daily</li>\r\n	<li><strong>Directly observed therapy (DOT)</strong>: 50 mg/kg/dose (maximum: 2 g/dose) twice weekly</li>\r\n</ul>\r\n\r\n<p>HIV-exposed/infected patients:</p>\r\n\r\n<ul>\r\n	<li><strong>Daily therapy</strong>: 20 to 40 mg/kg/dose once daily (maximum: 2 g/day)</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>', '<p>Antagonises the effect of uricosuric agents (e.g. probenecid, sulfinpyrazone). May reduce the contraceptive effect of oestrogens. May inactivate oral typhoid vaccine. May increase the serum concentration of ciclosporin. May enhance the hepatotoxic effect of rifampicin.</p>', '<p>Pyrazinamide is contraindicated in persons:</p>\r\n\r\n<ul>\r\n	<li>With severe hepatic damage.</li>\r\n	<li>Who have shown hypersensitivity to it.</li>\r\n	<li>With acute gout.</li>\r\n</ul>', '<p><strong>General</strong>: Fever, porphyria and dysuria have rarely been reported.&nbsp;Gout.<br />\r\n<br />\r\n<strong>Gastrointestinal</strong>: The principal adverse effect is a hepatic reaction. Hepatotoxicity appears to be dose related, and may appear at any time during therapy. GI disturbances including nausea, vomiting and anorexia have also been reported.<br />\r\n<br />\r\n<strong>Hematologic and Lymphatic</strong>: Thrombocytopenia and sideroblastic anemia with erythroid hyperplasia, vacuolation of erythrocytes and increased serum iron concentration have occurred rarely with this drug. Adverse effects on blood clotting mechanisms have also been rarely reported.<br />\r\n<br />\r\n<strong>Other</strong>: Mild arthralgia and myalgia have been reported frequently. Hypersensitivity reactions including rashes, urticaria, and pruritis have been reported. Fever, acne, photosensitivity, porphyria, dysuria and interstitial nephritis have been reported rarely.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C. Animal reproduction studies have not been conducted with Pyrazinamide. It is also not known whether Pyrazinamide can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Pyrazinamide should be given to a pregnant woman only if clearly needed.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: Pyrazinamide has been found in small amounts in breast milk. Therefore, it is advised that Pyrazinamide be used with caution in nursing mothers taking into account the risk-benefit of this therapy.</p>', '<p>Pyrazinamide is contraindicated in patients with severe hepatic disease and with acute gout.<br />\r\n<br />\r\nPatients started on pyrazinamide should have baseline serum uric acid and liver function test results. Liver function should be monitored closely during therapy. Patients with preexisting liver disease or those at increased risk of drug related hepatitis should be monitored closely.<br />\r\n<br />\r\nPyrazinamide should be discontinued and not restarted if signs of hepatocellular damage or hyperuricemia with an acute gouty arthritis appear.<br />\r\n<br />\r\nPolyarthralgias have been reported in patients. The pain may respond to aspirin or other nonsteroidal anti-inflammatory agents.<br />\r\n<br />\r\nCaution should be used in patients with a history of diabetes mellitus, as management of the disease may be more difficult.<br />\r\n<br />\r\nPrimary resistance of Mycobacterium tuberculosis to pyrazinamide is not common. In cases with known or suspected drug resistance, in vitro susceptibility tests with recent cultures of Mycobacterium tuberculosis against pyrazinamide and the usual primary drugs should be conducted. There are few reliable in vitro tests for pyrazinamide resistance. A reference laboratory capable of performing these tests must be utilized.<br />\r\n<br />\r\nClinical experience has not identified differences in responses between elderly and younger patients. In general, dose selection for elderly patients should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased renal or hepatic function, and of concomitant disease or other drug therapy.</p>', '<p>Overdosage experience is limited. In one case report of overdose, abnormal liver function tests developed. These spontaneously reverted to normal when the drug was stopped. Clinical monitoring and supportive therapy should be employed. Pyrazinamide is dialyzable.</p>', '<p>Anti-Tubercular Chemotherapeutics.</p>', '<p>Store between 15-30&deg; C.</p>', '<p><strong>Usage in Children</strong>: Pyrazinamide regimens employed in adults are probably equally effective in children. Pyrazinamide appears to be well tolerated in children.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of Pyrazinamide did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently from younger patients. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic or renal function, and of concomitant disease or other drug therapy.<br />\r\n<br />\r\nIt does not appear that patients with impaired renal function require a reduction in dose. It may be prudent to select doses at the low end of the dosing range, however.<br />\r\n<br />\r\n<strong>Renal Dose Adjustments</strong>: The manufacturer recommends to start therapy at low end of dosage range and monitor patient closely.<br />\r\n<br />\r\nFor the treatment of active tuberculosis, the CDC, ATS, and IDSA recommend against daily dosing. For patients with CrCl less than 30 mL/min or patients receiving hemodialysis the recommended dose is 25 to 35 mg/kg per dose three times per week.<br />\r\n<br />\r\n<strong>Liver Dose Adjustments</strong>: Monitor patients closely.<br />\r\n<br />\r\n<strong>Dose Adjustments</strong>: In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic or renal function, and of concomitant disease or other drug therapy.<br />\r\n<br />\r\nIf organism is susceptible to isoniazid and rifampin, pyrazinamide is continued for the first 2 months of a 6-month course of therapy (9-months if HIV positive). If primary drug resistance is shown, drug regimens should be adjusted as needed and continued for at least 6 months, or 3 months beyond culture conversion (9 months, or 6 months beyond culture conversion if HIV positive). If multiple-drug resistance is demonstrated, therapy should be continued for 12 to 24 months following culture conversion.</p>', '2022-03-14 05:15:59', '2022-03-14 05:15:59'),
(1198, 1198, '<p>Pyridostigmine is useful in the treatment of myasthenia gravis.</p>', '<p>Pyridostigmine tablet is an orally active cholinesterase inhibitor. Pyridostigmine inhibits the destruction of acetylcholine by cholinesterase and thereby permits freer transmission of nerve impulses across the neuromuscular junction. Pyridostigmine is an analog of neostigmine, but differs from it in certain clinically signihcant respects; for example, Pyridostigmine is characterized by a longer duration of action and fewer gastrointestinal side effects.</p>', '<p>The size and frequency of the dosage must be adjusted to the needs of the individual patient. The average dose is 10 tablets (600 mg) spaced to provide maximum relief when maximum strength is needed. In severe cases as many as 25 tablets (1500 mg) a day may be required, while in mild cases one to six tablets a day may sufhce. The interval between doses should be at least 6 hours.</p>', '<p>A potential interaction between the antimalarial drug mefloquine and pyridostigmine bromide exists through a possible additive effect on the gastrointestinal tract. Theoretically, drugs such as dexpanthenol, which are converted to pantothenic acid in vivo, may have additive effects with pyridostigmine by increasing production of acetylcholine.</p>', '<p>Pyridostigmine is contraindicated in mechanical intestinal or urinary obstruction, and particular caution should be used in its administration to patients with bronchial asthma. Care should be observed in the use of atropine for counteracting side effects.</p>', '<p>The side effects of Pyridostigmine are most commonly related to overdose and generally are of two varieties, muscarinic and nicotinic. Muscarinic side effects are nausea, vomiting, diarrhea, abdominal cramps, increased peristalsis movement, increased salivation, increased bronchial secretions, miosis and diaphoresis. Nicotinic side effects are comprised chiefly of muscle cramps, fasciculation and weakness. Muscarinic side effects can usually be counteracted by atropine. As with any compound containing the bromide radical, a skin rash may be seen in an occasional patients. Such reactions usually subside promptly upon discontinuance of the medication.</p>', '<p><strong>Pregnancy&nbsp;</strong>Category C.&nbsp;Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Pyridostigmine is mainly excreted unchanged by the kidney. Therefore, lower doses may be required in patients with renal disease, and treatment should be based on titration of drug dosage to effect.</p>', '<p>Symptoms may include diarrhea; fainting; increased production of saliva; increased sweating; muscle weakness; nausea; small pupils; stomach cramps; trouble breathing; vision changes; vomiting; weakness.</p>', '<p>Drugs used in Myasthenia Gravis.</p>', '<p>Store in cool and dry place, protected from light. Keep out of children&rsquo;s reach.</p>', '<p><strong>Renal Impairment:</strong>&nbsp;Lower initial dose may be needed, titrate to desired effect.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.</p>', '2022-03-14 05:18:19', '2022-03-14 05:18:19');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1199, 1199, '<p>Pyridoxine&nbsp;(vitamin B6) is used to prevent or treat low levels of vitamin B6 in people who do not get enough of the vitamin from their diets. Most people who eat a normal diet do not need extra vitamin B6. However, some conditions (such as alcoholism, liver disease,&nbsp;overactive thyroid,&nbsp;heart failure) or medications&nbsp;(such as isoniazid, cycloserine, hydralazine,&nbsp;penicillamine) can cause low levels of vitamin B6. Vitamin B6 plays an important role in the body. It is needed to maintain the health of nerves,&nbsp;skin, and red&nbsp;blood cells.<br />\r\n<br />\r\nPyridoxine has been used to prevent or treat a certain nerve disorder (peripheral neuropathy) caused by certain medications (such as isoniazid). It has also been used to treat certain hereditary disorders (such as xanthurenic aciduria, hyperoxaluria, homocystinuria).</p>', '<p>Pyridoxine is a water-soluble vitamin which functions in the metabolism of carbohydrates, proteins and fats. It is essential in Hb formation and GABA synthesis within the CNS. It also aids in the release of glycogen stored in the liver and muscles.</p>', '<p>ADULTS:</p>\r\n\r\n<p>BY MOUTH:</p>\r\n\r\n<ul>\r\n	<li><strong>For hereditary sideroblastic anemia</strong>: Initially, 200-600 mg of vitamin B6 is used. The dose is decreased to 30-50 mg per day after an adequate response.</li>\r\n	<li><strong>For vitamin B6 deficiency</strong>: In most adults, the typical dose is 2.5-25 mg daily for three weeks then 1.5-2.5 mg per day thereafter. In women taking birth control pills, the dose is 25-30 mg per day.</li>\r\n	<li><strong>For abnormally high levels of homocysteine in the blood</strong>: For reducing high levels of homocysteine in the blood after childbirth, 50-200 mg of vitamin B6 has been taken alone. Also, 100 mg of vitamin B6 has been taken in combination with 0.5 mg of folic acid.</li>\r\n	<li><strong>For preventing macular degeneration</strong>: 50 mg of vitamin B6 in the form of pyridoxine has been used daily in combination with 1000 mcg of vitamin B12 (cyanocobalamin) 1000 mcg and 2500 mcg of folic acid for about 7 years.</li>\r\n	<li><strong>For hardening of the arteries (atherosclerosis)</strong>: A specific supplement (Kyolic, Total Heart Health, Formula 108, Wakunga) containing 250 mg of aged garlic extract, 100 mcg of vitamin B12, 300 mcg of folic acid, 12.5 mg of vitamin B6, and 100 mg of L-arginine&nbsp;daily for 12 months.</li>\r\n	<li><strong>For kidney stones</strong>: 25-500 mg of vitamin B6 has been used daily.</li>\r\n	<li><strong>For nausea during pregnancy</strong>: 10-25 mg of vitamin B6 taken three or four times per day has been used. In people who don&#39;t respond to vitamin B6 alone, a combination product containing vitamin B6 and the drug doxylamine (Diclectin, Duchesnay Inc.) is used three or four times per day. Also, another product containing 75 mg of vitamin B6, 12 mcg of vitamin B12, 1 mg of folic acid, and 200 mg of calcium (PremesisRx, KV Pharmaceuticals) is used daily.</li>\r\n	<li><strong>For symptoms of premenstrual syndrome (PMS)</strong>: 50-100 mg of vitamin B6 is used daily, alone or along with 200 mg of magnesium.</li>\r\n	<li><strong>For treating tardive dyskinesia</strong>: 100 mg of vitamin B6 per day has been increased weekly up to 400 mg per day, given in two divided doses.</li>\r\n</ul>\r\n\r\n<p>INJECTED INTO THE MUSCLE:</p>\r\n\r\n<ul>\r\n	<li><strong>Hereditary sideroblastic anemia</strong>: 250 mg of vitamin B6 daily, reduced to 250 mg of vitamin B6 weekly once adequate response is achieved.</li>\r\n</ul>\r\n\r\n<p><br />\r\nCHILDREN:</p>\r\n\r\n<p>BY MOUTH:</p>\r\n\r\n<ul>\r\n	<li><strong>For kidney stones</strong>: Up to 20 mg/kg daily in children aged 5 years and up.</li>\r\n</ul>\r\n\r\n<p>INJECTED INTO THE VEIN OR MUSCLE:</p>\r\n\r\n<ul>\r\n	<li><strong>For seizures that respond to vitamin B6 (pyridoxine-dependent seizures)</strong>: 10-100 mg is recommended.</li>\r\n</ul>\r\n\r\n<p>The daily recommended dietary allowances (RDAs) of vitamin B6 are:</p>\r\n\r\n<ul>\r\n	<li>Infants 0-6 months, 0.1 mg</li>\r\n	<li>Infants 7-12 months, 0.3 mg</li>\r\n	<li>Children 1-3 years, 0.5 mg</li>\r\n	<li>Children 4-8 years, 0.6 mg</li>\r\n	<li>Children 9-13 years, 1 mg</li>\r\n	<li>Males 14-50 years, 1.3 mg</li>\r\n	<li>Males over 50 years, 1.7 mg</li>\r\n	<li>Females 14-18 years, 1.2 mg</li>\r\n	<li>Females 19-50 years, 1.3 mg</li>\r\n	<li>Females over 50 years, 1.5 mg</li>\r\n	<li>Pregnant women, 1.9 mg</li>\r\n	<li>Breast-feeding women, 2 mg</li>\r\n	<li>Some researchers think the RDA for women 19-50 years should be increased to 1.5-1.7 mg per day.&nbsp;</li>\r\n</ul>\r\n\r\n<p>The recommended maximum daily intake is:</p>\r\n\r\n<ul>\r\n	<li>Children 1-3 years, 30 mg</li>\r\n	<li>Children 4-8 years, 40 mg</li>\r\n	<li>Children 9-13 years, 60 mg</li>\r\n</ul>\r\n\r\n<p>Adults, pregnant and breast-feeding women:</p>\r\n\r\n<ul>\r\n	<li>14-18 years, 80 mg</li>\r\n	<li>over 18 years, 100 mg</li>\r\n</ul>', '<p>The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions&nbsp;are possible, but do not always occur. Your doctor or&nbsp;pharmacist&nbsp;can often prevent or manage interactions by changing how you use your medications or by close monitoring.<br />\r\n<br />\r\nTo help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including&nbsp;prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor&#39;s approval.<br />\r\n<br />\r\nSome products that may interact with this vitamin include:&nbsp;altretamine,&nbsp;cisplatin, phenytoin.<br />\r\n<br />\r\nThis vitamin may interfere with certain laboratory tests (including&nbsp;urine test&nbsp;for urobilinogen), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this vitamin.</p>', NULL, '<p>Pyridoxine&nbsp;usually has no side effects when used in recommended doses.<br />\r\n<br />\r\nIf your doctor has prescribed this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.<br />\r\n<br />\r\nPyridoxine can cause side effects when taken in large doses for a long time. Tell your doctor right away if any of these unlikely but serious side effects occur: headache, nausea, drowsiness, numbness/tingling of arms/legs.<br />\r\n<br />\r\nA very serious&nbsp;allergic reaction&nbsp;to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious&nbsp;allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.<br />\r\n<br />\r\nThis is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or&nbsp;pharmacist.</p>', '<p><strong>Category A:</strong>&nbsp;Controlled studies in women fail to demonstrate a risk to the foetus in the 1st trimester (and there is no evidence of a risk in later trimesters), and the possibility of foetal harm remains remote.</p>', '<p>Before taking&nbsp;pyridoxine, tell your doctor or&nbsp;pharmacist&nbsp;if you are allergic to it; or if you have any other&nbsp;allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.<br />\r\n<br />\r\nDuring&nbsp;pregnancy, this vitamin has been found to be safe when used in recommended doses.<br />\r\n<br />\r\nThis vitamin passes into&nbsp;breast&nbsp;milk and is considered to be safe during&nbsp;breast-feeding when used in recommended doses. Consult your doctor for more information.</p>', NULL, '<p>Vitamin-B preparations.</p>', NULL, NULL, '2022-03-14 05:20:29', '2022-03-14 05:20:29'),
(1200, 1200, '<p>This is indicated for the treatment of nausea and vomiting of pregnancy in women who do not respond to conservative management.</p>', '<p>Doxylamine Succinate is an antihistamine that blocks Histamine (H1) receptor. It can cross the blood brain barrier and has a high affinity for H1 receptors in the brain that blocks H1 receptors. It also decreases the action of histamine at the H1 receptor by inhibiting both vestibular system &amp; Muscarinic receptor. It affects the vestibular system &amp; decreases the stimulation of the vomiting center. Its muscarinic receptor inhibition may also play a role in antihistamine antiemetic activity. Pyridoxine Hydrochloride is a vitamin B6 analog. It is used to prevent nausea and vomiting due to its antiemetic properties.</p>', '<p>Initially, take one tablet orally at bedtime (Day 1). If this dose adequately controls symptoms the next day, continue taking one tablet daily at bedtime only. However, if symptoms persist on Day 2, increase the daily dose to one tablet in the morning and one tablet at bedtime. The maximum recommended dose is two tablets per day, one in the morning and one at bedtime. Take on an empty stomach with a glass of water. Swallow tablets whole. Do not crush, chew, or split this tablets. Take daily and not on an as needed basis.</p>', '<p>Use of Doxylamine Succinate &amp; Pyridoxine Hydrochloride is contraindicated in women who are taking monoamine oxidase inhibitors (MAOIs), which prolong and intensify the adverse central nervous system effects (the anticholinergic effects) of antihistamines. Concurrent use of alcohol and other CNS depressants (such as hypnotic sedatives and tranquilizers) with Doxylamine Succinate &amp; Pyridoxine Hydrochloride is not recommended.</p>', '<p>Doxylamine Succinate &amp; Pyridoxine Hydrochloride is contraindicated in women with any of the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Known hypersensitivity to Doxylamine Succinate, other ethanolamine derivative antihistamines, Pyridoxine Hydrochloride or any inactive ingredient in the formulation</li>\r\n	<li>Monoamine oxidase (MAO) inhibitors intensify and prolong the adverse central nervous system effects of Doxylamine Succinate &amp; Pyridoxine Hydrochloride</li>\r\n</ul>', '<p>Somnolence or other accidents resulting from the effect of the combined use of Doxylamine Succinate &amp; Pyridoxine Hydrochloride with CNS depressants.</p>', '<p>Pregnancy category A. This is intended for the treatment of nausea and vomiting of pregnancy in women who do not respond to conservative management. Both Doxylamine Succinate &amp; Pyridoxine Hydrochloride are excreted into breast milk. Therefore, caution should be exercised while breastfeeding.</p>', '<p>Doxylamine Succinate &amp; Pyridoxine Hydrochloride may cause somnolence due to the anticholinergic properties of Doxylamine Succinate, an antihistamine. Women should avoid engaging in activities, such as driving or operating heavy machinery, while using Doxylamine Succinate &amp; Pyridoxine Hydrochloride. Doxylamine Succinate &amp; Pyridoxine Hydrochloride use is not recommended if a woman is concurrently using central nervous system (CNS) depressants including alcohol.<br />\r\n<br />\r\nDoxylamine Succinate &amp; Pyridoxine Hydrochloride has anticholinergic properties and, therefore, should be used with caution in women with asthma, increased intraocular pressure, narrow angle glaucoma, stenosing peptic ulcer, pyloroduodenal obstruction or urinary bladder-neck obstruction.</p>', '<p>Doxylamine Succinate &amp; Pyridoxine Hydrochloride is an extended-release or Delayed Release formulation; therefore, signs and symptoms of intoxication may not be apparent immediately. Signs and symptoms of overdose may include restlessness, dryness of mouth, dilated pupils, sleepiness, vertigo, mental confusion and tachycardia. At toxic doses, Doxylamine Succinate exhibits anticholinergic effects, including seizures, rhabdomyolysis, acute renal failure and death. If treatment is needed, it consists of gastric lavage or activated charcoal, whole bowel irrigation and symptomatic treatment.</p>', '<p>Anti-emetic drugs</p>', '<p>Store at below 30&deg;C in a dry place protected from light. Keep out of reach of children.</p>', NULL, '2022-03-14 05:22:19', '2022-03-14 05:22:19'),
(1201, 1201, '<p><strong>Treatment of Toxoplasmosis</strong>: Pyrimethamine is indicated for the treatment of toxoplasmosis when used conjointly with a sulfonamide, since synergism exists with this combination.<br />\r\n<br />\r\n<strong>Treatment of Acute Malaria</strong>: Pyrimethamine is also indicated for the treatment of acute malaria. It should not be used alone to treat acute malaria. Fast-acting schizonticides such as chloroquine or&nbsp;quinine&nbsp;are indicated and preferable for the treatment of acute malaria. However, conjoint use of Pyrimethamine with a sulfonamide (e.g., sulfadoxine) will initiate transmission control and suppression of susceptible strains of plasmodia.<br />\r\n<br />\r\n<strong>Chemoprophylaxis of Malaria</strong>: Pyrimethamine is indicated for the chemoprophylaxis of malaria due to susceptible strains of plasmodia. However, resistance to pyrimethamine is prevalent worldwide. It is not suitable as a prophylactic agent for travelers to most areas.</p>', '<p>Pyrimethamine is a folic acid antagonist structurally similar to trimethoprim. It inhibits parasitic dihydrofolate reductase, thus inhibiting vital tetrahydrofolic acid synthesis. It is active against pre-erythrocytic forms and is also a slow-acting schizontocide.</p>', '<p><strong>For Treatment of Toxoplasmosis</strong>: The dosage of Pyrimethamine for the treatment of toxoplasmosis must be carefully adjusted so as to provide maximum therapeutic effect and a minimum of side effects. At the dosage required, there is a marked variation in the tolerance to the drug. Young patients may tolerate higher doses than older individuals. Concurrent administration of&nbsp;folinic acid&nbsp;is strongly recommended in all patients.<br />\r\n<br />\r\nThe adult&nbsp;starting&nbsp;dose is 50 to 75 mg of the drug daily, together with 1 to 4 g daily of a sulfonamide of the sulfapyrimidine type, e.g. sulfadoxine. This dosage is ordinarily continued for 1 to 3 weeks, depending on the response of the patient and tolerance to therapy. The dosage may then be reduced to about one half that previously given for each drug and continued for an additional 4 to 5 weeks.<br />\r\n<br />\r\nThe pediatric dosage of Pyrimethamine is 1 mg/kg/day divided into 2 equal daily doses; after 2 to 4 days this dose may be reduced to one half and continued for approximately 1 month. The usual pediatric sulfonamide dosage is used in conjunction with Pyrimethamine.<br />\r\n<br />\r\n<strong>For Treatment of Acute Malaria</strong>: Pyrimethamine is NOT recommended alone in the treatment of acute malaria. Fast-acting schizonticides, such as chloroquine or quinine, are indicated for treatment of acute malaria. However, Pyrimethamine at a dosage of 25 mg daily for 2 days with a sulfonamide will initiate transmission control and suppression of non-falciparum malaria.&nbsp;Pyrimethamine is only recommended for patients infected in areas where susceptible plasmodia exist. Should circumstances arise wherein Pyrimethamine must be used alone in semi- immune persons, the adult dosage for acute malaria is 50 mg for 2 days; children 4 through 10 years old may be given 25 mg daily for 2 days. In any event, clinical cure should be followed by the once-weekly regimen described below for chemoprophylaxis. Regimens which include suppression should be extended through any characteristic periods of early&nbsp;recrudescence&nbsp;and late relapse, i.e., for at least 10 weeks in each case.<br />\r\n<br />\r\nFor Chemoprophylaxis of Malaria:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and pediatric patients over 10 years</strong>: 25 mg (1 tablet) once weekly</li>\r\n	<li><strong>Children 4 through 10 years:</strong>&nbsp;12.5 mg (&frac12; tablet) once weekly</li>\r\n	<li><strong>Infants and children under 4 years:</strong>&nbsp;6.25 mg (&frac14; tablet) once weekly.</li>\r\n</ul>', '<p>Pyrimethamine may be used with sulfonamides, quinine and other antimalarials, and with other antibiotics. However, the concomitant use of other antifolic drugs or agents associated with myelosuppression including sulfonamides or trimethoprim-sulfamethoxazole combinations, proguanil, zidovudine, or cytostatic agents (e.g., methotrexate), while the patient is receiving pyrimethamine, may increase the risk of bone marrow suppression. If signs of folate deficiency develop, pyrimethamine should be discontinued. Folinic acid (leucovorin) should be administered until normal hematopoiesis is restored</p>', '<p>Use of Pyrimethamine is contraindicated in patients with known hypersensitivity to pyrimethamine or to any component of the formulation. Use of the drug is also contraindicated in patients with documented megaloblastic anemia due to folate deficiency.</p>', '<p>Hypersensitivity reactions, occasionally severe (such as Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme, and anaphylaxis), and hyperphenylalaninemia, can occur particularly when pyrimethamine is administered concomitantly with a sulfonamide. Consult the complete prescribing information for the relevant sulfonamide for sulfonamideassociated adverse events. With doses of pyrimethamine used for the treatment of toxoplasmosis, anorexia and vomiting may occur. Vomiting may be minimized by giving the medication with meals; it usually disappears promptly upon reduction of dosage. Doses used in toxoplasmosis may produce megaloblastic anemia, leukopenia, thrombocytopenia, pancytopenia, neutropenia, atrophic glossitis, hematuria, and disorders of cardiac rhythm.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C. Pyrimethamine has been shown to be teratogenic in rats when given in oral doses 7 times the human dose for chemoprophylaxis of malaria or 2.5 times the human dose for treatment of toxoplasmosis. At these doses in rats, there was a significant increase in abnormalities such as cleft palate, brachygnathia, oligodactyly, and microphthalmia. Pyrimethamine has also been shown to produce terata such as meningocele in hamsters and cleft palate in miniature pigs when given in oral doses 170 and 5 times the human dose, respectively, for chemoprophylaxis of malaria or for treatment of toxoplasmosis.<br />\r\n<br />\r\nThere are no adequate and well-controlled studies in pregnant women. Pyrimethamine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\nConcurrent administration of folinic acid is strongly recommended when used for the treatment of toxoplasmosis during pregnancy.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: Pyrimethamine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from pyrimethamine and from concurrent use of a sulfonamide with Pyrimethamine for treatment of some patients with toxoplasmosis, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother</p>', '<p>The recommended dosage for chemoprophylaxis of malaria should not be exceeded. Pyrimethamine should be used with caution in patients with impaired renal or hepatic function or in patients with possible folate deficiency, such as individuals with malabsorption syndrome, alcoholism, or pregnancy, and those receiving therapy, such as phenytoin, affecting folate levels.</p>', NULL, '<p>Anti-malarial drugs.</p>', NULL, '<p><strong>Geriatric Use:</strong>&nbsp;Clinical studies of Pyrimethamine did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.</p>', '2022-03-14 05:24:02', '2022-03-14 05:24:02'),
(1202, 1202, '<p><strong>Chronic Hepatitis C</strong>: Peginterferon alfa-2a alone or in combination with Ribavirin, is indicated for the treatment of adults with chronic hepatitis C (CHC) virus infection who have compensated liver disease and have not been previously treated with interferon alpha.<br />\r\n<br />\r\n<strong>Chronic Hepatitis B</strong>: Peginterferon alfa-2a is indicated for the treatment of adult patients with HBeAg positive and HBeAg negative chronic hepatitis B who have compensated liver disease and evidence of viral replication and liver inflammation.</p>', '<p>Peginterferon alfa-2a are interferon proteins bound to polyethylene glycol (PEG) molecules resulting in higher and more prolonged serum interferon concentrations. It has antiviral, antiproliferative and immune-regulating activity. Interferons are activated when it interacts with cells through high affinity cell surface receptors. The effects of this activation include the induction of gene transcription, inhibition of cellular growth, alteration of cellular differentiation, interference with oncogene expression, alteration of cell surface antigen expression, increase in phagocytic activity of macrophages and augmentation of cytotoxicity of lymphocytes for target cells.</p>', '<p><strong>Chronic hepatitis C</strong>: The recommended dose of Peg interferon is 180 mcg once weekly for 48 weeks by subcutaneous administration on abdomen or thigh<br />\r\n<br />\r\n<strong>Chronic hepatitis B</strong>: The recommended dose of Peg interferon is 180 mcg once weekly for 48 weeks by subcutaneous administration on abdomen or thigh<br />\r\n<br />\r\nHepatitis C Genotype 1 &amp; 4:</p>\r\n\r\n<ul>\r\n	<li><strong>Pegylated Interferon alfa-2a Monotherapy</strong>: 180 mcg once weekly for 48 weeks</li>\r\n	<li><strong>Pegylated Interferon alfa-2a dual therapy</strong>: 180 mcg once weekly for 48 weeks; Celbarin: &lt;75 kg= (400+0+600) mg, &gt;75 kg= (600+0+600) mg.</li>\r\n</ul>\r\n\r\n<p>Hepatitis C Genotype 2 &amp; 3:</p>\r\n\r\n<ul>\r\n	<li><strong>Pegylated Interferon alfa-2a Monotherapy</strong>: 180 mcg once weekly for 48 weeks</li>\r\n	<li><strong>Pegylated Interferon&nbsp;</strong>alfa<strong>-2a dual therapy</strong>: 180 mcg once weekly for 24 weeks; Celbarin: (400+0+400) mg.</li>\r\n</ul>', '<ul>\r\n	<li>Drugs metabolized by CYP1A2: monitor for increased serum levels of theophylline and adjust dose accordingly</li>\r\n	<li>Methadone: monitor for signs and symptoms of methadone toxicity</li>\r\n	<li>Nucleoside analogues: closely monitor for toxicities and dose reduce or discontinue Peginterferon alfa 2a/ Ribavirin or both should event worsen</li>\r\n	<li>Zidovudine: monitor for worsening neutropenia and/or anemia with peginterferon alfa/rifavirin</li>\r\n	<li>Azathioprine.</li>\r\n</ul>', '<ul>\r\n	<li>Hypersensitivity to any component of the product</li>\r\n	<li>Autoimmune hepatitis</li>\r\n	<li>Hepatic decompensation in cirrhotic patients before or during treatment</li>\r\n	<li>Hepatic decompensation with Child-Pugh score greater than or equal to 6 in cirrhotic CHC patients co infected with HIV during or before treatment</li>\r\n	<li>Neonate or infants.</li>\r\n</ul>', '<ul>\r\n	<li>Depression, suicide, relapse of drug abuse and bacterial infection</li>\r\n	<li>Flu like symptoms: Fatigue, pyrexia,</li>\r\n	<li>Gastrointestinal: Nausea/Vomiting, diarrhea, abdominal pain</li>\r\n	<li>Metabolic and Nutritional: Anorexia</li>\r\n	<li>Musculoskeletal: Myalgia, arthralgia</li>\r\n	<li>Neurological: Headache, dizziness, insomnia</li>\r\n	<li>Psychiatric reactions: Irritability, anxiety</li>\r\n	<li>Injection site reaction, skin problems, hair loss</li>\r\n	<li>Endocrine: Hypothyroidism</li>\r\n</ul>', '<p><strong>Pregnancy</strong>&nbsp;Category C: Peginterferon alfa-2a monotherapy. There are no adequate and well controlled trial on pregnant women &amp; developing fetus due to teratogenic effects. Peginterferon alfa-2a is recommended for use in women of childbearing potential only when they are using effective contraception during therapy.<br />\r\n<br />\r\n<strong>Pregnancy&nbsp;</strong>Category X. It is not known whether peginterferon or ribavirin or its components are excreted in human milk. Because of the potential for adverse reactions from the drugs in nursing infants, a decision must be made whether to discontinue nursing or discontinue peginterferon and ribavirin treatment.</p>', '<ul>\r\n	<li>Patients who have failed alpha interferon treatment with or without ribavirin</li>\r\n	<li>Liver or other organ transplant recipients</li>\r\n	<li>Hepatitis B patients coinfected with HCV or HIV</li>\r\n	<li>Hepatitis C patients coinfected with HBV or coinfected with HIV with a CD4+ cell count &lt; 100 cells/&micro;L</li>\r\n	<li>Caution should be exercised in initiating treatment in any patient with baseline risk of severe anemia</li>\r\n</ul>', '<p>There are limited experiences of overdose. There were no serious reactions attributed to overdose. There is no specific antidote. Dialysis is not effective.</p>', '<p>Hepatic viral infections (Hepatitis B), Hepatic viral infections (Hepatitis C).</p>', '<p>Store in refrigerator at 2-8&deg; C; do not freeze or shake. Protect from light.</p>', '<p><strong>Hepatic Impairment:</strong><br />\r\n<br />\r\n<strong>Chronic hepatitis C:</strong>&nbsp;Alanine transaminase (ALT) progressively rising above baseline: Decrease dose to 135 mcg/wk. If ALT continues to rise or is accompanied by increased bilirubin or hepatic decompensation, discontinue immediately.<br />\r\n<strong>Chronic hepatitis B:</strong>&nbsp;Alanine transaminase (ALT) &gt;5 times the upper limits of normal: Monitor LFTs more frequently; consider 135 mcg/wk or temporarily discontinuing (may resume after ALT flare subsides). ALT &gt;10 times the upper limits of normal: Consider discontinuing.<br />\r\n<br />\r\n<strong>Dose modifications:</strong><br />\r\n<br />\r\nFor moderate-to-severe adverse reactions: Initially, 135 mcg/wk or in some cases, 90 mcg/wk. Haematologic parameters: ANC &lt;750/mm3: 135 mcg/wk; ANC &lt;500/mm3: Discontinue therapy until &gt;1000/mm3, then restart at 90 mcg/wk; monitor ANC. Platelet count: &lt;50,000/mm3: 90 mcg/wk; &lt;25,000/mm3: Discontinue therapy. Depression: Moderate: Decrease to 90-135 mcg once/wk; evaluate once wkly, if symptoms improve and remain stable for 4 wk, continue reduced dosing or return to normal dose; Severe: Discontinue treatment permanently. Administer in the abdomen or thigh.<br />\r\n<br />\r\n<strong>Renal Impairment:</strong><br />\r\nCrCl &lt;50:&nbsp;Use caution; monitor for toxicity .</p>', '2022-03-15 04:13:11', '2022-03-15 04:13:11'),
(1203, 1203, '<p>Pegylated erythropoietin is indicated for the treatment of anemia associated with chronic kidney disease (CKD) in adult patients on dialysis and patients, not on dialysis.<br />\r\n<br />\r\nIt is not indicated for use:</p>\r\n\r\n<ul>\r\n	<li>In the treatment of anemia due to cancer chemotherapy.</li>\r\n	<li>As a substitute for RBC transfusions in patients who require immediate correction of anemia.</li>\r\n</ul>', '<p>Pegylated erythropoietin is an erythropoietin receptor activator with greater activity in vivo as well as increased half-life, in contrast to erythropoietin. It differs from erythropoietin through the integration of an amide bond between the N-terminal amino group or the &epsilon;-amino group of any lysine present in erythropoietin, predominantly Lys52 and Lys45 and Pegylated Erythropoietin (PEG).</p>', '<p>Initiate Pegylated Erythropoietin treatment when the hemoglobin level is less than 10 g/dL. If the hemoglobin level approaches or exceeds 11 g/dL, reduce or interrupt the dose of Pegylated Erythropoietin.<br />\r\n<br />\r\nIf the hemoglobin rises rapidly (e.g, more than 1 g/dL in any 2 week period), reduce the dose of Pegylated Erythropoietin by 25% or more as needed to reduce rapid responses. And for patients who do not respond adequately, if the hemoglobin has not increased by more than 1 g /dL after 4 weeks of therapy, increase the dose by 25%<br />\r\n<br />\r\nFor patients who do not respond adequately over a 12 week escalation period, increasing the Pegylated Erythropoietin dose further is unlikely to improve response and may increase risks<br />\r\n<br />\r\nFor patients with CKD on dialysis:</p>\r\n\r\n<ul>\r\n	<li>The recommended starting dose of Pegylated Erythropoietin for the treatment of anemia in adult CKD patients who are not currently treated with an ESA is 0.6 mcg/kg body weight administered as a single IV or SC injection once every two weeks.</li>\r\n	<li>Once the hemoglobin has been stabilized, it may be administered once monthly using a dose that is twice that of the every two-week dose and subsequently titrated as necessary.</li>\r\n</ul>\r\n\r\n<p>For patients with CKD not on dialysis:</p>\r\n\r\n<ul>\r\n	<li>The recommended starting dose of Pegylated erythropoietin for the treatment of anemia in adult CKD patients who are not currently treated with an ESA is 0.6 mcg/kg body weight administered as a single IV or SC injection once every two weeks.</li>\r\n	<li>Once the hemoglobin has been stabilized, it may be administered once monthly using a dose that is twice that of the every two-week dose and subsequently titrated as necessary.</li>\r\n	<li>Conversion from another ESA to Pegylated erythropoietin: It can be administered once every two weeks or once monthly to patients whose hemoglobin has been stabilized by treatment with an ESA.</li>\r\n</ul>', NULL, NULL, '<ul>\r\n	<li>Increased Mortality, Myocardial Infarction, Stroke, and Thromboembolism</li>\r\n	<li>Increased mortality and/or tumor progression in patients with cancer</li>\r\n	<li>Hypertension</li>\r\n	<li>Seizures</li>\r\n	<li>Pure red cell aplasia</li>\r\n	<li>Serious allergic reactions</li>\r\n</ul>', '<p>Pregnancy Category C. It is not known whether it is excreted into human breast milk. Because many drugs are excreted in human milk, caution should be exercised when it is administered to a nursing woman.<br />\r\n<br />\r\nEvaluation of Iron stores: Supplementary iron therapy is recommended for all patients with serum ferritin values below 100 mcg/L or with transferrin saturation below 20%. To ensure effective erythropoiesis, iron status has to be evaluated for all patients prior to and during treatment.</p>', '<ul>\r\n	<li>Using ESA to target a hemoglobin level of &gt;11 g/dL increase the rate of serious adverse cardiovascular reactions. It should be used with caution in patients with co-existant cardiovascular disease, stroke, seizure etc.</li>\r\n	<li>Control hypertension prior to initiating of and during treatment with it</li>\r\n	<li>Monitoring of patients for the change in seizure frequency or premonitory symptoms.</li>\r\n	<li>If severe anemia and low reticulocyte count develop during the treatment, withhold it and evaluate patients for neutralizing antibodies to erythropoietin</li>\r\n</ul>', '<p>Pegylated Erythropoietin overdosage can elevate hemoglobin levels above the desired level, which should be managed with discontinuation or reduction of Pegylated Erythropoietin dosage and/or with phlebotomy. Cases of severe hypertension have been observed following overdose with ESAs.</p>', '<p>Drugs for Haemolytic Hypoplastic &amp; Renal Anemia.</p>', '<p>Store at 2&deg;C to 8&deg;C at the refrigerator. Protect from light. Do not shake the syringe. Keep out of the reach of children.</p>', NULL, '2022-03-15 04:16:01', '2022-03-15 04:16:01'),
(1204, 1204, '<p>Pembrolizumab is a programmed death receptor-1 (PD-1)-blocking antibody indicated:<br />\r\n<br />\r\n<strong>Melanoma</strong>:</p>\r\n\r\n<ul>\r\n	<li>for the treatment of patients with unresectable or metastatic melanoma.</li>\r\n	<li>for the adjuvant treatment of patients with melanoma with involvement of lymph node(s) following complete resection.</li>\r\n</ul>\r\n\r\n<p><strong>Non-Small Cell Lung Cancer (NSCLC)</strong>:</p>\r\n\r\n<ul>\r\n	<li>in combination with pemetrexed and platinum chemotherapy, as first-line treatment of patients with metastatic nonsquamous NSCLC, with no EGFR or ALK genomic tumor aberrations.</li>\r\n	<li>in combination with carboplatin and either paclitaxel or paclitaxel protein-bound, as first-line treatment of patients with metastatic squamous NSCLC.</li>\r\n	<li>as a single agent for the first-line treatment of patients with NSCLC expressing PD-L1 [Tumor Proportion Score (TPS) &ge;1%] as determined by an FDA-approved test, with no EGFR or ALK genomic tumor aberrations, and is: stage III where patients are not candidates for surgical resection or definitive chemoradiation, or metastatic.</li>\r\n	<li>as a single agent for the treatment of patients with metastatic NSCLC whose tumors express PD-L1 (TPS &ge;1%) as determined by an FDA-approved test, with disease progression on or after platinum-containing chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving Pembrolizumab.</li>\r\n</ul>\r\n\r\n<p><strong>Small Cell Lung Cancer (SCLC)</strong>: for the treatment of patients with metastatic SCLC with disease progression on or after platinum-based chemotherapy and at least one other prior line of therapy.<br />\r\n<br />\r\n<strong>Head and Neck Squamous Cell Cancer (HNSCC)</strong>:</p>\r\n\r\n<ul>\r\n	<li>in combination with platinum and FU for the first-line treatment of patients with metastatic or with unresectable, recurrent HNSCC.</li>\r\n	<li>as a single agent for the first-line treatment of patients with metastatic or with unresectable, recurrent HNSCC whose tumors express PD-L1 [Combined Positive Score (CPS) &ge;1] as determined by an FDA-approved test.</li>\r\n	<li>as a single agent for the treatment of patients with recurrent or metastatic HNSCC with disease progression on or after platinum-containing chemotherapy.</li>\r\n</ul>\r\n\r\n<p><strong>Classical Hodgkin Lymphoma (cHL)</strong>: for the treatment of adult and pediatric patients with refractory cHL, or who have relapsed after 3 or more prior lines of therapy.<br />\r\n<br />\r\n<strong>Primary Mediastinal Large B-Cell Lymphoma (PMBCL)</strong>: for the treatment of adult and pediatric patients with refractory PMBCL, or who have relapsed after 2 or more prior lines of therapy.&nbsp;<br />\r\n<br />\r\n<strong>Urothelial Carcinoma</strong>:</p>\r\n\r\n<ul>\r\n	<li>for the treatment of patients with locally advanced or metastatic urothelial carcinoma who are not eligible for cisplatin-containing chemotherapy and whose tumors express PD-L1 [Combined Positive Score (CPS) &ge;10] as determined by an FDA-approved test, or in patients who are not eligible for any platinum-containing chemotherapy regardless of PD-L1 status.</li>\r\n	<li>for the treatment of patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.</li>\r\n	<li>for the treatment of patients with Bacillus Calmette-Guerin (BCG)-unresponsive, high-risk, non-muscle invasive bladder cancer (NMIBC) with carcinoma in situ (CIS) with or without papillary tumors who are ineligible for or have elected not to undergo cystectomy.</li>\r\n</ul>\r\n\r\n<p><strong>Microsatellite Instability-High Cancer</strong>: for the treatment of adult and pediatric patients with unresectable or metastatic, microsatellite instability-high (MSI-H) or mismatch repair deficient. solid tumors that have progressed following prior treatment and who have no satisfactory alternative treatment options, or colorectal cancer that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan.<br />\r\n<br />\r\n<strong>Gastric Cancer</strong>: for the treatment of patients with recurrent locally advanced or metastatic gastric or gastroesophageal junction adenocarcinoma whose tumors express PD-L1 [Combined Positive Score (CPS) &ge;1] as determined by an FDA-approved test, with disease progression on or after 2 or more prior lines of therapy including fluoropyrimidine- and platinum-containing chemotherapy and if appropriate, HER2/neu-targeted therapy.<br />\r\n<br />\r\n<strong>Esophageal Cancer</strong>: for the treatment of patients with recurrent locally advanced or metastatic squamous cell carcinoma of the esophagus whose tumors express PD-L1 [Combined Positive Score (CPS) &ge;10] as determined by an FDA-approved test, with disease progression after one or more prior lines of systemic therapy.<br />\r\n<br />\r\n<strong>Cervical Cancer</strong>: for the treatment of patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy whose tumors express PD-L1 [Combined Positive Score (CPS) &ge;1] as determined by an FDA-approved test.<br />\r\n<br />\r\n<strong>Hepatocellular Carcinoma (HCC)</strong>: for the treatment of patients with HCC who have been previously treated with sorafenib.<br />\r\n<br />\r\n<strong>Merkel Cell Carcinoma (MCC)</strong>: for the treatment of adult and pediatric patients with recurrent locally advanced or metastatic Merkel cell carcinoma.<br />\r\n<br />\r\n<strong>Renal Cell Carcinoma (RCC)</strong>: in combination with axitinib, for the first-line treatment of patients with advanced RCC.<br />\r\n<br />\r\n<strong>Endometrial Carcinoma</strong>: in combination with lenvatinib, for the treatment of patients with advanced endometrial carcinoma that is not MSI-H or dMMR, who have disease progression following prior systemic therapy and are not candidates for curative surgery or radiation.</p>', '<p>Binding of the PD-1 ligands, PD-L1 and PD-L2, to the PD-1 receptor found on T cells, inhibits T cell proliferation and cytokine production. Upregulation of PD-1 ligands occurs in some tumors and signaling through this pathway can contribute to inhibition of active T-cell immune surveillance of tumors. Pembrolizumab is a monoclonal antibody that binds to the PD-1 receptor and blocks its interaction with PD-L1 and PD-L2, releasing PD-1 pathway-mediated inhibition of the immune response, including the anti-tumor immune response. In syngeneic mouse tumor models, blocking PD-1 activity resulted in decreased tumor growth.</p>', '<ul>\r\n	<li>Melanoma: 200 mg every 3 weeks</li>\r\n	<li>NSCLC: 200 mg every 3 weeks</li>\r\n	<li>SCLC: 200 mg every 3 weeks</li>\r\n	<li>HNSCC: 200 mg every 3 weeks</li>\r\n	<li>cHL or PMBCL: 200 mg every 3 weeks for adults; 2 mg/kg (up to 200 mg) every 3 weeks for pediatrics</li>\r\n	<li>Urothelial Carcinoma: 200 mg every 3 weeks</li>\r\n	<li>MSI-H Cancer: 200 mg every 3 weeks for adults and 2 mg/kg (up to 200 mg) every 3 weeks for pediatrics</li>\r\n	<li>Gastric Cancer: 200 mg every 3 weeks</li>\r\n	<li>Esophageal Cancer: 200 mg every 3 weeks</li>\r\n	<li>Cervical Cancer: 200 mg every 3 weeks</li>\r\n	<li>HCC: 200 mg every 3 weeks</li>\r\n	<li>MCC: 200 mg every 3 weeks for adults; 2 mg/kg (up to 200 mg) every 3 weeks for pediatrics</li>\r\n	<li>RCC: 200 mg every 3 weeks with axitinib 5 mg orally twice daily</li>\r\n	<li>Endometrial Carcinoma: 200 mg every 3 weeks with lenvatinib 20 mg orally once daily for tumors that are not MSI-H or dMMR.</li>\r\n</ul>\r\n\r\n<p>Administer Pembrolizumab as an intravenous infusion over 30 minutes.</p>', NULL, '<p>None.</p>', '<p>Most common adverse reactions (reported in &ge;20% of patients) were:<br />\r\n<br />\r\n<strong>Pembrolizumab as a single agent</strong>: fatigue, musculoskeletal pain, decreased appetite, pruritus, diarrhea, nausea, rash, pyrexia, cough, dyspnea, constipation, pain, and abdominal pain.<br />\r\n<br />\r\n<strong>Pembrolizumab in combination with chemotherapy</strong>: fatigue/asthenia, nausea, constipation, diarrhea, decreased appetite, rash, vomiting, cough, dyspnea, pyrexia, alopecia, peripheral neuropathy, mucosal inflammation, and stomatitis.<br />\r\n<br />\r\n<strong>Pembrolizumab in combination with axitinib</strong>: diarrhea, fatigue/asthenia, hypertension, hepatotoxicity, hypothyroidism, decreased appetite, palmar-plantar erythrodysesthesia, nausea, stomatitis/mucosal inflammation, dysphonia, rash, cough, and constipation.<br />\r\n<br />\r\n<strong>Pembrolizumab in combination with lenvatinib</strong>: fatigue, hypertension, musculoskeletal pain, diarrhea, decreased appetite, hypothyroidism, nausea, stomatitis, vomiting, decreased weight, abdominal pain, headache, constipation, urinary tract infection, dysphonia, hemorrhagic events, hypomagnesemia, palmar-plantar erythrodysesthesia, dyspnea, cough, and rash.</p>', '<p>Based on its mechanism of action, Pembrolizumab can cause fetal harm when administered to a pregnant woman. There are no available human data informing the risk of embryo-fetal toxicity. There are no data on the presence of pembrolizumab in either animal or human milk or its effects on the breastfed child or on milk production. Because of the potential for serious adverse reactions in breastfed children, advise women not to breastfeed during treatment with Pembrolizumab and for 4 months after the final dose.</p>', '<p><strong>Immune-mediated pneumonitis</strong>: Withhold for moderate, and permanently discontinue for severe, life-threatening or recurrent moderate pneumonitis.<br />\r\n<br />\r\n<strong>Immune-mediated colitis</strong>: Withhold for moderate or severe, and permanently discontinue for life-threatening colitis.<br />\r\n<br />\r\n<strong>Immune-mediated hepatitis (Pembrolizumab) and hepatotoxicity (Pembrolizumab in combination with axitinib)</strong>: Monitor for changes in hepatic function. Based on severity of liver enzyme elevations, withhold or discontinue Pembrolizumab, axitinib, or Pembrolizumab and axitinib. Consider corticosteroid therapy.<br />\r\n<br />\r\nImmune-mediated endocrinopathies:</p>\r\n\r\n<ul>\r\n	<li><strong>Adrenal insufficiency</strong>: Withhold for moderate and withhold or permanently discontinue for severe or life-threatening adrenal insufficiency.</li>\r\n	<li><strong>Hypophysitis</strong>: Withhold for moderate and withhold or permanently discontinue for severe or life-threatening hypophysitis.</li>\r\n	<li><strong>Thyroid disorders</strong>: Monitor for changes in thyroid function. Withhold or permanently discontinue for severe or life-threatening hyperthyroidism.</li>\r\n	<li><strong>Type 1 diabetes mellitus</strong>: Monitor for hyperglycemia. Withhold Pembrolizumab in cases of severe hyperglycemia.</li>\r\n</ul>\r\n\r\n<p><strong>Immune-mediated nephritis</strong>: Monitor for changes in renal function. Withhold for moderate, and permanently discontinue for severe or life-threatening nephritis.<br />\r\n<br />\r\n<strong>Immune-mediated skin adverse reactions including, Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)</strong>: Withhold for severe and permanently discontinue for life-threatening skin reactions.<br />\r\n<br />\r\n<strong>Other immune-mediated adverse reactions</strong>: In organ transplant recipients, consider the benefit of treatment with Pembrolizumab versus the risk of possible organ rejection.<br />\r\n<br />\r\n<strong>Infusion-related reactions</strong>: Stop infusion and permanently discontinue Pembrolizumab for severe or life-threatening infusion reactions.<br />\r\n<br />\r\n<strong>Complications of allogeneic HSCT</strong>: Allogeneic HSCT after treatment with Pembrolizumab: Monitor for hepatic veno-occlusive disease, grade 3-4 acute GVHD including hyperacute GVHD, steroid-requiring febrile syndrome, and other immune-mediated adverse reactions. Transplant-related mortality has occurred. Allogeneic HSCT prior to treatment with Pembrolizumab: In patients with a history of allogeneic HSCT, consider the benefit of treatment with Pembrolizumab versus the risk of GVHD.<br />\r\n<br />\r\nTreatment of patients with multiple myeloma with a PD-1 or PD-L1 blocking antibody in combination with a thalidomide analogue plus dexamethasone is not recommended outside of controlled clinical trials.<br />\r\n<br />\r\n<strong>Embryo-Fetal toxicity</strong>: Can cause fetal harm. Advise females of reproductive potential of the potential risk to a fetus and to use effective method of contraception.</p>', NULL, '<p>Immunological Chemotherapy, Immunosuppressant.</p>', '<p>Store vials under refrigeration at 2&deg;C to 8&deg;C.</p>', '<p>The safety and effectiveness of Pembrolizumab in pediatric patients have not been established. No overall differences in safety or effectiveness were observed between elderly patients and younger patients.</p>', '2022-03-15 04:17:50', '2022-03-15 04:17:50');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1205, 1205, '<p>Pemetrexed is indicated for:</p>\r\n\r\n<ul>\r\n	<li>Initial treatment of patients with locally advanced or metastatic, non-squamous,&nbsp;non-small cell lung cancer&nbsp;(NSCLC) in combination with&nbsp;cisplatin.</li>\r\n	<li>Maintenance treatment of patients with locally advanced or metastatic, non-squamous NSCLC whose disease has not progressed after four cycles of platinum-based first-line&nbsp;chemotherapy, as a single agent.</li>\r\n	<li>Treatment of patients with&nbsp;recurrent, metastatic non-squamous, NSCLC after prior chemotherapy, as a single agent.</li>\r\n</ul>', '<p>Pemetrexed is a thymidylate synthase inhibitor. It works by inhibiting thymidylate synthase, dihydrofolate reductase, glycinamide ribonucleotide formyltransferase and aminoimidazole carboxamide ribonucleotide formyltransferase, the enzymes involved in folate metabolism and DNA synthesis, thus inhibiting purine and thymidine nucleotide and protein synthesis.</p>', '<p>Recommended Dosage And Schedule For Non-Squamous NSCLC:</p>\r\n\r\n<ul>\r\n	<li><strong>The recommended dose of Pemetrexed in combination with cisplatin for initial treatment of NSCLC in patients with a creatinine clearance (calculated by Cockcroft-Gault equation) of 45 mL/min or greater</strong>&nbsp;is 500 mg/m&sup2; as an intravenous infusion over 10 minutes administered prior to cisplatin on Day 1 of each 21-day cycle for up to six cycles in the absence of disease progression or unacceptable toxicity.</li>\r\n	<li><strong>The recommended dose of Pemetrexed for maintenance treatment of NSCLC in patients with a creatinine clearance (calculated by Cockcroft-Gault equation) of 45 mL/min or greater</strong>&nbsp;is 500 mg/m&sup2; as an intravenous infusion over 10 minutes on Day 1 of each 21-day cycle until disease progression or unacceptable toxicity after four cycles of platinum-based first-line chemotherapy.</li>\r\n	<li><strong>The recommended dose of Pemetrexed for treatment of recurrent NSCLC in patients with a creatinine clearance (calculated by Cockcroft-Gault equation) of 45 mL/min or greater</strong>&nbsp;is 500 mg/m&sup2; as an intravenous infusion over 10 minutes on Day 1 of each 21-day cycle until disease progression or unacceptable toxicity.</li>\r\n</ul>\r\n\r\n<p><strong>Recommended Dosage And Schedule For Mesothelioma</strong>: The recommended dose of Pemetrexed, administered in combination with cisplatin, in patients with a creatinine clearance (calculated by Cockcroft-Gault equation) of 45 mL/min or greater is 500 mg/m&sup2; as an intravenous infusion over 10 minutes on Day 1 of each 21-day cycle until disease progression or unacceptable toxicity.</p>', '<p>High doses of NSAIDs and aspirin may reduce the elimination of pemetrexed; avoid usage 2 days (5 days for longer-acting NSAIDs) before, during and 2 days after treatment with pemetrexed in patients with impaired renal function. Additive GI side effects when used with SSRIs, acetylcholinesterase inhibitors, aripiprazole or ziprasidone. Additive sedation when used with psychotropics. Concurrent use with nephrotoxic drugs (e.g. aminoglycosides, loop diuretics, platinum compounds and ciclosporin) may decrease pemetrexed clearance, thus increasing the risk of toxicity. Clearance may be reduced when used with drugs that are cleared by tubular secretion e.g. probenecid and penicillin.</p>', '<p>Pemetrexed is contraindicated in patients with a history of severe hypersensitivity reaction to pemetrexed.</p>', '<p>The following adverse reactions are discussed in greater detail in other sections of the labeling:</p>\r\n\r\n<ul>\r\n	<li>Myelosuppression</li>\r\n	<li>Renal failure</li>\r\n	<li>Bullous&nbsp;and exfoliative skin toxicity&nbsp;</li>\r\n	<li>Interstitial&nbsp;pneumonitis</li>\r\n	<li>Radiation&nbsp;recall</li>\r\n</ul>', '<p><strong>Pregnancy&nbsp;</strong>Category D. There is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).<br />\r\n<br />\r\n<strong>Lactation</strong>: Advise women not to breastfeed during treatment with Pemetrexed and for 1 week after the final dose.</p>', '<p>Monitor CBC. Premedication with folate and vitamin B12 are recommended as prophylaxis against haematological and GI toxicity during treatment. Pre-treatment with a corticosteroid also reduces the incidence and severity of skin reactions. Caution when used in renal or hepatic impairment. Not recommended for use in pregnancy and lactation.</p>', '<p>No drugs are approved for the treatment of Pemetrexed overdose. Based on animal studies, administration of leucovorin may mitigate the toxicities of Pemetrexed overdosage. It is not known whether pemetrexed is dialyzable.</p>', '<p>Cytotoxic Chemotherapy.</p>', '<p>Store at 25&deg;C (77&deg;F); excursions permitted to 15-30&deg;C (59-86&deg;F).</p>', '<p><strong>Renal Impairment</strong>: Pemetrexed dosing recommendations are provided for patients with a creatinine clearance (calculated by Cockcroft-Gault equation) of 45 mL/min or greater. There is no recommended dose for patients whose creatinine clearance is less than 45 mL/min<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: The safety and effectiveness of Pemetrexed in pediatric patients have not been established.&nbsp;<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Of the 3,946 patients enrolled in clinical studies of Pemetrexed, 34% were 65 and over and 4% were 75 and over. No overall differences in effectiveness were observed between these patients and younger patients. The incidences of Grade 3-4 anemia, fatigue, thrombocytopenia, hypertension, and neutropenia were higher in patients 65 years of age and older as compared to younger patients: in at least one of five randomized clinical trials.</p>', '2022-03-15 04:19:44', '2022-03-15 04:19:44'),
(1206, 1206, '<p>Pemirolast ophthalmic solution is indicated for the prevention of itching of the eye due to allergic conjunctivitis.</p>', '<p>Pemirolast binds to the histamine H1 receptor. This blocks the action of endogenous histamine, which subsequently leads to temporary relief of the negative symptoms brought on by histamine. Pemirolast has also been observed to inhibit antigen-stimulated calcium ion influx into mast cells through the blockage of calcium channels. Pemirolast inhibits the chemotaxis of eosinophils into ocular tissue, and prevents inflammatory mediator release from human eosinophils.</p>', '<p><strong>Adult</strong>: 1 to 2 drops in each affected eye four times daily.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients below the age of 3 years have not been established.</p>', NULL, '<p>Pemirolast ophthalmic solution is contraindicated in patients with previously demonstrated hypersensitivity to any of the ingredients of this product.</p>', '<p>Burning of eye, dry eye, ocular discomfort, non ocular allergy, sinusitis, headache and sneezing or nasal congestion.</p>', '<p><strong>Pregnancy:</strong>&nbsp;There are no adequate and well-controlled studies in pregnant women. Pemirolast ophthalmic solution should be used during pregnancy only if the benefit outweighs the risk.<br />\r\n<br />\r\n<strong>Lactation:</strong>&nbsp;It is not known whether Pemirolast Potassium is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Pemirolast ophthalmic solution is administered to a nursing woman.</p>', '<p>To prevent contaminating the dropper tip and solution, do not touch the eyelids or surrounding areas with &nbsp;the dropper tip. Keep the bottle tightly closed when not in use Patients should be advised not to wear contact lens if their eye is red Pemirolast should not be used to treat contact lens related irritation Patients should wait 10 minutes after applying Pemirolast before they insert contact lenses.</p>', NULL, '<p>Ophthalmic Non-Steroid drugs.</p>', '<p>Store at 15-25&deg; C. Keep out of reach of children. Do not use more than 4 weeks after opening.</p>', NULL, '2022-03-15 04:21:09', '2022-03-15 04:21:09'),
(1207, 1207, '<p>For the relief of moderate to severe pain. Pentazocine may also be used for preoperativeor preanesthetic medication and as a supplement to surgical&nbsp;anesthesia.</p>', '<p>Pentazocine is a benzomorphan derivative with mixed opioid agonist and antagonist actions. It alters perception of and response to pain and produces generalised CNS depression by binding to opiate receptors in the CNS and acting as a partial agonist/antagonist.</p>', '<p>Tablet:</p>\r\n\r\n<p><strong>Adults</strong>: The usual initial adult dose is 1 tablet every three or four hours. This may be increased to 2 tablets when needed. Total daily dosage should not exceed 12 tablets.<br />\r\n&nbsp;</p>\r\n\r\n<p>Injection:</p>\r\n\r\n<p><strong>Adults, Excluding Patients in Labor</strong>: The recommended single&nbsp;parenteral&nbsp;dose is 30 mg by&nbsp;intramuscular, subcutaneous, or intravenous route. This may be repeated every 3 to 4 hours. Doses in excess of 30 mg intravenously or 60 mg intramuscularly or subcutaneously are not recommended. Total daily dosage should not exceed 360 mg. Elderly patients may be more sensitive to the&nbsp;analgesic&nbsp;effects of Pentazocine than younger patients. Elderly patients generally should be started on low doses of Pentazocine and observed closely.<br />\r\n<br />\r\nThe subcutaneous route of administration should be used only when necessary because of possible severe tissue damage at injection sites. When frequent injections are needed, the drug should be administered intramuscularly. In addition, constant rotation of injection sites (e.g., the upper outer quadrants of the buttocks, mid-lateral&nbsp;aspects of the thighs, and the&nbsp;deltoid&nbsp;areas) is&nbsp;essential.<br />\r\n<br />\r\n<strong>Patients in Labor</strong>: A single, intramuscular 30 mg dose has been most commonly administered. An intravenous 20 mg dose has given adequate pain relief to some patients in labor when contractions become regular, and this dose may be given two or three times at two- to three-hour intervals, as needed.<br />\r\n<br />\r\n<strong>Pediatric Patients Excluding Patients Less Than One-Year-Old</strong>: The recommended single parenteral dose as premedication for sedation is 0.5 mg/kg by intramuscular route.</p>', '<p>Depressant affects potentiated by alcohol, CNS depressants; concurrent use with fluoxetine may lead to diaphoresis, ataxia flushing and tremor associated with serotonin syndrome.</p>', '<p>Pentazocine should not be administered to patients who are hypersensitive to it.</p>', '<p>Physical dependence; sedation, dizziness, euphoria, lightheadedness, alterations of mood; respiratory depression; visual hallucinations, disorientation, confusion; hypertension, tachycardia, circulatory depression; shock; hypotension; nausea, vomiting, constipation; seizures, diaphoresis; rash; blood dyscrasias; local tissue damages (SC), muscle fibrosis (IM).</p>', '<p>Safe use of Pentazocine during pregnancy (other than labor) has not been established. Animal reproduction studies have not demonstrated&nbsp;teratogenic&nbsp;or embryotoxic effects. However, Pentazocine should be administered to pregnant patients (other than labor) only when, in the judgment of the physician, the potential benefits outweigh the possible hazards. Patients receiving Pentazocine during labor have experienced no adverse effects other than those that occur with commonly used analgesics. Pentazocine should be used with caution in women delivering premature infants.</p>', '<p>May precipitate withdrawal in narcotic addicts. Impaired respiratory, renal and hepatic function; morbidly obese patients; thyroid dysfunction; prostatic hyperplasia or urinary stricture; biliary tract impairment; adrenal insufficiency (including Addison&#39;s disease); abdominal conditions. Elderly or debilitated patients; seizure-prone patients; children and infants (safety and efficacy not established in less than 1 yr); lactation. May impair ability to drive or operate machinery. Administer IM rather than SC (when frequent inj are needed) and inj sites should be varied.</p>', NULL, '<p>Opioid analgesics.</p>', NULL, '<p><strong>Pediatric Use</strong>: The safety and efficacy of Pentazocine as&nbsp;preoperative&nbsp;or preanesthetic medication have been established in pediatric patients 1 to 16 years of age. Use of Pentazocine in these age groups is supported by evidence from adequate and controlled studies in adults with additional data from published controlled trials in pediatric patients. The safety and efficacy of Pentazocine as a premedication for sedation have not been established in pediatric patients less than one year old. Information on the safety profile of Pentazocine as a postoperative analgesic in children less than 16 years is limited.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Elderly patients may be more sensitive to the analgesic effects of Pentazocine than younger patients. Clinical data indicate that differences in various pharmacokinetic parameters of Pentazocine may exist between elderly and younger patients.&nbsp;Sedating drugs may cause confusion and oversedation in the elderly; elderly patients generally should be started on low doses of Pentazocine and observed closely.<br />\r\n<br />\r\nThis drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.</p>', '2022-03-15 04:22:42', '2022-03-15 04:22:42'),
(1208, 1208, '<p>Pentosan polysulfate sodium is indicated for the relief of bladder pain or discomfort associated with interstitial cystitis.</p>', '<p>Pentosan polysulfate is a polymer of xylose hydrogen sulfate and contains two sulfate groups per carbohydrate monomer. It binds Fibroblast growth factors (FGFs) as well as other heparin-binding growth factors. It has been shown to interact also with the heparin-binding site of FGFR-1. It inhibits the growth of SW13 adrenocortical cells transfected with FGF-4 and tumorigenicity of MCF-7 breast carcinoma cells transfected with FGF-1 or FGF-4.</p>', '<p>The recommended dose of Pentosan Polysulfate Sodium is 300 mg/day taken as one 100 mg capsule orally three times daily. The capsules should be taken with water at least 1 hour before meals or 2 hours after meals. Patients receiving Pentosan Polysulfate Sodium should be reassessed after 3 months. If improvement has not occurred and if limiting adverse events are not present, Pentosan Polysulfate Sodium may be continued for another 3 months. The clinical value and risks of continued treatment in patients whose pain has not improved by 6 months is not known.<br />\r\n<br />\r\nPediatric Use: Safety and effectiveness in pediatric patients below the age of 16 years have not been established.</p>', '<p>In a study in which healthy subjects received pentosan polysulfate sodium 100 mg capsule or placebo every 8 hours for 7 days, and were titrated with warfarin to an INR of 1.4 to 1.8, the pharmacokinetic parameters of R-warfarin and S-warfarin were similar in the absence and presence of pentosan polysulfate sodium. INR for warfarin + placebo and warfarin + pentosan polysulfate sodium were comparable.</p>', '<p>Pentosan Polysulfate Sodium is contraindicated in patients with known hypersensitivity to the drug, structurally related compounds, or excipients.</p>', '<p>Alopecia (4%), diarrhea (4%), nausea (4%), headache (3%), rash (3%), dyspepsia (2%), abdominal pain (2%), liver function abnormalities (1%), dizziness (1%).</p>', '<p><strong>Pregnancy</strong>: Reproduction studies have been performed in mice and rats with intravenous daily doses of 15 mg/kg, and in rabbits with 7.5 mg/kg. These doses are 0.42 and 0.14 times the daily oral human doses of Pentosan Polysulfate Sodium when normalized to body surface area. These studies did not reveal evidence of impaired fertility or harm to the fetus from Pentosan Polysulfate Sodium. Direct in vitro bathing of cultured mouse embryos with pentosan polysulfate sodium (PPS) at a concentration of 1 mg/mL may cause reversible limb bud abnormalities. Adequate and well-controlled studies have not been performed in pregnant women. Because animal studies are not always predictive of human response, this drug should be used in pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Pentosan Polysulfate Sodium is administered to a nursing woman.</p>', '<p>Pentosan Polysulfate Sodium is a weak anticoagulant (1/15 the activity of heparin). At a daily dose of 300 mg (n=128), rectal hemorrhage was reported as an adverse event in 6.3% of patients. Bleeding complications of ecchymosis, epistaxis, and gum hemorrhage have been reported. Patients undergoing invasive procedures or having signs/symptoms of underlying coagulopathy or other increased risk of bleeding (due to other therapies such as coumarin anticoagulants, heparin, t-PA, streptokinase, high dose aspirin, or nonsteroidal anti inflammatory drugs) should be evaluated for hemorrhage. Patients with diseases such as aneurysms, thrombocytopenia, hemophilia, gastrointestinal ulcerations, polyps, or diverticula should be carefully evaluated before starting Pentosan Polysulfate Sodium. A similar product that was given subcutaneously, sublingually, or intramuscularly (and not initially metabolized by the liver) is associated with delayed immunoallergic thrombocytopenia with symptoms of thrombosis and hemorrhage. Caution should be exercised when using Pentosan Polysulfate Sodium in patients who have a history of heparin induced thrombocytopenia. Alopecia is associated with pentosan polysulfate and with heparin products. In clinical trials of Pentosan Polysulfate Sodium, alopecia began within the first 4 weeks of treatment. Ninety-seven percent (97%) of the cases of alopecia reported were alopecia areata, limited to a single area on the scalp.</p>', NULL, '<p>Other genito-urinary preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-15 04:25:24', '2022-03-15 04:25:24'),
(1209, 1209, '<p>This is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Peripheral arterial occlusive disease (PAOD) of arteriosclerotic or diabetic origin (e.g. with intermittent claudication and rest pain)</li>\r\n	<li>Trophic lesions (e.g. leg ulcers and gangrene)</li>\r\n	<li>Cerebral vascular diseases&nbsp;</li>\r\n	<li>Circulatory disturbances of the eye in conjunction with degenerative vascular disorders.</li>\r\n</ul>', '<p>Pentoxifylline and its metabolites improve the flow properties of blood by decreasing its viscosity. In patients with chronic peripheral arterial disease, this increases blood flow to the affected microcirculation and enhances tissue oxygenation. The precise mode of action of pentoxifylline and the sequence of events leading to clinical improvement are still to be defined. Pentoxifylline administration has been shown to produce dose-related hemorrheologic effects, lowering blood viscosity, and improving erythrocyte flexibility. Leukocyte properties of hemorrheologic importance have been modified in animal and in vitro human studies. Pentoxifylline has been shown to increase leukocyte deformability and to inhibit neutrophil adhesion and activation. Tissue oxygen levels have been shown to be significantly increased by therapeutic doses of pentoxifylline in patients with peripheral arterial disease.</p>', '<p>In principle, dosage is based on the type and severity of the circulatory disorders and on how the individual patient tolerates the drug. Usual dosage is 400 mg pentoxifylline 2 to 3 times daily. Tablets are to be swallowed whole during or shortly after a meal with sufficient amounts of liquid (approx. &frac12; glass).</p>', '<ul>\r\n	<li>Precautions for use: The blood-sugar-lowering effect of insulin or oral antidiabetics may be potentiated. Therefore it is recommended that patients under medication for diabetes mellitus be carefully monitored. Post-marketing cases of increased anti-coagulant activity have been reported in patients concomitantly treated with pentoxifylline and anti-vitamin K. Monitoring of anti-coagulant activity in these patients is recommended when pentoxifylline is introduced or the dose is changed.</li>\r\n	<li>Take into account: The blood-pressure-lowering efect of antihypertensive agents and other drugs with blood-pressure-lowering potential may be increased by Pentoxifylline.</li>\r\n	<li>Concomitant administration of pentoxifylline and theophylline may increase theophylline levels in some patients. Therefore, there may be an increase in and intensifcation of adverse reactions from theophylline.</li>\r\n	<li>Concomitant administration with ciprofoxacin may increase the serum concentration of pentoxifylline in some patients. Therefore, there may be an increase in and intensifcation of adverse reactions associated with co-administration.</li>\r\n	<li>Potential additive efect with platelet aggregation inhibitors: Because of the increased risk of bleeding, the concomitant administration of a platelet aggregation inhibitor (such as clopidogrel, eptifibatide, tirofiban, epoprostenol, iloprost, abciximab, anagrelide, NSAIDs other than selective COX-2 inhibitors, acetylsalicylates [ASA/LAS], ticlopidine, dipyridamole) with pentoxifylline should be undertaken with caution.</li>\r\n	<li>Concomitant administration with cimetidine may increase the plasma concentration of pentoxifylline and the active Metabolite.</li>\r\n</ul>', '<p>Pentoxifylline must not be used:</p>\r\n\r\n<ul>\r\n	<li>in patients with hypersensitivity to pentoxifylline, other methylxanthines or any of the excipients of Pentoxifylline.</li>\r\n	<li>in patients with massive bleeding (risk of increased bleeding).</li>\r\n	<li>in patients with extensive retinal bleeding (risk of increased bleeding).</li>\r\n</ul>', '<p>These adverse reactions have been reported in clinical trials or post-marketing-</p>\r\n\r\n<ul>\r\n	<li>Investigations: Transaminases increased (Transaminase elevation), Blood pressure decreased (Fall in blood pressure)</li>\r\n	<li>Cardiac disorders: Arrhythmia (Cardiac arrhythmia), Tachycardia, Angina Pectoris</li>\r\n	<li>Blood and lymphatic system disorders: Thrombocytopenia (Thrombopenia), Leucopenia/neutropenia</li>\r\n	<li>Nervous system disorders: Dizziness, headache, meningitis aseptic (Aseptic meningitis)</li>\r\n	<li>Gastrointestinal disorders: Gastrointestinal disorder (Gastrointestinal complaints), Epigastric discomfort (Gastric pressure), Abdominal distension (Fullness), Nausea, Vomiting, Diarrhoea, Constipation, Hypersalivation</li>\r\n	<li>Skin and subcutaneous tissue disorders: Pruritus, Erythema (Reddening of the skin), Urticaria, Rash</li>\r\n	<li>Vascular disorders: Hot fush (Flushes), Haemorrhage (Bleedings)</li>\r\n	<li>Immune system disorders: Anaphylactic reaction, Anaphylactoid reaction, Angioedema (Angioneurotic edema), Bronchospasm, Anaphylactic shock (shock)</li>\r\n	<li>Hepatobiliary disorders: Cholestasis (Intrahepatic cholestasis)</li>\r\n	<li>Psychiatric disorders: Agitation, Sleep disorder (Sleep disturbances)</li>\r\n</ul>', '<p>Insufficient experience has been gained concerning use in pregnancy. Therefore, it is recommended that Pentoxifylline is not used during pregnancy. Pentoxifylline passes into breast milk in minute quantities. Because insufficient experience has been gained, the physician must carefully weigh the possible risks and benefits before administering Pentoxifylline in breast-feeding women.</p>', '<p>At the first signs of an anaphylactic/anaphylactoid reaction, Pentoxifylline must be discontinued or the infusion be halted immediately, and a physician must be informed. Particularly careful monitoring is required:</p>\r\n\r\n<ul>\r\n	<li>in patients with severe cardiac arrhythmias</li>\r\n	<li>in patients with myocardial infarction</li>\r\n	<li>in hypotensive patients</li>\r\n	<li>in patients with impaired renal function (creatinine clearance below 30 ml/min)</li>\r\n	<li>in patients with severely impaired liver function</li>\r\n	<li>in patients with increased bleeding</li>\r\n	<li>in patients treated concomitantly with pentoxifylline and anti-vitamin K or platelet aggregation inhibitors</li>\r\n	<li>in patients treated concomitantly with pentoxifylline and antidiabetic agents</li>\r\n	<li>in patients treated concomitantly with pentoxifylline and ciprofoxacin</li>\r\n	<li>in patients treated concomitantly with pentoxifylline and theophylline</li>\r\n</ul>', '<p>Initial symptoms of acute overdose with pentoxifylline may be nausea, dizziness, tachycardia or a fall in blood pressure. Furthermore, signs such as fever, agitation, flush, loss of consciousness, areflexia, tonic -clonic convulsions and as a sign of gastrointestinal bleeding - coffee-ground vomiting may occur. No specific antidote is known. If ingestion has only just taken place, attempts may be made to prevent further systemic absorption of the active ingredient by primary elimination of the toxin (e.g. gastric lavage) or by delaying its absorption (e.g. activated charcoal).</p>', '<p>Peripheral Vasodilator drugs: Intermittent Claudication.</p>', '<p>Keep in a cool and dry place, away from light. Do not use later than date of expiry. Keep all medicine out of the reach of children. To be dispensed only on the prescription of a registered physician.</p>', '<p><strong>Hepatic impairment</strong>: A dose reduction- guided by individual tolerance- is necessary in patients with severely impaired liver function.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: In patients with impairment of renal function (creatinine clearance below 30 mL/min) a dose reduction by approx. 30% to 50% may be necessary guided by individual tolerance.<br />\r\n<br />\r\n<strong>Other</strong>: Treatment must be started at low-dose levels in hypotensive patients or patients whose circulation is unstable as well as in patients, who would be at particular risk from a reduction in blood pressure (e.g. patients with severe coronary heart disease or relevant stenoses of blood vessels supplying the brain); in such cases, the dose must only be increased gradually.</p>', '2022-03-15 04:27:18', '2022-03-15 04:27:18'),
(1210, 1210, '<p>Perampanel an anti-epileptic drug is indicated for:</p>\r\n\r\n<ul>\r\n	<li>Treatment of partial-onset seizures with or without secondarily generalized seizures in patients with epilepsy from 4 years of age and older.</li>\r\n	<li>Adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients with epilepsy from 12 years of age and older.</li>\r\n</ul>', '<p>Perampanel is a non-competitive antagonist of the ionotropic &alpha;-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) glutamate receptor on post-synaptic neurons. Glutamate is the primary excitatory neurotransmitter in the central nervous system and is implicated in a number of neurological disorders caused by neuronal over excitation. The precise mechanism by which Perampanel exerts its antiepileptic effects in humans is unknown.</p>', '<p>Perampanel can be taken without regard to food. The dosage of Perampanel is as follows-</p>\r\n\r\n<ul>\r\n	<li>Starting dose: 2 mg once daily at bedtime. May increase dose based on clinical response and tolerability by increments of 2 mg once daily no more frequently than at weekly intervals.</li>\r\n	<li>Recommended maintenance dose in monotherapy or adjunctive therapy for partial-onset seizures: 8 mg to 12 mg once daily at bedtime.</li>\r\n	<li>Recommended maintenance dose in adjunctive therapy for primary generalized tonic-clonic seizures: 8 mg once daily at bedtime.</li>\r\n</ul>\r\n\r\n<p><strong>Mild and Moderate Hepatic Impairment</strong>: Maximum recommended daily dose is 6 mg (mild) and 4 mg (moderate) once daily at bedtime.<br />\r\n<br />\r\n<strong>Severe Hepatic Impairment</strong>: Not recommended.<br />\r\n<br />\r\n<strong>Severe Renal Impairment</strong>: Not recommended.<br />\r\n<br />\r\n<strong>Elderly</strong>: Increase dose no more frequently than every 2 weeks.</p>', '<ul>\r\n	<li>Contraceptives: 12 mg once daily may decrease the effectiveness of hormonal contraceptives containing levonorgestrel.</li>\r\n	<li>Moderate and Strong CYP3A4 Inducers (including carbamazepine, oxcarbazepine, and phenytoin): increase the clearance of Perampanel and decrease Perampanel plasma concentrations.</li>\r\n</ul>', '<p>None.</p>', '<p>Perampanel may cause Serious Psychiatric and Behavioral Reactions, Suicidal Behavior and Ideation, Dizziness, Somnolence, Fatigue, Irritability, Falls, Nausea, Ataxia, Balance Disorder etc.</p>', '<p>Based on animal data, may cause fetal harm. There are no data on the presence of perampanel in human milk, the effects on the breastfed child, or the effects of the drug on milk production.</p>', '<ul>\r\n	<li>Suicidal Behavior and Ideation: Monitor for suicidal thoughts or Behaviour.</li>\r\n	<li>Neurologic Effects: Monitor for dizziness, gait disturbance, somnolence and fatigue.</li>\r\n	<li>Falls: Monitor for falls and injuries.</li>\r\n	<li>Drug Reaction with Eosinophilia and Systemic Symptoms/Multi-organ Hypersensitivity: Discontinue if no alternate etiology.</li>\r\n	<li>Withdrawal of Antiepileptic Drugs: In patients with epilepsy, there may be an increase in seizure frequency.</li>\r\n</ul>', NULL, '<p>Adjunct anti-epileptic drugs.</p>', '<p>Protect from light and moisture, store below 30&deg;C. Keep out of the reach of children.</p>', NULL, '2022-03-15 04:28:51', '2022-03-15 04:28:51'),
(1211, 1211, '<p>Perindopril is a long-acting ACE (Angiotensin Converting Enzyme) inhibitor and is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Essential hypertension,</li>\r\n	<li>Stable coronary artery disease,</li>\r\n	<li>Congestive heart failure.</li>\r\n</ul>', '<p>Perindopril is an ACE inhibitor. It works by blocking the action of angiotensin converting enzyme (ACE). ACE produces angiotensin II, as part of the body&#39;s natural control of blood pressure. Angiotensin II causes blood vessels to constrict and narrow, which increases the pressure within the blood vessels. Perindopril blocks the action of ACE, it reduces the production of angiotensin II, thus allows the blood vessels to relax and widen. The overall effect of this is a drop in blood pressure.</p>', '<p><strong>Hypertension</strong>: One Perindopril 4 tablet once daily preferably in the morning. If necessary, the dose may be increased to 8 mg after 1 month of treatment. Perindopril should be taken before food.<br />\r\n<br />\r\n<strong>Stable coronary artery disease</strong>: Perindopril 4 once daily for two weeks, then increased to 8 mg once daily, depending on renal function and provided that the 4 mg dose is well tolerated. Elderly patients should receive Perindopril 2 mg once daily for one week, then Perindopril 4 once daily the next week, before increasing the dose up to 8 mg once daily, depending on renal, function. The dose should be increased only if the previous lower dose is well tolerated.<br />\r\n<br />\r\n<strong>Congestive heart failure</strong>: Perindopril should be started under close medical supervision at a starting dose of 2 mg in the morning. If necessary dose may be increased to 4 mg.<br />\r\n<br />\r\n<strong>Elderly patients</strong>: Start at low daily dose (4 mg or less) and titrate slowly as needed. Experience with doses exceeding 8 mg is limited.</p>', '<p>May enhance hypotensive effect with diuretics. Additive hyperkalaemic effect with K supplements, K-sparing diuretics, and other drugs (e.g. ciclosporin, heparin, indometacin). May increase serum levels and toxicity of lithium. Antihypertensive effect may be reduced by aspirin or other NSAIDs. Coadministration with NSAIDs may also increase the risk of renal impairment. Increased risk of hypoglycaemia with antidiabetic agents. Rarely, nitritoid reactions occur with concomitant use of gold (Na aurothiomalate).</p>', '<p>Perindopril is contraindicated in patients with a history of hypersensitivity to Perindopril. This drug is contraindicated in case of management of hypertension of Children, during Pregnancy &amp; Lactation.</p>', '<p><strong>Rare and mild</strong>: usually at the start of&nbsp;treatment cough, fatigue, asthenia, headache, disturbances of mood and/or sleep have been reported.<br />\r\n<br />\r\n<strong>Less often</strong>: Taste impairment, epigastric discomfort, nausea, abdominal pain and&nbsp;rash.&nbsp;Reversible increase in blood urea and creatinine may be observed. Proteinuria has occurred in some patients.<br />\r\n<br />\r\n<strong>Rarely</strong>: Angioneurotic edema and decrease in hemoglobin, red cells and platelets have been reported.</p>', '<p>Perindopril should not be used during pregnancy &amp; lactation.</p>', '<p>In the following cases, Perindopril should be used with caution:</p>\r\n\r\n<ul>\r\n	<li>Renovascular hypertension</li>\r\n	<li>Surgery/Anesthesia</li>\r\n	<li>Renal failure: The dose should be cautiously adjusted in accordance with the creatinine clearance</li>\r\n	<li>Symptomatic hypotension is rarely seen, but is more likely in volume-depleted patients, those receiving diuretics, or with the first two doses</li>\r\n	<li>In diuretic-treated patients: stop the diuretic 3 days before starting Perindopril. A&nbsp;diuretic may later be given in combination if necessary; potassium-sparing diuretics are not recommended</li>\r\n	<li>Combination with neuroleptics or imipramine-type drugs may increase the hypotensive effect. Serum lithium concentrations may rise during lithium therapy</li>\r\n</ul>', NULL, '<p>Angiotensin-converting enzyme (ACE) inhibitors, Direct Renin Inhibitors.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-15 04:30:18', '2022-03-15 04:30:18'),
(1212, 1212, '<p>This combination is indicated as substitution therapy for the treatment of hypertension and/or stable coronary heart disease in patients already controlled with separate doses of perindopril and amlodipine, given concurrently at the same dose level. Treatment should not be initiated with this combination.</p>', '<p>Perindopril, a pro-drug, is hydrolyzed to perindoprilat, which inhibits ACE in humans and in animals. ACE is a peptidyl dipeptidase that catalyzes the conversion of the inactive decapeptide, angiotensin I, to the vasoconstrictor substance angiotensin II. Angiotensin II is a potent peripheral vasoconstrictor, which stimulates aldosterone secretion by the adrenal cortex, and provides negative feedback on renin secretion. Inhibition of ACE results in decreased plasma angiotensin II, leading to decreased vasoconstriction, increased plasma renin activity and decreased aldosterone secretion. The latter results in diuresis and natriuresis and may be associated with an increase in serum potassium&nbsp;<br />\r\n<br />\r\nAmlodipine is a dihydropyridine calcium antagonist (calcium ion antagonist or slow channel blocker) that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. Experimental data suggest that amlodipine binds to both dihydropyridine and nondihydropyridine binding sites. The contractile processes of cardiac muscle and vascular smooth muscle are dependent upon the movement of extracellular calcium ions into these cells through specific ion channels. Amlodipine inhibits calcium ion influx across cell membranes selectively, with a greater effect on vascular smooth muscle cells than on cardiac muscle cells. Negative inotropic effects can be detected in vitro but such effects have not been seen in intact animals at therapeutic doses.</p>', '<p>perindopril arginine &amp; amlodipine is as substitution therapy for patients already controlled with separate doses of perindopril (5 or 10 mg) and amlodipine (5 or 10 mg), given concurrently at the dose level. Treatment should not be initiated with this combination.<br />\r\n<br />\r\nFood intake may reduce hepatic biotransformation of perindopril to perindoprilat. Recommended treatment is one tablet per day as a single dose, preferably to be taken in the morning and before a meal. As perindopril and amlodipine may be used for different clinical indications, dose adjustments should be based on clinical judgment and the individual patient profile.<br />\r\n<br />\r\nAdjustments can be made by decreasing or increasing the dose of either perindopril and/or amlodipine using separate perindopril and/or amlodipine products within the recommended dose range until clinical stability is re-established. Consult the Product Information of the individual perindopril and/or amlodipine products being used when adjusting the dose.<br />\r\n<br />\r\nIn the event that down-titration is required, adjustments using amlodipine 2.5 mg or a dose of perindopril equivalent to perindopril arginine 2.5 mg, as separate products should be considered until clinical stability is re-established.</p>', '<p>Baclofen may increase the antihypertensive effect of this combination. Monitor blood pressure and renal function, and adjust the dose of this combination if necessary. Combined use of these medicines may increase the hypotensive effects of perindopril and amlodipine. Combined use with nitroglycerine and other nitrates or other vasodilators, may further reduce blood pressure and therefore should be considered with caution.</p>', '<p>This combination is contraindicated:</p>\r\n\r\n<ul>\r\n	<li>In patients with a history of previous hypersensitivity to either of the active ingredients; perindopril or amlodipine, ACE inhibitors, dihydropyridines or excipient ingredients present in this combination.</li>\r\n	<li>During pregnancy and for lactating women.</li>\r\n</ul>', '<p>The most commonly reported adverse reactions with perindopril and amlodipine given separately are: oedema, somnolence, dizziness, headache (especially at the beginning of the treatment), dysgeusia, paraesthesia, visual impairment (including diplopia), tinnitus, vertigo, palpitations, flushing, hypotension (and effects related to hypotension), dyspnoea, cough, abdominal pain, nausea, vomiting, dyspepsia, change of bowel habit, diarrhoea, constipation, pruritus, rash, exanthema, joint swelling (ankle swelling), muscle spasms, fatigue, asthenia.</p>', '<p>This combination should not be initiated during pregnancy and lactation. Patients planning pregnancy should be changed to alternative anti-hypertensive treatments which have an established safety profile for use in pregnancy. When pregnancy is diagnosed, treatment with this combination should be stopped immediately, and, if appropriate, alternative treatment should be started.</p>', '<p>As this combination contains lactose monohydrate, patients with rare hereditary problems of galactose intolerance, glucose galactose malabsorption, or total lactase deficiency should not take This combination.<br />\r\n<br />\r\nSince ACE inhibitors reduce angiotensin II formation resulting in decreased production of aldosterone, increases in serum potassium have been observed in some patients treated with ACE inhibitors including perindopril. Serum electrolytes (including sodium potassium and urea) should be measured from time to time when ACE inhibitors are given especially in combination with diuretics.</p>', NULL, '<p>Combined antihypertensive preparations.</p>', '<p>Store in a dry place below 25⁰C. Keep the container tightly closed and protect from light.</p>', '<p>Paediatric use: Use of this combination in children is not recommended as no data establishing safety or effectiveness in children are available.</p>', '2022-03-15 04:31:53', '2022-03-15 04:31:53'),
(1213, 1213, '<p>This is indicated for Peritoneal Dialysis.</p>', '<p><strong>Calcium chloride</strong>&nbsp;is used to prevent or treat negative calcium balance. It also regulates action potential excitation threshold to facilitate nerve and muscle performance.<br />\r\n<br />\r\n<strong>Potassium chloride</strong>&nbsp;is a major cation of the intracellular fluid. It plays an active role in the conduction of nerve impulses in the heart, brain and skeletal muscle; contraction of cardiac skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism and gastric secretion.<br />\r\n<br />\r\n<strong>Sodium chloride</strong>&nbsp;is the major extracellular cation. It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes. It is also used as diluents for infusion of compatible drug additives.<br />\r\n<br />\r\n<strong>Sodium lactate</strong>&nbsp;is a sterile, nonpyrogenic solution that is used for fluid and electrolyte replenishment. It has metabolic alkalinising ability and is capable of inducing diuresis depending on the clinical condition of the patient.<br />\r\n<br />\r\n<strong>Dextrose</strong>&nbsp;is a monosaccharide that is used as a source of calories and water for hydration. It helps to reduce loss of body protein and nitrogen. It also promotes glycogen deposition in the liver. When used with insulin, it stimulates the uptake of potassium by cells, especially in muscle tissue, thus lowering serum potassium levels.</p>', '<p>In case of intermittent peritoneal dialysis (IPD): 2 liters solution is instill into the abdominal cavity over a period of 1 hour then drained from the cavity.<br />\r\n<br />\r\nThe exchange should be continued for 8-36 hours.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Patients with excessive obesity and in pregnancy.</p>', '<p>During dialysis amino acids and water soluble vitamins may be lost. Fluid and electrolyte imbalance, hypovolemia, hypotension or muscle cramping may occur.</p>', '<p>Category - Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>It is used for peritoneal dialysis purposes only.</p>', NULL, '<p>Peritoneal dialysis solution.</p>', NULL, NULL, '2022-03-15 04:33:18', '2022-03-15 04:33:18'),
(1214, 1214, '<p>Permethrin cream is indicated for the treatment of scabies and crab lice infestations (Pediculosis). Scabies can affect everyone in the family. If one is infected, all family members must be treated together.</p>', '<p>Permethrin cream contains Permethrin, a pyrethroid, which is a topical scabicidal agent for the treatment of infestation with Sarcoptes Scabiei (scabies). It acts on the nerve cell membrane to disrupt the sodium channel current by which the polarization of the membrane is regulated. Delayed repolarization &amp; paralysis of the pests are the consequences of this disturbance.<br />\r\n<br />\r\n<strong>Pharmacokinetics</strong>: The only approved route of administration is the topical route and there are few human data available on systemic exposure or kinetics following permethrin application to the skin. Some presystemic metabolism occurs in skin. Less than 0.5% of applied permethrin is absorbed during the first 48 hours. Absorbed permethrin is rapidly metabolized by ester hydrolysis, most likely in the liver and the products are excreted primarily in the urine.</p>', '<p>Recommended duration of Treatment:</p>\r\n\r\n<ul>\r\n	<li>Adults and children over 12 years: a full tube</li>\r\n	<li>Children aged 6-12 years: up to 1&frasl;2 of a tube</li>\r\n	<li>Children aged 1-5 years: up to &nbsp;&frac14; of a tube</li>\r\n	<li>Children aged 2 months to 1 year: up to ⅛ of a tube</li>\r\n	<li>Children Less then 2 month: dose is not established</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Before application of Permethrin cream the skin should be clean, cool and dry. Do not have a hot shower or bath before applying.<br />\r\n<br />\r\n<strong>For adults and children over 2 years</strong>: Apply the cream to the whole body from the neck down, rubbing lightly into the skin until the cream disappears. It is important to include all skin surfaces, such as between the fingers and toes, under the nails and on the soles of the feet.<br />\r\n<br />\r\n<strong>For babies under 2 years</strong>: Apply to the face, neck, ears and scalp as well, only avoiding the area immediately around the eyes and mouth.<br />\r\n<br />\r\nLeave cream on for at least 8 hours, before washing off. Reapply to any area that may be washed during the 8h treatment time (such as after washing the hands). If necessary, permethrin cream should be used again after 7 days as per the advice of the doctor.</p>', '<p>The treatment of eczemodous like reactions with corticosteroids should be withheld prior to treatment with permethrin, as there is a risk of exacerbating the scabies infestation by reducing the immune response to the mite.</p>', '<p>Permethrin is contraindicated in patients with known hypersensitivity to any component of pyrethroids or permethrin. Nursing staff who routinely apply permethrin may wear globes to avoid any possible irritation to the hands.</p>', '<p>In Scabies patients, skin discomfort, usually described as burning, stinging or tingling occurs in a few individuals soon after the cream is applied. Others transient signs and symptoms of irritation including enythema, edema, eczema, rash and puritis.</p>', '<p>In the absence of specific studies in pregnant women, its use in pregnancy should only follow medical advice. It is not known whether permethrin is excreted in human milk so it should not be used in nursing mothers.</p>', '<p>Scabies infestation is often accompanied by pruritus, edema &amp; erythema. Treatment with permethrin may temporarily exacerbate these conditions. Patients should be advised to avoid contact with eyes during application &amp; to flash with water immediately if the cream gets in the eyes.</p>', NULL, '<p>Parasiticidal preparations.</p>', '<p>Store in a cool, dry place, away from light &amp; keep out of the reach of children...</p>', NULL, '2022-03-15 04:35:04', '2022-03-15 04:35:04');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1215, 1215, '<p>This lotion is indicated for the treatment of scabies and pruritus.</p>', '<p><strong>Permethrin</strong>&nbsp;is a pyrethroid pediculocide and scabicide. It causes paralysis and death of the pest by inhibiting sodium ion influx through nerve cell membrane channels delaying repolarisation.<br />\r\n<br />\r\n<strong>Crotamiton</strong>&nbsp;has scabicidal and antipruritic action against Sarcoptes scabei. It is an effective pediculocide as well.</p>', '<p><strong>Adult</strong>: Permethrin &amp; Crotamiton lotion is suitable for adults, children of 2 months of age and above, and the elderly. It is&nbsp;for external use only and should not be applied to broken skin, mucous membranes or near the&nbsp;eyes. Permethrin &amp; Crotamiton lotion should be applied to skin which is clean, dry and cool. It should not be used&nbsp;immediately after a hot bath. Permethrin &amp; Crotamiton lotion is intended for a single application over the whole&nbsp;body. Permethrin &amp; Crotamiton lotion should be left on for at least 8 hours. Reapply the lotion to the hands if they&nbsp;are washed within 8 hours of treatment. The whole body should be washed thoroughly 8-12&nbsp;hours after application.&nbsp;Adults &amp; children over 2 years: Apply the lotion over the whole body but not the head and face.&nbsp;Pay particular attention to the areas between fingers and toes, under nails, wrists, armpits,&nbsp;external genitalia, breasts and buttocks.<br />\r\n<br />\r\n<strong>The elderly</strong>: Apply the lotion over the whole body including the neck, face, ears and scalp. Pay&nbsp;particular attention to the areas between fingers and toes, under nails, wrists, armpits, external&nbsp;genitalia, breasts and buttocks. Avoid the area close to the eyes.<br />\r\n<br />\r\n<strong>Children under 2 years</strong>: Children under 2 years should only be treated under medical supervision.&nbsp;Apply the lotion over the whole body including the neck, face, ears and scalp. Pay particular&nbsp;attention to the areas between fingers and toes, under nails, wrists, armpits, palms of hands and&nbsp;soles of feet, external genitals and buttocks. Avoid the area around the mouth where the lotion&nbsp;could be licked off and the area around the eyes</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Lotion should be applied to clean, dry skin. If the body is hot due to warm bath or any other reason, skin should be allowed to cool. It should be applied to the whole body excluding head. The whole body should be washed thoroughly 8-12 hours after treatment. On the next day cloths and bed sheets should be cleaned with warm water. The lotion should be applied if lotion is washed out by water. Other members of the family should use this lotion as preventive in the same way due to its highly contagious effects. The lotion should not be applied to the vicinity of mouth and areas close to eyes.</p>', '<p>The treatment of eczematous-like reactions with corticosteroids should be&nbsp;withheld prior to treatment with permethrin, as there is a risk of exacerbating the scabies&nbsp;infestation by reducing the immune response to the mite. The likelihood of interactions between the two treatments leading to potentiated adverse reactions or reduced efficacy is, however&nbsp;small.</p>', '<p>Combination of permethrin 5% and crotamiton 10% is contra-indicated in&nbsp;patients with known hypersensitivity to permethrin or crotamiton.</p>', '<p>Occasional reports of burning or stinging sensation which passes quickly. This is&nbsp;usually mild and occurs more frequently in patients with severe scabies. Transient signs and&nbsp;symptoms of skin irritation including rash or itching, erythema, edema and eczema. These are&nbsp;generally considered to be part of the natural history of scabies.</p>', '<p>There is no experience to judge the safety of permethrin &amp;&nbsp;crotamiton in pregnancy, therefore it is not recommended during pregnancy, especially in the&nbsp;first three months. It is not known whether the active substance passes into breast milk. Nursing&nbsp;mothers should avoid applying it in the area of the nipples.</p>', '<p>This lotion should be kept out of the reach of children. This lotion&nbsp;is for external use only. Nursing staff who routinely apply this lotion may wish to wear gloves&nbsp;to avoid any possible irritation to the hand. Avoid contact with the eyes. The lotion can cause eye&nbsp;irritation. If lotion goes to the eyes, rinse with water immediately.</p>', '<p>There are no reports of overdosage of permethrin &amp; crotamiton. Excessive application&nbsp;to the skin might result in local adverse reactions. In the event of accidental ingestion by a child,&nbsp;gastric lavage should be considered if within 2 hours of ingestion. Treatment of hypersensitivity&nbsp;reactions should be symptomatic.</p>', '<p>Local Antipruritic, Parasiticidal preparations.</p>', '<p>Store in a cool place (do not store above 25&deg; C &amp; do not freeze) and protected from light.</p>', NULL, '2022-03-15 04:37:01', '2022-03-15 04:37:01'),
(1216, 1216, '<p>Pertuzumab is a HER2/neu receptor antagonist indicated for:<br />\r\n<br />\r\nUse in combination with trastuzumab and docetaxel for treatment of patients with HER2-positive metastatic breast cancer (MBC) who have not received prior anti-HER2 therapy or chemotherapy for metastatic disease.<br />\r\n<br />\r\nUse in combination with trastuzumab and chemotherapy as:</p>\r\n\r\n<ul>\r\n	<li>Neoadjuvant treatment of patients with HER2-positive, locally advanced, inflammatory, or early stage breast cancer (either greater than 2 cm in diameter or node positive) as part of a complete treatment regimen for early breast cancer.</li>\r\n	<li>Adjuvant treatment of patients with HER2-positive early breast cancer at high risk of recurrence</li>\r\n</ul>', '<p>Pertuzumab is a humanized monoclonal antibody designed to bind to the HER2 receptor and inhibit the ability of HER2 to interact with other HER family members (HER1, HER2, HER3, and HER4) on the surface of cancer cells. The HER signaling pathway plays a role in the formation and growth of numerous cancers, and previous clinical trials of pertuzumab in a single agent setting had suggested clinical activity-including stable disease-in heavily pretreated patients with advanced ovarian and breast cancers.</p>', '<p>For intravenous infusion only. Do not administer as an intravenous push or bolus.<br />\r\n<br />\r\n<strong>HER2 testing</strong>: Perform using FDA-approved tests by laboratories with demonstrated proficiency.<br />\r\n<br />\r\nThe initial Pertuzumab dose is 840 mg administered as a 60-minute intravenous infusion, followed every 3 weeks thereafter by 420 mg administered as a 30 to 60 minute intravenous infusion.<br />\r\n<br />\r\n<strong>MBC</strong>: Administer Pertuzumab, trastuzumab, and docetaxel by intravenous infusion every 3 weeks.&nbsp;<br />\r\n<br />\r\n<strong>Neoadjuvant</strong>: Administer Pertuzumab, trastuzumab, and chemotherapy by intravenous infusion preoperatively every 3 weeks for 3 to 6 cycles.<br />\r\n<br />\r\n<strong>Adjuvant</strong>: Administer Pertuzumab, trastuzumab, and chemotherapy by intravenous infusion postoperatively every 3 weeks for a total of 1 year (up to 18 cycles).</p>', '<p>No drug-drug interactions were observed between pertuzumab and trastuzumab, or between pertuzumab and docetaxel, paclitaxel, or carboplatin.</p>', '<p>Pertuzumab is contraindicated in patients with known hypersensitivity to pertuzumab or to any of its excipients.</p>', '<p>Metastatic Breast Cancer:</p>\r\n\r\n<ul>\r\n	<li>The most common adverse reactions (&gt; 30%) with Pertuzumab in combination with trastuzumab and docetaxel were diarrhea, alopecia,neutropenia, nausea, fatigue, rash, and peripheral neuropathy.</li>\r\n</ul>\r\n\r\n<p>Neoadjuvant Treatment of Breast Cancer:</p>\r\n\r\n<ul>\r\n	<li>The most common adverse reactions (&gt; 30%) with Pertuzumab in combination with trastuzumab and docetaxel were alopecia, diarrhea, nausea, and neutropenia.</li>\r\n	<li>The most common adverse reactions (&gt;30%) with Pertuzumab in combination with trastuzumab and docetaxel when given for 3 cycles following 3 cycles of FEC were fatigue, alopecia, diarrhea, nausea, vomiting, and neutropenia.&nbsp;</li>\r\n	<li>The most common adverse reactions (&gt;30%) with Pertuzumab in combination with docetaxel, carboplatin, and trastuzumab (TCH) were fatigue, alopecia, diarrhea, nausea, vomiting, neutropenia, thrombocytopenia, and anemia.</li>\r\n	<li>The most common adverse reactions (&gt;30%) with Pertuzumab in combination with trastuzumab and paclitaxel when given for 4 cycles following 4 cycles of ddAC were nausea, diarrhea, alopecia, fatigue, constipation and headache.</li>\r\n	<li>The most common adverse reactions (&gt;30%) with Pertuzumab in combination with trastuzumab and docetaxel when given for 4 cycles following 4 cycles of FEC were diarrhea, nausea, alopecia, asthenia, constipation, fatigue, mucosal inflammation, vomiting, myalgia, and anemia.</li>\r\n</ul>\r\n\r\n<p>Adjuvant Treatment of Breast Cancer:</p>\r\n\r\n<ul>\r\n	<li>The most common adverse reactions (&gt;30%) with Pertuzumab in combination with trastuzumab and chemotherapy were diarrhea, nausea, alopecia, fatigue, peripheral neuropathy and vomiting.</li>\r\n</ul>', '<p><strong>Females and Males of Reproductive Potential</strong>: Verify the pregnancy status of females prior to initiation of Pertuzumab.&nbsp;There is no information regarding the presence of pertuzumab in human milk, the effects on the breastfed infant or the effects on milk production.</p>', '<p><strong>Infusion-Related Reactions</strong>: Monitor for signs and symptoms. If a significant infusion-associated reaction occurs, slow or interrupt the infusion and administer appropriate medical therapies.<br />\r\n<br />\r\n<strong>Hypersensitivity Reactions/Anaphylaxis</strong>: Monitor for signs and symptoms. If a severe hypersensitivity reaction/anaphylaxis occurs, discontinue the infusion immediately and administer appropriate medical therapies.</p>', NULL, '<p>Targeted Cancer Therapy.</p>', '<p>Store vials in a refrigerator at 2&deg;C to 8&deg;C until time of use. Keep vial in the outer carton in order to protect from light.</p>', NULL, '2022-03-15 04:38:39', '2022-03-15 04:38:39'),
(1217, 1217, '<p>Pethidine is indicated for short-term (24-36 hours) relief of moderate to severe pain. It can be given via the following routes of administration: intramuscular, subcutaneous, slow intravenous bolus injection, intravenous infusion and patient controlled analgesia (PCA).<br />\r\n<br />\r\nPethidine is indicated for administration as an anaesthetic adjunct and for obstetric analgesia.&nbsp;An opioid antagonist and facilities for administration of oxygen and control of respiration should be immediately available during and immediately following intravenous administration of pethidine</p>', '<p>Pethidine is a phenylpiperidine derivative opioid analgesic. It acts mainly as mu-receptor agonist. Like most, opioid analgesics, it mimics endogenous opioids by activating opioid receptors in the central and peripheral nervous system. It reduces the release of neurotransmitter substances and also reduces the activity of postsynaptic neurons in the spinal cord thus preventing transmission of pain impulse.</p>', '<p>Adult Dosage:</p>\r\n\r\n<p><strong>Analgesia</strong>:</p>\r\n\r\n<ul>\r\n	<li>Dosage should be adjusted according to the severity of pain and the response of the patient and also depends on patient profile eg: age, weight, sex, previous exposure to narcotics.</li>\r\n	<li>25 to 100 mg by IM (preferred) or S.C. injection, every 3 to 4 hours.</li>\r\n	<li>25 to 50 mg slow IV injection, every 3 to 4 hours&nbsp;</li>\r\n	<li>Usual dose is 200 mg/day by the IV route. Intravenous injection should be made very slowly, preferably using a diluted solution.</li>\r\n	<li>For continuous intravenous infusion adequate analgesia should be established prior to commencement of the infusion. A dosage of 0.3 mg/kg/hr is recommended as the initial intravenous infusion rate.</li>\r\n	<li>Clinical experience suggests that patients with normal renal function receiving more than 1000 mg/24 hrs pethidine are at particular risk of developing pethidine associated neurotoxicity (PAN). Patients receiving over 800 mg/24 hrs pethidine should usually be monitored for early signs of norpethidine toxicity</li>\r\n</ul>\r\n\r\n<p><strong>Obstetric Analgesia</strong>: 50 to 100 mg by IM (preferred) or S.C. injection, administered when pain becomes regular. May be repeated 3 to 4 times at one to three hour intervals if necessary. Maximum of 4 doses in 24 hours<br />\r\n<br />\r\n<strong>Anaesthesia Adjunct</strong>: As premedication, intramuscular (preferred) or subcutaneous, 50 to 100 mg thirty to ninety minutes prior to anaesthesia. As an adjunct to anaesthesia, intravenous, by repeated slow injection of fractional doses of a solution diluted to 10 mg per mL. Dosage by this route should not exceed 25 to 50 mg.&nbsp;Dosage must be titrated to the needs of the patient, depending on the premedication given, the type of anaesthesia, and the nature and duration of the surgical procedure.<br />\r\n<br />\r\n<strong>Patient-Controlled Analgesia</strong>:</p>\r\n\r\n<ul>\r\n	<li>Patient-controlled analgesia (PCA) allows patients to assess their own level of pain and consequently titrate the amount of pethidine they require for adequate pain control against sedation and other side effects. Adequate analgesia should be established prior to commencement of PCA.</li>\r\n	<li>The dosages and time intervals are preset into a microprocessor-controlled infusion pump. When the patient experiences pain, a button is depressed by the patient and a dose of pethidine is administered intravenously. If the patient should depress the button before the preset time interval (lockout interval) has elapsed, no extra drug is administered. For adults, demand doses, of 5 mg to a maximum of 20 mg pethidine have been given via PCA using a lockout interval of 6 to 20 minutes. Along with the self-administered dose of pethidine, some syringe pumps also deliver a background continuous infusion of pethidine at a basal rate. Some PCA pumps allow a maximum dosage over a defined period to be preset in order to avoid patient overdosage.</li>\r\n	<li>The demand dosage and lockout interval should be determined according to the patient&rsquo;s analgesic requirements. Patients receiving a background infusion of pethidine should generally receive a smaller demand dose relative to equivalent patients utilising a demand dose only.</li>\r\n	<li>Clinical experience suggests that patients with normal renal function receiving more than 1000 mg/24hrs pethidine are at particular risk of developing pethidine associated neurotoxicity (PAN). Patients receiving over 800 mg/24hrs pethidine should usually be monitored for early signs of norpethidine toxicity. Pethidine-associated neurotoxicity is dose related, so pethidine should not be used for periods greater than 24 to 36 hours</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Paediatric Dose:</p>\r\n\r\n<ul>\r\n	<li><strong>Analgesia</strong>: Intramuscular (preferred) or subcutaneous, 0.5 to 2 mg per kg of body weight, not to exceed 100 mg, every three to four hours as needed.</li>\r\n	<li><strong>Preoperative</strong>: Intramuscular (preferred) or subcutaneous, 1 to 2 mg per kg of body weight, not to exceed 100 mg, thirty to ninety minutes prior to anaesthesia.</li>\r\n	<li><strong>Neonates</strong>: Excretion and metabolism of pethidine in the neonate is reduced compared with adults. Safety has not been established in neonates and due to lack of data, no dosage regimen can be recommended.</li>\r\n</ul>', '<p>Increased pethidine metabolite levels with aciclovir, cimetidine, ritonavir. Reduced analgesic effects with phenytoin, barbiturates. Additive sedative and/or respiratory depressive effects with alcohol, barbiturates, benzodiazepines, phenothiazines, TCAs, other CNS depressants.</p>', '<p>Hypersensitivity to Pethidine.<br />\r\n<br />\r\nRespiratory depression, or where respiratory reserve is depleted (acute bronchial asthma, chronic airway disease, severe emphysema, severe chronic bronchitis, kyphoscoliosis).<br />\r\n<br />\r\nHead injury, raised intracranial pressure (apart form introducing monitoring and diagnostic problems, hypercapnia associated with respiratory depression can itself result in elevated intracranial pressure), brain tumour.<br />\r\n<br />\r\nCardiac arrythmias, especially supraventricular tachycardias, cor pulmonale. Pethidine has a vagolytic action and may produce a significant increase in the ventricular response rate.<br />\r\n<br />\r\nConcurrent use of monoamine oxidase inhibitors (MAOI&rsquo;s), including selegeline, or use of MAOI&rsquo;s within two weeks prior. The combination of monoamine oxidase inhibitors and pethidine has caused hypotension, hypertension, excitation, rigidity, hyperpyrexia and/or convulsions and in some cases fatalities have been reported. This combination should be avoided.<br />\r\n<br />\r\nPre-eclampsia, eclampsia.<br />\r\n<br />\r\nConvulsive states such as status epilepticus, tetanus and strychnine poisoning, due to the stimulatory effects of pethidine on the spinal cord.<br />\r\n<br />\r\nDiabetic acidosis where there is a danger of coma.<br />\r\n<br />\r\nAcute alcoholism or delirium tremens.<br />\r\n<br />\r\nSevere liver disease, incipient hepatic encephalopathy.<br />\r\n<br />\r\nPatients with a low platelet count, coagulation disorders or receiving anticoagulant treatment.<br />\r\n<br />\r\n<strong>Continuous Intravenous Infusion</strong>: The administration of pethidine via continuous intravenous infusion in patients with renal impairment is contraindicated.<br />\r\n<br />\r\n<strong>Patient-Controlled Analgesia</strong>: The administration of pethidine via patient-controlled analgesia (PCA) in young children and adults with poor cognitive function is contraindicated. The administration of pethidine via PCA in patients with renal impairment is contraindicated.</p>', '<p><strong>Central Nervous System</strong>:&nbsp; Lightheadedness, dizziness, sedation, sweating, bizarre feelings, disorientation, hallucinations, psychosis. Some of these effects seem to be more prominent in ambulatory patients and those not experiencing severe pain, and may be relieved by reducing the dose slightly and lying down.<br />\r\n<br />\r\n<strong>Gastrointestinal</strong>: Nausea and vomiting, constipation.</p>', '<p><strong>Pregnancy&nbsp;</strong>Category C. Opioid analgesics may cause respiratory depression in the newborn infant. These products should therefore only be used after weighing the needs of the mother during labour against the risk to the foetus. Animal reproduction studies have not been conducted with pethidine hydrochloride and safe use in pregnancy prior to labour has not been established with regard to possible adverse effects on foetal development.<br />\r\n<br />\r\n<strong>Breast-feeding</strong>: Pethidine is excreted in breast milk; however, clinical data on the rate of excretion or concentration of pethidine in breast milk is not available. The clinical significance of these findings is yet to be determined. It is not recommended that pethidine be administered to nursing mothers.</p>', '<p>Serious or life-threatening reactions such as respiratory depression, coma, convulsions, possibly due to elevated levels of norpethidine and hypotension have been associated with the use of pethidine. Therefore the recommendations in the Warnings and Precautions sections should be carefully observed.<br />\r\n<br />\r\nPethidine should be used with caution in patients taking other CNS depressant drugs such as hypnotics and sedatives including barbiturates and benzodiazepines, phenothiazines, and other tranquillisers, anaesthetics, alcohol and antidepressants.<br />\r\n<br />\r\nPatients with severe pain may tolerate very high doses of pethidine but may exhibit respiratory depression should their pain suddenly subside.<br />\r\n<br />\r\nThe elderly demonstrate an increased sensitivity to opioids relative to younger patients. Reduced liver function, renal function and plasma protein binding may contribute to the elevated plasma levels found in elderly subjects.<br />\r\n<br />\r\nSince pethidine is metabolised in the liver and excreted via the kidneys, the possibility of accumulation of the toxic metabolic norpethidine should be considered in patients with hepatic and/or renal impairment<br />\r\n<br />\r\nReduced cardiac output may lead to reduced hepatic perfusion and diminished metabolism of pethidine leading to accumulation of pethidine with possible toxic results.<br />\r\n<br />\r\nPethidine may cause a transient rise in blood pressure and systemic vascular resistance and increased heart rate. Therefore, it is not recommended for pain relief in cardiac infarction.<br />\r\n<br />\r\nPethidine in patients with phaeochromocytoma may result in a hypertensive crisis.<br />\r\n<br />\r\nIn an individual physically dependent on opioids, the administration of the usual dose of an opioid antagonist will precipitate an acute withdrawal syndrome. The severity of this syndrome will depend on the degree of physical dependence and the dose of antagonist administered. The use of opioid antagonists in such individuals should be avoided if possible. If an opioid antagonist must be used to treat serious respiratory depression in the physically dependent patient, the antagonist should be administered with extreme care and only 10 to 20% of the usual initial dose administered.<br />\r\n<br />\r\nPethidine may aggravate pre-existing convulsions in patients with convulsive disorders. If dosage is escalated substantially above recommended levels because of tolerance development, convulsions may occur in individuals without a history of convulsive disorders.<br />\r\n<br />\r\nIn eclampsia the combination of pethidine with phenothiazines has been reported to induce recurrence of seizures rather than stopping them. Therefore, the use of pethidine in eclampsia and pre-eclampsia is not recommended.<br />\r\n<br />\r\nPethidine, while commonly used for pain relief in obstetrics, is known to pass the placenta and may cause neonatal depression, including respiratory depression. An opioid antagonist such as naloxone may be required to reverse such depression. In the neonate, pethidine is excreted and metabolised at a significantly reduced rate compared to adults.<br />\r\n<br />\r\nOrthostatic hypotension has been reported in ambulatory patients administered pethidine.<br />\r\n<br />\r\nPethidine should be given with caution and the initial dose should be reduced in patients with hypothyroidism or Addison&rsquo;s disease.<br />\r\n<br />\r\nPethidine should be used with caution in patients with prostatic hypertrophy or urethral stricture.<br />\r\n<br />\r\nAs opiate agonists may produce hyperglycaemia, this effect should be considered when diabetics require pethidine.<br />\r\n<br />\r\nThere are conflicting reports about the effect of pethidine on the eye. Some reports state that pethidine and its congeners produce miosis, whereas others indicate that these drugs tend to produce mydriasis or no pupillary change. Until the effects are better defined intraocular tension should be monitored in patients with glaucoma who received pethidine.</p>', '<p><strong>Symptoms:</strong>&nbsp;CNS/respiratory depression, mydriasis, bradycardia, pulmonary oedema, chronic tremor, CNS excitability, seizures.<br />\r\n<br />\r\n<strong>Treatment:</strong>&nbsp;Symptomatic. Naloxone can be used to reverse opioid effects. Do not use naloxone for pethidine-induced seizures.</p>', '<p>Opioid analgesics</p>', '<p>Store at room temperature. Do not freeze and protect from light.</p>', '<p><strong>Geriatric patients</strong>: Dose reduction to half normal adult dose is recommended in geriatric patients (over 70 years).<br />\r\n<br />\r\n<strong>Liver impairment</strong>: Dosage reduction and/or increased dosage intervals are recommended.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: Due to the possibility of accumulation of norpethidine in patients with renal failure, caution should be exercised when pethidine is administered to these patients, especially over prolonged periods of time. Therefore, a decrease in the dose or increase in the dosing interval is recommended.</p>', '2022-03-15 04:40:50', '2022-03-15 04:40:50'),
(1218, 1218, '<p>Pheniramine Maleate is indicated for-</p>\r\n\r\n<ul>\r\n	<li>Allergic conditions including hay fever, drug rashes, angioneurotic edema, serum sickness, allergic conjunctivitis, food allergy etc.</li>\r\n	<li>Conditions of the respiratory tract that are accompanied by increased secretion, including vasomotor rhinitis and acute rhinitis.</li>\r\n	<li>All itching skin conditions, including neurodermatitis, eczema of any origin, lichen planus, acute and chronic urticaria, pruritis of the anus or genitals, pruritus in icterus and diabetes, radiation sickness etc.</li>\r\n	<li>Prevention and treatment of motion sickness.</li>\r\n	<li>Prevention and treatment of nausea, vomiting and vertigo due to Meniere&rsquo;s disease and other labyrinthine disturbances.</li>\r\n</ul>', '<p>Pheniramine competes with histamine for the histamine H1 receptor, acting as an inverse agonist once bound. The reduction in H1 receptor activity is responsible for reduced itching as well as reduced vasodilation and capillary leakage leading to less redness and edema. This can be seen in the suppression of the histamine-induced wheal (swelling) and flare (vasodilation) response. Inverse agonism of the H1 receptor in the CNS is also responsible for the sedation produced by first-generation antihistamines like pheniramine. The binding of pheniramine to H4 receptors, and subsequent inverse agonism, may also contribute to reduced itching by antagonizing inflammation.</p>', '<p>Doses must be individually determined in all cases and should be taken with or soon after food. Treatment should be commenced at the lowest possible dose because experience has shown that antihistamines are often effective at low doses. The maximum dose of 3 mg/kg per day should not be exceeded. Elderly patients should use the adult dose with caution.<br />\r\n<br />\r\nTo prevent travel sickness, it is recommended that the first dose be taken at least 30 minutes before traveling. Due to the risk of drowsiness, the patient should not drive a motor vehicle or operate machinery after taking a dose.<br />\r\n<br />\r\nPheniramine Maleate tablets:</p>\r\n\r\n<ul>\r\n	<li><strong>In adults and children over 10 years of age</strong>: Treatment is commenced with half a tablet taken up to three times daily. This dose may be increased to one tablet taken up to three times daily if required.</li>\r\n	<li><strong>Children 5-10 years of age</strong>: Half a tablet up to three times daily. Pheniramine Maleate tablets are not recommended in children under 5 years of age.</li>\r\n</ul>', '<ul>\r\n	<li>MAO-inhibitors may prolong and intensify the anticholinergic effect of pheniramine (see Contraindications).</li>\r\n	<li>Adverse CNS effects of pheniramine may be enhanced when it is taken with alcohol or other CNS depressants (eg. hypnotics, sedatives, tranquilizers).</li>\r\n	<li>Atropine and related drugs may enhance the anticholinergic activity of pheniramine.</li>\r\n</ul>', '<ul>\r\n	<li>Patients with hypersensitivity to pheniramine or any other ingredient (eg. Methyl hydroxybenzoate or propyl hydroxybenzoate in the syrup).</li>\r\n	<li>Patients with symptomatic prostatic hypertrophy.</li>\r\n	<li>Patients receiving MAO-inhibitor therapy.</li>\r\n	<li>Newborn and premature infants.</li>\r\n</ul>', '<p>The most common adverse reaction is sedation, which often disappears after a few days if tolerance is acquired. Hypersensitivity reactions have been reported.</p>\r\n\r\n<ul>\r\n	<li><strong>Central Nervous System</strong>: Lassitude, dizziness, tinnitus, inability to concentrate, incoordination, irritability, insomnia and tremors. Agitation and convulsions, especially in children and restlessness, disorientation and hallucinations in adults, are common symptoms following overdose.</li>\r\n	<li><strong>Gastrointestinal</strong>: Nausea, vomiting, diarrhoea, colic, epigastric pain, anorexia, dryness of mouth and constipation.</li>\r\n	<li><strong>Genitourinary</strong>: Urinary retention.</li>\r\n	<li><strong>Cardiovascular</strong>: Palpitations, headache.</li>\r\n	<li><strong>Ocular</strong>: Blurred vision, increased intraocular pressure.</li>\r\n	<li><strong>Musculoskeletal</strong>: Muscular weakness.</li>\r\n	<li><strong>Haematological</strong>: Rare cases of blood dyscrasias including agranulocytosis and haemolytic anaemia have been reported.</li>\r\n</ul>', '<p>pregnancy Category A. Use only if strictly indicated. Use only if strictly indicated.</p>', '<ul>\r\n	<li>Pheniramine Maleate may cause drowsiness. Both the dosage and the time of administration should be carefully considered in patients whose activities (e.g. driving a car or operating machinery) demand special concentration.</li>\r\n	<li>Patients should be cautioned against the simultaneous ingestion of alcohol and other central nervous system depressants. Pheniramine Maleate may possibly be hallucinogenic in toxic doses. Due to the possible CNS stimulating effects of antihistamines, pheniramine has the potential for abuse.</li>\r\n	<li>Due to the anticholinergic effect of pheniramine, caution and close monitoring are required if it is used in patients with conditions such as prostatic hypertrophy, narrow angle glaucoma, asthma or severe cardiovascular disease.</li>\r\n	<li>The anti-emetic effect of pheniramine may mask the signs of other conditions. Products containing pheniramine should not be taken on an empty stomach.</li>\r\n</ul>', '<p><strong>Symptoms</strong>: Antihistamine drugs in toxic doses produce a complex of CNS excitatory and depressant effects. Accidental ingestion in small children has resulted in convulsions and sometimes death.<br />\r\n<br />\r\n<strong>Management</strong>: As there is no specific antidote, treatment should be symptomatic and supportive. Induction of vomiting should only be used immediately after ingestion as the sedative action of any absorbed antihistamine can lead to life-threatening pulmonary aspiration during emesis. Gastric lavage with a cuffed endotracheal tube in situ may be useful for some time after ingestion of antihistamines as their anticholinergic action slows down gastric emptying. Stimulants should not be used as they may precipitate convulsions. Diazepam or short-acting barbiturates may be used to control convulsions. Vasopressors may be used to treat hypotension. Mechanical support of respiration may be required if respiration is seriously depressed. Continuous ECG monitoring is recommended if cardiac toxicity develops, which can be treated with centrally-acting anticholinesterases such as physostigmine.</p>', '<p>Sedating Anti-histamine</p>', '<p>Store in a cool and dry place, protected from light. Do not use later than the date of expiry. Keep all medicines out of the reach of children. To be dispensed only on the prescription of a registered physician</p>', NULL, '2022-03-15 04:42:31', '2022-03-15 04:42:31'),
(1219, 1219, '<p>Phenobarbital is indicated for the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Sedatives</li>\r\n	<li>Hypnotics for the short-term treatment of insomnia</li>\r\n	<li>Pre-anesthetics</li>\r\n	<li>Long-term anticonvulsants for the treatment of generalized tonic-clonic and cortical local seizures. And, in the emergency control of certain acute convulsive episodes, (those associated with status epilepticus, eclampsia meningitis, tetanus, and toxic reactions to Strychnine or local anesthetics).</li>\r\n</ul>', '<p>Phenobarbital, the longest-acting barbiturate, is used for its anticonvulsant and sedative-hypnotic properties in the management of all seizure disorders except absence (petit mal). Phenobarbital acts on GABAA&nbsp;receptors, increasing synaptic inhibition. This has the effect of elevating seizure threshold and reducing the spread of seizure activity from a seizure focus. Phenobarbital may also inhibit calcium channels, resulting in a decrease in excitatory transmitter release. The sedative-hypnotic effects of phenobarbital are likely the result of its effect on the polysynaptic midbrain reticular formation, which controls CNS arousal.</p>', '<p>Suggested doses of Phenobarbital for specific indications are as follows:<br />\r\n<br />\r\nPediatric Oral Dosage:</p>\r\n\r\n<ul>\r\n	<li><strong>Preoperative</strong>: 1 mg to 3 mg/kg.</li>\r\n	<li><strong>Anticonvulsant</strong>: 1 mg to 6 mg/kg per day</li>\r\n</ul>\r\n\r\n<p>Adult Oral Dosage:</p>\r\n\r\n<ul>\r\n	<li><strong>Daytime sedative</strong>: 30 mg to 120 mg daily in 2 to 3 divided doses.</li>\r\n	<li><strong>Bedtime hypnotic</strong>: 100 mg to 320 mg.</li>\r\n	<li><strong>Anticonvulsant</strong>: 50 mg to 100 mg 2 to 3 times daily.</li>\r\n</ul>\r\n\r\n<p>Pediatric Injection Dosage:</p>\r\n\r\n<ul>\r\n	<li>15 to 20 mg/kg IV over 10 to 15 min.</li>\r\n	<li><strong>Preoperative Sedation</strong>:1 to 3 mg/kg IM/IV;</li>\r\n	<li><strong>Anticonvulsant</strong>: 4 to 6 mg/kg IM/IV per day, for 10 days. Alternatively, use 10 to 15 mg/kg IM/IV per day to reach therapeutic level more quickly. Maxium IV rate 60 mg/min.</li>\r\n</ul>\r\n\r\n<p>Adult Injection Dosage:</p>\r\n\r\n<ul>\r\n	<li><strong>Insomnia</strong>: 100 to 320 mg IM/IV;</li>\r\n	<li><strong>Convulsions</strong>: 100 to 320 mg IV. Repeat if needed (maximum, 600 mg per day);</li>\r\n	<li><strong>Status Epilepticus</strong>: 10 to 20 mg/kg IV. Repeat if needed.</li>\r\n</ul>', '<p>The concomitant use of Alcohol or other CNS depressants may produce additive CNS depressant effects.</p>', '<p>Phenobarbital is contraindicated in patients with known Phenobarbital sensitivity or a history of latent porphyria.</p>', '<p>The most common adverse reaction is somnolence. Other less frequent adverse reactions are agitation, confusion, hyperkinesia, ataxia, CNS depression, nightmares, nervousness, psychiatric disturbance, hallucinations, insomnia, anxiety, dizziness, thinking abnormality, apnea, bradycardia, hypotension, nausea, vomiting and constipation.</p>', '<p>Pregnancy Category D. Phenobarbital can cause fetal damage when administered to a pregnant woman. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be in risk of the potential hazard to the fetus. Caution should be taken when Phenobarbital is administered to a nursing woman since small amounts of Phenobarbital are excreted in the milk.</p>', '<p>Tolerance and psychological and physical dependence may occur with continuing use. Phenobarbital should be administered with caution to patients who are mentally depressed, have suicidal tendencies, or a history of drug abuse. In patients with hepatic damage, Phenobarbital should be administered with caution and initially reduced doses.</p>', '<p>The toxic dose of barbiturates varies considerably. In general, an oral dose of 1 gram of most barbiturates produces serious poisoning in an adult. Death commonly occurs after 2 to 10 grams of ingested barbiturate. Acute overdosage with barbiturates is manifested by CNS and respiratory depression Treatment of overdosage is mainly supportive and immediate hospitalization is necessary.</p>', '<p>Adjunct anti-epileptic drugs, Barbiturates</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-15 04:44:10', '2022-03-15 04:44:10'),
(1220, 1220, '<p>For the treatment of mild to moderately severe bacterial infections, if these are due to penicillin susceptible pathogens and respond to therapy with oral penicillin, such as:</p>\r\n\r\n<ul>\r\n	<li>infections of the ear, nose and throat regions, e.g., tonsillitis, pharyngitis, laryngitis, otitis media, sinusitis.</li>\r\n	<li>infections of the lower respiratory tract, e.g., bronchitis and pneumonia, bronchopneumonia.</li>\r\n	<li>infections due to beta-hemolytic streptococci of group A, e.g., scarlet fever, erysipelas, rheumatic fever.</li>\r\n	<li>skin infections, e.g., pyodermia, furunculosis, phlegmon, erysipeloid, erythema migrans, insofar as the micro-organisms are penicillin-susceptible.</li>\r\n	<li>lymphadenitis and lymphangitis of bacterial origin.</li>\r\n	<li>infections of the buccal cavity, gums or jaws, e.g., inflammatory infiltrates, delayed dentition stages II and III, antral fistulae, secondary bacterial infection with Gram-positive pathogens following virus-induced gingivitis or stomatitis.</li>\r\n</ul>\r\n\r\n<p>For prophylaxis of scarlet fever; also to prevent recurrences of rheumatic fever. For prophylaxis of infection after dental and oral surgical procedures or dental extractions in certain high risk patients (e.g. with congenital cardiac defects, artificial heart valves, rheumatic endocarditis). In some cases, combination with another appropriate antibiotic may be indicated.</p>', '<p>Phenoxymethyl penicillin or penicillin V is acid-stable and is absorbed from the upper part of the small intestine. Of different forms of Phenoxymethyl penicillin, the potassium salt of Phenoxymethyl penicillin is best absorbed. This may be given with meals but maximum absorption is achieved when drug is administered orally at least 1 hour before or 2 hours after the meal. Phenoxymethyl penicillin offers a very convenient means of treating Grampositive infections. Phenoxymethyl penicillin has the distinct advantage over penicillin G in resistance to inactivation by gastric acid.</p>', '<p>The dosage of Phenoxymethyl penicillin should be determined according to the sensitivity of the causative micro-organism and the severity of the infection, and adjusted to the clinical response of the patient.<br />\r\n<br />\r\n<strong>Adults</strong>: 250-500 mg 6 hourly<br />\r\n<br />\r\n<strong>Children (above 1 year)</strong>:</p>\r\n\r\n<ul>\r\n	<li>125-250 mg 6 hourly</li>\r\n	<li>125 mg/5 ml powder for suspension: 1-2 teaspoonful (5-10 ml) 6 hourly</li>\r\n	<li>250 mg/5 ml powder for suspension: &frac12;-1 teaspoonful (2.5-5 ml) 6 hourly</li>\r\n</ul>\r\n\r\n<p><strong>Infants (below 1 year)</strong>:</p>\r\n\r\n<ul>\r\n	<li>62.5-125 mg 6 hourly.</li>\r\n	<li>125 mg/5 ml powder for suspension: &frac12;-1 teaspoonful (2.5-5 ml) 6 hourly, or as prescribed by the physician.</li>\r\n</ul>\r\n\r\n<p>Phenoxymethyl penicillin is best taken with an empty stomach, preferably at least 1 hour before or 2 hour after meal.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Phenoxymethyl Penicillin is best taken on an empty stomach, preferably one hour before meals. The tablets are swallowed without chewing with sufficient amounts of liquid. Before each use of this syrup, the bottle has to be shaken vigorously.</p>', '<p><strong>Food</strong>: Concurrent intake of food leads to a reduction in the rate of absorption. Therefore, Phenoxymethyl penicillin is best taken on an empty stomach, preferably one hour before meals, in order to reach the highest possible rate of absorption.<br />\r\n<br />\r\n<strong>Drug interactions</strong>: Concomitant administration of penicillins may lead to increased levels of methotrexate in serum and potentiate its toxic effects. Monitoring of methotrexate serum levels is therefore necessary.<br />\r\n<br />\r\nIf diarrhoea occurs as a consequence of treatment with Phenoxymethyl penicillin, the absorption of other orally administered drugs may be disturbed and their effcacy may consequently be impaired. If penicillins are combined with bacteriostatic chemotherapeutics or antibiotics (e.g., tetracyclines, chloramphenicol), the activity of penicillins may be attenuated or abolished. Concurrent administration of probenecid inhibits the renal excretion of penicillins. Concurrent use of indomethacin, phenylbutazone, salicylates or sulfinpyrazone may cause elevated and prolonged serum levels of phenoxymethylpenicillin.<br />\r\n<br />\r\nAdministration of penicillins may cause a transient reduction in plasma concentrations of oestrogens and gestagens. The effectiveness of oral contraceptives is therefore uncertain.<br />\r\n<br />\r\nThe absorption of Phenoxymethyl penicillin may be reduced where intestinal sterilization with aminoglycosides (e.g. neomycin) has just been performed or is still in progress. Combined use of penicillins and oral anticoagulants (e.g. warfarin) may prolong prothrombin time/INR.<br />\r\n<br />\r\n<strong>Interference with laboratory and diagnostic tests</strong>: Non-enzymatic urine glucose determinations and tests for urobilinogen may give false-positive results.</p>', '<p>Phenoxymethyl Penicillin must not be administered in patients with hypersensitivity to penicillins or any of the excipients of this. Phenoxymethyl Penicillin must not be used to treat patients with severe gastrointestinal disorders accompanied by vomiting and diarrhea.</p>', '<p>Occasionally, hypersensitivity reactions involving the skin (e.g. urticaria, morbilliform or scarlatiniform rashes, pruritus), eosinophilia or more serious allergic reactions, e.g. drug fever, vasculitis, serum sickness or interstitial nephritis, may develop. Anaphylactic or anaphylactoid reactions accompanied by, e.g- angioneurotic oedema, oedema of the larynx, bronchial spasm and shock may occur.<br />\r\n<br />\r\nIn the event of signs pointing to anaphylactic/anaphylactoid reactions, the treatment must be terminated immediately. In occasional instances, there may be skin rashes or inflammation of mucous membranes, especially in the region of the mouth (stomatitis); dryness of the mouth and disorders of taste may rarely occur.<br />\r\n<br />\r\nThe occurrence of severe bullous skin reactions- usually involving the mucosae- has been reported in isolated cases (Stevens-Johnson syndrome, Lyell&#39;s syndrome). Gastrointestinal disturbances with, e.g., nausea, vomiting, abdominal pain, loose stools, or diarrhoea may develop.<br />\r\n<br />\r\nDiarrhoea may sometimes be a symptom of enterocolitis which may, in some cases, be haemorrhagic. A particular form of enterocolitis that can occur with antibiotics is pseudomembranous colitis (in most cases due to Clostridium diffcile). This must be considered in patients in whom severe, persistent diarrhoea occurs during treatment or in the initial weeks thereafter. Even if pseudomembranous colitis is only suspected, administration of Phenoxymethyl penicillin must be halted immediately. This type of colitis requires immediate and appropriate treatment by a physician. Drugs that inhibit intestinal peristalsis must not be taken in such cases. In isolated cases, particularly after high doses and prolonged administration, changes in blood picture such as reduction in the number of white blood cells (e.g.,leucopenia, granulocytopenia, agranulocytosis), erythrocytes (e.g., due to haemolytic anaemia), thrombocytes, or pancytopenia and myelosuppression may occur. During treatment for spirochaetal infections, Herxheimer&#39;s reaction characterized by the occurrence or worsening of general symptoms such as fever, chills, headache, and joint pains may develop. In isolated cases, drug-induced aseptic meningitis may occur.<br />\r\n<br />\r\nIn extremely rare cases, transient discolouration of the teeth may be seen during treatment with Phenoxymethyl penicillin. Administration of antibiotics, especially if prolonged, may lead to the proliferation of resistant micro organisms.<br />\r\n<br />\r\nBeta-lactams predispose the patient to encephalopathy risk (which may include convulsions, confusion, impairment of consciousness, movement disorders), particularly in case of overdose or renal impairment.</p>', '<p>Phenoxymethylpenicillin crosses the placenta. Given the appropriate indication, this may be used at any time throughout pregnancy. Phenoxymethylpenicillin passes into the breast milk in small amounts. This may be used during lactation; however, diarrhoea and yeast colonization of mucous membranes may occur in the infant.</p>', '<p>The possibility of cross-allergy between cephalosporins and penicillins must be considered. When treating patients with heart diseases or serious electrolyte disturbances of other origin, the potassium content of Phenoxymethyl Penicillin may have to be considered. Beta-lactams predispose the patient to encephalopathy risk (which may include convulsions, confusion, impairment of consciousness, movement disorders), particularly in case of overdose or renal impairment.<br />\r\n<br />\r\nAdministration of antibiotics, especially if prolonged, may lead to the proliferation of resistant micro-organisms. The patient&#39;s condition must therefore be checked at regular intervals. If a secondary infection occurs, appropriate measures must be taken. In patients with diabetes mellitus, the sugar content of Phenoxymethyl Penicillin syrup must be taken into consideration.<br />\r\n<br />\r\nThere is no indication of impaired ability to drive, or to operate machinery. Beta-lactams predispose the patient to encephalopathy risk. In the case of adverse reactions such as encephalopathy (which may include convulsions, confusion, impairment of consciousness, movement disorders), the patient should not operate machines or drive a vehicle.</p>', '<p>The toxicity of phenoxymethylpenicillin is low, and it has a broad therapeutic range. When a multiple therapeutic dose is taken orally once only, phenoxymethylpenicillin has no acute toxicity. There is a risk of encephalopathy in cases of administration of beta-lactam antibiotics, particularly in case of overdose or renal impairment. Special measures in the event of overdosage, other than discontinuation of the medication, are not required. Elimination of phenoxymethylpenicillin can be accomplished through haemodialysis.</p>', '<p>Benzylpenicillin &amp; Phenoxymethyl penicillin.</p>', '<p>Store in a cool and dry place, protect from light.</p>', NULL, '2022-03-15 04:46:08', '2022-03-15 04:46:08');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1221, 1221, '<p>Parenteral&nbsp;Phenytoin is indicated for the treatment of generalized tonic-clonic&nbsp;status epilepticus, and prevention and treatment of seizures occurring during neurosurgery. Intravenous Phenytoin can also be substituted, as short-term use, for oral&nbsp;phenytoin. Parenteral Phenytoin should be used only when oral Phenytoin administration is not possible.</p>', '<p>Phenytoin acts as an anticonvulsant by increasing efflux or decreasing influx of sodium ions across cell membranes in the motor cortex during generation of nerve impulses; thus stabilising neuronal membranes and decreasing seizure activity. It acts as an antiarrhythmic by extending the effective refractory period and suppressing ventricular pacemaker automaticity, shortening action potential in the heart.</p>', '<p><strong>Oral:&nbsp;</strong>Epilepsy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initially, 3-4 mg/kg daily as single dose or in divided doses. Alternatively, 150-300 mg daily increased gradually to 600 mg daily if necessary. Maintenance: 200-500 mg daily.</li>\r\n	<li><strong>Child:</strong>&nbsp;Initially, 5 mg/kg daily in 2-3 divided doses. Maintenance: 4-8 mg/kg daily in divided doses. Max dose: 300 mg daily.</li>\r\n</ul>\r\n\r\n<p><strong>Intravenous:&nbsp;</strong>Tonic-clonic status epilepticus:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Adjunctive therapy with a benzodiazepine (e.g. diazepam): 10-15 mg/kg by slow inj or intermittent infusion at a max rate of 50 mg/min. Maintenance: 100 mg IV (or orally) given every 6-8 hr.</li>\r\n	<li><strong>Child:</strong>&nbsp;Neonates: 20 mg/kg as a loading dose, then 2.5-5 mg/kg bid; 1 mth-12 yr: 18 mg/kg as a loading dose, then 2.5-5 mg/kg bid; &gt;12 yr: 18 mg/kg as a loading dose, then up to 100 mg 3-4 times daily.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken with food. When administering to patients on nasogastric or other enteral feeds, do not administer feeds 2 hr before or after a dose. Be consistent throughout therapy in relation to feed times. Do not switch dosage forms/brands w/o prior consideration.</p>', '<p>Effects with other sedative drugs or ethanol may be potentiated. Enhances toxic effects of paracetamol, lithium. Increased risk of osteomalacia with acetazolamide. Decreased serum levels/effects with acyclovir, antineoplastics, benzodiazeines, ciprofloxacin, CYP2C9 inducers (e.g. carbamazepine), CYP2C19 inducers (e.g. rifampin), folic acid, vigabatrin. Increased serum concentrations with allopurinol, capecitabine, cimetidine, CYP2C9 inhibitors (e.g. fluconazole), CYP2C19 inhibitors (e.g. delavirdine), disulfiram, methylphenidate, metronidazole, omeprazole, SSRI, trazodone, trimethoprim. Increases metabolism of antiarrhythmics, anticonvulsants, antipsychotics, beta-blockers, calcium channel blockers, chloramphenicol, corticosteroids, doxycycline, oestrogens, HMG-CoA reductase inhibitors, methadone, theophylline, TCAs. Decreases levels/effects of clozapine, ciclosporin, tacrolimus, CYP2B6 substrates (e.g. bupropion, selegiline), CYP2C8 substrates (e.g. amiodarone), CYP2C9 substrates (e.g. celecoxib), CYP2C19 substrates (e.g. citalopram), CYP3A4 substrates (e.g. benzodiazepines), digoxin, itraconazole, levodopa, neuromuscular-blocking agents, thyroid hormones, topiramate. Increases levels/effect of dopamine, ticlopidine. Valproic acid may displace phenytoin from binding sites; and affect phenytoin serum concentrations. Transiently increases the hypothrombinaemia response to warfarin initially, followed by an inhibition of the response.</p>', '<p>Phenytoin Sodium is contraindicated in patients with:</p>\r\n\r\n<ul>\r\n	<li>A history of hypersensitivity to phenytoin, its inactive ingredients, or other hydantoins&nbsp;</li>\r\n	<li>Sinus bradycardia, sino-atrial&nbsp;block, second and third degree A-V block, and Adams-Stokes syndrome because of the effect of&nbsp;parenteral&nbsp;phenytoin on&nbsp;ventricular&nbsp;automaticity.</li>\r\n	<li>A history of prior acute hepatotoxicity attributable to phenytoin&nbsp;</li>\r\n	<li>Coadministration with delavirdine because of the potential for loss of virologic response and possible resistance to delavirdine or to the class of non-nucleoside&nbsp;reverse transcriptase&nbsp;inhibitors.</li>\r\n</ul>', '<p>Hypersensitivity, lack of appetite, headache, dizziness, tremor, transient nervousness, insomnia, GI disturbances (e.g. nausea, vomiting, constipation), tenderness and hyperplasia of the gums, acne, hirsutism, coarsening of the facial features, rashes, osteomalacia. Phenytoin toxicity as manifested as a syndrome of cerebellar, vestibular, ocular effects, notably nystagmus, diplopia, slurred speech, and ataxia; also with mental confusion, dyskinesias, exacerbations of seizure frequency, hyperglycaemia. Solutions for inj may cause local irritation or phlebitis. Prolonged use may produce subtle effects on mental function and cognition, especially in children.</p>', '<p><strong>Category D</strong>: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Cardiovascular disease, e.g. sinus bradycardia, heart blocks; DM; hepatic impairment; hypoalbuminemia; porphyria; seizures (may increase frequency of petit mal seizures); debilitated patients; elderly. Caution in IV admin in hypotension, heart failure or MI, monitor BP and ECG during therapy. IV must be given slowly (too rapid admin may cause hypotension, CNS depression, cardiac arrhythmias and impaired heart conduction). Extravasation and intra-arterial admin must be avoided. Do not discontinue abruptly (may increase seizure frequency), unless safety concerns require a more rapid withdrawal. May impair ability to drive or operate machinery.</p>', '<p>The&nbsp;lethal&nbsp;dose in pediatric patients is not known. The lethal dose in adults is estimated to be 2 to 5 grams. The initial symptoms are&nbsp;nystagmus,&nbsp;ataxia, and&nbsp;dysarthria. Other signs are&nbsp;tremor, hyperreflexia,&nbsp;lethargy, slurred speech, blurred vision, nausea, and vomiting. The patient may become comatose and&nbsp;hypotensive. Death is caused by respiratory and&nbsp;circulatory&nbsp;depression.<br />\r\n<br />\r\nThere are marked variations among individuals with respect to&nbsp;phenytoin&nbsp;serum levels where toxicity may occur. Nystagmus, on&nbsp;lateral&nbsp;gaze, usually appears at 20 mcg/mL, ataxia at 30 mcg/mL, dysarthria and lethargy appear when the serum concentration is over 40 mcg/mL, but as high a concentration as 50 mcg/mL has been reported without evidence of toxicity. As much as 25 times the therapeutic dose has been taken to result in a serum concentration over 100 mcg/mL with complete recovery. Irreversible cerebellar dysfunction and&nbsp;atrophy&nbsp;have been reported.<br />\r\n<br />\r\n<strong>Treatment</strong>: Treatment is nonspecific since there is no known&nbsp;antidote. The adequacy of the respiratory and circulatory systems should be carefully observed and appropriate supportive measures employed.&nbsp;Hemodialysis&nbsp;can be considered since phenytoin is not completely bound to plasma proteins. Total exchange&nbsp;transfusion&nbsp;has been used in the treatment of severe intoxication in pediatric patients. In acute overdosage the possibility of other CNS depressants, including alcohol, should be borne in mind.</p>', '<p>Adjunct anti-epileptic drugs.</p>', '<p><strong>Intravenous:</strong>&nbsp;Store at room temperature of 15-30&deg;C.<br />\r\n<strong>Oral:</strong>&nbsp;</p>\r\n\r\n<ul>\r\n	<li>Tablet/capsule: Store below 30&deg;C. Protect from light and moisture;</li>\r\n	<li>Oral suspension: Store at room temperature of 20-25&deg;C, do not freeze, protect from light.</li>\r\n</ul>', '<p><strong>Pediatric Use</strong>: A loading dose of 15 to 20 mg/kg of Phenytoin intravenously will usually produce serum concentrations of phenytoin within the generally accepted serum total concentrations between 10 and 20 mcg/mL (unbound phenytoin concentrations of 1 to 2 mcg/mL). Because of the increased risk of adverse cardiovascular reactions associated with rapid administration Phenytoin should be injected slowly intravenously at a rate not exceeding 1 to 3 mg/kg/min or 50 mg per minute, whichever is slower<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Phenytoin clearance tends to decrease with increasing age. Lower or less frequent dosing may be required&nbsp;<br />\r\n<br />\r\n<strong>Renal and Hepatic Impairment Or Hypoalbuminemia</strong>: The liver is the site of biotransformation. Patients with impaired liver function, elderly patients, or those who are gravely ill may show early toxicity. Because the fraction of unbound phenytoin is increased in patients with renal or hepatic disease, or in those with hypoalbuminemia, the monitoring of phenytoin serum levels should be based on the unbound fraction in those patients.</p>', '2022-03-15 04:48:11', '2022-03-15 04:48:11'),
(1222, 1222, '<p>Phospholipids is indicated for prevention and treatment of Respiratory Distress Syndrome (RDS) (hyaline membrane disease) in premature infants.<br />\r\n<br />\r\n<strong>Prevention:&nbsp;</strong>In premature infants less than 1250 g birthweight, or with evidence of surfactant deficiency, give Phospholipids as soon as possible, preferably within 15 minutes of birth.<br />\r\n<br />\r\n<strong>Rescue:&nbsp;</strong>To treat infants with RDS confirmed by X-ray and requiring mechanical ventilation, give Phospholipids as soon as possible, preferably by 8 hours of age.<br />\r\n<br />\r\nResults from clinical studies suggest that little benefit is likely to be gained from giving Phospholipids to infants who have completed a prenatal course of corticosteroids, unless they develop RDS within the first 6-8 hours of life.<br />\r\n<br />\r\nThe results of outborn compared to inborn infants were not analysed separately in the clinical trials.Outborn infants were distributed equally between the treatment groups and were not considered likely to bias the estimation of treatment effect. Therefore, there does not appear to be any evidence to suggest that outborn infants&nbsp; respond less well to treatment with Phospholipids.</p>', '<p>Endogenous pulmonary surfactant lowers surface tension on alveolar surfaces during respiration and stabilizes the alveoli against collapse at resting transpulmonary pressures. Deficiency of pulmonary surfactant causes Respiratory Distress Syndrome (RDS) in premature infants. Phospholipid replenishes surfactant and restores surface activity to the lungs of these infants.<br />\r\n<br />\r\nIn vitro, Phospholipid reproducibly lowers minimum surface tension to less than 8 dynes/cm on the pulsating bubble surfactometer and Wilhelmy Surface Balance.<br />\r\n<br />\r\nIn vivo, single Phospholipid doses improve lung pressure-volume measurements, &nbsp;lung compliance, and oxygenation in premature rabbit and sheep.</p>', '<p>Each dose of Phospholipid is 100 mg of phospholipid/kg birth weight (4 mL/kg). The Phospholipid Dosage Chart shows the total dosage for a range of birth weights.<br />\r\n<br />\r\nFour doses of Phospholipid can be administered in the first 48 hours of life. Doses should be given no more frequently than every 6 hours.<br />\r\n<br />\r\nFor Intratracheal Administration Only. Phospholipid should be administered by or under the supervision of clinicians experienced in intubation, ventilator management and general care of premature infants.<br />\r\n<br />\r\nMarked improvements in oxygenation may occur within minutes of administration of Phospholipid. Therefore, frequent and careful clinical observation and monitoring of systemic oxygenation are essential to avoid hyperoxia.</p>\r\n\r\n<p><a href=\"https://medex.com.bd/news/104/danger-of-taking-medication-without-doctors-advice\" target=\"_blank\"><em>* চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন</em></a>&#39;</p>\r\n\r\n<p>Administration</p>\r\n\r\n<p><strong>Directions for Use:</strong>&nbsp;Phospholipid should be inspected visually for discolouration prior to administration. The colour of Phospholipid is off-white to light brown. If settling occurs during storage, swirl the vial gently (DO NOT SHAKE) to redisperse. Some foaming at the surface may occur during handling and is inherent in the nature of the product.<br />\r\n<br />\r\nSurvanta is stored refrigerated (2- 8&deg;C). Before administration, Survanta should be warmed by standing at room temperature for at least 20 minutes or warmed in the hand for at least 8 minutes. If a prevention dose is to be given, preparation of Survanta should begin before the infant&rsquo;s birth.<br />\r\n<br />\r\nUnopened, unused vials of Survanta that have been warmed to room temperature may be returned to the refrigerator within 8 hours of warming and stored for future use. Drug should not be warmed and returned to the refrigerator more than once. Each single-use vial of Survanta should be entered only once. &nbsp;Used vials with residual drug should be discarded.<br />\r\n<br />\r\n<strong>Dosing Precautions</strong>: If an infant experiences bradycardia or oxygen desaturation during the dosing procedure, stop the dosing procedure and initiate appropriate measures to alleviate the condition. After the infant has stabilised, resume the dosing procedure. Rales and moist breath sounds can occur transiently after administration of Survanta. Endotracheal suctioning or other remedial action is unnecessary unless clear-cut signs of airway obstruction are present.<br />\r\n<br />\r\nMethods of Administration:</p>\r\n\r\n<ul>\r\n	<li><strong>Method A</strong>&nbsp;outlined below was the original method of administration in all the controlled clinical studies that established the efficacy and safety of Phospholipid. The two additional methods of administering Phospholipid were compared to the original method in a multi-centre, randomised clinical trial involving 299 infants weighing 600g or more with RDS requiring mechanical ventilation. There were no significant differences among the three methods in average FiO2 a/A PO2 or MAP at 72 hours of age, or in the incidence of pulmonary air leaks, pulmonary interstitial emphysema, patent ductus arteriosus, or mortality at 72 hours of age.</li>\r\n	<li><strong>Method B</strong>&nbsp;keeping the infant on the ventilator is considered the delivery method of choice as it was associated with less clinical deterioration (expressed as falls in heart rate and in oxygen saturation) during and immediately following treatment. Method B was associated with a greater degree of Phospholipid reflux than the other&nbsp; methods. This&nbsp; reflux was&nbsp; not associated with any clinical consequence.</li>\r\n	<li><strong>Method C</strong>: Survanta can be administered by inserting the 5 French catheter through the endotracheal tube while the endotracheal tube is briefly disconnected from the ventilator. The half doses were administered in the two positions described as for Method B. The procedure for dosing is similar to Method A, the only difference being the use of two half doses instead of four quarter doses. With the infant supine, the head and body of the infant were turned approximately 45&deg; to the right. The infant is removed from the ventilator and the primed catheter inserted into the endotracheal tube. The first half of the Survanta is then delivered and the catheter withdrawn. The infant is then returned to the ventilator for at least 30 seconds of mechanical ventilation. The head and body of the infant is turned approximately 45&deg; to the left. The second half dose of Survanta is delivered in the same manner as the first. The catheter is withdrawn and the infant returned to mechanical ventilation.</li>\r\n</ul>', NULL, NULL, '<p>Transient bradycardia. 02 desaturation, endotracheal tube reflux &amp; blockage, pallor, vasoconstriction, hypotension, HTN, hypocarbia, hypercarbia &amp; apnea.</p>', '<p>Category not classified.</p>', '<p>If an infant experiences bradycardia or oxygen desaturation during the dosing procedure, stop the dosing procedure and initiate appropriate measures to alleviate the condition. After the infant has stabilised, resume the dosing procedure.<br />\r\n<br />\r\nRales and moist breath sounds can occur transiently after administration of Phospholipid . Endotracheal suctioning or other remedial action is unnecessary unless clear-cut signs of airway obstruction are present.</p>', '<p>Overdosage with Phospholipids has not been reported. Based on animal data, overdosage might result in acute airway obstruction. Treatment should be symptomatic and supportive. Rales and moist breath sounds can transiently occur after Phospholipids is given, and do not indicate overdosage. Endotracheal suctioning or other remedial action is not required unless clear-cut signs of airway obstruction are present.</p>', '<p>Cholagogues, Cholelitholytics &amp; Hepatic Protectors, Pulmonary surfactants.</p>', '<p>Store unopened vials at refrigeration temperature (2-8&deg;C). Protect from light. Store vials in carton until ready for use. Vials are for single use only. &nbsp;Upon opening, discard unused drug.</p>', NULL, '2022-03-15 05:09:28', '2022-03-15 05:09:28'),
(1223, 1223, '<p>Phytomenadione (Vitamin K-1) is indicated in following indications-</p>\r\n\r\n<ul>\r\n	<li>Prophylaxis and treatment of haemorrhagic disease in the newborn.</li>\r\n	<li>Haemorrhage or risk of haemorrhage as a result of severe hypoprothrombinemia (i.e. deficiency of clotting factors II, VII, IX and X) of various etiologies, including overdosage of courmarin-type anticoagulants, their combination with phenylbutazone, and other forms of hypovitaminosis K (e.g. in obstructive jaundice as well as liver and intestinal disorders, and after prolonged treatment with antibiotics, sulphonamides or salicylates).</li>\r\n	<li>Prevention and treatment of bleeding due to vitamin K deficiency.</li>\r\n</ul>', '<p>Phytomenadione is a procoagulant factor. As a component of a hepatic carboxylase system, Phytomenadione is involved in the post translational carboxylation of clotting factors II (prothrombin), VII, IX and X and the clotting inhibitors protein C and protein S. Phytomenadione is ineffective in hereditary hypoprothrombinemia or hypoprothrombinemia induced by severe hepatic failure. Lack of Phytomenadione leads to an increased tendency to haemorrhagic disease in the newborn. Phytomenadione administration, which promotes synthesis of the above-mentioned coagulation factors by the liver, can reverse an abnormal coagulation status and bleeding due to Phytomenadione deficiency.</p>', '<p><strong>Prophylaxis</strong>: Mild Hemorrhage or hemorrhagic tendency: The usual dose for Neonates is 2 mg orally at or just after birth. Then 2 mg on 4th-5th&nbsp;day and another 2 mg on 28th-30th&nbsp;day orally. If the oral route is unsuitable then 2 mg of drug can be administered by IM or IV route.<br />\r\n<br />\r\n<strong>Children over 1 year of age</strong>: Could be given 5-10 mg orally. A single 1 mg (0.1 ml) dose IM is recommended in children who are not assured of receiving a second oral dose or, in the case of breast-fed children, who are not assured of receiving a third oral dose.<br />\r\n<br />\r\n<strong>Therapy</strong>: Initially, 1 mg by intravenous injection, with further doses as required, based on the clinical picture and coagulation status.<br />\r\n<br />\r\n<strong>Neonates with special risk factors</strong>: Pre-maturity, birth asphyxia (inadequate intake of oxygen by the baby during birth process), obstructive jaundice, inability to swallow, maternal use of anticoagulants or anti-epileptics-</p>\r\n\r\n<ul>\r\n	<li>1 mg intramuscularly or intravenously at birth or shortly after birth if the oral route is unsuitable.</li>\r\n	<li>Intramuscular and intravenous doses should not exceed 0.4 mg/kg in premature infants weighing less than 2.5 kg.</li>\r\n	<li>The size and frequency of further doses should be based on coagulation status</li>\r\n</ul>\r\n\r\n<p>To ensure a total protection of the newborns, 3 prophylactic doses of Vitamin K should be administered orally following the dosing schedule mentioned above.</p>', '<p>Phytomenadione antagonises the effect of coumarin-type anticoagulants. Coadministration of anticonvulsants can impair the action of vitamin K-1.</p>', '<p>It is contraindicated in patients with known hypersensitivity to any of its constituents.</p>', '<p>There are isolated unconfirmed reports on the possible occurrence of anaphylactoid reactions and venous irritation or phlebitis after parenteral use of Phytomenadione injections.</p>', NULL, '<p>Careful monitoring of the coagulation parameters is necessary for patients with severely impaired liver function after administration of Phytomenadione .</p>', NULL, '<p>Vitamin-K Preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-15 05:10:58', '2022-03-15 05:10:58'),
(1224, 1224, '<p>Phytomenadione is indicated for the prevention of Vitamin K Deficiency Bleeding (VKDB) in newborn babies.</p>', '<p>Vitamin K1 is an essential co-factor in the hepatic synthesis of prothrombin (factor II) and other blood clotting factors (factor VII, IX, X). Vitamin K1 does not readily cross the placenta barrier from mother to child and is poorly excreted in breast milk. Low levels at birth may lead to the development of the hemorrhagic disease of the newborn (HDN). Administration of Phytomenadione promotes the synthesis of essential coagulation factors in the liver and minimizes the risk of Vitamin K1 Deficiency Bleeding (VKDB). After oral administration of Phytomenadione, it is absorbed from small intestine and taken up by the liver, even in the absence of biliary and pancreatic secretions. Its plasma half-life is 2-3 hours.</p>', '<p>The contents of Vitamin K1 capsule should be administered by cutting the narrow tubular tip off the capsule and squeezing the liquid into the baby&rsquo;s mouth.</p>\r\n\r\n<ul>\r\n	<li>One Vitamin K1 (1 mg) capsule is to be administered at birth and another dose should be given if the first dose is spat out.</li>\r\n	<li>For babies who are being exclusively breastfed, a dose of 1 mg once weekly for 12 weeks is recommended for the prevention of late Vitamin K Deficiency Bleeding.</li>\r\n</ul>', '<p>Vitamin K1 acts as an antidote to the anticoagulant drugs of the coumarin type, therefore concomitant use is not recommended except in the treatment of warfarin overdosage. It is not an antidote to heparin.</p>', '<p>Further doses of Vitamin K1 soft gelatin capsules should be avoided to any baby showing evidence of hypersensitivity to any of the constituents of the product.</p>', '<p>No adverse effects have been associated with oral administration.</p>', '<p>Not relevant.</p>', '<p>Before giving Vitamin K1, physicians&#39; advice should be taken for babies currently on treatment with warfarin for protein C or protein S deficiency.</p>', NULL, '<p>Vitamin-K Preparations</p>', '<p>Store in a cool and dry place. Protect from light and keep out of reach of children. Do not freeze.</p>', NULL, '2022-03-15 05:12:36', '2022-03-15 05:12:36'),
(1225, 1225, '<p>Pilocarpine is indicated for chronic open angle glaucoma, acute or chronic narrow angle glaucoma, suspected glaucoma and ocular hypertension.</p>', '<p>Pilocarpine Hydrochloride directly stimulates cholinergic receptors. It produces contraction of the iris sphincter muscle, resulting in pupillary constriction (miosis); constriction of the ciliary muscle, resulting in increased accommodation; and reduction in intraocular pressure associated with an increase in the outflow and a decrease in the inflow of aqueous humor. In chronic open angle glaucoma, the exact mechanism by which miotics lower intraocular pressure is not exactly known; however, contraction of the ciliary muscle apparently opens the intertrabecular spaces and facilitates aqueous humor outflow. There is also a decrease in the rate of inflow of aqueous humor. In angle-closure glaucoma, constriction of the pupil apparently pulls the iris away from the trabeculum, thereby relieving blockage of the trabecular meshwork.</p>', '<p>Instill 1 drop 2-4 times daily. To minimize systemic absorption of the active ingredient of the eye drops, pressure should be applied for one minute on the tear duct after application.</p>', '<p>Belladonna alkaloids or cyclopentolate used ophthalmically may interfere with the miotic effects of pilocarpine and may have their own mydriatic effects dampened. This latter may be used to therapeutic advantage.</p>', '<p>Hypersensitivity to any ingredient including excipients. Conditions where pupillary constriction is undesirable (e.g. acute iritis). Retinal detachment; past history of retinal detachment or conditions that predispose to retinal detachment.</p>', '<p><strong>Common</strong>: Temporary blurred vision, burning, stinging, redness, watering of the eyes, decrease in night vision, eye irritation, headache.<br />\r\n<br />\r\n<strong>Rare</strong>: Eye pain, increased sweating, muscle tremors, nausea, vomiting, diarrhea, watering of the mouth, troubled breathing or wheezing.</p>', '<p>Safe use during pregnancy has not been established. Problems in human pregnancy have not been documented. However, ophthalmic Pilocarpine is systemically absorbed.</p>', '<p>If blurred vision or changes in near or far sight occur, especially at night, patients should exercise caution when involved in night driving or hazardous work in poor light. It is recommended that intraocular pressure measurements be performed regularly during therapy.</p>', '<p>Dilution with water and other fluids is the usual response to accidental or deliberate overdose.</p>', '<p>Drugs affecting exocrine secretions.</p>', '<p>Store at room temperature and protect from light. It is desirable that the contents should not be used more than 4 weeks after first opening of the bottle.</p>', NULL, '2022-03-15 05:14:15', '2022-03-15 05:14:15'),
(1226, 1226, '<p>Pimavanserin is indicated for the treatment of hallucinations and delusions associated with Parkinson&#39;s disease psychosis.</p>', '<p>The mechanism of action of pimavanserin in the treatment of hallucinations and delusions associated with Parkinson&#39;s disease psychosis is unknown. However, the effect of pimavanserin could be mediated through a combination of inverse agonist and antagonist activity at serotonin 5-HT 2A receptors and to a lesser extent at serotonin 5-HT2C&nbsp;receptors.</p>', '<p>The recommended dose of Pimavanserin is 34 mg, taken orally as two 17 mg strength tablets once daily, without titration. Pimavanserin can be taken with or without food.</p>', '<ul>\r\n	<li>Strong CYP3A4 Inhibitors (e.g., ketoconazole): Reduce Pimavanserin dose by one-half.</li>\r\n	<li>Strong CYP3A4 Inducers: Monitor for reduced efficacy. Increase in Pimavanserin dosage may be needed.</li>\r\n</ul>', NULL, '<p>Nausea, Constipation, Peripheral edema, Gait disturbance, Hallucination, Confusional state.</p>', '<p>There are no data on Pimavanserin use in pregnant women that would allow assessment of the drug-associated risk of major congenital malformations or miscarriage. There is no information regarding the presence of pimavanserin in human milk, the effects on the breastfed infant, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for Pimavanserin and any potential adverse effects on the breastfed infant from Pimavanserin or from the underlying maternal condition.</p>', '<p><strong>Increased Mortality in Elderly Patients with Dementia-Related Psychosis</strong>: Antipsychotic drugs increase the all-cause risk of death in elderly patients with dementia-related psychosis. Analyses of 17 dementia-related psychosis placebo-controlled trials (modal duration of 10 weeks and largely in patients taking atypical antipsychotic drugs) revealed a risk of death in the drug-treated patients of between 1.6 to 1.7 times that in placebo-treated patients. Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in placebo-treated patients. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. Pimavanserin is not approved for the treatment of patients with dementia-related psychosis unrelated to the hallucinations and delusions associated with Parkinson&rsquo;s disease psychosis.<br />\r\n<br />\r\n<strong>QT Interval Prolongation</strong>: Pimavanserin prolongs the QT interval. The use of Pimavanserin should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong QT interval including Class 1A antiarrhythmics (e.g., quinidine, procainamide) or Class 3 antiarrhythmics (e.g., amiodarone, sotalol), certain antipsychotic medications (e.g., ziprasidone, chlorpromazine, thioridazine), and certain antibiotics (e.g., gatifloxacin, moxifloxacin). Pimavanserin should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes and/or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval</p>', NULL, '<p>Antiparkinson drugs.</p>', '<p>Store at 20&deg;C to 25&deg;C.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of Pimavanserin have not been established in pediatric patients.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No dose adjustment is required for elderly patients.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No dosage adjustment for Pimavanserin is needed in patients with mild to moderate (CrCL &ge;30 mL/min, Cockcroft-Gault) renal impairment.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Use of Pimavanserin is not recommended in patients with hepatic impairment. Pimavanserin has not been evaluated in this patient population.</p>', '2022-03-15 05:37:47', '2022-03-15 05:37:47'),
(1227, 1227, '<p>Pimecrolimus Cream is indicated as second-line therapy for the short-term and non-continuous chronic treatment of mild to moderate&nbsp;atopic dermatitis&nbsp;in non-immunocompromised&nbsp;adults and children 2 years of age and older, who have failed to respond adequately to other topical prescription treatments, or when those treatments are not advisable.<br />\r\n<br />\r\nPimecrolimus Cream is not indicated for use in children less than 2 years of age.</p>', '<p>Pimecrolimus is a macrolactam and is a derivative of ascomycin. It is an immunosuppressant which inhibits the activation of T-cells and prevents the release of inflammatory mediators from mast cells. It is used for the short term or intermittent long term treatment for mild to moderate atopic eczema.<br />\r\n<br />\r\nThe mechanism of action of pimecrolimus in atopic dermatitis is not known. While the following have been observed, the clinical significance of these observations in&nbsp;atopic dermatitis&nbsp;is not known. It has been demonstrated that pimecrolimus binds with high&nbsp;affinity&nbsp;to macrophilin-12 (FKBP-12) and inhibits the calcium-dependent phosphatase, calcineurin. As a consequence, it inhibits&nbsp;T cell&nbsp;activation by blocking the&nbsp;transcription&nbsp;of early cytokines. In particular, pimecrolimus inhibits at nanomolar concentrations&nbsp;Interleukin-2&nbsp;and interferon gamma (Th1-type) and&nbsp;Interleukin-4&nbsp;and&nbsp;Interleukin-10&nbsp;(Th2-type)&nbsp;cytokine&nbsp;synthesis in human T-cells. In addition, pimecrolimus prevents the release of inflammatory cytokines and mediators from mast cells&nbsp;in vitro&nbsp;after stimulation by&nbsp;antigen/IgE.</p>', '<p>Apply a thin layer of Pimecrolimus Cream, 1% to the affected skin twice daily. The patient should stop using Pimecrolimus Cream, 1% when signs and symptoms (e.g., itch, rash and redness) resolve and should be instructed on what actions to take if symptoms recur.<br />\r\n<br />\r\nIf signs and symptoms persist beyond 6 weeks, patients should be re-examined by their health care provider to confirm the diagnosis of&nbsp;atopic&nbsp;dermatitis.<br />\r\n<br />\r\nContinuous long-term use of Pimecrolimus Cream, 1% should be avoided, and application should be limited to areas of involvement with atopic dermatitis<br />\r\n<br />\r\nThe safety of Pimecrolimus Cream, 1% under&nbsp;occlusion, which may promote systemic exposure, has not been evaluated. Avoid use of Pimecrolimus Cream, 1% with occlusive dressings.</p>', '<p>Potential interactions between Pimecrolimus Cream, 1% and other drugs, including immunizations, have not been systematically evaluated. Due to low blood levels of pimecrolimus detected in some patients after topical application, systemic drug interactions are not expected, but cannot be ruled out. The concomitant administration of known CYP3A family of inhibitors in patients with widespread and/or erythrodermic disease should be done with caution. Some examples of such drugs are&nbsp;erythromycin, itraconazole, ketoconazole, fluconazole, calcium channel blockers and cimetidine.</p>', '<p>Pimecrolimus Cream, 1% is contraindicated in individuals with a history of hypersensitivity to pimecrolimus or any of the components of the cream.</p>', '<p>Common side effects include headache, common cold&nbsp;or&nbsp;stuffy nose,&nbsp;sore throat, cough flu (influenza), fever, viral infection. Some people may get viral skin infections (like cold sores, chicken pox,&nbsp;shingles, or warts) or swollen lymph nodes (glands).</p>', '<p>Pregnancy Category C. There are no adequate and well-controlled studies with Pimecrolimus Cream, 1% in pregnant women. Therefore, Pimecrolimus Cream, 1% should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.&nbsp;It is not known whether this drug is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from pimecrolimus, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<ul>\r\n	<li>Should not be used in immunocompromised adults and children, including patients on systemic immunosuppressive medications.</li>\r\n	<li>Avoid treatment on malignant or pre-malignant skin conditions, as these can present as dermatitis.</li>\r\n	<li>Should not be used in patients with Netherton&#39;s Syndrome or skin diseases with a potential for increased systemic absorption.</li>\r\n</ul>', NULL, '<p>Drugs affecting the immune response.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-15 05:39:28', '2022-03-15 05:39:28'),
(1228, 1228, '<p>Pioglitazone is indicated as an adjunct to diet and exercise to improve glycaemic control in patients with type II diabetes (NIDDM). Pioglitazone is indicated for monotherapy and also indicated for use in combination with sulphonylurea, Metformin or Insulin when diet and exercise plus the single agent does not result in adequate glycaemic control.</p>', '<p>Pioglitazone is a preparation of Pioglitazone which is a member of the newest class of oral antidiabetic agent called thiazolidinediones. It depends on the presence of Insulin for its mechanism of action. Pioglitazone decreases Insulin resistance in the periphery and in the liver, resulting in increased Insulin dependent glucose disposal and decreased hepatic glucose output. It also improves abnormality in lipid metabolism by activating peroxisome proliferator activated receptor gamma (PPAR-&gamma;).</p>', '<p>Pioglitazone can be taken once daily without regard to meals. The management of antidiabetic therapy should be individualized. Pioglitazone monotherapy may be initiated at 15 mg or 30 mg once daily dosages in patients not adequately controlled with diet and exercise alone. For patients who respond inadequately to the initial dose of Pioglitazone, the dose can be increased up to 45 mg once daily. For patients not responding adequately to monotherapy, combination therapy should be considered.<br />\r\n<br />\r\nMaximum recommended daily dose of Pioglitazone should not exceed 45 mg since doses higher than 45 mg have not been studied in placebo controlled clinical studies. Besides, no placebo controlled clinical studies of more than 30 mg once daily have been conducted in combination therapy.</p>', '<p>Administration of thiazolidinediones with an oral contraceptive containing ethinyl oestradiol and norethindrone reduces the plasma concentration of both hormones by approximately 30% which could result in loss of contraception.</p>', '<p>Pioglitazone is contraindicated in patients with known hypersensitivity to any of its components.</p>', '<p>The overall incidence and types of adverse events reported in placebo controlled clinical trials of Pioglitazone monotherapy at doses of 7.5 mg, 15 mg, 30 mg or 45 mg once daily are upper respiratory tract infection (13.2%), headache (9.1%), sinusitis (6.3%), myalgia (5.4%), tooth disorder (5.3%), and pharyngitis (5.1%).</p>', '<p><strong>Pregnancy:</strong>&nbsp;There are no adequate and well controlled studies in pregnant women. Pioglitazone should be used during pregnancy only if the potential benefit justifies the potential risk to the foetus.<br />\r\n<br />\r\n<strong>Lactation:</strong>&nbsp;It is not known whether Pioglitazone is secreted in human milk. As many drugs are excreted in human milk, it should not be administered to a lactating women.</p>', '<p>Pioglitazone exerts its antihyperglycaemic effect only in the presence of Insulin. Therefore, it should not be used in Type 1 diabetes or for the treatment of diabetic ketoacidosis. Pioglitazone should be used with caution in case of combination antidiabetic therapy and hepatic insufficiency. Liver enzyme should be monitored regularly.</p>', NULL, '<p>Thiazolidinedione Group.</p>', '<p>Store at 25&deg; C.</p>', NULL, '2022-03-15 05:41:44', '2022-03-15 05:41:44');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1229, 1229, '<p>This is indicated as an adjunct to diet and exercise as a once-daily combination therapy to improve glycemic control in patients with type 2 diabetes who are already treated with a combination of Pioglitazone and a sulfonylurea or whose diabetes is not adequately controlled with a sulfonylurea alone, or for those patients who have initially responded to Pioglitazone alone and require additional glycemic control.</p>', '<p>Pioglitazone &amp;&nbsp;Glimepiride combines two antihyperglycemic agents with different mechanisms of action to improve glycemic control in patients with type 2 diabetes: Pioglitazone, a member of the thiazolidinedione class, and Glimepiride, a member of the sulfonylurea class.<br />\r\n<br />\r\nPioglitazone is an insulin-sensitizing agent that acts primarily by enhancing peripheral glucose utilization. It depends on the presence of insulin for its mechanism of action. Pioglitazone decreases insulin resistance in the periphery and in the liver resulting in increased insulin dependent glucose disposal and decreased hepatic glucose output. Pioglitazone is a potent and highly selective agonist for peroxisome proliferator-activated receptor-gamma (PPAR&gamma;). Activation of PPAR&gamma; nuclear receptors modulates the transcription of a number of insulin responsive genes involved in the control of glucose and lipid metabolism.<br />\r\n<br />\r\nThe primary mechanism of action of Glimepiride in lowering blood glucose appears to be dependent on stimulating the release of insulin from functioning pancreatic beta cells. In addition, extrapancreatic effects may also play a role in the activity of sulfonylureas such as Glimepiride. This is supported by both preclinical and clinical studies demonstrating that Glimepiride administration can lead to increased sensitivity of peripheral tissues to insulin.</p>', '<p>Selecting the starting dose of Glimepiride &amp; Pioglitazone should be based on the patient&#39;s current regimen of Pioglitazone and/or sulfonylurea. Those patients who may be more sensitive to antihyperglycemic drugs should be monitored carefully during dose adjustment. It is recommended that a single dose of Pioglitazone &amp; Glimepiride be administered once daily with the first main meal.<br />\r\n<br />\r\n<strong>Starting dose for patients currently on Glimepiride monotherapy:</strong>&nbsp;Based on the usual starting dose of Pioglitazone (15 mg or 30 mg daily), Pioglitazone &amp; Glimepiride may be initiated at 30 mg/2 mg or 30 mg/4 mg tablet strengths once&nbsp;daily, and adjusted after assessing&nbsp;adequacy of therapeutic response.<br />\r\n<br />\r\n<strong>Starting dose for patients currently on Pioglitazone monotherapy:</strong>&nbsp;Based on the usual starting doses of Glimepiride (1 mg or 2 mg once daily), and Pioglitazone 15 mg or 30 mg, Pioglitazone &amp; Glimepiride may be initiated at 30 mg/2 mg once daily, and adjusted after assessing adequacy of therapeutic response.<br />\r\n<br />\r\n<strong>Starting dose for patients switching from combination therapy of Pioglitazone plus Glimepiride as separate tablets</strong>: Pioglitazone &amp; Glimepiride may be initiated with 30 mg/2 mg or 30 mg/4 mg tablet strengths based on the dose of Pioglitazone and Glimepiride already being taken. Patients who are not controlled with 15 mg of Pioglitazone in combination with Glimepiride should be carefully monitored when switched to&nbsp; Pioglitazone &amp; Glimepiride.<br />\r\n<br />\r\n<strong>Starting dose for patients currently on a different sulfonylurea monotherapy or switching from combination therapy of Pioglitazone plus a different sulfonylurea:&nbsp;</strong>No exact dosage relationship exists between Glimepiride and the other sulfonylurea agents. Therefore, based on the maximum starting dose of 2 mg Glimepiride, Pioglitazone &amp; Glimepiride should be limited initially to a starting dose of 30 mg/2 mg once daily, and adjusted after assessing adequacy of therapeutic response.</p>', '<p><strong>Glimepiride</strong>: Certain drugs tend to produce hyperglycemia and may lead to loss of control. These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, and isoniazid. When these drugs are administered to a patient receiving Glimepiride, the patient should be closely observed for loss of control. When these drugs are withdrawn from a patient receiving Glimepiride, the patient should be observed closely for hypoglycemia. A potential interaction between oral miconazole and oral hypoglycemic agents leading to severe hypoglycemia has been reported. Whether this interaction also occurs with the IV, topical, or vaginal preparations of miconazole is not known. Potential interactions of Glimepiride with other drugs metabolized by cytochrome P450 2C9 also include phenytoin, diclofenac, ibuprofen, naproxen, and mefenamic acid.<br />\r\n<br />\r\n<strong>Pioglitazone</strong>: Co-administration of Pioglitazone and an oral contraceptive resulted in decrease in ethinyl estradiol plasma concentrations. There were no significant changes in norethindrone AUC (0-24h) and Cmax. In other drug-drug interaction studies, Pioglitazone had no significant effect on the pharmacokinetics of fexofenadine, metformin, digoxin, warfarin, ranitidine, or theophylline.</p>', '<p>Combination of Pioglitazone and Glimepiride is contraindicated in patients with:</p>\r\n\r\n<ul>\r\n	<li>Known hypersensitivity to Pioglitazone or Glimepiride or any of the components of combination of Pioglitazone or Glimepiride.</li>\r\n	<li>Diabetic ketoacidosis, with or without coma. This condition should be treated with insulin.</li>\r\n</ul>', '<p><strong>Pioglitazone</strong>: The most common adverse experiences with Pioglitazone monotherapy (&ge;5%) were upper respiratory tract infection, injury, and headache. Overall, the types of adverse experiences reported when Pioglitazone was used in combination with a sulfonylurea were similar to those during monotherapy with Pioglitazone. Other adverse events reported in at least 5% of patients in controlled clinical studies between placebo and Pioglitazone monotherapy included myalgia (2.7% and 5.4%), tooth disorder (2.3% and 5.3%), diabetes mellitus aggravated (8.1% and 5.1%) and pharyngitis (0.8% and 5.1%), respectively. In monotherapy studies, edema was reported for 4.8% (with doses from 7.5 mg to 45 mg) of patients treated with Pioglitazone versus 1.2% of placebo treated patients.<br />\r\n<br />\r\n<strong>Glimepiride</strong>: Hypoglycemia: The incidence of hypoglycemia with Glimepiride is documented. In patients treated with Glimepiride, adverse events, other than hypoglycemia, considered to be possibly or probably related to study drug that occurred in more than 1% of patients included dizziness (1.7%), asthenia (1.6%), headache (1.5%), and nausea (1.1%). Dermatologic Reactions: Allergic skin reactions, e.g., pruritus, erythema, urticaria, and morbilliform or maculopapular eruptions, occur in less than 1% of treated patients. These may be transient and may disappear despite continued use of Glimepiride.</p>', '<p><strong>Pregnancy</strong>&nbsp;category C. Because current information strongly suggests that abnormal blood glucose levels during pregnancy are associated with a higher incidence of congenital anomalies as well as increased neonatal morbidity and mortality, most experts recommend that insulin monotherapy be used during pregnancy to maintain blood glucose levels as close to normal as possible. Combination of Pioglitazone and Glimepiride should not be used during pregnancy.<br />\r\n<br />\r\n<strong>Nursing mothers</strong>: No studies have been conducted with combination of Pioglitazone and Glimepiride. It is not known whether Pioglitazone and/or Glimepiride are excreted in human milk. Because many drugs are excreted in human milk, combination of Pioglitazone and Glimepiride should not be administered to a nursing woman.</p>', '<p><strong>General</strong>: Due to the mechanisms of action, Pioglitazone is active only in the presence of endogenous insulin. Therefore, combination&nbsp;of Pioglitazone and Glimepiride should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis.<br />\r\n<br />\r\n<strong>Hypoglycemia:</strong>&nbsp;All sulfonylurea drugs are capable of producing severe hypoglycemia. Proper patient selection, dosage, and instructions are important to avoid hypoglycemic episodes. Elderly patients are particularly susceptible to hypoglycemic&nbsp;action of glucose lowering drugs. Debilitated or malnourished patients and those with adrenal, pituitary, renal, or hepatic insufficiency are particularly susceptible to the hypoglycemic action of glucose lowering drugs.<br />\r\n<br />\r\n<strong>Loss of Control of Blood Glucose</strong>: When a patient stabilized on any antidiabetic regimen is exposed to stress such as fever, trauma, infection, or surgery, a temporary loss of glycemic control may occur. At such times, it may be necessary to withhold combination of Pioglitazone and Glimepiride and temporarily administer insulin. Combination of Pioglitazone and Glimepiride may be reinstituted after the acute episode is resolved.<br />\r\n<br />\r\n<strong>Edema</strong>: Combination of Pioglitazone and Glimepiride should be used with caution in patients with edema. Since thiazolidinediones, including Pioglitazone can cause fluid retention, which can exacerbate or lead to congestive heart failure,&nbsp;combination of Pioglitazone and Glimepiride should be used with caution in patients at risk for heart failure.<br />\r\n<br />\r\n<strong>Weight Gain</strong>: Dose-related weight gain was seen with Pioglitazone alone and in combination with other hypoglycemic agents. The mechanism of weight gain is unclear but probably involves a combination of fluid retention and fat accumulation.<br />\r\n<br />\r\n<strong>Hepatic Effects</strong>: Liver enzymes should be checked prior to the initiation of therapy with combination of Pioglitazone and Glimepiride in all patients and periodically thereafter per the clinical judgment of the healthcare professional. Therapy with combination of Pioglitazone and Glimepiride should not be initiated in patients with increased baseline liver enzyme levels (ALT &gt;2.5X upper limit of normal). If at any time ALT levels increase to &gt;3X the upper limit of normal in patients on therapy with&nbsp;combination of Pioglitazone and Glimepiride, liver enzyme levels should be rechecked as soon as possible. If ALT levels remain &gt;3X the upper limit of normal, therapy with combination of Pioglitazone and Glimepiride should be discontinued. If any patient develops symptoms suggesting hepatic dysfunction, which may include unexplained nausea, vomiting, abdominal pain, fatigue, and anorexia, and/or dark urine, liver enzymes should be checked.</p>', '<p><strong>Symptoms:</strong>&nbsp;Severe hypoglycaemia with coma, seizure, or neurological impairment.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Admin glucagon or IV glucose. Additional carbohydrate intake may be necessary as hypoglycaemia may recur after apparent clinical recovery.</p>', '<p>Combination Oral hypoglycemic preparations.</p>', '<p>Store in a cool and dry place. Protect from light and moisture. Keep out of the reach of the children.</p>', '<p><strong>Pediatric Uses:</strong>&nbsp;Safety and effectiveness of combination of Pioglitazone and Glimepiride in pediatric patients have not been established.<br />\r\n<br />\r\nGeriatric use:</p>\r\n\r\n<ul>\r\n	<li><strong>Pioglitazone:</strong>&nbsp;Results of the population pharmacokinetic analysis showed that age does not significantly affect the pharmacokinetics of Pioglitazone. Therefore, no dosage adjustments are required for the elderly.</li>\r\n	<li><strong>Glimepiride:</strong>&nbsp;The drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.</li>\r\n</ul>', '2022-03-15 05:43:57', '2022-03-15 05:43:57'),
(1230, 1230, '<p>Pioglitazone &amp; Metformin combination is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes who are already treated with a combination of Pioglitazone and Metformin or whose diabetes is not adequately controlled with Metformin alone or for those patients who have initially responded to Pioglitazone and require additional glycemic control.</p>', '<p><strong>Pioglitazone</strong>&nbsp;depends on the presence of insulin for its mechanism of action. Pioglitazone decreases insulin resistance in the periphery and in the liver resulting in increased insulindependent glucose disposal and decreased hepatic glucose output. Pioglitazone is a potent and highly selective agonist for peroxisome proliferator-activated receptor-gamma (PPARg). Activation of PPARg nuclear receptors modulates the transcription of a number of insulin responsive genes involved in the control of glucose and lipid metabolism.<br />\r\n<br />\r\n<strong>Metformin hydrochloride</strong>&nbsp;improves glucose tolerance in patients with type 2 diabetes, lowering both basal and postprandial plasma glucose. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Unlike sulfonylureas, metformin does not produce hypoglycemia in either patients with type 2 diabetes or normal subjects and does not cause hyperinsulinemia.</p>', '<p><strong>General</strong>: The use of antihyperglycemic therapy in the management of type 2 diabetes should be individualized on the basis of effectiveness and tolerability while not exceeding the maximum recommended daily dose of Pioglitazone 45 mg and Metformin 2550 mg.<br />\r\n<br />\r\n<strong>Dosage Recommendations</strong>: Selecting the starting dose of Pioglitazone &amp; Metformin should be based on the patient&#39;s current regimen of Pioglitazone and/or Metformin. Pioglitazone &amp; Metformin should be given in divided daily doses with meals to reduce the gastrointestinal side effects associated with Metformin.<br />\r\n<br />\r\nStarting dose for patients inadequately controlled on Metformin monotherapy Based on the usual starting dose of Pioglitazone (15-30 mg daily), Pioglitazone &amp; Metformin may be initiated at either the 15 mg/500 mg or 15 mg/850 mg tablet strength once or twice daily, and gradually titrated after assessing adequacy of therapeutic response. Starting dose for patients who initially responded to Pioglitazone monotherapy and require additional glycemic control<br />\r\n<br />\r\nBased on the usual starting doses of Metformin (500 mg twice daily or 850 mg daily), Pioglitazone &amp; Metformin may be initiated at either the 15 mg/500 mg twice daily or 15 mg/850 mg tablet strength once daily, and gradually titrated after assessing adequacy of therapeutic response.<br />\r\n<br />\r\nStarting dose for patients switching from combination therapy of Pioglitazone plus Metformin as separate tablets Pioglitazone &amp; Metformin may be initiated with either the 15 mg/500 mg or 15 mg/850 mg tablet strengths based on the dose of Pioglitazone and Metformin already being taken.<br />\r\n<br />\r\n<strong>Maximum Recommended Dose</strong>: Pioglitazone &amp; Metformin tablets are available as a 15 mg Pioglitazone plus 500 mg Metformin or a 15 mg Pioglitazone plus 850 mg Metformin formulation for oral administration. The maximum recommended dose for Pioglitazone is 45 mg daily. The maximum recommended daily dose for Metformin is 2550 mg in adults. Special Patient Populations: The initial and maintenance dosing of combination of Pioglitazone and Metformin should be conservative in patients with advanced age, due to the potential for decreased renal function in this population. Generally, elderly, debilitated, and malnourished patients should not be titrated to the maximum dose of combination of Pioglitazone and Metformin. Monitoring of renal function is necessary to aid in prevention of Metformin associated lactic acidosis, particularly in the elderly. Therapy with combination of Pioglitazone and Metformin should not be initiated if the patient exhibits clinical evidence of active liver disease or increased serumtransaminase levels (ALT greater than 2.5 times the upper limit of normal) at start of therapy. Liver enzyme monitoring is recommended in all patients prior to initiation of therapy with combination of Pioglitazone and Metformin and periodically thereafter.</p>', '<p>May impair vit B12 absorption. Increased plasma levels with strong CYP2C8 inhibitors (e.g. gemfibrozil). Decreased plasma levels with CYP2C8 inducers (e.g. rifampicin). Reduced metabolism with cationic drugs eliminated by renal tubular secretion.</p>', '<p>Contraindicated in patients with:</p>\r\n\r\n<ul>\r\n	<li>Renal disease or renal dysfunction (e.g. as suggested by serum creatinine levels &gt;1.5 mg/dl in male, &gt;1.4 mg/dl in females or abnormal creatinine clearance), which may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction and septicemia.</li>\r\n	<li>Known hypersensitivity to Pioglitazone, Metformin or any other component of this combination.</li>\r\n	<li>Acute or chronic metabolic acidosis including diabetic ketoacidosis with or without coma.</li>\r\n</ul>', '<p>Generally this combined preparation is well tolerated. However, the most common side effects are upper respiratory tract infection, diarrhea, peripheral edema and headache, respectively. These are mild in severity.</p>', '<p><strong>Pregnancy:</strong>&nbsp;There are no adequate and well-controlled studies in pregnant women with this combination or its individual components. So, it should only be used if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Nursing mother:</strong>&nbsp;It is not known whether Pioglitazone and/or Metformin are secreted in human milk. Because many drugs are excreted in human milk, this combination should not be administered to a breastfeeding woman.</p>', '<p>Pioglitazone exerts its antihyperglycemic effect only in the presence of insulin. Therefore, Pioglitazone should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis. Pioglitazone should be used with caution in combination especially with insulin, hepatic insufficiency and heart diseases.<br />\r\n<br />\r\nMetformin is known to be substantially excreted by the kidney and the risk of Metformin accumulation and lactic acidosis increases with the degree of impairment of renal function. Thus patients with serum creatinine levels above the upper limit of normal for their age should not receive this combination.</p>', '<p>In the event of Overdosage, appropriate supportive treatment should be initiated according to patient&#39;s clinical signs and symptoms.</p>', '<p>Combination Oral hypoglycemic preparations.</p>', '<p>Store in a cool and dry place. Protect from light and moisture. Keep out of the reach of the children.</p>', '<p>The initial and maintenance dose of Pioglitazone &amp; Metformin should be carefully selected in patients with advanced age due to the potential for decreased renal function in these populations. Monitoring of renal function is necessary to aid in prevention of Metformin associated lactic acidosis, particularly in the elderly. Pioglitazone &amp; Metformin should not be initiated if the patients exhibit clinical evidence of active liver disease. Liver enzyme monitoring is recommended in all patients prior to initiation of therapy with combination of Pioglitazone and Metformin and periodically thereafter.</p>', '2022-03-15 05:46:04', '2022-03-15 05:46:04'),
(1231, 1231, '<p>Used as a muscle relaxant during anesthesia and surgical procedures.</p>', '<p>Pipecuronium is a nondepolarizing neuromuscular blocking agent. Neuromuscular blocking agents produce skeletal muscle paralysis by blocking neural transmission at the myoneural junction. The paralysis is selective initially and usually appears in the following muscles consecutively: levator muscles of eyelids, muscles of mastication, limb muscles, abdominal muscles, muscles of the glottis, and finally, the intercostal muscles and the diaphragm. Neuromuscular blocking agents have no clinically significant effect on consciousness or the pain threshold.<br />\r\n<br />\r\nNondepolarizing neuromuscular blocking agents inhibit neuromuscular transmission by competing with acetylcholine for the cholinergic receptors of the motor end plate, thereby reducing the response of the end plate to acetylcholine. This type of neuromuscular block is usually antagonized by anticholinesterase agents.</p>', '<p>Intravenous (Adult)-</p>\r\n\r\n<ul>\r\n	<li><strong>Initial dose</strong>: 80-100 mcg/kg.</li>\r\n	<li><strong>Subsequent doses</strong>: 10-20 mcg/kg.</li>\r\n	<li><strong>Initial dose following suxamethonium admin or in patients at high risk</strong>: 50-60 mcg/kg.</li>\r\n	<li><strong>Initial dose for caesarean section</strong>: 35 mcg/kg.</li>\r\n</ul>', '<p>Actions antagonised by cholinesterases and long term carbamazepine, phenytoin or corticosteroids usage. Enhanced block when used with drugs that have neuromuscular blocking activity such as lidocaine, quinidine, verapamil and aminoglycosides.</p>', '<p>Hypersensitivity.</p>', '<p>Transient hypotension, bradycardia, reduced cardiac output.</p>', '<p><strong>Pregnancy&nbsp;</strong>Category C.&nbsp;Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Pulmonary disease, respiratory insufficiency, asthma, neuromuscular disease, dehydration, severely ill patients, hepatic or renal impairment. Doses in obese patients should be based on patient&#39;s ideal body weight. Pregnancy, lactation.</p>', '<p>Prolonged apnoea due to paralysis of the intercostal muscles and diaphragm, with CV collapse and effects of histamine release.</p>', '<p>Non depolarizing muscle relaxants.</p>', NULL, NULL, '2022-03-15 05:47:41', '2022-03-15 05:47:41'),
(1232, 1232, '<p><strong>Cerebral vascular accidents and cerebral insufficiencies:&nbsp;</strong>Ischaemic or even haemorrhagic acute accidents, chronic manifestations of the above accidents or of cerebral atherosclerosis.<br />\r\n<br />\r\n<strong>Mental retardation in children:</strong>&nbsp;Ease of resuming individual contact, sociability and learning, improved intellectual performances and school results.<br />\r\n<br />\r\n<strong>Behaviour and psychotic problems in old age:</strong>&nbsp;Memory deficits, particularly&nbsp;with regard to fixation and evocation asthenia adaption disorders, disturbed psychomotor reactions. Patients suffering from myoclonus of cortical origin.</p>', '<p>Piracetam&#39;s mechanism of action is not fully understood. The drug influences neuronal and vascular functions and influences cognitive function without acting as a sedative or stimulant. Piracetam is a positive allosteric modulator of the AMPA receptor. It is hypothesized to act on ion channels or ion carriers, thus leading to increased neuron excitability. GABA brain metabolism and GABA receptors are not affected by piracetam<br />\r\n<br />\r\nIt has been found to increase blood flow and oxygen consumption in parts of the brain, but this may be a side effect of increased brain activity rather than a primary effect or mechanism of action for the drug.<br />\r\n<br />\r\nPiracetam improves the function of the neurotransmitter acetylcholine via muscarinic cholinergic (ACh) receptors, which are implicated in memory processes. Furthermore, piracetam may have an effect on NMDA glutamate receptors, which are involved with learning and memory processes. Piracetam is thought to increase cell membrane permeability. Piracetam may exert its global effect on brain neurotransmission via modulation of ion channels (i.e., Na+, K+). It has been found to increase oxygen consumption in the brain, apparently in connection to ATP metabolism, and increases the activity of adenylate kinase in rat brains. Piracetam, while in the brain, appears to increase the synthesis of cytochrome b5, which is a part of the electron transport mechanism in mitochondria. But in the brain, it also increases the permeability of the mitochondria of some intermediaries of the Krebs cycle.</p>', '<p><strong>Oral: Adults:</strong></p>\r\n\r\n<ul>\r\n	<li><strong>In cerebro-cortical insufficiency disorders</strong>, usual dose is one tablet (800 mg) 3 times a day.</li>\r\n	<li><strong>In myoclonic seizures</strong>, a dose of 7.2 gm daily, increasing by 4.8 gm per day every 3 to 4 days up to maximum of 20 gm daily, given in 2 or 3 divided doses.</li>\r\n</ul>\r\n\r\n<p><strong>Oral: Children:</strong>&nbsp;The daily dosage depends on the weight of the child, 50 mg/kg of body weight in 3 divided doses. Once the desired results has been obtained, reduce the initial dose by half.<br />\r\n<br />\r\n<strong>Parenteral formulations</strong>: When parenteral administration is needed (e.g. swallowing difficulties, unconsciousness) Piracetam can be administered intravenously.&nbsp;When treating severe symptoms, 12 g daily may need to be administered as an intravenous infusion.</p>', '<p>In a single case, confusion, irritability and sleep disorders were reported in concomitant use with thyroid extract. At present, no interaction has been observed with the following anti-epileptic drugs, clonazepam, carbamazepine, phenyton, phenobarbitone and sodium valporate, based on a small number of studies.</p>', '<p>Piracetam is contra-indicated in patients with severe renal insufficiency (creatinine clearance &lt; 20 ml/min) and hepatic impairment. As the principal route of elimination for Piracetam is via the kidney, special care must be taken when treating patients known to suffer from renal insufficiency. Monitoring of renal function is recommended in such cases. The increase in half-life is directly related to the decrease in renal function and creatinine clearance. This is also true for the older patient in whom creatinine clearance is dependent on age. When the creatinine clearance is &lt; 60 ml/min, or serum creatinine is &gt;1.25 mg/100 ml, the dosage prescribed should be calculated as following:<br />\r\n<br />\r\n<strong>CrCl&nbsp;60-40&nbsp;ml/min</strong>:&nbsp;Dosage should be 1/2 of normal dose<br />\r\n<strong>CrCl 40-20 ml/min</strong>:&nbsp;Dosage should be 1/4 of normal dose</p>', '<p>The side effects reported include nervousness, agitation, irritability, anxiety and sleep disturbances. The incidence of these during clinical trials was (&le; 5%) and they were more often noted in the older patients taking &gt; 2.4 gm daily. In the majority of cases, a dose reduction sufficed to make these symptoms disappear. Some patients may complain of fatigue or drowsiness, gastrointestinal problems, e.g. nausea, vomiting, diarrhoea and stomachache have also been reported but their incidence during clinical trials was &le; 2%. Other symptoms e.g. vertigo, headache, trembling and sexual stimulation have occasionally been reported.</p>', '<p>Piracetam should not be prescribed during pregnancy or when breast feeding, except under exceptional circumstances. Piracetam is able to cross the placenta.</p>', NULL, '<p>Piracetam appears to be devoid of toxicity even at very high doses and, therefore, the need for specific measures to be taken in case of an overdose is avoided. Drug Interactions: In a single case, confusion, irritability and sleep disorders were reported in concomitant use with thyroid extract. At present, no interaction has been observed with the following anti-epileptic drugs, clonazepam, carbamazepine, phenytoin, phenobarbitone and sodium valproate, based on a small number of studies.</p>', '<p>Adjunct anti-epileptic drugs, Drugs used in tremor, tics &amp; related disorder</p>', '<p>Store in a cool and dry place at a temperature below 30˚C , Keep away from sunlight. Keep out of the reach of children.</p>', '<p><strong>Children</strong>: No formal pharmacokinetic study has been conducted in children.<br />\r\n<br />\r\n<strong>Elderly</strong>: In the elderly, the half-life of piracetam is increased and the increase is related to the decrease in renal function in this population (see Section Dosage and Administration).<br />\r\n<br />\r\n<strong>Renal impairment</strong>: Piracetam clearance is correlated to creatinine clearance. It is therefore recommended to adjust the daily dose of piracetam based on creatinine clearance in patients with renal impairment&nbsp;<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: The influence of hepatic impairment on the pharmacokinetics of piracetam has not been evaluated. Because 80 to 100% of the dose is excreted in the urine as unchanged drug, hepatic impairment solely would not be expected to have a significant effect on piracetam elimination.</p>', '2022-03-15 05:58:29', '2022-03-15 05:58:29'),
(1233, 1233, '<p>Pirfenidone is indicated in adults for the treatment of mild to moderate Idiopathic Pulmonary Fibrosis (IPF).</p>', '<p>Pirfenidone is an orally active, small molecule that shows a wide range of biologic activity. In vitro evidence has shown that pirfenidone inhibits collagen synthesis, down-regulates profibrotic cytokines and decreases fibroblast proliferation. Pirfenidone leads to a reduction of TGF-beta2 mRNA levels and of the mature TGF-beta2 protein due to decreased expression and direct inhibition of the TGF-beta pro-protein convertase furin. In addition, pirfenidone reduces the protein levels of the matrix metalloproteinase (MMP)-11, a TGF-beta target gene and furin substrate involved in carcinogenesis.</p>', '<p>Treatment with Pirfenidone should be initiated and supervised by specialist physicians experienced in the diagnosis and treatment of IPF. Upon initiating treatment, the dose should be titrated to the recommended daily dose of nine 267 mg tablets or one 801 mg tablet per day over a 14-days period for adult as follows:</p>\r\n\r\n<ul>\r\n	<li><strong>Days 1 to 7</strong>: One 267 mg tablet administered three times a day (801 mg/day)</li>\r\n	<li><strong>Days 8 to 14</strong>: One 534 mg tablets administered three times a day (1602 mg/day)</li>\r\n	<li><strong>Day 15 onward</strong>: Three 267 mg tablets or one 801 mg tablet administered three times a day (2403 mg/day)</li>\r\n</ul>\r\n\r\n<p>The recommended daily dose of Pirfenidone for patients with IPF is three 267 mg tablets or one 801 mg three times a day with food for a total of 2403 mg/day. Doses above 2403 mg/day are not recommended for any patient. Patients who miss 14 consecutive days or more of Pirfenidone treatment should re-initiate therapy by undergoing the initial 2-week titration regimen up to the recommended daily dose. For treatment interruption of less than 14 consecutive days, the dose can be resumed at the previous recommended daily dose without titration.<br />\r\n<br />\r\n<strong>Dose adjustments and other considerations for safe use</strong>: Gastrointestinal events: In patients who experience intolerance to therapy due to gastrointestinal side effects, patients should be reminded to take the medicinal product with food. If symptoms persist Pirfenidone may be reduced to 1-2 capsules (267 mg-534 mg) 2-3 times/day with food with re-escalation to the recommended daily dose as tolerated. If symptoms continue, patients may be instructed to interrupt treatment for 1 to 2 weeks to allow symptoms to resolve.<br />\r\n<br />\r\n<strong>Photosensitivity reaction or rash</strong>: Patients who experience a mild to moderate photosensitivity reaction or rash should be reminded of the instruction to use a sunblock daily and to avoid sun exposure. The dose of Pirfenidone may be reduced to 3 capsules/day (1 capsule three times a day). If the rash persists after 7 days, Pirfenidone should be discontinued for 15 days, with re-escalation to the recommended daily dose in the same manner as the dose escalation period. Patients who experience severe photosensitivity reaction or rash should be instructed to interrupt the dose and to seek medical advice. Once the rash has resolved, Pirfenidone may be re-introduced and re-escalated up to the recommended daily dose at the discretion of the physician.<br />\r\n<br />\r\n<strong>Hepatic function</strong>: In the event of significant elevation of alanine and/or aspartate aminotransferases (ALT/AST) with or without bilirubin elevation, the dose of Pirfenidone should be adjusted or treatment discontinued according to the guidelines.</p>', NULL, '<p>Hypersensitivity to the active substance or to any of the excipients, concomitant use of fluvoxamine, severe hepatic impairment or end stage liver disease, severe renal impairment (CrCl &lt;30 ml/min) or end stage renal disease requiring dialysis.<br />\r\n<br />\r\n<strong>Hepatic function</strong>: Elevations in ALT and AST &gt;3 &times; upper limit of normal (ULN) have been reported in patients receiving therapy with Pirfenidone. Rarely these have been associated with concomitant elevations in total serum bilirubin. Liver function tests (ALT, AST and bilirubin) should be conducted prior to the initiation of treatment with Pirfenidone, and subsequently at monthly intervals for the first 6 months and then every 3 months thereafter. In the event of significant elevation of liver aminotransferases the dose of Pirfenidone should be adjusted or treatment discontinued according to the guidelines listed below. For patients with confirmed elevations in ALT, AST or bilirubin during treatment, the following dose adjustments may be necessary.<br />\r\n<br />\r\n<strong>Recommendations in case of ALT/AST elevations</strong>: If a patient exhibits an aminotransferase elevation to &gt;3 to &le;5 X ULN after starting Pirfenidone therapy, confounding medicinal products should be discontinued, other causes excluded, and the patient monitored closely. If clinically appropriate the dose of Pirfenidone should be reduced or interrupted. Once liver function tests are within normal limits Pirfenidone may be re-escalated to the recommended daily dose if tolerated. If a patient exhibits an aminotransferase elevation to &gt;5 X ULN accompanied by symptoms or hyperbilirubinaemia, Pirfenidone should be discontinued and the patient should not be rechallenged. If a patient exhibits an aminotransferase elevation to &gt;5 X ULN, Pirfenidone should be discontinued and the patient should not be rechallenged.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: In subjects with moderate hepatic impairment (i.e. Child-Pugh Class B), Pirfenidone exposure was increased by 60%. Pirfenidone should be used with caution in patients with pre-existing mild to moderate hepatic impairment (i.e. Child-Pugh Class A and B) given the potential for increased Pirfenidone exposure. Patients should be monitored closely for signs of toxicity especially if they are concomitantly taking a known CYP1A2 inhibitor. Pirfenidone has not been studied in individuals with severe hepatic impairment and Pirfenidone should not be used in patients with severe hepatic impairment.<br />\r\n<br />\r\n<strong>Photosensitivity reaction and rash</strong>: Exposure to direct sunlight (including sunlamps) should be avoided or minimised during treatment with Pirfenidone. Patients should be instructed to use a sunblock daily, to wear clothing that protects against sun exposure, and to avoid other medicinal products known to cause photosensitivity. Patients should be instructed to report symptoms of photosensitivity reaction or rash to their physician. Severe photosensitivity reactions are uncommon. Dose adjustments or temporary treatment discontinuation may be necessary in mild to severe cases of photosensitivity reaction or rash.<br />\r\n<br />\r\n<strong>Dizziness</strong>: Dizziness has been reported in patients taking Pirfenidone. Therefore, patients should know how they react to this medicinal product before they engage in activities requiring mental alertness or coordination. In clinical studies, most patients who experienced dizziness had a single event, and most events resolved, with a median duration of 22 days. If dizziness does not improve or if it worsens in severity, dose adjustment or even discontinuation of Pirfenidone may be warranted.<br />\r\n<br />\r\n<strong>Fatigue</strong>: Fatigue has been reported in patients taking Pirfenidone. Therefore, patients should know how they react to this medicinal product before they engage in activities requiring mental alertness or coordination.<br />\r\n<br />\r\n<strong>Weight loss</strong>: Weight loss has been reported in patients treated with Pirfenidone. Physicians should monitor patients&rsquo; weight, and when appropriate encourage increased caloric intake if weight loss is considered to be of clinical significance. Interactions with other medicinal products and other forms of interaction. Approximately 70-80% of pirfenidone is metabolised via CYP1A2 with minor contributions from other CYP isoenzymes including CYP2C9, 2C19, 2D6 and 2E1. Consumption of grapefruit juice is associated with inhibition of CYP1A2 and should be avoided during treatment with pirfenidone.<br />\r\n<br />\r\n<strong>Fluvoxamine and inhibitors of CYP1A2</strong>: In a Phase 1 study, the co-administration of Pirfenidone and fluvoxamine (a strong inhibitor of CYP1A2 with inhibitory effects on other CYP isoenzymes [CYP2C9, 2C19, and 2D6]) resulted in a 4-fold increase in exposure to pirfenidone in non-smokers. Pirfenidone is contraindicated in patients with concomitant use of fluvoxamine. Fluvoxamine should be discontinued prior to the initiation of Pirfenidone therapy and avoided during Pirfenidone therapy due to the reduced clearance of pirfenidone. Other therapies that are inhibitors of both CYP1A2 and one or more other CYP isoenzymes involved in the metabolism of pirfenidone (e.g. CYP2C9, 2C19, and 2D6) should be avoided during pirfenidone treatment. In vitro in vivo extrapolations indicate that strong and selective inhibitors of CYP1A2 (e.g. enoxacin) have the potential to increase the exposure to pirfenidone by approximately 2 to 4-fold. If concomitant use of Pirfenidone with a strong and selective inhibitor of CYP1A2 cannot be avoided, the dose of Pirfenidone should be reduced to 801 mg daily (one capsule, three times a day). Patients should be closely monitored for emergence of adverse reactions associated with Pirfenidone therapy. Discontinue Pirfenidone if necessary.<br />\r\n<br />\r\nCo-administration of Pirfenidone and 750 mg of ciprofloxacin (a moderate inhibitor of CYP1A2) increased the exposure to pirfenidone by 81%. If ciprofloxacin at the dose of 750 mg twice daily cannot be avoided, the dose of Pirfenidone should be reduced to 1602 mg daily (two capsules, three times a day). Pirfenidone should be used with caution when ciprofloxacin is used at a dose of 250 mg or 500 mg once or twice daily. Pirfenidone should be used with caution in patients treated with other moderate inhibitors of CYP1A2 (e.g. amiodarone, propafenone). Special care should also be exercised if CYP1A2 inhibitors are being used concomitantly with potent inhibitors of one or more other CYP isoenzymes involved in the metabolism of pirfenidone such as CYP2C9 (e.g. amiodarone, fluconazole), 2C19 (e.g. chloramphenicol) and 2D6 (e.g. fluoxetine, paroxetine).<br />\r\n<br />\r\n<strong>Cigarette smoking and inducers of CYP1A2</strong>: A Phase 1 interaction study evaluated the effect of cigarette smoking (CYP1A2 inducer) on the pharmacokinetics of Pirfenidone. The exposure to pirfenidone in smokers was 50% of that observed in non-smokers. Smoking has the potential to induce hepatic enzyme production and thus increase medicinal product clearance and decrease exposure. Concomitant use of strong inducers of CYP1A2 including smoking should be avoided during Pirfenidone therapy based on the observed relationship between cigarette smoking and its potential to induce CYP1A2. Patients should be encouraged to discontinue use of strong inducers of CYP1A2 and to stop smoking before and during treatment with pirfenidone. In the case of moderate inducers of CYP1A2 (e.g. omeprazole), concomitant use may theoretically result in a lowering of pirfenidone plasma levels. Co-administration of medicinal products that act as potent inducers of both CYP1A2 and the other CYP isoenzymes involved in the metabolism of pirfenidone (e.g. rifampicin) may result in significant lowering of pirfenidone plasma levels. These medicinal products should be avoided whenever possible.</p>', '<p>The safety of Pirfenidone has been evaluated in clinical studies including 1345 healthy volunteers and patients. The most commonly reported (10%) adverse reactions during clinical study experience with Pirfenidone at a dose of 2403 mg/day compared to placebo, respectively, were nausea (32.8% versus 13.3%), rash (28.7% versus 8.6%), fatigue (22.3% versus 13.3%), diarrhoea (21.7% versus 13.5%), dyspepsia (16.8% versus 5.5%), and photosensitivity reaction (12.2% versus 1.7%). Serious adverse reactions were recorded at similar frequencies among patients treated with 2403 mg/day of Pirfenidone and placebo in clinical studies. The adverse reactions reported at a frequency of 2% in 345 patients receiving Pirfenidone at the recommended dose of 2403 mg/day in two pivotal Phase 3 studies. Adverse reactions from post-marketing experience are also listed. Adverse reactions are listed by System Organ Class (SOC) and within each frequency grouping the adverse reactions are presented in order of decreasing seriousness.</p>', '<p><strong>Pregnancy</strong>: There are no data from the use of Pirfenidone in pregnant women. In animals placental transfer of pirfenidone and/or its metabolites occurs with the potential for accumulation of pirfenidone and/or its metabolites in amniotic fluid. At high doses (1000 mg/kg/day) rats exhibited prolongation of gestation and reduction in fetal viability. As a precautionary measure, it is preferable to avoid the use of Pirfenidone during pregnancy.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is unknown whether pirfenidone or its metabolites are excreted in human milk. Available pharmacokinetic data in animals have shown excretion of pirfenidone and/or its metabolites in milk with the potential for accumulation of pirfenidone and/or its metabolites in milk. A risk to the suckling child cannot be excluded. A decision must be made whether to discontinue breast-feeding or to discontinue from Pirfenidone therapy, taking into account the benefit of breast-feeding for the child and the benefit of Pirfenidone therapy for the mother.<br />\r\n<br />\r\n<strong>Fertility</strong>: No adverse effects on fertility were observed in preclinical studies. Effects on ability to drive and use machines: No studies on the effects of the ability to drive and use machines have been performed. Pirfenidone may cause dizziness and fatigue, which could influence the ability to drive or use machines.</p>', NULL, '<p>There is limited clinical experience with overdose. Multiple doses of pirfenidone up to a dose of 4806 mg/day were administered as six 267 mg capsules three times daily to healthy adult volunteers over a 12-day dose escalation period. Adverse reactions were mild, transient, and consistent with the most frequently reported adverse reactions for pirfenidone.</p>', '<p>Immunosuppressant</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-15 06:00:17', '2022-03-15 06:00:17'),
(1234, 1234, '<p>Pitavastatin is indicated as an adjunctive therapy to diet to reduce elevated total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (Apo B), triglycerides (TG) and to increase HDL-C in adult patients with primary hyperlipidemia or mixed dyslipidemia.</p>', '<p>Pitavastatin lowers plasma cholesterol and lipoprotein levels by inhibiting HMG-CoA reductase and cholesterol synthesis in the liver and increases the number of hepatic LDL receptors on the cell surface for enhanced uptake and catabolism of LDL.</p>', '<p>The dose range for Pitavastatin is 1 to 4 mg orally once daily at any time of the day with or without food. The recommended starting dose is 2 mg and the maximum dose is 4 mg. After initiation or upon titration of Pitavastatin, lipid levels should be analyzed after 4 weeks and the dosage adjusted accordingly.<br />\r\n<br />\r\n<strong>Dosage in Patients with Renal Impairment:</strong>&nbsp;Patients with moderate renal impairment and end&ndash;stage renal disease receiving hemodialysis should receive a starting dose of Pitavastatin 1 mg once daily and a maximum dose of Pitavastatin 2 mg once daily. Pitavastatin should not be used in patients with severe renal impairment.</p>', '<p><strong>Cyclosporine:</strong>&nbsp;Co-administration of cyclosporine with Pitavastatin is contraindicated.<br />\r\n<br />\r\n<strong>Erythromycin:</strong>&nbsp;Erythromycin significantly increased Pitavastatin exposure. In patients taking erythromycin, a dose of Pitavastatin 1 mg once daily should not be exceeded.<br />\r\n<br />\r\n<strong>Rifampin:</strong>&nbsp;Rifampin significantly increased Pitavastatin exposure. In patients taking rifampin, a dose of Pitavastatin 2 mg once daily should not be exceeded.<br />\r\n<br />\r\n<strong>Fibrates:</strong>&nbsp;Pitavastatin should be administered with caution when used concomitantly with gemfibrozil or other fibrates.<br />\r\n<br />\r\n<strong>Warfarin:</strong>&nbsp;Pitavastatin had no significant pharmacokinetic interaction with warfarin.</p>', '<p>Patients with a known hypersensitivity to any component of this product. Hypersensitivity reactions including rash, pruritus and urticaria have been reported with Pitavastatin. Patients with active liver disease which may include unexplained persistent elevations of hepatic transaminase levels.</p>', '<p>Rhabdomyolysis, myopathy and Liver enzyme abnormalities.</p>', '<p>Pregnancy Category X. Pitavastatin is contraindicated in women who are or may become pregnant. It is not known whether Pitavastatin is excreted in human milk, however, it has been shown that a small amount of another drug in this class passes into human milk.</p>', '<p>Pitavastatin should be prescribed with caution in patients with predisposing factors for myopathy. These factors include advanced age (&gt;65 years), renal impairment, and inadequately treated hypothyroidism. Increase in serum transaminases have been reported with HMG-CoA reductase inhibitors, including Pitavastatin. In most cases, the elevations were transient and resolved or improved on continued therapy or after a brief interruption in therapy.</p>', '<p>There is no known specific treatment in the event of overdose of Pitavastatin. In the event of overdose, the patient should be treated symptomatically and supportive measures instituted as required. Hemodialysis is unlikely to be of benefit due to high protein binding ratio of Pitavastatin.</p>', '<p>Other Anti-anginal &amp; Anti-ischaemic drugs, Statins.</p>', '<p>Store in a cool and dry place, protect from light &amp; moisture . Keep out of the reach of children.</p>', NULL, '2022-03-15 06:05:34', '2022-03-15 06:05:34');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1235, 1235, '<p>Pivmecillinam is indicated for treatment of infections caused by mecillinam-sensitive organisms, e.g. acute cystitis, complicated urinary tract infections, salmonellosis, shigellosis, enteropathic E. coli diarrhoea, gram-negative septicaemia, billiary infections.</p>', '<p>Pivmecillinam belongs to a new class of penicillin-the amdinopenicillin. Pivmecillinam is a prodrug formulation of mecillinam which allows the drug to be administered by mouth. The prodrug form lacks antibacterial activity, but the active drug is liberated by enzymatic hydrolysis during absorption in the gastrointestinal tract.<br />\r\n<br />\r\nPivmecillinam is bactericidal. It acts by interfering with bacterial cell wall synthesis, but the site of action differs from that of other penicilins. Pivmecillinam is very active against Enterobacteriaceae. It is active against E. coli, Klebsiella, Proteus, Enterobacter, Salmonella, Shigella and Yersinia. Pivmecillinam has poor activity against Gram- positive organisms. It has poor activity against Pseudomonas aeruginosa and has practically no activity against Enterococcus faecalis.</p>', '<p>Adults:</p>\r\n\r\n<ul>\r\n	<li><strong>The usual dose</strong>: 1-2 tablets 3 times daily according to severity of the infection.</li>\r\n	<li><strong>In acute uncomplicated cystitis:</strong>&nbsp;initially 400 mg then 200 mg every 8 hours for 3 days.</li>\r\n	<li><strong>In chronic or recurrent bacteriurea:</strong>&nbsp;400 mg 6-8 hours.</li>\r\n	<li><strong>For the treatment of salmonellosis (including enteric fever):</strong>&nbsp;1.2-2.4 gm daily for 14 days. To eliminate salmonella carriage, therapy may be prolonged for 2-4 weeks. In complicated urinary tract infection the usual treatment time is 1-2 weeks.</li>\r\n	<li><strong>For prophylactic treatment of recurrent urinary tract infections:</strong>&nbsp;1 tablet every evening is recommended.</li>\r\n</ul>\r\n\r\n<p>Children:</p>\r\n\r\n<ul>\r\n	<li>Weighing less than 20 kg should be given 20-60 mg/kg divided into 3-4 daily doses. Those weighing more than 20 kg should receive normal adult dose.</li>\r\n	<li><strong>In shigellosis:</strong>&nbsp;20 mg/kg 4 times a day for 5 days.</li>\r\n	<li><strong>For UTI:</strong>&nbsp;20-40 mg/kg/day in 3-4 divided doses</li>\r\n	<li><strong>For salmonellosis:</strong>&nbsp;30-60 mg/kg/day in 3-4 divided doses</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>The tablet should be taken with at least 50-100 ml fluid. As the bioavailability is practically unaffected by simultaneous food intake, This&nbsp;tablets are best taken with or immediately after a meal.</p>', NULL, '<p>There have been no reports on allergy to Pivmecillinam among patients with a known history of hypersensitivity to penicillins and cephalosporins. Nevertheless, it seems reasonable to exclude such patients from treatment with Pivmecillinam until further experience has been gained.</p>', '<p>Pivmecillinam is generally well tolerated, even by patients with reduced kidney function. Upper gastrointestinal disturbances such as nausea, vomiting and diarrhoea or indigestion may occur when a dose has been given on an empty stomach. Skin rashes have been reported in some cases, but the characteristic ampicillin-rash has never been observed, nor has there been any evidence of hepato-, nephro-, or ototoxicity. The occurrence of anaphylaxis, though not yet reported, cannot be entirely excluded.</p>', '<p>Mecillinam concentrations approximately 1/3 of the serum levels have been found in the umbilical cord, and low but detectable amounts in the amniotic fluid. So, use of pivmecillinam in pregnancy should be avoided. Mecillinam is not excreted into the milk of lactating mother.</p>', '<p>As with other antibiotics, which are excreted mainly by the kidneys, raised blood levels of mecillinam may occur if repeated doses are given with impaired renal function.</p>', '<p>There is no experience with over dosage of pivmecillinam. However, excessive doses are likely to cause nausea, vomiting and gastritis. Treatment should be restricted to symptomatic and supportive measures. If necessary haemodialysis will reduce the blood level.</p>', '<p>Mecillinams</p>', '<p>Store at a cool and dry place, protect from light and moisture.</p>', '<p>Based on information available to date for patients with impaired renal function, the initial dose can remain unchanged as can the interval between doses. However, the amount administered as the maintenance dose should be changed according to the following criteria:</p>\r\n\r\n<ul>\r\n	<li><strong>CrCl 30 ml/min or greater</strong>: full dosage</li>\r\n	<li><strong>CrCl 10-30 ml/min</strong>: 50% dosage</li>\r\n	<li><strong>CrCl &lt;10 ml/min</strong>: 25% dosage</li>\r\n</ul>\r\n\r\n<p>Use of Pivmecillinam in infants under 3 months of age should be avoided.</p>', '2022-03-15 06:08:05', '2022-03-15 06:08:05'),
(1236, 1236, '<p>Pizotifen is indicated as prophylactic treatment of vascular headache of migraine type such as classical migraine, common migraine and cluster headache. It is not effective in relieving migraine attacks once in progress.</p>', '<p>Pizotifen works by inhibiting the peripheral actions of serotonin and histamine in increasing the membrane permeability of cranial vessels and transudation of plasmakinin, while altering pain thresholds in migraines. By blocking 5-HT receptors, pizotifen attenuates the signalling of serotonin in causing cranial vasoconstriction, as well as serotonin-enhanced platelet function and aggregation. There is evidence that it also inhibits the peripheral actions of bradykinin. Pizotifen may inhibit serotonin reuptake by blood platelets, which affects the tonicity and decreases passive distension of extracranial arteries. The effects of pizotifen leading to appetite stimulation may be due to the drug acting at the metabolic level rather than a direct stimulation of the appetite centre.</p>', '<p><strong>Adults</strong>: Usually 1.5 mg daily. This may be taken as a single dose at night or in three divided doses. Dosage should be adjusted to the individual patient requirements up to a maximum of 4.5 mg daily. Up to 3 mg may be given as a single dose.<br />\r\n<br />\r\n<strong>Children (aged over 2 years)</strong>: Up to 1.5 mg daily, usually as a divided dose, although up to 1 mg has been given as a single dose at night.</p>', '<p>The central effects of sedatives, hypnotics, antihistamines (including certain common cold preparations) and alcohol may be enhanced by Pizotifen. Pizotifen antagonizes the hypotensive effect of adrenergic neurone blockers.</p>', '<p>Pizotifen is contraindicated in patients with known hypersensitivity to any of its ingredients.</p>', '<p>The most common side effects are appetite stimulating effect, increase in body weight and drowsiness.</p>', '<p>Information of using Pizotifen in pregnancy is limited, although no ill effects have been reported. The drug should therefore only be given during pregnancy if the potential benefit to mother justifies the potential risk to the fetus. The safety of Pizotifen during lactation has not been established, so mothers should avoid taking it when breast feeding.</p>', '<p>Urinary retention, renal impairment should be taken in consideration. Drowsiness may affect the performance driving vehicles &amp; operation of machineries. Pizotifen enhances the action of alcohol.</p>', NULL, '<p>Anti-histamine Preparations, Other drugs for migraine</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-15 06:09:46', '2022-03-15 06:09:46'),
(1237, 1237, '<p>For the removal of external genital warts located on the penis and vulva.</p>', '<p>Podophyllotoxin has an antimitotic action and is used mainly as a topical treatment for anogenital warts.</p>', '<p>Apply twice daily, morning and evening (every 12 hours) for three consecutive days followed by four days without treatment. The use of 0.5% Podophyllotoxin Topical Solution is twice a day for three days constitutes a treatment cycle. Treatment cycles should be repeated up to four times until there is no visible wart tissue.</p>', NULL, '<p>Hypersensitivity; pregnancy; lactation; child.</p>', '<p>Irritating to the eyes and mucous membranes; GI disturbances; thrombocytopenia, leucopenia; renal failure; hepatotoxicity; CNS effects; EEG changes; peripheral and autonomic neuropathies; local reactions.</p>', '<p>Pregnancy&nbsp;Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Avoid excessive application. Avoid contact with eyes and inflamed skin. Not to be used on cervical or urethral warts.</p>', NULL, '<p>Anti neoplastic preparations.</p>', NULL, NULL, '2022-03-15 06:11:07', '2022-03-15 06:11:07'),
(1238, 1238, '<p>Polyethylene Glycol is indicated in the treatment of constipation. This should be used for 2 weeks or less or as directed by physician.&nbsp;Polyethylene Glycol 3350 is a prescription only laxative that has been prescribed by physician to treat constipation. This product should only be used by the person for whom it is prescribed.</p>', '<p>The primary mode of action is thought to be through the osmotic effect of polyethylene glycol 3350 which causes water to be retained in the colon and produces a watery stool. Polyethylene Glycol induces as diarrhea which rapidly cleanses the bowel, usually within four hours.</p>', '<p>The usual dose of Polyethylene Glycol is 17 gm of powder per day (or as directed by physician) in a glass of water, juice, coke, coffee or tea. Each bottle of Polyethylene Glycol is supplied with a cup that is used to measure 17 gm or 8.5 gm of laxative powder when filled upto the marked line.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>It should always be taken by mouth. Measure the dose using the supplied cup, stir and dissolve in a glass of water, juice, coke, coffee or tea. Taking more than the prescribed dose may cause loss of fluid due to severe diarrhea.</p>', '<p>No specific drug interactions have been demonstrated.</p>', '<p>Polyethylene glycol is contraindicated in patients with known or suspected bowel obstruction and patients known to be allergic to polyethylene glycol.</p>', '<p>Nausea, abdominal bloating, cramping and flatulence may occur. High doses may produce diarrhea and excessive stool frequency, particularly in elderly nursing home patients. Patients taking other medications containing polyethylene glycol have occasionally developed urticaria suggestive of an allergic reaction.</p>', '<p><strong>Pregnancy:</strong>&nbsp;It is not known whether Polyethylene glycol can cause fetal harm when administered to a pregnant woman, or can effect reproductive capacity. Polyethylene glycol should only be administered to a pregnant woman if clearly needed.<br />\r\n<br />\r\n<strong>Lactation:</strong>&nbsp;There is no information on the use of Polyethylene glycol while nursing. Consultation with a physician is necessary in case of breastfeeding.</p>', '<p>Patients with symptoms suggestive of bowel obstruction (nausea, vomiting, abdominal pain or distention) should be evaluated to rule out this condition before initiating Polyethylene Glycol therapy. Polyethylene Glycol should be administered after being dissolved in water, juice, coke, coffee or tea.</p>', '<p>There have been no reports of accidental overdosage. In the event of overdosage diarrhea would be the expected major event. If an overdose of drug occurred without concomitant ingestion of fluid, dehydration due to diarrhea may result. Medication should be terminated and free water administered.</p>', '<p>Osmotic purgatives.</p>', NULL, NULL, '2022-03-15 06:12:51', '2022-03-15 06:12:51'),
(1239, 1239, '<p>This sterile eye drops is indicated for the temporary relief of burning and irritation due to dryness of the eye.</p>', '<p>The combination of Polyethylene Glycol 400 &amp; Propylene Glycol is clinically proven to reduce both signs and symptoms of dry eye. The mechanism of action is thought to be due to its unique gelling and lubricating system formulated to adjust to each users individual tear pH. When the ingredients of this eye drops combine with natural tears, a soft gel forms a network of protection over the eye surface. Since it promotes a healthy environment in eye surfaces, damaged surface cells of eye can repair more easily.</p>', '<p>Instill 1 drop 4 times daily in the affected eye(s) or as needed.</p>', NULL, '<p>It is contraindicated in patients with known hypersensitivity to any ingredient in this formulation.</p>', '<p>Generally well tolerated. This sterile eye drops should not be used if allergic condition occurs to any ingredients of the product.</p>', NULL, '<p>Never touch the tip of the container with any surface to avoid contamination. Replace cap after each use.</p>', NULL, '<p>Drugs for Dry eyes.</p>', '<p>Store in a cool &amp; dry place, protect from light. Do not use longer than one month after the first opening. Keep out of the reach of children.</p>', NULL, '2022-03-16 03:50:32', '2022-03-16 03:50:32'),
(1240, 1240, '<p>For effective relief from constipation and treatment of chronic constipation. Resolving fecal impaction.</p>', '<p><strong>Polyethylene Glycol 3350</strong>&nbsp;exerts an osmotic action in the gut, which induces a laxative effect. Polyethylene Glycol 3350 increases the stool volume, which triggers colon motility via neuromuscular pathways. Electrolytes combined with Polyethylene Glycol 3350 are exchanged across the intestinal barrier (mucosa) with serum electrolytes and excreted in fecal water without net gain or loss of sodium, potassium and water.<br />\r\n<br />\r\n<strong>Sodium chloride</strong>&nbsp;is the major extracellular cation. It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes. It is also used as diluents for infusion of compatible drug additives.<br />\r\n<br />\r\n<strong>Sodium bicarbonate</strong>&nbsp;raises blood and urinary pH by dissociation to provide bicarbonate ions, which neutralises the hydrogen ion concentration. It also neutralises gastric acid via production of carbon dioxide.<br />\r\n<br />\r\n<strong>Potassium chloride</strong>&nbsp;is a major cation of the intracellular fluid. It plays an active role in the conduction of nerve impulses in the heart, brain and skeletal muscle; contraction of cardiac skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism and gastric secretion.</p>', '<p><strong>For adults and children aged 12 years and above</strong>: (Powder for Suspension)</p>\r\n\r\n<ul>\r\n	<li><strong>Constipation</strong>: The dose is 1 sachet daily. This may be increased to 2-3 sachets daily, if required.&nbsp;</li>\r\n	<li><strong>Fecal Impaction</strong>:&nbsp;8 sachets daily, consumed within 6 hours. A course of treatment for fecal impaction does not normally exceed 3 days.&nbsp;</li>\r\n	<li><strong>Patients with renal insufficiency</strong>:&nbsp;No dosage change is necessary for treatment of either constipation or fecal impaction.</li>\r\n	<li><strong>Direction of use</strong>:&nbsp;Each sachet should be dissolved in 125 ml water. For fecal impaction 8 sachets may be dissolved in 1 litre of water. Store the solution refrigerated and discard any solution not used within 6 hours.&nbsp;</li>\r\n</ul>\r\n\r\n<p><strong>For adults and children aged 12 years and above</strong>: (Oral Solution)&nbsp;</p>\r\n\r\n<ul>\r\n	<li><strong>Constipation</strong>: 25 ml of Polyethylene Glycol 3350 and electrolytes oral solution added to 100 ml of water once daily (to make a total volume of 125 ml). This may be increased to 2-3 doses of 25 ml daily (each 25 ml dose added to 100 ml of water), if required according to individual response.</li>\r\n	<li><strong>Fecal Impaction</strong>: 8 doses of 25 ml daily (each 25 ml dose added to 100 ml of water). A course of treatment for fecal impaction does not normally exceed 3 days.</li>\r\n	<li><strong>Direction of use</strong>:&nbsp;25 ml of oral solution added to 100 ml of water (to make a total volume of 125 ml). Any unused diluted solution should be discarded within 24 hours.&nbsp;</li>\r\n</ul>', '<p>No specific drug interactions have been found.</p>', '<p>Polyethylene Glycol 3350 and electrolytes is contraindicated in patients with known hypersensitivity to the active substance or any of the excipients, intestinal perforation or obstruction, crohn&rsquo;s disease and ulcerative colitis.</p>', '<p>Generally well tolerated. However side effects like allergic reactions, electrolyte disturbances particularly hyperkalaemia and hypokalaemia, abdominal pain, diarrhea, headache, peripheral edema may appear.</p>', '<p><strong>Use in Pregnancy</strong>:&nbsp;There is no experience of the use of Polyethylene Glycol 3350 during pregnancy and lactation. It should only be used if considered essential by the physician.&nbsp;<br />\r\n<br />\r\n<strong>Use in Lactation</strong>: It is unknown whether Polyethylene Glycol 3350 is excreted in human breast milk.</p>', '<p><strong>Patients with impaired cardiovascular function</strong>: For the treatment of fecal impaction the dose should be divided so that no more than two sachets are taken in any one hour.&nbsp;<br />\r\n<br />\r\nIf patients develop any symptoms indicating shifts of fluid/electrolytes (e.g. edema, shortness of breath, increasing fatigue, dehydration, cardiac failure) Movilax should be stopped immediately and any abnormality should be treated appropriately. Prolonged use with all laxatives is undesirable and may lead to dependence.</p>', '<p>Severe pain or distention can be treated by nasogastric aspiration. Extensive fluid loss by diarrhea or vomiting may require correction of electrolyte disturbances.</p>', '<p>Osmotic purgatives.</p>', '<p>Store below 30&deg; C and in a place protected from light. Do not refrigerate.</p>', NULL, '2022-03-16 03:52:31', '2022-03-16 03:52:31'),
(1241, 1241, '<p>Polygeline improved hemodynamic stability in patients with hypovolemia due to traumatic injury. The improvement was seen within 1 h (golden hour) of polygeline administration and maintained consistently. Polygeline can be safely administered to patients with traumatic injury to improve hemodynamic parameters and achieve stability.<br />\r\n<br />\r\nThis Infusion contains calcium chloride, sodium chloride and potassium chloride that protect the patient from dehydration and electrolyte disorders after any trauma or injury. Appropriate fluid replacement is very essential to restore normal brain activity and other vital functions of the body to promote healing as well as speedy recovery.<br />\r\n<br />\r\nIn Short term fluid replacement after trauma.</p>', '<p>This Infusion injection comprises of a combination of medicines. It is given as a short term fluid replacement after trauma. This Infusion works by replenishing the body&rsquo;s fluid and electrolytes. This injection should be administered under the supervision of a healthcare professional. You should not self administer this injection.</p>', NULL, NULL, '<p>Hypersensitivity to any other ingredient of this preparation.</p>', '<p>Some common side effects of this medicine can be injection site reactions such as redness, pain or swelling. If these side effects persist for a longer duration, please consult your doctor.</p>', NULL, '<p>Before taking this medicine, tell your doctor if you have any other health conditions may be required. Inform your doctor if you are taking any other medicines or if you are pregnant or breastfeeding. It is advised not to consume alcohol after taking this medicine.</p>', NULL, '<p>Intravenous fluid preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-16 03:53:54', '2022-03-16 03:53:54'),
(1242, 1242, '<p>Acute infections caused by susceptible strains of Pseudomonas aeruginosa:<br />\r\n<br />\r\nPolymyxin B Sulfate is a drug of choice in the treatment of infections of the urinary tract, meninges, and bloodstream caused by susceptible strains of Pseudomonas aeruginosa.<br />\r\n<br />\r\nIt may be indicated in serious infections caused by susceptible strains of the following organisms, when less potentially toxic drugs are ineffective or contraindicated:</p>\r\n\r\n<ul>\r\n	<li>H. influenzae: Specifically meningeal infections</li>\r\n	<li>Escherichia coli: Specifically urinary tract infections</li>\r\n	<li>Aerobacter aerogenes: Specifically bacteremia</li>\r\n	<li>Klebsiella pneumoniae: Specifically bacteremia</li>\r\n</ul>', '<p><strong>Intravenous</strong>: Dissolve Polymyxin B 500,000 units in 300 to 500 ml solutions for parenteral Dextrose injection 5% for continuous drip.<br />\r\n<br />\r\n<strong>Intramuscular</strong>: Dissolve Polymyxin B 500,000 units in 2 ml 0.9% Sodium Chloride solution. It is not recommended routinely because of severe pain at injection site, particularly in infants and children.<br />\r\n<br />\r\n<strong>Intrathecal</strong>: Dissolve Polymyxin B 500,000 units in 10 ml 0.9% Sodium Chloride solution for 50,000 units per ml dosage unit.<br />\r\n<br />\r\nIn meningeal infections, Polymyxin B Sulfate should be administered only by the intrathecal route.<br />\r\n<br />\r\nFor IV route:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult &amp; Children (Normal kidney function)</strong>: Dose (Units/kg/day) is 15,000-25,000(Not exceed 25,000) and Dosage frequency/Duration is infusions may be given every 12 hours over a period of approximately 60 to 90 minutes.</li>\r\n	<li><strong>Adult &amp; Children (Renal impairment)</strong>: Dose (Units/kg/day) is Less than 15,000 and Dosage frequency/Duration is Infusions may be given every 12 hours over a period of approximately 60 to 90 minutes.</li>\r\n	<li><strong>Infants (Normal kidney function)</strong>: Dose (Units/kg/day) is Maximum 40,000</li>\r\n</ul>\r\n\r\n<p>For IM route:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult &amp; Children</strong>: Dose (Units/kg/day) is 25,000-30,000 and Dosage frequency/Duration is Dose should be reduced in the presence of renal impairment. The dosage may be divided and given at either 4 or 6 hour intervals.</li>\r\n	<li><strong>Infants (Normal kidney function)</strong>: Dose (Units/kg/day) is Maximum 40,000</li>\r\n</ul>\r\n\r\n<p>For Intrathecal:</p>\r\n\r\n<ul>\r\n	<li><strong>Children under 2 years of age</strong>: Dosage frequency/Duration is 20,000 units once daily, intrathecally for 3 to 4 days or 25,000 units once every other day. Continue with a dose of 25,000 units once every other day for at least 2 weeks after cultures of the cerebrospinal fluid are negative and sugar content has returned to normal.</li>\r\n	<li><strong>Adults and children over 2 years of age</strong>: 50,000 units once daily for 3 to 4 days, then 50,000 units once every other day for at least 2 weeks after cultures of the cerebrospinal fluid are negative and sugar content has returned to normal.</li>\r\n</ul>', NULL, '<p>The concurrent or sequential use of other neurotoxic and/or nephrotox-ic drugs with Polymyxin B sulfate, particularly bacitracin, kanamycin, streptomycin, tobramycin, amikacin, cephaloridine, cephalothin, paromycin, polymyxin E (colistin), neomycin, gentamicin, and vancomycin, Bumetanide, celecoxib, cisplatin, cyclosporine, diclofenac, misoprostol, diphenhydramine, ibuprofen, naproxen, esomeprazole, etodolac, general anesthetic, gentamycin, ketorolac, meloxicam, tenofovir etc should be avoided.</p>', NULL, '<p>Clostridium difficile associated diarrhea has been reported with use of Polymyxin B. Nephrotixic reactions: Albuminuria, cylinduria, azotemia, and rising blood levels, Neurotoxic reactions: Facial flushing, dizziness progressing to ataxia, drowsiness, peripheral aresthesias (circumoral and stocking glove), apnea due to concurrent use of curariform muscle relaxants, other neurotoxic drugs or inadvertent overdosage, and signs of meningeal irritation with intrathecal administration, e.g., fever, headache, stiff neck. Other reactions occasionally reported: Drug fever, urticaria rash, severe pain at IM injections sites and thrombophelbitis at IV injections sites.</p>', '<p>There are no controlled data in human pregnancy. Safety has not been established during pregnancy. There is no recommendation regarding use during lactation. There is no study on whether it is secreted with human milk.</p>', '<p>Baseline renal function should be done prior to therapy, with frequent monitoring of renal function and blood levels of the drug during parenteral therapy.</p>', '<p>Polymyxin-induced toxicity associated with overdose has been reported. Overdose of Polymyxin can result in neuromuscular blockade, which can lead to apnea, muscular weakness, vertigo, transient facial paresthesia, slurred speech, vasomotor instability, visual disturbance, confusion, psychosis and possible respiratory arrest. Overdose can also cause renal failure characterized by decreased urine output and increased serum concentrations of BUN and creatinine. There is no specific antidote for Polymyxin B Sulfate overdose. In case of Polymyxin B Sulfate overdose, the drug should be stopped and symptomatic treatment instituted. Quick diuresis by IV administered mannitol may help to enhance renal clearance of the drug and thus to reduce serum drug levels. Hemodialysis or peritoneal dialysis may help in order to manage renal complications.</p>', '<p>Other antibacterial preparation.</p>', '<p>Before reconstitution, do not store above 30&deg;C; and keep away from light and out of the reach of children. After reconstitution or dilution, unused portion must be stored at 2&deg; to 8&deg;C and should be discarded after 72 hours if not used.</p>', NULL, '2022-03-16 03:56:22', '2022-03-16 03:56:22'),
(1243, 1243, '<p>Polysaccharide Diphtheria Toxoid Conjugate Vaccine is indicated for active immunization to prevent invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y and W-135. This vaccine is approved for use in individuals 9 months through 55 years of age. Menactra does not prevent N meningitidis serogroup B disease.</p>', '<p>The presence of bactericidal anti-capsular meningococcal antibodies has been associated with protection from invasive meningococcal disease. Menactra induces the production of bactericidal antibodies specific to the capsular polysaccharides of serogroups A, C, Y and W-135.</p>', '<p>Primary Vaccination:</p>\r\n\r\n<ul>\r\n	<li>Children 9 through 23 months of age: Two doses, three months apart.</li>\r\n	<li>Individuals 2 through 55 years of age: A single dose.</li>\r\n</ul>\r\n\r\n<p>Booster Vaccination:</p>\r\n\r\n<ul>\r\n	<li>A single booster dose may be given to individuals 15 through 55 years of age at continued risk for meningococcal disease, if at least 4 years have elapsed since the prior dose.</li>\r\n</ul>', '<p>When Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed) are to be administered to children 4 through 6 years of age, preference should be given to simultaneous administration of the 2 vaccines or administration of Menactra prior to Polysaccharide Diphtheria Toxoid Conjugate Vaccine. Administraton of Menactra one month after Polysaccharide Diphtheria Toxoid Conjugate Vaccine has been shown to reduce meningococcal antibody responses to Menactra<br />\r\n<br />\r\nPneumococcal antibody responses to some serotypes in Prevnar (PCV7) were decreased following co-administration of Menactra and PCV7.</p>', '<p>Severe allergic reaction (eg, anaphylaxis) after a previous dose of a meningococcal capsular polysaccharide-, diphtheria toxoid- or CRM 197-containing vaccine, or to any component of Menactra.</p>', '<p><strong>Common (&ge;10%)</strong>: solicited adverse events in infants and toddlers 9 and 12 months of age were injection site tenderness, erythema, and swelling; irritability, abnormal crying, drowsiness, appetite loss, vomiting, and fever.<br />\r\n<br />\r\n<strong>Common (&ge;10%)</strong>: solicited adverse events in individuals 2 through 55 years of age who received a single dose were injection site pain, redness, induration, and swelling; anorexia and diarrhea. Other common solicited adverse events were irritability and drowsiness (2-10 years of age), headache, fatigue, malaise, and arthralgia (11-55 years of age).</p>', '<p>Safety and effectiveness of Polysaccharide Diphtheria Toxoid Conjugate Vaccine have not been established in children younger than 9 months of age, pregnant women, nursing mothers, and adults older than 55 years of age.</p>', '<p>Persons previously diagnosed with Guillain-Barre syndrome (GBS) may be at increased risk of GBS following receipt of Menactra. The decision to give Menactra should take into account the potential benefits and risks.</p>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', '<p>Keep out of the reach and sight of children. Store at +2&deg;C to +8&deg;C. Transportation should also be at +2&deg;C to +8 &deg;C. Do not freeze. Discard solution if frozen. Protect from light.</p>', NULL, '2022-03-16 03:58:19', '2022-03-16 03:58:19'),
(1244, 1244, '<p>Polysaccharide Pneumococcal Vaccine is a vaccine indicated for active immunization for the prevention of pneumococcal disease caused by the 23 serotypes contained in the vaccine (1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F , and 33F). Polysaccharide Pneumococcal Vaccine is approved for use in persons 50 years of age or older and persons aged &ge; 2 years who are at increased risk for pneumococcal disease.</p>', '<p>Pneumococcal Vaccine induces type-specific antibodies that enhanced opsonization, phagocytosis, and killing of pneumococci by leukocytes and other phagocytic cells. The levels of antibodies that correlate with protection against pneumococcal disease have not been clearly defined.</p>', '<p><strong>Preparation</strong>:</p>\r\n\r\n<ul>\r\n	<li>Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. If either of these two conditions exists, the vaccine should not be administered.</li>\r\n	<li>Do not mix Pneumococcal Vaccine with other vaccines in the same syringe or vial.</li>\r\n	<li>Use a separate sterile syringe and needle for each individual patient to prevent transmission of infectious agents from one person to another.</li>\r\n</ul>\r\n\r\n<p><strong>Single-Dose Vial</strong>: Withdraw 0.5 mL from the vial using a sterile needle and syringe free of preservatives, antiseptics, and detergents.<br />\r\n<br />\r\n<strong>Single-Dose, Prefilled Syringe</strong>: The package does not contain a needle. Attach a sterile needle to the prefilled syringe by twisting in a clockwise direction until the needle fits securely on the syringe.<br />\r\n<br />\r\n<strong>Administration</strong>:<br />\r\n<br />\r\nAdminister Pneumococcal Vaccine&nbsp;intramuscularly or subcutaneously into the deltoid muscle or lateral mid-thigh. Do not inject intravascularly or intradermally.<br />\r\n<br />\r\n<strong>Single-Dose Vial</strong>: Administer a single 0.5-mL dose of Pneumococcal Vaccine using a sterile needle and syringe. Discard vial after use.<br />\r\n<br />\r\n<strong>Single-Dose, Prefilled Syringe</strong>: Administer the entire contents of the single-dose, prefilled syringe per standard protocol using a sterile needle. Discard syringe after use.<br />\r\n<br />\r\n<strong>Revaccination</strong>: The Advisory Committee on Immunization Practices (ACIP) has recommendations for revaccination against pneumococcal disease for persons at high risk who were previously vaccinated with Pneumococcal Vaccine. Routine revaccination of immunocompetent persons previously vaccinated with a 23-<br />\r\nvalent vaccine, is not recommended.</p>', '<p>Concomitant Administration with Other Vaccines: In a randomized clinical study, a reduced immune response to ZOSTAVAX as measured by gpELISA was observed in individuals who received concurrent administration of Pneumococcal Vaccine and ZOSTAVAX compared with individuals who received these vaccines 4 weeks apart. Consider administration of the two vaccines separated by at least 4 weeks. Limited safety and immunogenicity data from clinical trials are available on the concurrent administration of Pneumococcal Vaccine and vaccines other than ZOSTAVAX.</p>', '<p>Do not administer Pneumococcal Vaccine to individuals with a history of anaphylactic/anaphylactoid or severe allergic reaction to any component of the vaccine.</p>', '<p>The most common adverse reactions, reported in &gt;10% of subjects vaccinated with p neumococcal vaccine for the first time in a clinical trial, were: injection-site pain/soreness/tenderness (60.0%), injection-site swelling/ induration (20.3%), headache (17.6%), injection-site erythema (16.4%), asthenia and fatigue (13.2%), and myalgia (11.9%).</p>', '<p><strong>Pregnancy</strong>: All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15- 20%, respectively. Available human data from clinical trials of Pneumococcal Vaccine in pregnancy have not established the presence or absence of a vaccine-associated risk. Developmental toxicity studies have not been conducted with Pneumococcal Vaccine in animals.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether Pneumococcal Vaccine is excreted in human milk. Data are not available to assess the effects of Pneumococcal Vaccine on the breastfed infant or on milk production/excretion. The developmental and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for Pneumococcal Vaccine and any potential adverse effects on the breastfed child from Pneumococcal Vaccine&nbsp;or from the underlying maternal condition. For preventive vaccines, the underlying maternal condition is susceptibility to the disease prevented by the vaccine.</p>', '<p><strong>Persons with Moderate or Severe Acute Illness</strong>: Defer vaccination with Pneumococcal Vaccine in persons with moderate or severe acute illness.<br />\r\n<br />\r\n<strong>Persons with Severely Compromised Cardiovascular or Pulmonary Function</strong>: Caution and appropriate care should be exercised in administering Pneumococcal Vaccine to individuals with severely compromised cardiovascular and/or pulmonary function in whom a systemic reaction would pose a significant risk.<br />\r\n<br />\r\n<strong>Use of Antibiotic Prophylaxis</strong>: This vaccine does not replace the need for penicillin (or another antibiotic) prophylaxis against pneumococcal infection. In patients who require penicillin (or another antibiotic) prophylaxis against pneumococcal infection, such prophylaxis should not be discontinued after vaccination with Pneumococcal Vaccine.<br />\r\n<br />\r\n<strong>Persons with Altered Immunocompetence</strong>: Persons who are immunocompromised, including persons receiving immunosuppressive therapy, may have a diminished immune response to Pneumococcal Vaccine.<br />\r\n<br />\r\n<strong>Persons with Chronic Cerebrospinal Fluid Leakage</strong>: Pneumococcal Vaccine&nbsp;may not be effective in preventing pneumococcal meningitis in patients who have chronic cerebrospinal fluid (CSF) leakage resulting from congenital lesions, skull fractures, or neurosurgical procedures.</p>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', '<p>Store refrigerated at 2&deg; to 8&deg;C. Protect vials from light.</p>', '<p><strong>Pediatrics</strong>: Pneumococcal vaccine is not approved for use in children younger than 2 years of age because children in this age group do not develop an effective immune response to capsular types contained in the polysaccharide vaccine.<br />\r\n<br />\r\n<strong>Geriatrics</strong>: For subjects aged 65 years or older in a clinical study systemic adverse reactions, determined by the investigator to be vaccine-related, were higher following revaccination (33.1%) than following initial vaccination (21.7%). Routine revaccination of immunocompetent persons previously vaccinated with a 23-valent vaccine is not recommended.</p>', '2022-03-16 04:00:23', '2022-03-16 04:00:23'),
(1245, 1245, '<p>Ponatinib is a kinase inhibitor indicated for the:</p>\r\n\r\n<ul>\r\n	<li>Treatment of adult patients with chronic phase, accelerated phase, or blast phase chronic myeloid leukemia (CML) or Ph+ ALL for whom no other tyrosine kinase inhibitor (TKI) therapy is indicated.</li>\r\n	<li>Treatment of adult patients with T315I-positive CML (chronic phase, accelerated phase, or blast phase) or T315I-positive Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL).</li>\r\n</ul>', '<p>Ponatinib is a kinase inhibitor. Ponatinib inhibited the in vitro tyrosine kinase activity of ABL and T315I mutant ABL with IC 50 concentrations of 0.4 nM and 2.0 nM, respectively. Ponatinib inhibited the in vitro activity of additional kinases with IC 50 concentrations between 0.1 nM and 20 nM, including members of the VEGFR, PDGFR, FGFR, EPH receptors and SRC families of kinases, and KIT, RET, TIE2, and FLT3. Ponatinib inhibited the in vitro viability of cells expressing native or mutant BCR-ABL, including T315I. In mice, treatment with ponatinib reduced the size of tumors expressing native or T315I mutant BCR-ABL when compared to controls.</p>', '<p><strong>Recommended dose</strong>: 45 mg taken orally once daily with or without food<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: 30 mg orally once daily. Modify or interrupt dosing for hematologic and non-hematologic toxicity.</p>', NULL, '<p>None.</p>', '<p>The most common non-hematologic adverse reactions (&ge;20%) were, abdominal pain, rash, constipation, headache, dry skin, arterial occlusion, fatigue, hypertension, pyrexia, arthralgia, nausea, diarrhea, lipase increased, vomiting, myalgia and pain in extremity.</p>', '<p>Based on its mechanism of action and findings in animals, Ponatinib can cause fetal harm when administered to a pregnant woman. There are no available data on Ponatinib use in pregnant women. In animal reproduction studies, oral administration of ponatinib to pregnant rats during organogenesis caused adverse developmental effects at doses lower than human exposures at the recommended human dose. Advise pregnant women of the potential risk to a fetus.<br />\r\n<br />\r\nThere is no data on the presence of ponatinib in human milk, the effects on the breastfed infant or on milk production.</p>', NULL, NULL, '<p>Tyrosine Kinase Inhibitor.</p>', '<p>Store Ponatinib at room temperature between 20&deg; C to 25&deg; C.</p>', '<p>Pediatric Use: Safety and effectiveness have not been established in pediatric patients.</p>', '2022-03-16 04:02:18', '2022-03-16 04:02:18'),
(1246, 1246, '<p>Posaconazole is indicated in patients aged 13 years and above for the treatment of the following fungal infections:</p>\r\n\r\n<ul>\r\n	<li>Invasive aspergillosis in patients with disease that is refractory or intolerant to Amphotericin B or Itraconazole</li>\r\n	<li>Fusariosis in patients with disease that is refractory or intolerant to Amphotericin B</li>\r\n	<li>Chromoblastomycosis and mycetoma in patients with disease that is refractory or intolerant to Itraconazole</li>\r\n	<li>Coccidioidomycosis in patients with disease that is refractory or intolerant to Amphotericin B, Itraconazole or Fluconazole or in patients who are intolerant of these medicinal products.</li>\r\n</ul>\r\n\r\n<p>Also indicated for prophylaxis of invasive fungal infections in the following patients:</p>\r\n\r\n<ul>\r\n	<li>Patients receiving remission-induction chemotherapy for Acute Myelogenous Leukemia (AML) or Myelodysplastic Syndromes (MDS) expected to result in prolonged neutropenia and who are at high risk of developing invasive fungal infections</li>\r\n	<li>Hematopoietic Stem Cell Transplant (HSCT) recipients who are undergoing high-dose immunosuppressive therapy for graft versus host disease and who are at high risk of developing invasive fungal infections Refractoriness is defined as progression of infection or failure to improve after a minimum of 7 days of prior therapeutic doses of effective antifungal therapy</li>\r\n</ul>', '<p>Posaconazole blocks the synthesis of ergosterol, a key component of the fungal cell membrane. It inhibits the cytochrome P-450 dependent enzyme Lanosterol 14-&alpha;-demethylase responsible for the conversion of lanosterol to ergosterol in the fungal cell membrane. This results in an accumulation of methylated sterol precursors and a depletion of ergosterol within the cell membrane, thus weakening the structure and function of the fungal cell membrane.</p>', '<p>Posaconazole Tablets can be taken with or without food. The tablets should be swallowed whole with water and should not be crushed, chewed, or broken.<br />\r\n<br />\r\n<strong>Loading Dose</strong>: 300 mg (3 Tablets) twice a day on the first day.<br />\r\n<br />\r\n<strong>Maintenance Dose</strong>: 300 mg (3 Tablets) once a day from the second day.<br />\r\n<br />\r\nDuration of therapy should be based on the severity of the underlying disease, recovery from immunosuppression and clinical response.</p>', '<p>Posaconazole is an inhibitor of CYP3A4 and should only be used under specific circumstances during treatment with other medicinal products that are metabolized by CYP3A4 like Midazolam, Triazolam, Alprazolam. Posaconazole concentrations may be significantly lowered in combination with Rifamycin antibacterials (Rifampicin, Rifabutin), certain anticonvulsants (Phenytoin, Carbamazepine, Phenobarbital, Primidone and Efavirenz).</p>', '<p>Posaconazole is contraindicated in persons with known hypersensitivity to Posaconazole or other azole antifungal agents. Co-administration with ergot alkaloids, CYP3A4 substrates, Terfenadine, Astemizole, Cisapride, Pimozide, Halofantrine or Quinidine since this may result in increased plasma concentrations of these medicinal products leading to QTc prolongation and rare occurrences of torsades de pointes, HMG-CoA reductase inhibitors simvastatin, lovastatin and atorvastatin is contraindicated.</p>', '<p>Common treatment-emergent adverse reactions in studies with Posaconazole are diarrhea, nausea, fever, vomiting, headache, coughing and hypokalemia.</p>', '<p>Posaconazole must not be used during pregnancy unless the benefit to the mother clearly outweighs the potential risk to the fetus. Breast-feeding must be stopped on initiation of treatment with this drug.</p>', NULL, NULL, '<p>Aural Anti-fungal preparations.</p>', '<p>Store below 25&deg;C. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients below the age of 13 years has not been established. Therefore, Posaconazole is not recommended for pediatric patients less than 13 years of age.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No dose adjustment is necessary for geriatric patients.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Posaconazole should be used with caution in patients with hepatic impairment due to limited clinical experience and the possibility that posaconazole plasma levels may be higher in these patients. Liver function tests should be evaluated at the start of and during the course of posaconazole therapy.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No dose adjustment is required in patients with mild (eGFR: 50-80 mL/min/1.73 m2) to moderate renal impairment (eGFR: 20-49 mL/min/1.73 m2). Patients with severe renal impairment should be monitored closely for breakthrough fungal infections.</p>', '2022-03-16 04:05:42', '2022-03-16 04:05:42'),
(1247, 1247, '<p>Potassium Chloride is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Replacement of potassium deficit</li>\r\n	<li>Diuretic (Potassium losing)-induced hypokalaemia</li>\r\n	<li>Hypokalaemia from renal potassium wasting</li>\r\n	<li>Hypokalaemia from gastrointestinal losses</li>\r\n	<li>Hypochloraemic alkalosis associated with hypokalaemia</li>\r\n</ul>', '<p>Potassium Chloride is used for the treatment of hypokalaemia and of potassium deficiency states. Potassium ion is the principal intracellular cation of most body tissues. It participates in a number of essential physiological processes, including the maintenance of intracellular tonicity, the transmission of nerve impulses, the contraction of cardiac, skeletal and smooth muscle and the maintenance of normal renal function.</p>', '<p><strong>Oral dose</strong>: It should be taken with or after meals with plenty of fluid (water/fruit juice). Typical doses for the prevention of hypokalaemia may be upto 50 mmol (about 37.5 mL) daily by mouth. Oral treatment may be suitable in some cases of hypokalaemia and similar doses to those used for prevention may be adequate in mild potassium deficiency. However, higher doses may be needed in more severe deficiency.<br />\r\n<br />\r\n<strong>Parenteral dose</strong>: Intravenous administration may be required in acute hypokalaemia. One ampoule (10 mL) i.e. 1.5 gm (20 mmol k+) may be added to 500 mL of sodium chloride or glucose intravenous infusion and given slowly over 2 to 3 hours with specialist advice and ECG monitoring in difficult cases. Repeated measurements of potassium are necessary to determine whether further infusions are required and to avoid the development of hyperkalaemia. This is especially liable to occur in renal impairment.</p>', '<p>Combined treatment with the following increase the risk of hyperkalaemia: Angiotensin-converting enzyme inhibitors, cyclosporin, NSAIDs, beta-blockers, heparin, digoxin, potassium-sparing diuretics.</p>', '<p>Hypersensitivity to potassium administration e.g. hyperkalaemic periodic paralysis, congenital paramyotonia, marked renal failure (even when not yet associated with manifest hyperkalaemia), untreated Addison&#39;s disease, hyporeninaemic hypoaldosteronism, acute dehydration, hyperkalaemia and conditions involving extensive cell destruction (e.g. severe burns). In case of metabolic acidosis, the hypokalaemia should be treated not with potassium chloride.</p>', '<p>Excessive administration of potassium leads to development of hyperkalaemia, the symptoms of which include paraesthesia of the extremitis, muscle weakness, paralysis, hypotension, cardiac arrhythmias, heart block and cardiac arrest. Pain or phlebitis may occur during I.V. administration of solutions containing about 30 mmol or more potassium per litre. Nausea, vomiting, diarrhoea and abdominal cramps may occur following oral administration.</p>', '<p>As a general rule, no drugs should be taken during the first three months of pregnancy and the risks &amp; benefits of taking drugs should be carefully considered throughout pregnancy. There are no contraindications to breastfeeding while taking potassium salts.</p>', '<p>It should be administered with caution to patients with renal or adrenocortical insufficiency, cardiac disease, acute dehydration, heat cramps, extensive tissue destruction as occurs with severe burns, or to patients receiving potassium-sparing diuretics. Excessive use of potassium-containing salt substitutes or concurrent administration with potassium supplements may lead to accumulation of potasssium especially in patients with renal insufficiency. Attention should be paid to the concurrent use of other drugs that either contain potassium or have the potential for hyperkalaemia. Treatment should be discontinued if severe nausea, vomiting or abdominal distress develops.</p>', NULL, '<p>Electrolytes preparations, Oral electrolytes preparations.</p>', '<p>Store below 25&deg;C in a dry place, away from light. Keep out of the reach of children.</p>', '<p>Use in children: No special precautions are required.</p>', '2022-03-16 04:08:25', '2022-03-16 04:08:25');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1248, 1248, '<p>This preparation is indicated in the following cases:</p>\r\n\r\n<ul>\r\n	<li>To relieve discomfort in urinary tract infections</li>\r\n	<li>To prevent kidney stone</li>\r\n	<li>With uricosuric agent to prevent gout</li>\r\n	<li>Acidosis caused by kidney diseases</li>\r\n</ul>', '<p>Potassium Citrate and Citric Acid oral solution is a stable and pleasant-tasting oral systemic alkalizer. Potassium Citrate is absorbed and metabolized to Potassium Bicarbonate, thus acting as a systemic alkalizer. This product alkalinizes the urine without producing a systemic alkalosis in recommended doses. It is highly palatable, pleasant tasting and tolerable, even when administered for long periods. Potassium Citrate does not neutralize the gastric juice or disturb digestion.</p>', '<p>To relieve discomfort in UTI:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children over 6 years</strong>: 10 ml 3 times daily, diluted with 1 glass of water.</li>\r\n	<li><strong>Children 1-6 years</strong>: 5 ml 3 times daily, diluted with &frac12; glass of water.</li>\r\n</ul>\r\n\r\n<p>To prevent kidney stones, With a uricosuric agent to prevent gout, Acidosis caused by kidney diseases:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 10-15 ml 4 times daily (or as directed by the physician) diluted with 1 glass of water.</li>\r\n	<li><strong>Pediatric</strong>: 5-10 ml 4 times daily (or as directed by the physician) diluted with &frac12; glass of water.</li>\r\n</ul>', '<p>Concurrent administration of potassium-containing medication, potassium-sparing diuretics, angiotensin-converting enzyme (ACE) inhibitors or cardiac glycosides may lead to toxicity.</p>', '<p>The drug is contraindicated in severe renal impairment with oliguria or azotemia, untreated Addison&#39;s disease, acute dehydration, severe myocardial damage and hyperkalemia from any cause.</p>', '<p>This solution is generally well tolerated without any unpleasant side effect when given in recommended doses to patients with normal renal function and urinary output. However, as with any alkalinizing agent, caution must be used in certain patients with abnormal renal mechanisms to avoid development of hyperkalemia or alkalosis. Potassium intoxication causes listlessness, weakness, mental confusion, tingling of extremities and other symptoms associated with a high concentration of Potassium in the serum.</p>', '<p>No information is available regarding the use of this drug during pregnancy and lactation.</p>', '<p>The solution should be used with caution in patients with low urinary output. It should be diluted adequately with water to minimize the possibility of gastrointestinal injury associated with the oral ingestion of concentrated Potassium salt preparations; and preferably, to take each dose after meals. Large doses may cause hyperkalemia and alkalosis, especially in the presence of renal disease.</p>', '<p>The administration of oral Potassium salts to persons with normal excretory mechanisms for potassium rarely causes serious hyperkalemia. However, if excretory mechanisms are impaired, hyperkalemia can result. Hyperkalemia, when detected, must be treated immediately because lethal levels can be reached in a few hours. If hyperkalemia occurs, treatment measures will include the followings: (1) Elimination of foods or medications containing potassium. (2) The intravenous administration of 300 to 500 ml/hr of dextrose solution (10 to 25%), containing 10 units of insulin/20 gm dextrose. (3) The use of exchange resins, hemodialysis or peritoneal dialysis.</p>', '<p>Prevention of repeated kidney stone formation, Urinary Alkalinizing Agent.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-16 04:10:35', '2022-03-16 04:10:35'),
(1249, 1249, '<p><strong>Cream or ointment</strong>:<br />\r\nTherapeutically: As an adjunct to systemic therapy in the following indications-</p>\r\n\r\n<ul>\r\n	<li>Primary or secondary topical infections</li>\r\n	<li>Infected surgical incisions</li>\r\n	<li>Infected decubitus or stasis ulcers</li>\r\n	<li>Pyodermas</li>\r\n	<li>Secondarily infected dermatoses</li>\r\n	<li>Infected traumatic lesions</li>\r\n</ul>\r\n\r\n<p>Prophylactically:</p>\r\n\r\n<ul>\r\n	<li>To prevent microbial contaminations in burns, incisions and other topical lesions</li>\r\n	<li>For degerming skin in hyperalimentation, the umbilical area or circumcision</li>\r\n	<li>Its use for abrasions, minor cuts, and wounds prevents the development of infections and permits wound healing.</li>\r\n</ul>\r\n\r\n<p><strong>Solution</strong>:</p>\r\n\r\n<ul>\r\n	<li>For the prevention and treatment of surface infections as well as to degerm the skin, mucous membrane and hyperalimentation procedures</li>\r\n	<li>For seborrhea</li>\r\n	<li>For preoperative and postoperative scrubbing and washing of hospital operating room and equipments</li>\r\n	<li>For preoperative prepping of operative site, including the vagina</li>\r\n	<li>For disinfection of wounds, burns, lacerations and abrasions</li>\r\n	<li>As a prophylactic anti-infective agent in house, hospital &amp; office procedures</li>\r\n	<li>Postoperative application to incisions to help prevent infection</li>\r\n	<li>In oral moniliasis (thrush); bacterial and mycotic skin infections, decubitus &amp; stasis ulcers</li>\r\n	<li>As a preoperative swab in the mouth &amp; throat</li>\r\n</ul>\r\n\r\n<p><strong>Gargle &amp; Mouthwash</strong>: It is a pleasantly flavoured solution which is used:</p>\r\n\r\n<ul>\r\n	<li>For the treatment of acute mucosal infections of the mouth and pharynx.</li>\r\n	<li>For oral hygiene prior to, during and after dental and oral surgery.</li>\r\n</ul>\r\n\r\n<p><strong>Surgical Scrub</strong>: It is a golden surfactant solution, forms rich, golden lather which is used: As an antiseptic skin cleanser for preoperative and postoperative scrubbing and washing by surgeons and operation theatre staff and preoperative preparation of patients&#39; skin<br />\r\n<br />\r\n<strong>Powder</strong>: It is used for topical application in the following indications: Superficial wounds, Minor cuts, Burns, Abrasions, Lacerations, In the treatment and prevention of infections.<br />\r\n<br />\r\n<strong>Ophthalmic Solution</strong>: Povidone is used for the symptomatic treatment of dry eye conditions including keratoconjunctivitis sicca. It is also given as a substitute for tear fluid in case of the unstable tear film or insufficient moistening of the eye surface.</p>', '<p>Povidone Iodine is a complex of iodine and an organic polymer, povidone. This polymerization makes Povidone Iodine superior to ordinary elemental iodine. It prolongs the germicidal activity of iodine by liberating elemental iodine slowly. Consequently it has a lower toxicity than elemental iodine. It gives rapid microbicidal activity against both Gram-positive and Gram-negative bacteria, protozoa, viruses and fungi/yeasts. It is also sporicidal. It is the only microbicide with this broad spectrum of activity. It is non-staining, exerts prolong germicidal action and is also active in the presence of soap, blood, serum, pus, mucosal secretions and water.</p>', '<p><strong>Cream or ointment</strong>:</p>\r\n\r\n<ul>\r\n	<li>For the treatment of infection: Apply once or twice daily or at dressing changes for a maximum of 14 days.</li>\r\n	<li>For the prevention of infection: Apply once or twice a week for as long as necessary. The affected skin should be cleaned and dried and can be covered with a dressing or bandage.</li>\r\n</ul>\r\n\r\n<p><strong>Solution</strong>: Apply full strength as often as needed as paint, spray, or wet soak. Maybe bandaged (where necessary).<br />\r\n<br />\r\n<strong>Gargle &amp; Mouthwash</strong>: Adults and children over 6 years of age: Use undiluted or diluted with an equal volume of warm water. Gargle or rinse with up to 10 mL for up to 30 seconds without swallowing. Repeat up to four times daily, for up to 14 consecutive days, or as advised by the Registered Dental Surgeon/Physician.<br />\r\n<br />\r\n<strong>Surgical Scrub</strong>:</p>\r\n\r\n<ul>\r\n	<li>For Preoperative and Postoperative washing by Operating Personnel: Wet hands and forearms with water. Pour about 5 mL of Povidone Iodine Surgical Scrub on the palm of the hand and spread over both hands and forearms. Without adding more water, rub the Scrub thoroughly over all areas for about five minutes. Use a brush if desired. Clean thoroughly under fingernails. Add a little water and develop copious suds. Rinse thoroughly under running water. Complete the wash by scrubbing with another 5 mL of Povidone Iodine Surgical Scrub in the same way.</li>\r\n	<li>For Preoperative use on Patients: After the skin area is shaved, wet it with water. Apply Povidone Iodine Surgical Scrub (1 mL is sufficient to cover an area of 20-30 square inches), develop lather and scrub thoroughly for about five minutes. Rinse off by aid of sterile gauze saturated with water.</li>\r\n	<li>For use in the Physician&#39;s Office: Use for washing whenever a germicidal soap is required.</li>\r\n</ul>\r\n\r\n<p><strong>Powder</strong>: Apply a light dusting of powder to the affected area. When dry, this forms a protective antiseptic layer over the area treated. Or use as advised by the Registered Physician. There are no special dosage recommendations for children or elderly patients.<br />\r\n<br />\r\n<strong>Ophthalmic Solution</strong>: 1 drop 4 times daily or as required, depending upon the severity of the disease, to be instilled into the conjunctival sac.</p>', '<p>It exhibits interaction with strong alkali, sodium thiosulphate, sodium metabisulphite and thiomersal. Use with concurrent lithium therapy has been shown to exhibithypothyroidic effect.</p>', '<p>It can cause hypersensitivity reactions. Regular use in patients with thyroid disorders (in particular nodular colloid goitre, endemic goitre and Hashimoto&#39;s thyroiditis) or those receiving lithium therapy is to be avoided. In severely burnt patients serum iodide levels should be assessed due to possible hepatic and renal impairment. Povidone Iodine Powder should not be used in serious cavities and in Children under the age of 2 years.</p>', '<p>Povidone Iodine may cause hypersensitivity reactions and irritation of the skin and mucous membranes. The application of povidone Iodine to severe burns or to large areas otherwise denuded of skin may produce systemic adverse effects such as metabolic acidosis, hypernatraemia, and impairment of renal function. It may interfere with thyroid function tests.</p>', '<p>Povidone Iodine Cream, Solution &amp; Powder are not recommended for use during pregnancy because of the possibility of absorption of sufficient iodine to affect the fetal thyroid. American Academy of Pediatrics considers that the use of Povidone-Iodine is usually compatible with breast feeding. Consult Registered Physician. Regular use of Gargle &amp; Mouthwash and Surgical Scrub should also be avoided in pregnant and lactating women.<br />\r\n<br />\r\nThere is no experience regarding the safety of the Povidone eye drops in human pregnancy or lactation. Administration during pregnancy and lactation is therefore not recommended, except for compelling reasons.</p>', '<p><strong>Cream or ointment</strong>: In case of deep or puncture wounds or serious burns, consult Registered Physician. If redness, irritation, swelling or pain persists or increases or if infection occurs, discontinue use and consult Registered Physician.<br />\r\n<br />\r\n<strong>Solution</strong>: In preoperative prepping, avoid &#39;pooling&#39; beneath the patient. Prolonged exposure to wet solution may cause irritation or rarely, severe skin reactions. In case of deep or puncture wounds or serious burns, consult Registered Physician. If redness, irritation, swelling or pain persists or increases or if infection occurs, discontinue use and consult Registered Physician.<br />\r\n<br />\r\n<strong>Gargle &amp; Mouthwash</strong>: Regular use should be avoided as prolonged use may lead to the absorption of a significant amount of iodine. Do not use for more than 14 days. If sores or ulcers in the mouth do not heal within 14 days seek dental or medical advice. It is also not for use in children under 6 years of age. Regular use should be avoided in patients on concurrent lithium therapy.<br />\r\n<br />\r\n<strong>Surgical Scrub</strong>: Special caution is needed when regular applications to broken skin are made to patients with pre-existing renal insufficiency. Regular use should be avoided in patients on concurrent lithium therapy. It can permanently discolor white gold jewellery and it is recommended that this type of jewellery should be removed before using this product.<br />\r\n<br />\r\n<strong>Powder</strong>: Care must be taken when used on known iodine sensitivity, although do not normally react to Povidone-Iodine. Excess powder can be washed off readily with warm water. It should be used directly from the container. Not to be administered internally.<br />\r\n<br />\r\n<strong>Ophthalmic Solution</strong>: Patients, who experience blurred vision after application of the eye drops, should not drive or use machinery until their vision has cleared. Contact lenses should not be worn during the instillation of the drug. After instillation, there should be an interval of at least 30 minutes before reinsertion.</p>', NULL, '<p>Iodine compounds (Anti-septic Preparations).</p>', '<p>Store below 25&deg;C. Do not freeze. Store in a cool and dry place, protected from light. Keep out of the reach of children. Do not touch the ophthalmic solution dropper tip to any surface as this may contaminate this preparation. Do not use it after one month of the first opening.</p>', NULL, '2022-03-16 04:12:39', '2022-03-16 04:12:39'),
(1250, 1250, '<p>Pralidoxime chloride is indicated as an antidote:</p>\r\n\r\n<ul>\r\n	<li>In the treatment of poisoning due to those pesticides and chemicals (e.g., nerve agents) of the organophosphate class which have anticholinesterase activity and</li>\r\n	<li>In the control of overdosage by anticholinesterase drugs used in the treatment of&nbsp;myasthenia gravis.</li>\r\n</ul>\r\n\r\n<p>The principal indications for the use of Pralidoxime chloride are muscle weakness and respiratory depression. In severe poisoning, respiratory depression may be due to muscle weakness.</p>', '<p>Pralidoxime reactivates cholinesterase outside the CNS that had been inactivated by phosphorylation due to exposure to certain organophosphates by displacing the enzyme from its receptor sites. It removes the phosphoryl group from the active site of the inactivated enzyme by nucleophilic attack, regenerating active cholinesterase and forming an oxime complex. It also detoxifies certain organophosphates by direct chemical reaction.</p>', '<p>Intramuscular-</p>\r\n\r\n<p>Organophosphorus poisoning:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Mild: 600 mg, repeat 1-2 times at 15 min intervals as needed. Severe: 1.8 g given as 3 inj of 600 mg in rapid succession. Persistent: May repeat the entire series (1.8 g) beginning 1 hr after admin of the last inj.</li>\r\n	<li><strong>Child</strong>:&nbsp;&lt;40 kg: Mild: 15 mg/kg, repeat as needed every 15 min. Max: 45 mg/kg. Severe: 15 mg/kg, repeat twice in rapid succession to a total dose of 45 mg/kg. Persistent: May repeat the entire series (45 mg/kg) beginning 1 hr after admin of the last inj; &ge;40 kg: Same as adult dose.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Intravenous-</p>\r\n\r\n<p>Organophosphorus poisoning:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;In combination with atropine: Loading dose: 1-2 g by infusion over 15-30 min or slow inj over at least 5 min, may repeat dose after 1 hr then 10-12 hrly, as needed. Administer as soon as the effects of atropine are observed. Maintain atropinisation for at least 48 hr.</li>\r\n	<li><strong>Child:</strong>&nbsp;&le;16 yr Loading dose: 20-50 mg/kg (max: 2 g/dose) by inj over 15-30 min followed by 10-20 mg/kg/hr as continuous infusion. Alternatively, a repeat bolus of 20-50 mg/kg after 1 hr and repeated 10-12 hrly as needed; &gt;16 yr Same as adult dose.</li>\r\n</ul>\r\n\r\n<p>Poisoning or overdosage with compounds having muscarinic actions:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initially, 1-2 g, followed by 0.5-1 g/hr as infusion. Alternatively, the initial dose may be repeated after 1 hr and then 3-8 hrly as needed.</li>\r\n</ul>', NULL, '<p>There are no known absolute contraindications for the use of Pralidoxime Chloride. Relative contraindications include known hypersensitivity to the drug and other situations in which the risk of its use clearly outweighs possible benefit.</p>', '<p>Drowsiness, dizziness, visual disturbances, nausea, HTN, tachycardia, headache, hyperventilation, muscle weakness, impaired renal function, elevated liver enzymes, transient increase in creatine phosphokinase, transient neuromuscular blockade; mild to moderate pain at inj site.</p>', '<p><strong>Pregnancy&nbsp;</strong>Category C.&nbsp;Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Patient with myasthenia gravis receiving anticholinesterase agents. Not indicated in the treatment of poisoning due to phosphorous, inorganic phosphates, or organophosphates without anticholinesterase activity and carbamate pesticides. Renal impairment. Pregnancy and lactation.</p>', '<p><strong>Manifestations of Overdosage</strong>: Observed in normal subjects only: dizziness, blurred vision, diplopia, headache, impaired accommodation, nausea, slight tachycardia. In therapy it has been difficult to differentiate side effects due to the drug from those due to the effects of the poison.</p>', '<p>Antidote preparations.</p>', '<p>Store between 20-25&deg; C.</p>', NULL, '2022-03-16 04:14:45', '2022-03-16 04:14:45'),
(1251, 1251, '<p>Pramipexole is indicated for the treatment of-</p>\r\n\r\n<ul>\r\n	<li>Parkinson&#39;s disease used alone or as an adjunct to levodopa with dopa-decarboxylase inhibitor</li>\r\n	<li>Moderate to severe restless legs syndrome</li>\r\n</ul>', '<p>The exact mechanism of action of pramipexole as a treatment for Parkinson&#39;s disease is unknown at this time. It is thought, however, that the ability of pramipexole to cause stimulation of the dopamine receptors in the striatum of the brain, a region that receives a vast array of neurological input and is responsible for a wide variety of functions, may be involved. Studies performed in animals show that pramipexole influences striatal neuronal transmission rates following activation of dopamine receptors. Pramipexole is considered a non-ergot dopamine agonist that shows specificity and strong activity at the D2 subfamily of dopamine receptors in vitro, binding selectively and dopamine D2 receptors and showing a preference for the dopamine D3 receptor subtype rather than other subtypes. The clinical significance of this binding specificity is unknown.</p>', '<p>The recommended dose of Pramipexole is as follows-<br />\r\n<br />\r\nParkinson&#39;s disease:</p>\r\n\r\n<ul>\r\n	<li><strong>Initial&nbsp;dose</strong>: 88 micrograms 3 times daily, dose doubled every 5-7 days if tolerated to 350 micrograms 3 times daily; further increased if necessary by 180 micrograms 3 times daily at weekly intervals</li>\r\n	<li><strong>Maximum dose</strong>: 3.3 mg daily in 3 divided doses. During pramipexole dose titration and maintenance Levodopa dose should be reduced.</li>\r\n</ul>\r\n\r\n<p>Restless legs syndrome:</p>\r\n\r\n<ul>\r\n	<li><strong>Initial dose</strong>: 88 micrograms once daily 2-3 hours before bedtime, dose doubled every 4-7 days if necessary to 350 micrograms daily.</li>\r\n	<li><strong>Maximum dose</strong>: 540 micrograms daily.</li>\r\n</ul>\r\n\r\n<p>Use in children: Pramipexole is not recommended for children below 18 years of age.</p>', '<p>Pramipexole is the only dopamine agonist not appreciably metabolized by the P450 system which minimizes about possible drug-drug interactions. Cimetidine and amantadine may reduce the renal clearance of pramipexole. Sedating medicinal products or alcohol in&nbsp;combination with pramipexole may cause additive effects.</p>', '<p>Pramipexole is contraindicated in patients with known Hypersensitivity to the active substance or to any of the excipients.</p>', '<p>The common side effects are dizziness, dyskinesia, nausea, hypotension, abnormal dreams, confusion, constipation, delusion, hallucinations, headache, hyperkinesia, increased eating (binge eating, hyperphagia), insomnia, libido disorders, nausea, peripheral oedema, paranoia, pathological gambling, hypersexuality and other abnormal behaviour, somnolence, weight increase, sudden onset of sleep, pruritus and rash and other hypersensitivity.</p>', '<p>The effect of pramipexole on pregnancy and lactation has not been investigated in humans so it should be used during pregnancy only if the potential benefit justifies the potential risk to the foetus. Pramipexole inhibits secretion of prolactin in humans. The excretion of pramipexole into breast milk has not been studied in women so it should not be used during breast-feeding. However, if its use is unavoidable then breast-feeding should be discontinued.</p>', '<p>Caution should be taken in patients with psychotic disorder, ophthalmologic monitoring is recommended at regular intervals, severe cardiovascular disease and&nbsp;renal impairment.</p>', '<p>There is no clinical experience with massive overdose. Symptoms of overdose are nausea, vomiting, hyperkinesia, hallucinations, agitation and hypotension. There is no established antidote. If signs of central nervous system stimulation are present, a neuroleptic agent may be indicated. Management of the overdose may require general supportive measures, along with gastric lavage, intravenous fluids, administration of activated charcoal and electrocardiogram monitoring.</p>', '<p>Antiparkinson drugs.</p>', '<p>Store in a cool and dry place. Protect from light.</p>', NULL, '2022-03-16 04:19:09', '2022-03-16 04:19:09'),
(1252, 1252, '<p>For temporary relief of pain and itching associated with minor burns, sunburns, minor cuts, scrapes, insect bites, minor skin irritations and rashes.</p>', '<p>Pramoxine Hydrochloride blocks Na+&nbsp;ion channel in neuronal cell membrane and prevents pain transmission, thereby effecting local anesthetic action. Calamine causing a cooling sensation and provides anti-itching action.</p>', '<p><strong>Adults and children 2 years of age and older</strong>: Apply to affected area not more than 3 to 4 times daily.<br />\r\n<br />\r\n<strong>Children under 2 years of age</strong>: Consult with a doctor.</p>', '<p>No significant interactions known or found for this cream. Caution always advised with multiple medications.</p>', NULL, '<p>Local skin reaction, e.g. anaphylactoid, burning, stinging, contact dermatitis, tenderness, urticaria, skin peeling and skin lesions.</p>', '<p>Pregnancy Category: Undetermined. No safety information is available on the use of this product during pregnancy and lactation. Pregnant and breastfeeding patients should seek advice of health professional before using this cream.</p>', '<p>This preparation is for topical use only. Avoid contact of this medicine with the eyes, nose, ears and mouth. If the medication gets in these areas, wipe it off and rinse immediately with water. Stop using this medication and tell your doctor if your condition worsens, if symptoms do not improve within 7 days or persist after 7 days of treatment or if symptoms clear up and return in a few days. Do not apply to wound or damage skin and not bandage tightly in the affected area. This medicine may be harmful if swallowed. If swallowed get medical help or contact a poison center immediately.</p>', NULL, '<p>Topical Analgesics.</p>', '<p>This cream should be stored at room temperature of 20&deg;C - 25&deg;C. Keep out of the reach of children.</p>', NULL, '2022-03-16 04:21:28', '2022-03-16 04:21:28'),
(1253, 1253, '<p>Prasugrel is indicated to reduce the rate of thrombotic cardiovascular (CV) events (including stent thrombosis) in patients with acute coronary syndrome (ACS) who are to be managed with percutaneous coronary intervention (PCI) as follows:</p>\r\n\r\n<ul>\r\n	<li>Patients with unstable angina (UA) or non-ST-elevation myocardial infarction (NSTEMI).</li>\r\n	<li>Patients with ST-elevation myocardial infarction (STEMI) when managed with primary or delayed PCI.</li>\r\n</ul>', '<p>Prasugrel is an inhibitor of platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y12 class of ADP receptors on platelets.</p>', '<p>Treatment should be initiated with a single 60 mg oral loading dose. Continue at 10 mg once daily with or without food. Consider 5 mg once daily for patients &lt;60 kg. Patients should also take aspirin (75 mg to 325 mg) daily.</p>', '<ul>\r\n	<li>Coadministration of Prasugrel and warfarin increases the risk of bleeding.</li>\r\n	<li>Coadministration of Prasugrel and NSAIDs (used chronically) may increase the risk of bleeding.</li>\r\n	<li>Prasugrel can be administered with drugs that are inducers or inhibitors of cytochrome P450 enzymes. Prasugrel can be administered with aspirin (75 mg to 325 mg per day), heparin, GPIIb/IIIa inhibitors, statins, and drugs that elevate gastric pH, including proton pump inhibitors and H2 blockers.</li>\r\n</ul>', '<ul>\r\n	<li>Active pathological bleeding such as peptic ulcer or intracranial haemorrhage.</li>\r\n	<li>Patient with a history of prior transient ischemic attack or stroke</li>\r\n</ul>', '<ul>\r\n	<li>Bleeding</li>\r\n	<li>Thrombotic thrombocytopenic purpura</li>\r\n	<li>Other side effects (Headache, back pain, dyspnea, nausea, hypertension, bradycardia, rash etc)</li>\r\n</ul>', '<p>There are no adequate and well-controlled studies of Prasugrel use in pregnant women. Reproductive and developmental toxicology studies in rats and rabbits at doses of up to 30 times the recommended therapeutic exposures in humans revealed no evidence of fetal harm; however, animal studies are not always predictive of a human response.<br />\r\n<br />\r\nIt is not known whether Prasugrel is excreted in human milk. Because many drugs are excreted in human milk, Prasugrel should be used during nursing only if the potential benefit to the mother justifies the potential risk to the nursing infant.</p>', '<ul>\r\n	<li>CABG-related bleeding: Risk increases in patients receiving Prasugrel who undergo CABG.</li>\r\n	<li>Discontinuation of Prasugrel: Premature discontinuation increases risk of stent thrombosis, MI, and death</li>\r\n</ul>', '<p>In rats, lethality was observed after administration of 2000 mg/kg. Platelet transfusion may restore clotting ability. The prasugrel active metabolite is not likely to be removed by dialysis.</p>', '<p>Anti-platelet drugs.</p>', '<p>Keep in dry place and away from light and heat. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Patients &gt; 75 years of age who received Prasugrel had an increased risk of fatal bleeding events (1.0%) compared to patients who received Clopidogrel (0.1%).<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No dosage adjustment is necessary for patients with renal impairment. There is limited experience in patients with end-stage renal disease.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No dosage adjustment is necessary in patients with mild to moderate hepatic impairment.</p>', '2022-03-16 04:23:40', '2022-03-16 04:23:40'),
(1254, 1254, '<p>Hypertension (Primary and Secondary Hypertension). Raynaud&#39;s phenomenon and Raynaud&#39;s disease, Congestive heart failure (Prazosin may be used alone or added to the therapeutic regimen in those patients with congestive heart failure who are resistant or refractory to conventional therapy with diuretics and/or cardiac glycosides) &amp; Benign prostatic hyperplasia (For the symptomatic treatment of urinary obstruction due to BPH and in patients awaiting prostatic surgery).</p>', '<p>Prazosin causes a decrease in total peripheral vascular resistance through selective inhibition of postsynaptic alpha-1-adrenoreceptors in vascular smooth muscle. In hypertensive patients, blood pressure is lowered in both the supine and standing positions; this effect is more pronounced on the diastolic blood pressure. Rebound elevation of blood pressure does not occur following abrupt cessation of Prazosin therapy.<br />\r\n<br />\r\nThe therapeutic efficacy of Prazosin in patients with congestive heart failure is ascribed to a reduction in left ventricular filling pressure, reduction in cardiac impedance and an augmentation of cardiac output. The use of Prazosin in congestive heart failure does not provoke a reflex tachycardia and blood pressure reduction is minimal in normotensive patients. Prazosin reduce the severity of the signs, symptoms, frequency and duration of attacks, in patients with Raynaud&#39;s disease. In low dosage, antagonism of alpha-1-receptors on prostatic and urethral smooth muscle has been shown to improve the urinary pressure profile in men and to improve symptoms of benign prostatic hyperplasia. Clinical studies have shown that Prazosin therapy is not associated with adverse changes in the serum lipid profile.</p>', '<p>Hypertension:</p>\r\n\r\n<ul>\r\n	<li><strong>Recommended starting dose</strong>: 0.5 mg (in the evening), twice or thrice daily for 3 to 7 days. This dose should be increased to 1 mg twice or three times daily for a further 3 to 7 days. Thereafter, the daily dose should be increased gradually as determined by the patient&#39;s response to the blood pressure lowering effect. Most patients are likely to be maintained on a dosage regimen of Prazosin alone of up to 15 mg daily in divided doses.</li>\r\n	<li><strong>Maximum dose</strong>: 20 mg in divided doses.</li>\r\n</ul>\r\n\r\n<p>Patients receiving other antihypertensive therapy but with inadequate&nbsp;control:</p>\r\n\r\n<ul>\r\n	<li>The dosage of the other drug should be reduced to a maintenance level and Prazosin initiated at 0.5 mg in the evening, then continuing with 0.5 mg twice or three times daily.</li>\r\n	<li>Subsequent dosage increases should be made gradually depending upon the patient&#39;s response.</li>\r\n</ul>\r\n\r\n<p>Congestive heart failure:</p>\r\n\r\n<ul>\r\n	<li><strong>The recommended starting dose</strong>: 0.5 mg two, three or four times daily, increasing to 4 mg in divided doses. Dosage should be adjusted according to the patient&#39;s response, based on careful monitoring of cardiopulmonary signs and symptoms.</li>\r\n	<li><strong>Usual daily maintenance dosage</strong>: 4 mg to 20 mg in divided doses.</li>\r\n</ul>\r\n\r\n<p>Raynaud&#39;s disease:</p>\r\n\r\n<ul>\r\n	<li><strong>The recommended starting dosage</strong>: 0.5 mg twice daily given for a period of 3 to 7 days and should be adjusted according to the patient&#39;s clinical response.</li>\r\n	<li><strong>Usual maintenance dosage</strong>: 1 mg or 2 mg twice daily.</li>\r\n</ul>\r\n\r\n<p>Benign prostatic hyperplasia:</p>\r\n\r\n<ul>\r\n	<li><strong>The recommended dosage</strong>: 0.5 mg twice daily for a period of 3 to 7 days, with the initial dose administered in the evening. The dosage should then be adjusted according to clinical response.</li>\r\n	<li><strong>The usual&nbsp;maintenance dosage</strong>: 2 mg twice daily.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>May be taken with or without food. Starting dose is best taken within dinner, at least 2-3 hr before retiring. Maintenance doses may be taken with or without meals.</p>', '<p><strong>Use with phosphodiesterase-5 inhibitors (PDE-5 Inhibitors)</strong>: Concomitant useo f PDE-5 inhibitors (e.g. Sildenafil, Tadalafil, Vardenafil) and Prazosin may lead to symptomatic hypotension in some patients. Adding Prazosin to beta-adrenergic antagonist or calcium antagonist therapy may produce a substantial reduction in blood pressure.</p>', '<p>Prazosin is contraindicated in patients with known sensitivity to Prazosin &amp; other quinazolines or any of the excipients.</p>', '<p>The most common side effects of Prazosin are&nbsp;allergic reaction, depression, nervousness, insomnia, Hallucinations, dizziness, drowsiness, headache, faintness, syncope, paraesthesia, worsening of pre-existing narcolepsy, blurred vision, eye pain, reddened sclera, vertigo, tinnitus, palpitations etc.</p>', '<p>Pregnancy category C. It should be used only when, in the opinion of the physician, potential benefit outweighs potential risk. Prazosin has been shown to be excreted in small amounts in human milk. Caution should be exercised when Prazosin is administered to nursing mothers.</p>', '<p><strong>In patients with benign prostatic hyperplasia</strong>: Prazosin is not recommended for patients with a history of micturition syncope. It should not normally be administered to patients already receiving another alpha-1-antagonist.<br />\r\n<br />\r\n<strong>In patients with congestive heart failure</strong>: Prazosin is not recommended in the treatment of congestive cardiac failure due to&nbsp;mechanical&nbsp;obstruction such as aortic valve stenosis, mitral valve stenosis, pulmonary embolism and restrictive pericardial disease.<br />\r\n<br />\r\n<strong>In patients with hypertension</strong>: Postural hypotension evidenced by dizziness and weakness, or rarely loss of consciousness, has been reported, particularly with the commencement of therapy.</p>', '<p><strong>Symptoms:</strong>&nbsp;Hypotension, profound drowsiness, depressed reflexes.<br />\r\n<br />\r\n<strong>Management</strong>: Symptomatic and supportive treatment. May be treated with activated charcoal if patient presents within 1 hr of ingestion. Postural measures and parenteral fluid volume replacement for severe hypotension and if necessary, cautious IV infusion of a vasopressor.</p>', '<p>Alpha adrenoceptor blocking drugs.</p>', '<p>Keep away from light and moisture, store below 30&deg; C. Keep away from reach&nbsp;out of the children.</p>', '<p><strong>Patients with moderate to severe grades of renal impairment</strong>: Evidence to date shows that Prazosin does not further compromise renal function when used in patients with renal impairment. As some patients in this category have responded to small doses of Prazosin, it is recommended that therapy be initiated at 0.5 mg daily and that dosage increases be instituted cautiously.<br />\r\n<br />\r\n<strong>Patients with hepatic dysfunction</strong>: it is recommended that therapy should be initiated at 0.5 mg daily and that dosage should be increased cautiously.<br />\r\n<br />\r\n<strong>Use in the elderly</strong>: Since the elderly may be more susceptible to hypotension, therapy should be initiated with the lowest possible dose.</p>', '2022-03-16 04:26:18', '2022-03-16 04:26:18'),
(1255, 1255, '<p>Salicylic acid and sulfur combination is used to treat acne and other skin disorders and dandruff and other scalp disorders, such as seborrheic dermatitis.</p>', '<p>Salicylic acid is a potent keratolytic with mild antiseptic action when applied topically. Sulfur topical is a scabicide and keratolytic agent.<br />\r\n<br />\r\nThe mechanism of action when these two ingredients are combined, may be a synergistic keratolytic effect. The mechanism of action of salicylic acid in the treatment of acne may also include anti-inflammatory activity.</p>', '<p>The dose of salicylic acid and sulfur will be different for different patients. Follow your doctor&#39;s orders or the directions on the label. The following information includes only the average doses of salicylic acid and sulfur. If your dose is different, do not change it unless your doctor tells you to do so.<br />\r\n<br />\r\nThe amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.</p>\r\n\r\n<p>For acne or oily skin-</p>\r\n\r\n<p>Bar dosage form:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children</strong>: Use on the affected skin two or three times a day.</li>\r\n</ul>\r\n\r\n<p>Cleansing lotion dosage form:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children</strong>: Use on wet skin one to three times a day. Rub lather into skin for one minute then rinse.</li>\r\n</ul>\r\n\r\n<p><br />\r\nFor dandruff and seborrheic dermatitis of the scalp-</p>\r\n\r\n<p>Bar and shampoo dosage forms:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children</strong>: Use on the scalp once a day at least two times a week or as directed by doctor. May be used each day if needed.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Use salicylic acid and sulfur only as directed. Do not use more of it and do not use it more often than recommended on the label, unless otherwise directed by your doctor. Immediately after using salicylic acid and sulfur, wash your hands to remove any medicine that may be on them. Keep salicylic acid and sulfur away from the eyes. If you should accidentally get some in your eyes, flush them thoroughly with water.<br />\r\n<br />\r\n<strong>To use the skin cleansing lotion</strong>: After wetting the skin, apply salicylic acid and sulfur with your fingertips or a wet sponge and rub in gently to work up a lather. Then rinse thoroughly and pat dry.<br />\r\n<br />\r\n<strong>To use the shampoo or bar as a shampoo</strong>: Wet the hair and scalp with lukewarm water. Then apply enough medicine to work up a lather and rub into the scalp. Continue rubbing the lather into the scalp for several minutes or allow it to remain on the scalp for about 5 minutes, depending on the product being used, then rinse. Apply the medicine again and rinse thoroughly.<br />\r\n<br />\r\n<strong>To use the bar as a soap</strong>: After wetting the skin, use salicylic acid and sulfur to wash the face and other affected areas. Then rinse thoroughly and pat dry.</p>', '<p>Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.</p>', '<p>Hyppersensitivity.</p>', '<p>Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.<br />\r\n<br />\r\nCheck with your doctor as soon as possible if any of the following side effects occur: Skin irritation not present before use of salicylic acid and sulfur<br />\r\n<br />\r\nSome side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:</p>\r\n\r\n<ul>\r\n	<li>Redness and peeling of skin (may occur after a few days)</li>\r\n	<li>unusual dryness of skin</li>\r\n</ul>', '<p><strong>Breast Feeding</strong>: There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.</p>', '<p>When using salicylic acid and sulfur combination medicine, do not use any of the following preparations on the same affected area as salicylic acid and sulfur, unless otherwise directed by your doctor:</p>\r\n\r\n<ul>\r\n	<li>Abrasive soaps or cleansers</li>\r\n	<li>Alcohol-containing preparations</li>\r\n	<li>Any other topical acne preparation or preparation containing a peeling agent (for example, benzoyl peroxide, resorcinol, or tretinoin [vitamin A acid])</li>\r\n	<li>Cosmetics or soaps that dry the skin</li>\r\n	<li>Medicated cosmetics</li>\r\n	<li>Other topical medicine for the skin</li>\r\n</ul>\r\n\r\n<p>To use any of the above preparations on the same affected area as salicylic acid and sulfur combination medicine may cause severe irritation of the skin.<br />\r\n<br />\r\nDo not use any topical mercury-containing preparation, such as ammoniated mercury ointment, on the same affected area as salicylic acid and sulfur . To do so may cause a foul odor, may be irritating to the skin, and may stain the skin black. If you have any questions about this, check with your health care professional.<br />\r\n<br />\r\nTaking large doses of aspirin or other salicylates (including diflunisal) while using topical salicylic acid (contained in salicylic acid and sulfur) may lead to overdose. If you have any questions about this, check with your health care professional.</p>', NULL, '<p>Local Antipruritic, Other scalp preparations.</p>', '<p>Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed.</p>', '<p><strong>Pediatric</strong>: Young children may be at increased risk of unwanted effects because of increased absorption of salicylic acid through the skin. Products containing salicylic acid should not be applied to large areas of the body or used for long periods of time in infants and children.<br />\r\n<br />\r\n<strong>Geriatric</strong>: Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of salicylic acid and sulfur combination in the elderly with use in other age groups.</p>', '2022-03-16 04:28:58', '2022-03-16 04:28:58'),
(1256, 1256, '<p><strong>Rheumatic Disorders</strong>: Psoriatic arthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, ankylosing spondylitis, acute and subacute bursitis, acute nonspecific tenosynovitis, acute gouty arthritis, post-traumatic osteoarthritis.<br />\r\n<br />\r\n<strong>Endocrine Disorders</strong>: Primary or secondary adrenocortical insufficiency, congenital adrenal hyperplasia, nonsuppurative thyroiditis, hypercalcemia associated with cancer.<br />\r\n<br />\r\n<strong>Dermatologic Diseases</strong>: Pemphigus, bullous dermatitis herpetiformis, severe erythema multiforme, exfoliative dermatitis, mycosis fungoides, severe psoriasis.<br />\r\n<br />\r\n<strong>Allergic States</strong>: Seasonal or perennial allergic rhinitis, bronchial asthma, contact dermatitis, atopic dermatitis, serum sickness, drug hypersensitivity reactions.<br />\r\n<br />\r\n<strong>Respiratory Diseases</strong>: Symptomatic sarcoidosis, berylliosis, fulminating, aspiration pneumonitis.<br />\r\n<br />\r\n<strong>Hematologic Disorders</strong>: Idiopathic thrombocytopenic purpura, secondary thrombocytopenia, acquired (autoimmune) hemolytic anemia, erythroblastopenia (RBC anemia).<br />\r\n<br />\r\n<strong>Edematous States</strong>: To induce a diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus.<br />\r\n<br />\r\n<strong>Gastrointestinal Diseases</strong>: Ulcerative colitis, regional enteritis.</p>', '<p>Prednisolone is a synthetic adrenocortical drug with predominantly glucocorticoid properties. Prednisolone directly inhibits the action of the Phospholipase A2 enzyme which is responsible for the production of different inflammatory mediators like Leukotrienes, SRS-A, Prostaglandins etc. Prednisolone is rapidly and well absorbed from the Gl tract following oral administration. Prednisolone is 70- 90% protein-bound in the plasma and it is eliminated from the plasma with a half-life of 2 to 4 hours. It is metabolized mainly in the liver and excreted in the urine.</p>', '<p>Adult-<br />\r\n<strong>Nephrotic Syndrome</strong>:</p>\r\n\r\n<ul>\r\n	<li>Initial: 2 mg/kg/day (maximum 80 mg/day) in divided doses 3 to 4 times/day until urine is protein free for 3 consecutive days (maximum: 28 days); followed by 1 to 1.5 mg/kg/dose given every other day for 4 weeks.</li>\r\n	<li>Maintenance dose: 0.5 to 1 mg/kg/ dose given every other day for 3 to 6 months.</li>\r\n</ul>\r\n\r\n<p><strong>Anti-inflammatory</strong>: 5 to 60 mg per day in divided doses 1 to 4 times/day.<br />\r\n<br />\r\n<strong>Acute Asthma</strong>: 40-60 mg/day PO in single daily dose or divided q12 hr for 3-10 days.<br />\r\n<br />\r\n<strong>Allergic Conditions</strong>:</p>\r\n\r\n<ul>\r\n	<li>Day 1: 10 mg PO before breakfast, 5 mg after lunch and after dinner, and 10 mg at bedtime.</li>\r\n	<li>Day 2: 5 mg PO before breakfast, after lunch, and after dinner and 10 mg at bedtime.</li>\r\n	<li>Day 3: 5 mg PO before breakfast, after lunch, after dinner, and at bedtime.</li>\r\n	<li>Day 4: 5 mg PO before breakfast, after lunch, and at bedtime.</li>\r\n	<li>Day 5: 5 mg PO before breakfast and at bedtime.</li>\r\n	<li>Day 6: 5 mg PO before breakfast.</li>\r\n</ul>\r\n\r\n<p><br />\r\nPediatric-<br />\r\n<strong>Asthma</strong>:</p>\r\n\r\n<ul>\r\n	<li>1 year: Acute: 10 mg orally every 12 hours. Maintenance: 10 mg orally every other day.</li>\r\n	<li>1 to 4 years: Acute: 20 mg orally every 12 hours. Maintenance: 20 mg orally every other day.</li>\r\n	<li>5 to 12 years: Acute: 30 mg orally every 12 hours. Maintenance: 30 mg orally every other day.</li>\r\n	<li>12 years: Acute: 40 mg orally every 12 hours. Maintenance: 40 mg orally every other day.</li>\r\n</ul>\r\n\r\n<p><strong>Anti-inflammatory</strong>: 0.05 to 2 mg/kg/day divided 1 to 4 times/day.<br />\r\n<br />\r\n<strong>Immunosuppression</strong>: 0.05 to 2 mg/kg/day divided 1 to 4 times/day.</p>', '<p>The efficacy of prednisolone is reduced by Aminoglutethimide, Antacids, Barbiturates, Carbamazepine, Griseofulvin, Mitotane, Phenylbutazone, Phenytoin, Primidone and Rifampin. Prednisolone reduces the amount of potassium in the blood. Digitalis can cause Cardiac arrhythmias if hypokalemia occurs. Immunization should be done very carefully.</p>', '<p>Systemic infections unless specific anti-infective therapy is employed. Hypersensitivity to any ingredient. Ocular herpes simplex because of possible perforation.</p>', '<p>Common side effects include increased appetite, indigestion, nervousness or restlessness. Less frequent or rare side effects are darkening or lightening of skin color, dizziness or lightheadedness, flushing of face or cheeks, hiccups, increased sweating, the sensation of spinning.</p>', '<p>This medicine is not recommended for use during pregnancy unless considered essential by your doctor. It should only be used if the expected benefit to the mother is greater than any possible risk to the foetus. Corticosteroids appear in breast milk and could suppress growth, interfere with endogenous corticosteroid production or cause other unwanted effects.</p>', '<p>Precaution has to be taken in diabetes, hypertension, Psychological disturbances, osteoporosis, post-menopausal women, pregnancy and in chronic nephritis. Long-term use of Prednisolone can cause Cushing&#39;s habitus, hyperglycemia, muscular weakness, increased susceptibility to infection, delayed wound healing, and psychiatric disturbances.</p>', '<p>Adverse effects related to prednisone normally develop only after prolonged use of doses in excess of the normal physiological requirement. Treatment is symptomatic and where possible the prednisone dose should be reduced gradually.</p>', '<p>Glucocorticoids.</p>', '<p>Store in a cool and dry place, protected from light. Keep out of the reach of the children.</p>', NULL, '2022-03-16 04:31:09', '2022-03-16 04:31:09');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1257, 1257, '<p>This is indicated for steroid-responsive inflammatory ocular conditions where bacterial infection or a risk of bacterial ocular infection exists.</p>', '<p><strong>Prednisolone</strong>&nbsp;decreases inflammation by inhibition of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It suppresses the immune system by reducing the activity and production of the lymphocytes and eosinophils.<br />\r\n<br />\r\n<strong>Neomycin</strong>: Interferes with bacterial protein synthesis by binding to 30S ribosomal subunits.<br />\r\n<br />\r\n<br />\r\n<strong>Polymixin B Sulphate</strong>: Bactericidal; causes leakage of bacterial membrane</p>', '<p><strong>Adult Use</strong>: Instill one drop into the conjunctival sac two to four times daily. During the initial 24 to 48 hours, the dosing frequency may be increased if necessary. Care should be taken not to discontinue the therapy before completing the course.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.</p>', '<p>Synergistic effects with penicillins. Additive toxicity with neurotoxic, ototoxic or nephrotoxic drugs. May decrease absorption of digoxin and methotrexate. May increase effects of oral anticoagulants.</p>', '<p>Prednisolone Acetate is contraindicated in viral diseases of the cornea, conjunctiva and known hypersensitivity to any of the ingredients of this preparation or other corticosteroids.</p>', '<p>Elevation of intraocular pressure (IOP) with possible development of glaucoma and infrequent optic nerve damage, posterior subcapsular cataract formation and delayed wound healing.<br />\r\n<br />\r\nFungal and viral infections of the cornea are particularly may develop coincidentally with long-term applications of steroid.</p>', '<p>Pregnancy Category C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.</p>', '<p>This combination should be used with caution in patients with known hypersensitivity to the components of this preparation. Prolonged use of corticosteroids may result in damage to the optic nerve and defects in vision. If this product is used for longer period of time, intraocular pressure should be routinely monitored.</p>', NULL, '<p>Ophthalmic steroid - antibiotic combined preparations.</p>', NULL, NULL, '2022-03-16 04:33:21', '2022-03-16 04:33:21'),
(1258, 1258, '<p>Prednisolone eye drops is indicated for the treatment of steroid-responsive inflammation of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe.</p>', '<p>Prednisolone decreases inflammation by inhibition of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It suppresses the immune system by reducing the activity and production of the lymphocytes and eosinophils.</p>', '<p><strong>Adult</strong>: Instill one drop into the conjunctival sac two to four times daily. During the initial 24 to 48 hours, the dosing frequency may be increased if necessary. Care should be taken not to discontinue the therapy before completing the course.&nbsp;<br />\r\n<br />\r\n<strong>Paediatric</strong>: Safety and effectiveness in pediatric patients have not been established.</p>', '<p>No significant drug interactions have been reported.</p>', '<p>Prednisolone Acetate is contraindicated in viral diseases of the cornea, conjunctiva and known hypersensitivity to any of the ingredients of this preparation or other corticosteroids.</p>', '<p>Elevation of intraocular pressure (IOP) with possible development of glaucoma and infrequent optic nerve damage, posterior subcapsular cataract formation and delayed wound healing.&nbsp; Fungal and viral infections of the cornea are particularly may develop coincidentally with long-term applications of steroid.</p>', '<p>Prednisolone Acetate is pregnancy category C. So, this drug should be used during pregnancy only if clearly needed. It is not known whether topical administration of corticosteroids would result in sufficient systemic absorption to produce detectable quantities in human milk. Because many drugs are excreted in human milk, caution should be exercised when Prednisolone Acetate is administered to a nursing woman.</p>', '<p>Shake the bottle well before use. Prolonged use of corticosteroids may result in damage to the optic nerve and defects in vision. If this product is used for longer period of time, intraocular pressure should be routinely monitored.</p>', '<p>A one-time accidental overdose of Prednisolone Ophthalmic Suspension generally will not cause acute problems. Long time overdose may show general side-effects. In accidental overdose sufficient water should be taken to dilute the medication.</p>', '<p>Glucocorticoids.</p>', '<p>Store in a cool, dry place and protect from light. Keep out of the reach of children. Protect from freezing.&nbsp; Shake well before using.</p>', NULL, '2022-03-16 04:37:47', '2022-03-16 04:37:47'),
(1259, 1259, '<p>Pregabalin is indicated for:</p>\r\n\r\n<ul>\r\n	<li>Management of neuropathic pain associated with diabetic peripheral neuropathy</li>\r\n	<li>Management of post-herpetic neuralgia</li>\r\n	<li>Adjunctive therapy for adult patients with partial onset seizures</li>\r\n	<li>Management of fibromyalgia</li>\r\n	<li>Neuropathic pain associated with spinal cord injury.</li>\r\n</ul>', '<p>Pregabalin is a structural derivative of the inhibitory neurotransmitter gamma-amino butyric acid (GABA). It does not bind directly to GABAA, GABAB, or benzodiazepine receptor. Pregabalin binds with high affinity to the alpha-2-delta site (an auxiliary subunit of voltage-gated calcium channels) in central nervous system tissues. Oral bioavailability of Pregabalin is &ge;90% and is independent of dose. It is eliminated from the systemic circulation primarily by renal excretion as unchanged drug with a mean elimination half-life of 6.3 hours in subjects with normal renal function.</p>', '<p><strong>Neuropathic pain associated with diabetic peripheral neuropathy</strong>: The maximum recommended dose of Pregabalin is 100 mg three times a day (300 mg/day) in patients with creatinine clearance of at least 60 mL/min. Dosing should begin at 50 mg three times a day (150 mg/day) and may be increased to 300 mg/day within 1 week based on efficacy and tolerability.<br />\r\n<br />\r\n<strong>Post-herpetic neuralgia</strong>: The recommended dose of Pregabalin is 75 to 150 mg two times a day, or 50 to 100 mg three times a day (150 to 300 mg/day) in patients with creatinine clearance of at least 60 mL/min. Dosing should begin at 75 mg two times a day, or 50 mg three times a day (150 mg/day) and may be increased to 300 mg/day within 1 week based on efficacy and tolerability.<br />\r\n<br />\r\n<strong>Adjunctive therapy for adult patients with partial onset seizures</strong>: In general, it is recommended that patients be started on a total daily dose no greater than 150 mg/day (75 mg two times a day, or 50 mg three times a day). Based on individual patient response and tolerability, the dose may be increased to a maximum dose of 600 mg/day.<br />\r\n<br />\r\n<strong>Management of Fibromyalgia</strong>: The recommended dose of Pregabalin for fibromyalgia is 300 to 450 mg/day. Dosing should begin at 75 mg two times a day (150 mg/day) and may be increased to 150 mg two times a day (300 mg/day) within 1 week based on efficacy and tolerability.<br />\r\n<br />\r\n<strong>Neuropathic pain associated with spinal cord injury</strong>: The recommended dose range is 150 to 600 mg/day. The recommended starting dose is 75 mg two times a day (150 mg/day). The dose may be increased to 150 mg two times a day (300 mg/day) within 1 week based on efficacy and tolerability.<br />\r\n<br />\r\nPregabalin capsules can be taken without regards to meals.</p>', '<p>There are no significant interactions between Pregabalin with other antiepileptic drugs &amp; oral contraceptive. Pregabalin may potentiate the effects of ethanol and lorazepam.</p>', '<p>Pregabalin is contraindicated in patients with known hypersensitivity to Pregabalin or any of its components.</p>', '<p>The most common side effects include dizziness, somnolence, dry mouth, edema, blurred vision, weight gain and abnormal thinking.</p>', '<p>Pregnancy category of Pregabalin is C. So it should only used if potential benefit justifies the potential risks to the fetus.<br />\r\n<br />\r\nPregabalin may be secreted through the breast milk like other drugs, so it should be used in nursing women only if the benefits clearly overweigh the risk.</p>', '<p>Discontinuation of Pregabalin without tapering may produce insomnia, nausea, headache and diarrhea. So it should be tapered gradually over a minimum of 1 week rather than discontinued abruptly. Creatinine kinase may be elevated if treated with Pregabalin. It should be discontinued rapidly if myopathy is diagnosed or suspected or if creatinine kinase is elevated markedly.</p>', NULL, '<p>Adjunct anti-epileptic drugs.</p>', '<p>Keep in a cool &amp; dry place (below 30&deg; C), protected from light &amp; moisture. Keep out of the reach of children.</p>', '<p>The safety and efficacy of Pregabalin in paediatric patients have not been established.</p>', '2022-03-16 04:39:41', '2022-03-16 04:39:41'),
(1260, 1260, '<p>Primaquine phosphate is indicated for the radical cure (prevention of relapse) of vivax malaria.</p>', '<p>Primaquine is an 8-aminoquinoline antimalarial which eliminates the exoerythrocytic forms of malarial parasite Plasmodium vivax, Plasmodium ovale and Plasmodium falciparum by disrupting mitochondria and binding to DNA.<br />\r\n<br />\r\nPrimaquine&#39;s mechanism of action is not well understood. It may be acting by generating reactive oxygen species or by interfering with the electron transport in the parasite. Also, although its mechanism of action is unclear, primaquine may bind to and alter the properties of protozoal DNA.</p>', '<p>Primaquine phosphate is recommended only for the radical cure of vivax malaria, the prevention of relapse in vivax malaria, or following the termination of chloroquine phosphate suppressive therapy in an area where vivax malaria is endemic. Patients suffering from an attack of vivax malaria or having parasitized red blood cells should receive a course of chloroquine phosphate, which quickly destroys the erythrocytic parasites and terminates the paroxysm. Primaquine phosphate should be administered concurrently in order to eradicate the exoerythrocytic parasites in a dosage of 1 tablet (equivalent to 15 mg base) daily for 14 days.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken with food. Take with meals to avoid GI discomfort.</p>', '<p>Enhanced effect with other drugs that prolong the QT interval.</p>', '<p>Acutely ill patients suffering from systemic disease manifested by tendency to develop granulocytopenia (e.g. rheumatoid arthritis, lupus erythematosus). Concurrent use with other potentially haemolytic drugs or depressants of myeloid elements of the bone marrow. Concomitant admin with mepacrine.</p>\r\n\r\n<p>&nbsp;</p>', '<p>Abdominal pain, gastric distress, nausea, vomiting; methaemoglobinaemia, haemolytic anaemia (in patients with G6PD deficiency), mild anaemia, leucocytosis; HTN, cardiac arrhythmias, prolonged QT interval on ECG, accommodation disturbance. Rarely, leucopenia, agranulocytosis.</p>', '<p><strong>Pregnancy&nbsp;</strong>Category C. Safe usage of this preparation in pregnancy has not been established. Primaquine is contraindicated in pregnant women. Even if a pregnant woman is G6PD normal, the fetus may not be.&nbsp;Animal data show toxicity to reproduction.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether Primaquine is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Primaquine, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>Patient with G6PD deficiency, NADH methaemoglobin reductase deficiency. Childn. Pregnancy and lactation.</p>', '<p>Symptoms of overdosage of Primaquine phosphate include abdominal cramps, vomiting, burning epigastric distress, central nervous system and cardiovascular disturbances, including cardiac arrhythmia and QT&nbsp;interval prolongation, cyanosis, methemoglobinemia, moderate leukocytosis or leukopenia, and anemia. The most striking symptoms are granulocytopenia and acute hemolytic anemia in G6PD deficient patients. Acute hemolysis occurs, but patients recover completely if the dosage is discontinued.</p>', '<p>Anti-malarial drugs.</p>', '<p>Store at 25&deg; C. Protect from light.</p>', NULL, '2022-03-16 04:42:38', '2022-03-16 04:42:38'),
(1261, 1261, '<p>The original multi-strain this probiotic product containing 14 strains of probiotics for everyday use.<br />\r\n<br />\r\nThis probiotic is a unique multispecies, multi-strain probiotic supplement with 14 strains of beneficial bacteria. This means that this probiotic can deliver high concentrations of beneficial bacteria to the colonisation sites in the gut- and therefore be able to help a more diverse range of digestive disorders.<br />\r\n<br />\r\nThe beneficial bacteria in this probiotic are cryoprotected&nbsp;during the freeze drying process, which gives two main benefits:</p>\r\n\r\n<ul>\r\n	<li>They are protected from the harsh acid environment of the stomach and are therefore able to colonise the full length of the gastrointestinal tract.</li>\r\n	<li>The process allows this probiotic to be stored at room temperature without the need for refrigeration.</li>\r\n</ul>\r\n\r\n<p>This probiotic can be used on a continuous basis or for a short period of time, e.g. when taking antibiotics.<br />\r\n<br />\r\nContains soya and milk, used in the fermentation process. Content of milk is at a level that would not affect lactose intolerant sufferers.</p>', NULL, '<ul>\r\n	<li>Take 1-2 capsules once or twice daily with food. If taking two or more capsules daily, you may wish to split the dose between two meals</li>\r\n	<li>This probiotic is a completely safe probiotic, has no contraindications and carries no risk of overdose</li>\r\n	<li>This probiotic&nbsp;probiotic capsules can be swallowed whole or pulled apart and the contents sprinkled on to food, or mixed in a drink.</li>\r\n</ul>\r\n\r\n<p>If you are taking antibiotics: Take 4 capsules daily, ideally at a different time of the day from the antibiotics<br />\r\nContinue taking for at least 2 weeks after completion of the antibiotic course.<br />\r\n<br />\r\nFor travellers:</p>\r\n\r\n<ul>\r\n	<li>2 weeks before travel follow guidelines for general use</li>\r\n	<li>During travel take 4 capsules daily</li>\r\n	<li>Continue to take for at least 2 weeks following the end of travel.</li>\r\n</ul>\r\n\r\n<p>Children under 12: Take 1/2 to 1 capsule once or twice daily with food. If you are taking any medications or have any medical conditions please consult your doctor before taking any food supplement.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Probiotic</p>', '<p>Keep sealed and store in cool, dry conditions.&nbsp; Can be stored at room temperature without the need for refrigeration. In high, ambient temperatures (25&deg;C+) air-conditioning or refrigeration would be cautionary to assist in maintaining shelf life. Total bacteria count viable until end of the shelf life.</p>', NULL, '2022-03-16 04:45:12', '2022-03-16 04:45:12'),
(1262, 1262, '<p>The drug is used to support digestive health in patients suffering from diarrhea. The drug restores gut flora and overcomes gut discomfort in individuals on an antibiotic regimen. It also improves IBS (Irritable Bowel Syndrome) related to abdominal pain and bloating.</p>', '<p>This is a unique freeze-dried probiotic blend of Bifidobacterium Lactis Bl-04, Bifidobacterium Lactis Bi-07, Lactobacillus Acidophilus NCFM and Lactobacillus Paracasei Lpc-37 that provides support to individuals who have high demands on their digestive tract or their immune system due to diarrhea, antibiotic use and stress. Extensive in vitro and in vivo studies support the health benefit of these strains. Has high tolerance to gastrointestinal conditions and strong adhesion to intestinal cell-lines. It has been found to restore and maintain microbiota after antibiotic use. Moreover, it also improves specific immune response.</p>', '<p>1 capsule daily with a meal or as recommended by the physician. In diarrhea and after antibiotic course the duration of the treatment should be 2-4 weeks and in IBS the duration should be 4-12 weeks. In children unable to swallow the capsule- the content of the capsule can be mixed in a glass with water, juice or normal milk to drink.</p>', '<p>There is no known drug interaction.</p>', '<p>The drug is contraindicated if patient has any hypersensitivity to it.</p>', '<p>Generally safe for most of the people but some may feel stomach gas and bloating.</p>', '<p>If pregnant or nursing, consult with your physician before using this product.</p>', '<p>Consult your physician before using the product if you are pregnant, nursing or trying to conceive.</p>', NULL, '<p>Probiotic.</p>', '<p>Do not store above 25&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-16 04:46:54', '2022-03-16 04:46:54'),
(1263, 1263, '<p>This is indicated for the management of gastrointestinal problems e.g. IBS, constipation, flatulence, indigestion, etc.</p>', '<p>The antimicrobial activity of probiotics is thought to be accounted for, in large part, by their ability to colonize the colon and reinforce the barrier function of the intestinal mucosa. In addition, some probiotics have been found to secrete antimicrobial substances known as bacteriocins. It reduced gastrointestinal pH through stimulation of lactic acid producing bacteria and provides a direct antagonistic action on GI pathogen. Lactobacillus acidophilus, Lactobacillus bulgaricus and Bifidobaterium, have also demonstrated antioxidative ability. Mechanisms include chelation of metal ions (iron, copper), scavenging of reactive oxygen species and reducing activity.</p>', '<p>Adults and children over six years of age: one capsule 2 to 3 times daily or as advised by a physician.</p>', NULL, '<p>Probiotics are contraindicated in those who are hypersensitive to any component of a probiotic-containing product.</p>', '<p>Probiotics are generally well tolerated.</p>', '<p>Should be used with caution or seek the advice of a healthcare professional before use.</p>', '<p>Probiotic</p>', NULL, NULL, '<p>Store below 15&deg;C, cool and dry place, away from direct sun light &amp; moisture. To maintain optimum shelf life and potency store in the refrigerator. Keep the medicine out of reach of children.</p>', NULL, '2022-03-16 04:48:13', '2022-03-16 04:48:13'),
(1264, 1264, '<p>It is indicated for the treatment or prevention of any infection caused by Penicillin sensitive bacteria where a long acting Penicillin is required. It is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Gonorrhoea caused by Penicillin sensitive microorganisns</li>\r\n	<li>Prevention of endocarditis during dental procedures</li>\r\n	<li>Gas-gangrene following amputation</li>\r\n</ul>', '<p>Benzylpenicillin has a bactericidal action against gram-positive bacteria, gram-&shy;negative cocci, some other gram-negative bacteria, spirochetes and actinomycetes. It inhibits final cross-linking stage of peptidoglycan production through binding and inactivation of transpeptidases on the inner surface of the bacterial cell membrane thus inhibiting bacterial cell wall synthesis. It is inhibited by penicillinase and other lactamases.<br />\r\n<br />\r\nInterferes with cell wall mucopeptide synthesis during active multiplication, resulting in bactericidal activity against susceptible microorganisms.</p>', '<p>Add 3 ml of water for injection and shake vigorously.<br />\r\n<br />\r\n<strong>Adults:</strong>&nbsp;4,00,000 units once daily or twice daily.<br />\r\n<strong>Children:</strong>&nbsp;Over 25 kg as for adults; under 25 kg reduce proportionally. In severe cases dose may be doubled.<br />\r\n<br />\r\nIntramuscular injection is the only route of administration of Procaine Penicillin.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>This&nbsp;should be injected IM into the buttocks, thigh, deltoid or triceps muscle. In case continuous injection is necessitated, the injection site should be changed every time.</p>', '<p>Potentially hazardous interactions: invitro Penicillin inactivates Amino- glycosides, so that they should not be mixed in infusion fluids.</p>', '<p>Hypersensitivity to penicillin.</p>', '<p>Allergic reactions may occur but usually resolve on cessation of therapy.</p>', '<p>Pregnancy&nbsp;Category B. Either animal-reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect that was not confirmed in controlled studies in women in the 1st trimester.</p>', '<p>Hypersensitivity to cephalosporins. Renal impairment. CHF. Infant. Elderly.</p>', NULL, '<p>Benzylpenicillin &amp; Phenoxymethyl penicillin.</p>', '<p>Store at room temperature.</p>', NULL, '2022-03-16 04:49:55', '2022-03-16 04:49:55'),
(1265, 1265, '<p>Prochlorperazine Maleate is indicated-</p>\r\n\r\n<ul>\r\n	<li>To control severe nausea and vomiting caused by radiation therapy, cancer chemotherapy, surgery, and other conditions.</li>\r\n	<li>Relieving nausea, vomiting, and attacks of dizziness or spinning sensations (vertigo) associated with Meniere&#39;s disease and other inner ear disorders.</li>\r\n	<li>For the treatment of psychotic illness such as schizophrenia (hallucinations and hostility).</li>\r\n	<li>Acute mania.</li>\r\n	<li>For the short-term treatment of generalized non-psychotic anxiety.</li>\r\n</ul>', '<p>Prochlorperazine is a dopamine &amp; histamine antagonist. The mechanism of antiemetic activity is due to the blockade of histamine H, &amp; dopamine D2 neurotransmitter receptors in the chemoreceptor trigger zone and vomiting centre. It also has a weak anticholinergic effect and prevents acid reflux by increasing the tone of the lower oesophageal sphincter.</p>', '<p><strong>Antiemetic</strong>-<br />\r\nChildren (not recommended in children &lt;10 kg or &lt;2 years):</p>\r\n\r\n<ul>\r\n	<li>10-14 kg: 2.5 mg every 12-24 hours as needed;maximum: 7.5 mg/day</li>\r\n	<li>15-18 kg: 2.5 mg every 8-12 hours as needed;maximum:10 mg/day</li>\r\n	<li>19-39 kg: 2.5 mg every 8 hours or 5 mg every 12 hours as needed; maximum: 15 mg/day.</li>\r\n</ul>\r\n\r\n<p>Adults: 5-10 mg 3-4 times/day;usual maximum:40 mg/day<br />\r\n<br />\r\n<strong>Antipsychotic</strong>-<br />\r\nChildren (not recommended in children &lt;10 kg or &lt;2 years):</p>\r\n\r\n<ul>\r\n	<li>2-12 years: 2.5 mg 2-3 times/day</li>\r\n	<li>Increase dosage as needed to a maximum daily dose of 20 mg for 2-5 years and 25 mg for 6-12 years</li>\r\n</ul>\r\n\r\n<p>Adults: 5-10 mg 3-4 times/day; doses up to 150 mg/day may be required in some patients for treatment of severe disturbances<br />\r\n<br />\r\n<strong>Nonpsychotic anxiety</strong>-</p>\r\n\r\n<ul>\r\n	<li>Adults: Usual dose: 15-20 mg/day in divided doses; do not give doses &gt;20 mg/day or for longer than 12 weeks</li>\r\n	<li>Elderly: Initial: 2.5-5 mg 1-2 times/day; increase dose at 4 to 7 day intervals by 2.5-5 mg/day; increase dosing intervals (twice daily, thrice daily, etc) as necessary to control response or side effects; maximum daily dose should probably not exceed 75 mg in elderly; gradual increases (titration) may prevent some side effects or decrease their severity.</li>\r\n</ul>\r\n\r\n<p>Prochlorperazine may be administered without regard to the meal.</p>', '<p>Alcohol, barbiturate &amp; other sedatives may increase the CNS depressant action. Some drugs like Antacids, antiparkinson&#39;s drug, lithium may interfere the absorption of Prochlorperazine. This drug may interfere with the plasma concentration of Propanolol and Phenobarbital.</p>', '<p>Hypersensitivity to prochlorperazine or any component of the formulation, severe CNS<br />\r\ndepression; coma; should not be used in children &lt;2 years of age or &lt;10 kg.</p>', '<p>Drowsiness; jaw, neck, and back muscle spasms; fine worm-like tongue movements; rhythmic face, mouth, or jaw movements; slow or difficult speech; difficulty swallowing; restlessness and pacing; tremors; shuffling walk; skin rash; yellowing of the skin or eyes.</p>', '<p>No evidence of adverse effects of this drug has been reported during pregnancy &amp; lactation.</p>', '<p>Caution should be taken while performing tasks that require alertness, such as driving or using machinery. The use of alcohol can cause extreme drowsiness. This medication may increase sensitivity to sunlight. Prolonged sun exposure should be avoided and sunscreen and protective clothing should be taken when anybody is exposed to the sun. This medication can reduce sweating making it more susceptible to heatstroke.</p>', '<p>Symptoms of overdose include deep sleep, coma, extrapyramidal symptoms, abnormal involuntary muscle movements, and hypotension.</p>', '<p>Anti vertigo drugs, Anti-emetic drugs</p>', '<p>Store below 30&deg;C.Protect from light and moisture. Keep out of the reach of children.</p>', NULL, '2022-03-16 04:51:44', '2022-03-16 04:51:44'),
(1266, 1266, '<p>Procyclidine is used for the adjunctive treatment of all forms of parkinsonian syndrome. It is mainly used for the symptomatic treatment of idiopathic (paralysis agitants), postencephalitic and arteriosclerotic parkinsonian. It is used to control troublesome extrapyramidal symptoms including pseudoparkinsonian, acute dystonic reactions and akathisia induced by neuroleptic drugs such as phenothiazine derivatives.</p>', '<p>Procyclidine hydrochloride is an antimuscarinic antiparkinsonian agent of relatively low toxicity. It is a synthetic tertiary amine. This drug exerts their antiparkinsonian effect by correcting the relative cholinergic excess which is thought to occur in parkinsonian as a result of dopamine deficiency. It is absorbed from G.I. tract and disappears rapidly from the tissues. After intravenous administration, it acts within 5 to 20 minutes and has a duration of effect up to 4 hours.</p>', '<p><strong>Tablet</strong>: This is administered orally, preferably after meals.</p>\r\n\r\n<ul>\r\n	<li><strong>Parkinsonism</strong>: Initially 2.5 mg 3 times a day, then 5 mg 3 times a day and occasionally 5 mg at bedtime. The dosage being adjusted as tolerated or until the total daily dose reaches 20 to 30 mg divided into 3 to 4 doses.</li>\r\n	<li><strong>Drug induced extrapyramidal symptom</strong>: Initially 2.5 mg 3 times a day. The dosage being increased by 2.5 mg increment per day as needed and tolerated.</li>\r\n</ul>\r\n\r\n<p><strong>IM or IV injection</strong>: 5-10 mg, repeated if necessary after 20 minutes; maximum 20 mg daily can be given.</p>', '<p>The anticholinergic activity of procyclidine may be increased by agents having anticholinergic amantadine. The absorption of ketoconazole may be reduced by concomitant administration of procyclidine.</p>', '<p>It should be given with caution in children and geriatric patients. It is advisable to be cautious in giving Procyclidine to patients with diarrhoea and cardiovascular disease, glaucoma, urinary retention, hepatic or renal impairment. The safety of using procyclidine during pregnancy has not been established. No data are available on the excretion of this drug in breast milk.</p>', '<p>At usual dosage levels dryness of the mouth is generally the only adverse effect. Mydriasis, blurred vision and adverse G.I. effects (nausea, vomiting, epigastric distress, constipation) occur occasionally. An allergic reaction (e.g. rash) or muscular weakness may occasionally occur. High doses may cause vertigo and possibly confusion and hallucination. Adverse effect may&nbsp;usually be minimized by adjustment of dosage and administration after meal.</p>', '<p>The safe use of this drug in pregnancy, lactation or in women of childbearing age requires that the potential benefits be weighed against the possible hazards to the mother and child.</p>', '<p>Precaution should be taken in case of hepatic &amp; renal impairment, children, elderly, pregnancy and lactation condition. Patients with mental disorders occasionally experience a precipitation of a psychotic episode when Procyclidine is administered for the treatment of the extrapyramidal side-effects of neuroleptic. Procyclidine should not be withdrawn abruptly as rebound Parkinsonism symptoms may occur.</p>', NULL, '<p>Antiparkinson drugs.</p>', '<p>Protect from light and moisture, store below 25&deg;C. Keep out of the reach of children.</p>', '<p><strong>Use in children</strong>: Safety and efficacy have not been established in the pediatric age group; therefore the use of Procyclidine hydrochloride is this group requires that the potential benefits be weighed against the possible hazards to children.</p>', '2022-03-16 04:53:36', '2022-03-16 04:53:36'),
(1267, 1267, '<p>Progesterone softgel capsule is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Maintenance of Pregnancy in cases of Threatened / Recurrent abortion.</li>\r\n	<li>Luteal support during IUI and ART procedures IVF-ET.</li>\r\n	<li>Luteal support in cases of proven luteal phase insufficiency.</li>\r\n	<li>Along with estrogen in post-menopausal hormone replacement therapy (HRT) either in sequential or in continuous regimen.</li>\r\n	<li>To prevent endometrial hyperplasia where endogenous estrogen is present.</li>\r\n	<li>As progesterone challenge test in secondary amenorrhoea.</li>\r\n	<li>For cycle control along with estrogen therapy.</li>\r\n	<li>Dysfunctional uterine bleeding (DUB)</li>\r\n	<li>Premenstrual tension.</li>\r\n	<li>Endometriosis.</li>\r\n	<li>Oocyte donation programme.</li>\r\n	<li>Benign mastopathy.</li>\r\n</ul>', '<p>Progesterone softgel capsule contains micronised progesterone, which is structurally and biologically identical to natural endogenous progesterone. Micronisation increases the bioavailability of progesterone. When micronised progesterone is administered after meals, maximal serum progesterone levels are significantly increased. Progesterone concentrations in the endometrial and breast tissue attain high level. Progesterone is approximately 96%-99% bound to serum proteins, primarily to serum albumin (50%-54%). Progesterone is metabolized to pregnanediols and pregnanolones in the liver. The glucuronide and sulfate conjugates of pregnanediol and pregnanolone are excreted in the bile and urine. Progesterone metabolites, which are excreted in bile, may undergo enterohepatic circulation.</p>', '<p><strong>The usual recommended dose</strong>: Progesterone 100mg/200mg 2 to 3 soft gel capsules daily by the oral or vaginal routes in divided doses. Flexible dosage regimen can be followed depending on the indication and requirements of patients.<br />\r\n<br />\r\n<strong>Maintenance of Pregnancy in cases of Threatened / Recurrent abortion</strong>: Progesterone 200 to 400 mg per day in divided doses.<br />\r\n<br />\r\n<strong>In-vitro fertilization and embryo transfer</strong>: Progesterone 200 mg thrice a day from the day of embryo transfer till pregnancy is confirmed. If pregnant, it is continued till 12th&nbsp;week of pregnancy.<br />\r\n<br />\r\n<strong>HRT</strong>: In sequential regimen: Progesterone 200mg daily for 12 days in last 2 weeks of each therapeutic cycle. In continuous regimen: Progesterone 100 mg daily throughout the month along with estrogen.<br />\r\n<br />\r\n<strong>Oocyte donation program</strong>: Progesterone 100mg twice daily from the day of transfer till pregnancy is confirmed. This may be increased to a maximum of 600 mg per day and continued till 12th&nbsp;week of pregnancy.<br />\r\n<br />\r\n<strong>Luteal support</strong>: Progesterone 100mg thrice a day from the 17th&nbsp;day of the cycle for 10 days in induced cycle. If pregnant, it is continued till 12th&nbsp;week of pregnancy.<br />\r\n<br />\r\n<strong>Luteal phase insufficiency</strong>: Progesterone 10mg thrice daily to be continued up to 12 weeks of pregnancy, increasing the dose by 100mg/day/week to a maximum of 600mg/day in divided doses if required.<br />\r\n<br />\r\n<strong>In secondary amenorrhoea</strong>: Progesterone 300mg for 10 days results in withdrawal bleeding in 80% of cases.<br />\r\n<br />\r\n<strong>Premenstrual syndrome</strong>: Progesterone 100-200mg daily for 10 days from 17th&nbsp;to 26th&nbsp;day of each menstrual cycle.<br />\r\n<br />\r\n<strong>Benign mastopathy</strong>: Progesterone 200-300 mg for 10 days per month, usually from 17th&nbsp;to 26th&nbsp;day of the monthly cycle.</p>', '<p>Ketoconazole inhibits the metabolism of progesterone.</p>', '<p>Hypersensitivity, hepatic dysfunction, undiagnosed vaginal bleeding, porphyria, cancers of uterus and genital organs, breast cancers, history of stroke or blood clots. It should not be used in a case of miscarriage and tissue left in the uterus.</p>', '<p>Progesterone is devoid of estrogenic, androgenic and mineralocorticoid effects. Mild somnolence and other CNS side effects like depression, breast tenderness and bloating are reported. Side effects are less when vaginal route is used.</p>', NULL, '<p>Severe renal insufficiency, diabetes mellitus, seizures, migraine, headache, heart diseases, depression.</p>', NULL, '<p>Drugs for menopausal symptoms: Hormone replacement therapy, Female Sex hormones, Oral Contraceptive preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-16 04:55:16', '2022-03-16 04:55:16'),
(1268, 1268, '<p>This gel contains a hormone called progesterone. When the gel is inserted into your vagina, the progesterone is slowly released into your bloodstream throughout the day. Progesterone is used to give you extra progesterone in the treatment of infertility due to incorrect levels of progesterone during the menstrual cycle or when you are having an assisted fertility procedure. This is to help you get pregnant. You may also be asked to continue using Progesterone to support your new pregnancy.</p>', NULL, '<p>Insert the contents of one applicator of Progesterone into your vagina each day, starting after your doctor tells you that you have ovulated, or on the 18 th -21 st day of your menstrual cycle. (The first day of your menstrual cycle is the day your period starts.)<br />\r\n<br />\r\nWhen used during in-vitro fertilisation, from the day of the embryo transfer, insert the contents of one applicator of Progesterone into your vagina each day, preferably in the morning. Once tests confirm that you are pregnant, you may be asked to keep using Progesterone to support your new pregnancy- for a total of 30 days.<br />\r\n<br />\r\nThe applicator is designed in such a way that an exact amount of gel (1.125 g, containing 90 mg progesterone) is delivered. It is expected that a small amount of gel will be left in the applicator. This can be thrown away as you will have received all of the medicine that you need.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p><strong>Getting your applicator ready</strong>: Grip the applicator by the thick end between your thumb and index finger. Face the thin end of the applicator down to the ground and shake the applicator down to move all the gel inside to the thin end. Grip the applicator by the flat part of the thick end. Twist off and remove the cap from the opposite thin end. To stop the gel from flowing out before use, do not press the air tank at the thick end at this stage.<br />\r\n<br />\r\n<strong>Inserting your applicator</strong>: Lean back or lie down with your knees bent and spread apart. Carefully insert the applicator well into your vagina, until your hand touches your body. Press the air tank at the thick end of the applicator firmly to deliver the gel from the applicator into your vagina.<br />\r\n<br />\r\n<strong>After using your applicator</strong>: Throw away the applicator, including the small amount of gel that is left inside. Use each applicator only once. Progesterone gel can stay in your vagina for several days. You may get a beige to brownish clumpy or cloudy white discharge during this time. This is nothing to worry about.</p>', '<p>Do not use Progesterone at the same time as any other medicines that are inserted into your vagina.</p>', '<ul>\r\n	<li>if you are allergic to the active substance or any of the other ingredients of this medicine.</li>\r\n	<li>if you have unexplained vaginal bleeding.</li>\r\n	<li>if you have porphyria (an inability to break down certain substances (porphyrins) in your blood that is passed down in families).</li>\r\n	<li>if you have or think you might have cancer in your breasts or genital organs.</li>\r\n	<li>if you have ever had a blood clot due to swollen veins (thrombophlebitis), a blocked blood vessel (thromboembolic disorder) or a stroke.</li>\r\n	<li>if you are pregnant but your baby has died inside of you (missed abortion).</li>\r\n</ul>', '<p>Common (may affect up to 1 in 10 people):</p>\r\n\r\n<ul>\r\n	<li>headache</li>\r\n	<li>feeling very tired</li>\r\n	<li>stomach or gut (gastro-intestinal) cramps</li>\r\n	<li>breast tenderness</li>\r\n</ul>', '<p>Progesterone is not normally used during pregnancy. However, if you used Progesterone to help you get pregnant, you may be asked to continue using it to support your new pregnancy. The use of Progesterone during breast-feeding is not recommended.</p>', '<p>Caution should be taken</p>\r\n\r\n<ul>\r\n	<li>if you have liver or kidney problems</li>\r\n	<li>if you have heart problems or diabetes</li>\r\n	<li>if you have asthma</li>\r\n	<li>if you have epilepsy or often get migraines</li>\r\n	<li>if you have ever had depression.</li>\r\n</ul>', NULL, '<p>Drugs for Infertility.</p>', '<p>Keep this medicine out of the sight and reach of children. Do not store above 25&deg;C. Use each applicator only once. Any gel left in the applicator must be thrown away. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.</p>', '<p>Progesterone&nbsp;is not for use in children or adolescents.</p>', '2022-03-16 04:57:21', '2022-03-16 04:57:21'),
(1269, 1269, '<p>Micronized Progesterone is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Luteal phase support as part of an Assisted Reproductive Technology (ART) treatment for women.</li>\r\n	<li>Treatment of premenstrual syndrome, including premenstrual tension and depression.</li>\r\n	<li>Treatment of puerperal depression.</li>\r\n</ul>', '<p>Micronized Progesterone Vaginal Pessary is structurally and biologically identical to natural endogenous progesterone.</p>\r\n\r\n<ul>\r\n	<li><strong>Absorption</strong>: Vaginal administration of Progesterone 400 mg every 12 h in healthy women has been shown effective in rapidly achieving and maintaining serum progesterone concentrations at physiological levels appropriate to the mid-luteal phase of the ovarian cycle and early pregnancy.</li>\r\n	<li><strong>Distribution</strong>: Progesterone is approximately 96 % to 99 % bound to serum proteins, primarily to serum albumin and corticosteroid binding globulin.</li>\r\n	<li><strong>Biotransformation</strong>: Progesterone is metabolized primarily by the liver largely to pregnanediols and pregnanolones. Pregnanediols and pregnanolones are conjugated in the liver to glucuronide and sulfate metabolites. Progesterone metabolites that are excreted in the bile may be deconjugated and may be further metabolized in the gut via reduction, dehydroxylation and epimerization.</li>\r\n	<li><strong>Elimination</strong>: Progesterone undergoes renal and biliary elimination.</li>\r\n</ul>', '<p><strong>For luteal phase support as part of an ART treatment</strong>: 400 mg administered vaginally twice a day starting at oocyte retrieval. The administration of Progesterone should be continued for 38 days, if pregnancy has been confirmed.<br />\r\n<br />\r\n<strong>For maintenance of Pregnancy in cases of Threatened or recurrent abortion</strong>: 200 to 400 mg per day in divided doses.<br />\r\n<br />\r\n<strong>For the treatment of premenstrual syndrome and puerperal depression</strong>: 200 mg daily to 400mg twice a day, by vaginal or rectal insertion. For premenstrual syndrome commence treatment on day 14 of menstrual cycle and continue treatment until onset of menstruation. If symptoms are present at ovulation commence treatment on day 12.</p>', '<p>Drugs known to induce the hepatic cytochrome-P450-3A4 system (e.g. rifampicin, carbamazepine or phenytoin) may increase the elimination rate and thereby decrease the bioavailability of progesterone. The effect of concomitant vaginal products on the exposure of progesterone from Micronized Progesterone has not been assessed and is therefore not recommended.</p>', '<ul>\r\n	<li>Hypersensitivity to the active substance or to any of the excipients</li>\r\n	<li>Undiagnosed vaginal bleeding</li>\r\n	<li>Known or suspected progesterone sensitive malignant tumors Porphyria</li>\r\n	<li>Severe hepatic dysfunction or disease</li>\r\n	<li>Known missed abortion or ectopic pregnancy</li>\r\n	<li>Active arterial or venous thromboembolism or severe thrombophlebitis or a history of these events</li>\r\n</ul>', '<p>Micronized Progesterone is devoid of estrogenic, androgenic and mineralocorticoid effects. Mild somnolence and other CNS side effects like depression, breast tenderness and bloating are reported. Side effects are less when vaginal route is used.</p>', NULL, '<p>Micronized Progesterone is not indicated in threatened miscarriage. Treatment should be discontinued in the event of a missed miscarriage. Micronized Progesterone should be discontinued if any of the following conditions are suspected: Myocardial infarction, cerebrovascular disorders, arterial or venous thromboembolism (venous thromboembolism or pulmonary embolism), thrombophlebitis or retinal thrombosis.</p>', NULL, '<p>Corticosteroid, Other Topical corticosteroids</p>', '<p>Keep in a cool (below 30&deg;C), dry and dark place. Keep out of the reach of children.</p>', '<p><strong>Renal impaired patient</strong>: There is no experience with the use of Progesterone in patients with impaired liver or renal function.<br />\r\n<br />\r\n<strong>Pediatric population</strong>: There is no relevant use of Progesterone in the pediatric population.<br />\r\n<br />\r\n<strong>Elderly</strong>: No clinical data have been collected in patients over age 65.</p>', '2022-03-16 04:59:10', '2022-03-16 04:59:10');
