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
(541, 541, '<p>Hormone replacement therapy (HRT) for the treatment of:</p>\r\n\r\n<ul>\r\n	<li>Climacteric syndrome in postmenopausal women including vasomotor symptoms (such.as hot flushes and sweating attacks), sleep disorders, depressed moods, nervousness and atrophic, urogenital conditions caused by deficient endogenous estrogen production due to natural menopause, hypogonadism, castration or primary ovarian failure in women with an intact uterus.</li>\r\n	<li>Prevention of postmenopausal osteoporosis.</li>\r\n</ul>', '<p>173-estradiol, which is chemically and biologically identical to endogenous human E2, and the synthetic progestogen, DRSP. 173-estradiol provides hormone replacement during and after the climacteric. The addition of DRSP helps to provide bleeding control and opposes the development of endometrial hyperplasia caused by estrogens.<br />\r\n<br />\r\nEffects of estradiol: The loss of the ovarian function, accompanied by a depletion of estrogen and progesterone production, leads to the menopausal syndrome, characterized by vasomotor and organic symptoms. Hormone replacement therapy is indicated to eliminate these complaints. Of all physiological estrogens, E2 is the most potent one with the highest affinity to the estrogen receptor. Estrogen target organs include, in particular, uterus, hypothalamus, pituitary, vagina, breast, bones (osteoclasts).<br />\r\n<br />\r\nOther effects of estrogens include reduction of insulin and blood glucose concentrations local vasoactive effects mediated by receptors, and receptor-independent effects on vascular smooth muscle. Estrogen receptors have been identified in the heart and coronary arteries. Oral administration of natural estrogens is advantageous in certain cases of hypercholesterolemia in order to maximize beneficial metabolic liver effects on lipids.</p>', '<p><strong>How to start</strong>: Women who do not take estrogens or women who change from a continuous combination product may start treatment at any time. Women changing from a continuous sequential or cyclic HRT should complete the current cycle of therapy before initiating this therapy.<br />\r\n<br />\r\n<strong>Dosage</strong>: One tablet is taken daily.<br />\r\n<br />\r\n<strong>Missed tablets</strong>: In case a tablet is forgotten, it should be taken as soon as possible. If more than 24 hours have elapsed, no extra tablet needs to be taken. If several tablets are forgotten, bleeding may occur</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Each pack covers 28 days of treatment. Treatments continuous, which means that the next pack follows immediately without a break. The tablets are to be swallowed whole with some liquid irrespective of food intake. The tablets should preferably be taken at the same time every day. For the treatment of postmenopausal symptoms, the lowest effective dose should be used. For initiation and continuation of treatment of postmenopausal symptoms, the lowest effective dose for the shortest duration should be used.</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>', '<p>An increased clearance of sex hormones due to hepatic enzyme induction may reduce the clinical efficacy of the drug and eventually cause irregular bleeding. Such hepatic enzyme-inducing properties have been established for hydantoins, barbiturates, primidone, carbamazepine, and rifampicin and are also suspected for oxcarbazepine, topiramate, felbamate and griseofulvin. The mechanism of this interaction appears to be based on the hepatic enzyme-inducing properties of these drugs. Maximal enzyme induction is generally not seen for 2-3 weeks but may then be sustained for at least 4 weeks after the cessation of drug therapy. In rare cases reduced E2 levels have been observed under the simultaneous use of certain antibiotics (e.g. penicillins and tetracycline).<br />\r\nThe main metabolites of DRSP are generated without involvement of the cytochrome P450 system. Inhibitors of this enzyme system are therefore unlikely to influence the metabolism of DRSP. Nevertheless, inhibitors of&#39;CYP3A4, like cimetidine, ketoconazole and others, may inhibit the metabolism of E2.</p>\r\n\r\n<ul>\r\n	<li>Interaction with alcohol</li>\r\n	<li>Acute alcohol ingestion during use of HRT may lead to elevations</li>\r\n	<li>Known or suspected premalignant conditions or malignancies, if sex steroid-influenced</li>\r\n	<li>Presence or history of liver tumors (benign or malignant)</li>\r\n	<li>Severe hepatic disease</li>\r\n	<li>Presence or history of severe renal disease as long as renal function values have not returned to normal</li>\r\n	<li>Acute arterial thromboembolism (e.g. myocardialinfarction, stroke)</li>\r\n	<li>Active deep venous thrombosis,thromboembolic disorders,or a documented history of these conditions</li>\r\n	<li>A high risk of venous or arterial thrombosis</li>\r\n	<li>Severe hypertriglyceridemia</li>\r\n	<li>Pregnancy or lactation (see section 4.6 Pregnancy and lactation)</li>\r\n	<li>Hypersensitivity to the active substances or to any of the excipients</li>\r\n</ul>', '<p>Hormone replacement therapy (HRT) should not be started in the presence of any of the conditions listed below. The product should be stopped immediately, if any of the conditions appear during HRT use.</p>\r\n\r\n<ul>\r\n	<li>Undiagnosed abnormal genital bleeding</li>\r\n	<li>Known or suspected cancer of the breast</li>\r\n	<li>Known or suspected premalignant conditions or malignancies, if sex steroid-influenced</li>\r\n</ul>\r\n\r\n<p>The excess risk disappears within a few years after stopping HRT. HRT increases the density of mammographic images which may adversely affect the radiological detection of breast cancer in some cases.<br />\r\n<br />\r\nEndometrial cancer: Prolonged exposure to unopposed estrogens increases the risk of development of endometrial hyperplasia or carcinoma. The addition of DRSP opposes the development of endometrial hyperplasia caused by estrogens.<br />\r\n<br />\r\nLiver tumors: In rare cases benign, and even more rarely, malignant liver tumors have been observed after the use of hormonal substances such as those contained in HRT products. In isolated cases, these tumors led to life-threatening intra-abdominal hemorrhage.</p>', '<p>The most commonly reported adverse drug reactions (ADRs) with Ethinylestradiol &amp; Drospirenone are breast pain, female genital tract bleeding and gastrointestinal and abdominal pains. They occur in &gt;6% of users. Bleeding irregularities usually subside during continued treatment. The frequency of bleeding decreases with the duration of treatment. Serious adverse reactions are arterial and venous thromboembolic events as well as breast cancer</p>', '<p>Ethinylestradiol &amp; Drospirenone must not be used during pregnancy and lactation. If pregnancy occurs during medication with Ethinylestradiol &amp; Drospirenone, treatment must be discontinued immediately. Small amounts of DRSP are excreted with the milk.</p>', '<p>Before initiating therapy, all conditions/risk factors mentioned below should be considered when determining the individual benefit/risk of treatment for the patient. During HRT use, therapy should be discontinued immediately in case a contraindication is discovered, as well as in the following situations:</p>\r\n\r\n<ul>\r\n	<li>Migrainous or frequent and unusually severe headaches that occur for the first time or other symptoms that are possible prodromal of cerebrovascular occlusion.</li>\r\n	<li>Recurrence of cholestatic jaundice or cholestatic pruritus which occurred first during pregnancy or previous use of sex steroids.</li>\r\n	<li>Symptoms of a thrombotic event.</li>\r\n</ul>\r\n\r\n<p>In the event of new onset or deterioration of the following conditions or risk factors, the individual benefit/risk analysis should be re-done, taking into consideration the possible necessity of discontinuing therapy. The potential for an increased synergistic risk of thrombosis should be considered in women who possess a combination of risk factors or exhibit a greater severity of an individual risk factor. This increased risk may be greater than a simple cumulative risk of the factors. HRT should not be prescribed in case of a negative risk benefit assessment.<br />\r\n<br />\r\nVenous thromboembolism: Both randomized-controlled and epidemiological studies have suggested an increased relative risk of developing venous thromboembolism (VTE), i.e. deep venous thrombosis or pulmonary embolism. Benefit/Risk should therefore be carefully weighed in consultation with the patient when prescribing HRT to women with a risk factor for VIE. Generally recognized risk factors for VTE include a personal history, a family history (the occurrence of VTE in a direct relative at a relatively early age may indicate genetic disposition) and severe obesity. The risk of VTE also increases with age. There is no consensus about the possible role of varicose veins in VTE. The risk of VTE may be temporarily increased with prolonged immobilization, major elective or post-traumatic surgery, or major trauma. Depending on the nature of the event and the duration of the immobilization, consideration should be given to a temporary discontinuation of HRT.</p>', '<p>Acute toxicity studies indicate that, even in the case of inadvertent intake of a multiple of the therapeutic dose, no acute toxicity risk is to be expected. In clinical studies up to 100 mg of DRSP and estrogen/ progestogen preparations containing 4 mg E2 were well tolerated.</p>', '<p>Drugs for menopausal symptoms: Hormone replacement therapy</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Children and adolescents</strong>: This is not indicated for use in children and adolescents.<br />\r\n<br />\r\n<strong>Geriatric patients</strong>: There are no data suggesting a need for dosage adjustment in elderly patients.<br />\r\n<br />\r\n<strong>Patients with hepatic impairment</strong>: In women with mild or moderate hepatic impairment, DRSP is well tolerated. This is<br />\r\ncontraindicated in women with severe hepatic disease<br />\r\n<br />\r\n<strong>Patients with renal impairment</strong>: In women with mild or moderate renal impairment, a slight increase of DRSP exposure was observed but is not expected to be of clinical relevance. This is contraindicated in women with severe renal disease.</p>', '2022-02-21 23:27:36', '2022-06-12 00:59:20'),
(542, 542, '<p><strong>Oral Contraceptive</strong>: This is indicated for use by women to prevent pregnancy.<br />\r\n<br />\r\n<strong>Premenstrual Dysphoric Disorder (PMDD)</strong>: This contraceptive preparation is also indicated for the treatment of symptoms of premenstrual dysphoric disorder (PMDD) in women who choose to use an oral contraceptive as their method of contraception. The effectiveness of This contraceptive preparation for PMDD when used for more than three menstrual cycles has not been evaluated. The essential features of PMDD according to the Diagnostic and Statistical Manual-4th edition (DSM-IV) include markedly depressed mood, anxiety or tension, affective lability, and persistent anger or irritability. Other features include decreased interest in usual activities, difficulty concentrating, lack of energy, change in appetite or sleep, and feeling out of control. Physical symptoms associated with PMDD include breast tenderness, headache, joint and muscle pain, bloating and weight gain. In this disorder, these symptoms occur regularly during the luteal phase and remit within a few days following onset of menses; the disturbance markedly interferes with work or school, or with usual social activities and relationships with others. Diagnosis is made by healthcare providers according to DSM-IV criteria, with symptomatology assessed prospectively over at least two menstrual cycles. In making the diagnosis, care should be taken to rule out other cyclical mood disorders. This contraceptive preparation has not been evaluated for the treatment of premenstrual syndrome (PMS).<br />\r\n<br />\r\n<strong>Acne</strong>: This is indicated for the treatment of moderate acne vulgaris in women at least 14 years of age, who have no known contraindications to oral contraceptive therapy and have achieved menarche. This contraceptive preparation should be used for the treatment of acne only if the patient desires an oral contraceptive for birth control.<br />\r\n<br />\r\n<strong>Folate Supplementation</strong>: This contraceptive preparation is indicated in women who choose to use an oral contraceptive as their method of contraception, to raise folate levels for the purpose of reducing the risk of a neural tube defect in a pregnancy conceived while taking the product or shortly after discontinuing the product.</p>', NULL, '<p><strong>How to Take this contraceptive pill</strong>: Take one tablet by mouth at the same time every day. The failure rate may increase when pills are missed or taken incorrectly. To achieve maximum contraceptive and PMDD effectiveness, this contraceptive pill must be taken as directed, in the order directed on the blister pack. Single missed pills should be taken as soon as remembered.<br />\r\n<br />\r\n<strong>How to Start this contraceptive pill</strong>: Instruct the patient to begin taking this contraceptive pill either on the first day of her menstrual period (Day 1 Start) or on the first Sunday after the onset of her menstrual period (Sunday Start).<br />\r\n<br />\r\n<strong>Day 1 Start</strong>: During the first cycle of this contraceptive pill use, instruct the patient to take one pink contraceptive pill daily, beginning on Day 1 of her menstrual cycle. (The first day of menstruation is Day 1.) She should take one pink contraceptive pill daily for 24 consecutive days, followed by one light orange tablet daily on Days 25 through 28. this contraceptive pill should be taken in the order directed on the package at the same time each day, preferably after the evening meal or at bedtime with some liquid, as needed. this contraceptive pill can be taken without regard to meals. If this contraceptive pill is first taken later than the first day of the menstrual cycle, this contraceptive pill should not be considered effective as a contraceptive until after the first 7 consecutive days of product administration. Instruct the patient to use a non-hormonal contraceptive as backup during the first 7 days. The possibility of ovulation and conception prior to initiation of medication should be considered.<br />\r\n<br />\r\n<strong>Sunday Start</strong>: During the first cycle of this contraceptive pill use, instruct the patient to take one pink contraceptive pill daily, beginning on the first Sunday after the onset of her menstrual period. She should take one pink contraceptive pill daily for 24 consecutive days, followed by one light orange tablet daily on Days 25 through 28. this contraceptive pill should be taken in the order directed on the package at the same time each day, preferably after the evening meal or at bedtime with some liquid, as needed. this contraceptive pill can be taken without regard to meals. this contraceptive pill should not be considered effective as a contraceptive until after the first 7 consecutive days of product administration. Instruct the patient to use a non-hormonal contraceptive as backup during the first 7 days. The possibility of ovulation and conception prior to initiation of medication should be considered.<br />\r\n<br />\r\nThe patient should begin her next and all subsequent 28-day regimens of this contraceptive pill on the same day of the week that she began her first regimen, following the same schedule. She should begin taking her pink tablets on the next day after ingestion of the last light orange folate tablet, regardless of whether or not a menstrual period has occurred or is still in progress. Anytime a subsequent cycle of this contraceptive pill is started later than the day following administration of the last light orange tablet, the patient should use another method of contraception until she has taken a pink contraceptive pill daily for seven consecutive days.<br />\r\n<br />\r\n<strong>When switching from a different birth control pill</strong>: When switching from another birth control pill, this contraceptive pill should be started on the same day that a new pack of the previous oral contraceptive would have been started.</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>', '<p>Drugs or herbal products that induce certain enzymes (for example, CYP3A4) may decrease the effectiveness of COCs or increase breakthrough bleeding. Counsel patients to use a back-up or alternative method of contraception when enzyme inducers are used with COCs.</p>', '<ul>\r\n	<li>Renal impairment</li>\r\n	<li>Adrenal insufficiency</li>\r\n	<li>A high risk of arterial or venous thrombotic diseases</li>\r\n	<li>Undiagnosed abnormal uterine bleeding</li>\r\n	<li>Breast cancer or other estrogen- or progestin-sensitive cancer</li>\r\n	<li>Liver tumors or liver disease</li>\r\n	<li>Pregnancy</li>\r\n</ul>', '<p>The most frequent adverse reactions (&ge; 2%) in contraception, acne and folate clinical trials are headache/migraine (5.9%), menstrual irregularities (4.1%), nausea/vomiting (3.5%) and breast pain/tenderness (3.2%). The most frequent adverse reactions (&ge; 2%) in PMDD clinical trials are menstrual irregularities (24.9%), nausea (15.8%), headache (13.0%), breast tenderness (10.5%), fatigue (4.2%), irritability (2.8%), decreased libido (2.8%), increased weight (2.5%), and affect lability (2.1%)</p>', '<p>Nursing mothers: Not recommended; can decrease milk production.</p>', '<p><strong>Vascular risks</strong>: Stop this contraceptive pill if a thrombotic event occurs. Stop at least 4 weeks before and through 2 weeks after major surgery. Start no earlier than 4 weeks after delivery, in women who are not breastfeeding. COCs containing DRSP may be associated with a higher risk of venous thromboembolism (VTE) than COCs containing levonorgestrel or some other progestins. Before initiating this contraceptive pill in a new COC user or a woman who is switching from a contraceptive that does not contain DRSP, consider the risks and benefits of a DRSP-containing COC in light of her risk of a VTE.<br />\r\n<br />\r\n<strong>Hyperkalemia</strong>: DRSP has antimineralocorticoid activity. Do not use in patients predisposed to hyperkalemia. Check serum potassium concentration during the first treatment cycle in women on long-term treatment with medications that may increase serum potassium concentration.<br />\r\n<br />\r\n<strong>Liver disease</strong>: Discontinue this contraceptive pill if jaundice occurs.<br />\r\n<br />\r\n<strong>High blood pressur</strong>e: Do not prescribe this contraceptive pill for women with uncontrolled hypertension or hypertension with vascular disease.<br />\r\n<br />\r\n<strong>Carbohydrate and lipid metabolic effects</strong>: Monitor prediabetic and diabetic women taking this contraceptive pill. Consider an alternate contraceptive method for women with uncontrolled dyslipidemia.<br />\r\n<br />\r\n<strong>Headache</strong>: Evaluate significant change in headaches and discontinue this contraceptive pill if indicated.<br />\r\n<br />\r\n<strong>Uterine bleeding</strong>: Evaluate irregular bleeding or amenorrhea</p>', NULL, '<p>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, '2022-02-21 23:28:26', '2022-06-12 01:01:37'),
(543, 543, '<p>This pill is indicated for the prevention of pregnancy.</p>', '<p>This contains two active ingredients, Gestodene and Ethinylestradiol. Ethinylestradiol is a synthetic version of oestrogen and Gestodene is a synthetic form of progesterone. If this tablet is taken according to instructions the egg cells (normally released by the ovary each month) are prevented from maturing to the point where they can be fertilized. Secondary mechanisms, which may contribute to the effectiveness of Gestop 28 as a contraceptive, include changes in the cervical mucus (which increase the difficulty of sperm penetration) and changes in the endometrium (which reduce the likelihood of implantation).</p>', '<p><strong>How to Take this pill</strong>: To achieve maximum contraceptive effectiveness, Gestodene &amp; Ehinylestradiol must be taken in the order directed on the package and at intervals not exceeding 24 hours. Women should be instructed to take the tablets at about the same time every day, preferably after the evening meal or at bedtime. One tablet is to be taken daily for 28 consecutive days. Each subsequent pack is started on the day after the current pack is completed.&nbsp;</p>\r\n\r\n<ul>\r\n	<li>If you have decided to take Gestodene &amp; Ehinylestradiol for contraception, wait for your next menstruation begins.</li>\r\n	<li>From the first day of your menstruation, start taking the first white tablet from the left corner of the top row (with arrow mark indicating begin) of your Gestodene &amp; Ehinylestradiol tablet pack.</li>\r\n	<li>Continue taking one white tablet each day along the arrow mark.&nbsp;</li>\r\n	<li>After taking 21 white tablets for 21 days, then continue taking the light red placebo tablet every day from the last row in the pack for next 7 days.</li>\r\n	<li>It is most likely that your menstruation will start while taking the light red inactive tablets. Do not discontinue taking the light red inactive tablets. Taking of the light red tablets for 7 days will help you keep your tablet taking routine. If your menstruation does not start during this time, check with your doctor to make sure you are not pregnant.</li>\r\n	<li>After completing the seven light red inactive tablets, start taking white active tablets from another Gestodene &amp; Ehinylestradiol pack and continue taking the tablet as long as you don&#39;t want to be pregnant.</li>\r\n</ul>\r\n\r\n<p><strong>Management of Missed Tablets</strong>: If you forgot to take a tablet one day, take the missed tablet as soon as you remember. This may mean taking two tablets the very next day. Additionally you should use some other method of contraception while you are taking the tablets &amp; until your next menstruation.&nbsp;</p>\r\n\r\n<p>If you forget to take the tablets for two continuous days, then it is likely that you will no longer be protected against pregnancy. You should therefore discontinue taking the tablet and adopt some other temporary methods (condom/foam tablet) till your next menstruation. Discard the unfinished pack of tablets and start taking tablets from the very first white tablet of the top row from a fresh pack from the first day of next menstruation.&nbsp;</p>\r\n\r\n<p><strong>How to Delay a Period</strong>: To delay a period you should continue with another new pack of Gestodene &amp; Ehinylestradiol just after finishing the white active tablet of the present pack (that is no need to take light redplacebo tablet of present pack). The extension can be carried on for as long as wished until the end of the second pack. When you wish your period to begin, just stop tablet taking. While using the second pack woman may have some breakthrough bleeding or spotting. Start with your next pack after the usual 7 day light red inactive tablet interval.</p>\r\n\r\n<p><strong>Advice in Case of Vomiting</strong>: If vomiting occurs within 3-4 hours after white active tablet taking, absorption may not be complete. In such an event, the advice concerning Management of Missed Tablets is applicable. The woman must take the extra active tablet(s) needed from a back up pack after vomiting.</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>', '<ul>\r\n	<li>Interactions between ethinyloestradiol and other drugs may lead to decreased or increased ethinyloestradiol concentrations, respectively. Decreased ethinyloestradiol serum concentrations may cause an increased incidence of breakthrough bleeding and menstrual irregularities and may possibly reduce efficacy of the oral contraceptive. Example of substances that may decrease serum ethinyloestradiol concentrations include rifampicin, phenytoin, primidone, rifabutin, dexamethasone, griseofulvin, topiramate, some protease inhibitors, modafinil, ritonavir and barbiturates.</li>\r\n	<li>Certain antibiotics including ampicillin, other penicillins and tetracyclines may reduce the efficacy of oral contraceptives.</li>\r\n	<li>During concomitant use of Gestodene &amp; Ehinylestradiol &amp; other drugs that may lead to decreased ethinyloestradiol serum concentrations, it is recommended that a non hormonal back-up method of contraception to be used in addition to the regular intake of this pill.</li>\r\n</ul>', NULL, '<p>At the initial stage some women may experience side-effects like dizziness, headache, nausea, diarrhea, abdominal pain, weight gain, fluid retension, depression, mood changes, breast pain, breast tenderness, rash, vaginal discharge, erythema etc. If taken regularly, such types of side-effects normally lessen with time. If she continues to have the side effects beyond 2-3 months, she could consult with a doctor</p>', '<p><strong>Use during pregnancy</strong>: The administration of this pill is contraindicated during pregnancy.&nbsp;<br />\r\n<br />\r\n<strong>Use during lactation</strong>: The use of this pill during breast-feeding is not recommended.</p>', '<p>Some medications may interfere with the efficacy of the tablet. Contact your doctor if you are taking any drugs, such as antibiotics, rifampicin or medicines for seizures. You may have to use another method of contraception during this time.</p>', '<p>Symptoms of oral contraceptive overdosage in adults and children may include nausea, vomiting, breast tenderness, dizziness, abdominal pain, drowsiness, fatigue; withdrawal bleeding may occur in females. There is no specific antidote and further treatment of overdose, if necessary, is directed to the symptoms.</p>', '<p>Oral Contraceptive preparations</p>', '<p>Store in a cool, dry place. Keep away from light &amp; out of reach of children.</p>', NULL, '2022-02-21 23:29:22', '2022-06-16 00:27:33'),
(544, 544, '<p>This pill is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Inhibit Ovulation</li>\r\n	<li>Inhibit sperm to enter into the uterus by condensing uterine mucus</li>\r\n	<li>Inhibit fertilized egg to accept by uterus by protecting the growth of membrane inside the uterus</li>\r\n	<li>It reduces the movement of sperm by minimizing normal movement of fallopian tube. So sperms die as it takes long time to come into contact of Ova</li>\r\n</ul>\r\n\r\n<p>This pill is Suitable for:</p>\r\n\r\n<ul>\r\n	<li>Women aged between 15-69 years (except smoker and who use tobacco regularly)</li>\r\n	<li>Women who want an effective, temporary contraceptive method</li>\r\n	<li>Women who is suffering from anemia due to excessive blood loss during menstruation</li>\r\n	<li>Women having irregular menstruation cycle</li>\r\n	<li>Breastfeeding mother (if child age is more than 6 months).</li>\r\n</ul>', '<p>This pill is an effective, temporary and short term birth control management for women. This tablet contains two hormones, Levonorgestrel and Ethinyl Estradiol. Every single strip contains 28 tablets from which 21 tablets contains hormone and 7 tablets contains Iron. Combination oral contraceptives lower the risk of becoming pregnant primarily by suppressing ovulation. Other possible mechanism may include cervical mucus changes that inhibit sperm penetration and endometrial changes that reduce the likelihood of implantation.</p>', '<p>One should start taking this tablet from the first day of menstruation. It can be starts any day in first 5 days of menstruation. One tablet should be taken same time of each day with food, but best time is after dinner or before sleeping at night. Start your dose with one white tablet each day for 3 (three) weeks. After that, take one brown color tablet each day for 7(seven) days. If menstruation starts while taking brown color tablet, don&rsquo;t stop the medicine. If not pregnant is confirmed then dose can be start from any day of menstruation, but after menstruation must have to use condom during sexual intercourse for next 7 (seven) days. When 7(seven) brown tablet finished, either menstruation starts or not, start the dose from beginning with white Tablet.<br />\r\n<br />\r\nIf forget to take tablet for a day, one should take the tablet as soon as patient noticed it, and take another tablet as the dose of present day. If forget to take the tablet for consecutive two days, then this contraceptive will not work. However, to maintain the date of menstruation cycle one should take two tablets at a time as soon as patient noticed it.</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>', '<p><strong>With medicine</strong>: Drugs or herbal products that induce certain enzymes, including CYP3A4 may decrease the effectiveness of COCs or increase breakthrough bleeding. Counsel patients to use a back-up method or alternative method of contraception when enzyme inducers are used with COCs.<br />\r\n<br />\r\n<strong>With food and other</strong>: It is recommended to avoid caffeine, dairy foods, phytic acid containing food while taking the drug.</p>', '<p>Contraindicated in case of known hypersensitivity to any of the components of this product.</p>', '<p>Common: Headache, nausea, mood changes including depression, vaginal infections, irregular vaginal bleeding, pain and discomfort. Rare: liver tumors, jaundice, high blood pressure &amp; gallbladder problem.</p>', '<p>This pill is contraindicated in pregnancy. Discontinue this pill if pregnancy occurs. Combined hormonal contraceptives (CHCs) and/or metabolites are present in human milk and in breast-fed infants. CHCs including this pill can reduce milk production in breastfeeding females.</p>', '<ul>\r\n	<li>Thrombotic disorder and other vascular problems: Stops this pill if a thrombotic disorder occurs. Stop at least 4 weeks before through 2 weeks after major surgery. Start no earlier than 4 weeks after delivery in women who are not breastfeeding</li>\r\n	<li>Liver disease: Discontinue this pill if jaundice occurs</li>\r\n	<li>High blood pressure: If used in women with well-controlled hypertension, monitor blood pressure and stop this pill if blood pressure rises significantly</li>\r\n	<li>Carbohydrate and lipid metabolic effects: Monitor prediabetic and diabetic women taking this pill. Consider an alternative contraceptive method for women with uncontrolled dyslipidemia</li>\r\n	<li>Headache: Evaluate significant change in headaches and discontinue this pill if indicated</li>\r\n	<li>Bleeding irregularities and amenorrhea: Evaluate irregular bleeding or amenorrhea</li>\r\n</ul>', '<p>There have been no reports of serious illness effects from overdose of oral contraceptives including ingestion by children. Over dosage may cause withdrawal bleeding in females and nausea.</p>', '<p>Oral Contraceptive preparations</p>', '<p>Store below 30&deg;C, protected from light &amp; moisture. Keep all medicines out of reach of children.</p>', '<p>Safety and efficacy of this pill have been established in women of reproductive age. Efficacy is expected to be the same in post-pubertal adolescents under the age of 18 years as for users 18 years and older. Use of this product before menarche is not indicated.</p>', '2022-02-21 23:30:18', '2022-06-16 00:31:40'),
(545, 545, '<p>লাইনেসট্রেনল ও ইথিনাইল এস্ট্রাডিয়েল একটি কম্বাইন্ড গর্ভনিরোধক পিল যা খাওয়ার গর্ভনিরোধক হিসাবে নির্দেশিত।</p>', '<p>প্রতিদিন যথাসম্ভব একই সময়ে নির্দেশ অনুযায়ী পিল খেতে হবে। আপনার মাসিক শুরুর প্রথম দিনই পিল খেতে শুরু করবেন। মাসিকের ২-৫ দিনের ভিতরে যে কোন দিন পিল খাওয়া শুরু করা যায় , কিন্তু সেইক্ষেত্রে প্রথম মাসে পিল খাওয়াকালীন প্রথম সাত দিন কনডম ব্যবহার করা উচিত। প্রতিদিন ১ টি করে , পর পর ২২ দিন পিল খাবেন। ৬ দিনের পিল মুক্ত সময়ের পর পরবর্তী নতুন প্যাকেট থেকে পিল খাওয়া শুরু করবেন ।<br />\r\n<br />\r\nএই ৬ দিনের ভিতরেই আপনার মাসিক হবে যা কখনো কখনো পরবর্তী প্যাকেট শুরুর আগে পর্যন্ত চলতে পারে। মাসিক চলতে থাকলেও এই পিল&nbsp;এর পরবর্তী প্যাকেট সপ্তম দিনে আরম্ভ করুন। আপনি যত দিন সন্তান না চাইবেন , ততদিন এই নিয়মে পিল খাওয়া চালিয়ে যাবেন।</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>', NULL, '<p>অ্যাম্পিসিলিন, টেট্রাসাইক্লিন, বারবিচুরেটস, হাইড্যান্টয়েনস, প্রিমিডন, কার্বামাজেপিন ও রিফামপিসিন এই জাতীয় কিছু কিছু ঔষধ পিলের কার্যকারিতা কমিয়ে দিতে পারে। পিল খাওয়াকালীন সময়ে যদি আরও কোন ঔষধ কোন কারনে খাওয়ার প্রয়োজন পড়ে তাহলে অবশ্যই ডাক্তারের সাথে পরামর্শ করুন।</p>', '<p>যে সব ক্ষেত্রে আপনি কম্বাইন্ড গর্ভনিরোধক ব্যবহার করতে পারবেন না-</p>\r\n\r\n<ul>\r\n	<li>ভেনাস থ্রম্বসিস বর্তমানে উপস্থিত অথবা পূর্বে ছিল</li>\r\n	<li>কার্ডিওভাসকুলার অ্যাক্সিডেন্ট ও মায়োকার্ডিয়াল ইনফারকশন অথবা ব্যাধির পূর্ব লক্ষণ</li>\r\n	<li>ডায়াবেটিস মেলিটাসের সঙ্গে সংবহণ নালী সংক্রান্ত লক্ষণ থাকলে</li>\r\n	<li>মারাত্মক রকমের উচ্চ রক্তচাপ</li>\r\n	<li>সিভিয়ার ডিসলিপোপ্রোটিনেমিয়া</li>\r\n	<li>জন্মগত অথবা অন্য কোন ভাবে ভেনাস অথবা আর্টারিয়াল থ্রম্বসিসের প্রবণতা থাকলে</li>\r\n	<li>জনন অঙ্গসমূহ, স্তন অথবা লিভারে ম্যালিগন্যান্ট অবস্থার কথা জানা থাকলে অথবা সন্দেহ করলে</li>\r\n	<li>লিভারের জটিল রোগ থাকলে এমনকি লিভার ফাংশন স্বাভাবিক অবস্থায় ফিরে আসতে ব্যর্থ হওয়ার পূর্ব বিবরন থাকলে</li>\r\n	<li>অজ্ঞাত কারণে ভ্যাজাইনাল ব্লিডিং হলে</li>\r\n	<li>এই পিলের যে কোন উপাদানে অতি সংবেদনশীলতা থাকলে</li>\r\n</ul>', '<p>প্রাথমিক পর্যায়ে কারও কারও সাময়িক কিছু পার্শ্ব প্রতিক্রিয়া যেমন মাথা ব্যাথা, মাথা ঘোরা, বমি বমি ভাব অথবা পিল খাওয়াকালীন সময়ে সামান্য ফোটা ফোঁটা আকারে মাসিক হতে পারে। কিন্তু নিয়মিত পিল খেতে থাকলে স্বাভাবিকভাবেই এই সমস্ত উপসর্গ দুই থেকে তিন মাসের মধ্যে দূরীভূত হয়ে যাবে। এই সকল উপসর্গের জন্য অতিরিক্ত চিন্তিত হবার কোন কারণ নাই। তবে পার্শ্ব প্রতিক্রিয়া যদি আরও বেশি দিন চলতে থাকে তখন অবশ্যই ডাক্তারের পরামর্শ নিতে হবে।</p>', '<p>গর্ভধারণ করলে অথবা এ ব্যাপারে সন্দেহ দেখা দিলে কম্বাইন্ড গর্ভনিরোধক ব্যবহার করতে পারবেন না।</p>', '<p>যদি নির্দিষ্ট সময়ে পিল না খাওয়া হয় এবং যদি ১২ ঘন্টা অতিক্রম না করে তা হলে পিলের কার্যক্ষমতা বজায় থাকে। এক্ষেত্রে যখনই মনে পড়বে তখনই পিলটি খেয়ে নিন এবং পরের পিল গুলি সঠিক সময়ে খাবেন।<br />\r\n<br />\r\nযদি ১২ ঘন্টার বেশী সময় পার হয় তবে পিলের কার্যক্ষমতা কমে যায়। তখন আপনাকে নিম্নলিখিত নিয়ম পালন করতে হবে। মনে রাখবেন ১ম ও ৩য় সপ্তাহে যে কোন দিন পিল খেতে ভুলে গেলে বিশেষ সতর্কতার প্রয়োজন। অন্যথায় গর্ভধারনের ঝুঁকি বেশি হতে পারে।<br />\r\n<br />\r\nপ্রথম সপ্তাহে পিল খেতে ভুলে গেলে এবং ভুলে যাওয়ার আগে ঐ সন্তাহে যৌন মিলন করে থাকলে&nbsp; ডাক্তারের পরামর্শ নিন । যদি যৌন মিলন না করে থাকেন তাহলেঃ</p>\r\n\r\n<ul>\r\n	<li>ভুলে যাওয়া ট্যাবলেটটি খান</li>\r\n	<li>সাতদিন অতিরিক্ত সাবধানতা গ্রহন করুন</li>\r\n	<li>প্যাক শেষ করুন</li>\r\n</ul>\r\n\r\n<p>দ্বিতীয় সপ্তাহে পিল খেতে ভুলে গেলেঃ</p>\r\n\r\n<ul>\r\n	<li>ভুলে যাওয়া ট্যাবলেটটি খান</li>\r\n	<li>প্যাক শেষ করুন</li>\r\n</ul>\r\n\r\n<p>তৃতীয় সপ্তাহে পিল খেতে ভুলে গেলেঃ</p>\r\n\r\n<ul>\r\n	<li>ভুলে যাওয়া ট্যাবলেটটি খান</li>\r\n	<li>প্যাক শেষ করুন</li>\r\n	<li>ট্যাবলেটহীন বিরতি বাদ দিন</li>\r\n	<li>পরবর্তী প্যাক শুরু করুন</li>\r\n</ul>\r\n\r\n<p>অথবা</p>\r\n\r\n<ul>\r\n	<li>বর্তমান প্যাক বন্ধ করুন</li>\r\n	<li>ট্যাবলেটহীন বিরতি পালন করুন</li>\r\n	<li>ভুলে যাওয়া ট্যাবলেটের দিনসহ ৬ দিনের বেশি নয়</li>\r\n	<li>পরবর্তী প্যাক শুরু করুন</li>\r\n</ul>\r\n\r\n<p>প্যাকের একাধিক পিল ভুলে গেলে অবশ্যই ডাক্তারের পরামর্শ নিতে হবে। আপনি যদি প্যাকের পিল খেতে ভুলে যান এবং প্রথম পিল মুক্ত দিনে আপনার মাসিক না হয় তবে আপনি গর্ভবতী হতে পারেন। পরবর্তী প্যাক আরম্ভের আগে ডাক্তারের পরামর্শ নিন।<br />\r\n<br />\r\nসতর্কতাঃ<br />\r\n<br />\r\nঅন্যান্য শারীরিক অবস্থা, যার জন্য সংবহনগত সমস্যা দেখা দিতে পারে, কিন্তু কম্বাইন্ড গর্ভনিরোধক ব্যবহারের সঙ্গে কোন সম্পর্ক নাই এই সকল ক্ষেত্রে অবশ্যই সতর্কতার প্রয়োজন। যেমন- ডায়াবেটিস মেলিটাস, সিষ্টেমিক লুপাস এরিথমেটোসাস, হিমোলাইটিক ইউরেমিক সিনড্রোম, পেটের নাড়িতে দীর্ঘস্থায়ী প্রদাহ ইত্যাদি এই সকল ক্ষেত্রে অবশ্যই সতর্কতার প্রয়োজন আছে। ঘন ঘন মাইগ্রেন দেখা দেওয়া, টিউমার, লিভারের কার্যকারিতার দীর্ঘদিনের সমস্যা এই সকল ক্ষেত্রেও সতর্কতার প্রয়োজন। বাচ্চাকে বুকের দুধ দিচ্ছেন এমন মহিলাদেরও সতর্কতার প্রয়োজন কারণ কম্বাইন্ড গর্ভনিরোধক পিল বুকের দুধের পরিমান এবং গুনগতমানের পরিবর্তন করতে পারে। ডায়াবেটিক আছে এমন মহিলারা খাওয়ার কম্বাইন্ড গর্ভনিরোধক ব্যবহারকালে বিশেষ করে যখন খাওয়া শুরু করবেন, তখন সতর্কতার প্রয়োজন। যে সব মহিলার ক্ষেত্রে ক্লোয়েসমা গ্রাভিডেরামের পূর্ব বিবরণ রয়েছে তারা চড়া রোদ উপেক্ষা করবেন।<br />\r\n<br />\r\nকম্বাইন্ড গর্ভনিরোধক পিল ব্যবহারকারীদের নিম্নলিখিত অনাকাঙ্খিত সমস্যাসমূহ, যেমন স্তনের স্পর্শকাতরতা, মাথাধরা, মাইগ্রেন, কন্টাক্টলেন্সে অস্বস্তিবোধ হওয়া, ত্বকের বিভিন্ন সমস্যা, ইডিমা, শারীরিক ওজনের পরিবর্তন ইত্যাদি দেখা দিলে ডাক্তারের পরামর্শ নিন।</p>', NULL, '<p>Oral Contraceptive preparations</p>', '<p>আলো থেকে দূরে, ২&deg;C-২৫&deg;C তাপমাত্রায় শুষ্ক স্থানে রাখুন। শিশুদের নাগালের বাইরে রাখুন।</p>', NULL, '2022-02-21 23:30:58', '2022-06-16 00:34:07'),
(546, 546, '<p>লাইনেসট্রেনল ও ইথিনাইল এস্ট্রাডিয়েল একটি কম্বাইন্ড গর্ভনিরোধক পিল যা খাওয়ার গর্ভনিরোধক হিসাবে নির্দেশিত।</p>', NULL, '<p>মাসিক শুরু হওয়ার প্রথম দিনেই প্রথম প্যাকেটের প্রথম ট্যাবলেটটি খেতে হবে। ব্রান্ড বদল করে অন্য ব্রান্ডের খাওয়ার গর্ভনিরোধক ব্যবহারের বেলায়ও একই পদ্ধতি অনুসরণ করতে হবে। &nbsp;২২ দিনের এক দিনও ছেদ না ঘটিয়ে প্রতিদিন একই সময়ে একটি করে বড়ি খেতে &nbsp;হবে। &nbsp;বাকি ৬ দিন হল ট্যাবলেট-মুক্ত সময়। বড়ি মুক্ত সময়ের মেয়াদ ওই ৬ দিন শেষ হওয়ার পর পরবর্তী প্যাকেটে ট্যাবলেট খাওয়া শুরু করতে হবে।</p>\r\n\r\n<p>আপনি যদি বর্তমানে কোন ট্যাবলেট না খানঃ</p>\r\n\r\n<ul>\r\n	<li>পরবর্তী মাসিক শুরু হওয়া পর্যন্ত অপেক্ষা করুন।&nbsp; মাসিক শুরুর প্রথম দিন হতে প্যাকেটের উপরের সারি থেকে নির্দিষ্ট দিন চিহ্নিত প্রথম এই&nbsp;ট্যাবলেট খাওয়া শুরু করুন, যেমন আপনার মাসিক যদি বুধবার শুরু হয় তাহলে প্যাকেটের উপরের সারি থেকে বুধবার চিহ্নিত ট্যাবলেটটি খান । &nbsp;একই নিয়মে প্রতিদিন একই সময়ে তীর চিহ্ন অনুসরণ করে ১ টি করে ট্যাবলেট খেয়ে ২২ টি ট্যাবলেট খাওয়া শেষ করুন। মনে রাখবেন আপনার মাসিকের প্রথম দিন থেকে ট্যাবলেট খাওয়া শুরু করলে এবং কোন ট্যাবলেট খাওয়া ভুলে না গেলে আপনাকে অতিরিক্ত কোন সতর্কতামূলক জন্মনিরোধক ব্যবস্থা গ্রহণ করতে হবেনা ।</li>\r\n	<li>আপনার মাসিকের যদি ইতিমধ্যে ৫ দিন অতিক্রান্ত হয়ে যায় তাহলে মাসিক শুরুর দিনকে প্রথম দিন হিসাব করে পঞ্চম দিন থেকে প্রথম ট্যাবলেট খাওয়া শুরু করুন । এই ৫ দিনের মধ্যে মাসিকের নিঃসরণ বন্ধ হয়ে গেলেও কোন অসুবিধা নাই । তীর চিহ্ন অনুসরণ করে পুরা প্যাকেটের ট্যাবলেট (১ নং পয়েন্টে বর্ণিত নিয়মানুযায়ী) খাওয়া শেষ করুন । &nbsp;এই ক্ষেত্রে ট্যাবলেট গ্রহনের প্রথম ১৪ দিন আপনার সঙ্গীকে অবশ্যই অতিরিক্ত সতর্কতামূলক জন্ম নিরোধক ব্যবস্থা (যেমন- কনডম) ব্যবহার করতে হবে ।</li>\r\n	<li>যদি আপনার মাসিক ৫ দিনের বেশী সময় আগে শুরু হয়ে থাকে সেক্ষেত্রে আপনাকে এই&nbsp;ট্যাবলেট গ্রহনের জন্য পরবর্তী মাসিক শুরু হওয়া পর্যন্ত অপেক্ষা করতে হবে।</li>\r\n</ul>\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>', NULL, '<ul>\r\n	<li>কার্ডিওভাসকুলার ব্যাধি, যেমন- থ্রোম্বফ্লেবাইতিস ও থ্রোম্বএম্বলিক প্রসেস অথবা অতীতে এসব অবস্থার সৃষ্টি হলে।</li>\r\n	<li>মারাত্মক রকমের উচ্চ রক্তচাপ।</li>\r\n	<li>লিভারের মারাত্মক রকমের রোগ অথবা যদি পরীক্ষায় দেখা যায় লিভার ফাংশন স্বাভাবিক অবস্থায় ফিরে আসতে ব্যর্থ হয়েছিল এমন পূর্ব বিবরণ জানা থাকলে, কোলেস্ট্যাটিক জন্ডিস; গর্ভাবস্থায় জন্ডিস অথবা স্টেরয়েড ব্যবহারের ফলে জন্ডিসের পূর্ব বিবরণ থাকলে; রোটোর সিনড্রোম ও ডুবিন-জনসন সিনড্রোম।</li>\r\n	<li>এস্ট্রোজেন-নির্ভর টিউমার থাকলে অথবা সন্দেহ করলে।&nbsp;</li>\r\n	<li>এন্ডোমেট্রিয়াল হাইপারপ্লাসিয়া।</li>\r\n	<li>অজ্ঞাত কারণে ভ্যাজাইনাল রক্তস্রাব হলে।</li>\r\n	<li>পোরফাইরিয়া।</li>\r\n	<li>হাইপার লাইপোপ্রোটিনামিয়া, বিশেষ করে কার্ডিওভাসকুলার রোগের সম্ভাবনা বাড়িয়ে দিতে পারে এমন রিস্ক ফ্যাক্টরের উপস্থিতিতে।</li>\r\n	<li>গর্ভাবস্থায় বা তার আগে সিভিয়ার প্রুরাইটাসে অথবা হারপেস জেসটেশনাইটিস-এ স্টেরয়েড ব্যবহারের পূর্ব বিবরণ থাকলে।</li>\r\n	<li>আপনার বয়স যদি ৩৫ বছরের বেশী হয় এবং আপনি যদি ধুমপায়ী হন তাহলে এই পিল খেতে আপনাকে অবশ্যই ধুমপান পরিহার করতে হবে।</li>\r\n</ul>', '<p>প্রাথমিক পর্যায়ে কারও কারও সাময়িক কিছু পার্শ্ব প্রতিক্রিয়া যেমন, মাথা ব্যাথা, বমি বমি ভাব, ওজন বৃদ্ধি, মানসিকতার পরিবর্তন, স্তনে ব্যাথা, উচ্চ রক্তচাপ, ধমনীতে রক্ত জমাট বাধা, যকৃত এবং বৃক্কের কার্যক্ষমতার অসুবিধা ইত্যাদি হতে পারে।</p>', '<p>গর্ভাবস্থায় ইহা ব্যবহার করা যাবে না।</p>', '<p>আপনি যদি এক বা একাধিক ট্যাবলেট খাওয়া ভুলে যানঃ<br />\r\n<br />\r\nযদি নির্দিষ্ট সময়ে ট্যাবলেট খাওয়া না হয় এবং ১২ ঘন্টা অতিক্রম না করে তাহলে যখনই মনে পড়বে তখনই ভুলে যাওয়া ট্যাবলেটটি খেয়ে নিন। &nbsp;পরবর্তী ট্যাবলেট গুলি নিয়মানুযায়ী সঠিক সময়ে খাবেন। এই ক্ষেত্রে ট্যাবলেটের পূর্ণ কার্যক্ষমতা বজায় থাকবে। যদি ১২ ঘন্টার বেশী সময় পার হয় তবে ট্যাবলেটের কার্যক্ষমতা কমে যায়। এক্ষেত্রে পরবর্তী দিন আপনাকে দুটি ট্যাবলেট খেতে হবে। প্রথম ভুলে যাওয়া ট্যাবলেটটি যখন মনে পড়বে তখনই খাবেন এবং অপরটি নিয়মানুযায়ী দিনের নির্দিষ্ট সময়ে খাবেন। &nbsp;পুরা প্যাকেটের ট্যাবলেট নিয়ম মত খাওয়া শেষ করুন। &nbsp;এক্ষেত্রে পরবর্তী ১৪ দিন অথবা আপনার পরবর্তী মাসিকের শুরু, যেটা সর্বাধিক সেই পর্যন্ত আপনার সঙ্গীকে অবশ্যই অতিরিক্ত সতর্কতামূলক জন্ম নিরোধক ব্যবস্থা (যেমন-কনডম) ব্যবহার করতে হবে।</p>', NULL, '<p>Oral Contraceptive preparations</p>', '<p>আলো থেকে দূরে, ২&deg;C-৩০&deg;C তাপমাত্রায় শুষ্ক স্থানে রাখুন। শিশুদের নাগালের বাইরে রাখুন। অতিরিক্ত শুষ্ক , ঠান্ডা এবং আলোবিহীন স্থানে সংরক্ষণ করুন।</p>', NULL, '2022-02-21 23:33:47', '2022-06-16 00:38:09'),
(547, 547, '<p>Ethosuximide is indicated for the control of absence (petit mal)&nbsp;epilepsy.</p>', '<p>Ethosuximide suppresses the paroxysmal three cycle per second spike and wave activity associated with lapses of consciousness which is common in absence (petit mal) seizures. The frequency of epileptiform attacks is reduced, apparently by&nbsp;depression&nbsp;of the motor cortex and elevation of the threshold of the&nbsp;central nervous system&nbsp;to convulsive stimuli.</p>', '<p>Ethosuximide is administered by the oral route. The initial dose for patients 3 to 6 years of age is 250 mg per day; for patients 6 years of age and older, 500 mg per day. The dose thereafter must be individualized according to the patient&#39;s response. Dosage should be increased by small increments. One useful method is to increase the daily dose by 250 mg every four to seven days until control is achieved with minimal side effects. Dosages exceeding 1.5 g daily, in divided doses, should be administered only under the strictest supervision of the physician. The&nbsp;optimal&nbsp;dose for most&nbsp;pediatric&nbsp;patients is 20 mg/kg/day. This dose has given average&nbsp;plasma&nbsp;levels within the acceptedtherapeutic range of 40 to 100 mcg/mL. Subsequent dose schedules can be based on effectiveness and plasma level determinations.<br />\r\n<br />\r\nEthosuximide may be administered in combination with other anticonvulsants when other forms of epilepsy coexist with absence (petit mal). The&nbsp;optimal&nbsp;dose for most pediatric patients is 20 mg/kg/day.</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>', '<p>Isoniazid may increase the serum concentration of ethosuximide, leading to toxicity. Antipsychotics, antidepressants, MAOIs, and mefloquine may antagonise anticonvulsant effects of ethosuximide. Plasma conc of ethosuximide may be reduced by carbamazepine, phenobarbital, phenytoin, and primidone; and affected by valproate. Chloroquine or hydroxychloroquine may increase risk of convulsions. Isoniazid.</p>', '<p>Hypersensitivity. Pregnancy and lactation.</p>', '<p>Blood toxicities and disorders; headache, fatigue, lethargy, drowsiness, dizziness, ataxia, hiccup and mild euphoria; more rarely, psychotic states, rashes, hepatic and renal changes, and haematological disorders. SLE, erythema multiforme. Gum hypertrophy, swelling of tongue, irritability, hyperactivity, sleep disturbances, night terrors, inability to concentrate, aggressiveness, increased libido, myopia, vag bleeding.</p>', '<p><strong>Category C</strong>: 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>Hepatic or renal impairment, porphyria. Complete blood cell count, liver function tests, and urinalysis should be performed periodically. May increase the risk of grand mal seizures when used alone in mixed types of epilepsy. Avoid sudden withdrawal. May impair ability to drive or operate machinery.</p>', NULL, '<p>Primary anti-epileptic drugs</p>', NULL, NULL, '2022-02-21 23:34:08', '2022-06-16 00:45:08'),
(548, 548, '<p>For the disinfection of clean and intact skin. For pre-operative surgical hand disinfection, hand disinfection on the ward prior to aseptic procedures or after handling contaminated materials. For disinfection of the patients&rsquo; skin prior to surgery or other invasive procedures</p>', '<p>Glycerol: used as humectant, but other emollients may be used for skin care, provided that they are cheap, widely available and miscible in water and alcohol and do not add to toxicity, or promote allergy.<br />\r\n<br />\r\nHydrogen peroxide: used to inactivate contaminating bacterial spores in the solution and is not an active substance for hand antisepsis.<br />\r\n<br />\r\nAny further additive to both formulations should be clearly labelled and be non-toxic in case of accidental ingestion.<br />\r\n<br />\r\nA colorant may be added to allow differentiation from other fluids, but should not add to toxicity, promote allergy, or interfere with antimicrobial properties. The addition of perfumes or dyes is not recommended due to risk of allergic reactions.</p>', '<p>As required</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>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Bleaching and Disinfectants</p>', '<p>Should be stored in cool and dry place</p>', NULL, '2022-02-21 23:34:53', '2022-06-16 00:46:45'),
(549, 549, '<p>This cream acts against dengue, chikungunya, zika, malaria, and filariasis. It protects up to 8 hours. Ethyl Butylacetylaminopropionate is used for over 30 years.</p>', '<p>Ethyl butylacetylaminopropionate (trade name IR3535) is an insect repellent. As ethyl butylacetylaminopropionate is solely a repellent, it has no killing action and does not give rise to selection pressure or development of resistance. It is a colorless and almost odorless oil and is intended to be applied to the skin of humans and animals. It has a broad efficacy against various insects like mosquitoes, ticks, lice, and other bugs. Ethyl butylacetylaminopropionate is safe for use on infants, pregnant and breastfeeding women. It is biodegradable and completely degraded in the environment within a very short time.</p>', '<p>Apply liberally on exposed areas of the body as often as needed. For best results, reapply every 8 hours.</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>Precautions &amp; Warnings</p>', NULL, NULL, NULL, NULL, '<p>Do not apply to eyes, lips, mouth, cuts, and wounds, or irritated skin. This is for external use only.</p>', NULL, '<p>Miscellaneous topical agents</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-21 23:35:33', '2022-06-16 00:48:04');
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
(550, 550, '<p>Etodolac is indicated-</p>\r\n\r\n<ul>\r\n	<li>For acute and long-term use in the management of signs and symptoms: Osteoarthritis,&nbsp;Rheumatoid arthritis</li>\r\n	<li>For the management of acute pain</li>\r\n	<li>Acute gout</li>\r\n</ul>', '<p>Similar to other NSAIDs, the anti-inflammatory effects of etodolac result from inhibition of the enzyme cycooxygenase (COX). This decreases the synthesis of peripheral prostaglandins involved in mediating inflammation. Etodolac binds to the upper portion of the COX enzyme active site and prevents its substrate, arachidonic acid, from entering the active site. Etodolac was previously thought to be a non-selective COX inhibitor, but it is now known to be 5-50 times more selective for COX-2 than COX-1. Antipyresis may occur by central action on the hypothalamus, resulting in peripheral dilation, increased cutaneous blood flow, and subsequent heat loss.</p>', '<p>Adults and over 18 years:</p>\r\n\r\n<ul>\r\n	<li>Etodolac 300 mg capsule: 600 mg daily in 1-2 divided doses</li>\r\n	<li>Etodolac 600 mg ER tablet: Once daily</li>\r\n</ul>\r\n\r\n<p>Pediatric: Safety and effectiveness in pediatric patients below the age of 18 years have not been established.</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>', '<p>Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors. This interaction should be given consideration in patients taking NSAIDs concomitantly with ACE-inhibitors. When Etodolac is administered with Aspirin, its protein binding is reduced, although the clearance of free Etodolac is not altered. The clinical significance of this interaction is not known; however, as with other NSAIDs, concomitant administration of Etodolac and Aspirin is not generally recommended because of the potential of increased adverse effects.</p>', '<p>Etodolac is contraindicated in patients with known hypersensitivity to Etodolac. Etodolac should not be given to patients who have experienced asthma, urticaria or other allergic type reactions after taking Aspirin or other NSAIDs.</p>', '<p>The common side effects of Etodolac involve the gastrointestinal system. It can cause abdominal pain, constipation, diarrhea, dyspepsia, flatulence, heartburn, nausea, Gl ulcers, vomiting. Other events including abnormal renal function, anemia, dizziness, edema, elevated liver enzymes, headaches, increased bleeding time, pruritis, rashes, tinnitus etc.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. It should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Etodolac is excreted in human milk. 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>Etodolac should be given with caution in patients with severe hepatic reactions, pre existing asthma, fluid retention, hypertension or heart failure. If clinical sings and symptoms consistent with liver disease develop, or if systemic manifestations occur (e.g. eosinophilia, rash etc.), it should be discontinued.</p>', '<p>Symptoms following acute NSAID overdose are usually limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain which are generally reversible with supportive care.</p>', '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-02-21 23:35:47', '2022-06-16 00:50:29'),
(551, 551, '<p>Small Cell Lung Cancer: Etoposide Capsules in combination with other approved chemotherapeutic agents as first line treatment in patients with small cell lung cancer.<br />\r\n<br />\r\nEtoposide is also indicated in Testicular cancer,&nbsp;Small cell lung cancer</p>', '<p>Etoposide is a derivative of podophyllotoxin that inhibits DNA synthesis resulting in the arrest of the cell cycle. At low doses, it inhibits cells from entering cell cycle and at high doses, cells entering mitosis are lysed.</p>', '<p>Intravenous (Adult)-</p>\r\n\r\n<p><strong>Small cell lung cancer</strong>:&nbsp;35 mg/m2/day for 4 days to 50 mg/m2/day for 5 days. May repeat course at 3-4 wkly intervals after recovery from any toxicity. Inj must be diluted with 5% dextrose or normal saline to give a final concentration of 0.2-0.4 mg/ml and injected over 30-60 minutes. When given via oral capsules: the recommended dose is twice the IV dose rounded to the nearest 50 mg.<br />\r\n<br />\r\n<strong>Testicular cancer</strong>:&nbsp;For combination therapy: 50-100 mg/m2/day from days 1-5, or 100 mg/m2&nbsp;on days 1, 3 and 5. May repeat course at 3-4 wkly intervals after recovery from any toxicity. Inj must be diluted with 5% dextrose or normal saline to give a final concentration of 0.2-0.4 mg/ml and injected over 30-60 minutes.</p>\r\n\r\n<p>Oral (Adult)-</p>\r\n\r\n<p><strong>Small cell lung cancer</strong>:&nbsp;Twice the IV dose, rounded to the nearest 50 mg.</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>', '<p>Synergism with other cytotoxic drugs. Caution when admin with drugs that inhibit phosphatase activity. Cyclosporin A may reduce the clearance of etoposide.</p>', '<p>Hypersensitivity, pregnancy, lactation.</p>', '<p>Leukopenia, Nausea and Vomiting, Thrombocytopenia, Alopecia, Anorexia, Diarrhea, Leukopenia, Anemia, Pancytopenia, Stomatitis, Hepatic toxicity, Type 1 hypersensitivity, Orthostatic hypotension, Peripheral neuropathy<br />\r\n<br />\r\nMalaise,Shivering,Asthenia,Fever,Mucous membrane inflammation, Hyperuricemia, Local soft tissue toxicity has been reported following extravasation;</p>', '<p>Pregnancy category D.&nbsp;There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.<br />\r\n<br />\r\nLactation: not known if excreted in breast milk, discontinue drug or do not nurse</p>', '<p>Skin reactions may occur with accidental exposure; renal or hepatic disease. Periodic CBCs should be done before, during and after therapy. Increased risk of etoposide-toxicity in patients with low serum albumin. Acrylic material has been shown to crack and leak when used with undiluted etoposide inj.</p>', NULL, '<p>Cytotoxic Chemotherapy</p>', NULL, '<p>Renal impairment: CrCI: 15-50 ml/min- 75% of the recommended dose.</p>', '2022-02-21 23:36:24', '2022-06-16 00:52:51'),
(552, 552, '<p>Dental cavities, Tooth decay, Bad breath, Dental plaque, Gingivitis</p>', '<p><strong>Eucalyptol&nbsp;</strong>is a natural organic compound which is a colorless liquid. It is a cyclic ether and a monoterpenoid.&nbsp;Eucalyptol&nbsp;is an ingredient in many brands of mouthwash and cough suppressant. It controls airway mucus hypersecretion and asthma via anti-inflammatory cytokine inhibition.<br />\r\n<br />\r\n<strong>Menthol:&nbsp;</strong>It provides cooling sensation by stimulation of cooling receptor and gives local anesthetic action<br />\r\n<br />\r\n<strong>Methyl Salicylate</strong>: It penetrates and reaches at high concentration in pain regions and inhibit the prostaglandin synthesis and relieves pain effectively<br />\r\n<br />\r\n<strong>Thymol</strong>, one of the chemicals in&nbsp;thyme, is used with another chemical, chlorhexidine, as a dental varnish to prevent&nbsp;tooth decay. In foods,&nbsp;thyme&nbsp;is used as a&nbsp;flavoring agent. In manufacturing, red&nbsp;thyme&nbsp;oil is used in perfumes. It is also used in soaps, cosmetics, and toothpastes.<br />\r\n<br />\r\n<strong>Fluoride salts</strong>&nbsp;are often added to municipal drinking water (as well as certain food products in some countries) for the purposes of maintaining dental health. The fluoride enhances the strength of teeth by the formation of&nbsp;fluorapatite, a naturally occurring component of&nbsp;tooth enamel. Toothpaste&nbsp;often contains sodium fluoride to prevent&nbsp;cavities, although&nbsp;tin(II) fluoride&nbsp;is generally considered superior for this application.</p>', '<p><strong>Adults and children 6 years of age and older</strong>: Rinse full strength for 1 minute with 10 ml in morning and night. Do not swallow.<br />\r\n<br />\r\n<strong>Children under 6 years of age</strong>: Consult a dentist or doctor.</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>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity</p>', '<p>Local irritation of mouth, nausea &amp; vomiting.</p>', '<p>Pregnancy Category: Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Do not swallow. It is not indicated below 12 years of age. Do not rinse, eat, or smoke for thirty minutes after using a mouthwash. Doing so will diminish the effects of the mouthwash.</p>', NULL, '<p>Oral preparations</p>', '<p>Store in a cool &amp; dry place. Keep out of reach of children. Cold weather may cloud this product but its antiseptic &amp; anticavity properties are not affected.</p>', NULL, '2022-02-21 23:37:23', '2022-06-16 00:55:36'),
(553, 553, '<p>Eucalypytol, Menthol &amp; Thymol mouthwash is indicated for Gingivitis, Oral hygiene, Cavities, Bad breath, Plaque, Gum disease, Teeth cleaner &amp; brighter.</p>', NULL, '<p>Rinse with 20 ml Antiseptic Mouthwash for 30 seconds, twice daily (morning and evening). Then rinse with water. Do not swallow. Not indicated below 12 years of age.</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>', NULL, '<p>Hypersensitivity</p>', '<p>Do not rinse, eat, or smoke for thirty minutes after using a mouthwash. Doing so will diminish the effects of the mouthwash.</p>', '<p>FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Do not swallow. It is not indicated below 12 years of age. Keep out of the reach of&nbsp;children. Keep in a cool and dry palace. Do not use if cap seal is broken</p>', NULL, '<p>Topical Analgesics, Topical anti-inflammatory preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-21 23:37:51', '2022-06-16 00:57:45'),
(554, 554, '<p>Everolimus is indicated in advanced Hormone Receptor-Positive, HER2-Negative Breast Cancer (Advanced HR+ BC),&nbsp;Advanced Neuroendocrine Tumors (NET);&nbsp;Advanced Renal Cell Carcinoma (RCC);&nbsp;Renal Angiomyolipoma With Tuberous Sclerosis Complex (TSC);&nbsp;Subependymal Giant Cell Astrocytoma (SEGA) With Tuberous Sclerosis Complex (TSC)<br />\r\n<br />\r\nIn combination with ciclosporin for microemulsion &amp; corticosteroids for the prophylaxis of organ rejection in adult patients at low to moderate immunological risk receiving an allogeneic renal or cardiac transplant. In combination with tacrolimus &amp; corticosteroids for the prophylaxis of organ rejection in patients receiving hepatic transplant.</p>', '<p>Everolimus, a proliferation signal inhibitor, prevents allograft rejection in rodent and nonhuman primate models of allotransplantation. It exerts its immunosuppressive effect by inhibiting the proliferation and thus, clonal expansion, of antigen-activated T cells which is driven by T cell-specific interleukins eg, interleukin-2 and interleukin-15. Everolimus inhibits an intracellular signaling pathway that normally leads to cell proliferation when triggered by the binding of these T cell growth factors to their receptors. The blockage of this signal by everolimus causes cells to be arrested at the G1 stage of the cell cycle.<br />\r\n<br />\r\nAt the molecular level, everolimus forms a complex with the cytoplasmic protein FKBP-12. In the presence of everolimus, the growth factor-stimulated phosphorylation of the p70 S6 kinase is inhibited. Since p70 S6 kinase phosphorylation is under the control of FRAP (also called m-TOR), this finding suggests that the everolimus-FKBP-12 complex binds to and thus, interferes with the function of FRAP. FRAP is a key regulatory protein which governs cell metabolism, growth and proliferation; disabling FRAP function thus explains the cell cycle arrest caused by everolimus.</p>', '<p><strong>General kidney &amp; heart transplant population</strong>: Initially 0.75 mg bd administered as soon as possible after transplantation.&nbsp;<br />\r\n<br />\r\n<strong>Hepatic transplant</strong>: 1 mg bd with initial dose starting 4 wk after transplantation.<br />\r\n<br />\r\n<strong>Advanced Hormone Receptor-Positive, HER2-Negative Breast Cancer, Advanced NET, Advanced RCC, And Renal Angiomyolipoma With TSC</strong>: The recommended dose is 10 mg, to be taken once daily at the same time every day. Administer either consistently with food or consistently without food. Everolimus Tablets should be swallowed whole with a glass of water. Do not break or crush tablets. Continue treatment until disease progression or unacceptable toxicity occurs.</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>', '<p>CYP3A4 inhibitors &amp;/or inducers, CYP2D6 substrates with narrow therapeutic index, PgP inhibitors, rifampicin, ACE inhibitors, grapefruit juice &amp; live vaccines.</p>', '<p>Patients with hypersensitivity to the active substance, to other rapamycin derivatives, or to any of the excipients. Hypersensitivity reactions manifested by symptoms including, but not limited to, anaphylaxis, dyspnea, flushing, chest pain, or angioedema (e.g., swelling of the airways or tongue, with or without respiratory impairment) have been observed with everolimus and other rapamycin derivatives</p>', '<p>Stomatitis, Constipation, Infections, Asthenia, Fatigue, Cough, Diarrhea, Rash, Anemia, Nausea, Anorexia, Edema, peripheral, Dyspnea, Pyrexia, Vomiting, Headache, Epistaxis, Decreased lymphocytes, Grade 3, Increased glucose, Grade 3, Pneumonitis, Pruritus, Dry skin, Decreased Hgb, Grade 3, Menstrual irregularities, Dysgeusia, Hypertension, Hemorrhage, Tachycardia, CHF</p>', '<p>Pregnancy Category D.&nbsp;There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.<br />\r\n<br />\r\nLactation: Distribution into breast milk is unknown; not recommended</p>', '<p>Patients taking concomitant ACE inhibitor therapy may be at increased risk for angioedema. Interstitial lung disease/noninfectious pneumonitis; monitor for clinical symptoms or radiological changes; fatal cases have occurred; manage by dose reduction or discontinuation until symptoms resolve, and consider use of corticosteroids; pulmonary hypertension (including pulmonary arterial hypertension) as a secondary event reported<br />\r\n<br />\r\nElicits immunosuppressive effects and may increase risk for infections; some infections have been severe or fatal; monitor for signs and symptoms and treat promptly. Pneumocystis jiroveci pneumonia, some with a fatal outcome, reported; this may be associated with concomitant use of corticosteroids or other immunosuppressive agents<br />\r\n<br />\r\nMouth ulcers, stomatitis, and oral mucositis are common; management includes mouthwashes (without alcohol or peroxide) and topical treatments May delay wound healing and increase wound-related complications (eg, dehiscence, wound infection, incisional hernia, lymphocele, and seroma)</p>\r\n\r\n<ul>\r\n	<li>Cases of renal failure (including acute renal failure), some fatal, have been observed</li>\r\n	<li>May cause angioedema and fluid accumulation</li>\r\n	<li>Decreases Hgb, lymphocytes, ANC, platelets; increases cholesterol, TG, glucose, creatinine</li>\r\n	<li>Elevations of serum creatinine, urinary protein, blood glucose, and lipids may occur;</li>\r\n	<li>decreases in hemoglobin, neutrophils, and platelets may also occur; monitor renal</li>\r\n	<li>function, blood glucose, lipids, and hematologic parameters prior to treatment and periodically thereafter</li>\r\n	<li>May impair male fertility</li>\r\n	<li>Child-Pugh Class C hepatic impairment</li>\r\n	<li>Avoid use of live vaccines during treatment and close contact with live vaccine recipients</li>\r\n	<li>Can cause fetal harm when administered to a pregnant woman; advise female patients of reproductive potential to use highly effective contraception while receiving everolimus and for up to 8 weeks after ending treatment.</li>\r\n</ul>', NULL, '<p>Immunosuppressant</p>', NULL, NULL, '2022-02-21 23:38:11', '2022-06-16 00:59:40'),
(555, 555, '<p><strong>Primary Hypercholesterolemia:</strong>&nbsp;Ezetimibe co-administered with statin is indicated as adjunctive therapy to diet for use in patients with primary (heterozygous familial and non-familial) hypercholesterolemia who are not appropriately controlled with a statin alone.<br />\r\nEzetimibe monotherapy is indicated as adjunctive therapy to diet for use in patients with primary (heterozygous familial and non-familial) hypercholesterolemia in whom a statin is considered inappropriate or is not tolerated.<br />\r\n<br />\r\n<strong>Prevention of Cardiovascular Events:</strong>&nbsp;Ezetimibe is indicated to reduce the risk of cardiovascular events in patients with coronary heart disease (CHD) and a history of acute coronary syndrome (ACS) when added to ongoing statin therapy or initiated concomitantly with a statin.<br />\r\n<br />\r\n<strong>Homozygous Familial Hypercholesterolaemia (HoFH):</strong>&nbsp;Ezetimibe co-administered with a statin, is indicated as adjunctive therapy to diet for use in patients with HoFH. Patients may also receive adjunctive treatments (e.g., LDL apheresis).<br />\r\n<br />\r\n<strong>Homozygous Sitosterolemia (Phytosterolemia):</strong>&nbsp;Ezetimibe is indicated as adjunctive therapy to diet for use in patients with homozygous familial sitosterolemia</p>', '<p>Ezetimibe localises at the brush border of the small intestine and inhibits absorption of cholesterol via the sterol transporter, Niemann-Pick C1-Like1 (NPC1L1). This results in decreased delivery of cholesterol to the liver, reduction of hepatic cholesterol stores and increased clearance of cholesterol from the blood.</p>', '<p>The recommended dose of Ezetimibe is 10 mg once daily. Ezetimibe can be administered with or without food.</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>', '<p>Fibrates may increase cholesterol excretion into the bile, leading to cholelithiasis. In a preclinical study in animals, Ezetimibe increased cholesterol in the gallbladder bile. Coadministration of Ezetimibe with fibrates is not therefore recommended until use in patients is studied.</p>', '<p>Hypersensitivity to any component of this medication. The combination of Ezetimibe<br />\r\nwith an HMG-CoA reductase inhibitor is contraindicated in patients with active liver<br />\r\ndisease or unexplained persistent elevations in serum transaminases.</p>', '<p>Clinical studies of Ezetimibe (administered alone or with an HMG-CoA reductase<br />\r\ninhibitor) demonstrated that Ezetimibe was generally well tolerated. The overall<br />\r\nincidence of adverse events reported with Ezetimibe was similar to that reported with<br />\r\nplacebo, and the discontinuation rate due to adverse events was also similar for Ezetimibe<br />\r\nand placebo.</p>', '<p>There are no adequate and well-controlled studies of Ezetimibe in pregnant women. Ezetimibe should be used during pregnancy only if the potential benefit justifies the risk to the fetus</p>', '<p>Exclude or treat secondary causes of dyslipidaemia prior to initiating therapy. Renal and hepatic impairment. Pregnancy and lactation.</p>', '<p>No cases of overdosage with Ezetimibe have been reported. Administration of Ezetimibe,<br />\r\n50 mg/day, to 15 subjects for up to 14 days was generally well tolerated. In the event of<br />\r\nan overdose, symptomatic and supportive measures should be employed.</p>', '<p>Ezetimibe</p>', '<p>Store in a cool &amp; dry place protected from light and moisture. Keep out of reach of children.</p>', '<p><strong>Pediatric Use-</strong><br />\r\n<br />\r\n<strong>10 to 17 years</strong>: No dosage adjustment is required. The clinical experience in pediatric and adolescent patients is however limited. When Ezetimibe is administered with statin, the dosage instructions for statin, in adolescents should be consulted.<br />\r\n<br />\r\n<strong>Children &lt; 10 years</strong>: Ezetimibe is not recommended for use in children below age 10 due to insufficient data on safety and efficacy.</p>', '2022-02-21 23:38:29', '2022-06-16 01:01:56'),
(556, 556, '<p>Herpes zoster (shingles),&nbsp;Recurrent herpes labialis,&nbsp;Genital herpes,&nbsp;Acute treatment of recurrent mucocutaneous herpes in HIV-infected patients,&nbsp;Acute treatment of recurrent episodes of genital herpes,&nbsp;Suppression of recurrent episodes of genital herpes.</p>', '<p>Famciclovir rapidly undergoes biotransformation to penciclovir, which has inhibitory activity against HSV types 1 (HSV-1) and 2 (HSV-2), varicella-zoster virus (VZV). Thymidine kinase then phosphorylates penciclovir to a monophosphate form, which is then converted to penciclovir triphosphate. This inhibits HSV-2 DNA polymerase by competing with deoxyguanosine triphosphate, thus inhibiting herpes viral DNA synthesis and replication.</p>', '<p><strong>Oral (Adult)-</strong><br />\r\n<br />\r\n<strong>Herpes zoster (shingles):</strong>&nbsp;500 mg tid for 7 days. Immunocompromised patients: 500 mg tid for 10 days.<br />\r\n<br />\r\nHaemodialysis patients: 250 mg after each dialysis run during 7 days. Immunocompromised patients: Same dose but treatment is given for 10 days.</p>\r\n\r\n<ul>\r\n	<li>CrCl (mL/min) &lt;20: 250 mg once daily for 7 days.</li>\r\n	<li>CrCl (mL/min) 20-39: 500 mg once daily for 7 days.</li>\r\n	<li>CrCl (mL/min) 40-59: 500 mg bid for 7 days.</li>\r\n</ul>\r\n\r\n<p><strong>Recurrent herpes labialis:</strong>&nbsp;1.5 g as a single dose.<br />\r\n<br />\r\nHaemodialysis patients: 250 mg after dialysis run.</p>\r\n\r\n<ul>\r\n	<li>CrCl (mL/min) &lt;20: 250 mg as a single dose.</li>\r\n	<li>CrCl (mL/min) 20-39: 500 mg as a single dose.</li>\r\n	<li>CrCl (mL/min) 40-59: 750 mg as a single dose.</li>\r\n</ul>\r\n\r\n<p><strong>Genital herpes:</strong>&nbsp;1st episode: 250 mg tid for 5 days. Immunocompromised patients: 500 mg bid for 7 days.<br />\r\n<br />\r\nHaemodialysis patients: 250 mg after each dialysis run during 5 days.</p>\r\n\r\n<ul>\r\n	<li>CrCl (mL/min) &lt;20: 250 mg once daily for 5 days.</li>\r\n	<li>CrCl (mL/min) 20-39: 250 mg bid for 5 days.</li>\r\n</ul>\r\n\r\n<p><strong>Acute treatment of recurrent mucocutaneous herpes in HIV-infected patients:</strong>&nbsp;500 mg bid for 7 days.<br />\r\n<br />\r\nHaemodialysis patients: 250 mg after each dialysis run during 7 days.</p>\r\n\r\n<ul>\r\n	<li>CrCl (mL/min) &lt;20: 250 mg once daily for 7 days.</li>\r\n	<li>CrCl (mL/min) 20-39: 500 mg once daily for 7 days.</li>\r\n</ul>\r\n\r\n<p><strong>Acute treatment of recurrent episodes of genital herpes:</strong>&nbsp;125 mg bid for 5 days or 1 g bid for 1 day. Immunocompromised patients: 500 mg bid for 7 days.<br />\r\n<br />\r\nHaemodialysis patients: 125 mg after each dialysis run during 5 days. Haemodialysis patients (immunocompromised): 250 mg after each dialysis run during 7 days.</p>\r\n\r\n<ul>\r\n	<li>CrCl (mL/min) &lt;20: 125 mg once daily for 5 days.</li>\r\n	<li>CrCl (mL/min) &ge;20: 125 mg bid for 5 days.</li>\r\n	<li>CrCl (mL/min) &lt;20: Immunocompromised: 250 mg once daily for 7 days.</li>\r\n	<li>CrCl (mL/min) 20-39: Immunocompromised: 500 mg once daily for 7 days.</li>\r\n</ul>\r\n\r\n<p><strong>Suppression of recurrent episodes of genital herpes:</strong>&nbsp;250 mg bid. Immunocompromised patients: 500 mg bid. Suppressive treatment is interrupted every 6-12 mth for observation.<br />\r\n<br />\r\nHaemodialysis patients: 125 mg after each dialysis run. Haemodialysis patients (immunocompromised): 250 mg after each dialysis run.</p>\r\n\r\n<ul>\r\n	<li>CrCl (mL/min) 20: 125 mg once daily. Immunocompromised: 250 mg once daily.</li>\r\n	<li>CrCl (mL/min) 20-39: 125 mg bid. Immunocompromised: 500 mg once daily.</li>\r\n</ul>', '<p>Reduced renal excretion resulting to increased plasma concentration w/ probenecid. Raloxifen may reduce the formation of penciclovir, the active metabolite of famciclovir.</p>', '<p>Hypersensitivity to famciclovir and penciclovir.</p>', '<p>Headache, nausea, diarrhoea, fatigue, dizziness, fever, paraesthesia, somnolence, vomiting, constipation, anorexia, abdominal pain, flatulence, dyspepsia; increased serum levels of ALT, alkaline phosphatase, total bilirubin and albumin; pruritus, pharyngitis, sinusitis, injury, generalised pain, rigors, back pain, arthralgia; increased serum phosphate, Na and K levels; abnormal leukocyte counts, purpura, angioedema.</p>', '<p><strong>Category B</strong>: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).</p>', '<p>Renal impairment. Pregnancy and lactation.</p>', '<p>Acute renal failure in patients with renal disease. Management: Supportive and symptomatic treatment. May be removed by haemodialysis.</p>', '<p>Herpes simplex &amp; Varicella-zoster virus infections</p>', '<p>Store at 20-25&deg;C.</p>', NULL, '2022-02-21 23:40:55', '2022-02-21 23:40:55'),
(557, 557, '<p>Famotidine is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Gastric ulcer</li>\r\n	<li>Duodenal ulcer</li>\r\n	<li>Anastomotic ulcer</li>\r\n	<li>Acute stress ulcer</li>\r\n	<li>Reflux esophagitis and</li>\r\n	<li>Zollinger-Ellison syndrome.</li>\r\n</ul>\r\n\r\n<p>Famotidine is also indicated for the treatment of acute gastritis, chronic gastritis in the acute exacerbation stage.</p>', '<p>Famotidine is a histamine H2-receptor antagonist. Famotidine completely inhibits the action of histamine on H2- receptors of parietal cell. It inhibits basal, overnight and pentagastrin stimulated gastric acid secretion. The H2- receptor antagonist activity of Famotidine is slowly reversible, since the drug dissociates slowly from H2-receptor.</p>', '<p>Tablet:</p>\r\n\r\n<ul>\r\n	<li><strong>For gastric ulcer, duodenal ulcer, anastomotic ulcer, upper gastro-intestinal hemorrhage, reflux esophagitis and Zollinger-Ellison syndrome</strong>: Usual dose for adults: Famotidine 20 mg twice daily (after breakfast and after supper or before bed time) or Famotidine 40 mg can be administered orally once daily at bed time.</li>\r\n	<li><strong>For the treatment of acute gastritis, chronic gastritis in acute exacerbation stage</strong>: Usual dosage for adults is Famotidine 20 mg orally twice a day (after breakfast and after supper or before bed time). Also Famotidine 40 mg can be orally administered once a day (before bed time), dosage should be adjusted according to age and symptoms. Most ulcer patients heal within 4-8 weeks. For maintenance therapy the recommended oral dose is 20 mg once daily. Or, as directed by the registered physician.</li>\r\n</ul>\r\n\r\n<p><br />\r\nPowder for Suspension:<br />\r\nGastroesophageal Reflux Disease(GERD):</p>\r\n\r\n<ul>\r\n	<li><strong>&lt;1 year of age</strong>: 0.5 mg/kg/dose of famotidine oral suspension up to 8 weeks once daily in patients</li>\r\n	<li><strong>Age 3 to 11 months</strong>: 0.5 mg/kg/dose twice daily up to 8 weeks</li>\r\n	<li><strong>Age 1 to 2 months</strong>: 0.5 mg/kg/dose once daily up to 8 weeks</li>\r\n	<li><strong>Neonates</strong>: 0.5 mg/kg/dose maximum once daily up to 8 weeks</li>\r\n</ul>\r\n\r\n<p>Patients 1-16 years of age:</p>\r\n\r\n<ul>\r\n	<li><strong>Gastroesophageal Reflux Disease(GERD)</strong>: 1 mg/kg/day p.o. divided b.i.d. up to 40 mg b.i.d.</li>\r\n	<li><strong>Duodonal ulcer</strong>: 0.5 mg/kg/day p.o. at bedtime or divided b.i.d. up to 40 mg/day.</li>\r\n	<li><strong>Peptic ulcer</strong>: 0.5 mg/kg/day p.o. at bedtime or divided b.i.d. up to 40 mg/day.</li>\r\n	<li><strong>Maintenance therapy</strong>: 40 mg at daily night.</li>\r\n	<li><strong>Reflux esophagitis</strong>: 2 mg/kg/day</li>\r\n	<li><strong>Zollinger-Ellison Syndrome</strong>: 40 mg 3 times daily.</li>\r\n</ul>', '<p>Drug interactions&nbsp;may change how your&nbsp;medications&nbsp;work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and&nbsp;pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor&#39;s approval.</p>\r\n\r\n<p>Some products need&nbsp;stomach&nbsp;acid so that the body can absorb them properly.&nbsp;Famotidine&nbsp;decreases&nbsp;stomach&nbsp;acid, so it may change how well these products work. Some affected products include&nbsp;atazanavir,&nbsp;dasatinib,&nbsp;delavirdine, certain azole antifungals (such as&nbsp;itraconazole,&nbsp;ketoconazole), levoketoconazole, pazopanib, among others.</p>\r\n\r\n<p>Do not take this&nbsp;medication&nbsp;with other products that contain famotidine or other H2 blockers (cimetidine, nizatidine,&nbsp;ranitidine).</p>', '<p>Known hypersensitivity to any component of the drug.</p>', '<p>Eruption, constipation, diarrhoea, dry mouth, nausea, vomiting, tachycardia, high blood pressure, headache, drowsiness or insomnia may rarely occur.</p>', '<p>Pregnancy category B. There are no adequate and well-controlled studies in pregnant women. This drug should be used during pregnancy only if clearly needed. Caution should be exercised when Famotid is administered to a nursing woman.</p>', '<p>The drug should be used in the minimum required amount depending upon the conditions of the diseases. The drug should be administered carefully with elderly patients, patients with renal failure and hepatic disorders.</p>', '<p>N/A</p>', '<p>H2 Receptor Antagonist</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>N/A</p>', '2022-02-22 01:45:21', '2022-02-22 01:45:21'),
(558, 558, '<p>Treatment of novel or re-emerging pandemic influenza virus infections (limited to cases in which other influenza antiviral drugs are ineffective or not sufficiently effective).</p>\r\n\r\n<p>Favipiravir is approved for manufacture and sale in Japan as an influenza antiviral. It selectively inhibits the RNA polymerase of the influenza virus, an enzyme required for viral replication once human host cells are infected. COVID-19 also uses this enzyme to replicate and is classified into the same type of single-stranded RNA virus as influenza; hence, it is believed that Favipiravir may be effective in treating COVID-19.<br />\r\n<br />\r\nFavipiravir is only used when there is an outbreak of novel or re-emerging influenza virus infections in which other influenza antiviral drugs are either not effective or insufficiently effective. Its production and distribution is at the discretion of Japan&rsquo;s Health, Labor and Welfare Ministry, so has never been distributed in the market and is not available at hospitals and pharmacies in Japan or overseas.</p>', '<p>Favipiravir is a new antiviral drug against influenza. It is metabolized into favipiravir ribosyl triphosphate (favipiravir RTP) by an intracellular enzyme, and favipiravir RTP selectively inhibits RNA polymerase (RNA-dependent RNA polymerase) of the influenza virus, preventing replication of the influenza virus. It is a drug with a mechanism of action different from that of the existing influenza antiviral drugs and effective against all types and sub-types of human influenza A, B, and C viruses in vitro, showing a wide range of anti-viral activity against various influenza virus strains including avian and swine viruses.</p>', '<p>The usual adult dosage is 1600 mg of Favipiravir administered orally twice daily on Day 1, followed by 600 mg orally twice daily from Day 2 to Day 5 or as directed by physicians. The total treatment duration should be 5 days.</p>', '<p>In animal studies, decreased RBC production,and increases in liver function parameters such as AST, ALP, ALT and total bilirubin, and increased vacuolization in hepatocytes. Toxicity information regarding Favipiravir in humans is not readily available.</p>', '<p>Favipiravir is contraindicated for pregnant women and women who may possibly be pregnant.</p>', '<p>Most common side effects are Diarrhea and increase of blood uric acid levels.</p>', '<p>Favipiravir may cause delayed development or death of embryos during the early stage of pregnancy. Should not be given during pregnancy.</p>', '<p>Favipiravir should not be given in pregnant women, requirement of the confirmation of non-pregnancy in women of childbearing potential before use, thorough contraception measures from the start of the treatment to 7 days after the end of the treatment. Caution should be taken for Hepatic and renal impaired patient or use Favipiravir as per the direction of registered Physician.&nbsp;</p>', '<p>In animal studies, decreased RBC production,and increases in liver function parameters such as AST, ALP, ALT and total bilirubin, and increased vacuolization in hepatocytes. Toxicity information regarding Favipiravir in humans is not readily available.</p>', '<p>Anti-viral Drugs</p>', '<p>Keep below 30&deg;C temperature, protected from light &amp; moisture. Keep out of the reach of children.</p>', '<p>This drug is only approved as an experimental drug and still a lot of studies is needed about it&rsquo;s efficacy and also toxic reactions and use in children.</p>', '2022-02-22 01:47:29', '2022-02-22 01:47:29'),
(559, 559, '<p>Febuxostat is indicated for the chronic management of hyperuricemia in patients with gout. Febuxostat is not recommended for the treatment of asymptomatic hyperuricemia.</p>', '<p>Febuxostat is a non-purine, selective xanthine oxidase (XO) inhibitor. It decreases serum uric acid level by inhibiting xanthine oxidase, which is responsible for uric acid production. Xanthine oxidase breaks down hypoxanthine to xanthine and thus to uric acid. Febuxostat is not expected to inhibit other enzymes involved in purine and pyrimidine synthesis and metabolism at therapeutic concentrations.</p>', '<p>Febuxostat is recommended at 40 mg or 80 mg once daily. The recommended starting dose of Febuxostat is 40 mg once daily. For patients who do not achieve a serum uric acid less than 6 mg /dL after 2 weeks with 40 mg, Febuxostat 80 mg is recommended. Febuxostat can be administered without regard to food or antacid use. No dose adjustment is necessary when administering Febuxostat to patients with mild to moderate renal or hepatic impairment.</p>', '<p>Concomitant administration of Febuxostat with azathioprine, mercaptopurine or theophylline could increase plasma concentrations of these drugs resulting in severe toxicity.</p>', '<p>Febuxostat is contraindicated in patients being treated with azathioprine, mercaptopurine, or theophylline.</p>', '<p>The most common adverse events associated with the use of Febuxostat may include liver function abnormalities, nausea, arthralgia, and rash.</p>', '<p>Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Febuxostat should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether this drug is excreted in human milk. Caution should be exercised when Febuxostat is administered to a nursing woman.</p>', '<p><strong>Gout Flare</strong>: An increase in gout flares is frequently observed during initiation of anti-hyperuricemic agents, including Febuxostat. If a gout flare occurs during treatment, Febuxostat need not be discontinued. Prophylactic therapy (i.e., non-steroidal anti-inflammatory drug (NSAID) or colchicine upon initiation of treatment) may be beneficial for up to six months.<br />\r\n<br />\r\n<strong>Cardiovascular Events</strong>: A higher rate of cardiovascular thromboembolic events was observed in patients treated with febuxostat than allopurinol in clinical trials. Monitor for signs and symptoms of MI and stroke.<br />\r\n<br />\r\n<strong>Liver Enzyme Elevation</strong>: Transaminase elevations have been observed in febuxostat -treated patients. Monitor liver function tests periodically.</p>', '<p>Febustat was studied in healthy subjects in doses up to 300 mg daily for seven days without evidence of dose-limiting toxicities.</p>', '<p>Drugs used in Gout</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use:</strong>&nbsp;Safety and effectiveness in pediatric patients under 18 years of age have not been established</p>', '2022-02-22 01:49:01', '2022-02-22 01:49:01'),
(560, 560, '<p>Fenofibrate is indicated for hyperlipidemias of type lla, llb, III, IV &amp; V in patients who have not responded adequately to diet &amp; other appropriate measures.</p>', '<p>Fenofibrate is a fibric acid derivative. Fenofibrate is rapidly hydrolyzed after oral ingestion to its pharmacologically active form, fenofibric acid. Fenofibric acid produces reductions in total cholesterol, LDL cholesterol, Apo-lipoprotein B, Total triglycerides and VLDL. In addition, treatment with Fenofibrate results in increases in HDL and apo-proteins apoAI apoAII. Fenofibrate also reduces serum uric acid levels in hyperuricemic and normal individuals by increasing the urinary excretion of uric acid. The micronised form of Nofiate (Fenofibrate) has enhanced absorption over the non-micronised formulation.</p>', '<ul>\r\n	<li>For the treatment of adult patients with hypercholesterolemia or mixed hyperlipidemia, the initial dose of Fenofibrate is 200 mg per day.</li>\r\n	<li>For adult patients with hypertriglyceridemia, the initial dose is 67 to 200 mg per day.</li>\r\n	<li>Dose should be individualized according to patient response. Fenofibrate should be given with meal there by, optimizing the bioavailability of the medication. Or, as directed by the registered physician.</li>\r\n</ul>', '<p>Fenofibrate has been reported to potentiate the anticoagulant effects of warfarin. When administered with antidiabetic drug it may improve glucose tolerance and have additive effect. Fenofibrate may also increase the nephrotoxicity of cyclosporine. Due to a potential increase in the risk of rhabdomyolysis, cautions should be taken against the use of Fenofibrate with HMG-CoA reductase inhibitors. However, the use of low-dose statins with Fenofibrate appears to be well tolerated.</p>', '<p>Fenofibrate is contraindicated in patients with hypersensitivity to Fenofibrate, severe renal or hepatic impairment, existing gall bladder disease, breast feeding mothers, photosensitivity to ketoprofen.</p>', '<p>Gastro-intestinal (e.g. nausea, anorexia, gastric pain), pruritus, urticaria, impotence, also headache, dizziness, vertigo, fatigue, hair loss; myotoxicity.</p>', '<p>Fenofibrate is not recommended for pregnant women.</p>', '<p>Special care needed in patients with renal disease, as progressive increases in serum creatinine concentration or failure to follow dosage guidelines may result in myotoxicity; discontinue if myotoxicity suspected or creatinine kinase concentration increases significantly. Liver function tests recommended every 3 months for first year.</p>', '<p>There is no specific treatment for overdose with Fenofibrate. General supportive care of the patients is indicated, including monitoring of vital signs and observation of clinical status, should an overdose occur. Because Fenofibrate is highly bound to plasma proteins, hemodialysis should not be considered.</p>', '<p>Fibrates class</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-02-22 01:53:56', '2022-02-22 01:53:56');
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
(561, 561, '<p>Fentanyl is indicated for the management of breakthrough pain in patients with cancer who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain. Patients considered opioid tolerant are those who are taking at least 60 mg of oral morphine/day, at least 25 mcg of transdermal Fentanyl/hour, at least 30 mg of oxycodone daily, at least 8 mg of oral hydromorphone daily or an equianalgesic dose of another opioid for a week or longer.</p>', '<p>Fentanyl is an opioid analgesic. Fentanyl interacts predominately with the opioid mu-receptor but also binds to kappa and delta-type opioid receptors. These mu-binding sites are discretely distributed in the human brain, spinal cord, and other tissues. In clinical settings, Fentanyl exerts its principal pharmacologic effects on the central nervous system. Its primary actions of therapeutic value are analgesia and sedation. Fentanyl may increase the patient&#39;s tolerance for pain and decrease the perception of suffering, although the presence of the pain itself may still be recognized. In addition to analgesia, alterations in mood, euphoria and dysphoria, and drowsiness commonly occur. Fentanyl depresses the respiratory centers, depresses the cough reflex, and constricts the pupils.</p>', '<p><strong>Oral-</strong></p>\r\n\r\n<ul>\r\n	<li><strong>Starting Dose:&nbsp;</strong>The initial dose of Fentanyl should be 100 mcg.</li>\r\n	<li><strong>Re-dosing patients within a single episode:</strong>&nbsp; Dosing may be repeated once during a single episode of breakthrough pain if pain is not adequately relieved by one Fentanyl dose. Re-dosing may occur 30 minutes after the start of administration of Fentanyl and the same dosage strength should be used.</li>\r\n	<li><strong>Increasing the dose:</strong>&nbsp; Titration should be initiated using multiples of the 100 mcg Fentanyl tablet. Patients require to titrate above 100 mcg can be instructed to use two 100 mcg tablets (one on each side of the mouth in the buccal cavity). If this dose is not successful in controlling the breakthrough pain episode, the patient may be instructed to place two 100 mcg tablets on each side of the mouth in the buccal cavity (total of four 100 mcg tablets). Titrate above 400 mcg by 200 mcg increments bearing in mind using more than 4 tablets simultaneously has not been studied and it is important to minimize the number of strengths available to patients at any time to prevent confusion and possible overdose. To reduce the risk of overdose during titration, patients should have only one strength of Fentanyl tablet available at any one time.</li>\r\n	<li><strong>Dosage Adjustment:&nbsp;</strong>Generally, the dose of Fentanyl should be increased when patients require more than one dose per breakthrough pain episode for several consecutive episodes.</li>\r\n</ul>\r\n\r\n<p><strong>Injection-</strong></p>\r\n\r\n<ul>\r\n	<li>Fentanyl injection can be administered intravenously either as a bolus or by infusion &amp; by intramuscular route also. The dose of fentanyl should be individualized according to age, body weight, physical status, underlying pathological condition, use of other drugs and type of surgery and anesthesia.</li>\r\n</ul>\r\n\r\n<ul>\r\n	<li>Doses in excess of 200mcg are for use in anesthesia only. As a premedicant, 1-2 ml fentanyl may be given intramuscularly 45 minutes before induction of anesthesia. After IV administration in unpremedicated adult patients, 2ml fentanyl may be expected to provide sufficient analgesia for 10-20 minutes in surgical procedures involving low pain intensity. 10 ml fentanyl injected as a bolus gives analgesia lasting about one hour. The analgesia produced is sufficient for surgery involving moderately painful procedures. Giving a dose of 50mcglkg fentanyl will provide intense analgesia for some four to six hours, for intensely stimulating surgery.</li>\r\n</ul>\r\n\r\n<ul>\r\n	<li>Fentanyl may also be given as an infusion. In ventilated patients, a loading dose of fentanyl may be given as a fast infusion of approximately 1 mcg/kg/min for the first 10 minutes followed by an infusion of approximately 0.1 mcg/kg/min. Alternatively the loading dose of fentanyl may be given as a bolus. Infusion rates should be titrated to individual patient response; lower infusion rates may be adequate. Unless it is planned to ventilate post operatively, the infusion should be terminated at about 40 minutes before the end of surgery.</li>\r\n</ul>\r\n\r\n<ul>\r\n	<li>Lower infusion rates, e.g. 0.05-0.08 mcg/kg/min. are necessary if spontaneous ventilation .is to be maintained. Higher infusion rates (up to 3 mcg/kg/min) have been used in cardiac surgery. Fentanyl is chemically incompatible with the induction agents thiopentone &amp; methohexitone because of wide differences in pH</li>\r\n</ul>\r\n\r\n<ul>\r\n	<li>Use in elderly and debilitated patients: It is wise to reduce the dosage in the elderly and debilitated patients. The effect of the initial dose should be taken into account in determining supplemental doses.</li>\r\n</ul>\r\n\r\n<p><strong>Transdermal-</strong><br />\r\nIntractable chronic pain:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;Patches deliver fentanyl in doses that range from: 12-100 mcg/hr. Doses should be individually titrated based on previous use of opioids. Opioid-naive patients: Initially, &le;25 mcg/hr; it is recommended to initially titrate w/ low doses of short-acting opioids before starting fentanyl patches. Patients receiving a strong opioid analgesic: Initial dose should be based on the previous 24-hr opioid requirements. During transfer to fentanyl patches, previous opioid treatment should be phased out gradually. If patient requires doses &gt;100 mcg/hr, &gt;1 patch may be used; consider alternative or additional therapy if doses &gt;300 mcg/hr are required. Replace patch every 72 hr and apply the new patch to a different site; avoid using the same area of skin for a few days.</li>\r\n	<li><strong>Elderly</strong>:&nbsp;Dose reduction may be needed.</li>\r\n</ul>\r\n\r\n<p><strong>Tablet Administration:</strong>&nbsp;Patients should remove the tablet from the blister strip and immediately place the entire tablet in the buccal cavity (above a rear molar, between the upper cheek and gum). Patients should not attempt to split the tablet. The tablet should not be chewed or swallowed, as this will result in lower plasma concentrations than when taken as directed. The tablet should be left between the cheek and gum until it has disintegrated, which usually takes approximately 14-25 minutes. After 30 minutes, if remnants from the tablet remain, they may be swallowed with a glass of water.</p>', '<p>Co-administration of different antifungals, macrolide antibiotics, CNS depressant drugs like ketoconazole, itraconazole, troleandomycin, clarithromycin, nelfinavir, and nefazadone may enhance or prolong the effects of Fentanyl. The concomitant use of amprenavir, aprepitant, diltiazem, erythromycin, fluconazole, fosamprenavir, grapefruit juice, and verapamil with Fentanyl may also result in an increase in Fentanyl plasma concentrations, which could increase or prolong adverse drug effects and may cause potentially fatal respiratory depression.</p>', '<p>Fentanyl is contraindicated in the management of acute or postoperative pain. This product must not be used in opioid non-tolerant patients. Fentanyl is contraindicated in patients with known intolerance or hypersensitivity to any of its components or the drug Fentanyl.</p>', '<p>As with other narcotic analgesics, the most common serious adverse reactions reported to occur with Fentanyl are respiratory depression, apnoea, muscular rigidity, myoclonic movements, and bradycardia. Respiratory depression is more likely to occur with intravenous administration if a dose is given too rapidly and it rarely occurs with intramuscular administration.</p>', '<p><strong>Pregnancy category C.</strong>&nbsp;There are no adequate and well-controlled studies in pregnant women. Fentanyl should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Fentanyl is excreted in human milk; therefore Fentanyl should not be used in nursing women because of the possibility of sedation and/or respiratory depression in their infants.</p>', '<p>Opioid analgesics impair the mental and/or physical ability required for the performance of potentially dangerous tasks (e.g. driving a car or operating machinery). Patients taking Fentanyl should be warned of these dangers and should be counseled accordingly. The use of concomitant CNS active drugs requires special patient care and observation.<br />\r\n<br />\r\n<strong>Chronic pulmonary disease</strong>: Fentanyl should be titrated with caution in patients with chronic obstructive pulmonary disease or pre-existing medical conditions predisposing them to respiratory depression.&nbsp;<br />\r\n<br />\r\n<strong>Head injuries and increased intracranial pressure</strong>: Opioids may obscure the clinical course of a patient with a head injury and should be used only if clinically warranted.<br />\r\n<br />\r\n<strong>Cardiac disease</strong>: Intravenous Fentanyl may produce bradycardia. Therefore, Fentanyl should be used with caution in patients with bradyarrhythmias.<br />\r\n<br />\r\n<strong>Hepatic or renal disease</strong>: Fentanyl should be used with caution because of the hepatic metabolism and renal excretion of Fentanyl.</p>', '<p>In insufficient overdosage, Fentanyl would produce narcosis, marked skeletal muscle rigidity. Cardio-respiratory depression and cyanosis may also occur. In the presence of hypoventilation or apnoea, oxygen should be administered and respiration should be assisted. A specific narcotic antagonist, such as naloxane, should be available for use as indicated to manage respiratory depression.</p>', '<p>Opioid analgesics</p>', '<p>Store between 20-25&deg;C. Protect from light.</p>', NULL, '2022-02-22 01:58:19', '2022-02-22 01:58:19'),
(562, 562, '<p>Fenticonazole Nitrate is used for the treatment of vulvovaginal candidiasis.</p>', '<p>Fenticonazole is a broad-spectrum antimycotic agent with activity against dermatophytes and yeasts. Fenticonazole has also been shown to exhibit antibacterial action, with a spectrum of activity that includes bacteria commonly associated with vaginal infections and antiparasitic action against the protozoan Trichomonas vaginalis. Therefore, Fenticonazole may be an ideal topical alternative to multi-agent treatment of mixed infections involving mycotic, bacterial, dermatophyte and/or Trichomonas spp.</p>', '<p>Route of application is intravaginal. For adults, one applicator full (about 5 gm) is to be administered into the vagina in the morning and evening for three days.<br />\r\n<br />\r\nAfter each application, clean it carefully with warm water and soap. Do not use water which is hotter than 50&deg;C or solvents. Then wipe the applicator and store in its packet. Always wash your hands with mild soap and warm water afterwards. Fenticonazole is not greasy and can easily be removed with water.</p>\r\n\r\n<p>Follow the instructions to use Fenticonazole cream-</p>\r\n\r\n<ul>\r\n	<li>Screw the applicator onto the tube in place of the cap.</li>\r\n	<li>Squeeze the tube gently at its lower end, so as to fill the applicator at 5 gm mark. Unless prescribed by the physician, the applicator must be completely filled up to 5 gm.</li>\r\n	<li>After taking measured amount cream, remove the applicator from the tube, which should be closed immediately with the cap.</li>\r\n	<li>In a lying down position, with knees raised and spread apart, delicately insert the applicator into the vagina as deeply as possible. Push the piston to penetrate cream completely, then pull out the applicator without touching the piston.</li>\r\n</ul>', '<p>Not investigated. Since systemic absorption of Fenticonazole after application is low, interactions with other drugs are unlikely.</p>', '<p>Hypersensitivity to Fenticonazole or any component of the formulation.</p>', '<p>After intravaginal administration, slight transient burning may occasionally occur, which usually disappears rapidly.</p>', '<p>Since there is no data of use during pregnancy or lactation, So Fenticonazole should not be used without physician&#39;s advice.</p>', '<p>It should not be used in conjunction with barrier contraceptives. In the event of a hypersensitivity reaction or development of resistant organisms, treatment should be discontinued and take physician consultation.</p>', '<p>Because of the low systemic absorption after vaginal application, overdosage is unlikely.</p>', '<p>Topical Antifungal preparations</p>', '<p>Protect from light &amp; moisture. Keep below 30&deg; C temperature, protected from light &amp; moisture. Do not freeze. Keep out of the reach of children.</p>', '<p>The use of Fenticonazole vaginal cream in children is not recommended.</p>', '2022-02-22 02:10:02', '2022-02-22 02:10:02'),
(563, 563, '<p>Fenticonazole Nitrate vaginal tablet is indicated for:</p>\r\n\r\n<ul>\r\n	<li>Genital candidiasis (vulvovaginitis, colpitis, infectious fluor)</li>\r\n	<li>Trichomonasis</li>\r\n	<li>Vaginal infections sustained by mixed forms of Trichomonas vaginalis and Candida albicans.</li>\r\n</ul>', '<p>Fenticonazole is a potent broad-spectrum antimycotic agent. It exerts fungistatic and fungicidal actions on dermatophytes, pathogenic yeasts, dimorphous fungi and molds. In addition, Fenticonazole is active against gram-positive bacteria and is therefore indicated in mycoses associated with bacterial super infections. Fenticonazole is also active, both in vitro and in vivo, against Trichomonas vaginalis. Fenticonazole exerts its unique antimycotic action through following three ways:</p>\r\n\r\n<ul>\r\n	<li>Inhibiting the biosynthesis of ergosterol leading to the damage of fungal cell membrane.</li>\r\n	<li>Causing certain changes in oxidative and peroxidative enzyme activities inside fungal cell. This leads to an intracellular build-up of toxic concentrations of hydrogen peroxide resulting in cell necrosis.</li>\r\n	<li>Inhibiting the secretion of aspartic proteases (responsible for pathogenicity) by Candida albicans.</li>\r\n</ul>\r\n\r\n<p>The amount of Fenticonazole absorbed by the transcutaneous route is negligible.</p>', '<p><strong>Trichomonas or mixed (Trichomonas and Candida albicans) vaginal infections</strong>: One 600 mg VT (followed by a second administration 24 hours later, if necessary).<br />\r\n<br />\r\n<strong>Candida albicans infections</strong>: One single 600 mg VT administration in the evening. Should the symptoms persist, a second administration may be repeated after three days. The tablet must be introduced deep into the vagina and pushed well up to the fornix. To avoid re-infection, it is recommended that the partner undergoes concurrent treatment with Fenticonazole Cream or similar Azole Cream.</p>', '<p>Not available data found&nbsp;</p>', '<p>Contraindicated in case of hypersensitivity to Fenticonazole and other Imidazoles.</p>', '<p>After intravaginal administration slight transient burning (which usually disappears rapidly) may occasionally happen. Prolonged topical application may cause sensitisation reactions. Fenticonazole is generally well tolerated by the mucous membranes; only exceptionally mild and transient erythematous reactions have been reported. After topical application or intravaginal administration, a slight burning sensation may occur, usually subsiding soon. Should more persistent irritation occur or resistant micro-organism develop, suspend the treatment and seek the doctor&#39;s advice. Due to poor absorption of Fenticonazole, no systemic effects should occur, provided the above instructions are carefully observed.</p>', '<p>It is not recommended in pregnancy. Safety in breastfeeding has not been established.</p>', NULL, '<p>As systemic absorption is very low, the possibility of overdose is rare. In case of accidental swallowing, emesis or gastric lavage should be done. After vomiting, active charcoal along with water/lemon juice and laxative should be given to the patient.</p>', '<p>Topical Antifungal preparations</p>', '<p>Store below 25&deg;C. Protect from light &amp; moisture.</p>', '<p>Fenticonazole Nitrate is not recommended for children.</p>', '2022-02-22 02:25:44', '2022-02-22 02:25:44'),
(564, 564, '<p>Ferric Carboxymaltose is indicated for the treatment of&nbsp;iron deficiency anemia&nbsp;in adult patients-</p>\r\n\r\n<ul>\r\n	<li>Who have intolerance to oral iron or have had unsatisfactory response to oral iron</li>\r\n	<li>Who have non-dialysis&nbsp;dependent chronic kidney disease.</li>\r\n</ul>', '<p>Non-dextran, IV is a colloidal iron hydroxide in complex with carboxymaltose, a carbohydrate polymer that releases iron; replaces iron stores found in hemoglobin, myoglobin, and enzymes; works to transport oxygen via hemoglobin Macrophage engulf FCM from blood and control iron release. Transferrin saturates and, Iron into the liver, spleen and Bone marrow.</p>', '<p><strong>For patients weighing 50 kg or more</strong>: Give Ferric Carboxymaltose in two doses separated by at least 7 days. Give each dose as 750 mg for a total cumulative dose not to exceed 1500 mg of iron per course.<br />\r\n<br />\r\n<strong>For patients weighing less than 50 kg</strong>: Give Ferric Carboxymaltose in two doses separated by at least 7 days. Give each dose as 15 mg/kg body weight for a total cumulative dose not to exceed 1500 mg of iron per course.<br />\r\n<br />\r\nThe dosage of Ferric Carboxymaltose is expressed in mg of elemental iron. Each mL of Ferric Carboxymaltose contains 50 mg of elemental iron. Ferric Carboxymaltose treatment may be repeated if iron deficiency&nbsp;anemia&nbsp;reoccurs.<br />\r\n<br />\r\nAdminister Ferric Carboxymaltose intravenously, either as an undiluted slow intravenous push or by infusion. When administering as a slow intravenous push, give at the rate of approximately 100 mg (2 mL) per minute. When administered via infusion, dilute up to 750 mg of iron in no more than 250 mL of sterile 0.9% sodium chloride injection, USP, such that the concentration of the infusion is not less than 2 mg of iron per mL and administer over at least 15 minutes.<br />\r\n<br />\r\nWhen added to an infusion bag containing 0.9% Sodium Chloride Injection, USP, at concentrations ranging from 2 mg to 4 mg of iron per mL, Ferric Carboxymaltose solution is physically and chemically stable for 72 hours when stored at room temperature. To maintain stability, do not dilute to concentrations less than 2 mg iron/mL.<br />\r\n<br />\r\nInspect&nbsp;parenteral&nbsp;drug products visually for the absence of particulate matter and discoloration prior to administration. The product contains no preservatives. Each vial of Ferric Carboxymaltose is intended for single use only. Any unused drug remaining after injection must be discarded.<br />\r\n<br />\r\nAvoid extravasation of Ferric Carboxymaltose since brown discoloration of the extravasation site may be long lasting. Monitor for extravasation. If extravasation occurs, discontinue the Ferric Carboxymaltose administration at that site.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity to any of its components.</p>', '<p>Nausea, Hypertension, Flushing, Decreased blood phosphorus, Dizziness, Vomiting, Pruritus, Rash, Urticaria, Wheezing, Injection site discoloration, Headache, Increased alanine aminotransferase), Dysgeusia, Hypotension, Constipation, Serious anaphylactic/anaphylactoid reactions</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><strong>Hypersensitivity Reactions:&nbsp;</strong>Serious hypersensitivity reactions, including anaphylactic-type reactions, some of which have been life-threatening and fatal, have been reported in patients receiving Ferric carboxymaltose. Patients may present with shock, clinically significant hypotension, loss of consciousness, and/or collapse. Monitor patients for signs and symptoms of hypersensitivity during and after Ferric carboxymaltose administration for at least 30 minutes and until clinically stable following completion of the infusion. Only administer Ferric carboxymaltose when personnel and therapies are immediately available for the treatment of serious hypersensitivity reactions. Other serious or severe adverse reactions potentially associated with hypersensitivity which included, but not limited to, pruritus, rash, urticaria, wheezing, or hypotension may occur.<br />\r\n<br />\r\n<strong>Hypertension:&nbsp;</strong>Transient elevations in systolic blood pressure, sometimes occurring with facial flushing, dizziness, or nausea were observed. These elevations generally occurred immediately after dosing and resolved within 30 minutes. Monitor patients for signs and symptoms of hypertension following each Ferric carboxymaltose administration.</p>', NULL, '<p>Parenteral Iron Preparations</p>', '<p>Do not store above 30&deg;C. Do not freeze.</p>', NULL, '2022-02-22 02:39:25', '2022-02-22 02:39:25'),
(565, 565, '<p>Ferric Citrate is a phosphate binder indicated for the control of serum phosphorus levels in adult patients with chronic kidney disease on dialysis. Ferric Citrate is an iron replacement product indicated for the treatment of iron deficiency anemia in adult patients with chronic kidney disease not on dialysis.</p>', '<p>Hyperphosphatemia in chronic kidney disease on dialysis: Ferric iron binds dietary phosphate in the GI tract and precipitates as ferric phosphate. This compound is insoluble and is excreted in the stool. By binding phosphate in the GI tract and decreasing absorption, ferric citrate lowers the phosphate concentration in the serum.<br />\r\n<br />\r\nIron deficiency anemia in chronic kidney disease not on dialysis: Ferric iron is reduced from the ferric to the ferrous form by ferric reductase in the GI tract. After transport through the enterocytes into the blood, oxidized ferric iron circulates bound to the plasma protein transferrin, and can be incorporated into hemoglobin.</p>', '<p>Hyperphosphatemia in chronic kidney disease on dialysis:</p>\r\n\r\n<ul>\r\n	<li>Starting dose is 2 tablets orally 3 times per day with meals.</li>\r\n	<li>Adjust dose by 1 to 2 tablets as needed to maintain serumphosphorus at target levels, up to a maximum of 12 tablets daily. Dose can be titrated at 1-week or longer intervals.</li>\r\n</ul>\r\n\r\n<p>Iron deficiency anemia in chronic kidney disease not on dialysis:</p>\r\n\r\n<ul>\r\n	<li>Starting dose is 1 tablet orally 3 times per day with meals.</li>\r\n	<li>Adjust dose as needed to achieve and maintain hemoglobin goal, up to a maximum of 12 tablets daily.</li>\r\n</ul>', '<p>When clinically significant drug interactions are expected, consider separation of the timing of administration. Consider monitoring clinical responses or blood levels of the concomitant medication.</p>', '<p>Ferric Citrate is contraindicated in patients with iron overload syndromes.</p>', '<p>Most common adverse reactions (incidence &ge;5%) are discolored feces, diarrhea, constipation, nausea, vomiting, cough, abdominal pain, and hyperkalemia.</p>', '<p>There are no available data on Ferric Citrate use in pregnant women to inform a drug-associated risk of major birth defects and miscarriage. There are no human data regarding the effect of Ferric Citrate in human milk, the effects on the breastfed child, or the effects on milk production.</p>', '<p>Iron absorption from Ferric Citrate may lead to excessive elevations in iron stores. Increases in serum ferritin and transferrin saturation (TSAT) levels were observed in clinical trials. In a 56-week safety and efficacy trial evaluating the control of serum phosphate levels in patients with chronic kidney disease on dialysis in which concomitant use of intravenous iron was permitted, 55 (19%) of patients treated with Ferric Citrate had a ferritin level &gt;1500 ng/mL as compared with 13 (9%) of patients treated with active control. Assess iron parameters (e.g., serum ferritin and TSAT) prior to initiating Ferric Citrate and monitor iron parameters while on therapy. Patients receiving intravenous iron may require a reduction in dose or discontinuation of intravenous iron therapy.</p>', '<p>No data are available regarding overdose of Ferric Citrate in patients. In patients with chronic kidney disease, the maximum dose studied was 2,520 mg ferric iron (12 tablets of Ferric Citrate) per day. Iron absorption from Ferric Citrate may lead to excessive elevations in iron stores, especially when concomitant intravenous iron is used.</p>', '<p>Oral Iron preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use: </strong>The safety and efficacy of Ferric Citrate have not been established in pediatric patients.<br />\r\n<br />\r\n<strong>Geriatric Use:</strong> Clinical studies of Ferric Citrate included 292 subjects aged 65 years and older (104 subjects aged 75 years and older). Overall, the clinical study experience has not identified any obvious differences in responses between the elderly and younger patients in the tolerability or efficacy of Ferric Citrate.</p>', '2022-02-22 02:41:27', '2022-02-22 02:41:27'),
(566, 566, '<p>Ferric Derisomaltose is an iron replacement product indicated for the treatment of iron deficiency anemia in adult patients:</p>\r\n\r\n<ul>\r\n	<li>who have intolerance to oral iron or have had unsatisfactory response to oral iron.</li>\r\n	<li>who have non-hemodialysis dependent chronic kidney disease.</li>\r\n</ul>', '<p>This is an iron replacement product containing ferric derisomaltose for intravenous infusion. Ferric derisomaltose is an iron carbohydrate complex with a matrix structure composed of interchanging layers of ferric hydroxide and the carbohydrate derisomaltose. Derisomaltose consists of linear, hydrogenated isomaltooligosaccharides with an average molecular weight of 1000 Da and a narrow molecular weight distribution that is almost devoid of mono- and disaccharides. Ferric derisomaltose is a complex of iron (III) hydroxide and derisomaltose, an iron carbohydrate oligosaccharide that releases iron. Iron binds to transferrin for transport to erythroid precursor cells to be incorporated into hemoglobin.</p>', '<p><strong>For patients weighing 50 kg or more</strong>: Administer 1,000 mg of Ferric Derisomaltose by intravenous infusion over at least 20 minutes as a single dose. Repeat dose if iron deficiency anemia reoccurs.<br />\r\n<br />\r\n<strong>For patients weighing less than 50 kg</strong>: Administer Ferric Derisomaltose as 20 mg/kg actual body weight by intravenous infusion over at least 20 minutes as a single dose. Repeat dose if iron deficiency anemia reoccurs.<br />\r\n<br />\r\nThe dosage of Ferric Derisomaltose is expressed in mg of elemental iron. Each mL of Ferric Derisomaltose contains 100 mg of elemental iron. Only administer Ferric Derisomaltose when personnel and therapies are immediately available for the treatment of serious hypersensitivity reactions</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Inspect parenteral drug products visually for the absence of particulate matter and discoloration prior to administration. The product contains no preservatives. Each vial of Ferric Derisomaltose is single-dose only. Discard unused portion.</p>\r\n\r\n<ul>\r\n	<li>Withdraw the appropriate volume of Ferric Derisomaltose and dilute in 100 mL to 500 mL of 0.9% Sodium Chloride Injection, USP.</li>\r\n	<li>Final diluted concentration should be more than 1 mg iron/mL.</li>\r\n	<li>Compatibility of Ferric Derisomaltose with other drugs has not been established. Ferric Derisomaltose should not be mixed with or physically added to solutions containing other drugs.</li>\r\n	<li>Administer the prepared solution via intravenous infusion over at least 20 minutes.</li>\r\n	<li>Following dilution with 0.9% Sodium Chloride Injection, USP, Ferric Derisomaltose solution may be stored at room temperature for up to 8 hours.</li>\r\n	<li>Extravasation of Ferric Derisomaltose may cause brown discoloration at the extravasation site which may be long lasting. Monitor for extravasation. If extravasation occurs, discontinue the Ferric Derisomaltose administration at that site.</li>\r\n</ul>', NULL, '<p>Ferric Derisomaltose is contraindicated in patients with a history of serious hypersensitivity to Ferric Derisomaltose or any of its components. Reactions have included shock, clinically significant hypotension, loss of consciousness, and/or collapse.</p>', '<p>Most commonly reported adverse reactions (incidence &ge;1%) are rash and nausea.</p>', '<p>There are no available data on Ferric Derisomaltose use in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. Published studies on the use of intravenous iron products in pregnant women have not reported an association with adverse developmental outcomes. However, these studies cannot establish or exclude the absence of any drug-related risk during pregnancy because the studies were not designed to assess for the risk of major birth defects.<br />\r\n<br />\r\nThe available data on the use of Ferric Derisomaltose in lactating women demonstrate that iron is present in breast milk. However, the data do not inform the potential exposure of iron for the breastfed child 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 Ferric Derisomaltose in addition to any potential adverse effects on the breastfed child from the drug or from the underlying maternal condition.</p>', '<p><strong>Hypersensitivity Reactions</strong>: Serious hypersensitivity reactions, including anaphylactic-type reactions, some of which have been life-threatening and fatal, have been reported in patients receiving Ferric Derisomaltose. Patients may present with shock, clinically significant hypotension, loss of consciousness, and/or collapse. Monitor patients for signs and symptoms of hypersensitivity during and after Ferric Derisomaltose administration for at least 30 minutes and until clinically stable following completion of the infusion. Only administer Ferric Derisomaltose when personnel and therapies are immediately available for the treatment of serious hypersensitivity reactions. Ferric Derisomaltose is contraindicated in patients with prior serious hypersensitivity reactions to Ferric Derisomaltose or any of its components. In clinical trials in patients with IDA and CKD, serious or severe hypersensitivity were reported in 0.3% (6/2008) of the Ferric Derisomaltose treated subjects. These included 3 events of hypersensitivity in 3 patients; 2 events of infusion-related reactions in 2 patients and 1 event of asthma in one patient.<br />\r\n<br />\r\n<strong>Iron Overload</strong>: Excessive therapy with parenteral iron can lead to excess iron storage and possibly iatrogenic hemosiderosis or hemochromatosis. Monitor the hematologic response (hemoglobin and hematocrit) and iron parameters (serum ferritin and transferrin saturation) during parenteral iron therapy. Do not administer Ferric Derisomaltose to patients with iron overload</p>', '<p>Excessive dosages of Ferric Derisomaltose may lead to the accumulation of iron in storage sites potentially leading to hemosiderosis and hemochromatosis. Avoid use of Ferric Derisomaltose in patients with iron overload.</p>', '<p>Parenteral Iron Preparations</p>', '<p>Store at 20&deg; to 25&deg;C; excursions permitted to 15&deg; to 30&deg;C. Do not freeze.</p>', '<p>Pediatric Use: Safety and effectiveness have not been established in pediatric patients.</p>', '2022-02-22 02:43:17', '2022-02-22 02:43:17'),
(567, 567, '<p>Ferric Pyrophosphate Citrate is indicated for the replacement of iron to maintain hemoglobin in adult patients with hemodialysis-dependent chronic kidney disease (HDD-CKD).&nbsp;</p>', '<p>Ferric Pyrophosphate Citrate solution is a mixed-ligand iron complex in which iron (III) is bound to pyrophosphate and citrate. Ferric Pyrophosphate Citrate solution is a clear, slightly yellow-green color sterile solution containing 27.2 mg iron (III) per 5 mL. Each ampoule contains</p>\r\n\r\n<ul>\r\n	<li>Iron (7.5-9.0% w/w)</li>\r\n	<li>Citrate (15-22% w/w)</li>\r\n	<li>Pyrophosphate (15-22% w/w)</li>\r\n	<li>Phosphate (&lt; 2% w/w)</li>\r\n	<li>Sodium (18-25% w/w)</li>\r\n	<li>Sulfate (20-35%)</li>\r\n</ul>\r\n\r\n<p>One ampoule is added to 2.5 gallons (9.46 L) of bicarbonate concentrate.</p>', '<p>Inspect Ferric Pyrophosphate Citrate ampoule for signs of precipitation prior to mixing with the bicarbonate concentrate. Ferric Pyrophosphate Citrate should only be added to the bicarbonate concentrate and should not be added to acid concentrate mixtures. Add Ferric Pyrophosphate Citrate to bicarbonate concentrate used for generation of hemodialysate. The final concentration of&nbsp;iron (III) in the final hemodialysate is 2 micromolar (110 mcg/L). Multiple ampoules can be added to the master bicarbonate mix at each center at a ratio of one ampoule to each 2.5 gallons of bicarbonate concentrate.<br />\r\n<br />\r\nAdminister Ferric Pyrophosphate Citrate to patients at each dialysis procedure for as long as patients are receiving maintenance hemodialysis therapy for CKD.<br />\r\n<br />\r\nHemodialysis solutions should be used within 24 hours of the preparation of the Ferric Pyrophosphate Citrate /bicarbonate concentrate mixture.</p>', NULL, NULL, '<p>The most common side effects are headache, peripheral edema, asthenia, AV fistula thrombosis, urinary tract infection, AV fistula site hemorrhage, pyrexia, fatigue, hypotension, muscle spasms, pain in extremity, back pain, and dyspnea.</p>', '<p>Pregnant women Category C. Lactating mothers It is not known whether Ferric Pyrophosphate Citrate is present in human milk or not.</p>', '<p><strong>Hypersensitivity Reactions</strong>: Anaphylactic-type reactions, shock, hypotension, loss of consciousness and collapse can occur. Monitor patients for signs and symptoms of hypersensitivity during and after hemodialysis until he/she is clinically stable. Personnel and therapies should be immediately available for the treatment of serious hypersensitivity reactions.<br />\r\n<br />\r\n<strong>Iron laboratory testing</strong>: Iron status should be determined on pre-dialysis blood samples. Post dialysis serum iron parameters may overestimate serum iron and transferrin saturation.</p>', '<p>No data are available regarding overdose of Ferric Pyrophosphate Citrate.</p>', '<p>Parenteral Iron Preparations</p>', '<p>Keep in a cool and dry place, away from light. Keep out of reach of children.</p>', NULL, '2022-02-22 02:53:59', '2022-02-22 02:53:59'),
(568, 568, '<p>Ferrous Ascorbate is indicated in the treatment of iron deficiency anemia.</p>', '<p>Ferrous ascorbate, a synthetic molecule of ascorbic acid and iron. Iron replenishes the iron stores in your body and corrects iron deficiency anemia. Vitamin C (ascorbate) is added to enhance the absorption of iron in the body.</p>', '<p><strong>Adult &amp; Elderly</strong>:&nbsp;One tablet a day before or after meal (food independent absorption) or as directed by the physician. In more severe cases, two tablets a day may be required as prescribed by the physician.<br />\r\n<br />\r\n<strong>Pediatric patients</strong>: Safety and effectiveness in pediatric patients have not been established.</p>', NULL, '<p>It is contraindicated in hemosiderosis, hemochromatosis, hemolytic anemia.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>&nbsp;</p>', '<p>The treatment of a neurotic patient was interrupted because of nausea and regurgitation. In pregnant women, the incidence of pyrosis and chronic constipation is slightly increased.</p>', NULL, '<p>Oral iron preparations may aggravate existing peptic ulcer, regional enteritis and ulcerative colitis. Iron compounds taken orally can impair the absorption of tetracycline antibiotics. Antacids given concomitantly with iron compounds decrease iron absorption.</p>', '<p>The chance of poisoning is rare in adults with iron overdose.</p>', '<p>Oral Iron preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-22 02:56:12', '2022-02-22 02:56:12'),
(569, 569, '<p>It is indicated on prophylaxis of iron deficiency especially when inadequate diet calls for supplementary zinc and iron during pregnancy and anemia.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>It is an oral iron, folic acid and zinc preparation indicated for the treatment of iron, folic acid and zinc deficiency.</p>', '<p>Ferrous Ascorbate, Folic Acid &amp; Zinc is a combination of three nutritional supplements. Ferrous Ascorbate is a combination of iron and vitamin C. Iron replenishes the iron stores in your body and corrects iron deficiency anemia. Vitamin C (ascorbate) is added to enhance the absorption of iron in the body. Folic Acid is a form of vitamin B. It plays a vital role in the formation of red blood cells, which carry oxygen throughout the body. It is also essential in pregnancy due to its role in the development of the unborn baby&#39;s brain and spinal cord. Zinc is a micromineral that provides nutrition.</p>', '<p><strong>Adult &amp; Elderly:</strong>&nbsp;One tablet a day before or after meal (food independent absorption) or as directed by the physician. In more severe cases, two tablets a day may be required as prescribed by the physician.<br />\r\n<br />\r\n<strong>Pediatric patients</strong>: Safety and effectiveness in pediatric patients have not been established.</p>', '<p>Iron chelates with tetracycline. Since oral iron products interfere with absorption of oral tetracycline antibiotics, this product should not be taken within two hours of each other. Occasional gastrointestinal discomfort may be minimized by taking with meals. Absorption of iron may be impaired by concurrent administrations of penicillamine and antacid. In patients with renal failure, a risk of zinc accumulation may exist.</p>', '<p>It is contraindicated in patients with haemolytic anaemia and in conditions with increased hypersensitivity to any of its components and increased body iron content.</p>', '<p>Side effects of iron, folic acid and zinc supplementation are mild and transient. These include epigastric pain, nausea, constipation, vomiting, diarrhoea, heart burn, etc. Allergic sensitization has been reported following both oral and parenteral administration of folic acid.</p>', '<p>If pregnant, or planning to become pregnant or are currently breast-feeding please contact your physician, before taking or continuing the drug. Administration in first trimester of pregnancy should be avoided unless definite evidence of iron deficiency is observed. Prophylaxis of iron deficiency is justified during the remainder of pregnancy specifically when zinc supplementation is required.</p>', '<p>Care should be taken in patients who may develop iron overload, such as those with haemochromatosis, haemolytic anemia or red cell aplasia. Failure to respond to treatment may indicate other causes of anemia and should be further investigated.</p>', '<p>The clinical course of acute iron overdosage can be variable. Initial symptoms may include abdominal pain, nausea, vomiting, diarrhoea, tarry stools, melena, hematemesis, hypotension, tachycardia, metabolic acidosis, hyperglycemia, dehydration, drowsiness, pallor, cyanosis, lassitude, seizures, shock and coma.</p>', '<p>Iron, Vitamin &amp; Mineral Combined preparation</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-22 02:58:22', '2022-02-22 02:58:22'),
(570, 570, '<p>Ferrous Fumarate is used to prevent or treat iron deficiency anaemia. The prevention of iron deficiency during pregnancy usually requires a combination of iron and folic acid. Iron is usually found in foods and is necessary for the normal development of red blood cells. A lack of iron affects the development of the red blood cells and causes a reduction in the number of red blood cells found in the body (iron deficiency anaemia).</p>', '<p>Ferrous fumarate is an iron preparation that is used in the prevention and treatment of iron deficiency. The amount of elemental iron is 330 mg/g of ferrous fumarate.</p>', '<p>Iron-deficiency anemia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Usual dose range: Up to 600 mg daily. May increase up to 1.2 g daily if necessary.</li>\r\n	<li><strong>Child:</strong>&nbsp;Preterm neonate: 0.6-2.4 ml / kg daily; up to 6 yr: 2.5-5 ml bid.</li>\r\n</ul>\r\n\r\n<p>Should be taken on an empty stomach. Best taken on an empty stomach. May be taken with meals to reduce GI discomfort.</p>', '<p>Oral absorption of iron may be increased when taken with ascorbic acid. May reduce the absorption of quinolones and tetracyclines when taken concurrently via the oral route. Concurrent admin with antacids may reduce the absorption of ferrous fumarate from the GI tract. May reduce the absorption of penicillamine in the gut when taken concurrently.</p>', '<p>Patients with a known hypersensitivity to any of the ingredients. Hemochroma</p>', '<p>Like all medicines, Ferrous Fumarate Tablets can sometimes cause side effects, although not everybody gets them. They might be:</p>\r\n\r\n<ul>\r\n	<li>Heartburn</li>\r\n	<li>Feeling sick or being sick</li>\r\n	<li>Diarrhoea or constipation.</li>\r\n</ul>\r\n\r\n<p>Also, you might find your stools are darker in color after you have taken this medicine. This is quite commonly seen with all iron preparations and is normal.</p>', '<p>Pregnancy Category- Not Classified. FDA has not yet classified the drug into a specified pregnancy category</p>', '<p>Patients with intestinal strictures and diverticular disease. May worsen diarrhoea in patients with inflammatory bowel disease. May cause constipation and faecal impaction in elderly. Avoid prolonged admin (&gt;6 mth) except in patients with continued bleeding, menorrhagia or repeated pregnancies. Not for routine use in treatment of haemolytic anaemia unless an iron-deficient state exists. Parenteral iron should not be used concurrently with oral iron treatment. Avoid use in patients receiving repeated blood tranfusions. Pregnancy.</p>', '<p><strong>Symptoms:</strong>&nbsp;Nausea, vomiting, abdominal pain, diarrhoea, haematemesis and rectal bleeding. Hypotension, coma and hepatocellular necrosis may occur later.<br />\r\n<br />\r\n<strong>Treatment:</strong>&nbsp;Empty stomach contents by gastric lavage within 1 hr of ingestion. In severe toxicity, IV desferrioxamine may be given. Whole bowel irrigation may also be considered in severe poisoning.</p>', '<p>Oral Iron preparations</p>', '<p>Safe Storage and Handling of Ferrous Sulfate. Do not smoke or eat in storage areas.&nbsp;<strong>Use stainless steel or fiberglass tanks</strong>&nbsp;for storage. Keep product away from heat sources and direct sunlight.</p>', NULL, '2022-02-22 03:02:48', '2022-02-22 03:02:48'),
(571, 571, '<p>For treatment of iron deficiency and prevention of concomitant Folic acid deficiency in adults. For maintenance of maternal haematopoiesis during pregnancy particularly when diet is abnormal or substandard.</p>', '<p>Iron is an essential constituent of the body being necessary for haemoglobin formation and for the oxidative processes of living tissues. Iron salts should only be given for the treatment and as prophylaxis of Iron deficiency anaemia. Iron deficiency anaemias are most often the result of chronic haemorrhage, nutritional deficiency, pregnancy or parasite infestation or malabsorption of iron.<br />\r\n<br />\r\nA deficiency of Folic acid typically during pregnancy has long been known to cause a megaloblastic anaemia. The vitamin is not storable in the body and the combination of fetal demand during pregnancy and malnutrition can lead to a deficiency, hence anaemia. It has been observed that the rapid production of red blood cells following treatment with iron may deplete body folate if there is inadequate intake; combination of folic acid and ferrous fumerate avoids the complication. Iron and Folic acid are absorbed in the proximal small intestine particularly the duodenum. Ferrous Fumerate &amp; Folic acid supplements replenish iron deficiency. Thereby arresting the anaemia process. Absorbed iron is taken upto the bone marrow&#39;s tissues that form blood cells where it is used to synthesize haemoglobin.</p>', '<p><strong>In anaemia</strong>: The usual dose is one tablet or capsule daily.<br />\r\n<br />\r\n<strong>In severe or refractory iron deficiency anaemia:&nbsp;</strong>The usual dose is one tablet&nbsp;or capsule twice daily may be given.<br />\r\n<br />\r\nIn Pregnancy, it is recommended that the dose should be started at the first antenatal consultation and continued until 3 months after delivery.</p>', '<p>When Ferrous Fumerate &amp; Folic acid combination&nbsp;and Tetracycline are taken concomitantly, absorption of both drugs are reduced. Concurrent administration of antacid may reduce absorption of iron. Serum anticonvulsant levels may be reduced by administration of folate.</p>', '<p>This&nbsp;is contraindicated in patients with pernicious anaemia and anaemia other than those due to iron deficiency.&nbsp;The nature and causes of anaemia should be established. Absorption of Ferrous Fumerate &amp; Folic acid&nbsp;is inhibited by Magnesium trisillicate and Antacid containing carbonate.</p>', '<p>Gastric distress, abdominal cramps, diarrhoea, allergic reaction.</p>', '<p>There is no contraindication in pregnancy and lactation.</p>', '<p>Administration of Ferrous Fumerate &amp; Folic acid&nbsp;during the first trimester of pregnancy may be undesirable. Very few pregnant women are not protected by physiological doses of Folic acid. If anaemia is developed despite prophylaxis with Ferrous Fumerate &amp; Folic acid, patients should be investigated further. Some postgastrectomy patients show poor absorption of iron. Care is needed when treating patients with peptic ulcer.</p>', NULL, '<p>Iron &amp; Vitamin Combined preparations</p>', NULL, NULL, '2022-02-22 03:05:10', '2022-02-22 03:05:10'),
(572, 572, '<p>Iron-deficiency anemia.</p>', '<p>Ferrous gluconate is used in the prevention and treatment of iron-deficiency anaemia. It replaces iron found in haemoglobin, myoglobin and enzymes. It also allows transportation of oxygen via haemoglobin.</p>', '<p>Iron-deficiency anaemia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;60 mg bid up to 60 mg 4 times daily. Prevention: 60 mg daily.</li>\r\n	<li><strong>Child:</strong>&nbsp;Severe: 4-6 mg/kg/day in 3 divided doses; Mild to moderate: 3 mg/kg/day in 1-2 divided doses. Prevention: 1-2 mg/ kg/ day.</li>\r\n</ul>\r\n\r\n<p>Should be taken on an empty stomach. Best taken on an empty stomach. May be taken with meals to reduce GI discomfort.</p>', '<p>Concurrent admin with antacids/ H2 antagonists may reduce absorption of iron. Chloramphenicol may delay response to iron. Iron may reduce the absorption of levodopa, methyldopa and penicillamine when given together. Absorption may be reduced when used with quinolones or tetracyclines. Concurrent admin with vitamin C may increase iron absorption.</p>', '<p>Haemochromatosis, haemolytic anemia.</p>', '<p>GI symptoms e.g. stomach cramping, constipation, nausea, vomiting, dark stools, heartburn, diarrhea, teeth staining, urine discoloration.</p>', '<p><strong>Pregnancy Category- A.</strong>&nbsp;Adequate and well-controlled human studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).</p>', '<p>Avoid in patients with peptic ulcer, enteritis, or ulcerative colitis and those who receive frequent blood transfusions. Not to be used in premature infants until the vitamin E stores (deficient at birth) are replenished. Avoid prolonged treatment (&gt;6 mth) except in patients with continuous menorrhagia or bleeding.</p>', '<p>Overdose may lead to severe iron toxicity, espcially in children.</p>', '<p>Oral Iron preparations</p>', NULL, NULL, '2022-02-22 03:06:48', '2022-02-22 03:06:48');
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
(573, 573, '<p>Ferrous Sulfate is indicated in the treatment and prevention of iron deficiency anaemia and anaemia of pregnancy where routine administration of iron is necessary.</p>', '<p>Ferrous Sulphate has the general properties of iron salts and is one of the most widely used iron salts in the treatment of iron deficiency anaemia. Ferrous sulfate facilitates O2&nbsp;transport via haemoglobin. It is used as iron source as it replaces iron found in haemoglobin, myoglobin and other enzymes.</p>', '<p>Adult-</p>\r\n\r\n<ul>\r\n	<li><strong>Initial therapeutic dose:</strong>&nbsp;3-4&frac12; teaspoonful daily in divided doses or as prescribed by the physician.</li>\r\n	<li><strong>Maintenance dose:</strong>&nbsp;1&frac12; teaspoonful daily, but if needed up to 1.8g (9 teaspoonful) daily can be given.</li>\r\n</ul>\r\n\r\n<p>Children-</p>\r\n\r\n<ul>\r\n	<li><strong>Under 1 year:</strong>&nbsp;&frac14; th teaspoonful thrice daily or as directed by physician</li>\r\n	<li><strong>1-5 years:</strong>&nbsp;1 teaspoonful thrice daily</li>\r\n	<li><strong>6-12 years:</strong>&nbsp;1&frac12; teaspoonful twice daily.</li>\r\n</ul>\r\n\r\n<p>Mix with water or fruit juice to avoid temporary staining of teeth. Do not mix with milk.</p>', '<p>Absorption of iron salt and Tetracycline is diminished when taken concomitantly by mouth. If treatment with both drugs is required iron salt should be given 3 hours before or 2 hours after Tetracycline. Absorption of iron is also decreased in the presence of antacids or when taken with tea.</p>', '<p>Iron therapy is contraindicated in haemachromatosis and haemosiderosis.It should not be given to patients receiving repeated blood transfusion or with anaemia not produced by iron deficiency.</p>', '<p>Therapeutic doses of iron may cause gastrointestinal symptoms like diarrhoea, nausea and vomiting. Although iron is better absorbed between meals, side effects can be reduced by taking it with or immediately after food. Continuous administration may sometimes cause constipation. Iron containing liquid medication may cause temporary staining of teeth (this is less likely when diluted).</p>', '<p>Should be administered with caution when given to patients with iron storage or iron absorption disease, haemoglobinopathies or existing gastrointestinal disease.</p>', NULL, NULL, '<p>Oral Iron preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-22 03:18:45', '2022-02-22 03:18:45'),
(574, 574, '<p>This capsule is a haematinic preparation for the treatment and prophylaxis of iron and folic acid deficiency, especially during pregnancy and lactation.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>This is a capsule preparation of ferrous sulfate (in timed release form) and folic acid. This timed release capsule is designed in such a way that it prevents release of iron in stomach and thus prevents gastric side effects. This capsule ensures maximum absorption of iron by releasing it at the site of its absorption.</p>', '<p>Iron is an essential constituent of the body, being necessary for haemoglobin formation and for the oxidative processes of living tissues. Iron is primarily absorbed from the duodenum and upper jejunum. The ferrous salt form is absorbed three times more readily than the ferric salt form. The adult male has a requirement of only 13 &micro;g/kg per day (about 1 mg), whereas the menstruating female requires about 21 &micro;g/kg per day (about 1.4 mg). In the last two trimesters of pregnancy, requirements increase to about 80 &micro;g/kg per day (5 to 6 mg). Folic acid is an important factor in cell division and without it, division stops. Adequate folic acid is required for normal erythropoiesis. Deficiency of Folic Acid causes megaloblastic anaemia</p>', '<p>1 (one) capsule a day, throughout pregnancy and lactation. Some patients may need a higher dose because of dietary or other factors.</p>', '<p>The absorption of both iron salts and tetracyclines is diminished when they are taken concomitantly by mouth. The absorption of iron salts may also be decreased by magnesium trisilicate-containing antacid.</p>', '<p>Contraindicated in patients receiving repeated blood transfusions or in patients with anaemias not produced by iron deficiency unless iron deficiency is also present.</p>', '<p>Because iron salts are astringent, gastrointestinal irritation may occur. Nausea and epigastric pain are dose related.</p>', NULL, '<p>Iron chelates with antacid and tetracycline and absorption of all these may be impaired if taken concurrently. However, the administration of tetracycline during pregnancy is contraindicated.</p>', '<p>Symptoms of overdosage with iron salts include epigastric pain, nausea and vomiting, haematemesis and circulatory collapse. In severe cases encephalopathy, acute hepatic necrosis and acute renal failure may develop after a latent period. The timed release capsule presentation of ferrous sulfate may delay excessive absorption of iron and allow more time for the initiation of appropriate counter measures. Treatment consists of gastric lavage followed by the introduction of 5 gm desferrioxamine into the stomach. Serum iron levels should be monitored, in severe cases intravenous desferrioxamine should be given together with supportive and symptomatic measures as required.</p>', '<p>Iron &amp; Vitamin Combined preparations</p>', '<p>Do not store above 25&deg;C temperature, keep away from light and wet place. Keep out of reach of children.</p>', NULL, '2022-02-22 03:23:47', '2022-02-22 03:23:47'),
(575, 575, '<p>This is indicated for the treatment and prophylaxis of Iron, Folic Acid and Zinc deficiency especially during pregnancy and lactation.</p>', NULL, '<p><strong>Adult or Elderly</strong>: 1 capsule daily. In more severe cases, 2 capsules daily may be required.<br />\r\n<br />\r\n<strong>Children</strong>: Aged over 1 year: 1 capsule daily. The capsule may be opened and the pellets to be mixed with soft cool food, but they must not be chewed.</p>', NULL, '<p>Do not use in patients hypersensitive to the components of the product or those with iron overload.</p>', '<p>Dark stools are usual during iron therapy and nausea and other symptoms of gastrointestinal irritation such as anorexia, vomiting, discomfort, constipation and diarrhoea are sometimes encountered. Zinc may also produce a gastrointestinal upset. These timed-release capsules are designed to reduce the possibility of gastrointestinal irritation. There have been rare reports of allergic reactions</p>', '<p>Use of any drug during the first trimester of pregnancy should be avoided if possible. Thus administration of Iron during the first trimester requires definite evidence of Iron deficiency where inadequate diet calls for supplementary Zinc and Folic acid is justified during the remainder of the pregnancy.</p>', '<p>Care should be taken in patients who may develop Iron overloads, such as those with haemochromatosis, haemolytic anaemia or red cell aplasia. Failure to respond to treatment may indicate other causes of anaemia and should be further investigated. Iron &amp; Zinc chelate with tetracycline and absorption of all three agents may be impaired. The absorption of Zinc may be reduced in the presence of Iron. Absorption of Iron may be impaired by penicillamine and by antacids. Such potential interactions can be reduced by separating the administration of each product by several hours. In patients with renal failure a risk of Zinc accumulation could exist.</p>', '<p>Iron overdosage is dangerous, particularly in children and requires immediate attention. Gastric lavage should be carried out in the early stages, or if this is not possible vomiting should be induced. These procedures should not be undertaken where signs of the corrosive effects of zinc are present. Give oral desferrioxamine (2 gm for a child or 5 gm for an adult) and demulcent. If serum Iron levels at 4 hours or more post-ingestion are over 5mg/l in a child or 8 mg/l in adults, or if the patient is in shock of coma, intravenous desferrioxamine should be used. Zinc Sulphate in gross over dosage is corrosive. Symptoms are those of gastrointestinal irritation leading in severe cases to haemorrhage, corrosion of the mucosa and possible later stricture formation. Gastric lavage or emesis should be avoided. Demulcents such as milk should be given. Chelating agents such as Dimercaprol, Penicillamine or Edetic Acid have been recommended.<br />\r\n<br />\r\nSymptomatic and supportive measures should be given as required. The timed-release capsule presentation may delay excessive absorption of Iron and Zinc and allow more time for initiation of appropriate counter-measure.</p>', '<p>Iron, Vitamin &amp; Mineral Combined preparation</p>', '<p>Protected from light and moisture, store below 30˚C. Keep out of reach of children.</p>', NULL, '2022-02-22 03:35:08', '2022-02-22 03:35:08'),
(576, 576, '<p>For the relief of symptoms associated with seasonal and perennial allergic complications in adults and children 12 years of age and older. Symptoms treated effectively include sneezing, rhinorrhea, itchy nose/ palate/ and/or throat, itchy/ watery/ red eyes, and nasal congestion.<br />\r\n<br />\r\nIt should be administered when both the antihistaminic properties of Fexofenadine Hydrochloride and the nasal decongestant properties of Pseudoephedrine Hydrochloride are desired.</p>', '<p>Fexofenadine Hydrochloride is an antihistamine with selective peripheral H1 receptor antagonist activity. It does not cross the blood brain barrier.<br />\r\n<br />\r\nPseudoephedrine is an orally active sympathomimetic amine and exerts a decongestant action on the nasal mucosa. This is recognized as an effective agent for the relief of nasal congestion due to allergic rhinitis.&nbsp;<br />\r\n<br />\r\nPseudoephedrine 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.</p>', '<p>The recommended dose is one tablet twice daily administered on an empty stomach with water for adults and children 12 years of age and older. It is recommended that the administration of this Tablet with food should be avoided.<br />\r\n<br />\r\nOne tablet once daily is recommended as the starting dose in patients with decreased renal function. This must be swallowed whole and never crushed or chewed.</p>', '<p>Fexofenadine Hydrochloride and Pseudoephedrine Hydrochloride do not influence the pharmacokinetics of each other when administered concomitantly. However, co-administration of Fexofenadine Hydrochloride with either ketoconazole or Erythromycin lead to increased plasma concentrations of Fexofenadine.</p>', '<p>This drug is contraindicated in patients with known hypersensitivity to any of its ingredients.</p>', '<p>The reported side effects are insomnia, headache, nausea, dry mouth, dizziness, agitation, nervousness, anxiety, and palpitation etc.</p>', '<p><strong>Pregnancy:</strong>&nbsp;Category C. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Lactation:</strong>&nbsp;Caution should be exercised when this drug is administered to nursing women.</p>', '<p>Hyperthyroidism; ischaemic heart disease, arrhythmia or tachycardia; occlusive vascular disorders e.g. arteriosclerosis, hypertension or aneurysms; DM and closed-angle glaucoma; renal impairment, prostatic enlargement. Pregnancy; lactation.</p>', '<p><strong>For Fexofenadine:</strong>&nbsp;There is limited information, however, dizziness, drowsiness, and dry mouth etc. have been reported.<br />\r\n<br />\r\n<strong>For Pseudoephedrine:</strong>&nbsp;headache, nausea, vomiting, sweating, thirst, tachycardia, pericardial pain, palpitations, difficulty in micturition, muscular weakness and tenseness, anxiety, restlessness, and insomnia etc have been reported.</p>', '<p>Anti-histamine &amp; decongestant</p>', '<p>Store at a cool and dry place, protected from light &amp; moisture. Keep out of reach of children.</p>', '<p><strong>Pediatric Uses:</strong>&nbsp;This drug is not recommended for pediatric patients under 12 years of age.</p>', '2022-02-26 02:07:49', '2022-02-26 02:07:49'),
(577, 577, '<p>Fexofenadine Hydrochloride is indicated for the relief of symptoms associated with seasonal allergic rhinitis in adults and children. It is also indicated for the treatment of uncomplicated skin manifestations of chronic idiopathic urticaria.</p>', '<p>Fexofenadine Hydrochloride is an antihistamine with selective peripheral H1-receptor antagonist activity. It is rapidly absorbed after oral administration and peak plasma concentration is reached in 2-3 hours. It does not appear to cross the blood brain barrier.</p>', '<p><strong>Seasonal Allergic Rhinitis-</strong><br />\r\n<br />\r\nAdults and children 12 years and older:</p>\r\n\r\n<ul>\r\n	<li>Tablet: 60 mg twice daily or 120 mg once daily or 180 mg once daily</li>\r\n	<li>In case of impaired renal function: 60 mg once daily</li>\r\n</ul>\r\n\r\n<p>Children from 6 to 11 years:</p>\r\n\r\n<ul>\r\n	<li>Tablet: 30 mg twice daily or 60 mg once daily</li>\r\n	<li>In case of impaired renal function: 30 mg once daily</li>\r\n</ul>\r\n\r\n<p>Children from 2 to 11 years</p>\r\n\r\n<ul>\r\n	<li>Suspension: 30 mg or 5 ml&nbsp;twice daily</li>\r\n	<li>In case of impaired renal function: 30 mg or 5 ml once daily</li>\r\n</ul>\r\n\r\n<p><br />\r\n<br />\r\n<strong>Chronic Idiopathic Urticaria-</strong><br />\r\n<br />\r\nAdults and children 12 years and older:</p>\r\n\r\n<ul>\r\n	<li>Tablet: 60 mg twice daily or 120 mg once daily or 180 mg once daily&nbsp;</li>\r\n	<li>In case of impaired renal function: 60 mg once daily</li>\r\n</ul>\r\n\r\n<p>Children from 6 to 11 years:</p>\r\n\r\n<ul>\r\n	<li>Tablet: 30 mg twice daily or 60 mg once daily</li>\r\n	<li>In case of impaired renal function: 30 mg once daily</li>\r\n</ul>\r\n\r\n<p>Children from 6 months to less than 2 years:</p>\r\n\r\n<ul>\r\n	<li>Suspension: 15 mg or 2.5 ml (1/2 tsp) twice daily</li>\r\n	<li>In case of impaired renal function: 15 mg or 2.5 ml (1/2 tsp) once daily</li>\r\n</ul>\r\n\r\n<p>Children from 2 to 11 years:</p>\r\n\r\n<ul>\r\n	<li>Suspension: 30 mg or 5 ml (1 tsp) twice daily</li>\r\n	<li>In case of impaired renal function: 30 mg or 5 ml (1 tsp) once daily</li>\r\n</ul>', '<p>Plasma concentration of Fexofenadine Hydrochloride have been increased when given with erythromycin or ketoconazole. Aluminium and magnesium hydroxide containing antacid reduces the absorption of Fexofenadine Hydrochloride.</p>', '<p>Contraindicated in patients with known hypersensitivity to Fexofenadine Hydrochloride or any of its ingredients.</p>', '<p>Common side effects are headache, fatigue, drowsiness, nausea, dry mouth and gastrointestinal disturbances.</p>', '<p>US FDA pregnancy category of Fexofenadine Hydrochloride is C. So, Fexofenadine Hydrochloride should be avoided in pregnancy and lactation unless the potential benefits to the other outweigh the possible risks to the fetus.</p>', '<p>Caution should be exercised in elderly patient and patient with decreased renal function.</p>', '<p>In case of an overdose, standard measures to remove any unabsorbed drug should be employed. Symptomatic and supportive treatment is recommended. There has been no reported case of an acute overdose of Fexofenadine hydrochloride.</p>', '<p>Non-sedating antihistamines</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-02-26 02:09:17', '2022-02-26 02:09:17'),
(578, 578, '<p>Filgrastim is indicated to those:</p>\r\n\r\n<ul>\r\n	<li>Cancer patients receiving myelosuppressive chemotherapy</li>\r\n	<li>Patients with Acute Myeloid Leukemia receiving induction or consolidation chemotherapy</li>\r\n	<li>Cancer patients receiving bone marrow transplant</li>\r\n	<li>Patients with severe neutropenia</li>\r\n	<li>Peripheral blood progenitor cell collection and therapy</li>\r\n</ul>\r\n\r\n<p>Filgrastim is a human granulocyte colony stimulating factor (G-CSF) produced by recombinant DNA technology. G-CSF regulates the production of neutrophils within the bone marrow and affects neutrophil progenitor proliferation, differentiation and enhances phagocytic activity.</p>', '<p>Filgrastim is a granulocyte-colony stimulating factor which binds to cell surface receptors on haemetopoietic cells thus stimulating the development of granulocytes to increase their migration and cytotoxicity.<br />\r\n<br />\r\nFilgrastim is a glycoprotein which regulates the production and release of functional neutrophils from the bone marrow. Filgrastim causes marked increases in peripheral blood neutrophil counts within 24 hours, with minor increases in monocytes. Elevations of neutrophil counts are dose-dependent at recommended doses. Following termination of Filgrastim therapy, circulating neutrophil counts decrease by 50% within 1 to 2 days, and to normal levels within 1 to 7 days.</p>', '<p><strong>Parenteral-</strong></p>\r\n\r\n<p><strong>Chemotherapy-induced neutropenia</strong>:&nbsp;5 mcg/kg daily as a single daily SC inj, as a continuous IV or SC infusion, or as a daily IV infusion over 15-30 minutes, starting not<br />\r\n<br />\r\n<strong>Bone marrow transplantation</strong>:&nbsp;10 mcg/kg daily by IV infusion over 30 min or 4 hr or continuous IV or SC infusion over 24 hr. Adjust according to response.</p>\r\n\r\n<p><br />\r\n<strong>Subcutaneous-</strong></p>\r\n\r\n<p><strong>Mobilisation of peripheral blood progenitor cells for autologous peripheral blood stem cell transplantation</strong>:&nbsp;10 mcg/kg daily, as a single inj or by continuous infusion, for 4-7 days until the last leucapheresis procedure. If it is given after myelosuppressive chemotherapy: 5 mcg/kg daily by inj; given from the 1st day after chemotherapy completion until expected neutrophil nadir is passed and neutrophil count has returned to normal range, so that leucapheresis can be performed.<br />\r\n<br />\r\n<strong>Congenital neutropenia</strong>:&nbsp;12 mcg/kg daily in single or divided doses. Adjust according to response. In patients with cyclic or idiopathic neutropenia: 5 mcg/kg daily in single or divided doses. Adjust according to response.<br />\r\n<br />\r\n<strong>HIV infection and persistent neutropenia</strong>: Initially, 1 mcg/kg daily. Dose may be increased to 4 mcg/kg daily until normal neutrophil count is achieved. Maintenance: 300 mcg daily. Max: 4 mcg/kg daily.</p>', '<p>Drug interactions between Filgrastim and other drugs have not been fully evaluated. Drugs which may potentiate the release of neutrophils, such as lithium should be used with caution.</p>', '<p>Filgrastim is contraindicated in patients hypersensitive to the drug, any ingredient in the formulation, or proteins derived from Escherichia coli.</p>', '<p>Musculoskeletal pain, bone pain, hypersensitivity reactions, splenic enlargement, hepatomegaly, thrombocytopaenia, anaemia, epistaxis, headache, nausea, vomiting, diarrhoea, urinary abnormalities (dysuria, proteinuria, haematuria), osteoporosis, exacerbation of rheumatoid arthritis, transient decrease in blood glucose, raised uric acid, cutaneous vasculitis, transient hypotension.</p>', '<p><strong>Category C</strong>: 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>Filgrastim should not be administered within 24 hours before and after chemotherapy &nbsp;The possibility of Filgrastim acting as a growth factor for any tumor type cannot be excluded. To avoid adverse effects of excessive neutrophils complete blood count is recommended twice per week during treatment. Filgrastim is given by subcutaneous or intravenous infusion as required</p>', '<p>The possibility of Filgrastim acting as a growth factor for any tumor type and adverse effects of excessive neutrophils may occur in overdose of Filgrastim.</p>', '<p>Haematopoietic Agents</p>', '<p>Refrigerate at 2-8&deg; C. Do not freeze.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Reconstitution: Dilution of Filgrastim conc less than 5 mcg/ml is not recommended at any time. Filgrastim may be diluted in 5% dextrose as required</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>&nbsp;</p>', '<p><strong>Pediatric precautions:</strong>&nbsp;Filgrastim has been used in children 3 months to 18 years of age without unusual adverse effect. However, safety and efficacy of the drug in neonates or patients with autoimmune neutropenia of infancy have not been established.</p>', '2022-02-26 02:12:04', '2022-02-26 02:12:04'),
(579, 579, '<p>Finasteride is indicated for the treatment of male pattern hair loss (androgenic alopecia) in men only.</p>', '<p>Finasteride, a competitive inhibitor of steroid Type II 5&alpha; reductase, an intracellular enzyme that converts the androgen testosterone into 5&alpha; dihydrotestosterone (DHT). Finasteride is a competitive and specific inhibitor of Type II 5&alpha; reductase, an intracellular enzyme that converts the androgen testosterone into DHT. Finasteride has no affinity for the androgen receptor and has no androgenic or antiandrogenic effects. Inhibition of Type II 5&alpha; reductase blocks the conversion of testosterone to DHT, resulting in significant decreases in serum and tissue DHT concentrations. In men with male pattern hair loss, the balding scalp contains miniaturised hair follicles and increased amounts of DHT compared with hairy scalp. Administration of Finasteride decreases scalp and serum DHT concentrations in these men.</p>', '<p>The recommended dosage is 1 mg once a day. Recur may be administered with or without meals. In general, daily use for three months or more is necessary before benefit is observed. Continued use is recommended to sustain benefit. Withdrawal of treatment leads to reversal of effect within 12 months.</p>', '<p>No drug interactions of clinical importance have been identified.</p>', '<p>Hypersensitivity to any component of this medication. Finasteride use is also contraindicated in women and paediatric patient.</p>', '<p>Finasteride is well tolerated. In clinical studies, the following adverse reactions were reported as possibly drug related in &gt;1% of patients treated for 12 months with Finasteride 1 mg daily : decreased libido (1.8%), erectile dysfunction (1.3%), ejaculation disorder (1.2%) and decreased volume of ejaculate (0.8%).</p>', NULL, '<p>Caution should be used in the administration of Recur in patients with liver function abnormalities, as Finasteride is metabolised extensively in the liver. Women who are or may potentially be pregnant should not handle crushed or broken tablets of Recur.</p>', NULL, '<p>Miscellaneous topical agents</p>', NULL, NULL, '2022-02-26 02:13:41', '2022-02-26 02:13:41'),
(580, 580, '<p>Finasteride is indicated for the treatment and control of benign prostatic hyperplasia (BPH)-</p>\r\n\r\n<ul>\r\n	<li>To cause regression of the enlarged prostate</li>\r\n	<li>To improve urinary flow</li>\r\n	<li>To improve the symptoms associated with BPH.</li>\r\n</ul>', '<p>Finasteride, a competitive inhibitor of the 5&alpha; reductase enzyme which is used in the treatment of benign prostatic hyperplasia. It is selective for 5&alpha; reductase type 2 enzyme and has no affinity for androgen receptors. The development of the prostate gland and subsequent BPH is dependent upon conversion of testosterone to dihydrotestosterone (DHT) within the prostate. Finasteride belongs to a new class of specific inhibitors of 5&alpha; reductase, an intracellular enzyme, which metabolises testosterone into the more potent androgen, DHT. Finasteride has no affinity for the androgen receptor.</p>', '<p>The recommended dosage is one 5 mg tablet daily. Although early improvement may be seen, treatment for at least six months may be necessary to assess whether a beneficial response has been achieved. Thereafter, treatment should be continued.</p>', '<p>No clinically important drug interactions have been identified. Finasteride does not appear to significantly affect the cytochrome P450 linked drug metabolising enzyme system. Compounds which have been tested in man include Propranolol, Digoxin, Glibenclamide, Warfarin, Theophylline, and antipyrine.</p>', '<p>Hypersensitivity to any component of this medication. Finasteride use is also contraindicated in women and paediatric patient.</p>', '<p>Finasteride is well tolerated. In clinical studies, the following adverse experiences have been reported as possibly drug related in 1% of patients treated for 12 months with 5 mg Finasteride daily: impotence (3.7%), decreased libido (3.3%), and decreased volume of ejaculate (2.8%).</p>', '<p>Finasteride is contraindicated in women who are or may become pregnant. Finasteride is not indicated for use in women. It is not known whether finasteride is excreted in human milk.<br />\r\n<br />\r\n<strong>Exposure to finasteride-risk to male fetus</strong>: Crushed or broken Finasteride Tablets should not be handled by women who are or may become pregnant because of the possibility of absorption of finasteride and the subsequent potential risk to a male fetus. Similarly, small amounts of finasteride have been recovered from the semen in subjects receiving Finasteride 5 mg/day. It is not known whether a male fetus may be adversely affected if his mother is exposed to the semen of a patient being treated with finasteride. Therefore, when the patients sexual partner is or may become pregnant, the patient should either avoid exposure of his partner to semen (e.g. by use of a condom) or discontinue Finasteride.</p>', '<p><strong>General</strong>: Since the beneficial response to Finasteride may not be manifested immediately, patients with large residual urine volume and/or severely diminished urinary flow should be carefully monitored for obstructive uropathy.<br />\r\n<br />\r\n<strong>Prostate cancer</strong>: Digital rectal examination, as well as, other evaluations for prostate cancer, should be performed on patients with BPH prior to initiating therapy with Finasteride and periodically thereafter. Finasteride causes a decrease in serum concentration of markers of prostatic cancer such as prostate specific antigen (PSA); therefore, reduction of serum levels of these markers in patients with BPH treated with Finasteride does not rule out concomitant prostate cancer. No clinical benefit has yet been demonstrated in patients with prostate cancer treated with Finasteride.</p>', NULL, '<p>BPH/ Urinary retention/ Urinary incontinence</p>', '<p>Store at cool and dry place (below 30&deg;C). Protect from light and moisture. Keep all the medicines out of the reach of children.</p>', '<p><strong>Renal insufficiency</strong>: Dosage adjustments are not necessary in patients with renal insufficiency since pharmacokinetic studies did not indicate any change in the disposition of Finasteride.<br />\r\n<strong>Hepatic insufficiency</strong>: There are no data available in patients with hepatic insufficiency.<br />\r\n<strong>Elderly</strong>: No dosage adjustment is required in elderly patients.</p>', '2022-02-26 02:15:33', '2022-02-26 02:15:33'),
(581, 581, '<p>Flavoxate is indicated for symptomatic relief of dysuria, urgency, nocturia, suprapubic pain, frequency and incontinence as may occur in cystitis, prostatitis, urethritis and urethrocystitis.</p>\r\n\r\n<p>Flavoxate is a spasmolytic flavone derivative that acts by relaxing the smooth muscle in the urinary tract. Flavoxate is a competitive muscarinic receptor antagonist indicated for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and urinary frequency. Muscarinic receptors play an important role in several major cholin-ergically mediated functions, including contractions of urinary bladder smooth muscle and stimulation of salivary secretion.</p>', '<p>Flavoxate acts as a direct antagonist at muscarinic acetylcholine receptors in cholinergically innervated organs. Its anticholinergic-parasympatholytic action reduces the tonus of smooth muscle in the bladder, effectively reducing the number of required voids, urge incontinence episodes, urge severity and improving retention, facilitating increased volume per void.</p>', '<p><strong>Adults and children over 12 years of age</strong>: 100 mg to 200 mg 3 times a day. With improvement of symptoms, the dose may be reduced.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness in children below the age of 12 years have not been established.</p>', NULL, '<p>Flavoxate is contraindicated in patients who have any of the following obstructive conditions: pyloric or duodenal obstruction, obstructive intestinal lesions or ileus, achalasia, gastrointestinal hemorrhage and obstructive uropathies of the lower urinary tract.</p>', '<p><strong>Gastrointestinal:</strong>&nbsp;Nausea, vomiting, dry mouth.<br />\r\n<br />\r\n<strong>CNS:</strong>&nbsp;Vertigo, headache, mental confusion, especially in the elderly, drowsiness, nervousness.<br />\r\n<br />\r\n<strong>Hematologic:</strong>&nbsp;Leukopenia (which is reversible upon discontinuation of the drug).<br />\r\n<br />\r\n<strong>Cardiovascular:</strong>&nbsp;Tachycardia and palpitation.<br />\r\n<br />\r\n<strong>Allergic:</strong>&nbsp;Urticaria and other dermatoses, eosinophilia and hyperpyrexia.<br />\r\n<br />\r\n<strong>Ophthalmic:</strong>&nbsp;Increased ocular tension, blurred vision, disturbance in eye accommodation.</p>', '<p><strong>Pregnancy:</strong>&nbsp;Pregnancy Category B. This drug should be used during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Nursing Mothers:</strong>&nbsp;It is not known whether this drug is excreted in human milk. Caution should be exercised when flavoxate is administered to a nursing woman.</p>', '<p>Flavoxate should be given cautiously in patients with suspected glaucoma.</p>', NULL, '<p>BPH/ Urinary retention/ Urinary incontinence</p>', '<p>Store Flavoxate at room temperature, between 20 and 25 degrees C.</p>', NULL, '2022-02-26 02:17:14', '2022-02-26 02:17:14'),
(582, 582, '<p>Flucloxacillin is indicated for the treatment of infections due to Gram-positive organisms, including infections caused by penicillinase producing staphylococci. These indications include:</p>\r\n\r\n<ul>\r\n	<li>Skin and soft tissue infections: Boils, abscess, carbuncles, infected skin conditions (e.g. ulcer, eczema, acne, furunculosis, cellulitis, infected wounds, infected burns, otitis media and externa, impetigo).</li>\r\n	<li>Respiratory tract infections: Pneumonia, lung abscess, empyema, sinusitis, pharyngitis, tonsillitis, quinsy.</li>\r\n	<li>It is also used for the treatment of other infections i.e. osteomyelitis, enteritis, endocarditis, urinary tract infection, meningitis, septicaemia caused by Flucloxacillin-sensitive organisms.</li>\r\n	<li>As a prophylactic agent, it is used during major surgical procedures where appropriate; for example, cardiothoracic and orthopedic surgery.</li>\r\n</ul>', '<p>Flucloxacillin is active against Gram-positive organisms including penicillinase producing strains. It has little activity against Gram-negative bacilli. Flucloxacillin acts by inhibiting the formation of cell wall of bacteria. Flucloxacillin is isoxazolyl penicillin which combined the properties of resistance to hydrolysis by penicillinase, gastric acid stability and activity against gram-positive bacteria. Flucloxacillin is a bactericidal antibiotic that is particularly useful against penicillinase-producing staphylococci. Flucloxacillin kills bacterial cellwall, thus interfering with peptidoglycan synthesis. Peptidoglycan is a heteropolymeric structure that provides the cell wall with its mechanical stability. The final stage of peptidoglycan synthesis involves the completion of the cross-linking with the terminal glycine residue of the pentaglycin bridge linking to the fourth residue of the pentapeptide (D-alanine). The transpeptidase enzyme that performs this step is inhibited by Flucloxacillin. As a result the bacterial cellwall is weakened, the cell swells and then ruptures. Flucloxacillin resists the action of bacterial penicillinase probably because of the steric hindrance induced by the acyl side chain which prevents the opening of the &beta;- lactam ring.</p>', '<p>Oral administration:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 250 mg four times daily. Dosage may be doubled in severe infections. In osteomyelitis and endocarditis, up to 8 gm daily is used in 6-8 hourly divided doses.</li>\r\n	<li><strong>Children (2-10 years)</strong>: 1/2 of adult dose.</li>\r\n	<li><strong>Children (Under 2 years)</strong>: 1/4 of adult dose.</li>\r\n</ul>\r\n\r\n<p>Parenteral administration:<br />\r\nAdult or Elderly:</p>\r\n\r\n<ul>\r\n	<li><strong>Intramuscular Injection</strong>: 250 mg four times daily.</li>\r\n	<li><strong>Intravenous Injection</strong>: 250 mg-1 g four times daily by slow injection over 3 to 4 minutes or by intravenous infusion.</li>\r\n	<li><strong>All systemic doses may be doubled in severe infections</strong>: doses up to 8 g daily have been suggested for endocarditis or osteomyelitis.</li>\r\n</ul>\r\n\r\n<p>Children:</p>\r\n\r\n<ul>\r\n	<li><strong>2-10 years</strong>: half of the adult dose.</li>\r\n	<li><strong>Under 2 years</strong>: a quarter of the adult dose.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Oral doses should be administered 1 hour before meal.</strong></p>', '<p>Concurrent use of Flucloxacillin and may result in increased level of Flucloxacillin in blood for prolonged period.</p>', '<p>Flucloxacillin is contraindicated in penicillin hypersensitive patients.</p>', '<p>There have been some common side effects of gastrointestinal tract such as nausea, vomiting, diarrhoea, dyspepsia and other minor gastrointestinal disturbances. Besides these rashes, urticaria, purpura, fever, interstitial nephritis, hepatitis and cholestatic jaundice have been reported.</p>', '<p>US FDA Pregnancy Category of Flucloxacillin is B. There are, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Flucloxacillin have been shown to be excreted in human milk. So, caution should be exercised when Flucloxacillin is administered to a lactating mother.</p>', '<p>Flucloxacillin should be used with caution in patients with evidence of hepatic dysfunction. Caution should also be exercised in the treatment of patients with an allergic diathesis.</p>', NULL, '<p>Penicillinase-resistant penicillins</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Flucloxacillin has been used in other routes in conjunction with systemic therapy. It has been administered in a dose of 250 mg to 500 mg daily by intraarticular injection, dissolved if necessary in a 0.5% solution of lignocaine hydrochloride, and by intrapleural injection in a dose of 250 mg daily. Using powder for injection, 125 mg-250 mg has been dissolved in 3 ml of sterile water and inhaled by nebuliser four times daily.</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', '<p>In severe renal failure (creatinine clearance &lt;10 ml/min), a reduction in dose or an extension of dose interval should be considered.</p>', '2022-02-26 02:20:05', '2022-02-26 02:20:05'),
(583, 583, '<p>Fluconazole is indicated for the treatment of vaginal candidiasis, oropharyngeal &amp; esophageal candidiasis and cryptococcal meningitis. It is also effective for the treatment of urinary tract infection caused by candida, peritonitis and systemic candida infections (including candidemia, disseminated candidiasis and pneumonia).</p>', '<p>Fluconazole is a triazole antifungal agent. It is a potent inhibitor of fungal cytochrome P-450 dependent enzymes. Cytochrome P-450 enzyme system is essential component of fungal cell membrane which is responsible for the synthesis of ergosterol.</p>', '<p>Adult (oral)-</p>\r\n\r\n<ul>\r\n	<li><strong>Vaginal candidiasis</strong>: 150 mg as a single dose.</li>\r\n	<li><strong>Oropharyngeal candidiasis</strong>: 200 mg on the first day, followed by 100 mg once daily. Clinical evidence of this infection generally resolves within several days, but treatment should be continued for at least 2 weeks to decrease the likelihood of relapse.</li>\r\n	<li><strong>Esophageal candidiasis</strong>: 200 mg on the first day, followed by 100 mg once daily. Doses up to 400 mg/day may be used. Patients should be treated for a minimum of three weeks and for at least two weeks following resolution of symptoms.</li>\r\n	<li><strong>Systemic candida infections</strong>: Optimal therapeutic dosage and duration of therapy have not been established. Sometimes, doses of up to 400 mg daily have been used.</li>\r\n	<li><strong>Urinary tract infections caused by candida and peritonitis</strong>: 50-200 mg daily have been used.</li>\r\n	<li><strong>Cryptococcal meningitis</strong>: 400 mg on the first day, followed by 200 mg once daily.</li>\r\n	<li><strong>Prophylaxis in patients undergoing bone marrow transplantation</strong>: 400 mg once daily.</li>\r\n</ul>\r\n\r\n<p>Child (oral):</p>\r\n\r\n<ul>\r\n	<li>Doses of 3-6 mg/kg daily have been used. Doses up to 12 mg/kg is recommended.</li>\r\n</ul>\r\n\r\n<p><br />\r\nIntravenous-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Invasive candidal infections including candidaemia and disseminated candidiasis and cryptococcal infections including meningitis, by IV, 400 mg initially then 200 mg daily, increased if necessary to 400 mg daily, treatment continued according to response (at least 6-8 weeks for cryptococcal meningitis)</li>\r\n	<li><strong>Child</strong>: 6-12 mg/kg daily (every 72 hours in neonate up to 2 weeks old, every 48 hours in neonate 2-4 weeks old); maximum 400 mg daily. Prevention of relapse of cryptococcal meningitis, by IV, 100-200 mg daily.</li>\r\n</ul>', '<p>Concomitant use of cyclosporin or phenytoin with Fluconazole increases the plasma level of cyclosporin or phenytoin. Concomitant use of Fluconazole &amp; warfarin prolongs the prothrombin time. Rifampicin level is decreased when used with Fluconazole.</p>', '<p>Fluconazole should not be used in patients with known hypersensitivity to Fluconazole or to related triazole compounds.</p>', '<p>Fluconazole is well tolerated. Most common side effects of using Fluconazole includes nausea, vomiting, abdominal pain, diarrhoea, headache and skin rash.</p>', '<p>US FDA Pregnancy category of Fluconazole is C. So, Fluconazole should be avoided in pregnancy and lactation unless the potential benefits to the other outweigh the possible risks to the fetus.</p>', '<p>Fluconazole should be administered with caution to patients having proarrhythmic conditions.</p>', NULL, '<p>Drugs for subcutaneous and mycoses</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-02-26 02:21:36', '2022-02-26 02:21:36'),
(584, 584, '<p>For the treatment of fungal corneal ulcers/ keratitis.</p>', '<p>Fluconazole is fungistatic in action. It inhibits cytochrome P-450 14-&alpha; demethylase in susceptible fungi which leads to accumulation of lanosterol and decreased concentration of ergosterol thereby altering cellular membrane resulting in increased membrane permeability, leakage of essential elements and impaired uptake of precursor molecules to DNA.</p>', '<p>Instill 1 drop to be instilled into the affected eye(s) 5 times daily.</p>', '<p>Fluconazole can alter pharmacokinetics of certain drugs undergoing hepatic metabolism.</p>', '<p>The drug is contraindicated in patients with hypersensitivity to azoles.</p>', '<p>This drug is generally well tolerated. Eosinophillia has been reported in some patients.</p>', '<p><strong>Use in pregnancy</strong>: Pregnancy category C. There are no adequate and well-controlled studies in pregnant women. Fluconazole should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: Nursing mother should not be given as the drug is excreted in breast milk in concentration similar to plasma.</p>', '<p>Use of fluconazole may result in overgrowth of non-susceptible strains of candida other than Candida albicans.</p>', NULL, '<p>Ophthalmic Anti-fungal Products</p>', '<p>Keep out of the reach of children. Store in a cool, dry place, away from heat and direct light. Do not use more than 4 weeks after opening the bottle.</p>', NULL, '2022-02-26 02:23:05', '2022-02-26 02:23:05'),
(585, 585, '<p>Fludarabine Phosphate is indicated for the treatment of adult patients with B-cell&nbsp;chronic lymphocytic leukemia&nbsp;(CLL) who have not responded to or whose disease has progressed during treatment with at least one standard alkylating-agent containing regimen. The safety and effectiveness of Fludarabine Phosphate in previously untreated or non-refractory&nbsp;patients with CLL have not been established.</p>', '<p>Fludarabine phosphate is rapidly dephosphorylated to 2-fluoro-ara-A and then phosphorylated intracellularly by deoxycytidine kinase to the active triphosphate, 2-fluoro-ara-ATP. This metabolite appears to act by inhibiting&nbsp;DNA polymerase&nbsp;alpha, ribonucleotide reductase and DNA primase, thus inhibiting DNA synthesis leading to cell death. The mechanism of action of this&nbsp;antimetabolite&nbsp;is not completely characterized and may be multi-faceted.</p>', '<p>Intravenous (Adult):<br />\r\n<strong>Chronic lymphocytic leukaemia</strong>:&nbsp;25 mg/m2&nbsp;BSA daily given by bolus inj or by IV infusion over 30 minutes for 5 consecutive days. Courses may be repeated every 28 days, usually for up to 6 cycles.<br />\r\n<br />\r\nOral (Adult):<br />\r\n<strong>Chronic lymphocytic leukaemia</strong>:&nbsp;40 mg/m2&nbsp;BSA daily for 5 consecutive days. Courses may be repeated every 28 days, usually for up to 6 cycles.</p>', '<p>Co-administration with pentostatin may lead to pulmonary toxicity. Reduced metabolic activation of fludarabine with cytarabine. Reduced therapeutic efficacy with dipyridamole and other adenosine uptake inhibitors.</p>', '<p>Renal impairment (CrCl &lt;30 mL/min); decompensated haemolytic anaemia. Pregnancy and lactation. Concomitant use of live vaccines.</p>', '<p>Fever, chills, cough, dyspnoea, pneumonia; GI disturbances, stomatitis; oedema; tumour lysis syndrome; skin rashes; haemolytic anaemia, haemorrhagic cystitis; neurological disturbances including peripheral neuropathy, agitation, confusion, visual disturbances and coma. Progressive encephalopathy and blindness (high doses).</p>', '<p>Pregnancy&nbsp;Category D. 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>Routine monitoring of blood counts and Hb conc. Monitor for signs of autoimmune haemolytic anaemia; elderly. Avoid contact with skin and eyes; avoid inhalation. Myelosuppression may be cumulative and severe increasing risk of opportunistic infections. Increased risk of tumour lysis syndrome in patients with high tumour burden.</p>', NULL, '<p>Cytotoxic Chemotherapy</p>', '<p>Refrigerate at 2-8&deg; C</p>', '<p>Renal Impairment:</p>\r\n\r\n<ul>\r\n	<li>CrCl 30-70: May reduce the doses by up to 50%</li>\r\n	<li>Severe impairment:&nbsp;Avoid&nbsp;</li>\r\n</ul>', '2022-02-26 02:24:37', '2022-02-26 02:24:37'),
(586, 586, '<p>Used for oral mineralocorticoid replacement therapy in:</p>\r\n\r\n<ul>\r\n	<li>Primary and secondary adrenocortical insufficiency in Addison&rsquo;s disease</li>\r\n	<li>Salt losing adrenogenital syndrome</li>\r\n	<li>Postural hypotension</li>\r\n</ul>\r\n\r\n<p>Fludrocortisone is a synthetic adrenocortical steroid possessing very potent mineralocorticoid properties and high glucocorticoid activity. It is indicated as partial replacement therapy for primary and secondary adrenocortical insufficiency in Addison&rsquo;s disease and for the treatment of salt-losing adrenogenital syndrome. The physiologic action of fludrocortisone acetate is similar to that of hydrocortisone. However, the effects of fludrocortisone acetate, particularly on electrolyte balance, but also on carbohydrate metabolism, are considerably heightened and prolonged. Mineralocorticoids act on the distal tubules of the kidney to enhance the reabsorption of sodium ions from the tubular fluid into the plasma; they increase the urinary excretion of both potassium and hydrogen ions.</p>', '<p>Fludrocortisone binds the mineralocorticoid receptor (aldosterone receptor). This binding (or activation of the mineralocorticoid receptor by fludrocortisone) in turn causes an increase in ion and water transport and thus raises&nbsp;extracellular fluid volume and blood pressure and lowers potassium levels.</p>', '<p><strong>Primary and secondary Adrenocortical Insufficiency in Addison&rsquo;s disease</strong>: Usual dose may range from 0.2 mg 3 times weekly to 0.2 mg daily. If hypertension occurs, reduce dosage to 0.05 mg daily. Administer concomitantly with Cortisone or hydrocortisone.<br />\r\n<br />\r\n<strong>Salt-Losing Adrenogenital Syndrome</strong>: 0.1 to 0.2 mg/day.<br />\r\n<br />\r\n<strong>Postural Hypotension</strong>: 0.1-0.4 mg daily to diabetic patients with postural hypotension; 0.05-0.2 mg daily to patients with postural hypotension secondary to Levodopa therapy.</p>', '<p>Interactions can occur with following drugs: Amphotericin B, potassium depleting diuretics, anticholinesterases, anticoagulants, antidiabetics. Antitubercular drugs, cyclosporine, digitalis glycosides, oral contraceptives and ketoconazole .</p>', '<p>In case of adrenal insufficiency, no absolute contraindications are applicable. In the treatment of non-endocrine diseases where pharmacological dose are more likely to be used, the contraindications to be considered carefully. Relative contraindications include: systemic fungal infection, hypersensitivity to Fludrocortisone, diabetic mellitus, osteoporosis and acute infection.</p>', '<p>Most adverse reactions are caused by the drug&rsquo;s mineralocorticoid activity (retention of sodium andwater) include erythema, purpura, vertigo, pancreatitis, increased intraocular pressure, muscular weakness, hypertension, edema, cardiac enlargement, congestive heart failure, steroid myopathy, peptic ulcer, osteoporosis, convulsions, menstrual irregularities, potassium loss, hypokalemic alkalosis, allergic and anaphylactic reaction etc. When Fludrocortisones is used in the small dosages recommended, side effects are not usually a problem; however the above mentioned unwanted effects should be kept in mind, particularly when Fludrocortisones is used over a prolonged period of time or in conjunction with cortisone or a similar glucocorticoid.</p>', '<p><strong>Pregnancy</strong>&nbsp;category C. There are no adequate and well-controlled studies in pregnant women. Fludrocortisone is only recommended for use during pregnancy when there are no alternatives and benefit outweighs risk.<br />\r\n<br />\r\n<strong>Lactation</strong>: There are no data on the excretion of fludrocortisone into human milk. However, corticosteroids (systemic therapy) are distributed into breast milk and could cause growth suppression and/or other adverse effects in nursing infants. The manufacturer recommends that caution be used when administering Fludrocortisone to nursing women.</p>', '<p>Because of its marked effect on sodium retention, the use of Fludrocortisone in the treatment of conditions other than those indicated herein is not advised. Fludrocortisone should be used with caution in patients suffering from different infections (like tuberculosis, measles, chicken pox, herpes zoster or threadworm infestation), congestive cardiac failure, hypertension, renal insufficiency, osteoporosis, drug-induced secondary adrenocortical insufficiency, peptic ulcer, intestinal anastomosis and ulcerative colitis.</p>', '<p>Overdose is unlikely; however, treatment of overdose is by supportive and symptomatic therapy.</p>', '<p>Corticosteroid</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-02-26 02:26:50', '2022-02-26 02:26:50');
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
(587, 587, '<p><strong>Flunarizine is indicated for</strong></p>\r\n\r\n<ul>\r\n	<li>Prophylaxis of classic (with aura) or common (without aura) migraine</li>\r\n	<li>Symptomatic treatment of vestibular vertigo (due to a diagnosed functional disorder of the vestibular system).</li>\r\n	<li>Peripheral Vascular Disease (PVD)</li>\r\n	<li>Motion sickness</li>\r\n	<li>Refractory epilepsy resistant to conventional antiepileptic therapy.</li>\r\n</ul>', '<p>Flunarizine is the difluorinated derivative of cinnarizine. It is a selective calcium channel antagonist. By reducing excessive transmembrane influx of calcium Flunarizine prevents cellular calcium overload. It does not interfere with normal cellular calcium homeostasis. Flunarizine also has some antihistaminic and sedative properties. It binds at an affinity of 99% to plasma protein.</p>', '<p>Migraine Prophylaxis:</p>\r\n\r\n<ul>\r\n	<li><strong>Starting Dose:</strong>&nbsp;10 mg at night in patients less than 65 years of age and 5 mg daily in patients older than 65 years. If, during this treatment depressive, extrapyramidal or other unacceptable symptoms occur, administration should be discontinued. If, after 2 months of this initial treatment, no significant improvement is observed, the patient should be considered a non-responder and administration should be discontinued.</li>\r\n	<li><strong>Maintenance Treatment:</strong>&nbsp;If a patient is responding satisfactorily and if a maintenance treatment is needed, the dose should be decreased to 5 days treatment at the same daily dose with two successive medicine free days every week. Even if the prophylactic maintenance treatment is successful and well tolerated, it should be interrupted after 6 months and it should be re-initiated only if the patient relapses.</li>\r\n</ul>\r\n\r\n<p><strong>Peripheral Vascular disease:</strong>&nbsp;10 mg twice daily, up to 30 mg per day if required.<br />\r\n<br />\r\n<strong>Vertigo &amp; motion sickness:</strong>&nbsp;10-20 mg daily for adults and 5 mg daily for children (&gt; 40 kg).<br />\r\n<br />\r\n<strong>Epileptic seizure:</strong>&nbsp;15-20 mg daily in adults and 5 to 10 mg daily for children as an add-on therapy.</p>', '<p>Galactorrhoea has been reported in few women on oral contraceptives within the first two months of Flunarizine treatment. Hepatic enzyme inducers such as Carbamazepine and Phenytoin may interact with flunarizine by increasing its metabolism. So an increase in dosage of flunarizine may be required.</p>', '<p>Hypersensitivity to Flunarizine. Flunarizine is contra-indicated in patients with a history of depressive illness, or with pre-existing symptoms of Parkinson&#39;s disease or other extrapyramidal disorders.</p>', '<p>Drowsiness and/or fatigue, as well as weight gain and/or increased appetite may occur. The following adverse experiences have been reported during chronic treatment with Flunarizine: depression, of which female patients with a history of depressive illness may be particularly at risk; extrapyramidal symptoms (such as bradykinesia, rigidity, akathisia, orofacial dyskinesia, tremor), of which elderly patients seem particularly at risk. Infrequently reported adverse reaction are: heartburn; nausea; gastralgia; insomnia; anxiety; galactorrhoea; dry mouth; muscle ache; skin rash.</p>', '<p>Safety in pregnancy and lactation has not been established.</p>', '<p>Flunarizine may lead to drowsiness which is aggravated by the simultaneous intake of alcohol or other central nervous system depressants. Patients should be cautioned against driving motor vehicles or performing other potentially hazardous tasks where a loss of mental alertness may lead to accidents. Flunarizine is not suited for aborting a migraine attack. The possible occurrence of an attack is therefore no reason to increase the dose of Flunarizine. This treatment may give rise to extrapyramidal and depressive symptoms and reveal Parkinsonism, especially in predisposed patients such as the elderly. Flunarizine should therefore be used with caution in such patients.</p>', NULL, '<p>Miscellaneous prophylactic migraine preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-26 02:28:27', '2022-02-26 02:28:27'),
(588, 588, '<p>This cream or ointment are suitable for treating a wide variety of local inflammatory, pruritic and allergic disorders of the skin. This is particularly suitable for topical application in:</p>\r\n\r\n<ul>\r\n	<li>Eczema and dermatitis: Atopic eczema, seborrhoeic eczema, discoid eczema, otitis externa, contact dermatitis, neurodermatitis.</li>\r\n	<li>Prurigo, Psoriasis, lichen planus. Discoid lupus erythematosus.</li>\r\n</ul>\r\n\r\n<p>This is indicated for inflammatory dermatoses, where secondary bacterial infection is present or likely to occur.</p>', '<p><strong>Fluocinolone acetonide</strong>&nbsp;is a corticosteroid primarily used in dermatology to reduce skin inflammation and relieve itching. It is a synthetic hydrocortisone derivative. Fluocinolone acetonide was also found to strongly potentiate TGF-&beta;-associated chondrogenesis of bone marrow mesenchymal stem/progenitor cells, by increasing the levels of collagen type II by more than 100 fold compared to the widely used dexamethasone.</p>', '<p>A small quantity of cream or ointment is applied lightly up to two or three times a day, and massaged gently and thoroughly into the skin. These recommendations apply to both children and adults, including the elderly.</p>', NULL, '<p>Primary infections of the skin and in rosacea, acne, perioral dermatitis, anogenital pruritis and napkin eruption. Also known hypersensitivity to neomycin.</p>', '<p>Side-effects are extremely rare, but as with all topical corticosteroids, patient may show hypersensitivity reaction.</p>', '<p>Topical administration of corticosteroids to pregnant animals can cause abnormalities of fetal development, including cleft palate intrauterine growth retardation. There may be a small risk of such effects on the human fetus. When topical steroid treatment is necessary, minimize the amount and length of treatment.</p>', '<p>Topical administration of corticosteroids to pregnant animals can cause abnormalities of fetal development, including cleft palate intrauterine growth retardation. There may be a small risk of such effects on the human fetus. When topical steroid treatment is necessary, minimize the amount and length of treatment.</p>', NULL, '<p>Fluocinolone &amp; Combined Preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-26 02:29:53', '2022-02-26 02:29:53'),
(589, 589, '<p>This cream is indicated in inflammatory skin conditions such as eczema, dermatitis or psoriasis that are infected or likely to become infected.</p>', '<p>Fluocinolone is a type of medicine called a topical corticosteroid. Corticosteroids are medicines used for reducing inflammation. Inflammation of the skin happens as a result of allergy or irritation of the skin, and is caused by the release of various substances that are important in the immune system. These substances cause blood vessels to widen and result in the irritated area becoming red, swollen, itchy and painful, such as is seen in dermatitis or eczema.<br />\r\n<br />\r\nWhen fluocinolone is applied to the skin it works by acting inside the cells to decrease the release of these inflammatory substances. This reduces swelling, redness and itch.<br />\r\n<br />\r\nThere is a range of potencies of corticosteroids available for application to the skin. This medicine contains fluocinolone 0.025% and is classed as a potent corticosteroid. It is prescribed to treat various inflammatory skin disorders, such as eczema and dermatitis, that have not responded to milder steroids.<br />\r\n<br />\r\nClioquinol has antifungal and antibacterial actions. It works by preventing the growth and multiplication of the organisms.<br />\r\n<br />\r\nThe combination of fluocinolone and clioquinol is used to treat inflammatory skin disorders that are either infected or likely to become infected.<br />\r\n<br />\r\nThis cream is more suitable for moist, weeping areas of skin, while the thicker, more greasy ointment is more suitable for dry, scaly areas of skin.</p>', '<p>This medicine is for external use on the skin only. The cream or ointment should be applied thinly and evenly to the affected area(s). Avoid getting the medicine in the eyes, or in contact with the inside of the mouth or nose. Rinse with cold water if accidental contact occurs. Wash your hands thoroughly after applying this medicine, unless the hands are the area being treated. If your doctor has advised you to use dressings with this medicine, the skin should be cleansed before applying the cream/ointment under a fresh dressing.</p>', '<p>This medicine is not known to affect other medicines. However, as with all medicines, it is important to tell your doctor or pharmacist what medicines you are already using, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before using any new medicines while using this one, to make sure that the&nbsp;combination is safe.<br />\r\n<br />\r\nIf you are using&nbsp;other medicines on the same area of skin&nbsp;it is recommended that you leave several minutes between applying each product. This is to allow each product time to be absorbed and avoid them mixing on the skin.<br />\r\n<br />\r\nIf you apply&nbsp;moisturisers&nbsp;shortly before or after applying this medicine these can dilute the corticosteroid and potentially make it less effective. Try to apply your moisturisers at a different time of day, or at least 30 minutes before or after this one.</p>', '<p>This cream should not be used in</p>\r\n\r\n<ul>\r\n	<li>Children under one year of age.</li>\r\n	<li>Allergy&nbsp;to iodine.</li>\r\n	<li>Primary bacterial skin infections, such as&nbsp;impetigo.</li>\r\n	<li>Primary fungal skin infections such as&nbsp;thrush,&nbsp;ringworm,&nbsp;athlete&#39;s foot.</li>\r\n	<li>Viral skin infections, such as&nbsp;chickenpox,&nbsp;shingles,&nbsp;cold sores&nbsp;or&nbsp;herpes simplex.</li>\r\n	<li>Acne.</li>\r\n	<li>Chronic inflammatory disorder of the facial skin (acne rosacea).</li>\r\n	<li>Inflammatory rash around the mouth (perioral dermatitis).</li>\r\n	<li>Itching around the back passage and genitals.</li>\r\n	<li>Nappy rash.</li>\r\n	<li>Widespread plaque&nbsp;psoriasis.</li>\r\n</ul>', '<p>Medicines and their possible side effects can affect individual people in different ways. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect. The following side effects are known to be associated with this medicine.</p>\r\n\r\n<ul>\r\n	<li>Skin irritation at site of application, such as burning, itching and redness.</li>\r\n	<li>Allergic inflammation of the skin (contact dermatitis).</li>\r\n	<li>Thinning of the skin.</li>\r\n	<li>Changes in skin pigmentation.</li>\r\n	<li>Stretch marks (striae).</li>\r\n	<li>Groupings of fine blood vessels becoming prominent under the skin (telangiectasia).</li>\r\n</ul>', '<p>Certain medicines should not be used during&nbsp;pregnancy&nbsp;or&nbsp;breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.<br />\r\n<br />\r\nThis medicine should not be used during pregnancy unless considered essential by your doctor. If it is prescribed by your doctor it should not be used on large areas of skin, underneath airtight dressings, or for prolonged periods of time. Consult your doctor for further information.<br />\r\n<br />\r\nThis medicine should not be used during breastfeeding unless considered essential by your doctor. If it is prescribed by your doctor it should not be used on large areas of skin, underneath airtight dressings or for prolonged periods of time. If it is applied to the breasts it should be washed off carefully before breastfeeding and then reapplied afterwards.</p>', NULL, NULL, '<p>Fluocinolone &amp; Combined Preparations, Topical Antifungal preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-26 02:32:01', '2022-02-26 02:32:01'),
(590, 590, '<p>This cream is indicated for the short-term treatment of moderate to severe melasma of the face, after starting the treatment avoid presence of sun. Use a sunscreen of at least SPF 30 or more.</p>', '<p>This cream contains three active ingredients Fluocinolone Acetonide, Hydroquinone and Tretinoin. All of them are used to treat melasma. However, the mechanism of action of the active ingredients in This cream in the treatment of melasma is unknown but Fluocinolone Acetonide is a corticosteroid for topical dermatological use and is classified therapeutically as an anti-inflammatory. Hydroquinone is classified therapeutically as a depigmenting agent, which may interrupt one or more steps in the tyrosine-tyrosinase pathway of melanin synthesis. Tretinoin is classified therapeutically as a keratolytic agent.</p>', '<p>This cream should be applied once daily at night. It should be applied at least 30 minutes before bedtime. Gently wash the face and neck with a mild cleanser. Rinse and pat the skin dry. Apply a thin film of the cream to the hyperpigmented areas of melasma including about &frac12; inch of normal-appearing skin surrounding each lesion. Rub lightly and uniformly into the skin. During the day, use sunscreen and wear protective clothing. Avoid sunlight exposure. Patients may use moisturizers and/or cosmetics during the day.<br />\r\n<br />\r\nPediatric Use: The safety&nbsp;and effectiveness of this cream in pediatric patients have not been established.</p>', '<p>Avoid use of medicated or abrasive soaps, cleansers, soaps, cosmetics with drying effects, products with high concentration of alcohol, astringent &amp; other irritants or keratolytic drugs. Also avoid concomitant use of medications with photosensitizing effects.</p>', '<p>This cream is contraindicated in individuals with a history of hypersensitivity, allergy or intolerance to this product or any of its components.</p>', '<p>A very few patients may get severe allergic reactions from this cream. They may have trouble breathing or severe asthma attacks. While patients use this cream, skin may develop mild to moderate redness, peeling, burning, dryness or itching.</p>', '<p>Pregnancy Category C. This cream contains the teratogen, tretinoin, which may cause embryo-fetal death, altered fetal growth, congenital malformations and potential neurologic deficits. It is difficult to interpret the animal studies on teratogenicity with this cream, because the availability of the dermal applications in these studies cannot be assured and comparison with clinical dosing is not possible. There are no adequate and well controlled studies in pregnant women. This cream should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\nLactation: Corticosteroids, when systemically administered, the drug appear in human milk. It is not known whether topical application of this cream could result in sufficient systemic absorption to produce detectable quantities of Fluocinolone Acetonide, Hydroquinone or Tretinoin in human milk. Because many drugs are secreted in human milk, caution should be exercised when this cream is administered to nursing women.</p>', '<p>This cream contains Hydroquinone and Tretinoin that may cause mild to moderate irritation. Local irritation, such as skin reddening, peeling, mild burning sensation, dryness and pruritus may be expected at the site of application. Transient skin reddening or mild burning sensation does not preclude treatment. If a reaction suggests hypersensitivity or chemical irritation, the use of the medication should be discontinued. This cream also contains the corticosteroid Fluocinolone Acetonide. Systemic absorption of topical corticosteroids can produce reversible Hypothalamic-Pituitary-Adrenal (HPA) axis suppression with the potential for glucocorticosteroid insufficiency after withdrawal of treatment. Manifestations of Cushing&#39;s syndrome, hyperglycemia and glucosuria can also be produced by systemic absorption of topical corticosteroid while on treatment. If HPA axis suppression is noted, the use of this cream should be discontinued. Recovery of HPA axis function generally occurs upon discontinuation of topical corticosteroids.</p>', NULL, '<p>Hydroquinone Preparations</p>', '<p>Store in a cool &amp; dry place, protected from light. Do not freeze. Keep out of reach of children.</p>', NULL, '2022-02-26 02:36:13', '2022-02-26 02:36:13'),
(591, 591, '<p>This cream or ointment are suitable for treating a wide variety of local inflammatory, pruritic and allergic disorders of the skin. This is particularly suitable for topical application in:</p>\r\n\r\n<ul>\r\n	<li>Eczema and dermatitis: Atopic eczema, seborrhoeic eczema, discoid eczema, otitis externa, contact dermatitis, neurodermatitis.</li>\r\n	<li>Prurigo, Psoriasis, lichen planus. Discoid lupus erythematosus.</li>\r\n</ul>\r\n\r\n<p>This is indicated for inflammatory dermatoses, where secondary bacterial infection is present or likely to occur.</p>', '<p><strong>Fluocinolone acetonide</strong>&nbsp;is a corticosteroid primarily used in dermatology to reduce skin inflammation and relieve itching. It is a synthetic hydrocortisone derivative. Fluocinolone acetonide was also found to strongly potentiate TGF-&beta;-associated chondrogenesis of bone marrow mesenchymal stem/progenitor cells, by increasing the levels of collagen type II by more than 100 fold compared to the widely used dexamethasone.<br />\r\n<br />\r\n<strong>Neomycin Sulfate</strong>&nbsp;actively transported across the bacterial cell membrane, binds to a specific receptor protein on the 30 S subunit of bacterial ribosomes, and interferes with an initiation complex between mRNA (messenger RNA) and the 30 S subunit, inhibiting protein synthesis.</p>', '<p>A small quantity of cream is applied lightly up to two or three times a day, and massaged gently and thoroughly into the skin. These recommendations apply to both children and adults, including the elderly.</p>', NULL, '<p>Primary infections of the skin and in rosacea, acne, perioral dermatitis, anogenital pruritis and napkin eruption. Also known hypersensitivity to neomycin.</p>', '<p>Side-effects are extremely rare, but as with all topical corticosteroids, patient may show hypersensitivity reaction.</p>', '<p>Topical administration of corticosteroids to pregnant animals can cause abnormalities of fetal development, including cleft palate intrauterine growth retardation. There may be a small risk of such effects on the human fetus. When topical steroid treatment is necessary, minimize the amount and length of treatment.</p>', '<p>The appropriate anti-infective cover should be given in the presence of viral or fungal infection. Prolonged use should be avoided in conditions where absorption of neomycin is possible. Do not apply to the external auditory canal of patients with perforated eardrums. Long-term continuous topical steroid therapy can produce atrophic skin changes. Do not apply to the face for prolonged periods. Prolonged use or treatment of extensive areas can produce adrenal suppression, especially in infants and children.</p>', NULL, '<p>Fluocinolone &amp; Combined Preparations, Topical Antifungal preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-26 02:38:44', '2022-02-26 02:38:44'),
(592, 592, '<p>Fluorescein does not stain a normal cornea but conjunctival abrasions are stained yellow or orange, corneal abrasions or ulcers are stained a bright green and foreign bodies are surrounded by a green ring. Fluorescein can be used in diagnostic examinations including Goldmann tonometry and in the fitting of hard contact lenses.</p>', '<p>Fluorescein sodium responds to electromagnetic radiation and light between the wavelengths of 465- 490 nm and fluoresces, i.e., emits light at wavelengths of 520-530 nm. Thus, the hydrocarbon is excited by blue light and emits light that appears yellowish-green. Following intravenous injection of fluorescein sodium in an aqueous solution, the unbound fraction of the fluorescein can be excited with a blue light flash from a fundus camera as it circulates through the ocular vasculature, and the yellowish green fluorescence of the dye is captured by the camera. In the fundus, the fluorescence of the dye demarcates the retinal and/or choroidal vasculature under observation, distinguishing it from adjacent areas/structures.</p>', '<p>Ophthalmic-<br />\r\nAid in the fitting of hard contact lenses, Detection of corneal lesions and foreign bodies, Diagnostic ophthalmic procedures:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Apply 1% or 2% solution as eye drops or as sterile papers impregnated with fluorescein sodium. May also be given in combination with a local anaesthetic: as a 0.25% solution with oxybuprocaine HCl or proxymetacaine HCl.</li>\r\n</ul>', NULL, '<p>Acute necrotising pancreatitis (oral fluorescein dilaurate).</p>', '<p>Nausea and vomiting (IV); extravasation is painful; hypersensitivity reactions; transient yellow coloration of skin and urine; staining of the skin, clothing and soft contact lenses.</p>', '<p>Safety for use in pregnancy and lactation has not been established, therefore use only when considered essential by the physician.</p>', '<p>Special care should be taken to avoid microbial contamination. Pseudomonas aeruginosa grows well in fluorescein solutions, therefore, a single dose solution is preferred.</p>', NULL, '<p>Preparations for Ophthalmic diagnosis</p>', '<p>Store below 25&deg;C. Do not freeze. Protect from light.</p>', NULL, '2022-02-26 02:54:16', '2022-02-26 02:54:16'),
(593, 593, '<p>This ophthalmic solution is used for the treatment of conjunctivitis (sticky eyes) due to organisms sensitive to neomycin. This may be used for the treatment of infections at the front of the eye by bacteria sensitive to the antibiotic neomycin. This&nbsp; can be used following removal of something from your eye, as well as before and after surgery, where there is a possibility of infection with susceptible organisms.</p>', '<p>There is no generally accepted explanation for the mechanism of action of ocular corticosteroids. However, corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2. Their primary target is the cytosolic glucocorticoid receptor. After binding the receptor the newly formed receptor-ligand complex translocates itself into the cell nucleus, where it binds to many glucocorticoid response elements (GRE) in the promoter region of the target genes. The DNA bound receptor then interacts with basic transcription factors, causing the increase in expression of specific target genes.<br />\r\n<br />\r\nLike other aminoglycoside antibiotic drugs, neomycin inhibits bacterial ribosomes by binding to the 30S ribosomal subunit of susceptible bacteria and disrupting the translational machinery of bacterial protein synthesis. Bacterial translation is normally initiated by the mRNA binding to the 30S ribosomal subunit and subsequent binding with 50S subunit for elongation.</p>', '<p>The usual dose for adults is one to two drops in eye two to four times a day. During the first 24 to 48 hours, the dose may be safely increased to one drop every hour or as directed by physician.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>You must not use the bottle if the tamper-proof seal on the bottle neck is broken before you first use it. Apply your eye drops in the following way:</p>\r\n\r\n<ul>\r\n	<li>Wash your hands. Shake the bottle well before use. Tilt your head back and look at the ceiling.</li>\r\n	<li>Gently pull the lower eyelid down until there is a small pocket.</li>\r\n	<li>Turn the bottle upside down and squeeze it to release one or two drops into each eye that needs treatment.</li>\r\n	<li>Let go of the lower lid, and close your eye. Press your finger against the corner of your eye (the side where your eye meets your nose) for one minute.</li>\r\n</ul>', NULL, '<p>Do not use this ophthalmic solution:</p>\r\n\r\n<ul>\r\n	<li>If you are hypersensitive (allergic) to fluorometholone or neomycin sulfate or to any of the other ingredients of this preparation.</li>\r\n	<li>If you have an eye infection (with pus) caused by micro-organisms not sensitive to the antibiotic neomycin;</li>\r\n	<li>If you have an active viral or fungal infection of the eye;</li>\r\n	<li>If you have tuberculosis of the eye;</li>\r\n	<li>If you have glaucoma;</li>\r\n	<li>If you are pregnant or breastfeeding.</li>\r\n</ul>', '<p>The following side effects may occur: Increased eye pressure (glaucoma), loss of part of the usual field of vision, blurred vision, cataracts (cloudy lens), eye irritation, red eye, eye pain, foreign body sensation, eyelid or eye swelling, itchy or watery eye, ulcers on the surface of the eye, secondary eye infections from fungi or viruses, skin rash, allergic reactions, change in your sense of taste.</p>', '<p>This ophthalmic solution should not be used during pregnancy and breastfeeding. It is unknown whether the active ingredients of this preparation are excreted in breast milk. Therefore it is not recommended for mothers who are breast feeding.</p>', '<p>If you use this ophthalmic solution for a long period of time:</p>\r\n\r\n<ul>\r\n	<li>It may cause the pressure inside your eye (intraocular pressure) to increase which can lead to glaucoma. The pressure in your eye should be regularly measured.</li>\r\n	<li>It may cause cataracts (cloudy lens), lack of clearness of vision, or a delay in wound healing of the eye.</li>\r\n	<li>Damage to the front part of the eye (due to a fungal infection), may occur during or after the use of this ophthalmic solution.</li>\r\n	<li>It may increase the risk of corneal damage, cause thinning of the cornea or small ulcerations in the surface of your eye.</li>\r\n	<li>It may also suppress the body&rsquo;s immune response which leads to secondary eye infections.</li>\r\n</ul>', NULL, '<p>Ophthalmic steroid - antibiotic combined preparations</p>', '<p>Store at or below 25&deg;C. Do not freeze. Do not use 30 days after first opening the bottle, even if there is still some liquid remaining.</p>', '<p>The safety and efficacy in children aged 2 years or younger has not been established.</p>', '2022-02-26 02:56:27', '2022-02-26 02:56:27'),
(594, 594, '<p>Inflammation associated with infections in the anterior segment of the eye due to bacteria susceptible to Gentamicin it is also indicated in postoperative infection.</p>', '<p>Gentamicin belongs to the group of aminoglycoside antibiotics. It covers a broad spectrum of gram-positive and gram-negative pathogens, including Pseudomonas aeruginosa, Staphylococci, Haemophilus influenzae H. aegypticus, Klebsiella, Enterobacteria, Proteus, Escherichia coli, Shigella and Salmonella. It inhibits specifically bacterial protein synthesis. Fluorometholone is a synthetic fluorinated corticosteroid possessing anti-inflammatory properties. The combination brings concomitantly the bacterial treatment or prophylaxis and the anti-inflammatory effect. In addition, the presence of gentamicin protects from a risk of potential aggravation of a bacterial infection due to the steroid.</p>', '<p>Sterile Ophthalmic Suspension:&nbsp;</p>\r\n\r\n<ul>\r\n	<li><strong>Bacterial infection</strong>: The dosage depends on the severity of the disease. The application of 1 drop 5 times daily into the conjunctival sac of the affected eye is recommended. In severe cases the dosage can be increased up to 1 drop per hour for 1 to 2 days.</li>\r\n	<li><strong>Ocular postoperative infection</strong>: 1 drop 4 times daily into the conjunctival sac for 1 week. Then a reduced application frequency is recommended for the remaining part of the treatment.</li>\r\n</ul>\r\n\r\n<p>Sterile Eye Ointment:</p>\r\n\r\n<ul>\r\n	<li><strong>Bacterial infection</strong>: Apply 3-4 times daily into the affected eye.</li>\r\n	<li><strong>Ocular postoperative infection</strong>: To support the therapy with Ophthalmic Suspension during the night apply ointment before retiring.</li>\r\n</ul>', NULL, '<ul>\r\n	<li>Hypersensitivity to any of the components. Injuries and ulceration of the cornea. Viral infections (e.g. Herpes simplex, Vaccinia) or mycosis.</li>\r\n	<li>Eye tuberculosis.</li>\r\n	<li>Glaucoma.</li>\r\n</ul>', '<p>A transient burning sensation may occur after instillation. Rare: Hypersensitivity reactions including eczema of the eyelid and puncture keratitis. Prolonged use of topical steroids may delay wound healing, increase of IOP, develop cataract and cause thinning of cornea &amp; sclera.</p>', '<p>Administration during pregnancy and lactation is therefore not recommended, except for compelling reasons.</p>', '<ul>\r\n	<li>Steroids can mask, activate or aggravate ocular infections.</li>\r\n	<li>Long-term treatment with steroid may enhance thinning of cornea and sclera and rarely perforation of the cornea has been reported.&nbsp;</li>\r\n	<li>In case no improvement is observed after 7-8 days of treatment, other therapeutical means should be considered.&nbsp;</li>\r\n	<li>Patients experiencing blurred vision after application of the product, particularly the ointment, should refrain from driving vehicles or operating machinery.</li>\r\n	<li>Contact lenses should be removed before each application.</li>\r\n</ul>', NULL, '<p>Ophthalmic steroid - antibiotic combined preparations</p>', '<p>Store in a cool and dry place, protect from light. Do not use longer than 30 days after first opening. Keep out of reach of children.</p>', NULL, '2022-02-26 02:58:11', '2022-02-26 02:58:11'),
(595, 595, '<p>This eye drops is indicated in acute allergic, noninfectious conjunctivitis &amp; keratitis, severe swelling &amp; hyperaemia, noninfectious inflammation of the anterior segment of the eye (including anterior uveitis, episcleritis &amp; scleritis) and post-operative conditions.</p>', '<p>Fluorometholone is thought to act by the induction of phospholipase A2 inhibitory proteins which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. On the other hand, Tetrahydrozoline is an alpha agonist which constricts the conjunctival blood vessels and thereby relieves the redness of the eye.</p>', '<p><strong>Use in adult</strong>: Instill 1 drop into the conjunctival sac 2-3 times daily. The dose may be increased for severe and adult patient to 1 drop hourly for first one to two days.<br />\r\n<br />\r\n<strong>Use in children</strong>: Safety &amp; effectiveness in children below 2 years of age have not been established.</p>', NULL, '<p>It is contraindicated in infectious conjunctivitis or keratitis, injuries or ulcerous processes of the cornea, glaucoma, diseases associated with stromal damage of the cornea or sclera &amp; dry eyes.</p>', '<p>Mild burning sensation, reversible increase in intraocular pressure, reactive hyperemia, cataract &amp; corneal defects, glaucoma, systemic effects (chronic use).</p>', '<p>There are no adequate and well-controlled studies of Fluorometholone &amp; Tetrahydrozoline in pregnancy or while breast-feeding. Therefore, this combination should be used during pregnancy only if the potential benefits justify the potential risk to the fetus.</p>', '<p>Avoid prolonged use. This preparation should be used after a careful risk benefit evaluation in case of patients with severe blood circulation diseases, metabolic disturbances, under treatment with MAOIs &amp; other potentially hypertensive drugs, history of cataract, herpes simplex infection, rhinitis sicca.</p>', '<p>When the product is used as directed, there is almost no likelihood of an overdose. No information on overdosage with fluorometholone is&nbsp; available. Overdosage with fluorometholone is unlikely to cause acute problems. The symptoms of acute overdosage with tetryzoline are CNS, cardiac and psychiatric disturbances, mydriasis, cyanosis and fever. CNS functions may be inhibited under certain circumstances.<br />\r\n<br />\r\nThe following measures are possible in case of accidental ingestion and the occurrence of symptoms of intoxication: administration of activated charcoal, gastric lavage, artificial ventilation with oxygen, use of phentolamine to lower blood pressure (5 mg in saline solution, given i.v.). Vasopressors are contraindicated. Antipyretic and anticonvulsive therapy can be administered as necessary.</p>', '<p>Ophthalmic Steroid preparations</p>', '<p>Should not be used after the date marked &quot;EXP&quot; on the pack. This must be kept out of the reach and sight of children.</p>', NULL, '2022-02-26 02:59:47', '2022-02-26 02:59:47'),
(596, 596, '<p>Fluorometholone Acetate ophthalmic suspension is indicated for the treatment of-</p>\r\n\r\n<ul>\r\n	<li>Acute and chronic non-infectious conjunctivitis and keratitis of allergic origin.</li>\r\n	<li>Non-infectious inflammation of the anterior chamber of the eye (including anterior uveitis, episcleritis and scleritis).</li>\r\n	<li>Post-operative irritative conditions after strabismus, cataract and glaucoma surgery.</li>\r\n</ul>', '<p>Fluorometholone is a corticosteroid with an excellent anti-inflammatory action with no significant influence on the intraocular pressure. The anti-inflammatory activity of Fluorometholone is at least 40 times stronger than that of Hydrocortisone. Corticosteroids are thought to act by the introduction of phospholipase A2 inhibitory proteins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandin and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2. In comparison with other corticosteroids Fluorometholone is more rapidly degraded in tissue and therefore has less effect on the intraocular pressure. The immunosuppressive action of Fluorometholone is less pronounced than that of Dexamethasone.</p>', '<p>1 drop instilled into the conjunctival sac 2-4 times daily. During the initial 24 to 48 hours the dosage may be safely increased to 1 drop every hour. Care should be taken not to discontinue therapy prematurely. Shake well before use.</p>', '<p>Specific drug interaction studies have not been conducted with Fluorometholone ophthalmic suspension.</p>', '<ul>\r\n	<li>Hypersensitivity to any ingredient of the formulation.</li>\r\n	<li>Infectious conjunctivitis or keratitis.</li>\r\n	<li>Injuries and ulcerous processes of cornea, especially infections caused by virus, bacteria and fungi.</li>\r\n	<li>Dry eyes, especially keratoconjunctivitis sicca.</li>\r\n	<li>Glaucoma.</li>\r\n</ul>', '<p>Glaucoma with optic nerve damage, visual acuity or field defects, cataract formation, secondary ocular infection following suppression of host immunity, perforation of the globe.</p>', '<p>Safety of the use of topical steroids during pregnancy and lactation has not been established. Fluorometholone ophthalmic suspension should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.</p>', '<p>Shake well before using. If this product is used for 10 days or longer, intraocular pressure should be monitored.</p>', NULL, '<p>Ophthalmic Steroid preparations</p>', '<p>Store in a cool, dry place and protected from light. Keep out of the reach of children. Discard the container 4 weeks after opening.</p>', NULL, '2022-02-26 03:13:12', '2022-02-26 03:13:12'),
(597, 597, '<p>Fluorouracil is indicated alone or in combination for-&nbsp;</p>\r\n\r\n<ul>\r\n	<li>Carcinoma of the colon or rectum</li>\r\n	<li>Carcinoma of the stomach and exocrine pancreas</li>\r\n	<li>Carcinoma of the liver</li>\r\n	<li>Carcinoma of the breast</li>\r\n	<li>Carcinoma of the bladder</li>\r\n	<li>Carcinoma of the lung</li>\r\n	<li>Epithelial ovarian carcinoma</li>\r\n	<li>Cervical carcinoma.</li>\r\n</ul>', '<p>Fluorouracil is inactive as such in mammalian cells but is converted into the active 5-fluorodeoxyuridine monophosphate (FdUMP) by a variety of different metabolic pathways. The drug works by inhibiting the enzyme thymidylate kinase which results in reduced formation of thymidine and thus of DNA. The active metabolite FdUMP appears to form a stable complex with the folate cofactor N-5, 10-methylene tetrahydrofolate which inactivates thymidylate kinase. Fluorouracil as FdUMP is also incorporated into RNA which results in fluorination of RNA. The effect of fluorouracil on living cells is limited mainly to those in the proliferative phase but while cells in the G2 and S phase are most affected there may be effects at any stage of the cell cycle.</p>', '<p>Intravenous 5-fluorouracil can be delivered by rapid intravenous bolus injection or slow infusion. The vial contents can rapidly be injected directly into a peripheral vein, the commonest schedules being: 12-13.5 mg/Kg (500 mg/m2) daily for 5 days repeated at 4-weekly intervals. Slow intravenous infusion requires the drug, to be diluted in 500 ml of dextrose 5% solution, then infused over 2-3 hr on 5 successive days.<br />\r\n<br />\r\n<strong>For palliative management of cancer</strong>: Initial Dose: 12 mg/kg intravenously once daily for 4 successive days. Maximum Dose: 800 mg/day. If no toxicity is observed, 6 mg/kg may be administered on the 6th, 8th, 10th, and 12th day (No therapy is given on days 5, 7, 9, or 11). Discontinue at the end of day 12, even with no apparent toxicity.<br />\r\n<br />\r\n<strong>Poor risk patients and those who are not in an adequate nutritional state</strong>: Initial Dose: 6 mg/kg/day for 3 days. Maximum Dose: 400 mg/day. If no toxicity is observed, 3 mg/kg may be administered on days 5, 7, and 9 (No therapy is to be administered on days 4, 6, or 8). Discontinue at the end of day 9, even with no apparent toxicity.<br />\r\n<br />\r\n<strong>Maintenance therapy</strong>: In instances where toxicity has not been a problem, it is recommended that therapy be continued using either of the following schedules:</p>\r\n\r\n<ul>\r\n	<li>Repeat the dosage of the first course every 30 days after the last day of the previous course, or</li>\r\n	<li>When the toxic signs resulting from the initial course of therapy have subsided, administer a maintenance dose of 10 to 15 mg/kg/week as a single dose. Maximum Dose: 1g/week .The reaction by the patient to the previous course of therapy should be taken into account and the dosage should be adjusted accordingly.</li>\r\n</ul>\r\n\r\n<p><strong>Usual adult dose for cervical cancer</strong>: In combination with cisplatin 1 gm/m2 IV on day 1. The cycle is repeated every 21 days.<br />\r\n<br />\r\n<strong>Usual pediatric dose for malignant disease</strong>: The manufacturer has reported that the safety and effectiveness of fluorouracil have not been established in children. However, the drug has been used in children following adult guidelines.<br />\r\n<br />\r\n<strong>Intra-arterial infusion</strong>: Fluorouracil has also been given by intra-arterial infusion for adult in doses of 5 to 7.5 mg/kg body weight is dissolved in 20-100 ml of 5% Dextrose solution and administered 10-20 days by using an infusion pump.<br />\r\n<br />\r\n<strong>Combination with radiation</strong>: Usual adult daily dose of 5-10 mg/kg body weight is given in combination with radiation according to systemic administration method or intra-arterial infusion method.<br />\r\n<br />\r\n<strong>Combination with other anticancer drugs</strong>: Fluorouracil is used alone or in combination in the adjuvant treatment of breast and gastro-intestinal cancer, and palliation of inoperable malignant neoplasms, especially those of the gastro-intestinal tract, breast, head and neck, liver, genito-urinary system, and pancreas. It is also used with cyclophosphamide and methotrexate in the combination chemotherapy of breast cancer. A usual adult dose of 5 to 10 mg/kg body weight daily is given in combination with other anticancer drugs every day or intermittently once to twice a week by systemic administration method or intra-arterial infusion method.</p>', '<p>Pre-treatment with cimetidine for 4 weeks led to increased plasma concentrations of fluorouracil following intravenous and oral administration in 6 patients. The effect was probably due to a combination of hepatic enzyme inhibition and reduced hepatic blood flow.</p>', '<p>It is contraindicated in patients that are severely debilitated or in patients with bone marrow suppression due to either radiotherapy or chemotherapy. It is likewise contraindicated in pregnant or breastfeeding women. It should also be avoided in patients that do not have malignant illnesses.</p>', '<p><strong>Potentially life-threatening effects</strong>: Severe effects from 5-fluorouracil are related to the dosage and duration of therapy.<br />\r\n<br />\r\n<strong>Cardiac effects</strong>: Occasional case reports associating 5-fluorouracil therapy with &#39;ischemic cardiac events&#39; evidence against the autoimmune phenomenon is the fact that in several cases cardiotoxicity occurred within several hours of the first dose.<br />\r\n<br />\r\n<strong>Hematological effects</strong>: Potentially lethal effects caused by severe hematological toxicity may develop within the first 10 days of treatment being instituted but generally resolves within 3 weeks. At the recommended dose and schedule it is rather uncommon for hematological toxicity to be severe. Any ontribute to severe effects from 5-fluorouracil on the blood-forming cells. Thus extensive prior irradiation or the concomitant use of cytotoxic drugs tend to exacerbate the severity of the hematological side effects of 5-fluorouracil.<br />\r\n<br />\r\n<strong>Neurological effects</strong>: Effects on the central nervous system have been occasionally reported and cerebral ataxia is dose-dependent with an incidence of between 3.1 and 7%. Acute cerebellar syndromes and myelopathy have been described following intrathecal 5-fluorouracil. Neurological syndromes may occur rarely after carotid artery perfusion in head and neck cancer. Other effects Allergic reaction (including difficulty in breathing, closing of the throat, swelling of the lips, tongue, or face, or hives), decreased bone marrow function and blood problems (extreme fatigue, easy bruising or bleeding, black, bloody or tarry stools, or fever, chills, or signs of infection), hand-foot syndrome (tingling, pain, redness, swelling or tenderness of the hands and feet), severe vomiting, diarrhoea, frequent bowel movements or watery stools, or sores in the mouth or throat, or stomach pain or heartburn or black, bloody or tarry stools. Other less serious side effects may include mild to moderate nausea, vomiting or loss of appetite, balance problems, confusion, rash and itching, or temporary hair loss. Conjunctivitis, both acute and chronic can proceed to tear duct stenosis and ectropion following prolonged administration. Very chronic administration, extending beyond 3 months, of low dosage has been associated with low systemic toxicity but includes the possibility of painful and tender hands and feet associated with erythema of the extremities.</p>', '<p>Fluorouracil is contraindicated throughout pregnancy. The literature pertaining to pregnancy and cytotoxic drugs is necessarily limited but it appears in general that risk of teratogenesis diminishes with the advancement of pregnancy. Therefore most cytotoxic drugs are absolutely contraindicated in the first trimester and 5-fluorouracil, used in the first trimester has been reported to cause multiple congenital abnormalities. There are many case reports, however, of pregnancy being conducted successfully with combination chemotherapy being given to the mother during the second and third trimesters. Because of the age of the population and the natural history of the tumors treated, most of the data on long-term follow-up pertain to therapy for leukemias. More data need to be accrued on the subsequent development of neonates before it is certain that any of these compounds are free of late effects.<br />\r\n<br />\r\nIt is not known whether fluorouracil is excreted in human milk. Because fluorouracil inhibits DNA, RNA and protein synthesis, mothers should not nurse while receiving this drug.</p>', '<p>5-fluorouracil is highly toxic drug with a narrow margin of safety. Therefore patients should be carefully supervised, since therapeutic response is unlikely to occur without some evidence of toxicity. Daily dose should not exceed 1 gram. Treatment should be discontinued promptly when one of the following signs of toxicity appears: Leucopenia (WBC under 3500/mm3). Thrombocytopenia (platelet under 100000/mm3). Stomatitis ( the first small ulceration at the inner margin of the lips is a signal for stopping treatment). Severe diarrhoea (frequent bowel movements and watery stools). Gastro-intestinal ulceration and bleeding.</p>', '<p>Cases of deliberate overdose are unknown but excessive toxicity because of the hematological effects as described above. There is no specific antidote to 5-fluorouracil toxicity; treatment consists in supportive care. In addition to the hematological toxicity other toxicities will occur with overdose. Sign and symptoms are qualitatively similar to the side effects. Treatment should be performed promptly and appropriate drugs are given to control symptoms of overdose.</p>', NULL, '<p>Store the vial in original carton not exceeding 25℃. Do not refrigerate. Protect from light.</p>', '<p><strong>Neonates</strong>: No dosage recommendations are made for neonates.<br />\r\n<br />\r\n<strong>Children</strong>: Safety and effectiveness in children have not been established.<br />\r\n<br />\r\n<strong>The elderly</strong>: No special precautions are required, doses being adjusted for the patient&#39;s weight and height.</p>\r\n\r\n<p><strong>Reconstitution:</strong></p>\r\n\r\n<p>5-Fluorouracil is a cytotoxic anticancer drug and, caution should be exercised in handling 5-Fluorouracil. Special, trained personnel should reconstitute the drug. Preparation requires a room reserved for this purpose. The work surface should be covered with disposable plastic-backed absorbent paper. Smoking, eating and drinking are prohibited in the room. The handling staff must have a set of appropriate equipment, particularly long-sleeved coats, protective masks, caps, protective goggles, sterile disposable gloves, worktop protection sheets and waste collection containers and bags. If 5-Fluorouracil solution contacts the skin, wash the skin immediately and thoroughly with soap and water. Following topical exposure, events have included tingling, burning and redness. If 5-Fluorouracil contacts mucous membranes, the membranes should be flashed thoroughly with water. Pregnant women must be warned and avoid handling cytotoxic agents. All broken containers must be treated with the same precautions and regarded as contaminated waste. Contaminated waste is to be disposed of by incineration in rigid containers labeled for this purpose or must be destroyed as per the government rules.</p>', '2022-02-26 03:35:26', '2022-02-26 03:35:26');
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
(598, 598, '<p>Fluoxetine is indicated for the treatment of-</p>\r\n\r\n<ul>\r\n	<li>depressive illness</li>\r\n	<li>bulimia nervosa</li>\r\n	<li>obsessive compulsive disorder.</li>\r\n</ul>', '<p>Fluoxetine has been shown to selectively inhibit the reuptake of serotonin at the presynaptic neuronal membrane which causes increased synaptic concentration of serotonin in the CNS. This result in numerous functional changes associated with enhanced serotonergic neurotransmission. Fluoxetine appears to have no effect on the reuptake of norepinephrine and dopamine and does not exhibit anticholinergic, antihistaminic or &alpha;1 adrenergic blocking activity at usual therapeutic doses.</p>', '<p><strong>Initial treatment</strong>: Recent studies suggest that 20 mg/day of Fluoxetine may be sufficient to obtain satisfactory antidepressant response. Consequently, a dose of 20 mg/day administered in the morning is recommended as the initial dose.<br />\r\n<br />\r\nA dose increase may be considered after several weeks if no clinical improvement is observed. Dosage above 20 mg/day, should be administered on a bid schedule (i.e. morning and noon) and should not exceed a maximum dose of 80 mg/day. As with other antidepressants, the full antidepressant effect may be delayed until 4 weeks of treatment or longer. As with many other medications, a lower or less frequent dosage should be used in patients with renal and/or hepatic impairment.<br />\r\n<br />\r\nA lower or less frequent dosage should also be considered for patients, such as elderly, with concurrent disease or on multiple medication. A recommended maximum dose for elderly patients is 60 mg per day.<br />\r\n<br />\r\n<strong>Maintenance treatment</strong>: It is generally agreed among expert psychopharmacologists that acute episode of depression requires several months or longer sustained pharmacologic therapy. Fluoxetine is also used in dosage of 60 mg daily for the management of bulimia nervosa.<br />\r\n<br />\r\n<strong>Use in children</strong>: The use of Fluoxetine in children is not recommended as safety and efficacy have not been established.</p>', '<ul>\r\n	<li><strong>MAO inhibitors</strong>: Sometimes serious fatal reactions have been reported with concomitant use.</li>\r\n	<li><strong>Antidepressants</strong>: There have been greater than two fold increases of previously stable plasma levels of other antidepressants.</li>\r\n	<li><strong>Lithium</strong>: There have been reports of increased or decreased lithium levels when used concomitantly with Fluoxetine.</li>\r\n	<li><strong>Antipsychotics</strong>: Elevation of blood levels of haloperidol and clozapine has been observed in patients receiving concomitant Fluoxetine.</li>\r\n	<li><strong>Anticonvulsants</strong>: Patients on stable dose of phenytoin and carbamazepine have developed elevated plasma anticonvulsant concentrations and clinical anticonvulsant toxicity following initiation of concomitant fluoxetine treatment.</li>\r\n	<li><strong>CNS active drugs</strong>: Caution is advised if concomitant administration of Fluoxetine is required.</li>\r\n</ul>', '<p>Fluoxetine Hydrochloride is contraindicated in patients known to be hypersensitive to it.<br />\r\n<br />\r\n<strong>Monoamine oxidase inhibitors</strong>: There have been reports of serious, sometimes fatal reactions (including hyperthermia, rigidity, myoclonus, autonomic instability with possible rapid fluctuations of vital signs and changes of mental status that include extreme agitation progressing to delirium and coma) in patients receiving Fluoxetine in combination with monoamine oxidase inhibitors (MAOIs), and in patients who have recently discontinued Fluoxetine and are then started on MAOIs. Some cases presented with features resembling neuroleptic malignant syndrome. Therefore, Fluoxetine should not be used in combination with MAOI, or within 14 days of discontinuing therapy with MAOI. Since Fluoxetine and its major metabolites have very long elimination half-lives, at least 5 weeks should be allowed after stopping Fluoxetine and before starting MAOI.</p>', '<p><strong>Gastrointestinal:</strong>&nbsp;Nausea, vomiting, dyspepsia, dry mouth, and diarrhoea.<br />\r\n<br />\r\n<strong>Neurological:</strong>&nbsp;Anxiety, nervousness, insomnia/ drowsiness and fatigue.<br />\r\n<br />\r\n<strong>Others</strong>: Excessive sweating, pruritus, skin rashes associated with liver, kidney and lung involvement. It has therefore been advised that Fluoxetine therapy should be discontinued in any patient who develops a skin rash.</p>', '<p>In animal studies, no teratogenicity or harmful effect was found. Because animal reproductive studies are not always predictive of human responses, Fluoxetine should be used in pregnancy only if clearly needed.&nbsp;As Fluoxetine is excreted in human milk, caution should be exercised when Fluoxetine is administered to nursing women.</p>', '<p>As Fluoxetine undergoes hepatic metabolism and renal excretion, it should be used with caution and in reduced doses in patients with impaired hepatic or renal function. Because of its epileptogenic effect, it should be used with caution in patients with epilepsy or a history of such disorders. Fluoxetine may alter glycaemic control and therefore caution is also warranted in diabetic subjects. Depressed patients with suicidal tendencies should be carefully supervised during treatment. Fluoxetine is not usually considered a suitable form of therapy for the depressive component of bipolar (manic depressive) illness as mania may be precipitated.</p>', NULL, '<p>Phenothiazine related drugs</p>', '<p>Protect from light &amp; moisture. Keep in cool &amp; dry place. Store below 30&deg;C. Keep all the medicines out of the reach of children.</p>', NULL, '2022-02-26 03:37:12', '2022-02-26 03:37:12'),
(599, 599, '<p>Psychoses,&nbsp;Depression with or without anxiety,&nbsp;Psychoses</p>', '<p>Flupentixol is a thioxanthene antipsychotic that inhibits dopamine-mediated effects by blocking postsynaptic dopamine receptors in the CNS.May potentiate the adverse effects of drugs with antimuscarinic effects e.g. TCAs. Reduced efficacy of levodopa. Increases adverse extrapyramidal symptoms with dopamine antagonists (metoclopramide and prochlorperazine).</p>', '<p>Oral-<br />\r\nDepression with or without anxiety:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initially, 1 mg daily increased after 1 wk to 2 mg daily and then to a max of 3 mg daily, last dose should be given not later than 4 p.m. Doses &gt;2 mg should be given in 2 divided doses. Discontinue treatment if there is no improvement within 1 wk of using the max dose.</li>\r\n	<li><strong>Elderly:</strong>&nbsp;Initially, 0.5 mg daily increased after 1 wk to 1 mg daily with the last dose given not later than 4 p.m. Max: 2 mg daily in 2 divided doses.</li>\r\n</ul>\r\n\r\n<p>Psychoses:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initially, 3-9 mg bid, adjusted according to response. Max: 18 mg daily.</li>\r\n	<li><strong>Elderly:</strong>&nbsp;Initial dose: &frac14; or &frac12; of the usual initial dose.</li>\r\n</ul>\r\n\r\n<p><br />\r\nIntramuscular-<br />\r\nPsychoses:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;Initially, 20 mg (1 ml of a 2% oily solution) is given as test dose. After at least 7 days and depending on the response, subsequent doses of 20-40 mg may be given at intervals of 2-4 wk. Usual maintenance dose: 50 mg every 4 wk to 300 mg every 2 wk. Up to 400 mg wkly may be used in severe or resistant cases.</li>\r\n	<li><strong>Elderly</strong>: Initial dose: &frac14; or &frac12; of the usual initial dose.</li>\r\n</ul>', '<p>May potentiate the adverse effects of drugs with antimuscarinic effects e.g. TCAs. Reduced efficacy of levodopa. Increases adverse extrapyramidal symptoms with dopamine antagonists (metoclopramide and prochlorperazine).</p>', '<p>Hypersensitivity. Extremely excitable and overactive patients; mania; porphyria; coma; preexisting CNS depression; bone-marrow supression; phaeochromocytoma. Lactation.</p>', '<p>Rigidity, tremors, restlessness, tardive dyskinesia, insomnia, dryness of mouth, wt gain, sexual dysfunction, galactorrhoea and menstrual disturbances.<br />\r\n<br />\r\n<strong>Potentially Fatal:</strong>&nbsp;Neuroleptic malignant syndrome (hyperthermia, hypertonicity of skeletal muscles, unconsciousness and autonomic nervous system instability).</p>', '<p><strong>Category C:</strong>&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>Patients with convulsive disorders; advanced hepatic, renal, CV or resp disease; tasks requiring mental alertness; elderly (especially with dementia), and debilitated patients; neuroleptics with sedative effect must be withdrawn gradually; history of angle-closure glaucoma; urinary retention; prostatic hyperplasia; breast cancer, prolactin dependent tumours; parkinsonism; myasthenia gravis; pregnancy; Avoid direct sunlight.</p>', NULL, '<p>SSRIs &amp; related anti-depressant drugs</p>', '<p>Store below 25&deg; C.</p>', NULL, '2022-02-26 03:38:55', '2022-02-26 03:38:55'),
(600, 600, '<p>Flupentixol and Melitracen tablet is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Anxiety</li>\r\n	<li>Depression</li>\r\n	<li>Apathy</li>\r\n	<li>Psychogenic depression.</li>\r\n	<li>Depressive neurosses.</li>\r\n	<li>Masked depression.</li>\r\n	<li>Psychosomatic affections accompanied by anxiety and apathy.</li>\r\n	<li>Menopausal depressions.</li>\r\n	<li>Dysphoria and depression in alcoholics and drug addicts.</li>\r\n</ul>', '<p>This consists of two well known and well proven compounds: flupentixol-a neuroleptic with anxiolytic and antidepressant properties of its own when given in small doses, and melitracen-a bipolar thymoleptic with activating properties in low doses. In combination the compounds render a preparation with antidepressant, anxiolytic and activating properties. Maximal serum concentration is reached in about 4 hours after oral administration of flupentixol and in about 4 hours after oral administration of melitracen. The biological half-life of flupentixol is about 35 hours and that of melitracen is about 19 hours. The combination of flupentixol and melitracen does not seem to influence the pharmacokinetic properties of the individual compounds.</p>', '<p><strong>Adults</strong>: Usually 2 tablets orally daily in the morning and noon. In severe cases, the morning dose may be increased to 2 tablets.<br />\r\n<br />\r\n<strong>Elderly patients</strong>: 1 tablet in the morning.<br />\r\n<br />\r\n<strong>Maintenance dose</strong>: Usually 1 tablet orally in the morning. In cases of insomnia or severe restlessness, additional treatment with a sedative in the acute phase is recommended.</p>', '<p>This tablet may enhance the response to alcohol, barbiturates and other CNS depressants. Simultaneous administration of MAO-inhibitors may cause hypertensive crises. Neuroleptics and thymoleptics reduce the antihypertensive effect of guanethidine and similar acting compounds and thymoleptics enhance the effects of adrenaline and noradrenaline.</p>', '<ul>\r\n	<li>The immediate recovery phase after myocardial infarction.</li>\r\n	<li>Defects in bundle-branch conduction.</li>\r\n	<li>Untreated narrow-angle glaucoma.</li>\r\n	<li>Acute alcohol, barbiturate and opiate intoxications.</li>\r\n	<li>This tablet should not be given to patients who have received an MAO-inhibitor within two weeks.</li>\r\n	<li>Not recommended for excitable or overactive patients since its activating effect may lead to exaggeration of these characteristics.</li>\r\n</ul>', '<p>In the recommended doses side effects are rare. These could be transient restlessness and insomnia.</p>', '<p>This tablet should preferably not be given during pregnancy and lactation.</p>', '<p>If previously the patient has been treated with tranquillizers with sedative effect these should be withdrawn gradually.</p>', '<p>In cases of overdosage the symptoms of intoxications by melitracen, especially of anticholinergic nature, dominate. More rarely extrapyramidal symptoms due to flupentixol occur. Symptomatic and Supportive. Gastric lavage should be carried out as soon as possible and activated charcoal may be administered. Measures aimed at supporting the respiratory and cardiovascular systems should be instituted. Epinephrine (adrenaline) must not be used for such patients. Convulsions may be treated with diazepam and extrapyramidal symptoms with biperiden.</p>', '<p>Combined anxiolytics &amp; anti-depressant drugs</p>', '<p>Store at a temperature not exceeding 30&deg;C in a dry place. Protect from light. Keep out of reach of children.</p>', NULL, '2022-02-26 03:40:38', '2022-02-26 03:40:38'),
(601, 601, '<p>This is indicated in</p>\r\n\r\n<ul>\r\n	<li>Mild to moderate mixed anxiety/depression</li>\r\n	<li>Emotional disturbance</li>\r\n	<li>Sleep disorder</li>\r\n	<li>Gastric problems</li>\r\n</ul>\r\n\r\n<p>Fluphenazine is a tranquilizer of the phenothiazine type. Nortriptyline is a tricyclic antidepressant having less sedative action. This combination has been found as effective preparation for the patients suffering from &quot;anxiety&quot; or &quot;depression&quot; or both and helps to restore functional ability without developing any drug dependence.</p>', '<p><strong>Nortriptyline hydrochloride</strong>&nbsp;is a tricyclic antidepressant. Nortriptyline inhibits the uptake of norepinephrine and serotonin at nerve terminals. In contrast to its parent compound amitriptyline which is equally potent in inhibiting the uptake of norepinephrine and serotonin, Nortriptyline has a greater effect on norepinephrine reuptake than on serotonin reuptake.<br />\r\n<br />\r\n<strong>Fluphenazine</strong>&nbsp;is a tranquilizer of the phenothiazine type with piperazine side chain. Fluphenazine primarily acts as a neuroleptic drug whose main therapeutic effect is believed to reside in potent dopamine (specially D2) receptor antagonism.</p>', '<p>Adults: One tablet 2 to 3 times daily.</p>', '<p>Interactions with barbiturates, alcohol, and narcotic drugs may occur, so central depressants should be administered with caution.</p>', '<p>It is contraindicated in :</p>\r\n\r\n<ul>\r\n	<li>History of gradual epilepsy or organic brain damage</li>\r\n	<li>Blood dyscrasia</li>\r\n	<li>Severe cardiac insufficiency</li>\r\n	<li>Renal or liver damage</li>\r\n	<li>Patients taking monoamine oxidase inhibitor (MAOI)</li>\r\n	<li>Younger children</li>\r\n	<li>Hypersensitivity to any component of the preparation</li>\r\n</ul>', '<p>Tardive dyskinesias have been reported in phenothiazine therapy; usually after prolonged courses given at doses adequately to control psychotic illness. Blood dyscrasia, Malignant Neuroleptic syndrome and sudden death have been reported rarely. Agranulocytosis is a rare but potentially fatal adverse effect of Nortriptyline Hydrochloride.</p>', '<p>The safety in human pregnancy has not been yet established. The use of this drug in lactation is not recommended, as it is excreted in breast milk.</p>', '<p>Precautions should be taken in patients with glaucoma, prostate enlargement, cardiac failure and myocardial infarction, and in concurrent administration with CNS depressants. The drug may impair alertness and abilities to drive a car or operate machinery.</p>', NULL, '<p>Combined anxiolytics &amp; anti-depressant drugs</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-26 03:42:08', '2022-02-26 03:42:08'),
(602, 602, '<p>In the long-term management of psychotic disorders including:</p>\r\n\r\n<ul>\r\n	<li>Schizophrenia</li>\r\n	<li>Mania and</li>\r\n	<li>Organic brain syndrome.</li>\r\n</ul>', '<p>Fluphenazine blocks postsynaptic mesolimbic dopaminergic D1 and D2 receptors in the brain; depresses the release of hypothalamic and hypophyseal hormones and is believed to depress the reticular activating system thus affecting basal metabolism, body temperature, wakefulness, vasomotor tone, and emesis.</p>', '<p>Fluphenazine Decanoate by deep intramuscular injection into the gluteal muscle, test dose 12.5 mg (6.25 mg in elderly), then after 4-7 days 12.5-100 mg repeated at intervals of 14-35 days, adjusted according to response; it is not recommended for children.</p>', '<p>Fluphenazine reverses antihypertensive effects of Guanethidine, Methyldopa and Clonidine. It also causes lithium toxicity by interacting with it. Antacids may reduce bioavailability of phenothiazines. Additive CNS depressant effects produced with alcohol, barbiturates, hypnotics, sedatives, opiates and antihistamines.</p>', '<p>Fluphenazine Decanoate oily Injection is contraindicated in patients with hypersensitivity to the drug. Also contraindicated in comatose or severely depressed states, blood dyscrasias, liver disease, pregnancy (3rd trimester), lactation.</p>', '<p>The side effects include tardive dyskinesia, sedation, mental confusion; hypotension; hyperprolactinaemia leading to galactorrhoea and amenorrhoea in women; loss of libido, impotence and sterility in males. Also include allergic reactions, cholestatic jaundice, corneal and lens deposists, skin pigmentation. Other potential adverse reactions are agranulocytosis; neuroleptic syndrome.</p>', '<p>The safety for the use of Fluphenazine decanoate during pregnancy has not yet been established; therefore the possible hazards should be weighed against the potential benefits when administering this drug to pregnant patients.</p>', '<p>Special precaution should be practiced in presence of convulsive disorders; hepatic, renal, cerebrovascular, respiratory and cardiovascular diseases. Also precaution should be observed in case of phenochromocytoma; bone marrow suppression; elderly or debilitated patients.</p>', NULL, '<p>Phenothiazine drugs</p>', '<p>Store at 15-30&deg;C.</p>', NULL, '2022-02-26 03:44:34', '2022-02-26 03:44:34'),
(603, 603, '<p>Flurazepam is indicated in the following conditions-</p>\r\n\r\n<ul>\r\n	<li>Insomnia is characterized by difficulty in falling asleep, frequent nocturnal awakenings or early morning awakenings</li>\r\n	<li>Recurring insomnia or poor sleeping habits</li>\r\n	<li>In acute or chronic medical situations requiring restful sleep.</li>\r\n</ul>', '<p>Flurazepam, a benzodiazepine derivative, is a hypnotic agent which does not appear to decrease dream time as measured by rapid eye movements (REM). Furthermore, it decreases sleep latency and number of awakenings for a consequent increase in total sleep time. Flurazepam binds to an allosteric site on GABA-A receptors. Binding potentiates the action of GABA on GABA-A receptors by opening the chloride channel within the receptor, causing chloride influx and hyperpolarization.</p>', '<p><strong>Adult</strong>: Usual dosage is 30 mg at bedtime. In some patients, 15 mg may sufficient.<br />\r\n<strong>Elderly or debilitated</strong>: 15 mg is usually sufficient for a therapeutic response.<br />\r\n<strong>Children</strong>: Not recommended.<br />\r\n<strong>In hepatic and renal impairment</strong>: Dosage may need to be reduced in patients with impaired hepatic or renal function.</p>', '<p>Flurazepam potentiates other CNS depressants such as alcohol, barbiturates, sedative antidepressants, antihistamines and antipsychotic drugs. Cimetidine moderately prolongs the already long half-life of the active metabolite desalkyl flurazepam. Antacids may delay the absorption of benzodiazepines.</p>', '<p>Patients with known hypersensitivity to benzodiazepines or any other ingredients of the capsule.</p>', '<p>Dizziness, drowsiness, light-headedness, staggering, ataxia have occurred, particularly in elderly or debilitated persons. Severe sedation, lethargy, disorientation and coma have been reported.</p>', '<p>Pregnancy category-C. Flurazepam is contraindicated in pregnant women. Lactating mothers should avoid it.</p>', '<p>Since the risk of the development of oversedation, dizziness, confusion or ataxia increases substantially with larger doses in elderly and debilitated patients, it is recommended that in such patients the dosage should be limited to 15 mg. The usual precautions are indicated for severely depressed patients or those in whom there is any evidence of latent depression; particularly the recognition that suicidal tendencies may be present and protective measures may be necessary. The usual precautions should be observed in patients with chronic pulmonary insufficiency.</p>', '<p>Flurazepam overdosage includes somnolence, confusion and coma. Respiration, pulse and blood pressure should be monitored as in all cases of drug overdosage. General supportive measures should be employed, along with immediate gastric lavage.</p>', '<p>Benzodiazepine hypnotics</p>', '<p>Capsules should be stored in a dry place at 20&deg;-25&deg;C temperature.</p>', NULL, '2022-02-26 03:47:14', '2022-02-26 03:47:14'),
(604, 604, '<p>Carefully consider the potential benefits and risks of Flurbiprofen and other treatment options before deciding to use Flurbiprofen . Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.<br />\r\n<br />\r\nFlurbiprofen is indicated:</p>\r\n\r\n<ul>\r\n	<li>For relief of the signs and symptoms of&nbsp;rheumatoid arthritis.</li>\r\n	<li>For relief of the signs and symptoms of&nbsp;osteoarthritis.</li>\r\n</ul>', '<p>Flurbiprofen inhibits prostaglandin synthesis by decreasing the activity of cyclooxygenase resulting in reduced prostaglandin levels. It is also a potent inhibitor of platelet aggregation.</p>', '<p>After observing the response to initial therapy with Flurbiprofen , the dose and frequency should be adjusted to suit an individual patient&#39;s needs. For relief of the signs and symptoms of rheumatoid arthritis or osteoarthritis, the recommended starting dose of Flurbiprofen is 200 to 300 mg per day, divided for administration two, three, or four times a day. The largest recommended single dose in a multiple-dose daily regimen is 100 mg.</p>\r\n\r\n<p><strong>Should be taken with food.</strong></p>\r\n\r\n<p>&nbsp;</p>', '<p>Reduced antihypertensive effect of ACE inhibitors, angiotensin II receptor antagonists and &beta;-blockers. Slight reduction in blood glucose concentration in patients with DM receiving certain antidiabetic agents (e.g. glyburide, metformin). Reduced diuretic effect of furosemide and thiazides. May increase toxicity of lithium and methotrexate. May increase risk of bleeding with antiplatelets, anticoagulants, SSRIs, corticosteroids.</p>', '<p>Known hypersensitivity to flurbiprofen, history of asthma, urticaria, or allergic-type reactions precipitated by aspirin or other NSAIDs, NSAID-related history of GI bleeding or perforation, treatment of perioperative pain in the setting of CABG surgery. Pregnancy (3rd trimester) and lactation.</p>', '<p>Oedema, abdominal pain, constipation, diarrhoea, dyspepsia/heartburn, liver enzyme elevations, flatulence, nausea, vomiting, wt change, headache, nervousness, CNS stimulation (e.g. anxiety), CNS inhibition (e.g. somnolence), rhinitis, vision changes, dizziness/vertigo, tinnitus, signs and symptoms of UTI, rash. Ocular hyperaemia, eye irritation, fibrosis, miosis, mydriasis.</p>', '<p>Pregnancy&nbsp;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>Patients with known CV disease or risk factors for CV disease, fluid retention. Hepatic and renal impairment. Lactation.</p>', '<p>Symptoms: Headache, nausea, vomiting, epigastric pain, GI bleeding, diarrhoea, disorientation, excitation, coma, drowsiness, dizziness, tinnitus, fainting and occasionally convulsions, acute renal failure and liver damage.<br />\r\n<br />\r\nManagement: Supportive and symptomatic treatment. Admin activated charcoal w/in 1 hr after ingestion. In adults, gastric lavage should be considered.</p>', '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs).</p>', '<p>Store between 15-25&deg; C.</p>', NULL, '2022-02-26 03:49:08', '2022-02-26 03:49:08'),
(605, 605, '<p>Flutamide is indicated for use in combination with LHRH agonists for the management of locally confined&nbsp;Stage&nbsp;B2-C and Stage D2&nbsp;metastatic carcinoma of the&nbsp;prostate.<br />\r\n<br />\r\n<strong>Stage B2-C Prostatic Carcinoma</strong>: Treatment with Flutamide and the LHRH agonist&nbsp;should start 8 weeks prior to initiating radiation therapy and continue during&nbsp;radiation&nbsp;therapy.<br />\r\n<br />\r\n<strong>Stage D2&nbsp;Metastatic Carcinoma</strong>: To achieve benefit from treatment, Flutamide should be initiated with the LHRH agonist and continued until progression.</p>', '<p>Flutamide is a nonsteroidal &#39;pure&#39; antiandrogen which acts directly on the target tissues either by blocking androgen uptake or by inhibiting cytoplasmic and nuclear binding of androgen.</p>', '<p>Oral (Adult)-&nbsp;<br />\r\n<strong>Palliative treatment of prostatic carcinoma</strong>: 250 mg tid preferably at least 3 days before gonadorelin analogue treatment. May be taken with or without food.</p>', '<p>Increased prothrombin time in patients on long-term warfarin treatment.</p>', '<p>Hypersensitivity, severe hepatic impairment, pregnancy and lactation.</p>', '<p>Hot flushes, loss of libido, impotence, gynaecomastia, nausea, vomiting, diarrhoea, increased appetite, sleep disturbances, skin reactions, anaemias, headache, dizziness, malaise, anxiety, hypertension, gastric and chest pain, oedema, blurred vision, hepatitis, jaundice, rash, thirst, pruritus, SLE-like syndrome, drowsiness, confusion, depression, nervousness.</p>', '<p><strong>Category D:</strong>&nbsp;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>Perform liver function tests before starting treatment and at regular intervals. Treatment is not recommended in patients whose ALT values exceed twice the upper limit of normal. Regular assessment of prostate specific antigen level may help to monitor disease progression. Advise patient against discontinuing drug on their own. Exercise caution in patients with cardiac disease.</p>', NULL, '<p>Hormonal Chemotherapy</p>', '<p>Store at 25&deg; C.</p>', NULL, '2022-02-26 03:50:41', '2022-02-26 03:50:41'),
(606, 606, '<p>Fluticasone Furoate Nasal Spray is indicated for the treatment of the symptoms of seasonal and perennial allergic rhinitis in patients aged 2 years and older.<br />\r\n<br />\r\nFluticasone Furoate inhalation powder is indicated for the once-daily maintenance treatment of asthma as prophylactic therapy in patients aged 5 years and older. This is not indicated for the relief of acute bronchospasm.</p>\r\n\r\n<p>Fluticasone Furoate is a synthetic, fluorinated corticosteroid with anti-inflammatory activity. It is an aqueous suspension of microfine Fluticasone Furoate for topical administration to the nasal mucosa by means of a metering and atomizing spray pump. It is necessary to prime the pump before first use or after a period of non-use (1 week or more). Each bottle of Fluticasone Furoate nasal spray provides 120 metered sprays. After 120 metered sprays, the amount of Fluticasone Furoate delivered per actuation may not be consistent and the bottle should be discarded.</p>', '<p>Fluticasone Furoate is a synthetic trifluorinated corticosteroid with potent anti inflammatory activity. Like other corticosteroids Fluticasone Furoate is found to have a wide range of actions on multiple cell types (e.g., mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (e.g.- histamine, eicosanoids, leukotrienes, cytokines) involved in inflammation.</p>', '<p><strong>Fluticasone Furoate Nasal Spray</strong>:</p>\r\n\r\n<ul>\r\n	<li>Adults &amp; Children over 12 years: 2 sprays in each nostril once a day. In some cases 2 sprays into each nostril twice daily, not exceeding 4 sprays.</li>\r\n	<li>Children under 12 years (2-11 Years): 1 spray in each nostril once a day. Patients should use Fluticasone Furoate nasal spray at regular intervals as directed since its effectiveness depends on its regular use.</li>\r\n	<li>Children (under 2 years of age): There are no data to recommend use of Fluticasone Furoate Nasal Spray for the treatment of seasonal or perennial allergic rhinitis in children under 2 years of age.</li>\r\n</ul>\r\n\r\n<p><strong>Fluticasone Furoate Inhalation Capsule</strong>: should be administered as 1 inhalation once daily by the orally inhaled route. Fluticasone Furoate should be used at the same time every day. Do not use fluticasone furoate more than 1 time every 24 hours.</p>\r\n\r\n<ul>\r\n	<li>Adults and Adolescents Aged 12 Years and Older: The starting dosage for Fluticasone Furoate should be based upon patients&#39; asthma severity.</li>\r\n	<li>The usual recommended starting dose for adults and adolescents aged 12 years and older not on an inhaled corticosteroid (ICS) is 100 mcg.</li>\r\n	<li>For other adults and adolescents aged 12 years and older, the starting dose should be based on previous asthma drug therapy and disease severity.</li>\r\n	<li>For adults and adolescents aged 12 years and older who do not respond to Fluticasone Furoate 100 mcg after 2 weeks of therapy, replacement with Fluticasone Furoate 200 mcg may provide additional asthma control.</li>\r\n</ul>\r\n\r\n<p>If a dosage regimen of Fluticasone Furoate fails to provide adequate control of asthma, the therapeutic regimen should be re-evaluated and additional therapeutic options, e.g., replacing the current strength of Fluticasone Furoate with a higher strength, initiating an ICS and long- acting beta 2 -agonist (LABA) combination product, or initiating oral corticosteroids, should be considered.<br />\r\n<br />\r\nThe highest recommended daily dose in adults and adolescents aged 12 years and older is 200 mcg. After asthma stability has been achieved, it is desirable to titrate to the lowest effective dosage to help reduce the possibility of side effects.<br />\r\n<br />\r\nPediatric Patients Aged 5 to 11 Years: The recommended dosage for children aged 5 to 11 years is 50 mcg administered once daily.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>How to use the Nasal Spray-</p>\r\n\r\n<ul>\r\n	<li>Shake the bottle gently and remove the dust cover.</li>\r\n	<li>Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.</li>\r\n	<li>Gently blow the nose to clear the nostrils.</li>\r\n	<li>Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.</li>\r\n	<li>Breathe out through your mouth.</li>\r\n	<li>Repeat the above steps in the same/ other nostril for consecutive doses.</li>\r\n</ul>\r\n\r\n<p>Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-</p>\r\n\r\n<ul>\r\n	<li>Remove the dust cover.</li>\r\n	<li>Gently pull off the nasal applicator.</li>\r\n	<li>Wash the applicator and dust cover in warm water.</li>\r\n	<li>Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.</li>\r\n	<li>Gently push the applicator back on the top of the bottle and re-fix the dust cover.</li>\r\n</ul>', '<p>Potent inhibitors of cytochrome P450 3A4 (CYP3A4) may increase exposure to Fluticasone Furoate. Coadministration of ritonavir is not recommended. Use caution with coadministration of other potent CYP3A4 inhibitors, such as ketoconazole.<br />\r\n<br />\r\nSpecial instruction: Patients should be instructed that the device must be primed: before first use, and if the cap is left off or if the device does not seem to be working or if the nasal spray has not been used for 30 days or more. In order to prime the device, the nasal spray needs to be shaken vigorously for about 10 seconds with the cap on. The patient must then press the button firmly all the way in, approximately 6 times until a fine mist is seen. Once primed, the patient must shake the nasal spray vigorously each time before use.</p>', '<p>Fluticasone Furoate nasal spray is contraindicated in patients with a hypersensitivity to any of its ingredients.</p>', '<p>Fluticasone Furoate nasal spray is absorbed less into the rest of the body, therefore fewer side effects are seen. With the nasal spray, drying of the nose and an increase in the incidence of nosebleeds may occur.<br />\r\n<br />\r\nMost common adverse reactions of Fluticasone Furoate inhalation capsule reported in &ge;5% of adult and adolescent subjects are nasopharyngitis, bronchitis, upper respiratory tract infection, and headache. Most common adverse reactions reported in &ge;3% of pediatric subjects aged 5 to 11 years are pharyngitis, bronchitis, and viral infection.</p>', '<p><strong>Use in pregnancy</strong>: Pregnancy category C. There are no adequate and well-controlled studies in pregnant women. Fluticasone Furoate nasal spray should be used during pregnancy only if the potential benefit justifies the potential risk of the fetus.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: It is not known whether Fluticasone Furoate is excreted in human breast milk. However, since other corticosteroids have been detected in human milk, caution should be exercised when Fluticasone Furoate is administered to a nursing woman.</p>', '<p>Rarely, immediate hypersensitivity reactions or contact dermatitis may occur after the administration of Fluticasone Furoate nasal spray. Rare instances of wheezing, nasal septum perforation, cataracts, glaucoma and increased intraocular pressure have been reported following the intranasal application of corticosteroids, including Fluticasone Furoate. Although systemic effects have been minimal with recommended doses of Fluticasone Furoate nasal spray, potential risk increases with larger doses. Therefore, larger than recommended doses of Fluticasone Furoate nasal spray should be avoided.</p>', NULL, '<p>Nasal Steroid Preparations</p>', '<p>Store at a temperature not exceeding 30&deg;C. Do not refrigerate. Protect from light and moisture.&nbsp;Keep out of the reach of children.</p>', '<p><strong>Geriatric use</strong>: In general, dose selection for the elderly patient should be cautious, keeping in mind the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.<br />\r\n<br />\r\n<strong>Use in hepatic impairment</strong>: Use Fluticasone Furoate with caution in patients with severe hepatic impairment.<br />\r\n<br />\r\n<strong>Use in renal impairment</strong>: No dosage adjustment is required in patients with renal impairment.</p>', '2022-02-26 04:10:50', '2022-02-26 04:10:50'),
(607, 607, '<p>Fluticasone Propionate HFA is an inhaled corticosteroid (ICS) indicated for: Maintenance treatment of asthma as prophylactic therapy in patients aged 4 years and older.</p>', '<p>Fluticasone propionate is a synthetic trifluorinated corticosteroid with anti-inflammatory activity.&nbsp; Fluticasone propionate has been shown in vitro to exhibit a binding affinity for the human glucocorticoid receptor that is 18 times that of dexamethasone, almost twice that of beclomethasone-17-monopropionate (BMP), the active metabolite of beclomethasone dipropionate, and over 3 times that of budesonide. Data from the McKenzie vasoconstrictor assay in man are consistent with these results. The clinical significance of these findings is unknown.<br />\r\n<br />\r\nInflammation is an important component in the pathogenesis of asthma. Corticosteroids have been shown to have a wide range of actions on multiple cell types (e.g., mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (e.g., histamine, eicosanoids, leukotrienes, cytokines) involved in inflammation. These anti-inflammatory actions of corticosteroids contribute to their efficacy in asthma.<br />\r\n<br />\r\nThough effective for the treatment of asthma, corticosteroids do not affect asthma symptoms immediately. Individual patients will experience a variable time to onset and degree of symptom relief. Maximum benefit may not be achieved for 1 to 2 weeks or longer after starting treatment. When corticosteroids are discontinued, asthma stability may persist for several days or longer.<br />\r\n<br />\r\nTrials in subjects with asthma have shown a favorable ratio between topical anti-inflammatory activity and systemic corticosteroid effects with recommended doses of orally inhaled fluticasone propionate. This is explained by a combination of a relatively high local anti-inflammatory effect, negligible oral systemic bioavailability (&lt;1%), and the minimal pharmacological activity of the only metabolite detected in man.</p>', '<p><strong>Adult and adolescent patients aged 12 Years and older</strong>: The starting dosage is based on previous asthma therapy and asthma severity, including consideration of patients&rsquo; current control of asthma symptoms and risk of future exacerbation. The recommended starting dosage for patients aged 12 years and older who are not on an inhaled corticosteroid (ICS) is 88 mcg twice daily, approximately 12 hours apart. For other patients, and for patients who do not respond adequately to the starting dosage after 2 weeks of therapy, higher dosages may provide additional asthma control. The maximum recommended dosage for patients aged 12 years and older is 880 mcg twice daily.<br />\r\n<br />\r\n<strong>Pediatric patients aged 4 to 11 years</strong>: The recommended dosage for patients aged 4 to 11 years is 88 mcg twice daily, approximately 12 hours apart.</p>\r\n\r\n<p>Using an Inhaler seems simple, but most patients do not know how to use it in the right way. If the Inhaler is used in the wrong way, less medicine can reach the lungs. Correct and regular use of the Inhaler will prevent or lessen the severity of asthma attacks.<br />\r\n<br />\r\nFollowing simple steps can help to use Inhaler effectively (According to &quot;<strong>National Asthma Guidelines for Medical Practitioners</strong>&quot; published by Asthma Association):</p>\r\n\r\n<ol>\r\n	<li>Take off the cap.</li>\r\n	<li>Shake the inhaler (at least six times) vigorously before each use.</li>\r\n	<li>If the inhaler is new or if it has not been used for a week or more, shake it well and release one puff into the air to make sure that it works.</li>\r\n	<li>Breathe out as full as comfortably possible &amp; hold the inhaler upright.</li>\r\n	<li>Place the actuator into mouth between the teeth and close lips around the mouthpiece.</li>\r\n	<li>While breathing deeply and slowly through the mouth, press down firmly add fully on the canister to release medicine.</li>\r\n	<li>Remove the inhaler from mouth. Continue holding breath for at least for 10 seconds or as long as it is comfortable.</li>\r\n	<li>If doctor has prescribed more than one inhalation per treatment, wait 1 minute between puffs (inhalations). Shake the inhaler well and repeat steps 4 to 7.</li>\r\n	<li>After use, replace the cap on the mouthpiece. After each treatment, rinse mouth with water.</li>\r\n	<li>Check your technique in front of a mirror from time to time, if you see a white mist during the inhalation, you may not have closed your lips properly around mouthpiece, or you may not be breathing in as you press the can. This indicates failure of technique. If this happens, repeat the procedure from step 4 carefully.</li>\r\n</ol>\r\n\r\n<p><strong>Instructions for Cleaning Inhaler</strong>: Clean your Inhaler at least once a week. Remove canister and rinse the plastic actuator and cap in warm water but do not put the metal canister into water. Dry the actuator and cap thoroughly and gently replace the metal canister into the actuator with a twisting motion. Put the cap on the mouthpiece.</p>', '<p>Inhibitors of Cytochrome P450 3A4: Fluticasone propionate is a substrate of CYP3A4. The use of strong CYP3A4 inhibitors (e.g., ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, ketoconazole, telithromycin) with Fluticasone Propionate HFA is not recommended because increased systemic corticosteroid adverse effects may occur.<br />\r\n<br />\r\nRitonavir: A drug interaction trial with fluticasone propionate aqueous nasal spray in healthy subjects has shown that ritonavir (a strong CYP3A4 inhibitor) can significantly increase plasma fluticasone propionate exposure, resulting in significantly reduced serum cortisol concentrations. During postmarketing use, there have been reports of clinically significant drug interactions in patients receiving fluticasone propionate and ritonavir, resulting in systemic corticosteroid effects including Cushing&rsquo;s syndrome and adrenal suppression.<br />\r\n<br />\r\nKetoconazole: Coadministration of orally inhaled fluticasone propionate (1,000 mcg) and ketoconazole (200 mg once daily) resulted in a 1.9-fold increase in plasma fluticasone propionate exposure and a 45% decrease in plasma cortisol area under the curve (AUC), but had no effect on urinary excretion of cortisol.</p>', '<p>The use of Fluticasone Propionate Inhaler is contraindicated in the following conditions: Primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required. Hypersensitivity to any of the ingredients.</p>', '<p>Most common adverse reactions (incidence &gt;3%) are upper respiratory tract infection or inflammation, throat irritation, sinusitis, dysphonia, candidiasis, cough, bronchitis, and headache.</p>', '<p>There are insufficient data on the use of Fluticasone propionate HFA in pregnant women. There are clinical considerations with the use of Fluticasone propionate HFA in pregnant women. There are no available data on the presence of fluticasone propionate in human milk, the effects on the breastfed child, or the effects on milk production. Other corticosteroids have been detected in human milk.</p>', '<ul>\r\n	<li>Candida albicans infection of the mouth and pharynx may occur. Monitor patients periodically. Advise the patient to rinse his/her mouth with water without swallowing after inhalation to help reduce the risk.</li>\r\n	<li>Potential worsening of infections (e.g., existing tuberculosis; fungal, bacterial, viral, or parasitic infections; ocular herpes simplex). Use with caution in patients with these infections. More serious or even fatal course of chickenpox or measles can occur in susceptible patients.</li>\r\n	<li>Risk of impaired adrenal function when transferring from systemic corticosteroids. Taper patients slowly from systemic corticosteroids if transferring to Fluticasone propionate HFA.</li>\r\n	<li>Hypercorticism and adrenal suppression may occur with very high dosages or at the regular dosage in susceptible individuals. If such changes occur, discontinue Fluticasone propionate HFA slowly.</li>\r\n	<li>Assess for decrease in bone mineral density initially and periodically thereafter.</li>\r\n	<li>Monitor growth of pediatric patients.</li>\r\n	<li>Glaucoma and cataracts may occur with long-term use of ICS. Consider referral to an ophthalmologist in patients who develop ocular symptoms or use Fluticasone propionate HFA long term.</li>\r\n</ul>', '<p>Chronic overdosage may result in signs/symptoms of hypercorticism. Inhalation by healthy volunteers of a single dose of 1,760 or 3,520 mcg of fluticasone propionate CFC inhalation aerosol was well tolerated. Fluticasone propionate given by inhalation aerosol at dosages of 1,320 mcg twice daily for 7 to 15 days to healthy human volunteers was also well tolerated. Repeat oral doses up to 80 mg daily for 10 days in healthy volunteers and repeat oral doses up to 20 mg daily for 42 days in subjects were well tolerated. Adverse reactions were of mild or moderate severity, and incidences were similar in active and placebo treatment groups.</p>', '<p>Fluocinolone &amp; Combined Preparations, Respiratory corticosteroids</p>', '<p>Store at room temperature between 20&deg;C and 25&deg;C. Keep away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Pediatric Use: The safety and effectiveness of Fluticasone Propionate Inhaler in children aged 4 years and older have been established.</p>', '2022-02-26 04:13:13', '2022-02-26 04:13:13');
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
(608, 608, '<p>Fluticasone Propionate is indicated for-</p>\r\n\r\n<ul>\r\n	<li>The prophylaxis and treatment of seasonal allergic rhinitis including hay fever and perennial rhinitis.</li>\r\n	<li>It has potent anti-inflammatory activity on the nasal mucosa without detectable systemic activity.</li>\r\n</ul>\r\n\r\n<p>Fluticasone Propionate is a synthetic trifiuorinated corticosteroid with anti-inflammatory activity. It is an aqueous suspension of microfine Fluticasone Propionate for topical administration to the nasal mucosa by means of a metering, atomizing spray pump. Each bottle of Fluticasone Nasal Spray provides 120 metered sprays.</p>', '<p>Following topical administration into the nasal mucosa, Fluticasone propionate produces anti-inflammatory and vasoconstrictor effects. The exact mechanism of these actions remains unknown but may involve a reduction in the following: number of mediator cells (basophil, leukocytes and mast cells) at the epithelial level, number of eosinophils, the sensitivity of sensory nerves to mechanical stimuli, secretory response to cholinergic receptor stimulation, and fibroblast activity. Other mechanisms may involve - inhibition of capillary dilation and permeability, stabilization of lysosomal membranes and subsequent prevention of release of proteolytic enzymes.</p>', '<p><strong>Adults &amp; children over 12 years</strong>: 2 sprays in each nostril once a day preferably in the morning. In some cases 2 sprays into each nostril twice daily, not exceeding 4 sprays.<br />\r\n<br />\r\n<strong>Children under 12 years (4-11 years)</strong>: 1 spray in each nostril once a day. The maximum total daily dosage should not exceed 4 sprays. For perennial rhinitis in children, there are insufficient clinical data to recommend its use.<br />\r\n<br />\r\n<strong>Children below 4 years</strong>: The safety and effectiveness of Fluticasone Propionate nasal spray in children below 4 years of age have not been established.<br />\r\n<br />\r\nPatients should use Fluticasone Propionate Nasal Spray at regular intervals as directed since its effectiveness depends on its regular use. Or as directed by the physician.</p>\r\n\r\n<p>How to use the Nasal Spray-</p>\r\n\r\n<ul>\r\n	<li>Shake the bottle gently and remove the dust cover.</li>\r\n	<li>Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.</li>\r\n	<li>Gently blow the nose to clear the nostrils.</li>\r\n	<li>Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.</li>\r\n	<li>Breathe out through your mouth.</li>\r\n	<li>Repeat the above steps in the same/ other nostril for consecutive doses.</li>\r\n</ul>\r\n\r\n<p>Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-</p>\r\n\r\n<ul>\r\n	<li>Remove the dust cover.</li>\r\n	<li>Gently pull off the nasal applicator.</li>\r\n	<li>Wash the applicator and dust cover in warm water.</li>\r\n	<li>Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.</li>\r\n	<li>Gently push the applicator back on the top of the bottle and re-fix the dust cover.</li>\r\n</ul>', NULL, '<p>Fluticasone Propionate nasal spray is contraindicated in patients with a hypersensitivity to any of its ingredients.</p>', '<p>Fluticasone Propionate nasal spray is absorbed less into the rest of the body, therefore fewer side effects are seen. With the nasal spray, drying of the nose and throat, unpleasant taste and smell and an increase in the incidence of nosebleeds may occur.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. Fluticasone Propionate should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Fluticasone Propionate is excreted in human breast milk. Because other corticosteroids are excreted in human milk, caution should be exercised when Fluticasone Propionate nasal spray is administered to a nursing woman.</p>', '<p>Rare instances of wheezing, nasal septum perforation, cataracts, glaucoma and increased intraocular pressure have been reported following the intranasal application of corticosteroids, including Fluticasone Propionate. Although systemic effects have been minimal with recommended doses of Fluticasone Propionate nasal spray. Potential risk increases with larger doses. Therefore, larger than recommended doses of Fluticasone Propionate nasal spray should be avoided.</p>', NULL, '<p>Fluocinolone &amp; Combined Preparations, Nasal Steroid Preparations</p>', '<p>Keep all medicines out of reach of the children. Store in a cool and dry place protected from light.</p>', NULL, '2022-02-26 04:15:17', '2022-02-26 04:15:17'),
(609, 609, '<p><strong>Adults and adolescents over 16 years of age</strong>: Prophylactic management in severe asthma (patients requiring high dose inhaled or oral corticosteroid therapy).<br />\r\n<br />\r\n<strong>Children and adolescents from 4 to 16 years of age</strong>: Treatment of mild to moderate acute exacerbations of asthma.</p>', '<p>Fluticasone propionate is a synthetic, trifluorinated glucocorticoid&nbsp;with potent anti-inflammatory activity.&nbsp;In vitro assays using human lung cytosol preparations have established fluticasone propionate as a human glucocorticoid receptor&nbsp;agonist&nbsp;with an&nbsp;affinity&nbsp;18 times greater than dexamethasone, almost twice that of beclomethasone-17-monopropionate (BMP), the active metabolite of beclomethasone dipropionate, and over 3 times that of budesonide. Data from the McKenzie vasoconstrictor&nbsp;assay&nbsp;in man are consistent with these results.<br />\r\n<br />\r\nThe precise mechanisms of glucocorticoid action in&nbsp;asthma&nbsp;are unknown.&nbsp;Inflammation&nbsp;is recognized as an important component in the&nbsp;pathogenesis&nbsp;of asthma. Glucocorticoids have been shown to inhibit multiple&nbsp;cell&nbsp;types (e.g., mast cells, eosinophils, basophils, lymphocytes, macrophages, and neutrophils) and mediator production or secretion (e.g.,&nbsp;histamine, eicosanoids, leukotrienes, and cytokines) involved in the&nbsp;asthmatic response. These anti-inflammatory actions of glucocorticoids may contribute to their efficacy in asthma.<br />\r\n<br />\r\nThough highly effective for the treatment of asthma, glucocorticoids do not affect asthma symptoms immediately. However, improvement following inhaled administration of fluticasone propionate can occur within 24 hours of beginning treatment, although maximum benefit may not be achieved for 1 to 2 weeks or longer after starting treatment. When glucocorticoids are discontinued, asthma stability may persist for several days or longer.</p>', '<p><strong>Adults and adolescents over 16 years (prophylactic management in severe asthma)</strong>: 0.5-2 mg twice daily. The recommended initial dose is 2 mg twice daily. The dosage should then be adjusted until control is achieved or reduced to the minimum effective dose according to the individual response.<br />\r\n<br />\r\n<strong>Children and adolescents 4 to 16 years of age (treatment of acute exacerbations of asthma)</strong>: 1 mg twice daily.</p>', '<p>Clinically significant drug interactions mediated by Fluticasone Propionate are unlikely.</p>', '<p>Fluticasone Propionate Nebuliser Suspension is contraindicated in patients with a history of hypersensitivity to any component of the preparation.</p>', '<p>Candidiasis of the mouth and throat and/or hoarseness is commonly reported. Patients may find it helpful to rinse out their mouth with water after inhalation. As with other inhalation therapy, paradoxical bronchospasm may occur rarely, with an immediate increase in wheezing after dosing. There have also been rare reports of hypersensitivity reactions manifesting as angioedema, bronchospasm and very rarely, anaphylactic reactions. Other adverse events that may occur rarely include depression of plasma cortisol in adult patients on higher doses, bone density reduction, growth retardation, cataract, glaucoma.</p>', '<p>Pregnancy category B3. There is inadequate evidence of safety of Fluticasone Propionate in human pregnancy. However, as with other drugs the administration of Fluticasone Propionate during pregnancy should only be considered if the expected benefit to the mother is greater than any possible risk to the foetus.<br />\r\n<br />\r\nUse in Lactation: The excretion of Fluticasone Propionate into human breast milk has not been investigated.</p>', '<p>Fluticasone Propionate Nebuliser Suspension should not be used for the treatment of severe acute exacerbations of asthma in children and adolescents as efficacy in this situation has not been established. Patients receiving treatment with nebulised Fluticasone Propionate must be warned that if their clinical condition deteriorates, or if a dose fails to give the usual relief, they should not increase the dose or the frequency of administration, but should seek medical advice. Prolonged therapy with inhaled Fluticasone Propionate Nebuliser Suspension should be reduced gradually and not stopped abruptly, and this should be done under medical supervision.</p>', '<p>Acute inhalation of Fluticasone Propionate doses in excess of those recommended may lead to temporary suppression of adrenal function. This does not need emergency action as adrenal function is recovered in a few days, and can be verified by plasma cortisol measurements. However, if higher than recommended dosage is continued over prolonged periods, some degree of adrenal suppression may result. Monitoring of adrenal reserve may be necessary. In cases of Fluticasone Propionate overdose, therapy may still be continued at a suitable dosage for symptom control.</p>', '<p>Fluocinolone &amp; Combined Preparations, Respiratory corticosteroids</p>', '<p>Store below 30&deg;C. Protect from frost and light. Do not freeze. Store upright. Once ampoules have been removed from their pack, they should be protected from light and used within 28 days. Opened ampoules should be refrigerated and used within 12 hours of opening.</p>', NULL, '2022-02-26 04:17:10', '2022-02-26 04:17:10'),
(610, 610, '<p>Fluticasone Propionate is indicated for the relief of inflammatory and pruritic manifestations of corticosteroid responsive eczema/dermatitis.</p>', '<p>Fluticasone propionate is a glucocorticoid with high topical anti-inflammatorypotency, but a low HPA-axis suppressive activity after dermal administration. It, therefore, has a therapeutic index which is greater than most of the commonly available steroids. Fluticasone propionate has a high degree of selectivity for the glucocorticoid receptor. In vitro studies show that fluticasone propionate has a strong affinity for, and agonist activity at, human glucocorticoid receptors. This receptor is believed to be responsible for the anti-inflammatory properties of glucocorticoids. Fluticasone propionate has weak affinity forthe progesterone receptor, andvirtually no affinity for the mineralocorticoid, estrogen, or androgen receptors. The therapeutic potency of glucocorticoids is related to the half-life of the glucocorticoid-receptor complex. The half-life of the Fluticasone propionate glucocorticoid-receptor complex is approximately 10 hours.</p>', '<p><strong>Cream</strong>: Apply a thin layer of Fluticasone propionate cream to the affected skin areas once daily.<br />\r\n<strong>Ointment</strong>: Apply a thin layer of Fluticasone propionate Ointment to the affected skin areas twice daily.</p>', NULL, '<p>Fluticasone propionate is contraindicated in Rosacea, Acne vulgaris, Perioral dermatitis, Primary cutaneous viral infections (e.g., Herpes simplex, chicken pox), Hypersensitivity to any of the ingredients, Perianal and genital pruritus, etc. The use of Fluticasone propionate is not indicated in the treatment of primarily infected skin lesions caused by infection with fungi or bacteria and dermatoses in children under one year of age, including dermatitis and napkin eruptions.</p>', '<p>The fluticasone propionate preparations are usually well tolerated; local burning and pruritus have been reported. If signs of hypersensitivity appear, application should be stopped immediately. Prolonged and intensive treatment with potent corticosteroid preparations may cause local atrophic changes in the skin such as thinning, striae, dilatation of the superficial blood vessels, hypertrichosis and hypopigmentation.<br />\r\n<br />\r\nSecondary infection, particularly when occlusive dressings are used or when skin folds are involved and allergic contact dermatitis have also been reported with corticosteroid use. Exacerbation of the signs and symptoms of the dermatoses have been reported with corticosteroid use.<br />\r\n<br />\r\nProlonged use of large amounts of corticosteroids, or treatment of extensive areas, can result in sufficient systemic absorption to produce the features of hypercorticism. This effect is more likely to occur in infants and children, and if occlusive dressings are used. In infants, the napkin may act as an occlusive dressing.</p>', '<p>Administration of fluticasone propionate during pregnancy should only be considered if the expected benefit to the mother is greater than any possible risk to the fetus. The excretion of fluticasone propionate into human breast milk has not been investigated. Plasma levels in patients following dermal application of fluticasone propionate at recommended doses are likely to be low. When fluticasone propionate is used in breastfeeding mothers, the therapeutic benefits must be weighed against the potential hazards to the mother and baby.</p>', '<p>Fluticasone propionate has a very low propensity for systemic absorption, nevertheless, prolonged application of high doses to large areas of the body surface, especially in infants and small children might lead to adrenal suppression. Children may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity. The face, more than other areas of the body, may exhibit atropic changes after prolonged treatment with potent topical corticosteroids. This must be borne in mind when treating severe eczema. Appropriate antimicrobial therapy should be used whenever treating inflammatory lesions which have become infected. Any spread of infection requires withdrawal of topical corticosteroid therapy and systemic administration of antimicrobial agents. Bacterial infection is encouraged by the warm, moist conditions induced by occlusive dressing, and so the skin should be cleansed before a fresh dressing is applied.</p>', '<p>Acute overdosage is very unlikely to occur, however, in case of chronic overdosage or misuse the features of hypercorticism may appear, and in this situation, as with any corticosteroid, the application should be discontinued. Overdosage by ingestion of fluticasone propionate cream or ointment is extremely unlikely to occur due to the very low oral bioavailability of fluticasone propionate.</p>', '<p>Fluticasone &amp; combined preparations topical</p>', '<p>Fluticasone &amp; combined preparations topical</p>', NULL, '2022-02-26 04:18:53', '2022-02-26 04:18:53'),
(611, 611, '<p><strong>Asthma</strong>: This fixed-dose combination of Fluticasone Propionate and Formoterol Fumarate is indicated in the regular treatment of asthma where the use of a combination product (an inhaled corticosteroid and a long-acting &szlig;2 agonist) is appropriate:</p>\r\n\r\n<ul>\r\n	<li>For patients not adequately controlled with inhaled corticosteroids and &quot;as required&quot; inhaled short-acting &szlig;2 agonist. Or,</li>\r\n	<li>For patients already adequately controlled on both an inhaled corticosteroid and a long-acting &szlig;2 agonist.</li>\r\n</ul>\r\n\r\n<p>Fluticasone Propionate 125 mcg and Formoterol Fumarate 5 mcg inhaler are indicated in adults and adolescents aged 12 years and above.<br />\r\n<br />\r\n<strong>COPD</strong>: Fluticasone Propionate and Formoterol Fumarate is recommended when a long-acting &szlig;2 agonist/Inhaled corticosteroid is indicated &amp; patients are unable to use other long-acting &szlig;2 agonist/Inhaled corticosteroid.<br />\r\n<br />\r\nFluticasone Propionate 125 mcg and Formoterol Fumarate 5 mcg inhaler is indicated in adults only.</p>', '<p>This inhaler (a pressurised inhalation, suspension) which contains two active ingredients:</p>\r\n\r\n<ul>\r\n	<li>Fluticasone propionate which belongs to a group of medicines called steroids. Steroids help to reduce swelling and inflammation in the lungs.</li>\r\n	<li>Formoterol fumarate dihydrate which belongs to a group of medicines called long-acting beta 2 agonists. Long-acting beta 2 agonists are long-acting bronchodilators which help the airways in your lungs to stay open, making it easier for you to breathe.</li>\r\n</ul>\r\n\r\n<p>Together these two active ingredients help to improve your breathing. It is advised that you should use this medicine every day as directed by your doctor or asthma nurse.<br />\r\n<br />\r\nThis medicine helps to prevent breathing problems such as asthma and helps to stop you becoming breathless and wheezy. However, it does not work if you are already having an asthma attack i.e. you are already breathless and wheezing. You will need to use a fast acting &lsquo;reliever&rsquo; medicine such as salbutamol if this happens.</p>', '<p>Patients will need to be trained on the use of the inhaler and their asthma should be regularly reassessed by a doctor, so that the strength of this inhaler they are receiving remains optimal and is only changed on medical advice. The dose should be titrated to the lowest dose at which effective control of symptoms is maintained.<br />\r\n<br />\r\nPatients should be given the strength of this inhaler containing the appropriate Fluticasone Propionate dosage for the severity of their disease.<br />\r\n<br />\r\n<strong>Asthma</strong>:<br />\r\nFluticasone Propionate 125 mcg &amp; Formoterol Fumarate 5 mcg inhaler only</p>\r\n\r\n<ul>\r\n	<li>The recommended dose for adults and adolescents aged 12 years and above: Two inhalations (puffs) twice daily normally taken in the morning and in the evening.</li>\r\n	<li>For adults only: The total daily dose can be further increased if asthma still remains poorly controlled by administering the highest strength of this combination product- i.e. Fluticasone Propionate 250 mcg &amp; Formoterol Fumarate 10 mcg inhaler- two inhalations (puffs) twice daily. This highest strength is for use in adults only; it should not be used in adolescents aged 12 years and above.</li>\r\n	<li>Children under 12 years: No data are available for this strength of this inhaler in children.</li>\r\n	<li>This inhaler in any strength is not recommended for use in children less than 12 years of age.</li>\r\n</ul>\r\n\r\n<p>Fluticasone Propionate 250 mcg &amp; Formoterol Fumarate 10 mcg inhaler only</p>\r\n\r\n<ul>\r\n	<li>The recommended dose for adults: Fluticasone Propionate 250 mcg &amp; Formoterol Fumarate 10 mcg inhaler- two inhalations (puffs) twice daily normally taken in the morning and in the evening.</li>\r\n	<li>Adolescents under 18 years and children: No data are available for this strength of this inhaler in children or adolescents. This inhaler in any strength is not recommended for use in children less than 12 years of age.</li>\r\n	<li>This inhaler 250 microgram/10 microgram per actuation should not be used in adolescents.</li>\r\n</ul>\r\n\r\n<p><strong>COPD</strong>: Fluticasone Propionate 250 mcg &amp; Formoterol Fumarate 10 mcg, two inhalations (puffs) twice daily normally taken in the morning and in the evening.</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Using an Inhaler seems simple, but most patients do not know how to use it in the right way. If the Inhaler is used in the wrong way, less medicine can reach the lungs. Correct and regular use of the Inhaler will prevent or lessen the severity of asthma attacks.<br />\r\n<br />\r\nFollowing simple steps can help to use Inhaler effectively (According to &quot;<strong>National Asthma Guidelines for Medical Practitioners</strong>&quot; published by Asthma Association):</p>\r\n\r\n<ol>\r\n	<li>Take off the cap.</li>\r\n	<li>Shake the inhaler (at least six times) vigorously before each use.</li>\r\n	<li>If the inhaler is new or if it has not been used for a week or more, shake it well and release one puff into the air to make sure that it works.</li>\r\n	<li>Breathe out as full as comfortably possible &amp; hold the inhaler upright.</li>\r\n	<li>Place the actuator into mouth between the teeth and close lips around the mouthpiece.</li>\r\n	<li>While breathing deeply and slowly through the mouth, press down firmly add fully on the canister to release medicine.</li>\r\n	<li>Remove the inhaler from mouth. Continue holding breath for at least for 10 seconds or as long as it is comfortable.</li>\r\n	<li>If doctor has prescribed more than one inhalation per treatment, wait 1 minute between puffs (inhalations). Shake the inhaler well and repeat steps 4 to 7.</li>\r\n	<li>After use, replace the cap on the mouthpiece. After each treatment, rinse mouth with water.</li>\r\n	<li>Check your technique in front of a mirror from time to time, if you see a white mist during the inhalation, you may not have closed your lips properly around mouthpiece, or you may not be breathing in as you press the can. This indicates failure of technique. If this happens, repeat the procedure from step 4 carefully.</li>\r\n</ol>\r\n\r\n<p><strong>Instructions for Cleaning Inhaler</strong>: Clean your Inhaler at least once a week. Remove canister and rinse the plastic actuator and cap in warm water but do not put the metal canister into water. Dry the actuator and cap thoroughly and gently replace the metal canister into the actuator with a twisting motion. Put the cap on the mouthpiece.</p>', '<p>Fluticasone Propionate, an individual component of this inhaler, is a substrate of CYP 3A4. The effects of short-term co-administration of strong CYP 3A4 inhibitors (e.g. Ritonavir, Atazanavir, Clarithromycin, Indinavir, Itraconazole, Nelfinavir, Saquinavir, Ketoconazole, Telithromycin) together with this inhaler is of minor clinical relevance, but caution needs to be taken in long-term treatment and co-administration with such drugs should be avoided if possible.</p>', '<p>This inhaler should not be used to treat acute asthma symptoms for which a fast and short-acting bronchodilator is required. Patients should be advised to have their medicine to be used for relief in an acute asthma attack available at all times.<br />\r\n<br />\r\nThe prophylactic use of this inhaler in exercise-induced asthma has not been studied. For such use, a separate rapid-acting bronchodilator should be considered. Patients should be reminded to take their this inhaler maintenance dose as prescribed, even when asymptomatic. Patients should not be initiated on this inhaler during an exacerbation, or if they have significantly worsening or acutely deteriorating asthma. Serious asthma-related adverse events and exacerbations may occur during treatment with this inhaler. Patients should be asked to continue treatment but to seek medical advice if asthma symptoms remain uncontrolled or worsen after initiation on this inhaler.<br />\r\n<br />\r\nThis inhaler should not be used as the first treatment for asthma.<br />\r\n<br />\r\nThis inhaler should be administered with caution in patients with pulmonary tuberculosis, quiescent tuberculosis or patients with fungal, viral or other infections of the airway. This inhaler should be used with caution in patients with thyrotoxicosis, phaeochromocytoma, diabetes mellitus, uncorrected hypokalaemia or patients predisposed to low levels of serum potassium, hypertrophic obstructive cardiomyopathy, idiopathic subvalvular aortic stenosis, severe hypertension, aneurysm or other severe cardiovascular disorders, such as ischaemic heart disease, cardiac arrhythmias or severe heart failure. Caution must be observed when treating patients with existing prolongation of the QTc interval. Formoterol itself may induce prolongation of the QTc interval.<br />\r\n<br />\r\nAs for all &szlig;2 agonists, additional blood sugar controls should be considered in diabetic patients. As with other inhalation therapy paradoxical bronchospasm may occur with an immediate increase in wheezing and shortness of breath after dosing. This inhaler should be discontinued immediately, the patient assessed and alternative therapy instituted if necessary.<br />\r\n<br />\r\nSystemic effects may occur with any inhaled corticosteroid, particularly at high doses prescribed for long periods. These effects are much less likely to occur than with oral corticosteroids. Possible systemic effects include Cushing&rsquo;s syndrome, Cushingoid features, adrenal suppression, growth retardation in children and adolescents, decrease in bone mineral density, cataract glaucoma and more rarely, a range of psychological or behavioural effects including psychomotor hyperactivity, sleep disorders, anxiety, depression or aggression (particularly in children). It is important, therefore, that the patient is reviewed regularly and the dose of inhaled corticosteroid is reduced to the lowest dose at which effective control of asthma is maintained.</p>', '<p>Undesirable effects which have been associated with this inhaler during clinical development are given in the table below, listed by system organ class. The following frequency categories form the basis for classification of the undesirable effects as: very common (&ge;1/10), common (&ge;1/100 and &lt;1/10), uncommon (&ge;1/1,000 and &lt;1/100), rare (&ge;1/10,000 &lt; 1/1,000), very rare (&lt;1/10,000) and not known (cannot be estimated from the available data). Within each frequency grouping, undesirable effects are presented in order of decreasing seriousness.</p>', '<p><strong>Pregnancy</strong>: There are limited data on the use of Fluticasone Propionate and FormoterolFumarate, either administered alone or together but administered from separate inhalers, or on the use of this fixed-dose combination, this inhaler in pregnant women. Studies in animals have shown reproductive toxicity. Administration of this inhaler is not recommended during pregnancy, and should only be considered if expected benefit to the mother is greater than any possible risk to the fetus. If this is the case, then the lowest effective dose needed to maintain adequate asthma control should be used.<br />\r\n<br />\r\n<strong>Breastfeeding</strong>: It is not known whether Fluticasone Propionate or FormoterolFumarateare excreted in human breast milk. Therefore, a decision must be made whether to discontinue breastfeeding or to discontinue/abstain from this inhaler therapy taking into account the benefit of breastfeeding for the child and the benefit of therapy for the woman.<br />\r\n<br />\r\n<strong>Fertility</strong>: There are no data available on effects on fertility following administration of this inhaler. In animal studies, no effects on fertility have been seen following administration of the individual active substances at clinically relevant doses.</p>', NULL, '<p>There are no data available from clinical trials on overdose with this inhaler, however, data on overdose with both single drugs are given below:<br />\r\n<br />\r\nFormoterolFumarate: An overdose of Formoterol would likely lead to an exaggeration of effects that are typical for &szlig;2 agonists; in which case the following adverse experiences may occur: angina, hypertension or hypotension, palpitations, tachycardia, arrhythmia, prolonged QTc interval, headache, tremor, nervousness, muscle cramps, dry mouth, insomnia, fatigue, malaise, seizures, metabolic acidosis, hypokalaemia, hyperglycaemia, nausea and vomiting.<br />\r\n<br />\r\nFluticasone Propionate: Acute overdose with Fluticasone Propionate usually does not constitute a clinical problem. The only harmful effect after inhalation of a large amount of the drug over a short period is suppression of hypothalamic pituitary adrenocortical (HPA) axis function. HPA axis function usually recovers in a few days, as verified by plasma cortisol measurements. Treatment with the inhaled corticosteroid should be continued at the recommended dose to control asthma.</p>', '<p>Respiratory corticosteroids</p>', '<p>Store in a cool and dry place, protected from light.</p>', '<p><strong>Special patient groups</strong>: There is no need to adjust the dose in elderly patients.<br />\r\n<br />\r\n<strong>Hepatic or renal</strong>: There are no data available for use of this inhaler in patients with hepatic or renal impairment.<br />\r\n<br />\r\n<strong>Paediatric population</strong>: It is recommended that the height of children receiving prolonged treatment with inhaled corticosteroids is regularly monitored. If growth is slowed, therapy should be reviewed with the aim of reducing the dose of inhaled corticosteroid, if possible, to the lowest dose at which effective control of asthma is maintained. In addition, consideration should be given to referring the patient to a paediatric respiratory specialist.<br />\r\n<br />\r\nOnly limited data are available in respect of the use of this&nbsp;inhaler in children under 12 years of age. This inhaler is not recommended for use in children under 12 years of age until further data become available.</p>', '2022-02-26 04:21:11', '2022-02-26 04:21:11'),
(612, 612, '<p>Therapy with lipid-altering agents should be only one component of multiple risk factor intervention in individuals at significantly increased risk for atherosclerotic vascular disease due to&nbsp;hypercholesterolemia. Drug therapy is indicated as an adjunct to diet when the response to a diet restricted in&nbsp;saturated fat&nbsp;and cholesterol and other non-pharmacologic measures alone has been inadequate.</p>', '<p>Fluvastatin acts by competitively inhibiting HMG-CoA reductase, the enzyme for cholesterol synthesis. It reduces total cholesterol, triglycerides, LDL and VLDL concentrations in plasma. It also increases HDL concentrations.</p>', '<p><strong>Oral-</strong><br />\r\nHyperlipidaemias:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initially, 20-40 mg once daily in the evening, may increase at intervals of 4 wk to max 80 mg/day.</li>\r\n	<li><strong>Child:</strong>&nbsp;Heterozygous familial hypercholesterolaemia: 9-16 yr 20 mg once daily. If necessary, may increase dose at 6-wkly intervals to 40 mg bid or 80 mg once daily as modified-release.</li>\r\n</ul>\r\n\r\n<p><strong>May be taken with or without food</strong></p>', '<p>Bleeding and increased prothrombin time with coumarin anticoagulants. May increase the risk of myopathy rhabdomyolysis with HIV protease inhibitors, colchicine, bezafibrate, ciprofibrate or niacin (nicotinic acid), ciclosporin and fluconazole. Reduced bioavailability with concomitant rifampicin.</p>', '<p>Acute liver disease or unexplained persistent elevation of serum aminotransferases. Pregnancy and lactation. Avoid admin of two 40 mg conventional cap at one time.</p>', '<p>Headache, nausea, abdominal pain, dyspepsia, diarrhoea, bronchitis, sinusitis, insomnia, fatigue, myopathy, myalgia and UTI. Increased blood creatinine phosphokinase and transaminase.</p>', '<p><strong>Category X</strong>: Studies in animals or human beings have demonstrated foetal abnormalities or there is evidence of foetal risk based on human experience or both, and the risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant.</p>', '<p>History of liver disease and hereditary muscular disorders; high alcohol intake; patients who undergone major surgery and under immunosuppressive agents. Manage hypothyroidism prior to treatment. Severe renal impairment.</p>', '<p><strong>Management</strong>: Symptomatic and supportive treatment.</p>', '<p>Other Anti-anginal &amp; Anti-ischaemic drugs, Statins</p>', '<p>Store between 15-30&deg; C.</p>', '<p>Mild to moderate renal impairment: No dosage adjustment needed.</p>', '2022-02-26 05:18:09', '2022-02-26 05:18:09'),
(613, 613, '<p><strong>Obsessive-Compulsive Disorder</strong>: Fluvoxamine Maleate are indicated for the treatment of obsessions and compulsions in patients with obsessive compulsive disorder (OCD), as defined in&nbsp;DSM-III-R or&nbsp;DSM-IV. The obsessions or compulsions cause marked distress, are time-consuming, or significantly interfere with social or occupational functioning.<br />\r\n<br />\r\nObsessive compulsive disorder is characterized by recurrent and persistent ideas, thoughts, impulses or images (obsessions) that are ego-dystonic and/or repetitive, purposeful, and intentional behaviors (compulsions) that are recognized by the person as excessive or unreasonable.</p>', '<p>The mechanism of action of fluvoxamine maleate in obsessive compulsive disorder is presumed to be linked to its specific serotonin reuptake inhibition in brain neurons. Fluvoxamine has been shown to be a potent inhibitor of the serotonin reuptake transporter in preclinical studies, both in vitro and in vivo.<br />\r\n<br />\r\nIn in vitro studies, fluvoxamine maleate had no significant affinity for histaminergic, alpha or beta adrenergic, muscarinic, or dopaminergic receptors. Antagonism of some of these receptors is thought to be associated with various sedative, cardiovascular, anticholinergic, and extrapyramidal effects of some psychotropic drugs.</p>', '<p><strong>Adults</strong>: The recommended starting dose for Fluvoxamine Maleate Tablets in adult patients is 50 mg, administered as a single daily dose at bedtime. In the controlled clinical trials establishing the effectiveness of Fluvoxamine Maleate Tablets in OCD, patients were titrated within a dose range of 100 to 300 mg/day. Consequently, the dose should be increased in 50 mg increments every 4 to 7 days, as tolerated, until maximum therapeutic benefit is achieved, not to exceed 300 mg per day. It is advisable that a total daily dose of more than 100 mg should be given in two divided doses. If the doses are not equal, the larger dose should be given at bedtime.<br />\r\n<br />\r\n<strong>Pediatric Population (children and adolescents)</strong>: The recommended starting dose for Fluvoxamine Maleate Tablets in pediatric populations (ages 8-17 years) is 25 mg, administered as a single daily dose at bedtime. In a controlled clinical trial establishing the effectiveness of Fluvoxamine Maleate Tablets in OCD, pediatric patients (ages 8-17) were titrated within a dose range of 50 to 200 mg/day. Physicians should consider age and gender differences when dosing pediatric patients. The maximum dose in children up to age 11 should not exceed 200 mg/day. Therapeutic effect in female children may be achieved with lower doses. Dose adjustment in adolescents (up to the adult maximum dose of 300 mg) may be indicated to achieve therapeutic benefit. The dose should be increased in 25 mg increments every 4 to 7 days, as tolerated, until maximum therapeutic benefit is achieved. It is advisable that a total daily dose of more than 50 mg should be given in two divided doses. If the two divided doses are not equal, the larger dose should be given at bedtime.<br />\r\n<br />\r\n<strong>Elderly Or Hepatically Impaired Patients</strong>: Elderly patients and those with hepatic impairment have been observed to have a decreased clearance of fluvoxamine maleate. Consequently, it may be appropriate to modify the initial dose and the subsequent dose titration for these patient groups.</p>', '<p>Co-admin with fluvoxamine may increase carbamazepine toxicity and serum levels of theophylline. Lithium enhances the serotonergic effects of fluvoxamine. Anticoagulants may require dosage adjustments. Diltiazem with fluvoxamine may lead to bradycardia. Avoid alcohol.<br />\r\n<br />\r\n<strong>Potentially Fatal:</strong>&nbsp;Fluvoxamine should not be used in combination with MAOIs, or within 14 days of discontinuing treatment with MAOIs.</p>', '<p>Hypersensitivity. Not to be used with thioridazine, terfenadine, astemizole, cisapride, pimozide, aloestron, tizanidine. Lactation.</p>', '<p>Nausea, vomiting, asthenia, headache, malaise, palpitations/tachycardia, abdominal pain, anorexia, constipation, diarrhoea, dry mouth, dyspepsia, agitation, anxiety, dizziness, insomnia, nervousness, somnolence, tremor, sweating.</p>', '<p><strong>Category C</strong>: 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>History of mania or seizures; liver dysfunction; presence of depressive symptoms; smokers. Treatment with MAOI should only be started at least 2 wk after stopping fluvoxamine treatment. Increased risk of suicidal ideation and behaviour when used in children, adolescents and young adults &lt;24 yr. Pregnancy, elderly; operating hazardous machinery; withdraw gradually. Monitor prothrombin time in patients who are taking oral anticoagulants concurrently.</p>', NULL, '<p>SSRIs &amp; related anti-depressant drugs</p>', '<p>Store Fluvoxamine Maleate Tablets at room temperature between 15&deg;C to 30&deg;C. Keep Fluvoxamine Maleate Tablets away from high humidity.</p>', '<p><strong>Elderly Or Hepatically Impaired Patients</strong>: Elderly patients and those with hepatic impairment have been observed to have a decreased clearance of fluvoxamine maleate. Consequently, it may be appropriate to modify the initial dose and the subsequent dose titration for these patient groups.<br />\r\n<br />\r\n<strong>Pregnant Women During The Third Trimester</strong>: Neonates exposed to Fluvoxamine Maleate Tablets and other SSRIs or SNRIs late in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and&nbsp;tube feeding&nbsp;and may be at risk for persistent&nbsp;pulmonary hypertension&nbsp;of the newborn (PPHN). When treating pregnant women with Fluvoxamine Maleate Tablets during the third trimester, the physician should carefully consider the potential risks and benefits of treatment.</p>', '2022-02-26 05:20:08', '2022-02-26 05:20:08'),
(614, 614, '<p>Folic acid is indicated for the treatment of-</p>\r\n\r\n<ul>\r\n	<li>Folic acid deficiency</li>\r\n	<li>Megaloblastic anemia</li>\r\n	<li>Anemias of nutritional origins, pregnancy, infancy, or childhood.</li>\r\n</ul>', '<p>Folic acid, as it is biochemically inactive, is converted to tetrahydrofolic acid and methyltetrahydrofolate by dihydrofolate reductase (DHFR). These folic acid congeners are transported across cells by receptor-mediated endocytosis where they are needed to maintain normal erythropoiesis, synthesize purine and thymidylate nucleic acids, interconvert amino acids, methylate tRNA, and generate and use formate. Using vitamin B12 as a cofactor, folic acid can normalize high homocysteine levels by remethylation of homocysteine to methionine via methionine synthetase.</p>', '<p>Adults-</p>\r\n\r\n<ul>\r\n	<li>Initially: 5 mg daily for 4 months.</li>\r\n	<li>maintenance: 5 mg every 1-7 days depending on the underlying disease.</li>\r\n</ul>\r\n\r\n<p>Children-</p>\r\n\r\n<ul>\r\n	<li>Up to 1 year: 500 mcg/kg daily.</li>\r\n	<li>Over 1 year: Same as adult dose.</li>\r\n</ul>', NULL, '<p>Folic acid is contraindicated in patients who have shown previous intolerance to the drug.</p>', '<p>Folic acid is generally well tolerated. Gastro-intestinal disturbances may occur. Hypersensitivity reactions have been reported rarely.</p>', NULL, '<p>It should be used with caution in patients who may have folate dependent tumours. It should never be given alone or in conjunction with inadequate amounts of vitamin B12 for the treatment of undiagnosed megaloblastic anaemia. Although folic acid may produce a haematopoietic response in patients with a megaloblastic anaemia due to vitamin B12 deficiency it should not be given alone in vitamin B12 deficiency states as it may precipitate the onset of subacute combined degeneration of the cord. In elderly people a cobalamin absorption test should be done before long term folate. No harmful results found from short courses of folate.</p>', NULL, '<p>Drugs for Megaloblastic Anemia, Vitamin-B preparations</p>', '<p>Store below 30&deg;C in a dry place, away from light. Keep out of the reach of children.</p>', NULL, '2022-02-26 05:28:49', '2022-02-26 05:28:49'),
(615, 615, '<p>FOLIC ACID+ZINC SULFATE contains Zinc sulfate and Folic acid. Zinc sulfate is used&nbsp;<strong>to treat zinc deficiency, acute diarrhoea in children, slow wound healing, and Wilson&#39;s disease</strong>&nbsp;(a genetic disorder causing copper build-up in the body). Folic acid treats folic acid deficiency and anaemia (lack of red blood cells).</p>', '<p>This tablet is a special preparation of Folic Acid &amp; Zinc Sulfate Monohydrate. Zinc is an essential trace element required for human nutrition and involved in a number of body enzyme system. Severe Zinc deficiency causes skin lesion, alopecia, diarrhoea, increased susceptibility of infections, cognitive impairment, etc. Folic Acid is a member of the B-Vitamins group. It is reduced in the body to tetrahydrofolate, which is the coenzyme for various metabolic processes including the synthesis of purine and pyrimidine nucleotides, and hence the synthesis of DNA. It is also involved in some amino acid conversions. Deficiency of Folic Acid may cause megaloblastic anaemia, develops when the dietary intake is inadequate, as in malnutrition, from malabsorption, from increased utilization as in pregnancy of conditions such as haemolytic anaemia, and as a result of administration of folate antagonists.</p>', '<p>Orally 1 tablet daily or as directed by the physician.</p>', '<p>A large amount of Calcium decreases the absorption of Zinc. In case of Folic Acid, no drug interactions have been reported.</p>', '<p>Zinc is contraindicated in patients having hypersensitivity to Zinc. Folic Acid is contraindicated in untreated cobalamine deficiency.</p>', '<p>Folic Acid &amp; Zinc is well tolerated in the recommended dose. Occasionally gastrointestinal disturbances like abdominal pain, dyspepsia, nausea, vomiting, fever and respiratory distress may occur.</p>', '<p>Recommended during pregnancy &amp; lactation.</p>', NULL, '<p>Zinc Sulfate is corrosive in overdose. Symptoms are corrosion and inflammation of the mucous membrane of the mouth and stomach.</p>', '<p>Specific mineral &amp; vitamin combined preparations.</p>', '<p>Store at temperature of below 30&deg;C, protect from light &amp; moisture. Keep out of reach of children.</p>', NULL, '2022-02-26 05:31:08', '2022-02-26 05:31:08');
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
(616, 616, '<p>In the Female:</p>\r\n\r\n<ul>\r\n	<li><strong>Ovulation Induction</strong>: FSH administered IM or SC with HCG in a sequential manner, which is indicated for ovulation induction in patients who have previously received pituitary suppression.</li>\r\n	<li><strong>Multi-follicular Development</strong>: During ART FSH administered IM in conjunction with HCG is indicated for multiple follicular developments (controlled ovarian stimulation) during ART cycles in patients who have previously received pituitary suppression.</li>\r\n	<li><strong>Polycystic Ovarian Syndrome (PCOS)</strong>: Used to treat Polycystic Ovarian Syndrome (PCOS) related infertility</li>\r\n</ul>\r\n\r\n<p>In the Male: Male infertility treatment in combination with HCG Induction of Spermatogenesis in men deficient spermatogenesis due to Hypogonadotrophic-hypogonadism.</p>', '<p>FSH is a product containing a highly purified preparation of human follicle stimulating hormone (FSH-HP) extracted from the urine of postmenopausal women. Third generation of urinary gonadotrophins FSH-HP;Use of monoclonal antibodies specific to FSH resulted in further refinements in manufacture, and the production of highly purified (HP) urinary FSH. The presence of LH is less than 0.1% per 75 IU of FSH &amp; Unidentified urinary proteins are less than 5% in Human FSH-HP. FSH consists of two non-covalently linked glycoproteins designated as the alfa and beta subunits. The alfa subunit has 92 amino acids of which two are modified by attachment of carbohydrates. The beta subunit has 111 amino acids of which two are modified by attachment of carbohydrates. FSH is a sterile, lyophilized powder intended for subcutaneous (SC) or intramuscular (IM) injection after reconstitution with sterile 0.9% Sodium Chloride Injection. Each vial of FSH contains 75 International Units (IU) of Follicle Stimulating Hormone (FSH) which is reconstituted with diluents. The in vivo biological activity of Urofollitropin (FSH) for injection, purified is determined by using reference standards calibrated against the First International Standard for follicle- stimulating hormone (FSH, Urofollitropin), Urinary, and Human for Bioassay, National Institute for Biological Standards and Control (NIBSC) at its 46th meeting in 1995. FSH is a glycoprotein that is acidic and water-soluble.</p>', '<p>There are great inter-and intra-individual variations in the response of the ovaries to exogenous gonadotrophins. This makes it impossible to set a uniform dosage scheme. The dosage should, therefore, be adjusted individually depending on the ovarian response. This requires ultrasonography and monitoring of oestradiol levels. There should be consideration to minimize the risk of unwanted ovarian hyperstimulation. FSH can be given either alone, or in combination with a GnRH analogue to prevent premature luteinisation. In the latter case, especially when using a GnRH agonist, a higher total treatment dose of FSH may be required to achieve an adequate follicular response. Clinical experience with FSH is based on up to three treatment cycles in both indications. Overall experience with IVF indicates that in general the treatment success rate remains stable during the first four attempts and gradually declines thereafter.<br />\r\n<br />\r\n<strong>Ovulation Induction in Women</strong>: Starting daily dose of 50 international units (IU) of FSH is administered subcutaneously or intramuscularly for at least the first 7 days. The dose is increased by 25 or 50 international units (IU) at weekly intervals until follicular growth and/or serum estradiol levels indicate an adequate response. When an acceptable pre-ovulatory state is achieved, final oocyte maturation is achieved with 5000 to 10,000 international units (IU) of human chorionic gonadotropin (HCG). The woman and her partner should have intercourse daily, beginning on the day prior to the administration of HCG and until ovulation becomes apparent<br />\r\n<br />\r\n<strong>Assisted Reproductive Technology (ART)</strong>: In Women; Starting dose of 150 to 225 international units (IU) of FSH is administered intramuscularly for at least the first 4 days of treatment. Subsequent doses are adjusted based upon ovarian response as determined by ultrasound evaluation of follicular growth and serum estradiol levels. Final oocyte maturation is induced with a dose of 5000-10,000 international units of HCG Oocyte (egg) retrieval is performed 34 to 36 hours later<br />\r\n<br />\r\n<strong>Polycystic Ovarian Hyperstimulation (PCOS)</strong>: FSH injections are therefore given each morning as an intramuscular injection. It is best to start with the lowest dose of FSH per day (using 50 IU per day). These doses are used for 4 to 6 days at a time. The ovarian response is determined by measuring oestrogen levels in the blood. When the oestrogen begins to rise, the FSH is successfully growing an egg or eggs. If there is no response to a dose of FSH in 5- 6 days of injections the dose will be increased. The normal dose increments are 75 units, 112 units, 150 units and 225 units per day. Most patients respond with 75 to 150 IU per day. However it is very important that increments are only made cautiously.<br />\r\n<br />\r\n<strong>Dosage in Male</strong>: Induction of Spermatogenesis in Men Pre-treatment with HCG alone (1500 international units (IU) twice weekly) is required. If serum testosterone levels have not normalized after 8 weeks of HCG treatment, the dose may be increased to 3000 international units (IU) twice a week. After normalization of serum testosterone levels, administer 450 international units (IU) per week (225 international units twice weekly or 150 international units (IU) three times weekly) of FSH subcutaneously with the same pre-treatment HCG dose used to normalize testosterone level.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>To prevent painful injections and minimize leakage from the injection site FSH should be slowly administered intramuscularly or subcutaneously. The subcutaneous injection site should be alternated to prevent lipoathrophy. Any unused solution should be discarded. Subcutaneous injection of FSH may be carried out by patient or partner, provided that proper instructions are given by the physician. Self administration of FSH should only be performed by patients who are well-motivated, adequately trained and with access to expert advice.</p>', '<p>No drug interaction studies have been conducted for Urofollitropin in humans.</p>', '<ul>\r\n	<li>Tumours of the ovary, breast, uterus, pituitary or hypothalamus</li>\r\n	<li>Pregnancy or lactation</li>\r\n	<li>Undiagnosed vaginal bleeding</li>\r\n	<li>Hypersensitivity to the active substance or to any of the excipients</li>\r\n	<li>Primary ovarian failure</li>\r\n	<li>Fibroid tumors of the uterus incompatible with pregnancy</li>\r\n	<li>Primary testicular failure</li>\r\n</ul>', '<p>FSH sometimes excites the ovaries too much. This may cause pelvic pain or breathing problems. It may also make you urinate less. In rare cases, patients with this problem have had serious lung problems, including fluid in the lungs, troublebreathing, and worsening of asthma blood clots and strokes, severe pelvic pain, chest pain, or abdominal pain, Nausea, Vomiting, Sudden weight gain, Bloating, Trouble, breathing. FSH may cause twins or multiple births. The most common side effects with FSH are headache, vaginal bleeding, nausea, and hot flashes. Sometimes there is a reaction at the spot where you give yourself the injection. This can include bruising, pain, or redness.</p>', '<p>Pregnancy Category X. FSH must not be used during pregnancy and lactation.</p>', '<p>The presence of uncontrolled non gonodalendocrinopathies (e.g. thyroid, adrenal or pituitary disorders) should be excluded</p>\r\n\r\n<ul>\r\n	<li>In pregnancies occurring after induction of ovulation with gonadotrophin preparations, there is an increased risk of multiple gestations (Multiple birth)</li>\r\n	<li>There has been no reports of hypersensitivity to FSH, but there remains the possibility of anaphylactic responses</li>\r\n	<li>The first injection of FSH should be performed under direct medical supervision</li>\r\n	<li>Since infertile women undergoing assisted reproduction, and particularly IVF, often have tubal abnormalities the incidence of ectopic pregnancies might be increased. Early ultrasound confirmation that a pregnancy is intrauterine is therefore important.</li>\r\n	<li>Rates of pregnancy loss in women undergoing assisted reproduction techniques are higher than in the normal population.</li>\r\n	<li>Unwanted ovarian hyperstimulation in the treatment of female patients, ultrasonographic assessment of follicular development, and determination of oestradiol levels should be performed prior to treatment and at regular intervals during treatment. Apart from the development of a high number of follicles, oestradiol levels may rise very rapidly, e.g. more than a daily doubling for two or three consecutive days, and possibly reaching excessively high values. The diagnosis of ovarian hyperstimulation may be confirmed by ultrasound examination. If this unwanted ovarian hyperstimulation occurs (i.e. not as part of controlled</li>\r\n	<li>ovarian hyperstimulation in medically assisted reproduction programs), the administration of FSH should be discontinued. In that case pregnancy should be avoided and HCG must be withheld, because it may induce, in addition to multiple ovulation, the ovarian hyperstimulation syndrome (OHSS).</li>\r\n	<li>In men, semen analysis is recommended 4 to 6 months after the beginning of treatment in assessing the response</li>\r\n</ul>', '<p>No data on acute toxicity of FSH in humans is available, but the acute toxicity of FSH and of urinary gonadotrophin preparations in animal studies has been shown to be very low. Too high a dosage of FSH may lead to hyperstimulation of the ovaries.</p>', '<p>Drugs for Infertility, Trophic Hormones &amp; Related Synthetic Drugs</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Reconstitution:&nbsp;</strong>To prepare the solution, inject 1 ml of sterile saline for injection into the vial of 75 IU FSH. Do not shake, but gently swirl until the solution is clear. Generally FSH dissolves immediately. Check the liquid in the container; if it is not clear or contains particles, do not use it. For patients requiring a single injection from multiple vials of FSH up to 4 vials can be reconstituted with 1 ml of sterile saline for injection. This can be accomplished by reconstituting a single vial as described above. Then draw the entire contents of the first vial into a syringe and inject the contents into a second vial of lyophilized Urofollitropin. Gently swirl the second vial, once again checking to make sure the solution is clear and free of particles. This step can be repeated with 2 additional vials for a total up to 4 vials (300 IU) of 75 IU FSH.</p>', '<p>Store at 2&deg;C to 8&deg;C (in a refrigerator). Do not keep in deep freeze. Can be stored below 25&deg;C for a maximum of 3 months. Protect from light &amp; keep in dry place.&nbsp;</p>', NULL, '2022-02-26 05:34:06', '2022-02-26 05:34:06'),
(617, 617, '<p><strong>Women</strong>: Follitropin alfa is indicated for the induction of&nbsp;ovulation&nbsp;and pregnancy in the&nbsp;anovulatory&nbsp;infertile&nbsp;patient in whom the cause of&nbsp;infertility&nbsp;is functional and not due to primary&nbsp;ovarian&nbsp;failure. Follitropin alfa is also indicated for the development of multiple follicles in the&nbsp;ovulatory&nbsp;patient participating in an Assisted Reproductive Technology (ART) program.<br />\r\n<br />\r\n<strong>Men</strong>: Follitropin alfa for injection is indicated for the induction of&nbsp;spermatogenesis&nbsp;in men with primary and secondary hypogonadotropic hypogonadism&nbsp;in whom the cause of infertility is not due to primary testicular failure.</p>', '<p>Follitropin alfa is a human FSH preparation of recombinant DNA origin. It stimulates ovarian follicular growth in women who do not have primary ovarian failure and stimulates spermatogenesis in men with hypogonadotrophic hypogonadism.</p>', '<p><strong>Female infertility:</strong>&nbsp;Dose should be individualised. Recommended initial: 75 IU/day; may increase by up to 37.5 IU after 14 days; further increases of the same magnitude may be made every 7 days, if needed. Max: 300 IU/day. If response is appropriate, administer hCG 1 day after the last dose.<br />\r\n<br />\r\n<strong>Assisted reproductive technologies</strong>&nbsp;Initial: 150-225 IU/day for at least 4 days, to be started on day 2 or 3 of cycle, until follicular development is adequate. Adjust dose based on ovarian response. Usual max: 450 IU/day. Once follicular development is adequate, administer hCG to induce final follicular maturation. Withhold hCG if ovaries are abnormally enlarged.<br />\r\n<br />\r\n<strong>Spermatogenesis induction</strong>&nbsp;150 IU 3 times/week with continued chorionic gonadotrophin for at least 4 mth. Max: 300 IU 3 times/week.</p>', '<p>Other ovulation stimulating agents (eg hCG, clomiphene citrate) may potentiate the follicular response, concurrent use of GnRH agonist-induced pituitary desensitisation may increase the dosage of Gonal-f needed to elicit an adequate ovarian response.</p>', '<p>Hypersensitivity. Abnormal genital bleeding of undetermined origin, sex hormone sensitive malignancies of the reproductive tract and accessory organs, an organic intracranial lesion e.g. pituitary tumor, ovarian cysts or enlargement of undetermined origin, high levels of FSH indicating primary gonadal failure, uncontrolled thyroid or adrenal dysfunction, pregnancy, lactation.</p>', '<p>Ovarian cysts, mild to severe Inj site reactions, headache, mild to moderate ovarian hyperstimulation syndrome (OHSS), abdominal pain, GI disturbances. Rarely, severe OHSS, ovarian torsion, thromboembolism, mild systemic allergic reactions.</p>', '<p>Pregnancy category X.&nbsp;Studies in animals or human beings have demonstrated foetal abnormalities or there is evidence of foetal risk based on human experience or both, and the risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant.</p>', '<p>May result in multiple births. Ovarian hyperstimulation syndrome, serious pulmonary conditions and thromboembolic events may occur. Evaluate patients for hypothyroidism, adrenocortical deficiency, hyperprolactinaemia, pituitary and hypothalamic tumors before starting therapy.</p>', NULL, '<p>Drugs for Infertility</p>', '<p>Store at 2-25&deg; C.</p>', NULL, '2022-02-26 05:35:41', '2022-02-26 05:35:41'),
(618, 618, '<p>This injection is indicated for the stimulation of follicular development in adult women with severe LH and FSH deficiency. In clinical trials, these patients were defined by an endogenous serum LH level &lt; 1.2 IU/L.</p>', '<p>This injection is a preparation of recombinant human follicle stimulating hormone (follitropin alfa, r-hFSH) and recombinant human luteinising hormone (lutropin alfa, r-hLH) produced in Chinese hamster ovary (CHO) cells by recombinant DNA technology. In clinical trials the efficacy of the combination of follitropin alfa and lutropin alfa has been demonstrated in women with hypogonadotropic hypogonadism. In the stimulation of follicular development in anovulatory women deficient in LH and FSH, the primary effect resulting from administration of lutropin alfa is an increase in oestradiol secretion by the follicles, the growth of which is stimulated by FSH.<br />\r\n<br />\r\nIn clinical trials, patients with severe FSH and LH deficiency were defined by an endogenous serum LH level &lt; 1.2 IU/L as measured in a central laboratory. However, it should be taken into account that there are variations between LH measurements performed in different laboratories. In these trials the ovulation rate per cycle was 70-75%.</p>', '<p>In LH and FSH deficient women (hypogonadotrophic hypogonadism), the objective of this injection therapy is to develop a single mature Graafian follicle from which the oocyte will be liberated after the administration of human chorionic gonadotrophin (hCG). This injection should be given as a course of daily injections. Since these patients are amenorrhoeic and have low endogenous oestrogen secretion, treatment can commence at any time.<br />\r\n<br />\r\nTreatment should be tailored to the individual patient&#39;s response as assessed by measuring follicle size by ultrasound and oestrogen response.<br />\r\n<br />\r\nA recommended regimen commences with one vial of this injection daily. If less than one vial daily is used, the follicular response may be unsatisfactory because the amount of lutropin alfa may be insufficient.<br />\r\n<br />\r\nIf an FSH dose increase is deemed appropriate, dose adaptation should preferably be after 7-14 day intervals and preferably by 37.5-75 IU increments using a licensed follitropin alfa preparation. It may be acceptable to extend the duration of stimulation in any one cycle to up to 5 weeks.<br />\r\n<br />\r\nWhen an optimal response is obtained, a single injection of 250 micrograms of r-hCG or 5,000 IU to 10,000 IU hCG should be administered 24-48 hours after the last this injection. The patient is recommended to have coitus on the day of, and on the day following, hCG administration. Alternatively, intrauterine insemination (IUI) may be performed.<br />\r\n<br />\r\nLuteal phase support may be considered since lack of substances with luteotrophic activity (LH/hCG) after ovulation may lead to premature failure of the corpus luteum.<br />\r\n<br />\r\nIf an excessive response is obtained, treatment should be stopped and hCG withheld. Treatment should recommence in the next cycle at a dose of FSH lower than that of the previous cycle.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration: </strong>This injection is intended for subcutaneous administration. The first injection should be performed under direct medical supervision. The powder should be reconstituted immediately prior to use with the solvent provided. Self-administration should only be performed by patients who are well motivated, adequately trained and with access to expert advice.</p>', '<p>This injection should not be administered as a mixture with other medicinal products, in the same injection, except follitropin alfa for which studies have shown that co-administration does not significantly alter the activity, stability, pharmacokinetic nor pharmacodynamic properties of the active substances.</p>', '<p>This injection is contraindicated in patients with:</p>\r\n\r\n<ul>\r\n	<li>hypersensitivity to the active substances or to any of the excipients</li>\r\n	<li>tumours of the hypothalamus and pituitary gland</li>\r\n	<li>ovarian enlargement or ovarian cyst unrelated to polycystic ovarian disease and of unknown origin</li>\r\n	<li>gynaecological haemorrhages of unknown origin</li>\r\n	<li>ovarian, uterine or mammary carcinoma</li>\r\n</ul>\r\n\r\n<p>This injection must not be used when an effective response cannot be obtained, such as:</p>\r\n\r\n<ul>\r\n	<li>primary ovarian failure</li>\r\n	<li>malformations of sexual organs incompatible with pregnancy</li>\r\n	<li>fibroid tumours of the uterus incompatible with pregnancy</li>\r\n</ul>', NULL, '<p>There is no indication for the use of this injection during pregnancy. Data on a limited number of exposed pregnancies indicate no adverse reactions of follitropin alfa and lutropin alfa on pregnancy, embryonal or foetal development, parturition or postnatal development following controlled ovarian stimulation. No teratogenic effect of such gonadotropins has been reported in animal studies. In case of exposure during pregnancy, clinical data are not sufficient to exclude a teratogenic effect of this injection. This not indicated during breast-feeding.</p>', '<p>This injection contains potent gonadotrophic substances capable of causing mild to severe adverse reactions, and should only be used by physicians who are thoroughly familiar with infertility problems and their management.<br />\r\n<br />\r\nGonadotrophin therapy requires a certain time commitment by physicians and supportive health care professionals, as well as the availability of appropriate monitoring facilities. In women, safe and effective use of this injection calls for monitoring of ovarian response with ultrasound, alone or preferably in combination with measurement of serum oestradiol levels, on a regular basis. There may be a degree of interpatient variability in response to FSH/LH administration, with a poor response to FSH/LH in some patients. The lowest effective dose in relation to the treatment objective should be used in women.</p>', NULL, '<p>Drugs for Infertility</p>', '<p>Do not store above 25&deg;C. Store in the original package in order to protect from light.</p>', '<p><strong>Elderly</strong>: There is no relevant indication for the use of this injection in the elderly population. Safety and effectiveness of this medicinal product in elderly patients have not been established.<br />\r\n<br />\r\n<strong>Renal and hepatic impairment</strong>: Safety, efficacy, and pharmacokinetics of this medicinal product in patients with renal or hepatic impairment have not been established.<br />\r\n<br />\r\n<strong>Paediatric population</strong>: There is no relevant use of this medicinal product in the paediatric population.</p>', '2022-02-26 05:37:17', '2022-02-26 05:37:17'),
(619, 619, '<p>Follitropin beta injection is indicated for the development of multiple follicles in&nbsp;ovulatory&nbsp;patients participating in an Assisted Reproductive Technology (ART) program. Follitropin beta is also indicated for the induction of ovulation and pregnancy in anovulatory infertile patients in whom the cause of&nbsp;infertility&nbsp;is functional and not due to primary&nbsp;ovarian&nbsp;failure.</p>', '<p>Follitropin beta is a human FSH preparation of recombinant DNA origin. It stimulates ovarian follicular growth in women who do not have primary ovarian failure.</p>', '<p><strong>Ovulation induction:</strong>&nbsp;IM or SC admin: Initiate with 75 IU daily for up to 14 days, may increase by 37.5 IU at wkly intervals. Once follicular growth or serum estradiol levels indicates an adequate response, administer a single dose of hCG (5,000-10,000 IU) after the last dose to induce ovulation. Withhold hCG if the ovaries are abnormally enlarged or if abdominal pain occurs. Max: 300 IU/day.<br />\r\n<br />\r\n<strong>Assisted reproductive technologies:</strong>&nbsp;IM or SC admin: 150-225 IU /day for at least 1st 4 days of treatment. Adjust dose based on individual ovarian response. Usual maintenance dose: 75-300 IU for 6-12 days; 375-600 IU for poor responders. Max (clinical studies): 600 IU/day. Upon adequate follicular development, a single dose of hCG (5,000-10,000 IU) is administered for final oocyte maturation. Oocyte retrieval can be done 34-36 hr later. Withhold hCG if ovaries are abnormally enlarged on the last day of follicular treatment.</p>', NULL, '<p>Abnormal genital bleeding of undetermined origin, hormone sensitive malignancies; ovary, breast, uterus, hypothalamus, testes or pituitary gland tumor; ovarian cysts or enlargement not due to the polycystic ovary syndrome; high levels of FSH indicating primary gonadal failure (ovarian or testicular); uncontrolled thyroid or adrenal dysfunction; presence of any cause of infertility other than anovulation; hypersensitivity; pregnancy, lactation.</p>', '<p>Ovarian cysts, mild to severe inj site reactions, headache, mild to moderate OHSS, abdominal pain, GI disturbances. Rarely, severe OHSS, ovarian torsion, thromboembolism, mild systemic allergic reactions.</p>', '<p>Category X: Studies in animals or human beings have demonstrated foetal abnormalities or there is evidence of foetal risk based on human experience or both, and the risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant.</p>', '<p>May result in multiple births. Ovarian hyperstimulation syndrome (OHSS), serious pulmonary conditions and thromboembolic events may occur. Evaluate patients for hypothyroidism, adrenocortical deficiency, hyperprolactinaemia, pituitary and hypothalamic tumors before starting therapy.</p>', '<p>May lead to OHSS and multiple gestations.</p>', '<p>Drugs for Infertility</p>', '<p>Store at 2-8&deg;C.</p>', NULL, '2022-02-26 05:38:47', '2022-02-26 05:38:47'),
(620, 620, '<p><strong>Prophylaxis Of Deep Vein Thrombosis-&nbsp;</strong>Fondaparinux is indicated for the&nbsp;prophylaxis&nbsp;of deep vein thrombosis (DVT), which may lead to&nbsp;pulmonary embolism&nbsp;(PE):</p>\r\n\r\n<ul>\r\n	<li>In patients undergoing&nbsp;hip fracture&nbsp;surgery, including extended prophylaxis;</li>\r\n	<li>In patients undergoing hip replacement surgery;</li>\r\n	<li>In patients undergoing knee replacement surgery;</li>\r\n	<li>In patients undergoing abdominal surgery who are at risk for thromboembolic complications.</li>\r\n</ul>\r\n\r\n<p><strong>Treatment Of Acute Deep Vein Thrombosis</strong>: Fondaparinux&nbsp;is indicated for the treatment of acute deep vein thrombosis when administered in conjunction with warfarin sodium.<br />\r\n<br />\r\n<strong>Treatment Of Acute Pulmonary Embolism</strong>: Fondaparinux is indicated for the treatment of acute pulmonary embolism when administered in conjunction with warfarin sodium when initial therapy is administered in the hospital.</p>', '<p>Fondaparinux, a synthetic pentasaccharide, acts as a selective inhibitor of activated factor X. It works by binding selectively to antithrombin III and potentiates the neutralisation of factor Xa. This will interrupt the blood coagulation cascade and inhibit both thrombin formation and thrombus development.</p>', '<p>Superficial vein thrombosis: 2.5 mg once daily for 30-45 days.<br />\r\n<br />\r\nVenous thromboembolism:&nbsp;</p>\r\n\r\n<ul>\r\n	<li>50-100 kg: 7.5 mg once daily;</li>\r\n	<li>&gt;100 kg: 10 mg once daily.</li>\r\n	<li>Treatment duration: 5-9 days, or until oral anticoagulation is established.</li>\r\n</ul>\r\n\r\n<p>Prophylaxis of deep vein thrombosis in abdominal and orthopaedic surgery:&nbsp;2.5 mg once daily, starting 6-8 hr after surgery, continue for at least 5-9 days. In high-risk patients, 6-14 days or up to 32 days in hip fracture.</p>', '<p>Increased risk of bleeding with (e.g. desirudin, fibrinolytic drugs, glycoprotein IIb/IIIa-receptor antagonists, heparin, heparinoids or LMWH).</p>', '<p>Hypersensitivity. Active clinically significant bleeding, acute bacterial endocarditis.</p>', '<p>Hip-fracture, hip-replacement, or knee-replacement surgery: Anaemia, fever, nausea, oedema, constipation, rash, vomiting, insomnia, increased wound drainage, hypokalaemia, UTI, dizziness, purpura, hypotension, confusion, bullous eruption, urinary retention, haematoma, major bleeding, diarrhoea, dyspepsia, post-op haemorrhage, and headache. Treatment of venous thromboembolism: Constipation, headache, insomnia, fever, nausea, UTI, and coughing. Abdominal surgery: Post-op wound infection and haemorrhage, fever, surgical site reaction, anaemia, HTN, pneumonia, vomiting.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category B.&nbsp;Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).<br />\r\n<br />\r\n<strong>Lactation</strong>: Unknown whether drug is excreted in milk; use with caution</p>', '<p>Patient with increased risk of haemorrhage (e.g. congenital or acquired bleeding disorders, history or active Gl ulceration, intracranial haemorrhage, recent brain, spinal or ophth surgery)</p>', NULL, '<p>Parenteral anti-coagulants</p>', '<p>Store below 25&deg; C. Do not freeze.</p>', NULL, '2022-02-26 05:40:14', '2022-02-26 05:40:14'),
(621, 621, '<p><strong>Treatment of Asthma</strong>: Formoterol Fumarate is indicated for the treatment of asthma and in the prevention of bronchospasm only as concomitant&nbsp;therapy&nbsp;with a long-term asthma control medication, such as an inhaled&nbsp;corticosteroid, in adults and children 5 years of age and older with reversible obstructive airways disease, including patients with symptoms of nocturnal asthma.<br />\r\n<br />\r\n<strong>Prevention of Exercise-Induced Bronchospasm</strong>: Formoterol Fumarate is also indicated for the acute prevention of exercise-induced bronchospasm in adults and children 5 years of age and older, when administered on an occasional, as-needed basis. Use of Formoterol Fumarate as a single agent for the prevention of exercise-induced bronchospasm may be clinically indicated in patients who do not have persistent asthma. In patients with persistent asthma, use of Formoterol Fumarate for the prevention of exercise-induced bronchospasm may be clinically indicated, but the treatment of asthma should include a long-term asthma control medication, such as an inhaled corticosteroid.<br />\r\n<br />\r\n<strong>Maintenance Treatment of Chronic Obstructive Pulmonary Disease</strong>: Formoterol Fumarate is indicated for the long-term, twice daily (morning and evening) administration in the maintenance treatment of bronchoconstriction in patients with Chronic Obstructive Pulmonary Disease including chronic bronchitis and&nbsp;emphysema.</p>', '<p>Formoterol fumarate is a long-acting &beta;2-adrenergic receptor agonist (&beta;2-agonist). Inhaled formoterol fumarate acts locally in the lung as a bronchodilator. In vitro studies have shown that formoterol has more than 200-fold greater agonist activity at &beta;2-receptors than at &beta;1-receptors. Although &beta;2-receptors are the predominant adrenergic receptors in bronchial&nbsp;smooth muscle&nbsp;and &beta;1-receptors are the predominant receptors in the heart, there are also &beta;2-receptors in the human heart comprising 10%-50% of the total beta-adrenergic receptors. The precise function of these receptors has not been established, but they raise the possibility that even highly selective &beta;2-agonists may have cardiac effects.<br />\r\n<br />\r\nThe pharmacologic effects of &beta;2-adrenoceptor agonist drugs, including formoterol, are at least in part attributable to stimulation of&nbsp;intracellular&nbsp;adenyl cyclase, the&nbsp;enzyme&nbsp;that catalyzes the conversion of&nbsp;adenosine triphosphate&nbsp;(ATP) to cyclic-3&#39;, 5&#39;-adenosine monophosphate (cyclic AMP). Increased cyclic AMP levels cause relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from cells, especially from mast cells.<br />\r\n<br />\r\nIn vitro tests show that formoterol is an inhibitor of the release of&nbsp;mast cell&nbsp;mediators, such as histamine and leukotrienes, from the human lung. Formoterol also inhibits histamine-induced plasma albumin extravasation in anesthetized guinea pigs and inhibits allergen-induced eosinophil influx in dogs with airway hyper-responsiveness. The relevance of these&nbsp;in vitro&nbsp;and animal findings to humans is unknown.</p>', '<p><strong>Inhalation Acute bronchospasm; Reversible airways obstruction</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>As inhalation cap</strong>: 12 mcg twice daily, up to 24 meg twice daily in severe cases.</li>\r\n	<li><strong>As dry powder inhaler</strong>: 6 or 12 mcg 1 -2 times/day, up to to 24 mcg twice daily in sever cases. As metered doses from aerosol inhaler: 12 or 24 mcg twice daily.</li>\r\n</ul>\r\n\r\n<p><strong>Prevention of exercise-induced bronchospasm</strong>: 6 or 12 mcg at least 15 mins before exercise. Additional doses may be given 12 hr later.</p>', '<p>Concomitant treatment with xanthine derivatives, steroids or diuretics may potentiate a possible hypokalaemic effect of beta-agonists. Increased susceptibility to cardiac arrhythmias in patients treated with digitalis. Concomitant use with quinidine, disopyramide, procainamide, phenothiazines, antihistamines, MAOI or TCAs can prolong the QT-interval and increase the risk of ventricular arrhythmias. L-dopa, L-thyroxine, oxytocin and alcohol can impair cardiac tolerance towards beta2-sympathomimetics. beta-adrenergic blockers can inhibit the effect of formoterol. Increased risk of arrhythmias in patients receiving concomitant anaesthesia with halogenated hydrocarbons.</p>', '<p>Hypersensitivity.</p>', '<p>Common side effects are Viral infection, Bronchitis, Chest infection, Dyspnea , Chest pain, Tremor, Dizziness, Angina, Arrhythmias, Hypo/hypertension, Tachycardia, Hypokalemia, Hyperglycemia, Metabolic acidosis, Headache, Insomnia, Paradoxical bronchospasm, Severe asthma exacerbation</p>', '<p>Pregnancy&nbsp;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<br />\r\n<br />\r\nLactation: Not known if it is excreted in breast milk or not.</p>', '<p>Thyrotoxicosis; severe CV disorders e.g. ischaemic heart disease, tachyarrhythmias or severe heart burn; prolonged QT-interval. DM; pregnancy; lactation; children,&nbsp;do not initiate or increase the dose during an exacerbation. May produce paradoxical bronchospasm.</p>', NULL, '<p>Long-acting selective &beta;-adrenoceptor stimulants</p>', '<p><strong>Prior to dispensing</strong>:&nbsp;Store in a refrigerator, 2&deg;C to 8&deg;C<br />\r\n<strong>After dispensing to patient</strong>:&nbsp;Store at 20&deg;C to 25&deg;C</p>', NULL, '2022-02-26 05:41:52', '2022-02-26 05:41:52'),
(622, 622, '<p>This inhaler is indicated for the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD). This Inhaler is not indicated for the relief of acute bronchospasm or for the treatment of asthma.</p>', '<p>This Inhaler is a pressurized metered-dose inhaler that delivers a combination of micronized Budesonide, an inhaled corticosteroid (ICS), micronized glycopyrrolate (an anticholinergic), and micronized formoterol fumarate, an inhaled long-acting beta2-adrenergic agonist (a LABA), for oral inhalation. ICS medicines such as budesonide help to decrease inflammation in the lungs. Inflammation in the lungs can lead to breathing problems. Anticholinergic medicines, such as glycopyrrolate, and LABA medicines, such as formoterol fumarate help the muscles around the airways in the lungs stay relaxed to prevent symptoms, such as wheezing, cough, chest tightness, and shortness of breath.</p>', '<p>The recommended dosage of is two inhalations twice daily, once in the morning and again in the evening, by oral inhalation. Do not take more than two inhalations twice daily. After inhalation, rinse mouth with water without swallowing.</p>', '<ul>\r\n	<li>Strong cytochrome P450 3A4 inhibitors (e.g. ritonavir): Use with caution. May cause systemic corticosteroid effects.</li>\r\n	<li>Other adrenergic drugs may potentiate effect: Use with caution.</li>\r\n	<li>Diuretics, xanthine derivatives or steroids may potentiate hypokalemia or ECG changes. Use with caution.</li>\r\n	<li>Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. May potentiate effect of formoterol fumarate on cardiovascular system.</li>\r\n	<li>Beta-blockers: Use with caution. May block bronchodilatory effects of beta-agonists and produce severe bronchospasm.</li>\r\n	<li>Anticholinergics: May interact additively with concomitantly used anticholinergic medications. Avoid administration of this spray&nbsp;with other anticholinergic-containing drugs.</li>\r\n</ul>', '<p>This is contraindicated in patients who have demonstrated hypersensitivity to budesonide, glycopyrrolate, formoterol, or any of the excipients.</p>', '<p>Serious asthma-related events-hospitalizations, intubations, death, Candida albicans infection, increased risk of pneumonia, immunosuppression and risk of infections, hypercorticism and adrenal suppression, paradoxical bronchospasm, hypersensitivity reactions including anaphylaxis, cardiovascular effects, reduction in bone mineral density, worsening of narrow-angle glaucoma and cataracts, worsening of urinary retention</p>', '<p>There are no adequate and well-controlled studies with this inhaler or with two of its individual components, Glycopyrrolate or Formoterol Fumarate, in pregnant women to inform a drug-associated risk. There are no available data on the effects of this inhaler on the breastfed child or on milk production. Budesonide, like other ICS, is present in human milk. There are no available data on the presence of Glycopyrrolate or Formoterol Fumarate in human milk. The developmental and health benefits of breastfeeding should be considered along with the mother&#39;s clinical need for this inhaler and any potential adverse effects on the breastfed child from this inhaler or from the underlying maternal condition.</p>', '<p>The safety and efficacy of this inhaler in patients with asthma have not been established. this inhaler is not indicated for the treatment of asthma. This inhaler has not been studied in patients with acutely deteriorating COPD. The use of this inhaler in this setting is not appropriate. This inhaler should not be used for the relief of acute symptoms, i.e., as rescue therapy for the treatment of acute episodes of bronchospasm. This inhaler has not been studied in the relief of acute symptoms and extra doses should not be used for that purpose. Acute symptoms should be treated with an inhaled short-acting beta2-agonist. When beginning treatment with this inhaler, patients who have been taking inhaled, short-acting beta2-agonists on a regular basis (e.g., four times a day) should be instructed to discontinue the regular use of these drugs and use them only for symptomatic relief of acute respiratory symptoms. When prescribing this inhaler, the healthcare provider should also prescribe an inhaled, short acting beta 2-agonist and instruct the patient on how it should be used. Increasing inhaled beta 2-agonist use is a signal of deteriorating disease for which prompt medical attention is indicated.<br />\r\n<br />\r\nThe daily dosage of this inhaler should not be increased beyond the recommended dose. As with other inhaled drugs containing beta2-adrenergic agents, this inhaler should not be used more often than recommended, at higher doses than recommended, or in conjunction with other medications containing LABA, as an overdose may result. Clinically significant cardiovascular effects and fatalities have been reported in association with excessive use of inhaled sympathomimetic drugs.</p>', '<p>No cases of overdose have been reported with this inhaler; therefore, the risks associated with overdosage for the individual components described below apply to this inhaler. Treatment of overdosage consists of discontinuation of this inhaler together with institution of appropriate symptomatic and/or supportive therapy. The judicious use of a cardioselective beta-receptor blocker may be considered, bearing in mind that such medication can produce bronchospasm. Cardiac monitoring is recommended in case of overdosage.<br />\r\n<br />\r\n<strong>Budesonide</strong>: If used at excessive doses for prolonged periods, systemic corticosteroid effects, such as hypercorticism may occur.<br />\r\n<br />\r\n<strong>Glycopyrrolate</strong>: High doses of Glycopyrrolate, a component of this inhaler, may lead to anticholinergic signs and symptoms such as nausea, vomiting, dizziness, lightheadedness, blurred vision, increased intraocular pressure (causing pain, vision disturbances or reddening of the eye), obstipation, or difficulties in voiding.<br />\r\n<br />\r\n<strong>Formoterol Fumarate</strong>: An overdose of Formoterol Fumarate would likely lead to an exaggeration of effects that are typical for beta2-agonists: seizures, angina, hypertension, hypotension, tachycardia, atrial and ventricular tachyarrhythmias, nervousness, headache, tremor, palpitations, muscle cramps, nausea, dizziness, sleep disturbances, metabolic acidosis, hyperglycemia, hypokalemia. As with all sympathomimetic medications, cardiac arrest, and even death may be associated with overdosage of Formoterol Fumarate.</p>', '<p>Combined bronchodilators</p>', '<p>Do not store above 30&deg; C. Keep in a dry place. Protect from light and keep out of the reach of children. Keep away from eyes. Discard within three months after removing from the foil pouch.</p>', '<p><strong>Hepatic impairment</strong>: Budesonide and formoterol fumarate systemic exposure may increase in patients with severe hepatic impairment. Monitor patients for signs of increased drug exposure.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: In patients with severe renal impairment, use should be considered only if the potential benefit of the treatment outweighs the risk.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: This is not indicated for use in children. The safety and effectiveness of this spray&nbsp;have not been established in pediatric patients.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Based on available data, no adjustment of the dosage of This in geriatric patients is necessary, but greater sensitivity in some older individuals cannot be ruled out.</p>', '2022-02-26 05:44:53', '2022-02-26 05:44:53'),
(623, 623, '<p>It is indicated only for the treatment of uncomplicated urinary tract infections (acute cystitis) in women caused by susceptible strains of Escherichia coli and Enterococcus faecalis.</p>', '<p>Fosfomycin has in vitro activity against a broad range of gram-positive and gram-negative aerobic microorganisms, associated with uncomplicated urinary tract infections. Fosfomycin Trometamol is a phosphonic acid derivative. It is a synthetic, broad spectrum, bactericidal antibiotic for oral administration. The bactericidal action of Fosfomycin is due to its inactivation of the enzyme enolpyruvyl transferase, thereby irreversibly blocking the condensation of uridine diphosphate N-acetylglucosamine with p-enolpyruvate, one of the first steps in bacterial cell wall synthesis.</p>', '<p>The recommended dosage for women 18 years of age and older for acute cystitis is one sachet of Fosfomycin with or without food. This medicine should not used in children.<br />\r\n<br />\r\n<strong>Preparation</strong>: At first pour the 100 ml purified water in a glass. Then add full contents of one Fosfomycin sachet into purified water and stir to dissolve completely. Drink full mixture immediately after preparation.</p>', '<p>When Fosfomycin is coadministered with metoclopramide, which increases gastrointestinal motility, lowers the serum concentration and urinary excretion of fosfomycin. Other drugs that increase gastrointestinal motility may produce similar effects.</p>', '<p>Fosfomycin is contraindicated in patients with known hypersensitivity to the drug and patients with severe renal insufficiency and patients undergoing haemodialysis.</p>', '<p>In clinical trials, the most frequently reported adverse events occurring in &gt;1% of the study population regardless of drug relationship were: diarrhea 10.4%, headache 10.3%, vaginitis 7.6%, nausea 5.2%, rhinitis 4.5%, back pain 3.0%, dysmenorrhea 2.6%, pharyngitis 2.5%, dizziness 2.3%, abdominal pain 2.2%, pain 2.2%, dyspepsia 1.8%, asthenia 1.7%, and rash 1.4%.The following adverse events occurred in clinical trials at a rate of less than 1%, regardless of drug relationship: abnormal stools, anorexia, constipation, dry mouth, dysuria, ear disorder, fever, flatulence, flu syndrome, hematuria, infection, insomnia, lymphadenopathy, menstrual disorder, migraine, myalgia, nervousness, paresthesia, pruritus, SGPT increased, skin disorder, somnolence, and vomiting.</p>', '<p>Fosfomycin is pregnancy category B. This drug should not be used during pregnancy unless the benefit outweighs the risk. A decision should be made to discontinue breastfeeding or to not administer the drug, taking into account the importance of the drug to the mother.</p>', '<p>Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including Fosfomycin. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile. Do not use more than one single dose of Fosfomycin to treat a single episode of acute cystitis. Repeated daily doses of Fosfomycin did not improve the clinical success or microbiological eradication rates compared to single dose therapy, but did increase the incidence of adverse events.</p>', '<p>When Fosfomycin is coadministered with metoclopramide, which increases gastrointestinal motility, lowers the serum concentration and urinary excretion of fosfomycin. Other drugs that increase gastrointestinal motility may produce similar effects.</p>', '<p>Intracellular antibiotic</p>', '<p>Keep out of reach of children. Store in a dry place, below 25&deg;C temperature and protected from light.</p>', NULL, '2022-02-26 05:46:24', '2022-02-26 05:46:24'),
(624, 624, '<p>Fructose is used intravenously as a carbohydrate nutrient. It is converted to liver glycogen and metabolized more rapidly than dextrose without requiring insulin and thus may be used in diabetic patients. Fructose is indicated in patients requiring fluid replacement and caloric feeding. It is better &quot;nitrogen sparer&quot; than glucose.</p>', NULL, '<p>The volume and rate of infusion of fructose IV solution will depend upon the requirements of the patient and the judgement of attending physician. But the rate of infusion of fructose should not exceed 0.5-1 gm/kg body weight per hour.The usual recommended flow rate for adult is 30-75 drops per minute infused intravenously.</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>Check infusion set and infusion solution prior to use.</li>\r\n	<li>Pull moderately to tear off the protective cover of the Eurocap.</li>\r\n	<li>Hold lightly the Eurocap but not the bottle body.</li>\r\n	<li>Open the flow regulator fully and hold the giving set on the top white area, but not the memorane venting region.</li>\r\n	<li>Insert the spike of the administration set to the Eurocap and fit the connector of the administration set firmly to the needle.</li>\r\n	<li>Gradually allow the fluid to flow down to the needletip and close.</li>\r\n	<li>Remove the protective cover of the needle.</li>\r\n	<li>Locate the venpuncture site and clean the site with an antiseptic solution, and then insert the needle.</li>\r\n	<li>Securely tape the puncture site.</li>\r\n	<li>Securely tape the wings and tubing</li>\r\n	<li>Start infusion while adjusting drip speed.</li>\r\n</ul>', NULL, '<p>Fructose is contraindicated in certain inborn errors of fructose metabolism, methyl alcohol poisoning, hyperuricemia, liver failure, and lactic acidosis.</p>', '<p>Intravenous administration of fructose may cause lactic acidosis and hyperuricemia.The rapid infusion of fructose results in facial flushing, abdominal pain and sweating.</p>', '<p>Fructose should not be given to patients with hereditary fructose intolerance. It should be given with caution to patients with impaired kidney function or severe liver damage. Infusion of fluid should be immediately discontinued if rigor arises for any reason during the process. Do not use if the solution is cloudy, contains particles, or after expiry date.</p>', NULL, NULL, NULL, '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-26 05:47:41', '2022-02-26 05:47:41');
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
(625, 625, '<h1>Fucidic Acid + Betamethasone</h1>', '<p>Betamethasone is a topical fluorinated corticosteroid that has an anti-inflammatory and antipruritic effect. Fusidic acid is a potent topical antibacterial agent which is effective against Staphylococcus aureus, Streptococci, Corynebacteria, Neiserria and certain Clostridia and Bacteroides.</p>', '<p>Apply this cream or ointment to the affected area twice daily. Max duration is 2 weeks.</p>', '<p><strong>Fucidic Acid</strong>: Synergistic action with antistaphylococcal penicillin. Antagonism with ciprofloxacin.<br />\r\n<br />\r\n<strong>Betamethasone</strong>: Increased hyperglycaemia and hypokalaemia with thiazide diuretics. Increased incidence of peptic ulcer or Gl bleeding with concurrent NSAIDs admin. Response to anticoagulants altered. Dose of antidiabetics and antihypertensives needs to be increased. Decreases serum cone of salicylates and antimuscarinic agents.<br />\r\n<br />\r\n<strong>Potentially Fatal</strong>: Reduced efficacy with concurrent use of carbamazepine, phenytoin, primidone, barbiturates and rifampicin. Enhanced effect in women taking oestrogens or oral contraceptives.</p>', '<p>Skin lesions of viral, fungal or bacterial origin (e.g. herpes or varicella), skin manifestations in relation to TB or syphilis, perioral dermatitis and rosacea, ulcerative condition.</p>', '<p>Hypersensitivity, contact dermatitis, eczema (aggravated condition), skin burning sensation, pruritus, dry skin, application site pain or irritation. Rarely, erythema, urticaria (including rash erythematous and generalised rash), application site swelling or vesicles.</p>', '<p>Topical administration of any corticosteroid to pregnant animals can cause abnormalities of foetal development. The relevance of this finding to human beings has not been established; however, topical steroids should not be used extensively in pregnancy, i.e. in large amounts or for prolonged periods.</p>', '<p>May increase risk of developing antibiotic resistance. Stasis dermatitis and other skin disease w/ impaired circulation. Not to be used for &gt;7 days if there is no clinical improvement. Avoid prolonged continuous treatment esp in infants and children. Pregnancy and lactation.</p>', NULL, '<p>Betamethasone &amp; Combined preparations</p>', '<p>Do not store above 25&ordm; C. Store in original container.</p>', NULL, '2022-02-26 05:49:17', '2022-02-26 05:49:17'),
(626, 626, '<p>Furosemide is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Fluid retention associated with chronic congestive cardiac failure (if diuretic treatment is required).</li>\r\n	<li>Fluid retention associated with acute congestive cardiac failure.</li>\r\n	<li>Fluid retention associated with chronic renal failure.</li>\r\n	<li>Maintenance of fluid excretion in acute renal failure, including that due to pregnancy or burns.</li>\r\n	<li>Fluid retention associated with nephrotic syndrome (if diuretic treatment is required).</li>\r\n	<li>Fluid retention associated with liver disease (if necessary to supplement treatment with aldosterone antagonists).</li>\r\n	<li>Hypertension.</li>\r\n	<li>Hypertensive crisis (as a supportive measure).</li>\r\n	<li>Support of forced diuresis.</li>\r\n</ul>', '<p>Furosemide is a monosulphonyl diuretic. It is an effective diuretic that retains its activity even in low glomerular filtration rate (GFR). Furosemide has a distinctive action on renal tubular function. It affects a peak diuresis far greater than that observed with other agents. Other features are (I) prompt onset of action (II) inhibition of sodium and chloride transport in the ascending limb of the loop of Henle and (III) independence of their action from acid-base balance changes. Furosemide acts primarily to inhibit electrolyte reabsorption in the thick ascending limb of the loop of Henle. Furosemide is readily absorbed from the gastrointestinal tract and considerable proportions are bound to plasma proteins. It is rapidly excreted in the urine. With an hour after intravenous injection, its effect is evident in about 5 minutes and last for about 2 hours.</p>', '<p><strong>Furosemide 40 mg Tablet</strong>-<br />\r\nEdema:</p>\r\n\r\n<ul>\r\n	<li>Adults: The initial adult dose is 40 mg daily, reduced to 20 mg daily or 40mg on alternate days. In some patients daily doses of 80mg or higher (given in divided doses) may be required. The individually determined single dose should then be given once or twice daily (eg, at 8 am and 2 pm). For resistant edema, 80-120 mg daily. In patients with clinically severe edematous states the dose of furosemide may be carefully titrated up to 600 mg/day. When doses exceeding 80 mg/day are given for prolonged periods, careful clinical observation and laboratory monitoring are particularly advisable.</li>\r\n	<li>Children: Neonate: 0.5-2 mg/kg every 12-24 hours (every 24 hours if postmenstrual age under 31 weeks).</li>\r\n	<li>Child 1 month-12 years: 0.5-2 mg/kg 2-3 times daily (every 24 hours if postmenstrual age less than 31 weeks); higher doses may be required in resistant edema; max. 12 mg/kg daily, not to exceed 80 mg daily.</li>\r\n	<li>Child 12-18 years:20-40 mg daily, increased in resistant edema to 80-120 mg daily.</li>\r\n	<li>Elderly: In the elderly furosemide is generally eliminated more slowly. Dosage should be titrated until the required response is achieved.</li>\r\n</ul>\r\n\r\n<p>Hypertension:</p>\r\n\r\n<ul>\r\n	<li>Adults: The usual initial dose of furosemide for hypertension is 80 mg, usually divided into 40 mg twice a day. Dosage should then be adjusted according to response. If response is not satisfactory, add other antihypertensive agents.</li>\r\n	<li>Children: The usual dose is 1 - 3 mg/kg body weight daily up to a maximum dose of 40mg/day.</li>\r\n	<li>Elderly: In the elderly furosemide is generally eliminated more slowly. Dosage should be titrated until the required response is achieved.</li>\r\n</ul>\r\n\r\n<p><strong>Furosemide 250 mg Tablet</strong>: For selected patients with advanced chronic renal failure, diuretic therapy may be started with Furosemide&nbsp;orally. If conventional doses (80 to 160 mg orally) fail to produce an adequate diuresis, a single dose of 250 mg is given as a starting dose. If a satisfactory diuresis does not ensue within 4-6 hours, the initial dose may be doubled to 500 mg. The criterion of optimal dosage is a urinary output of at least 2.5 liters per day. A maximum daily dose of 1000 mg should not be exceeded.<br />\r\n<br />\r\n<strong>Furosemide Syrup</strong>: Furosemide Liquid has an exceptionally wide therapeutic range, the effect being proportional to the dosage. Furosemide Liquid is best given as a single dose either daily or on alternate days. The usual initial daily dose is 40 mg. This may require adjustment until the effective dose is achieved as a maintenance dose. In mild cases, 20 mg daily or 40 mg on alternate days may be sufficient, whereas in cases of resistant edema, daily doses of 80 mg and above may be used as one or two daily, or intermittently. Severe cases may require gradual titration of the furosemide dosage up to 600 mg daily. The recommended maximum daily dose of furosemide administration is 1,500 mg.<br />\r\n<br />\r\n<strong>Furosemide Injection</strong>-<br />\r\nEdema:<br />\r\n<br />\r\nAdults: Doses of 20-50 mg intramuscularly or intravenously may be given initially. If larger doses are required, they should be given increasing by 20 mg increments and not given more often than every two hours. If doses greater than 50 mg are required it is recommended that they should be given by slow intravenous infusion. The recommended maximum daily dose of furosemide administration is 1,500 mg.<br />\r\n<br />\r\nBy slow intravenous injection:</p>\r\n\r\n<ul>\r\n	<li>Neonate: 0.5-1 mg/kg every 12-24 hours (every 24 hours if postmenstrual age under 31 weeks).</li>\r\n	<li>Child 1 month-12 years: 0.5-1 mg/kg repeated every 8 hours as necessary;maximum 2 mg/kg (max. 40 mg) every 8 hours.</li>\r\n	<li>Child 12-18 years: 20-40 mg repeated every 8 hours as necessary; higher doses may be required in resistant cases.</li>\r\n</ul>\r\n\r\n<p>By continuous intravenous infusion:</p>\r\n\r\n<ul>\r\n	<li>Child 1 month-18 years: 0.1-2 mg/kg/hour (following cardiac surgery, initially 100 micrograms/kg/hour, doubled every 2 hours until urine output exceeds 1 mL/kg/hour).</li>\r\n	<li>Elderly: In the elderly furosemide is generally eliminated more slowly. Dosage should be titrated until the required response is achieved.</li>\r\n</ul>\r\n\r\n<p>Hypertension:</p>\r\n\r\n<ul>\r\n	<li>Adults: Doses of 20 to 50 mg intramuscularly or intravenously may be given initially. If larger doses are required, they should be given increasing by 20 mg increments and not given more often than every two hours. If doses greater than 50 mg are required it is recommended that they should be given by slow intravenous infusion. The recommended maximum daily dose of furosemide administration is 1,500 mg. Children: Parenteral doses for children range from 0.5-1.5 mg/kg body weight daily up to a maximum total daily dose of 20 mg.</li>\r\n	<li>Elderly: In the elderly furosemide is generally eliminated more slowly. Dosage should be titrated until the required response is achieved.</li>\r\n</ul>', '<p>A marked fall in blood pressure may be seen when ACE inhibitors are added to furosemide therapy. Serum lithium levels may be increased when lithium is given concomitantly with furosemide. The toxic effects of nephrotoxic antibiotics may be increased by concomitant administration of potent diuretics such as furosemide.</p>', '<p>Furosemide is contraindicated in anuria, electrolyte deficiency and pre-comatose states associated with liver cirrhosis. Hypersensitivity to furosemide or sulphonamides.</p>', '<p>As with other diuretics, electrolytes and water balance may be disturbed as a result of diuresis of prolonged therapy. Prolonged use can produce alkalosis. It may also cause uric acid retention and may rarely produce acute gout. Furosemide may provoke hyperglycemia and glycosuria.</p>', '<p>Pregnancy category C. Furosemide should be cautiously used in cardiogenic shock complicated by pulmonary oedema and in the first trimester of pregnancy. Blood pressure and pulse during rapid diuresis should be monitored. Caution should be observed in patients liable to electrolyte deficiency. In case of nursing mother, furosemide may inhibit lactation or may pass into breast milk. In that case it should be used with caution.</p>', '<p>Patients with prostatic hypertrophy or impairment of micturition have an increased risk of developing acute retention. A marked fall in blood pressure may be seen when ACE inhibitors are added to furosemide therapy. The toxic effects of nephrotoxic antibiotics may be increased by concomitant administration of potent diuretics such furosemide.<br />\r\n<br />\r\n<strong>Driving a vehicle or performing other hazardous tasks</strong>: Some adverse effects (e.g. an undesirably pronounced fall in blood pressure) may impair the patient&#39;s ability to concentrate and react, and, therefore, constitute a risk in situations where these abilities are of special importance (e.g. operating a vehicle or machinery).</p>', '<p><strong>Signs and symptoms</strong>: The clinical picture in acute or chronic overdose depends primarily on the extent and consequences of electrolyte and fluid loss, e.g. hypovolaemia, dehydration, haemoconcentration, cardiac arrhythmias (including AV block and ventricular fibrillation).</p>\r\n\r\n<p><br />\r\n<strong>Management</strong>: No specific antidote to furosemide is known. If ingestion has only just taken place, attempts may be made to limit further systemic absorption of the active ingredient by measures such as gastric lavage or those designed to reduce absorption (e.g. activated charcoal).</p>', '<p>Loop diuretics</p>', '<p>Protect from light. Do not use it 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, '2022-02-26 05:51:04', '2022-02-26 05:51:04'),
(627, 627, '<p>Frusemide &amp; Spironolactone combination is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Essential hypertension</li>\r\n	<li>Chronic congestive heart failure</li>\r\n	<li>Hepatic cirrhosis, with collection of fluid in the abdominal cavity (ascites)</li>\r\n	<li>Swelling due to excess fluid retention (edema)</li>\r\n	<li>Hyperaldosteronism</li>\r\n	<li>Resistant edema associated with secondary hyperaldosteronism</li>\r\n</ul>', '<p>Spironolactone (potassium sparing diuretic) and Furosemide (loop diuretic) have different but complementary mechanisms and sites of action. Therefore, when given together they produce additive or synergistic diuretic. The Furosemide component inhibits the Na+/K+/2Cl- co-transporter in the ascending Loop of Henle and blocks the reabsorption of sodium, potassium and chloride ions; thereby increasing the quantity of sodium and the volume of water excreted in the urine. This characteristically induces potassium loss. The spironolactone component inhibits the reabsorption of sodium in exchange for potassium at the distal tubule by antagonising the action of aldosterone so that sodium excretion is greatly favoured and the excess loss of potassium, induced by the Furosemide, is reduced.</p>', '<p><strong>Furosemide 20 and spironolactone 50 mg</strong>: 1 to 4 tablets daily (20 to 80 mg of Furosemide and 50 to 200 mg of spironolactone) according to the patient&rsquo;s response.<br />\r\n<br />\r\n<strong>Furosemide 40 and spironolactone 50 mg</strong>: For previously stabilized patients requiring a higher dosage of spironolactone and Furosemide, This tablet can be used at a dose of one to two tablets daily (Furosemide 40 to 80 mg and spironolactone 50 to 100 mg).<br />\r\n<br />\r\n<strong>Use in children</strong>:&nbsp;Spironolactone and Furosemide is not suitable for use in children. Spironolactone and Furosemide may both be excreted more slowly in the elderly.</p>', '<p>When taken together with ACE inhibitors or potassium salts there is an increased risk of hyperkalemia. Spironolactone increases the levels of cardiac glycosides such as digoxin in the blood and this may result in digitalis toxicity. Corticosteroids may cause hypokalemia if they are used with Spironolactone. The blood pressure lowering and diuretic effects of Furosemide may be reduced or abolished when used together with indomethacin and possibly other non-steroidal anti-inflammatory drugs (NSAIDs). Furosemide may increase the ototoxicity of aminoglycoside antibiotics. Simultaneous administration of sucralfate and Furosemide may reduce the natriuretic and anti-hypertensive effect of Furosemide.</p>', '<p>Contraindicated in patients with anuria, acute renal insufficiency, rapidly deteriorating or severe impairment of renal function (creatinine clearance &lt;30 ml/min), hyperkalaemia, Addison&#39;s disease and in patients who are hypersensitive to Spironolactone, Furosemide or sulphonamides.</p>', '<p>Spironolactone may give rise to headache and drowsiness and gastrointestinal distress, including cramp and diarrhoea. Ataxia, mental confusion, and skin rashes have been reported as side effect. Gynaecomastia is not uncommon and in rare cases breast enlargement may persist. Other endocrine disorders including hirsutism, deepening of the voice, menstrual irregularities and impotence. Transient increase in blood-urea-nitrogen concentrations may occur and mild acidosis has been reported. Spironolactone may cause hyponatremia and hyperkalemia. Excessive diuresis may result in dehydration and reduction in blood volume with circulatory collapse with the possibility of vascular thrombosis and embolism particularly in elderly patients. Serious depletion of potassium and magnesium may lead to cardiac arrhythmias.</p>', '<p><strong>Pregnancy</strong>: Spironolactone and its metabolites may cross the placental barrier. The use of spironolactone in pregnant women requires that the anticipated benefit be weighed against the possible hazards to the mother and fetus. Animal teratology studies indicate that Furosemide may cause fetal abnormalities. Therefore, Furosemide should only be used in women in child bearing age when appropriate contraceptive measures are taken or if the potential benefits justify the potential risks to the fetus.<br />\r\n<br />\r\n<strong>Lactation</strong>: Metabolites of Spironolactone have been detected in breast milk. If use of Spironolactone is considered essential, an alternative method of infant feeding should be instituted. Furosemide is excreted in breast milk and breast-feeding should be discontinued if treatment is essential.</p>', '<p>Caution should be taken in patients liable to electrolyte deficiency. This preparation should also be used with caution in diabetes, enlarged prostate, hypotension and in hypovolemia.</p>', NULL, '<p>Potassium-sparing diuretics, Potassium-sparing diuretics &amp; Aldosterone antagonists</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-26 05:52:52', '2022-02-26 05:52:52'),
(628, 628, '<p>Fusidic Acid is indicated for the topical treatment of superficial bacterial infections of the eye and its adnexa. These may include - bacterial conjunctivitis, blepharoconjunctivitis, blepharitis, sty and keratitis. It may also be used for the management of corneal and conjunctival abrasions and foreign body injuries.</p>', '<p>Fusidic acid is an antimicrobial agent that inhibits bacterial protein synthesis. Fusidic acid interferes with amino acid transfer from aminoacyl-tRNA to protein on the ribosomes. Fusidic acid is active against a wide range of gram-positive organisms. The sustained release formulation ensures prolonged contact with the conjunctival sac. Fusidic acid penetrates well into the aqueous humor.</p>', '<p><strong>Adults and children (&ge; 2 years)</strong>: Instill one drop in the affected eye(s) twice daily for 7 days. Treatment should be continued for at least 48 hours after the eye returns to normal.</p>', '<p>Synergistic action with antistaphylococcal penicillin. Antagonism with ciprofloxacin.</p>', '<p>Fusidic acid viscous eye drops is contraindicated in patients who are hypersensitive to any component of this preparation.</p>', '<p>Fusidic acid is generally associated with very few adverse effects. The most frequently reported treatment-related side-effect is slight stinging or irritation.</p>', '<p><strong>Use in pregnancy</strong>: There are no adequate and well-controlled studies in pregnant women. Fusidic acid should be used during pregnancy unless the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: It is not clear if enough medication from the eye drop would pass into breast milk. Caution should be exercised while giving this eye drops to a nursing mother.</p>', '<ul>\r\n	<li>For ophthalmic use only</li>\r\n	<li>To avoid possible contamination of the drops, do not touch the tube nozzle or to any surface</li>\r\n	<li>Do not wear contact lenses during the treatment</li>\r\n	<li>If more than one topical eye drug is being used, the drugs should be administered at least five (5) minutes interval between applications&nbsp;</li>\r\n</ul>', NULL, '<p>Macrolides</p>', '<p>Store between 2-25&deg;C. Discard 1 mth after opening.</p>', '<p><strong>Use in children</strong>: Safety &amp; effectiveness in children below the age of 2 years have not been established.</p>', '2022-02-26 05:54:18', '2022-02-26 05:54:18'),
(629, 629, '<p>This cream is indicated in eczema and dermatitis with secondary infections including atopic dermatitis, allergic and seborrhoeic dermatitis and primary irritant dermatitis.</p>\r\n\r\n<p>This cream combines the potent topical antibacterial activity of fusidic acid with the anti-inflammatory and anti-pruritic activity of the moderately potent corticosteroid betamethasone valerate. When applied topically, fusidic acid is effective against Staphylococci, Streptococci, Corynebacteria, Neisseria and certain Clostridia and Bacteroides. The antibacterial activity of fusidic acid is not diminished in the presence of betamethasone.</p>', '<p>Fusidic acid is only effective against gram-positive bacteria such as Streptococcus, Staphylococcus aureus and Corynebacterium minutissimum. The antibacterial action of fusidic acid results from inhibition of bacterial protein synthesis. The drug interferes with amino acid transfer from aminoacyl-tRNA to protein on the ribosomes. Betamethasone induces lipocortin which inhibits phospholipase A-2 enzyme which results in the inhibition of different inflammartory mediators synthesis like prostaglandins, cinins, histamines.<br />\r\n<br />\r\nPharmacokinetics: Fusidic acid can penetrate intact human skin. As much as 2% of the amount of topically applied fusidic acid penetrates intact skin. The degree of penetration depends on factors such as the duration of exposure to fusidic acid and the condition of the skin. Fusidic acid is excreted mainly in the bile with little excreted in the urine. Dermal absorption and potency of any topical corticosteroid including betamethasone depends on the vehicle in which the steroid is delivered. Absorption of betamethasone may be higher in certain body areas such as the face, groin, axilla, or on injured or inflamed skin such as the lesions of atopic dermatitis.</p>', '<p><strong>Adults</strong>: It should be applied 2 times daily and gently massaged into the affected areas for 2 weeks. A shorter course should be considered if symptoms improve.<br />\r\n<br />\r\n<strong>Children</strong>: It is not recommended in children under 3 years of age.</p>', '<p>Other topical (skin-applied) medications contain corticosteroids.</p>', '<p>Topical hydrocortisone is contraindicated in viral tuberculosis and fungal skin infections. Hypersensitivity to any of the components.</p>', '<p>Possible side effects are allergic reactions, headache, skin rash, redness or itching, unusual tiredness or weakness, yellow eyes or skin.</p>', '<p>Fusidic acid and betamethasone should not be used in pregnancy. Both of them have been detected in the breast milk, so nursing mothers are advised not to use the drug.</p>', '<p>Long term continuous therapy should be avoided, particularly in the face, on flexures and intertriginous areas and in infants and children.</p>', NULL, '<p>Other Topical corticosteroids</p>', '<p>Keep out of reach of children. Store in a dry place, below 25˚C temperature and protected from light.</p>', NULL, '2022-02-26 05:56:12', '2022-02-26 05:56:12'),
(630, 630, '<p>In following skin diseases where bacterial infections are already present or suspected to occur-</p>\r\n\r\n<ul>\r\n	<li>Primary irritant dermatitis</li>\r\n	<li>Contact allergic dermatitis</li>\r\n	<li>Eczema (atopic, infantile, discoid, stasis)</li>\r\n	<li>Seborrhoeic dermatitis</li>\r\n</ul>', '<p>Fusidic Acid BP 2% &amp; Hydrocortisone Acetate BP 1% combination cream contains the potent topical antibacterial action of Fusidic Acid with the anti-inflammatory &amp; anti-pruritic effects of Hydrocortisone Acetate. When applied topically, Fusidic Acid is effective against Staphylococci, Streptococci, Corynebacteria, Neisseria and certain Clostridia &amp; Bacteroides. Fusidic Acid is an antimicrobial agent that acts as an inhibitor of protein synthesis in the microorganism. It interferes with translocation step by stabilizing the ribosome-guanosine diphosphate elongation factor G-complex. This prevents binding of aminoacyl t-RNA to the ribosome and thereafter stops transfer of additional amino acids to the growing polypeptide. In humans, Hydrocortisone is the principal naturally occurring glucocorticosteroid. In pharmaceutical dosage, its main action is to reduce the response of the skin to injury (i.e. anti-in ammatory). It also has immuno suppressant &amp; anti-mitotic actions.</p>', '<p><strong>Adults</strong>: This Cream should be applied 3 times daily and gently massaged onto the affected areas for 2 weeks. A shorter course should be considered if symptoms improve.<br />\r\n<br />\r\n<strong>Children</strong>: It is not recommended in children under 3 years of age.</p>', '<p>If absorbed systemically, Fusidic Acid may inhibit the metabolism of drugs that undergo extensive biotransformation in the liver, but no evidence for this is available. No hazardous drug interactions are reported with topical Hydrocortisone Acetate.</p>', '<p>This preparation is contraindicated in patients with hypersensitivity to Fusidic Acid, Hydrocortisone Acetate, or other components of the cream. As with other topical antibiotic/corticosteroid combination preparations, it is contraindicated in bacterial infections due to non-susceptible organisms, fungal infections, tuberculosis of the skin, syphilitic skin infections, chicken pox, eruptions following vaccinations and viral diseases of the skin in general.</p>', '<p>Fusidic Acid has been reported to cause mild irritation at the application site, but did not usually require discontinuation of therapy. Reports of hypersensitivity reactions have been rare. Adverse effects are generally local and include: dryness, itching, burning, local irritation, striae, skin atrophy, atrophy of subcutaneous tissues, telangiectasia, hypertrichosis, change in pigmentation and secondary infection. If applied to the face, acne rosacea or perioral dermatitis can occur.</p>', '<p>The safety of Fusidic Acid and/or topical Hydrocortisone Acetate during pregnancy or lactation has not been established. The use of this cream during pregnancy or lactation requires that the potential bene ts be weighed against the risks to the fetus or nursing infant.</p>', '<p>Fusidic Acid and Hydrocortisone Acetate should not be used in or near the eye because of the possibility of conjuctival irritation by Fusidic Acid. When used under occlusive dressing, over extensive areas or on the face, scalp, axillae and scrotum, suffcient absorption may occur, giving rise to adrenal suppression and other systemic effects.</p>', NULL, '<p>Hydrocortisone &amp; Combined preparations</p>', '<p>Store below 30&deg;C, away from light and moisture. Keep out of the reach of children.</p>', '<p><strong>Use in children</strong>: Clinical trials with Fusidic Acid &amp; Hydrocortisone Acetate have not demonstrated any increased incidence of adverse effects in children 3 years and over. There are no data from randomized, controlled clinical trials on the safety and efficacy of this combination in children under 3 years of age.</p>', '2022-02-26 05:57:38', '2022-02-26 05:57:38'),
(631, 631, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 05:58:11', '2022-02-26 05:58:11'),
(632, 632, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 05:58:27', '2022-02-26 05:58:27'),
(633, 633, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 05:58:44', '2022-02-26 05:58:44'),
(634, 634, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 05:59:03', '2022-02-26 05:59:03'),
(635, 635, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 05:59:30', '2022-02-26 05:59:30'),
(636, 636, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 05:59:51', '2022-02-26 05:59:51'),
(637, 637, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:00:11', '2022-02-26 06:00:11'),
(638, 638, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:00:33', '2022-02-26 06:00:33'),
(639, 639, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:00:50', '2022-02-26 06:00:50'),
(640, 640, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:01:05', '2022-02-26 06:01:05'),
(641, 641, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:01:22', '2022-02-26 06:01:22'),
(642, 642, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:01:37', '2022-02-26 06:01:37'),
(643, 643, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:02:09', '2022-02-26 06:02:09'),
(644, 644, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:02:42', '2022-02-26 06:02:42'),
(645, 645, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:03:04', '2022-02-26 06:03:04'),
(646, 646, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:03:22', '2022-02-26 06:03:22'),
(647, 647, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:03:37', '2022-02-26 06:03:37'),
(648, 648, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:04:04', '2022-02-26 06:04:04'),
(649, 649, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:04:24', '2022-02-26 06:04:24'),
(650, 650, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:04:37', '2022-02-26 06:04:37'),
(651, 651, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:05:07', '2022-02-26 06:05:07'),
(652, 652, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:05:30', '2022-02-26 06:05:30'),
(653, 653, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:05:46', '2022-02-26 06:05:46'),
(654, 654, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:06:20', '2022-02-26 06:06:20'),
(655, 655, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:06:46', '2022-02-26 06:06:46'),
(656, 656, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:07:24', '2022-02-26 06:07:24'),
(657, 657, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:07:47', '2022-02-26 06:07:47'),
(658, 658, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:08:19', '2022-02-26 06:08:19'),
(659, 659, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:08:58', '2022-02-26 06:08:58'),
(660, 660, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:09:24', '2022-02-26 06:09:24'),
(661, 661, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:09:40', '2022-02-26 06:09:40'),
(662, 662, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:09:51', '2022-02-26 06:09:51'),
(663, 663, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:10:10', '2022-02-26 06:10:10'),
(664, 664, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:10:39', '2022-02-26 06:10:39'),
(665, 665, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:11:03', '2022-02-26 06:11:03'),
(666, 666, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:11:59', '2022-02-26 06:11:59'),
(667, 667, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:13:30', '2022-02-26 06:13:30'),
(668, 668, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:13:52', '2022-02-26 06:13:52'),
(669, 669, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:14:12', '2022-02-26 06:14:12'),
(670, 670, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:14:27', '2022-02-26 06:14:27'),
(671, 671, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:14:48', '2022-02-26 06:14:48'),
(672, 672, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:15:05', '2022-02-26 06:15:05'),
(673, 673, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:15:37', '2022-02-26 06:15:37'),
(674, 674, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:15:52', '2022-02-26 06:15:52'),
(675, 675, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:16:20', '2022-02-26 06:16:20'),
(676, 676, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:16:57', '2022-02-26 06:16:57'),
(677, 677, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:17:44', '2022-02-26 06:17:44'),
(678, 678, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:20:42', '2022-02-26 06:20:42'),
(679, 679, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:22:45', '2022-02-26 06:22:45'),
(680, 680, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:23:04', '2022-02-26 06:23:04'),
(681, 681, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:23:27', '2022-02-26 06:23:27'),
(682, 682, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:23:50', '2022-02-26 06:23:50'),
(683, 683, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:24:10', '2022-02-26 06:24:10'),
(684, 684, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:24:23', '2022-02-26 06:24:23'),
(685, 685, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:24:42', '2022-02-26 06:24:42'),
(686, 686, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:24:59', '2022-02-26 06:24:59'),
(687, 687, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:25:18', '2022-02-26 06:25:18'),
(688, 688, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:25:45', '2022-02-26 06:25:45'),
(689, 689, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:26:15', '2022-02-26 06:26:15'),
(690, 690, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:26:39', '2022-02-26 06:26:39'),
(691, 691, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:27:02', '2022-02-26 06:27:02'),
(692, 692, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:27:34', '2022-02-26 06:27:34'),
(693, 693, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:28:20', '2022-02-26 06:28:20'),
(694, 694, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:28:48', '2022-02-26 06:28:48'),
(695, 695, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:29:06', '2022-02-26 06:29:06'),
(696, 696, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:29:49', '2022-02-26 06:29:49'),
(697, 697, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:30:41', '2022-02-26 06:30:41'),
(698, 698, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:31:04', '2022-02-26 06:31:04'),
(699, 699, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:31:31', '2022-02-26 06:31:31'),
(700, 700, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:31:58', '2022-02-26 06:31:58'),
(701, 701, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:32:16', '2022-02-26 06:32:16'),
(702, 702, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:32:44', '2022-02-26 06:32:44'),
(703, 703, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:33:23', '2022-02-26 06:33:23'),
(704, 704, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:33:41', '2022-02-26 06:33:41'),
(705, 705, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:33:54', '2022-02-26 06:33:54'),
(706, 706, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:34:11', '2022-02-26 06:34:11'),
(707, 707, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:34:46', '2022-02-26 06:34:46'),
(708, 708, '<p>Hydrogen peroxide&nbsp;is a mild antiseptic used on the&nbsp;skin&nbsp;to prevent infection of minor cuts, scrapes, and burns. It may also be used as a&nbsp;mouth&nbsp;rinse to help remove&nbsp;mucus&nbsp;or to relieve minor&nbsp;mouth&nbsp;irritation (e.g., due to canker/cold sores,&nbsp;gingivitis). This product works by releasing oxygen when it is applied to the affected area. The release of oxygen causes foaming, which helps to remove dead skin and clean the area. This product should not be used to treat deep wounds, animal bites, or serious burns.</p>', '<p>Hydrogen peroxide is an oxidising agent with antibacterial and antiviral activity. It is used as an antiseptic, disinfectant, and deodorant. It also has a mild haemostatic action. It exerts its antiseptic action partly by its ready release of oxygen when applied to tissues, but this effect is reduced in the presence of organic matter. The mechanical effect of effervescence may be more useful for wound cleansing than the antimicrobial action.</p>', '<p>Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or&nbsp;pharmacist. Do&nbsp;not use in the&nbsp;eyes&nbsp;or apply over large areas of&nbsp;skin.<br />\r\n<br />\r\nIf you are using this product on the skin, clean the affected area before use. Apply a small amount of product on the affected area, usually 1 to 3 times daily or as directed by your doctor. If you apply a bandage after using this product, let the area dry first.<br />\r\n<br />\r\nIf you are using this product as a&nbsp;mouth&nbsp;rinse, mix with an equal amount of water before using. Swish in the&nbsp;mouth&nbsp;over the affected area for at least 1 minute, then spit out. Do not swallow this product. Rinse up to 4 times daily or as directed by your dentist or doctor.<br />\r\n<br />\r\nUse this product regularly in order to get the most benefit from it. To help you remember, use it at the same time(s) each day.<br />\r\n<br />\r\nTell your doctor if your condition does not improve in 7 days or if it worsens. If you think you may have a serious medical problem, seek immediate medical attention.</p>', '<p>If you are using this product under your doctor&#39;s direction, your doctor or&nbsp;pharmacist&nbsp;may already be aware of any possible&nbsp;drug interactions&nbsp;and may be monitoring you for them.&nbsp;Do&nbsp;not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first. Keep a list of all your&nbsp;medications&nbsp;with you, and share the list with your doctor and pharmacist.</p>', '<p>Inj or instillation of hydrogen peroxide into closed body cavities.</p>', '<p>Irritating burns on the skin and mucous membranes (strong solutions); reversible hypertrophy of the papillae of the tongue with continued use as mouthwash; gas embolism, rupture of the colon, proctitis, ulcerative colitis and gangrene of the intestines have occurred following colonic lavage with hydrogen peroxide solution.</p>', '<p>This product is safe to use during&nbsp;pregnancy. It is unlikely that this product passes into&nbsp;breast&nbsp;milk. Consult your doctor before&nbsp;breast-feeding.</p>', '<p>Before using&nbsp;hydrogen peroxide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.</p>', NULL, '<p>Oxidising agent with antibacterial and antiviral properties</p>', '<p>Store at 15-30&deg; C.</p>', NULL, '2022-02-26 06:36:10', '2022-02-26 06:36:10'),
(709, 709, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:36:34', '2022-02-26 06:36:34'),
(710, 710, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:36:45', '2022-02-26 06:36:45'),
(711, 711, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:37:05', '2022-02-26 06:37:05'),
(712, 712, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:37:25', '2022-02-26 06:37:25'),
(713, 713, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:37:44', '2022-02-26 06:37:44'),
(714, 714, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:38:03', '2022-02-26 06:38:03'),
(715, 715, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:38:18', '2022-02-26 06:38:18'),
(716, 716, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:38:32', '2022-02-26 06:38:32'),
(717, 717, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:38:45', '2022-02-26 06:38:45'),
(718, 718, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:39:05', '2022-02-26 06:39:05'),
(719, 719, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:39:23', '2022-02-26 06:39:23'),
(720, 720, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:39:37', '2022-02-26 06:39:37'),
(721, 721, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:39:50', '2022-02-26 06:39:50'),
(722, 722, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:40:10', '2022-02-26 06:40:10'),
(723, 723, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:40:28', '2022-02-26 06:40:28'),
(724, 724, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-26 06:40:47', '2022-02-26 06:40:47');
