INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1235, 1235, '<p>Pivmecillinam is indicated for treatment of infections caused by mecillinam-sensitive organisms, e.g. acute cystitis, complicated urinary tract infections, salmonellosis, shigellosis, enteropathic E. coli diarrhoea, gram-negative septicaemia, billiary infections.</p>', '<p>Pivmecillinam belongs to a new class of penicillin-the amdinopenicillin. Pivmecillinam is a prodrug formulation of mecillinam which allows the drug to be administered by mouth. The prodrug form lacks antibacterial activity, but the active drug is liberated by enzymatic hydrolysis during absorption in the gastrointestinal tract.<br />\r\n<br />\r\nPivmecillinam is bactericidal. It acts by interfering with bacterial cell wall synthesis, but the site of action differs from that of other penicilins. Pivmecillinam is very active against Enterobacteriaceae. It is active against E. coli, Klebsiella, Proteus, Enterobacter, Salmonella, Shigella and Yersinia. Pivmecillinam has poor activity against Gram- positive organisms. It has poor activity against Pseudomonas aeruginosa and has practically no activity against Enterococcus faecalis.</p>', '<p>Adults:</p>\r\n\r\n<ul>\r\n	<li><strong>The usual dose</strong>: 1-2 tablets 3 times daily according to severity of the infection.</li>\r\n	<li><strong>In acute uncomplicated cystitis:</strong>&nbsp;initially 400 mg then 200 mg every 8 hours for 3 days.</li>\r\n	<li><strong>In chronic or recurrent bacteriurea:</strong>&nbsp;400 mg 6-8 hours.</li>\r\n	<li><strong>For the treatment of salmonellosis (including enteric fever):</strong>&nbsp;1.2-2.4 gm daily for 14 days. To eliminate salmonella carriage, therapy may be prolonged for 2-4 weeks. In complicated urinary tract infection the usual treatment time is 1-2 weeks.</li>\r\n	<li><strong>For prophylactic treatment of recurrent urinary tract infections:</strong>&nbsp;1 tablet every evening is recommended.</li>\r\n</ul>\r\n\r\n<p>Children:</p>\r\n\r\n<ul>\r\n	<li>Weighing less than 20 kg should be given 20-60 mg/kg divided into 3-4 daily doses. Those weighing more than 20 kg should receive normal adult dose.</li>\r\n	<li><strong>In shigellosis:</strong>&nbsp;20 mg/kg 4 times a day for 5 days.</li>\r\n	<li><strong>For UTI:</strong>&nbsp;20-40 mg/kg/day in 3-4 divided doses</li>\r\n	<li><strong>For salmonellosis:</strong>&nbsp;30-60 mg/kg/day in 3-4 divided doses</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>The tablet should be taken with at least 50-100 ml fluid. As the bioavailability is practically unaffected by simultaneous food intake, This&nbsp;tablets are best taken with or immediately after a meal.</p>', NULL, '<p>There have been no reports on allergy to Pivmecillinam among patients with a known history of hypersensitivity to penicillins and cephalosporins. Nevertheless, it seems reasonable to exclude such patients from treatment with Pivmecillinam until further experience has been gained.</p>', '<p>Pivmecillinam is generally well tolerated, even by patients with reduced kidney function. Upper gastrointestinal disturbances such as nausea, vomiting and diarrhoea or indigestion may occur when a dose has been given on an empty stomach. Skin rashes have been reported in some cases, but the characteristic ampicillin-rash has never been observed, nor has there been any evidence of hepato-, nephro-, or ototoxicity. The occurrence of anaphylaxis, though not yet reported, cannot be entirely excluded.</p>', '<p>Mecillinam concentrations approximately 1/3 of the serum levels have been found in the umbilical cord, and low but detectable amounts in the amniotic fluid. So, use of pivmecillinam in pregnancy should be avoided. Mecillinam is not excreted into the milk of lactating mother.</p>', '<p>As with other antibiotics, which are excreted mainly by the kidneys, raised blood levels of mecillinam may occur if repeated doses are given with impaired renal function.</p>', '<p>There is no experience with over dosage of pivmecillinam. However, excessive doses are likely to cause nausea, vomiting and gastritis. Treatment should be restricted to symptomatic and supportive measures. If necessary haemodialysis will reduce the blood level.</p>', '<p>Mecillinams</p>', '<p>Store at a cool and dry place, protect from light and moisture.</p>', '<p>Based on information available to date for patients with impaired renal function, the initial dose can remain unchanged as can the interval between doses. However, the amount administered as the maintenance dose should be changed according to the following criteria:</p>\r\n\r\n<ul>\r\n	<li><strong>CrCl 30 ml/min or greater</strong>: full dosage</li>\r\n	<li><strong>CrCl 10-30 ml/min</strong>: 50% dosage</li>\r\n	<li><strong>CrCl &lt;10 ml/min</strong>: 25% dosage</li>\r\n</ul>\r\n\r\n<p>Use of Pivmecillinam in infants under 3 months of age should be avoided.</p>', '2022-03-15 06:08:05', '2022-03-15 06:08:05'),
(1236, 1236, '<p>Pizotifen is indicated as prophylactic treatment of vascular headache of migraine type such as classical migraine, common migraine and cluster headache. It is not effective in relieving migraine attacks once in progress.</p>', '<p>Pizotifen works by inhibiting the peripheral actions of serotonin and histamine in increasing the membrane permeability of cranial vessels and transudation of plasmakinin, while altering pain thresholds in migraines. By blocking 5-HT receptors, pizotifen attenuates the signalling of serotonin in causing cranial vasoconstriction, as well as serotonin-enhanced platelet function and aggregation. There is evidence that it also inhibits the peripheral actions of bradykinin. Pizotifen may inhibit serotonin reuptake by blood platelets, which affects the tonicity and decreases passive distension of extracranial arteries. The effects of pizotifen leading to appetite stimulation may be due to the drug acting at the metabolic level rather than a direct stimulation of the appetite centre.</p>', '<p><strong>Adults</strong>: Usually 1.5 mg daily. This may be taken as a single dose at night or in three divided doses. Dosage should be adjusted to the individual patient requirements up to a maximum of 4.5 mg daily. Up to 3 mg may be given as a single dose.<br />\r\n<br />\r\n<strong>Children (aged over 2 years)</strong>: Up to 1.5 mg daily, usually as a divided dose, although up to 1 mg has been given as a single dose at night.</p>', '<p>The central effects of sedatives, hypnotics, antihistamines (including certain common cold preparations) and alcohol may be enhanced by Pizotifen. Pizotifen antagonizes the hypotensive effect of adrenergic neurone blockers.</p>', '<p>Pizotifen is contraindicated in patients with known hypersensitivity to any of its ingredients.</p>', '<p>The most common side effects are appetite stimulating effect, increase in body weight and drowsiness.</p>', '<p>Information of using Pizotifen in pregnancy is limited, although no ill effects have been reported. The drug should therefore only be given during pregnancy if the potential benefit to mother justifies the potential risk to the fetus. The safety of Pizotifen during lactation has not been established, so mothers should avoid taking it when breast feeding.</p>', '<p>Urinary retention, renal impairment should be taken in consideration. Drowsiness may affect the performance driving vehicles &amp; operation of machineries. Pizotifen enhances the action of alcohol.</p>', NULL, '<p>Anti-histamine Preparations, Other drugs for migraine</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-15 06:09:46', '2022-03-15 06:09:46'),
(1237, 1237, '<p>For the removal of external genital warts located on the penis and vulva.</p>', '<p>Podophyllotoxin has an antimitotic action and is used mainly as a topical treatment for anogenital warts.</p>', '<p>Apply twice daily, morning and evening (every 12 hours) for three consecutive days followed by four days without treatment. The use of 0.5% Podophyllotoxin Topical Solution is twice a day for three days constitutes a treatment cycle. Treatment cycles should be repeated up to four times until there is no visible wart tissue.</p>', NULL, '<p>Hypersensitivity; pregnancy; lactation; child.</p>', '<p>Irritating to the eyes and mucous membranes; GI disturbances; thrombocytopenia, leucopenia; renal failure; hepatotoxicity; CNS effects; EEG changes; peripheral and autonomic neuropathies; local reactions.</p>', '<p>Pregnancy&nbsp;Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Avoid excessive application. Avoid contact with eyes and inflamed skin. Not to be used on cervical or urethral warts.</p>', NULL, '<p>Anti neoplastic preparations.</p>', NULL, NULL, '2022-03-15 06:11:07', '2022-03-15 06:11:07'),
(1238, 1238, '<p>Polyethylene Glycol is indicated in the treatment of constipation. This should be used for 2 weeks or less or as directed by physician.&nbsp;Polyethylene Glycol 3350 is a prescription only laxative that has been prescribed by physician to treat constipation. This product should only be used by the person for whom it is prescribed.</p>', '<p>The primary mode of action is thought to be through the osmotic effect of polyethylene glycol 3350 which causes water to be retained in the colon and produces a watery stool. Polyethylene Glycol induces as diarrhea which rapidly cleanses the bowel, usually within four hours.</p>', '<p>The usual dose of Polyethylene Glycol is 17 gm of powder per day (or as directed by physician) in a glass of water, juice, coke, coffee or tea. Each bottle of Polyethylene Glycol is supplied with a cup that is used to measure 17 gm or 8.5 gm of laxative powder when filled upto the marked line.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>It should always be taken by mouth. Measure the dose using the supplied cup, stir and dissolve in a glass of water, juice, coke, coffee or tea. Taking more than the prescribed dose may cause loss of fluid due to severe diarrhea.</p>', '<p>No specific drug interactions have been demonstrated.</p>', '<p>Polyethylene glycol is contraindicated in patients with known or suspected bowel obstruction and patients known to be allergic to polyethylene glycol.</p>', '<p>Nausea, abdominal bloating, cramping and flatulence may occur. High doses may produce diarrhea and excessive stool frequency, particularly in elderly nursing home patients. Patients taking other medications containing polyethylene glycol have occasionally developed urticaria suggestive of an allergic reaction.</p>', '<p><strong>Pregnancy:</strong>&nbsp;It is not known whether Polyethylene glycol can cause fetal harm when administered to a pregnant woman, or can effect reproductive capacity. Polyethylene glycol should only be administered to a pregnant woman if clearly needed.<br />\r\n<br />\r\n<strong>Lactation:</strong>&nbsp;There is no information on the use of Polyethylene glycol while nursing. Consultation with a physician is necessary in case of breastfeeding.</p>', '<p>Patients with symptoms suggestive of bowel obstruction (nausea, vomiting, abdominal pain or distention) should be evaluated to rule out this condition before initiating Polyethylene Glycol therapy. Polyethylene Glycol should be administered after being dissolved in water, juice, coke, coffee or tea.</p>', '<p>There have been no reports of accidental overdosage. In the event of overdosage diarrhea would be the expected major event. If an overdose of drug occurred without concomitant ingestion of fluid, dehydration due to diarrhea may result. Medication should be terminated and free water administered.</p>', '<p>Osmotic purgatives.</p>', NULL, NULL, '2022-03-15 06:12:51', '2022-03-15 06:12:51'),
(1239, 1239, '<p>This sterile eye drops is indicated for the temporary relief of burning and irritation due to dryness of the eye.</p>', '<p>The combination of Polyethylene Glycol 400 &amp; Propylene Glycol is clinically proven to reduce both signs and symptoms of dry eye. The mechanism of action is thought to be due to its unique gelling and lubricating system formulated to adjust to each users individual tear pH. When the ingredients of this eye drops combine with natural tears, a soft gel forms a network of protection over the eye surface. Since it promotes a healthy environment in eye surfaces, damaged surface cells of eye can repair more easily.</p>', '<p>Instill 1 drop 4 times daily in the affected eye(s) or as needed.</p>', NULL, '<p>It is contraindicated in patients with known hypersensitivity to any ingredient in this formulation.</p>', '<p>Generally well tolerated. This sterile eye drops should not be used if allergic condition occurs to any ingredients of the product.</p>', NULL, '<p>Never touch the tip of the container with any surface to avoid contamination. Replace cap after each use.</p>', NULL, '<p>Drugs for Dry eyes.</p>', '<p>Store in a cool &amp; dry place, protect from light. Do not use longer than one month after the first opening. Keep out of the reach of children.</p>', NULL, '2022-03-16 03:50:32', '2022-03-16 03:50:32'),
(1240, 1240, '<p>For effective relief from constipation and treatment of chronic constipation. Resolving fecal impaction.</p>', '<p><strong>Polyethylene Glycol 3350</strong>&nbsp;exerts an osmotic action in the gut, which induces a laxative effect. Polyethylene Glycol 3350 increases the stool volume, which triggers colon motility via neuromuscular pathways. Electrolytes combined with Polyethylene Glycol 3350 are exchanged across the intestinal barrier (mucosa) with serum electrolytes and excreted in fecal water without net gain or loss of sodium, potassium and water.<br />\r\n<br />\r\n<strong>Sodium chloride</strong>&nbsp;is the major extracellular cation. It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes. It is also used as diluents for infusion of compatible drug additives.<br />\r\n<br />\r\n<strong>Sodium bicarbonate</strong>&nbsp;raises blood and urinary pH by dissociation to provide bicarbonate ions, which neutralises the hydrogen ion concentration. It also neutralises gastric acid via production of carbon dioxide.<br />\r\n<br />\r\n<strong>Potassium chloride</strong>&nbsp;is a major cation of the intracellular fluid. It plays an active role in the conduction of nerve impulses in the heart, brain and skeletal muscle; contraction of cardiac skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism and gastric secretion.</p>', '<p><strong>For adults and children aged 12 years and above</strong>: (Powder for Suspension)</p>\r\n\r\n<ul>\r\n	<li><strong>Constipation</strong>: The dose is 1 sachet daily. This may be increased to 2-3 sachets daily, if required.&nbsp;</li>\r\n	<li><strong>Fecal Impaction</strong>:&nbsp;8 sachets daily, consumed within 6 hours. A course of treatment for fecal impaction does not normally exceed 3 days.&nbsp;</li>\r\n	<li><strong>Patients with renal insufficiency</strong>:&nbsp;No dosage change is necessary for treatment of either constipation or fecal impaction.</li>\r\n	<li><strong>Direction of use</strong>:&nbsp;Each sachet should be dissolved in 125 ml water. For fecal impaction 8 sachets may be dissolved in 1 litre of water. Store the solution refrigerated and discard any solution not used within 6 hours.&nbsp;</li>\r\n</ul>\r\n\r\n<p><strong>For adults and children aged 12 years and above</strong>: (Oral Solution)&nbsp;</p>\r\n\r\n<ul>\r\n	<li><strong>Constipation</strong>: 25 ml of Polyethylene Glycol 3350 and electrolytes oral solution added to 100 ml of water once daily (to make a total volume of 125 ml). This may be increased to 2-3 doses of 25 ml daily (each 25 ml dose added to 100 ml of water), if required according to individual response.</li>\r\n	<li><strong>Fecal Impaction</strong>: 8 doses of 25 ml daily (each 25 ml dose added to 100 ml of water). A course of treatment for fecal impaction does not normally exceed 3 days.</li>\r\n	<li><strong>Direction of use</strong>:&nbsp;25 ml of oral solution added to 100 ml of water (to make a total volume of 125 ml). Any unused diluted solution should be discarded within 24 hours.&nbsp;</li>\r\n</ul>', '<p>No specific drug interactions have been found.</p>', '<p>Polyethylene Glycol 3350 and electrolytes is contraindicated in patients with known hypersensitivity to the active substance or any of the excipients, intestinal perforation or obstruction, crohn&rsquo;s disease and ulcerative colitis.</p>', '<p>Generally well tolerated. However side effects like allergic reactions, electrolyte disturbances particularly hyperkalaemia and hypokalaemia, abdominal pain, diarrhea, headache, peripheral edema may appear.</p>', '<p><strong>Use in Pregnancy</strong>:&nbsp;There is no experience of the use of Polyethylene Glycol 3350 during pregnancy and lactation. It should only be used if considered essential by the physician.&nbsp;<br />\r\n<br />\r\n<strong>Use in Lactation</strong>: It is unknown whether Polyethylene Glycol 3350 is excreted in human breast milk.</p>', '<p><strong>Patients with impaired cardiovascular function</strong>: For the treatment of fecal impaction the dose should be divided so that no more than two sachets are taken in any one hour.&nbsp;<br />\r\n<br />\r\nIf patients develop any symptoms indicating shifts of fluid/electrolytes (e.g. edema, shortness of breath, increasing fatigue, dehydration, cardiac failure) Movilax should be stopped immediately and any abnormality should be treated appropriately. Prolonged use with all laxatives is undesirable and may lead to dependence.</p>', '<p>Severe pain or distention can be treated by nasogastric aspiration. Extensive fluid loss by diarrhea or vomiting may require correction of electrolyte disturbances.</p>', '<p>Osmotic purgatives.</p>', '<p>Store below 30&deg; C and in a place protected from light. Do not refrigerate.</p>', NULL, '2022-03-16 03:52:31', '2022-03-16 03:52:31'),
(1241, 1241, '<p>Polygeline improved hemodynamic stability in patients with hypovolemia due to traumatic injury. The improvement was seen within 1 h (golden hour) of polygeline administration and maintained consistently. Polygeline can be safely administered to patients with traumatic injury to improve hemodynamic parameters and achieve stability.<br />\r\n<br />\r\nThis Infusion contains calcium chloride, sodium chloride and potassium chloride that protect the patient from dehydration and electrolyte disorders after any trauma or injury. Appropriate fluid replacement is very essential to restore normal brain activity and other vital functions of the body to promote healing as well as speedy recovery.<br />\r\n<br />\r\nIn Short term fluid replacement after trauma.</p>', '<p>This Infusion injection comprises of a combination of medicines. It is given as a short term fluid replacement after trauma. This Infusion works by replenishing the body&rsquo;s fluid and electrolytes. This injection should be administered under the supervision of a healthcare professional. You should not self administer this injection.</p>', NULL, NULL, '<p>Hypersensitivity to any other ingredient of this preparation.</p>', '<p>Some common side effects of this medicine can be injection site reactions such as redness, pain or swelling. If these side effects persist for a longer duration, please consult your doctor.</p>', NULL, '<p>Before taking this medicine, tell your doctor if you have any other health conditions may be required. Inform your doctor if you are taking any other medicines or if you are pregnant or breastfeeding. It is advised not to consume alcohol after taking this medicine.</p>', NULL, '<p>Intravenous fluid preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-16 03:53:54', '2022-03-16 03:53:54'),
(1242, 1242, '<p>Acute infections caused by susceptible strains of Pseudomonas aeruginosa:<br />\r\n<br />\r\nPolymyxin B Sulfate is a drug of choice in the treatment of infections of the urinary tract, meninges, and bloodstream caused by susceptible strains of Pseudomonas aeruginosa.<br />\r\n<br />\r\nIt may be indicated in serious infections caused by susceptible strains of the following organisms, when less potentially toxic drugs are ineffective or contraindicated:</p>\r\n\r\n<ul>\r\n	<li>H. influenzae: Specifically meningeal infections</li>\r\n	<li>Escherichia coli: Specifically urinary tract infections</li>\r\n	<li>Aerobacter aerogenes: Specifically bacteremia</li>\r\n	<li>Klebsiella pneumoniae: Specifically bacteremia</li>\r\n</ul>', '<p><strong>Intravenous</strong>: Dissolve Polymyxin B 500,000 units in 300 to 500 ml solutions for parenteral Dextrose injection 5% for continuous drip.<br />\r\n<br />\r\n<strong>Intramuscular</strong>: Dissolve Polymyxin B 500,000 units in 2 ml 0.9% Sodium Chloride solution. It is not recommended routinely because of severe pain at injection site, particularly in infants and children.<br />\r\n<br />\r\n<strong>Intrathecal</strong>: Dissolve Polymyxin B 500,000 units in 10 ml 0.9% Sodium Chloride solution for 50,000 units per ml dosage unit.<br />\r\n<br />\r\nIn meningeal infections, Polymyxin B Sulfate should be administered only by the intrathecal route.<br />\r\n<br />\r\nFor IV route:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult &amp; Children (Normal kidney function)</strong>: Dose (Units/kg/day) is 15,000-25,000(Not exceed 25,000) and Dosage frequency/Duration is infusions may be given every 12 hours over a period of approximately 60 to 90 minutes.</li>\r\n	<li><strong>Adult &amp; Children (Renal impairment)</strong>: Dose (Units/kg/day) is Less than 15,000 and Dosage frequency/Duration is Infusions may be given every 12 hours over a period of approximately 60 to 90 minutes.</li>\r\n	<li><strong>Infants (Normal kidney function)</strong>: Dose (Units/kg/day) is Maximum 40,000</li>\r\n</ul>\r\n\r\n<p>For IM route:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult &amp; Children</strong>: Dose (Units/kg/day) is 25,000-30,000 and Dosage frequency/Duration is Dose should be reduced in the presence of renal impairment. The dosage may be divided and given at either 4 or 6 hour intervals.</li>\r\n	<li><strong>Infants (Normal kidney function)</strong>: Dose (Units/kg/day) is Maximum 40,000</li>\r\n</ul>\r\n\r\n<p>For Intrathecal:</p>\r\n\r\n<ul>\r\n	<li><strong>Children under 2 years of age</strong>: Dosage frequency/Duration is 20,000 units once daily, intrathecally for 3 to 4 days or 25,000 units once every other day. Continue with a dose of 25,000 units once every other day for at least 2 weeks after cultures of the cerebrospinal fluid are negative and sugar content has returned to normal.</li>\r\n	<li><strong>Adults and children over 2 years of age</strong>: 50,000 units once daily for 3 to 4 days, then 50,000 units once every other day for at least 2 weeks after cultures of the cerebrospinal fluid are negative and sugar content has returned to normal.</li>\r\n</ul>', NULL, '<p>The concurrent or sequential use of other neurotoxic and/or nephrotox-ic drugs with Polymyxin B sulfate, particularly bacitracin, kanamycin, streptomycin, tobramycin, amikacin, cephaloridine, cephalothin, paromycin, polymyxin E (colistin), neomycin, gentamicin, and vancomycin, Bumetanide, celecoxib, cisplatin, cyclosporine, diclofenac, misoprostol, diphenhydramine, ibuprofen, naproxen, esomeprazole, etodolac, general anesthetic, gentamycin, ketorolac, meloxicam, tenofovir etc should be avoided.</p>', NULL, '<p>Clostridium difficile associated diarrhea has been reported with use of Polymyxin B. Nephrotixic reactions: Albuminuria, cylinduria, azotemia, and rising blood levels, Neurotoxic reactions: Facial flushing, dizziness progressing to ataxia, drowsiness, peripheral aresthesias (circumoral and stocking glove), apnea due to concurrent use of curariform muscle relaxants, other neurotoxic drugs or inadvertent overdosage, and signs of meningeal irritation with intrathecal administration, e.g., fever, headache, stiff neck. Other reactions occasionally reported: Drug fever, urticaria rash, severe pain at IM injections sites and thrombophelbitis at IV injections sites.</p>', '<p>There are no controlled data in human pregnancy. Safety has not been established during pregnancy. There is no recommendation regarding use during lactation. There is no study on whether it is secreted with human milk.</p>', '<p>Baseline renal function should be done prior to therapy, with frequent monitoring of renal function and blood levels of the drug during parenteral therapy.</p>', '<p>Polymyxin-induced toxicity associated with overdose has been reported. Overdose of Polymyxin can result in neuromuscular blockade, which can lead to apnea, muscular weakness, vertigo, transient facial paresthesia, slurred speech, vasomotor instability, visual disturbance, confusion, psychosis and possible respiratory arrest. Overdose can also cause renal failure characterized by decreased urine output and increased serum concentrations of BUN and creatinine. There is no specific antidote for Polymyxin B Sulfate overdose. In case of Polymyxin B Sulfate overdose, the drug should be stopped and symptomatic treatment instituted. Quick diuresis by IV administered mannitol may help to enhance renal clearance of the drug and thus to reduce serum drug levels. Hemodialysis or peritoneal dialysis may help in order to manage renal complications.</p>', '<p>Other antibacterial preparation.</p>', '<p>Before reconstitution, do not store above 30&deg;C; and keep away from light and out of the reach of children. After reconstitution or dilution, unused portion must be stored at 2&deg; to 8&deg;C and should be discarded after 72 hours if not used.</p>', NULL, '2022-03-16 03:56:22', '2022-03-16 03:56:22'),
(1243, 1243, '<p>Polysaccharide Diphtheria Toxoid Conjugate Vaccine is indicated for active immunization to prevent invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y and W-135. This vaccine is approved for use in individuals 9 months through 55 years of age. Menactra does not prevent N meningitidis serogroup B disease.</p>', '<p>The presence of bactericidal anti-capsular meningococcal antibodies has been associated with protection from invasive meningococcal disease. Menactra induces the production of bactericidal antibodies specific to the capsular polysaccharides of serogroups A, C, Y and W-135.</p>', '<p>Primary Vaccination:</p>\r\n\r\n<ul>\r\n	<li>Children 9 through 23 months of age: Two doses, three months apart.</li>\r\n	<li>Individuals 2 through 55 years of age: A single dose.</li>\r\n</ul>\r\n\r\n<p>Booster Vaccination:</p>\r\n\r\n<ul>\r\n	<li>A single booster dose may be given to individuals 15 through 55 years of age at continued risk for meningococcal disease, if at least 4 years have elapsed since the prior dose.</li>\r\n</ul>', '<p>When Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed) are to be administered to children 4 through 6 years of age, preference should be given to simultaneous administration of the 2 vaccines or administration of Menactra prior to Polysaccharide Diphtheria Toxoid Conjugate Vaccine. Administraton of Menactra one month after Polysaccharide Diphtheria Toxoid Conjugate Vaccine has been shown to reduce meningococcal antibody responses to Menactra<br />\r\n<br />\r\nPneumococcal antibody responses to some serotypes in Prevnar (PCV7) were decreased following co-administration of Menactra and PCV7.</p>', '<p>Severe allergic reaction (eg, anaphylaxis) after a previous dose of a meningococcal capsular polysaccharide-, diphtheria toxoid- or CRM 197-containing vaccine, or to any component of Menactra.</p>', '<p><strong>Common (&ge;10%)</strong>: solicited adverse events in infants and toddlers 9 and 12 months of age were injection site tenderness, erythema, and swelling; irritability, abnormal crying, drowsiness, appetite loss, vomiting, and fever.<br />\r\n<br />\r\n<strong>Common (&ge;10%)</strong>: solicited adverse events in individuals 2 through 55 years of age who received a single dose were injection site pain, redness, induration, and swelling; anorexia and diarrhea. Other common solicited adverse events were irritability and drowsiness (2-10 years of age), headache, fatigue, malaise, and arthralgia (11-55 years of age).</p>', '<p>Safety and effectiveness of Polysaccharide Diphtheria Toxoid Conjugate Vaccine have not been established in children younger than 9 months of age, pregnant women, nursing mothers, and adults older than 55 years of age.</p>', '<p>Persons previously diagnosed with Guillain-Barre syndrome (GBS) may be at increased risk of GBS following receipt of Menactra. The decision to give Menactra should take into account the potential benefits and risks.</p>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', '<p>Keep out of the reach and sight of children. Store at +2&deg;C to +8&deg;C. Transportation should also be at +2&deg;C to +8 &deg;C. Do not freeze. Discard solution if frozen. Protect from light.</p>', NULL, '2022-03-16 03:58:19', '2022-03-16 03:58:19'),
(1244, 1244, '<p>Polysaccharide Pneumococcal Vaccine is a vaccine indicated for active immunization for the prevention of pneumococcal disease caused by the 23 serotypes contained in the vaccine (1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F , and 33F). Polysaccharide Pneumococcal Vaccine is approved for use in persons 50 years of age or older and persons aged &ge; 2 years who are at increased risk for pneumococcal disease.</p>', '<p>Pneumococcal Vaccine induces type-specific antibodies that enhanced opsonization, phagocytosis, and killing of pneumococci by leukocytes and other phagocytic cells. The levels of antibodies that correlate with protection against pneumococcal disease have not been clearly defined.</p>', '<p><strong>Preparation</strong>:</p>\r\n\r\n<ul>\r\n	<li>Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. If either of these two conditions exists, the vaccine should not be administered.</li>\r\n	<li>Do not mix Pneumococcal Vaccine with other vaccines in the same syringe or vial.</li>\r\n	<li>Use a separate sterile syringe and needle for each individual patient to prevent transmission of infectious agents from one person to another.</li>\r\n</ul>\r\n\r\n<p><strong>Single-Dose Vial</strong>: Withdraw 0.5 mL from the vial using a sterile needle and syringe free of preservatives, antiseptics, and detergents.<br />\r\n<br />\r\n<strong>Single-Dose, Prefilled Syringe</strong>: The package does not contain a needle. Attach a sterile needle to the prefilled syringe by twisting in a clockwise direction until the needle fits securely on the syringe.<br />\r\n<br />\r\n<strong>Administration</strong>:<br />\r\n<br />\r\nAdminister Pneumococcal Vaccine&nbsp;intramuscularly or subcutaneously into the deltoid muscle or lateral mid-thigh. Do not inject intravascularly or intradermally.<br />\r\n<br />\r\n<strong>Single-Dose Vial</strong>: Administer a single 0.5-mL dose of Pneumococcal Vaccine using a sterile needle and syringe. Discard vial after use.<br />\r\n<br />\r\n<strong>Single-Dose, Prefilled Syringe</strong>: Administer the entire contents of the single-dose, prefilled syringe per standard protocol using a sterile needle. Discard syringe after use.<br />\r\n<br />\r\n<strong>Revaccination</strong>: The Advisory Committee on Immunization Practices (ACIP) has recommendations for revaccination against pneumococcal disease for persons at high risk who were previously vaccinated with Pneumococcal Vaccine. Routine revaccination of immunocompetent persons previously vaccinated with a 23-<br />\r\nvalent vaccine, is not recommended.</p>', '<p>Concomitant Administration with Other Vaccines: In a randomized clinical study, a reduced immune response to ZOSTAVAX as measured by gpELISA was observed in individuals who received concurrent administration of Pneumococcal Vaccine and ZOSTAVAX compared with individuals who received these vaccines 4 weeks apart. Consider administration of the two vaccines separated by at least 4 weeks. Limited safety and immunogenicity data from clinical trials are available on the concurrent administration of Pneumococcal Vaccine and vaccines other than ZOSTAVAX.</p>', '<p>Do not administer Pneumococcal Vaccine to individuals with a history of anaphylactic/anaphylactoid or severe allergic reaction to any component of the vaccine.</p>', '<p>The most common adverse reactions, reported in &gt;10% of subjects vaccinated with p neumococcal vaccine for the first time in a clinical trial, were: injection-site pain/soreness/tenderness (60.0%), injection-site swelling/ induration (20.3%), headache (17.6%), injection-site erythema (16.4%), asthenia and fatigue (13.2%), and myalgia (11.9%).</p>', '<p><strong>Pregnancy</strong>: All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15- 20%, respectively. Available human data from clinical trials of Pneumococcal Vaccine in pregnancy have not established the presence or absence of a vaccine-associated risk. Developmental toxicity studies have not been conducted with Pneumococcal Vaccine in animals.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether Pneumococcal Vaccine is excreted in human milk. Data are not available to assess the effects of Pneumococcal Vaccine on the breastfed infant or on milk production/excretion. The developmental and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for Pneumococcal Vaccine and any potential adverse effects on the breastfed child from Pneumococcal Vaccine&nbsp;or from the underlying maternal condition. For preventive vaccines, the underlying maternal condition is susceptibility to the disease prevented by the vaccine.</p>', '<p><strong>Persons with Moderate or Severe Acute Illness</strong>: Defer vaccination with Pneumococcal Vaccine in persons with moderate or severe acute illness.<br />\r\n<br />\r\n<strong>Persons with Severely Compromised Cardiovascular or Pulmonary Function</strong>: Caution and appropriate care should be exercised in administering Pneumococcal Vaccine to individuals with severely compromised cardiovascular and/or pulmonary function in whom a systemic reaction would pose a significant risk.<br />\r\n<br />\r\n<strong>Use of Antibiotic Prophylaxis</strong>: This vaccine does not replace the need for penicillin (or another antibiotic) prophylaxis against pneumococcal infection. In patients who require penicillin (or another antibiotic) prophylaxis against pneumococcal infection, such prophylaxis should not be discontinued after vaccination with Pneumococcal Vaccine.<br />\r\n<br />\r\n<strong>Persons with Altered Immunocompetence</strong>: Persons who are immunocompromised, including persons receiving immunosuppressive therapy, may have a diminished immune response to Pneumococcal Vaccine.<br />\r\n<br />\r\n<strong>Persons with Chronic Cerebrospinal Fluid Leakage</strong>: Pneumococcal Vaccine&nbsp;may not be effective in preventing pneumococcal meningitis in patients who have chronic cerebrospinal fluid (CSF) leakage resulting from congenital lesions, skull fractures, or neurosurgical procedures.</p>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', '<p>Store refrigerated at 2&deg; to 8&deg;C. Protect vials from light.</p>', '<p><strong>Pediatrics</strong>: Pneumococcal vaccine is not approved for use in children younger than 2 years of age because children in this age group do not develop an effective immune response to capsular types contained in the polysaccharide vaccine.<br />\r\n<br />\r\n<strong>Geriatrics</strong>: For subjects aged 65 years or older in a clinical study systemic adverse reactions, determined by the investigator to be vaccine-related, were higher following revaccination (33.1%) than following initial vaccination (21.7%). Routine revaccination of immunocompetent persons previously vaccinated with a 23-valent vaccine is not recommended.</p>', '2022-03-16 04:00:23', '2022-03-16 04:00:23'),
(1245, 1245, '<p>Ponatinib is a kinase inhibitor indicated for the:</p>\r\n\r\n<ul>\r\n	<li>Treatment of adult patients with chronic phase, accelerated phase, or blast phase chronic myeloid leukemia (CML) or Ph+ ALL for whom no other tyrosine kinase inhibitor (TKI) therapy is indicated.</li>\r\n	<li>Treatment of adult patients with T315I-positive CML (chronic phase, accelerated phase, or blast phase) or T315I-positive Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL).</li>\r\n</ul>', '<p>Ponatinib is a kinase inhibitor. Ponatinib inhibited the in vitro tyrosine kinase activity of ABL and T315I mutant ABL with IC 50 concentrations of 0.4 nM and 2.0 nM, respectively. Ponatinib inhibited the in vitro activity of additional kinases with IC 50 concentrations between 0.1 nM and 20 nM, including members of the VEGFR, PDGFR, FGFR, EPH receptors and SRC families of kinases, and KIT, RET, TIE2, and FLT3. Ponatinib inhibited the in vitro viability of cells expressing native or mutant BCR-ABL, including T315I. In mice, treatment with ponatinib reduced the size of tumors expressing native or T315I mutant BCR-ABL when compared to controls.</p>', '<p><strong>Recommended dose</strong>: 45 mg taken orally once daily with or without food<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: 30 mg orally once daily. Modify or interrupt dosing for hematologic and non-hematologic toxicity.</p>', NULL, '<p>None.</p>', '<p>The most common non-hematologic adverse reactions (&ge;20%) were, abdominal pain, rash, constipation, headache, dry skin, arterial occlusion, fatigue, hypertension, pyrexia, arthralgia, nausea, diarrhea, lipase increased, vomiting, myalgia and pain in extremity.</p>', '<p>Based on its mechanism of action and findings in animals, Ponatinib can cause fetal harm when administered to a pregnant woman. There are no available data on Ponatinib use in pregnant women. In animal reproduction studies, oral administration of ponatinib to pregnant rats during organogenesis caused adverse developmental effects at doses lower than human exposures at the recommended human dose. Advise pregnant women of the potential risk to a fetus.<br />\r\n<br />\r\nThere is no data on the presence of ponatinib in human milk, the effects on the breastfed infant or on milk production.</p>', NULL, NULL, '<p>Tyrosine Kinase Inhibitor.</p>', '<p>Store Ponatinib at room temperature between 20&deg; C to 25&deg; C.</p>', '<p>Pediatric Use: Safety and effectiveness have not been established in pediatric patients.</p>', '2022-03-16 04:02:18', '2022-03-16 04:02:18'),
(1246, 1246, '<p>Posaconazole is indicated in patients aged 13 years and above for the treatment of the following fungal infections:</p>\r\n\r\n<ul>\r\n	<li>Invasive aspergillosis in patients with disease that is refractory or intolerant to Amphotericin B or Itraconazole</li>\r\n	<li>Fusariosis in patients with disease that is refractory or intolerant to Amphotericin B</li>\r\n	<li>Chromoblastomycosis and mycetoma in patients with disease that is refractory or intolerant to Itraconazole</li>\r\n	<li>Coccidioidomycosis in patients with disease that is refractory or intolerant to Amphotericin B, Itraconazole or Fluconazole or in patients who are intolerant of these medicinal products.</li>\r\n</ul>\r\n\r\n<p>Also indicated for prophylaxis of invasive fungal infections in the following patients:</p>\r\n\r\n<ul>\r\n	<li>Patients receiving remission-induction chemotherapy for Acute Myelogenous Leukemia (AML) or Myelodysplastic Syndromes (MDS) expected to result in prolonged neutropenia and who are at high risk of developing invasive fungal infections</li>\r\n	<li>Hematopoietic Stem Cell Transplant (HSCT) recipients who are undergoing high-dose immunosuppressive therapy for graft versus host disease and who are at high risk of developing invasive fungal infections Refractoriness is defined as progression of infection or failure to improve after a minimum of 7 days of prior therapeutic doses of effective antifungal therapy</li>\r\n</ul>', '<p>Posaconazole blocks the synthesis of ergosterol, a key component of the fungal cell membrane. It inhibits the cytochrome P-450 dependent enzyme Lanosterol 14-&alpha;-demethylase responsible for the conversion of lanosterol to ergosterol in the fungal cell membrane. This results in an accumulation of methylated sterol precursors and a depletion of ergosterol within the cell membrane, thus weakening the structure and function of the fungal cell membrane.</p>', '<p>Posaconazole Tablets can be taken with or without food. The tablets should be swallowed whole with water and should not be crushed, chewed, or broken.<br />\r\n<br />\r\n<strong>Loading Dose</strong>: 300 mg (3 Tablets) twice a day on the first day.<br />\r\n<br />\r\n<strong>Maintenance Dose</strong>: 300 mg (3 Tablets) once a day from the second day.<br />\r\n<br />\r\nDuration of therapy should be based on the severity of the underlying disease, recovery from immunosuppression and clinical response.</p>', '<p>Posaconazole is an inhibitor of CYP3A4 and should only be used under specific circumstances during treatment with other medicinal products that are metabolized by CYP3A4 like Midazolam, Triazolam, Alprazolam. Posaconazole concentrations may be significantly lowered in combination with Rifamycin antibacterials (Rifampicin, Rifabutin), certain anticonvulsants (Phenytoin, Carbamazepine, Phenobarbital, Primidone and Efavirenz).</p>', '<p>Posaconazole is contraindicated in persons with known hypersensitivity to Posaconazole or other azole antifungal agents. Co-administration with ergot alkaloids, CYP3A4 substrates, Terfenadine, Astemizole, Cisapride, Pimozide, Halofantrine or Quinidine since this may result in increased plasma concentrations of these medicinal products leading to QTc prolongation and rare occurrences of torsades de pointes, HMG-CoA reductase inhibitors simvastatin, lovastatin and atorvastatin is contraindicated.</p>', '<p>Common treatment-emergent adverse reactions in studies with Posaconazole are diarrhea, nausea, fever, vomiting, headache, coughing and hypokalemia.</p>', '<p>Posaconazole must not be used during pregnancy unless the benefit to the mother clearly outweighs the potential risk to the fetus. Breast-feeding must be stopped on initiation of treatment with this drug.</p>', NULL, NULL, '<p>Aural Anti-fungal preparations.</p>', '<p>Store below 25&deg;C. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients below the age of 13 years has not been established. Therefore, Posaconazole is not recommended for pediatric patients less than 13 years of age.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No dose adjustment is necessary for geriatric patients.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Posaconazole should be used with caution in patients with hepatic impairment due to limited clinical experience and the possibility that posaconazole plasma levels may be higher in these patients. Liver function tests should be evaluated at the start of and during the course of posaconazole therapy.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No dose adjustment is required in patients with mild (eGFR: 50-80 mL/min/1.73 m2) to moderate renal impairment (eGFR: 20-49 mL/min/1.73 m2). Patients with severe renal impairment should be monitored closely for breakthrough fungal infections.</p>', '2022-03-16 04:05:42', '2022-03-16 04:05:42'),
(1247, 1247, '<p>Potassium Chloride is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Replacement of potassium deficit</li>\r\n	<li>Diuretic (Potassium losing)-induced hypokalaemia</li>\r\n	<li>Hypokalaemia from renal potassium wasting</li>\r\n	<li>Hypokalaemia from gastrointestinal losses</li>\r\n	<li>Hypochloraemic alkalosis associated with hypokalaemia</li>\r\n</ul>', '<p>Potassium Chloride is used for the treatment of hypokalaemia and of potassium deficiency states. Potassium ion is the principal intracellular cation of most body tissues. It participates in a number of essential physiological processes, including the maintenance of intracellular tonicity, the transmission of nerve impulses, the contraction of cardiac, skeletal and smooth muscle and the maintenance of normal renal function.</p>', '<p><strong>Oral dose</strong>: It should be taken with or after meals with plenty of fluid (water/fruit juice). Typical doses for the prevention of hypokalaemia may be upto 50 mmol (about 37.5 mL) daily by mouth. Oral treatment may be suitable in some cases of hypokalaemia and similar doses to those used for prevention may be adequate in mild potassium deficiency. However, higher doses may be needed in more severe deficiency.<br />\r\n<br />\r\n<strong>Parenteral dose</strong>: Intravenous administration may be required in acute hypokalaemia. One ampoule (10 mL) i.e. 1.5 gm (20 mmol k+) may be added to 500 mL of sodium chloride or glucose intravenous infusion and given slowly over 2 to 3 hours with specialist advice and ECG monitoring in difficult cases. Repeated measurements of potassium are necessary to determine whether further infusions are required and to avoid the development of hyperkalaemia. This is especially liable to occur in renal impairment.</p>', '<p>Combined treatment with the following increase the risk of hyperkalaemia: Angiotensin-converting enzyme inhibitors, cyclosporin, NSAIDs, beta-blockers, heparin, digoxin, potassium-sparing diuretics.</p>', '<p>Hypersensitivity to potassium administration e.g. hyperkalaemic periodic paralysis, congenital paramyotonia, marked renal failure (even when not yet associated with manifest hyperkalaemia), untreated Addison&#39;s disease, hyporeninaemic hypoaldosteronism, acute dehydration, hyperkalaemia and conditions involving extensive cell destruction (e.g. severe burns). In case of metabolic acidosis, the hypokalaemia should be treated not with potassium chloride.</p>', '<p>Excessive administration of potassium leads to development of hyperkalaemia, the symptoms of which include paraesthesia of the extremitis, muscle weakness, paralysis, hypotension, cardiac arrhythmias, heart block and cardiac arrest. Pain or phlebitis may occur during I.V. administration of solutions containing about 30 mmol or more potassium per litre. Nausea, vomiting, diarrhoea and abdominal cramps may occur following oral administration.</p>', '<p>As a general rule, no drugs should be taken during the first three months of pregnancy and the risks &amp; benefits of taking drugs should be carefully considered throughout pregnancy. There are no contraindications to breastfeeding while taking potassium salts.</p>', '<p>It should be administered with caution to patients with renal or adrenocortical insufficiency, cardiac disease, acute dehydration, heat cramps, extensive tissue destruction as occurs with severe burns, or to patients receiving potassium-sparing diuretics. Excessive use of potassium-containing salt substitutes or concurrent administration with potassium supplements may lead to accumulation of potasssium especially in patients with renal insufficiency. Attention should be paid to the concurrent use of other drugs that either contain potassium or have the potential for hyperkalaemia. Treatment should be discontinued if severe nausea, vomiting or abdominal distress develops.</p>', NULL, '<p>Electrolytes preparations, Oral electrolytes preparations.</p>', '<p>Store below 25&deg;C in a dry place, away from light. Keep out of the reach of children.</p>', '<p>Use in children: No special precautions are required.</p>', '2022-03-16 04:08:25', '2022-03-16 04:08:25');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1248, 1248, '<p>This preparation is indicated in the following cases:</p>\r\n\r\n<ul>\r\n	<li>To relieve discomfort in urinary tract infections</li>\r\n	<li>To prevent kidney stone</li>\r\n	<li>With uricosuric agent to prevent gout</li>\r\n	<li>Acidosis caused by kidney diseases</li>\r\n</ul>', '<p>Potassium Citrate and Citric Acid oral solution is a stable and pleasant-tasting oral systemic alkalizer. Potassium Citrate is absorbed and metabolized to Potassium Bicarbonate, thus acting as a systemic alkalizer. This product alkalinizes the urine without producing a systemic alkalosis in recommended doses. It is highly palatable, pleasant tasting and tolerable, even when administered for long periods. Potassium Citrate does not neutralize the gastric juice or disturb digestion.</p>', '<p>To relieve discomfort in UTI:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children over 6 years</strong>: 10 ml 3 times daily, diluted with 1 glass of water.</li>\r\n	<li><strong>Children 1-6 years</strong>: 5 ml 3 times daily, diluted with &frac12; glass of water.</li>\r\n</ul>\r\n\r\n<p>To prevent kidney stones, With a uricosuric agent to prevent gout, Acidosis caused by kidney diseases:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 10-15 ml 4 times daily (or as directed by the physician) diluted with 1 glass of water.</li>\r\n	<li><strong>Pediatric</strong>: 5-10 ml 4 times daily (or as directed by the physician) diluted with &frac12; glass of water.</li>\r\n</ul>', '<p>Concurrent administration of potassium-containing medication, potassium-sparing diuretics, angiotensin-converting enzyme (ACE) inhibitors or cardiac glycosides may lead to toxicity.</p>', '<p>The drug is contraindicated in severe renal impairment with oliguria or azotemia, untreated Addison&#39;s disease, acute dehydration, severe myocardial damage and hyperkalemia from any cause.</p>', '<p>This solution is generally well tolerated without any unpleasant side effect when given in recommended doses to patients with normal renal function and urinary output. However, as with any alkalinizing agent, caution must be used in certain patients with abnormal renal mechanisms to avoid development of hyperkalemia or alkalosis. Potassium intoxication causes listlessness, weakness, mental confusion, tingling of extremities and other symptoms associated with a high concentration of Potassium in the serum.</p>', '<p>No information is available regarding the use of this drug during pregnancy and lactation.</p>', '<p>The solution should be used with caution in patients with low urinary output. It should be diluted adequately with water to minimize the possibility of gastrointestinal injury associated with the oral ingestion of concentrated Potassium salt preparations; and preferably, to take each dose after meals. Large doses may cause hyperkalemia and alkalosis, especially in the presence of renal disease.</p>', '<p>The administration of oral Potassium salts to persons with normal excretory mechanisms for potassium rarely causes serious hyperkalemia. However, if excretory mechanisms are impaired, hyperkalemia can result. Hyperkalemia, when detected, must be treated immediately because lethal levels can be reached in a few hours. If hyperkalemia occurs, treatment measures will include the followings: (1) Elimination of foods or medications containing potassium. (2) The intravenous administration of 300 to 500 ml/hr of dextrose solution (10 to 25%), containing 10 units of insulin/20 gm dextrose. (3) The use of exchange resins, hemodialysis or peritoneal dialysis.</p>', '<p>Prevention of repeated kidney stone formation, Urinary Alkalinizing Agent.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-16 04:10:35', '2022-03-16 04:10:35'),
(1249, 1249, '<p><strong>Cream or ointment</strong>:<br />\r\nTherapeutically: As an adjunct to systemic therapy in the following indications-</p>\r\n\r\n<ul>\r\n	<li>Primary or secondary topical infections</li>\r\n	<li>Infected surgical incisions</li>\r\n	<li>Infected decubitus or stasis ulcers</li>\r\n	<li>Pyodermas</li>\r\n	<li>Secondarily infected dermatoses</li>\r\n	<li>Infected traumatic lesions</li>\r\n</ul>\r\n\r\n<p>Prophylactically:</p>\r\n\r\n<ul>\r\n	<li>To prevent microbial contaminations in burns, incisions and other topical lesions</li>\r\n	<li>For degerming skin in hyperalimentation, the umbilical area or circumcision</li>\r\n	<li>Its use for abrasions, minor cuts, and wounds prevents the development of infections and permits wound healing.</li>\r\n</ul>\r\n\r\n<p><strong>Solution</strong>:</p>\r\n\r\n<ul>\r\n	<li>For the prevention and treatment of surface infections as well as to degerm the skin, mucous membrane and hyperalimentation procedures</li>\r\n	<li>For seborrhea</li>\r\n	<li>For preoperative and postoperative scrubbing and washing of hospital operating room and equipments</li>\r\n	<li>For preoperative prepping of operative site, including the vagina</li>\r\n	<li>For disinfection of wounds, burns, lacerations and abrasions</li>\r\n	<li>As a prophylactic anti-infective agent in house, hospital &amp; office procedures</li>\r\n	<li>Postoperative application to incisions to help prevent infection</li>\r\n	<li>In oral moniliasis (thrush); bacterial and mycotic skin infections, decubitus &amp; stasis ulcers</li>\r\n	<li>As a preoperative swab in the mouth &amp; throat</li>\r\n</ul>\r\n\r\n<p><strong>Gargle &amp; Mouthwash</strong>: It is a pleasantly flavoured solution which is used:</p>\r\n\r\n<ul>\r\n	<li>For the treatment of acute mucosal infections of the mouth and pharynx.</li>\r\n	<li>For oral hygiene prior to, during and after dental and oral surgery.</li>\r\n</ul>\r\n\r\n<p><strong>Surgical Scrub</strong>: It is a golden surfactant solution, forms rich, golden lather which is used: As an antiseptic skin cleanser for preoperative and postoperative scrubbing and washing by surgeons and operation theatre staff and preoperative preparation of patients&#39; skin<br />\r\n<br />\r\n<strong>Powder</strong>: It is used for topical application in the following indications: Superficial wounds, Minor cuts, Burns, Abrasions, Lacerations, In the treatment and prevention of infections.<br />\r\n<br />\r\n<strong>Ophthalmic Solution</strong>: Povidone is used for the symptomatic treatment of dry eye conditions including keratoconjunctivitis sicca. It is also given as a substitute for tear fluid in case of the unstable tear film or insufficient moistening of the eye surface.</p>', '<p>Povidone Iodine is a complex of iodine and an organic polymer, povidone. This polymerization makes Povidone Iodine superior to ordinary elemental iodine. It prolongs the germicidal activity of iodine by liberating elemental iodine slowly. Consequently it has a lower toxicity than elemental iodine. It gives rapid microbicidal activity against both Gram-positive and Gram-negative bacteria, protozoa, viruses and fungi/yeasts. It is also sporicidal. It is the only microbicide with this broad spectrum of activity. It is non-staining, exerts prolong germicidal action and is also active in the presence of soap, blood, serum, pus, mucosal secretions and water.</p>', '<p><strong>Cream or ointment</strong>:</p>\r\n\r\n<ul>\r\n	<li>For the treatment of infection: Apply once or twice daily or at dressing changes for a maximum of 14 days.</li>\r\n	<li>For the prevention of infection: Apply once or twice a week for as long as necessary. The affected skin should be cleaned and dried and can be covered with a dressing or bandage.</li>\r\n</ul>\r\n\r\n<p><strong>Solution</strong>: Apply full strength as often as needed as paint, spray, or wet soak. Maybe bandaged (where necessary).<br />\r\n<br />\r\n<strong>Gargle &amp; Mouthwash</strong>: Adults and children over 6 years of age: Use undiluted or diluted with an equal volume of warm water. Gargle or rinse with up to 10 mL for up to 30 seconds without swallowing. Repeat up to four times daily, for up to 14 consecutive days, or as advised by the Registered Dental Surgeon/Physician.<br />\r\n<br />\r\n<strong>Surgical Scrub</strong>:</p>\r\n\r\n<ul>\r\n	<li>For Preoperative and Postoperative washing by Operating Personnel: Wet hands and forearms with water. Pour about 5 mL of Povidone Iodine Surgical Scrub on the palm of the hand and spread over both hands and forearms. Without adding more water, rub the Scrub thoroughly over all areas for about five minutes. Use a brush if desired. Clean thoroughly under fingernails. Add a little water and develop copious suds. Rinse thoroughly under running water. Complete the wash by scrubbing with another 5 mL of Povidone Iodine Surgical Scrub in the same way.</li>\r\n	<li>For Preoperative use on Patients: After the skin area is shaved, wet it with water. Apply Povidone Iodine Surgical Scrub (1 mL is sufficient to cover an area of 20-30 square inches), develop lather and scrub thoroughly for about five minutes. Rinse off by aid of sterile gauze saturated with water.</li>\r\n	<li>For use in the Physician&#39;s Office: Use for washing whenever a germicidal soap is required.</li>\r\n</ul>\r\n\r\n<p><strong>Powder</strong>: Apply a light dusting of powder to the affected area. When dry, this forms a protective antiseptic layer over the area treated. Or use as advised by the Registered Physician. There are no special dosage recommendations for children or elderly patients.<br />\r\n<br />\r\n<strong>Ophthalmic Solution</strong>: 1 drop 4 times daily or as required, depending upon the severity of the disease, to be instilled into the conjunctival sac.</p>', '<p>It exhibits interaction with strong alkali, sodium thiosulphate, sodium metabisulphite and thiomersal. Use with concurrent lithium therapy has been shown to exhibithypothyroidic effect.</p>', '<p>It can cause hypersensitivity reactions. Regular use in patients with thyroid disorders (in particular nodular colloid goitre, endemic goitre and Hashimoto&#39;s thyroiditis) or those receiving lithium therapy is to be avoided. In severely burnt patients serum iodide levels should be assessed due to possible hepatic and renal impairment. Povidone Iodine Powder should not be used in serious cavities and in Children under the age of 2 years.</p>', '<p>Povidone Iodine may cause hypersensitivity reactions and irritation of the skin and mucous membranes. The application of povidone Iodine to severe burns or to large areas otherwise denuded of skin may produce systemic adverse effects such as metabolic acidosis, hypernatraemia, and impairment of renal function. It may interfere with thyroid function tests.</p>', '<p>Povidone Iodine Cream, Solution &amp; Powder are not recommended for use during pregnancy because of the possibility of absorption of sufficient iodine to affect the fetal thyroid. American Academy of Pediatrics considers that the use of Povidone-Iodine is usually compatible with breast feeding. Consult Registered Physician. Regular use of Gargle &amp; Mouthwash and Surgical Scrub should also be avoided in pregnant and lactating women.<br />\r\n<br />\r\nThere is no experience regarding the safety of the Povidone eye drops in human pregnancy or lactation. Administration during pregnancy and lactation is therefore not recommended, except for compelling reasons.</p>', '<p><strong>Cream or ointment</strong>: In case of deep or puncture wounds or serious burns, consult Registered Physician. If redness, irritation, swelling or pain persists or increases or if infection occurs, discontinue use and consult Registered Physician.<br />\r\n<br />\r\n<strong>Solution</strong>: In preoperative prepping, avoid &#39;pooling&#39; beneath the patient. Prolonged exposure to wet solution may cause irritation or rarely, severe skin reactions. In case of deep or puncture wounds or serious burns, consult Registered Physician. If redness, irritation, swelling or pain persists or increases or if infection occurs, discontinue use and consult Registered Physician.<br />\r\n<br />\r\n<strong>Gargle &amp; Mouthwash</strong>: Regular use should be avoided as prolonged use may lead to the absorption of a significant amount of iodine. Do not use for more than 14 days. If sores or ulcers in the mouth do not heal within 14 days seek dental or medical advice. It is also not for use in children under 6 years of age. Regular use should be avoided in patients on concurrent lithium therapy.<br />\r\n<br />\r\n<strong>Surgical Scrub</strong>: Special caution is needed when regular applications to broken skin are made to patients with pre-existing renal insufficiency. Regular use should be avoided in patients on concurrent lithium therapy. It can permanently discolor white gold jewellery and it is recommended that this type of jewellery should be removed before using this product.<br />\r\n<br />\r\n<strong>Powder</strong>: Care must be taken when used on known iodine sensitivity, although do not normally react to Povidone-Iodine. Excess powder can be washed off readily with warm water. It should be used directly from the container. Not to be administered internally.<br />\r\n<br />\r\n<strong>Ophthalmic Solution</strong>: Patients, who experience blurred vision after application of the eye drops, should not drive or use machinery until their vision has cleared. Contact lenses should not be worn during the instillation of the drug. After instillation, there should be an interval of at least 30 minutes before reinsertion.</p>', NULL, '<p>Iodine compounds (Anti-septic Preparations).</p>', '<p>Store below 25&deg;C. Do not freeze. Store in a cool and dry place, protected from light. Keep out of the reach of children. Do not touch the ophthalmic solution dropper tip to any surface as this may contaminate this preparation. Do not use it after one month of the first opening.</p>', NULL, '2022-03-16 04:12:39', '2022-03-16 04:12:39'),
(1250, 1250, '<p>Pralidoxime chloride is indicated as an antidote:</p>\r\n\r\n<ul>\r\n	<li>In the treatment of poisoning due to those pesticides and chemicals (e.g., nerve agents) of the organophosphate class which have anticholinesterase activity and</li>\r\n	<li>In the control of overdosage by anticholinesterase drugs used in the treatment of&nbsp;myasthenia gravis.</li>\r\n</ul>\r\n\r\n<p>The principal indications for the use of Pralidoxime chloride are muscle weakness and respiratory depression. In severe poisoning, respiratory depression may be due to muscle weakness.</p>', '<p>Pralidoxime reactivates cholinesterase outside the CNS that had been inactivated by phosphorylation due to exposure to certain organophosphates by displacing the enzyme from its receptor sites. It removes the phosphoryl group from the active site of the inactivated enzyme by nucleophilic attack, regenerating active cholinesterase and forming an oxime complex. It also detoxifies certain organophosphates by direct chemical reaction.</p>', '<p>Intramuscular-</p>\r\n\r\n<p>Organophosphorus poisoning:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Mild: 600 mg, repeat 1-2 times at 15 min intervals as needed. Severe: 1.8 g given as 3 inj of 600 mg in rapid succession. Persistent: May repeat the entire series (1.8 g) beginning 1 hr after admin of the last inj.</li>\r\n	<li><strong>Child</strong>:&nbsp;&lt;40 kg: Mild: 15 mg/kg, repeat as needed every 15 min. Max: 45 mg/kg. Severe: 15 mg/kg, repeat twice in rapid succession to a total dose of 45 mg/kg. Persistent: May repeat the entire series (45 mg/kg) beginning 1 hr after admin of the last inj; &ge;40 kg: Same as adult dose.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Intravenous-</p>\r\n\r\n<p>Organophosphorus poisoning:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;In combination with atropine: Loading dose: 1-2 g by infusion over 15-30 min or slow inj over at least 5 min, may repeat dose after 1 hr then 10-12 hrly, as needed. Administer as soon as the effects of atropine are observed. Maintain atropinisation for at least 48 hr.</li>\r\n	<li><strong>Child:</strong>&nbsp;&le;16 yr Loading dose: 20-50 mg/kg (max: 2 g/dose) by inj over 15-30 min followed by 10-20 mg/kg/hr as continuous infusion. Alternatively, a repeat bolus of 20-50 mg/kg after 1 hr and repeated 10-12 hrly as needed; &gt;16 yr Same as adult dose.</li>\r\n</ul>\r\n\r\n<p>Poisoning or overdosage with compounds having muscarinic actions:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initially, 1-2 g, followed by 0.5-1 g/hr as infusion. Alternatively, the initial dose may be repeated after 1 hr and then 3-8 hrly as needed.</li>\r\n</ul>', NULL, '<p>There are no known absolute contraindications for the use of Pralidoxime Chloride. Relative contraindications include known hypersensitivity to the drug and other situations in which the risk of its use clearly outweighs possible benefit.</p>', '<p>Drowsiness, dizziness, visual disturbances, nausea, HTN, tachycardia, headache, hyperventilation, muscle weakness, impaired renal function, elevated liver enzymes, transient increase in creatine phosphokinase, transient neuromuscular blockade; mild to moderate pain at inj site.</p>', '<p><strong>Pregnancy&nbsp;</strong>Category C.&nbsp;Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Patient with myasthenia gravis receiving anticholinesterase agents. Not indicated in the treatment of poisoning due to phosphorous, inorganic phosphates, or organophosphates without anticholinesterase activity and carbamate pesticides. Renal impairment. Pregnancy and lactation.</p>', '<p><strong>Manifestations of Overdosage</strong>: Observed in normal subjects only: dizziness, blurred vision, diplopia, headache, impaired accommodation, nausea, slight tachycardia. In therapy it has been difficult to differentiate side effects due to the drug from those due to the effects of the poison.</p>', '<p>Antidote preparations.</p>', '<p>Store between 20-25&deg; C.</p>', NULL, '2022-03-16 04:14:45', '2022-03-16 04:14:45'),
(1251, 1251, '<p>Pramipexole is indicated for the treatment of-</p>\r\n\r\n<ul>\r\n	<li>Parkinson&#39;s disease used alone or as an adjunct to levodopa with dopa-decarboxylase inhibitor</li>\r\n	<li>Moderate to severe restless legs syndrome</li>\r\n</ul>', '<p>The exact mechanism of action of pramipexole as a treatment for Parkinson&#39;s disease is unknown at this time. It is thought, however, that the ability of pramipexole to cause stimulation of the dopamine receptors in the striatum of the brain, a region that receives a vast array of neurological input and is responsible for a wide variety of functions, may be involved. Studies performed in animals show that pramipexole influences striatal neuronal transmission rates following activation of dopamine receptors. Pramipexole is considered a non-ergot dopamine agonist that shows specificity and strong activity at the D2 subfamily of dopamine receptors in vitro, binding selectively and dopamine D2 receptors and showing a preference for the dopamine D3 receptor subtype rather than other subtypes. The clinical significance of this binding specificity is unknown.</p>', '<p>The recommended dose of Pramipexole is as follows-<br />\r\n<br />\r\nParkinson&#39;s disease:</p>\r\n\r\n<ul>\r\n	<li><strong>Initial&nbsp;dose</strong>: 88 micrograms 3 times daily, dose doubled every 5-7 days if tolerated to 350 micrograms 3 times daily; further increased if necessary by 180 micrograms 3 times daily at weekly intervals</li>\r\n	<li><strong>Maximum dose</strong>: 3.3 mg daily in 3 divided doses. During pramipexole dose titration and maintenance Levodopa dose should be reduced.</li>\r\n</ul>\r\n\r\n<p>Restless legs syndrome:</p>\r\n\r\n<ul>\r\n	<li><strong>Initial dose</strong>: 88 micrograms once daily 2-3 hours before bedtime, dose doubled every 4-7 days if necessary to 350 micrograms daily.</li>\r\n	<li><strong>Maximum dose</strong>: 540 micrograms daily.</li>\r\n</ul>\r\n\r\n<p>Use in children: Pramipexole is not recommended for children below 18 years of age.</p>', '<p>Pramipexole is the only dopamine agonist not appreciably metabolized by the P450 system which minimizes about possible drug-drug interactions. Cimetidine and amantadine may reduce the renal clearance of pramipexole. Sedating medicinal products or alcohol in&nbsp;combination with pramipexole may cause additive effects.</p>', '<p>Pramipexole is contraindicated in patients with known Hypersensitivity to the active substance or to any of the excipients.</p>', '<p>The common side effects are dizziness, dyskinesia, nausea, hypotension, abnormal dreams, confusion, constipation, delusion, hallucinations, headache, hyperkinesia, increased eating (binge eating, hyperphagia), insomnia, libido disorders, nausea, peripheral oedema, paranoia, pathological gambling, hypersexuality and other abnormal behaviour, somnolence, weight increase, sudden onset of sleep, pruritus and rash and other hypersensitivity.</p>', '<p>The effect of pramipexole on pregnancy and lactation has not been investigated in humans so it should be used during pregnancy only if the potential benefit justifies the potential risk to the foetus. Pramipexole inhibits secretion of prolactin in humans. The excretion of pramipexole into breast milk has not been studied in women so it should not be used during breast-feeding. However, if its use is unavoidable then breast-feeding should be discontinued.</p>', '<p>Caution should be taken in patients with psychotic disorder, ophthalmologic monitoring is recommended at regular intervals, severe cardiovascular disease and&nbsp;renal impairment.</p>', '<p>There is no clinical experience with massive overdose. Symptoms of overdose are nausea, vomiting, hyperkinesia, hallucinations, agitation and hypotension. There is no established antidote. If signs of central nervous system stimulation are present, a neuroleptic agent may be indicated. Management of the overdose may require general supportive measures, along with gastric lavage, intravenous fluids, administration of activated charcoal and electrocardiogram monitoring.</p>', '<p>Antiparkinson drugs.</p>', '<p>Store in a cool and dry place. Protect from light.</p>', NULL, '2022-03-16 04:19:09', '2022-03-16 04:19:09'),
(1252, 1252, '<p>For temporary relief of pain and itching associated with minor burns, sunburns, minor cuts, scrapes, insect bites, minor skin irritations and rashes.</p>', '<p>Pramoxine Hydrochloride blocks Na+&nbsp;ion channel in neuronal cell membrane and prevents pain transmission, thereby effecting local anesthetic action. Calamine causing a cooling sensation and provides anti-itching action.</p>', '<p><strong>Adults and children 2 years of age and older</strong>: Apply to affected area not more than 3 to 4 times daily.<br />\r\n<br />\r\n<strong>Children under 2 years of age</strong>: Consult with a doctor.</p>', '<p>No significant interactions known or found for this cream. Caution always advised with multiple medications.</p>', NULL, '<p>Local skin reaction, e.g. anaphylactoid, burning, stinging, contact dermatitis, tenderness, urticaria, skin peeling and skin lesions.</p>', '<p>Pregnancy Category: Undetermined. No safety information is available on the use of this product during pregnancy and lactation. Pregnant and breastfeeding patients should seek advice of health professional before using this cream.</p>', '<p>This preparation is for topical use only. Avoid contact of this medicine with the eyes, nose, ears and mouth. If the medication gets in these areas, wipe it off and rinse immediately with water. Stop using this medication and tell your doctor if your condition worsens, if symptoms do not improve within 7 days or persist after 7 days of treatment or if symptoms clear up and return in a few days. Do not apply to wound or damage skin and not bandage tightly in the affected area. This medicine may be harmful if swallowed. If swallowed get medical help or contact a poison center immediately.</p>', NULL, '<p>Topical Analgesics.</p>', '<p>This cream should be stored at room temperature of 20&deg;C - 25&deg;C. Keep out of the reach of children.</p>', NULL, '2022-03-16 04:21:28', '2022-03-16 04:21:28'),
(1253, 1253, '<p>Prasugrel is indicated to reduce the rate of thrombotic cardiovascular (CV) events (including stent thrombosis) in patients with acute coronary syndrome (ACS) who are to be managed with percutaneous coronary intervention (PCI) as follows:</p>\r\n\r\n<ul>\r\n	<li>Patients with unstable angina (UA) or non-ST-elevation myocardial infarction (NSTEMI).</li>\r\n	<li>Patients with ST-elevation myocardial infarction (STEMI) when managed with primary or delayed PCI.</li>\r\n</ul>', '<p>Prasugrel is an inhibitor of platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y12 class of ADP receptors on platelets.</p>', '<p>Treatment should be initiated with a single 60 mg oral loading dose. Continue at 10 mg once daily with or without food. Consider 5 mg once daily for patients &lt;60 kg. Patients should also take aspirin (75 mg to 325 mg) daily.</p>', '<ul>\r\n	<li>Coadministration of Prasugrel and warfarin increases the risk of bleeding.</li>\r\n	<li>Coadministration of Prasugrel and NSAIDs (used chronically) may increase the risk of bleeding.</li>\r\n	<li>Prasugrel can be administered with drugs that are inducers or inhibitors of cytochrome P450 enzymes. Prasugrel can be administered with aspirin (75 mg to 325 mg per day), heparin, GPIIb/IIIa inhibitors, statins, and drugs that elevate gastric pH, including proton pump inhibitors and H2 blockers.</li>\r\n</ul>', '<ul>\r\n	<li>Active pathological bleeding such as peptic ulcer or intracranial haemorrhage.</li>\r\n	<li>Patient with a history of prior transient ischemic attack or stroke</li>\r\n</ul>', '<ul>\r\n	<li>Bleeding</li>\r\n	<li>Thrombotic thrombocytopenic purpura</li>\r\n	<li>Other side effects (Headache, back pain, dyspnea, nausea, hypertension, bradycardia, rash etc)</li>\r\n</ul>', '<p>There are no adequate and well-controlled studies of Prasugrel use in pregnant women. Reproductive and developmental toxicology studies in rats and rabbits at doses of up to 30 times the recommended therapeutic exposures in humans revealed no evidence of fetal harm; however, animal studies are not always predictive of a human response.<br />\r\n<br />\r\nIt is not known whether Prasugrel is excreted in human milk. Because many drugs are excreted in human milk, Prasugrel should be used during nursing only if the potential benefit to the mother justifies the potential risk to the nursing infant.</p>', '<ul>\r\n	<li>CABG-related bleeding: Risk increases in patients receiving Prasugrel who undergo CABG.</li>\r\n	<li>Discontinuation of Prasugrel: Premature discontinuation increases risk of stent thrombosis, MI, and death</li>\r\n</ul>', '<p>In rats, lethality was observed after administration of 2000 mg/kg. Platelet transfusion may restore clotting ability. The prasugrel active metabolite is not likely to be removed by dialysis.</p>', '<p>Anti-platelet drugs.</p>', '<p>Keep in dry place and away from light and heat. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Patients &gt; 75 years of age who received Prasugrel had an increased risk of fatal bleeding events (1.0%) compared to patients who received Clopidogrel (0.1%).<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No dosage adjustment is necessary for patients with renal impairment. There is limited experience in patients with end-stage renal disease.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No dosage adjustment is necessary in patients with mild to moderate hepatic impairment.</p>', '2022-03-16 04:23:40', '2022-03-16 04:23:40'),
(1254, 1254, '<p>Hypertension (Primary and Secondary Hypertension). Raynaud&#39;s phenomenon and Raynaud&#39;s disease, Congestive heart failure (Prazosin may be used alone or added to the therapeutic regimen in those patients with congestive heart failure who are resistant or refractory to conventional therapy with diuretics and/or cardiac glycosides) &amp; Benign prostatic hyperplasia (For the symptomatic treatment of urinary obstruction due to BPH and in patients awaiting prostatic surgery).</p>', '<p>Prazosin causes a decrease in total peripheral vascular resistance through selective inhibition of postsynaptic alpha-1-adrenoreceptors in vascular smooth muscle. In hypertensive patients, blood pressure is lowered in both the supine and standing positions; this effect is more pronounced on the diastolic blood pressure. Rebound elevation of blood pressure does not occur following abrupt cessation of Prazosin therapy.<br />\r\n<br />\r\nThe therapeutic efficacy of Prazosin in patients with congestive heart failure is ascribed to a reduction in left ventricular filling pressure, reduction in cardiac impedance and an augmentation of cardiac output. The use of Prazosin in congestive heart failure does not provoke a reflex tachycardia and blood pressure reduction is minimal in normotensive patients. Prazosin reduce the severity of the signs, symptoms, frequency and duration of attacks, in patients with Raynaud&#39;s disease. In low dosage, antagonism of alpha-1-receptors on prostatic and urethral smooth muscle has been shown to improve the urinary pressure profile in men and to improve symptoms of benign prostatic hyperplasia. Clinical studies have shown that Prazosin therapy is not associated with adverse changes in the serum lipid profile.</p>', '<p>Hypertension:</p>\r\n\r\n<ul>\r\n	<li><strong>Recommended starting dose</strong>: 0.5 mg (in the evening), twice or thrice daily for 3 to 7 days. This dose should be increased to 1 mg twice or three times daily for a further 3 to 7 days. Thereafter, the daily dose should be increased gradually as determined by the patient&#39;s response to the blood pressure lowering effect. Most patients are likely to be maintained on a dosage regimen of Prazosin alone of up to 15 mg daily in divided doses.</li>\r\n	<li><strong>Maximum dose</strong>: 20 mg in divided doses.</li>\r\n</ul>\r\n\r\n<p>Patients receiving other antihypertensive therapy but with inadequate&nbsp;control:</p>\r\n\r\n<ul>\r\n	<li>The dosage of the other drug should be reduced to a maintenance level and Prazosin initiated at 0.5 mg in the evening, then continuing with 0.5 mg twice or three times daily.</li>\r\n	<li>Subsequent dosage increases should be made gradually depending upon the patient&#39;s response.</li>\r\n</ul>\r\n\r\n<p>Congestive heart failure:</p>\r\n\r\n<ul>\r\n	<li><strong>The recommended starting dose</strong>: 0.5 mg two, three or four times daily, increasing to 4 mg in divided doses. Dosage should be adjusted according to the patient&#39;s response, based on careful monitoring of cardiopulmonary signs and symptoms.</li>\r\n	<li><strong>Usual daily maintenance dosage</strong>: 4 mg to 20 mg in divided doses.</li>\r\n</ul>\r\n\r\n<p>Raynaud&#39;s disease:</p>\r\n\r\n<ul>\r\n	<li><strong>The recommended starting dosage</strong>: 0.5 mg twice daily given for a period of 3 to 7 days and should be adjusted according to the patient&#39;s clinical response.</li>\r\n	<li><strong>Usual maintenance dosage</strong>: 1 mg or 2 mg twice daily.</li>\r\n</ul>\r\n\r\n<p>Benign prostatic hyperplasia:</p>\r\n\r\n<ul>\r\n	<li><strong>The recommended dosage</strong>: 0.5 mg twice daily for a period of 3 to 7 days, with the initial dose administered in the evening. The dosage should then be adjusted according to clinical response.</li>\r\n	<li><strong>The usual&nbsp;maintenance dosage</strong>: 2 mg twice daily.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>May be taken with or without food. Starting dose is best taken within dinner, at least 2-3 hr before retiring. Maintenance doses may be taken with or without meals.</p>', '<p><strong>Use with phosphodiesterase-5 inhibitors (PDE-5 Inhibitors)</strong>: Concomitant useo f PDE-5 inhibitors (e.g. Sildenafil, Tadalafil, Vardenafil) and Prazosin may lead to symptomatic hypotension in some patients. Adding Prazosin to beta-adrenergic antagonist or calcium antagonist therapy may produce a substantial reduction in blood pressure.</p>', '<p>Prazosin is contraindicated in patients with known sensitivity to Prazosin &amp; other quinazolines or any of the excipients.</p>', '<p>The most common side effects of Prazosin are&nbsp;allergic reaction, depression, nervousness, insomnia, Hallucinations, dizziness, drowsiness, headache, faintness, syncope, paraesthesia, worsening of pre-existing narcolepsy, blurred vision, eye pain, reddened sclera, vertigo, tinnitus, palpitations etc.</p>', '<p>Pregnancy category C. It should be used only when, in the opinion of the physician, potential benefit outweighs potential risk. Prazosin has been shown to be excreted in small amounts in human milk. Caution should be exercised when Prazosin is administered to nursing mothers.</p>', '<p><strong>In patients with benign prostatic hyperplasia</strong>: Prazosin is not recommended for patients with a history of micturition syncope. It should not normally be administered to patients already receiving another alpha-1-antagonist.<br />\r\n<br />\r\n<strong>In patients with congestive heart failure</strong>: Prazosin is not recommended in the treatment of congestive cardiac failure due to&nbsp;mechanical&nbsp;obstruction such as aortic valve stenosis, mitral valve stenosis, pulmonary embolism and restrictive pericardial disease.<br />\r\n<br />\r\n<strong>In patients with hypertension</strong>: Postural hypotension evidenced by dizziness and weakness, or rarely loss of consciousness, has been reported, particularly with the commencement of therapy.</p>', '<p><strong>Symptoms:</strong>&nbsp;Hypotension, profound drowsiness, depressed reflexes.<br />\r\n<br />\r\n<strong>Management</strong>: Symptomatic and supportive treatment. May be treated with activated charcoal if patient presents within 1 hr of ingestion. Postural measures and parenteral fluid volume replacement for severe hypotension and if necessary, cautious IV infusion of a vasopressor.</p>', '<p>Alpha adrenoceptor blocking drugs.</p>', '<p>Keep away from light and moisture, store below 30&deg; C. Keep away from reach&nbsp;out of the children.</p>', '<p><strong>Patients with moderate to severe grades of renal impairment</strong>: Evidence to date shows that Prazosin does not further compromise renal function when used in patients with renal impairment. As some patients in this category have responded to small doses of Prazosin, it is recommended that therapy be initiated at 0.5 mg daily and that dosage increases be instituted cautiously.<br />\r\n<br />\r\n<strong>Patients with hepatic dysfunction</strong>: it is recommended that therapy should be initiated at 0.5 mg daily and that dosage should be increased cautiously.<br />\r\n<br />\r\n<strong>Use in the elderly</strong>: Since the elderly may be more susceptible to hypotension, therapy should be initiated with the lowest possible dose.</p>', '2022-03-16 04:26:18', '2022-03-16 04:26:18'),
(1255, 1255, '<p>Salicylic acid and sulfur combination is used to treat acne and other skin disorders and dandruff and other scalp disorders, such as seborrheic dermatitis.</p>', '<p>Salicylic acid is a potent keratolytic with mild antiseptic action when applied topically. Sulfur topical is a scabicide and keratolytic agent.<br />\r\n<br />\r\nThe mechanism of action when these two ingredients are combined, may be a synergistic keratolytic effect. The mechanism of action of salicylic acid in the treatment of acne may also include anti-inflammatory activity.</p>', '<p>The dose of salicylic acid and sulfur will be different for different patients. Follow your doctor&#39;s orders or the directions on the label. The following information includes only the average doses of salicylic acid and sulfur. If your dose is different, do not change it unless your doctor tells you to do so.<br />\r\n<br />\r\nThe amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.</p>\r\n\r\n<p>For acne or oily skin-</p>\r\n\r\n<p>Bar dosage form:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children</strong>: Use on the affected skin two or three times a day.</li>\r\n</ul>\r\n\r\n<p>Cleansing lotion dosage form:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children</strong>: Use on wet skin one to three times a day. Rub lather into skin for one minute then rinse.</li>\r\n</ul>\r\n\r\n<p><br />\r\nFor dandruff and seborrheic dermatitis of the scalp-</p>\r\n\r\n<p>Bar and shampoo dosage forms:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children</strong>: Use on the scalp once a day at least two times a week or as directed by doctor. May be used each day if needed.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Use salicylic acid and sulfur only as directed. Do not use more of it and do not use it more often than recommended on the label, unless otherwise directed by your doctor. Immediately after using salicylic acid and sulfur, wash your hands to remove any medicine that may be on them. Keep salicylic acid and sulfur away from the eyes. If you should accidentally get some in your eyes, flush them thoroughly with water.<br />\r\n<br />\r\n<strong>To use the skin cleansing lotion</strong>: After wetting the skin, apply salicylic acid and sulfur with your fingertips or a wet sponge and rub in gently to work up a lather. Then rinse thoroughly and pat dry.<br />\r\n<br />\r\n<strong>To use the shampoo or bar as a shampoo</strong>: Wet the hair and scalp with lukewarm water. Then apply enough medicine to work up a lather and rub into the scalp. Continue rubbing the lather into the scalp for several minutes or allow it to remain on the scalp for about 5 minutes, depending on the product being used, then rinse. Apply the medicine again and rinse thoroughly.<br />\r\n<br />\r\n<strong>To use the bar as a soap</strong>: After wetting the skin, use salicylic acid and sulfur to wash the face and other affected areas. Then rinse thoroughly and pat dry.</p>', '<p>Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.</p>', '<p>Hyppersensitivity.</p>', '<p>Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.<br />\r\n<br />\r\nCheck with your doctor as soon as possible if any of the following side effects occur: Skin irritation not present before use of salicylic acid and sulfur<br />\r\n<br />\r\nSome side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:</p>\r\n\r\n<ul>\r\n	<li>Redness and peeling of skin (may occur after a few days)</li>\r\n	<li>unusual dryness of skin</li>\r\n</ul>', '<p><strong>Breast Feeding</strong>: There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.</p>', '<p>When using salicylic acid and sulfur combination medicine, do not use any of the following preparations on the same affected area as salicylic acid and sulfur, unless otherwise directed by your doctor:</p>\r\n\r\n<ul>\r\n	<li>Abrasive soaps or cleansers</li>\r\n	<li>Alcohol-containing preparations</li>\r\n	<li>Any other topical acne preparation or preparation containing a peeling agent (for example, benzoyl peroxide, resorcinol, or tretinoin [vitamin A acid])</li>\r\n	<li>Cosmetics or soaps that dry the skin</li>\r\n	<li>Medicated cosmetics</li>\r\n	<li>Other topical medicine for the skin</li>\r\n</ul>\r\n\r\n<p>To use any of the above preparations on the same affected area as salicylic acid and sulfur combination medicine may cause severe irritation of the skin.<br />\r\n<br />\r\nDo not use any topical mercury-containing preparation, such as ammoniated mercury ointment, on the same affected area as salicylic acid and sulfur . To do so may cause a foul odor, may be irritating to the skin, and may stain the skin black. If you have any questions about this, check with your health care professional.<br />\r\n<br />\r\nTaking large doses of aspirin or other salicylates (including diflunisal) while using topical salicylic acid (contained in salicylic acid and sulfur) may lead to overdose. If you have any questions about this, check with your health care professional.</p>', NULL, '<p>Local Antipruritic, Other scalp preparations.</p>', '<p>Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed.</p>', '<p><strong>Pediatric</strong>: Young children may be at increased risk of unwanted effects because of increased absorption of salicylic acid through the skin. Products containing salicylic acid should not be applied to large areas of the body or used for long periods of time in infants and children.<br />\r\n<br />\r\n<strong>Geriatric</strong>: Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of salicylic acid and sulfur combination in the elderly with use in other age groups.</p>', '2022-03-16 04:28:58', '2022-03-16 04:28:58'),
(1256, 1256, '<p><strong>Rheumatic Disorders</strong>: Psoriatic arthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, ankylosing spondylitis, acute and subacute bursitis, acute nonspecific tenosynovitis, acute gouty arthritis, post-traumatic osteoarthritis.<br />\r\n<br />\r\n<strong>Endocrine Disorders</strong>: Primary or secondary adrenocortical insufficiency, congenital adrenal hyperplasia, nonsuppurative thyroiditis, hypercalcemia associated with cancer.<br />\r\n<br />\r\n<strong>Dermatologic Diseases</strong>: Pemphigus, bullous dermatitis herpetiformis, severe erythema multiforme, exfoliative dermatitis, mycosis fungoides, severe psoriasis.<br />\r\n<br />\r\n<strong>Allergic States</strong>: Seasonal or perennial allergic rhinitis, bronchial asthma, contact dermatitis, atopic dermatitis, serum sickness, drug hypersensitivity reactions.<br />\r\n<br />\r\n<strong>Respiratory Diseases</strong>: Symptomatic sarcoidosis, berylliosis, fulminating, aspiration pneumonitis.<br />\r\n<br />\r\n<strong>Hematologic Disorders</strong>: Idiopathic thrombocytopenic purpura, secondary thrombocytopenia, acquired (autoimmune) hemolytic anemia, erythroblastopenia (RBC anemia).<br />\r\n<br />\r\n<strong>Edematous States</strong>: To induce a diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus.<br />\r\n<br />\r\n<strong>Gastrointestinal Diseases</strong>: Ulcerative colitis, regional enteritis.</p>', '<p>Prednisolone is a synthetic adrenocortical drug with predominantly glucocorticoid properties. Prednisolone directly inhibits the action of the Phospholipase A2 enzyme which is responsible for the production of different inflammatory mediators like Leukotrienes, SRS-A, Prostaglandins etc. Prednisolone is rapidly and well absorbed from the Gl tract following oral administration. Prednisolone is 70- 90% protein-bound in the plasma and it is eliminated from the plasma with a half-life of 2 to 4 hours. It is metabolized mainly in the liver and excreted in the urine.</p>', '<p>Adult-<br />\r\n<strong>Nephrotic Syndrome</strong>:</p>\r\n\r\n<ul>\r\n	<li>Initial: 2 mg/kg/day (maximum 80 mg/day) in divided doses 3 to 4 times/day until urine is protein free for 3 consecutive days (maximum: 28 days); followed by 1 to 1.5 mg/kg/dose given every other day for 4 weeks.</li>\r\n	<li>Maintenance dose: 0.5 to 1 mg/kg/ dose given every other day for 3 to 6 months.</li>\r\n</ul>\r\n\r\n<p><strong>Anti-inflammatory</strong>: 5 to 60 mg per day in divided doses 1 to 4 times/day.<br />\r\n<br />\r\n<strong>Acute Asthma</strong>: 40-60 mg/day PO in single daily dose or divided q12 hr for 3-10 days.<br />\r\n<br />\r\n<strong>Allergic Conditions</strong>:</p>\r\n\r\n<ul>\r\n	<li>Day 1: 10 mg PO before breakfast, 5 mg after lunch and after dinner, and 10 mg at bedtime.</li>\r\n	<li>Day 2: 5 mg PO before breakfast, after lunch, and after dinner and 10 mg at bedtime.</li>\r\n	<li>Day 3: 5 mg PO before breakfast, after lunch, after dinner, and at bedtime.</li>\r\n	<li>Day 4: 5 mg PO before breakfast, after lunch, and at bedtime.</li>\r\n	<li>Day 5: 5 mg PO before breakfast and at bedtime.</li>\r\n	<li>Day 6: 5 mg PO before breakfast.</li>\r\n</ul>\r\n\r\n<p><br />\r\nPediatric-<br />\r\n<strong>Asthma</strong>:</p>\r\n\r\n<ul>\r\n	<li>1 year: Acute: 10 mg orally every 12 hours. Maintenance: 10 mg orally every other day.</li>\r\n	<li>1 to 4 years: Acute: 20 mg orally every 12 hours. Maintenance: 20 mg orally every other day.</li>\r\n	<li>5 to 12 years: Acute: 30 mg orally every 12 hours. Maintenance: 30 mg orally every other day.</li>\r\n	<li>12 years: Acute: 40 mg orally every 12 hours. Maintenance: 40 mg orally every other day.</li>\r\n</ul>\r\n\r\n<p><strong>Anti-inflammatory</strong>: 0.05 to 2 mg/kg/day divided 1 to 4 times/day.<br />\r\n<br />\r\n<strong>Immunosuppression</strong>: 0.05 to 2 mg/kg/day divided 1 to 4 times/day.</p>', '<p>The efficacy of prednisolone is reduced by Aminoglutethimide, Antacids, Barbiturates, Carbamazepine, Griseofulvin, Mitotane, Phenylbutazone, Phenytoin, Primidone and Rifampin. Prednisolone reduces the amount of potassium in the blood. Digitalis can cause Cardiac arrhythmias if hypokalemia occurs. Immunization should be done very carefully.</p>', '<p>Systemic infections unless specific anti-infective therapy is employed. Hypersensitivity to any ingredient. Ocular herpes simplex because of possible perforation.</p>', '<p>Common side effects include increased appetite, indigestion, nervousness or restlessness. Less frequent or rare side effects are darkening or lightening of skin color, dizziness or lightheadedness, flushing of face or cheeks, hiccups, increased sweating, the sensation of spinning.</p>', '<p>This medicine is not recommended for use during pregnancy unless considered essential by your doctor. It should only be used if the expected benefit to the mother is greater than any possible risk to the foetus. Corticosteroids appear in breast milk and could suppress growth, interfere with endogenous corticosteroid production or cause other unwanted effects.</p>', '<p>Precaution has to be taken in diabetes, hypertension, Psychological disturbances, osteoporosis, post-menopausal women, pregnancy and in chronic nephritis. Long-term use of Prednisolone can cause Cushing&#39;s habitus, hyperglycemia, muscular weakness, increased susceptibility to infection, delayed wound healing, and psychiatric disturbances.</p>', '<p>Adverse effects related to prednisone normally develop only after prolonged use of doses in excess of the normal physiological requirement. Treatment is symptomatic and where possible the prednisone dose should be reduced gradually.</p>', '<p>Glucocorticoids.</p>', '<p>Store in a cool and dry place, protected from light. Keep out of the reach of the children.</p>', NULL, '2022-03-16 04:31:09', '2022-03-16 04:31:09');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1257, 1257, '<p>This is indicated for steroid-responsive inflammatory ocular conditions where bacterial infection or a risk of bacterial ocular infection exists.</p>', '<p><strong>Prednisolone</strong>&nbsp;decreases inflammation by inhibition of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It suppresses the immune system by reducing the activity and production of the lymphocytes and eosinophils.<br />\r\n<br />\r\n<strong>Neomycin</strong>: Interferes with bacterial protein synthesis by binding to 30S ribosomal subunits.<br />\r\n<br />\r\n<br />\r\n<strong>Polymixin B Sulphate</strong>: Bactericidal; causes leakage of bacterial membrane</p>', '<p><strong>Adult Use</strong>: Instill one drop into the conjunctival sac two to four times daily. During the initial 24 to 48 hours, the dosing frequency may be increased if necessary. Care should be taken not to discontinue the therapy before completing the course.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.</p>', '<p>Synergistic effects with penicillins. Additive toxicity with neurotoxic, ototoxic or nephrotoxic drugs. May decrease absorption of digoxin and methotrexate. May increase effects of oral anticoagulants.</p>', '<p>Prednisolone Acetate is contraindicated in viral diseases of the cornea, conjunctiva and known hypersensitivity to any of the ingredients of this preparation or other corticosteroids.</p>', '<p>Elevation of intraocular pressure (IOP) with possible development of glaucoma and infrequent optic nerve damage, posterior subcapsular cataract formation and delayed wound healing.<br />\r\n<br />\r\nFungal and viral infections of the cornea are particularly may develop coincidentally with long-term applications of steroid.</p>', '<p>Pregnancy Category C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.</p>', '<p>This combination should be used with caution in patients with known hypersensitivity to the components of this preparation. Prolonged use of corticosteroids may result in damage to the optic nerve and defects in vision. If this product is used for longer period of time, intraocular pressure should be routinely monitored.</p>', NULL, '<p>Ophthalmic steroid - antibiotic combined preparations.</p>', NULL, NULL, '2022-03-16 04:33:21', '2022-03-16 04:33:21'),
(1258, 1258, '<p>Prednisolone eye drops is indicated for the treatment of steroid-responsive inflammation of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe.</p>', '<p>Prednisolone decreases inflammation by inhibition of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It suppresses the immune system by reducing the activity and production of the lymphocytes and eosinophils.</p>', '<p><strong>Adult</strong>: Instill one drop into the conjunctival sac two to four times daily. During the initial 24 to 48 hours, the dosing frequency may be increased if necessary. Care should be taken not to discontinue the therapy before completing the course.&nbsp;<br />\r\n<br />\r\n<strong>Paediatric</strong>: Safety and effectiveness in pediatric patients have not been established.</p>', '<p>No significant drug interactions have been reported.</p>', '<p>Prednisolone Acetate is contraindicated in viral diseases of the cornea, conjunctiva and known hypersensitivity to any of the ingredients of this preparation or other corticosteroids.</p>', '<p>Elevation of intraocular pressure (IOP) with possible development of glaucoma and infrequent optic nerve damage, posterior subcapsular cataract formation and delayed wound healing.&nbsp; Fungal and viral infections of the cornea are particularly may develop coincidentally with long-term applications of steroid.</p>', '<p>Prednisolone Acetate is pregnancy category C. So, this drug should be used during pregnancy only if clearly needed. It is not known whether topical administration of corticosteroids would result in sufficient systemic absorption to produce detectable quantities in human milk. Because many drugs are excreted in human milk, caution should be exercised when Prednisolone Acetate is administered to a nursing woman.</p>', '<p>Shake the bottle well before use. Prolonged use of corticosteroids may result in damage to the optic nerve and defects in vision. If this product is used for longer period of time, intraocular pressure should be routinely monitored.</p>', '<p>A one-time accidental overdose of Prednisolone Ophthalmic Suspension generally will not cause acute problems. Long time overdose may show general side-effects. In accidental overdose sufficient water should be taken to dilute the medication.</p>', '<p>Glucocorticoids.</p>', '<p>Store in a cool, dry place and protect from light. Keep out of the reach of children. Protect from freezing.&nbsp; Shake well before using.</p>', NULL, '2022-03-16 04:37:47', '2022-03-16 04:37:47'),
(1259, 1259, '<p>Pregabalin is indicated for:</p>\r\n\r\n<ul>\r\n	<li>Management of neuropathic pain associated with diabetic peripheral neuropathy</li>\r\n	<li>Management of post-herpetic neuralgia</li>\r\n	<li>Adjunctive therapy for adult patients with partial onset seizures</li>\r\n	<li>Management of fibromyalgia</li>\r\n	<li>Neuropathic pain associated with spinal cord injury.</li>\r\n</ul>', '<p>Pregabalin is a structural derivative of the inhibitory neurotransmitter gamma-amino butyric acid (GABA). It does not bind directly to GABAA, GABAB, or benzodiazepine receptor. Pregabalin binds with high affinity to the alpha-2-delta site (an auxiliary subunit of voltage-gated calcium channels) in central nervous system tissues. Oral bioavailability of Pregabalin is &ge;90% and is independent of dose. It is eliminated from the systemic circulation primarily by renal excretion as unchanged drug with a mean elimination half-life of 6.3 hours in subjects with normal renal function.</p>', '<p><strong>Neuropathic pain associated with diabetic peripheral neuropathy</strong>: The maximum recommended dose of Pregabalin is 100 mg three times a day (300 mg/day) in patients with creatinine clearance of at least 60 mL/min. Dosing should begin at 50 mg three times a day (150 mg/day) and may be increased to 300 mg/day within 1 week based on efficacy and tolerability.<br />\r\n<br />\r\n<strong>Post-herpetic neuralgia</strong>: The recommended dose of Pregabalin is 75 to 150 mg two times a day, or 50 to 100 mg three times a day (150 to 300 mg/day) in patients with creatinine clearance of at least 60 mL/min. Dosing should begin at 75 mg two times a day, or 50 mg three times a day (150 mg/day) and may be increased to 300 mg/day within 1 week based on efficacy and tolerability.<br />\r\n<br />\r\n<strong>Adjunctive therapy for adult patients with partial onset seizures</strong>: In general, it is recommended that patients be started on a total daily dose no greater than 150 mg/day (75 mg two times a day, or 50 mg three times a day). Based on individual patient response and tolerability, the dose may be increased to a maximum dose of 600 mg/day.<br />\r\n<br />\r\n<strong>Management of Fibromyalgia</strong>: The recommended dose of Pregabalin for fibromyalgia is 300 to 450 mg/day. Dosing should begin at 75 mg two times a day (150 mg/day) and may be increased to 150 mg two times a day (300 mg/day) within 1 week based on efficacy and tolerability.<br />\r\n<br />\r\n<strong>Neuropathic pain associated with spinal cord injury</strong>: The recommended dose range is 150 to 600 mg/day. The recommended starting dose is 75 mg two times a day (150 mg/day). The dose may be increased to 150 mg two times a day (300 mg/day) within 1 week based on efficacy and tolerability.<br />\r\n<br />\r\nPregabalin capsules can be taken without regards to meals.</p>', '<p>There are no significant interactions between Pregabalin with other antiepileptic drugs &amp; oral contraceptive. Pregabalin may potentiate the effects of ethanol and lorazepam.</p>', '<p>Pregabalin is contraindicated in patients with known hypersensitivity to Pregabalin or any of its components.</p>', '<p>The most common side effects include dizziness, somnolence, dry mouth, edema, blurred vision, weight gain and abnormal thinking.</p>', '<p>Pregnancy category of Pregabalin is C. So it should only used if potential benefit justifies the potential risks to the fetus.<br />\r\n<br />\r\nPregabalin may be secreted through the breast milk like other drugs, so it should be used in nursing women only if the benefits clearly overweigh the risk.</p>', '<p>Discontinuation of Pregabalin without tapering may produce insomnia, nausea, headache and diarrhea. So it should be tapered gradually over a minimum of 1 week rather than discontinued abruptly. Creatinine kinase may be elevated if treated with Pregabalin. It should be discontinued rapidly if myopathy is diagnosed or suspected or if creatinine kinase is elevated markedly.</p>', NULL, '<p>Adjunct anti-epileptic drugs.</p>', '<p>Keep in a cool &amp; dry place (below 30&deg; C), protected from light &amp; moisture. Keep out of the reach of children.</p>', '<p>The safety and efficacy of Pregabalin in paediatric patients have not been established.</p>', '2022-03-16 04:39:41', '2022-03-16 04:39:41'),
(1260, 1260, '<p>Primaquine phosphate is indicated for the radical cure (prevention of relapse) of vivax malaria.</p>', '<p>Primaquine is an 8-aminoquinoline antimalarial which eliminates the exoerythrocytic forms of malarial parasite Plasmodium vivax, Plasmodium ovale and Plasmodium falciparum by disrupting mitochondria and binding to DNA.<br />\r\n<br />\r\nPrimaquine&#39;s mechanism of action is not well understood. It may be acting by generating reactive oxygen species or by interfering with the electron transport in the parasite. Also, although its mechanism of action is unclear, primaquine may bind to and alter the properties of protozoal DNA.</p>', '<p>Primaquine phosphate is recommended only for the radical cure of vivax malaria, the prevention of relapse in vivax malaria, or following the termination of chloroquine phosphate suppressive therapy in an area where vivax malaria is endemic. Patients suffering from an attack of vivax malaria or having parasitized red blood cells should receive a course of chloroquine phosphate, which quickly destroys the erythrocytic parasites and terminates the paroxysm. Primaquine phosphate should be administered concurrently in order to eradicate the exoerythrocytic parasites in a dosage of 1 tablet (equivalent to 15 mg base) daily for 14 days.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken with food. Take with meals to avoid GI discomfort.</p>', '<p>Enhanced effect with other drugs that prolong the QT interval.</p>', '<p>Acutely ill patients suffering from systemic disease manifested by tendency to develop granulocytopenia (e.g. rheumatoid arthritis, lupus erythematosus). Concurrent use with other potentially haemolytic drugs or depressants of myeloid elements of the bone marrow. Concomitant admin with mepacrine.</p>\r\n\r\n<p>&nbsp;</p>', '<p>Abdominal pain, gastric distress, nausea, vomiting; methaemoglobinaemia, haemolytic anaemia (in patients with G6PD deficiency), mild anaemia, leucocytosis; HTN, cardiac arrhythmias, prolonged QT interval on ECG, accommodation disturbance. Rarely, leucopenia, agranulocytosis.</p>', '<p><strong>Pregnancy&nbsp;</strong>Category C. Safe usage of this preparation in pregnancy has not been established. Primaquine is contraindicated in pregnant women. Even if a pregnant woman is G6PD normal, the fetus may not be.&nbsp;Animal data show toxicity to reproduction.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether Primaquine is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Primaquine, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>Patient with G6PD deficiency, NADH methaemoglobin reductase deficiency. Childn. Pregnancy and lactation.</p>', '<p>Symptoms of overdosage of Primaquine phosphate include abdominal cramps, vomiting, burning epigastric distress, central nervous system and cardiovascular disturbances, including cardiac arrhythmia and QT&nbsp;interval prolongation, cyanosis, methemoglobinemia, moderate leukocytosis or leukopenia, and anemia. The most striking symptoms are granulocytopenia and acute hemolytic anemia in G6PD deficient patients. Acute hemolysis occurs, but patients recover completely if the dosage is discontinued.</p>', '<p>Anti-malarial drugs.</p>', '<p>Store at 25&deg; C. Protect from light.</p>', NULL, '2022-03-16 04:42:38', '2022-03-16 04:42:38'),
(1261, 1261, '<p>The original multi-strain this probiotic product containing 14 strains of probiotics for everyday use.<br />\r\n<br />\r\nThis probiotic is a unique multispecies, multi-strain probiotic supplement with 14 strains of beneficial bacteria. This means that this probiotic can deliver high concentrations of beneficial bacteria to the colonisation sites in the gut- and therefore be able to help a more diverse range of digestive disorders.<br />\r\n<br />\r\nThe beneficial bacteria in this probiotic are cryoprotected&nbsp;during the freeze drying process, which gives two main benefits:</p>\r\n\r\n<ul>\r\n	<li>They are protected from the harsh acid environment of the stomach and are therefore able to colonise the full length of the gastrointestinal tract.</li>\r\n	<li>The process allows this probiotic to be stored at room temperature without the need for refrigeration.</li>\r\n</ul>\r\n\r\n<p>This probiotic can be used on a continuous basis or for a short period of time, e.g. when taking antibiotics.<br />\r\n<br />\r\nContains soya and milk, used in the fermentation process. Content of milk is at a level that would not affect lactose intolerant sufferers.</p>', NULL, '<ul>\r\n	<li>Take 1-2 capsules once or twice daily with food. If taking two or more capsules daily, you may wish to split the dose between two meals</li>\r\n	<li>This probiotic is a completely safe probiotic, has no contraindications and carries no risk of overdose</li>\r\n	<li>This probiotic&nbsp;probiotic capsules can be swallowed whole or pulled apart and the contents sprinkled on to food, or mixed in a drink.</li>\r\n</ul>\r\n\r\n<p>If you are taking antibiotics: Take 4 capsules daily, ideally at a different time of the day from the antibiotics<br />\r\nContinue taking for at least 2 weeks after completion of the antibiotic course.<br />\r\n<br />\r\nFor travellers:</p>\r\n\r\n<ul>\r\n	<li>2 weeks before travel follow guidelines for general use</li>\r\n	<li>During travel take 4 capsules daily</li>\r\n	<li>Continue to take for at least 2 weeks following the end of travel.</li>\r\n</ul>\r\n\r\n<p>Children under 12: Take 1/2 to 1 capsule once or twice daily with food. If you are taking any medications or have any medical conditions please consult your doctor before taking any food supplement.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Probiotic</p>', '<p>Keep sealed and store in cool, dry conditions.&nbsp; Can be stored at room temperature without the need for refrigeration. In high, ambient temperatures (25&deg;C+) air-conditioning or refrigeration would be cautionary to assist in maintaining shelf life. Total bacteria count viable until end of the shelf life.</p>', NULL, '2022-03-16 04:45:12', '2022-03-16 04:45:12'),
(1262, 1262, '<p>The drug is used to support digestive health in patients suffering from diarrhea. The drug restores gut flora and overcomes gut discomfort in individuals on an antibiotic regimen. It also improves IBS (Irritable Bowel Syndrome) related to abdominal pain and bloating.</p>', '<p>This is a unique freeze-dried probiotic blend of Bifidobacterium Lactis Bl-04, Bifidobacterium Lactis Bi-07, Lactobacillus Acidophilus NCFM and Lactobacillus Paracasei Lpc-37 that provides support to individuals who have high demands on their digestive tract or their immune system due to diarrhea, antibiotic use and stress. Extensive in vitro and in vivo studies support the health benefit of these strains. Has high tolerance to gastrointestinal conditions and strong adhesion to intestinal cell-lines. It has been found to restore and maintain microbiota after antibiotic use. Moreover, it also improves specific immune response.</p>', '<p>1 capsule daily with a meal or as recommended by the physician. In diarrhea and after antibiotic course the duration of the treatment should be 2-4 weeks and in IBS the duration should be 4-12 weeks. In children unable to swallow the capsule- the content of the capsule can be mixed in a glass with water, juice or normal milk to drink.</p>', '<p>There is no known drug interaction.</p>', '<p>The drug is contraindicated if patient has any hypersensitivity to it.</p>', '<p>Generally safe for most of the people but some may feel stomach gas and bloating.</p>', '<p>If pregnant or nursing, consult with your physician before using this product.</p>', '<p>Consult your physician before using the product if you are pregnant, nursing or trying to conceive.</p>', NULL, '<p>Probiotic.</p>', '<p>Do not store above 25&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-16 04:46:54', '2022-03-16 04:46:54'),
(1263, 1263, '<p>This is indicated for the management of gastrointestinal problems e.g. IBS, constipation, flatulence, indigestion, etc.</p>', '<p>The antimicrobial activity of probiotics is thought to be accounted for, in large part, by their ability to colonize the colon and reinforce the barrier function of the intestinal mucosa. In addition, some probiotics have been found to secrete antimicrobial substances known as bacteriocins. It reduced gastrointestinal pH through stimulation of lactic acid producing bacteria and provides a direct antagonistic action on GI pathogen. Lactobacillus acidophilus, Lactobacillus bulgaricus and Bifidobaterium, have also demonstrated antioxidative ability. Mechanisms include chelation of metal ions (iron, copper), scavenging of reactive oxygen species and reducing activity.</p>', '<p>Adults and children over six years of age: one capsule 2 to 3 times daily or as advised by a physician.</p>', NULL, '<p>Probiotics are contraindicated in those who are hypersensitive to any component of a probiotic-containing product.</p>', '<p>Probiotics are generally well tolerated.</p>', '<p>Should be used with caution or seek the advice of a healthcare professional before use.</p>', '<p>Probiotic</p>', NULL, NULL, '<p>Store below 15&deg;C, cool and dry place, away from direct sun light &amp; moisture. To maintain optimum shelf life and potency store in the refrigerator. Keep the medicine out of reach of children.</p>', NULL, '2022-03-16 04:48:13', '2022-03-16 04:48:13'),
(1264, 1264, '<p>It is indicated for the treatment or prevention of any infection caused by Penicillin sensitive bacteria where a long acting Penicillin is required. It is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Gonorrhoea caused by Penicillin sensitive microorganisns</li>\r\n	<li>Prevention of endocarditis during dental procedures</li>\r\n	<li>Gas-gangrene following amputation</li>\r\n</ul>', '<p>Benzylpenicillin has a bactericidal action against gram-positive bacteria, gram-&shy;negative cocci, some other gram-negative bacteria, spirochetes and actinomycetes. It inhibits final cross-linking stage of peptidoglycan production through binding and inactivation of transpeptidases on the inner surface of the bacterial cell membrane thus inhibiting bacterial cell wall synthesis. It is inhibited by penicillinase and other lactamases.<br />\r\n<br />\r\nInterferes with cell wall mucopeptide synthesis during active multiplication, resulting in bactericidal activity against susceptible microorganisms.</p>', '<p>Add 3 ml of water for injection and shake vigorously.<br />\r\n<br />\r\n<strong>Adults:</strong>&nbsp;4,00,000 units once daily or twice daily.<br />\r\n<strong>Children:</strong>&nbsp;Over 25 kg as for adults; under 25 kg reduce proportionally. In severe cases dose may be doubled.<br />\r\n<br />\r\nIntramuscular injection is the only route of administration of Procaine Penicillin.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>This&nbsp;should be injected IM into the buttocks, thigh, deltoid or triceps muscle. In case continuous injection is necessitated, the injection site should be changed every time.</p>', '<p>Potentially hazardous interactions: invitro Penicillin inactivates Amino- glycosides, so that they should not be mixed in infusion fluids.</p>', '<p>Hypersensitivity to penicillin.</p>', '<p>Allergic reactions may occur but usually resolve on cessation of therapy.</p>', '<p>Pregnancy&nbsp;Category B. Either animal-reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect that was not confirmed in controlled studies in women in the 1st trimester.</p>', '<p>Hypersensitivity to cephalosporins. Renal impairment. CHF. Infant. Elderly.</p>', NULL, '<p>Benzylpenicillin &amp; Phenoxymethyl penicillin.</p>', '<p>Store at room temperature.</p>', NULL, '2022-03-16 04:49:55', '2022-03-16 04:49:55'),
(1265, 1265, '<p>Prochlorperazine Maleate is indicated-</p>\r\n\r\n<ul>\r\n	<li>To control severe nausea and vomiting caused by radiation therapy, cancer chemotherapy, surgery, and other conditions.</li>\r\n	<li>Relieving nausea, vomiting, and attacks of dizziness or spinning sensations (vertigo) associated with Meniere&#39;s disease and other inner ear disorders.</li>\r\n	<li>For the treatment of psychotic illness such as schizophrenia (hallucinations and hostility).</li>\r\n	<li>Acute mania.</li>\r\n	<li>For the short-term treatment of generalized non-psychotic anxiety.</li>\r\n</ul>', '<p>Prochlorperazine is a dopamine &amp; histamine antagonist. The mechanism of antiemetic activity is due to the blockade of histamine H, &amp; dopamine D2 neurotransmitter receptors in the chemoreceptor trigger zone and vomiting centre. It also has a weak anticholinergic effect and prevents acid reflux by increasing the tone of the lower oesophageal sphincter.</p>', '<p><strong>Antiemetic</strong>-<br />\r\nChildren (not recommended in children &lt;10 kg or &lt;2 years):</p>\r\n\r\n<ul>\r\n	<li>10-14 kg: 2.5 mg every 12-24 hours as needed;maximum: 7.5 mg/day</li>\r\n	<li>15-18 kg: 2.5 mg every 8-12 hours as needed;maximum:10 mg/day</li>\r\n	<li>19-39 kg: 2.5 mg every 8 hours or 5 mg every 12 hours as needed; maximum: 15 mg/day.</li>\r\n</ul>\r\n\r\n<p>Adults: 5-10 mg 3-4 times/day;usual maximum:40 mg/day<br />\r\n<br />\r\n<strong>Antipsychotic</strong>-<br />\r\nChildren (not recommended in children &lt;10 kg or &lt;2 years):</p>\r\n\r\n<ul>\r\n	<li>2-12 years: 2.5 mg 2-3 times/day</li>\r\n	<li>Increase dosage as needed to a maximum daily dose of 20 mg for 2-5 years and 25 mg for 6-12 years</li>\r\n</ul>\r\n\r\n<p>Adults: 5-10 mg 3-4 times/day; doses up to 150 mg/day may be required in some patients for treatment of severe disturbances<br />\r\n<br />\r\n<strong>Nonpsychotic anxiety</strong>-</p>\r\n\r\n<ul>\r\n	<li>Adults: Usual dose: 15-20 mg/day in divided doses; do not give doses &gt;20 mg/day or for longer than 12 weeks</li>\r\n	<li>Elderly: Initial: 2.5-5 mg 1-2 times/day; increase dose at 4 to 7 day intervals by 2.5-5 mg/day; increase dosing intervals (twice daily, thrice daily, etc) as necessary to control response or side effects; maximum daily dose should probably not exceed 75 mg in elderly; gradual increases (titration) may prevent some side effects or decrease their severity.</li>\r\n</ul>\r\n\r\n<p>Prochlorperazine may be administered without regard to the meal.</p>', '<p>Alcohol, barbiturate &amp; other sedatives may increase the CNS depressant action. Some drugs like Antacids, antiparkinson&#39;s drug, lithium may interfere the absorption of Prochlorperazine. This drug may interfere with the plasma concentration of Propanolol and Phenobarbital.</p>', '<p>Hypersensitivity to prochlorperazine or any component of the formulation, severe CNS<br />\r\ndepression; coma; should not be used in children &lt;2 years of age or &lt;10 kg.</p>', '<p>Drowsiness; jaw, neck, and back muscle spasms; fine worm-like tongue movements; rhythmic face, mouth, or jaw movements; slow or difficult speech; difficulty swallowing; restlessness and pacing; tremors; shuffling walk; skin rash; yellowing of the skin or eyes.</p>', '<p>No evidence of adverse effects of this drug has been reported during pregnancy &amp; lactation.</p>', '<p>Caution should be taken while performing tasks that require alertness, such as driving or using machinery. The use of alcohol can cause extreme drowsiness. This medication may increase sensitivity to sunlight. Prolonged sun exposure should be avoided and sunscreen and protective clothing should be taken when anybody is exposed to the sun. This medication can reduce sweating making it more susceptible to heatstroke.</p>', '<p>Symptoms of overdose include deep sleep, coma, extrapyramidal symptoms, abnormal involuntary muscle movements, and hypotension.</p>', '<p>Anti vertigo drugs, Anti-emetic drugs</p>', '<p>Store below 30&deg;C.Protect from light and moisture. Keep out of the reach of children.</p>', NULL, '2022-03-16 04:51:44', '2022-03-16 04:51:44'),
(1266, 1266, '<p>Procyclidine is used for the adjunctive treatment of all forms of parkinsonian syndrome. It is mainly used for the symptomatic treatment of idiopathic (paralysis agitants), postencephalitic and arteriosclerotic parkinsonian. It is used to control troublesome extrapyramidal symptoms including pseudoparkinsonian, acute dystonic reactions and akathisia induced by neuroleptic drugs such as phenothiazine derivatives.</p>', '<p>Procyclidine hydrochloride is an antimuscarinic antiparkinsonian agent of relatively low toxicity. It is a synthetic tertiary amine. This drug exerts their antiparkinsonian effect by correcting the relative cholinergic excess which is thought to occur in parkinsonian as a result of dopamine deficiency. It is absorbed from G.I. tract and disappears rapidly from the tissues. After intravenous administration, it acts within 5 to 20 minutes and has a duration of effect up to 4 hours.</p>', '<p><strong>Tablet</strong>: This is administered orally, preferably after meals.</p>\r\n\r\n<ul>\r\n	<li><strong>Parkinsonism</strong>: Initially 2.5 mg 3 times a day, then 5 mg 3 times a day and occasionally 5 mg at bedtime. The dosage being adjusted as tolerated or until the total daily dose reaches 20 to 30 mg divided into 3 to 4 doses.</li>\r\n	<li><strong>Drug induced extrapyramidal symptom</strong>: Initially 2.5 mg 3 times a day. The dosage being increased by 2.5 mg increment per day as needed and tolerated.</li>\r\n</ul>\r\n\r\n<p><strong>IM or IV injection</strong>: 5-10 mg, repeated if necessary after 20 minutes; maximum 20 mg daily can be given.</p>', '<p>The anticholinergic activity of procyclidine may be increased by agents having anticholinergic amantadine. The absorption of ketoconazole may be reduced by concomitant administration of procyclidine.</p>', '<p>It should be given with caution in children and geriatric patients. It is advisable to be cautious in giving Procyclidine to patients with diarrhoea and cardiovascular disease, glaucoma, urinary retention, hepatic or renal impairment. The safety of using procyclidine during pregnancy has not been established. No data are available on the excretion of this drug in breast milk.</p>', '<p>At usual dosage levels dryness of the mouth is generally the only adverse effect. Mydriasis, blurred vision and adverse G.I. effects (nausea, vomiting, epigastric distress, constipation) occur occasionally. An allergic reaction (e.g. rash) or muscular weakness may occasionally occur. High doses may cause vertigo and possibly confusion and hallucination. Adverse effect may&nbsp;usually be minimized by adjustment of dosage and administration after meal.</p>', '<p>The safe use of this drug in pregnancy, lactation or in women of childbearing age requires that the potential benefits be weighed against the possible hazards to the mother and child.</p>', '<p>Precaution should be taken in case of hepatic &amp; renal impairment, children, elderly, pregnancy and lactation condition. Patients with mental disorders occasionally experience a precipitation of a psychotic episode when Procyclidine is administered for the treatment of the extrapyramidal side-effects of neuroleptic. Procyclidine should not be withdrawn abruptly as rebound Parkinsonism symptoms may occur.</p>', NULL, '<p>Antiparkinson drugs.</p>', '<p>Protect from light and moisture, store below 25&deg;C. Keep out of the reach of children.</p>', '<p><strong>Use in children</strong>: Safety and efficacy have not been established in the pediatric age group; therefore the use of Procyclidine hydrochloride is this group requires that the potential benefits be weighed against the possible hazards to children.</p>', '2022-03-16 04:53:36', '2022-03-16 04:53:36'),
(1267, 1267, '<p>Progesterone softgel capsule is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Maintenance of Pregnancy in cases of Threatened / Recurrent abortion.</li>\r\n	<li>Luteal support during IUI and ART procedures IVF-ET.</li>\r\n	<li>Luteal support in cases of proven luteal phase insufficiency.</li>\r\n	<li>Along with estrogen in post-menopausal hormone replacement therapy (HRT) either in sequential or in continuous regimen.</li>\r\n	<li>To prevent endometrial hyperplasia where endogenous estrogen is present.</li>\r\n	<li>As progesterone challenge test in secondary amenorrhoea.</li>\r\n	<li>For cycle control along with estrogen therapy.</li>\r\n	<li>Dysfunctional uterine bleeding (DUB)</li>\r\n	<li>Premenstrual tension.</li>\r\n	<li>Endometriosis.</li>\r\n	<li>Oocyte donation programme.</li>\r\n	<li>Benign mastopathy.</li>\r\n</ul>', '<p>Progesterone softgel capsule contains micronised progesterone, which is structurally and biologically identical to natural endogenous progesterone. Micronisation increases the bioavailability of progesterone. When micronised progesterone is administered after meals, maximal serum progesterone levels are significantly increased. Progesterone concentrations in the endometrial and breast tissue attain high level. Progesterone is approximately 96%-99% bound to serum proteins, primarily to serum albumin (50%-54%). Progesterone is metabolized to pregnanediols and pregnanolones in the liver. The glucuronide and sulfate conjugates of pregnanediol and pregnanolone are excreted in the bile and urine. Progesterone metabolites, which are excreted in bile, may undergo enterohepatic circulation.</p>', '<p><strong>The usual recommended dose</strong>: Progesterone 100mg/200mg 2 to 3 soft gel capsules daily by the oral or vaginal routes in divided doses. Flexible dosage regimen can be followed depending on the indication and requirements of patients.<br />\r\n<br />\r\n<strong>Maintenance of Pregnancy in cases of Threatened / Recurrent abortion</strong>: Progesterone 200 to 400 mg per day in divided doses.<br />\r\n<br />\r\n<strong>In-vitro fertilization and embryo transfer</strong>: Progesterone 200 mg thrice a day from the day of embryo transfer till pregnancy is confirmed. If pregnant, it is continued till 12th&nbsp;week of pregnancy.<br />\r\n<br />\r\n<strong>HRT</strong>: In sequential regimen: Progesterone 200mg daily for 12 days in last 2 weeks of each therapeutic cycle. In continuous regimen: Progesterone 100 mg daily throughout the month along with estrogen.<br />\r\n<br />\r\n<strong>Oocyte donation program</strong>: Progesterone 100mg twice daily from the day of transfer till pregnancy is confirmed. This may be increased to a maximum of 600 mg per day and continued till 12th&nbsp;week of pregnancy.<br />\r\n<br />\r\n<strong>Luteal support</strong>: Progesterone 100mg thrice a day from the 17th&nbsp;day of the cycle for 10 days in induced cycle. If pregnant, it is continued till 12th&nbsp;week of pregnancy.<br />\r\n<br />\r\n<strong>Luteal phase insufficiency</strong>: Progesterone 10mg thrice daily to be continued up to 12 weeks of pregnancy, increasing the dose by 100mg/day/week to a maximum of 600mg/day in divided doses if required.<br />\r\n<br />\r\n<strong>In secondary amenorrhoea</strong>: Progesterone 300mg for 10 days results in withdrawal bleeding in 80% of cases.<br />\r\n<br />\r\n<strong>Premenstrual syndrome</strong>: Progesterone 100-200mg daily for 10 days from 17th&nbsp;to 26th&nbsp;day of each menstrual cycle.<br />\r\n<br />\r\n<strong>Benign mastopathy</strong>: Progesterone 200-300 mg for 10 days per month, usually from 17th&nbsp;to 26th&nbsp;day of the monthly cycle.</p>', '<p>Ketoconazole inhibits the metabolism of progesterone.</p>', '<p>Hypersensitivity, hepatic dysfunction, undiagnosed vaginal bleeding, porphyria, cancers of uterus and genital organs, breast cancers, history of stroke or blood clots. It should not be used in a case of miscarriage and tissue left in the uterus.</p>', '<p>Progesterone is devoid of estrogenic, androgenic and mineralocorticoid effects. Mild somnolence and other CNS side effects like depression, breast tenderness and bloating are reported. Side effects are less when vaginal route is used.</p>', NULL, '<p>Severe renal insufficiency, diabetes mellitus, seizures, migraine, headache, heart diseases, depression.</p>', NULL, '<p>Drugs for menopausal symptoms: Hormone replacement therapy, Female Sex hormones, Oral Contraceptive preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-16 04:55:16', '2022-03-16 04:55:16'),
(1268, 1268, '<p>This gel contains a hormone called progesterone. When the gel is inserted into your vagina, the progesterone is slowly released into your bloodstream throughout the day. Progesterone is used to give you extra progesterone in the treatment of infertility due to incorrect levels of progesterone during the menstrual cycle or when you are having an assisted fertility procedure. This is to help you get pregnant. You may also be asked to continue using Progesterone to support your new pregnancy.</p>', NULL, '<p>Insert the contents of one applicator of Progesterone into your vagina each day, starting after your doctor tells you that you have ovulated, or on the 18 th -21 st day of your menstrual cycle. (The first day of your menstrual cycle is the day your period starts.)<br />\r\n<br />\r\nWhen used during in-vitro fertilisation, from the day of the embryo transfer, insert the contents of one applicator of Progesterone into your vagina each day, preferably in the morning. Once tests confirm that you are pregnant, you may be asked to keep using Progesterone to support your new pregnancy- for a total of 30 days.<br />\r\n<br />\r\nThe applicator is designed in such a way that an exact amount of gel (1.125 g, containing 90 mg progesterone) is delivered. It is expected that a small amount of gel will be left in the applicator. This can be thrown away as you will have received all of the medicine that you need.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p><strong>Getting your applicator ready</strong>: Grip the applicator by the thick end between your thumb and index finger. Face the thin end of the applicator down to the ground and shake the applicator down to move all the gel inside to the thin end. Grip the applicator by the flat part of the thick end. Twist off and remove the cap from the opposite thin end. To stop the gel from flowing out before use, do not press the air tank at the thick end at this stage.<br />\r\n<br />\r\n<strong>Inserting your applicator</strong>: Lean back or lie down with your knees bent and spread apart. Carefully insert the applicator well into your vagina, until your hand touches your body. Press the air tank at the thick end of the applicator firmly to deliver the gel from the applicator into your vagina.<br />\r\n<br />\r\n<strong>After using your applicator</strong>: Throw away the applicator, including the small amount of gel that is left inside. Use each applicator only once. Progesterone gel can stay in your vagina for several days. You may get a beige to brownish clumpy or cloudy white discharge during this time. This is nothing to worry about.</p>', '<p>Do not use Progesterone at the same time as any other medicines that are inserted into your vagina.</p>', '<ul>\r\n	<li>if you are allergic to the active substance or any of the other ingredients of this medicine.</li>\r\n	<li>if you have unexplained vaginal bleeding.</li>\r\n	<li>if you have porphyria (an inability to break down certain substances (porphyrins) in your blood that is passed down in families).</li>\r\n	<li>if you have or think you might have cancer in your breasts or genital organs.</li>\r\n	<li>if you have ever had a blood clot due to swollen veins (thrombophlebitis), a blocked blood vessel (thromboembolic disorder) or a stroke.</li>\r\n	<li>if you are pregnant but your baby has died inside of you (missed abortion).</li>\r\n</ul>', '<p>Common (may affect up to 1 in 10 people):</p>\r\n\r\n<ul>\r\n	<li>headache</li>\r\n	<li>feeling very tired</li>\r\n	<li>stomach or gut (gastro-intestinal) cramps</li>\r\n	<li>breast tenderness</li>\r\n</ul>', '<p>Progesterone is not normally used during pregnancy. However, if you used Progesterone to help you get pregnant, you may be asked to continue using it to support your new pregnancy. The use of Progesterone during breast-feeding is not recommended.</p>', '<p>Caution should be taken</p>\r\n\r\n<ul>\r\n	<li>if you have liver or kidney problems</li>\r\n	<li>if you have heart problems or diabetes</li>\r\n	<li>if you have asthma</li>\r\n	<li>if you have epilepsy or often get migraines</li>\r\n	<li>if you have ever had depression.</li>\r\n</ul>', NULL, '<p>Drugs for Infertility.</p>', '<p>Keep this medicine out of the sight and reach of children. Do not store above 25&deg;C. Use each applicator only once. Any gel left in the applicator must be thrown away. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.</p>', '<p>Progesterone&nbsp;is not for use in children or adolescents.</p>', '2022-03-16 04:57:21', '2022-03-16 04:57:21'),
(1269, 1269, '<p>Micronized Progesterone is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Luteal phase support as part of an Assisted Reproductive Technology (ART) treatment for women.</li>\r\n	<li>Treatment of premenstrual syndrome, including premenstrual tension and depression.</li>\r\n	<li>Treatment of puerperal depression.</li>\r\n</ul>', '<p>Micronized Progesterone Vaginal Pessary is structurally and biologically identical to natural endogenous progesterone.</p>\r\n\r\n<ul>\r\n	<li><strong>Absorption</strong>: Vaginal administration of Progesterone 400 mg every 12 h in healthy women has been shown effective in rapidly achieving and maintaining serum progesterone concentrations at physiological levels appropriate to the mid-luteal phase of the ovarian cycle and early pregnancy.</li>\r\n	<li><strong>Distribution</strong>: Progesterone is approximately 96 % to 99 % bound to serum proteins, primarily to serum albumin and corticosteroid binding globulin.</li>\r\n	<li><strong>Biotransformation</strong>: Progesterone is metabolized primarily by the liver largely to pregnanediols and pregnanolones. Pregnanediols and pregnanolones are conjugated in the liver to glucuronide and sulfate metabolites. Progesterone metabolites that are excreted in the bile may be deconjugated and may be further metabolized in the gut via reduction, dehydroxylation and epimerization.</li>\r\n	<li><strong>Elimination</strong>: Progesterone undergoes renal and biliary elimination.</li>\r\n</ul>', '<p><strong>For luteal phase support as part of an ART treatment</strong>: 400 mg administered vaginally twice a day starting at oocyte retrieval. The administration of Progesterone should be continued for 38 days, if pregnancy has been confirmed.<br />\r\n<br />\r\n<strong>For maintenance of Pregnancy in cases of Threatened or recurrent abortion</strong>: 200 to 400 mg per day in divided doses.<br />\r\n<br />\r\n<strong>For the treatment of premenstrual syndrome and puerperal depression</strong>: 200 mg daily to 400mg twice a day, by vaginal or rectal insertion. For premenstrual syndrome commence treatment on day 14 of menstrual cycle and continue treatment until onset of menstruation. If symptoms are present at ovulation commence treatment on day 12.</p>', '<p>Drugs known to induce the hepatic cytochrome-P450-3A4 system (e.g. rifampicin, carbamazepine or phenytoin) may increase the elimination rate and thereby decrease the bioavailability of progesterone. The effect of concomitant vaginal products on the exposure of progesterone from Micronized Progesterone has not been assessed and is therefore not recommended.</p>', '<ul>\r\n	<li>Hypersensitivity to the active substance or to any of the excipients</li>\r\n	<li>Undiagnosed vaginal bleeding</li>\r\n	<li>Known or suspected progesterone sensitive malignant tumors Porphyria</li>\r\n	<li>Severe hepatic dysfunction or disease</li>\r\n	<li>Known missed abortion or ectopic pregnancy</li>\r\n	<li>Active arterial or venous thromboembolism or severe thrombophlebitis or a history of these events</li>\r\n</ul>', '<p>Micronized Progesterone is devoid of estrogenic, androgenic and mineralocorticoid effects. Mild somnolence and other CNS side effects like depression, breast tenderness and bloating are reported. Side effects are less when vaginal route is used.</p>', NULL, '<p>Micronized Progesterone is not indicated in threatened miscarriage. Treatment should be discontinued in the event of a missed miscarriage. Micronized Progesterone should be discontinued if any of the following conditions are suspected: Myocardial infarction, cerebrovascular disorders, arterial or venous thromboembolism (venous thromboembolism or pulmonary embolism), thrombophlebitis or retinal thrombosis.</p>', NULL, '<p>Corticosteroid, Other Topical corticosteroids</p>', '<p>Keep in a cool (below 30&deg;C), dry and dark place. Keep out of the reach of children.</p>', '<p><strong>Renal impaired patient</strong>: There is no experience with the use of Progesterone in patients with impaired liver or renal function.<br />\r\n<br />\r\n<strong>Pediatric population</strong>: There is no relevant use of Progesterone in the pediatric population.<br />\r\n<br />\r\n<strong>Elderly</strong>: No clinical data have been collected in patients over age 65.</p>', '2022-03-16 04:59:10', '2022-03-16 04:59:10');
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
(1270, 1270, '<ul>\r\n	<li>Potent long-acting antihistamine with additional anti-emetic and sedative/calming effects.</li>\r\n	<li>Indicated in symptomatic treatment of allergic conditions of the respiratory tract and skin.</li>\r\n	<li>Sensitization reactions to drug or foreign proteins, anaphylactic reactions.</li>\r\n	<li>For sedation, allergic rhinitis, urticaria and insomnia.</li>\r\n	<li>As an adjunct in pre-operative sedation in surgery and obstetrics.</li>\r\n	<li>As a paediatric sedative</li>\r\n</ul>', '<p>Promethazine is a phenothiazine derivative which blocks postsynaptic mesolimbic dopaminergic receptors in the brain. It exhibits strong &alpha;-adrenergic blocking effect and depresses the release of hypothalamic and hypophyseal hormones. It competes with histamine for the H1-receptor; muscarinic blocking effect may be responsible for antiemetic activity. It also reduces stimuli to the brainstem reticular system.<br />\r\n<br />\r\nPromethazine is well absorbed from the gastrointestinal tract. Clinical effects are apparent within 20 minutes after oral administration and generally last four to six hours, although they may persist as long as 12 hours. Promethazine is metabolized by the liver to a variety of compounds; the sulfoxides of promethazine and N-demethylpromethazine are the predominant metabolites appearing in the urine.</p>', '<p><strong>Adults</strong>: Initial dose one 25 mg tablet at night; may be increased to two or three 25 mg tablets at night if necessary. In allergic conditions more frequently administration, twice or three times daily, may be necessary, starting with one or two 10 mg tablets and increasing as required.<br />\r\n<br />\r\n<strong>Elderly</strong>: No specific dosage recommendations.<br />\r\n<br />\r\n<strong>Children</strong>: They may be treated more conveniently by the elixir containing 5 mg/5 ml.<br />\r\n<br />\r\nAs an antihistamine in allergy:</p>\r\n\r\n<ul>\r\n	<li>Children of 2-5 years: 5-15 mg</li>\r\n	<li>Children of 5-10 years: 10-25 mg</li>\r\n	<li>In the case where two doses in 24 hours are required, the lower dose stated should be given.</li>\r\n</ul>\r\n\r\n<p>As a sedative:</p>\r\n\r\n<ul>\r\n	<li>Children of 2-5 years: 15-20 mg</li>\r\n	<li>Children of 5-10 years: 20-25 mg</li>\r\n	<li>Given as a single night-time dose</li>\r\n</ul>', '<ul>\r\n	<li>Promethazine Hydrochloride may enhance the action of any anticholinergic agent, tricyclic antidepressant, sedative or hypnotic, Alcohol should be avoided during drug treatment.</li>\r\n	<li>Phenergan may interfere with immunologic urine pregnancy tests to produce false-positive or false-negative results.</li>\r\n	<li>Phenergan should be discontinued at least 72 hours before the start of skin tests using allergen extracts as it may inhibit the cutaneous histamine response thus producing false-negative results.</li>\r\n</ul>', '<ul>\r\n	<li>Promethazine is contraindicated for use in children less than two years of age</li>\r\n	<li>Hypersensitivity to promethazine or to any of the excipients.</li>\r\n	<li>Phenergan should not be used in patients who are in a coma or suffering from CNS depression of any cause. It must not be given to neonates or premature infants.</li>\r\n	<li>Phenergan should be avoided in patients who have been taking monoamine oxidase inhibitors within the previous 14 days</li>\r\n</ul>', '<ul>\r\n	<li>Nervous system disorders: Frequency Unknown: Neuroleptic Malignant Syndrome the elderly are particularly susceptible to the anticholinergic efects and confusion due to Promethazine, somnolence, dizziness, headaches, extrapyramidal efects including muscle spasm, tic-like movements of the head and face. A very serious and sometimes deadly health problem called neuroleptic malignant syndrome (NMS) may happen. Stop treatment and call your doctor right away if you have high fever, muscle cramps or stifness, dizziness, very bad headache, fast heartbeat, confusion, agitation, hallucinations, or are sweating a lot.</li>\r\n	<li>Immune System Disorders- Frequency unknown: Allergic reactions, including urticaria, rash, pruritus, and anaphylaxis, have been reported.</li>\r\n	<li>Skin and Subcutaneous Tissue Disorders- Frequency unknown: Photosensitivity reaction</li>\r\n	<li>Metabolism and Nutrition Disorders- Frequency unknown: Anorexia</li>\r\n	<li>Gastrointestinal Disorders- Frequency unknown: Epigastric discomfort, dry mouth</li>\r\n	<li>Eye Disorders- Frequency unknown: Blurred vision</li>\r\n	<li>Blood and Lymphatic System Disorders- Frequency unknown: Blood dyscrasias including hemolytic anemia, agranulocytosis</li>\r\n	<li>Renal and Urinary Disorders- Frequency unknown: Urinary retention</li>\r\n	<li>Psychiatric Disorders- Frequency unknown: Infants, newborns and premature are susceptible to the anticholinergic efects of promethazine, while other children may display paradoxical hyperexcitability, restlessness, nightmares, disorientation</li>\r\n	<li>Cardiac Disorders- Frequency unknown: Palpitations, arrhythmias</li>\r\n	<li>Vascular disorders- Frequency unknown: Hypotension</li>\r\n	<li>Hepatobiliary disorders- Frequency unknown: Jaundice</li>\r\n	<li>General Disorders and Administration Site Conditions- Frequency unknown: Tiredness</li>\r\n</ul>\r\n\r\n<p>Use this drug only as recommended. Do not exceed the recommended dose. There have been case reports of promethazine abuse. Do not take for longer than 10 days.</p>', '<p>There is epidemiological evidence for the safety of promethazine in pregnancy and animal studies have shown no hazard, nevertheless, it should not be used in pregnancy unless the physician considers it essential. The use of Phenergan is not recommended in the two weeks prior to delivery in view of the risk of irritability and excitement in the neonate. When promethazine has been given in high doses during late pregnancy, promethazine has caused prolonged neurological disturbances in the infant. Promethazine should be used in pregnancy only if the potential benefts to the patient are weighed against the possible risk to the fetus. Promethazine is excreted in breastmilk. There are risks of neonatal irritability and excitement.</p>', '<ul>\r\n	<li>The use of promethazine should be avoided in children and adolescents with signs and symptoms suggestive of Reye&rsquo;s syndrome.</li>\r\n	<li>Promethazine may thicken or dry lung secretions and impair expectoration. It should therefore be used with caution in patients with asthma, bronchitis or bronchiectasis.</li>\r\n	<li>Use with care in patients with severe coronary artery disease.</li>\r\n	<li>Use with care in patients with narrow angle glaucoma.</li>\r\n	<li>Use with care in patients with epilepsy.</li>\r\n	<li>Use with care in patients with hepatic insufciency.</li>\r\n	<li>Use with care in patients with renal insufciency.</li>\r\n	<li>Caution should be exercised in patients with bladder neck obstruction.</li>\r\n	<li>Caution should be exercised in patients with pyloro-duodenal obstruction.</li>\r\n</ul>', '<p>Symptoms of severe over dosage are variable. They are characterised in children by various combinations of excitation, ataxia, incoordination, athetosis and hallucinations, while adults may become drowsy and lapse into coma. Convulsions may occur in both adults and children; coma or excitement may precede their occurrence. Tachycardia may develop. Cardiorespiratory depression is uncommon. If the patient is seen soon enough after ingestion, it should be possible to induce vomiting with ipecacuanha despite the antiemetic efect of promethazine; alternatively, gastric lavage may be used. Treatment is otherwise supportive with attention to maintenance of adequate respiratory and circulatory status. Convulsions should be treated with diazepam or other suitable anticonvulsant.</p>', '<p>Anti-emetic drugs, Miscellaneous sedatives &amp; hypnotics, Sedating Anti-histamine.</p>', '<p>Protect from light. Do not use later than the date of expiry. Keep all medicines out of the reach of children. To be dispensed only on the prescription of a registered physician.</p>', NULL, '2022-03-16 05:01:09', '2022-03-16 05:01:09'),
(1271, 1271, '<p>Promethazine hydrochloride injection is indicated for the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Amelioration of allergic reactions to blood or plasma.</li>\r\n	<li>In anaphylaxis as an adjunct to epinephrine and other standard measures after the acute symptoms have been controlled.</li>\r\n	<li>For other uncomplicated allergic conditions of the immediate type when oral therapy is impossible or contraindicated.</li>\r\n	<li>For sedation and relief of apprehension and to produce light sleep from which the patient can be easily aroused.</li>\r\n	<li>Active treatment of motion sickness.</li>\r\n	<li>Prevention and control of nausea and vomiting associated with certain types of anesthesia and surgery.</li>\r\n	<li>As an adjunct to analgesics for the control of postoperative pain.</li>\r\n	<li>Preoperative, postoperative, and obstetric (during labor) sedation.</li>\r\n	<li>Intravenously in special surgical situations, such as repeated bronchoscopy, ophthalmic surgery, and poor-risk patients, with reduced amounts of meperidine or other narcotic analgesic as an adjunct to anesthesia and analgesia.</li>\r\n</ul>', '<p>Promethazine is a phenothiazine derivative which blocks postsynaptic mesolimbic dopaminergic receptors in the brain. It exhibits strong &alpha;-adrenergic blocking effect and depresses the release of hypothalamic and hypophyseal hormones. It competes with histamine for the H1-receptor; muscarinic blocking effect may be responsible for antiemetic activity. It also reduces stimuli to the brainstem reticular system.<br />\r\n<br />\r\nClinical effects are generally apparent within 5 minutes of an intravenous injection and within 20 minutes of an intramuscular injection. Duration of action is four to six hours, although effects may persist up to 12 hours. Promethazine hydrochloride injection is metabolized in the liver, with the sulfoxides of promethazine and N-desmethylpromethazine being the predominant metabolites appearing in the urine. Following intravenous administration in healthy volunteers, the plasma half-life for promethazine has been reported to range from 9 to 16 hours. The mean plasma half-life for promethazine after intramuscular administration in healthy volunteers has been reported to be 9.8&plusmn;3.4 hours.</p>', '<p><strong>Allergic Conditions</strong>: The average adult dose is 25 mg. This dose may be repeated within two hours if necessary, but continued therapy, if indicated, should be via the oral route as soon as existing circumstances permit. After initiation of treatment, dosage should be adjusted to the smallest amount adequate to relieve symptoms. The average adult dose for amelioration of allergic reactions to blood or plasma is 25 mg.<br />\r\n<br />\r\n<strong>Sedation</strong>: In hospitalized adult patients, nighttime sedation may be achieved by a dose of 25 to 50 mg of Promethazine Hydrochloride injection.<br />\r\n<br />\r\n<strong>Nausea and Vomiting</strong>: For control of nausea and vomiting, the usual adult dose is 12.5 to 25 mg, not to be repeated more frequently than every four hours. When used for control of postoperative nausea and vomiting, the medication may be administered either intramuscularly or intravenously and dosage of analgesics and barbiturates reduced accordingly.<br />\r\n<br />\r\n<strong>Preoperative and Postoperative Use</strong>: As an adjunct to preoperative or postoperative medication, 25 to 50 mg Promethazine Hydrochloride injection in adults may be combined with appropriately reduced doses of analgesics and atropine-like drugs as desired. Dosage of concomitant analgesic or hypnotic medication should be reduced accordingly.</p>', '<p><strong>CNS Depressants</strong>: Promethazine hydrochloride (promethazine hydrochloride injection) may increase, prolong, or intensify the sedative action of central-nervous-system depressants, such as alcohol, sedative-hypnotics (including barbiturates), general anesthetics, narcotics, narcotic analgesics, tranquilizers, etc. When given concomitanty with promethazine hydrochloride (promethazine hydrochloride injection), the dose of barbiturates should be reduced by at least one-half, and the dose of narcotics should be reduced by one-quarter to one-half. Dosage must be individualized. Excessive amounts of promethazine hydrochloride (promethazine hydrochloride injection) relative to a narcotic may lead to restlessness and motor hyperactivity in the patient with pain; these symptoms usually disappear with adequate control of the pain.<br />\r\n<br />\r\n<strong>Epinephrine</strong>: Although reversal of the vasopressor effect of epinephrine has not been reported with promethazine hydrochloride (promethazine hydrochloride injection), it is recommended that epinephrine NOT be used in the case of promethazine hydrochloride (promethazine hydrochloride injection) overdose.</p>', '<p>Promethazine hydrochloride injection is contraindicated in comatose states and in patients who have demonstrated an idiosyncrasy or hypersensitivity to promethazine or other phenothiazines. Under no circumstances should Promethazine hydrochloride injection be given by intra-arterial injection due to the likelihood of severe arteriospasm and the possibility of resultant&nbsp;gangrene.<br />\r\n<br />\r\nPromethazine hydrochloride injection should not be given by the&nbsp;subcutaneous&nbsp;route; evidence of chemical irritation has been noted, and&nbsp;necrotic&nbsp;lesions have resulted on rare occasions following subcutaneous injection. The preferred parenteral route of administration is by deep&nbsp;intramuscularinjection.</p>', '<p><strong>CNS Effects</strong>: Drowsiness is the most prominent CNS effect of the drug. Extrapyramidal reactions may occur with high doses; this is almost always responsive to a reduction in dosage. Other reported reactions include dizziness, lassitude, tinnitus, incoordination, fatigue, blurred vision, euphoria, diplopia, nervousness, insomnia, tremors, convulsive seizures, oculogyric crises, excitation, catatonic-like states, hysteria, and hallucinations.<br />\r\n<br />\r\n<strong>Cardiovascular Effects</strong>: Tachycardia, bradycardia, faintness, dizziness, and increases and decreases in blood pressure have been reported following the use of Promethazine hydrochloride injection. Venous thrombosis at the injection site has been reported.<br />\r\n<br />\r\n<strong>Gastrointestinal Effects</strong>: Nausea and vomiting have been reported, usually in association with surgical procedures and combination drug therapy.<br />\r\n<br />\r\n<strong>Allergic Reactions</strong>: These include urticaria, dermatitis, asthma, and photosensitivity. Angioneurotic edema has been reported.<br />\r\n<br />\r\n<strong>Other Reported Reactions</strong>: Leukopenia and agranulocytosis, usually when promethazine has been used in association with other known marrow-toxic agents, have been reported. Thrombocytopenic purpura and jaundice of the obstructive type have been associated with the use of promethazine. The jaundice is usually reversible on discontinuation of the drug. Subcutaneous injection has resulted in tissue necrosis. Nasal stuffiness may occur. Dry mouth has been reported.</p>', '<p>Pregnancy Category C. Teratogenic effects have not been demonstrated in rat-feeding studies at doses of 6.25 and 12.5 mg/kg (approximately 2.1 and 4.2 times the maximum recommended human daily dose) of Promethazine hydrochloride injection . Daily doses of 25 mg/kg intraperitoneally have been found to produce fetal mortality in rats.<br />\r\n<br />\r\nThere are no adequate and well-controlled studies of Promethazine hydrochloride injection in pregnant women. Because animal reproduction studies are not always predictive of human response, Promethazine hydrochloride injection should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.</p>', '<p><strong>General</strong>: Drugs having anticholingeric properties should be used with caution in patients with narrow-angle&nbsp;glaucoma, prostatic&nbsp;hypertrophy, stenosing&nbsp;peptic ulcer, pyloroduodenal obstruction, and bladder-neck obstruction. Promethazine hydrochloride (promethazine hydrochloride injection) should be used cautiously in persons with&nbsp;cardiovascular disease&nbsp;or impairment of liver function.<br />\r\n<br />\r\n<strong>Carcinogenesis, Mutagenesis&nbsp;</strong>and<strong>&nbsp;Impairment of Fertility</strong>: Long term animal studies have not been performed to assess the carcinogenic potential of promethazine hydrochloride (promethazine hydrochloride injection), nor are there other animal or human data concerning carcinogenicity, mutagenicity, or impairment of fertility. Promethazine hydrochloride was nonmutagenic in the Ames&nbsp;Salmonella&nbsp;test system.</p>', '<p><strong>Signs and symptoms</strong>&nbsp;of overdosage range from mild depression of the&nbsp;central nervous system&nbsp;and&nbsp;cardiovascular system&nbsp;to profound&nbsp;hypotension, respiratory depression, and unconsciousness.<br />\r\n<br />\r\nStimulation may be evident, especially in pediatric patients and geriatric patients. Convulsions may rarely occur. A paradoxical reaction has been reported in pediatric patients receiving single doses of 75 mg to 125 mg orally, characterized by hyperexcitability and nightmares.<br />\r\n<br />\r\nAtropine-like and symptoms: dry mouth, fixed, dilated pupils, flushing, etc., as well as&nbsp;gastrointestinal&nbsp;symptoms, may occur.<br />\r\n<br />\r\n<strong>Treatment</strong>: Treatment of overdosage is essentially&nbsp;symptomatic&nbsp;and supportive. Only in cases of extreme overdosage or individual sensitivity do vital signs, including respiration, pulse, blood pressure, temperature, and EKG, need to be monitored. Attention should be given to the reestablishment of adequate respiratory exchange through provision of a patent airway and institution of assisted or controlled ventilation. Diazepam may be used to control convulsions.&nbsp;Acidosis&nbsp;and&nbsp;electrolyte&nbsp;losses should be corrected. Note that any depressant effects of promethazine hydrochloride (promethazine hydrochloride injection) are not reversed by&nbsp;naloxone.<br />\r\n<br />\r\nAvoid analeptics, which may cause convulsions. The treatment of choice for resulting hypotension is administration of intravenous fluids, accompanied by repositioning if indicated. In the event that vasopressors are considered for the management of severe hypotension which does not respond to intravenous fluids and repositioning, the administration of levarterenol or phenylephrine should be considered.&nbsp;EPINEPHRINE&nbsp;SHOULD NOT BE USED, since its use in a patient with partial adrenergic blockade may further lower the blood pressure. Extrapyramidal reactions may be treated with&nbsp;anticholinergic&nbsp;antiparkinson agents, diphenhydramine, or barbiturates. Oxygen may also be administered. Limited experience with&nbsp;dialysis&nbsp;indicates that it is not helpful.</p>', '<p>Anti-emetic drugs, Miscellaneous sedatives &amp; hypnotics, Sedating Anti-histamine.</p>', '<p>Store between 15-30&deg; C. Protect from light..</p>', '<p><strong>Pediatric Patients</strong>: Promethazine hydrochloride are contraindicated for children under 2 years of age. In pediatric patients 2 years of age and older, the dosage should not exceed half that of the suggested adult dose. As an adjunct to premedication, the suggested dose is 0.5 mg per lb. of body weight in combination with an appropriately reduced dose of narcotic or barbiturate and the appropriate dose of an atropine-like drug. Antiemetics should not be used in vomiting of unknown&nbsp;etiology&nbsp;in pediatric patients&nbsp;<br />\r\n<br />\r\n<strong>Geriatric Patients&nbsp;(approximately 60 years or older)</strong>: Since therapeutic requirements for sedative drugs tend to be less in geriatric patients, the dosage should be reduced for these patients.</p>', '2022-03-16 05:03:22', '2022-03-16 05:03:22'),
(1272, 1272, '<p>Promethazine Theoclate Tablets are an anti-emetic (anti-sickness drug) which helps to prevent, and treat nausea and vomiting, including travel sickness, and vertigo. Promethazine Theoclate contains promethazine which belongs to a group of medicines called phenothiazines. Your doctor may prescribe this medicine for giddiness or light-headedness (vertigo), or for sickness after an operation, and in such cases the tablets should be taken as instructed by your doctor.</p>', '<p>Promethazine Theoclate works by stopping histamine from binding to its receptors in&nbsp;an area in the brain known as the vomiting centre. The vomiting centre is responsible for causing feelings of sickness and for the vomiting reflex. It is activated when it receives nerve messages from the vestibular apparatus in the middle ear.<br />\r\n<br />\r\nThe vestibular apparatus provides constant feedback to the brain about the position of our body. When something disturbs the vestibular apparatus, such as movements of the head when travelling by boat or car, nerve signals are sent from the vestibular apparatus to the vomiting centre. This can cause the symptoms of motion sickness, such as nausea, dizziness or spinning sensations (vertigo) and vomiting.<br />\r\n<br />\r\nBy blocking the histamine receptors in the vomiting centre, Promethazine Theoclate&nbsp;prevents disturbances in the middle ear from activating the vomiting centre.</p>', '<p><strong>To prevent travel sickness on short journeys</strong>: Promethazine Theoclate should be taken at least one or two hours before travelling. Adults and children aged over 10 years&nbsp;should take one tablet. Children aged 5 to 10 years should be given half a tablet.<br />\r\n<br />\r\n<strong>To prevent travel sickness on&nbsp;long journeys</strong>: Promethazine Theoclate should be taken at bedtime each night during the journey, starting&nbsp;the night before you travel.&nbsp;Adults and children&nbsp;aged over 10 years&nbsp;should take one tablet.&nbsp;Children aged 5 to 10 years should be given half a tablet.<br />\r\n<br />\r\n<strong>To treat travel sickness</strong>:&nbsp;Adults and children over 10 years should take one tablet as soon as you feel sick, followed by a second tablet the same evening. Take a third tablet the following evening if necessary. Children aged 5 to 10 years should treated in the same way, but with half a tablet each time.<br />\r\n<br />\r\n<strong>For sickness and vomiting due to other causes, and for treating vertigo</strong>: Adults and children aged over 10 years should take one tablet up to three times a&nbsp;day. Children aged 5 to 10 years should be given half a tablet up to three times a day.&nbsp;Alternatively&nbsp;you should follow the instructions given by your doctor.</p>', '<p>It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start taking Promethazine Theoclate. Similarly, check with your doctor or pharmacist before taking any new medicines while taking Promethazine Theoclate, to make&nbsp;sure that the&nbsp;combination is safe.<br />\r\n<br />\r\nPromethazine Theoclate&nbsp;should not be taken by anyone who has&nbsp;taken&nbsp;a type of antidepressant called a monoamine oxidase inhibitor (MAOI), eg&nbsp;phenelzine,&nbsp;tranylcypromine,&nbsp;isocarboxazid,&nbsp;in the previous 14 days.<br />\r\n<br />\r\nYou are more likely to feel drowsy if you take Promethazine Theoclate&nbsp;with any of the following (which can also cause drowsiness):</p>\r\n\r\n<ul>\r\n	<li>alcohol</li>\r\n	<li>antipsychotic medicines, eg&nbsp;chlorpromazine</li>\r\n	<li>barbiturates, eg&nbsp;phenobarbital</li>\r\n	<li>benzodiazepines, eg&nbsp;diazepam,&nbsp;temazepam</li>\r\n	<li>sedating antihistamines, eg&nbsp;chlorphenamine,&nbsp;brompheniramine,&nbsp;hydroxyzine</li>\r\n	<li>sleeping tablets, eg&nbsp;zopiclone</li>\r\n	<li>strong opioid painkillers, eg&nbsp;morphine,&nbsp;codeine,&nbsp;dihydrocodeine, tramadol</li>\r\n	<li>tricyclic antidepressants, eg&nbsp;amitriptyline.</li>\r\n</ul>', '<ul>\r\n	<li>Children under five&nbsp;years of age.</li>\r\n	<li>People with reduced awareness, slow reactions or extreme drowsiness caused by medicines or illnesses&nbsp;that reduce activity in the central nervous system.</li>\r\n	<li>People who have taken a type of medicine called a&nbsp;monoamine-oxidase inhibitor antidepressant&nbsp;(MAOI) in the past 14 days.</li>\r\n	<li>Children and adolescents who have signs and symptoms suggestive of Reye&#39;s syndrome.</li>\r\n	<li>People who are allergic to any ingredients of the tablets.</li>\r\n	<li>Promethazine Theoclate tablets contain lactose and should not be taken by people with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption.</li>\r\n</ul>', '<p>Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with promethazine. Just because a side effect is stated here does not mean that all people using Promethazine Theoclate will experience that or any side effect.</p>\r\n\r\n<ul>\r\n	<li>Drowsiness or feeling tired.</li>\r\n	<li>Dizziness.</li>\r\n	<li>Restlessness.</li>\r\n	<li>Headache.</li>\r\n	<li>Nightmares.</li>\r\n	<li>Blurred vision.</li>\r\n	<li>Difficulty passing urine.</li>\r\n	<li>Dry mouth.</li>\r\n	<li>Confusion.</li>\r\n	<li>Feeling disorientated.</li>\r\n	<li>Unexpected increase in excitability in children.</li>\r\n	<li>Increased sensitivity of the skin to sunlight (photosensitivity). If affected you should avoid sun lamps and direct sunlight while you are taking this medicine.</li>\r\n	<li>Loss of appetite.</li>\r\n	<li>Awareness of your heartbeat (palpitations).</li>\r\n	<li>Abnormal heartbeats (arrhythmias).</li>\r\n	<li>Low blood pressure (hypotension).</li>\r\n	<li>Abnormal movements of the hands, legs, face, neck and tongue, eg tremor, twitching, rigidity (extrapyramidal effects).</li>\r\n	<li>Blood disorders.</li>\r\n</ul>', '<p>If you are pregnant you should not take Promethazine Theoclate without consulting your doctor first. Promethazine Theoclate should only be used&nbsp;during pregnancy if essential, and&nbsp;only if the expected benefit to the mother outweighs any potential risks to the developing baby. It&nbsp;should not be used during the last two weeks of&nbsp;pregnancy, because if taken during this time it may cause irritability or excitement in the baby after birth. Seek further medical advice from your doctor.<br />\r\n<br />\r\nSmall amounts of Promethazine Theoclate may pass into breast milk. This is not expected to be harmful to a nursing infant with occasional short-term use of Promethazine Theoclate, but there&nbsp;is a risk that it may cause drowsiness,&nbsp;irritability or excitement in a newborn baby. If you are breastfeeding you should not take Promethazine Theoclate without getting medical advice from your doctor first.</p>', '<p>Promethazine Theoclate tablets can make some people feel drowsy, dizzy, confused or disorientated and this&nbsp;may reduce your ability to drive or operate machinery safely.&nbsp;Do not drive or operate machinery until you know how this medicine affects you&nbsp;and you are sure it won&#39;t affect your performance.&nbsp;If your child is affected in this way they should avoid potentially hazardous activities such as riding bikes. You should not leave your child unattended after giving them this medicine.<br />\r\n<br />\r\nAvoid drinking&nbsp;alcohol&nbsp;while taking Promethazine Theoclate&nbsp;because this is likely to make the above effects more likely&nbsp;or worse.<br />\r\n<br />\r\nPromethazine Theoclate tablets may make your skin more sensitive to sunlight than usual, so you should avoid exposing your skin to direct sunlight or sunlamps until you know how your skin reacts. If you can&#39;t avoid strong sunlight you should use a sunscreen lotion or make sure your skin is protected with clothing.<br />\r\n<br />\r\nThis medicine may interfere with some&nbsp;pregnancy tests, causing false negative or false positive results.<br />\r\n<br />\r\nIf you are due to have any&nbsp;skin prick tests&nbsp;to diagnose allergies you should stop taking Promethazine Theoclate at least 72 hours before the tests. This is because antihistamines can prevent or lessen the skin reactions that indicate an allergy, and so can make the test results unreliable.</p>', NULL, '<p>Anti-emetic drugs, Miscellaneous sedatives &amp; hypnotics, Sedating Anti-histamine.</p>', '<p>Store between 15-30&deg; C. Protect from light.</p>', NULL, '2022-03-16 05:05:32', '2022-03-16 05:05:32'),
(1273, 1273, '<p>Propafenone is indicated for the treatment of paroxysmal atrial fibrillation/flutter (PAF), paroxysmal supraventricular tachycardia (PSVT). Propafenone is also indicated for the treatment of documented ventricular arrhythmias.</p>', '<p>Propafenone works by slowing the influx of sodium ions into the cardiac muscle cells, causing a decrease in excitability of the cells. Propafenone is more selective for cells with a high rate, but also blocks normal cells more than class Ia or Ib. Propafenone differs from the prototypical class Ic antiarrhythmic in that it has additional activity as a beta-adrenergic blocker which can cause bradycardia and bronchospasm.</p>', '<p>The dose of Propafenone must be individually titrated on the basis of response and tolerance. It is recommended that therapy be initiated with Propafenone 150 mg given every eight hours (450 mg/day). Dosage may be increased at a minimum of 3 to 4 day intervals to 225 mg every 8 hours (675 mg/day) and if necessary, to 300 mg every 8 hours (900 mg/day). The usefulness and safety of dosages exceeding 900 mg per day have not been established.</p>', '<p>Propafenone is metabolized by CYP2D6 (major pathway) and CYP1A2 and CYP3A4. Drugs that inhibit CYP2D6 (such as desipramine, paroxetine, ritonavir, sertraline), CYP1A2 (such as amiodarone) and CYP3A4 (such as ketoconazole, ritonavir, saquinavir, erythromycin and grapefruit juice) can be expected to cause increased plasma levels of propafenone. In addition, propafenone is an inhibitor of CYP2D6. Coadministration of propafenone with drugs metabolized by CYP2D6 (such as desipramine, imipramine, haloperidol, venlafaxine) might lead to increase plasma concentrations of these drugs.</p>', '<p>Propafenone is contraindicated in the presence of uncontrolled congestive heart failure, cardiogenic shock, sinoatrial, atrioventricular and intraventricular disorders of impulse generation and/or conduction (e.g. sick sinus node syndrome, atrioventricular block) in the absence of an artificial pacemaker, bradycardia, marked hypotension, bronchospastic disorders, manifest electrolyte imbalance and known hypersensitivity to the drug.</p>', '<p>Adverse reactions associated with propafenone occur most frequently in the gastrointestinal, cardiovascular and central nervous systems. Change in taste, constipation, diarrhea, dizziness, drowsiness, dry mouth, gas, headache, light-headedness, nausea, tiredness etc. may happen. Severe allergic reactions also reported with propafenone.</p>', '<p><strong>Pregnancy:</strong>&nbsp;Propafenone has been assigned to&nbsp;pregnancy category C by the FDA.&nbsp;There are no controlled data in human&nbsp;pregnancy. Limited data indicate that&nbsp;propafenone has been administered&nbsp;during the third trimester of pregnancy&nbsp;without adverse maternal or fetal&nbsp;effects. Propafenone should be given&nbsp;during pregnancy only when benefit&nbsp;outweighs risk.<br />\r\n<br />\r\n<strong>Nursing Mothers:</strong>&nbsp;It is not known whether this drug is&nbsp;excreted in human milk. Because many&nbsp;drugs are excreted in human milk and&nbsp;because of the potential for serious&nbsp;adverse reactions in nursing infants&nbsp;from propafenone, a decision should be&nbsp;made whether to discontinue nursing or&nbsp;to discontinue the drug, taking into&nbsp;account the importance of the drug to&nbsp;the mother.</p>', '<p><strong>Hepatic Dysfunction:</strong>&nbsp;Propafenone is highly metabolized by&nbsp;the liver and should therefore, be&nbsp;administered cautiously to patients with impaired hepatic function. As a result,&nbsp;the dose of propafenone given to patients with impaired hepatic function&nbsp;should be approximately 20 to 30% of&nbsp;the dose given to patients with normal&nbsp;hepatic function.<br />\r\n<br />\r\n<strong>Renal Dysfunction:</strong>&nbsp;A considerable percentage of propafenone metabolites (18.5% to 38% of the&nbsp;dose/48 hours) are excreted in the urine. Until further data are available, propafenone should be administered&nbsp;cautiously to patients with impaired&nbsp;renal function.<br />\r\n<br />\r\n<strong>Neuromuscular Dysfunction:</strong>&nbsp;Exacerbation of myasthenia gravis has been reported during propafenone&nbsp;therapy.</p>', NULL, '<p>Membrane stabilizing agent (Sodium channel blockers).</p>', '<p>Store at 25&deg; C. Store in a cool and dry place, protected from light. Keep out of children&rsquo;s reach.</p>', '<p><strong>Pediatric Use:&nbsp;</strong>The safety and effectiveness of&nbsp;propafenone in pediatric patients have&nbsp;not been established.<br />\r\n<br />\r\n<strong>Geriatric Use:&nbsp;</strong>Clinical studies of propafenone did not&nbsp;include sufficient numbers of subjects&nbsp;aged 65 and over to determine whether&nbsp;they respond differently from younger&nbsp;subjects. In general, dose selection for&nbsp;an elderly patient should be cautious.</p>', '2022-03-16 05:07:17', '2022-03-16 05:07:17'),
(1274, 1274, '<p>Propantheline Bromide is indicated in the treatment of-</p>\r\n\r\n<ul>\r\n	<li>Adjunctive therapy in the treatment of peptic ulcer (gastric and duodenal)</li>\r\n	<li>Relief of the symptoms of gastritis (stomach upset, gastrointestinal bleeding, blood in vomit, blood in stool, persistent pain)</li>\r\n	<li>Symptomatic treatment of the diarrhoea related irritable bowel syndrome (irritable colon, spastic colon, acute enterocolitis, functional Gl disorders etc)</li>\r\n	<li>Urinary incontinence</li>\r\n	<li>Control of salivation and enuresis</li>\r\n	<li>Improves lactose intolerance</li>\r\n	<li>Prevents excessive sweating (Hyperhidrosis)</li>\r\n</ul>', '<p>Propantheline Bromide acts by dual mechanism of action.</p>\r\n\r\n<ul>\r\n	<li>Specific anticholinergic effect (antimuscarinic) at the acetylcholine-receptor sites</li>\r\n	<li>Direct effect upon smooth muscle (musculotropic).</li>\r\n</ul>\r\n\r\n<p>This medication is a muscarinic antagonist having antispasmodic properties. It reduces the effect of acetylcholine, a chemical released from nerves that stimulates muscles, by blocking the receptors for acetylcholine on smooth muscle. It also has a direct relaxing effect on smooth muscle. In addition, Propantheline inhibits gastrointestinal motility and decreases gastric acid secretion and controls excessive pharyngeal, tracheal and bronchial secretions. Other secretions like pancreatic juice, sweat and saliva are also reduced.</p>', '<p>The usual initial adult dose of Propantheline Bromide is 75 mg daily. One tablet 30 min before each meal (15 mg three times daily). Two tablets at bedtime Dosage adjustment should be made according to the patient&#39;s individual response and tolerance. But the maximum daily dosage should not exceed 120 mg.<br />\r\n<br />\r\nPediatric use: Safety and effectiveness in pediatric patients have not been established.</p>', '<p>Antacids or Absorbent Antidiarrhoeals may reduce the absorption of propantheline bromide, therefore resulting in a reduction of its therapeutic effectiveness. Therefore, take two to three hours apart from doses of propantheline bromide. Anticholinergics may delay absorption of other medication given concomitantly. Significant drug interaction also occurs with concomitant use of digoxin, haloperidol, corticosteroides, ketoconazole, levodopa, opioid analgesics, phenothiazines, urinary alkalizers.</p>', '<p>Propantheline Bromide is contraindicated in patients with-</p>\r\n\r\n<ul>\r\n	<li>Hypersensitivity to Propantheline bromide or other anticholinergic agents;</li>\r\n	<li>Glaucoma;</li>\r\n	<li>Obstructive disease of the gastrointestinal tract (pyloroduodenal stenosis, paralytic ileus etc.);</li>\r\n	<li>Obstructive uropathy (e.g. prostatic hypertrophy) intestinal atony of elderly;</li>\r\n	<li>Myasthenia gravis.</li>\r\n</ul>', '<p>The adverse effects of Propantheline Bromide are usually dose-related and are usually reversible when the therapy is discontinued. Variable degrees of dry mouth, dry skin, mydriasis might be noted. Other reported adverse effects include urinary retention, nausea, vomiting, constipation, headache, nervousness, mental confusion etc.</p>', '<p>Propantheline Bromide is in pregnancy category C. Animal reproduction studies have not been conducted with propantheline bromide. Propantheline bromide should be given to a pregnant woman only if clearly needed. It is not known whether this drug is excreted in milk. Because many drugs are excreted in milk, caution should be exercised when propantheline bromide is administered to a nursing woman. Suppression of lactation may occur with anticholinergic drugs.</p>', '<p>Propantheline Bromide should be used with caution in the elderly and in all patients with autonomic neuropathy, hepatic or renal disease, hyperthyroidism, coronary heart disease, congestive heart failure, cardiac tachyarrhythmias, hypertension, since anticholinergics may aggravate this condition.</p>', '<p>The symptoms of overdosage with Propantheline Bromide progress from an intensification of the usual side effects (from nausea and vomiting) to CNS disturbances (from restlessness and excitement to psychotic behaviour), circulatory changes, (flushing, fall in blood pressure, circulatory failure), respiratory failure, paralysis.</p>', '<p>Anticholinergics (antimuscarinics)/ Anti-spasmodics.</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-16 05:09:04', '2022-03-16 05:09:04'),
(1275, 1275, '<p>Proparacaine is indicated for procedures in which a topical ophthalmic anesthetic is indicated: corneal anesthesia of short duration, e.g. tonometry, gonioscopy, removal of corneal foreign bodies, and for short corneal and conjunctival procedures. It is also indicated for use prior to surgical operations such as cataract extraction.</p>', '<p>The main site of anesthetic action is the nerve cell membrane where proparacaine interferes with the large transient increase in the membrane permeability to sodium ions that is normally produced by a slight depolarization of the membrane. As the anesthetic action progressively develops in a nerve, the threshold for electrical stimulation gradually increases and the safety factor for conduction decreases; when this action is sufficiently well developed, block of conduction is produced. Several studies indicate that local anesthetics may limit sodium ion permeability by closing the pores through which the ions migrate in the lipid layer of the nerve cell membrane.</p>', '<p><strong>Deep anesthesia as in cataract extraction</strong>: Instill 1 drop to the eye every 5 to 10 minutes for 5 to 7 doses.<br />\r\n<br />\r\n<strong>Removal of sutures</strong>: Instill 1 or 2 drops to the eye 2 or 3 minutes before removal of stitches.<br />\r\n<br />\r\n<strong>Removal of foreign bodies</strong>: Instill 1 or 2 drops to the eye prior to operating.<br />\r\n<br />\r\n<strong>Tonometry</strong>: Instill 1 or 2 drops to the eye immediately before measurement.</p>\r\n\r\n<p>&nbsp;</p>', NULL, '<p>Proparacaine eye drops should be considered contraindicated in patients with known hypersensitivity to any of the ingredients of this preparation.</p>', '<p>Occasional temporary stinging, burning and conjunctival redness may occur with the use of Proparacaine.</p>', '<p><strong>Use in pregnancy</strong>: It is not known whether Proparacaine can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Proparacaine should be administered to a pregnant woman only if clearly needed.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Proparacaine is administered to a nursing mother.</p>', '<p>Prolonged use of a topical ocular anesthetic is not recommended. It may produce permanent corneal opacification with accompanying visual loss.</p>', NULL, '<p>Ocular perioperative drugs.</p>', '<p>Store bottles under refrigeration at 2&deg; to 8&deg; C &amp; protect from light. It is desirable that the contents should not be used more than 4 weeks after first opening of the bottle. If solution shows more than a faint yellow color, it should not be used. Keep bottle tightly closed.</p>', '<p><strong>Pediatric Use:</strong>&nbsp;Safety and effectiveness of Proparacaine ophthalmic solution in pediatric patients have been established. Use of Proparacaine is supported by evidence from adequate and well-controlled studies in adults and children over the age of twelve, and safety information in neonates and other pediatric patients.<br />\r\n<br />\r\n<strong>Geriatric Use:</strong>&nbsp;No overall clinical differences in safety or effectiveness have been observed between the elderly and other adult patients.</p>', '2022-03-16 05:10:43', '2022-03-16 05:10:43');
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
(1276, 1276, '<p>Induction and maintenance of general anaesthesia. Sedation during intensive care. Sedation for surgical and diagnostic procedures.</p>', '<p>Propofol is a sedative-hypnotic agent for use in the induction and maintenance of anesthesia or sedation. Intravenous injection of a therapeutic dose of propofol produces hypnosis rapidly with minimal excitation, usually within 40 seconds from the start of an injection (the time for one arm-brain circulation).&nbsp;The action of propofol involves a positive modulation of the inhibitory function of the neurotransmitter gama-aminobutyric acid (GABA) through GABA-A receptors.</p>', '<p>Adults:</p>\r\n\r\n<p><strong>Induction of general anaesthesia</strong>: The dosage of Propofol should be titrated individually against the response of the patient. The ordinary initial dosage in adults is 40 mg (4 ml) by slow intravenous bolus injection at intervals of 10 seconds until the clinical signs show the onset of anaesthesia. The ordinary induction dose in healthy patient below 55 years of age is 2.2-2.5 mg/kg. A dose of 1.0-1.5 mg/kg is often sufficient for older patient. Lower doses, most often 20 mg (2 ml) at intervals of 10 seconds, are recommended for patient of ASA grades 3 and 4.<br />\r\n<br />\r\n<strong>Maintenance of general anaesthesia</strong>: Anaesthesia can be maintained by administering Propofol either by continuous infusion or by repeat bolus injections to maintain sufficient anaesthesia.&nbsp;<br />\r\n<br />\r\n<strong>Continuous infusion</strong>: The required rate of infusion varies considerably between patients. At the onset of anaesthesia (during roughly the first 10-20 minutes), some patient may require a slightly higher infusion rate (8-10 mg/kg/h). However, sufficient anaesthesia is normally achieved by infusing 4-6 (up to 12) mg/kg/h of Propofol. Repeat bolus injections: 25-50 mg (2.5-5.0 ml) bolus injections, depending on response.<br />\r\n<br />\r\n<strong>Sedation during intensive care</strong>: A bolus injection of 1.0-2.0 mg/kg should be given first, followed by continuous infusion adjusted according to required degree of sedation. An infusion rate of 0.3-4 mg/kg/h is usually sufficient.<br />\r\n<br />\r\n<strong>Sedation for surgical and diagnostic procedures</strong>: Dosages shall be adjusted individually. Sufficient sedation for surgical and diagnostic procedures can usually be achieved by administering initially 0.5-1 mg/kg during 1-5 minutes, and maintained by continuous at a rate of 1-4.5 mg/kg/h. Bolus dose of 10-20 mg can be given in addition, should deeper sedation be suddenly required. Lower doses of Propofol are often sufficient for patient of ASA grades 3 and 4, and for older patient.&nbsp;<br />\r\n&nbsp;</p>\r\n\r\n<p>Children:</p>\r\n\r\n<p>Propofol is not recommended for use in children less then 3 years of age as its safety has not been demonstrated.&nbsp;<br />\r\n<br />\r\n<strong>Induction of general anaesthesia</strong>: Dosage of Propofol in children shell be adjusted for weight and age. The mean induction dosage in children over 8 years is 2.5 mg/kg, given by slow intravenous injection until the clinical signs show the onset of anaesthesia. Younger children may need slightly higher doses of propofol per kilogram of weight. Lower dosages are recommended for children of ASA grades 3 and 4.<br />\r\n<br />\r\n<strong>Maintenance of general anaesthesia</strong>: Anaesthesia can be maintained by administering Propofol either by continuous infusion or by repeat bolus injections. Dosage shall be adjusted individually, but an infusion rate of 9-15 mg/kg/h is usually sufficient to achieve satisfactory anaesthesia.<br />\r\n<br />\r\n<strong>Sedation during intensive care, surgical diagnostic procedures</strong>: Propofol is not recommended for sedation in children as its efficacy and safety have not been demonstrated. Although no casual relationship has been established, serious adverse events (including fatalities) have been reported in cases, where propofol has been used against recommendations. Adverse events have most commonly been seen in children with respiratory tract infections given doses in excess of those recommended for adults.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p><strong>Method of administration</strong>: In order to reduce pain on injection, the induction dose of propofol may be mixed immediately before injection in the palstic syringe with lidocaine 10 mg/ml injection, in a ratio of 1 part of lidocaine injection for 20 parts of Propofol.<br />\r\n<br />\r\nPropofol can be administered either undiluted or diluted for infusion. Before injection or dilution, each ampoule or vial shall be ispected for any irregularity. Should any changes be observed, the product shall not be used. Suitable equipment shall be used to ensure correct rate of infusion. Volumetric infusion pumps and syringe pumps, for example, are suitable for this purpose. The ordinary infusion set used alone is not sufficient to prevent accidential overdosage reliably enough.<br />\r\n<br />\r\n<strong>Compatibility</strong>: Propofol may be diluted only with 5% dextrose infusion. Dilution shall not exceed 1 in 5 (containing 2 mg/ml Propofol) and shall be prepared in a PVC infusion bag or glass infusion bottle. If a PVC infusion bag is used, the bag should be full and the dilution be prepared by withdrawing a volume of infusion fluid and replacing it with an equal volume of Propofol. Special attention shall be paid to preparing the dilution aseptically, immediately before administration. Any diluted solution shall be used within 6 hours of preparation. Any remaining solution shall be discarded.</p>', '<p>Propofol has been used in association with spinal and epidural anaesthesia as well as with various types of premedicants, muscle relaxants, inhalation anaesthetics and analgetics. No pharmacological incompatibility has been observed. Lower doses of Propofol may be sufficient in case Propofol is used as an adjunct to local anaesthetic techniques. In doses applied clinically, propofol will not inhibit the synthesis of adrenocortical hormones. Simultaneous administration of opiates may potentiate respiratory depression caused by Propofol.</p>', '<p>Allergy to propofol or any other ingredient in the preparation.</p>', '<p><strong>Local</strong>: Propofol is normally well tolerated. Its most common undesirable effect is pain at the site of injection that can be reduced by mixing the preparation with lidocaine or by injecting it into one of the larger veins of the forearm or the intercubital fossa. Thrombosis and phlebitis are rare.<br />\r\n<br />\r\n<strong>General</strong>: Hypotension and transient apnea may occur at the induction of anaesthesia, and may be severe especially in patients who are in a poor general condition. Epileptic movement, convulsions and dystonic reactions have been seen in rare cases. Pulmonary oedema has also been reported. Headache, nausea and, more rarely, vomiting may occur in some patients during recovery. Recovery may also be associated with another short period of impaired consciousness. Hypersensitivity has been reported in some cases, connected with anaphylactic symptoms such as marked hypotension, bronchospasm, oedema and facial erythema. Some cases of cardiac arrest have occurred in connection with the administration of propofol. In connection with long-term administration of propofol, green or reddish brown discolouration of urine may occur. This is caused by the quinol metabolites of propofol, and is not dangerous. As with other anaesthetics, altered sexual behaviour may occur.</p>', '<p>Due to insufficient experience, propofol shall not be used during pregnancy. Propofol is rapidly distributed to the foetus and shall therefore not be used for obstetric anaesthesia. Safety to the neonate has not been established in cases, where propofol has been administered to lactating women.</p>', '<p>Propofol should only be given by specialists in anaesthesiology or under their supervision. The physician performing a surgical or diagnostic procedure should not administer propofol. Facilities for resuscitation in case of any complication should be available at the treatment unit. During the administration of Propofol, patients shall be monitored continuously to observe possible hypotension, obstruction in the respiratory tract, hypoventilation or insufficient oxygen intake at a sufficiently early stage. Special attention shall be paid to patients sedated by Propofol for a surgical or diagnostic procedure, who are not artificially ventilated. Caution shall be taken in administering Propofol to patients with cardiac, respiratory, renal or hepatic insufficiency. Hypovolemic patients and those with poor general condition form another risk group.<br />\r\n<br />\r\nSince propofol lacks vagolytic activity, bradycardia, even asystole, may occur. Intravenous administration of an anticholinergic agent before induction and during maintenance of anaesthesia should be considered, especially if propofol is used in conjunction with other agents likely to cause bradycardia and in situations where vagal tone is likely to predominate. Since Propofol is a lipid emulsion, appropriate care should be applied in patients with severe disorders of fat metabolism such as pathological hyperlipidemia. If Propofol is administered to a patient for whom excessive fat intake may be risky, blood lipid values shall be monitored and Propofol dosage decreased if necessary. If the patient is receiving other paranteral lipid emulsions in addition to Propofol, the amount of lipid in Propofol (0.1 g/ ml) shall be taken into account, when calculating the total intake of fat. In epileptic patients, propofol may lead to convulsions. The analgetic effect of propofol as such is insufficient. Analgetics shall be used to ensure sufficient analgesia. Full recovery from general anaesthesia shall be confirmed prior to discharge. It shall be noted that the aftermath of general anaesthesia may impair the patient&#39;s ability to understand instructions given postoperatively.</p>', '<p>Overdosage may cause cardiorespiratory depression. Respiratory depression should be treated by artificial ventilation with oxygen, and cardiovascular depression by lowering of the patient&#39;s head and elevating of his/her legs. Pressor agents and plasma expanders or Ringer-type electrolyte solutions may be used, if necessary.</p>', '<p>General (Intravenous) anesthetics.</p>', '<p>Propofol should be stored at a temperature not exceeding 25&ordm; C. It must not be frozen. Any unused solution shall be discarded.</p>', '<p><strong>Use in children</strong>: Propofol is not recommended for use in children less then 3 years of age as its safety has not been demonstrated.</p>', '2022-03-16 05:13:00', '2022-03-16 05:13:00'),
(1277, 1277, '<p>Propranolol is indicated in:</p>\r\n\r\n<ul>\r\n	<li>Essential hypertension</li>\r\n	<li>Angina pectoris</li>\r\n	<li>Cardiac arrhythmia</li>\r\n	<li>Thyrotoxicosis</li>\r\n	<li>Anxiety</li>\r\n	<li>Prophylaxis of migraine, etc.</li>\r\n</ul>', '<p>Propranolol Hydrochloride is a B-adrenergic receptor blocking drug which is widely used in hypertension and angina pectoris. Propranolol antagonizes catecholamines at B-adrenergic receptors, thus prevents excess rate and force of contraction of the heart and decreases the excess consumption of oxygen by the heart.<br />\r\n<br />\r\nPropranolol is almost completely absorbed from the gastrointestinal tract, but a portion is immediately metabolized by the liver when passing through the portal circulation. Peak plasma concentration occurs in 1 to 1.5 hours after oral administration. The plasma half-life of propranolol is from 3 to 6 hours. The metabolites of propranolol are excreted through the urine.</p>', '<p>Adult (above 18 years):</p>\r\n\r\n<ul>\r\n	<li><strong>Hypertension</strong>: Initially 80 mg twice daily, may be increased at weekly intervals and then maintenance dose of 160-320 mg daily is recommended.</li>\r\n	<li><strong>Angina pectoris</strong>: Initially 40 mg 2-3 times daily and then maintenance dose of 120-240 mg daily is given.</li>\r\n	<li><strong>Thyrotoxicosis</strong>: 10-40 mg, 3-4 times daily is given.</li>\r\n	<li><strong>Anxiety</strong>: 40 mg once daily, may&nbsp;be increased to three times daily.</li>\r\n	<li><strong>Prophylaxis of migraine</strong>: Initially 40 mg 2-3 times daily; then maintenance dose of 80-160 mg daily is recommended.</li>\r\n</ul>\r\n\r\n<p>Child (From day 1 to 18 years): Hypertension:</p>\r\n\r\n<ul>\r\n	<li><strong>Neonate</strong>: 0.25-0.5 mg/kg 3 times daily, adjusted according to response.</li>\r\n	<li><strong>Child 1 month</strong>: 12 years: 0.25-1 mg/kg 3 times daily, maximum dose 5 mg/kg daily in divided dose.</li>\r\n	<li><strong>Child 12-18 years</strong>: initially 80 mg twice daily, maintain 160-320 mg daily.</li>\r\n</ul>', '<p>Patients receiving verapamil, salbutamol, Levosalbutamol, ergot alkaloids, lidocain, phenobarbital drugs should be closely observed during therapy.</p>', '<p>Bronchospasm, cardiogenic shock, second or third degree heart block, diabetes mellitus etc.</p>', '<p>Cold extremities, lassitude, nausea, dizziness, insomnia, paresthesia etc.</p>', '<p>Pregnancy category C, should not be used in pregnant women. Propranolol is excreted in human milk. Caution should be taken when propranolol is administered to a nursing mother.</p>', '<p>It should be taken with caution in hepatic and renal impairment, pregnancy and lactating mother.</p>', NULL, '<p>Beta-adrenoceptor blocking drugs, Beta-blockers.</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-16 05:14:40', '2022-03-16 05:14:40'),
(1278, 1278, '<p><strong>Chronic Lymphocytic Leukemia (CLL)</strong>: Bendamustine is indicated for the treatment of patients with&nbsp;chronic lymphocytic leukemia. Efficacy relative to first line therapies other than chlorambucil has not been established.<br />\r\n<br />\r\n<strong>Non-Hodgkin Lymphoma (NHL)</strong>: Bendamustineis indicated for the treatment of patients with indolent B-cell non-Hodgkin lymphoma that has progressed during or within six months of treatment with rituximab or a rituximab-containing regimen.<br />\r\n<br />\r\nAlso indicated in&nbsp;Multiple myeloma.</p>', '<p>Bendamustine is a bifunctional mechlorethamine derivative capable of forming electrophilic alkyl groups that covalently bond to other molecules. Through this function as an alkylating agent, bendamustine causes intra- and inter-strand crosslinks between DNA bases resulting in cell death. It is active against both active and quiescent cells, although the exact mechanism of action is unknown.</p>', '<p><strong>Chronic lymphocytic leukaemia</strong>:&nbsp;100 mg/m2&nbsp;infused over 30-60 min on days 1 and 2 of a 28-day cycle for up to 6 cycles. For severe haematological or non-haematological toxicity: Reduce dose to 50 mg/m2&nbsp;on days 1 and 2 of each cycle. If severe haematological toxicity recurs, further reduce dose to 25 mg/m2&nbsp;on days 1 and 2 of each cycle. May consider dose re-escalation in subsequent cycles.<br />\r\n<br />\r\n<strong>Multiple myeloma</strong>:&nbsp;120-150 mg/m2&nbsp;infused over 30-60 min on days 1 and 2 of a 28-day cycle. IV or oral prednisone may be given at a dose of 60 mg/m2&nbsp;on days 1-4 of the cycle.<br />\r\n<br />\r\n<strong>Non-Hodgkin&#39;s lymphoma</strong>:&nbsp;120 mg/m2&nbsp;infused over 30-60 min on days 1 and 2 of a 21-day cycle for up to 8 cycles. For severe haematological or non-haematological toxicity: Reduced to 90 mg/m2&nbsp;on days 1 and 2 of each cycle. If severe toxicity recurs, further reduce dose to 60 mg/m2&nbsp;on days 1 and 2 of each cycle.</p>', '<p>May increase plasma levels with CYP1A2 inhibitors (e.g. ciprofloxacin, fluvoxamine). May reduce plasma levels with CYP1A2 inducers (e.g. omeprazole and tobacco smoking).</p>', '<p>Patient with history of hypersensitivity (e.g. anaphylaxis and anaphylactoid reactions); jaundice, severe bone marrow suppression, low leukocyte or platelet count. Severe hepatic impairment. Major surgery &lt;30 days prior to treatment.</p>', '<p>Malignant and pre-malignant disease; pyrexia, nausea, vomiting, cough, headache, fatigue, diarrhoea, constipation, anorexia, wt decrease, rash, stomatitis, lymphopenia, anaemia, thrombocytopenia, leucopenia, neutropenia.</p>', '<p>Pregnancy category D. There is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Mild to moderate hepatic and renal impairment. Pregnancy and lactation.</p>', '<p><strong>Symptoms</strong>: Cardiotoxicity, thrombocytopenia.<br />\r\n<br />\r\n<strong>Management</strong>: May perform bone marrow transplantation and transfusions to control haematological effects. It is dialysable to a small extent.</p>', '<p>Cytotoxic Chemotherapy</p>\r\n\r\n<p><strong>Reconstitution</strong></p>\r\n\r\n<p>Reconstitute powder for inj by adding 5 ml or 20 ml of sterile water for inj to a vial containing 25 mg or 100 mg, respectively to provide a soln containing 5 mg/ml. The lyophilised powder should be dissolved w/in 5 min, shake well to facilitate dissolution. within 30 min of reconstitution, the appropriate volume should be withdrawn from the vial to further dilute in 500 ml of either NaCl 0.9% inj or dextrose 2.5% and NaCl 0.45% inj to a final concentration of 0.2-0.6 mg/ml.</p>', '<p><strong>Chronic Lymphocytic Leukemia (CLL)</strong>: Bendamustine is indicated for the treatment of patients with&nbsp;chronic lymphocytic leukemia. Efficacy relative to first line therapies other than chlorambucil has not been established.<br />\r\n<br />\r\n<strong>Non-Hodgkin Lymphoma (NHL)</strong>: Bendamustineis indicated for the treatment of patients with indolent B-cell non-Hodgkin lymphoma that has progressed during or within six months of treatment with rituximab or a rituximab-containing regimen.<br />\r\n<br />\r\nAlso indicated in&nbsp;Multiple myeloma.</p>', '<p>Hepatic Impairment: Moderate: Reduce dose by 30%.</p>', '2022-03-17 04:41:46', '2022-03-17 04:45:20'),
(1279, 1279, '<p>Retapamulin is indicated for use in adults and pediatric patients aged 9 months and older for the topical treatment of impetigo (up to 100 cm 2 in total area in adults or 2% total body surface area in pediatric patients aged 9 months or older) due to Staphylococcus aureus (methicillin-susceptible isolates only) or Streptococcus pyogenes. Safety in patients younger than 9 months has not been established. To reduce the development of drug-resistant bacteria and maintain the effectiveness of Retapamulin and other antibacterial drugs, Retapamulin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria.</p>', '<p>Retapamulin selectively inhibits bacterial protein synthesis by interacting at a site on the 50S subunit of the bacterial ribosome through an interaction that is different from that of other antibiotics. This binding site involves ribosomal protein L3 and is in the region of the ribosomal P-site and peptidyl transferase center. By virtue of binding to this site, pleuromutilins inhibit peptidyl transfer, block P-site interactions, and prevent the normal formation of active 50S ribosomal subunits. Retapamulin is bacteriostatic against Staphylococcus aureus and Streptococcus pyogenes at the Retapamulin in vitro minimum inhibitory concentration (MIC) for these organisms.</p>', '<p>A thin layer of Topibac should be applied to the affected area (up to 100 cm2&nbsp;in total area in adults or 2% total body surface area in pediatric patients aged 9 months or older) twice daily for 5 days. The treated area may be covered with a sterile bandage or gauze dressing if desired.</p>', '<p>The effect of concurrent application of Retapamulin and other topical products to the same area of skin has not been studied.</p>', '<p>Contraindicated in patients with hypersensitivity of any ingredient of this preparation.</p>', '<p>Adverse effects: Application site irritation (&lt;2% of patients may experience).</p>', '<p>Pregnancy Category B. It is not known whether Retapamulin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Retapamulin is administered to a nursing woman.</p>', '<p>Local Irritation: In the event of sensitization or severe local irritation from Retapamulin, usage should be discontinued. Not for Systemic or Mucosal Use: Retapamulin is not intended for ingestion or for oral, intranasal, ophthalmic, or intravaginal use.</p>', NULL, '<p>Topical Antibiotic preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-17 23:52:49', '2022-03-17 23:52:49'),
(1280, 1280, '<p>This oral solution is indicated in the treatment of acute and chronic inflammations of the mucosas of the mouth, gums and throat (Aphthous Ulcer, Cold Sore, Gingivitis, Periodontitis, Dental Hypersensitivity, Dental Plaque, Denture Irritation).</p>', '<p>Salicylic acid works by blocking the action of a substance in the body called cyclo-oxygenase. This extract contains anthraquinone glycosides, which relieve inflammation. This is well absorb into the oral mucosa.</p>', '<p><strong>Adults</strong>: To be applied to the inflamed oral mucosa (after removing any dentures) 3 to 4 times daily using the brush provided. Avoid rinsing the mouth or eating for 15 minutes after application. Always keep the cap closed immediately after every use.<br />\r\n<br />\r\n<strong>Children</strong>: As per consultation with a registered physician, it is recommended below the age of 12 years.</p>', '<p>There are no known interactions with the preparation documented.</p>', '<p>Hypersensitivity to any of the constituents.</p>', '<p>A transient local burning sensation at the site of application occurs very commonly. Temporary discoloration of teeth or oral mucosa has been described commonly following administration of the oral solution.</p>', '<p><strong>Pregnancy</strong>: Animal studies are insufficient with respect to effects on pregnancy and-or embryonal/foetal development. The potential risk for humans is unknown. Caution should be exercised when prescribing to pregnant women.<br />\r\n<br />\r\n<strong>Lactation</strong>: Anthraquinone glycosides derived from rhubarb may be excreted in breast milk. However, at therapeutic doses of oral solution, it is not known whether these or salicylic acid are excreted in breast milk. A decision on whether to continue breast feeding or to continue therapy with an oral solution should be made taking into account the benefit of breast-feeding to the child and benefit of oral solution therapy to the woman.</p>', '<p>Each bottle of the oral solution should be used by only one person.</p>', '<p>Overdose associated with a local application is unlikely, although the extent of systemic absorption of salicylic acid and anthraquinone derivatives is not known. Systemic overdose following ingestion might lead to abdominal cramping, diarrhea, and possibly salicylism (presenting as hyperventilation, tinnitus, deafness, vasodilation, sweating).</p>', '<p>Oral preparations</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-18 00:54:21', '2022-03-18 00:54:21'),
(1281, 1281, '<p>Ribavirin is indicated for the treatment of chronic hepatitis C (CHC) virus infection in combination with other antiviral drugs in patients with compensated liver disease not previously treated with interferon alpha and in adult CHC patients coinfected with HIV. Ribavirin should not be used alone.</p>', '<p>Ribavirin is a synthetic nucleoside which has inhibitory action against respiratory syncytial virus, influenza virus and herpes simplex virus. The mechanism of action is not clear. It may act at several sites including cellular enzymes to interfere with viral nucleic acid synthesis. The mono- and triphosphate derivatives are known to be responsible for the antiviral action of the compound.</p>', '<p>The recommended duration of treatment for patients previously untreated with interferon is 24 to 48 weeks. After 24 weeks of treatment virologic response should be assessed. Treatment discontinuation should be considered in any patient who has not achieved an HCV RNA below the limit of detection of the assay by 24 weeks. There are no safety and efficacy data on treatment for longer than 48 weeks in the previously untreated patient population. In patients who relapse following interferon therapy, the recommended duration of treatment is 24 weeks. There are no safety and efficacy data on treatment for longer than 24 weeks in the relapse patient populations.<br />\r\n<br />\r\n<strong>Ribavirin + Interferon:&nbsp;</strong>Genotype Ribavirin Daily Interferon alpha-2a Duration or interferon alpha-2b.</p>\r\n\r\n<ul>\r\n	<li><strong>All &lt;75 kg:&nbsp;</strong>(400+600) mg 3 MIU 3 times weekly 48 weeks Genotypes subcutaneously (Genotype1&amp;4)</li>\r\n	<li><strong>&gt;75 kg:&nbsp;</strong>(600+600) mg 24 weeks (Genotype2&amp;3)</li>\r\n</ul>\r\n\r\n<p><strong>Ribavirin + Peg-Interferon:&nbsp;</strong>Genotype Ribavirin Daily Peg-Interferon alpha-2a Duration or Peg-interferon alpha-2b:</p>\r\n\r\n<ul>\r\n	<li><strong>1 &amp; 4 &lt; 75 kg</strong>: (400+600) mg 180 gm once weekly 48 weeks</li>\r\n	<li><strong>&gt; 75 kg</strong>: (600+600) mg subcutaneously 2 &amp; 3 (400+400) mg 24 weeks</li>\r\n</ul>\r\n\r\n<p>Ribavirin may be administered without regard to food, but should be administered in a consistent manner. Drink plenty of water while being treated with this medication; drinking water will decrease the risk of serious side effects.</p>', '<p>Nucleoside reverse transcriptase inhibitors or reduce dose or discontinue interferon, ribavirin or both with worsening toxicities<br />\r\n<br />\r\nAzathioprine: Concomitant use of azathioprine with ribavirin has been reported to induce severe pancytopenia and may increase the risk of azathioprine-related myelotoxicity.</p>', '<p>Women who are pregnant. Ribavirin&nbsp;may cause fetal harm when administered to a pregnant woman. Ribavirin&nbsp;is contraindicated in women who are or may become pregnant. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus. Patients with hemoglobinopathies (e.g., thalassemia major or sickle-cell anemia). In combination with didanosine. Reports of fatal hepatic failure, as well as peripheral neuropathy, pancreatitis and symptomatic hyperlactatemia/lactic acidosis have been reported in clinical trials.</p>', '<p>The most common adverse reactions in adults receiving combination therapy are psychiatric and central nervous system effects, severe ocular disorder, dental and periodontal disorders &amp; growth inhibition in children and adolescents that may be irreversible in some patients. The most common adverse reactions in pediatric subjects were similar to those seen in adults.</p>', '<p><strong>Pregnancy&nbsp;</strong>Category X. Ribavirin produced significant embryocidal and/or teratogenic effects in all animal species in which adequate studies have been conducted. Malformations of the skull, palate, eye, jaw, limbs, skeleton and gastrointestinal tract were noted. The incidence and severity of teratogenic effects increased with escalation of the drug dose. Survival of fetuses and offspring was reduced.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether Ribavirin is excreted in human milk. Because many drugs are excreted in human milk and to avoid any potential for serious adverse reactions in nursing infants from ribavirin, a decision should be made either to discontinue nursing or therapy with Ribavirin, based on the importance of the therapy to the mother.</p>', '<p><strong>Birth defects and fetal death with ribavirin</strong>: Do not use in pregnancy and for 6 months after treatment. Patients must have a negative pregnancy test prior to therapy, use at least 2 forms of contraception and undergo monthly pregnancy tests. For a male patient, it is very important for his female partner to avoid becoming pregnant during treatment and during the 7 months after treatment and do not have sex with a pregnant women.</p>', NULL, '<p>Hepatic viral infections (Hepatitis C)</p>', '<p>Keep out of the reach of children. Keep in a cool &amp; dry place. Protect from light.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of Ribavirin in combination with Peginterferon has not been established in pediatric patients below the age of 3 years.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: The risk of toxic reactions to this drug may be greater in patients with impaired renal function. The dose of Ribavirin&nbsp;should be reduced in patients with creatinine clearance less than or equal to 50 ml/min; and the dose of Interferon should be reduced in patients with creatinine clearance less than 30 ml/min.</p>', '2022-03-18 03:48:00', '2022-03-18 03:48:00'),
(1282, 1282, '<p>To prevent and to treat deficiencies of vitamin B2 such as cheilosis, angular stomatitis, glossitis, keratitis, seborrhoeic dermatitis.</p>', '<p>Riboflavin or vitamin B2 is an easily absorbed, water-soluble micronutrient with a key role in maintaining human health. Like the other B vitamins, it supports energy production by aiding in the metabolising of fats, carbohydrates, and proteins. Vitamin B2 is also required for red blood cell formation and respiration, antibody production, and for regulating human growth and reproduction. It is essential for healthy skin, nails, hair growth and general good health, including regulating thyroid activity. Riboflavin also helps in the prevention or treatment of many types of eye disorders, including some cases of cataracts.<br />\r\n<br />\r\nBinds to riboflavin hydrogenase, riboflavin kinase, and riboflavin synthase. Riboflavin is the precursor of flavin mononucleotide (FMN, riboflavin monophosphate) and flavin adenine dinucleotide (FAD). The antioxidant activity of riboflavin is principally derived from its role as a precursor of FAD and the role of this cofactor in the production of the antioxidant reduced glutathione. Reduced glutathione is the cofactor of the selenium-containing glutathione peroxidases among other things. The glutathione peroxidases are major antioxidant enzymes. Reduced glutathione is generated by the FAD-containing enzyme glutathione reductase.</p>', '<p><strong>For treating low levels of riboflavin (riboflavin deficiency) in adults</strong>: 5-30 mg of riboflavin daily in divided doses.<br />\r\n<br />\r\n<strong>For preventing migraine headaches</strong>: 400 mg of riboflavin (Vitamin B2) per day. It may take up to three months to get best results.<br />\r\n<br />\r\n<strong>For preventing cataracts</strong>: approximately 2.6 mg of riboflavin (Vitamin B2)</p>', '<p>Drying medications (Anticholinergic drugs), Medications for depression (Tricyclic antidepressants), Phenobarbital, Probenecid.</p>', '<p>Hypersensitivity to Riboflavin.</p>', '<p>Riboflavin is likely safe for most people. In some people, Riboflavin can cause the urine to turn a yellow- orange color. When taken in high doses, Riboflavin might cause diarrhea, an increase in urine, and other side effects.</p>', '<p>Riboflavin is likely safe for pregnant or breastfeeding women when taken in the amounts recommended.</p>', '<p>Riboflavin is non-toxic. No warnings or precautions have been established .</p>', NULL, '<p>Vitamin-B preparations.</p>', '<p>Store at a cool and dry place. Protect from light.</p>', NULL, '2022-03-18 03:49:50', '2022-03-18 03:49:50'),
(1283, 1283, '<p>In the treatment of both&nbsp;tuberculosis&nbsp;and the meningococcal carrier state, the small number of resistant cells present within large populations of susceptible cells can rapidly become the predominant type. Bacteriologic cultures should be obtained before the start of therapy to confirm the susceptibility of the organism to&nbsp;rifampinand they should be repeated throughout therapy to monitor the response to treatment. Since resistance can emerge rapidly, susceptibility tests should be performed in the event of persistent positive cultures during the course of treatment. If test results show resistance to rifampin and the patient is not responding to therapy, the drug regimen should be modified.</p>', '<p>Rifampicin suppresses initiation of chain formation for RNA synthesis in susceptible bacteria by binding to the &beta; subunit of DNA-dependent RNA polymerase, thus blocking RNA transcription.</p>', '<p>Rifampin can be administered by the oral route or by IV infusion. IV doses are the same as those for oral.<br />\r\n<br />\r\nTuberculosis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 10 mg/kg, in a single daily administration, not to exceed 600 mg/day, oral or IV</li>\r\n	<li><strong>Pediatric Patients</strong>: 10&ndash;20 mg/kg, not to exceed 600 mg/day, oral or IV</li>\r\n</ul>\r\n\r\n<p>It is recommended that oral rifampin be administered once daily, either 1 hour before or 2 hours after a meal with a full glass of water.<br />\r\n<br />\r\nRifampin is indicated in the treatment of all forms of tuberculosis. A three-drug regimen consisting of rifampin, isoniazid, and pyrazinamide is recommended in the initial phase of shortcourse therapy which is usually continued for 2 months. The Advisory Council for the Elimination of Tuberculosis, the American Thoracic Society, and the&nbsp;Centers for Disease Control and Prevention&nbsp;recommend that either streptomycin or ethambutol be added as a fourth drug in a regimen containing isoniazid (INH), rifampin and pyrazinamide for initial treatment of tuberculosis unless the likelihood of INH resistance is very low. The need for a fourth drug should be reassessed when the results of susceptibility testing are known. If community rates of INH resistance are currently less than 4%, an initial treatment regimen with less than four drugs may be considered.<br />\r\n<br />\r\nFollowing the initial phase, treatment should be continued with rifampin and isoniazid for at least 4 months. Treatment should be continued for longer if the patient is still sputum or culture positive, if resistant organisms are present, or if the patient is HIV positive.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken on an empty stomach. Best taken on an empty stomach 1 hr before or 2 hr after meals.</p>', '<p>May accelerate the metabolism and reduce the effect of drugs that are metabolised by CYP450 enzymes (e.g. quinidine, phenytoin, theophylline). Decreased concentrations of atovaquone and increased concentrations of rifampicin when taken concomitantly. Concurrent use of ketoconazole and rifampicin may result in decreased serum concentrations of both drugs. May decrease serum concentrations of enalaprilat. Reduced absorption by antacids. Increased risk of hepatotoxicity with halothane or isoniazid.</p>', '<p>Rifampicin is contraindicated in patients with a history of hypersensitivity to rifampin or any of the components, or to any of the rifamycins. Rifampin is contraindicated in patients who are also receiving ritonavir-boosted saquinavir due to an increased risk of severe hepatocellular toxicity.<br />\r\n<br />\r\nRifampin is contraindicated in patients who are also receiving atazanavir, darunavir, fosamprenavir, saquinavir, or tipranavir due to the potential of rifampin to substantially decrease plasma concentrations of these antiviral&nbsp;drugs, which may result in loss of antiviral efficacy and/or development of viral resistance.</p>', '<p>Facial flushing and itching, with or without a rash, flu-like syndrome characterised by episodes of fever, chills, headache, dizziness, bone pain, shortness of breath, and malaise; GI adverse effects (e.g. nausea, vomiting, anorexia, diarrhoea, epigastric distress), pseudomembranous colitis, eosinophilia, leucopenia, haemolytic anaemia; alterations in kidney function and renal failure, menstrual disturbances, oedema, myopathy, muscular weakness; orange-red discolouration of the urine, faeces, sweat, saliva, sputum, tears, and other body fluids; thrombophlebitis, local irritation and inflammation after prolonged IV infusion. Rarely, eye irritation and visual disturbances, anaphylaxis or shock.</p>', '<p><strong>Pregnancy</strong>: When administered during the last few weeks of pregnancy, rifampin can cause post natal hemorrhages in the mother and infant for which treatment with&nbsp;vitamin K&nbsp;may be indicated.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: Because of the potential for tumorigenicity shown for rifampin in animal studies, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>Rifampicin has been shown to produce liver dysfunction. Fatalities associated with&nbsp;jaundice&nbsp;have occurred in patients with&nbsp;liver disease&nbsp;and in patients taking rifampin with other&nbsp;hepatotoxic&nbsp;agents. Patients with impaired liver function should be given rifampin only in cases of necessity and then with caution and under strict medical supervision. In these patients, careful monitoring of liver function, especially&nbsp;SGPT/ALT and SGOT/AST should be carried out prior to therapy and then every 2 to 4 weeks during therapy. If signs of hepatocellular damage occur, rifampin should be withdrawn.<br />\r\n<br />\r\nIn some cases, hyperbilirubinemia resulting from competition between rifampin and bilirubin for excretory pathways of the liver at the cell level can occur in the early days of treatment. An isolated report showing a moderate rise in bilirubin and/or transaminase level is not in itself an indication for interrupting treatment; rather, the decision should be made after repeating the tests, noting trends in the levels, and considering them in conjunction with the patient&#39;s clinical condition.<br />\r\n<br />\r\nRifampin has enzyme-inducing properties, including induction of delta amino levulinic acid synthetase. Isolated reports have associated&nbsp;porphyria&nbsp;exacerbation with rifampin administration.</p>', '<p>Nausea, vomiting, abdominal pain, pruritus, headache, and increasing lethargy&nbsp;will probably occur within a short time after ingestion; unconsciousness may occur when there is severe hepatic disease. Transient increases in liver enzymes and/or bilirubin may occur. Brownish-red or orange discoloration of the skin, urine, sweat, saliva, tears, and feces will occur, and its intensity is proportional to the amount ingested.<br />\r\n<br />\r\nLiver enlargement, possibly with tenderness, can develop within a few hours after severe overdosage; bilirubin levels may increase and&nbsp;jaundice&nbsp;may develop rapidly. Hepatic involvement may be more marked in patients with prior impairment of hepatic function. Other physical findings remain essentially normal. A direct effect upon the hematopoietic&nbsp;system,&nbsp;electrolyte&nbsp;levels, or&nbsp;acid-base balance&nbsp;is unlikely.<br />\r\n<br />\r\nFacial or periorbital edema has also been reported in pediatric patients. Hypotension, sinus tachycardia, ventricular arrhythmias, seizures and cardiac arrest were reported in some fatal cases.</p>', '<p>Anti-Tubercular Antibiotics.</p>', '<p>Store between 15-30&deg; C. Avoid excessive heat and protect from light.</p>', '<p><strong>Geriatric Use</strong>: Clinical studies of Rifampicin did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. Caution should therefore be observed in using rifampin in elderly patients.</p>', '2022-03-18 03:51:57', '2022-03-18 03:51:57'),
(1284, 1284, '<p>Rifampicin and Isoniazid belongs to a group of medicines called antituberculosis agents. It is a fixed combination of two very effective antituberculosis agents which stop the growth of mycobacteria. These mycobacteria cause tuberculosis. Rifampicin and Isoniazid is used for the continuation phase treatment of tuberculosis.</p>', '<p>Rifampicin and isoniazid are active bactericidal anti-TB drugs which are particularly active against the rapidly growing extracellular organisms and also have bactericidal activity intracellularly. Rifampicin inhibits DNA-dependent RNA polymerase activity in susceptible cells. Specifically, it interacts with bacterial RNA polymerase but does not inhibit the mammalian enzyme. Cross-resistance to rifampicin has only been shown with other rifamycins. It has activity against slow-and intermittently-growing M. tuberculosis. Isoniazid acts against actively growing tubercle bacilli.</p>', '<p><strong>Body weight &lt;50 kg</strong>: 3 tablet of 150/100 once daily or 1 tablet of 450/300 once daily<br />\r\n<strong>Body weight &gt;50 kg</strong>: 2 tablet of 300/150 once daily.<br />\r\n<strong>Hepatic impairment</strong>: Max: 8 mg/kg daily.</p>', '<p>May reduce effectivity of hormonal contraceptives. Reduced absorption with antacids. May decrease plasma concentrations of antivirals (e.g. atazanavir, darunavir, fosamprenavir), atovaquone with rifampicin. Rifampicin may reduce serum levels of anticonvulsants (e.g. phenytoin), antiarrhythmics (e.g. disopyramide), oral anticoagulants, antifungals (e.g. ketoconazole), barbiturates, ?-blockers, Ca channel blockers (e.g. diltiazem), chloramphenicol, clarithromycin, corticosteroids, ciclosporin, cardiac glycosides, clofibrate, dapsone, diazepam, doxycycline, fluoroquinolones (e.g. ciprofloxacin), haloperidol, oral hypoglycemic agents (sulfonylureas), levothyroxine, methadone, narcotic analgesics, progestins, quinine, tacrolimus, theophylline, TCAs (e.g. amitriptyline, nortriptyline) and zidovudine. Increased risk of hepatotoxicity with halothane.<br />\r\n<br />\r\nIsoniazid may inhibit the metabolism of anticonvulsants (e.g. carbamazepine, phenytoin), benzodiazepines (e.g. diazepam), haloperidol, ketoconazole, theophylline, and warfarin. May enhance the CNS effects of meperidine, cycloserine, and disulfiram with isoniazid. Loss of glucose control in patients on oral hypoglycaemics with isoniazid.</p>', '<p>Known or suspected hypersensitivity to rifamycins and/or to INH, and/or to any of the excipients including a history of drug-induced hepatitis; acute liver diseases, regardless of their origin; peripheral neuritis.</p>', '<p>Unwanted effects which may occur during continuous daily or intermittent therapy: Rifampicin: Rifampicin may cause reddish discolouration of body fluids and occasionally other body secretions eg, urine, sputum, lacrimal fluid, faeces, saliva and sweat. It may permanently discolour soft contact lenses.<br />\r\n<br />\r\n<strong>Hepatic Effects</strong>: Very common (&gt;10%) is an asymptomatic increase in liver enzymes; severe life-threatening hepatic reactions eg, hepatic failure and acute fulminant hepatitis are uncommon (&gt;0.1% and &lt;1%). In isolated cases (&lt;0.01 %), a fatal outcome was observed.<br />\r\n<br />\r\n<strong>Renal Effects</strong>: Elevations of BUN and serum uric acid, haemolysis, haematuria, interstitial nephritis, renal insufficiency. Gastrointestinal Effects: Nausea, abdominal pains, vomiting or diarrhoea, pseudomembranous colitis.<br />\r\n<br />\r\n<strong>Central and Peripheral Nervous System Effects</strong>: Tiredness, drowsiness, headache, dizziness, ataxia, mental confusion, muscular weakness, visual disturbances. Haematological Changes: Leucopenia, eosinophilia, thrombocytopenia and thrombocytopenic purpura. Effects on Skin and Appendages: Flushing, itching with or without skin rash, urticaria, reddening of the eyes, exudative conjunctivitis or generalised hypersensitivity reactions involving the skin eg, exfoliative dermatitis, Lyell&#39;s syndrome and pemphigoid reactions. Endocrine Effects: Disturbances in the menstrual cycle, induction of crisis in Addison patients. Unwanted effects chiefly occurring during intermittent therapy or upon resumption of treatment after temporary interruption</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>Use of isoniazid should be carefully monitored in the following:</p>\r\n\r\n<ul>\r\n	<li>Daily users of alcohol. Daily ingestion of alcohol may be associated with a higher incidence of isoniazid hepatitis.</li>\r\n	<li>Patients with active chronic liver disease or severe renal dysfunction.</li>\r\n	<li>Age &gt;35.</li>\r\n	<li>Concurrent use of any chronically administered medication.</li>\r\n	<li>History of previous discontinuation of isoniazid.</li>\r\n	<li>Existence of peripheral neuropathy or conditions predisposing to neuropathy. Pregnancy.</li>\r\n	<li>Injection drug use.</li>\r\n	<li>Women belonging to minority groups, particularly in the post-partum period.</li>\r\n	<li>HIV seropositive patients.</li>\r\n</ul>', NULL, '<p>Combined anti- Tubercular Preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-18 03:53:39', '2022-03-18 03:53:39');
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
(1285, 1285, '<p>Rifampin, isoniazid, and pyrazinamide is indicated in the initial phase of the short-course treatment of pulmonary tuberculosis. During this phase, which should last 2 months, this drug should be administered on a daily, continuous basis.&nbsp;<br />\r\n&nbsp;<br />\r\nFollowing the initial phase and treatment with this drug, treatment should be continued with rifampin and isoniazid for at least 4 months. Treatment should be continued for a longer period of time if the patient is still sputum or culture positive, if resistant organisms are present, or if the patient is HIV positive.<br />\r\n<br />\r\nIn the treatment of tuberculosis, the small number of resistant cells present within large populations of susceptible cells can rapidly become the predominant type. Since resistance can emerge rapidly, susceptibility tests should be performed in the event of persistent positive cultures during the course of treatment. Bacteriologic smears or cultures should be obtained before the start of therapy to confirm the susceptibility of the organism to rifampin, isoniazid, and pyrazinamide and they should be repeated throughout therapy to monitor response to the treatment. If test results show resistance to any of the components of this drug and the patient is not responding to therapy, the drug regimen should be modified.</p>', '<p>Rifampicin, isoniazid and pyrazinamide are all active bactericidal antituberculosis drugs. Rifampicin and isoniazid are particularly active against the rapidly growing extracellular organisms and have an intracellular bactericidal activity. Rifampicin also inhibits DNA-dependent RNA polymerase activity in susceptible cells and it has activity against slow and intermittently-growing M tuberculosis. Pyrazinamide, particularly in the acid pH environment of macrophages is active against intracellular organisms. Combination of these agents covers activity against the 3 different bacterial populations.</p>', '<p>Total Dosage Requirement:</p>\r\n\r\n<ul>\r\n	<li><strong>Rifampicin</strong>: 10 (8-12) mg/kg body mass/day.</li>\r\n	<li><strong>Isoniazid</strong>: 5 (4-6) mg/kg body mass/day.</li>\r\n	<li><strong>Pyrazinamide</strong>: 25 (20-30) mg/kg body mass/day.</li>\r\n</ul>\r\n\r\n<p><strong>Pediatric Patients:&nbsp;</strong>The ratio of the drugs may not be appropriate in pediatric patients under the age of 15 (e.g., higher mg/kg doses of isoniazid are usually given in pediatric patients than adults).<br />\r\n<br />\r\nThe tablets should be given as a single dose, preferably on an empty stomach, at least 30 min before breakfast to ensure a high peak serum concentration.<br />\r\n<br />\r\nTablets are recommended in the initial intensive phase of the short course treatment of tuberculosis. During this phase which lasts for 2 months</p>', '<p>Rifampicin may reduce effectivity of hormonal contraceptives, ACE inhibitors (e.g. enalapril, imidapril), antiemetics (e.g. aprepitant), antineoplastics (e.g. imatinib), diuretics (e.g. eplerenone), drugs for erectile dysfunction (e.g. tadalafil), oral hypoglycaemics (e.g. nateglinide, repaglinide), NSAIDs (e.g. etoricoxib). Rifampicin may reduce serum levels of atovaquone, ketoconazole. Antacids may reduce absorption of rifampicin. Anaesthetics and halothane may increase risk for hepatotoxicity with rifampicin and isoniazid.<br />\r\n<br />\r\nIsoniazid may increase serum levels of phenytoin and theophylline; and may decrease carbamazepine metabolism. Stavudine may increase risk of distal sensory neuropathy with isoniazid. Antacids may reduce isoniazid absorption. May increase plasma levels of isoniazid with para-aminosalicylic acid. Increased risk of CNS toxicity when isoniazid is used concomitantly with cycloserine.<br />\r\n<br />\r\nPyrazinamide antagonizes the effects of probenecid and sulfinpyrazone.<br />\r\n<br />\r\nPotentially Fatal: Concominant use with saquinavir/ritonavir may increase risk of severe hepatotoxicity. May reduce antiviral efficacy of atazanavir, darunavir, fosamprenavir, saquinavir, or tipranavir.</p>', '<p>Known or suspected hypersensitivity to rifamycins and/or to isoniazid and to pyrazinamide and/or to any of the excipients including a history of drug-induced hepatitis, acute liver diseases regardless of their origin, and peripheral neuritis.</p>', '<p><strong>Unwanted effects which may occur during continuous daily or intermittent therapy</strong>: Rifampicin: Rifampicin may cause reddish discolouration of body fluids and occasionally other body secretions eg, urine, sputum, lacrimal fluid, faeces, saliva and sweat. It may permanently discolour soft contact lenses.<br />\r\n<br />\r\n<strong>Hepatic Effects</strong>: Very common (&gt;10%) is an asymptomatic increase in liver enzymes; severe life-threatening hepatic reactions eg, hepatic failure and acute fulminant hepatitis are uncommon (&gt;0.1% and &lt;1%). In isolated cases (&lt;0.01 %), a fatal outcome was observed.<br />\r\n<br />\r\n<strong>Renal Effects:</strong>&nbsp;Elevations of BUN and serum uric acid, haemolysis, haematuria, interstitial nephritis, renal insufficiency.<br />\r\n<br />\r\n<strong>Gastrointestinal Effects</strong>: Nausea, abdominal pains, vomiting or diarrhoea, pseudomembranous colitis.<br />\r\n<br />\r\n<strong>Central and Peripheral Nervous System Effects:</strong>&nbsp;Tiredness, drowsiness, headache, dizziness, ataxia, mental confusion, muscular weakness, visual disturbances.<br />\r\n<br />\r\n<strong>Haematological Changes:</strong>&nbsp;Leucopenia, eosinophilia, thrombocytopenia and thrombocytopenic purpura.<br />\r\n<br />\r\n<strong>Effects on Skin and Appendages:</strong>&nbsp;Flushing, itching with or without skin rash, urticaria, reddening of the eyes, exudative conjunctivitis or generalised hypersensitivity reactions involving the skin eg, exfoliative dermatitis, Lyell&#39;s syndrome and pemphigoid reactions.<br />\r\n<br />\r\n<strong>Endocrine Effects:</strong>&nbsp;Disturbances in the menstrual cycle, induction of crisis in Addison patients.<br />\r\n<br />\r\nUnwanted effects chiefly occurring during intermittent therapy or upon resumption of treatment after temporary interruption</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>Caution is advised in patients with impaired renal or liver function, diabetes mellitus, chronic alcoholism and undernourished patients, patients with a history of gout and patients suffering from convulsive disorders and acute porphyria. Precautions need to be taken: Blood counts and liver function tests (SGPT, SGOT) should be performed periodically (especially in prolonged treatment) and at baseline, if possible.<br />\r\n<br />\r\nPatients with current chronic liver disease or impaired liver function should be treated with caution and under strict medical supervision. Careful monitoring of liver function should be carried out and attention should be paid to possible prodromal symptoms of hepatitis eg, fatigue, weakness, malaise, anorexia, nausea or vomiting. If these symptoms appear or if signs suggestive of hepatic damage are detected, treatment should be discontinued promptly. The occurrence of severe and sometimes fatal hepatitis associated may develop even after many months of treatment.</p>', NULL, '<p>Combined anti- Tubercular Preparations.</p>', '<p>Should be stored in cool and dry place.</p>', NULL, '2022-03-18 04:09:00', '2022-03-18 04:09:00'),
(1286, 1286, '<p>Treatment of both pulmonary and extrapulmonary tuberculosis in the intensive initial phase of treatment.</p>', '<p><strong>Rifampicin:</strong>&nbsp;It is a semisynthetic derivative of rifamycin, suppresses bacterial RNA synthesis by binding to the &beta;-subunit of DNA-dependent RNA polymerase, thus inhibiting the attachment of the enzyme to DNA, blocking RNA transcription and elongation. It does not inhibit the counterpart mammalian enzyme.<br />\r\nRifampicin has a bactericidal action and a potent sterilizing effect against both intracellular and extracellular tubercle bacilli. Cross-resistance has been shown only with other rifamycin derivatives.<br />\r\n<br />\r\n<strong>Isoniazid:</strong>&nbsp;It kills actively growing tubercle bacilli by inhibiting the biosynthesis of mycolic acids, which are the major components of the bacterial cell wall of Mycobacterium tuberculosis.<br />\r\n<br />\r\n<strong>Pyrazinamide:</strong>&nbsp;Pyrazinamide, an antituberculous drug, is the pyrazine analog of nicotinamide. The precise mechanism of action of pyrazinamide is not known. Its metabolite, pyrazinoic acid, which is less active in vitro may possibly be involved in the in vivo activity of pyrazinamide.<br />\r\n<br />\r\n<strong>Ethambutol:</strong>&nbsp;Ethambutol diffuses slowly into actively growing Mycobacteria cells eg, tubercle bacilli. It inhibits the synthesis of 1 or more metabolites, thus causing impaired cell metabolism, arrest cell multiplication and induce cell death. No cross-resistance with other agents has been demonstrated.<br />\r\n<br />\r\n<strong>Spectrum of Activity:</strong>&nbsp;Rifampicin, isoniazid, pyrazinamide, and ethambutol, at therapeutic levels, have demonstrated bactericidal activity against both intracellular and extracellular Mycobacterium tuberculosis organism.</p>', '<p><strong>Adults:</strong>&nbsp;3 tablets/day for an average body weight of 50 kg.<br />\r\n<br />\r\nPatients weighing-&nbsp;</p>\r\n\r\n<ul>\r\n	<li><strong>&gt;70 kg</strong>: 5 tablets</li>\r\n	<li><strong>55-70 kg</strong>: 4 tablets</li>\r\n	<li><strong>38-54 kg</strong>: 3 tablets</li>\r\n	<li><strong>30-37 kg</strong>: 2 tablets</li>\r\n</ul>\r\n\r\n<p>All doses to be taken once daily for 2 months on intensive phase.</p>', '<p><strong>Rifampicin:</strong>&nbsp;Induces microsomal enzymes (accelerates clearance of methadone, oral anticoagulants, glucocorticoids, oestrogen, oral hypoglycaemic agents, digitoxin, antiarrhythmics, theophylline, anticonvulsants, azole antifungal, cyclosporin).<br />\r\n<br />\r\n<strong>Isoniazid:</strong>&nbsp;Inhibits metabolism of antiepileptics, benzodiazepines, warfarin, theophylline. Increases metabolism of enflurane. Alcohol, ASA, Al-containing antacids, corticosteroids, ketoconazole, propranolol.<br />\r\n<br />\r\n<strong>Pyrazinamide:</strong>&nbsp;Decreases efficacy of gout therapy agents.<br />\r\n<br />\r\n<strong>Ethambutol:</strong>&nbsp;Neurotoxic agents.</p>', '<p>Hypersensitivity to rifampicin, isoniazid, pyrazinamide or ethambutol.<br />\r\n<br />\r\n<strong>Isoniazid</strong>: Previous isoniazid-associated hepatic injury; severe adverse reactions to isoniazid eg, fever, chills and arthritis; acute liver disease of any etiology, a history of previous hypersensitivity reaction to isoniazid including drug-induced hepatitis.</p>', '<p><strong>Rifampicin:</strong>&nbsp;Reddish discolouration of body fluids, asymptomatic increase in liver enzymes, elevations of BUN &amp; uric acid, hemolysis, hematuria, intestinal nephritis, renal insufficiency, Gl discomfort, CNS effects, hematological changes, skin rash, endocrine effects.<br />\r\n<br />\r\n<strong>Isoniazid:</strong>&nbsp;Disturbances of liver function, hepatitis, Gl disturbances, peripheral neuropathy, dizziness, lightheadedness, hematological changes, allergic reactions.<br />\r\n<br />\r\n<strong>Pyrazinamide:</strong>&nbsp;Transient rise in serum transaminases, hepatotoxicity, hepatomegaly, jaundice, hyperuricemia, intestinal nephritis, dysuria, Gl disturbances, hematological changes, allergic reactions.<br />\r\n<br />\r\n<strong>Ethambutol:</strong>&nbsp;Confusion, disorientation, headache, visual disturbances, jaundice, transient liver dysfunction, Gl disturbances, hematological changes, allergic effects, acute gout (rare).</p>', '<p><strong>Rifampicin:</strong>&nbsp;Since rifampicin has been reported to cross the placental barrier and appear in cord blood and in maternal milk, neonates and newborns of rifampicin-treated mothers should be carefully observed for any evidence of untoward effects.<br />\r\n<br />\r\n<strong>Ethambutol:</strong>&nbsp;While administration of ethambutol to pregnant human patients has produced no detectable effect upon the fetus, the possible teratogenic potential in women capable of bearing children would be weighed carefully against the benefits of therapy. There are published reports of 5 women who received ethambutol during pregnancy without apparent adverse effect upon the fetus.</p>', '<p>Impaired renal or liver function, DM, chronic alcoholism, undernourishment, history of gout, patients with convulsive disorders, acute porphyria. Elderly. Pregnancy &amp; lactation. Perform periodic blood counts &amp; liver function tests. Avoid use with soft contact lenses.<br />\r\n<br />\r\nChildren &lt;8 year or patients who are not able to communicate visual disturbances. Check visual ability before starting treatment &amp; monitor during treatment.</p>', NULL, '<p>Combined anti- Tubercular Preparations.</p>', '<p>Store at temperatures not exceeding 30&deg;C.</p>', '<p><strong>Use in children:</strong>&nbsp;Ethambutol is not recommended for use in children &lt;13 years since safe conditions for use have not been established.</p>', '2022-03-18 04:12:10', '2022-03-18 04:12:10'),
(1287, 1287, '<p>Rifaximin is indicaed in-</p>\r\n\r\n<ul>\r\n	<li>Treatment of traveler&#39;s diarrhea by noninvasive strains of E. coli</li>\r\n	<li>reduction in risk of overt hepatic encephalopathy</li>\r\n	<li>bacterial overgrowth of irritable bowel syndrome.</li>\r\n</ul>', '<p>Rifaximin is a semisynthetic, rifamycin-based non-systemic antibiotic. Very little of the drug will pass the gastrointestinal wall into the circulation as is common for other types of orally administered antibiotics. Rifaximin inhibits bacterial RNA synthesis by its action on the beta-subunit of the DNA-dependent RNA polymerase. It shows the same broad spectrum activity as rifamycin which exerts bactericidal action against many species of Gram-positive and Gram-negative, aerobic and anaerobic bacteria.</p>', '<p><strong>Traveler&#39;s Diarrhea</strong>: For patients &ge;12 years of age: 200 mg 3 times daily for 3 days.<br />\r\n<strong>Hepatic Encephalopathy:&nbsp;</strong>For patients &ge;18 years of age: 550 mg 2 times daily.<br />\r\n<strong>Bacterial overgrowth of irritable bowel syndrome</strong>: 400 mg 3 times daily for 10 days or 550 mg 3 times daily for 14 days. Can be taken with or without food.</p>', '<p>In an in vitro study has suggested that Rifaximin induces CYP3A4. However, in patients with normal liver function, Rifaximin at the recommended dosing regimen is not expected to induce CYP3A4.</p>', '<p>Contraindicated in patients with a hypersensitivity to Rifaximin or to any of the rifamycin antimicrobial agents, or any components of this product.</p>', '<p>Side effects include flatulence, headache, abdominal pain, rectal tenesmus, defecation urgency, nausea, constipation, pyrexia, vomiting. Reactions have been reported, including anaphylaxis, angioneurotic edema, and exfoliative dermatitis.</p>', '<p>Pregnancy category C. It is not known whether Rifaximin is excreted in human milk or not.</p>', '<p>Rifaximin is not found to be effective in patients with diarrhea complicated by fever and/or blood in the stools. Rifaximin therapy should be discontinued if diarrhea symptoms get worse or persist for more than 24-48 hours and alternative antibiotic therapy should be considered. Pseudomembranous colitis has been reported with nearly all antibacterial agents and may range in severity from mild to life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea subsequent to the administration of antibacterial agents.</p>', '<p>No specific information is available on the treatment of over dosage with Rifaximin. In case of over dosage, discontinue Rifaximin, treat symptomatically and institute supportive measures as required.</p>', '<p>4-Quinolone preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Renal Impairment</strong>: The pharmacokinetics of Rifaximin in patients with impaired renal function has not been studied.<br />\r\n<strong>Hepatic Impairment</strong>: The systemic exposure of Rifaximin was markedly elevated in patients with hepatic impairment compared to healthy subjects.</p>', '2022-03-18 04:14:54', '2022-03-18 04:14:54'),
(1288, 1288, '<p>Riluzole is indicated for the treatment of amyotrophic lateral sclerosis (ALS).</p>', '<p>The mode of action of riluzole is unknown. Its pharmacological properties include the following, some of which may be related to its effect:</p>\r\n\r\n<ul>\r\n	<li>An inhibitory effect on glutamate release (activation of glutamate reuptake),</li>\r\n	<li>Inactivation of voltage-dependent sodium channels,&nbsp;</li>\r\n	<li>Ability to interfere with intracellular events that follow transmitter binding at excitatory amino acid receptors.</li>\r\n</ul>', '<p>The recommended dosage for Riluzole is 50 mg taken orally twice daily. Riluzole should be taken at least 1 hour before or 2 hours after a meal.&nbsp;Measure serum aminotransferases before and during treatment with Riluzole.</p>', '<p><strong>Strong to moderate CYP1A2 inhibitors</strong>: Coadministration may increase Riluzole-associated adverse reactions<br />\r\n<br />\r\n<strong>Strong to moderate CYP1A2 inducers</strong>: Coadministration may result in decreased efficacy&nbsp;<br />\r\n<br />\r\n<strong>Hepatotoxic drugs</strong>: Riluzole-treated patients that take other hepatotoxic drugs may be at increased risk for hepatotoxicity.</p>', '<p>Riluzole is contraindicated in patients with a history of severe hypersensitivity reactions to riluzole or to any of its components (anaphylaxis has occurred).</p>', '<p>The following adverse reactions are described below and elsewhere in the labeling: Hepatic Injury, Neutropenia, Interstitial lung disease.</p>', '<p><strong>Pregnancy</strong>: Based on animal data, may cause fetal harm<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known if riluzole is excreted in human milk. Riluzole or its metabolites have been detected in milk of lactating rat. Women should be advised that many drugs are excreted in human milk and that the potential for serious adverse reactions in nursing infants from Riluzole is unknown.</p>', '<p><strong>Hepatic Injury</strong>: Cases of drug-induced liver injury, some of which were fatal, have been reported in patients taking Riluzole. Asymptomatic elevations of hepatic transaminases have also been reported, and in some patients have recurred upon rechallenge with Riluzole.<br />\r\n<br />\r\nIn clinical studies, the incidence of elevations in hepatic transaminases was greater in Riluzoletreated patients than&nbsp;placebo-treated patients. The incidence of elevations of ALT above 5 times the upper limit of normal (ULN) was 2% in Riluzole-treated patients. Maximum increases in ALT occurred within 3 months after starting Riluzole. About 50% and 8% of Riluzoletreated patients in pooled Studies 1 and 2, had at least one elevated ALT level above ULN and above 3 times ULN, respectively&nbsp;<br />\r\n<br />\r\nMonitor patients for signs and symptoms of hepatic injury, every month for the first 3 months of treatment, and periodically thereafter. The use of Riluzole is not recommended if patients develop hepatic transaminases levels greater than 5 times the ULN. Discontinue Riluzole if there is evidence of liver dysfunction (e.g., elevated bilirubin).<br />\r\n<br />\r\n<strong>Neutropenia</strong>: Cases of severe neutropenia (absolute neutrophil count less than 500 per mm3) within the first 2 months of Riluzole treatment have been reported. Advise patients to report febrile illnesses.<br />\r\n<br />\r\n<strong>Interstitial Lung Disease</strong>: Interstitial lung disease, including hypersensitivity pneumonitis, has occurred in patients taking Riluzole. Discontinue Riluzole immediately if interstitial lung disease develops.</p>', '<p>Reported symptoms of overdose following ingestion of Riluzole ranging from 1.5 to 3 grams (30 to 60 times the recommended dose) included acute toxic encephalopathy, coma, drowsiness, memory loss, and methemoglobinemia. No specific antidote for the treatment of Riluzole overdose is available.</p>', '<p>Neurodegenerative Disease Drugs / Neuromuscular Disorder Drugs.</p>', '<p>Store at controlled room temperature, 20&deg;C to 25&deg;C, and protect from bright light.</p>', NULL, '2022-03-18 04:17:13', '2022-03-18 04:17:13'),
(1289, 1289, '<p>Rimexolone ophthalmic suspension is indicated for the treatment of postoperative inflammation following ocular surgery and in the treatment of anterior uveitis.</p>', '<p>Rimexolone is a glucocorticoid receptor agonist. The antiinflammatory actions of corticosteroids are thought to involve lipocortins, phospholipase A2 inhibitory proteins which, through inhibition of arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes. By binding to the glucocorticoid receptor, this drug ultimately leads to changes in genetic transcription involving the lipocortins and prostaglandins.</p>', '<p><strong>Post-Operative Inflammation</strong>: Apply one to two drops of Rimexolone&nbsp;1% Ophthalmic Suspension into the&nbsp;conjunctivalsac of the affected eye four times daily beginning 24 hours after surgery and continuing throughout the first 2 weeks of the postoperative period.<br />\r\n<br />\r\n<strong>Anterior Uveitis</strong>: Apply one to two drops of Rimexolone&nbsp;1% Ophthalmic Suspension into the conjunctival sac of the affected eye every hour during waking hours for the first week, one drop every two hours during waking hours of the second week, and then taper until uveitis is resolved.</p>', '<p>No information provided</p>', '<p>Rimexolone 1% (rimexolone ophthalmic suspension) is contraindicated in epithelial herpes simplex keratitis (dendritic keratitis), vaccinia,&nbsp;varicella, and most other viral diseases of the cornea and conjunctiva; mycobacterial infection of the eye;&nbsp;fungal&nbsp;diseases of the eye; acute purulent untreated infections which, like other diseases caused by microorganisms, may be masked or enhanced by the presence of the&nbsp;steroid; and in those persons with hypersensitivity to any component of the formulation.</p>', '<p>Reactions associated with ophthalmic steroids include elevated&nbsp;intraocular pressure, which may be associated with optic nerve damage, visual acuity and field defects, posterior subcapsular cataract formation, secondary ocular infection from pathogens including herpes simplex, and perforation of the globe where there is thinning of the&nbsp;cornea&nbsp;or&nbsp;sclera.<br />\r\n<br />\r\nOcular adverse reactions occurring in 1 - 5% of patients in clinical studies of Rimexolone&nbsp;1% (rimexolone ophthalmic suspension) included&nbsp;blurred vision, discharge, discomfort, ocular pain, increased intraocular pressure, foreign body sensation, hyperemia and&nbsp;pruritus.<br />\r\n<br />\r\nOther ocular adverse reactions occurring in less than 1% of patients included sticky sensation, increased&nbsp;fibrin, dry eye, conjunctival edema, corneal staining,&nbsp;keratitis, tearing,&nbsp;photophobia, edema, irritation, corneal ulcer, browache, lid margin crusting, corneal edema,&nbsp;infiltrate, and corneal erosion.<br />\r\n<br />\r\nNon-ocular adverse reactions occurred in less than 2% of patients. These included headache, hypotension, rhinitis, pharyngitis, and taste perversion.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C. Rimexolone has been shown to be&nbsp;teratogenic&nbsp;and embryotoxic in rabbits following subcutaneous administration at the lowest dose tested (0.5 mg/kg/day, approximately 2 times the recommended human ophthalmic dose). Corticosteroids are recognized to cause fetal resorptions and malformations in animals. There are no adequate and well-controlled studies in&nbsp;pregnant&nbsp;women. Rimexolone 1% (rimexolone ophthalmic suspension) should be used in pregnant women only if the potential benefit to the mother justifies the potential risk to the&nbsp;fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether topical ophthalmic administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human breast milk. Nevertheless, caution should be exercised when topical corticosteroids are administered to a nursing woman; a decision should be made whether to discontinue nursing or discontinue therapy, taking into consideration the importance of the drug to the mother.</p>', '<p>Fungal infections of the cornea are particularly prone to develop coincidentally with long-term local steroid application. Fungal invasion must be considered in any persistent corneal ulceration where a steroid has been or is in use.<br />\r\n<br />\r\nFor ophthalmic use only. Use of the same bottle for both eyes is not recommended with topical eye drops that are used in association with&nbsp;surgery.<br />\r\n<br />\r\nThe initial&nbsp;prescription&nbsp;and renewal of the medication order beyond 14 days should be made by a physician only after examination of the patient with the aid of magnification, such as slit lamp biomicroscopy and where appropriate, fluorescein staining. If signs and symptoms fail to improve after two days, the patient should be reevaluated. If this product is used for 10 days or longer,intraocular&nbsp;pressure should be monitored even though it may be difficult in children and uncooperative patients</p>', NULL, '<p>Ophthalmic Steroid preparations.</p>', '<p>Store upright between 2-25&deg; C. Do not freeze. Shake well before use.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No overall differences in safety or effectiveness have been observed between elderly and younger patients.</p>', '2022-03-18 04:20:00', '2022-03-18 04:20:00'),
(1290, 1290, '<p>Ringer&#39;s lactate solution is indicated for diarrhea, dehydration, water and electrolytes imbalance, alkalinizing agent, diabetic coma, cholera. This solution is very often used for fluid resuscitation after a&nbsp;blood loss&nbsp;due to&nbsp;trauma,&nbsp;surgery, or a&nbsp;burn injury. Ringer&#39;s lactate solution is used because the by-products of lactate metabolism in the liver counteract&nbsp;acidosis, which is a chemical imbalance that occurs with acute fluid loss or renal failure.</p>', '<p>Lactated Ringer&#39;s solution contains isotonic concentrations of electrolytes in water for inj. It is used for parenteral replacement of extracellular losses of fluid and electrolytes.&nbsp;Lactated Ringer&rsquo;s Injection, produces a metabolic alkalinizing effect. Lactate ions are metabolized ultimately to carbon dioxide and water, which requires the consumption of hydrogen cations.<br />\r\n<br />\r\n<strong>Calcium chloride</strong>&nbsp;is used to prevent or treat negative calcium balance. It also regulates action potential excitation threshold to facilitate nerve and muscle performance.<br />\r\n<br />\r\n<strong>Potassium chloride</strong>&nbsp;is a major cation of the intracellular fluid. It plays an active role in the conduction of nerve impulses in the heart, brain and skeletal muscle; contraction of cardiac skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism and gastric secretion.<br />\r\n<br />\r\n<strong>Sodium chloride</strong>&nbsp;is the major extracellular cation. It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes. It is also used as diluents for infusion of compatible drug additives.</p>', '<p>The IV dose of Ringer&#39;s lactate solution is usually calculated by estimated fluid loss and presumed fluid deficit. For fluid resuscitation the usual rate of administration is 20 to 30 ml/kg body weight/hour. RL is not suitable for maintenance therapy (i.e., maintenance fluids) because the sodium content (130 mEq/L) is considered too low, particularly for children, and the potassium content (4 mEq/L) is too low, in view of electrolyte daily requirement. Moreover, since the lactate is converted into bicarbonate, longterm use will cause patients to become&nbsp;alkalotic. Ringer&#39;s lactate and other crystalloids are also used as vehicles for the IV delivery of drugs.<br />\r\n<br />\r\nIn a large-volume resuscitation over several hours, LRS maintains a more stable blood pH than normal saline.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity.</p>', '<p>Reactions which may occur because of the solution or the technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation, and hypervolemia.</p>', '<p><strong>Pregnancy</strong>&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\n<strong>Nursing Mothers</strong>: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when 5% Dextrose in Lactated Ringer&rsquo;s Injection is administered to a nursing woman.</p>', '<p>IV infusion is obsolete in metabolic acidosis and carries the risk of producing lactic acidosis, particularly in seriously ill patients with poor tissue perfusion and on impaired hepatic function.</p>', NULL, '<p>Intravenous fluid preparations.</p>', NULL, NULL, '2022-03-18 04:21:38', '2022-03-18 04:21:38'),
(1291, 1291, '<p>This is in a group of medicines called bisphosphonates. It alters the cycle of bone formation and breakdown in the body. It slows bone loss while increasing bone mass, which may prevent bone fractures. Risedronate is a prescription medicine used:</p>\r\n\r\n<ul>\r\n	<li>To prevent and treat osteoporosis in postmenopausal women.</li>\r\n	<li>To increase bone mass in men with osteoporosis.</li>\r\n	<li>To prevent and treat osteoporosis in men and women that is caused by treatment with steroid medicines such as prednisone.</li>\r\n	<li>To treat Paget&rsquo;s disease of bone in men and women.</li>\r\n</ul>', '<p>Risedronate has an affinity for hydroxyapatite crystals in bone and acts as an antiresorptive agent. At the cellular level, Risedronat inhibits osteoclasts. The osteoclasts adhere normally to the bone surface, but show evidence of reduced active resorption.</p>', '<p><strong>Treatment of postmenopausal osteoporosis, to reduce the risk of vertebral fractures. Treatment of&nbsp;established postmenopausal osteoporosis, to reduce the risk of hip fractures</strong>: The recommended&nbsp;dose is Risedronate Sodium 5 mg once daily or Risedronate Sodium 35 mg once weekly on the same day each week or Risedronate Sodium 150 mg once monthly.&nbsp;<br />\r\n<br />\r\n<strong>Prevention of osteoporosis in postmenopausal women with increased risk of osteoporosis</strong>: The&nbsp;recommended dose is Risedronate Sodium 5 mg once daily.&nbsp;<br />\r\n<br />\r\n<strong>To maintain or increase bone mass in postmenopausal women undergoing long-term (more than&nbsp;3 months):&nbsp;</strong>Systemic corticosteroid treatment at doses 7.5 mg/day prednisone or equivalent. The&nbsp;recommended dose is Risedronate Sodium 5 mg once daily.&nbsp;<br />\r\n<br />\r\n<strong>Treatment of osteoporosis in men at high risk of fractures</strong>: The recommended dose is Risedronate Sodium 35 mg once weekly. The tablet should be taken on the same day&nbsp;each week.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>The absorption of Risedronate Sodium is affected by food, thus to ensure adequate absorption patients should take Risedronate tablets at least 30 minutes before the first food,&nbsp;other medicinal product or drink (other than plain water) of the day. In the particular instances&nbsp;that before breakfast dosing is not practical, Risedronate 5 mg tablet can be taken between meals or in&nbsp;the evening at the same time everyday, with strict adherence to the following instructions, to&nbsp;ensure Risedronate Sodium tablet is taken on an empty stomach-Between meals:<br />\r\n<br />\r\nRisedronate&nbsp;Sodium tablet should be taken at least 2 hours before and at least 2 hours after any food,&nbsp;medicinal product or drink (other than plain water). In the evening:<br />\r\n<br />\r\nRisedronate Sodium tablet&nbsp;should be taken at least 2 hours after the last food, medicinal product or drink (other than plain&nbsp;water) of the day.&nbsp;If a dose is missed: Risedronate 5 mg tablet: If an occasional dose is missed, Risedronate 5 mg tablet can be&nbsp;taken before breakfast, between meals, or in the evening according to the instructions above.<br />\r\n<br />\r\n<strong>Risedronate 35 mg tablet</strong>: Patients should be instructed that if a dose is missed, just take one Risedronate&nbsp;35 mg tablet on the morning after remember. Patients should then return to taking one tablet&nbsp;once a week on the day the tablet is normally taken. Two tablets should not be taken on the&nbsp;same day.<br />\r\n<br />\r\n<strong>Risedronate 150 mg tablet</strong>: Patient should be instructed that if a dose is missed and the next month&rsquo;s&nbsp;schedule dose is more than 7 days away, then should take the missed tablet in the morning after&nbsp;the day it is remembered. Patients should then return to taking one tablet once a month normally taken.The tablet must be swallowed whole and not sucked or chewed. To aid delivery of&nbsp;the tablet to the stomach Risedronate tablet is to be taken while in an upright position with a glass of&nbsp;plain water (120 ml or more). Patients should not lie down for 30 minutes after taking the tablet. Supplemental calcium and vitamin D should be considered if the dietary intake is inadequate.</p>', '<p>Please tell your doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription specially aspirin or other NSAIDs. Antacids, supplements, or medicines that contain aluminum, calcium, magnesium, or other minerals can interfere with how your body absorbs Risedronate Sodium. If you use these other medicines, do not take them for at least 30 minutes after taking a Risedronate Sodium tablet.</p>', '<p>Risedronate Sodium tablet is contraindicated in patients with known hypersensitivity to Risedronate Sodium and in patients with hypocalcaemia, severe renal&nbsp;impairment (creatinine clearance lower than 30 ml/min), during pregnancy and lactation.</p>', '<p>Serious side effects:</p>\r\n\r\n<ul>\r\n	<li>chest pain;</li>\r\n	<li>difficulty or pain when swallowing;</li>\r\n	<li>pain or burning under the ribs or in the back;</li>\r\n	<li>new or worsening heartburn;</li>\r\n	<li>severe joint, bone, or muscle pain; or</li>\r\n	<li>jaw pain, numbness, or swelling.</li>\r\n</ul>\r\n\r\n<p>Less serious side effects:</p>\r\n\r\n<ul>\r\n	<li>mild heartburn or stomach upset;</li>\r\n	<li>diarrhea, gas,or constipation;</li>\r\n	<li>mild joint or back pain;</li>\r\n	<li>headache.</li>\r\n</ul>', '<p><strong>Pregnancy:</strong>&nbsp;Risedronate Sodium is meant for use only in postmenopausal women. Therefore, Risedronate Sodium should not be taken during pregnancy. If you take it by accident during pregnancy, stop taking it straight away and talk to your doctor.<br />\r\n<br />\r\n<strong>Breast-feeding:</strong>&nbsp;Risedronate Sodium is meant for use only in postmenopausal women. Therefore, breast-feeding women should not take this medicine. If you take it by accident during breast-feeding, stop taking it straight away and talk to your doctor.</p>', '<p>Take special care with Risedronate if you:</p>\r\n\r\n<ul>\r\n	<li>Have low blood calcium (hypocalcemia)</li>\r\n	<li>Cannot sit or stand up for 30 minutes</li>\r\n	<li>Have kidneys that work poorly</li>\r\n	<li>Have an allergy to Risedronate Sodium</li>\r\n</ul>\r\n\r\n<p>Before taking Risedronate talk to doctor if you:</p>\r\n\r\n<ul>\r\n	<li>Are pregnant or may become pregnant. We do not know if Risedronate Sodium can harm your unborn child.</li>\r\n	<li>Are breast-feeding or plan to breast-feed. We do not know if Risedronate Sodium can passthrough your milk and if it can harm your baby.</li>\r\n	<li>Have kidney problems Risedronate Sodium may not be right for you.</li>\r\n	<li>Risedronate sodium is not intended for use in children.</li>\r\n</ul>\r\n\r\n<p>During treatment, if you experience an allergic reaction (such as swelling of the face, tongue or throat, difficulty in breathing or swallowing, skin rash), you must stop taking Risedronate sodium and seek medical advice immediately. If you have stopped treatment due to hypersensitivity reactions you should not re-start therapy with Risedronate sodium.</p>', '<p>Seek emergency medical attention if you think you have used too much of this medicine. Drink a full glass of milk right away. Do not make yourself vomit and do not lie down.<br />\r\n<br />\r\nOverdose symptoms may include nausea, heartburn, stomach pain, diarrhea, muscle cramps, numbness or tingling, tight muscles in your face, seizure (convulsions), irritability, and unusual thoughts or behavior.</p>', '<p>Bisphosphonate preparations</p>', '<p>Store in a cool and dry place. Protect from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Elderly</strong>: No dosage adjustment is necessary since bioavailability, distribution and elimination were&nbsp;similar in elderly (60 years of age or older) compared to younger subjects. This has also been&nbsp;shown in the very elderly, 75 years old and above postmenopausal population.&nbsp;<br />\r\n<br />\r\n<strong>Renal impairment</strong>: No dosage adjustment is required for those patients with mild to moderate&nbsp;renal impairment. The use of Risedronate Sodium is contra-indicated in patients with severe&nbsp;renal impairment (Creatinine clearance lower than 30ml/min).</p>', '2022-03-18 04:23:38', '2022-03-18 04:23:38'),
(1292, 1292, '<p>Risperidone injection is an atypical antipsychotic indicated:</p>\r\n\r\n<ul>\r\n	<li>For the treatment of schizophrenia.</li>\r\n	<li>As monotherapy or as adjunctive therapy to lithium or valproate for the maintenance treatment of Bipolar I Disorder.</li>\r\n</ul>', '<p>The mechanism of action of risperidone in schizophrenia is unclear. The drug&rsquo;s therapeutic activity in schizophrenia could be mediated through a combination of dopamine Type 2 (D2) and serotonin Type 2 (5HT2) receptor antagonism. The clinical effect from risperidone results from the combined concentrations of risperidone and its major active metabolite, 9-hydroxyrisperidone (paliperidone). Antagonism at receptors other than D2 and 5HT 2 may explain some of the other effects of risperidone.</p>', '<p>For patients who have never taken oral Risperidone, tolerability should be established with oral Risperidone prior to initiating treatment with Risperidone.<br />\r\n<br />\r\nAdminister by deep intramuscular (IM) deltoid or gluteal injection. Each injection should be administered by a health care professional using the appropriate enclosed safety needle (1-inch for deltoid administration alternating injections between the two arms and 2-inch for gluteal administration alternating injections between the two buttocks). Do not administer intravenously.<br />\r\n<br />\r\n25 mg intramuscular (IM) every 2 weeks. Patients not responding to 25 mg may benefit from a higher dose of 37.5 mg or 50 mg. The maximum dose should not exceed 50 mg every 2 weeks.<br />\r\n<br />\r\nOral Risperidone (or another antipsychotic medication) should be given with the first injection of Risperidone, and continued for 3 weeks (and then discontinued) to ensure adequate thera peutic plasma concentrations from Risperidone<br />\r\n<br />\r\nUpward dose adjustment of Risperidone should not be made more frequently than every 4 weeks. Clinical effects of each upward dose adjustment should not be anticipated earlier than 3 weeks after injection.<br />\r\n<br />\r\nAvoid inadvertent administration into a blood vessel.</p>', '<ul>\r\n	<li>Due to CNS effects, use caution when administering with other centrally-acting drugs. Avoid alcohol.</li>\r\n	<li>Due to hypotensive effects, hypotensive effects of other drugs with this potential may be enhanced.</li>\r\n	<li>Effects of levodopa and dopamine agonists may be antagonized.</li>\r\n	<li>Cimetidine and ranitidine increase the bioavailability of risperidone.</li>\r\n	<li>Clozapine may decrease clearance of risperidone.</li>\r\n	<li>Fluoxetine and paroxetine increase plasma concentrations of risperidone.</li>\r\n	<li>Carbamazepine and other enzyme inducers decrease plasma concentrations of risperidone.</li>\r\n</ul>', '<p>Known hypersensitivity to risperidone, paliperidone, or to any excipients in Risperidone.</p>', '<ul>\r\n	<li>Increased mortality in elderly patients with dementia-related psychosis</li>\r\n	<li>Cerebrovascular adverse events, including stroke, in elderly patients with dementia-related psychosis</li>\r\n	<li>Neuroleptic malignant syndrome</li>\r\n	<li>Tardive dyskinesia</li>\r\n	<li>Metabolic changes</li>\r\n	<li>Hyperprolactinemia</li>\r\n	<li>Orthostatic hypotension</li>\r\n	<li>Falls</li>\r\n	<li>Leukopenia/Neutropenia and Agranulocytosis</li>\r\n	<li>Potential for cognitive and motor impairment</li>\r\n	<li>Seizures</li>\r\n	<li>Dysphagia</li>\r\n	<li>Priapism</li>\r\n	<li>Thrombotic Thrombocytopenic Purpura (TTP)&nbsp;</li>\r\n	<li>Disruption of body temperature regulation</li>\r\n	<li>Avoidance of inadvertent injection into a blood vessel</li>\r\n</ul>', '<p><strong>Pregnancy</strong>: Advise patients to notify their healthcare provider if they become pregnant or intend to become pregnant during treatment with Risperidone<br />\r\n<br />\r\n<strong>Lactation</strong>: Advise breastfeeding women using Risperidone to monitor infants for somnolence, failure to thrive, jitteriness, and extrapyramidal symptoms (tremors and abnormal muscle movements) and to seek medical care if they notice these signs.</p>', '<ul>\r\n	<li>Increased Mortality in Elderly Patients with Dementia-Related Psychosis</li>\r\n	<li>Cerebrovascular Adverse Events, Including Stroke, in Elderly Patients with Dementia-Related Psychosis</li>\r\n	<li>Neuroleptic Malignant Syndrome</li>\r\n	<li>Tardive Dyskinesia</li>\r\n	<li>Hyperprolactinemia</li>\r\n	<li>Orthostatic Hypotension</li>\r\n</ul>', '<p>Atypical neuroleptic drugs</p>', '<p>The entire dose pack should be stored in the refrigerator (2&deg;-8&deg;C) and protected from light. Keep out of reach of children.</p>', NULL, '<p><strong>Renal or Hepatic Impairment</strong>: dose appropriately with oral Risperidone prior to initiating treatment with Risperidone. A lower starting dose of Risperidone of 12.5 mg may be appropriate in some patients.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: safety and effectiveness not established in patients less than 18 years of age.<br />\r\n<br />\r\n<strong>Elderly</strong>: dosing for otherwise healthy elderly patients is the same as for healthy nonelderly. Elderly may be more predisposed to orthostatic effects than nonelderly.</p>', '2022-03-18 04:25:45', '2022-03-18 04:25:45'),
(1293, 1293, '<p>Risperidone tablet is indicated for the treatment of-</p>\r\n\r\n<ul>\r\n	<li>Acute and chronic psychoses</li>\r\n	<li>Mania</li>\r\n	<li>Schizophrenia</li>\r\n</ul>', '<p>Risperidone is a selective monoaminergic antagonist having a high affinity for serotoninergic 5-HT2&nbsp;and dopaminergic D2&nbsp;receptors. Risperidone binds also to alpha1&nbsp;adrenergic receptors and with lower affinity, to H1&nbsp;histamine and alpha2&nbsp;adrenergic receptors. Risperidone has no affinity for 8 cholinergic receptors. Risperidone, as a potent D2&nbsp;antagonist, improves the positive symptoms of schizophrenia but causes less depression of motor activity. Balanced central serotonin and dopamine antagonism may reduce extrapyramidal side effect liability and extend the therapeutic activity to the negative and affective symptoms of schizophrenia.</p>', '<p><strong>Psychoses</strong>:</p>\r\n\r\n<ul>\r\n	<li>2 mg in 1-2 divided doses on 1st&nbsp;day then 4 mg in 1-2 divided doses on second day (Slower titration appropriate in some patients);</li>\r\n	<li>Usual dose range 4-6 mg daily; doses above 10 mg daily only if benefit considered to outweigh risk (max. 16 mg daily).</li>\r\n	<li>Elderly (or in hepatic or renal impairment) initially 1 mg daily in two divided doses increased in steps of 1-2 mg twice daily.</li>\r\n	<li>Child under 15 years not recommended.</li>\r\n</ul>\r\n\r\n<p><strong>Mania</strong>:</p>\r\n\r\n<ul>\r\n	<li>Initially, 2 mg once daily increased if necessary in step of 1 mg daily; usual dose range 1-6 mg daily;</li>\r\n	<li>Elderly (or in hepatic or renal impairment) initially 1 mg daily in two divided doses increased in steps of 1-2 mg twice daily.</li>\r\n</ul>\r\n\r\n<p><strong>Schizophrenia</strong>:</p>\r\n\r\n<ul>\r\n	<li>Risperidone should be generally administered at 1 mg BID initially, with increases in increments of 1 mg BID on the second and third day, as tolerated, to a target dose of 3 mg BID by the third day.</li>\r\n	<li>Further dosage adjustments, if indicated, should generally occur at intervals of not less than 1 week. When dosage adjustments are necessary, small dose increments/decrements of 1-2 mg are recommended.</li>\r\n</ul>', '<p>Risperidone May antagonize the effects of levodopa and dopamine agonists. Chronic administration with Carbamazepine reduces plasma clearance of Risperidone. Chronic administration with Clozapine may decrease the clearance of Risperidone. Risperidone may enhance the effects of certain antihypertensives.</p>', '<p>Risperidone is contraindicated in patients with a known hypersensitivity to the product.</p>', '<p>Insomnia, agitation, anxiety, headache, less commonly drowsiness, impaired concentration, fatigue, blurred vision, constipation, nausea and vomiting, dyspepsia, abdominal pain, hyperprolactinaemia, urine incontinence, tachycardia, hypertension, edema, rash, rhinitis, cerebrovascular accident, neurtropenia and thrombocytopenia have been reported.</p>', '<p>Although, in experimental animals, Risperidone did not show direct reproductive toxicity, some indirect, prolactin- and CNS-mediated effects were observed, No teratogenicity effect of Risperidone was noted in any study. The safety of Risperidone for use during human pregnancy has not been established. In animal studies, Risperidone and 9-hydroxyrisperidone are excreted in the milk. It has been demonstrated that Risperidone and 9-hydroxyrisperidone are also excreted in human breast milk. Therefore, women receiving Risperidone should not breastfeed.</p>', '<p>Special precaution should be taken in case of preexisting cardiovascular diseases, discontinue use if signs and symptoms of tardive dyskinesia occur, renal and hepatic impairment, elderly epilepsy, Parkinson&#39;s disease and in pregnancy.</p>', NULL, '<p>Atypical neuroleptic drugs.</p>\r\n\r\n<p>&nbsp;</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-18 04:34:17', '2022-03-18 04:34:17');
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
(1294, 1294, '<p>Ritodrine is indicated for the treatment of uncomplicated premature labour.</p>', '<p>A selective &beta;2-adrenoceptor agonist with its main action on the uterus, causing relaxation. It reduces the intensity and frequency of contractions. Heart rate is also increased while diastolic pressure is reduced. May cause bronchial relaxation but this is not clinically significant in its usage.</p>', '<p><strong>By intravenous infusion</strong>: Initially 50 mcg/minute, increased gradually according to response by 50 mcg/minute every 10 minutes until contractions stop or maternal heart rate reaches 140 beats/minute; continue for 12&ndash;48 hours after contractions cease (usual rate 150&ndash;350 mcg/minute); maximum rate 350 mcg/minute.<br />\r\n<br />\r\n<strong>Intramuscular injection</strong>: 10 mg in every 3&ndash;8 hours continued for 12&ndash;48 hours after contractions have ceased; then by mouth.<br />\r\n<br />\r\n<strong>Oral maintenance treatment</strong>: One tablet (10 mg) may be given approximately 30 minutes before termination of intravenous therapy, repeated every 2 hours for 24 hours, followed by 10&ndash;20 mg every 4&ndash;6 hours, maximum oral dose 120 mg daily.</p>', '<p>Increased risk of hypokalamia if high doses of corticosteroids, diuretics (acetazalamide, loop diuretics and thiazides) or theophylline given with high doses of ritodrine. A sufficient time interval should elapse prior to administration of another sympathomimetic drug. &beta;&ndash;adrenergic blocking drugs inhibit its action; coadministraton of these drugs should, therefore, be avoided. With anesthetics used in surgery, the possibility that hypotensive effects may be potentiated should be considered.</p>', '<p>It is contraindicated in patients with known hypersensitivity to the active ingredient or any of the excipients of this component. &beta;2-agonists are contra-indicated in cardiac disease and in patients with significant risk factors for myocardial ischaemia; they should also be avoided in antepartum haemorrhage, intra-uterine infection, intra-uterine fetal death, placenta praevia,&nbsp;abruptio placenta, threatened miscarriage, cord compression, and eclampsia or severe preeclampsia.</p>', '<p>The common side-effects of ritodrine hydrochloride are nausea, vomiting, flushing, sweating, tremor, hypokalaemia, tachycardia, palpitations, hypotension (left lateral position throughout infusion to minimize risk), uterine bleeding, pulmonary oedema; chest pain or tightness, arrhythmias and salivary gland enlargement. On prolonged administration for several weeks may cause leucopenia and agranulocytosis; liver function abnormalities including increased transaminases and hepatitis.</p>', '<p>Ritodrine is a drug of pregnancy category B. There are no adequate and well controlled studies of effects in pregnant women before 20 weeks gestation; therefore, this drug should not be used before the 20th week of pregnancy. Studies in pregnant women from the 20th week of gestation onwards have not shown increased risk of fetal abnormalities. Nonetheless, although clinical studies did not indicate a risk of permanent adverse fetal effects from ritodrine, the possibility cannot be excluded; therefore, it should be used only when clearly indicated. In frequently reported neonatal symptoms include hypoglycemia and ileus. In addition, hypocalcemia and hypotension have been reported in neonates whose mothers were treated with other beta mimetic agents. Caution should be exercised unless the potential benefit of treatment to the mother outweighs any possible risk of the infants.</p>', '<p>It should be used cautiously in patient with suspected cardiac diseases, hypertension, hyperthyroidism, hypokalaemia, diabetes mellitus, mild to moderate preeclampsia, monitor blood pressure and pulse rate and avoid over-hydration during taking ritodrine hydrochloride.</p>', '<p>Symptoms of overdosage are tachycardia (maternal and fetal), palpitation, cardiac arrhythmia, hypotension, nervousness, tremor, nausea and vomiting. If an excess of ritodrine tablets is ingested, gastric lavage or induction of emesis should be carried out followed by administration of activated charcoal. When symptoms of overdose occur as a result of parenteral administration, ritodrine should be discontinued; an appropriate &beta;-blocking agent may be used<br />\r\nas an antidote.</p>', '<p>Drugs acting on the Uterus.</p>', '<p>Keep away from the reach of the children. Store in cool &amp; dry place protected from light.</p>', NULL, '2022-03-18 04:37:12', '2022-03-18 04:37:12'),
(1295, 1295, '<p><strong>Non-Hodgkin&#39;s Lymphoma</strong>&nbsp;(NHL): Rituximab is indicated for the treatment of patients with-</p>\r\n\r\n<ul>\r\n	<li>Relapsed or&nbsp;refractory, low-grade or follicular, CD20-positive, B-cell NHL as a single agent</li>\r\n	<li>Previously untreated follicular, CD20-positive, B-cell NHL in combination with first line&nbsp;chemotherapy&nbsp;and, in patients achieving a complete or partial response to Rituxan in combination with chemotherapy, as single-agent&nbsp;maintenance therapy.</li>\r\n	<li>Non-progressing (including stable disease), low-grade, CD20-positive, B-cell NHL as a single agent after first-line CVP chemotherapy</li>\r\n	<li>Previously untreated diffuse large B-cell, CD20-positive NHL in combination with CHOP or other&nbsp;anthracycline-based chemotherapy regimens</li>\r\n</ul>\r\n\r\n<p><strong>Chronic Lymphocytic Leukemia</strong>&nbsp;(CLL): Rituximab is indicated, in combination with fludarabine and cyclophosphamide (FC), for the treatment of patients with previously untreated and previously treated CD20-positive&nbsp;CLL.<br />\r\n<br />\r\n<strong>Rheumatoid Arthritis</strong>&nbsp;(RA): Rituximab in combination with methotrexate is indicated for the treatment of adult patients with moderately- to severely- active&nbsp;rheumatoid arthritis&nbsp;who have had an inadequate response to one or more&nbsp;TNF&nbsp;antagonist&nbsp;therapies.<br />\r\n<br />\r\n<strong>Granulomatos Is With Polyangiitis (GPA) (Wegener&#39;s Granulomatosis) and Microscopic Polyangiitis (MPA)</strong>: Rituximab, in combination with glucocorticoids, is indicated for the treatment of adult patients with Granulomatosis with Polyangiitis (GPA) (Wegener&#39;s Granulomatosis) andMicroscopic&nbsp;Polyangiitis (MPA).</p>', '<p>Rituximab is a chimeric monoclonal antibody to CD20 antigen which regulates cell cycle initiation. It binds to the antigen on the cell surface, activating complement-dependent B-cell cytotoxicity; and to human Fc receptors, mediating cell killing through an antibody-dependent cellular toxicity.<br />\r\n<br />\r\n<strong>Duration</strong>: Detectable in serum 3-6 mth after completion of therapy; B-cell recovery 6-12 mth following completion of therapy.</p>', '<p>Intravenous (Adult)-<br />\r\n<br />\r\n<strong>Non-Hodgkin&#39;s lymphoma, Refractory or relapsed follicular lymphoma</strong>: As a single agent, 375 mg/m2&nbsp;infusion once wkly, for 4 doses at an initial rate of 50 mg/hr. May increase by 50 mg/hr every 30 min. If tolerated, subsequent infusions can be started at 100 mg/hr and increased by 100 mg/hr every 30 min. Max rate: 400 mg/hr. When used with CVP (cyclophosphamide, vincristine and prednisolone) for follicular lymphoma or CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) for diffuse large B-cell lymphoma, 375 mg/m2&nbsp;given on day 1 of the chemotherapy cycle after corticosteroid regimen, for up to 8 cycles. For patients who were treated with 6-8 cycles of CVP chemotherapy and have not progressed, 375 mg/m2&nbsp;may be given once wkly for 4 doses, may repeat every 6 mth, for up to 16 doses. Maintenance: 375 mg/m2&nbsp;given once every 3 mth (those who have responded to induction chemotherapy), once every 2 mth initiated 2 mth after the last dose of induction chemotherapy (previously untreated) for a max period of 2 yr.<br />\r\n<br />\r\n<strong>Chronic lymphocytic leukaemia</strong>: 375 mg/m2, given on the day prior to chemotherapy in cycle 1, followed by 500 mg/m2&nbsp;on day 1 (every 28 days) of cycles 2-6.<br />\r\n<br />\r\n<strong>Rheumatoid arthritis:</strong>&nbsp;Given as two 1 g IV infusion doses, separated by 2 wk and in combination with methotrexate. Corticosteroids may be given before each infusion to minimise the risk and severity of infusion reactions.</p>', '<p>Increased risk of renal toxicity with cisplatin.</p>', '<p>Hypersensitivity to murine proteins. Patients with active, severe infections. Severely immunocompromised state. Concomitant use with live viral vaccines. Lactation.</p>', '<p>Reactivation of hepatitis B virus. Fever and rigors. Pruritus, skin rashes, dyspnoea, bronchospasm, angioedema, transient hypotension, and flushing, asthenia, headache, rhinitis, thrombocytopenia, neutropenia, anaemia, abdominal pain, bowel obstruction, and perforation. Exacerbation of heart failure and angina pectoris. Reversible interstitial pneumonia and interstitial fibrosis. Depletion of immunoglobulin concentrations.</p>', '<p><strong>Pregnancy 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>Extensive tumour burden, pulmonary insufficiency or pulmonary tumour infiltration; history of cardiac disease. Pregnancy.</p>', NULL, '<p>Cytotoxic immunosuppressants</p>', '<p>Store between 2-8&deg; C.</p>', NULL, '2022-03-18 04:38:55', '2022-03-18 04:38:55'),
(1296, 1296, '<p><strong>Rivaroxaban 2.5 mg</strong>:</p>\r\n\r\n<ul>\r\n	<li>For the prevention of atherothrombotic events in adult patients after an Acute Coronary Syndrome (ACS) with elevated cardiac biomarkers (Troponin or CK-MB). It is co-administered with Aspirin alone or with Aspirin plus Clopidogrel orTidopidine.</li>\r\n</ul>\r\n\r\n<p><strong>Rivaroxaban 10-20 mg</strong>:</p>\r\n\r\n<ul>\r\n	<li>To reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation</li>\r\n	<li>Deep vein thrombosis (DVT) &amp; pulmonary embolism (PE) and reduction in the risk of recurrence of DVT and of PE</li>\r\n	<li>For the prophylaxis of DVT, which may lead to PE in patients undergoing knee or hip replacement surgery</li>\r\n</ul>', '<p>Rivaroxaban is a highly selective direct factor Xa inhibitor. Inhibition of factor Xa interrupts the intrinsic and extrinsic pathway of the blood coagulation cascade, inhibits thrombin formation. Rivaroxaban does not inhibit thrombin (activated factor II) and no effects on platelets have been demonstrated.</p>', '<p>Rivaroxaban 2.5 mg:</p>\r\n\r\n<ul>\r\n	<li><strong>The recommended dose</strong>: 2.5 mg twice daily. Patients should also take a daily dose of 75-100 mg Aspirin or a daily dose of 75-100 mg Aspirin in addition to either a daily dose of 75 mg clopidogrel or a standard daily dose of ticlopidine.</li>\r\n</ul>\r\n\r\n<p>Rivaroxaban 10-20 mg:</p>\r\n\r\n<ul>\r\n	<li><strong>Nonvalvular Atrial Fibrillation</strong>: For patients with Creatinin Clearance &gt;50 mL/min: 20 mg orally, once daily with the evening meal. For patients with Creatinin Clearance 15-50 ml/min: 15 mg orally, once daily with the evening meal.</li>\r\n	<li><strong>Treatment of DVT &amp; PE</strong>: 15 mg orally twice daily with food for the first 21 days for the initial treatment of acute DVT or PE. After the initial treatment period, 20 mg orally once daily with food for the remaining treatment.</li>\r\n	<li><strong>Prevention in the risk of recurrence of DVT and of PE</strong>: 20 mg once daily with food.</li>\r\n	<li><strong>Prophylaxis of DVT following Hip replacement surgery</strong>: 10 mg once daily for 35 days.</li>\r\n	<li><strong>Prophylaxis of DVT following knee replacement surgery</strong>: 10 mg once daily for 12 days.</li>\r\n</ul>\r\n\r\n<p>May be taken with or without food.</p>', '<p>Concomitant use with drugs that are combined P-gp and CYP3A4 inhibitors (ketoconazole, ritonavir, clarithromycin, erythromycin, fluconazole, diltiazem, verapamil, dronedarone) increases in Rivaroxaban exposure and pharmacodynamic effects (i.e., factor Xa inhibition and PT prolongation), that&rsquo;s why should be avoided. Co-administration of Rivaroxaban with a combined P-gp and strong CYP3A4 inducer (e.g., rifampicin, phenytoin, carbamazepine) decreases the efficacy of Rivaroxaban and also should be avoided. The concomitant use of other drugs like anti-platelet agents, heparin, fibrinolytic therapy, NSAIDs may cause an increased risk of bleeding.</p>', '<p>It is contraindicated in patients with known hypersensitivity of Rivaroxaban or any of the excipients of the product. It is also contraindicated in patients with active pathological bleeding.</p>', '<p>The most common side effects of Rivaroxaban have increased chance of bleeding, spinal or epidural hematoma and increased risk of stroke after discontinuation in nonvalvular atrial fibrillation.</p>', '<p>Rivaroxaban is a pregnancy category C drug. There are no adequate or well-controlled studies of Rivaroxaban in pregnant women, and dosing for pregnant women has not been established. It is not known if Rivaroxaban is excreted in human milk. The safety and efficacy of Rivaroxaban has not been established in breastfeeding women.</p>', '<p>Early discontinuation of Rivaroxaban, in the absence of adequate alternative anticoagulation increases the risk of thrombotic events. Rivaroxaban increases the risk of bleeding that can be fatal in presence of following risk factors- bleeding disorders, uncontrolled severe arterial hypertension, gastrointestinal disease (e.g., inflammatory bowel disease, oesophagitis, gastritis and gastroesophageal reflux disease), vascular retinopathy, bronchiectasis, history of pulmonary bleeding. Signs or symptoms of neurological impairment should be monitored in case of neuraxial anesthesia (spinal/epidural anesthesia) or spinal puncture as epidural or spinal hematoma can occur. Rivaroxaban is not recommended in patients with pulmonary embolism who present with hemodynamic instability or who may receive thrombolysis or pulmonary embolectomy.</p>', '<p>Overdose of Rivaroxaban may lead to hemorrhage. Rivaroxaban systemic exposure is not further increased at single doses &gt;50 mg due to limited absorption. A specific antidote for Rivaroxaban is not available. The use of activated charcoal to reduce absorption in case of Rivaroxaban overdose may be considered. Partial reversal of laboratory anticoagulation parameters may be achieved with use of plasma products.</p>', '<p>Oral Anti-coagulants</p>', '<p>Store in a cool (below 30&deg;C) &amp; dry place protected from light. Keep away from the reach of children.</p>', NULL, '2022-03-18 04:43:39', '2022-03-18 04:43:39'),
(1297, 1297, '<p>Symptomatic treatment of mild to moderately severe Alzheimer&#39;s dementia.&nbsp;Symptomatic treatment of mild to moderately severe dementia in patients with Idiopathic Parkinson&#39;s disease.</p>', '<p>Rivastigmine is a carbamate derivative that is structurally related to physostigmine, but not to donepezil and tacrine. The precise mechanism of rivastigmine has not been fully determined, but it is suggested that rivastigmine binds reversibly with and inactivates chlolinesterase (eg. acetylcholinesterase, butyrylcholinesterase), preventing the hydrolysis of acetycholine, and thus leading to an increased concentration of acetylcholine at cholinergic synapses. The anticholinesterase activity of rivastigmine is relatively specific for brain acetylcholinesterase and butyrylcholinesterase compared with those in peripheral tissues.</p>', '<p>Rivastigmine capsule-</p>\r\n\r\n<ul>\r\n	<li><strong>Initial dose</strong>: Rivastigmine 1.5 mg twice a day.</li>\r\n	<li><strong>Dose titration:</strong>&nbsp;The starting dose is Rivastigmine 1.5 mg twice a&nbsp;day. If this dose is well tolerated after a minimum of two weeks of treatment, the dose&nbsp;may be increased to Rivastigmine 3 mg twice a day. Subsequent&nbsp;increases to 4.5 mg and then 6 mg twice a day should also be based on good tolerability&nbsp;of the current dose and may be considered after a minimum of two weeks of treatment at&nbsp;that dose level.</li>\r\n	<li><strong>Maintenance dose</strong>: The effective dose is 3 mg to 6 mg twice a day; to achieve maximum therapeutic benefit patients should be maintained on their highest well tolerated dose. The recommended maximum&nbsp;daily dose is 6 mg twice a day. Maintenance treatment can be&nbsp;continued for as long as a therapeutic benefit for the patient exists.&nbsp;</li>\r\n	<li><strong>Re-initiation of therapy</strong>: If treatment is interrupted for more than several days, it should be re-initiated at 1.5 mg twice daily. Dose titration should then be carried out as described above.</li>\r\n</ul>\r\n\r\n<p>Rivastigmine transdermal patch: Apply patch on intact skin for a 24-hour period; replace with a new patch every 24 hours.</p>\r\n\r\n<ul>\r\n	<li><strong>Initial Dose</strong>: Initiate treatment with 4.6 mg/24 hours Rivastigmine transdermal patch.</li>\r\n	<li><strong>Dose Titration</strong>: After a minimum of 4 weeks, if tolerated, increase dose to 9.5 mg/24 hours, which is the minimum effective dose. Following a minimum additional 4 weeks, may increase dosage to maximum dosage of 13.3 mg/24 hours.</li>\r\n	<li><strong>Mild to Moderate Alzheimer&#39;s Disease and Parkinson&rsquo;s Disease Dementia</strong>: Rivastigmine transdermal patch 9.5 mg/24 hours or 13.3 mg/24 hours once daily.</li>\r\n	<li><strong>Severe Alzheimer&rsquo;s Disease</strong>: Rivastigmine transdermal patch 13.3 mg/24 hours once daily.</li>\r\n	<li>For treatment interruption longer than 3 days, retitrate dosage starting at 4.6 mg per 24 hours.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Rivastigmine should be administered twice a day, with morning and&nbsp;evening meals.</p>', '<p>As a cholinesterase inhibitor, Rivastigmine may&nbsp;exaggerate the effects of succinylcholine-type muscle relaxants during anaesthesia.&nbsp;Caution is recommended when selecting anaesthetic agents. Possible dose adjustments&nbsp;or temporarily stopping treatment can be considered if needed. In view of its&nbsp;pharmacodynamic effects, rivastigmine should not be given concomitantly with other&nbsp;cholinomimetic substances and might interfere with the activity of anticholinergic&nbsp;medicinal products. No pharmacokinetic interaction was observed between rivastigmine&nbsp;and digoxin, warfarin, diazepam or fluoxetine in studies in healthy volunteers. The increase in prothrombin time induced by warfarin is not affected by administration of&nbsp;rivastigmine. No untoward effects on cardiac conduction were observed following&nbsp;concomitant administration of digoxin and Rivastigmine.</p>', '<p>The use of this medicinal product is contraindicated in patients with hypersensitivity to the active substance or other carbamate derivatives.</p>', '<p>The most commonly reported adverse reactions are gastrointestinal,&nbsp;including nausea (38%) and vomiting (23%), especially during titration. Female patients&nbsp;in clinical studies were found to be more susceptible than male patients to&nbsp;gastrointestinal adverse reactions and weight loss.</p>', '<p>For Rivastigmine no clinical data are available.&nbsp;Rivastigmine should not be used during pregnancy unless clearly necessary. In animals,&nbsp;rivastigmine is excreted into milk. It is not known if rivastigmine is excreted into human&nbsp;milk. Therefore, women on rivastigmine should not breast-feed.</p>', '<p>Patients with sick sinus syndrome or conduction defects, resp diseases. Cholinergic stimulation may increase gastric acid secretion. May exacerbate urinary obstruction and seizures. Pregnancy. Renal impairment, mild to moderate hepatic impairment. Monitor body wt. Asthma or obstructive pulmonary disease. May worsen extrapyramidal symptoms. Lactation.</p>', '<p>Most cases of accidental overdose have not been associated with any clinical signs or symptoms and almost all of the patients concerned continued rivastigmine treatment. Where symptoms have occurred, they have included nausea, vomiting and diarrhoea, hypertension or hallucinations. Due to the known vagotonic effect of cholinesterase inhibitors on heart rate, bradycardia and/or syncope may also occur. Ingestion of 46 mg occurred in one case; following conservative management the patient fully recovered within 24 hours. As rivastigmine has a plasma half-life of about 1 hour and a duration of acetylcholinesterase inhibition of about 9 hours, it is recommended that in cases of asymptomatic overdose no further dose of rivastigmine should be administered for the next 24 hours. In overdose accompanied by severe nausea and vomiting, the use of antiemetics should be considered. Symptomatic treatment for other adverse reactions should be given as necessary. In massive overdose, atropine can be used. An initial dose of 0.03 mg/kg intravenous atropine sulphate is recommended, with subsequent doses based on clinical response. Use of scopolamine as an antidote is not recommended.</p>', '<p>Drugs for Dementia.</p>', '<p>Store in a cool and dry place, protected from light.</p>', '<p><strong>Renal and hepatic impairment</strong>: Due to increased exposure in moderate renal and mild to&nbsp;moderate hepatic impairment, dosing recommendations to titrate according to individual tolerability should be closely followed<br />\r\n<br />\r\n<strong>Use in children</strong>: Rivastigmine is not recommended for use in children.</p>', '2022-03-18 04:46:43', '2022-03-18 04:46:43'),
(1298, 1298, '<p>Rizatriptan Benzoate is indicated for the acute treatment of&nbsp;migraine&nbsp;with or without aura in adults and in pediatric patients 6 to 17 years old.</p>', '<p>Rizatriptan binds with high&nbsp;affinity&nbsp;to human cloned 5-HT1B/1D receptors. Rizatriptan Benzoate presumably exerts its therapeutic effects in the treatment of&nbsp;migraine headache&nbsp;by binding to 5-HT1B/1D receptors located on intracranial blood vessels and sensory nerves of the trigeminal system.</p>', '<p><strong>Dosing Information In Adults</strong>: The recommended starting dose of Rizatriptan Benzoate is either 5 mg or 10 mg for the acute treatment of migraines in adults. The 10-mg dose may provide a greater effect than the 5-mg dose, but may have a greater risk of adverse reactions.<br />\r\n<br />\r\n<strong>Redosing In Adults</strong>: Although the effectiveness of a second dose or subsequent doses has not been established in placebocontrolled trials, if the migraine headache returns, a second dose may be administered 2 hours after the first dose. The maximum daily dose should not exceed 30 mg in any 24-hour period. The safety of treating, on average, more than four headaches in a 30-day period has not been established.<br />\r\n<br />\r\n<strong>Dosing Information In Pediatric Patients (Age 6 to 17 Years)</strong>: Dosing in pediatric patients is based on the patient&#39;s body weight. The recommended dose of Rizatriptan Benzoate is 5 mg in patients weighing less than 40 kg, and 10 mg in patients weighing 40 kg or more.<br />\r\n<br />\r\nThe efficacy and safety of treatment with more than one dose of Rizatriptan Benzoate within 24 hours in pediatric patients 6 to 17 years of age have not been established.<br />\r\n<br />\r\n<strong>Dosage Adjustment For Patients On Propranolol</strong>: Sections or subsections omitted from the full prescribing information are not listed.</p>\r\n\r\n<ul>\r\n	<li><strong>Adult Patients</strong>: In adult patients taking propranolol, only the 5-mg dose of Rizatriptan Benzoate is recommended, up to a maximum of 3 doses in any 24-hour period (15 mg)</li>\r\n	<li><strong>Pediatric Patients</strong>: For pediatric patients weighing 40 kg or more, taking propranolol, only a single 5-mg dose of Rizatriptan Benzoate is recommended (maximum dose of 5 mg in a 24-hour period). Rizatriptan Benzoate should not be prescribed to</li>\r\n</ul>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Administration of Rizatriptan Benzoate Tablets, administration with liquid is not necessary. Orally disintegrating tablets are packaged in a blister within an outer aluminum pouch and patients should not remove the blister from the outer pouch until just prior to dosing. The blister pack should then be peeled open with dry hands and the orally disintegrating tablet placed on the tongue, where it will dissolve and be swallowed with the&nbsp;saliva.</p>', '<p><strong>Propranolol</strong>: The dose of Rizatriptan should be adjusted in propranolol-treated patients, as propranolol has been shown to increase the plasma AUC of rizatriptan by 70%&nbsp;<br />\r\n<br />\r\n<strong>Ergot-Containing Drugs</strong>: Ergot-containing drugs have been reported to cause prolonged vasospastic reactions. Because these effects may be additive, use of ergotamine-containing or ergot-type medications (like dihydroergotamine or methysergide) and Rizatriptan within 24 hours is contraindicated<br />\r\n<br />\r\n<strong>Other 5-HT1 Agonists</strong>: Because their vasospastic effects may be additive, co-administration of Rizatriptan and other 5-HT1 agonists within 24 hours of each other is contraindicated&nbsp;<br />\r\n<br />\r\n<strong>SSRIs /SNRIs And Serotonin Syndrome</strong>: Cases of serotonin syndrome have been reported during co-administration of triptans and selective serotonin&nbsp;reuptake&nbsp;inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs)&nbsp;<br />\r\n<br />\r\n<strong>Monoamine Oxidase Inhibitors</strong>: Rizatriptan is contraindicated in patients taking MAO-A inhibitors and non-selective MAO inhibitors. A specific MAO-A inhibitor increased the systemic exposure of rizatriptan and its metabolite.</p>', '<p>Rizatriptan Benzoate is contraindicated in patients with:</p>\r\n\r\n<ul>\r\n	<li>Ischemic&nbsp;coronary artery disease&nbsp;(angina pectoris, history of&nbsp;myocardial infarction, or documented silent ischemia), or other significant underlying&nbsp;cardiovascular disease</li>\r\n	<li>Coronary artery vasospasm including Prinzmetal&#39;s&nbsp;angina</li>\r\n	<li>History of&nbsp;stroke&nbsp;or&nbsp;transient ischemic attack&nbsp;(TIA)&nbsp;</li>\r\n	<li>Peripheral vascular disease&nbsp;(PVD)&nbsp;</li>\r\n	<li>Ischemic bowel disease&nbsp;</li>\r\n	<li>Uncontrolled hypertension&nbsp;</li>\r\n	<li>Recent use (i.e., within 24 hours) of another 5-HT1&nbsp;agonist, ergotamine-containing medication, or&nbsp;ergot-type medication (such as dihydroergotamine or methysergide)&nbsp;</li>\r\n	<li>Hemiplegic&nbsp;or&nbsp;basilar&nbsp;migraine</li>\r\n	<li>Concurrent administration or recent discontinuation (i.e., within 2 weeks) of a MAO-A inhibitor</li>\r\n	<li>Hypersensitivity to Rizatriptan Benzoate (angioedema and&nbsp;anaphylaxisseen)</li>\r\n</ul>', '<p>The following adverse reactions are discussed in more detail in other sections of the labeling:</p>\r\n\r\n<ul>\r\n	<li>Myocardial&nbsp;Ischemia,&nbsp;Myocardial Infarction, and Prinzmetal&#39;s&nbsp;Angina&nbsp;</li>\r\n	<li>Arrhythmias&nbsp;</li>\r\n	<li>Chest, Throat, Neck and/or Jaw Pain/Tightness/Pressure&nbsp;</li>\r\n	<li>Cerebrovascular&nbsp;Events&nbsp;</li>\r\n	<li>Other Vasospasm Reactions&nbsp;</li>\r\n	<li>Medication Overuse Headache&nbsp;</li>\r\n	<li>Serotonin&nbsp;Syndrome&nbsp;</li>\r\n	<li>Increase in Blood Pressure</li>\r\n</ul>', '<p><strong>Pregnancy</strong>: Inform patients that Rizatriptan Benzoate should not be used during pregnancy unless the potential benefit justifies the potential risk to the fetus<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Rizatriptan Benzoate is administered to a nursing woman. Rizatriptan is extensively excreted in rat milk, with levels in milk at least 5-fold higher than levels in maternal plasma.</p>', '<p>Elderly; mild to moderate hepatic or renal impairment; coronary artery disease; pregnancy, lactation. May cause drowsiness. History of seizures. Ensure an interval of at least 24 hr after stopping an ergotamine compound and starting a serotonin (5-HT1) agonist.</p>', '<p>May cause hypertension and CV symptoms. Gastric lavage using activated charcoal may be considered. Monitor ECG and clinical status of the patient.</p>', '<p>5-HT Agonists</p>', '<p>Store at 15-30&deg; C.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients under 6 years of age have not been established. The efficacy and safety of Rizatriptan in the acute treatment of migraine in patients aged 6 to 17 years was established in an adequate and well-controlled study. The incidence of adverse reactions reported for pediatric patients in the acute clinical trial was similar in patients who received Rizatriptan to those who received placebo. The adverse reaction pattern in pediatric patients is expected to be similar to that in adults.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of Rizatriptan did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients.<br />\r\n<br />\r\nAlthough the pharmacokinetics of rizatriptan were similar in elderly (aged &ge;65 years) and in younger adults (n=17), in general, dose selection for an elderly patient should be cautious, starting at the low end of the dosing range. This reflects the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.<br />\r\n<br />\r\nGeriatric patients who have other cardiovascular risk factors (e.g., diabetes, hypertension, smoking, obesity, strong family history of coronary artery disease) should have a cardiovascular evaluation prior to receiving Rizatriptan<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: For mild-moderate impairment, initate with 5 mg. Further dose of 5 mg may be taken after an interval of at least 2 hr. Max: 10 mg/24 hr. Avoid in severe impairment.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>:&nbsp;For mild-moderate impairment, initate with 5 mg. Further dose of 5 mg may be taken after an interval of at least 2 hr. Max: 10 mg/24 hr. Avoid in severe impairment.</p>', '2022-03-18 04:49:32', '2022-03-18 04:49:32'),
(1299, 1299, '<p>Rocuronium is indicated -</p>\r\n\r\n<ul>\r\n	<li>As an adjunct to general anesthesia to facilitate tracheal intubation during routine induction, and during rapid sequence induction when suxamethonium is contraindicated</li>\r\n	<li>To provide skeletal muscle relaxation during surgery</li>\r\n	<li>As an adjunct in the intensive care unit (ICU) to facilitate intubation and mechanical ventilation</li>\r\n</ul>', '<p>Rocuronium acts by competing for cholinergic receptors at the motor end-plate. This action is antagonized by acetylcholinesterase inhibitors, such as neostigmine and edrophonium. Rocuronium acts by competitively binding to nicotinic cholinergic receptors. The binding of vecuronium decreases the opportunity for acetylcholine to bind to the nicotinic receptor at the postjunctional membrane of the myoneural junction. As a result, depolarization is prevented, calcium ions are not released and muscle contraction does not occur. Evidence also suggests that nondepolarizing agents can affect ACh release. It has been hypothesized that nondepolarzing agents bind to postjunctional (&quot;curare&quot;) receptors and may therefore interfere with the sodium and potassium flux, which is responsible for depolarization and repolarization of the membranes involved in muscle contraction.</p>', '<p><strong>Dosage</strong>: Like other neuromuscular blocking agents, Rocuronium should only be administered by, or under supervision of, experienced clinicians who are familiar with the action and use of these agents. The dosage of Rocuronium should be individualized in each patient. The method of anesthesia and the expected duration of surgery, the method of sedation and the expected duration of mechanical ventilation, the possible interaction with other medicines that are administered concomitantly and the condition of the patient should be taken into account when determining the dose. The use of an appropriate neuromuscular monitoring technique is recommended for the evaluation of neuromuscular block and recovery. Inhalational anesthetics do potentiate the neuromuscular blocking effects of Rocuronium. This potentiation, however, becomes clinically relevant in the course of anesthesia, when the volatile agents have reached the tissue concentrations required for this interaction. Consequently, adjustments with Rocuronium should be made by administering smaller maintenance doses at less frequent intervals or by using lower infusion rates of Rocuronium during long lasting procedures (longer than 1 hour) under inhalational anesthesia. In adult patients the following dosage recommendations may serve as a general guideline for tracheal intubation and muscle relaxation for short to long lasting surgical procedures, and for use in the intensive care unit.&nbsp;<br />\r\n<br />\r\n<strong>Surgical Procedures</strong>:&nbsp;Tracheal Intubation: The standard intubating dose during routine anesthesia is 0.6mg Rocuronium Bromide per kg body weight, after which adequate intubation conditions are established within 60 seconds in nearly all patients. A dose of 1.0mg Rocuronium Bromide per kg body weight is recommended for facilitating tracheal intubation conditions during rapid sequence induction of anesthesia, after which adequate intubation conditions are also established within 60 seconds in nearly all patients. If a dose of 0.6mg Rocuronium Bromide per kg body weight is used for rapid sequence induction of anesthesia, it is recommended to intubate the patient 90 seconds after administration of Rocuronium Bromide. In patients undergoing Caesarean section it is recommended to only use a dose of 0.6mg Rocuronium Bromide per kg body weight, since a 1.0mg/kg dose has not been investigated in this patient group.&nbsp;<br />\r\n<br />\r\n<strong>Maintenance Dosing</strong>:&nbsp;The recommended maintenance dose is 0.15mg Rocuronium Bromide per kg body weight; in the case of long-term inhalational anesthesia this should be reduced to 0.075-0.1mg Rocuronium Bromide per kg body weight. The maintenance doses should best be given when twitch height has recovered to 25% of control twitch height, or when 2-3 responses to train of four stimulation are present.&nbsp;<br />\r\n<br />\r\n<strong>Continuous Infusion</strong>:&nbsp;If Rocuronium Bromide is administered by continuous infusion, it is recommended to give a loading dose of 0.6mg Rocuronium Bromide per kg body weight and, when neuromuscular block starts to recover, to start administration by infusion. The infusion rate should be adjusted to maintain twitch response at 10% of control twitch height, or to maintain 1 to 2 responses to train of four stimulation. In adults under intravenous anesthesia, the infusion rate required to maintain neuromuscular block at this level ranges from 0.3-0.6mg/kg/hr and under inhalational anesthesia the infusion rate ranges from 0.3-0.4mg/kg/hr. Continuous monitoring of neuromuscular block is recommended since infusion rate requirements vary from patient to patient and with the anaesthetic method used.&nbsp;<br />\r\n<br />\r\n<strong>Dosing in Paediatric Patients</strong>:&nbsp;Children (1-14 years) and infants (1-12 months) under halothane anesthesia manifest similar sensitivity to Rocuronium Bromide as adults. Onset of action is faster in infants and children than in adults. Clinical duration is shorter in children than in adults. For continuous infusion in paediatrics, the infusion rates, with exception of children, are the same as for adults. For children higher infusion rates might be necessary. For children the same initial infusion rates as for adults are recommended and this should be adjusted to maintain twitch response at 10% of control twitch height or to maintain 1 or 2 responses to train of four stimulation during the procedure. There are insufficient data to support dose recommendations for the use of Rocuronium Bromide in neonates (0-1 month). The experience with Rocuronium Bromide in rapid sequence induction in paediatric patients is limited. Rocuronium Bromide is therefore not recommended for facilitating tracheal intubation conditions during rapid sequence induction in paediatric patients.&nbsp;<br />\r\n<br />\r\n<strong>Dosing in Geriatric patients and patients with Hepatic and/or Biliary tract disease and/or Renal Failure</strong>:&nbsp;The standard intubation dose for geriatric patients and patients with hepatic and/or biliary tract disease and/or renal failure during routine anesthesia is 0.6mg Rocuronium Bromide per kg body weight. A dose of 0.6mg per kg body weight should be considered for rapid sequence induction of anesthesia in patients in which a prolonged duration of action is expected. Regardless of the anesthetic technique used, the recommended maintenance dose for these patients is 0.075-0.1mg Rocuronium Bromide per kg body weight, and the recommended infusion rate is 0.3-0.4mg/kg/hr.&nbsp;<br />\r\n<br />\r\n<strong>Dosing in Overweight and Obese Patients</strong>:&nbsp;When used in overweight or obese patients (defined as patients with a body weight of 30% or more above ideal body weight) doses should be reduced taking into account ideal body weight.&nbsp;<br />\r\n<br />\r\n<strong>Intensive Care Procedures (</strong><strong>Tracheal Intubation)</strong>: For tracheal intubation, the same doses should be used as described above under surgical procedures.&nbsp;<br />\r\n<br />\r\n<strong>Maintenance Dosing</strong>:&nbsp;The use of an initial loading dose of 0.6mg Rocuronium Bromide per kg body weight is recommended, followed by a continuous infusion as soon as twitch height recovers to 10% or upon reappearance of 1 to 2 twitches to train of four stimulation. Dosage should always be titrated to effect in the individual patient. The recommended initial infusion rate for the maintenance of a neuromuscular block of 80-90% (1 to 2 twitches to TOF stimulation) in adult patients is 0.3-0.6mg/kg/hr during the first hour of administration, which will need to be decreased during the following 6-12 hours, according to the individual response. Thereafter, individual dose requirements remain relatively constant. A large between patient variability in hourly infusion rates has been found in controlled clinical studies, with mean hourly infusion rates ranging from 0.2-0.5mg/kg/hr depending on nature and extent of organ failure(s), concomitant medication and individual patient characteristics. To provide optimal individual patient control, monitoring of neuromuscular transmission is strongly recommended. Administration up to 7 days has been investigated.&nbsp;<br />\r\n<br />\r\n<strong>Special Populations</strong>:&nbsp;Rocuronium Bromide is not recommended for the facilitation of mechanical ventilation in the intensive care in paediatric and geriatric patients due to a lack of data on safety and efficacy.</p>', '<p>The following agents have been shown to influence the magnitude and/or duration of action of non-depolarizing neuromuscular blocking agents:</p>\r\n\r\n<p>Effect of other agents on Rocuronium Bromide-</p>\r\n\r\n<p><strong>Increased Effect</strong>: Halogenated volatile anesthetics potentiate the neuromuscular block of Rocuronium Bromide. The effect only becomes apparent with maintenance dosing. Reversal of the block with anti-cholinesterase inhibitors could also be inhibited. Long-term concomitant use of corticosteroids and Rocuronium Bromide in the ICU may result in prolonged duration of neuromuscular block or myopathy.<br />\r\n<br />\r\nOther drugs:&nbsp;</p>\r\n\r\n<ul>\r\n	<li>Antibiotics: aminoglycoside, lincosamide and polypeptide antibiotics, acylamino-penicillin antibiotics.&nbsp;</li>\r\n	<li>Diuretics, quinidine and its isomer quinine, magnesium salts, calcium channel blocking agents, lithium salts, local anaesthetics (lidocaine i.v., bupivacaine epidural) and acute administration of phenytoin&nbsp;</li>\r\n	<li>Recurarization has been reported after post-operative administration of: aminoglycoside, lincosamide, polypeptide and acylamino-penicillin antibiotics, quinidine, quinine and magnesium.</li>\r\n</ul>\r\n\r\n<p><strong>Decreased Effect</strong>: Prior chronic administration of phenytoin or carbamazepine. Protease inhibitors (gabexate, ulinastatin)&nbsp;<br />\r\n<br />\r\n<strong>Variable Effect</strong>: Administration of other non-depolarizing neuromuscular blocking agents in combination with Rocuronium Bromide may produce attenuation or potentiation of the neuromuscular block, depending on the order of administration and the neuromuscular blocking agent used. Suxamethonium given after the administration of Rocuronium Bromide may produce potentiation or attenuation of the neuromuscular blocking effect of Rocuronium Bromide.&nbsp;<br />\r\n<br />\r\n<strong>Effect of Rocuronium Bromide on other drugs</strong>: Rocuronium Bromide combined with lidocaine may result in a quicker onset of action of lidocaine.</p>', '<p>Hypersensitivity to Rocuronium or to the Bromide ion or to any of the excipients.</p>', '<p>In clinical trials, the most common adverse reactions (2%) are transient hypotension and hypertension. Other are:</p>\r\n\r\n<ul>\r\n	<li>Anaphylaxis&nbsp;</li>\r\n	<li>Residual paralysis&nbsp;</li>\r\n	<li>Myopathy&nbsp;</li>\r\n	<li>Increased pulmonary vascular resistance</li>\r\n</ul>\r\n\r\n<p>Although very rare, severe anaphylactic reactions to neuromuscular blocking agents, including Rocuronium Bromide, have been reported. Anaphylactic/anaphylactoid reactions are: bronchospasm, cardiovascular changes (e.g. hypotension, tachycardia, circulatory collapse - shock), and cutaneous changes (e.g. angioedema, urticaria). These reactions have, in some cases, been fatal. Due to the possible severity of these reactions, one should always assume they may occur and take the necessary precautions.&nbsp;<br />\r\n<br />\r\nSince neuromuscular blocking agents are known to be capable of inducing histamine release both locally at the site of injection and systemically, the possible occurrence of itching and erythematosus reactions at the site of injection and/or generalized histaminoid (anaphylactoid) reactions (see also under Anaphylactic Reactions above) should always be taken into consideration when administering these agents.&nbsp;In clinical studies only a slight increase in mean plasma histamine levels has been observed following rapid bolus administration of 0.3 0.9mg/kg Rocuronium Bromide.<br />\r\n<br />\r\n<strong>Prolonged neuromuscular block</strong>: The most frequent adverse reaction to nondepolarizing blocking agents as a class consists of an extension of the agent&#39;s pharmacological action beyond the time period needed. This may vary from skeletal muscle weakness to profound and prolonged skeletal muscle paralysis resulting in respiratory insufficiency or apnoea.&nbsp;<br />\r\n<br />\r\n<strong>Myopathy</strong>: Myopathy has been reported after the use of various neuromuscular blocking agents in the ICU in combination with corticosteroids.<br />\r\n<br />\r\n<strong>Local injection site reactions</strong>: During rapid sequence induction of anesthesia, pain on injection has been reported, especially when the patient has not yet completely lost consciousness and particularly when propofol is used as the induction agent. In clinical studies, pain on injection has been noted in 16% of the patients who underwent rapid sequence induction of anesthesia with propofol and in less than 0.5% of the patients who underwent rapid sequence induction of anesthesia with fentanyl and thiopental.</p>', '<p><strong>Pregnancy</strong>:&nbsp;For Rocuronium Bromide, no clinical data on exposed pregnancies are available. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy, embryonal/foetal development, parturition or postnatal development. Caution should be exercised when prescribing Rocuronium Bromide to pregnant women.<br />\r\n<br />\r\n<strong>Caesarean section</strong>: In patients undergoing Caesarean section, Rocuronium Bromide can be used as part of a rapid sequence induction technique, provided no intubation difficulties are anticipated and a sufficient dose of anesthetic agent is administered or following suxamethonium facilitated intubation. Rocuronium Bromide, administered in doses of 0.6mg/kg, has been shown to be safe in parturient undergoing Caesarean section. Rocuronium Bromide does not affect Apgar score, foetal muscle tone nor cardio-respiratory adaptation. From umbilical cord blood sampling it is apparent that only limited placental transfer of Rocuronium Bromide occurs which does not lead to the observation of clinical adverse effects in the newborn.<br />\r\n<br />\r\n<strong>Lactation</strong>:&nbsp;It is unknown whether Rocuronium Bromide is excreted in human breast milk. Animal studies have shown insignificant levels of Rocuronium Bromide in breast milk. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy, embryonal/foetal development, parturition or postnatal development. Rocuronium Bromide should be given to lactating women only when the attending physician decides that the benefits outweigh the risks.</p>', '<p><strong>Instructions for use/handling</strong>: Compatibility studies with the following infusion fluids have been performed. In nominal concentrations of 0.5mg/mL and 2.0mg/mL, Rocuronium Bromide has been shown to be compatible with: 0.9% NaCl, 5% dextrose, 5% dextrose in saline, sterile water for injections, Lactated Ringers and Haemaccel. Administration should be commenced immediately after mixing, and should be completed within 24 hours. Unused solutions should be discarded.<br />\r\n<br />\r\n<strong>For use/handling</strong>: If Rocuronium Bromide is administered via the same infusion line that is also used for other medicines, it is important that this infusion line is adequately flushed (e.g. with 0.9% NaCl) between administration of Rocuronium Bromide and medicines for which incompatibility with Rocuronium Bromide has been demonstrated or for which compatibility with Rocuronium Bromide has not been established.</p>', '<p>In the event of overdosage and prolonged neuromuscular block, the patient should continue to receive ventilatory support and sedation. In this situation there are two options for the reversal of neuromuscular block:<br />\r\n<br />\r\nSugammadex can be used for reversal of intense (profound) and deep block. The dose of sugammadex to be administered depends of the level of neuromuscular block.<br />\r\n<br />\r\nAn acetylcholinesterase inhibitor (e.g. neostigmine, edrophonium, pyridostigmine), with appropriate vagolytic (e.g atropine) can be used at reappearance of T2 or at the first signs of clinical recovery and should be administered in adequate doses. When administration of an acetylcholinesterase inhibiting agent fails to reverse the neuromuscular effects of Rocuronium Bromide, ventilation must be continued until spontaneous breathing is restored. Repeated dosage of an acetylcholinesterase inhibitor can be dangerous.</p>', '<p>Non depolarizing muscle relaxants.</p>', '<p>Rocuronium Bromide should be stored in the refrigerator at 2-8&deg; C and not be frozen.</p>', NULL, '2022-03-18 04:52:20', '2022-03-18 04:52:20');
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
(1300, 1300, '<p>Roflumilast is indicated:</p>\r\n\r\n<ul>\r\n	<li>As add-on therapy to bronchodilator treatment.</li>\r\n	<li>For the maintenance treatment of severe Chronic Obstructive Pulmonary Disease (COPD) associated with chronic bronchitis (i.e. patients with a history of chronic cough and sputum) in adult patients with a history of frequent exacerbations.</li>\r\n</ul>\r\n\r\n<p>Roflumilast should not be used as a rescue medication.</p>', '<p>Roflumilast is a phosphodiesterase-4 (PDE-4) inhibitor which, due to its selective inhibition of the PDE4 isoenzyme, has potential antiinflammatory and antimodulatory effects in the pulmonary system. It is thought that the increased levels of intracellular cyclic AMP are responsible for the therapeutic actions of Roflumilast.</p>', '<p>The recommended dosage for patients with COPD is one 500 mcg tablet daily, with or without food.</p>', '<p>A major step in Roflumilast metabolism is the N-oxidation of Roflumilast to Roflumilast N-oxide by CYP3A4 and CYP1A2. Therefore, the use of strong cytochrome P450 enzyme inducers (e.g. rifampicin, phenobarbital, carbamazepine, phenytoin) with Roflumilast is not recommended. The co-administration of Roflumilast with CYP3A4 inhibitors or dual inhibitors that inhibit both CYP3A4 and CYP1A2 simultaneously (e.g., erythromycin, ketoconazole, fluvoxamine, enoxacin, cimetidine) may increase Roflumilast systemic exposure and may result in increased adverse reactions. The co-administration of Roflumilast with oral contraceptives containing gestodene and ethinyl estradiol may increase roflumilast systemic exposure and may result in increased side effects.</p>', '<p>Hypersensitivity to Roflumilast or to any of the excipients. Moderate to severe liver impairment.</p>', '<p><strong>General disorders</strong>: Fatigue.<br />\r\n<strong>Metabolism and nutrition disorders</strong>: Decreased appetite, Weight decreased.<br />\r\n<strong>Musculoskeletal and connective tissue disorders</strong>: Back pain, muscle spasms.<br />\r\n<strong>Nervous system disorders</strong>: Dizziness, Headache, Tremor.<br />\r\n<strong>Psychiatric disorders</strong>: Anxiety, Depression, Insomnia.</p>', '<p>Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Roflumilast should not be used during pregnancy &amp; lactation.</p>', '<p>Not as emergency treatment for relief of acute brochospasm. Monitor body wt regularly. Severe immunological disease, severe acute infections, cancers (except basal cell carcinoma) or patients on immunosuppressants; CHF (NYHA grades III &amp; IV). History of depression associated with suicidal ideation or behavior. Galactose intolerance, Lapp-lactase deficiency or glucose-galactose malabsorption. Hepatic impairment. Pregnancy &amp; lactation.</p>', '<p>No case of overdose has been reported in clinical studies with Roflumilast. However, during the Phase I studies of Roflumilast, at an increased rate after a single oral dose of 2500 mcg and a single dose of 5000 mcg,<br />\r\n<br />\r\n<strong>The following symptoms were observed</strong>:&nbsp;headache, gastrointestinal disorders, dizziness, palpitations, lightheadedness, clamminess and arterial hypotension.<br />\r\n<br />\r\n<strong>Missed Dose</strong>: Patients should be advised that if they forget to take a tablet at the usual time, they should take the tablet as soon as they remember or continue on the next day with the next tablet at the usual time. Patients should not take a double dose to make up for a forgotten dose.</p>', '<p>Antihistamines anti-allergies &amp; hypo-sensitisation.</p>', '<p>Store below 30&deg; C, keep away from light, moisture. Keep out of the reach of children.</p>', '<p><strong>Geriatrics ( 65 years of age)</strong>: There were no overall differences in safety and effectiveness of Roflumilast in the elderly compared to younger patients with COPD. Therefore, no dose adjustment is necessary.<br />\r\n<br />\r\n<strong>Pediatrics (&lt;18 years of age)</strong>: Safety and effectiveness of Roflumilast in children and adolescents below 18 years of age have not been established.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Roflumilast is not recommended for use in patients with moderate or severe liver impairment.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: No dosage adjustment is necessary for patients with renal impairment</p>', '2022-03-18 04:54:04', '2022-03-18 04:54:04'),
(1301, 1301, '<p>Ropinirole is indicated for the treatment of the signs and symptoms of idiopathic Parkinson&#39;s disease. It is also indicated for the treatment of moderate-to-severe primary Restless Legs Syndrome (RLS).</p>', '<p>Ropinirole is a non-ergoline dopamine agonist. Ropinirole has the highest affinity at the D3 receptors, which are concentrated in the limbic areas of the brain and may be responsible for some of the neuropsychiatric effects. The exact mechanism of action of ropinirole as a treatment for Parkinson&rsquo;s disease is unknown, however, it is believed to be related to its ability to selectively stimulate dopamine D2 receptors within the caudate-putamen system in the brain. This system affects body movement. Negligible affinity is seen for ropinirole at &alpha;2 adrenoreceptors in the periphery and 5HT-1 receptor. Ropinirole has no affinity at the D1-like receptors, benzodiazepine or GABA receptors. The precise mechanism of action of ropinirole as a treatment for Restless Legs Syndrome is unknown, however, it is believed to be related to its ability to stimulate dopamine receptors.</p>', '<p><strong>Dosing for Parkinson&#39;s disease</strong>: The recommended starting dose for Parkinson&#39;s disease is 0.25 mg three times daily. Based on individual patient therapeutic response and tolerability, if necessary, the dose should then be titrated with weekly increments as described below. Maximum recommended total daily dose of 24 mg (8 mg three times daily).</p>\r\n\r\n<ul>\r\n	<li><strong>Week 1</strong>: 0.25 mg 3 times daily. Total Daily Dose 0.75 mg</li>\r\n	<li><strong>Week 2</strong>: 0.5 mg 3 times daily. Total Daily Dose 1.50 mg</li>\r\n	<li><strong>Week 3</strong>: 0.75 mg 3 times daily. Total Daily Dose 2.25 mg</li>\r\n	<li><strong>Week 4</strong>: 1 mg 3 times daily. Total Daily Dose 3 mg</li>\r\n</ul>\r\n\r\n<p><strong>Dosing for Restless Legs Syndrome</strong>: The recommended adult starting dose for RLS is 0.25 mg once daily 1 to 3 hours before bedtime. After 2 days, if necessary, the dose can be increased to 0.5 mg once daily, and to 1 mg once daily at the end of the first week of dosing, then as shown below as needed to achieve efficacy. Titration should be based on individual patient therapeutic response and tolerability, up to a maximum recommended dose of 4 mg daily.</p>\r\n\r\n<ul>\r\n	<li><strong>Days 1 and 2</strong>: 0.25 mg, 1 to 3 hours before bedtime, to be taken once daily</li>\r\n	<li><strong>Days 3-7</strong>: 0.5 mg, 1 to 3 hours before bedtime, to be taken once daily</li>\r\n	<li><strong>Days 2</strong>: 1 mg, 1 to 3 hours before bedtime, to be taken once daily</li>\r\n	<li><strong>Days 3</strong>: 1.5 mg, 1 to 3 hours before bedtime, to be taken once daily</li>\r\n	<li><strong>Days 4</strong>: 2 mg, 1 to 3 hours before bedtime, to be taken once daily</li>\r\n	<li><strong>Days 5</strong>: 2.5 mg, 1 to 3 hours before bedtime, to be taken once daily</li>\r\n	<li><strong>Days 6</strong>: 3 mg, 1 to 3 hours before bedtime, to be taken once daily</li>\r\n	<li><strong>Days 7</strong>: 4 mg, 1 to 3 hours before bedtime, to be taken once daily</li>\r\n</ul>', '<p>Because Ropinirole is a dopamine agonist, it is possible that dopamine antagonists such as neuroleptics (phenothiazines, butyrophenones, thioxanthenes) or metodopramide may reduce the efficacy of Ropinirole.</p>', '<p>It is contraindicated in patients known to have a hypersensitivity to Ropinirole.</p>', '<p>The most common side effects of Ropinirole include fainting, drowsiness, hallucinations, dizziness, nausea or vomiting, uncontrolled sudden movements, leg swelling, fatigue, confusion, headache, upset stomach, abdominal pain or discomfort, increased sweating etc.</p>', '<p>Pregnancy category C. There is no adequate and well-controlled studies in pregnant women. It should be used during pregnancy only if the potential benefit outweighs the potential risk to the fetus. Ropinirole inhibits prolactin secretion in human and could potentially inhibit lactation.</p>', '<p>Patients treated with Ropinirole have reported falling asleep while engaged in activities of daily living. Dopamine agonists in clinical trials and clinical experience appear to impair the systemic regulation of blood pressure, with resulting orthostatic hypotension.</p>', NULL, '<p>Antiparkinson drugs.</p>', '<p>Protect from light and moisture, store below 25&deg;C. Keep out of the reach of children.</p>', NULL, '2022-03-18 04:59:18', '2022-03-18 04:59:18'),
(1302, 1302, '<p>Rosiglitazone is indicated</p>\r\n\r\n<ul>\r\n	<li>As monotherapy for glycemic control.</li>\r\n	<li>For use in combination with a sulfonylurea, metformin, or insulin when diet, exercise, and a single agent do not result in adequate glycemic control.</li>\r\n	<li>Also for use in combination with a sulfonylurea plus metformin when diet, exercise, and both agents do not result in adequate glycemic control.</li>\r\n</ul>', '<p>Rosiglitazone, a member of the thiazolidinedione class of antidiabetic agents, improves glycemic control by improving insulin sensitivity. Rosiglitazone is a highly selective and potent agonist for the peroxisome proliferator-activated receptor gamma (PPAR-&gamma;). In humans, PPAR receptors are found in key target tissues for insulin action such as adipose tissue, skeletal muscle, and liver. Activation of PPAR-&gamma; nuclear receptors regulates the transcription of insulinresponsive genes involved in the control of glucose production, transport, and utilization. In addition, PPAR-&gamma;-responsive genes also participate in the regulation of fatty acid metabolism. Pharmacological studies in animal models indicate that Rosiglitazone improves sensitivity to insulin in muscle and adipose tissue and inhibits hepatic gluconeogenesis. Rosiglitazone maleate is not chemically or functionally related to the sulfonylureas, the biguanides, or the alpha glucosidase inhibitors.</p>', '<p>The management of antidiabetic therapy should be individualized. Rosiglitazone may be administered either at a starting dose of 4 mg as a single daily dose or divided and administered in the morning and evening. For patients who respond inadequately following 8 to 12 weeks of treatment, as determined by reduction in FPG, the dose may be increased to 8 mg daily as monotherapy or in combination with metformin, sulfonylurea, or sulfonylurea plus metformin. Rosiglitazone may be taken with or without food.<br />\r\n<br />\r\n<strong>Monotherapy</strong>: The usual starting dose of Rosiglitazone is 4 mg administered either as a single dose once daily or in divided doses twice daily. In clinical trials, the 4 mg twice daily regimen resulted in the greatest reduction in FPG and HbA1c.<br />\r\n<br />\r\n<strong>Combination therapy</strong>: When Rosiglitazone is added to existing therapy, the current dose(s) of the agent(s) can be continued upon initiation of Rosiglitazone therapy.<br />\r\n<br />\r\n<strong>Sulfonylurea</strong>: When used in combination with sulfonylurea, the usual starting dose of Rosiglitazone is 4 mg administered as either a single dose once daily or in divided doses twice daily. If patients report hypoglycemia, the dose of the sulfonylurea should be decreased.<br />\r\n<br />\r\n<strong>Metformin</strong>: The usual starting dose of Rosiglitazone in combination with metformin is 4 mg administered as either a single dose once daily or in divided doses twice daily. It is unlikely that the dose of metformin will require adjustment due to hypoglycemia during combination therapy with Rosiglitazone.<br />\r\n<br />\r\n<strong>Insulin</strong>: For patients stabilized on insulin, the insulin dose should be continued upon initiation of therapy with Rosiglitazone. Rosiglitazone should be dosed at 4 mg daily. Doses of Rosiglitazone greater than 4 mg daily in combination with insulin are not currently indicated. It is recommended that the insulin dose be decreased by 10% to 25% if the patient reports hypoglycemia or if FPG concentrations decrease to less than 100 mg/dL. Further adjustments should be individualized based on glucose-lowering response.<br />\r\n<br />\r\n<strong>Sulfonylurea plus metformin</strong>: The usual starting dose of Rosiglitazone in combination with a sulfonylurea plus metformin is 4 mg administered as either a single dose once daily or in divided doses twice daily. If patients report hypoglycemia, the dose of the sulfonylurea should be decreased.<br />\r\n<br />\r\n<strong>Maximum Recommended Dose</strong>: The dose of Rosiglitazone should not exceed 8 mg daily, as a single dose or divided twice daily. The 8 mg daily dose has been shown to be safe and effective in clinical studies as monotherapy and in combination with metformin, sulfonylurea, or sulfonylurea plus metformin. Doses of Rosiglitazone greater than 4 mg daily in combination with insulin are not currently indicated. No dosage adjustments are required for the elderly. No dosage adjustment is necessary when Rosiglitazone is used as monotherapy in patients with renal impairment.</p>', '<p>In vitro drug metabolism studies suggest that Rosiglitazone does not inhibit any of the major P450 enzymes at clinically relevant concentrations. A decrease in the dose of Rosiglitazone may be needed when gemfibrozil is introduced. Dosage adjustment is also required when administered with rifampin. Rosiglitazone was shown to have no clinically relevant effect on the pharmacokinetics of nifedipine and oral contraceptives.</p>', '<p>Rosiglitazone is contraindicated in patients with known hypersensitivity to this product or any of its components.</p>', '<p>The incidence and types of adverse events reported in clinical trials of Rosiglitazone as monotherapy are similar to that of placebo. Overall, the types of adverse experiences reported when Rosiglitazone was used in combination with a sulfonylurea or metformin were similar to those during monotherapy with Rosiglitazone. Events of anemia and edema tended to be reported more frequently at higher doses, and were generally mild to moderate in severity and usually did not require discontinuation of treatment with Rosiglitazone.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. Rosiglitazone should not be used during pregnancy unless the potential benefit justifies the potential risk to the fetus. Drug-related material was detected in milk from lactating rats. It is not known whether Rosiglitazone is excreted in human milk. Because many drugs are excreted in human milk, Rosiglitazone should not be administered to a nursing woman.</p>', '<p>Due to its mechanism of action, Rosiglitazone is active only in the presence of endogenous insulin. Therefore, Rosiglitazone should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis. Rosiglitazone, like other thiazolidinediones, alone or in combination with other antidiabetic agents, can cause fluid retention, which may exacerbate or lead to heart failure. Patients should be observed for signs and symptoms of heart failure. In combination with insulin, thiazolidinediones may also increase the risk of other cardiovascular adverse events. Rosiglitazone should be discontinued if any deterioration in cardiac status occurs. Rosiglitazone should be used with caution in patients with edema. Liver enzymes should be checked prior to the initiation of therapy with Rosiglitazone in all patients and periodically thereafter per the clinical judgement of the healthcare professional. Therapy with Rosiglitazone should not be initiated in patients with increased baseline liver enzyme levels (ALT &gt;2.5X upper limit of normal).</p>', NULL, '<p>Thiazolidinedione Group.</p>', '<p>Protect from light and moisture. Store in a cool and dry place.</p>', '<p><strong>Use in Children</strong>: The safety and effectiveness of Rosiglitazone in pediatric patients have not been established.</p>', '2022-03-18 05:01:06', '2022-03-18 05:01:06'),
(1303, 1303, '<p>This is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus who are not adequately controlled on Metformin alone. Management of type 2 diabetes mellitus should include diet control. Caloric restriction, weight loss, and exercise are essential for the proper treatment of the diabetic patient because they help improve insulin sensitivity. This is important not only in the primary treatment of type 2 diabetes but also in maintaining the efficacy of drug therapy.</p>', '<p>Combination of two antidiabetic agents with different mechanisms of action to improve glycemic control in patients with type 2 diabetes: Rosiglitazone maleate, a member of the thiazolidinedione class, and Metformin hydrochloride, a member of the biguanide class. Thiazolidinediones are insulin sensitizing agents that act primarily by enhancing peripheral glucose utilization, whereas biguanides act primarily by decreasing endogenous hepatic glucose production.<br />\r\n<br />\r\nRosiglitazone is a highly selective and potent agonist for the peroxisome proliferator&ndash;activated receptor-gamma (PPAR&gamma;). Activation of PPAR&gamma; nuclear receptors regulates the transcription of insulin-responsive genes involved in the control of glucose production, transport, and utilization. In addition, PPAR&gamma;-responsive genes also participate in the regulation of fatty acid metabolism.<br />\r\n<br />\r\nThe pharmacologic mechanism of action of Metformin is different from other classes of oral antihyperglycemic agents. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and increases peripheral glucose uptake and utilization. Unlike sulfonylureas, With Metformin therapy, insulin secretion remains unchanged while fasting insulin levels and day-long plasma insulin&nbsp;response may actually decrease.</p>', '<p>The selection of the dose of Rosiglitazone and Metformin combination should be based on the patient&rsquo;s current doses of Rosiglitazone and/or Metformin. The safety and efficacy of Rosiglitazone and Metformin combination as initial therapy for patients with type 2 diabetes mellitus have not been established.<br />\r\n<br />\r\nThe following recommendations regarding the use of Rosiglitazone and Metformin combination in patients inadequately controlled on Rosiglitazone and Metformin monotherapies are based on clinical practice experience with Rosiglitazone and Metformin combination therapy.</p>\r\n\r\n<ul>\r\n	<li>The dosage of antidiabetic therapy with Rosiglitazone and Metformin combination should be individualized on the basis of effectiveness and tolerability while not exceeding the maximum recommended daily dose of 8 mg/2,000 mg.</li>\r\n	<li>Rosiglitazone and Metformin combination should be given in divided doses with meals, with gradual dose escalation. This reduces GI side effects (largely due to Metformin) and permits determination of the minimum effective dose for the individual patient.</li>\r\n	<li>Sufficient time should be given to assess adequacy of therapeutic response. Fasting plasma glucose (FPG) should be used to determine the therapeutic response to Rosiglitazone and Metformin combination . After an increase in Metformin dosage, dose titration is recommended if patients are not adequately controlled after 1 to 2 weeks. After an increase in Rosiglitazone dosage, dose titration is recommended if patients are not adequately controlled after 8 to 12 weeks.</li>\r\n</ul>\r\n\r\n<p><strong>For patients inadequately controlled on Metformin monotherapy</strong>: The usual starting dose of Rosiglitazone and Metformin combination is 4 mg Rosiglitazone (total daily dose) plus the dose of Metformin already being taken.<br />\r\n<br />\r\n<strong>For patients inadequately controlled on Rosiglitazone monotherapy</strong>: The usual starting dose of Rosiglitazone and Metformin combination is 1,000 mg Metformin (total daily dose) plus the dose of Rosiglitazone already being taken.</p>', '<p>If an inhibitor or an inducer of CYP2C8 (such as gemfibrozil or rifampin) is started or stopped during treatment with Rosiglitazone, changes in diabetes treatment may be needed based upon clinical response.<br />\r\n<br />\r\nAlthough drug interactions with cationic drugs (e.g., amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, and vancomycin) remain theoretical (except for cimetidine), careful patient monitoring and dose adjustment of combination of Rosiglitazone and Metformin and/or the interfering drug is recommended in patients who are taking cationic medications that are excreted via the proximal renal tubular secretory system.<br />\r\n<br />\r\nWhen drugs that produce hyperglycemia which may lead to loss of glycemic control are administered to a patient receiving combination of Rosiglitazone and Metformin, the patient should be closely observed to maintain adequate glycemic control.</p>', '<p>Combination of Rosiglitazone and Metformin tablets are<br />\r\ncontraindicated in patients with:</p>\r\n\r\n<ul>\r\n	<li>Renal disease or renal dysfunction which may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction, and septicemia</li>\r\n	<li>Congestive heart failure requiring pharmacologic treatment.</li>\r\n	<li>Known hypersensitivity to Rosiglitazone maleate or Metformin hydrochloride.</li>\r\n	<li>Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma. Diabetic ketoacidosis should be treated with insulin.</li>\r\n</ul>\r\n\r\n<p>Combination of Rosiglitazone and Metformin should be temporarily discontinued in patients undergoing radiologic studies involving intravascular administration of iodinated contrast materials, because use of such products may result in acute alteration of renal function.</p>', '<p>The incidence and types of adverse events reported in clinical trials of Rosiglitazone as monotherapy are upper respiratory tract infection, headache, back pain, hyperglycemia, fatigue, sinusitis, diarrhea, and hypoglycemia. Adverse reactions reported in greater than 5% of the Metformin patients, and that were more common in Metformin- than placebo-treated patients are diarrhea, nausea, vomiting, flatulence, asthenia, indigestion, abdominal discomfort, headache.</p>', '<p>Pregnancy Category C. Because current information strongly suggests that abnormal blood glucose levels during pregnancy are associated with a higher&nbsp;incidence of congenital anomalies as well as increased neonatal morbidity and mortality, most experts recommend that insulin monotherapy be used during pregnancy to maintain blood glucose levels as close to normal as possible. Combination of Rosiglitazone and Metformin should not be used during pregnancy unless the potential benefit justifies the potential risk to the fetus. There are no adequate and well-controlled studies in pregnant women with combination of Rosiglitazone and Metformin or its individual components.<br />\r\n<br />\r\nIt is not known whether Rosiglitazone and/or Metformin are excreted in human milk. Because many drugs are excreted in human milk,&nbsp;a combination of Rosiglitazone and Metformin should not be administered to a nursing woman.</p>', '<p>When a patient stabilized on any diabetic regimen is exposed to stress such as fever, trauma, infection, or surgery, a temporary loss of glycemic control may occur. At such times, it may be necessary to withhold combination of Rosiglitazone and Metformin and temporarily administer insulin. Combination of Rosiglitazone and Metformin may be reinstituted after the acute episode is resolved. Combination of Rosiglitazone and Metformin should be used with caution in patients with edema.</p>', NULL, '<p>Combination Oral hypoglycemic preparations.</p>', '<p>Store in a cool dry place protected from light. Keep out of reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of&nbsp;combination of Rosiglitazone and Metformin in pdiatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Because aging is associated with&nbsp;reduced renal function, combination of Rosi litazone and Metformin should be used with caution as age increases. Care should be taken in dose selection and should be based on careful and regular monitoring of renal function. Generally, elderly patients should not be titrated to the maximum dose of combination of Rosiglitazone and Metformin.</p>', '2022-03-18 05:02:54', '2022-03-18 05:02:54'),
(1304, 1304, '<p>Rosuvastatin is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Heterozygous Hypercholesterolemia (Familial and Non familial)</li>\r\n	<li>Homozygous Hypercholesterolemia (Familial)</li>\r\n	<li>Mixed Dyslipidemia (Fredrickson Type IIa and IIb)</li>\r\n	<li>Primary prevention of cardiovascular disease</li>\r\n</ul>', '<p>Rosuvastatin is a selective and competitive inhibitor of HMG-CoA reductase, the rate-limiting enzyme that converts 3-hydroxy-3-methyl glutaryl coenzyme A to mevalonate, a precursor of cholesterol. Rosuvastatin produces its lipid-modifying effects in two ways. First, it increases the number of hepatic LDL receptors on the cell surface to enhance uptake and catabolism of LDL. Second, Rosuvastatin inhibits hepatic synthesis of VLDL, which reduces the total number of VLDL and LDL particles.</p>', '<p><strong>Dose range</strong>: 5-40 mg once daily. Use 40 mg dose only for patients not reaching LDL-C goal with 20 mg<br />\r\n<br />\r\n<strong>HoFH</strong>: Starting dose 20 mg/day.<br />\r\n<br />\r\n<strong>Pediatric patients with HeFH</strong>: 5-10 mg/day for patients 8 to less than 10 years age, and 5-20 mg/day for patients 10 to 17 years of age.<br />\r\n<br />\r\n<strong>Pediatric patients with HoFH</strong>: 20 mg/day for patients 7 to 17 years of age.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Rosuvastatin can be taken with or without food, at any time of day.</p>', '<p>Remarkable drug interactions of Rosuvastatin are-</p>\r\n\r\n<ul>\r\n	<li><strong>Cyclosporine</strong>: Combination increases Rosuvastatin exposure. Rosuvastatin dose should be limited to 5 mg once daily.</li>\r\n	<li><strong>Gemfibrosil</strong>: Combination should be avoided. If used together, Rosuvastatin dose should be limited to 10 mg once daily.</li>\r\n	<li><strong>Lopinavir/Ritonavir or atazanavir/ritonavir</strong>: Combination increases Rosuvastatin exposure. Rosuvastatin dose should be to 10 mg once daily.</li>\r\n	<li><strong>Coumarin anticoagulants</strong>: Combination prolongs international normalized ratio (INR). Stable INR should be achieved prior to starting Rosuvastatin. INR should be monitored frequently until stable upon initiation or alteration of Rosuvastatin therapy.</li>\r\n	<li><strong>Concomitant lipid-lowering therapies</strong>: Use with fibrates and niacin products may increase the risk of skeletal muscle effects.</li>\r\n</ul>', '<p>Rosuvastatin is contraindicated if-</p>\r\n\r\n<ul>\r\n	<li>Known hypersensitivity to product components</li>\r\n	<li>Liver disease, which may include unexplained persistent elevations in hepatic transaminase levels</li>\r\n	<li>Pregnant women and women who may become pregnant</li>\r\n	<li>Nursing mothers</li>\r\n</ul>', '<p>Rosuvastatin is generally well tolerated. The most frequent adverse events thought to be related to Rosuvastatin were headache, myalgia, constipation, asthenia, abdominal pain and nausea.</p>', '<p>The safety in pregnant women has not been established. It is not known whether Rosuvastatin is excreted in human milk or not.</p>', '<p><strong>Skeletal muscle effects (e.g., myopathy and rhabdomyolysis)</strong>: Risks increase with use of 40 mg dose, advanced age (&gt;65 year), hypothyroidism, renal impairment and combination use with cyclosporine, lopinavir/ritonavir, atazanavir/ritonavir or certain other lipid-lowering drugs. Patients should be advised to promptly report unexplained muscle pain, tenderness or weakness. Rosuvastatin can be discontinued if signs or symptoms appear.<br />\r\n<br />\r\n<strong>Liver enzyme abnormalities and monitoring</strong>: Persistent elevations in hepatic transaminases can occur.<br />\r\n<br />\r\nLiver enzymes should be monitored before and during treatment</p>', NULL, '<p>Other Anti-anginal &amp; Anti-ischaemic drugs, Statins.</p>', '<p>Keep below 30oC temperature, protected from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Use in children</strong>: The safety and effectiveness in pediatric patients have not been established.</p>', '2022-03-18 05:04:49', '2022-03-18 05:04:49'),
(1305, 1305, '<p>Rotavirus vaccine is indicated for the prevention of rotavirus gastroenteritis in infants and children caused by Types G1, G2, G3, G4, and G9 when administered as a 3-dose series to infants between the ages of 6 to 32 weeks. The first dose of Rotavirus vaccine should be administered between 6 and 12 weeks of age.<br />\r\n<br />\r\nThe vaccination series consists of 3 ready-to-use liquid doses of Rotavirus vaccine administered orally starting at 6 to 12 weeks of age, with the subsequent doses administered at 4- to 10-week intervals. The third dose should not be given after 32 weeks of age.</p>', '<p>Rotavirus is one of the important causes of severe acute gastroenteritis in infants and young children. There are 2 commercially available forms of rotavirus vaccine. Rotavirus is a live, attenuated monovalent vaccine derived from human strain indicated for prevention of rotavirus gastroenteritis caused by G1, G3, G4 and G9 serotypes; Rotavirus as a live, pentavalent human-bovine reassortant vaccine indicated for prevention of gastreoenteritis caused by rotavirus serotypes G1, G2, G3 and G4. Although presence of porcine cirovirus (PCV1 and PCV2) DNA have been detected in the rotavirus vaccine, current available information shows that there is no evidence that PCV1 or PCV2 poses a safety risk to humans. Exact immunologic mechanism of action is not fully understood although it is known that vaccine viruses replicate in the small intestine and promote active immunity.</p>', '<p>The vaccination course consists of two doses. The first dose may be administered from the age of 6 weeks. There should be an interval of at least 4 weeks between the dosages. The vaccination course should be completed by the age of 24 weeks. Lyophilised vaccine to be recostituted with a liquid diluent before oral administration. After reconstitution, 1 dose (1 ml) contains- live attenuated human rotavirus RIX4414 strain not less than 106&nbsp;CCID50. Repeat dosing is not indicated if an infant should spit out, regurgitate or vomit during or after the administration of the vaccine. The vaccination course should be completed as recommended above. There are no restrictions on the infant&#39;s consumption of food or liquid, including breast-milk, either before or after vaccination.</p>', '<p>Rotavirus vaccine can be given concomitantly with any of the following administered either as monovalent or as combination vaccines: Diphtheria-tetanus-whole cell pertussis vaccine&nbsp;(DTPw), Diphtheria-tetanus-acellular pertussis vaccine (DTPa), Haemophilus influenzae type b vaccine (Hib). inactivated Polio vaccine (IPV), Hepatitis B vaccine and Pneumococcal vaccine.<br />\r\n<br />\r\nConcomitant administration of Rotavirus vaccine and oral polio vaccine (OPV) does not affect the immune response to the polio antigens. Although concomitant administration of OPV may slightly reduce the immune response to rota virus vaccine there is currently no evidence that clinical protection against severe rotavirus gastroenteritis would be affected. The immune response to Rotavirus vaccine is unaffected when OPV is administered two weeks apart from Rotavirus vaccine. Effects on ability to drive and use machines- not applicable.</p>', '<p>Subjects with history of intussusception. Subjects with Severe Combined Immunodeficiency (SCID) disorder The presence of a minor infection, such as a cold, is not a contraindication for immunisation.</p>', '<p>In controlled clinical studies, the adverse reaction profile observed in the subjects receiving Rotavirus vaccine was similar to the adverse reaction profile observed in subjects receiving placebo. No increase in the incidence or severity of these reactions was seen with the second dose.<br />\r\n<br />\r\nHowever, some adverse reactions considered as being at least possibly related to Rotavirus vaccine vaccination were reported. Very common areirritability, loss of appetite; common arediarrhoea, vomiting, flatulence, abdominal pain, regurgitation of food, fever, fatigue; uncommon are- crying, sleep disorder, somnolence, constipation rare; upper respiratory tract infection hoarseness, rhinorrhoea, dermatitis, rash, muscle cramp; very rare- gastro-enteritis. In a large safety trial, subjects vaccinated with Rotavirus vaccine gave evidence of no increased risk of intussusception when compared with subjects receiving a placebo.</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>It is good clinical practice that vaccination should be preceded by a review of the medical history (especially with regard to previous vaccination and possible occurrence of undesirable events) and a clinical examination. Parents/ guardians should be advised to seek medical advice promptly where these signs/symptoms are evident. There is a potential risk for transmission to non-vaccinated contacts. It should be administered with caution to infants with close contacts who are immunodeficient, such as household members with malignancies or who are otherwise immunocompromised or receiving immunosuppressive therapy. Contacts of recent vaccinees should be advised to observe personal hygiene</p>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', '<p>Store refrigerated at 2&deg; to 8&deg;C. Protect vials from light.</p>', NULL, '2022-03-18 05:06:32', '2022-03-18 05:06:32'),
(1306, 1306, '<p>For the treatment of disorders of the upper gastro intestinal region that are due to an excess of hydrochloric acid in the gastric juice, i.e. duodenal ulcers, benign gastric ulcers. Also for prophylaxis of recurrent gastric and duodenal ulcers.</p>', '<p>Roxatidine acetate suppresses the effect of histamine on the parietal cells of the stomach (H2-receptor antagonist). This suppressive action is dose-dependent. As a result, the production and secretion, particularly of gastric acid, are reduced. Roxatidine acetate has no antiandrogenic effects and does not influence drug-metabolizing enzymes in the liver.<br />\r\n<br />\r\nThe H2 antagonists are competitive inhibitors of histamine at the parietal cell H2 receptor. They suppress the normal secretion of acid by parietal cells and the meal-stimulated secretion of acid. They accomplish this by two mechanisms: histamine released by ECL cells in the stomach is blocked from binding on parietal cell H2 receptors which stimulate acid secretion, and other substances that promote acid secretion (such as gastrin and acetylcholine) have a reduced effect on parietal cells when the H2 receptors are blocked.</p>', '<p><strong>Zollinger-Ellison syndrome</strong>:&nbsp;75 mg bid.<br />\r\n<br />\r\n<strong>Gastro-oesophageal reflux disease</strong>:&nbsp;75 mg bid or 150 mg at bedtime for 6-8 wk.<br />\r\n<br />\r\n<strong>Premedication before&nbsp;</strong>anaesthesia:&nbsp;75 mg in the evening on the day before surgery and repeated 2 hr before induction of anaesthesia. Alternatively, 150 mg once on the night before surgery.<br />\r\n<br />\r\n<strong>Peptic ulcer</strong>:&nbsp;150 mg at bedtime or 75 mg bid daily for 4-6 wk. Maintenance: 75 mg at bedtime.<br />\r\n<br />\r\n<strong>Gastritis</strong>:&nbsp;75 mg once daily in the evening..</p>', '<p>May affect serum levels of protease inhibitors.</p>', '<p>Lactation, Porphyria.</p>', '<p>Occasional headache, GI disturbances, gynaecomastia, alopecia, blood dyscrasias, pancreatitis, sleep disturbances, restlessness, rarely dizziness. Hypersensitivity reactions e.g. rash and itching reported occasionally. Changes in pulse rate and transient impairment of sexual drive. Possible increase in liver enzyme activity. May reduce leucocytes and/or thrombocytes.</p>', '<p>Pregnancy category is not classified. Contraindications in lactation.</p>', '<p>Renal and hepatic impairment, pregnancy. May mask the symptoms of gastric malignancy.</p>', NULL, '<p>H2 receptor antagonist.</p>', NULL, '<p><strong>Renal Impairment:</strong><br />\r\n<br />\r\nZollinger-Ellison syndrome:</p>\r\n\r\n<ul>\r\n	<li>CrCl &lt;20: 75 mg every 2 days.</li>\r\n	<li>CrCl 20-50: 75 mg at bedtime.</li>\r\n</ul>\r\n\r\n<p>Gastro-oesophageal reflux disease:</p>\r\n\r\n<ul>\r\n	<li>CrCl &lt;20: 75 mg every 2 days.</li>\r\n	<li>CrCl 20-50: 75 mg at bedtime.</li>\r\n</ul>\r\n\r\n<p>Peptic ulcer:</p>\r\n\r\n<ul>\r\n	<li>CrCl &lt;20: 75 mg every 2 days.</li>\r\n	<li>CrCl 20-50: 75 mg at bedtime.</li>\r\n</ul>\r\n\r\n<p>Gastritis:</p>\r\n\r\n<ul>\r\n	<li>CrCl &lt;20: 75 mg every 2 days.</li>\r\n	<li>CrCl 20-50: 75 mg at bedtime.</li>\r\n</ul>', '2022-03-18 05:08:22', '2022-03-18 05:08:22'),
(1307, 1307, '<p>Roxithromycin is indicated in the treatment of infections caused by susceptible microorganisms-</p>\r\n\r\n<ul>\r\n	<li><strong>Respiratory infections</strong>&nbsp;like pneumonia, acute and chronic bronchitis, and bronchopneumonia</li>\r\n	<li><strong>ENT infections</strong>&nbsp;like tonsillitis, pharyngitis, sinusitis and otitis media.</li>\r\n	<li><strong>Skin infections</strong>&nbsp;like folliculitis, furuncles, cellulitis, carbuncles, pyoderma, impetigo and infected dermatitis.</li>\r\n	<li><strong>Genital infections</strong>&nbsp;like urethritis, prostatitis, cervicitis and salpingitis especially if produced by Chlamydia trachomatis.</li>\r\n</ul>', '<p>Roxithromycin inhibits protein synthesis by irreversibly binding to the 50s ribosomal subunits thus blocking the transpeptidation or translocation reactions of susceptible organisms resulting in stunted cell growth.</p>', '<p><strong>Adult dose</strong>: The usual dose for adults is one 300 mg tablet once daily or one 150 mg tablet twice a day for at least two days after resolution of symptoms, a normal course of therapy is between 5 and 10 days. Roxithromycin is best administered on empty stomach. In severe hepatic impairment the dose is 150 mg once daily.<br />\r\n<br />\r\n<strong>Pediatric dose</strong>: The dose for children is 2.5 to 5 mg/kg body weight twice a day. The following general guidelines can be followed</p>\r\n\r\n<ul>\r\n	<li><strong>6 to 11 Kg</strong>: 25 mg Roxithromycin 12 hourly.</li>\r\n	<li><strong>12 to 23 Kg</strong>: 50 mg Roxithromycin 12 hourly.</li>\r\n	<li><strong>24 to 40 Kg</strong>: 100 mg Roxithromycin 12 hourly.</li>\r\n</ul>\r\n\r\n<p>A normal course of therapy is between 5 and 10 days.</p>', '<p>Roxithromycin does not have any affinity for cytochrome P-450 binding sites and thus is unlikely to produce drug interaction mediated by this enzymatic system. Roxithromycin shows mild interaction with theophylline though this has not been found to produce clinically relevant effects. Alteration in the pharmacokinetics of carbamazepine or warfarin has not been found. Antacids, H2- receptor antagonists and food has no effect on the absorption of Roxithromycin.</p>', '<p>Roxithromycin should not be administered simultaneously with ergotamine or its derivatives as it may provoke arterial spasm and severe ischaemia.</p>', '<p>Roxithromycin is well tolerated by patients of all age groups. Less than 4% of treated patients complain of side effects mainly nausea, abdominal pain, diarrhoea and hypersensitivity rash. Other side effects reported include vomiting, dizziness, headache, pruritus, dyspepsia, flatulence, tinnitus, vertigo and constipation. These are in general minor and do not necessitate withdrawal of therapy.</p>', '<p>The safety of Roxithromycin in pregnancy has not been established. It appears in breast milk in small amounts and dose not produce adverse effects in the breast fed infant.</p>', '<p>Roxithromycin should not be used in patients with a history of hypersensitivity to the drug. In patients with hepatic diseases the dose of Roxithromycin should not exceed 150 mg twice a day.</p>', NULL, '<p>Macrolides.</p>', NULL, NULL, '2022-03-18 05:09:50', '2022-03-18 05:09:50'),
(1308, 1308, '<p>Rupatadine is indicated for the symptomatic treatment of Seasonal &amp; Perennial Allergic Rhinitis and Urticaria.</p>', '<p>Rupatadine is a long-acting, non-sedative antagonist of histamine H1-receptors. It also antagonizes the platelet activating factor (PAF). Both histamine and PAF cause broncho constriction which leads to an increase in the vascular permeability and act as a mediator in the inflammatory process. With the dual mode of action, Rupatadine shows better therapeutic effect than an isolated antihistamine. Rupatadine possesses other anti allergic properties such as the inhibition of the degranulation of mast cells induced by immunological and non immunological stimuli and inhibition of the release of cytokines, particularly of the tumor necrosis factor alpha (TNF &alpha;) in human mastocytes and monocytes.</p>', '<p>Adults and adolescents (over 12 years): The recommended dose is 10 mg once a day. Rupatadine may be taken with or without food.<br />\r\n<br />\r\nChildren aged 2 to 11 year:</p>\r\n\r\n<ul>\r\n	<li>Children weighing 25 kg or more: 1 teaspoonful (5 ml) of the oral solution once daily with or without food.</li>\r\n	<li>Children weighing equal or more than 10 kg to less than 25 kg: 1/2 teaspoonful (2.5 ml) oral solution once daily with or without food.</li>\r\n</ul>', '<p>With medicine: The concomitant administration of Rupatadine 20 mg and ketoconazole or erythromycin increases the systemic exposure. Rupatadine should be used with caution when it is administered concomitantly with these drug substances and other inhibitors of the isozyme CYP3A4. Rupatadine should be used with caution when it is co-administered with statins, CNS depressants or alcohol.<br />\r\n<br />\r\nWith food: Grapefruit and Grapefruit juice should not be taken simultaneously with Rupatadine</p>', '<p>Hypersensitivity to Rupatadine or to any of the excipients..</p>', '<p>Common: Asthenia, dizziness, drowsiness. Uncommon: Appetite increased, arthralgia, back pain, concentration impaired, constipation, cough, diarrhea, dry throat, epistaxis, fever, gastrointestinal discomfort, increased risk of infection, irritability, malaise, myalgia, nasal dryness, nausea, oropharyngeal pain, rash, thirst, vomiting, weight increased. Rare: Palpitations, tachycardia.</p>', '<p>There is no clinical data available on the exposure of Rupatadine during pregnancy. Pregnant women should therefore not use Rupatadine unless the potential benefit outweighs the potential risk for the infant. No information is available, whether Rupatadine is excreted in the mother&#39;s milk. Therefore, it should not be used during lactation, unless the potential benefits for the mother justify the potential risk to the infant.</p>', '<p>Rupatadine should be used with caution in patients with known prolongation of the QT interval, patients with uncorrected hypokalemia, and patients with ongoing proarrhythmic conditions, such as clinically significant bradycardia or acute myocardial ischemia. Rupatadine should be used with caution in elderly patients (65 years and older). As there is no clinical experience in patients with impaired kidney or liver function, the use of Rupatadine 10 mg tablets is at present not recommended in these patients.</p>', '<p>The most common adverse reaction was somnolence. If accidental ingestion of very high doses occurs, symptomatic treatment together with the required supportive measures should be given.</p>', '<p>Non-sedating antihistamines.</p>', '<p>Store in cool &amp; dry place below 30&deg;C, protect from light &amp; moisture. Keep out of reach of children.</p>', '<p><strong>Elderly:</strong>&nbsp;Rupatadine should be used with caution in elderly. No information is available that indicates the requirement of any dose adjustment in this population.<br />\r\n<br />\r\n<strong>Children:</strong>&nbsp;Neither the safety nor the efficacy of Rupatadine has been established in patients less than 12 years of age.<br />\r\n<br />\r\n<strong>Patients with renal or hepatic insufficiency:</strong>&nbsp;Use of Rupatadine is not recommended in patients with renal or hepatic insufficiency. As no relevant clinical data is available.</p>', '2022-03-18 05:11:48', '2022-03-18 05:11:48');
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
(1309, 1309, '<p><strong>Myelofibrosis (MF)</strong>: Ruxolitinib is indicated for the treatment of disease-related splenomegaly or symptoms in adult patients with primary myelofibrosis (also known as chronic idiopathic myelofibrosis), post polycythaemia vera myelofibrosis or post essential thrombocythaemia myelofibrosis.<br />\r\n<br />\r\n<strong>Polycythaemia vera (PV)</strong>: Ruxolitinib is indicated for the treatment of adult patients with polycythaemia vera who are resistant to or intolerant of hydroxyurea.</p>', '<p>Ruxolitinib is a selective inhibitor of the Janus Associated Kinases (JAKs) JAK1 and JAK2 (IC 50 values of 3.3 nM and 2.8 nM for JAK1 and JAK2 enzymes, respectively). These mediate the signalling of a number of cytokines and growth factors that are important for haematopoiesis and immune function.<br />\r\n<br />\r\nMF and PV are myeloproliferative neoplasms known to be associated with dysregulated JAK1 and JAK2 signalling. The basis for the dysregulation is believed to include high levels of circulating cytokines that activate the JAK-STAT pathway, gain-of-function mutations such as JAK2V617F, and silencing of negative regulatory mechanisms. MF patients exhibit dysregulated JAK signalling regardless of JAK2V617F mutation status. Activating mutations in JAK2 (V617F or exon 12) are found in &gt;95% of PV patients.<br />\r\n<br />\r\nRuxolitinib inhibits JAK-STAT signalling and cell proliferation of cytokine-dependent cellular models of haematological malignancies, as well as of Ba/F3 cells rendered cytokine-independent by expressing the JAK2V617F mutated protein, with IC 50 ranging from 80-320 nM.</p>', '<p>The recommended starting dose of ruxolitinib in MF is 15 mg twice daily for patients with a platelet count between 100,000/mm 3 and 200,000/mm 3 and 20 mg twice daily for patients with a platelet count of &gt;200,000/mm 3 . The recommended starting dose of ruxolitinib in PV is 10 mg given orally twice daily.<br />\r\n<br />\r\nThere is limited information to recommend a starting dose for patients with platelet counts between 50,000/mm 3 and &lt;100,000/mm 3 . The maximum recommended starting dose in these patients is 5 mg twice daily and the patients should be titrated cautiously.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Ruxolitinib is to be taken orally, with or without food. If a dose is missed, the patient should not take an additional dose, but should take the next usual prescribed dose.</p>', NULL, '<p>Hypersensitivity to the active substance or to any of the excipients</p>', NULL, '<p>Contraindicated in pregnancy &amp; lactation. There are no data from the use of ruxolitinib in pregnant women. Animal studies have shown that ruxolitinib is embryotoxic and foetotoxic.&nbsp;<br />\r\n<br />\r\nruxolitinib must not be used during breast-feeding and breast-feeding should therefore be discontinued when treatment is started. It is unknown whether ruxolitinib and/or its metabolites are excreted in human milk. A risk to the breast-fed child cannot be excluded. Available pharmacodynamic/toxicological data in animals have shown excretion of ruxolitinib and its metabolites in milk<br />\r\n<br />\r\nFertility: There are no human data on the effect of ruxolitinib on fertility. In animal studies, no effect on fertility was observed.</p>', NULL, '<p>There is no known antidote for overdoses with Ruxolitinib. Single doses up to 200 mg have been given with acceptable acute tolerability. Higher than recommended repeat doses are associated with increased myelosuppression including leukopenia, anaemia and thrombocytopenia. Appropriate supportive treatment should be given. Haemodialysis is not expected to enhance the elimination of ruxolitinib.</p>', '<p>Pyrrolopyrimidines.</p>', '<p>Do not store above 30&deg;C.</p>', '<p><strong>Renal impairment</strong>: No specific dose adjustment is needed in patients with mild or moderate renal impairment.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: In patients with any hepatic impairment the recommended starting dose based on platelet count should be reduced by approximately 50% to be administered twice daily.<br />\r\n<br />\r\n<strong>Elderly patients (&ge;65 years)</strong>: No additional dose adjustments are recommended for elderly patients.<br />\r\n<br />\r\n<strong>Paediatric population</strong>: The safety and efficacy of Ruxolitinib in children and adolescents aged up to 18 years have not been established. No data are available</p>', '2022-03-18 05:13:39', '2022-03-18 05:13:39'),
(1310, 1310, '<p>Valacyclovir is indicated for the treatment of Herpes zoster (shingles). It is indicated for the treatment or suppression of genital herpes in immuno-competent individuals and for the suppression of recurrent genital herpes in HIV infected individuals. It is also indicated for the treatment of cold sores (Herpes labialis).</p>', '<p>Valacyclovir is the hydrochloride salt of L-valyl ester of the antiviral drug acyclovir. Valacyclovir is an antiviral drug. It slows the growth and spread of the herpes virus so that the body can fight off the infection. Valacyclovir lessens the symptoms of infections and shortens the length of time of sickness. Valacyclovir is used in the treatment and suppression of genital herpes, shingles and cold sores.</p>', '<p>Adult Dosage:</p>\r\n\r\n<p><strong>Cold Sores</strong>: 2 grams every 12 hours for 1 day</p>\r\n\r\n<p><strong>Genital Herpes:</strong></p>\r\n\r\n<ul>\r\n	<li><strong>Initial episode</strong>: 1 gram twice daily for 10 days</li>\r\n	<li><strong>Recurrent episodes</strong>: 500 mg twice daily for 3 days Suppressive therapy</li>\r\n	<li><strong>Immunocompetent patients</strong>: 1 gram once daily</li>\r\n	<li><strong>Alternate dose in patients with &lt; 9 recurrences/year</strong>: 500 mg once daily</li>\r\n	<li><strong>HIV-infected patients</strong>: 500 mg twice daily</li>\r\n	<li><strong>Reduction of transmission</strong>: 500 mg once daily</li>\r\n</ul>\r\n\r\n<p><strong>Herpes Zoster</strong>: 1 gram 3 times daily for 7 days<br />\r\n&nbsp;</p>\r\n\r\n<p>Pediatric Dosage:</p>\r\n\r\n<ul>\r\n	<li><strong>Cold Sores</strong>&nbsp;(&gt; 12 years of age): 2 grams every 12 hours for 1 day</li>\r\n	<li><strong>Chickenpox</strong>&nbsp;(2 to &lt; 18 years of age): 20 mg/kg 3 times daily for 5 days; not to exceed 1 gram 3 times daily</li>\r\n</ul>', '<p>No dosage adjustment is recommended when valacyclovir is coadministered with digoxin, antacids, thiazide diuretics, cimetidine or probenecid in subjects with normal renal function.</p>', '<p>Valacyclovir is contraindicated in patients with a known hypersensitivity or intolerance to valacyclovir, acyclovir, or any component of the formulation.</p>', '<p>The most frequently reported adverse reactions were nausea (15%), headache (14%), vomiting (6%), dizziness (3%) and abdominal pain (3%).</p>', '<p><strong>Pregnancy</strong>&nbsp;category B. Valacyclovir was not teratogenic in rats or rabbits at 10 and 7 times human plasma levels, respectively, during the period of major organogenesis. There is no adequate and well-controlled studies of valacyclovir in pregnant women.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: Unchanged valacyclovir was not detected in maternal serum, breast milk, or infant urine. Valacyclovir should be administered to a nursing mother with caution and only when indicated.</p>', '<p>Dosage reduction is recommended when administering valacyclovir to patients with renal impairment. Similar caution should be exercised when administering valacyclovir to geriatric patients and patients receiving potentially nephrotoxic agents. The safety and efficacy of valacyclovir have not been established in immuno compromised patients other than for the suppression of genital herpes in HIVinfected patients.</p>', NULL, '<p>Herpes simplex &amp; Varicella-zoster virus infections.</p>', '<p>Store in cool &amp; dry place, away from children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of valacyclovir in pre-pubertal pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Elderly Use</strong>&nbsp;(Over 65 yr.): Elderly patients may require a dose reduction of valacyclovir due to a low body weight or disorders (renal, CNS etc.) associated with aging.</p>', '2022-03-18 19:36:56', '2022-03-18 19:36:56'),
(1311, 1311, '<p>Valganciclovir is indicated for the treatment of cytomegalovirus (CMV) retinitis in adult patients with acquired immunodeficiency syndrome (AIDS). Valganciclovir is indicated for the prevention of CMV disease in adult and pediatric solid organ transplant (SOT) patients who are at risk.</p>', '<p>Valganciclovir is an L-valyl ester (prodrug) of ganciclovir, which after oral administration is rapidly converted to ganciclovir by intestinal and hepatic esterases. Ganciclovir is a synthetic analogue of 2&rsquo;-deoxyguanosine, which inhibits replication of herpes viruses in vitro and in vivo. Sensitive human viruses include human cytomegalovirus (HCMV), herpes simplex virus-1 and -2 (HSV-1 and HSV-2), human herpes virus 6, 7 and 8 (HHV-6, HHV-7, HHV-8), Epstein-Barr virus (EBV), varicella-zoster virus (VZV) and hepatitis B virus.<br />\r\n<br />\r\nIn CMV-infected cells ganciclovir is initially phosphorylated to ganciclovir mono-phosphate by the viral protein kinase, UL97. Further phosphorylation occurs by cellular kinases to produce ganciclovir triphosphate, which is then slowly metabolized intracellularly. This has been shown to occur in HSV- and HCMV-infected cells with half-lives of 18 and between 6 and 24 hours respectively after removal of extracellular ganciclovir. As phosphorylation is largely dependent on the viral kinase, the phosphorylation of ganciclovir occurs preferentially in virus-infected cells.<br />\r\n<br />\r\nThe virustatic activity of ganciclovir is due to inhibition of viral DNA synthesis by: (a) competitive inhibition of incorporation of deoxyguanosine-triphosphate into DNA by viral DNA polymerase and (b) incorporation of ganciclovir triphosphate into viral DNA causing termination of, or very limited further viral DNA elongation. Typical antiviral IC 50 against CMV in vitro is in the range 0.08 &mu;M (0.02 &mu;g/ml) to 14 &mu;M (3.5 &mu;g/ml).<br />\r\n<br />\r\nThe clinical antiviral effect of Valganciclovir has been demonstrated in the treatment of AIDS patients with newly diagnosed CMV retinitis (clinical trial WV15376). CMV shedding was decreased from 46% (32/69) of patients at study entry to 7% (4/55) of patients following 4 weeks of Valganciclovir treatment.</p>', '<p><strong>Standard Dosage</strong>: Valganciclovir is administered orally, and should be taken with food. Valganciclovir is rapidly and extensively converted into the active ingredient ganciclovir. The bioavailability of ganciclovir from Valganciclovir is up to 10-fold higher than from oral ganciclovir.<br />\r\n<br />\r\nThe dosage and administration of Valganciclovir tablets or powder for oral solution as described below should be closely followed. The ganciclovir systemic exposure following administration of 900 mg Valganciclovir powder for oral solution is equivalent to a 900 mg Valganciclovir dose administered as two 450 mg tablets.<br />\r\n<br />\r\nAn oral dosing dispenser with 25 mg graduations up to 500 mg is provided with the powder for oral solution. It is recommended that this dispenser is used to measure and administer the dose.<br />\r\n&nbsp;</p>\r\n\r\n<p>Treatment of cytomegalovirus (CMV) retinitis-</p>\r\n\r\n<p><strong>Adult patients</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Induction treatment of CMV retinitis</strong>: For patients with active CMV retinitis, the recommended dose is 900 mg twice a day for 21 days. Prolonged induction treatment may increase the risk of bone marrow toxicity</li>\r\n	<li><strong>Maintenance treatment of CMV retinitis</strong>: Following induction treatment, or in adult patients with inactive CMV retinitis, the recommended dose is 900 mg once daily. Patients whose retinitis worsens may repeat induction treatment. The duration of maintenance treatment should be determined on an individual basis.</li>\r\n</ul>\r\n\r\n<p><strong>Pediatric patients</strong>: The safety and efficacy of Valganciclovir in the treatment of CMV retinitis have not been established in adequate and well-controlled clinical studies in pediatric patients.&nbsp;<br />\r\n&nbsp;</p>\r\n\r\n<p>Prevention of CMV disease in transplantation-</p>\r\n\r\n<p><strong>Adult patients</strong>: For kidney transplant patients, the recommended dose is 900 mg once daily starting within 10 days post-transplantation and continuing until 200 days post-transplantation. For patients who have received a solid organ transplant other than kidney, the recommended dose is 900 mg once daily starting within 10 days post-transplantation and continuing until 100 days post-transplantation.<br />\r\n<br />\r\n<strong>Pediatric patients</strong>: In pediatric solid organ transplant patients from birth, who are at risk of developing CMV disease, the recommended once daily dose of Valganciclovir is based on body surface area (BSA) and creatinine clearance (ClCr) derived from Schwartz formula (ClCr), and is calculated using the equation below:<br />\r\n<br />\r\nPediatric dose (mg)= 7 x BSA x ClCr. If the creatinine clearance exceeds 150 ml/min/1.73 m2, then a maximum value of 150 ml/min/1.73 m2</p>', '<p>In vivo drug-drug interaction studies were not conducted with valganciclovir. However, because valganciclovir is rapidly and extensively converted to ganciclovir, drug-drug interactions associated with ganciclovir will be expected for Valganciclovir. Drug-drug interaction studies with ganciclovir were conducted in patients with normal renal function. Following concomitant administration of Valganciclovir and other renally excreted drugs, patients with impaired renal function may have increased concentrations of ganciclovir and the coadministered drug. Therefore, these patients should be closely monitored for toxicity of ganciclovir and the coadministered drug.</p>', '<p>Valganciclovir is contraindicated in patients with known hypersensitivity to valganciclovir, ganciclovir or to any of the excipients.</p>', '<p>The following serious adverse reactions are discussed in greater detail in other sections of the labeling:</p>\r\n\r\n<ul>\r\n	<li>Hematologic Toxicity&nbsp;</li>\r\n	<li>Acute Renal Failure</li>\r\n	<li>Impairment of Fertility</li>\r\n	<li>Fetal Toxicity&nbsp;</li>\r\n	<li>Mutagenesis and Carcinogenesis</li>\r\n</ul>', '<p><strong>Pregnancy</strong>: The safety of Valganciclovir for use in pregnant women has not been established. However, ganciclovir readily diffuses across the human placenta. The use of Valganciclovir should be avoided in pregnant women unless the benefit to the mother outweighs the potential risk to the fetus. Reprotoxicity studies have not been repeated with valganciclovir because of the rapid and extensive conversion to ganciclovir. In animal studies ganciclovir was associated with reproductive toxicity and teratogenicity (see section 3.3.4 Reproductive Toxicity). The safe use of Valganciclovir during labor and delivery has not been established.<br />\r\n<br />\r\n<strong>Lactation</strong>: Peri- and postnatal development has not been studied with valganciclovir or with ganciclovir but the possibility of ganciclovir being excreted in breast milk and causing serious adverse reactions in the nursing infant cannot be discounted. Human data are not available but animal data indicates that ganciclovir is excreted in the milk of lactating rats. Therefore, a decision should be made to discontinue the drug or discontinue nursing taking into consideration the potential benefit of Valganciclovir to the nursing mother.</p>', NULL, NULL, '<p>Anti-viral drugs.</p>', '<p>Store Valganciclovir&nbsp;tablets at 20&deg;C to 25&deg;C; excursions are permitted to 15&deg;C to 30&deg;C.</p>', '<p><strong>Pediatric Use</strong>: A higher risk of hematological cytopenias in neonates and infants warrants careful monitoring of blood counts in these age groups. Monitoring of liver function abnormalities, renal function and gastrointestinal fluid loss is also recommended in pediatric patients.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Safety and efficacy have not been established in this patient population<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: In patients with impaired renal function, dosage adjustments based on creatinine clearance are required.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Safety and efficacy have not been established in this patient population</p>', '2022-03-18 19:39:01', '2022-03-18 19:39:01'),
(1312, 1312, '<p>Valsartan is indicated:</p>\r\n\r\n<ul>\r\n	<li>For hypertension</li>\r\n	<li>To reduce hospitalizations in patients with congestive heart failure</li>\r\n	<li>To reduce death in patients who developed congestive heart failure after myocardial infarction</li>\r\n</ul>', '<p>Valsartan is an oral medication that belongs to a class of drugs called angiotensin receptor blockers (ARBs). It is orally active and specific angiotensin II antagonist acting on the AT1 subtype. Angiotensin&#39;s attachment to the receptors cause the blood vessels to narrow (vasoconstrict) which leads to an increase in blood pressure (hypertension). Valsartan blocks the angiotensin II receptor. By blocking the action of angiotensin, Valsartan dilates blood vessels and reduces blood pressure without affecting pulse rate. Valsartan has much greater affinity (about 20,000-fold) for the AT1 receptor than for the AT2 receptor. It does not bind or block other hormone receptors or ion channels known to be important in cardiovascular regulation.</p>', '<p><strong>Hypertension</strong>: The usual dose of Valsartan is 80 to 160 mg once daily. The maximum dose is 320 mg daily. Maximum blood pressure reduction occurs within 4 weeks.&nbsp;<br />\r\n<br />\r\n<strong>Heart failure</strong>:&nbsp;The usual dose is 40 mg twice daily and may be increased to 80-160 mg twice daily.&nbsp;<br />\r\n<br />\r\n<strong>Post-Myocardial Infarction</strong>:&nbsp;The initial dose after myocardial infarction is 20 mg twice daily. The dose should be increased with a target of 160 mg daily if tolerated without side effects.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Administration of Valsartan with food decreases the absorption of Valsartan by about 40%, so it should be taken on an empty stomach. No initial dosage adjustment is required for elderly patients with mild to moderate renal and hepatic insufficiency.</p>', '<p>No drug interactions of clinical significance have been found. Compounds which have been studied in clinical trials include Cimetidine, Warfarin, Furosemide, Digoxin, Atenolol, Indomethacin, Hydrochlorothiazide, Amlodipine and Glibenclamide<br />\r\n<br />\r\nAs Valsartan&nbsp;is not metabolized to a significant extent, clinically relevant drug-drug interactions in the form of metabolic induction or inhibition of the cytochrome P450 system are not expected with Valsartan. Although valsartan is highly bound to plasma proteins, in vitrostudies have not shown any interaction at this level with a range of molecules which are also highly protein bound, such as Diclofenac, Furosemide, and Warfarin. Concomitant use of potassium sparing diuretics (e.g., Spironolactone, Triamterene, Amiloride) potassium supplements, or salt substitutes containing potassium may lead to increase in serum potassium. If co medication is considered necessary, caution is advisable.</p>', '<p>Valsartan is contraindicated in patients who are hypersensitive to any component of this product.</p>', '<p>Valsartan is generally well tolerated and side effects are rare. The most common side effects include headache, dizziness, fatigue, abdominal pain, cough, diarrhea and nausea. Patient may also experience hyperkalemia, impotency, reduced renal function, allergic reactions, dyspnea, constipation, back pain, muscle cramps, rash, anxiety, insomnia and vertigo. Hypotension may also occur if patient have been taking diuretics along with Valsartan.</p>', '<p><strong>Pregnancy</strong>: Valsartan should not be used in pregnancy, as in 2nd and 3rd trimester it can cause injury and even death to fetus. When pregnancy is detected, Valsartan should be stopped as soon as possible.<br />\r\n<br />\r\n<strong>Nursing mothers</strong>: It is not known whether Valsartan is excreted in human milk. Because of the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p><strong>Impaired Hepatic Function</strong>: As the majority of Valsartan is eliminated in the bile, care should be exercised in patients with mild to moderate hepatic impairment including biliary obstructive disorder.<br />\r\n<br />\r\n<strong>Impaired Renal Function</strong>: Dosage reduction or discontinuation may be required with patients having pre-existing renal impairment.<br />\r\n<br />\r\n<strong>Heart Failure and Myocardial Infarction</strong>: Caution should be exercised when initiating therapy in patients with heart failure and post-myocardial infarction patients.</p>', '<p>Limited data are available related to overdosage in humans. The most likely manifestations of overdosage would be hypotension and tachycardia, bradycardia could occur from parasympathetic (vagal) stimulation. If excessive hypotension occurs, the patient should be placed in the supine position and if necessary, has to be given an intravenous infusion of normal saline.</p>', '<p>Angiotensin-ll receptor blocker</p>', '<p>Store between 15-30&deg; C. Protect from moisture and heat.</p>', '<p><strong>Pediatric use</strong>: Safety and effectiveness in paediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: No overall difference in the efficacy or safety of Valsartan was observed in this patient population, but greater sensitivity of some elderly persons cannot be ruled out.<br />\r\n<br />\r\nHepatic Impairment:</p>\r\n\r\n<ul>\r\n	<li><strong>Mild to moderate</strong>: Max: 80 mg once daily.</li>\r\n	<li><strong>Severe</strong>: Contraindicated.</li>\r\n</ul>', '2022-03-18 19:49:36', '2022-03-18 19:49:36'),
(1313, 1313, '<p>This combination is indicated for the treatment of hypertension.</p>', '<p><strong>Valsartan</strong>&nbsp;is an oral medication that belongs to a class of drugs called angiotensin receptor blockers (ARBs). It is orally active and specific angiotensin II antagonist acting on the AT1 subtype. Angiotensin&#39;s attachment to the receptors cause the blood vessels to narrow (vasoconstrict) which leads to an increase in blood pressure (hypertension). Valsartan blocks the angiotensin II receptor. By blocking the action of angiotensin, Valsartan dilates blood vessels and reduces blood pressure without affecting pulse rate. Valsartan has much greater affinity (about 20,000-fold) for the AT1 receptor than for the AT2 receptor. It does not bind or block other hormone receptors or ion channels known to be important in cardiovascular regulation.<br />\r\n<br />\r\n<strong>Hydrochlorothiazide</strong>&nbsp;is a thiazide diuretic. Thiazides affect the renal tubular mechanisms of electrolyte reabsorption, directly increasing excretion of sodium and chloride in approximately equivalent amounts. Indirectly, the diuretic action of Hydrochlorothiazide reduces plasma volume, with consequent increases in plasma renin activity, increases in aldosterone secretion, increases in urinary potassium loss, and decreases in serum potassium. The renin-aldosterone link is mediated by angiotensin II, so co-administration of anangiotensin converting enzyme (ACE) inhibitor tends to reverse the potassium loss associated with these diuretics.</p>', '<p><strong>Hypertension</strong>: A patient whose blood pressure is not controlled with Valsartan and Hydrochlorothiazide monotherapy, should switch to Valsartan and Hydrochlorothiazide combination once daily. Highest allowed dose of Valsartan should not be greater than 320 mg in combination with hydrochlorothiazide 25 mg.&nbsp;<br />\r\n<br />\r\n<strong>For Elderly</strong>: No initial dosage adjustment is necessary for elderly patients.<br />\r\n<br />\r\n<strong>Pediatric use</strong>: Safety and effectiveness in pediatric patients have not been established.</p>', '<p>Valsartan:</p>\r\n\r\n<ul>\r\n	<li><strong>Diuretics</strong>: Patient on diuretics may occasionally experience excessive reduction in blood pressure after initiation of therapy with Valsartan. No drug interaction of clinical significance has been identified with thiazide diuretics.&nbsp;</li>\r\n	<li><strong>Agents increasing Serum Potassium</strong>: Since Valsartan decreases the production of aldosterone, potassium supplements or salt containing potassium substitutes may lead to hyperkalemia.&nbsp;</li>\r\n	<li><strong>Lithium Salts</strong>: As with other drugs which eliminate sodium, lithium clearance may be reduced. Therefore, serum lithium levels should be monitored carefully if lithium salts are to be administered.</li>\r\n	<li>Other drugs showing interaction are Warfarin, Digoxin.</li>\r\n</ul>\r\n\r\n<p>Hydrochlorothiazide:</p>\r\n\r\n<ul>\r\n	<li>When administered concurrently, the following drugs may interact with thiazide diuretics: alcohol, barbiturates, or narcotics may potentiate antihypertensive effect or orthostatic hypotension may occur.</li>\r\n	<li>Antidiabetic drugs (oral agents and insulin): dosage adjustment of the antidiabetic drug may be required.</li>\r\n	<li>Other antihypertensive drugs give additive effect.</li>\r\n	<li>Cholestyramine and colestipol resins: absorption of Hydrochlorothiazide is impaired in the presence of anionic exchange resins.</li>\r\n</ul>', '<p>The combination of Valsartan and Hydrochlorothiazide is contraindicated in patients who are hypersensitive to any component of this product. Because of the Hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs.</p>', '<p>The combination of Valsartan and Hydrochlorothiazide is generally well tolerated and side effects are rare. The most common side effects include headache, dizziness, fatigue, abdominal pain, cough, diarrhea and nausea. Patient may also experience hyperkalemia, impotency, reduced renal function, allergic reactions, dyspnea, constipation, back pain, muscle cramps, rash, anxiety, insomnia and vertigo. Hypotension may also occur.</p>', '<p><strong>Pregnancy</strong>: Valsartan should not be used in pregnancy, as in 2nd and 3rd trimester it can cause injury and even death to fetus. When pregnancy is detected, Valsartan should be stopped as soon as possible.<br />\r\n<br />\r\n<strong>Nursing mothers</strong>: It is not known whether Valsartan is excreted in human milk. Hydrochlorothiazide is excreted in breast milk.</p>', '<p><strong>Impaired Hepatic Function</strong>: As the majority of Valsartan is eliminated in the bile, care should be exercised in patients with mild to moderate hepatic impairment including biliary obstructive disorder.&nbsp;<br />\r\n<br />\r\n<strong>Impaired Renal Function</strong>: Dosage reduction or discontinuation may be required with patients having pre-existing renal impairment because thiazides may precipitate azotemia.&nbsp;<br />\r\n<br />\r\n<strong>Heart Failure and Myocardial Infarction</strong>: Caution should be observed when initiating therapy in patients with heart failure and post-myocardial infarction patients.</p>', '<p><strong>Valsartan</strong>: Limited data are available related to overdosage in humans. The most likely manifestations of overdosage would be hypotension and tachycardia; bradycardia could occur from parasympathetic (vagal) stimulation. If excessive hypotension occurs, the patient should be placed in the supine position and if necessary, has to be given an intravenous infusion of normal saline.&nbsp;<br />\r\n<br />\r\n<strong>Hydrochlorothiazide</strong>: The most common signs and symptoms observed are those caused by electrolyte depletion (hypokalemia, hypochloremia, and dehydration) resulting from excessive diuresis. if digitalis has also been administered with it, hypokalemia, may accentuate cardiac arrhythmias. The degree to which Hydrochlorothiazide is removed by hemodialysis has not been established.</p>', '<p>Combined antihypertensive preparations</p>', '<p>Store between 15-30&deg; C.</p>', '<p><strong>Use in Patients with Renal Impairment</strong>: The usual regimens of therapy with&nbsp;this combination may be followed as long as the patient&#39;s creatinine clearance is &gt;30 ml/min. In patients with more severe renal impairment, loop diuretics are preferred to thiazides. In that case, hydrochlorothiazide is not recommended.<br />\r\n<br />\r\n<strong>Use in patients with Hepatic Impairment</strong>: Care should be taken in patient with hepatic impairment.</p>', '2022-03-18 19:54:06', '2022-03-18 19:54:06'),
(1314, 1314, '<p>Vancomycin is indicated in potentially life-threatening infections which cannot be treated with other effective, less toxic antimicrobial drugs including the penicillins and cephalosporins.<br />\r\n<br />\r\nVancomycin is useful in the therapy of severe staphylococcal infections in patients who cannot receive or who have failed to respond to the penicillins and cephalosporins or who have infections with staphylococci, resistant to other antibiotics.<br />\r\n<br />\r\nVancomycin is used in the treatment of endocarditis and as prophylaxis against endocarditis in patients undergoing dental or surgical procedures.<br />\r\n<br />\r\nIts effectiveness has been documented in other infections due to staphylococci including osteomyelitis, pneumonia, septicemia and soft tissue infections.</p>', '<p>Vancomycin binds tightly to D-alanyl-D-alanine portion cell wall precursor causing blockage of glycopeptide polymerisation which produces immediate inhibition of cell wall synthesis and secondary damage to the cytoplasmic membrane.</p>', '<p>Concentrations of no more than 5 mg/ml and rates of no more than 10 mg/min are recommended in adults. In selected patients in need of fluid restriction, a concentration up to 10 mg/ml may be used.<br />\r\n<br />\r\n<strong>Patients with Normal Renal Function</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: Usual daily dose is 2 gm (in 4 or 2 divided doses).</li>\r\n	<li><strong>Children</strong>: Total daily dose is 40 mg/Kg (in 4 divided doses).</li>\r\n	<li><strong>Infants and Neonates</strong>: An initial dose of 15 mg/Kg is suggested followed by 10 mg/Kg every 12 hours in the first week, then every 8 hours up to 1 month.</li>\r\n</ul>\r\n\r\n<p><strong>Patients with Impaired Renal Function and Elderly Patients</strong>: Dosage adjustment must be made in patients with impaired renal function. In premature infants and the elderly, dosage reduction may be necessary to a greater extent than expected because of decreasing renal function.&nbsp; If creatinine clearance can be measured or estimated accurately, the dosage for most patients with renal impairment can be calculated using the following chart-</p>\r\n\r\n<ul>\r\n	<li>CrCl 100 ml/min: Vancomycin Dose 1545 mg/24 h</li>\r\n	<li>CrCl 90 ml/min:&nbsp;Vancomycin Dose 1390 mg/24 h</li>\r\n	<li>CrCl 80 ml/min:&nbsp;Vancomycin Dose&nbsp;1235 mg/24 h</li>\r\n	<li>CrCl 70 ml/min:&nbsp;Vancomycin Dose&nbsp;1080 mg/24 h</li>\r\n	<li>CrCl 60 ml/min:&nbsp;Vancomycin Dose&nbsp;925 mg/24 h</li>\r\n	<li>CrCl 50 ml/min:&nbsp;Vancomycin Dose&nbsp;770 mg/24 h</li>\r\n	<li>CrCl 40 ml/min:&nbsp;Vancomycin Dose&nbsp;620 mg/24 h</li>\r\n	<li>CrCl 30 ml/min:&nbsp;Vancomycin Dose&nbsp;465 mg/24 h</li>\r\n	<li>CrCl 20 ml/min:&nbsp;Vancomycin Dose&nbsp;310 mg/24 h</li>\r\n	<li>CrCl 10 ml/min:&nbsp;Vancomycin Dose 155 mg/24 h</li>\r\n</ul>\r\n\r\n<p>The initial dose should be not less than 15 mg/kg even in patients with mild to moderate renal insufficiency. Above chart is not valid for functionally anephric patients. For such patients, an initial dose of 15 mg/kg of body weight should be given in order to achieve prompt therapeutic serum concentrations. The dose required to maintain stable concentrations is 1.9 mg/kg/24 h. Since individual maintenance doses of 250-1,000 mg are convenient, 1 dose may be given every several days rather than on a daily basis in patients with marked renal impairment. In anuria, a dose of 1000 mg every 7-10 days has been recommended. Intermittent infusion is the recommended method of administration. Intraperitoneal administration is not recommended.</p>', NULL, '<p>Vancomycin is contraindicated in Patients with known hypersensitivity to Vancomycin.</p>', '<p>Vancomycin is well tolerated. However during or soon after rapid infusion of Vancomycin, patients may develop anaphylactic reactions including hypotension, wheezing, dyspnoea, urticaria or pruritus. Rapid infusion may also cause flushing of the upper body (&quot;red neck&quot;) or pain and muscle spasm of the chest and back. These reactions usually resolve within 20 minutes but may persist for several hours. Such events are infrequent if Vancomycin is given by a slow infusion over 60 minutes.</p>', '<p>It is not known whether it causes foetal harm or not. Vancomycin should be given in pregnancy only if clearly needed and blood levels should be monitored carefully to minimise the risk of foetal toxicity.<br />\r\n<br />\r\nVancomycin Hydrochloride is excreted in human milk. Caution should be exercised when Vancomycin is administered to a nursing woman. It is unlikely that a nursing infant can absorb a significant amount of Vancomycin from its gastro-intestinal tract</p>', '<p>Patients with borderline renal function and individuals over the age of 60 should be given serial tests of auditory function and of Vancomycin blood levels. All patients receiving the drug should have periodic haematological studies, urine analysis and renal function tests.<br />\r\n<br />\r\nVancomycin is very irritating to tissue and causes injection site necrosis when injected intramuscularly. It must be infused intravenously. Injection site pain and thrombophlebitis occur in many patients receiving Vancomycin and are occasionally severe.<br />\r\n<br />\r\nProlonged use of Vancomycin may result in the overgrowth of non-susceptible organisms. Careful observation of the patient is essential. If superinfection occurs during therapy, appropriate measures should be taken. In rare instances, there have been reports of pseudomembranous colitis due to C. difficile, developing in patients who received intravenous Vancomycin.</p>', '<p>Supportive care is advised with maintenance of glomerular filtration. Vancomycin is poorly removed from the blood by haemodialysis or peritoneal dialysis. Haemoperfusion with Amberlite resin XAD-4 has been reported to be of limited benefit</p>', '<p>Other antibiotic.</p>', '<p>Store in a cool and dry place, protected from light. Keep out of reach of children.</p>', NULL, '2022-03-18 20:03:53', '2022-03-18 20:03:53'),
(1315, 1315, '<p>Vardenafil is used to treat&nbsp;erectile dysfunction&nbsp;(ED).</p>', '<p>Vardenafil is a selective inhibitor of cyclic guanosine monophosphate (cGMP) specific phosphodiesterase type 5 (PDE5). Penile erection is a hemodynamic process initiated by the relaxation of smooth muscle in the corpus cavernosum and its associated arterioles. During sexual stimulation, nitric oxide is released in the corpus cavernosum &amp; activates the enzyme guanylate cyclase resulting in increased synthesis of cyclic guanosine monophosphate (cGMP) in the smooth muscle cells of the corpus cavernosum. The cGMP in turn triggers smooth muscle relaxation, allowing increased blood flow into the penis, resulting in an erection. Inhibition of PDE5 enhances erectile function by increasing the amount of cGMP. Because sexual stimulation is required to initiate the local release of nitric oxide, the inhibition of PDE5 has no effect in the absence of sexual stimulation.</p>', '<p><strong>The recommended starting dose</strong>: 10 mg once daily, taken orally approximately 60 minutes before sexual activity. The dose may be increased to a maximum dose of 20 mg or decreased to 5 mg based on efficacy and side effects. The maximum recommended dosing frequency is once per day. Vardenafil can be taken with or without food.<br />\r\n<br />\r\n<strong>Geriatrics</strong>: A starting dose of 5 mg should be considered in patients &gt;65 years of age.<br />\r\n<br />\r\n<strong>Renal impaired patients</strong>: In patients with renal impairment, no dose adjustment is required.<br />\r\n<br />\r\n<strong>Hepatic impaired patients</strong>: In patients with moderate hepatic impairment, a starting dose of 5 mg is recommended and the maximum dose should not exceed 10 mg. Do not use in patients with severe hepatic impairment.</p>', '<p>Vardenafil can potentiate the blood pressure lowering effect of antihypertensive agents. In clinical studies, single doses of Vardenafil 20 mg caused a mean decrease in blood pressure of 7 mmHg systolic and 8 mmHg diastolic. Caution should be taken when co-administered with other vasodilators including alpha blockers. Vardenafil does not potentiate the hypotensive effect of alcohol. CYP3A4 inhibitors (ketoconazole, indinavir, ritonavir and erythromycin) may reduce Vardenafil excretion from body.</p>', '<p>Administration of Vardenafil with nitrates (either regularly or intermittently) and nitric oxide donors is contraindicated because Vardenafil may potentiate hypotensive effect of nitrates. It is also contraindicated for patients who have shown hypersensitivity to Vardenafil or any of the ingredients of this product.</p>', '<p>The most common side effects with Vardenafil are headache, flushing, stuffy or runny nose, indigestion, upset stomach, dizziness or back pain.</p>', '<p>Vardenafil is not indicated for women.</p>', '<p>Physicians should consider the cardiovascular status of their patients, since there is a degree of cardiac risk associated with sexual activity. In men for whom sexual activity is not recommended because of their underlying cardiovascular status, Vardenafil generally should not be used.</p>', '<p>The maximum dose of Vardenafil for which human data are available is a single 120 mg. Where the majority of these subjects experienced blurred vision and back pain. Single doses up to 80 mg and multiple doses up to 40 mg administered once daily over 4 weeks did not show serious adverse effects. In cases of overdose, contact with the doctor immediately.</p>', '<p>Drugs for Erectile Dysfunction.</p>', '<p>Store at room temperature and protect from light and moisture. Keep out of the reach of children.</p>', NULL, '2022-03-18 20:05:35', '2022-03-18 20:05:35'),
(1316, 1316, '<p>Varenicline is indicated for use as an aid to smoking cessation treatment.</p>', '<p>Varenicline binds with high&nbsp;affinity&nbsp;and selectivity at &alpha;4&beta;2 neuronal nicotinic acetylcholinereceptors. The efficacy of Varenicline in smoking cessation is believed to be the result of varenicline&#39;s activity at &alpha;4&beta;2&nbsp;sub-type of the nicotinic receptor where its binding produces&nbsp;agonist&nbsp;activity, while simultaneously preventing nicotine binding to these receptors.<br />\r\n<br />\r\nElectrophysiology&nbsp;studies in vitro and neurochemical studies&nbsp;in vivo&nbsp;have shown that varenicline binds to &alpha;4&beta;2 neuronal nicotinic acetylcholine receptors and stimulates receptor-mediated activity, but at a significantly lower level than nicotine. Varenicline blocks the ability of nicotine to activate &alpha;4&beta;2 receptors and thus to stimulate the central nervous mesolimbic dopamine&nbsp;system, believed to be the neuronal mechanism underlying reinforcement and reward experienced upon smoking. Varenicline is highly selective and binds more potently to &alpha;4&beta;2 receptors than to other common nicotinic receptors ( &gt;500-fold &alpha;3&beta;4, &gt;3,500fold &alpha;7, &gt;20,000-fold &alpha;1&beta;&gamma;&delta;), or to non-nicotinic receptors and transporters (&gt; 2,000-fold). Varenicline also binds with moderate affinity (Ki = 350 nM) to the 5-HT3 receptor.</p>', '<p>Smoking cessation therapies are more likely to succeed for patients who are motivated to stop smoking and who are provided additional advice and support. Provide patients with appropriate educational materials and counseling to support the quit attempt.<br />\r\n<br />\r\nThe patient should set a date to stop smoking. Begin Varenicline dosing one week before this date. Alternatively, the patient can begin Varenicline dosing and then quit smoking between days 8 and 35 of treatment.<br />\r\n<br />\r\nThe recommended dose of Varenicline is 1 mg twice daily following a 1-week titration as follows:</p>\r\n\r\n<ul>\r\n	<li><strong>Days 1-3</strong>: 0.5 mg once daily</li>\r\n	<li><strong>Days 4-7</strong>: 0.5 mg twice daily</li>\r\n	<li><strong>Day 8-end of treatment</strong>: 1 mg twice daily</li>\r\n</ul>\r\n\r\n<p>Patients should be treated with Varenicline for 12 weeks. For patients who have successfully stopped smoking at the end of 12 weeks, an additional course of 12 weeks treatment with Varenicline is recommended to further increase the likelihood of long-term&nbsp;abstinence.<br />\r\n<br />\r\nFor patients who are sure that they are not able or willing to quit abruptly, consider a gradual approach to quitting smoking with Varenicline. Patients should begin Varenicline dosing and reduce smoking by 50% from baseline within the first four weeks, by an additional 50% in the next four weeks, and continue reducing with the goal of reaching complete abstinence by 12 weeks. Continue Varenicline treatment for an additional 12 weeks, for a total of 24 weeks of treatment. Encourage patients to attempt quitting sooner if they feel ready<br />\r\n<br />\r\nPatients who are motivated to quit, and who did not succeed in stopping smoking during prior Varenicline therapy for reasons other than intolerability due to adverse events or who relapsed after treatment, should be encouraged to make another attempt with Varenicline once factors contributing to the failed attempt have been identified and addressed.<br />\r\n<br />\r\nConsider a temporary or permanent dose reduction in patients who cannot tolerate the adverse effects of Varenicline.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Varenicline should be taken orally after eating and with a full glass of water.</p>', '<p>May increase intoxicating effects of alcohol.</p>', '<p>Known hypersensitivity to varenicline or to any of the excipients in the product (microcrystalline cellulose, dibasic calcium phosphate, anhydrous, croscarmellose sodium, colloidal silicon dioxide, magnesium stearate, Opadry Blue/White and Opadry Clear).</p>', '<p>Nasopharyngitis, bronchitis, sinusitis, increased wt, decreased &amp;/or increased appetite, abnormal dreams, insomnia, headache, somnolence, dizziness, dysgeusia, dyspnea, cough, nausea, GERD, vomiting, constipation, diarrhea, abdominal distension &amp; pain, toothache, dyspepsia, flatulence, dry mouth, rash, pruritus, arthralgia, myalgia, back pain, chest pain, fatigue, abnormal liver function test.</p>', '<p><strong>Use in Pregnancy</strong>: Category C. There are no adequate and well-controlled studies in pregnant women. Varenicline should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus&nbsp;<br />\r\n<br />\r\n<strong>Use in Lactation</strong>: It is unknown whether varenicline is excreted in human breast milk. Animal studies suggest that varenicline is excreted in breast milk. A decision on whether to discontinue breast-feeding or to discontinue therapy with varenicline should be made taking into account the benefit of breast-feeding to the child and the benefit of varenicline therapy to the woman</p>', '<p>Discontinue use if changes in behavior or thinking, agitation or depressed mood, anxiety, psychosis, mood swings, aggressive behavior, agitation, depressed mood, suicidal ideation &amp; behavior. Concomitant use in patients attempting to quit smoking. Patients with history of seizures or other conditions that potentially lower seizure threshold. Report if patients had history of psychiatric illness prior to initiation. Hypersensitivity reactions including angioedema, swelling of the face, mouth (tongue, lips, gums), neck (throat &amp; larynx) &amp; extremities. Severe cutaneous reactions including Stevens-Johnson syndrome &amp; erythema multiforme (rare).<br />\r\n<br />\r\nSpecial Precautions for Disposal and Other Handling: No special requirements for disposal.</p>', NULL, '<p>Drugs used in substance dependence.</p>', NULL, NULL, '2022-03-18 20:09:26', '2022-03-18 20:09:26');
