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
(1074, 1074, '<p>This ear drop is indicated for the treatment of superficial bacterial and fungal infections of the external auditory canal and the middle ear, caused by organisms susceptible to the action of Ofloxacin and Clotrimazole.</p>', '<p>It is a combination of an antibacterial, an antifungal, an anti-inflammatory and a topical local anesthetic agent. This ear drop has been specially formulated to maintain the natural environment of the external ear canal.<br />\r\n<br />\r\n<strong>Ofloxacin</strong>&nbsp;is a fluoroquinolone that has a broad spectrum of activity against otic pathogens without ototoxicity. Hence Ofloxacin is preferred to Aminoglycosides for any application within the middle ear space. Ofloxacin exerts antibacterial activity by inhibiting DNA gyrase of bacteria. Ofloxacin has been shown to be active against the following organisms responsible for otic infections: Gram-positive: Staphylococcus aureus, Streptococcus pneumoniae. Gram-negative: Escherichia coli, Haemophilus influenzae, Moraxella catarrhalis, Proteus mirabilis, Pseudomonas aeruginosa.<br />\r\n<br />\r\n<strong>Clotrimazole</strong>&nbsp;is a synthetic imidazole derivative, which is a broad-spectrum antifungal agent that exerts fungicidal activity against fungi responsible for superficial mycotic infections affecting the outer or middle ear including Candida, Microsporum &amp; Trichophyton. Clotrimazole inhibits Cytochrome P-450 synthesis of Ergosterol, which decreases fungal cell wall integrity thus inhibits fungal growth. Clotrimazole also has activity against certain bacteria such as Streptococci and Staphylococci. The antibacterial effect of Clotrimazole is advantageous to treat mixed bacterial-fungal infections.<br />\r\n<br />\r\n<strong>Beclomethasone Dipropionate</strong>&nbsp;is a potent steroid as compared with other topical corticosteroids. Beclomethasone like other topical corticosteroids, has anti-inflammatory, antipruritic, and vasoconstrictive properties. It induces phospholipase A2 and sequentially inhibits the release of arachidonic acid, thereby depressing the formation, release, and activity of prostaglandins, leukotrienes, and other inflammatory mediators.<br />\r\n<br />\r\n<strong>Lidocaine Hydrochloride</strong>&nbsp;is a topical local anesthetic which helps to reduce pain and stinging in the ear.</p>', '<ul>\r\n	<li>Adults &amp; Children: Instill 2-5 drops three to four times daily into the affected ear for 7-14 days.</li>\r\n	<li>Otitis Externa with intact tympanic membrane: From age 06 months &amp; older.</li>\r\n	<li>Chronic Suppurative Otitis Media with perforated tympanic membrane: 12 years &amp; older.</li>\r\n</ul>\r\n\r\n<p>Instruction to use: To apply, tilt head to one side so that the ear is facing up. Then gently pull the ear lobe up &amp; backward in case of adults and children older than 3 years. In case of pediatric patients gently pull the ear lobe down &amp; backward.</p>', NULL, '<p>This ear drop is contraindicated in patients with sensitive to Ofloxacin or other quinolone, or to any of the components of this medications. It is contra-indicated in viral infections of the ear.</p>', '<p>The systemic side-effects are not common with this ear drops. The following adverse reactions may be observed when using this product: itching, burning, irritation, dryness, earache, headache, vertigo, dizziness, redness, folliculitis, hypertrichosis, acne form eruptions and hypopigmentation.</p>', '<p>Safety during pregnancy or lactation has not been established. It is not known whether the active substances pass into breast milk when applied topically. Therefore, the potential benefit of this product during pregnancy or lactation, should be weighed against possible hazard to the fetus or the nursing infant.</p>', '<ul>\r\n	<li>If a favorable response does not occur in one week, discontinue the use of this preparation and obtain cultures to guide further treatment.</li>\r\n	<li>As with other anti-infective preparations, prolonged use may result in overgrowth of nonsusceptible organisms.</li>\r\n	<li>If local irritation or sensitization occurs, discontinue this preparation and institute appropriate therapy.</li>\r\n	<li>If otorrhea persists after a full course of therapy, or if two or more episodes of otorrhea occur within six months, further evaluation is recommended to exclude an underlying condition such as cholesteatoma, foreign body, or a tumor.</li>\r\n	<li>Not for Ophthalmic use. Not for injection.</li>\r\n</ul>', NULL, '<p>Anti-fungal or anti-bacterial ear drops.</p>', '<p>Keep away from light and moisture, store below 25&deg;C.</p>', NULL, '2022-03-11 04:54:14', '2022-03-11 04:54:14'),
(1075, 1075, '<p>Olanzapine is indicated for the acute and maintenance treatment of schizophrenia and related psychoses where positive symptoms (e.g. delusions, hallucinations, disordered thinking, hostility and suspiciousness) and/or negative symptoms (e.g. flattened affect, emotional and social withdrawal, poverty of speech) are prominent. Olanzapine is indicated for the treatment of acute manic or mixed episodes in bipolar disorder, with or without psychotic features and with or without a rapid cycling course.</p>', '<p>Olanzapine is an antipsychotic agent and has affinities for serotonin 5HT2A/2C, 5HT3, 5HT6; dopamine D1, D2, D3, D4, D5; cholinergic muscarinic receptors M1-M5; &alpha;1 adrenergic; and histamine H1 receptors. The mechanism of action of Olanzapine, as with other drugs having efficacy in schizophrenia, is unknown. However, it has been proposed that this drug&rsquo;s efficacy in schizophrenia is mediated through a combination of dopamine and serotonin type 2 (5HT2) antagonism. Olanzapine is well absorbed after oral administration, reaching peak plasma concentrations within 5 to 8 hours. The absorption is not affected by food. Olanzapine is not mutagenic or clastogenic as well as not carcinogenic.</p>', '<p><strong>Schizophrenia, combination therapy for Mania, Bipolar Disorder</strong>: The initial dose is 5-10 mg once daily. Daily dosage may subsequently be adjusted on the basis of individual clinical status within the range of 5-20 mg daily. Dosage greater than 10 mg daily only after reassessment. Maximum dose is 20 mg daily.<br />\r\n<br />\r\n<strong>Monotherapy for Mania</strong>: Initially 15 mg once daily. Daily dosage may subsequently be adjusted on the basis of individual clinical status within the range of 5-20 mg daily. Dosage greater than 15 mg only after reassessment. Maximum dose is 20 mg daily.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Olanzapine can be given without regard to meals. Gradual tapering of the dose should be considered while discontinuing Olanzapine.</p>', '<p>Olanzapine may antagonize the effects of levodopa and dopamine agonists. Drugs that induce CYP1A2 or glucoronyl transferase enzymes e.g, Omeprazole and Rifampicin, may increase Olanzapine clearance. Inhibitors of CYP1A2 may potentially inhibit Olanzapine elimination. Carbamazepine may increase the clearance of Olanzapine. Concomitant administration of activated charcoal reduces the oral bioavailability of Olanzapine by 50-60%. Caution should be taken when Olanzapine is administered with centrally acting drugs and alcohol.</p>', '<p>Olanzapine is contraindicated in those patients with a known hypersensitivity to any ingredient of the product as well as in patients with known risk for narrow-angle glaucoma.</p>', '<p>Very common undesirable effects are somnolence and weight gain. Besides increased appetite, elevated glucose levels, elevated triglyceride levels, dizziness, akathisia, Parkinson&#39;s disease, dyskinesia, orthostatic hypotension, mild and transient anticholinergic effects including constipation and dry mouth, asthenia, edema and photosensitivity reaction etc. may be observed.</p>', '<p>Olanzapine should be used in pregnancy only if the potential benefits justify the potential risk to the foetus. So, patients should be advised to notify their physician if they become pregnant or intend to become pregnant during treatment with Olanzapine. There is no report to show teratogenecity. Patients should not breast feed if they are taking Olanzapine.</p>', '<p>Olanzapine should be used cautiously in patients who have a history of seizures or have conditions associated with seizures.&nbsp;Olanzapine should be used cautiously in patients with low leukocyte and/or neutrophil counts for any reason, drug induced bone marrow depression/toxicity caused by radiation therapy or chemotherapy, hypereosinophilic conditions, impaired hepatic function, and patients using hepatotoxic medicines, centrally acting drug and medicines know to increase QT interval, especially in the elderly. Patients should be cautioned about operating hazardous machinery, including motor vehicles.</p>', NULL, '<p>Atypical neuroleptic drugs.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Children</strong>: Olanzapine has not been studied in subjects under 18 years of age.<br />\r\n<br />\r\n<strong>Elderly patients (age 65 and over)</strong>: starting dose 5 mg/day<br />\r\n<br />\r\n<strong>Patients with hepatic, renal impairment</strong>: starting dose 5 mg/day</p>', '2022-03-11 04:56:27', '2022-03-11 04:56:27'),
(1076, 1076, '<p><strong>Breast Cancer</strong>: Olaparib is indicated as monotherapy for the treatment of adult patients with deleterious or suspected deleterious germline BRCA-mutated (gBRCAm), human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer who have previously been treated with chemotherapy in the neoadjuvant, adjuvant or metastatic setting. Patients with hormone receptor (HR)-positive breast cancer should have progressed on or be considered inappropriate for endocrine therapy. Germline BRCA mutation must be confirmed before Olaparib treatment is initiated.<br />\r\n<br />\r\n<strong>Ovarian Cancer</strong>: Olaparib is indicated as monotherapy for the maintenance treatment of adult patients with platinum sensitive relapsed (PSR) high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer who are in response (complete response or partial response) to platinumbased chemotherapy.</p>', '<p>Olaparib is an inhibitor of poly (ADP-ribose) polymerase (PARP) enzymes, including PARP1, PARP2, and PARP3. PARP enzymes are involved in normal cellular homeostasis, such as DNA transcription, cell cycle regulation, and DNA repair. Olaparib has been shown to inhibit growth of select tumor cell lines in vitro and decrease tumor growth in mouse xenograft models of human cancer both as monotherapy or following platinum-based chemotherapy. Increased cytotoxicity and anti-tumor activity following treatment with olaparib were noted in cell lines and mouse tumor models with deficiencies in BRCA. In vitro studies have shown that olaparib-induced cytotoxicity may involve inhibition of PARP enzymatic activity and increased formation of PARP-DNA complex, resulting in disruption of cellular homeostasis and cell death.</p>', '<p>There is a risk of medication errors between Olaparib tablets and Olaparib capsules. In order to minimize this risk, check the bottle labels to ensure that the drug being prepared and dispensed is Olaparib tablets and not Olaparib capsules. Prescribers should specify the formulation and dosage of Olaparib on each prescription.<br />\r\n<br />\r\nThe recommended total daily dose of Olaparib tablets is 600 mg, taken as two 150 mg tablets twice daily. The 100 mg tablet is available for dose reduction.<br />\r\n<br />\r\n<strong>For treatment of ovarian cancer</strong>: Patients should start treatment with Olaparib no later than 8 weeks after completion of their final dose of the platinum-containing regimen. Patients should have recovered from prior hematologic toxicities prior to starting Olaparib therapy (hemoglobin, platelet, and neutrophil levels should be &le; CTCAE grade 1).<br />\r\n<br />\r\nIt is recommended that Olaparib treatment be continued until progression of the underlying disease or unacceptable toxicity. Olaparib should not be given in combination with other anti cancer therapy. Grapefruit or other similar fruit juices that are known to inhibit CYP3A should not be consumed while taking Olaparib.</p>', '<p>Clinical studies of olaparib in combination with other anti-cancer agents, including DNA damaging agents, indicate a potentiation and prolongation of myelosuppressive toxicity. The recommended Olaparib monotherapy dose is not suitable for combination with myelosuppressive anti-cancer agents. Olaparib is predominantly metabolised by CYP3A. Co-administered CYP3A inhibitors or inducers may respectively increase or decrease olaparib plasma concentration.</p>', '<p>Olaparib is contraindicated in patients who are hypersensitive to this drug or to any ingredient in the formulation.</p>', '<p>The most common serious adverse reaction reported was anemia (2.4% olaparib vs 2.2% chemotherapy). The following serious ADRs were reported in one patient each: dermatitis allergic, neutrophil count decreased and platelet count decreased. The proportion of patients who permanently discontinued Olaparib due to adverse events was 4.9% in the Olaparib arm compared with 7.7% in the chemotherapy arm. Anemia and platelet count decrease were the only adverse reactions leading to discontinuation of Olaparib in more than one patient.</p>', '<p><strong>Pregnancy</strong>: Olaparib can cause fetal harm when administered to a pregnant woman based on its mechanism of action and findings in animals. Olaparib wasteratogenic and caused embryo-fetal toxicity in rats at exposures below those in patients receiving the recommended human dose of 400 mg twice daily. If this drug is used during pregnancy, or if a patient becomes pregnant while taking this drug, apprise the patient of the potential hazard to the fetus and the potential risk for loss of the pregnancy.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether olaparib 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 olaparib, 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><strong>Myelodysplastic Syndrome/Acute Myeloid Leukemia (MDS/AML)</strong>: occurred in patients exposed to Olaparib, and the majority of reports were fatal. Monitor patients for hematological toxicity at baseline and monthly thereafter. Discontinue if MDS/AML is confirmed.<br />\r\n<br />\r\n<strong>Pneumonitis</strong>: occurred in patients exposed to Olaparib, and some cases were fatal. Interrupt treatment if pneumonitis is suspected. Discontinue if pneumonitis is confirmed.<br />\r\n<br />\r\n<strong>Embryo-Fetal Toxicity</strong>: Olaparib can cause fetal harm. Advise females of reproductive potential of the potential risk to a fetus and to use effective contraception.</p>', '<p>There is no specific treatment in the event of Olaparib overdose, and symptoms of overdose are not established. In the event of an overdose, physicians should follow general supportive measures and should treat symptomatically.</p>', '<p>Targeted Cancer Therapy.</p>', '<p>Store in a dry place below 30&deg;C, protect from light. Keep out of the reach of children.</p>', '<p>Pediatric Use: The safety and efficacy of Olaparib has not been established in pediatric patients.</p>', '2022-03-11 04:58:18', '2022-03-11 04:58:18'),
(1077, 1077, '<p>Olmesartan Medoxomil is indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive agents.</p>', '<p>Angiotensin-II formed from angiotensin-I in a reaction catalyzed by angiotensin-converting enzyme (ACE), is a potent vasoconstrictor, the primary vasoactive hormone of the renin-angiotensin system and an important component in the pathophysiology of hypertension. It also stimulates aldosterone secretion by the adrenal cortex. Olmesartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin-II by selectively blocking the binding of angiotensin-II to the AT 1 receptor found in many tissues (e.g. vascular smooth muscle, adrenal gland). In-vitro-binding studies indicate that Olmesartan is a reversible &amp; competitive inhibitor of AT 1 receptor. Olmesartan does not inhibit ACE (kinase-I, the enzyme that converts angiotensin-I to angiotensin-II and degrades bradykinin).</p>', '<p>Dosage must be individualized. The usual recommended starting dose of Olmesartan is 20 mg once daily when used as monotherapy in patients who are not volume-contracted. For patients requiring further reduction in blood pressure after 2 weeks of therapy, the dose of Olmesartan may be increased to 40 mg. Doses above 40 mg do not appear to have a greater effect. Twice-daily dosing offers no advantage over the same total dose given once daily.<br />\r\n<br />\r\nNo initial dosage adjustment is recommended for elderly patients, for patients with moderate to marked renal impairment (creatinine clearance &lt;40 ml/min) or with moderate to marked hepatic dysfunction. For patients with possible depletion of intravascular volume (e.g. patients treated with diuretics, particularly those with impaired renal function), Olmesartan should be initiated under close medical supervision and consideration should be given to use of a lower starting dose. Olmesartan may be administered with or without food.</p>', '<p><strong>With medicine</strong>: No significant drug interactions were reported in which Olmesartan was co-administered.<br />\r\n<strong>With food &amp; others</strong>: Food does not affect the bioavailability of Olmesartan.</p>', '<p>Olmesartan is contraindicated in patients who are hypersensitive to any component of this product.</p>', '<p><strong>Common</strong>: The most common side effects include Back pain, bronchitis, creatine phosphokinase increased, diarrhea, headache, hematuria, hyperglycemia, hypertriglyceridemia, influenza-like symptoms, pharyngitis, rhinitis, and sinusitis.<br />\r\n<br />\r\n<strong>Rare</strong>: Chest pain, peripheral edema, arthritis.</p>', '<p><strong>Pregnancy</strong>: When pregnancy is detected, discontinue this product as soon as possible. When used in pregnancy during the second and third trimesters, drugs that act directly on the renin-angiotensin system can cause injury and even death to the developing fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether Olmesartan is excreted in human milk, but Olmesartan is secreted at low concentration in the milk of lactating rats. 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>As a consequence of inhibiting the renin-angiotensin-aldosterone system, changes in renal function may be anticipated in susceptible individuals treated with olmesartan medoxomil. In patients whose renal function may depend upon the activity of the renin-angiotensin-aldosterone system (e.g. patients with severe congestive heart failure), treatment with angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists has been associated with oliguria and/or progressive azotemia and (rarely) with acute renal failure and/or death. Similar results may be anticipated in patients treated with olmesartan medoxomil.</p>', '<p><strong>Symptoms</strong>: There is no experience of overdose with Olmesartan. The most likely effects of olmesartan medoxomil overdosage are hypotension and tachycardia; bradycardia could be encountered if parasympathetic (vagal) stimulation occurred.<br />\r\n<br />\r\n<strong>Treatment</strong>: If intake is recent, gastric lavage or induction of emesis may be considered. Clinically significant hypotension due to an overdose of Olmesartan requires the active support of the cardiovascular system, including close monitoring of heart and lung function, the elevation of the extremities, and attention to circulating fluid volume and urine output.</p>', '<p>Angiotensin-ll receptor blocker.</p>', '<p>Store in cool &amp; dry place below 30&ordm;C, protect from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Paediatric use: Safety and effectiveness in paediatric patients have not been established.</p>', '2022-03-11 05:00:20', '2022-03-11 05:00:20'),
(1078, 1078, '<p>Olmesartan Medoxomil &amp; Hydrochlorothiazide combination is indicated for the treatment of hypertension.</p>', '<p>Angiotensin-II formed from angiotensin-I in a reaction catalyzed by angiotensin-converting enzyme (ACE), is a potent vasoconstrictor, the primary vasoactive hormone of the renin-angiotensin system and an important component in the pathophysiology of hypertension. It also stimulates aldosterone secretion by the adrenal cortex. Olmesartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin-II by selectively blocking the binding of angiotensin-II to the AT 1 receptor found in many tissues (e.g. vascular smooth muscle, adrenal gland). In-vitro-binding studies indicate that Olmesartan is a reversible &amp; competitive inhibitor of AT 1 receptor. Olmesartan does not inhibit ACE (kinase-I, the enzyme that converts angiotensin-I to angiotensin-II and degrades bradykinin).<br />\r\n<br />\r\nHydrochlorothiazide is a thiazide diuretic. Thiazides affect the renal tubular mechanisms of electrolyte reabsorption, directly increasing the 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 Aldosterone secretion &amp; urinary Potassium loss and decreases serum Potassium. The renin-aldosterone link is mediated by angiotensin-II. So, co-administration of an angiotensin-II receptor antagonist tends to reverse the potassium loss associated with these diuretics.</p>', '<p><strong>Hypertension</strong>: The usual starting dose is 20/12.5 mg one tablet once daily. Dosing should be individualized. Depending on the blood pressure response, the dose may be titrated at intervals of 2-4 weeks to two tablets 40/25 once daily.</p>', '<p><strong>Olmesartan</strong>: No significant drug interactions were reported in studies in which Olmesartan Medoxomil was co-administered with hydrochlorothiazide, digoxin or warfarin in healthy volunteers. Olmesartan Medoxomil is not metabolized by the cytochrome P450 system and has no effects on P450 enzymes; thus, interactions with drugs that inhibit, induce or are metabolized by those enzymes are not expected.<br />\r\n<br />\r\n<strong>Hydrochlorothiazide</strong>: When administered concurrently, the following drugs may interact with Thiazide diuretics:</p>\r\n\r\n<ul>\r\n	<li>Alcohol, Barbiturates or Narcotics: Potentiation of 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: Additive effect.</li>\r\n	<li>Corticosteroids, ACTH.</li>\r\n	<li>Lithium.</li>\r\n</ul>', '<p>The combination of Olmesartan 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 common side-effects are nausea, headache, dizziness, hyperuricemia, upper respiratory tract infection and urinary tract infection. Other adverse effects are chest pain, back pain, peripheral edema, abdominal pain, dyspepsia, gastroenteritis, diarrhea.</p>', '<p>Safety and effectiveness in nursing mother &amp; pregnancy have not been established. The drug should be discontinued during these conditions.</p>', '<ul>\r\n	<li>Periodic determination of serum electrolytes should be performed at appropriate intervals to detect possible electrolyte imbalance like hypokalemia, hyponatremia and hypochloremic alkalosis.</li>\r\n	<li>Hyperuricemia may occur in certain patients receiving thiazide therapy.</li>\r\n	<li>Impaired renal function.</li>\r\n</ul>', '<p><strong>Olmesartan</strong>: Limited data are available in regard to overdosage in humans. The most likely manifestation of overdosage would be hypotension and tachycardia. Supportive treatment should be instituted.<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, hypokalemia may accentuate cardiac arrhythmias.</p>', '<p>Combined antihypertensive preparations.</p>', '<p>Store in a cool and dry place, protect from light and moisture. Keep out of the reach of children.</p>', '<p><strong>Renal Impairment Patients</strong>: The usual regimens of therapy with this may be followed provided the patient&#39;s creatinine clearance is &gt;30 ml/min. In patients with more severe renal impairment, loop diuretics are preferred to thiazides. So, this preparation is not recommended.<br />\r\n<br />\r\n<strong>Hepatic Impairment Patients</strong>: No dosage adjustment is necessary with hepatic impairment.<br />\r\n<br />\r\n<strong>Paediatric use</strong>: Safety and effectiveness in paediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: Clinical studies of Olmesartan and Hydrochlorothiazide combination did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. In general, dose selection for an elderly patient should be cautious.</p>', '2022-03-11 05:02:37', '2022-03-11 05:02:37'),
(1079, 1079, '<p>Olopatadine Nasal Spray is an H1 receptor antagonist indicated for the relief of the symptoms of seasonal allergic rhinitis in adults and children 6 years of age and older.</p>', '<p>Olopatadine, an antihistamine, works by blocking the action of histamine in the body, which reduces allergy symptoms. Olopatadine Hydrochloride treats sneezing, itching, runny nose, and other nasal symptoms of allergies. Olopatadine Nasal Spray contains 0.6% w/v Olopatadine (base) in a nonsterile aqueous solution with pH of approximately 3.7. After initial priming (5 sprays), each metered spray from the nasal applicator delivers 100 microliters of the aqueous solution containing 665 mcg of olopatadine Hydrochloride, which is equivalent to 600 mcg of Olopatadine (base). Olopatadine Nasal Spray also contains benzalkonium chloride (0.01%), dibasic sodium phosphate, edetate disodium, sodium chloride, hydrochloric acid and/or sodium hydroxide (to adjust pH), and purified water.</p>', '<p><strong>Adults and Adolescents 12 years of age and older</strong>: Two sprays per nostril twice daily.<br />\r\n<br />\r\n<strong>Children 6 to 11 years of ag</strong>e: One spray per nostril twice daily.<br />\r\n<br />\r\nAdminister Olopatadine&nbsp;Nasal Spray by the intranasal route only.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>How to use the Nasal Spray-</p>\r\n\r\n<ul>\r\n	<li>Shake the bottle gently and remove the dust cover.</li>\r\n	<li>Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.</li>\r\n	<li>Gently blow the nose to clear the nostrils.</li>\r\n	<li>Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.</li>\r\n	<li>Breathe out through your mouth.</li>\r\n	<li>Repeat the above steps in the same/ other nostril for consecutive doses.</li>\r\n</ul>\r\n\r\n<p>Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-</p>\r\n\r\n<ul>\r\n	<li>Remove the dust cover.</li>\r\n	<li>Gently pull off the nasal applicator.</li>\r\n	<li>Wash the applicator and dust cover in warm water.</li>\r\n	<li>Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.</li>\r\n	<li>Gently push the applicator back on the top of the bottle and re-fix the dust cover.</li>\r\n</ul>', '<p>Interaction with other medications have not been investigated.</p>', NULL, '<p>A bitter taste in the mouth, nosebleeds, or irritation/soreness in the nose may occur. Drowsiness may rarely occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.</p>', '<p>Pregnancy Category C. No adequate and well-controlled studies in pregnant women have been conducted. Olopatadine Nasal Spray should be used in pregnant women only if the potential benefit to the mother justifies the potential risk to the embryo or fetus.<br />\r\n<br />\r\nLactation: It is not known whether topical nasal administration could result in sufficient systemic absorption to produce detectable quantities in human breast milk. Olopatadine Nasal Spray should be used by nursing mothers only if the potential benefit to the patient outweighs the potential risks to the infant.</p>', '<p>Before initial use, Olopatadine Nasal Spray by releasing 5 sprays or until a fine mist appears. When Olopatadine Nasal Spray has not been used for more than 7 days, re-prime by releasing 2 sprays. Avoid spraying Olopatadine Nasal Spray into the eyes. Patients should be informed to avoid spraying Olopatadine Nasal Spray in their eyes.</p>', '<p>There have been no reported overdoses with Olopatadine Nasal Spray.</p>', '<p>Nasal Anti-histamine preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-11 05:04:30', '2022-03-11 05:04:30'),
(1080, 1080, '<p>Olopatadine is indicated for the treatment of ocular itching associated with allergic conjunctivitis.</p>', '<p>Olopatadine is an inhibitor of the release of histamine from the mast cell and a relatively selective histamine H1‐antagonist that inhibits the in vivo and in vitro type 1 immediate hypersensitivity reaction including inhibition of histamine induced effects on human conjunctival epithelial cells. Olopatadine is devoid of effects on alpha adrenergic, dopamine and muscarinic type 1 and 2 receptors. Following topical ocular administration in human, olopatadine was shown to have low systemic exposure.</p>', '<p><strong>0.1% Sterile Eye Drops</strong>: One drop in each affected eye two times per day at an interval of 6 to 8 hours.<br />\r\n<br />\r\n<strong>0.2% Sterile Eye Drops</strong>: One drop in the affected eye once a day.<br />\r\n<br />\r\n<strong>0.7% Sterile Eye Drops</strong>: One drop in each affected eye once a day.</p>', '<p>May result in additive CNS depression with CNS depressants.</p>', '<p>Olopatadine Hydrochloride ophthalmic solution is contraindicated in persons with a known hypersensitivity to Olopatadine Hydrochloride.</p>', '<p>Headaches have been reported at an incidence of 7%. The following adverse experiences have been reported in less than 5% of patients: Asthenia, blurred vision, burning or stinging, cold syndrome, dry eye, foreign body sensation, hyperemia, hypersensitivity, keratitis, lid edema, nausea, pharyngitis, pruritus, rhinitis, sinusitis, and taste perversion</p>', '<p>There are no adequate and well controlled studies in pregnant women. Because animal studies are not always predictive of human responses, this drug should be used in pregnant women only if the potential benefit to the mother justifies the potential risk to the fetus.<br />\r\n<br />\r\nIt is not known whether topical ocular administration could result in sufficient systemic absorption to produce detectable quantities in the human breast milk. Nevertheless, caution should be exercised when Olopatadine Hydrochloride ophthalmic solution is administered to a nursing mother.</p>', '<p>Olopatadine HCl ophthalmic solution should not be used to treat contact lens related irritation. Patients who wear soft contact lenses should be instructed to wait at least ten minutes after instilling Olopatadine Hydrochloride ophthalmic solution before they insert their contact lenses.</p>', '<p><strong>Symptoms:</strong>&nbsp;Drowsiness in adults and, initially, agitation and restlessness, followed by drowsiness in childn.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Symptomatic or supportive treatment.</p>', '<p>Ophthalmic Non-Steroid drugs.</p>', '<p>Store below 30&deg; C in a cool and dry place protected from light. Keep out of reach of children. Do not touch the dropper tip to surfaces since this may contaminate the solution. Do not use after 30 days of first opening.</p>', '<p><strong>Geriatric Use</strong>: No overall differences in safety or effectiveness have been observed betweents.</p>', '2022-03-11 05:06:29', '2022-03-11 05:06:29'),
(1081, 1081, '<p><strong>Asthma</strong>: Omalizumab is indicated for patients 6 years of age and older with moderate to severe persistent&nbsp;asthma&nbsp;who have a positive skin test or in vitro reactivity to a perennial aeroallergen and whose symptoms are inadequately controlled with inhaled corticosteroids. Omalizumab has been shown to decrease the incidence of asthma exacerbations in these patients.<br />\r\n<br />\r\n<strong>Chronic Idiopathic Urticaria (CIU)</strong>: Omalizumab is indicated for the treatment of adults and adolescents 12 years of age and older with chronic&nbsp;idiopathic&nbsp;urticaria&nbsp;who remain symptomatic despite H1 antihistamine treatment.</p>', '<p><strong>Asthma</strong>: Omalizumab inhibits the binding of&nbsp;IgE&nbsp;to the high-affinity&nbsp;IgE receptor (Fc&epsilon;RI) on the surface of mast cells and basophils. Reduction in surface-bound IgE on Fc&epsilon;RI-bearing cells limits the degree of release of mediators of the allergic response. Treatment with Omalizumab also reduces the number of Fc&epsilon;RI receptors on basophils in&nbsp;atopic&nbsp;patients.<br />\r\n<br />\r\n<strong>Chronic Idiopathic Urticaria</strong>: Omalizumab binds to IgE and lowers free IgE levels. Subsequently, IgE receptors (Fc&epsilon;RI) on cells down-regulate. The mechanism by which these effects of omalizumab result in an improvement of CIU symptoms is unknown.</p>', '<p>Subcutaneous-</p>\r\n\r\n<p>Poorly controlled, moderate to severe asthma:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Doses (mg) and dosing frequency are based on pre-treatment serum IgE levels (IU/mL) and body wt (kg) as follows: &ge;30-100 IU/mL: 150 mg (30-90 kg); 300 mg (&gt;90-150 kg). &gt;100-200 IU/mL: 300 mg (30-90 kg). &gt;200-300 IU/mL: 300 mg (30-60 kg). All doses to be taken every 4 wk. &gt;100-200 IU/mL: 225 mg (&gt;90-150 kg). &gt;200-300 IU/mL: 225 mg (&gt;60-90 kg); 300 mg (&gt;90-150 kg). &gt;300-400 IU/mL: 225 mg (30-70 kg); 300 mg (&gt;70-90 kg). &gt;400-500 IU/mL: 300 mg (30-70 kg); 375 mg (&gt;70-90 kg). &gt;500-600 IU/mL: 300 mg (30-60 kg); 375 mg (&gt;60-70 kg). 375 mg (30-60 kg). All doses to be taken every 2 wk. Doses no more than 150 mg should be admin at 1 inj site.</li>\r\n	<li><strong>Child:</strong>&nbsp;&ge;12 yr Same as adult dose.</li>\r\n</ul>\r\n\r\n<p>Chronic idiopathic urticaria:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;150 or 300 mg every 4 wk.</li>\r\n	<li><strong>Child:</strong>&nbsp;&ge;12 yr Same as adult dose.</li>\r\n</ul>', NULL, '<p>Severe hypersensitivity reaction to Omalizumab or any ingredient of this preparation</p>', '<p>Generalised pain, arthralgia, myalgia, fatigue, dizziness, earache, headache, GI disturbances, fractures, pruritus, alopecia, dermatitis, upper resp tract infections, viral infections, sinusitis, pharyngitis, flu-like illness, systemic eosinophilia (e.g. Churg-Strauss syndrome).</p>', '<p><strong>Pregnancy&nbsp;</strong>Category B.&nbsp;Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).</p>', '<p>Not intended for treatment of acute asthma exacerbations, acute bronchospasm or status asthmaticus. Patient at risk of parasitic infections. May increase risk of malignancy. Delayed onset of anaphylaxis, it usually occurs 2 hr after admin but may also occur up to 4 days to &gt;1 yr after initiation of regular treatment. Avoid abrupt withdrawal of corticosteroid therapy. Renal and hepatic impairment. Childn. Pregnancy and lactation.</p>', '<p>The maximum tolerated dose of Omalizumab has not been determined. Single intravenous doses of up to 4,000 mg have been administered to patients without evidence of dose limiting toxicities. The highest cumulative dose administered to patients was 44,000 mg over a 20 week period, which was not associated with toxicities.</p>', '<p>Antihistamines anti-allergies &amp; hypo-sensitisation.</p>', '<p>Store between 2-8&deg;C. May be transferred at room temp. Do not freeze. Following reconstitution, protect from direct sunlight. Stable for up to 8 hr if refrigerated or 4 hr if at room temp.</p>', NULL, '2022-03-11 05:08:32', '2022-03-11 05:08:32'),
(1082, 1082, '<p>Omega-3 Acid Ethyl Esters is indicated as an adjunct to diet to reduce very high (&gt;500mg/dl) triglyceride (TG) levels in adult patients and as an adjunct in secondary prevention in those who have had a myocardial infarction in the preceding 3 months. It is also indicated to help reduce the joint inflammation associated with mild arthritis, mood disorders &amp; impulse control, age-related macular degeneration.</p>', '<p>Omega-3-acid ethyl esters reduce triglyceride production by the liver but this mechanism is not well understood. Omega-3-acid ethyl esters inhibit acyl-CoA: 1,2-diacylglycerol acyltransferase, reducing triglyceride synthesis and increasing paroxysmal beta-oxidation, which increases fatty aside metabolism. Omega-3-acid ethyl esters also inhibit the release of fatty acids by competing for enzymes involved in the synthesis of triglycerides, increase triglyceride clearance by increasing the activity of lipoprotein lipase, and decrease production of VLDL-C.</p>', '<p><strong>In hypertriglyceridaemia</strong>: it can be taken as a single dose of 4 capsules (4 gm) or 2 capsules (2 gm) twice daily.<br />\r\n<br />\r\n<strong>In previously myocardial infarction patients</strong>: It can be taken 1 capsule (1 gm ) daily with food. Patients should be placed on an appropriate lipid lowering diet before receiving Omega-3 Acid Ethyl Esters and should continue this diet during treatment.<br />\r\n<br />\r\n<strong>In joint inflammation associated with mild arthritis</strong>: The dose is 2.7 gm daily.<br />\r\n<br />\r\n<strong>In mood disorders &amp; impulse control and age-related macular degeneration</strong>: The dose is 1 capsule (1 gm) per day. Or, as directed by the registered physician.</p>', '<p>Patients receiving treatment with both Omega-3-acid ethyl esters and anticoagulants should be monitored periodically.</p>', '<p>It is contraindicated in patients who exhibit hypersensitivity to any component of this medication.</p>', '<p>Adverse events are rarely reported such as dyspepsia, nausea, constipation, gastritis, dizziness etc.</p>', '<p>Omega-3-acid ethyl esters should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether it is excreted in human milk. Caution should be exercised when Omega-3-acid ethyl esters are administered to a lactating mother.</p>', '<p>During therapy with omega-3-acid ethyl esters, LDL-C levels should be monitored and laboratory studies should be performed periodically to measure the patient&#39;s TG levels.</p>', NULL, '<p>Other lipid regulating drugs.</p>', '<p>Store below 25&deg;C in a dry &amp; cool place.</p>', NULL, '2022-03-11 05:10:12', '2022-03-11 05:10:12'),
(1083, 1083, '<p>Omeprazole is indicated for the treatment of-</p>\r\n\r\n<ul>\r\n	<li>Gastric and duodenal ulcer</li>\r\n	<li>NSAID-associated duodenal and gastric ulcer</li>\r\n	<li>As prophylaxis in patients with a history of NSAID-associated duodenal and gastric ulcer</li>\r\n	<li>Gastro-esophageal reflux disease</li>\r\n	<li>Long-term management of acid reflux disease</li>\r\n	<li>Acid-related dyspepsia</li>\r\n	<li>Severe ulcerating reflux esophagitis</li>\r\n	<li>Prophylaxis of acid aspiration during general anesthesia</li>\r\n	<li>Zollinger-Ellison syndrome</li>\r\n	<li>Helicobacter pylori-induced peptic ulcer.</li>\r\n</ul>', '<p>Omeprazole, a substituted benzimidazole, is an inhibitor of gastric acid secretion. It inhibits gastric acid secretion by blocking hydrogen-potassium-adenosine triphosphatase (H+/K+&nbsp;ATPase) enzyme system in the gastric parietal cell. After oral administration, the onset of the antisecretory effect occurs within one hour, with the maximum effect occurring within two hours and inhibition of secretion lasts up to 72 hours. When the drug is discontinued, secretory activity returns gradually, over 3 to 5 days.</p>', '<p>Oral-</p>\r\n\r\n<ul>\r\n	<li><strong>Benign gastric and duodenal ulcer</strong>: 20 mg once daily for 4 weeks in duodenal ulceration, 8 weeks in gastric ulceration; in severe or recurrent cases, dose to be increased to 40 mg daily; maintenance dose for recurrent duodenal ulcer, 20 mg once daily; in prevention of relapse in duodenal ulcer, 10-20 mg daily.</li>\r\n	<li><strong>NSAID-associated duodenal or gastric ulcer</strong>: 20 mg once daily for 4 weeks, continued for further 4 weeks, if not fully healed. 20 mg once daily is used as prophylaxis in patients with a history of NSAID-associated duodenal or gastric ulcers.</li>\r\n	<li><strong>Gastro-esophageal reflux disease</strong>: 20 mg once daily for 4 weeks, continued for further 4-8 weeks, if not fully healed; 40 mg once daily has been given for 8 weeks in gastro-esophageal reflux disease, refractory to other treatment; maintenance dose is 20 mg once daily.</li>\r\n	<li><strong>Long-term management of acid reflux disease</strong>: 10-20 mg daily.</li>\r\n	<li><strong>Acid-related dyspepsia</strong>: 10-20 mg once daily for 2-4 weeks.</li>\r\n	<li><strong>Prophylaxis of acid aspiration</strong>: 40 mg on the preceding evening, then 40 mg 2-6 hours before surgery.</li>\r\n	<li><strong>Zollinger-Ellison syndrome</strong>: Initially 60 mg once daily; usual range 20-120 mg daily (If daily dose is more than 80 mg, 2 divided dose should be used).</li>\r\n	<li><strong>Helicobacter pylori eradication regimen in peptic ulcer disease</strong>: Omeprazole is recommended at a dose of 20 mg twice daily in association with antimicrobial agents as detailed below: Amoxicillin 500 mg and Metronidazole 400 mg both three times a day for one week, or Clarithromycin 250 mg and Metronidazole 400 mg both twice a day for one week, or Amoxicillin 1 g and Clarithromycin 500 mg both twice a day for one week.</li>\r\n	<li><strong>Paeditaric use in severe ulcerating reflux esophagitis (Child&gt;1 year)</strong>: If body-weight 10-20 kg, 10-20 -mg once daily for 4-12 weeks; if body-weight over 20 kg, 20-40 mg once daily for 4-12 weeks.</li>\r\n</ul>\r\n\r\n<p><br />\r\nIV Injection-</p>\r\n\r\n<ul>\r\n	<li><strong>Prophylaxis of acid aspiration</strong>: Omeprazole 40 mg to be given slowly (over a period of 5 minutes) as an intravenous injection, one hour before surgery.</li>\r\n	<li><strong>Duodenal ulcer, gastric ulcer or reflux oesophagitis</strong>: In patients with duodenal ulcer, gastric ulcer or reflux oesophagitis where oral medication is inappropriate, Omeprazole IV 40 mg once daily is recommended.</li>\r\n	<li><strong>Zollinger- Ellison syndrome (ZES)</strong>: In patients with Zollinger-Ellison Syndrome the recommended initial dose of Omeprazole given intravenously is 60 mg daily. Higher daily doses may be required and the dose should be adjusted individually. When doses exceed 60 mg daily, the dose should be divided &amp; given 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><strong>Direction for use of IV Injection</strong>: Omeprazole lyophilized powder and water for injection is for intravenous administration only and must not be given by any other route. Omeprazole IV injection should be given as a slow intravenous injection. The solution for IV injection is obtained by adding 10 ml water for injection to the vial containing powder. After&nbsp;reconstitution the injection should be given slowly over a period of at least 2 to 5 minutes at a maximum rate of 4 ml/minute. Use only freshly prepared solution. The solution should be used within 4 hours of reconstitution.<br />\r\n<br />\r\n<strong>Direction for use of IV Infusion</strong>: Omeprazole IV infusion should be given as an intravenous infusion over a period of 20-30 minutes or more. The contents of one vial must be dissolved in 100 ml saline for infusion or 100 ml 5% Dextrose for infusion. The solution should be used within 12 hours when Omeprazole is dissolved in saline and within 6 hours when dissolved in 5% Dextrose. The reconstituted solution should not be mixed or co-administered in the same infusion set with any other drug.</p>', '<p>Omeprazole can prolong the elimination of diazepam, warfarin and phenytoin. So, reduction of warfarin or phenytoin dose may be necessary when Omeprazole is added to the treatment. There is no evidence of an interaction of Omeprazole with theophylline, propranolol or antacids.</p>', '<p>Omeprazole is contraindicated in patients with known hypersensitivity to any of the components of the formulation.</p>', '<p>Omeprazole is generally well tolerated. Nausea, abdominal colic, paresthesia, dizziness and headache have been stated to be generally mild and transient and not requiring a reduction in dosage.</p>', '<p>US FDA pregnancy category of Omeprazole is C. However, results from three prospective epidemiological studies indicate no adverse effects of Omeprazole on pregnancy or on the health of the fetus/newborn child. There is no information available on the passage of Omeprazole into breast milk or its effects on the neonate. Breast-feeding should, therefore, be discontinued, if the use of Omeprazole is considered essential.</p>', '<p>When gastric ulcer is suspected, the possibility of gastric malignancy should be excluded before treatment with Omeprazole is instituted, as treatment may alleviate the symptoms and delay diagnosis.</p>', NULL, '<p>Proton Pump Inhibitor</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-11 05:12:09', '2022-03-11 05:12:09');
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
(1084, 1084, '<p>Omeprazole MUPS tablet is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Duodenal and Gastric ulcers</li>\r\n	<li>NSAID-induced gastric and duodenal ulcers</li>\r\n	<li>Reflux Oesophagitis</li>\r\n	<li>GERD (Gastroesophageal Reflux Disease)</li>\r\n	<li>Eradication of H. pylori with appropriate antibiotics</li>\r\n	<li>Zollinger-Ellison Syndrome</li>\r\n</ul>', '<p>MUPS is abbreviation for Multiple-Unit Pellet System. However, from pharmaceutical industry and research perspective, the term in general refers to MUPS compacted into tablets. Thus, the resulting tablets prepared by compaction of modified release coated multiparticulates or pellets are called as MUPS. It is the more recent and challenging technology that combines the advantages of both tablets and pellet-filled capsules in one dosage form.<br />\r\n<br />\r\n<img src=\"https://i.imgur.com/YwkaPsO.png\" /><br />\r\n<br />\r\nClinical advantage of omeprazole MUPS tablet compared to conventional modified-release omeprazole tablets and pellet-filled omeprazole capsules:</p>\r\n\r\n<ul>\r\n	<li>Ensures greater bioavailability</li>\r\n	<li>Ensures uniform emptying of micro pellets from stomach into small intestine facilitates rapid dissolution of enteric coating and drug release resulting in early Tmax&nbsp;and Cmax&nbsp;(peak time and peak plasma concentration)</li>\r\n	<li>Ensures lesser possibility of dose dumping</li>\r\n	<li>Is a combination of fast acting and sustained action</li>\r\n	<li>Ensures uniform drug release</li>\r\n	<li>Once daily dosing</li>\r\n	<li>Ensures lesser chance of localized irritation</li>\r\n	<li>Ensures better and more uniform drug absorption</li>\r\n	<li>Better than capsules in reducing the esophageal residence time</li>\r\n	<li>Minimizes fluctuation in plasma concentration of drug.</li>\r\n</ul>\r\n\r\n<p>Pharmacodynamic advantage:</p>\r\n\r\n<ul>\r\n	<li>MUPS ensure rapid and uniform gastric emptying and subsequently uniform drug dissolution of pellets in the gastrointestinal tract due to their small size and larger surface, uniform drug absorption is facilitated which results in consistent and controlled pharmacological action.</li>\r\n	<li>A further reduction in inter-and intra-subject variability in drug absorption and clinical response is facilitated since the number of pellets per MUPS dosage form is much more than a conventional pellet-filled capsule and possibility of dose dumping(in stomach) and incomplete drug release is further minimized.</li>\r\n</ul>', '<p>Adult:</p>\r\n\r\n<ul>\r\n	<li>GERD (Gastroesophageal Reflux Disease):&nbsp;20 mg&nbsp;once daily for 4 weeks.</li>\r\n	<li>Gastric ulcer:&nbsp;20 mg&nbsp;once daily for 4-8 weeks; in severe cases Twice daily.</li>\r\n	<li>Duodenal ulcer:&nbsp;20 mg once daily for 2-4 weeks; in severe cases Twice daily.</li>\r\n	<li>NSAID-induced ulceration:&nbsp;20 mg once daily for 4-8 weeks.</li>\r\n	<li>Reflux esophagitis:&nbsp;20 mg once daily for 4-8 weeks; in severe cases Twice daily.</li>\r\n	<li>H. pylori eradication (Omeprazole MUPS tablet with Amoxicillin and Clarithromycin or Metronidazole): 20 mg twice daily for 1 week.</li>\r\n	<li>Zollinger-Ellison Syndrome:&nbsp;60 mg once daily; Usual maintenance, 20-120 mg daily.</li>\r\n</ul>\r\n\r\n<p>Children over 2 years old:</p>\r\n\r\n<ul>\r\n	<li>Acid regurgitation in GERD (Gastroesophageal Reflux Disease):&nbsp;20 mg once daily for 2-4 week.</li>\r\n	<li>Reflux esophagitis:&nbsp;20 mg once daily for 4-8 weeks.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Take the tablet before or after a meal.</li>\r\n	<li>Swallow the tablet whole with a glass of water. The tablet must not be chewed or crushed. OR</li>\r\n	<li>If the patients have trouble swallowing the tablets, put the tablet into a glass of water (Do not use other liquids). Stir the preparation until the tablets disintegrate. Then drink the liquid within 30 minutes. Stir the mixture just always before drinking.</li>\r\n</ul>', '<p>Omeprazole is metabolized through CYP2C19 . When starting or stopping treatment with Omeprazole should be taken into account potential interactions with medicines which are CYP2C19 metabolized.</p>', '<p>Omeprazole is contraindicated in those patients who have known hypersensitivity to any other components of the formulation.</p>', NULL, '<p>Not known to be harmful. Omeprazole can be used during pregnancy. Omeprazole is excreted in breast milk but is not likely to influence the child when therapeutic doses are used.</p>', '<p>Omeprazole tablet should be used carefully if the patient has severe liver dysfunction and severe renal impairment.</p>', NULL, '<p>Proton Pump Inhibitor.</p>', '<p>Store in a cool (below 25&deg;C) and dry place, protected from light and moisture.</p>', NULL, '2022-03-11 05:14:04', '2022-03-11 05:14:04'),
(1085, 1085, '<p>Ondansetron is a serotonin subtype 3 (5-HT3) receptor antagonist indicated:</p>\r\n\r\n<ul>\r\n	<li>Prevention of nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy.</li>\r\n	<li>Prevention and treatment of post-operative nausea and vomiting.</li>\r\n	<li>Prevention of radiotherapy-induced nausea and vomiting.</li>\r\n</ul>', '<p>Ondansetron is a potent, highly selective 5HT3&nbsp;receptor-antagonist. Its precise mode of action in the control of nausea and vomiting is not known. Chemotherapeutic agents and radiotherapy may cause release of 5HT in the small intestine initiating a vomiting reflex by activating vagal afferents via 5HT3&nbsp;receptors. Ondansetron blocks the initiation of this reflex. Activation of vagal afferents may also cause a release of 5HT in the area postrema, located on the floor of the fourth ventricle, and this may also promote emesis through a central mechanism. Thus, the effect of ondansetron in the management of the nausea and vomiting induced by cytotoxic chemotherapy and radiotherapy is probably due to antagonism of 5HT3&nbsp;receptors on neurons located both in the peripheral and central nervous system. The mechanisms of action in post-operative nausea and vomiting are not known but there may be common pathways with cytotoxic induced nausea and vomiting.</p>', '<p>Chemotherapy-Induced Nausea and Vomiting-<br />\r\nAdults, Pediatric patients (6 months to 18 years):</p>\r\n\r\n<ul>\r\n	<li><strong>8 mg tablet/orodispersible tablet</strong>: Three 0.15 mg/kg doses, up to a maximum of 16 mg per dose.</li>\r\n	<li><strong>4 mg orodispersible tablet</strong>: Three 0.15 mg/kg doses, up to a maximum of 16 mg per dose.</li>\r\n	<li><strong>Injection</strong>: Three 0.15 mg/kg doses, up to a maximum of 16 mg per dose, infused intravenously over 15 minutes.</li>\r\n</ul>\r\n\r\n<p>Radiotherapy-Induced Nausea and Vomiting-<br />\r\nAdults:</p>\r\n\r\n<ul>\r\n	<li><strong>8 mg tablet/orodispersible tablet</strong>: Initial Dose: 8 mg orally 1 to 2 hours before radiotherapy. Post Radiotherapy: 8 mg orally every 8 hours for up to 5 days after a course of treatment.</li>\r\n	<li><strong>4 mg orodispersible tablet</strong>: Three 0.15 mg/kg doses, up to a maximum of 16 mg per dose.</li>\r\n	<li><strong>Injection</strong>: Three 0.15 mg/kg doses, up to a maximum of 16 mg per dose, infused intravenously over 15 minutes.</li>\r\n</ul>\r\n\r\n<p>Postoperative Nausea and Vomiting-<br />\r\nAdults:</p>\r\n\r\n<ul>\r\n	<li><strong>8 mg tablet/orodispersible tablet</strong>: 16 mg given as two 8 mg tablets</li>\r\n	<li><strong>4 mg orodispersible tablet</strong>: 16 mg</li>\r\n	<li><strong>Injection</strong>: 4 mg</li>\r\n</ul>\r\n\r\n<p>Pediatrics (&gt;40 kg): Injection: 4 mg<br />\r\nPediatrics (40 kg): Injection: 0.1 mg/kg<br />\r\n<br />\r\n<strong>Oral Soluble Film:</strong><br />\r\nPrevention of nausea and vomiting associated with highly emetogenic cancer chemotherapy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult oral dose</strong>: 24 mg given successively as three 8 mg films 30 minutes before the start of chemotherapy.</li>\r\n</ul>\r\n\r\n<p>Prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and pediatric patients 12 years of age and older</strong>: One 8 mg film 30 minutes before chemotherapy followed by an 8 mg dose 8 hours later. Administer one 8 mg film twice a day (every 12 hours) for 1 to 2 days after completion of chemotherapy.</li>\r\n	<li><strong>Pediatric patients 4 through 11 years of age</strong>: One 4 mg film three times a day. Administer the first dose 30 minutes before chemotherapy, with subsequent doses 4 and 8 hours later. Administer one 4 mg film three times a day (every 8 hours) for 1 to 2 days after completion of chemotherapy.</li>\r\n	<li><strong>Prevention of nausea and vomiting associated with radiotherapy</strong>: The adult dosage is one 8 mg film three times a day.</li>\r\n	<li><strong>Postoperative nausea and vomiting</strong>: The adult dose is 16 mg given successively as two 8 mg films 1 hour before anesthesia.</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>Administration of Oral Soluble Film:</p>\r\n\r\n<ul>\r\n	<li>Step 1:&nbsp;Tear the pouch carefully along with the edge tear mark.</li>\r\n	<li>Step 2:&nbsp;Put the Ondansetron&nbsp;film on top of your tongue. It will dissolve within 20 seconds</li>\r\n	<li>Step 3:&nbsp;Do not chew or swallow the film whole.</li>\r\n	<li>Step 4:&nbsp;Swallow after the Onsaf oral soluble film dissolves. You may swallow the dissolved film with or without liquid.</li>\r\n	<li>Step 5:&nbsp;Wash your hands after taking Onsaf oral soluble film</li>\r\n</ul>', '<p>The potential for clinically significant drug interactions with Ondansetron appears to be low.</p>', '<p>Contraindicated in patients known to have hypersensitivity to the drug or any of its components. Concomitant use of apomorphine.</p>', '<p>The most common adverse reactions in chemotherapy-induced nausea and vomiting (incidence 7%) are diarrhea, headache and fever. The most common adverse reactions in postoperative nausea and vomiting in adults is headache (incidence 10%), and in pediatric patients aged 1 to 24 months is diarrhea (incidence 2%).</p>', '<p>Pregnancy Category B. Ondansetron is excreted in the breast milk of rats. It is not known whether ondansetron is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when ondansetron is administered to a nursing woman.</p>', '<p>Hypersensitivity reactions, including anaphylaxis and bronchospasm, have been reported with or without known hypersensitivity to other selective 5-HT3 receptor antagonists. QT prolongation occurs in a dose-dependent manner.</p>', NULL, NULL, '<p>Store at temperature not exceeding 30&ordm;C in a dry place. Protect from light and moisture.</p>', '<p><strong>Geriatric Use</strong>: Dosage adjustment is not needed in patients over the age of 65.<br />\r\n<strong>Hepatic Impairment</strong>: A total daily dose of 8mg should not be exceeded (patients with severe hepatic impairment).<br />\r\n<strong>Renal Impairment</strong>: No dosage adjustment is recommended.</p>', '2022-03-11 05:16:25', '2022-03-11 05:16:25'),
(1086, 1086, '<p>Ondansetron is indicated for the prevention and treatment of post-operative nausea and vomiting, and for the management of nausea and vomiting induced by cytotoxic chemotherapy and radiotherapy.</p>', '<p><strong>Pharmacokinetics</strong>:</p>\r\n\r\n<ul>\r\n	<li>Ondansetron is well absorbed from the gastrointestinal tract and undergoes some first-pass metabolism. Mean bioavailability in healthy subjects is approximately 56% and bioavailability is also slightly enhanced by the presence of food and at higher doses but unaffected by antacids.</li>\r\n	<li>Ondansetron is distributed with volume of distribution of 1.9-2.6 L/Kg, indicating that much of the drug is taken up by body tissues. Circulating drug also distributes into erythrocytes. Plasma protein binding is 70% and crosses membranes readily.</li>\r\n	<li>Biotransformation pathways involve the primary metabolic pathway is hydroxylation on the indole ring followed by subsequent glucuronide or sulfate conjugation.</li>\r\n	<li>Ondansetron is excreted in the urine (approximately 65%) and feces (35%) after extensive hepatic metabolism. The plasma half-life is 3.5 hours.</li>\r\n</ul>\r\n\r\n<p><strong>Pharmacodinetics</strong>: Ondansetron is a potent, highly selective 5HT3 receptor-antagonist. Its precise mode of action in the control of nausea and vomiting is not known. Chemotherapeutic agents and radiotherapy may cause release of 5HT in the small intestine initiating a vomiting reflex by activating vagal afferents via 5HT3 receptors. Ondansetron blocks the initiation of this reflex. Activation of vagal afferents may also cause a release of 5HT in the area postrema, located on the floor of the fourth ventricle, and this may also promote emesis through a central mechanism. Thus, the effect of ondansetron in the management of the nausea and vomiting induced by cytotoxic chemotherapy and radiotherapy is probably due to antagonism of 5HT3 receptors on neurons located both in the peripheral and central nervous system. The mechanisms of action in post-operative nausea and vomiting are not known but there may be common pathways with cytotoxic induced nausea and vomiting.</p>', '<p>Chemotherapy-induced Nausea and Vomiting-</p>\r\n\r\n<p>Adults/Geriatric/Child of 12 years or over:</p>\r\n\r\n<ul>\r\n	<li><strong>Highly emetogenic cancer chemotherapy</strong>: 30 ml (24 mg) Ondansetron Oral Solution administered 30 minutes before start of emetogenic chemotherapy.</li>\r\n	<li><strong>Moderate emetogenic cancer chemotherapy</strong>: 10 ml (8 mg) Ondansetron Oral Solution administered 30 minutes before start of emetogenic chemotherapy. A further 10 ml dose should be administered after 8 hours of the first dose. One 10 ml dose should be administered twice a day (every 12 hours) for 1-2 days after completion of chemotherapy.</li>\r\n</ul>\r\n\r\n<p>Pediatric (4-11 years): 5 ml (4 mg) Ondansetron Oral Solution should be taken 30 minutes before the start of chemotherapy. The other 2 doses should be taken 4 and 8 hours after the first dose. Then 5 ml oral solution should be administered 3 times a day (every 8 hours) for 1-2 days after completion of chemotherapy.</p>\r\n\r\n<p><br />\r\nRadiotherapy induced Nausea and Vomiting-</p>\r\n\r\n<p>Adults/Geriatric/Child of 12 years or over:</p>\r\n\r\n<ul>\r\n	<li><strong>The recommended oral dosage</strong>: 10 ml (8 mg) Ondansetron Oral Solution 3 times daily.</li>\r\n	<li><strong>For total body irradiation</strong>: 10 ml (8-mg) Ondansetron Oral Solution should be administered 1 to 2 hours before each fraction of radiotherapy administered each day.</li>\r\n	<li><strong>For single high-dose fraction radiotherapy to the abdomen</strong>: one 10 ml Ondansetron Oral Solution should be administered 1 to 2 hours before radiotherapy, with subsequent doses every 8 hours after the first dose for 1 to 2 days after completion of radiotherapy.</li>\r\n	<li><strong>For daily fractionated radiotherapy to the abdomen</strong>: 10 ml (8-mg) Ondansetron Oral Solution should be administered 1 to 2 hours before radiotherapy, with subsequent doses every 8 hours after the first dose for each day radiotherapy is given.</li>\r\n</ul>\r\n\r\n<p><br />\r\nPostoperative Nausea and Vomiting-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults/Geriatric/Child of 12 years or over</strong>: 20 ml (16 mg) Ondansetron Oral Solution 1 hour before induction of anesthesia</li>\r\n</ul>', '<p>Ondansetron does not itself appear to induce or inhibit the cytochrome P-450 drug-metabolizing enzyme system of the liver. Because Ondansetron is metabolized by hepatic cytochrome P-450 drug-metabolizing enzymes, inducers or inhibitors of these enzymes may change the clearance and hence, the half-life of Ondansetron. On the basis of available data, no dosage adjustment of Ondasetron is recommended for patients on these drugs.</p>', '<p>Ondansetron oral solution is contraindicated for patients known to have hypersensitivity to the drug.</p>', '<p>Frequently reported adverse events were headache, constipation and diarrhea, but the majority have been mild or moderate in nature. In chemotherapy-induced nausea and vomiting, rash has occurred in approximately 1% of patients receiving Ondansetron. There also have been reports to a sensation of flushing or warmth, hiccups and liver enzyme abnormalities. Rare cases of anaphylaxis, brochospasm, tachycardia, angina (chest pain), hypokalemia, shortness of breath have also been reported, except for bronchospasm and anaphylaxis, the relationship to Ondansetron&nbsp;is unclear. There have been no evidence to extrapyramidal reactions, in rare case oculogyric crisis appearing alone, as well as with other dystonic reactions without definitive clinical evidence. In case of PONV, with the exception of headache, rates of these events were not significantly different in the Ondansetron and placebo groups.</p>', '<p>Carcinogenic effects were not seen in 2-year studies in rats and mice with oral Ondansetron doses up to 10 and 30 mg/kg per day, respectively. Ondansetron was not mutagenic in standard tests for mutagenicity. Oral administration of Ondansetron up to 15 mg/kg per day did not affect fertility or general reproduction performance of male and female rats.<br />\r\n<br />\r\nReproduction studies have been performed in pregnant rats and rabbits at daily oral doses up to 15 and 30 mg/kg per day, respectively, and have revealed no evidence of impaired fertility or harm to the fetus due to Ondansetron. There are, however, no adequate and well-controlled studies in pregnant women. Ondansetron is excreted in the breast milk of rats. So caution should be exercised when Ondansetron is administered to a nursing women.</p>', '<p>Hypersensitivity reactions have been reported in patients who have exhibited hypersensitivity to other selective 5-HT3 receptor antagonists. Ondansetron is not a drug that stimulates gastric or intestinal peristalsis. It should not be used instead of nasogastric suction. The use of Ondansetron in patients following abdominal surgery or in patients with chemotherapy-induced nausea and vomiting may mask a progressive ileus and/or gastric distension.</p>', '<p>There is no specific antidote for Ondansetron overdose. In addition to the adverse events, hypotension (and faintness) occurred in a patient that took 60 ml of Ondansetron oral solution. In all instances, the events resolved completely.</p>', '<p>Anti-emetic drugs.</p>', '<p>Store in a cool and dry place below 30&ordm;C. Protect from light. keep out of reach of children.</p>', '<p>Dosage Adjustment for Patients With Impaired Renal Function: The dosage recommendation is the same as for the general population.<br />\r\n<br />\r\nDosage Adjustment for Patients With Impaired Hepatic Function: In patients with severe hepatic impairment, a single maximal daily dose of 8 mg to be infused over 15 minutes beginning 30 minutes before the start of the emetogenic chemotherapy is recommended.<br />\r\n<br />\r\nLittle information is available about dosage in pediatric patients 4 years of age or younger.<br />\r\n<br />\r\nDosage adjustment is not needed in patients over the age of 65.</p>', '2022-03-11 05:18:31', '2022-03-11 05:18:31'),
(1087, 1087, '<p>Oral Cholera Vaccine is indicated for active immunization against Vibrio cholerae. The vaccine can be administered to anyone above the age of 1 year. Data for the safety and efficacy of the vaccine in infants (less than 1 year of age) is not available. The earliest onset of protection can be expected 7-10 days after the completion of the primary series of the vaccine. Efficacy against Vibrio cholerae serogroup O139 was not demonstrated.</p>', NULL, '<p>The recommended dose of the vaccine (1.5 ml) is to be administered orally. The primary immunization schedule consists of two doses given at an interval of at least two weeks. Cholera vaccine should not be administered parenterally (intramuscular, subcutaneous or intravenously). The vaccine is only recommended for oral administration.<br />\r\n<br />\r\nMethod of administration: The vaccine is presented as a suspension. After vigorous shaking of the vial, 1.5 ml should be poured into the mouth of the recipient. The vaccine administration may be optionally followed by water to facilitate ingestion, if needed. The vaccine can alternatively be administered with a disposable syringe (without needle) after removing the contents from the vial and squirted into the mouth of the recipient. The vaccine should not be administered parenterally (intramuscular, subcutaneous or intravenously). The vaccine is only recommended for oral administration.</p>', NULL, '<p>Cholera vaccine should not be administered to subjects with either known hypersensitivity to any component of vaccine, or having shown signs of hypersensitivity after previous administration of the vaccine. Formaldehyde is used during the manufacturing process and trace amounts may be present in the final product. Caution should be taken in subjects with known hypersensitivity to formaldehyde. CVV V.N. 02 TM As with other vaccines, immunization with the cholera vaccine should be delayed in the presence of any acute illness, including acute gastrointestinal illness or acute febrile illness. A minor illness such as mild upper respiratory tract infection is not a reason to postpone immunization.</p>', '<p>The following adverse events are known to occur with cholera vaccine use. Acute gastroenteritis, diarrhea, fever, vomiting, abdominal pain, itching, rash, nausea, weakness, cough, vertigo, dryness of mouth, oral ulcer (rare), sore throat (rare) and yellowing of urine (rare). It has been observed that the incidence of adverse events is less after the second dose as compared to the first.</p>', '<p>No specific clinical studies have been performed to evaluate the safety and immunogenicity of cholera vaccine in pregnant women and for the fetus. However, administration of cholera vaccine to pregnant women and nursing mother may be considered after careful evaluation of the benefits and risks in case of a medical emergency or an epidemic.</p>', '<p>Vaccination should be provided by a review of the medical history (especilly with regard to previous vaccination &amp; possible occurrence of the undesirable events) and a clinical examination. As with any vaccine immunization with the cholera vaccine may not protect 100% susceptible individuals. This vaccine is also not a substitute for therapy in case of individuals suspected to be suffering from cholera or showing signs and symptoms of an acute episode of gastro intestinal disease or acute watery diarrhea. Immunocompromised persons (subsequent to a disease or immunosuppressive therapy) may not obtain the expected immune response after vaccination with the cholera vaccine. If possible, in the opinion of the medical practitioner, due consideration should be given to postpone vaccination until after the completion of the immunosuppressive treatment. As with all vaccines, appropriate medical treatment should always be available in case of a rare event of anaphylactic reactions following the administration of the vaccine. For this reason, it is recommended that the vaccinee should remain under medical supervision for at least 30 minutes after vaccination.</p>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', '<p>Keep out of the reach and sight of children. Store at +2 &ordm;C to +8 &ordm;C. Transportation should also be at +2 &ordm;C to +8 &ordm;C. Do not freeze. Discard vaccine if frozen. Protect from light.</p>', NULL, '2022-03-11 05:20:10', '2022-03-11 05:20:10'),
(1088, 1088, '<p>Polio&nbsp;vaccines are vaccines used to prevent poliomyelitis (polio)</p>', '<p>Parenteral inactivated poliovirus vaccine(IPV) chiefly induces formation of serum antibody. Infection, with oral poliovirus vaccine (OPV) or wild poliovirus, also induces development of secretory IgA antibody. In addition, infection results in virus shedding and, hence, in possible spread of virus to contacts (more likelywith wild than with vaccine virus). IPV induces a high level (90%&ndash;95%) of protection against disease, which presumably is mediated by serum antibody that prevents CNS invasion resulting from viremia. IPV induces little protection against infection but does modify the related virus shedding- chiefly that from the oropharynx. Infection, whether by OPV or wild virus, induces a high level of protection against disease. It also results in appreciable prevention or modification of infection because of the developmentof secretoryIgA antibody. This effect is directly protective for the vaccinee and also benefits the community, since the exposed vaccinee can play little or no part in the spread of wild virus. One major question remaining concerns the maintenance of immunity. Lifelong immunologic memory assures an enhanced serum antibody response to any infection that occurs, but will it be sufficiently rapid that when preinfection antibody cannot be detected newly formed antibody will block blood-borne viral invasion of the CNS? If not, booster doses of vaccineare indicated. OPV boosters might be indicated in any case to reinforce protection against infection and so maintain herd immunity.</p>', '<p>3 doses course, each dose (2-3 drops) given orally at an interval of 6-8 weeks.</p>', NULL, '<p>Diarrhoea; Hypogammaglobulinemia. Febrile illness or any active infection is present.</p>', '<p>Paralysis (very rarely reported).</p>', '<p>Data not available</p>', NULL, NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', NULL, NULL, '2022-03-11 05:21:57', '2022-03-11 05:21:57'),
(1089, 1089, '<p>Indicated for Diarrhea, Dehydration, Vomiting, Fluid and Electrolytes imbalance.</p>', '<p><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.<br />\r\n<br />\r\nIt is also used as diluents for infusion of compatible drug additives.<br />\r\n<br />\r\n<strong>Dextrose</strong>&nbsp;is a monosaccharide that is used as a source of calories and water for hydration. It helps to reduce loss of body protein and nitrogen. It also promotes glycogen deposition in the liver. When used with insulin, it stimulates the uptake of potassium by cells, especially in muscle tissue, thus lowering serum potassium levels.<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.</p>', '<p>Daily dose should be equivalent to patients fluid requirement for maintenance and replenishment of losses. During saline therapy mother should not stop breast-feeding to their child and normal food should be continued in case of adults.<br />\r\n<br />\r\n<strong>Children less than 2 years:</strong>&nbsp;After each loose stool or vomiting 10 to 20 spoonful (50-100 ml) of prepared saline.<br />\r\n<br />\r\n<strong>Children 2 to 10 years:</strong>&nbsp;After each loose stool or vomiting 100-200 ml of prepared oral saline.<br />\r\n<br />\r\n<strong>Adult and children above 10 years:</strong>&nbsp;After each loose stool or vomiting 200-400 ml of prepared saline.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Patients with known hypersensitivity.</p>', '<p>No significant side effects.</p>', '<p>Pregnancy Category- Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Depressed renal function, severe continuing diarrhoea or other critical fluid losses may need supplementation with parenteral fluids along with oral saline. Reconstitue saline should be used within 6 hours.</p>', NULL, '<p>Oral electrolytes preparations</p>', NULL, NULL, '2022-03-11 05:47:45', '2022-03-11 05:47:45'),
(1090, 1090, '<p>Oral Rehydration Salt replacement of fluid and electrolyte loss due to-</p>\r\n\r\n<ul>\r\n	<li>Acute diarrhea</li>\r\n	<li>Vomiting</li>\r\n	<li>Dehydration</li>\r\n</ul>\r\n\r\n<p>Other conditions of fluid loss or lack of intake in patients of all age groups.</p>', '<p>This is the preparation of oral rehydration salt. It is composed of anhydrous glucose, sodium chloride, potassium chloride and sodium citrate (as dihydrate). This is a single formulation of glucose based oral rehydration salt to treat or prevent dehydration from diarrhea of any etiology, including cholera and in individuals of any age. This also prevents acidosis due to electrolyte imbalance.</p>', '<p>Daily dose should be equivalent to patients&#39; fluid requirement for maintenance and replenishment of losses. During this therapy, mother should not stop breastfeeding to their child and normal food should be continued in case of adults.<br />\r\n<br />\r\n<strong>Children less than 2 years</strong>: After each loose stool or vomiting 50-100 mL (10 to 20 teaspoonful) of prepared this.<br />\r\n<br />\r\n<strong>Children 2 to 10 years</strong>: After each loose stool or vomiting 100-200 mL (1/2 to 1 glass) of prepared oral saline.<br />\r\n<br />\r\n<strong>Adult and children above 10 years</strong>: After each loose stool or vomiting 200-400 mL (1 to 2 glass) of prepared this.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Disperse the full contents of the sachet in 500 mL (1/2 liter) of pure drinking water.</li>\r\n	<li>Do not mix the oral saline with hot water or heat the prepared solution.</li>\r\n	<li>Discard the unused prepared oral saline after 12 hours of preparation.</li>\r\n</ul>', '<p>There are no known drug interactions and none well documented.</p>', NULL, NULL, NULL, '<p>Depressed renal function, severe continuing diarrhea or other critical fluid losses may need supplementation with parenteral fluids along with oral saline.</p>', NULL, '<p>Oral electrolytes preparations</p>', '<p>Do not store above 30&deg;C temperature. Keep away from light and wet places. Keep out of reach of children.</p>', NULL, '2022-03-11 05:49:12', '2022-03-11 05:49:12'),
(1091, 1091, '<p>This saline is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Acute fluid and electrolyte loss conditions such as cholera, acute diarrhea &amp; vomiting</li>\r\n	<li>Dehydration</li>\r\n	<li>Severely low concentrations of salts in the blood (severe electrolyte depletion)</li>\r\n</ul>', '<p>This saline contains essential electrolytes &amp; carbohydrate (in the form of processed rice) which are vital for a dehydrating patient in conditions such as cholera, acute diarrhoea, vomiting &amp; excessive sweating.<br />\r\n<br />\r\nIn the normal healthy intestine, there is a continuous exchange of water through the intestinal wall- up to 20 liters of water is secreted and very nearly as much is reabsorbed every 24 hours- this mechanism allows the absorption of soluble metabolites from digested food into the bloodstream.<br />\r\n<br />\r\nIn a state of diarrheal disease, the balance is upset and much more water is secreted than is reabsorbed causing a net loss to the body which can be as high as several liters a day. In addition to water, Chloride ion (CI-), extracellular sodium ion (Na+) &amp; intracellular potassium ion (K+) are also lost. This saline is effectively replenishes the lost electrolytes in the body.<br />\r\n<br />\r\nThe pharmacokinetics and therapeutic values of the substances of this saline are as follows:</p>\r\n\r\n<ul>\r\n	<li>Glucose (comes from rice) facilitates the absorption of sodium (and hence water) on a 1:1 molar basis in the small intestine</li>\r\n	<li>Sodium and potassium are needed to replace the body losses of these essential ions during diarrhoea and vomiting</li>\r\n	<li>Citrate corrects the acidosis that occurs as a result of diarrhoea and dehydration</li>\r\n</ul>\r\n\r\n<p>Rice, a carbohydrate is converted to glucose through digestion. Glucose is then absorbed through intestinal wall with salt. Addition of rice (instead of pure glucose) to this formula reduces the osmolarity of the solution,thus preventing additional loss of fluid through stools.</p>', '<p>The dose depends on the severity of the dehydrating conditions of the patients. Recommended dose after each watery stool are as follows:</p>\r\n\r\n<ul>\r\n	<li><strong>6 months to 2 years</strong>: 50 ml to 100 ml (10 to 20 Teaspoonfuls)</li>\r\n	<li><strong>2 years to 9 years</strong>: 100 ml to 200 ml (20 to 40 teaspoonfuls)</li>\r\n	<li><strong>10 years and above</strong>: 250 ml to 500 ml (1 to 2 glassfuls)</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Discard any unused reconstituted saline after 5 hours of preparation</li>\r\n	<li>After preparing the saline further heating or boiling is not necessary</li>\r\n	<li>Feeding-bottle should not be used</li>\r\n	<li>Mix the solution with a clean spoon each time before administration</li>\r\n	<li>Syringe without needle may be used to put a small amount of saline into babies&#39; mouth</li>\r\n</ul>', '<p>There is no known drug interaction reported.</p>', '<ul>\r\n	<li>Kidney failure resulting in diminished production of urine (oliguria)</li>\r\n	<li>Kidney failure, preventing the production of urine (anuria)</li>\r\n	<li>Obstruction of the stomach or intestines</li>\r\n	<li>Reduced blood flow to vital internal organs (shock)</li>\r\n	<li>Severe and continuous vomiting (intractable vomiting)</li>\r\n	<li>Severe dehydration</li>\r\n	<li>Severe diarrhea in infants.</li>\r\n</ul>', NULL, '<p>Recommended in pregnancy &amp; lactation, as there is no known harmful effects when this medicine is used.</p>', '<p>Precautions should be taken in case of significant overdose, especially for the following patients-</p>\r\n\r\n<ul>\r\n	<li>Children less than 1 year of age.</li>\r\n	<li>Patients with imbalance of salt concentrations in the blood (electrolyte imbalance).</li>\r\n	<li>Patients with severely decreased kidney and liver function.</li>\r\n</ul>', NULL, '<p>Oral electrolytes preparations.</p>', '<p>Store in a cool &amp; dry place, protected from light &amp; moisture.</p>', NULL, '2022-03-11 05:50:47', '2022-03-11 05:50:47'),
(1092, 1092, '<p><strong>Adults</strong>: Orlistat is indicated in conjunction with a mildly hypocaloric diet for the treatment of obese patients with a body mass index (BMI)&gt;30 kg/m2&nbsp;and overweight patients (BMI &gt;28 kg/m2&nbsp;) with associated risk factors such as type II diabetes, hyperlipidemia and hypertension. Treatment with Orlistat should be discontinued after 12 weeks in patients who have not lost at least 5% of their body weight as measured at the start of drug therapy.<br />\r\n<br />\r\n<strong>Adolescents (12 years &amp; older)</strong>: Obese adolescents should be treated with Orlistat only if an adequate reduction of body weight cannot be achieved by means of diet &amp; increased physical activity. Treatment with orlistat should be considered in particular if complications of obesity are present.</p>', '<p>Orlistat is a potent, specific and long-acting lipase inhibitor. It exerts its therapeutic activity in the lumen of the stomach and upper small intestine by forming a covalent bond with the active serine site of gastric and pancreatic lipases. The inactivated enzyme is thus rendered unable to hydrolyze dietary fats in the form of triglycerides into absorbable free fatty acids and monoglycerides. As undigested triglycerides can not be absorbed, a caloric deficit arises which has a positive effect on weight control. Systemic absorption of orlistat is therefore not needed for the activity. At the recommended therapeutic dose of 120 mg three times a day, orlistat inhibit dietary fat absorption by approximately 30%.</p>', '<p>The recommended dose of Orlistat is one 120 mg capsule to be taken immediately before, during or up to one hour after each main meal. If a meal is missed or contains no fat the dose of Orlistat should be omitted. Doses of Orlistat above 120 mg three times daily have not been shown to provide additional benefits. The effect of Orlistat results in an increase in fecal fat 24-48 hours after dosing. Upon discontinuation of therapy, fecal fat content usually returns to pretreatment levels within 48-72 hours.<br />\r\n<br />\r\nThe safety &amp; efficacy of Orlistat were investigated in clinical studies lasting up to 4 years. The recommended dose of Orlistat for adolescents is as same as adults.<br />\r\n<br />\r\nSpecial dosage instruction: The tolerability and efficacy of Orlistat have not been studied in elderly patients, or patients with hepatic and/ or renal impairments.</p>', '<p>No interactions with commonly prescribed medications such as alcohol, digoxin, nifedipine, oral contraceptives, phenytoin, pravastatin, warfarin, or metformin, glibenclamide, fibrates, furosemide, captopril, or atenolol have been observed in studies.</p>', '<p>Orlistat is contraindicated in patients with chronic malabsorption syndrome, in patients with cholestasis and in patients who are hypersensitive to orlistat or to any of the other ingredients of the capsules.</p>', '<p><strong>Common</strong>: Undesirable effects of Orlistat are largely gastrointestinal in nature. Common gastrointestinal side effects are oily spotting from the rectum, flatulence, fecal urgency, oily or fatty stool, abdominal discomfort etc.<br />\r\n<br />\r\n<strong>Rare</strong>: Influenza, anxiety. headache, fatigue etc may rarely occur in some patients. Rare cases of hypersensitivity have been reported. Main clinical symptoms are pruritus, exanthema, urticaria, angioedema and anaphylaxis.</p>', '<p>Use in pregnancy &amp; lactation: No clinical data are available on pregnancy exposed to Orlistat. As it is not known whether Orlistat is excreted in breast milk. Orlistat should not be used during breastfeeding.</p>', '<p>Organic causes of obesity (e.g. hypothyroidism) should be excluded before prescribing Orlistat. Orlistat and cyclosporine should not be coadministered. Cyclosporine should be taken at least 2 hours before or after Orlistat in patients taking both drugs. Cyclosporine level should be measured and frequently monitored.<br />\r\n<br />\r\nIn clinical trial, the decrease in body weight with Orlistat therapy was less in type II diabetic patients than in non-diabetic patients. Antidiabetic drug treatment should be closely monitored during Orlistat therapy. Because of the improvement in glycemic control, the dose of oral antidiabetics or of insulin may need to be adjusted.<br />\r\n<br />\r\nPatients should be advised to adhere to the dietary recommendations. The probability of occurrence of gastrointestinal side effects may increase when Orlistat is taken with a fatty meal. The daily intake of fat should be distributed between three main meals. Patients should be strongly encouraged to take a multivitamin supplement that contains fat soluble vitamins to ensure adequate nutrition because orlistat has been shown to reduce the absorption of some fat soluble vitamins &amp; beta-carotene. In addition, the levels of vitamin D &amp; beta carotene may be low in obese patients compared with non-obese patients.</p>', '<p>Single doses of 800 mg Orlistat and multiple doses of up to 400 mg three times a day for 15 days have been studied in normal weight and obese subjects without significant adverse findings.</p>', '<p>Appetite suppressant drugs/Anti-obesity drugs</p>', '<p>Store in cool &amp; dry place below 30&deg;C, protect from light &amp; moisture. Keep out of reach of children.</p>', NULL, '2022-03-11 05:53:15', '2022-03-11 05:53:15'),
(1093, 1093, '<p>Ornidazole is indicated for Amoebiasis (Intestinal and hepatic), Giardiasis, Trichomoniasis, Bacterial vaginosis, Treatment of susceptible anaerobic infections.</p>', '<p>Ornidazole is a 5-nitroimidazole derivative active against protozoa and anaerobic bacteria. It is converted to reduction products that interact with DNA to cause destruction of helical DNA structure and strand leading to a protein synthesis inhibition and cell death in susceptible organisms.</p>', '<p>Amoebiasis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 500 mg twice a day for 5 days.</li>\r\n	<li><strong>Children</strong>: 10-25 mg per kg body weight in two divided doses.</li>\r\n</ul>\r\n\r\n<p>Amoebic dysentery:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 1.5 gm once a day for 3 days.</li>\r\n	<li><strong>Children</strong>: 40 mg per kg body weight, once a day for 3 days.</li>\r\n</ul>\r\n\r\n<p>Giardiasis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 1.5 gm once daily for 1-2 days.</li>\r\n	<li><strong>Children</strong>: 40 mg per kg body weight for 2 days.</li>\r\n</ul>\r\n\r\n<p><strong>Trichomoniasis</strong>: 1.5 gm once or 500 mg twice a day for 5 days. Sexual partner should also be treated at the same time.<br />\r\n<br />\r\n<strong>Bacterial vaginosis</strong>: 3 tablets of 500 mg each as a single dose or one tablet of 500 mg once daily for 5-7 days.</p>', '<p>Like other imidazoles, Ornidazole has a mild potential to cause disulfiramlike reactions. Concomitant administration of oral anticoagulants may increase the risk of haemorrhage due to diminished hepatic metabolism. Ornidazole has been reported to decrease the clearance of 5-fluorouracil.</p>', '<p>Previous hypersensitivity to Ornidazole and to other nitroimidazoles. Ornidazole is contraindicated in central nervous system disorders, particularly in epilepsy or in peripheral neuropathy.</p>', '<p>Side effects of Ornidazole have been mainly limited to the gastrointestinal tract (nausea, vomiting, epigastric pain) and central nervous system (dizziness, headache, lassitude). Unlike other nitroimidazoles, Ornidazole does not interact with alcohol, although this requires further study.<br />\r\n<br />\r\nLeukopenia has been described occasionally during therapy. Adverse central nervous system (CNS) effects of Ornidazole have mainly included headache, dizziness, lassitude or somnolence, fatigue and weakness. Adverse CNS effects of Ornidazole may be less than that happens with metronidazole. Seizures have not been reported with Ornidazole in studies available to date.</p>', '<p>Adequate clinical trials have not been conducted. Ornidazole should be prescribed only if the potential benefit justifies the potential risk to fetus/neonate.</p>', '<p>In patient with ataxia, vertigo, and mental confusion, Ornidazole should be prescribed with caution. During prolonged treatment with Ornidazole, blood dyscrasia namely mild leukopenia have been reported rarely. In case leukopenia occurs, the decision to discontinue the therapy should depend upon the gravity of infection.</p>', NULL, '<p>Amoebicides, Anti-diarrhoeal Antiprotozoal.</p>', '<p>Store at room temperature and protect from light and moisture.</p>', '<p><strong>Renal Impairment</strong>&nbsp;Haemodialysis patients: Give a supplemental dose (50% of the usual dose) before dialysis.<br />\r\n<br />\r\n<strong>Hepatic Impairment Severe</strong>: Double the interval between doses.</p>', '2022-03-11 05:55:11', '2022-03-11 05:55:11'),
(1094, 1094, '<p>Oseltamivir is indicated for prevention of flu (influenza) in adults and adolescents aged 13 years and over who have been in contact with someone diagnosed with flu; treatment of flu (influenza) in adults and in children over one year of age when the influenza virus is circulating in the community.</p>', '<p>Oseltamivir is a prodrug of oseltamivir carboxylate. Oseltamivir carboxylate inhibits neuraminidase (sialidase), a viral surface enzyme which is responsible for the replication and infectivity of influenza virus A and B, thereby preventing the release of viruses from infected cells.</p>', '<p>Oseltamivir Phosphate may be taken with or without food. However, when taken with food, tolerability may be enhanced in some patients.<br />\r\n<br />\r\nStandard oral dose for the treatment of influenza:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and Adolescents</strong>: The recommended oral dose of Oseltamivir for treatment of influenza in adults and adolescents 13 years and older is 75 mg twice daily for 5 days. Treatment should begin within 2 days of onset of symptoms of influenza.</li>\r\n	<li><strong>Pediatric patients</strong>: The safety and efficacy of Oseltamivir for prophylaxis of influenza in pediatric patients younger than 13 years of age have not been established.</li>\r\n</ul>\r\n\r\n<p>Recommended oral dose for the treatment of influenza:</p>\r\n\r\n<ul>\r\n	<li><strong>For prophylaxis of influenza in adults and adolescents 13 years and older following close contact with an infected individual</strong>: 75 mg once daily for at least 7 days. Therapy&nbsp;should begin within 2 days of exposure.</li>\r\n	<li><strong>For prophylaxis during a community outbreak of influenza</strong>: 75 mg once daily. Safety and efficacy have been demonstrated for up to 6 weeks. The duration of protection lasts for as long as dosing is continued.</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. May be taken with meals to reduce GI discomfort. Cap may be opened &amp; mixed with sweetened food products eg chocolate syr, sweetened condensed milk, apple sauce or yogurt. Swallow mixture immediately after preparation.</p>', '<p>Information derived from pharmacology and pharmacokinetic studies of Oseltamivir suggests that clinically significant drug interactions are unlikely. Co-administration with amoxicillin does not alter plasma levels of either compound.</p>', '<p>Oseltamivir is contraindicated in patients with known hypersensitivity to any of the components of the product.</p>', '<p>The most frequently reported adverse events are nausea and vomiting. These events generally of mild to moderate degree and usually are occurred on the first 2 days of administration. Additional adverse events occurring in &lt;1% of patients receiving Oseltamivir for treatment include unstable angina, anemia, pseudomembranous colitis, humerus fracture, pneumonia, pyrexia, and peritonsillar abscess.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C: There are insufficient human data upon which to base an evaluation of risk of Oseltamivir Phosphate to the pregnant woman or developing fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers:</strong>&nbsp;It is not known whether oseltamivir or oseltamivir carboxylate is excreted in human milk. Oseltamivir Phosphate should, therefore, be used only if the potential benefit for the lactating mother justifies the potential risk to the breast-fed infant.</p>', '<p>There is no evidence for efficacy of Oseltamivir Phosphate in any illness caused by agents other than influenza viruses Types A and B. Efficacy of Oseltamivir Phosphate in patients who begin treatment after 40 hours of symptoms has not been established.</p>', '<p>At present there has been no experience of over dose. Single dose of up to 1000 mg of Oseltamivir have been associated with nausea and/or vomiting.</p>', '<p>Respiratory viral infections (Influenza).</p>', '<p>Store at 25&deg;C. Reconstituted susp: Store between 2-8&deg;C for up to 17 days or at 25&deg;C for up to 10 days. Do not freeze.</p>', '<p><strong>Hepatic Impairment:</strong>&nbsp;The safety and pharmacokinetics in patients with hepatic impairment have not been evaluated.<br />\r\n<br />\r\n<strong>Renal Impairment:</strong>&nbsp;Dose adjustment is recommended for patients with a serum creatinine clearance &lt;30 mL/min.<br />\r\n<br />\r\n<strong>Geriatric Use:</strong>&nbsp;The safety of Oseltamivir Phosphate has been established in clinical studies.<br />\r\n<br />\r\n<strong>Pediatric Use:</strong>&nbsp;The safety and efficacy of Oseltamivir Phosphate in pediatric patients younger than 1 year of age have not been studied. Oseltamivir Phosphate is not indicated for either treatment or prophylaxis of influenza in pediatric patients younger than 1 year of age.</p>', '2022-03-11 05:57:13', '2022-03-11 05:57:13');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1095, 1095, '<p>Osimertinib is indicated for the treatment of patients with metastatic&nbsp;epidermal growth factor receptor&nbsp;(EGFR) T790M mutation-positive&nbsp;non-small cell lung cancer&nbsp;(NSCLC), as detected by an FDA-approved test, whose disease has progressed on or after EGFR tyrosine kinase inhibitor (TKI) therapy.</p>', '<p>Osimertinib is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that binds to certain mutant forms of EGFR (T790M, L858R, and exon 19 deletion) that predominate in non-small cell lung cancer (NSCLC) tumours following treatment with first-line EGFR-TKIs. As a third-generation tyrosine kinase inhibitor, osimertinib is specific for the gate-keeper T790M mutation which increases ATP binding activity to EGFR and results in poor prognosis for late-stage disease. Furthermore, osimertinib has been shown to spare wild-type EGFR during therapy, thereby reducing non-specific binding and limiting toxicity.</p>', '<p>The recommended dose of Osimertinib is 80 mg once a day until disease progression or unacceptable toxicity. Osimertinib can be taken with or without food. If a dose of Osimertinib is missed, do not make up the missed dose and take the next dose as scheduled.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p><strong>Administration To Patients Who Have Difficulty Swallowing Solids:&nbsp;</strong>Disperse tablet in 60 ml (2 ounces) of non-carbonated water only. Stir until tablet is dispersed into small pieces (the tablet will not completely dissolve) and swallow immediately. Do not crush, heat, or ultrasonicate during preparation. Rinse the container with 120 ml to 240 ml (4 to 8 ounces of) water and immediately drink.<br />\r\n<br />\r\nIf administration via&nbsp;nasogastric tube&nbsp;is required, disperse the tablet as above in 15 ml of non-carbonated water, and then use an additional 15 ml of water to transfer any residues to the syringe. The resulting 30 ml liquid should be administered as per the nasogastric tube instructions with appropriate water flushes (approximately 30 ml).</p>', '<p><strong>Strong CYP3A4 Inducers</strong>: If concurrent use is unavoidable, increase Osimertinib dosage to 160 mg daily when coadministering with a strong CYP3A inducer. Resume Osimertinib at 80 mg 3 weeks after discontinuation of the strong CYP3A4 inducer.</p>', NULL, '<p>Common side effects are&nbsp;Interstitial Lung Disease or Pneumonitis,&nbsp;QTc Interval Prolongation, Cardiomyopathy, Keratitis</p>', '<p><strong>Use in Pregnancy</strong>:&nbsp;There are no or limited amount of data from the use of Osimertinib in pregnant women. Studies in animals have shown reproductive toxicity. Based on its mechanism of action and preclinical data, Osimertinib may cause foetal harm when administered to a pregnant woman. Administration of osimertinib to pregnant rats was associated with embryolethality, reduced foetal growth and neonatal death at exposures similar to what is expected in humans. Osimertinib is not recommended during pregnancy and in women of childbearing potential not using contraception.<br />\r\n<br />\r\n<strong>Use in Lactation</strong>:&nbsp;It is not known whether osimertinib or its metabolites are excreted in human milk. Administration to rats during gestation and early lactation was associated with adverse effects, including reduced growth rates and neonatal death. There is insufficient information on the excretion of osimertinib or its metabolites in animal milk. A risk to the suckling child cannot be excluded. Breast-feeding should discontinue during treatment with Osimertinib.<br />\r\n<br />\r\n<strong>Fertility</strong>:&nbsp;There are no data on the effect of Osimertinib on human fertility. Results from animal studies have shown that Osimertinib has effects on male and female reproductive organs and could impair fertility.</p>', NULL, NULL, '<p>Cytotoxic Chemotherapy.</p>', '<p>Store Osimertinib at room temperature between 20&deg;C to 25&deg;C. Safely throw away medicine that is out of date or that you no longer need. Keep Osimertinib and all medicines out of the reach of children.</p>', NULL, '2022-03-11 05:58:50', '2022-03-11 05:58:50'),
(1096, 1096, '<p>Ospemifene is indicated for:</p>\r\n\r\n<ul>\r\n	<li>The Treatment of Moderate to Severe Dyspareunia, a Symptom of Vulvar and Vaginal Atrophy, Due to Menopause.</li>\r\n	<li>The Treatment of Moderate to Severe Vaginal Dryness, a Symptom of Vulvar and Vaginal Atrophy, Due to Menopause.</li>\r\n</ul>', '<p>Ospemifene is an estrogen receptor agonist/antagonist with tissue selective effects. Its biological actions are mediated through binding to estrogen receptors. This binding results in activation of estrogenic pathways in some tissues (agonism) and blockade of estrogenic pathways in others (antagonism).</p>', '<p>Ospemifene is an estrogen agonist/antagonist which has agonistic effects on the endometrium. Use of Ospemifene should be for the shortest duration consistent with treatment goals and risks for the individual woman. Postmenopausal women should be re-evaluated periodically as clinically appropriate to determine if treatment is still necessary.</p>\r\n\r\n<ul>\r\n	<li>Treatment of Moderate to Severe Dyspareunia, a Symptom of Vulvar and Vaginal Atrophy, Due to Menopause: Take one 60 mg tablet with food once daily.</li>\r\n	<li>Treatment of Moderate to Severe Vaginal Dryness, a Symptom of Vulvar and Vaginal Atrophy, Due to Menopause: Take one 60 mg tablet with food once daily.</li>\r\n</ul>', '<ul>\r\n	<li>Do not use estrogens or estrogen agonist/antagonist concomitantly with Ospemifene.</li>\r\n	<li>Do not use fluconazole concomitantly with Ospemifene. Fluconazole increases serum concentrations of Ospemifene.</li>\r\n	<li>Do not use rifampin concomitantly with Ospemifene. Rifampin decreases serum concentration of Ospemifene.</li>\r\n</ul>', '<p>Ospemifene is contraindicated in women with any of the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Undiagnosed abnormal genital bleeding</li>\r\n	<li>Known or suspected estrogen-dependent neoplasia</li>\r\n	<li>Active DVT, pulmonary embolism (PE), or a history of these conditions</li>\r\n	<li>Active arterial thromboembolic disease [for example, stroke and myocardial infarction (MI)], or a history of these conditions</li>\r\n	<li>Hypersensitivity (for example, angioedema, urticaria, rash, pruritus) to Ospemifene or any ingredients</li>\r\n	<li>Ospemifene is contraindicated in women who are or may become pregnant. Ospemifene may cause fetal harm when administered to a pregnant woman. Ospemifene was embryo-fetal lethal with labor difficulties and increased pup deaths in rats at doses below clinical exposures, and embryo-fetal lethal in rabbits at 10 times the clinical exposure based on mg/m 2 . If this drug is used during pregnancy, or if a woman becomes pregnant while taking this drug, she should be apprised of the potential hazard to a fetus.</li>\r\n</ul>', '<p>Adverse reactions (&ge;1 percent) include hot flush, vaginal discharge, muscle spasms, headache, hyperhidrosis, vaginal hemorrhage, night sweats.</p>', '<p><strong>Pregnancy</strong>: Ospemifene is contraindicated in women who are or may become pregnant. If this drug is used during pregnancy, or if a woman becomes pregnant while taking this drug, she should be apprised of the potential hazard to a fetus. Based on animal data, Ospemifene is likely to increase the risk of adverse outcomes during pregnancy and labor. Adverse findings at maternally toxic doses included embryofetal lethality in rats and rabbits, and neonatal mortality and difficult labor in rats. The reproductive effects observed are consistent with and are considered to be related to the estrogen receptor activity of Ospemifene.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether Ospemifene is excreted in human breast milk. There are no data on the effects of Ospemifene on the breastfed child or the effects on milk production. Do not breastfeed while taking Ospemifene. Ospemifene was excreted in rat milk</p>', '<ul>\r\n	<li>Venous Thromboembolism: Risk of DVT and pulmonary embolism</li>\r\n	<li>Known, suspected, or history of breast cancer</li>\r\n	<li>Severe Hepatic Impairment</li>\r\n</ul>', NULL, '<p>Drugs used in Vaginal and Vulval condition.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: Ospemifene is not indicated in children. Clinical studies have not been conducted in the pediatric population.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Of the 2209 Ospemifene-treated women enrolled in the ten phase 2/3 trials of Ospemifene, &gt;19 percent were 65 years of age or older. No clinically meaningful differences in safety or effectiveness were observed between these women and younger women less than 65 years of age.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: The pharmacokinetics of ospemifene in women with severe renal impairment (CrCL &lt;30 mL/min) was similar to those in women with normal renal function. No dose adjustment of Ospemifene is required in women with renal impairment.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: The pharmacokinetics of ospemifene has not been studied in women with severe hepatic impairment (Child-Pugh Class C); therefore, do not use Ospemifene in women with severe hepatic impairment.</p>', '2022-03-11 06:00:35', '2022-03-11 06:00:35'),
(1097, 1097, '<p>Oxaliplatin, used in combination with infusional 5-fluorouracil/leucovorin, is indicated for:</p>\r\n\r\n<ul>\r\n	<li>Adjuvant treatment of stage III colon cancer in patients who have undergone complete&nbsp;resection&nbsp;of the primary tumor.</li>\r\n	<li>Treatment of advanced&nbsp;colorectal cancer.</li>\r\n</ul>', '<p>Oxaliplatin, a platinum-containing complex similar to cisplatin, is an alkylating agent. After intracellular hydrolysis, the platinum compound binds to DNA forming cross-links which inhibit DNA replication and transcription, resulting in cell death.</p>', '<p>Intravenous (Adult)-<br />\r\n<br />\r\n<strong>Adjuvant therapy in stage III colon cancer:</strong>&nbsp;In combination with fluorouracil/ leucovorin: 85 mg/m2&nbsp;every 2 wk for 12 cycles. Dose to be given by IV infusion over 2-6 hr, dissolved in 250-500 ml of glucose 5%, every 2 wk; given for 12 cycles. After recovery from toxicity, reduce dose to 75 mg/m2. Administer before fluoropyrimidines.<br />\r\n<br />\r\n<strong>Advanced colorectal cancer: In combination with fluorouracil/ leucovorin:</strong>&nbsp;85 mg/m2&nbsp;every 2 wk until disease progression or unacceptable toxicity. Dose to be given by IV infusion over 2-6 hr, dissolved in 250-500 ml of glucose 5%, . After recovery from toxicity, reduce dose to 65 mg/m2. Administer before fluoropyrimidines.</p>', '<p>May decrease plasma levels of digoxin. May increase risk of toxicity with nephrotoxic drugs. When administered as sequential infusions, taxane derivatives (docetaxel, paclitaxel) should be administered before oxaliplatin to limit myelosuppression and enhance efficacy.</p>', '<p>Pregnancy. Peripheral neuropathy with functional impairment. Severe renal impairment.</p>', '<p>Fatigue, fever, pain, headache, insomnia, nausea, diarrheoa, vomiting, abdominal pain, constipation, anorexia, stomatitis, anemia, thrombocytopenia, leukopenia, aspartate and alanine transaminases increased, total bilirubin increased, peripheral neuropathy, back pain, dyspnoea, cough, oedema, chest pain, peripheral oedema, flushing , thromboembolism, dizziness, rash, alopecia , hand-foot syndrome dehydration, hypokalaemia, dyspepsia, taste perversion, flatulence, mucositis, gastroesophageal reflux, dysphagia, dysuria, neutropenia, inj site reaction, rigors, arthralgia, abnormal lacrimation, serum creatinine increased, rhinitis, epistaxis, pharyngitis, pharyngolaryngeal dysesthesia, allergic reactions, hiccup.</p>', '<p><strong>Category D:</strong>&nbsp;There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Should be administered under the supervision of an experienced cancer chemotherapy physician. Use appropriate precautions for handling and disposal. Monitor neurological status and dose should be reduced if symptoms are prolonged or severe. Monitor blood counts during treatment and courses should not be repeated until blood counts have recovered. Caution in elderly, moderate degrees of renal impairment. Avoid using aluminum-containing needles or IV admin sets that may come into contact with oxaliplatin as aluminum has been reported to cause degradation of platinum compounds. Lactation.</p>', '<p>Extensions of known adverse reaction (e.g. thrombocytopenia, myelosuppression, nausea, vomiting, neurotoxicity, respiratory symptoms). Treatment is supportive.</p>', '<p>Cytotoxic Chemotherapy.</p>', '<p>Store intact vials at 15-30&deg;C; do not freeze. Reconstituted solution: May store at 2-8&deg;C for up to 24 hr. Diluted solutions: Stable up to 6 hr at 20-25&deg;C or up to 24 hr under refrigeration at 2-8&deg;C.</p>', '<p><strong>Renal Impairment:</strong>&nbsp;Dose adjustment may be needed.</p>', '2022-03-11 06:02:40', '2022-03-11 06:02:40'),
(1098, 1098, '<p>Oxaprozin is indicated:</p>\r\n\r\n<ul>\r\n	<li>For relief of the signs and symptoms of osteoarthritis</li>\r\n	<li>For relief of the signs and symptoms of rheumatoid arthritis</li>\r\n	<li>For relief of the signs and symptoms of juvenile rheumatoid arthritis</li>\r\n</ul>', '<p>Oxaprozin, the&nbsp;potassium&nbsp;salt of oxaprozin, is a nonsteroidal anti-inflammatory drug (NSAID), which dissociates into the active moiety oxaprozin&nbsp;in vivo. Oxaprozin has&nbsp;analgesic, anti-inflammatory, and&nbsp;antipyretic&nbsp;properties.<br />\r\n<br />\r\nThe mechanism of action of Oxaprozin, like that of other NSAIDs, is not completely understood but involves inhibition of&nbsp;cyclooxygenase&nbsp;(COX-1&nbsp;and&nbsp;COX-2).<br />\r\n<br />\r\nOxaprozin is a potent inhibitor of&nbsp;prostaglandin&nbsp;synthesis&nbsp;in vitro. Oxaprozin concentrations reached during therapy have produced&nbsp;in vivo&nbsp;effects. Prostaglandins sensitize afferent nerves and potentiate the action of bradykinin in inducing pain in animal models. Prostaglandins are mediators of inflammation. Because oxaprozin potassium is an inhibitor of prostaglandin synthesis, its mode of action may be due to a decrease of prostaglandins in peripheral tissues.</p>', '<p><strong>General Dosing Instructions</strong>: Carefully consider the potential benefits and risks of&nbsp;Oxaprozin and other treatment options before deciding to use Oxaprozin. Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. After observing the response to initial therapy with Oxaprozin, the dose and frequency should be adjusted to suit an individual patient&rsquo;s needs.<br />\r\n<br />\r\nDivided doses may be tried in patients unable to tolerate single doses. For osteoarthritis patients of low body weight or with milder disease, an initial dose of one 600 mg tablet once a day may be appropriate. The maximum total daily dose is 1200 mg.<br />\r\n<br />\r\n<strong>Osteoarthritis</strong>: For Osteoarthritis, the dosage is 1200 mg (two 600 mg tablets) given orally once a day.<br />\r\n<br />\r\n<strong>Rheumatoid Arthritis</strong>: For Rheumatoid Arthritis, the dosage is 1200 mg (two 600 mg tablets) given orally once a day.</p>', '<p>Increased risk of salicylate toxicity with aspirin. May increase effects of oral anticoagulants. May reduce effects of &beta;-blockers, diuretics and other antihypertensive agents. May increase risk of methotrexate and lithium toxicity.</p>', '<p>Previous or active peptic ulceration, known hypersensitivity to NSAIDs. Perioperative pain in CABG setting.</p>', '<p>Common side effects are depression, sedation, somnolence, confusion, disturbance of sleep, weakness, malaise; rash, prutitus, urticaria, photosensitivity; abdominal pain/distress, anorexia, flatulence, vomiting, constipation, diarrhoea, dyspepsia, nausea, peptic ulcer and/or GI bleeding, abnormalities in LFTs, stomatitis, haemorrhoidal or rectal bleeding; tinnitus; dysuria or frequency; oedema, BP changes; haematuria, renal insufficiency, decreased menstrual flow; anaemia, thrombocytopenia, leukopenia, ecchymoses; wt gain/loss; blurred vision, conjunctivitis.<br />\r\n<br />\r\nThe following adverse reactions may occur:</p>\r\n\r\n<ul>\r\n	<li>Cardiovascular&nbsp;Thrombotic Events&nbsp;</li>\r\n	<li>GI&nbsp;Bleeding,&nbsp;Ulceration&nbsp;and Perforation&nbsp;</li>\r\n	<li>Hepatotoxicity&nbsp;</li>\r\n	<li>Hypertension&nbsp;</li>\r\n	<li>Heart Failure&nbsp;and Edema&nbsp;</li>\r\n	<li>Renal Toxicity and&nbsp;Hyperkalemia</li>\r\n	<li>Anaphylactic Reactions</li>\r\n	<li>Serious Skin Reactions&nbsp;</li>\r\n	<li>Hematologic Toxicity&nbsp;</li>\r\n</ul>', '<p>Pregnancy categaory: C, D (in 3rd trimester or near delivery).</p>', '<p>Be alert for ulceration and bleeding in patients treated chronically. History of serious GI events, alcoholism, smoking, other factors known to be associated with peptic ulcer. Elderly or debilitated patients. Uncompensated cardiac failure, history of hypertension, cardiac decompensation, chronic diuretic therapy, conditions predisposing to fluid retention. Renal and hepatic impairment. Underlying coagulation defects or patients who are undergoing surgical procedures where a high degree of haemostasis is required. Pregnancy (avoid in 3rd trimester) and lactation.</p>', '<p><strong>Symptoms:</strong>&nbsp;Acute renal failure, vomiting, drowsiness, leukocytosis.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Supportive and symptomatic. Multiple admin of charcoal may be required to reduce potential for delayed toxicities.</p>', '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs).</p>', '<p>Store at 25&deg; C. Protect from light.</p>', '<p>Renal Impairment-<br />\r\n<br />\r\n<strong>Osteoarthritis:</strong>&nbsp;Severe or on dialysis: 600 mg once daily. Increase to 1.2 g daily if needed.<br />\r\n<strong>Rheumatoid arthritis:</strong>&nbsp;Severe or on dialysis: 600 mg once daily. Increase to 1.2 g daily if needed.</p>', '2022-03-11 06:04:56', '2022-03-11 06:04:56'),
(1099, 1099, '<p>Oxazepam is used in the treatment of anxiety disorders, including anxiety associated with depression. This drug seems to be particularly effective for anxiety, tension, agitation and irritability in older people. It is also prescribed to relieve symptoms of acute alcohol withdrawal.</p>', '<p>Oxazepam belongs to a class of drugs called &quot;Benzodiazepine&quot; which act on the brain and nerves (central nervous system) to produce a calming effect. It works by enhancing the effect of a natural chemical in the brain (GABA).</p>', '<p><strong>Adult</strong>:</p>\r\n\r\n<ul>\r\n	<li>Mild to Moderate Anxiety with Tension, Irritability and Agitation: The usual dose is 10 to 15 milligrams 3 or 4 times per day.</li>\r\n	<li>Severe Anxiety, Depression with Anxiety, or Alcohol Withdrawal: The usual dose is 15 to 30 milligrams, 3 or 4 times per day.</li>\r\n</ul>\r\n\r\n<p><strong>Children</strong>:</p>\r\n\r\n<ul>\r\n	<li>Safety and effectiveness have not been established for children less than 6 years of age,</li>\r\n	<li>Nor have dosage guidelines been established for children 6 to 12 years. The doctor will adjust the dosage to fit the child&#39;s needs.</li>\r\n</ul>\r\n\r\n<p><strong>Older adults</strong>: The usual starting dose is 10 milligrams, 3 times a day. The doctor may increase the dose to 15 milligrams 3 or 4 times a day if needed.</p>', '<p>Oxazepam may intensify the effects of alcohol. It may be best to avoid alcohol while taking this medication. If Oxazepam is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with a doctor before combining Oxazepam with the following: Antihistamines such as Diphenhydramine Narcotic painkillers such as Oxycodone and Pethidine Sedatives such as Secobarbital and Triazolam Tranquilizers such as Diazepam and Alprazolam.</p>', '<p>The drug is contraindicated in individuals who have an allergic reaction to Oxazepam or other benzodiazepines such as diazepam. Oxazepam should not be prescribed if any patient is being treated for mental disorders which are more serious than anxiety.</p>', '<p>Side effects cannot be anticipated. If any develop or change in intensity, doctor should be informed immediately. Doctor will determine if it is safe for a patient to continue taking Oxazepam. More common side effect includes drowsiness. Less common or rare side effects include: Blood disorders, change in libido, dizziness, excitement, fainting, headache, liver problems, loss or lack of muscle control, nausea, skin rashes or eruptions, sluggishness or unresponsiveness, slurred speech, swelling due to fluid retention, tremors, vertigo, yellowed eyes and skin. Side effects due to rapid decrease or abrupt withdrawal from Oxazepam: Abdominal and muscle cramps, convulsions, depressed mood, inability to fall or stay asleep, sweating, tremors, vomiting.</p>', '<p>This medication is not recommended for use during pregnancy due to the potential possible fetal harm. Based on information from related drugs, this drug may pass into breast milk and may have undesirable effects on a nursing infant. Therefore, breastfeeding while using this medication is not recommended.</p>', '<p>This drug may make dizzy, drowsy or cause blurred vision; caution should be taken while engaging in activities requiring alertness such as driving or using machinery. The limit should be maintained while taking alcoholic beverages. Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug, especially the drowsiness effect.</p>', NULL, '<p>Tricyclic Anti-depressant</p>', '<p>Store in a cool and dry place, protected from light and moisture. Keep out of reach of children.</p>', NULL, '2022-03-11 06:06:49', '2022-03-11 06:06:49'),
(1100, 1100, '<p>Oxcarbazepine is indicated for:<br />\r\n<br />\r\n<strong>Adults</strong>: Monotherapy or adjunctive therapy in the treatment of partial seizures<br />\r\n<br />\r\n<strong>Pediatrics</strong>:</p>\r\n\r\n<ul>\r\n	<li>Monotherapy in the treatment of partial seizures in children 4-16 years</li>\r\n	<li>Adjunctive therapy in the treatment of partial seizures in children 2&ndash;16 years</li>\r\n</ul>', '<p>The pharmacological activity of Oxcarbazepine is primarily exerted through the metabolite derivative (the monohydroxy derivative, MHD) of Oxcarbazepine. The mechanism of action of Oxcarbazepine and MHD is thought to be mainly based on blockade of voltage-sensitive sodium channels, thus resulting in stabilization of hyper excited neural membranes, inhibition of repetitive neuronal firing and diminishment of propagation of synaptic impulses.</p>', '<p><strong>Adults</strong>: initiate with a dose of 600 mg/day, given twice-a-day</p>\r\n\r\n<ul>\r\n	<li><strong>Adjunctive Therapy</strong>: Maximum increment of 600 mg/day at approximately weekly intervals. The recommended daily dose is 1200 mg/day</li>\r\n	<li><strong>Conversion to Monotherapy</strong>: withdrawal concomitant over 3 to 6 weeks;reach maximum dose of Oxcarbazepine in 2 to 4 weeks with increments of 600 mg/day at weekly intervals to a recommended daily dose of 2400 mg/day</li>\r\n	<li><strong>Initiation of Monotherapy</strong>: Increments of 300 mg/day every third day to a dose of 1200 mg/day.</li>\r\n	<li><strong>Creatinine Clearance &lt;30 mL/min</strong>: Initiate at one half the usual starting dose and increase slowly</li>\r\n</ul>\r\n\r\n<p><strong>Pediatrics</strong>: initiation with 8 to 10 mg/kg/day, given twice-a-day. For patients aged 2 to &lt;4 years and under 20 kg, a starting dose of 16 to 20 mg/kg/day may be considered. Recommended daily dose is dependent upon patient weight.</p>\r\n\r\n<ul>\r\n	<li><strong>Adjunctive Patients (Aged 2&ndash;16 Years)</strong>: For patients aged 4 to 16 years, target maintenance dose should be achieved over 2 weeks. For patients aged 2 to &lt;4 years, maximum maintenance dose should be achieved over 2 to 4 weeks and should not to exceed 60 mg/kg/day</li>\r\n	<li><strong>Conversion to Monotherapy for Patients (Aged 4-16 Years)</strong>: Maximum increment of 10 mg/kg/day at weekly intervals, concomitant antiepileptic drugs can be completely withdrawn over 3 to 6 weeks</li>\r\n	<li><strong>Initiation of Monotherapy for Patients (Aged 4&ndash;16 Years)</strong>: Increments of 5 mg/kg/day every third day</li>\r\n</ul>', '<p>Oxcarbazepine and its metabolite inhibit the enzyme CYP2C19 and therefore, interactions could arise when co-administering high doses of Oxazep with medicinal products that are metabolised by CYP2C19 (e.g. phenobarbital, phenytoin). Concurrent use of Oxazep with hormonal contraceptives may render few contraceptives ineffective (e.g. Ethinylestradiol and Levonorgestrel preparations). Co-administration of Oxazep lowers AUC of felodipine and Verapamil decreases bioavailability of MHD.</p>', '<p>It is contraindicated to patients with hypersensitivity to the active substance or to any of the excipients.</p>', '<p>The most commonly reported adverse reactions are somnolence, headache, dizziness, diplopia, nausea; vomiting and fatigue. Very rarely clinically significant hyponatraemia can develop during Oxazep use. Class I (immediate) hypersensitivity reactions including rash, pruritus, urticaria, angioedema and reports of anaphylaxis have been received.</p>', '<p><strong>Pregnancy</strong>: Data on a limited number of pregnancies indicate that Oxcarbazepine may cause serious birth defects (e.g. cleft palate) when administered during pregnancy. In the newborn child. Bleeding disorders in the newborn caused by antiepileptic agents have been reported. As a precaution, vitamin K1 should be administered as a preventive measure in the last few weeks of pregnancy and to the newborn. Oxcarbazepine and its active metabolite (MHD) cross the placenta. Neonatal and maternal plasma MHD concentrations were similar in one case.<br />\r\n<br />\r\n<strong>Lactation</strong>: Oxcarbazepine and its active metabolite (MHD) are excreted in human breast milk. Therefore, Oxazep should not be used during breast-feeding.</p>', '<p><strong>Alcohol</strong>: Caution should be exercised if alcohol is taken in combination with Oxazep therapy, due to a possible additive sedative effect.<br />\r\n<br />\r\n<strong>Withdrawal</strong>: As with all antiepileptic medicinal products, Oxazep should be withdrawn gradually to minimise the potential of increased seizure frequency.</p>', NULL, '<p>Adjunct anti-epileptic drugs</p>', NULL, NULL, '2022-03-11 06:14:23', '2022-03-11 06:14:23'),
(1101, 1101, '<p>Oxiconazole topical preparation is indicated for the topical treatment of the following dermal infections: tinea pedis, tinea cruris, and tinea corporis due to Trichophyton rubrum, Trichophyton mentagrophytes, or Epidermophyton floccosum. Oxiconazole Cream is indicated for the topical treatment of tinea (pityriasis) versicolor due to Malassezia furfur.</p>', '<p>This topical preparation contains the antifungal active compound Oxiconazole Nitrate. For topical dermatological use only. Oxiconazole Nitrate is an imidazole derivative whose antifungal activity is derived primarily from the inhibition of ergosterol biosynthesis, which is critical for cellular membrane integrity. It has in vitro activity against a wide range of pathogenic fungi. Oxiconazole has been shown to be active against most strains of the following organisms both in vitro and in clinical infections at indicated body sites: Epidermophyton floccosum, Trichophyton mentagrophytes, Trichophyton rubrum, Malassezia furfur. Oxiconazole exhibits satisfactory in vitro minimum inhibitory concentrations (MICs) against most strains of the following organisms: Microsporum audouini, Microsporum canis, Microsporum gypseum, Trichophyton tonsurans,Trichophyton violaceum.</p>', '<p>This topical preparation should be applied to affected and immediately surrounding areas once to twice daily in patients with tinea pedis, tinea corporis, or tinea cruris. Oxiconazole Cream should be applied once daily in the treatment of tinea (pityriasis) versicolor. Tinea corporis, tinea cruris, and tinea (pityriasis) versicolor should be treated for 2 weeks and tinea pedis for 1 month to reduce the possibility of recurrence.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Use Oxiconazole topical preparation as directed by the physician. The hands should be washed after applying the medication to the affected area(s). Avoid contact with the eyes, nose, mouth, and other mucous membranes. Oxiconazole cream isfor external use only.</li>\r\n	<li>Use the medication for the full treatment time recommended by the physician, even though symptoms may have improved. Notify the physician if there is no improvement after 2 to 4 weeks orsooner if the condition worsens.</li>\r\n	<li>Inform the physician if the area of application shows signs of increased irritation, itching, burning, blistering, swelling, or oozing.</li>\r\n	<li>Avoid the use of occlusive dressings unless otherwise directed by the physician.</li>\r\n	<li>Do not use this medication for any disorder other than that for which it was prescribed</li>\r\n</ul>', '<p>Potential drug interactions between Oxiconazole and other drugs have not been systematically evaluated.</p>', '<p>Oxiconazole topical preparation is contraindicated in individuals who have shown previous hypersensitivity to Oxiconazole.</p>', '<p>Pruritus, burning, irritation and allergic contact dermatitis, folliculitis, erythema, and papules, fissure, maceration, rash, stinging and nodules.</p>', '<p>Pregnancy category B. Because Oxiconazole Nitrate is excreted in human milk, caution should be exercised when the drug is administered to a nursing woman.</p>', '<p>Oxiconazole topical preparation is not for ophthalmic or intravaginal use.</p>', NULL, '<p>Topical Antifungal preparations.</p>', '<p>Store in a cool and dry place,protected from light. Do not freeze.</p>', NULL, '2022-03-11 06:16:30', '2022-03-11 06:16:30'),
(1102, 1102, '<p>Used to temporarily numb the front surface of the eye so that the eye pressure can be measured or a foreign body removed.</p>', '<p>Oxybuprocaine is a local anaesthetic. It may be less irritating than tetracaine, and the onset and duration of action are similar to tetracaine. Oxybuprocaine binds to sodium channel and reversibly stabilizes the neuronal membrane which decreases its permeability to sodium ions. Depolarization of the neuronal membrane is inhibited thereby blocking the initiation and conduction of nerve impulses.</p>', '<p>Use as a 0.4% solution in short ophthalmic procedures. Instil 1 drop into the conjunctival sac to allow tonometry after 60 sec; a further drop after a 90 sec interval produces sufficiReduce systemic absorption by compressing the lacrimal sac at the medial canthus for a minute during and following instillation. Heart block; epilepsy, impaired cardiac conduction, myasthenia gravis; not to be applied to inflamed, infected tissues or damaged mucosa. Protect anaesthetised eye from dust and bacterial contamination; cornea may be damaged by prolonged application. Do not drive until normal vision restored.ent anaesthesia for the fitting of contact lenses; 3 drops at 90 sec intervals produces sufficient anaesthesia after 5 min for a foreign body to be removed from the corneal epithelium or for incision of a meibomian cyst through the conjunctiva.</p>', NULL, NULL, '<p>Hypersensitivity reactions; transient stinging and blurring of vision; excitation of CNS; muscle twitching and tremors; convulsions.</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>Reduce systemic absorption by compressing the lacrimal sac at the medial canthus for a minute during and following instillation. Heart block; epilepsy, impaired cardiac conduction, myasthenia gravis; not to be applied to inflamed, infected tissues or damaged mucosa. Protect anaesthetised eye from dust and bacterial contamination; cornea may be damaged by prolonged application. Do not drive until normal vision restored.</p>', NULL, '<p>Ocular perioperative drugs.</p>', NULL, NULL, '2022-03-11 06:17:52', '2022-03-11 06:17:52'),
(1103, 1103, '<p>Oxybutynin Chloride is a muscarinic antagonist indicated for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency. Oxybutynin Chloride Extended Release Tablets are also indicated for the treatment of pediatric patients aged 6 years and older with symptoms of detrusor overactivity associated with a neurological condition (e.g., spina bifida).</p>', '<p>Oxybutynin exerts direct antispasmodic effect on the smooth muscle by inhibiting the muscarinic action of acetylcholine. It exhibits moderate anticholinergic effect, but has potent antispasmodic effects on urinary smooth muscle.</p>', '<p>The recommended starting dose of Uricon is 5 mg once daily, with or without food. Dosage may be adjusted in 5 mg increments to achieve a balance of efficacy and tolerability (up to a maximum of 30 mg/day). In general, dosage adjustment may proceed at approximately weekly intervals.</p>\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.</p>', '<p>Anticholinergic agents, cytochrome P450 enzyme inhibitors, such as antimycotic agents (e.g., Ketoconazole, Itraconazole, and Miconazole) or macrolide antibiotics (e.g., erythromycin and clarithromycin), have not been performed. No specific drug-drug interaction studies have been performed with Oxybutynin.</p>', '<p>Oxybutynin Chloride is contraindicated in patients with urinary retention, gastric retention, or uncontrolled narrow angle glaucoma and in patients who are at risk for these conditions. It is also contraindicated in patients who have demonstrated hypersensitivity to the drug substance or other components of the product.</p>', '<p>The incidence of dry mouth may occur which is dose-related. Abdominal pain, dry nasal and sinus mucous membranes, back pain, hypertension, palpitation, vasodilatation, flatulence, gastro-esophageal reflux, insomnia, nervousness, confusion, cough, sinusitis, bronchitis, dry skin, rash, impaired urination (hesitancy), urinary retention, etc. may be reported.</p>', '<p>Oxybutynin Chloride should not be given to pregnant women unless, the probable clinical benefits outweigh the possible hazards, caution should be exercised when it is administered to a nursing woman.</p>', '<p>Oxybutynin Chloride should be used with caution in patients with hepatic or renal impairment, clinically significant bladder outflow obstruction because of the risk of urinary retention, gastrointestinal obstructive disorders because of the risk of gastric retention, conditions such as ulcerative colitis, intestinal atony, and myasthenia gravis, gastro-esophageal reflux and/or who are concurrently taking drugs (such as bisphosphonates) that can cause or exacerbate esophagitis.</p>', '<p>Anticholinergic effects including CNS excitation (e.g. restlessness, tremor, irritability, convulsions, delirium, hallucinations), flushing, fever, dehydration, cardiac arrhythmia, vomiting, and urinary retention may occur after overdose. Treatment should be symptomatic and supportive. Activated charcoal may be administered.</p>', '<p>Anticholinergics (antimuscarinics)/ Anti-spasmodics.</p>', '<p>Store at 15-30&deg; C.</p>', NULL, '2022-03-11 06:19:40', '2022-03-11 06:19:40'),
(1104, 1104, '<p>Oxygen therapy, also known as&nbsp;supplemental oxygen, is the use of&nbsp;oxygen&nbsp;as a&nbsp;medical treatment. This can include for&nbsp;low blood oxygen,&nbsp;carbon monoxide toxicity,&nbsp;cluster headaches, and to maintain enough oxygen while&nbsp;inhaled anesthetics&nbsp;are given. Long term oxygen is often useful in people with chronically low oxygen such as from severe&nbsp;COPD&nbsp;or&nbsp;cystic fibrosis. Oxygen can be given in a number of ways including&nbsp;nasal cannula,&nbsp;face mask, and inside a&nbsp;hyperbaric chamber.</p>', '<p>Oxygen is required for normal cell metabolism. Excessively high concentrations can cause oxygen toxicity such as lung damage or result in respiratory failure in those who are predisposed. Higher oxygen concentrations also increase the risk of fires, particularly while smoking, and without humidification can also dry out the nose. The target oxygen saturation recommended depends on the condition being treated. In most conditions a saturation of 94-98% is recommended, while in those at risk of carbon dioxide retention saturations of 88-92% are preferred, and in those with carbon monoxide toxicity or cardiac arrest they should be as high as possible. Air is typically 21% oxygen by volume while oxygen therapy increases this by some amount up to 100%.<br />\r\n<br />\r\nThe use of oxygen in medicine become common around 1917. It is on the&nbsp;World Health Organization&#39;s List of Essential Medicines, the most effective and safe medicines needed in a&nbsp;health system.</p>', '<p><strong>Adult</strong>: Use as required<br />\r\n<strong>Child</strong>: Safety and efficacy has not been established</p>', NULL, '<p>Hypersensitivity</p>', NULL, NULL, NULL, NULL, '<p>Other preparations</p>', '<p>Oxygen should be kept as compressed gas or liquid at cryogenic temperature, in appropriate containers complying with the safety regulations of the national authority. Valves or taps should not be lubricated with oil or grease.</p>', NULL, '2022-03-11 06:20:48', '2022-03-11 06:20:48'),
(1105, 1105, '<p>Oxymetazoline Hydrochloride cream is indicated for the topical treatment of persistent facial erythema associated with rosacea in adults.</p>', '<p>Oxymetazoline is an alpha1A adrenoceptor&nbsp;agonist. Oxymetazoline acts as a vasoconstrictor.</p>', '<p>For topical use only, it is not for oral, ophthalmic or intravaginal use. Apply a little amount of the cream, once daily in a thin layer to cover the entire face (forehead, nose, each cheek and chin) avoiding eyes and lips. Wash hands immediately after applying the cream.</p>', NULL, NULL, '<p>Most common side effects are application site dermatitis, worsening inflammatory lesions of rosacea, application site pruritis, application site erythema and application site pain.</p>', '<p>The safety of oxymetazoline during pregnancy and lactation has not been established, but use during this period is not considered to constitute a hazard.</p>', '<p>Alpha-adrenergic agonists may impact blood pressure. Advise patients with ardiovascular disese, orthostatic hypotension and/or uncontolled hypertension or hypotension to seek medical care if their condition worsens. Use with caution in patients with cerebral or coronary insufficiency, Raynaud&rsquo;s phenomenon, thromboangiitis obliterans, scleroderma or Sj&ouml;gren&rsquo;s syndrome and advisepatients to seek medical care if signs and symptoms of potentiation of vascular insufficiency develop. Advise patients to seek immediate medical care if signs and symptoms of acute narrow-angle glaucoma develop.</p>', '<p>Oxymetazoline&nbsp;is not for oral use. If oral ingestion occurs, seek medical advice. Monitor patient closely and administer appropriate supportive measures as necessary.</p>', '<p>Vasoconstrictor/Venotonic</p>', '<p>Do not store above 30&deg; C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-11 06:22:26', '2022-03-11 06:22:26'),
(1106, 1106, '<p>Oxymetazoline Hydrochlorid is indicated for the treatment of nasal congestion associated with acute or chronic rhinitis, common cold, sinusitis, upper respiratory allergies, epistaxis and hay fever. It is also used as nasal decongestant in otitis media.</p>', '<p>Oxymetazoline Hydrochloride is an imidazoline derivative sympathomimetic amine. It is a direct agonist at &alpha;-adrenoceptors but has no action on &beta;- adrenoceptors. It is used as a topical agent on the nasal mucosa, produces a rapid and long acting vasoconstriction of the arterioles, thus reducing the blood flow and diminishing swelling of the mucosa. This results in improved potency of the airway and better drainage of the nasal sinus.</p>', '<p>Oxymetazoline nasal spray-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children (6 years of age and older)</strong>: 2 or 3 sprays in each nostril twice daily for 3-5 days.</li>\r\n	<li><strong>Elderly</strong>: There is no need for dosage reduction in the elderly for nasal administration.</li>\r\n	<li><strong>Children below 6 years of age</strong>: It is not suitable for children below 6 years of age.</li>\r\n</ul>\r\n\r\n<p>Oxymetazoline nasal drop-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults &amp; children 6 years of age</strong>: 2-3 drops of 0.05% Nasal Drops in each nostril twice daily in the morning and evening.</li>\r\n	<li><strong>Children 2-5 years of age</strong>: 2-3 drops of 0.025% Nasal Drops in each nostril twice daily in the morning and evening</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>How to use the Nasal Spray-</p>\r\n\r\n<ul>\r\n	<li>Shake the bottle gently and remove the dust cover.</li>\r\n	<li>Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.</li>\r\n	<li>Gently blow the nose to clear the nostrils.</li>\r\n	<li>Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.</li>\r\n	<li>Breathe out through your mouth.</li>\r\n	<li>Repeat the above steps in the same/ other nostril for consecutive doses.</li>\r\n</ul>\r\n\r\n<p>Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-</p>\r\n\r\n<ul>\r\n	<li>Remove the dust cover.</li>\r\n	<li>Gently pull off the nasal applicator.</li>\r\n	<li>Wash the applicator and dust cover in warm water.</li>\r\n	<li>Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.</li>\r\n	<li>Gently push the applicator back on the top of the bottle and re-fix the dust cover.</li>\r\n</ul>', '<p>Oxymetazoline Hydrochloride Nasal preparation should not be given to patients being treated with MAO inhibitors or within 14 days of ceasing such treatment.</p>', '<p>It is contraindicated in patients with cardiovascular disease, hyperthyroidism, prostatic enlargement, angle closure glaucoma and hypersensitivity to any of its ingredients.</p>', '<p>Occasionally it may cause local irritation and dryness of the mouth and throat. Temporarily discomfort such as burning, stinging, sneezing or increase in nasal discharge may occur.</p>', '<p>The safety of Oxymetazoline Hydrochloride Nasal Spray during pregnancy and lactation has not been established, but is not thought to constitute a hazard during those periods.</p>', '<p>Keep away from the eyes. The spray should not be used for longer than seven days without medical advice. Frequent or prolonged use may cause nasal congestion to recur or worsen.</p>', '<p>Overdose may give rise to local irritation and rebound congestion. Treatment need only be symptomatic.</p>', '<p>Nasal Anti-histamine preparations, Nasal Decongestants &amp; Other Nasal Preparations.</p>', '<p>Keep below 30&deg; C temperature in a dry place, protect from light. Do not refrigerate or freeze. Keep out of the reach of children.</p>', NULL, '2022-03-11 06:24:41', '2022-03-11 06:24:41');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1107, 1107, '<p>Tablet is indicated for treatment of moderate to severe pain like chronic cancer, arthritis, postoperative &amp; low back pain.<br />\r\n<br />\r\nInjection is indicated for the relief of moderate to severe pain. It is also indicated for pre-operative &amp; post-operative medication for support of anesthesia, for obstetrical analgesia and for relief of anxiety in patients with dyspnea associated with pulmonary edema secondary to acute left ventricular dysfunction.</p>', '<p>Oxymorphone is a full opioid agonist and is relatively selective for the mu-opioid receptor, although it can bind to other opioid receptors at higher doses. The principal therapeutic action of oxymorphone is analgesia. Like all full opioid agonists, there is no ceiling effect for analgesia with oxymorphone. Clinically, dosage is titrated to provide adequate analgesia and may be limited by adverse reactions, including respiratory and CNS depression.<br />\r\n<br />\r\nThe precise mechanism of the analgesic action is unknown. However, specific CNS opioid receptors for endogenous compounds with opioid-like activity have been identified throughout the brain and spinal cord and are thought to play a role in the analgesic effects of this drug.</p>', '<p><strong>Oxymorphone Tablet</strong>: This may be used as needed in the treatment of acute post-surgical pain with a dose of 5-10 mg every 4 hours. Administer Oxymorphone Tablet on an empty stomach at least one hour prior to or two hours after eating.<br />\r\n<br />\r\n<strong>Oxymorphone Injection</strong>:</p>\r\n\r\n<ul>\r\n	<li>Subcutaneous or Intramuscular Administration: Initially 1 mg to 1.5 mg, repeated every 4 to 6 hours as needed.</li>\r\n	<li>Intravenous: 0.5 mg initially. For analgesia during labor 0.5 mg to 1 mg intramuscularly is recommended.</li>\r\n</ul>\r\n\r\n<p><strong>Conversion from Oral Oxymorphone to Oxymorphone Injection</strong>: Given the absolute oral bioavailability of approximately 10%, patients receiving oral Oxymorphone may be converted to Oxymorphone Hydrochloride injection by administering one-tenth the patient&#39;s total daily oral Oxymorphone dose as Oxymorphone Hydrochloride injectable in four or six equally divided doses (e.g., total daily oral dose/ [10X4]). For example, approximately 1 mg of Oxymorphone Hydrochloride injectable IM every 6 hours (4 mg total IM dose) may be required to provide pain relief equivalent to a total daily dose of 40 mg oral Oxymorphone. As with any opioid drug product, it is necessary to adjust the dosing regimen for each patient individually taking into account the patient&#39;s prior analgesic treatment experience.</p>', '<p>Clinical drug interaction studies with Oxymorphone showed no induction of CYP450 3A4 or 2C9 enzyme activity indicating that no dose adjustment for CYP 3A4 or 2C9 mediated drug-drug interactions is required.</p>', '<ul>\r\n	<li>Significant respiratory depression</li>\r\n	<li>Acute or severe bronchial asthma or hypercarbia</li>\r\n	<li>Known or suspected paralytic ileus</li>\r\n	<li>Moderate and severe hepatic impairment</li>\r\n	<li>Hypersensitivity (e.g. anaphylaxis) to oxymorphone</li>\r\n</ul>', '<p><strong>General Disorders</strong>: Respiratory depression, Fatigue, Asthenia.<br />\r\n<strong>Metabolism and Nutrition Disorders</strong>: Anorexia.<br />\r\n<strong>Cardiac Disorders</strong>: Tachycardia, Bradycardia, Palpitations.<br />\r\n<strong>Eye Disorders</strong>: Miosis, Diplopia, Blurred vision.<br />\r\n<strong>Gastrointestinal Disorders</strong>: Vomiting, Constipation.<br />\r\n<strong>Psychiatric Disorders</strong>: Dysphoria, Euphoric mood, Nervousness, Restlessness, Insomnia, Agitation, Hallucination, Depression.<br />\r\n<strong>Vascular Disorders</strong>: Hypotension &amp; Flushing.</p>', '<p>Pregnancy Category C. The safety of using Oxymorphone in pregnancy has not been established with regard to possible adverse effects on fetal development. The use of Oxymorphone in pregnancy, in nursing mothers, or in women of child-bearing potential requires that the possible benefits of the drug be weighed against the possible hazards to the mother and the child.</p>', '<p>Do not stop abruptly; taper gradually to stop treatment. Use caution in patients with acute pancreatitis, Addison disease, benign prostatic hyperplasia, cardiac arrhythmias, central nervous system (CNS) depression, drug abuse or dependence, emotional lability, gallbladder disease, gastrointestinal (Gl) disorder, pseudomembranous colitis, Gl surgery, head injury, hypothyroidism or untreated myxedema, intracranial hypertension, brain tumor, toxic psychosis, urethral stricture, urinary tract surgery, seizures, acute alcoholism, delirium tremens, shock, cor pulmonale, chronic pulmonary disease, emphysema, kyphoscoliosis, severe obesity, renal or hepatic impairment, elderly or debilitated patients.<br />\r\n<br />\r\nAvoid alcohol. Reduce dosage if drug is coadministered with other CNS depressants. Thrombocytopenia purpura resulting in kidney failure or death has been reported when extended-release tablets are dissolved and injected IV. May obscure diagnosis of abdominal conditions.<br />\r\n<br />\r\nRisk of opioid addiction, abuse, and misuse, which can lead to overdose and death Assess each patient&#39;s risk prior to prescribing and monitor all patients regularly for the development of these behaviors or conditions Life-threatening respiratory depression, life-threatening, or fatal respiratory depression may occur<br />\r\n<br />\r\nMonitor for respiratory depression, especially during initiation or following a dose increase</p>', '<p><strong>Signs and Symptoms</strong>: Acute overdosage with Oxymorphone is characterized by respiratory depression, extreme somnolence progressing to stupor or coma, skeletal muscle flaccidity, cold and clammy skin, constricted pupils and sometimes bradycardia and hypotension.<br />\r\n<br />\r\n<strong>Treatment</strong>: In the treatment of Oxymorphone overdosage, primary attention should be given to the re-establishment of a patient airway and institution of assisted or controlled ventilation. Supportive measures (including oxygen and vasopressors) should be employed in the management of circulatory shock and pulmonary edema accompanying overdose as indicated. The opioid antagonist naloxone hydrochloride is a specific antidote against respiratory depression that may result from overdosage or unusual sensitivity to opioids including Oxymorphone</p>', '<p>Opioid analgesics</p>', '<p>Tablet: Store in a cool and dry place, protect from light.<br />\r\nInjection: Store at 25&deg;C, protect from light.</p>', '<p><strong>Pediatric use</strong>: Safety and effectiveness of Oxymorphone Hydrochloride tablet and injection in pediatric patients below the age of 18 years have not been established.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: Oxymorphone Hydrochloride tablet and injection should be used with caution in elderly patients. These adverse events included dizziness, somnolence, confusion and nausea.</p>', '2022-03-11 06:26:51', '2022-03-11 06:26:51'),
(1108, 1108, '<p>Oxyphencyclimine is indicated for the treatment of peptic ulcer disease and the relief of smooth muscle spasms in gastrointestinal disorders.</p>', '<p>Oxyphencyclimine binds the muscarinic acetylcholine receptor. It may block all three types of muscarinic receptors including M-1 receptors in the CNS and ganglia, M-2 receptors in the heart (vagus) and M-3 receptors at the parasympathetic NEJ system. The muscarinic acetylcholine receptors mediate various cellular responses, including inhibition of adenylate cyclase, breakdown of phosphoinositides and modulation of potassium channels through the action of G proteins. Oxphencyclimine inhibits vagally mediated reflexes by antagonizing the action of acetylcholine. This in turn reduces the secretion of gastric acids in the stomach.</p>', '<p><strong>Adult</strong>: 10 mg twice daily orally.</p>', '<p>Enhanced effect with concurrent admin of other drugs with antimuscarinic properties and MAOIs. May affect absorption of other drugs. Antagonistic effect with parasympathomimetics.</p>', '<p>Closed-angle glaucoma; obstructive uropathy; GI obstruction, paralytic ileus, intestinal atony, ulcerative colitis; toxic megacolon; myasthenia gravis.</p>', '<p>Xerostomia, decreased sweating, urinary hesitancy and retention, blurred vision, cycloplegia, increased ocular tension, loss of taste, headache, nervousness, mental confusion, impotence, suppression of lactation, urticaria, constipation.</p>', '<p>Pregnancy category- Not classified.</p>', '<p>Elderly; autonomic neuropathy; hepatic or renal disease; hyperthyroidism, CHF, thyrotoxicosis, MI, tachyarrhythmias, hypertension, prostatic hypertrophy; hiatal hernia. May impair ability to drive or operate machinery. Pregnancy and lactation. Down&#39;s syndrome.</p>', '<p>Symptoms range from increased side effects to CNS disturbances, circulatory changes, respiratory failure, paralysis and coma. treat with immediate gastric lavage and injection of physostimine 0.5-2 mg up to a total of 5 mg. Treat symptomatically and supportively.</p>', '<p>Anticholinergics (antimuscarinics)/ Anti-spasmodics.</p>', NULL, NULL, '2022-03-11 06:29:19', '2022-03-11 06:29:19'),
(1109, 1109, '<p>Oxyphenonium is indicated in Gastro-intestinal spasm and hypermotility, cardiospasm, esophagospasm, gastroduodenitis, spastic constipation, pylorospasm, peptic ulcer, spasm associated with carcinoma. Pain and spasm of the biliary tract. Pain and spasm of the urinary tract.</p>', '<p>Oxyphenonium is an anticholinergic drug, a medication that reduces the effect of acetylcholine, a chemical released from nerves that stimulates muscles, by blocking the receptors for acetylcholine on smooth muscle (a type of muscle). It also has a direct relaxing effect on smooth muscle. Oxyphenonium is used to treat or prevent spasm in the muscles of the gastrointestinal tract in the irritable bowel syndrome. In addition, Oxyphenonium inhibits gastrointestinal propulsive motility and decreases gastric acid secretion and controls excessive pharyngeal, tracheal and bronchial secretions.</p>', '<p>Average adult dosage is 10 mg (2 tablets) 4 times daily for several days. Dosage may be reduced depending on patient&#39;s response or as directed by the physician.</p>', '<p>Reduced gastric motility interferes with absorption of other drugs. Effects potentiated by other antimuscarinics including amantadine, some antihistamines, phenothiazines and TCA.</p>', '<p>Glaucoma, obstructive uropathy (for example, bladder neck obstruction due to prospective hypertrophy), obstructive disease of the gastrointestinal tract (as in achalasia, paralytic ileus, pyloroduodenal stenosis, etc.), intestinal atony of the elderly or debilitated patient, unstable cardiovascular status in acute hemorrhage, severe ulcerative colitis, toxic megacolon, complicating ulcerative colitis, myasthenia gravis, hypersensitivity.</p>', '<p>Common side effects are dryness of mouth, headache, palpitations, etc.</p>', '<p>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>Children; elderly; benign prostatic hyperplasia; acute MI, cardiac failure, hypertension, thyrotoxicosis; pregnancy and lactation; fever; angle-closure glaucoma.</p>', '<p>Treatment is the same as for atropine overdosage.</p>', '<p>Anticholinergics (antimuscarinics)/ Anti-spasmodics.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-11 06:32:19', '2022-03-11 06:32:19'),
(1110, 1110, '<p>Oxytetracycline is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Respiratory tract infections</li>\r\n	<li>Mycoplasma pneumonia</li>\r\n	<li>Urinary tract infections</li>\r\n	<li>Sexually transmitted diseases: Infections due to Chlamydia trachomatis including uncom-plicated urethral, endocervical or rectal infections, non gonococcal urethritis, chancroid, granuloma inguinale, lymphogranuloma venereum, gonorrhoea, syphilis</li>\r\n	<li>Skin infections: Acne and rosacea</li>\r\n	<li>Ophthalmic infections: Trachoma</li>\r\n	<li>Rickettsial infections</li>\r\n	<li>Other infections: Psittacosis, brucellosis, cholera, acute</li>\r\n	<li>intestinal amoebiasis etc.</li>\r\n</ul>', '<p>Oxytetracycline inhibits cell growth by inhibiting translation. It binds to the 30S ribosomal subunit and prevents the amino-acyl tRNA from binding to the A site of the ribosome. The binding is reversible in nature. Oxytetracycline is lipophilic and can easily pass through the cell membrane or passively diffuses through porin channels in the bacterial membrane.</p>', '<p>Adults: 250-500 mg every 6 hours. Food, milk and some dairy products interfere with the absorption of Tetracyclines. So Tetracyclines should be given one hour before or two hours after meals.</p>', '<p>Antacids containing Aluminium, Calcium, Magnesium, Zinc or Iron salts may impair the absorption of Oxytetracycline. In long term therapy, Tetracyclines depress plasma prothrombin activity and reduced doses of concomitant anticoagulants may be necessary. A few cases of pregnancy or breakthrough bleeding have been attributed to the concurrent use of Tetracyclines or Oxytetracyclines with oral contraceptives.</p>', '<p>Oxytetracycline should not be used with patients who are hypersensitive to Tetracyclines. It should not be used in children under 12 years of age. It is contraindicated in pregnant women because of tooth staining in the fetus and possible growth retardation effects.</p>', '<p>Side effects of Oxytetracycline, which have been reported in some patients, are anorexia, nausea, vomiting, diarrhoea, glossitis, skin rashes and urticaria.</p>', '<p>Results of animal studies indicate that tetracyclines cross the placenta, are found in fetal tissues and can have toxic effects on the developing fetus. Evidence of embryotoxicity has also been noted in animals treated early in pregnancy. Tetracyclines are present in the milk of lactating women who are taking a drug in this class.</p>', '<p>Oxytetracycline should be used with caution in renal impairment.</p>', NULL, '<p>Eye Anti-Infectives &amp; Antiseptics, Tetracycline group of drugs, Topical antibiotics for Acne</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-11 06:35:20', '2022-03-11 06:35:20'),
(1111, 1111, '<p>This is indicated for the prophylaxis and local treatment of superficial ocular infections due to oxytetracycline and polymyxin-sensitive organisms, including infections due to streptococci, rickettsiae, E. coli, and A. aerogenes, such as conjunctivitis, keratitis, pink eye, corneal ulcer, blepharitis in dogs, cats, cattle, sheep, and horses; ocular infections due to secondary bacterial complications of distemper in dogs, and bacterial inflammatory conditions which may occur secondary to other infectious diseases in the above species.</p>', '<p>Oxytetracycline inhibits cell growth by inhibiting translation. It binds to the 30S ribosomal subunit and prevents the amino-acyl tRNA from binding to the A site of the ribosome. The binding is reversible in nature. Oxytetracycline is lipophilic and can easily pass through the cell membrane or passively diffuses through porin channels in the bacterial membrane.<br />\r\n<br />\r\nThe broad-spectrum effectiveness of this ointment against both gram-positive and gram-negative organisms is enhanced by the particular effectiveness of polymyxin B against infections associated with gram-negative organisms, especially those due to Pseudomonas aeruginosa, where polymyxin B is the antibiotic of choice. In addition, there is evidence to indicate that polymyxin B sulfate possesses some antifungal activity.</p>', '<p>Oxytetracycline Hydrochloride and Polymyxin B Sulfate Ophthalmic Ointment should be administered topically to the eye 2-4 times daily.</p>', NULL, NULL, '<p>All medicines may cause side effects, but many people have no, or minor, side effects. When used in small doses, no common side effects have been reported with this product. Seek medical attention right away if any of these severe side effects occur: Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); eye swelling or redness.</p>', '<p>If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using oxytetracycline or polymyxin b sulfate ointment while you are pregnant. It is not known if this medicine is found in breast milk. If you are or will be breast-feeding while you use oxytetracycline or polymyxin b sulfate ointment, check with your doctor. Discuss any possible risks to your baby.</p>', '<p>Serious, life threatening, hypersensitivity (anaphylactic) reactions have been reported in some cats following application of antibiotic ophthalmic preparations. If your cat has swelling of the face, itching, appears weak, vomits, or has difficulty breathing within 4 hours of application you should discontinue treatment and contact your veterinarian immediately. The use of oxytetracycline and other antibiotics may result in an overgrowth of resistant organisms such as Monilia, staphylococci, and other species of bacteria. If new infections due to nonsensitive bacteria or fungi appear during therapy, appropriate measures should be taken.</p>', NULL, '<p>Topical Antibiotic preparations.</p>', '<p>Store at controlled room temperature between 20&deg; to 25&deg;C.</p>', NULL, '2022-03-11 06:36:54', '2022-03-11 06:36:54'),
(1112, 1112, '<p>In Antepartum:</p>\r\n\r\n<ul>\r\n	<li>Induction of labor in patients with a medical indication for the initiation of labor, such as Rh problems, maternal diabetes, (pre-) eclampsia at or near term, when delivery is in the best interests of mother and fetus or when membranes are prematurely ruptured and delivery is indicated;&nbsp;</li>\r\n	<li>Stimulation or reinforcement of labor, as in selected cases of uterine inertia;</li>\r\n	<li>As adjunctive therapy in the management of incomplete or inevitable abortion.&nbsp;</li>\r\n</ul>\r\n\r\n<p>In Postpartum:</p>\r\n\r\n<ul>\r\n	<li>Oxytocin is indicated to produce uterine contractions during the third stage of labor and to control postpartum bleeding or hemorrhage.</li>\r\n</ul>', '<p>Uterine motility depends on the formation of the contractile protein actomyosin under the influence of the Ca2+&nbsp;dependent phosphorylating enzyme myosin light-chain kinase. Oxytocin promotes contractions by increasing the intracellular Ca2+, which in turn activates myosin&#39;s light chain kinase. Oxytocin has specific receptors in the muscle lining of the uterus and the receptor concentration increases greatly during pregnancy, reaching a maximum in early labor at term.</p>', '<p>Induction or Stimulation of Labor:</p>\r\n\r\n<ul>\r\n	<li>The standard solution for infusion of Oxytocin is prepared by adding the contents of one 1ml vial containing 10 units of Oxytocin to 1000 ml of infusion fluids. The combined solution containing 10 mU (1mU=0.001U) of Oxytocin/ml is rotated in the infusion bottle for thorough mixing.</li>\r\n	<li>The initial dose should be 0.5-1 mU/min (equal to 3-6 ml of the dilute Oxytocin solution per hour). At 30-60 minutes intervals the dose should be gradually increased in increments of 1-2 mU/min until the desired contraction pattern has been established. Once the desired frequency of contractions has been reached and labor has progressed to 5-6 cm dilation, the dose may be reduced by similar increments.</li>\r\n	<li>At term, higher infusion rates should be given with great care and rates exceeding 9-10 mU/min are rarely required.</li>\r\n	<li>Before term, when the sensitivity of the uterus is lower because of a lower concentration of Oxytocin receptors, a higher infusion rate may be required.</li>\r\n</ul>\r\n\r\n<p>Control of Postpartum Uterine Bleeding:</p>\r\n\r\n<ul>\r\n	<li><strong>Intravenous Infusion (Drip Method)</strong>: To control postpartum bleeding, 10 to 40 units of Oxytocin may be added to the bottle, depending on the amount of infusion fluids solution remaining (maximum 40 units to 1000 ml). Adjust infusion rate to sustain uterine contraction and control uterine atony.</li>\r\n	<li><strong>Intramuscular Administration</strong>: 1 mL (10 units) of Oxytocin can be given after the delivery of the placenta.</li>\r\n</ul>\r\n\r\n<p>Treatment of Incomplete or Inevitable Abortion:</p>\r\n\r\n<ul>\r\n	<li>Intravenous infusion of 10 units of Oxytocin added to 500 ml of a 0.9% sodium chloride solution may help the uterus contract after a suction or sharp curettage for an incomplete, inevitable or elective abortion.</li>\r\n	<li>Subsequent to intra-amniotic injection of hypertonic saline, prostaglandins, urea etc., for mid trimester elective abortion, the injection-to-abortion time may be shortened by infusion of Oxytocin at the rate of 10 to 20 mU (20 to 40 drops) per minute. The total dose should not exceed 30 units in a 12-hour period due to the risk of water intoxication.</li>\r\n</ul>', '<p>Severe hypertension has been reported when Oxytocin was given three to four hours following prophylactic administration of a vasoconstrictor in conjunction with caudal-block anesthesia. Cyclopropane anesthesia may modify Oxytocin&rsquo;s cardiovascular effects, so as to produce unexpected results such as hypotension. Maternal sinus bradycardia with abnormal atrioventricular rhythms has also been noted when Oxytocin was used concomitantly with cyclopropane anesthesia.</p>', '<p>This drug is contraindicated in- significant cephalopelvic disproportion; unfavorable fetal positions or presentations which are undeliverable without conversion prior to delivery, e.g., transverse lies; in obstetrical emergencies where the benefit-to-risk ratio for either the fetus or the mother favors surgical intervention; in cases of fetal distress where delivery is not imminent; hypertonic uterine patterns; hypersensitivity to the drug. Prolonged use in uterine inertia or severe toxemia is contraindicated. Oxytocin should not be used in cases where vaginal delivery is not indicated.</p>', '<ul>\r\n	<li>Hypersensitivity to the drug may result in uterine hypertonicity, spasm, titanic contraction or rupture of the uterus.&nbsp;</li>\r\n	<li>The possibility of increased blood loss and afbrinigenemia should be kept in mind when administering the drug.</li>\r\n	<li>Severe water intoxication with convulsions and coma has occurred.&nbsp;</li>\r\n	<li>Oxytocin may occasionally cause nausea, vomiting, haemorrhage or cardiac arrhythmias, anaphylactic reaction.</li>\r\n</ul>', '<p>Pregnancy category C. It is not known whether Oxytocin is excreted in human milk</p>', '<p>Oxytocin should not be administered in the following conditions: prematurity, borderline cephalopelvic disproportion, previous major surgery on the cervix or uterus including caesarean section, overdistention of the uterus, grand multiparity or invasive cervical carcinoma.</p>', '<p>Overdosage with Oxytocin depends essentially on uterine hyperactivity whether or not due to hypersensitivity to this agent. Hyperstimulation with strong (hypertonic) or prolonged (tetanic) contractions, or a resting tone of 15 to 20 mm H2O or more between contractions can lead to tumultuous labor, uterine rupture, cervical and vaginal lacerations, postpartum hemorrhage, utero-placental hypoperfusion, and variable deceleration of fetal heart, fetal hypoxia, hypercapnia, or death. Water intoxication with convulsions, which is caused by the inherent antidiuretic effect of Oxytocin, is a serious complication that may occur if large doses (40 to 50 mU/minute) are infused for long periods. Management consists of immediate discontinuation of Oxytocin and symptomatic and supportive therapy.</p>', '<p>Drugs acting on the Uterus</p>', '<p>Store in between 2 to 8&deg;C, in dark &amp; frost free place. Keep out of the reach of children.</p>', NULL, '2022-03-11 06:38:59', '2022-03-11 06:38:59'),
(1113, 1113, '<p>Ozenoxacin is indicated for the topical treatment of impetigo due to Staphylococcus aureus or Streptococcus pyogenes in adult and pediatric patients 2 months of age and older.</p>', '<p><strong>Mechanism of Action</strong>: Ozenoxacin is a quinolone antimicrobial drug. The mechanism of action involves the inhibition of bacterial DNA replication enzymes, DNA gyrase A and topoisomerase IV. Ozenoxacin has been shown to be bactericidal against S. aureus and S. pyogenes organisms.<br />\r\n<br />\r\n<strong>Absorption</strong>: Four pharmacokinetic studies were conducted in 110 patients utilizing varying strengths of ozenoxacin cream, up to 2% (twice the concentration of the marketed formulation). Three of these studies assessed systemic absorption in healthy subjects and in subjects with impetigo. These studies were conducted with either single or repeated application of up to 1 g ozenoxacin cream to intact or abraded skin (up to 200 cm2&nbsp;surface area). No systemic absorption was observed in 84 of 86 subjects, and negligible systemic absorption was observed at the level of detection (0.489 ng/mL) in 2 subjects.<br />\r\n<br />\r\n<strong>Distribution</strong>: Plasma protein binding of ozenoxacin was moderate (~80 to 85%) and did not appear to be dependent on concentration. Since negligible systemic absorption was observed in clinical studies, tissue distribution has not been investigated in humans.<br />\r\n<br />\r\n<strong>Metabolism</strong>: Ozenoxacin was not metabolized in the presence of fresh human skin discs and was minimally metabolized in human hepatocytes.<br />\r\n<br />\r\n<strong>Excretion</strong>: Studies have not been investigated in humans due to the negligible systemic absorption observed in clinical studies.</p>', '<p>Apply a thin layer of Ozenoxacin topically to the affected area twice daily for five days. The affected area may be up to 100 cm2&nbsp;in adult and pediatric patients 12 years of age and older or 2% of the total body surface area and not exceeding 100 cm2&nbsp;in pediatric patients less than 12 years of age.</p>\r\n\r\n<ul>\r\n	<li>Wash hands after applying Ozenoxacin cream.</li>\r\n	<li>Ozenoxacin cream is for topical use only.</li>\r\n	<li>Not for oral, ophthalmic, intranasal, or intravaginal use.</li>\r\n	<li>The treated area may be covered with a sterile bandage or gauze dressing.</li>\r\n</ul>', NULL, '<p>None</p>', '<p>Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The safety profile of Ozenoxacin was assessed in two clinical trials (Trial 1 and Trial 2) in 362 adult and pediatric patients two months of age and older with impetigo. The patients used at least one dose from a 5-day, twice a day regimen of Ozenoxacin. Control groups included 361 patients who used placebo and 152 patients who used retapamulin ointment. The median age of the patients enrolled in the clinical trials was 10 years; 3 % of patients were 2 months to less than 2 years of age, 55 % of patients were 2 to less than 12 years of age, 11 % of patients were 12 to less than 18 years of age, and 31 % of patients were 18 years of age or older. Adverse reactions (rosacea and seborrheic dermatitis) were reported in 1 adult patient treated with Ozenoxacin.</p>', '<p><strong>Pregnancy</strong>: There are no available data on the use of ozenoxacin in pregnant women to inform a drug associated risk. Systemic absorption of ozenoxacin in humans is negligible following topical administration of ozenoxacin (up to twice the concentration of the marketed formulation). Due to the negligible systemic exposure, it is not expected that maternal use of ozenoxacin will result in fetal exposure to the drug. Animal reproduction studies were not conducted with ozenoxacin. However, toxicity studies conducted in pregnant rats and rabbits administered the oral form of ozenoxacin showed no significant adverse developmental effects (at &gt;10,000 times the maximum human plasma concentration seen with dermal application of ozenoxacin). The estimated background risk of major birth defects and miscarriage for the indicated population are unknown. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.<br />\r\n<br />\r\n<strong>Lactation</strong>: No data are available regarding the presence of ozenoxacin in human milk, and the effects of ozenoxacin on the breastfed infant or on milk production. However, breastfeeding is not expected to result in exposure of the child to ozenoxacin due to the negligible systemic absorption of ozenoxacin in humans following topical administration of ozenoxacin. The developmental and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for ozenoxacin and any potential adverse effects on the breast-fed child from ozenoxacin or from the underlying maternal condition.</p>', '<p>Potential for Microbial Overgrowth: The prolonged use of Ozenoxacin may result in overgrowth of nonsusceptible bacteria and fungi. If such infections occur during therapy, discontinue use and institute appropriate supportive measures.</p>', '<p>Any sign or symptom of overdose, either topically or by accidental ingestion, should be treated symptomatically. No specific antidote is known.</p>', '<p>Topical Antibiotic preparations.</p>', '<p>Store at 20&ordm;C - 25&ordm;C; excursions permitted to 15&ordm;C to 30&ordm;C. Keep away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: The safety and effectiveness of ozenoxacin in the treatment of impetigo have been established in pediatric patients 2 months to 17 years of age. Use of ozenoxacin in pediatric patients (2 months to 17 years of age) is supported by evidence from adequate and well-controlled studies of ozenoxacin in which 251 pediatric patients received at least one dose of ozenoxacin. The median age of the patients enrolled in the clinical trials was 10 years; 3% of patients were 2 months to less than 2 years of age, 55 % of patients were 2 to less than 12 years of age, 11% of patients were 12 to less than 18 years of age, and 31 % of patients were 18 years of age or older. In these studies, the maximum dose applied was approximately 0.5 g of ozenoxacin applied twice daily for up to 5 days (i.e., up to 10 applications total). The safety profile of ozenoxacin in pediatric patients 2 months and older was similar to that of adults. The safety and effectiveness of ozenoxacin in pediatric patients younger than 2 months of age have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of ozenoxacin did not include sufficient numbers of subjects aged 65 and older 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.</p>', '2022-03-11 06:40:50', '2022-03-11 06:40:50'),
(1114, 1114, '<p>Zafirlukast is indicated for the prophylaxis and chronic treatment of asthma in adults and children 5 years of age and older.</p>', '<p>Zafirlukast is a selective and competitive leukotriene-receptor antagonist (LTRA) of leukotriene D4 and E4 (LTD4 and LTE4), components of slow-reacting substance of anaphylaxis (SRSA). Cysteinyl leukotriene production and receptor occupation have been correlated with the pathophysiology of asthma, including airway oedema, smooth muscle constriction, and altered cellular activity associated with the inflammatory process, which contribute to the signs and symptoms of asthma.</p>', '<p>Zafirlukast should be taken continuously.<br />\r\n<br />\r\n<strong>Children under 7 years of age:</strong>&nbsp;There is no clinical experience of the use of Zafirlukast in children under 7 years of age until safety information is available.<br />\r\n<br />\r\n<strong>Children over 7 years through 11 years of age</strong>: The recommended dose of Zafirlukast in this age group is 10 mg twice daily.<br />\r\n<br />\r\n<strong>Adult and children aged 12 years and over</strong>: The dosage is one 20 mg tablet twice daily. This dosage should not be exceeded. Higher doses may be associated with elevations of one or more liver enzymes consistent with hepatotoxicity. As food may reduce the bioavailability of Zafirlukast, Zafirlukast should not be taken with meals<br />\r\n<br />\r\n<strong>Elderly</strong>: The clearance of Zafirlukast is significantly reduced in elderly patients (over 65 years old), and Cmax and AUC are approximately double than those of younger adults. However, accumulation of Zafirlukast is not greater than that seen in multiple dose trials conducted in adult subjects with asthma and the consequences of the altered kinetic in the elderly are unknown. Clinical experience with Zafirlukast in the elderly (over 65 years) is limited and caution is recommended until further information is available.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: No dosage adjustment is necessary in patients with mild renal impairment.</p>', '<p>Zafirlukast may be administered with other therapies routinely used in the management of asthma and allergy. Inhaled steroids, inhaled and oral bronchodilator therapy, antibiotics and antihistamines are examples of agents which have been co-administered with Zafirlukast without adverse interaction.<br />\r\n<br />\r\nZafirlukast may be administered with oral contraceptives without adverse interaction. Co-administration with Warfarin results in an increase in maximum prothrombin time by approximately 35%. It is therefore recommended that if Zafirlukast is co-administered with Warfarin, prothrombin time should be closely monitored. The interaction is probably due to an inhibition by Zafirlukast of the cytochrome P450 2C9 enzyme system. In clinical trials co-administration with Theophylline resulted in decreased plasma levels of Zafirlukast, by approximately 30%, but with no effect on plasma Theophylline levels. However, during postmarketing surveillance, there have been rare cases of patients experiencing increased Theophylline levels when co-administered with Zafirlukast.<br />\r\n<br />\r\nCo-administration with Terfenadine resulted in a 54% decrease in AUC for Zafirlukast, but with no effect on plasma Terfenadine levels. Coadministration with Acetylsalicylic acid (650 mg four times a day) may result in increased plasma levels of Zafirlukast, by approximately 45%.<br />\r\n<br />\r\nCo-administration with Erythromycin will result in decreased plasma levels of Zafirlukast, by approximately 40%. The clearance of Zafirlukast in smokers may be increased by approximately 20%</p>', '<p>Zafirlukast should not be given to patients who have previously experienced hypersensitivity to the product or any of its ingredients. Zafirlukast is contraindicated in patients with a history of moderate or severe renal impairment. Zafirlukast is contraindicated in patients with hepatic impairment or cirrhosis; it has not been studied in patients with hepatitis or in long term studies of patients with cirrhosis. Zafirlukast is contraindicated in children under 7 years of age until safety information is available.</p>', '<p><strong>Effect on ability to drive or operate machinery</strong>: There is no evidence that Zafirlukast affects the ability to drive and use machinery. Administration of Zafirlukast in clinical trials against placebo has been associated with headache (9.9% vs. 9.0%) or gastrointestinal disturbance (nausea 2.6% vs. 2.2%, vomiting 1.2% vs. 1.0%, diarrhoea 2.3% vs. 1.8%, abdominal pain 1.6% vs. 1.2%). These symptoms are usually mild and do not necessitate withdrawal from therapy. During post-marketing experience, bruising, bleeding disorders, including menorrhagia (rare), thrombocytopaenia and agranulocytosis (very rare) have also been reported.<br />\r\n<br />\r\nHypersensitivity reactions, including urticaria and angio-oedema have been reported. Rashes, including blistering, have also been reported. The above events have usually resolved during continued treatment or following cessation of therapy.<br />\r\n<br />\r\nInfrequently, elevated serum transaminase levels have been observed in clinical trials against placebo with Zafirlukast (increased AST 1.0% vs. 0.9%, increased AST 0.6% vs. 0.6%); at recommended doses the incidence was equivalent to placebo. Rarely the transaminase profile has been consistent with drug-induced hepatitis, which resolved following cessation of Zafirlukast therapy. During post-marketing experience there have been rare reports of hepatitis, with or without elevated bilirubin levels. These cases were usually reversible.<br />\r\n<br />\r\nIn placebo controlled clinical trials, an increased incidence of infection has been observed in elderly patients given Zafirlukast (7.8% vs. 1.4%). Infections were usually mild, predominantly affecting the respiratory tract.</p>', '<p><strong>Pregnancy</strong>: The safety of Zafirlukast in human pregnancy has not been established. In animal studies, Zafirlukast did not have any apparent effect on fertility and did not appear to have any teratogenic or selective toxic effect on the foetus. The potential risks should be weighed against the benefits of continuing therapy during pregnancy and Zafirlukast should be used during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Lactation</strong>: Zafirlukast is excreted in human breast milk. Zafirlukast should not be administered to nursing mothers.</p>', '<p>Zafirlukast should be taken regularly to achieve benefit, even during symptom free periods. Zafirlukast therapy should normally be continued during acute exacerbations of asthma. Zafirlukast does not allow a reduction in existing steroid treatment. As with inhaled steroids and hormones (disodium cromoglycate, nedocromil sodium), Zafirlukast is not indicated for use in the reversal of bronchospasm in acute asthma attacks. Zafirlukast has not been evaluated in the treatment of labile (brittle) or unstable asthma.<br />\r\n<br />\r\nCases of Churg Strauss syndrome have been reported in association with Zafirlukast usage. A causal relationship has neither been confirmed nor refuted. If a patient develops a Churg Strauss syndrome type illness, Zafirlukast should be stopped, a re-challenge test should not be performed and treatment should not be restarted.<br />\r\n<br />\r\nElevations in serum transaminases can occur during treatment with Zafirlukast. These are usually asymptomatic and transient but could represent early evidence of hepatotoxicity.<br />\r\n<br />\r\nIf clinical symptoms or signs suggestive of liver dysfunction occur (e.g., nausea, vomiting, right upper quadrant pain, fatigue, lethargy, flu-like symptoms, enlarged liver, pruritus and jaundice), the serum transaminases, in particular serum ALT, should be measured and the patient managed accordingly. A decision to discontinue Zafirlukast should be individualized to the patient&rsquo;s condition, weighing the risk of hepatic dysfunction against the clinical benefit of Zafirlukast to the patient.</p>', NULL, '<p>Leukotriene receptor antagonists</p>', '<p>Store between 20-25&deg; C. Protect from light and moisture.</p>', NULL, '2022-03-12 00:17:15', '2022-03-12 00:17:15'),
(1115, 1115, '<p>Zaleplon is indicated for the short-term treatment of insomnia. Zaleplon has been shown to decrease the time to sleep onset for up to 30 days in controlled clinical trials.</p>', '<p>Zaleplon is a newer non-benzodiazepine hypnotic from the pyrazolopyrimidine class. So, its chemical structure is unrelated to benzodiazepines, barbiturates, or other drugs with known hypnotic properties. It interacts with the gamma aminobutyric acid-benzodiazepine (GABA-BZ) receptor complex.</p>', '<p>The dose of Zaleplon should be individualized. The recommended dose of Zaleplon for most non elderly adults is 10 mg. For certain low weight individuals, 5 mg may be a sufficient dose. Although the risk of certain adverse events associated with the use of Zaleplon appears to be dose dependent, the 20 mg dose has been shown to be adequately tolerated and may be considered for occasional patient who does not benefit from a trial of lower dose. Dosage above 20 mg has not been adequately evaluated and is not recommended.<br />\r\n<br />\r\nZaleplon should be taken immediately before bedtime. Taking Zaleplon with or immediately after a heavy, high fat meal results in slower absorption and would be expected to reduce the effect of Zaleplon on sleep latency. Elderly patients and debilitated patients appear to be more sensitive to the effects of hypnotic, and respond to 5 mg of Zaleplon. The recommended dose for these patients is therefore 5 mg, doses over 10 mg are not recommended.<br />\r\n<br />\r\nFor patients with mild to moderate renal impairment, no dose adjustment is necessary.<br />\r\n<br />\r\nAn initial dose of 5 mg should be given to patients concomitantly taking Cimetidine because Zaleplon clearance is reduced in this population.<br />\r\n<br />\r\n<strong>Pediatric use</strong>: The safety and effectiveness of Zaleplon in pediatric patients have not been established.</p>', '<p>Zaleplon has been shown to have minimal effects on the kinetic of Warfarin, Imipramine, Ethanol, Ibuprofen, Diphenhydramine, Thioridazine, and Digoxin.</p>', '<p>Zaleplon is contraindicated in patients with known hypersensitivity to any of its components.</p>', '<p>Side effects of Zaleplon appear to be dose related. So, it is important to use the lowest possible effective dose, specially in the elderly. The side effects are usually mild and transient, the most common are diarrhoea, nausea, vomiting, vertigo, headache, asthenia, nightmare etc.</p>', '<p><strong>Pregnancy</strong>: There are no studies of Zaleplon in pregnant women; therefore, it is not recommended for use in women during pregnancy. Zaleplon has no established use in labour and delivery.<br />\r\n<br />\r\n<strong>Lactation</strong>: A study in lactating mothers indicated that the clearance and half-life of Zaleplon is similar to that in young normal subjects. A small amount of Zaleplon is excreted in breast milk, with the highest excreted amount occurring during a feeding at approximately 1 hour after Zaleplon administration. Since the small amount of the drug from breast milk may result in potentially important concentrations in infants, and because the effects of Zaleplon on a nursing infant are not known, it is not recommended in nursing mothers.</p>', '<p><strong>Timing of drug administration</strong>: Zaleplon should be taken immediately before bedtime or after the patient has gone to bed.<br />\r\n<br />\r\n<strong>Use in the elderly and/or debilitated patients</strong>: Impaired motor and/or cognitive performance after repeated exposure or unusual sensitivity to sedative/hypnotic drugs is a concern in the treatment of elderly and/or debilitated patients. A dose of 5 mg is recommended for elderly patients to decrease the possibility of side effects. Elderly and/or debilitated patients should be monitored closely.<br />\r\n<br />\r\n<strong>Use in patients with concomitant illness</strong>: Zaleplon should be used with caution in patients with diseases or conditions that could affect metabolism or haemodynamic responses. Although preliminary studies did not reveal respiratory depressant effects at hypnotic doses of Zaleplon in normal subjects, caution should be observed if Zaleplon is prescribed to patients with compromised respiratory function, because sedative/hypnotic have the capacity to depress respiratory drive. However, patients with compromised respiration due to preexisting illness should be monitored carefully. The dose of Zaleplon should be reduced to 5 mg in patients with mild to moderate hepatic impairment. It is not recommended for use in patients with severe hepatic impairment.<br />\r\n<br />\r\n<strong>Renal impairment patients</strong>: No dose adjustment is necessary in patients with mild to moderate renal impairment. Zaleplon has not been adequately studied in patients with severe renal impairment.<br />\r\n<br />\r\n<strong>Use in patients with depression</strong>: As with other sedative or hypnotic drugs, Zaleplon should be administered with caution to patients exhibiting signs or symptoms of depression.</p>', NULL, '<p>Benzodiazepine hypnotics, Benzodiazepine sedatives.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-12 00:19:03', '2022-03-12 00:19:03');
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
(1116, 1116, '<p>Zidovudine, a nucleoside&nbsp;reverse transcriptase&nbsp;inhibitor, is indicated in combination with other&nbsp;antiretroviral&nbsp;agents for the treatment of&nbsp;HIV-1 infection.<br />\r\n<br />\r\nPrevention Of Maternal-Fetal HIV-1 Transmission Zidovudine is indicated for the prevention of maternal-fetal HIV-1 transmission. The indication is based on a dosing regimen that included 3 components:</p>\r\n\r\n<ul>\r\n	<li>Antepartum therapy of HIV-1&ndash;infected mothers</li>\r\n	<li>Intrapartum therapy of HIV-1&ndash;infected mothers</li>\r\n	<li>Post-partum therapy of HIV-1&ndash;exposed&nbsp;neonate</li>\r\n</ul>\r\n\r\n<p>Points to consider prior to initiatingZidovudine in pregnant women for the prevention of maternal-fetal HIV-1 transmission include:</p>\r\n\r\n<ul>\r\n	<li>In most cases,Zidovudine for prevention of maternal-fetal HIV-1 transmission should be given in combination with other antiretroviral drugs.</li>\r\n	<li>Prevention of HIV-1 transmission in women who have receivedZidovudine for a prolonged period before pregnancy has not been evaluated.</li>\r\n	<li>Because the fetus is most susceptible to the potential&nbsp;teratogenic&nbsp;effects of drugs during the first 10 weeks of gestation and the risks of therapy withZidovudine during that period are not fully known, women in the first trimester of pregnancy who do not require immediate initiation of&nbsp;antiretroviral therapy&nbsp;for their own health may consider delaying use; this indication is based on use after 14 weeks&rsquo; gestation.</li>\r\n</ul>', '<p>Zidovudine is converted intracellularly to zidovudine triphosphate, which inhibits replication of retroviruses, including HIV, by interfering with viral RNA-directed DNA polymerase (reverse transcriptase).</p>', '<p>Prophylaxis of HIV infection in neonates:</p>\r\n\r\n<ul>\r\n	<li><strong>Child</strong>:&nbsp;2 mg/kg 6 hrly, starting within 12 hr after birth and continuing for 6 wk.</li>\r\n</ul>\r\n\r\n<p>HIV infection:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;250 mg or 300 mg bid, in combination with other antiretroviral agents.</li>\r\n	<li><strong>Child</strong>:&nbsp;As soln: 4 to &lt;9 kg: 12 mg/kg bid; 9 to &lt;30 kg: 9 mg/kg bid; &ge;30 kg: 250 mg or 300 mg bid. As cap/tab: 8-13 kg: 100 mg bid; 14-21 kg: 100 mg in the morning, 200 mg in the evening; 22-30 kg: 200 mg bid; &ge;30 kg: 250 mg or 300 mg bid. Alternatively (based on BSA), 480 mg/m2&nbsp;daily in 2-3 divided doses. Doses are given in combination with other antiretroviral agents.</li>\r\n</ul>\r\n\r\n<p>Prophylaxis of maternal-fetal HIV transmission:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;100 mg 5 times daily, starting on the 14th wk of gestation until the start of labour.</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.</p>', '<p>Decreased plasma concentration with rifampicin resulting in partial or total loss of efficacy of zidovudine. Increased risk of anaemia with ribavirin in patients co-infected with HCV. Antagonistic effect with stavudine or doxorubicn. Increased plasma level with probenecid, atovaquone, valproic acid, fluconazole, or methadone. May alter phenytoin blood levels. Increased adverse effect with potentially nephrotoxic or myelosuppressive drugs (e.g. systemic pentamidine, dapsone, pyrimethamine, co-trimoxazole, amphotericin, flucytosine, ganciclovir, interferon, vincristine, vinblastine, doxorubicin). Reduced absorption with clarithromycin.</p>', '<p>Hypersensitivity; abnormally low neutrophil counts (&lt;0.75 x 109/L) or Hb levels (&lt;7.5 g/dL or 4.65 mmol/L); newborn infants with hyperbilirubinaemia requiring treatment other than phototherapy, or with increased transaminase levels &gt;5 times the ULN. Lactation. Concomitant use with interferon alfa (with or witho ribavirin) in HIV and hepatitis B or C virus co-infected patients.</p>', '<p>Dizziness, headache, malaise, myalgia, GI symptoms (e.g. abdominal pain, diarrhoea, nausea, vomiting), anorexia, immune reconstitution syndrome, lipodystrophy, metabolic abnormalities, mitochondrial dysfunction, osteonecrosis; raised liver enzymes, creatine phosphokinase; hyperbilirubinaemia, myalgia, myositis. Rarely, aplastic anaemia, pure red cell aplasia, pancytopenia, thrombocytopenia, rhabdomyolysis, cardiomyopathy, convulsions, pancreatitis.</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>Severe renal and hepatic impairment. Childn. Pregnancy.</p>', '<p>Symptoms: Vomiting, CNS effects (e.g. fatigue, dizziness, drowsiness, lethargy, confusion), haematologic effects (e.g. anaemia, decreased Hb). Bone marrow hypoplasia, mild ataxia, tonic-clonic seizure and increased serum concentration of AST and ALT may also occur.<br />\r\n<br />\r\nManagement: Supportive and symptomatic treatment. Induce emesis and admin activated charcoal to prevent further absorption of unrecovered drug.</p>', '<p>Drugs for HIV / Anti-retroviral drugs</p>', '<p>Store between 15-25&deg; C.</p>', '<p>Renal Impairment:</p>\r\n\r\n<ul>\r\n	<li>ESRD maintained on haemodialysis or peritoneal dialysis: 100 mg 6-8 hrly.</li>\r\n	<li>CrCl &lt;10-15 mL/min: 100 mg 6-8 hrly.</li>\r\n</ul>\r\n\r\n<p>Hepatic Impairment: Dose reduction may be needed.</p>', '2022-03-12 00:21:23', '2022-03-12 00:21:23'),
(1117, 1117, '<p>Oral zinc therapy is indicated in zinc deficiency and/or zinc losing conditions like- Hair loss, Skin rashes, Major depression, Loss of smell, taste and memory, White spots on the fingernails, Increased susceptibility to infection, Loss of activity of growth hormone (GH), Visual impairment, fingernails, Diarrhea, Male infertility, Sickle cell anemia, Delayed wound healing, Type-2 diabetes.</p>', '<p>Zinc, a major mineral,&nbsp;plays a part in almost all the body&#39;s cellular and enzymatic processes. Its bioavailability and digestive assimilation increases significantly when bound to orotic acid. An essential component of over 80 enzymes, it plays a role in all metabolism and has a specific&nbsp;antioxidant, anti-free radical action.</p>', '<p><strong>Adults</strong>: One tablet twice daily with meal.</p>', '<p>Concomitant intake of tetracycline, quinolone and penicillamine along with zinc may decrease the absorption of both drugs.</p>', NULL, '<p>Zinc might cause nausea, vomiting, metallic taste and stomach upset etc.</p>', '<p>It should be used in pregnant or lactating mother after consultation with a health care professional.</p>', '<p>Patients with diabetes &amp; acute renal failure should use zinc products cautiously.</p>', '<p>Taking doses higher than 40 mg (elemental zinc) daily might cause fever, cough, upset stomach.</p>', '<p>Specific mineral preparations</p>', '<p>Store in a cool and dry place, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-12 00:23:08', '2022-03-12 00:23:08'),
(1118, 1118, '<p>Zinc Oxide helps treat and prevent diaper rash while it moisturizes and nourishes the skin. The Zinc Oxide based formulation provides a protective barrier on the skin against the natural causes of irritation. Zinc Oxide spreads on smooth and wipes off the baby easily, without causing irritation to the affected area.</p>', '<p>Zinc oxide is used to treat or prevent minor skin irritations such as burns, cuts, poison ivy, poison oak, poison sumac, and diaper rash. It is also used as sunscreen.</p>', '<p>Change wet and soiled diapers promptly, cleanse the diaper area, and allow drying. Apply ointment liberally as often as necessary, with each diaper change, especially at bedtime or anytime when exposure to wet diapers may be prolonged.</p>', '<p>No hazardous drug interactions have been reported.</p>', '<p>Known hypersensitivity to any component of the preparation.</p>', '<p>Usually well tolerated. Extremely low frequency of hypersensitivity reaction.</p>', '<p>This medication should be used with precautions only if clearly needed during pregnancy or while breast feeding.</p>', '<p>When using this product avoid contact with eyes Stop use and ask a doctor if the condition worsens or does not improve within 7 days. This may be a sign of a serious condition. Keep out of reach of children. If swallowed, get medical help immediately.</p>', '<p>No overdose related problem is yet reported.</p>', '<p>Drugs used in diaper rash</p>', '<p>Keep at cool and dry place, away from light. Keep out of the reach of children.</p>', NULL, '2022-03-12 00:27:44', '2022-03-12 00:27:44'),
(1119, 1119, '<p>Regular use may help protect against premature skin aging, appearance of wrinkles and pigmentation and sunburn. Improve quality of skin and leave the skin supple and healthy.</p>', '<p>Zinc oxide has astringent, soothing and protective properties and is used in topical preparations for eczema, slight excoriations, wounds and haemorrhoids. It also reflects ultraviolet radiation and can be used as a physical sunscreen.</p>', '<p>Apply on the area exposed to sunlight (such as face, neck &amp; body) at least 30 min before exposure and whenever necessary. Massage on to skin until absorbed. To ensure maximum protection, we recommend repeating the application every two hours after continuous exposure to the sun and after swimming, physical exercise (sweat or dry with towel).</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity to any ingredient in zinc oxide cream, lotion.</p>', '<p>Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue).</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>Zinc oxide cream may be harmful if swallowed. Pregnancy &amp; Lactation.</p>', NULL, '<p>Sunblock Preparation.</p>', '<p>Store below 30&deg;C.</p>', NULL, '2022-03-12 00:29:32', '2022-03-12 00:29:32'),
(1120, 1120, '<p>In the treatment of Napkin rash, Eczema, Bedsores, Acne, Minor burns, Surface wounds, Sunburn, Chilblains.</p>', '<ul>\r\n	<li>Zinc oxide: A&nbsp;dermatological agent with astringent, soothing and protective properties.</li>\r\n	<li>Benzyl alcohol: A&nbsp;local anaesthetic with disinfectant properties.</li>\r\n	<li>Benzyl benzoate: An acaricide and has been used as a pediculicide, insect repellent and pharmaceutical solubilising agent. It is a constituent of many natural balsams and is one of the principal esters of Peru Balsam.</li>\r\n	<li>Benzyl cinnamate: This is the other principal ester of Peru Balsal BPC 1973. It is synthetised from benzyl alcohol and cinnamic acid which has antibacterial and antifungal properties. Peru Balsam is categorised as having a mild antiseptic action because of cinnamic acid and its derivatives present.</li>\r\n	<li>Lanolin: Resembles the sebaceous secretions of human skin. The grade (hypoallergenic) used is manufactured so as to exclude many sensitising substances present in the lanolin.</li>\r\n</ul>', '<p>Apply a thin layer with suitable covering where necessary. Renew application as required. No distinction is required between indications or between adults, children and the elderly. Topical cream for external use only.</p>', NULL, '<p>Hypersensitivity to any of the ingredients.</p>', '<p>Side effects include local hypersensitivity occasionally.</p>', '<p>There are no known contraindications in pregnancy &amp; lactation.</p>', '<p>For external use only and should not be allowed to come into contact with the eyes and the mucous membranes. Instruct patients not to smoke or go near naked flames- risk of severe burns. Fabric (clothing, bedding, dressings etc) that has been in contact with this product burns more easily and is a serious fire hazard. Washing clothing and bedding may reduce product build-up but not totally remove it.</p>', '<p>No case of overdose has been reported. If large amounts are swallowed accidentally, this may cause vomiting, diarrhoea, CNS stimulation and convulsions. Symptomatic treatment should be provided.</p>', '<p>Drugs used in diaper rash, Sunblock Preparation.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-12 00:31:15', '2022-03-12 00:31:15'),
(1121, 1121, '<p>This cream is ideal for those with photodermatoses &amp; reduced skin pigmentation, Protection from harmful UV rays, Sunblock. Benefit of this cream is Sunblock with SPF60/ PA+++, Non-greasy &amp; hypoallergenic, Perfume-free, Contains Vitamin E, Water resistant.</p>', '<p>Zinc oxide has astringent, soothing and protective properties and is used in topical preparations for eczema, slight excoriations, wounds and haemorrhoids. It also reflects ultraviolet radiation and can be used as a physical sunscreen.</p>', '<p>Apply on the area exposed to sunlight (such as face, neck &amp; body) at least 30 min before exposure and whenever necessary. Massage on to skin until absorbed.<br />\r\n<br />\r\nTo ensure maximum protection, we recommend repeating the application every two hours after continuous exposure to the sun and after swimming, physical exercise (sweat or dry with towel).</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity to any ingredient in zinc oxide cream, lotion.</p>', '<p>Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue).</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>Zinc oxide cream may be harmful if swallowed. Pregnancy &amp; Lactation.</p>', NULL, '<p>Sunblock Preparation.</p>', NULL, NULL, '2022-03-12 00:33:50', '2022-03-12 00:33:50'),
(1122, 1122, '<p>For relief of the symptoms of nappy rash and as a protective water resistant cream for dry, chapped skin.</p>', '<p>Zinc oxide has a mild antiseptic action, and is useful for relieving the symptoms of nappy rash and other minor skin irritations. The formulation as a whole acts to provide a mildly antiseptic water resistant emollient barrier for dry skin conditions and nappy rash.</p>', '<p>Applied directly to the skin. As required, up to four times daily or at each nappy change. The product is suitable for use by adults, children and the elderly.</p>', '<p>May mask x-ray pictures under certain circumstances.</p>', '<p>Known hypersensitivity to any of the ingredients listed.</p>', NULL, '<p>No information is available on the safety of the product when used during pregnancy and lactation.</p>', '<p>For external use only. Keep all medicines out of sight and reach of children. Instruct patients not to smoke or go near naked flames&ndash; risk of severe burns. Fabric (clothing, bedding, dressings, etc.) that has been in contact with this product burns more easily and is a serious fire hazard. Washing clothing and bedding may reduce product build-up but not totally remove it.<br />\r\n<br />\r\nZinc and Castor Oil Ointment BP contains Arachis Oil (peanut oil) and should not be applied by patients known to be allergic to peanut. As there is a possible relationship between allergy to peanut and allergy to Soya, patients with soya allergy should also avoid Zinc and Castor Oil Ointment. or<br />\r\n<br />\r\nZinc and Castor Oil Cream contains Arachis Oil (peanut oil) and should not be applied by patients known to be allergic to peanut. As there is a possible relationship between allergy to peanut and allergy to Soya, patients with soya allergy should also avoid Zinc and Castor Oil Cream.</p>', '<p>Overdosage is unlikely. If accidentally ingested treatment should be symptomatic. Oral ingestion of large quantities of castor oil may cause nausea, vomiting, colic and diarrhoea.</p>', '<p>Emollients &amp; combined preparations.</p>', '<p>Store below 25&deg;C.</p>', NULL, '2022-03-12 00:35:59', '2022-03-12 00:35:59'),
(1123, 1123, '<p>This cream is indicated for protection from harmful UV rays and thus managing photodermatoses, skin pigmentation, solar urticaria, acute solar dermatitis, drug-induced photosensitivity, acute lupus erythematosus, polymorphic light eruption, etc.</p>', '<p>This cream is a combination of 4 ingredients which provide a highly protective sunscreen action.Thus, it protects against the harmful effects of ultraviolet rays of sun which can cause skin cancer, wrinkle, premature aging and darkening of skin. Its Sun Protection Factor (SPF) is 60 &amp; Protection Grade of UVA (PA) is +++, making it perfect for both UVA &amp; UVB protection. Zinc Oxide acts as screen and reflects &amp; scatters UV radiation in order to protect the skin.Avobenzone,Octinoxate and Enzacamene absorb UV radiation and convert it to heat, which is then released from the skin. Strong stay-on properties making it long lasting sunscreen.</p>', '<p>Apply on the exposed area of the body to sunlight (such as face, neck &amp; body) at least 30 minutes before exposure and whenever necessary. Massage on to skin until absorbed. To ensure maximum protection, repeat the application every two hours after continuous exposure to the sun and after swimming, physical exercise.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Take an adequate amount of cream</li>\r\n	<li>Apply as a thin layer on the face or, other exposed body area</li>\r\n	<li>Gently massage onto the skin</li>\r\n</ul>', '<p>It is not known whether this preparation has any interaction with other topically applied drug products.</p>', '<p>This preparation is contraindicated in patients with a history of sensitivity to any components of the preparation.</p>', '<p>Signs of irritations (erythema, burning or rash) may appear when applied to sensitive or broken skin.</p>', '<p>Pregnancy Category C. It is not known whether this preparation is excreted in human milk. Caution should be exercised when this cream is administered to a nursing woman.</p>', '<p>For external use only. Transient stinging or burning may occur when applied to abraded or broken skin.</p>', NULL, '<p>Sunblock Preparation</p>', '<p>Store below 30&deg;C. Do not freeze. Keep out of reach of children.</p>', '<p>Pediatric Use: The safety and effectiveness of this cream have not been established in pediatric patients.</p>', '2022-03-12 00:38:18', '2022-03-12 00:38:18'),
(1124, 1124, '<p>Zinc Sulfate Monohydrate is indicated in zinc deficiency and/or zinc losing conditions. Zinc deficiency can occur as a result of inadequate diet or malabsorption. Excessive loss of zinc can occur in trauma, burns, diarrhoea and protein losing conditions. A zinc supplement is given until clinical improvement occurs but it may need to be continued in severe malabsorption, metabolic disease or in zinc losing states.</p>', '<p>Zinc sulphate monohydrate is an essential trace element and is involved in a number of body enzyme systems. The body needs zinc for normal growth and health. Zinc is also vital for sexual maturation and reproduction, dark vision adaptation, olfactory and gustatory activity, insulin storage &amp; release and for a variety of host immune defenses. Zinc deficiency may lead to impaired immune function, delayed wound healing, a decrease in sense of taste and smell, a reduced ability to fight infections, poor night vision, increased risk of abortion, alopecia, mental lethargy, skin changes and poor development of reproductive organs.</p>', '<p><strong>Child under 10 kg</strong>: 5 ml (1 teaspoonful) 2 times daily after food.<br />\r\n<strong>Child between 10-30 kg</strong>: 10 ml (2 teaspoonfuls) 1-3 times daily after food.<br />\r\n<strong>Adults and child over 30 kg</strong>: 20 ml (4 teaspoonfuls) 1-3 times daily after food.<br />\r\n<br />\r\nThis drug is most effective if they are taken at least 1 hour before or 2 hour after meals. However, if causes stomach upset, this may be taken with a meal.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>For dispersible tablet<strong>-</strong></p>\r\n\r\n<ul>\r\n	<li>Place the tablet in a teaspoon</li>\r\n	<li>Add adequate amount of water</li>\r\n	<li>Let the tablet dissolve completely</li>\r\n	<li>Give the entire spoonful solution</li>\r\n</ul>', '<p>Concomitant intake of a tetracycline and zinc may decrease the absorption of both the tetracycline and zinc. Similarly concomitant administration of zinc and quinolone drug may also decrease the absorption of both. Concomitant intake of penicillamine and zinc may decrese absorption of zinc.</p>', '<p>It is contraindicated in those who are hypersensitive to any component of the ingredient of this preparation.</p>', '<p>Zinc may cause nausea, vomiting, diarrhoea, stomach upset, heartburn and gastritis.</p>', '<p>The safety of this product in human pregnancy has not been established. Zinc crosses the placenta and is present in breast milk.</p>', '<p>In acute renal failure, zinc accumulation may occur in body; so dose adjustment is needed.</p>', NULL, '<p>Specific mineral preparations</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-12 00:40:44', '2022-03-12 00:40:44'),
(1125, 1125, '<p>Ziprasidone is indicated for the treatment of&nbsp;schizophrenia, as monotherapy for the acute treatment of bipolar&nbsp;manic&nbsp;or mixed episodes, and as an adjunct to&nbsp;lithium&nbsp;or valproate for the maintenance treatment of bipolar disorder. Ziprasidone&nbsp;intramuscular&nbsp;is indicated for acute agitation in schizophrenic patients. When deciding among the alternative treatments available for the condition needing treatment, the prescriber should consider the finding of ziprasidone&#39;s greater capacity to prolong the QT/QTc interval compared to several other&nbsp;antipsychotic&nbsp;drugs. Prolongation of the QTc interval is associated in some other drugs with the ability to cause torsade de pointes-type&nbsp;arrhythmia, a potentially fatal&nbsp;polymorphic&nbsp;ventricular tachycardia, and sudden death. In many cases this would lead to the conclusion that other drugs should be tried first. Whether ziprasidone will cause torsade de pointes or increase the rate of sudden death is not yet known.</p>', '<p>Ziprasidone, a benzylisothiazolylpiperazine is an atypical antipsychotic which may produce antischizophrenic effect by the antagonism of central dopamine D2 receptors and central type 2 serotonergic (5-HT2) receptors.</p>', '<p><strong>Schizophrenia:</strong></p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Initially, 20 mg bid, increase if necessary at intervals of not</li>\r\n	<li><strong>Elderly</strong>: Lower initial dose and slower titration.</li>\r\n</ul>\r\n\r\n<p><strong>Acute mixed or manic episodes in bipolar disorder:</strong></p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Initially, 40 mg bid, increased to 60 mg or 80 mg bid on the 2nd day. Adjust subsequent doses according to patient&#39;s response and tolerance level. Maintenance treatment of bipolar I disorder (adjunctive therapy to either lithium or valproate): Continue at the same dosage on which the patient was initially stabilised within 40-80 mg bid.</li>\r\n	<li><strong>Elderly</strong>: Lower initial dose and slower titration.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken with food.</p>', '<p>May antagonise effects of levodopa and dopaminergics. May enhance effects of other CNS depressants and certain antihypertensives. Altered metabolism with CYP3A4 inducers (e.g. carbamazepine), and inhibitors (e.g. ketoconazole).</p>', '<p>Patient with history of QT prolongation or cardiac arrhythmias, recent acute MI or decompensated heart failure. Concurrent use with other drugs known to prolong the QT interval.</p>', '<p>Somnolence, rash or urticaria, GI disturbances, dizziness, flu-like symptoms, HTN, headache, agitation, confusion, dyspnoea, orthostatic hypotension, increased prolactin levels, wt gain, sexual dysfunction, extrapyramidal symptoms, tardive dyskinesia, hyperglycaemia. Rarely, cholestatic jaundice, hepatitis, seizures, leucopenia, neutropenia, thrombocytopenia, hyperlipidaemia.</p>', '<p>Pregnancy 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>Patient with history of seizures or conditions that lower the seizure threshold, CV or cerebrovascular disease, conditions which predispose to hypotension. Renal impairment. Elderly with dementia-related psychosis. Pregnancy and lactation.</p>', '<p><strong>Symptoms</strong>: Minimal sedation, slurred speech, transitory HTN, extrapyramidal symptoms, somnolence, tremor, anxiety.<br />\r\n<br />\r\n<strong>Management</strong>: Establish and maintain an airway, ensure adequate oxygenation and ventilation. Consider admin of activated charcoal together with a laxative, gastric lavage (after intubation for unconscious patient); established IV access. Treat hypotension and circulatory collapse with IV fluids. In case of severe extrapyramidal symptoms, anticholinergic medication should be given.</p>', '<p>Atypical neuroleptic drugs.</p>', '<p>Store between 15-30&deg; C.</p>', NULL, '2022-03-12 00:44:01', '2022-03-12 00:44:01'),
(1126, 1126, '<p>Zoledronic Acid is indicated in:</p>\r\n\r\n<ul>\r\n	<li>Hypercalcaemia of malignancy,&nbsp;</li>\r\n	<li>Bone metastases associated with solid tumours, Osteolytic lesions associated with multiple myeloma,&nbsp;</li>\r\n	<li>Corticosteroid-induced osteoporosis, Increase bone mass in men with osteoporosis, Osteoporosis in postmenopausal women</li>\r\n	<li>Paget&#39;s disease of bone</li>\r\n	<li>Prophylaxis of postmenopausal osteoporosis</li>\r\n</ul>', '<p>Zoledronic acid belongs to the class of nitrogen-containing bisphosphonates and acts primarily on bone. It is an inhibitor of osteoclast-mediated bone resorption. The action of bisphosphonates on bone is based on their high affinity for mineralized bone. Intravenously administered Zoledronic acid is rapidly distributed to bone. The main molecular target of Zoledronic acid in the osteoclast is the enzyme farnesyl pyrophosphate synthase, but this does not exclude other mechanisms. Clinical studies in tumour-induced hypercalcemia demonstrated that the effect of Zoledronic acid is characterized by decreases in serum calcium and urinary calcium excretion. In addition to its inhibitory activity against bone resorption, Zoledronic acid also possesses anti-tumour activity, anti-angiogenic activity, anti-pain activity, cytostatic and pro-apoptotic activity on tumour cells and synergistic cytostatic effect with other anti-cancer drugs. There was no accumulation of the active substance in plasma after multiple doses given every 28 days. Zoledronic acid is not metabolized and is excreted unchanged via the kidney.</p>', '<p><strong>Hypercalcemia of malignancy</strong>: The maximum recommended dose of Zoledronic Acid in hypercalcemia of malignancy (serum calcium 12 mg/dl or 3.0 mmol/l) is 4 mg. The 4 mg dose must be given as a single-dose intravenous infusion. Dose adjustment of Zoledronic Acid is not necessary in treating patients for hypercalcemia of malignancy presenting with mild-to-moderate renal impairment. Re-treatment with Zoledronic Acid may be considered if serum calcium does not return to normal after initial treatment. It is recommended that a minimum of 7 days elapse before re-treatment, to allow for full response to the initial dose.&nbsp;<br />\r\n<br />\r\n<strong>Multiple myeloma and bone metastases of solid tumors</strong>: The recommended dose of Zoledronic Acid in patients with multiple myeloma and metastatic bone lesions from solid tumors is 4 mg infused every 3-4 weeks. Patients should also be administered an oral calcium supplement of 500 mg and 400 IU of Vitamin-D daily.</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Prior to administration, the required amount of concentrate from one vial must be further diluted with 100 ml of calcium-free infusion solution (0.9% w/v sodium chloride solution or 5% w/v glucose solution). The duration of infusion must not be less than 15 minutes. After addition of the solution to the infusion media, the infusion solution should be used as soon as possible. If storage of the infusion solution is necessary, hold at 2-8&ordm; C for not more than 24 hours. If refrigerated, the solution must be allowed to reach room temperature before administration.<br />\r\n<br />\r\nZoledronic Acid must not be mixed with calcium or other divalent cation-containing infusion solutions, such as Lactated Ringer&#39;s solution, and should be administered as a single intravenous solution in a line separate from all other drugs.</p>', '<p>In clinical studies, Zoledronic acid has been administered concomitantly with commonly used anticancer agents, diuretics, antibiotics and analgesics without interactions. Caution is advised when Zoledronic acid are administered with aminoglycosides, since these agents may have an additive effect to lower serum calcium level for prolonged periods. In multiple myeloma patients, the risk of renal dysfunction may be increased when Zoledronic acid is used in combination with thalidomide. Concomitant use of loop diuretics with Zoledronic acid increases the risk of hypocalcemia. Caution is indicated when Zoledronic acid is used with other potentially nephrotoxic drugs.</p>', '<p>The drug is contraindicated if patients have hypersensitivity to the active substance or to any of the excipients or to any bisphosphonates; severe renal impairment (Creatinine clearance &lt;30 ml/min); pregnancy and lactation.</p>', '<p>The post-dose side-effects are headache, nausea, anorexia, fatigue, osteonecrosis of jaw, anemia, bone pain, constipation, fever, vomiting, flu-like syndrome, hypocalcemia, myalgia, arthralgia and hypophosphataemia.</p>', '<p>Zoledronic acid is contraindicated during pregnancy and in breast-feeding women. It is also not recommended for use in children and adolescents below 18 years of age.</p>', '<p>Patients must be appropriately hydrated prior to administration of Zoledronic Acid. This is especially important in the elderly and for patients receiving diuretic therapy. Adequate hydration can be achieved by the patient drinking two glasses of fluid (such as water) before and after the infusion. Serum levels of calcium, phosphate, magnesium and potassium, as well as serum creatinine should be carefully monitored after initiating Zoledronic Acid therapy. If hypocalcemia, hypophosphatemia or hypomagnesemia occurs, short-term supplemental therapy may be necessary. Moreover, careful renal function monitoring should be considered.</p>', '<p>Clinical experience with acute over dosage is limited. Over dosage may cause hypocalcemia, hypophosphatemia, and hypomagnesemia. In such case, reduction in serum levels of calcium, phosphorus, and magnesium should be corrected by intravenous administration of calcium gluconate, potassium or sodium phosphate and magnesium sulfate respectively.</p>', '<p>Bisphosphonate preparations.</p>', '<p>Store below 30&deg; C prior to opening. Protect from moisture and light. Zoledronic Acid must be kept out of the reach and sight of children.</p>', '<p><strong>Patients with renal impairment</strong>: The use of Zoledronic Acid is not recommended in patients with severe renal impairment (Creatinine clearance &lt;30 ml/min). No dose adjustment is necessary in patients with creatinine clearance &gt;60 ml/min. Based on creatinine clearance the following dose should be used in patient with impaired renal function:</p>\r\n\r\n<ul>\r\n	<li>CrCl &gt; 60 ml/min: 4 mg (5 ml)</li>\r\n	<li>CrCl 50-60 ml/min: 3.5 mg (4.4 ml)</li>\r\n	<li>CrCl 40-49 ml/min: 3.3 mg (4.1 ml)</li>\r\n	<li>CrCl 30-39 ml/min: 3 mg (3.8 ml)</li>\r\n</ul>', '2022-03-12 00:46:21', '2022-03-12 00:46:21'),
(1127, 1127, '<p>Zoledronic Acid is indicated for the treatment of osteoporosis in postmenopausal women to reduce the incidence of hip, vertebral and non-vertebral fractures; prevention of clinical fractures after a hip fracture; treatment and prevention of glucocorticoid-induced osteoporosis; treatment of osteoporosis in men and for the treatment of paget&#39;s disease of bone. Treatment should be restricted to three annual doses.</p>', '<p>Zoledronic acid belongs to the class of nitrogen-containing bisphosphonates and acts primarily on bone. It is an inhibitor of osteoclast-mediated bone resorption. The action of bisphosphonates on bone is based on their high affinity for mineralized bone. Intravenously administered Zoledronic acid is rapidly distributed to bone. The main molecular target of Zoledronic acid in the osteoclast is the enzyme farnesyl pyrophosphate synthase, but this does not exclude other mechanisms. There was no accumulation of the active substance in plasma after multiple doses given every 28 days. Zoledronic acid is not metabolized and is excreted unchanged via the kidney.</p>', '<p><strong>Treatment of postmenopausal osteoporosis</strong>: Recommended dose is a single intravenous infusion of 5 mg Zoledronic Acid administered once a year. Adequate supplemental Calcium and Vitamin-D intake is important in women with osteoporosis if dietary intake is inadequate.&nbsp;<br />\r\n<br />\r\n<strong>Prevention of clinical fractures after a hip fracture</strong>: Recommended dose is a single intravenous infusion of 5 mg Zoledronic Acid&nbsp;administered once a year. In patients with a recent low-trauma hip fracture, it is recommended to give the first Zoledronic Acid solution for infusion two or more weeks after hip fracture repairs. It is also recommended to have a loading dose of 50,000 to 125,000 IU of Vitamin-D given orally or via intramuscular route prior to the first administration of Zoledronic Acid solution for infusion. Supplemental Calcium and Vitamin-D intake is recommended for patients treated to prevent clinical fractures after a hip fracture.<br />\r\n<br />\r\n<strong>Treatment of osteoporosis in men</strong>: Recommended dose is a single intravenous infusion of 5 mg Zoledronic Acid administered once a year. Adequate supplemental Calcium and Vitamin-D intake is important in men with osteoporosis if dietary intake is inadequate.&nbsp;<br />\r\n<br />\r\n<strong>Treatment and prevention of glucocorticoid-induced osteoporosis</strong>: Recommended dose is a single intravenous infusion of 5 mg Zoledronic Acid administered once a year. Adequate supplemental Calcium and Vitamin-D intake is important in patients with osteoporosis if dietary intake is inadequate.<br />\r\n<br />\r\n<strong>Treatment of paget&#39;s disease of bone</strong>: Recommended dose is a single intravenous infusion of 5 mg Zoledronic Acid. Re-treatment with Zoledronic Acid may be considered in patients who have relapsed, based on increases in serum alkaline phosphatase, in patients who failed to achieve normalization of serum alkaline phosphatase, or in patients with symptoms, as dictated by medical practice 12 months after the initial dose.<br />\r\n<br />\r\nIn patients with paget&#39;s disease, adequate Vitamin-D intake is recommended in association with Zoledronic Acid administration. In addition, it is strongly advised that adequate supplemental Calcium corresponding to at least 500 mg elemental Calcium twice daily is ensured in patients with paget&#39;s disease for at least 10 days following Zoledronic Acid administration.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>The dose of 5 mg Zoledronic acid must be administered over at least 15 minutes. Zoledronic Acid&nbsp;should be administered intravenously via a infusion line, given at a constant infusion rate. The infusion time must not be less than 15 minutes.</p>', '<p>Specific drug-drug interaction studies have not been conducted with Zoledronic acid. Zoledronic acid is eliminated by renal excretion. Caution is indicated when Zoledronic Acid is administered in conjunction with drugs that can significantly impact renal function (e.g. aminoglycosides or diuretics that may cause dehydration).</p>', '<p>The drug is contraindicated if patients have hypersensitivity to the active substance or to any of the excipients or to any bisphosphonates, hypocalcaemia, renal impairment (creatinine clearance &lt;35 mL/min), current or recent uveitis, or a history of bisphosphonate-associated uveitis, pregnancy and lactation.</p>', '<p>The post-dose side-effects are fever, myalgia, flu-like symptoms, arthralgia and headache, the majority of which occur within the first 3 days following Zoledronic Acid administration. The majority of these symptoms were mild to moderate in nature and resolved within 3 days of the event onset. The incidence of these symptoms occurring within the first 3 days after administration of Zoledronic Acid, can be reduced with the administration of Paracetamol or Ibuprofen shortly following Zoledronic Acid administration. Severe and occasionally incapacitating bone, joint, and/or muscle pain have been infrequently reported in patients taking Zoledronic Acid.</p>', '<p>Zoledronic Acid is contraindicated during pregnancy and in breast-feeding women. It is also not recommended for use in children and adolescents below 18 years of age.</p>', '<p>Patients must be appropriately hydrated prior to administration of Zoledronic Acid. This is especially important in the elderly and for patients receiving diuretic therapy. Adequate hydration can be achieved by the patient drinking two glasses of fluid (such as water) before and after the infusion. Pre-existing hypocalcaemia must be treated by adequate intake of Calcium and Vitamin-D before initiating therapy with Zoledronic Acid. Other disturbances of mineral metabolism must also be effectively treated (e.g. diminished parathyroid reserve, thyroid surgery, parathyroid surgery, intestinal Calcium malabsorption). Physicians should consider clinical monitoring for these patients.</p>', '<p>Clinical experience with acute over dosage is limited. Patients who have received doses higher than those recommended should be carefully monitored. In the event of overdose leading to clinically significant hypocalcaemia, reversal may be achieved with supplemental oral Calcium and/or an infusion of Calcium.</p>', '<p>Bisphosphonate preparations.</p>', '<p>Store below 30&deg; C prior to opening. Protect from moisture and light. Zoledronic Acid must be kept out of the reach and sight of children.</p>', '<p><strong>Patients with renal impairment</strong>: The use of Zoledronic Acid in patients with creatinine clearance &lt;35 mL/min is not recommended due to limited clinical safety data in such patients. No dose adjustment is necessary in patients with creatinine clearance &gt;35 mL/min.<br />\r\n<br />\r\n<strong>Patients with hepatic impairment</strong>: No dose adjustment is required for patients with hepatic impairment.<br />\r\n<br />\r\n<strong>Elderly patients</strong>: No dose adjustment is required. However, because decreased renal function occurs more commonly in the elderly, special care should be taken to monitor renal function.<br />\r\n<br />\r\nZoledronic Acid must not be mixed or given intravenously with any other medication and must be given through a separate infusion line at a constant infusion rate. If refrigerated, allow the refrigerated solution to reach room temperature before administration. Aseptic techniques must be followed during the preparation of the infusion. Any unused solution should be discarded. Only clear solution free from particles and discoloration should be used.<br />\r\n<br />\r\nAfter opening, the solution is chemically and physically stable for at least 24 hours at 2&deg;C to 8&deg;C. From a microbiological point of view, the product should be used immediately. Zoledronic Acid solution for infusion must not be allowed to come into contact with any Calcium or other divalent cation-containing solutions.</p>', '2022-03-12 00:48:38', '2022-03-12 00:48:38'),
(1128, 1128, '<p>Zolmitriptan is indicated for the acute treatment of migraines with or without aura in adults.</p>', '<p>Migraines are likely due to local cranial vasodilatation and/or to the release of sensory neuropeptides through nerve endings in the trigeminal system. The therapeutic activity of Zolmitriptan&nbsp;for the treatment of migraine headache is thought to be due to the agonist effects at the 5-HT1B/1D&nbsp;receptors on intracranial blood vessels and sensory nerves of the trigeminal system which results in cranial vessel constriction and inhibition of pro-inflammatory neuropeptide release.</p>', '<p><strong>Tablet</strong>: The recommended starting dose of Zolmitriptan is 2.5 mg tablet. Maximum recommended single dose is 5 mg. If the migraine has not resolved by 2 hours after taking Zolmitriptan, or returns after a transient improvement, a second dose may be administered at least 2 hours after the first dose. The maximum daily dose is 10 mg in any 24-hours period.<br />\r\n<br />\r\n<strong>Nasal Spray</strong>: Administer one dose of Zolmitriptan Nasal Spray 5 mg for the treatment of acute migraine. If the headache returns the dose may be repeated after 2 hours. The maximum daily dose should not exceed 10 mg in any 24-hour period. In controlled clinical trials, single doses of 5 mg zolmitriptan nasal spray were administered into one nostril and were effective for the treatment of acute migraines in adults. Individuals may vary in response to Zolmitriptan Nasal Spray. The pharmacokinetics of a 5 mg nasal spray dose is similar to the 5 mg oral formulations. Doses lower than 5 mg can only be achieved through the use of an oral formulation. The choice of dose, and route of administration should therefore be made on an individual basis. The effectiveness of a second dose has not been established in placebo-controlled trials. The safety of treating an average of more than four headaches in a 30 day period has not been established.</p>', NULL, '<p>Contraindicated in patients with ischemic coronary artery disease, history of stroke, concurrent or recent use of a monoamine oxidase inhibitor and known hypersensitivity to Zolmitriptan.</p>', '<p>Most common adverse reactions were neck/throat/jaw pain or pressure, dizziness, paresthesia, asthenia, somnolence, warm/cold sensation, nausea, heaviness sensation, and dry mouth.</p>', '<p>Pregnancy Category C. Zolmitriptan should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Zolmitriptan is excreted in human milk. A decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>There have been rare reports of serious cardiac adverse reactions, including acute myocardial infarction, occurring within a few hours following administration. Sensations of tightness, pain, and pressure may occur in the chest, throat, neck, and jaw after treatment with Zolmitriptan.</p>', NULL, '<p>5-HT Agonists</p>', '<p>Protect from light and moisture, store below 30&deg;C. Keep the medicine out of the reach of children.</p>', '<p>Pediatric Use: Not recommended for use in patients under 18 years of age.</p>', '2022-03-12 00:50:31', '2022-03-12 00:50:31');
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
(1129, 1129, '<p>Zolpidem is indicated for the short-term treatment of insomnia characterized by difficulties with sleep initiation. Zolpidem has been shown to decrease sleep latency for up to 35 days in controlled clinical studies&nbsp;<br />\r\n<br />\r\nThe clinical trials performed in support of efficacy were 4-5 weeks in duration with the final formal assessments of sleep latency performed at the end of treatment.</p>', '<p>Zolpidem is an imidazopyridine derivative that acts by binding to the benzodiazepine (BZD) receptors of the GABA receptor complex resulting in neuronal hyperpolarisation, action potential inhibition, increased in chloride conductance and decreased in neuronal excitability. It has strong sedative action but only minimal anxiolytic, myorelaxant and anticonvulsant properties due to its selectivity for the BZ1-receptor over the BZ2-receptor. Zolpidem has a rapid onset but short duration of hypnotic action.</p>', '<p><strong>Dosage In Adults</strong>: Use the lowest&nbsp;effective dose&nbsp;for the patient. The recommended initial dose is 5 mg for women and either 5 or 10 mg for men, taken only once per night immediately before bedtime with at least 7&ndash;8 hours remaining before the planned time of awakening. If the 5 mg dose is not effective, the dose can be increased to 10 mg. In some patients, the higher morning blood levels following use of the 10 mg dose increase the risk of next day impairment of driving and other activities that require full alertness. The total dose of Zolpidem should not exceed 10 mg once daily immediately before bedtime. Zolpidem should be taken as a single dose and should not be readministered during the same night.<br />\r\n<br />\r\nThe recommended initial doses for women and men are different because zolpidem clearance is lower in women.<br />\r\n<br />\r\n<strong>Special Populations</strong>: Elderly or debilitated patients may be especially sensitive to the effects of zolpidem tartrate. The recommended dose of Zolpidem in these patients is 5 mg once daily immediately before bedtime<br />\r\n<br />\r\nPatients with mild to moderate hepatic impairment do not clear the drug as rapidly as normal subjects. The recommended dose of Zolpidem in these patients is 5 mg once daily immediately before bedtime. Avoid Zolpidem use in patients with severe hepatic impairment as it may contribute to&nbsp;encephalopathy<br />\r\n<br />\r\n<strong>Use With CNS Depressants</strong>: Dosage adjustment may be necessary when Zolpidem is combined with other CNS depressant drugs because of the potentially additive effects</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>The effect of Zolpidem may be slowed by ingestion with or immediately after a meal.</p>', '<p>Co-administration of zolpidem with other CNS depressants increases the risk of CNS depression. Concomitant use of zolpidem with these drugs may increase drowsiness and psychomotor impairment, including impaired driving ability. Zolpidem tartrate was evaluated in healthy volunteers in single-dose interaction studies for several CNS drugs.<br />\r\n<br />\r\n<strong>Imipramine, Chlorpromazine</strong>: Imipramine in combination with zolpidem produced no pharmacokinetic interaction other than a 20% decrease in peak levels of imipramine, but there was an additive effect of decreased alertness. Similarly, chlorpromazine in combination with zolpidem produced no pharmacokinetic interaction, but there was an additive effect of decreased alertness and psychomotor performance&nbsp;<br />\r\n<br />\r\n<strong>Haloperidol</strong>: A study involving haloperidol and zolpidem revealed no effect of haloperidol on the pharmacokinetics or pharmacodynamics of zolpidem. The lack of a drug interaction following single-dose administration does not predict the absence of an effect following chronic administration&nbsp;<br />\r\n<br />\r\n<strong>Alcohol</strong>: An additive&nbsp;adverse effect&nbsp;on psychomotor performance between alcohol and oral zolpidem was demonstrated&nbsp;<br />\r\n<br />\r\n<strong>Sertraline</strong>: Concomitant administration of zolpidem and sertraline&nbsp;increases exposure to zolpidem<br />\r\n<br />\r\n<strong>Fluoxetine</strong>: After multiple doses of zolpidem tartrate and fluoxetine an increase in the zolpidem half-life (17%) was observed. There was no evidence of an additive effect in psychomotor performance</p>', '<p>Severe hepatic impairment.</p>', '<p>Atypical thinking and behaviour, hallucination, nightmare, somnolence, somnambulism, headache, nausea, vomiting, dizziness, vertigo, drowsiness, asthenia, ataxia, rebound insomnia, amnesia, GI disturbances, upper and lower respiratory tract infection, fatigue, visual disturbances, increased ALT serum concentrations, abnormal LFT.</p>', '<p><strong>Pregnancy</strong>&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>Obstructive sleep apnoea, myasthenia gravis, compromised respiratory function. Patients exhibiting symptoms of depression. History of drug or alcohol abuse. Avoid abrupt withdrawal and rapid dose reduction after prolonged therapy. Re-evaluate if insomnia fail to remit after 7-10 days as this may indicate the presence of underlying psychiatric and/or medical condition. Pregnancy, lactation, childn &lt;18 yr.</p>', '<p><strong>Symptoms</strong>: Drowsiness, impairment of consciousness from somnolence to coma, compromised CV and respiratory function.<br />\r\n<br />\r\n<strong>Management</strong>: Treatment is largely symptomatic and supportive. IV fluids should be administered as needed. Activated charcoal may be given if presented w/in 1 hr of ingestion of &gt;1 mg/kg zolpidem in adults or childn. Gastric lavage may be considered if presented w/in 1 hr of ingestion of &gt;100 mg zolpidem and monitor for at least 12 hr. Flumazenil may be used if there is severe CNS depression, but generally not needed. Haemodialysis is unlikely to be useful.</p>', '<p>Miscellaneous sedatives &amp; hypnotics.</p>', '<p>Store between 20-25&deg; C.</p>', '<p><strong>Pediatric Use</strong>: Zolpidem is not recommended for use in children. Safety and effectiveness of zolpidem in pediatric patients below the age of 18 years have not been established.</p>', '2022-03-12 00:56:51', '2022-03-12 00:56:51'),
(1130, 1130, '<p>Zonisamide is indicated as adjunctive therapy in the treatment of partial seizures in adults with&nbsp;epilepsy.</p>', '<p>The precise mechanism(s) by which zonisamide exerts its antiseizure effect is unknown. Zonisamide demonstrated&nbsp;anticonvulsant&nbsp;activity in several experimental models. In animals, zonisamide was effective against tonic&nbsp;extension&nbsp;seizures induced by maximal electroshock but ineffective against clonic seizures induced by subcutaneous pentylenetetrazol. Zonisamide raised the threshold for generalized seizures in the kindled rat model and reduced the duration of&nbsp;cortical&nbsp;focal&nbsp;seizures induced by electrical stimulation of the visual&nbsp;cortex&nbsp;in cats. Furthermore, zonisamide suppressed both interictal spikes and the secondarily generalized seizures produced by cortical application of tungstic acid gel in rats or by cortical freezing in cats. The relevance of these models to human&nbsp;epilepsy&nbsp;is unknown.<br />\r\n<br />\r\nZonisamide may produce these effects through action at sodium and calcium channels. In vitro pharmacological studies suggest that zonisamide blocks sodium channels and reduces voltagedependent, transient inward currents (T-type Ca2+&nbsp;currents), consequently stabilizing neuronal membranes and suppressing neuronal hypersynchronization. In vitro binding studies have demonstrated that zonisamide binds to the GABA/benzodiazepine receptor ionophore complex in an allosteric fashion which does not produce changes in chloride flux. Other in vitro studies have demonstrated that zonisamide (10&ndash;30 &mu;g/mL) suppresses synaptically-driven electrical activity without affecting postsynaptic GABA or&nbsp;glutamate&nbsp;responses (cultured mouse&nbsp;spinal cord&nbsp;neurons) or neuronal or glial uptake of [3H]-GABA (rat hippocampal slices). Thus, zonisamide does not appear to potentiate the synaptic activity of GABA. In vivo microdialysis studies demonstrated that zonisamide facilitates both dopaminergic and serotonergic neurotransmission.<br />\r\n<br />\r\nZonisamide is a carbonic anhydrase inhibitor. The contribution of this pharmacological action to the therapeutic effects of zonisamide is unknown. However, as a carbonic anhydrase inhibitor, zonisamide may cause metabolic&nbsp;acidosis</p>', '<p>Zonisamide&nbsp;is recommended as adjunctive therapy for the treatment of partial seizures in adults. Safety and efficacy in pediatric patients below the age of 16 have not been established. Zonisamide should be administered once or twice daily, using 25 mg or 100 mg capsules. Zonisamide is given orally and can be taken with or without food. Capsules should be swallowed whole.<br />\r\n<br />\r\n<strong>Adults Over Age 16</strong>: The prescriber should be aware that, because of the long half-life of zonisamide, up to two weeks may be required to achieve steady state levels upon reaching a stable dose or following dosage adjustment. Although the regimen described below is one that has been shown to be tolerated, the prescriber may wish to prolong the duration of treatment at the lower doses in order to fully assess the effects of zonisamide at steady state, noting that many of the side effects of zonisamide are more frequent at doses of 300 mg per day and above. Although there is some evidence of greater response at doses above 100-200 mg/day, the increase appears small and formal dose-response studies have not been conducted.<br />\r\n<br />\r\nThe initial dose of Zonisamide should be 100 mg daily. After two weeks, the dose may be increased to 200 mg/day for at least two weeks. It can be increased to 300 mg/day and 400 mg/day, with the dose stable for at least two weeks to achieve steady state at each level. Evidence from controlled trials suggests that Zonisamide doses of 100-600 mg/day are effective, but there is no suggestion of increasing response above 400 mg/day. There is little experience with doses greater than 600 mg/day.</p>', NULL, '<p>Zonisamide is contraindicated in patients who have demonstrated hypersensitivity to&nbsp;sulfonamides&nbsp;or zonisamide.</p>', '<p>The most common adverse reactions with Zonisamide (an incidence at least 4% greater than placebo) in controlled clinical trials and shown in descending order of frequency were&nbsp;somnolence,&nbsp;anorexia, dizziness,&nbsp;ataxia, agitation/irritability, and difficulty with memory and/or concentration.<br />\r\n<br />\r\nIn controlled clinical trials, 12% of patients receiving Zonisamide as adjunctive therapy discontinued due to an adverse reaction compared to 6% receiving placebo. Approximately 21% of the 1,336 patients with&nbsp;epilepsy&nbsp;who received Zonisamide in clinical studies discontinued treatment because of an adverse reaction. The most common adverse reactions leading to discontinuation were somnolence, fatigue and/or ataxia (6%), anorexia (3%), difficulty concentrating (2%), difficulty with memory, mental slowing, nausea/vomiting (2%), and weight loss (1%). Many of these adverse reactions were doserelated.</p>', '<p>Zonisamide may cause serious adverse fetal effects, based on clinical and nonclinical data. Zonisamide was teratogenic in multiple animal species.<br />\r\n<br />\r\nZonisamide treatment causes metabolic acidosis in humans. The effect of zonisamide-induced metabolic acidosis has not been studied in pregnancy; however, metabolic acidosis in pregnancy (due to other causes) may be associated with decreased fetal growth, decreased fetal&nbsp;oxygenation, and fetal death, and may affect the fetus&#39;s ability to tolerate labor. Pregnant patients should be monitored for metabolic acidosis and treated as in the non-pregnant state.&nbsp;<br />\r\n<br />\r\nNewborns of mothers treated with zonisamide should be monitored for metabolic acidosis because of transfer of zonisamide to the fetus and possible occurrence of transient metabolic acidosis following birth. Transient metabolic acidosis has been reported in neonates born to mothers treated during pregnancy with a different carbonic anhydrase inhibitor.</p>', '<p>Somnolence is commonly reported, especially at higher doses of Zonisamide. Zonisamide is metabolized by the liver and eliminated by the kidneys; caution should therefore be exercised when administering Zonisamide to patients with hepatic and renal dysfunction.</p>', '<p><strong>Human Experience</strong>: Experience with Zonisamide daily doses over 800 mg/day is limited. During Zonisamide clinical development, three patients ingested unknown amounts of Zonisamide as suicide attempts, and all three were hospitalized with CNS symptoms. One patient became comatose and developed&nbsp;bradycardia,&nbsp;hypotension, and&nbsp;respiratory depression; the zonisamide plasma level was 100.1 &mu;g/mL measured 31 hours post-ingestion. Zonisamide plasma levels fell with a half-life of 57 hours, and the patient became alert five days later.<br />\r\n<br />\r\n<strong>Management</strong>: No specific antidotes for Zonisamide overdosage are available. Following a suspected recent overdose,&nbsp;emesis&nbsp;should be induced or&nbsp;gastriclavage performed with the usual precautions to protect the airway. General&nbsp;supportive care&nbsp;is indicated, including frequent monitoring of vital signs and close observation.<br />\r\n<br />\r\nZonisamide has a long half-life. Due to the low protein binding of zonisamide (40%), renal&nbsp;dialysis&nbsp;may be effective. The effectiveness of renal dialysis as a treatment of overdose has not been formally studied. A poison control center should be contacted for information on the management of Zonisamide overdosage.</p>', '<p>Adjunct anti-epileptic drugs.</p>', NULL, '<p><strong>Patients With Renal Or Hepatic Disease</strong>: Because zonisamide is metabolized in the liver and excreted by the kidneys, patients with renal or hepatic disease should be treated with caution, and might require slower titration and more frequent monitoring<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: The safety and effectiveness of Zonisamide in children under age 16 have not been established. Cases of oligohidrosis and hyperpyrexia have been reported. Zonisamide commonly causes metabolic acidosis in pediatric patients. Chronic untreated metabolic acidosis in pediatric patients may cause nephrolithiasis and/or nephrocalcinosis, osteoporosis and/or osteomalacia (potentially resulting in rickets), and may reduce growth rates. A reduction in growth rate may eventually decrease the maximal height achieved. The effect of zonisamide on growth and bonerelated sequelae has not been systematically investigated.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Single dose pharmacokinetic parameters are similar in elderly and young healthy volunteers. Clinical studies of zonisamide did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.</p>', '2022-03-12 00:58:58', '2022-03-12 00:58:58'),
(1131, 1131, '<p>Zopiclone is indicated for the short-term treatment and symptomatic relief of insomnia characterized by difficulty in falling asleep, frequent nocturnal awakenings and/or early morning awakenings.</p>', '<p>Zopiclone, a cyclopyrrolone derivative, is a short-acting hypnotic agent. This is structurally unrelated to existing hypnotics. However, the pharmacological profile of Zopiclone is similar to that of the benzodiazepines. Zopiclone pharmacological properties are: hypnotic, sedative, anxiolytic, anti-convulsant, muscle-relaxant. These effects are related to a specific agonist action at central receptors belonging to the GABAA&nbsp;macromolecular complex, modulating the opening of the chloride ion channel.</p>', '<p>The recommended initial dose is 3.75 mg (one-half of a 7.5 mg tablet). The dose can be increased to 5 mg and further to 7.5 mg if clinically indicated. In some patients, the higher doses result in zopiclone blood levels in the morning high enough to produce impairment of driving and other activities that require full alertness. The 7.5 mg dose should not be exceeded.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Treatment with Zopiclone should usually not exceed 7-10 consecutive days. Use for more than 2-3 consecutive weeks requires complete re-evaluation of the patient. Prescriptions for Zopiclone should be written for short-term use (7-10 days) and it should not be prescribed in quantities exceeding a 1-month supply. The use of hypnotics should be restricted for insomnia where disturbed sleep results in impaired daytime functioning.</p>', '<p>Zopiclone may produce more pronounced side effects when co- administered with:</p>\r\n\r\n<ul>\r\n	<li>Alcohol</li>\r\n	<li>Other tranquilizers or sleeping pills</li>\r\n	<li>Sedative antihistamines</li>\r\n	<li>Anticonvulsants (medicines used to control or prevent convulsions)</li>\r\n	<li>Narcotic analgesics (opioids)</li>\r\n	<li>Antipsychotics, antidepressants and other psychotropic medications (mood altering drugs) which themselves can make you sleepy.</li>\r\n</ul>', '<p>Zopiclone is contraindicated in patients with severe hepatic insufficiency, contraindicated in patients with severe impairment of respiratory function.</p>', '<p>Common side effects are somnolence, dizziness, confusion, anterograde amnesia or memory impairment, feeling of drunkenness, euphoria, nightmares, agitation, anxiety or nervousness, hostility, depression, decreased libido, libido disorder, coordination abnormality, headache, hypotonia, tremor, muscle spasms, paresthesia, and speech disorder, palpitations, dysgeusia (bitter taste), dry mouth, coated tongue, bad breath, nausea, vomiting, diarrhea, constipation, anorexia or increased appetite.</p>', '<p>Do no take Zopiclone at anytime during pregnancy, it may affect the developing baby. Zopiclone passes into breast milk. Therefore, if you are breast feeding, this medicine should be avoided. Your doctor will discuss this with you.</p>', '<ul>\r\n	<li>Do not take more Zopiclone than prescribed.</li>\r\n	<li>Do not use for longer than recommended by your physician. Treatment should be as short as possible, because the risk of dependence increases with the duration of treatment.</li>\r\n	<li>Do not take Zopiclone if you drink alcohol.</li>\r\n	<li>Talk to your doctor if you have had episodes of sleepwalking in the past, or if there is a history of sleepwalking in your family.</li>\r\n	<li>Talk to your doctor if you have a condition that affects your sleep, such as Periodic Limb Movement Disorder (involuntary movement of limbs during sleep) or Restless Legs Syndrome (urge to move legs, usually accompanied by uncomfortable and unpleasant sensations, that begins or worsens during periods of inactivity, typically in the evening and night).</li>\r\n</ul>', '<p>Overdose is usually manifested by varying degrees of central nervous system depression ranging from drowsiness to coma according to the quantity ingested. In mild cases, symptoms include drowsiness, confusion, and lethargy; in more severe cases, symptoms may include ataxia, hypotonia, hypotension, methaemoglobinaemia, respiratory depression, and coma. Overdose should not be life threatening unless combined with other CNS depressants, including alcohol. Other risk factors, such as the presence of concomitant illness and the debilitated state of the patient, may contribute to the severity of symptoms and very rarely can result in fatal outcome. Symptomatic and supportive treatment in adequate clinical environment is recommended, attention should be paid to respiratory and cardiovascular functions. Gastric lavage or activated charcoal is only useful when performed soon after ingestion.</p>', '<p>Miscellaneous sedatives &amp; hypnotics.</p>', '<p>Store in a dry place, at room temperature (15&deg;C to 30&deg;C). Protect from light. Keep in a safe place out of reach of children.</p>', '<p>Zopiclone is not indicated for patients under 18 years of age.</p>', '2022-03-12 01:01:54', '2022-03-12 01:01:54'),
(1132, 1132, '<p>Zuclopenthixol is indicated for the management of the manifestations of schizophrenia. This is intended for the initial treatment of acute psychotic episodes or exacerbation of psychosis associated with schizophrenia.</p>', '<p>Zuclopenthixol, a thioxanthene derivative, has high affinity for both dopamine D1 receptors and dopamine D2 receptors. Zuclopenthixol also has high affinity for &alpha;1 -adrenergic and 5 HT2 receptors. It has weaker histamine H1 receptor blocking activity, and even lower affinity for muscarinic cholinergic and &alpha;2 -adrenergic receptors.</p>', '<p><strong>Zuclopenthixol Tablets</strong>: When initiating treatment with Zuclopenthixol tablets, it is recommended that the drug be given in divided doses (BID or TID). During the maintenance phase of treatment Zuclopenthixol tablets may be given as a single nighttime dose. For acute psychosis, the usual starting dose is 10-50 mg/day, which may be increased by 10-20 mg every 2-3 days, according to the patient&rsquo;s response. The usual therapeutic range is 20 mg to 60 mg daily. However, as with other antipsychotic drugs, some patients may require lower, while others may require higher dosage in order to obtain optimal benefit. Daily dosage higher than 100 mg is not recommended. For maintenance therapy, dosage should be reduced to the lowest level compatible with symptom control. The usual maintenance dose is 20-40 mg/day.<br />\r\n<br />\r\n<strong>Zuclopenthixol Acuphase</strong>: Dosage should be individually adjusted according to the patient&rsquo;s condition. The usual dose is 50-150 mg (1-3 ml) administered intramuscularly and repeated if necessary, at intervals of 2-3 days. Some patients may need an additional injection 1 or 2 days after the first injection.<br />\r\n<br />\r\n<strong>Zuclopenthixol Depot</strong>: Close supervision is required during the period following initiation of Zuclopenthixol Depot treatment, in order to minimize the risk of over-medication or insufficient suppression of psychotic symptoms. Supplemental oral antipsychotic medication may be required in diminishing dosage during this period. The usual maintenance dose is 150-300 mg intramuscularly, every 2-4 weeks. Some patients may require higher or lower doses, or shorter intervals between doses.</p>', '<p>Drugs that may interact with Zuclopenthixol include:</p>\r\n\r\n<ul>\r\n	<li>tricyclic antidepressant medicines</li>\r\n	<li>guanethidine and similar medicines (used to lower the blood pressure)</li>\r\n	<li>barbiturates and similar medicines</li>\r\n	<li>levodopa and similar medicines (used to treat Parkinson&rsquo;s disease)</li>\r\n	<li>metoclopramide (used in the treatment of gastro-intestinal disorders)</li>\r\n	<li>other antipsychotic medicines (e.g. thioridazine)</li>\r\n	<li>medicines that change the heartbeat (e.g. quinidine, amiodarone, sotalol, erythromycine, moxifloxacin, lithium)</li>\r\n</ul>', '<ul>\r\n	<li>Acute alcohol, barbiturate or opiate intoxication.</li>\r\n	<li>CNS depression due to any cause, comatose states, suspected or established subcortical brain damage or circulatory collapse.</li>\r\n	<li>Patients with known hypersensitivity to thioxanthenes, zuclopenthixol or to any ingredient in the formulation or component of the container.</li>\r\n</ul>', '<p>Common side effects are Racing heart (tachycardia), a sensation of a rapid, forceful, or irregular beating of the heart (palpitations) Tremor, twisting or repetitive movements or abnormal postures due to sustained muscle contractions (dystonia), increased muscle stiffness (hypertonia).</p>', '<p>The safe use of zuclopenthixol during pregnancy has not been established. Zuclopenthixol is excreted in human milk. The safe use of zuclopenthixol during lactation has not been established.</p>', '<p>Caution should be taken if-</p>\r\n\r\n<ul>\r\n	<li>you have used zuclopenthixol or any other treatment for schizophrenia before and if you had any problems</li>\r\n	<li>you are taking any other prescription or non-prescription medicines</li>\r\n	<li>you are pregnant or thinking of becoming pregnant, or if you are breast-feeding</li>\r\n	<li>you regularly drink a lot of alcohol</li>\r\n	<li>you have any liver problems, Parkinson&rsquo;s disease or have ever had seizures</li>\r\n	<li>you have dementia</li>\r\n	<li>you have glaucoma</li>\r\n	<li>you have any kidney problems</li>\r\n	<li>you have risk factors for stroke (e.g. smoking, high blood pressure).</li>\r\n	<li>you have hypokalemia or hypomagnesia (too little potassium or magnesium in your blood)</li>\r\n	<li>you have a history of cardiovascular disorders</li>\r\n	<li>you or someone in your family has a history of blood clots</li>\r\n	<li>you are being treated for cancer (applies to zuclopenthixol Depot only)</li>\r\n	<li>you use any other antipsychotic medicine</li>\r\n</ul>', '<p>Symptoms of overdose may include: somnolence, coma, unusual movements, convulsions, shock, high or low body temperature.</p>', '<p>Phenothiazine related drugs.</p>', '<p>Should be stored between 15&deg;C and 25&deg;C. Protect from light.</p>', '<p>The safety and efficacy of zuclopenthixol in children under the age of 18 years have not been established, therefore its use is not recommended.</p>', '2022-03-12 01:04:36', '2022-03-12 01:04:36'),
(1133, 1133, '<p>Yellow Fever Vaccine provides protection against a serious infectious disease called yellow fever. Yellow fever occurs in certain areas of the world and is spread to man through the bites of infected mosquitoes.<br />\r\n<br />\r\nYellow Fever Vaccine is given to people who:</p>\r\n\r\n<ul>\r\n	<li>are travelling to, passing through or living in an area where yellow fever occurs,</li>\r\n	<li>are travelling to any country that requires an International Certificate of Vaccination for entry (this may depend on the countries previously visited during the same trip),</li>\r\n	<li>may handle infectious materials such as laboratory workers.</li>\r\n</ul>\r\n\r\n<p>To obtain a valid vaccination certificate against yellow fever, it is necessary to be vaccinated in an approved vaccination centre by a qualified and trained healthcare professional so that an International Certificate of Vaccination can be issued. This certificate is valid from 10 days after the first dose of vaccine. In some circumstances, when a booster is needed, the certificate (see Section 3) is valid immediately after the injection.</p>', '<p>Live, attenuated virus stimulates active immunity to Yellow fever; conveys active immunity via stimulation of production of endogenously produced antibodies. Yellow fever vaccine is used for active immunisation against yellow fever. Each dose (usually 0.5 ml) contains at least 1000 mouse LD50&nbsp;units.</p>', '<p>Yellow Fever Vaccine is given as a single, 0.5 millilitre dose to adults and children from 6 months of age. The first dose should be given at least 10 days before protection from yellow fever is needed. This is because it takes 10 days for the first dose of vaccine to work and provide good protection against the yellow fever virus. The protection provided by this dose is expected to last at least 10 years and maybe life-long. In some circumstances, a booster with one dose (0.5 millilitre) may be needed:</p>\r\n\r\n<ul>\r\n	<li>if you or your child had an insufficient response to the first dose and you or your child continue to be at risk for yellow fever virus infection.</li>\r\n	<li>or depending on official recommendations.</li>\r\n</ul>\r\n\r\n<p>Yellow Fever Vaccine is given as an injection by a qualified and trained healthcare professional. It is usually injected just underneath the skin but it can be given into a muscle. It must not be injected into a blood vessel.</p>', '<p>Tell your healthcare professional if you are taking, have recently taken or might take any other medicines. If you have recently had any treatment or medicine which may have weakened your immune system, the vaccination must be delayed until your laboratory results show that your immune system has recovered. Your doctor will advise you when it is safe for you to be vaccinated. Yellow Fever Vaccine can be given at the same time as measles vaccine or vaccines against typhoid fever (those containing the Vi capsular polysaccharide) and/or hepatitis A. Vaccination with Yellow Fever Vaccine may lead to false positive results of blood tests for dengue or Japanese encephalitis. If you or your child have in the future such tests prescribed, please inform your doctor about this vaccination.</p>', '<p>Do not use Yellow Fever Vaccine if you or your child are allergic to:</p>\r\n\r\n<ul>\r\n	<li>the active substance, or</li>\r\n	<li>any of the other ingredients of this vaccine (listed in Section 6), or</li>\r\n	<li>eggs or chicken proteins.</li>\r\n	<li>have experienced a severe allergic reaction after a previous dose of any yellow fever vaccine,</li>\r\n	<li>is less than 6 months old,</li>\r\n	<li>have a poor or weakened immune system for any reason, such as illness or medical treatments (for example high-dose steroids, or any other medicines that affect the immune system, or chemotherapy). If you are unsure whether the medication may affect your or your child&rsquo;s immune system, discuss with your healthcare professional before the vaccine is administered.</li>\r\n	<li>have a weakened immune system due to HIV infection. Your healthcare professional will advise you if you or your child can still receive Yellow Fever Vaccine based on the results of your blood tests,</li>\r\n	<li>are infected with HIV and have active symptoms due to the infection,</li>\r\n	<li>have a history of problems with your or your child&rsquo;s thymus gland or have had the thymus gland removed for any reason,</li>\r\n	<li>have an illness with a high or moderate fever or an acute illness. The vaccination will be postponed until you or your child have recovered.</li>\r\n</ul>', '<p>The following serious side effects have sometimes been reported: Allergic reactions:</p>\r\n\r\n<ul>\r\n	<li>Rash, itching or hives on the skin</li>\r\n	<li>Swelling of the face, lips, tongue or other parts of the body</li>\r\n	<li>Difficulty swallowing or breathing</li>\r\n	<li>Loss of consciousness</li>\r\n</ul>', '<p>If you are pregnant, or breastfeeding, think you may be pregnant or are planning to have a baby, ask your healthcare professional for advice before being vaccinated. You should not receive Yellow Fever Vaccine during pregnancy or breastfeeding unless this cannot be avoided. Also, it is recommended that you do not become pregnant within one month after receiving Yellow Fever Vaccine. Your healthcare professional can advise you on whether it is essential that you are vaccinated. In case vaccination is needed, it is recommended to interrupt breastfeeding for at least 2 weeks after you receive Yellow Fever Vaccine. In case you receive the vaccine while pregnant or breastfeeding, consult your healthcare professional.</p>', '<p>It is important to tell your healthcare professional if any of the points below apply to you or your child. If there is anything you do not understand, ask your healthcare professional to explain.<br />\r\n<br />\r\nBefore using Yellow Fever Vaccine, it is important that you complete a risk assessment with a trained healthcare professional, to determine whether you should receive the vaccine.</p>\r\n\r\n<ul>\r\n	<li>If you are over 60 years old or if your child is less than 9 months as you have an increased risk of certain types of severe but rare reactions to the vaccine (including serious reactions that affect the brain and nerves, and vital organs). You will only be given the vaccine if the risk of infection with the virus is well established in countries where you are going to stay.</li>\r\n	<li>If your child is aged 6 to 9 months. Yellow Fever Vaccine may be given to children aged between 6 and 9 months only in special situations and on the basis of current official advice.</li>\r\n	<li>If you or your child are infected by the HIV virus but do not have active symptoms due to the infection. Your healthcare professional will advise if Yellow Fever Vaccine can be given based on the results of laboratory tests and specialist advice.</li>\r\n	<li>If you or your child have any bleeding disorder (such as haemophilia or low level of platelets) or are taking any medicines that stop the blood clotting normally. You can still be given Yellow Fever Vaccine provided that it is injected under the skin and not into muscle.</li>\r\n	<li>If you had any allergic reaction to latex. The tip cap of the pre-filled syringe contains a natural rubber latex derivative which may cause an allergic reaction.</li>\r\n</ul>', NULL, NULL, '<p>Keep out of the sight and reach of children. Do not use this vaccine after the expiry date which is stated on the carton after EXP. The expiry date refers to the last day of that month. Store in a refrigerator (2&deg;C-8&deg;C). Do not freeze.</p>', NULL, '2022-03-12 01:07:57', '2022-03-12 01:07:57'),
(1134, 1134, '<p>Xylometazoline is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Nasal congestion in colds, rhinitis, sinusitis, headache.</li>\r\n	<li>Tubal block and serous otitis media associated with nasal congestion.</li>\r\n</ul>', '<p>Nasal congestion is caused by various etiologies, such as rhinosinusitis and allergic or non-allergic rhinitis, leading to congestion of the venous sinusoids lining the nasal mucosa. Activation of &alpha;-adrenergic receptors leads to vasoconstriction of the blood vessels of the nasal mucosa and resumption of nasal airflow. As the most abundantly expressed in the human nasal mucosa, &alpha;1A- and &alpha;2B-adrenoceptors may play the most important role in vasoconstriction of the human nasal mucosa. Xylometazoline is a more selective agonist at &alpha;2B-adrenoceptors, with affinity at &alpha;1A-, &alpha;2A-, &alpha;2C-, &alpha;1B-, and &alpha;1D-adrenoceptors. Xylometazoline decreases nasal resistance during inspiration and expiration and increases the volume of nasal airflow. Compared to oxymetazoline, another imidazoline nasal decongestant, xylometazoline had a slightly faster onset of action although they had a similar duration of action. In one study, subjects with nasal congestion reported relief of earache and sore throat in addition to nasal decongestion: it is speculated that oxymetazoline mediates this effect by causing vasoconstriction of the nasal mucosa that contains the venous sinuses and nasal decongestion allows breathing through the nose, providing relief from sore throat caused by mouth breathing that dries and irritates the throat.</p>', '<p><strong>Adults</strong>: Xylometazoline 0.1%: 2 or 3 drops in each nostril two to three times daily. Xylometazoline 0.1% should not be used for children under the age of 12 years.<br />\r\n<br />\r\n<strong>Children 6 to 12 years of age</strong>: Xylometazoline 0.05%: 2 or 3 drops in each nostril two or three times daily.<br />\r\n<br />\r\n<strong>Children less than 6 years of age</strong>: Xylometazoline 0.05%: 1 drop in each nostril two or three times daily.<br />\r\n<br />\r\n<strong>Infants less than 3 months</strong>: Not to be used in infants less than 3 months.</p>', '<p>No drug interactions have been reported.</p>', '<p>Xylometazoline nasal drops is contraindicated in patients with transsphenoidal hypophysectomy or surgery exposing the dura mater. It is also contraindicated in patients who are hypersensitive to Xylometazoline. Each Xylometazoline nasal drop should be used by one person only to prevent any cross-infection. Patients are advised not to take decongestants for more than seven consecutive days.</p>', '<p>The following side-effects have occasionally been encountered:</p>\r\n\r\n<ul>\r\n	<li>A burning sensation in the nose and throat</li>\r\n	<li>Local irritation</li>\r\n	<li>Nausea and dryness of the nasal mucosa.</li>\r\n</ul>', '<p>Pregnancy category C. Xylometazoline should not be used during pregnancy. The use of Otrivin while breastfeeding should only take place on the instructions of a doctor.</p>', '<p>Xylometazoline Hydrochloride nasal drops for adults (0.1%) should not be used for children below 12 years. Drops should not be used for long time in cases with chronic rhinitis. Prolonged use of the drops may cause rebound congestion and drug induced rhinitis.</p>', NULL, '<p>Nasal Anti-histamine preparations.</p>', '<p>Protect from light. For reasons of hygiene, do not use the bottle more than 28 days after opening it.</p>', NULL, '2022-03-12 01:26:38', '2022-03-12 01:26:38'),
(1135, 1135, '<p>Warfarin is indicated in the following conditions-</p>\r\n\r\n<ul>\r\n	<li>Prophylaxis and/or treatment of thromboembolic complications associated with atrial fibrillation and/or cardiac valve replacement</li>\r\n	<li>Indicated to reduce the risk of death, recurrent myocardial infarction, and thromboembolic events such as stroke or systemic embolization after myocardial infarction</li>\r\n	<li>Prophylaxis and treatment of venous thrombosis and pulmonary embolism</li>\r\n	<li>Transient ischaemic attacks.</li>\r\n</ul>', '<p>Warfarin is a [vitamin K] antagonist which acts to inhibit the production of vitamin K by vitamin K epoxide reductase. The reduced form of vitamin K, vitamin KH2&nbsp;is a cofactor used in the &gamma;-carboxylation of coagulation factors VII, IX, X, and thrombin. Carboxylation induces a conformational change allowing the factors to bind Ca2+&nbsp;and to phospholipid surfaces. Uncarboxylated factors VII, IX, X, and thrombin are biologically inactive and therefore serve to interrupt the coagulation cascade. The endogenous anticoagulation proteins C and S also require &gamma;-carboxylation to function. This is particularly true in the case of thrombin which must be activated in order to form a thrombus. vitamin KH2&nbsp;is converted to vitamin K epoxide as part of the &gamma;-carboxylation reaction catalyzed by &gamma;-glutamyl carboxylase. Vitamin K epoxide is then converted to vitamin K1&nbsp;by vitamin K epoxide reductase then back to vitamin KH2&nbsp;by vitamin K reductase. Warfarin binds to vitamin K epoxide reductase complex subunit 1 and irreversibly inhibits the enzyme thereby stopping the recycling of vitamin K by preventing the conversion of vitamin K epoxide to vitamin K1. This process creates a hypercoagulable state for a short time as proteins C and S degrade first with half lives of 8 and 24 hours, with the exception of factor VII which has a half life of 6 hours. Factors IX, X, and finally thrombin degrade later with half lives of 24, 36, and 50 hours resulting in a dominant anticoagulation effect. In order to reverse this anticoagulation vitamin K must be supplied, either exogenously or by removal of the vitamin K epoxide reductase inhibition, and time allowed for new coagulation factors to be synthesized. It takes approximately 2 days for new coagulation factors to be synthesized in the liver. Vitamin K2, functionally identical to vitamin K1, is synthesized by gut bacteria leading to interactions with antibiotics as elimination of these bacteria can reduce vitamin K2.</p>', '<p>Whenever possible, the baseline prothrombin time should be determined but the initial dose should not be delayed whilst awaiting the result.<br />\r\n<br />\r\n<strong>Use in adults</strong>: The usual adult induction dose of warfarin is 10 mg daily for 2 days. The subsequent maintenance dose depends upon the prothrombin time, reported as INR (international normalized ratio). The daily maintenance dose of warfarin is usually 3 to 9 mg (taken at the same time each day). The maintenance dose is omitted if the prothrombin time is excessively prolonged. Once the maintenance dose is established in the therapeutic range, it is rarely necessary to alter. In emergencies, anticoagulant therapy should be initiated with heparin and warfarin together. Where there is less urgency, as in patients disposed to or at special risk of thromboembolism, anticoagulant therapy may be initiated with warfarin alone. Control tests must be made at regular intervals and maintenance dosage further adjusted according to the results obtained.<br />\r\n<br />\r\n<strong>Use in children</strong>: Safety and efficacy in children &lt;18 years old have not been established. However, there is evidence of use and the initial dose is usually 0.1 mg.kg-1.d-1&nbsp;adjusted subsequently to aim for an INR range the same as in adults.</p>', '<p>Oral anticoagulants have a greater potential for clinically significant drug interactions. Warn all patients about potential hazards and instruct against taking or withdrawing any drug, including non-prescription products, without the advice of a physician.</p>', '<p>Warfarin can not be administered in the following cases;</p>\r\n\r\n<ul>\r\n	<li>Actual or potential hemorrhagic conditions, eg. Peptic ulcer, or to patients with uncontrolled hypertension</li>\r\n	<li>Severe hepatic or renal disease</li>\r\n	<li>Pregnancy</li>\r\n	<li>Known hypersensitivity to warfarin</li>\r\n	<li>Bacterial endocarditis</li>\r\n</ul>\r\n\r\n<p>Its use within 24 hours following surgery or labor should be undertaken with caution, if at all.</p>', '<p>Hemorrhage is the principal adverse effect of oral anticoagulants. Other adverse reactions include nausea, vomiting, diarrhea, hypersensitivity, rash, alopecia, and unexplained drop in haematocrit, &quot;purple toes&quot;, skin necrosis, jaundice, and hepatic dysfunction.</p>', '<p>Warfarin is contraindicated in the first trimester of pregnancy because of the risk of teratogenicity. It should not be used in women who are or may become pregnant because the drug passes through the placental barrier and may cause fatal hemorrhage to the fetus. Warfarin appears in the milk of nursing mothers in an inactive form. Infants nursed by mothers treated with Warfarin had no change in prothrombin times. Effects in premature infants have not been evaluated.</p>', '<p>Periodic determination of prothrombin time (PT)/international normalized ratio (INR) or other suitable coagulation test is essential. Numerous factors, alone or in combination, including travel, changes in diet, environment, physical state and medication may influence response of the patient to anticoagulants. It is generally good practice to monitor the patient&#39;s response with additional PT/INR determination in the period immediately after discharge from the hospital, and whenever other medications are initiated, discontinued or taken irregularly. The following factors may exaggerate the effects of warfarin and necessitate a reduction in dosage; loss of weight, elderly subject, acute illness, deficient renal function, decreased dietary intake of vitamin K, administration of certain drugs (see drug interaction). Factors which may call for an increase in maintenance dosage include weight gain, diarrhea and vomiting, increased intake of vitamin K, fats and oils, and the administration of certain drugs. Careful additional laboratory control is necessary if the patient is to be changed from one formulation to another. Reversal of warfarin anticoagulation by vitamin K takes several days. In emergency situations fresh frozen plasma should be given.</p>', '<p>If hemorrhage occurs or a potential bleeding state arises, excessive depression of the coagulation activity can be corrected by temporary withdrawal of warfarin accompanied, if necessary, by infusion of fresh-frozen plasma or whole blood. Vitamin K, 5 mg to 10 mg orally or intravenously, may be required to supplement specific treatment with co-factor concentrates.</p>', '<p>Anti-coagulants, Oral Anti-coagulants.</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-12 01:29:24', '2022-03-12 01:29:24'),
(1136, 1136, '<p>Water for injection is water of extra high quality without significant contamination. A sterile version is used for making solutions that will be given by injection. Before such use other substances generally must be added to make the solution more or less isotonic. It can be given by injection into a vein, muscle, or under the skin. A non-sterile version may be used in manufacturing with sterilization occurring later in the production process.</p>', '<p>If it is given by injection into a vein without making it more or less isotonic, breakdown of red blood cells may occur. This can then result in kidney problems. Excessive amount may also result in fluid overload. Water for injection is generally made by distillation or reverse osmosis. It should contain less than a mg of elements other than water per 100 ml. Versions with agents that stop bacterial growth are also available.</p>', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '<p>Other preparations.</p>', NULL, NULL, '2022-03-12 01:30:27', '2022-03-12 01:30:27'),
(1137, 1137, '<p>For general use as an emollient in the symptomatic relief of dry skin conditions.</p>', '<p>White Soft Paraffin and Liquid Paraffin are emollients with occlusive properties for topical application. There is no significant systemic absorption of the active ingredients but has substantial penetration into the stratum corneum.</p>', '<p>Apply a thin film of the ointment to the affected area of the skin, in the direction of hair growth, as required. Repeat as necessary. Ideally the product should be applied three or four times a day or at least twice a day. In adults, where a large area of the body is affected, up to 500 g a week may be used. For topical administration only.</p>', NULL, NULL, '<p>Prolong use may cause folliculitis, should this occur, use of the product should be discontinued.</p>', '<p>The safety of White Soft Paraffin and Liquid Paraffin during pregnancy and lactation has not been established, but use during this periods is not considered to constitute a hazard.</p>', '<p>This topical agent should be applied in the direction of hair growth to reduce the incidence of folliculitis.</p>', '<p>This topical agent has low toxicity and if ingested treatment should be supportive and symptomatic. Gastric lavage should not be attempted following ingestion of paraffin-based products, due to the risk of inhalation or aspiration into the lungs.</p>', '<p>Emollients &amp; combined preparations.</p>', '<p>Do not store above 30&deg; C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-12 01:32:10', '2022-03-12 01:32:10');
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
(1138, 1138, '<p>White soft paraffin, Liquid paraffin &amp; Wool alcohol combination eye ointment is indicated in dry eye condition particularly useful at night as it remains in the eye longer than drops. It is used as adjunctive therapy to lubricate and protect the eye in conditions such as exposure keratitis, decreased corneal sensitivity, recurrent corneal erosions, keratitis sicca, and ophthalmic surgery.</p>', '<p>White soft paraffin, Liquid paraffin &amp; Wool alcohol combination eye ointment produce a transparent, lubricating and moistening film on the surface of the eyeball. White soft paraffin, Liquid paraffin &amp; Wool alcohol eye ointment provides soothing relief from the symptoms of dry eyes such as soreness, irritation or a gritty sensation. These may be caused by inadequate production of tears to keep the eye moist or by things such as certain medical conditions or treatment. The ointment also helps to protect the eyeball and can thus be useful for people who suffer from recurrent corneal epithelial erosion.</p>', '<p>Apply a ribbon of ointment (1-1.5 cm) into the affected eye(s) prior to going to sleep or as directed by doctor.</p>', NULL, '<p>Hypersensivity to any components of the medication.</p>', '<p>Stinging/redness in the eye, widened pupils or blurred vision may occur.</p>', '<p><strong>Pregnancy</strong>: There is no data from the use of White paraffin, Liquid paraffin &amp; Wool alcohol combination eye ointment in pregnant women. However, all three components are pharmacologically inert, non-irritating and nontoxic.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is unknown that White paraffin, Liquid paraffin &amp; Wool alcohol eye ointment are excreted in human milk.</p>', '<p>Ophthalmic use only. If patients experience headache, eye pain, vision changes, irritation of the eyes, persistent redness or if the condition worsens or persists for more than 72 hours discontinue use and consult with doctor.</p>', NULL, '<p>Emollients &amp; combined preparations</p>', '<p>Store in a cool and dry place, away from light. Keep out of reach of children. Do not touch the tip to surfaces since this may contaminate the product. Do not use the medicine after one month of first opening.</p>', NULL, '2022-03-12 01:33:45', '2022-03-12 01:33:45'),
(1139, 1139, '<p>Ulipristal Acetate is indicated for emergency contraception within 120 hours (5 days) of unprotected sexual intercourse or contraceptive failure.</p>', '<p>Ulipristal Acetate is an orally-active synthetic SPRM that acts via high-affinity binding to the human progesterone receptor. The primary mechanism of action is inhibition or delay of ovulation. Data shows that even when taken immediately before ovulation is scheduled to occur, Ulipristal Acetate is able to postpone follicular rupture in some women.</p>', '<p>One 30 mg tablet must be taken as soon as possible but no later than 120 hours of unprotected intercourse or contraceptive failure, with or without food. If vomiting occurs within 3 hours of intake, then another tablet needed to be taken. Ulipristal Acetate can be taken at any time of menstrual cycle.</p>', '<p>Ulipristal Acetate interacts with the following drugs: Barbiturates, Carbamazepine, Phenobarbital, Rifampicin, Itraconazole, Ketoconazole etc.</p>', '<p>Ulipristal Acetate is contraindicated in case of hypersensitivity to active substances and in pregnancy.</p>', '<p>Most common side-effects are headache, nausea, abdominal pain, dysmenorrhea, fatigue, dizziness, breast tenderness etc.</p>', '<p>Contraindicated in suspected or existing pregnancy. Ulipristal Acetate excretes in breast milk. So breastfeeding is not recommended for one week after intake. Extremely limited data are available on the health of the fetus/newborn exposed to Ulipristal acetate.</p>', '<p><strong>Existing Pregnancy</strong>: Ulipristal Acetate is not indicated for termination of an existing pregnancy.<br />\r\n<br />\r\n<strong>Ectopic Pregnancy</strong>: A history of ectopic pregnancy is not a contraindication to the use of this emergency contraceptive method.<br />\r\n<br />\r\n<strong>Repeated Use</strong>: Ulipristal Acetate is for occasional use as an emergency contraceptive. It should not replace a regular method of contraception. Repeated use of Ulipristal Acetate within the same menstrual cycle is not recommended, as safety and efficacy of repeat use within the same cycle has not been evaluated.<br />\r\n<br />\r\n<strong>Fertility Following Use</strong>: A rapid return of fertility is likely following treatment with Ulipristal Acetate for emergency contraception. So, to prevent pregnancy on a later episode of sexual intercourse one should use the barrier method (ex. Condom).<br />\r\n<br />\r\n<strong>Effect on Menstrual Cycle</strong>: After Ulipristal Acetate intake, menses sometimes occur earlier or later than expected by a few days. In clinical trials, cycle length was increased by a mean of 2.5 days but returned to normal in the subsequent cycle. 7% of subjects reported menses occurring more than 7 days earlier than expected, and 19% reported a delay of more than 7 days. If there is a delay in the onset of expected menses beyond 1 week, a pregnancy test should be performed. 9% of women studied reported intermenstrual bleeding after the use of Ulipristal Acetate.</p>', '<p>Experience with Ulipristal Acetate overdose is limited, in a clinical study, a single dose equivalent to four times Ulipristal Acetate was administered to a limited number of subjects without any adverse reactions.</p>', '<p>Drugs acting on the Uterus, Emergency Contraceptive Pill.</p>', '<p>Store in a dry and cool place, protected from sunlight. Do not freeze. Keep out of reach of children.</p>', '<p><strong>Children and Adolescents</strong>: Limited safety and efficacy data available on women under 18 years old.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No studies have been conducted to evaluate the effect of hepatic disease on the disposition of Ulipristal Acetate.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No studies have been conducted to evaluate the effect of renal disease on the disposition of Ulipristal Acetate.</p>', '2022-03-12 01:36:25', '2022-03-12 01:36:25'),
(1140, 1140, '<p>Ulipristal Acetate is used before surgery to treat moderate to severe symptoms of uterine fibroids, which are noncancerous (benign) tumors of the womb (uterus). Ulipristal Acetate&nbsp;is used in adult women who have not yet reached menopause.</p>', '<p>Ulipristal acetate is a selective progesterone receptor modulator. It acts by blocking the receptor of a hormone in the body called progesterone, which is involved in controlling the growth of the lining of the womb. In some women, progesterone may promote the growth of fibroids, which may cause symptoms such as heavy uterine bleeding, anaemia and abdominal pain. When progesterone activity is blocked, fibroid cells stop dividing and eventually die which reduces the size of the fibroids and reduces the symptoms caused by them.</p>', '<p>Ulipristal acetate is taken by mouth and the recommended dose is one tablet (5 mg) a day for up to three months. The three month treatment can be repeated but only once. Treatment should always be started during the first week of the menstrual cycle (period bleeding).</p>', NULL, '<p>Contraindicated in patients with-</p>\r\n\r\n<ul>\r\n	<li>Hypersensitivity to the active substance or to any of the excipients.</li>\r\n	<li>Pregnancy and breastfeeding.</li>\r\n	<li>Genital bleeding of unknown aetiology or for reasons other than uterine fibroids.</li>\r\n	<li>Uterine, cervical, ovarian or breast cancer.</li>\r\n</ul>', '<p>Common side effects are&nbsp;Endometrial thickening, Hot flush, Headache, Uterine haemorrhage.</p>', '<p>Pregnancy Category X. Ulipristal acetate is contraindicated during pregnancy. Ulipristal acetate is excreted in human milk and is not recommended.</p>', '<p>Ulipristal acetate should only be prescribed after careful diagnosis and Pregnancy should be precluded prior to treatment.</p>\r\n\r\n<ul>\r\n	<li><strong>Contraception</strong>: Concomitant use of progestagen-only pills, a progestagen releasing intrauterine device or combined oral contraceptive pills is not recommended. Although a majority of women taking a therapeutic dose of ulipristal acetate have anovulation, a non-hormonal contraceptive method is recommended during treatment.</li>\r\n	<li><strong>Endometrial Changes</strong>: Endometrial Thickening or Progesterone receptor modulator Associated Endometrial Changes (PAEC). Ulipristal acetate has a specific pharmacodynamic action on the endometrium. An increase in thickness of the endometrium may occur. The thickness of the endometrium decreases to baseline levels upon treatment cessation. If the endometrial thickening persists beyond 3 months following the end of treatment and return of menstruations, this may need to be investigated as per usual clinical practice to exclude underlying conditions.</li>\r\n	<li><strong>Bleeding Pattern</strong>:&nbsp;Patients should be informed that treatment with ulipristal acetate usually leads to a significant reduction in menstrual blood loss or amenorrhea within the first 10 days of treatment. Should the excessive bleeding persist, patients should notify their physician.</li>\r\n	<li><strong>Asthma Patients</strong>:&nbsp;Use in women with severe asthma insufficiently controlled by oral glucocorticoids is not recommended.</li>\r\n</ul>', '<p>Experience with ulipristal acetate overdose is limited. Single doses up to 200 mg and daily doses of 50 mg for 10 consecutive days were administered to a limited number of subjects, and no severe or serious adverse reactions were reported.</p>', '<p>Drugs acting on the Uterus.</p>', '<p>Keep protected from light &amp; moisture, store below 25&deg; C. Keep out of reach of children.</p>', '<p><strong>Hepatic Impairment</strong>:&nbsp;Ulipristal acetate is not recommended in patients with severe hepatic impairment unless the patient is closely monitored.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>:&nbsp;Renal impairment is not expected to significantly alter the elimination of ulipristal acetate. In the absence of specific studies, ulipristal acetate is not recommended for patients with moderate and severe renal impairment unless the patient is closely monitored.</p>', '2022-03-12 01:38:19', '2022-03-12 01:38:19'),
(1141, 1141, '<p>Upadacitinib is a Janus kinase (JAK) inhibitor indicated for the treatment of adults with moderate to severe active rheumatoid arthritis who have had an inadequate response or intolerance to methotrexate.</p>', '<p>Upadacitinib is a Janus kinase (JAK) inhibitor. JAKs are intracellular enzymes which transmit signals arising from cytokine or growth factor-receptor interactions on the cellular membrane to influence cellular processes of hematopoiesis and immune cell function. Within the signaling pathway, JAKs phosphorylate and activate Signal Transducers and Activators of Transcription (STATs) which modulate intracellular activity including gene expression. Upadacitinib modulates the signaling pathway at the point of JAKs, preventing the phosphorylation and activation of STATs.</p>', '<p>The recommended dose of Upadacitinib is 15 mg once daily. Upadacitinib may be used as monotherapy or in combination with methotrexate or other non-biologic DMARDs. Avoid initiation or interrupt Upadacitinib if absolute lymphocyte count is less than 500 cells/mm3, absolute neutrophil count is less than 1000 cells/mm3&nbsp;or hemoglobin level is less than 8 g/dL.<br />\r\n<br />\r\nPediatric Use: The safety and efficacy of Upadacitinib in children and adolescents aged 0 to 18 years have not yet been established. No data are available.</p>', '<p><strong>Strong CYP3A4 Inhibitors</strong>: Upadacitinib exposure is increased when co-administered with strong CYP3A4 inhibitors (such as ketoconazole). Upadacitinib should be used with caution in patients receiving chronic treatment with strong CYP3A4 inhibitors.<br />\r\n<br />\r\n<strong>Strong CYP3A4 Inducers</strong>: Upadacitinib exposure is decreased when co-administered with strong CYP3A4 inducers (such as rifampin), which may lead to reduced therapeutic effect of Upadacitinib. Coadministration of Upadacitinib with strong CYP3A4 inducers is not recommended.</p>', NULL, '<p>Adverse reactions (greater than or equal to 1%) are: upper respiratory tract infections, nausea, cough, and pyrexia.</p>', '<p>The limited human data on use of Upadacitinib in pregnant women are not sufficient to evaluate a drug-associated risk for major birth defects or miscarriage. Based on animal studies, upadacitinib has the potential to adversely affect a developing fetus. Advise not to breastfeed.</p>', '<ul>\r\n	<li><strong>Serious Infections</strong>: Avoid use of Upadacitinib in patients with active, serious infection, including localized infections.</li>\r\n	<li><strong>Malignancy</strong>: Consider the risks and benefits of Upadacitinib treatment prior to initiating therapy in patients with a known malignancy.</li>\r\n	<li><strong>Thrombosis</strong>: Consider the risks and benefits prior to treating patients who may be at increased risk of thrombosis. Promptly evaluate patients with symptoms of thrombosis and treat appropriately.</li>\r\n	<li><strong>Gastrointestinal Perforations</strong>: Use with caution in patients who may be at increased risk.</li>\r\n	<li>Laboratory Monitoring: Recommended due to potential changes in lymphocytes, neutrophils, hemoglobin, liver enzymes and lipids.</li>\r\n	<li><strong>Embryo-Fetal Toxicity</strong>: Upadacitinib may cause fetal harm based on animal studies. Advise females of reproductive potential of the potential risk to a fetus and to use effective contraception.</li>\r\n	<li>Vaccinations: Avoid use of Upadacitinib with live vaccines.</li>\r\n</ul>', '<p>Upadacitinib was administered in clinical trials up to doses equivalent in daily AUC to 60 mg extended-release once daily. Adverse events were comparable to those seen at lower doses and no specific toxicities were identified. Approximately 90% of upadacitinib in the systemic circulation is eliminated within 24 hours of dosing (within the range of doses evaluated in clinical studies). In case of an overdose, it is recommended that the patient be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate treatment.</p>', '<p>Drugs used for Rheumatoid Arthritis.</p>', '<p>Do not store above 25&deg;C. Protect from light. Keep out of reach of children.</p>', NULL, '2022-03-12 01:40:36', '2022-03-12 01:40:36'),
(1142, 1142, '<p>Urea 10% cream is indicated for-</p>\r\n\r\n<ul>\r\n	<li>Ichthyosis and dry skin conditions</li>\r\n	<li>Management of eczemas</li>\r\n	<li>Management of psoriasis</li>\r\n</ul>', '<p>Topical urea is bacteriostatic, bactericidal, fungistatic, proteolytic, hygroscopic and has mild local anesthetic properties. These actions are dose dependent. Most of its therapeutic applications depend on its hygroscopic properties. The hygroscopic property is due to its ability to cause configurational change in proteins in the stratum corneum. A 10% urea cream has been shown to increase the water holding capacity of ichthyotic scale by 100% after 3 weeks of treatment. There is no information available about percutaneous absorption of urea. Therapeutic effects depend on local concentrations, not on systemic absorption of the drug. If absorbed, urea would be excreted unchanged in the urine.</p>', '<p>Urea 10% cream is applied topically. Wash affected areas well, rinse off all traces of soap, dry and apply sparingly twice daily. Occlusive dressings may be used, but are usually unnecessary because of the self-occlusive nature of the cream.<br />\r\n<br />\r\nUse in children: Urea 10% cream can be used in all age groups.</p>', '<p>No hazardous drug interaction has been reported.</p>', '<p>This is contraindicated in any other ingredient of this preaparation.</p>', '<p>No serious toxicity has been reported with topical urea. Historically it is considered a safe drug. But on some occasions, topical urea has been shown to cause burning and irritation, if applied to inflamed, broken or exudative skin eruptions.</p>', '<p>Urea cream can be used during pregnancy and lactation.</p>', '<p>In some instances, urea 10% cream may cause local irritation and edema, when applied to sensitive skin. If the condition is aggravated or there is no improvement the doctor should be consulted. Avoid application to moist or broken skin.</p>', NULL, '<p>Topical urea preparations.</p>', '<p>Keep out of the reach of children. Do not freeze. Keep at cool and dry place.</p>', NULL, '2022-03-12 01:42:14', '2022-03-12 01:42:14'),
(1143, 1143, '<p><strong>Adults &amp; children over 12 years</strong>: It is intended to be used for the symptomatic treatment of heels &amp; feet anhydrosis including in consumers and diabetics.</p>', '<p>Topical urea is bacteriostatic, bactericidal, fungistatic, proteolytic, hygroscopic and has mild local anesthetic properties. These actions are dose-dependent. Most of its therapeutic application depends on its hygroscopic properties. The hygroscopic property is due to its ability to cause a configurational change in proteins in the stratum corneum. Urea gently dissolves the intracellular matrix which results in loosening the horny layer of skin and shedding scaly skin at regular intervals, thereby softening hyperkeratotic areas. Therapeutic effects depend on local concentrations, not on systemic absorption of the drug. If absorbed, urea would be excreted unchanged in the urine.</p>', '<p>Apply enough Urea 25% Cream to cover affected area, once or twice daily or as directed by the physician. For external use only.</p>', '<p>No hazardous drug interaction has been reported.</p>', '<p>Allergy to any of the ingredients of this product.</p>', '<p>No serious toxicity has been reported with topical urea. Historically it is considered a safe drug. But on some occasions, topical urea has been shown to cause burning and irritation, if applied to inflamed, broken or exudative skin eruptions.</p>', '<p>There are no adequate &amp; well-controlled studies in pregnant women. Urea should only be used if the anticipated benefits outweigh the risks.</p>', '<p>Avoid contact with eyes. Do not use, if sensitive to any of the ingredients, on genitals or other areas of sensitive skin, on skin that is badly cracked, infected or bleeding and at the same time as other skin care products. Stop use if skin irritation or rash occurs during use.</p>', NULL, '<p>Topical urea preparations.</p>', '<p>Store in a cool &amp; dry place, protect from light. Do not freeze.</p>', NULL, '2022-03-12 01:44:05', '2022-03-12 01:44:05'),
(1144, 1144, '<p><strong>Urokinase injection is indicated in adults</strong>:</p>\r\n\r\n<ul>\r\n	<li>For the&nbsp;lysis&nbsp;of&nbsp;acute&nbsp;massive pulmonary emboli, defined as&nbsp;obstruction&nbsp;of blood flow to a&nbsp;lobe&nbsp;or multiple segments.</li>\r\n	<li>For the lysis of pulmonary emboli accompanied by unstable hemodynamics, i.e., failure to maintain&nbsp;blood pressure&nbsp;without supportive measures.</li>\r\n</ul>\r\n\r\n<p>The&nbsp;diagnosis&nbsp;should be confirmed by objective means, such as pulmonary&nbsp;angiography&nbsp;or noninvasive procedures such as lung scanning.</p>', '<p>Urokinase is used for the treatment of pulmonary embolisms. The low molecular weight form of human urokinase consists of an A chain of 2,000 daltons linked by a sulfhydryl bond to a B chain of 30,400 daltons. Urokinase is an enzyme (protein) produced by the kidney, and found in the urine. There are two forms of urokinase which differ in molecular weight but have similar clinical effects. Urokinase is the low molecular weight form. Urokinase acts on the endogenous fibrinolytic system. It converts plasminogen to the enzyme plasmin. Plasmin degrades fibrin clots as well as fibrinogen and some other plasma proteins.<br />\r\n<br />\r\nUrokinase acts on the endogenous fibrinolytic system. It cleaves the Arg-Val bond in plasminogen to produce active plasmin. Plasmin degrades fibrin clots as well as fibrinogen and other plasma proteins.</p>', '<p><strong>Deep vein thrombosis</strong>: Initial loading dose of 4,400 IU/kg in 15 mL soln over 10 min, followed by 4,400 IU/kg/hr IV infusion for 12-24 hr.&nbsp;<br />\r\n<br />\r\n<strong>Pulmonary embolism</strong>: Initial loading dose of 4,400 IU/kg in 15 mL soln over 10 min followed by 4,400 IU/kg/hr IV infusion for 12 hr.&nbsp;<br />\r\n<br />\r\n<strong>Peripheral vascular occlusion</strong>: Infuse 2,500 IU/mL (500,000 IU in 200 mL) into clot at a rate of 4,000 IU/min for 2 hr.<br />\r\n<br />\r\nAdvance the catheter into the remaining occluded area &amp; infuse at 4,000 IU/min for another 2 hr. This may be repeated up to 4 times.&nbsp;<br />\r\n<br />\r\n<strong>Hyphaema</strong>: 5,000 IU in 2 mL saline soln is injected and withdrawn repeatedly over the iris. If residual clot remains, leave 0.3 mL in the anterior chamber for 24-48 hr to facilitate further dissolution.&nbsp;<br />\r\n<br />\r\n<strong>Clotted arterio-venous shunts</strong>: Instill 5,000-25,000 IU into affected shunt limb &amp; clamp for 2-4 hr, followed by aspiration of lysate. Repeat if necessary.</p>', '<p>Concomitant use of oral anticoagulant or heparin &amp; drugs that affect platelet function may increase risk of haemorrhage.</p>', '<p>Recent surgery or biopsy, severe HTN, severe hepatic or renal insufficiency. Pregnancy &amp; immediate postpartum period.</p>', NULL, '<p>Pregnancy&nbsp;Category B. Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1sttrimester (and there is no evidence of a risk in later trimesters).</p>', '<p>GI lesions &amp; in multiple intracardiac or intravascular punctures as a consequence of cardiopulmonary resuscitation.</p>', '<p>If severe haemorrhage occurs, treatment with Urokinase-GCC must be stopped. Aprotinin and synthetic inhibitors eg, epsilon aminocaproic acid, tranexamic acid or p-aminomethylbenzoic acid can be used to inhibit the fibrinolytic action of Urokinase-GCC. In serious cases, human fibrinogen, Factor XIII, Cohn-Fraction I, packed red cells or whole blood can be given, as appropriate.</p>', '<p>Fibrinolytics (Thrombolytics).</p>', NULL, NULL, '2022-03-12 01:45:43', '2022-03-12 01:45:43'),
(1145, 1145, '<p>Ursodeoxycholic Acid is indicated for the treatment of</p>\r\n\r\n<ul>\r\n	<li>Cholestasis (Jaundice)</li>\r\n	<li>Viral Hepatitis</li>\r\n	<li>Alcoholic Fatty Liver</li>\r\n	<li>Primary Billiary Cirrhosis (PBC)</li>\r\n	<li>Primary Sclerosing Cholangitis (PSC)</li>\r\n	<li>Dissolution of Gallstones and Non-Alcoholic Steato Hepatitis (NASH).</li>\r\n</ul>', '<p>Ursodeoxycholic Acid is a naturally occurring bile acid used to treat different hepatobilliary disorders. The activity of Ursodeoxycholic Acid is achieved through a decrease in secretion of cholesterol in bile. Ursodeoxycholic Acid achieves this through a few mechanisms: it reduces cholesterol absorption, suppresses liver cholesterol synthesis and it does not inhibit bile acid synthesis.<br />\r\n<br />\r\nTherefore, alters bile composition from supersaturated to unsaturated. Ursodeoxycholic Acid also promotes the formation of liquid cholesterol crystal complexes which enhance removal of the cholesterol from the gallbladder into the intestine to be expelled. Ursodeoxycholic Acid improves cholestatic liver diseases by-</p>\r\n\r\n<ul>\r\n	<li>Protecting cholangiocytes against cytotoxicity of hydrophobic bile acids</li>\r\n	<li>Stimulating hepatobilliary secretion</li>\r\n	<li>Protecting hepatocytes against bile acid-induced apoptosis</li>\r\n</ul>\r\n\r\n<p>Ursodeoxycholic Acid is completely absorbed in the upper intestine. Time to peak serum concentration varies from 30 to 150 minutes. The rate of absorption ranges from 60-80%. After absorption Ursodeoxycholic Acid enters the portal vein and undergoes extraction from portal blood by liver where it is conjugated with amino acid &amp; that may be either glycine or taurine and then secreted into the hepatic bile ducts. Small quantities of Ursodeoxycholic Acid appear in the circulation and very small amounts are excreted into urine. The biologic half life of Ursodeoxycholic Acid ranges from 3.5-5.8 days.</p>', '<p><strong>Dissolution of Gall stones</strong>: 8-12 mg/kg/day either as single night time dose or in divided doses.<br />\r\n<br />\r\n<strong>Primary Billiary Cirrhosis</strong>: 10-15 mg/kg/day in 2-4 divided doses.<br />\r\n<br />\r\n<strong>Acute Viral Hepatitis</strong>: 600 mg/day.<br />\r\n<br />\r\n<strong>Alcoholic Fatty Liver</strong>: 300 mg/day.<br />\r\n<br />\r\n<strong>Primary Sclerosing Cholangitis</strong>: 25-30 mg/kg/day.<br />\r\n<br />\r\n<strong>Dissolution of Gallstones and Non-Alcoholic Steato Hepatitis</strong>: 13-15 mg/kg/day.</p>', '<p>Ursodeoxycholic Acid should not be used with drugs, such as oestrogenic hormones, that increase bile cholesterol. Concomitant administration with bile-acid binding drugs including antacids, charcoal and cholestyramine should be avoided, since this may reduce the effectiveness of therapy with Ursodeoxycholic acid.</p>', '<p>Non-functioning gall-bladder calcified and pigmented gallstones, inflammatory bowel disease.</p>', '<p>Commonly reported side effects are nausea, vomiting, diarrhoea, gallstone opacilication, pruritus.</p>', '<p>Pregnancy category B. No evidence of harm has been reported in pregnancy. It has been effectively used for the treatment of cholestasis of pregnancy during the last trimester without any side effects. Problems have not been documented in humans regarding breast feeding.</p>', '<p>It should be used cautiously in those with liver disease.</p>', NULL, '<p>Anti-gallstones drugs: Bile Acids.</p>', '<p>Store below 25&deg; C. Protected from light and moisture. Keep the medicine out of the reach of children.</p>', NULL, '2022-03-12 01:47:31', '2022-03-12 01:47:31'),
(1146, 1146, '<p>Quetiapine is indicated for the treatment of Acute and chronic psychoses, including schizophrenia, Bipolar Disorder including: treatment of manic episodes satisfying DSM-IV criteria for mania associated with bipolar&nbsp; disorder, treatment of depressive episodes associated with bipolar disorder, maintenance treatment of bipolar I disorder, in combination with a mood stabilizer, for the prevention of recurrence of manic, depressive or mixed episodes.</p>', '<p>The mechanism of action of Quetiapine, as with other drugs having efficacy in the treatment of schizophrenia and acute manic episodes associated with bipolar disorder, is unknown. However, it has been proposed that this drug&#39;s efficacy in schizophrenia is mediated through a combination of dopamine type 2 (D2 ) and serotonin type 2 (5HT2) antagonism. Antagonism at receptors other than dopamine and 5HT 2 with similar receptor affinities may explain some of the other effects of Quetiapine. Quetiapine&#39;s antagonism of histamine H1 receptors may explain the somnolence observed with this drug. Quetiapine&#39;s antagonism of adrenergic &alpha;1 receptors may explain the orthostatic hypotension observed with this drug.</p>', '<p><strong>Acute and chronic psychoses, including schizophrenia</strong>: Quetiapine should be administered twice daily, with or without food. The total daily dose for the first four days of therapy is 50 mg (Day 1), 100 mg (Day 2), 200 mg (Day 3) and 300 mg (Day 4). From Day 4 onwards, the dose should be titrated to the usual effective dose range of 300-450 mg/day. However, this may be adjusted, depending on the clinical response and tolerability of the individual patient, within the range 150 to 750 mg/day.<br />\r\n<br />\r\n<strong>Manic episodes associated with bipolar disorder</strong>: Quetiapine should be administered twice daily, with or without food. The total daily dose for the first four days of therapy is 100 mg (Day 1), 200 mg (Day 2), 300 mg (Day 3) and 400 mg (Day 4). Further dosage adjustments up to 800mg/day by Day 6 should be in increments of no greater than 200 mg/day. The dose may be adjusted depending on clinical response &amp; tolerability of the individual patient, within the range of 200 to 800 mg/day. The usual effective dose is in the range of 400 to 800mg/day.<br />\r\n<br />\r\n<strong>Depressive episodes associated with bipolar disorder</strong>: Quetiapine should be administered once daily at bedtime, with or without food. The usual dose is 300 mg/day. The daily dose for the first four days of therapy is 50 mg (Day 1), 100 mg (Day 2), 200 mg (Day 3) and 300 mg (Day 4). Quetiapine can be titrated to 400 mg on Day 5 and up to 600mg by Day 8. Antidepressant efficacy was demonstrated with Quetiapine at 300mg and 600 mg, however no additional benefit was seen in the 600mg group during short term treatment.<br />\r\n<br />\r\n<strong>Maintenance treatment of bipolar I disorder in combination with mood stabilizers</strong>: Patients who have responded to Quetiapine in combination therapy with a mood stabiliser for acute treatment of bipolar disorder should continue on Quetiapine therapy at the same dose. Quetiapine dose can be re-adjusted depending on clinical response and tolerability of the individual patient. Efficacy was demonstrated with Quetiapine (administered twice daily totalling 400mg to 800mg a day) as combination therapy with a mood stabilizer.</p>', '<p>Caution should be exercised when Quetiapine is used concomitantly with medicines known to cause electrolyte imbalance or to increase QT interval. Co-administration of Quetiapine and thioridazine or carbamazepine caused increases in the clearance of Quetiapine. Co-administration of Quetiapine with another microsomal enzyme inducer, phenytoin, also caused increases in the clearance of Quetiapine.</p>', '<p>Quetiapine is contra-indicated in patients who are hypersensitive to it.</p>', '<p>The most commonly reported Adverse Drug Reactions (ADRs) with Quetiapine are somnolence, dizziness, dry mouth, withdrawal (discontinuation) symptoms, elevations in serum triglyceride levels, elevations in total cholesterol (predominantly LDL cholesterol), decreases in HDL cholesterol, weight gain, decreased haemoglobin and extrapyramidal symptoms.</p>', '<p>The safety and efficacy of Quetiapine during human pregnancy have not been established. Therefore, Quetiapine should only be used during pregnancy if the benefits justify the potential risks and the administered dose and duration of treatment should be as low and as short as possible. The degree to which Quetiapine is excreted into human milk is unknown. Women who are breast-feeding should therefore be advised to avoid breast-feeding while taking Quetiapine.</p>', '<ul>\r\n	<li><strong>Suicide/suicidal thoughts or clinical worsening</strong>: Depression is associated with an increased risk of suicidal thoughts, self-harm and suicide (suicide-related events). This risk persists until significant remission occurs.&nbsp;</li>\r\n	<li><strong>Concomitant Illness</strong>:&nbsp;Quetiapine should be used with caution in patients with known cardiovascular disease, cerebrovascular disease, or other conditions predisposing to hypotension. Quetiapine may induce orthostatic hypotension especially during the initial dose-titration period.&nbsp;</li>\r\n	<li><strong>Seizures</strong>:&nbsp;As with other antipsychotics, caution is recommended when treating patients with a history of seizures.</li>\r\n	<li><strong>Tardive Dyskinesia and Extrapyramidal Symptoms (EPS)</strong>: If signs and symptoms of tardive dyskinesia appear, dose reduction or discontinuation of Quetiapine should be considered.</li>\r\n	<li><strong>Neuroleptic Malignant Syndrome</strong>: This syndrome has been associated with antipsychotic treatment. Quetiapine should be discontinued and appropriate medical treatment given.</li>\r\n	<li><strong>QT Prolongation</strong>: As with other antipsychotics, caution should be exercised when Quetiapine is prescribed in patients with cardiovascular disease or family history of QT prolongation.</li>\r\n	<li><strong>Neutropenia</strong>: Severe neutropenia (&lt;0.5x109/L) has been uncommonly reported in Quetiapine clinical trials. Most cases of severe neutropenia have occurred within the first two months of starting therapy with Quetiapine.</li>\r\n	<li><strong>Hyperglycemia &amp; diabetes mellitus</strong>: Increases in blood glucose and hyperglycaemia, and occasional reports of diabetes, have been observed in clinical trials with Quetiapine.</li>\r\n</ul>', '<p>In clinical trials, survival has been reported in acute overdoses of up to 30 grams of Quetiapine. There is no specific antidote to Quetiapine. In cases of severe intoxication, the possibility of multiple drug involvement should be considered, and intensive care procedures are recommended, including establishing and maintaining a patent airway, ensuring adequate oxygenation and ventilation, and monitoring and support of the cardiovascular system. In cases of Quetiapine overdose, refractory hypotension should be treated with appropriate measures such as intravenous fluids and/or sympathomimetic agents (adrenaline and dopamine should be avoided, since beta stimulation may worsen hypotension in the setting of Quetiapine-induced alpha blockade). Close medical supervision and monitoring should be continued until the patient recovers.</p>', '<p>Atypical neuroleptic drugs.</p>', '<p>Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the blister pack and the carton. The expiry date refers to the last day of that month. Store in a cool and dry place away from light.</p>', '<p><strong>Elderly</strong>: As with other antipsychotics, Quetiapine should be used with caution in the elderly, especially during the initial dosing period. The rate of dose titration may need to be slower, and the daily therapeutic dose lower, than that used in younger patients, depending on the clinical response and tolerability of the individual patient. The mean plasma clearance of Quetiapine was reduced by 30% to 50% in elderly subjects when compared with younger patients.<br />\r\n<br />\r\n<strong>Children and Adolescents</strong>: Quetiapine is not indicated for use in children and adolescents below 18 years of age.</p>', '2022-03-12 01:51:06', '2022-03-12 01:51:06'),
(1147, 1147, '<p>Quinine Sulfate is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Uncomplicated, severe and complicated falciparum malaria</li>\r\n	<li>Falciparum malaria resistant to other drugs</li>\r\n	<li>Prevention of nocturnal muscle cramps</li>\r\n	<li>Alleviation of muscle cramps in Thomsen&#39;s disease.</li>\r\n</ul>', '<p>Quinine is believed to interfere with protein metabolism and inhibits nucleic acid synthesis in malarial parasites. Quinine is a highly active blood schizonticide and suppresses the asexual cycle of development of malaria parasites in the erythrocytes. It is effective both as a suppressive drug and in the over clinical attack of malaria.</p>', '<p><strong>Adult</strong>:</p>\r\n\r\n<ul>\r\n	<li>Oral: 600 mg (of quinine salt) every 8 hours for 7 days.</li>\r\n	<li>Parenteral: lf the patient is seriously ill quinine should be given by intravenous infusion. The adult dosage regimen for quinine by infusion is loading dose of 20 mg/kg (up to maximum 1.4 g) of quinine salt infused over 4 hours then after 8-12 hours maintenance dose of 10 mg/kg (up to maximum 700 mg) of quinine salt infused over 4 hours every 8-12 hours (until patient can swallow tablets to complete the 7 days course).</li>\r\n</ul>\r\n\r\n<p><strong>Children</strong>:</p>\r\n\r\n<ul>\r\n	<li>Oral: Quinine is well tolerated by children. The dosage regimen for quinine by mouth for children is 10 mg/kg (of quinine salt) every 8 hours for 7 days.</li>\r\n	<li>Parenteral: The dosage regimen for quinine by intravenous infusion for children is calculated on a mg/kg basis as for adult.</li>\r\n</ul>\r\n\r\n<p><strong>Pregnancy:</strong>&nbsp;The adult treatment doses of oral and intravenous quinine given above (including the loading dose) can safely be given to pregnant women.</p>', NULL, '<p>Hypersensitivity reaction, optic neuritis, in case of black water fever etc.</p>', '<p>Cinchonism which includes tinnitus, headache, nausea and visual disturbances. Hematological disorders and skin reaction may occur.</p>', '<p>In pregnancy, the quinine is not necessarily contraindicated. It is considered to be safe when used in therapeutic dosage in pregnancy. It is excreted in breast milk in insignificant amount which does not discard the use in lactation.</p>', '<p>Severe heart disease, myasthenia gravis, diabetes mellitus, IV injection should be given slowly. Use of Mefloquine with Quinine sulphate may increase the chance of side effects.</p>', '<p>Cinchonism which includes tinnitus, headache, nausea and visual disturbances. Hematological disorders and skin reaction may occur.</p>', '<p>Anti-malarial drugs</p>', '<p>Use of Mefloquine with Quinine sulphate may increase the chance of side effects.</p>', NULL, '2022-03-12 01:54:27', '2022-03-12 01:54:27'),
(1148, 1148, '<p>Amoxicillin, Clarithromycin &amp; Rabeprazol combination is indicated for the eradication of H. pylori in active chronic gastric, duodenal and gastric ulcers.</p>', '<p><strong>Amoxicillin</strong>&nbsp;is similar to&nbsp;penicillin&nbsp;in its bactericidal action against susceptible bacteria during the stage of active multiplication. It acts through the inhibition of cell wall biosynthesis that leads to the death of the bacteria.<br />\r\n<br />\r\n<strong>Clarithromycin</strong>&nbsp;acts by inhibiting microsomal protein synthesis in susceptible organisms mainly by binding to the donor site on the 50S subunit of the bacterial ribosome and preventing translocation to that site.<br />\r\n<br />\r\n<strong>Rabeprazole</strong>&nbsp;belongs to a class of antisecretory compounds (substituted benzimidazole proton-pump inhibitors) that do not exhibit anticholinergic or histamine H2-receptor antagonist properties, but suppress gastric acid secretion by inhibiting the gastric H+,K+ ATPase at the secretory surface of the gastric parietal cell. Because this enzyme is regarded as the acid (proton) pump within the parietal cell, rabeprazole has been characterized as a gastric proton-pump inhibitor. Rabeprazole blocks the final step of gastric acid secretion.</p>', '<p>Each tablet twice daily for 7-14 days or as per the physician&#39;s advice.</p>', '<p>Rabeprazole is metabolized through the cytochrome P450 system, specially through the CYP3A and CYP2C19 isozymes. Studies have shown that Rabeprazole does not have clinically significant interactions with other drugs metabolized by the cytochrome P450 system, such as warfarin, antipyrine, indomethacin, ibuprofen, phenytoin, propranolol, prednisolone, diazepam, clarithromycin or terfenadine in healthy subjects. Use of Clarithromycin in patients who are receiving theophylline may be associated with an increase of serum theophylline concentrations. There have been reports of interactions of erythromycin and/or clarithromycin with carbamazepine, cyclosporine, tacrolimus, hexobarbital, phenytoin, alfetanil, disopyramide, lovastatin, bromocriptine, valproate, terfenadine, cisapride, pimozide &amp; astemizole.</p>', '<p>This drug is contraindicated in patients with known hypersensitivity to any of its component.</p>', '<p>Adverse reactions which were reported as possibly or probably related to treatment (&lt;3%) in clinical trials when all three components of this therapy were given concomitantly are listed below and divided by body systems.<br />\r\n<br />\r\n<strong>Digestive system</strong>: Nausea, vomiting, diarrhoea, dark stools, dry mouth, glossitis, oral moniliasis, stomatitis, tongue discoloration; Musculoskeletal system: Myalgia;<br />\r\n<br />\r\n<strong>Nervous System</strong>: Confusion, headache, dizziness; Skin: Skin reactions; Urogenital System: Vaginitis, vaginal moniliasis.</p>', '<p>There were no adequate and well-controlled studies of in pregnant women. Should be used during pregnancy only if the potential benefit justifies the potential risk of the mother.<br />\r\n<br />\r\nBecause of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug therapy, taking into account the importance of the therapy to the mother.<br />\r\n<br />\r\nClarithromycin should not be used in pregnant women except in clinical circumstances where no alternative therapy is appropriate. Amoxicillin is excreted in human milk in very small amounts.&nbsp;There are no available human data on Rabeprazol use in pregnant women to inform the drug associated risk.</p>', '<p>Serious and occasionally fatal hypersensitivity (anaphylactoid) reactions have been reported in patients on Amoxicillin therapy.</p>', '<p>There has been no experience of overdoses with Rabeprazole. In case of overdosage of Amoxicillin, medication is discontinued, treatment should be symptomatic and supportive measures are institued as required. Overdosage of Clarithromycin can cause gastrointestinal symptoms such as abdominal pain, vomiting, nausea and diarrhea.</p>', '<p>Anti H. pylori drugs.</p>', '<p>Store in a cool and dry place, protected from light.</p>', '<p><strong>Use in Geriatrics</strong>: Elderly patients may suffer from asymptomatic renal and hepatic dysfunction. Care should be taken when administering to this patient population.<br />\r\n<br />\r\n<strong>Renal Dose Adjustments</strong>: No adjustment recommended.<br />\r\n<br />\r\n<strong>Mild to moderate hepatic impairment</strong>: No adjustment recommended.<br />\r\n<br />\r\n<strong>Severe hepatic impairment</strong>: Use with caution.</p>', '2022-03-12 04:31:17', '2022-03-12 04:31:17');
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
(1149, 1149, '<p>Rabeprazole Gastro-resistant tablets are indicated for the treatment of:</p>\r\n\r\n<ul>\r\n	<li>Active duodenal ulcer</li>\r\n	<li>Active benign gastric ulcer</li>\r\n	<li>Symptomatic erosive or ulcerative gastro-esophageal reflux disease (GERD).</li>\r\n	<li>Gastro-esophageal Reflux Disease Long-term Management (GERD Maintenance)</li>\r\n	<li>Symptomatic treatment of moderate to very severe gastro-esophageal reflux disease (symptomatic GERD)</li>\r\n	<li>Zollinger-Ellison Syndrome</li>\r\n	<li>In combination with appropriate antibacterial therapeutic regimens for the eradication of Helicobacter pylori in patients with peptic ulcer disease.</li>\r\n</ul>', '<p>Rabeprazole suppresses gastric acid secretion by inhibiting the gastric H+/K+-ATPase at the secretory surface of the gastric parietal cell. Because this enzyme is regarded as the acid (proton) pump within the parietal cell, Rabeprazole has been characterized as a gastric proton-pump inhibitor.</p>', '<p><strong>Active Duodenal Ulcer and Active Benign Gastric Ulcer</strong>: The recommended oral dose for both bioactive duodenal ulcer and active benign gastric ulcer is 20 mg to be taken once daily in the morning. Most patients with active duodenal ulcer heal within four weeks. However, a few patients may require an additional four weeks of therapy to achieve healing. Most patients with active benign gastric ulcer heal within six weeks. However, again a few patients may require an additional six weeks of therapy to achieve healing.<br />\r\n<br />\r\n<strong>Erosive or Ulcerative Gastro-Esophageal Reflux Disease (GERD)</strong>: The recommended oral dose for this condition is 20 mg to be taken once daily for four to eight weeks.<br />\r\n<br />\r\n<strong>Gastro-Esophageal Reflux Disease Long-term Management (GERD Maintenance)</strong>: For long-term management, a maintenance dose of rabeprazole sodium 20 mg or 10 mg once daily can be used depending upon patient response.<br />\r\n<br />\r\n<strong>Symptomatic treatment of moderate to very severe Gastro-Esophageal Reflux Disease (symptomatic GERD)</strong>: 10 mg once daily in patients without oesophagitis. If symptom control has not been achieved during four weeks, the patient should be further investigated. Once symptoms have resolved, subsequent symptom control can be achieved using an on-demand regimen taking 10 mg once daily when needed.<br />\r\n<br />\r\n<strong>Zollinger-Ellison Syndrome</strong>: The recommended adult starting dose is 60 mg once a day. The dose may be titrated upwards to 120 mg/day based on individual patient needs. Single daily doses up to 100 mg/day may be given. 120 mg dose may require divided doses, 60 mg twice daily. Treatment should continue for as long as clinically indicated.<br />\r\n<br />\r\n<strong>Eradication of H. pylori</strong>: Patients with H. pylori infection should be treated with eradication therapy. The following combination given for 7 days is recommended. Rabeprazole sodium 20 mg twice daily, clarithromycin 500 mg twice daily and amoxicillin 1g twice daily.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>For indications requiring once-daily treatment Rabeprazole tablets should be taken in the morning, before eating; and although neither the time of day nor food intake was shown to have any effect on rabeprazole sodium activity, this regimen will facilitate treatment compliance. Patients should be cautioned that the Rabeprazole tablets should not be chewed or crushed, but should be swallowed whole.</p>', '<p>Respite produces a profound and long-lasting inhibition of gastric acid secretion. An interaction with a compound whose absorption is pH dependent may occur. Co-administration of rabeprazole sodium with ketoconazole or itraconazole may result in a significant decrease in antifungal plasma levels. Therefore individual patients may need to be monitored to determine if a dosage adjustment is necessary when ketoconazole or itraconazole are taken concomitantly with Respite. No interaction with liquid antacids was observed. The absorption of atazanavir is pH-dependent. Therefore PPIs, including rabeprazole, should not be co-administered with atazanavir.</p>', '<p>Hypersensitivity to the active substance or to any of the excipients. Rabeprazole is contra-indicated in pregnancy and during breastfeeding.</p>', '<p>In general, Rabeprazole is well-tolerated in both short-term and long-term studies. Rabeprazole may sometimes cause headache, diarrhoea, abdominal pain, vomiting, constipation, dry mouth, increased or decreased appetite, muscle pain, drowsiness, dizziness.</p>', '<p>US FDA pregnancy category &#39;C&#39;. Studies have been performed in animals and have revealed no evidence of impaired fertility or harm to the fetus due to Rabeprazole. There are however, no adequate and well-controlled studies in pregnant women. Rabeprazole is likely to be excreted in human milk, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<ul>\r\n	<li>Symptomatic response to therapy with Rabeprazole does not preclude the presence of gastric or oesophageal malignancy, therefore the possibility of malignancy should be excluded prior to commencing treatment with Rabeprazole 20 mg Gastro-resistant Tablets.</li>\r\n	<li>Patients on long-term treatment (particularly those treated for more than a year) should be kept under regular surveillance.</li>\r\n	<li>Proton pump inhibitors, especially if used in high doses and over long durations (&gt;1 year), may modestly increase the risk of hip, wrist and spine fracture, predominantly in the elderly or in presence of other recognised risk factors. Observational studies suggest that proton pump inhibitors may increase the overall risk of fracture by 10&ndash;40%. Some of this increase may be due to other risk factors. Patients at risk of osteoporosis should receive care and they should have an adequate intake of vitamin D and calcium.</li>\r\n	<li>A risk of cross-hypersensitivity reactions with other proton pump inhibitor or substituted benzimidazoles cannot be excluded.</li>\r\n	<li>Patients should be cautioned that Rabeprazole gastro-resistant tablets should not be chewed or crushed, but should be swallowed whole.</li>\r\n	<li>There have been post marketing reports of blood dyscrasias (thrombocytopenia and neutropenia). In the majority of cases where an alternative aetiology cannot be identified, the events were uncomplicated and resolved on discontinuation of rabeprazole.</li>\r\n	<li>Hepatic enzyme abnormalities have been seen in clinical trials and have also been reported since market authorisation. In the majority of cases where an alternative aetiology cannot be identified, the events were uncomplicated and resolved on discontinuation of rabeprazole.</li>\r\n	<li>No evidence of significant drug related safety problems was seen in a study of patients with mild to moderate hepatic impairment versus normal age and sex matched controls. However because there are no clinical data on the use of rabeprazole in the treatment of patients with severe hepatic dysfunction the prescriber is advised to exercise caution when treatment with Rabeprazole 20mg Gastro-resistant. Tablets is first initiated in such patients.</li>\r\n	<li>Co-administration of atazanavir with Rabeprazole is not recommended.</li>\r\n	<li>Treatment with proton pump inhibitors, including rabeprazole, may possibly increase the risk of gastrointestinal infections such as Salmonella, Campylobacter and Clostridium difficile.</li>\r\n</ul>\r\n\r\n<p><strong>Hypomagnesaemia</strong>: Severe hypomagnesaemia has been reported in patients treated with PPIs like rabeprazole for at least three months, and in most cases for a year. Serious manifestations of hypomagnesaemia such as fatigue, tetany, delirium, convulsions, dizziness and ventricular arrhythmia can occur but they may begin insidiously and be overlooked. In most affected patients, hypomagnesaemia improved after magnesium replacement and discontinuation of the PPI. For patients expected to be on prolonged treatment or who take PPIs with digoxin or drugs that may cause hypomagnesaemia (e.g., diuretics), health care professionals should consider measuring magnesium levels before starting PPI treatment and periodically during treatment.<br />\r\n<br />\r\n<strong>Influence on vitamin B12 absorption</strong>: Rabeprazole sodium, as all acid-blocking medicines, may reduce the absorption of vitamin B12 (cyanocobalamin) due to hypo- or a- chlorhydria. This should be considered in patients with reduced body stores or risk factors for reduced vitamin B12 absorption on long-term therapy or if respective clinical symptoms are observed.<br />\r\n<br />\r\n<strong>Subacute cutaneous lupus erythematosus (SCLE)</strong>: Proton pump inhibitors are associated with very infrequent cases of SCLE. If lesions occur, especially in sun-exposed areas of the skin, and if accompanied by arthralgia, the patient should seek medical help promptly and the health care professional should consider stopping Rabeprazole. SCLE after previous treatment with a proton pump inhibitor may increase the risk of SCLE with other proton pump inhibitors.<br />\r\n<br />\r\n<strong>Interference with laboratory tests</strong>: Increased Chromogranin A (CgA) level may interfere with investigations for neuroendocrine tumours. To avoid this interference, Rabeprazole 20mg Gastro-resistant Tablets treatment should be stopped for at least 5 days before CgA measurements. If CgA and gastrin levels have not returned to reference range after initial measurement, measurements should be repeated 14 days after cessation of proton pump inhibitor treatment.</p>', '<p>The maximum established exposure has not exceeded 60 mg twice daily, or 160 mg once daily. Effects are&nbsp; generally minimal, representative of the known adverse event profile and reversible without further medical intervention. No specific antidote is known. Rabeprazole&nbsp;is extensively protein bound and is, therefore, not dialysable. As in any case of overdose, treatment should be symptomatic and general supportive measures should be utilised.</p>', '<p>Proton Pump Inhibitor.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Renal and hepatic impairment</strong>: No dosage adjustment is necessary for patients with renal or hepatic impairment.<br />\r\n<br />\r\n<strong>Pediatric populations</strong>: Rabeprazole&nbsp;is not recommended for use in children due to a lack of data on safety and efficacy.</p>', '2022-03-12 04:33:40', '2022-03-12 04:33:40'),
(1150, 1150, '<p>For the seroprophylaxis (prevention by injecting antibodies) of rabies in subjects suspected to have been exposed to the rabies virus, particularly in the event of severe exposure e.g.:</p>\r\n\r\n<ul>\r\n	<li>Multiple transdermal bites or scratches</li>\r\n	<li>Contamination of mucous membrane with saliva</li>\r\n	<li>Severe bites located on the face, head, neck and hands</li>\r\n	<li>When the domestic or wild animal responsible cannot be examined or is infected or suspected to be infected by the rabies virus</li>\r\n	<li>Bites to young children</li>\r\n</ul>\r\n\r\n<p>Rabies Immunoglobulin provides passive immunization against rabies for prevention of rabies in patients after contact with a rabid animal or an animal presumed to be rabid. Anti rabies serum itself does not constitute an anti-rabies treatment and should always be used in conjunction with rabies vaccine.</p>', NULL, '<p>First-aid treatment: Prompt local treatment of bite wounds and scratches that may be contaminated with rabies virus is important, whatever the time elapsed since the contact. The recommended first-aid measures consist of immediate flushing and washing of the wound with soap and water, detergent or other substance of proven lethal effect on rabies virus. The rabies immune globulin should be injected as soon as possible after exposure.<br />\r\n<br />\r\nThe recommended dose for both adults and children is 40 IU/kg of body weight. If anatomically feasible, as much as possible of the dose should be infiltrated around and into the wound(s). The remainder should be administered intramuscularly (into the gluteal region) in a single injection.<br />\r\n<br />\r\nHowever, for children, particularly in the case of multiple wounds, it has been proposed to dilute the dose 2-3 times in a 0.9% sodium chloride solution to obtain a sufficient quantity of equine rabies immune globulin to infiltrate the wound(s) correctly. Wounds in certain anatomical sites (fingertips) should be infiltrated with care so as to prevent a local increase in pressure in the tissue.<br />\r\n<br />\r\nFor prevention of rabies, combined immune globulin-vaccine treatment is recommended. The 1st dose of the rabies vaccine should be given at the same time as the Rabies immunoglobulin, but in different parts of the body. If Rabies immunoglobulin is not available when the rabies vaccine is administered, it can be administered up to the 7th or 8th day after the first dose of rabies vaccine. When indicated, begin anti-tetanus treatment and administer anti-microbial drugs to control infections other than rabies.<br />\r\n<br />\r\nThe WHO expert committee on rabies has issued the following therapeutic recommendations:<br />\r\n<br />\r\nCategory Type of contact with a suspect or confirmed rabid domestic or wild animal or animal not available for observation Recommended Treatment:</p>\r\n\r\n<ul>\r\n	<li>Touching or feeding, licks on intact skin None, if reliable case history is available</li>\r\n	<li>Nibbling of uncovered skin, minor scratches superficial bites (except on head, neck, shoulder girdle, arms or hands) or abrasions without bleeding, licks on broken skin. Administer vaccine immediately on Day 0, D3, D7, D14 and D28. Stop treatment if animal remains healthy throughout the observation period of 10 days or if animal is killed humanely and found to be negative by appropriate laboratory techniques.</li>\r\n</ul>\r\n\r\n<p>Single or multiple transdermal bites or scratches specially on head, neck, shoulder girdle,arms or hands. Contamination of mucus membrane with saliva (i.e. licks on broken skin). Administer rabies vaccine immediately on Day 0, D3, D7, D14 and D28 or D90 (optional) and rabies immune globulin on D0 immediately. Stop treatment if animal remains healthy throughout the observation period of 10 days or if animal is killed humanely and found to be negative by appropriate laboratory techniques.</p>', NULL, '<p>Known history of allergic symptoms to horse proteins. Nevertheless, the lethal risk associated with rabies overcomes any potential contraindication.</p>', '<p>Immediate or delayed hypersensitive type reactions may be developed on administration of rabies immune globulin. The observed immediate reactions are hypotension, dyspnoea, and urticaria. Delayed reactions consist of inflammatory reaction, fever, pruritis, rash or urticaria, adenopathy and arthralgia.</p>', '<p>The safety of rabies immune globulin when used during pregnancy has not been established in clinical trials in human beings. Considering the lethal risk associated with rabies, pregnancy may not be a contraindication to the administration of rabies immune globulin subsequent to exposure.</p>', '<p>Do not administer rabies immunoglobulin intravenously (due to the risk of shock i.e., sudden collapse with drop in blood pressure). Consequently, make sure that the needle has not penetrated a blood vessel. Rabies immunoglobulin should not be administered in repeated doses. Once the vaccine treatment has been started, repeating injections of rabies immunoglobulin may reduce the protective efficacy that must be guaranteed by the vaccine. Shake well before use. Do not shake vigorously.</p>', '<p>If the recommended dosage is not strictly observed, there is a risk of immunosuppressive interference (suppression of immune defenses) with rabies vaccine.</p>', '<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. Protect from light. Do not freeze.</p>', NULL, '2022-03-12 04:35:21', '2022-03-12 04:35:21'),
(1151, 1151, '<p>Rabies vaccine is indicated for prophylactic immunization against rabies and treatment of patients following suspected rabies contact.<br />\r\n<br />\r\nPre-exposure Immunization:</p>\r\n\r\n<ul>\r\n	<li>Professional groups exposed to frequent contamination</li>\r\n	<li>Veterinary surgeons (including students at veterinary colleges)</li>\r\n	<li>Technical personnel working with veterinary surgeons</li>\r\n	<li>Laboratory personnel handling material contaminated with rabies vims</li>\r\n	<li>Personnel in abattoirs and knackers yards</li>\r\n	<li>Taxidermists</li>\r\n	<li>Gamekeepers, forestry workers and naturalists in enzootic areas</li>\r\n	<li>Infants particularly exposed to the risk of rabies</li>\r\n</ul>\r\n\r\n<p>Post-exposure Immunization:</p>\r\n\r\n<ul>\r\n	<li>Treatment of subjects bitten by rabid animals or those suspected of being so</li>\r\n	<li>Treatment of contact subjects.</li>\r\n</ul>', '<p>Rabies Vaccine for human use is a freeze-dried preparations of inactivated rabies virus produced on Vero cell. After reconstitution the vaccine is a clear, colorless sterile solution for intramuscular use.</p>', '<p>To reconstitute the vaccine, transfer content of supplied diluent into the vial containing freeze-dried preparation. Do not shake. After reconstitution the solution should be homogeneous, clear and free from any particles. Vaccine must be injected immediately after reconstitution and the syringe should be destroyed after use.<br />\r\n<br />\r\n<strong>Method of administration for intramuscular use</strong>: The 1 ml dose of Rabies vaccine should be given intramuscularly in the deltoid in adults and in the anterolateral aspect of the thigh muscle in children under 1 year. It should not be injected into the gluteal region. Do not inject intravenously.<br />\r\n<br />\r\n<strong>Pre-exposure immunization</strong>:</p>\r\n\r\n<ul>\r\n	<li>1 ml for children and adults.</li>\r\n	<li>Primary-vaccination: According to the WHO recommendations 1 injection by the intramuscular route on days DO, D7, D21 or D28, followed by a booster dose one year later.</li>\r\n	<li>Boosters: Thereafter, one injection every 5 years or when the titre is found to be less than 0.5 lU/ml</li>\r\n</ul>\r\n\r\n<p><strong>Post-exposure immunization</strong>:</p>\r\n\r\n<ul>\r\n	<li>Local treatment of the wound: Prompt and gentle through washing with soap or detergent and flushing the wound with running tap water for at least 15 minutes. After washing, disinfectants like either ethanol (700 ml/l) or tincture or aqueous solution of iodine or povidone iodine must be applied. Don&#39;t bandage or suture the wound.</li>\r\n	<li>Vaccination of non-immunized subjects</li>\r\n</ul>\r\n\r\n<p>Intramuscular schedules: One Intramuscular (IM) dose comprised of 1 ml.<br />\r\n<br />\r\nStandard intramuscular (1-1-1-1-1) regimen:</p>\r\n\r\n<ul>\r\n	<li>Day 0: 1 injection of 1 ml</li>\r\n	<li>Day 3: 1 injection of 1 ml</li>\r\n	<li>Day 7: 1 injection of 1 ml</li>\r\n	<li>Day 14: 1 injection of 1 ml</li>\r\n	<li>Day 28: 1 injection of 1 ml</li>\r\n</ul>\r\n\r\n<p>Or abbreviated multisite (2-1-1) regimen:</p>\r\n\r\n<ul>\r\n	<li>Day 0: 2 injections each of 1 ml at separate sites</li>\r\n	<li>Day 7: 1 injection of 1 ml</li>\r\n	<li>Day 21: 1 injection of 1 ml</li>\r\n</ul>\r\n\r\n<p>In case of severe (WHO category 3) wounds, rabies immunoglobulin should be administered as soon as possible with the first dose of rabies vaccine. The anti-rabies immunoglobulin should be used as local wound soakage injections as much as possible, with the rest part for muscle injection. The rabies vaccine should be administered in different injection site.<br />\r\n<br />\r\nVaccination of subjects already immunized: Patients had complete post exposure immunization schedule within 1 year. Bitten by suspected rabid animal, 1 dose injection is required on Day 0, Day 3, respectively. Patients had complete post-exposure immunization schedule 1 year ago, Bitten by suspected rabid animal, complete post-exposure immunization required. Patient had complete immunization schedule and booster immunization within 3 years. Bitten by suspected rabid animal, 1 dose injection is required on Day 0, Day 3, respectively. Patient had complete immunization schedule and booster immunization 3 years ago. Bitten by suspected rabid animal, complete post-exposure immunization required. Post-exposure vaccination must be administered on the basis of severity under medical supervision.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Co-administration: Corticosteroid and immunosuppressive treatment may interfere with antibody production and cause vaccination failure. In these cases, a titration of neutralizing antibodies should be performed.</p>', '<p>Concurrent use with immunosuppressants may reduce the efficacy of vaccines.</p>', '<p>Rabies vaccine is contraindicated in the following cases:<br />\r\n<br />\r\n<strong>Pre-exposure</strong>: Severe fever, febrile infection, acute disease, progressive chronic diseases. Known hypersensitivity reactions to rabies vaccine or any of its components<br />\r\n<br />\r\n<strong>Post-exposure</strong>: No contraindication to post-exposure treatment, because rabies is lethal disease, any contraindication to exposure, treatment should be considered carefully before disqualifying an individual for anti-rabies treatment.</p>', '<p>Minor local reactions like pain, erythema, oedema, pruritus and induration at the injection site and lasting to 24-48 hours. Moderate fever, shivering, fainting, asthenia, dizziness, respiratory manifestations (dyspnoea, wheezing), fever, abdominal pain, vomiting and allergic skin reactions (urticaria, rash, itching).</p>', '<p><strong>Pregnancy</strong>. The potential risk of administration of rabies vaccine during pregnancy is unknown. Due to the severity of the disease, pregnancy is not considered to be a contraindication to post-exposure prophylaxis.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether the vaccine is excreted in human breast milk. Due to the severity of the disease, breast-feeding is not considered a contraindication.</p>', '<ul>\r\n	<li>Intravenous injection is prohibited.</li>\r\n	<li>The vaccine and anti-rabies immunoglobulin must not be administered with same syringe and in the same injection site.</li>\r\n	<li>Before use, please carefully check package, label, appearance and the validity period.</li>\r\n	<li>After reconstitution, the freeze-dried rabies vaccine should be administered as soon as possible.</li>\r\n	<li>Any reconstituted vaccine should be used as soon as possible. It must be stored in a refrigerator at 2&deg;C to 8&deg;C and used within 8 hours after reconstitution or discarded.</li>\r\n</ul>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', '<p>Keep out of the reach and sight of children. Store &amp; transport at 2&deg;C to 8&deg;C. Protect from light. Do not keep in the deep freeze.</p>', NULL, '2022-03-12 04:59:08', '2022-03-12 04:59:08'),
(1152, 1152, '<p>Racecadotril is indicated for the symptomatic treatment of acute diarrhea.</p>', '<p>Racecadotril increases the availability of endogenous opioids (enkephalins) by inhibiting the membrane-bound enkephalinase. The enkephalins in turn mediate their effect through &delta; receptor ( delta opioid receptor) activation that induces a selective increase in Cl absorption by inhibiting adenylate cyclase.<br />\r\n<br />\r\nOnset: 30 min (plasma enkephalinase inhibition).</p>', '<p><strong>Adults</strong>: One capsule initially, regardless of the time of day. Then one capsule three times daily preferably before the main meals.<br />\r\n<br />\r\n<strong>Children</strong>&nbsp;(from 3 months of age): Racecadotril granules should be administered together with oral rehydration. The recommended dose is determined according to body weight: 1.5 mg/kg per administration, three times daily.</p>\r\n\r\n<ul>\r\n	<li><strong>Infants less than 9 kg</strong>: one 10 mg sachet 3 times daily.</li>\r\n	<li><strong>Infants from 9 kg to 13 kg</strong>: two 10 mg sachets 3 times daily.</li>\r\n	<li><strong>Children from 13 kg to 27 kg</strong>: one 30mg sachet 3 times daily.</li>\r\n	<li><strong>Children of more than 27 kg</strong>: two 30mg sachets 3 times daily.</li>\r\n</ul>', '<p>No drug interactions found. Joint treatment with Racecadotril and Loperamide or Nifuroxazide does not modify the kinetics of Racecadotril.</p>', '<p>Hypersensitivity to Racecadotril, or to any of the excipients.</p>', '<p>Headache, erythema multiforme, urticaria, angioedema may be seen.</p>', '<p>Due to a lack of clinical data, Racecadotril should not be administered to pregnant or breastfeeding women.</p>', '<p>The administration of Racecadotril does not modify the usual rehydration regimens. The presence of bloody stools and fever may indicate the presence of invasive bacteria as a reason for diarrhea or the presence of other severe disease. Racecadotril has not been tested in antibiotic-associated diarrhea and should therefore not be administered under these conditions. Caution should be taken in patients with renal or liver impairment.</p>', '<p>No cases of overdose have been reported. In adults, single doses above 2 g which is equivalent to 20 times the therapeutic dose, have been administered, and no harmful effects have been described.</p>', '<p>Anti-diarrhoeal</p>', NULL, NULL, '2022-03-12 05:00:51', '2022-03-12 05:00:51'),
(1153, 1153, '<p>For temporary relief of mild symptoms of intermittent asthma: Wheezing, tightness of chest and shortness of breath.</p>', '<p>Racepinephrine is an alpha- and beta-adrenoreceptor stimulant. Racepinephrine works by widening the airways, reducing spasms of bronchial muscles of asthma patients, which makes it easier to breathe.</p>', '<p>Adults and children 4 years of age and over-</p>\r\n\r\n<ul>\r\n	<li><strong>Jet Nebulizer</strong>: Nebulisation for fifteen minutes every 3 to 4 hours. One 0.5 ml ampoule should be diluted to a volume of 3 to 5 ml with sterile 0.9% sodium chloride solution.</li>\r\n	<li><strong>Hand-held Bulb Nebulizer</strong>: 1 to 3 inhalations not more often than every 3 hours. The racepinephrine inhalation solution does not require dilution. Should not use more than 12 inhalations in 24 hours.</li>\r\n</ul>\r\n\r\n<p>Children under 4 years of age: Use according to the physician&#39;s direction.</p>', '<p>Concurrent use with other adrenergic agents will have additive adrenergic side effects. Use with MAO inhibitors may lead to hypertensive crisis. Beta-blockers may negate the therapeutic effect. Tricyclic antidepressants enhance response to epinephrine.</p>', NULL, '<p>Side effects of Racepinephrine includes headache, loss of appetite, nausea &amp; vomiting, nervousness, tremors, trouble sleeping, fear, agitation, anxiety, restlessness, dizziness, impaired memory, hallucinations, and psychosis. Severe allergic reactions (rash, hives, itching, and difficulty in breathing, swelling of the mouth, face, lips, or tongue), chest pain, fast heartbeat and wheezing may occur. Besides, elevations of heart rate and blood pressure or arrhythmias may occur. Cardiac patients with coronary artery disease or hypertension may worsen condition.</p>', '<p>Racemic epinephrine is a 1:1 mixture of the Dextrorotatory and Levorotatory isomers of epinephrine. Epinephrine has been assigned to pregnancy category C by the US FDA. Epinephrine is only recommended for use during pregnancy when there are no alternatives and benefit outweighs the risk. Epinephrine is excreted into human milk. Due to the potential for serious adverse effects in nursing infants, a decision should be made to discontinue nursing or discontinue the drug.</p>', '<p>Racepinephrine should be used cautiously in patients with: cardiac disease (angina, tachycardia, myocardial infarction, hypertension), hyperthyroidism, diabetes, cerebral arteriosclerosis. Excessive use may lead to tolerance and paradoxical bronchospasm. Besides, it is advised not to use Racepinephrine if symptoms are not relieved within 20 minutes or become worse. Racepinephrine solution should not be used if it is brown in color or cloudy, pinkish or if it contains a precipitate.</p>', '<p>Excessive use may cause nervousness and rapid heartbeat, adverse effects on the heart. In case of overdose, the patient should get medical help right away.</p>', '<p>Other adrenoceptor stimulants.</p>', '<p>Store at 2&deg; to 8&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-12 05:02:35', '2022-03-12 05:02:35'),
(1154, 1154, '<p>Raloxifene is an estrogen agonist/antagonist indicated for:</p>\r\n\r\n<ul>\r\n	<li>Treatment and prevention of osteoporosis in postmenopausal women</li>\r\n	<li>Reduction in risk of invasive breast cancer in postmenopausal women with osteoporosis</li>\r\n	<li>Reduction in risk of invasive breast cancer in postmenopausal women at high risk for invasive breast cancer</li>\r\n</ul>\r\n\r\n<p>Important Limitations: Raloxifene is not indicated for the treatment of invasive breast cancer, reduction of the risk of recurrence of breast cancer, or reduction of risk of noninvasive breast cancer</p>', '<p>Raloxifene is a selective estrogen receptor modulator (SERM). The biological actions of Raloxifene are largely mediated through binding to estrogen receptor. This binding results in activation of certain estrogenic pathways and blockade of others. Raloxifene reduces resorption of bone and decreases overall bone turnover. These effects on bone are manifested as reductions in the serum and urine levels of bone turnover markers. Clinical trials and data suggest that Raloxifene lacks estrogen like effects on the uterus and breast tissues. Raloxifene is rapidly absorbed after oral administration, metabolized in liver, and primarily excreted in faeces and rest in urine.</p>', '<p>One tablet (60 mg) once daily orally. It can be taken without regard to meal. High fat meal increases the absorption of Raloxifene.</p>', '<p>Co-administered with cholestyramin, ampicillin and amoxicillin may reduce the absorption of Raloxifene.</p>', '<p>Hepatic &amp; renal impairment. In active or past history of venous thromboembolic events, including deep vein thrombosis, pulmonary embolism and retinal vein thrombosis. Hypersensitivity to Raloxifene or any other constituents of the tablet.</p>', '<p>Raloxifene is generally well tolerated. However, a few side effects like hot flushes, leg cramps, and influenza like symptoms, gastro-intestinal disturbances etc may be seen usually during first 6 months of treatment and were not different from placebo.</p>', '<p><strong>Pregnancy Category X:</strong>&nbsp;Raloxifene should not be used in women who are or may become pregnant.<br />\r\n<strong>Lactation:</strong>&nbsp;It is not known whether Raloxifene is excreted in breast milk. Lactating mother should not use Raloxifne.</p>', '<p><strong>Concurrent Estrogen Therapy:</strong>&nbsp;Concomitant use of Raloxifene with systemic estrogens is not recommended.<br />\r\n<br />\r\n<strong>Lipid Metabolism:</strong>&nbsp;Concurrent use of Raloxifene and lipid-lowering agents has not been studied.</p>', '<p>Incidents of overdose in humans have not been reported.</p>', '<p>Inhibiting bone resorption.</p>', NULL, '<p>Severe Renal Impairment: Contraindicated.<br />\r\nHepatic Impairment: Contraindicated.</p>', '2022-03-12 05:04:37', '2022-03-12 05:04:37'),
(1155, 1155, '<p>Ramelteoni s indicated for the treatment of insomnia characterized by difficulty with sleep onset.</p>', '<p>Ramelteon is a melatonin receptor agonist with both high affinity for melatonin MT1&nbsp;and MT2receptors, and lower selectivity for the MT3&nbsp;receptor. Melatonin production is concurrent with nocturnal sleep, meaning that an increase in melatonin levels is related to the onset of self-reported sleepiness and an increase in sleep propensity. MT1&nbsp;receptors are believed to be responsible for regulation of sleepiness and facilitation of sleep onset, and MT2&nbsp;receptors are believed to mediate phase-shifting effects of melatonin on the circadian rhythm. While MT1&nbsp;and MT2&nbsp;receptors are associated with the sleep-wake cycle, MT3&nbsp;has a completely different profile, and therefore is not likely to be involved in the sleep-wake cycle. Remelteon has no appreciable affinity for the gamma-aminobutyric acid (GABA) receptor complex or receptors that bind neuropeptides, cytokines, serotonin, dopamine, norepinephrine, acetylcholine, or opiates.</p>', '<p><strong>Adult dose</strong>: 8 mg taken within 30 minutes of going to bed. Should not be taken with or immediately after a high-fat meal. The total daily dose should not exceed 8 mg.</p>', '<p><strong>Rifampin (strong CYP enzyme inducer)</strong>: Decreases exposure to and effects of ramelteon.<br />\r\n<br />\r\n<strong>Ketoconazole (strong CYP3A4 inhibitor)</strong>: Increases AUC for ramelteon; administer with caution.<br />\r\n<br />\r\n<strong>Fluconazole (strong CYP2C9 inhibitor)</strong>: Increases systemic exposure of ramelteon; administer with caution. Donepezil increases systemic exposure of ramelteon; patients should be closely monitored when ramelteon is co administered with donepezil. Doxepin increases systemic exposure of ramelteon; patients should be closely monitored when ramelteon is co administered with doxepin.<br />\r\n<br />\r\n<strong>Alcohol</strong>: Causes additive psychomotor impairment; should not be used in combination</p>', '<ul>\r\n	<li>History of angioedema while taking Ramelteon.</li>\r\n	<li><strong>Fluvoxamine (strong CYP1A2 inhibitor)</strong>: Increases AUC for ramelteon and should not be used in combination</li>\r\n</ul>', '<p><strong>Most common adverse reactions (&ge;3% and more common than with placebo) are</strong>: somnolence, dizziness, fatigue, nausea, and exacerbated insomnia.</p>', '<p><strong>Pregnancy</strong>: Based on animal data may cause fetal harm. Do not use unless the potential benefit justifies the potential risk.<br />\r\n<br />\r\n<strong>Nursing mothers</strong>: Use with caution.</p>', '<p><strong>Severe anaphylactic/anaphylactoid reactions</strong>: Angioedema and anaphylaxis have been reported. Do not rechallenge if such reactions occur.<br />\r\n<br />\r\n<strong>Need to evaluate for co-morbid diagnoses</strong>: Reevaluate if insomnia persists after 7 to 10 days of treatment.<br />\r\n<br />\r\n<strong>Abnormal thinking, behavioral changes, complex behaviors</strong>: May include &quot;sleep-driving&quot; and hallucinations. Immediately evaluate any new onset behavioral changes.<br />\r\n<br />\r\n<strong>Depression</strong>: Worsening of depression or suicidal thinking may occur.<br />\r\n<br />\r\n<strong>CNS effects</strong>: Potential impairment of activities requiring complete mental alertness such as operating machinery or driving a motor vehicle, after ingesting the drug.&nbsp;<br />\r\n<br />\r\n<strong>Reproductive effects</strong>: Include decreased testosterone and increased prolactin levels. Effect on the reproductive axis in developing humans is unknown<br />\r\n<br />\r\n<strong>Patients with severe sleep apnea</strong>: Rozerem is not recommended for use in this population.</p>', NULL, '<p>Miscellaneous sedatives &amp; hypnotics.</p>', '<p>Store at 25&deg;C; excursions permitted to 15&deg; to 30&deg;C. Keep container tightly closed and protected from moisture and humidity.</p>', '<p><strong>Pediatric use</strong>: Safety and effectiveness not established.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: No overall differences in safety and efficacy between elderly and younger adult subjects.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Is not recommended in patients with severe impairment; use with caution in moderate impairment.</p>', '2022-03-12 05:06:29', '2022-03-12 05:06:29'),
(1156, 1156, '<p>Ramipril indicated in the following cases:</p>\r\n\r\n<ul>\r\n	<li>Hypertension; to lower blood pressure, as single-drug therapy or in combination with other antihypertensive agents.</li>\r\n	<li>Congestive heart failure; also in combination with diuretics.</li>\r\n	<li>Treatment of patients who- within the first few days after an acute myocardial infarction- have demonstrated clinical signs of congestive heart failure.</li>\r\n	<li>Treatment of non-diabetic or diabetic overt glomerular or incipient nephropathy.</li>\r\n	<li>Reduction in the risk of myocardial infarction, stroke, or cardiovascular death in patients with an increased cardiovascular risk, such as manifest coronary heart disease (with or without a history of myocardial infarction), a history of stroke, a history of peripheral vascular disease, or diabetes mellitus that is accompanied by at least one other cardiovascular risk factor (microalbuminuria, hypertension, elevated total cholesterol levels, low high-density lipoprotein cholesterol levels, smoking).</li>\r\n</ul>', '<p>Ramipril is an angiotensin converting enzyme (ACE) inhibitor, which after hydrolysis to ramiprilat, blocks the conversion of angiotensin I to the vasoconstrictor substance, angiotensin II. So, inhibition of ACE by ramipril results in decreased plasma angiotensin II, which leads to decreased vasopressor activity and decreased aldosterone secretion. Thus ramipril exerts its antihypertensive activity. It is also effective in the management of heart failure and reduction of the risk of stroke, myocardial infarction and death from cardiovascular events. It is long acting and well tolerated; so, can be used in long term therapy.</p>', '<p>Dosage of Ramipril must be adjusted according to the patient tolerance and response.<br />\r\n<br />\r\n<strong>Hypertension</strong>: For the management of hypertension in adults not receiving a diuretic, the usual initial dose of Ramipril is 1.25-2.5 mg once daily. Dosage generally is adjusted no more rapidly than at 2 week intervals. The usual maintenance dosage in adults is 2.5-20 mg daily given as a single dose or in 2 divided doses daily. If BP is not controlled with Ramipril alone, a diuretic may be added.<br />\r\n<br />\r\n<strong>Congestive heart failure after myocardial infarction</strong>: In this case, Ramipril therapy may be initiated as early as 2 days after myocardial infarction. An initial dose of 2.5 mg twice daily is recommended, but if hypotension occurs, dose should be reduced to 1.25 mg twice daily. Therapy is then titrated to a target daily dose of 5 mg twice daily.<br />\r\n<br />\r\n<strong>Prevention of major cardiovascular events</strong>: In this case, the recommended dose is 2.5 mg once daily for the first week of therapy and 5 mg once daily for the following 3 weeks; dosage then may be increased, as tolerated, to a maintenance dosage of 10 mg once daily.<br />\r\n<br />\r\n<strong>Dosage in renal impairment</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>For patients with hypertension and renal impairment</strong>: The recommended initial dose is 1.25 mg Ramipril once daily. Subsequent dosage should be titrated according to individual tolerance and BP response, up to a maximum of 5 mg daily.</li>\r\n	<li><strong>For patients with heart failure and renal impairment</strong>: The recommended dose is 1.25 mg once daily. The dose may be increased to 1.25 mg twice daily and up to a maximum dose of 2.5 mg twice daily depending upon clinical response and tolerability.</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>Ramipril tablets have to be swallowed with sufficient amounts of liquid. The tablets must not be chewed or crushed. Absorption of Ramipril is not significantly affected by food. Ramipril may, therefore, be taken before, during or after a meal.</p>', '<p>Concomitant administration with diuretics may lead to serious hypotension and in addition dangerous hyperkalemia with potassium sparing diuretics. Concomitant therapy with lithium may increase the serum lithium concentration. Reduction in BP may affect the ability to drive and operate machinery and this may be exacerbated by alcohol. NSAIDs may reduce the antihypertensive effect of Ramipril and cause deterioration of renal function.</p>', '<p>Ramipril must not be used</p>\r\n\r\n<ul>\r\n	<li>in patients with hypersensitivity to ramipril, to any other ACE inhibitor, or any of the excipients of Ramipril.</li>\r\n	<li>in patients with a history of angioedema.</li>\r\n	<li>concomitantly with sacubitril/valsartan therapy. Do not initiate Ramipril until sacubitril/valsartan is eliminated from the body. In case of switch from Ramipril to sacubitril/valsartan, do not start sacubitril/valsartan until Ramipril is eliminated from the body.</li>\r\n	<li>in patients with haemodynamically relevant renal artery stenosis, bilateral or unilateral in the single kidney.</li>\r\n	<li>in patients with hypotensive or haemodynamically unstable states.</li>\r\n	<li>with aliskiren-containing medicines in patients with diabetes or with moderate to severe renal impairment (creatinine clearance &lt;60 ml/min).</li>\r\n	<li>with angiotensin II receptor antagonists (AIIRAs) in patients with diabetic nephropathy.</li>\r\n	<li>during pregnancy.</li>\r\n</ul>\r\n\r\n<p>Concomitant use of ACE inhibitors and extracorporeal treatments leading to contact of blood with negatively charged surfaces must be avoided, since such use may lead to severe anaphylactoid reactions. Such extracorporeal treatments include dialysis or haemofiltration with certain high-fux (e.g. polyacrylonitril) membranes and low-density lipoprotein apheresis with dextran sulfate.</p>', '<p>Ramipril is generally well tolerated. Dizziness, headache, fatigue and asthenia are commonly reported side effects. Other side effects occurring less frequently include symptomatic hypotension, cough, nausea, vomiting, diarrhoea, rash, urticaria, oliguria, anxiety, amnesia etc. Angioneurotic oedema, anaphylactic reactions and hyperkalaemia have also been reported rarely.</p>', '<p>Ramipril must not be taken during pregnancy. Therefore, pregnancy must be excluded before starting treatment. Pregnancy must be avoided in cases where treatment with ACE inhibitors is indispensable. If the patient intends to become pregnant, treatment with ACE inhibitors must be discontinued, i.e. replaced by another form of treatment. If the patient becomes pregnant during treatment, medication with Ramipril must be replaced as soon as possible by a treatment regimen without ACE inhibitors. Otherwise, there is a risk of harm to the fetus. Ramipril is not recommended during breastfeeding.</p>', '<p>Ramipril should be used with caution in patients with impaired renal function, hyperkalaemia, hypotension, and impaired hepatic function.</p>', '<p><strong>Sign and symptom</strong>: Overdosage may cause excessive peripheral vasodilatation (with marked hypotension, shock), bradycardia, electrolyte disturbances, and renal failure.<br />\r\n<br />\r\n<strong>Management</strong>: Primary detoxifcation by, for example, gastric lavage, administration of adsorbents, sodium sulfate; (if possible during the frst 30 minutes). In the event of hypotension administration of &alpha;1-adrenergic agonists (e.g. norepinephrine, dopamine) or angiotensin II (angiotensinamide), which is usually available only in scattered research laboratories, must be considered in addition to volume and salt substitution.</p>', '<p>Angiotensin-converting enzyme (ACE) inhibitors.</p>', '<p>Store at 30&deg; or below, protect from light. Keep out of the reach of children. Do not use later than the date of expiry. To be dispensed only on the prescription of a registered physician.</p>', '<p><strong>Elderly</strong>: A reduced initial dose of 1.25 mg Ramipril daily must be considered.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Treatment in these patients must therefore be initiated only under close medical supervision. The maximum permitted daily dose in such cases is 2.5 mg Ramipril.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: With a creatinine clearance between 50 and 20 ml/min per 1.73 m2 body surface area, the initial daily dose is generally 1.25 mg Ramipril. The maximum permitted daily dose, in this case, is 5 mg Ramipril. Patients with incompletely corrected fuid or salt depletion, in patients with severe hypertension, as well as in patients in whom a hypotensive reaction would constitute a particular risk, (e.g., with relevant stenoses of the coronary vessels or those supplying the brain) A reduced initial dose of 1.25 mg Ramipril daily must be considered.<br />\r\n<br />\r\n<strong>Patients pretreated with a diuretic</strong>: Consideration must be given to discontinuing the diuretic for at least 2 to 3 days or- depending on the duration of action of the diuretic- longer before starting treatment with Ramipril, or at least to reducing the diuretic dose. The initial daily dose in patients previously treated with a diuretic is generally 1.25 mg Ramipril.</p>', '2022-03-12 05:08:45', '2022-03-12 05:08:45');
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
(1157, 1157, '<p>Indicated for the treatment of mild to moderate hypertension in patients (in whom combination therapy is appropriate) who have been stabilised on the individual components given in the same proportion.</p>', '<p><strong>Ramipril</strong>&nbsp;is an angiotensin converting enzyme (ACE) inhibitor, which after hydrolysis to ramiprilat, blocks the conversion of angiotensin I to the vasoconstrictor substance, angiotensin II. So, inhibition of ACE by ramipril results in decreased plasma angiotensin II, which leads to decreased vasopressor activity and decreased aldosterone secretion. Thus ramipril exerts its antihypertensive activity. It is also effective in the management of heart failure and reduction of the risk of stroke, myocardial infarction and death from cardiovascular events. It is long acting and well tolerated; so, can be used in long term therapy.<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>Dose Titration Guided by Clinical Effect. A patient whose blood pressure is not adequately controlled with ramipril (or another ACE inhibitor) alone or with hydrochlorothiazide (or another thiazide diuretic) alone may be switched to combination therapy with Ramipril 2.5 mg + Hydrochlorothiazide 12.5 mg or Ramipril 5 mg + Hydrochlorothiazide 25 mg tablet.<br />\r\n<br />\r\n<strong>Replacement Therapy</strong>: For convenience, patients receiving ramipril and hydrochlorothiazide from separate tablets may instead wish to receive tablets of combination of Ramipril 2.5 mg + Hydrochlorothiazide 12.5 mg or Ramipril 5 mg + Hydrochlorothiazide 25 mg. If necessary, the dose may be increased to two tablets of Ramipril 2.5 mg + Hydrochlorothiazide 12.5 mg or Ramipril 5 mg + Hydrochlorothiazide 25 mg once daily.<br />\r\n<br />\r\n<strong>Maximum daily dose</strong>: 10 mg ramipril and 50 mg hydrochlorothiazide (four tablets of Ramipril 2.5 mg + Hydrochlorothiazide 12.5 mg or two tablets of Ramipril 5 mg + Hydrochlorothiazide 25 mg).</p>', '<p>Combination with diuretics or other antihypertensive agents or nitrates and tricyclic antidepressants may potentiate the antihypertensive response to Ramipril and Hydrochlorothiazide combination. Patients previously treated with diuretics may experience a marked drop in blood pressure. Ramipril / Hydrochlorothiazide may weaken the effectiveness of blood sugar lowering medications (antidiabetic agents, e.g. insulin and sulphonylurea derivatives). When Ramipril/Hydrochlorothiazide is administered simultaneously with acetyl salicylic acid or indomethacin, attenuation of antihypertensive effect and moreover acute renal failure may occur. Ramipril / Hydrochlorothiazide may potentiate the effects of alcohol.</p>', '<p>This preparation must not be used in patients with hypersensitivity to ramipril, hydrochlorothiazide or other thiazide diuretics. History of hereditary angioneurotic oedema. Severe impairment of renal function. Haemodynamically relevant unilateral or bilateral renal artery stenosis, mitral stenosis, aortic stenosis, and in patients with low blood pressure (hypotensive patients) or in patients with an unstable circulatory situation (haemodynamically unstable patients) where there might be a risk of life-threatening fall in blood pressure and renal failure. Clinically relevant electrolyte disturbances e.g. hypokalemia, hyponatremia or hypercalcemia which may worsen following treatment.</p>', '<p>The combination of Ramipril and Hydrochlorothiazide is generally well tolerated. Side effects commonly reported include headache, dizziness, asthenia, nausea, vomiting, hypotension, cough, weakness, diarrhoea, fever, gastric irritation, pulmonary oedema, photosensitivity, electrolyte imbalance, hyperglycaemia, hyperuricaemia and vertigo.</p>', '<p>ACE inhibitors can cause foetal and neonatal morbidity and death when administered to pregnant women. Also, thiazides cross the placental barrier and appear in cord blood. There is a risk of foetal or neonatal jaundice, thrombocytopenia, and possibly other adverse reactions that have occurred in adults. When pregnancy is detected, Ramipril and Hydrochlorothiazide combination should be discontinued as soon as possible. This product is excreted in breast milk. Because of the potential for serious adverse reactions in nursing infants, women receiving Ramipril and Hydrochlorothiazide combination should not breast feed.</p>', '<p>Treatment with Ramipril and Hydrochlorothiazide combination requires regular medical supervision. Generally dehydration, reduced blood volume (hypovolumia) or salt depletion should be corrected before initiating the treatment (in patients with concomitant heart failure, however, this must be carefully weighed against the risk of volume overload).<br />\r\n<br />\r\n<strong>Special caution is necessary during the treatment of</strong>: Patients with severe and particularly with malignant hypertension. Patients with concomitant and particularly with severe heart failure. Patients in whom fluid or salt deficiency exists or may develop (as a result of inadequate fluid or salt intake) or as a result of diarrhoea, vomiting or excessive sweating in cases where salt and fluid replacement is inadequate. Patients with haemodynamically relevant renal artery stenosis. In patients with pre-existing impairment of renal function or in kidney transplant patients. White blood cell count should be monitored (more frequent in the initial phase of the treatment) so that leucopenia can be detected. Insufficient experience has been gained concerning the use of Ramipril and Hydrochlorothiazide combination in children.</p>', '<p><strong>Ramipril:</strong>&nbsp;Limited data on human overdosage are available. The most likely clinical manifestations would be symptoms attributable to hypotension. Because the hypotensive effect of Ramipril is achieved through vasodilation and effective hypovolemia, it is reasonable to treat Ramipril overdosage by infusion of normal saline solution.<br />\r\n<br />\r\n<strong>Hydrochlorothiazide:</strong>&nbsp;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, 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 in a cool and dry place, protected from light.</p>', '<p><strong>Dosage in renal impairment:</strong>&nbsp;In patients with a creatinine clearance between 60 and 30 ml/min, treatment should be initiated with Ramipril 1.25 mg monotherapy. If blood pressure is not adequately controlled, the dose of Ramipril may be increased to 2.5 mg. If blood pressure is still not controlled, patient may be switched to one tablet of Ramoril 2.5 Plus once daily. Dosage may be titrated upward to Ramoril 5 Plus until blood pressure is controlled.<br />\r\n<br />\r\n<strong>Uue in children</strong>: Safety and effectiveness in paediatric patients have not been established.</p>', '2022-03-12 05:39:06', '2022-03-12 05:39:06'),
(1158, 1158, '<p>Ramucirumab is a human vascular endothelial growth factor receptor 2 (VEGFR2) antagonist indicated:</p>\r\n\r\n<ul>\r\n	<li>As a single agent or in combination with paclitaxel, for treatment of advanced or metastatic gastric or gastro-esophageal junction adenocarcinoma with disease progression on or after prior fluoropyrimidine- or platinum-containing chemotherapy.</li>\r\n	<li>In combination with erlotinib, for first-line treatment of metastatic non-small cell lung cancer with epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) mutations.</li>\r\n	<li>In combination with docetaxel, for treatment of metastatic non-small&nbsp;cell lung cancer with disease progression on or after platinum-based chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving Ramucirumab.</li>\r\n	<li>In combination with FOLFIRI, for the treatment of metastatic colorectal cancer with disease progression on or after prior therapy with bevacizumab, oxaliplatin, and a fluoropyrimidine.</li>\r\n	<li>As a single agent, for the treatment of hepatocellular carcinoma in patients who have an alpha-fetoprotein of &ge;400 ng/mL and have been treated with sorafenib.</li>\r\n</ul>', '<p>Ramucirumab is a VEGFR2 antagonist that specifically binds VEGFR2 and blocks binding of VEGFR ligands, VEGF-A, VEGF-C, and VEGF-D. As a result, ramucirumab inhibits ligand-stimulated activation of VEGFR2, thereby inhibiting ligand-induced proliferation, and migration of human endothelial cells. Ramucirumab inhibited angiogenesis in an in vivo animal model.</p>', '<p>For intravenous infusion only. Do not administer as an intravenous push or bolus. Premedicate before each infusion.</p>\r\n\r\n<ul>\r\n	<li><strong>Gastric Cancer</strong>: Administer Ramucirumab 8 mg/kg every 2 weeks as a single agent or in combination with weekly paclitaxel.</li>\r\n	<li><strong>Non-Small Cell Lung Cancer</strong>: Administer Ramucirumab 10 mg/kg every 2 weeks with daily erlotinib. Administer Ramucirumab 10 mg/kg on Day 1 of a 21-day cycle prior to docetaxel.</li>\r\n	<li><strong>Colorectal Cancer</strong>: Administer Ramucirumab 8 mg/kg every 2 weeks prior to FOLFIRI.</li>\r\n	<li><strong>Hepatocellular Carcinoma</strong>: Administer Ramucirumab 8 mg/kg every 2 weeks.</li>\r\n</ul>', NULL, NULL, '<p>The most common adverse reactions observed in single agent Ramucirumab-treated gastric cancer patients at a rate of &ge;10% and &ge;2% higher than placebo were hypertension and diarrhea.<br />\r\n<br />\r\nThe most common adverse reactions observed in patients treated with Ramucirumab with paclitaxel at a rate of &ge;30% and &ge;2% higher than placebo with paclitaxel were fatigue/asthenia, neutropenia, diarrhea, and epistaxis.<br />\r\n<br />\r\nThe most common adverse reactions observed in patients treated with Ramucirumab with erlotinib at a rate of &ge;30% and &ge;2% higher than placebo with erlotinib were, infections, hypertension, stomatitis, proteinuria, alopecia, and epistaxis. The most common laboratory abnormalities at a rate of &ge;30% and &ge;2% higher difference in incidence between arms were increased alanine aminotransferase, increased aspartate aminotransferase, anemia, thrombocytopenia, and neutropenia.<br />\r\n<br />\r\nThe most common adverse reactions observed in patients treated with Ramucirumab with docetaxel at a rate of &ge;30% and &ge;2% higher than placebo with docetaxel were neutropenia, fatigue/asthenia, and stomatitis/mucosal inflammation.<br />\r\n<br />\r\nThe most common adverse reactions observed in patients treated with Ramucirumab with FOLFIRI at a rate of &ge;30% and &ge;2% higher than placebo with FOLFIRI were diarrhea, neutropenia, decreased appetite, epistaxis, and stomatitis.<br />\r\n<br />\r\nThe most common adverse reactions observed in single agent Ramucirumab-treated HCC patients at a rate of &ge;15% and &ge;2% higher than placebo were fatigue, peripheral edema, hypertension, abdominal pain, decreased appetite, proteinuria, nausea, and ascites. The most common laboratory abnormalities at a rate of &ge;30% and a &ge;2% higher difference in incidence between arms were thrombocytopenia, hypoalbuminemia, and hyponatremia.</p>', '<p>Based on its mechanism of action, Ramucirumab can cause fetal harm when administered to a pregnant woman. There are no available data on Ramucirumab use in pregnant women. Animal models link angiogenesis, VEGF and VEGFR2 to critical aspects of female reproduction, embryo-fetal development, and postnatal development. No animal studies have been conducted to evaluate the effect of ramucirumab on reproduction and fetal development. Advise a pregnant woman of the potential risk to a fetus. 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.<br />\r\n<br />\r\nThere is no information on the presence of ramucirumab in human milk or its effects on the breastfed child or on milk production. Human IgG is present in human milk, but published data suggest that breast milk antibodies do not enter the neonatal and infant circulation in substantial amounts. Because of the potential risk for serious adverse reactions in breastfed children from ramucirumab, advise women not to breastfeed during treatment with Ramucirumab and for 2 months after the last dose.</p>', '<p><strong>Hemorrhage</strong>: Ramucirumab increases the risk of hemorrhage and gastrointestinal hemorrhage, including severe and fatal events. Permanently discontinue Ramucirumab in patients who experience severe bleeding.<br />\r\n<br />\r\n<strong>Gastrointestinal Perforations</strong>: Ramucirumab increases the risk of gastrointestinal perforation, which can be fatal. Permanently discontinue Ramucirumab in patients who experience a gastrointestinal perforation.<br />\r\n<br />\r\n<strong>Impaired Wound Healing</strong>: Withhold Ramucirumab for 28 days prior to elective surgery. Do not administer Ramucirumab for at least 2 weeks following a major surgical procedure and until adequate wound healing. The safety of resumption of Ramucirumab after resolution of wound healing complications has not been established.<br />\r\n<br />\r\n<strong>Arterial Thromboembolic Events (ATEs)</strong>: Serious and sometimes fatal ATEs can occur with Ramucirumab. Permanently discontinue Ramucirumab in patients who experience an ATE.<br />\r\n<br />\r\n<strong>Hypertension</strong>: Monitor blood pressure and treat hypertension. Withhold Ramucirumab for severe hypertension. Permanently discontinue Ramucirumab for hypertension that cannot be controlled with antihypertensive therapy and for hypertensive crisis or hypertensive encephalopathy.<br />\r\n<br />\r\n<strong>Infusion-Related Reactions (IRR)</strong>: Monitor for signs and symptoms during infusion. Reduce the infusion rate for Grade 1 or 2 IRR and permanently discontinue for Grade 3 or 4 IRR.<br />\r\n<br />\r\n<strong>Worsening of Pre-existing Hepatic Impairment</strong>: New onset or worsening encephalopathy, ascites or hepatorenal syndrome can occur in patients with Child-Pugh B or C cirrhosis.<br />\r\n<br />\r\n<strong>Posterior Reversible Encephalopathy Syndrome</strong>: Permanently discontinue Ramucirumab.<br />\r\n<br />\r\n<strong>Proteinuria Including Nephrotic Syndrome</strong>: Monitor for proteinuria. Withhold Ramucirumab for urine protein levels greater than or equal to 2 g per 24 hours. Permanently discontinue Ramucirumab for urine protein levels greater than 3 g per 24 hours or nephrotic syndrome.<br />\r\n<br />\r\n<strong>Thyroid Dysfunction</strong>: Monitor thyroid function during treatment.<br />\r\n<br />\r\n<strong>Embryo-Fetal Toxicity</strong>: Can cause fetal harm. Advise females of reproductive potential of the potential risk to a fetus and to use effective contraception.</p>', NULL, '<p>Cytotoxic Chemotherapy</p>', '<p>Store vials in a refrigerator at 2&deg;C to 8&deg;C in the original carton to protect from light until time of use. Do not freeze or shake the vial.</p>', NULL, '2022-03-12 05:40:58', '2022-03-12 05:40:58'),
(1159, 1159, '<p>Ranibizumab is indicated for the treatment of patients with:</p>\r\n\r\n<ul>\r\n	<li>Neovascular (Wet) Age-Related Macular Degeneration (AMD)</li>\r\n	<li>Macular Edema Following Retinal Vein Occlusion (RVO)</li>\r\n	<li>Diabetic Macular Edema (DME)</li>\r\n	<li>Diabetic Retinopathy (Non Proliferative Diabetic Retinopathy (NPDR), Proliferative Diabetic Retinopathy (PDR)) in patients with Diabetic Macular Edema (DME)</li>\r\n	<li>Myopic Choroidal Neovascularization (mCNV)</li>\r\n</ul>', '<p>Ranibizumab is a recombinant humanised IgG1 kappa monoclonal antibody fragment which binds to active forms of human vascular endothelial growth factor A (VEGF-A) and inhibits their biologic activity. Binding of ranibizumab to VEGF-A inhibits VEGF from binding to its receptors, thereby suppressing neovascularisation (angiogenesis), endothelial cell proliferation and vascular permeability.</p>', '<p>Intravitreal (Adult)-<br />\r\n<br />\r\n<strong>Neovascular (wet) age-related macular degeneration:</strong>&nbsp;0.5 mg mthly into the affected eye as a single dose. Continue treatment until visual acuity is stable for 3 consecutive mth. Doses are given at intervals of at least 1 mth.<br />\r\n<br />\r\n<strong>Choroidal neovascularisation secondary to pathologic myopia</strong>: 0.5 mg into the affected eye as a single dose. Further injections may be given if monitoring reveals signs of disease activity (1-2 inj during the 1st yr; some patients may need more frequent treatment). Doses are given at intervals of at least 1 mth.<br />\r\n<br />\r\n<strong>Diabetic macular oedema, Macular oedema secondary to retinal vein occlusion</strong>: 0.5 mg mthly into the affected eye as a single dose. Continue treatment until visual acuity is stable for 3 consecutive mth. Doses are given at intervals of at least 1 mth. Discontinue treatment if no improvement in visual acuity after 3 initial inj.</p>', '<p>May enhance the adverse/toxic effect of belimumab. Serious intraocular inflammation may occur when used adjunctively with verteporfin photodynamic therapy (PDT).</p>', '<p>Active or suspected ocular or periocular infection, active severe intraocular inflammation, signs of irreversible ischaemic visual function loss in patients with retinal vein occlusion.</p>', '<p>Ocular pain, hyperaemia, irritation and pruritus; increased intraocular pressure, vitritis, vitreous detachment, retinal haemorrhage, visual disturbance, vitreous floaters, conjunctival haemorrhage, foreign body sensation in eyes, increased lacrimation, blepharitis, dry eye, headache, nasopharyngitis, arthralgia, thromboembolic events. Less frequently, endophthalmitis, blindness, retinal detachment, retinal tear and iatrogenic traumatic cataract.</p>', '<p><strong>Pregnancy</strong>&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>Patient with risk factors for retinal pigment epithelial tears, history of stroke or transient ischaemic attack, uncontrolled HTN, previous intravitreal inj, active systemic infections, proliferative diabetic retinopathy, diabetic macular oedema due to type 1 DM. Discontinue treatment if rhegmatogenous retinal detachment or stage 3 or 4 macular hole develops. Diabetic patients w/ glycosylated Hb over 12%.</p>', '<p><strong>Symptoms:</strong>&nbsp;Increased intraocular pressure, transient blindness, reduced visual acuity, corneal oedema, corneal pain, and eye pain.<br />\r\n<br />\r\n<strong>Management</strong>: Intraocular pressure should be monitored and treated by the attending physician, if necessary.</p>', '<p>Drugs for Age-Related Macular Degeneration (AMD).</p>', '<p>Store between 2-8&deg; C. Protect from light.</p>', NULL, '2022-03-12 05:42:42', '2022-03-12 05:42:42'),
(1160, 1160, '<p>Ranitidine is indicated in:</p>\r\n\r\n<ul>\r\n	<li>Treatment of active duodenal ulcer</li>\r\n	<li>Benign gastric ulcer</li>\r\n	<li>Treatment &amp; prevention of ulcer associated with non-steroidal anti-inflammatory agent</li>\r\n	<li>Post operative stress ulcer.</li>\r\n	<li>Zollinger-Ellison Syndrome.</li>\r\n	<li>Gastroesophageal reflux disease (GERD).</li>\r\n	<li>Gastro-intestinal haemorrhage from stress ulcer in seriously ill patient.</li>\r\n	<li>Recurrent haemorrhage in patients with bleeding peptic ulcer.</li>\r\n	<li>Before general anesthesia in patient considered to be at risk of acid aspiration particulary obstetric patients.</li>\r\n</ul>', '<p>Ranitidine competitively blocks histamine at H2-receptors of the gastric parietal cells which inhibits gastric acid secretion. It does not affect pepsin secretion, pentagastrin-stimulated intrinsic factor secretion or serum gastrin.</p>', '<p>Ranitidine Tablet &amp; Syrup:</p>\r\n\r\n<p><strong>Duodenal and gastric ulcer</strong>: The usual dosage is 150 mg twice daily taken in the morning and evening or 300 mg as a single daily dose at night for 4 to 8 weeks.<br />\r\n<br />\r\n<strong>Reflux oesophagitis</strong>: 150 mg twice daily or 300 mg at bed time for up to 8 weeks.<br />\r\n<br />\r\n<strong>Zollinger Ellison syndrome</strong>: 150 mg 3 times daily and increased if necessary up to 6 g daily in divided doses. Dosage should be continued as long as clinically indicated.<br />\r\n<br />\r\n<strong>Episodic dyspepsia</strong>: 150 mg twice daily or 300 mg at bed time for up to 6 weeks.<br />\r\n<br />\r\n<strong>Maintenance</strong>: 150 mg at night for preventing recurrences.<br />\r\n<br />\r\n<strong>Child (peptic ulcer)</strong>: 2-4 mg/kg twice daily, maximum 300 mg daily.<br />\r\n<br />\r\n&nbsp;</p>\r\n\r\n<p>Ranitidine IV injection &amp; IV Infusion:</p>\r\n\r\n<p>Ranitidine injection may be given either as a slow (over a period of at least two minutes) intravenous injection of 50 mg, after dilution to a volume of 20 ml per 50 mg dose, which may be repeated every six to eight hours; or as an intermittent intravenous infusion at a rate of 25 mg per hour for two hours; the infusion may be repeated at six to eight hour intervals; or as an intramuscular injection of 50 mg (2 ml) every six to eight hours. In the prophylaxis of haemorrhage from stress ulceration in seriously ill patients or the prophylaxis of recurrent haemorrhage in patients bleeding from peptic ulceration, parenteral administration may be continued until oral feeding commences.<br />\r\n<br />\r\nIn the prophylaxis of upper gastrointestinal haemorrhage from stress ulceration in seriously ill patient sapriming dose of 50 mg as low as intravenous injection followed by a continuous intravenous infusion of 0.125-0.250 mg/kg/hour may be preferred. In patients considered to be at risk of developing aspiration syndrome Ranitidine injection 50 mg may be given intramuscularly or by slow intravenous injection 45 to 60 minutes before induction of general anaesthesia.<br />\r\n<br />\r\n<strong>Children</strong>: The recommended oral dose for the treatment of peptic ulcer in children is 2 mg/kg to 4 mg/kg twice daily to a maximum of 300 mg ranitidine per day. Safety and effectiveness of Ranitidine injection have not been established in case of children.</p>', '<p>Delayed absorption and increased peak serum concentration with propantheline bromide. Ranitidine minimally inhibits hepatic metabolism of coumarin anticoagulants, theophylline, diazepam and propanolol. May alter absorption of pH-dependent drugs (e.g. ketoconazole, midazolam, glipizide). May reduce bioavailability with antacids.</p>', '<p>Patients hypersensitive to Ranitidine.</p>', '<p>Ranitidine is well tolerated and side effects are usually uncommon. Altered bowel habit, dizziness, rash, tiredness, reversible confusional states, headache, decreased blood counts, muscle or joint pain have rarely been reported.</p>', '<p><strong>Pregnancy</strong>: Ranitidine crosses the placenta. But there is no evidence of impaired fertility or harm to the foetus due to Ranitidine. Like other drugs, Ranitidine should only be used during pregnancy if considered essential.<br />\r\n<br />\r\n<strong>Lactation</strong>: Ranitidine is excreted in human breast milk. Caution should be exercised when the drug is administered to a nursing mother.</p>', '<p>Ranitidine should be given in reduced dosage to patients with impaired renal and hepatic function.</p>', '<p>Ranitidine is very specific in action and accordingly no particular problems are expected following overdosage with the drug. Symptomatic and supportive therapy should be given as appropriate. If required, the drug may be removed from the plasma by&nbsp;haemodiaiysis.</p>', '<p>H2 receptor antagonist.</p>', '<p>Store in a cool and dry place. protect from light.</p>', '<p><strong>Use in elderly patients</strong>: In clinical trial the ulcer healing rates have been found similar in patients age 65 and over with those in younger patients. Additionally, there was no difference in the incidence of adverse effects.</p>', '2022-03-12 05:44:42', '2022-03-12 05:44:42'),
(1161, 1161, '<p>Ranolazine is indicated for the treatment of chronic angina. Ranolazine may be used with beta-blockers, nitrates, calcium channel blockers, anti-platelet therapy, lipid-lowering therapy, ACE inhibitors, and angiotensin receptor blockers. It has been shown to decrease angina episodes in patients with coronary artery disease on maximal doses of amlodipine. Because Ranolazine prolongs the QT interval, it should be reserved for patients who have not achieved an adequate response with other antianginal drugs.The effect on angina rate or exercise tolerance appeared to be smaller in women than men.</p>', '<p>Ranolazine has anti-ischemlc and antlanginal effects that do not depend upon reductions in heart rate or blood pressure.The exact mechanism of action of ranolazine is unknown. Ranolazine at therapeutic levels can inhibit the cardiac late sodium current (INa). However, the relationship of this inhibition to angina symptoms is uncertain.<br />\r\n<br />\r\nThe QT prolongation effect of ranolazine on the surface electrocardiogram is the result of inhibition of IKr&nbsp;which prolongs the ventricular action potential.</p>', '<p>Initiate Ranolazine dosing at 500 mg twice daily and increase to 1000 mg twice daily, if needed, based on clinical symptoms. Take Ranolazine with or without meals. Swallow Ranolazine tablets whole; do not crush, break or chew. The maximum recommended daily dose of Ranolazine is 1000 mg twice daily. If a dose of Ranolazine is missed, take the prescribed dose at the next scheduled time; do not double the next dose.</p>', '<p><strong>CYP 3A Inhibitors</strong>: Do not use Ranolazine with strong CYP 3A inhibitors. With moderate CYP 3A inhibitors (e.g., diltiazem, verapamil, erythromycin) limit maximum dose of ranolazine to 500 mg twice daily.<br />\r\n<br />\r\n<strong>CYP 3A Inducers</strong>: Do not use Ranolazine with inducers.<br />\r\n<br />\r\n<strong>P-gp Inhibitors (e.g., Cyclosporin)</strong>: May need to lower the Ranolazine dose based on clinical dose.<br />\r\n<br />\r\n<strong>Drugs transported by P-gp or metabolized by CYP2D6 (eg., digoxin, TCA)</strong>: May need reduced doses of these drugs when used with ranolazine.</p>', '<p>Ranolazine is contraindicated in patients:</p>\r\n\r\n<ul>\r\n	<li>With pre-existing QT prolongation</li>\r\n	<li>With hepatic impairment</li>\r\n	<li>Taking QT prolonging drugs</li>\r\n	<li>Taking potent and moderately potent CYP3A inhibitors such as ketoconazole, itraconazole, clarithromycin, nefazodone, nelfinavir, ritonavir, indinavir, and saquinavir, including diltiazem.</li>\r\n</ul>', '<p><strong>Cardiac Disorders</strong>: bradycardia, palpitations<br />\r\n<strong>Ear and Labyrinth Disorders</strong>: tinnitus, vertigo<br />\r\n<strong>Gastrointestinal Disorders</strong>: abdominal pain, dry mouth, vomiting<br />\r\n<strong>General Disorders and Administrative Site Adverse Events</strong>: peripheral edema<br />\r\n<strong>Respiratory, Thoracic, and Mediastinal Disorders</strong>: dyspnea<br />\r\n<strong>Vascular Disorders:</strong>&nbsp;hypotension, orthostatic hypotension</p>', '<p>Pregnancy Category C. There are no adequate studies assessing the effect of ranolazine on the developing fetus. There are no adequate well-controlled studies in pregnant women. Ranolazine should be used during pregnancy only when the potential benefit to the patient justifies the potential risk to the fetus.lt is not known whether ranolazine is excreted in human milk. Because of the potentiality for serious adverse reactions from ranolazine in nursing infants, a decision should be made whether to discontinue nursing or to discontinue Ranolazine, taking into account the importance of the drug to the mother.</p>', '<p>Ranolazine blocks QTc and prolongs the QTc interval in a dose-related manner. Clinical experience in an acute coronary syndrome population did not show an increased risk of proarrhythmia or sudden death.<br />\r\n<br />\r\nCo-administration of ranolazine with digoxin increases the plasma concentrations of digoxin by approximately 1.5-fold and the dose of digoxin may have to be reduced accordingly. The dose of other P-gp substrates may have to be reduced as well when ranolazine Is co-admlnistered. Caution should be exercised when co-adminlstering ranolazine with P-gp inhibitors such as ritonavir or cydosporine.</p>', '<p><strong>Symptoms:</strong>&nbsp;Dizziness, nausea, vomiting, diplopia, lethargy, syncope, severe tremor, incoordination, dysplasia, hallucination.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Symptomatic and supportive treatment.</p>', '<p>Other Anti-anginal &amp; Anti-ischaemic drugs</p>', '<p>Store Ranolazine tablets at 25&deg;C with excursion permitted to 15&deg; to 30&deg;C. Protect from light and moisture.</p>', '<p><strong>Pediatric use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\nRenal Impairment:</p>\r\n\r\n<ul>\r\n	<li><strong>Mild to moderate (CrCl 30-80 mL/min)</strong>: Dose titration needed</li>\r\n	<li><strong>Severe (CrCl &lt;30 mL/min)</strong>: Contraindicated</li>\r\n</ul>\r\n\r\n<p>Hepatic Impairment:</p>\r\n\r\n<ul>\r\n	<li><strong>Mild</strong>: Dose titration needed</li>\r\n	<li><strong>Moderate to severe</strong>: Contraindicated</li>\r\n</ul>', '2022-03-12 05:47:25', '2022-03-12 05:47:25'),
(1162, 1162, '<p>Rasagiline is indicated for the treatment of the signs and symptoms of idiopathic Parkinson&#39;s disease as initial monotherapy, and as adjunct therapy to dopamine agonists or to levodopa.</p>', '<p>Rasagiline is a potent, irreversible, selective MAO-B inhibitor that effectively crosses the blood brain barrier after oral administration. The precise mechanisms of action of Rasagiline are unknown. One mechanism is believed to be related to its MAO-B inhibitory activity, which causes an increase in extracellular levels of dopamine in the brain. The elevated dopamine level and subsequent increased dopaminergic activity are likely to mediate Rasagiline&#39;s beneficial effects.</p>', '<p>Monotherapy: Rasagiline 1 mg once daily<br />\r\nAs adjunct without Levodopa: Rasagiline 1 mg once daily<br />\r\nAs adjunct to Levodopa: Rasagiline 0.5 mg once daily</p>', '<p>Concomitant use of Rasagiline with meperidine, dextromethorphan, antidepressants is not recommended.</p>', '<p>Rasagiline is contraindicated for use with meperidine, tramadol, methadone, propoxyphene and MAO inhibitors (MAOIs), including other selective MAO-B inhibitors, because of risk of serotonin syndrome.</p>', '<p>Common side effects of Rasagiline include: dizziness, spinning sensation, joint pain, headache, heartburn, nausea, muscle pain etc.</p>', '<p>Pregnancy Category C. Rasagiline should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether this drug is excreted in human milk. So, caution should be exercised when administered to a nursing woman.</p>', '<p>Exacerbation of hypertension may occur during treatment with Rasagiline. Medication adjustment may be necessary if elevation of blood pressure is sustained. Dose should not exceed 0.5 mg once daily for patients with mild hepatic impairment or taking concomitant Ciprofloxacin or other CYP1A2 inhibito</p>', NULL, '<p>Antiparkinson drugs</p>', '<p>Store below 30&deg; c, protected from light and moisture. Keep all the medicines out of reach of children.</p>', '<p><strong>Pediatric use</strong>: The safety and effectiveness in pediatric patients have not been established.</p>', '2022-03-12 05:49:21', '2022-03-12 05:49:21'),
(1163, 1163, '<p>In the Female:</p>\r\n\r\n<ul>\r\n	<li><strong>Ovulation Induction</strong>: rFSH administered SC with HCG in a sequential manner, which is indicated for ovulation induction in patients who have previously received pituitary suppression.</li>\r\n	<li><strong>Multi-follicular Development</strong>: During ART: rFSH administered SC in conjunction with HCG is indicated for multiple follicular developments (controlled ovarian stimulation) during ART cycles in patients who have previously received pituitary suppression.</li>\r\n	<li><strong>Polycystic Ovarian Syndrome (PCOS)</strong>: Used to treat Polycystic Ovarian Syndrome (PCOS) related infertility</li>\r\n</ul>\r\n\r\n<p>In the Male: Male infertility treatment in combination with HCG Induction of Spermatogenesis in men deficient spermatogenesis due to Hypogonadotrophic-hypogonadism.</p>', '<p>rFSH is a Follicle Stimulating Hormone (FSH) preparation of recombinant DNA origin, which consists of two non-covalently linked, nonidentical glycoproteins designated as the &alpha;- and &beta; subunits. The &alpha;- and &beta;-subunits have 92 and 111 amino acids respectively, and their primary and tertiary structure are indistinguishable from those of human Follicle Stimulating Hormone. Recombinant FSH production occurs in genetically modified Chinese Hamster Ovary (CHO) cells cultured in bioreactors. Purification by immunochromatography using an antibody specifically binding FSH results in a highly purified preparation with a consistent FSH isoform profile and a high specific activity. The biological activity of rFSH is determined by measuring the increase in ovary weight in female rats. The in vivo biological activity of rFSH has been calibrated against the first International Standard for Recombinant Human Follicle Stimulating Hormone established in 1995 by the Expert Committee on Biological Standards of the World Health Organization. rFSH contains no Luteinizing Hormone (LH) activity.</p>', '<p>To prevent painful injections and minimize leakage from the injection site rFSH should be slowly administered subcutaneously. The subcutaneous injection site should be alternated to prevent lipoathrophy. Any unused solution should be discarded. Subcutaneous injection of rFSH may be carried out by patient or partner, provided that proper instructions are given by the physician. Self-administration of rFSH should only be performed by patients who are well motivated, adequately trained and with access to expert advice.<br />\r\n<br />\r\n<strong>Dosage in Female:</strong>&nbsp;There are great inter and intra-individual variations in the response of the ovaries to exogenous gonadotrophins. This makes it impossible to set an uniform dosage scheme. The dosage should, therefore, be adjusted individually depending on the ovarian response. This requires ultrasonography and monitoring of estradiol levels. There should be consideration to minimize the risk of unwanted ovarian hyperstimulation. rFSH can be given either alone, or in combination with a GnRH analogue to prevent premature luteinisation. In the latter case, especially when using a GnRH agonist, a higher total treatment dose of rFSH may be required to achieve an adequate follicular response. Clinical experience with rFSH is based on up to three treatment cycles in both indications. Overall experience with IVF indicates that in general the treatment success rate remains stable during the first four attempts and gradually declines thereafter.<br />\r\n<br />\r\n<strong>Ovulation Induction in Women</strong>: Starting daily dose of 75 international units (IU) of rFSH is administered subcutaneously or subcutaneous for at least the first 7 days. The dose is increased by 25 or 75 international units (IU) at weekly intervals until follicular growth and/or serum estradiol levels indicate an adequate response. When an acceptable pre-ovulatory state is achieved, final oocyte maturation is achieved with 5000 to 10,000 international units (IU) of human chorionic gonadotropin (HCG). The woman and her partner should have intercourse daily, beginning on the day prior to the administration of HCG and until ovulation becomes apparent.<br />\r\n<br />\r\n<strong>Assisted Reproductive Technology (ART)</strong>: In Women, Starting dose of 150 to 300 international units (IU) of rFSH is administered subcutaneous for at least the first 4 days of treatment. Subsequent doses are adjusted based upon ovarian response as determined by ultrasound evaluation of follicular growth and serum estradiol levels. Final oocyte maturation is induced with a dose of 5000-10000 international units of HCG Oocyte (egg) retrieval is performed 34 to 36 hours later.<br />\r\n<br />\r\n<strong>PCOS</strong>: rFSH injections are therefore given each morning as a subcutaneous injection. It is best to start with the lowest dose of rFSH per day (using 75 IU per day). These doses are used for 4 to 6 days at a time. The ovarian response is determined by measuring estrogen levels in the blood. When the estrogen begins to rise, the rFSH is successfully growing an egg or eggs. If there is no response to a dose of rFSH in 5-6 days of injections the dose will be increased. The normal dose increments are 75 units, 100 units, 150 units and 300 units per day. Most patients respond with 75 IU to 150 IU per day. However it is very important that increments are only made cautiously.<br />\r\n<br />\r\n<strong>Dosage in Male</strong>: Induction of Spermatogenesis in Men: Pre-treatment with HCG alone (2500 international units twice weekly) is required. If serum testosterone levels have not normalized after 8 weeks of HCG treatment, the dose may be increased to 5000 international units (IU) twice a week. After normalization of serum testosterone levels, administer 300 international units (IU) per week (300 international units twice weekly or 100 international units three times weekly) of rFSH subcutaneously with the same pre-treatment HCG dose used to normalize testosterone level.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>rFSH administered for 7 to 12 days produces ovarian follicular growth in women who do not have primary ovarian failure. Treatment with rFSH in most instances results only in follicular growth and maturation. When sufficient follicular maturation has occurred, HCG must be given to induce ovulation.</p>', NULL, '<ul>\r\n	<li>Tumors of the ovary, breast, uterus, pituitary or hypothalamus</li>\r\n	<li>Pregnancy or lactation</li>\r\n	<li>Undiagnosed vaginal bleeding</li>\r\n	<li>Hypersensitivity to the active substance or to any of the excipients</li>\r\n	<li>Primary ovarian failure</li>\r\n	<li>Fibroid tumors of the uterus incompatible with pregnancy</li>\r\n	<li>Primary testicular failure.</li>\r\n</ul>', '<p>Recombinant FSH sometimes excites the ovaries too much. This may cause pelvic pain or breathing problems. It may also make you urinate less. In rare cases, patients with this problem have had serious lung problems, including fluid in the lungs, troublebreathing, and worsening of asthma blood clots, Severe Pelvic pain, Chest pain, or Abdominal pain, Nausea, Vomiting, Sudden weight gain, Bloating, Trouble, Breathing. Recombinant FSH may cause twins or multiple births.</p>', '<p>Pregnancy category X. Recombinant FSH must not be used during pregnancy and lactation.</p>', '<ul>\r\n	<li>The presence of uncontrolled non gonodal endocrinopathies (e.g. thyroid, adrenal or pituitary disorders) should be excluded.</li>\r\n	<li>In pregnancies occurring after induction of ovulation with gonadotrophin preparations, there is an increased risk of multiple gestations (Multiple birth).</li>\r\n	<li>There has been no reports of hypersensitivity to Recombinant FSH, but there remains the possibility of anaphylactic responses.</li>\r\n	<li>The first injection of Recombinant FSH should be performed under direct medical supervision.</li>\r\n	<li>Since infertile women undergoing assisted reproduction and particularly IVF, often have tubal abnormalities the incidence of ectopic pregnancies might be increased. Early ultrasound confirmation that a pregnancy is intrauterine is therefore important.</li>\r\n	<li>Rates of pregnancy loss in women undergoing assisted reproduction techniques are higher than in the normal population.</li>\r\n	<li>Unwanted ovarian hyperstimulation in the treatment of female patients, ultrasonographic assessment of follicular development, and determination of oestradiol levels should be performed prior to treatment and at regular intervals during treatment. Apart from the development of a high number of follicles, oestradiol levels may rise very rapidly, e.g. more than a daily doubling for two or three consecutive days, and possibly reaching excessively high values. The diagnosis of ovarian hyperstimulation may be confirmed by ultrasound examination. If this unwanted ovarian hyperstimulation occurs (i.e. not as part of controlled ovarian hyperstimulation in medically assisted reproduction programs), the administration of Recombinant FSH should be discontinued. In that case pregnancy should be avoided and HCG must be withheld, because it may induce in addition to multiple ovulation, the Ovarian Hyperstimulation Syndrome (OHSS).</li>\r\n	<li>In men, semen analysis is recommended 4 to 6 months after the beginning of treatment in assessing the response.</li>\r\n</ul>', '<p>No data on acute toxicity of Recombinant FSH in humans is available, but the acute toxicity of Recombinant FSH and of urinary gonadotrophin preparations in animal studies have been shown to be very low. Too high a dosage of Recombinant FSH may lead to hyperstimulation of the ovaries.</p>', '<p>Drugs for Infertility, Trophic Hormones &amp; Related Synthetic Drugs.</p>', '<p>Store at 2&deg;C-8&deg;C (in refrigerator). Do not keep in deep freeze. Keep out of reach of children.</p>', NULL, '2022-03-12 05:51:28', '2022-03-12 05:51:28'),
(1164, 1164, '<p>Red Clover is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Menopausal hot flashes, night sweats, redness</li>\r\n	<li>Mood swing</li>\r\n	<li>Osteoporosis</li>\r\n</ul>', '<p>Red Clover extracts act as an estrogen agonist by binding to intracellular estradiol receptors. it was defined as an antiprogestin, due to the extract&#39;s inhibition of progesterone induction of alkaline phosphate, an end product of progestin activity. Red Clover increases uterine weight and decreased cervical mucus viscoelasticity.<br />\r\n<br />\r\nRed Clover (Trifolium pratense) is a herbal extract, which is high in isoflavones (natural plant estrogens). Red Clover isoflavones mimic the action of estrogens and are widely used by women to maintain their health and vitality especially during the time of menopause. Red Clover contains 4 key isoflavones (Genistein, Daidzein, Biochanin A and Formonoetin) that help balance female hormones by mimicking the effects of estrogens in the body, which in turn help support women during menopause. Unlike traditional hormone therapy (HRT), these natural plant estrogens prefer to bond with beta estrogens receptors and show no affinity to bond with alpha estrogens receptors.</p>', '<p>1 or 2 capsules 1 to 3 times daily or as advised by the registered physician.</p>', NULL, '<p>Not to be used in patients with estrogen receptor-positive neoplasias.</p>', '<p>General side effects may include headache, nausea and rash. Due to its coumarin derivatives, Trifolium Pratense should be used with caution in individuals with coagulation disorders or currently undergoing anticoagulation therapy.</p>', '<p>Not to be used during pregnancy &amp; breastfeeding.</p>', NULL, NULL, '<p>Miscellaneous topical agents.</p>', '<p>Store in a cool and dry place. Keep away from light and children.</p>', NULL, '2022-03-12 05:52:56', '2022-03-12 05:52:56');
