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
(278, 278, '<p>Carvedilol is indicated for the treatment of mild, moderate or severe heart failure of ischemic or cardiomyopathic origin, in conjunction with digitalis, diuretics and ACE inhibitor, to reduce the progression of disease as evidenced by cardiovascular death, cardiovascular hospitalization, or the need to adjust other heart failure medications. Carvedilol may be used in patients unable to tolerate an ACE inhibitor. Carvedilol may be used in patients who are not receiving digitalis, hydralazine or nitrate therapy.</p>', '<p>Carvedilol is a cardiovascular drug whose main pharmacological action is non-selective antagonism of &beta;-adrenergic receptors but which also possesses appreciable a-adrenergic antagonistic activity. It also has antiproliferative properties and is a scavenger of reactive free oxidant radicals. It is used in the treatment of hypertension, angina pectoris and congestive heart failure.</p>', '<p><strong>In hypertension</strong>: initially, 12.5 mg once daily, increased after 2 days to the usual dose of 25 mg once daily; if necessary the dose may be further increased at intervals of at least 2 weeks to maximum 50 mg daily in single or divided doses. In elderly patients, the initial dose of 12.5 mg daily may provide satisfactory control.<br />\r\n<br />\r\n<strong>In angina pectoris</strong>: the recommended dose for initiation of therapy is 12.5 mg twice daily for the first 2 days. Thereafter, the recommended dosage is 25 mg twice daily. For elderly patients, the maximum daily dose is 50 mg daily in divided doses.<br />\r\n<br />\r\n<strong>In heart failure</strong>: initially, 3.125 mg twice daily (with food) may be given, the dose may be increased at intervals of at least 2 weeks to 6.25 mg twice daily, then to 12.5 mg twice daily, then to 25 mg twice daily. The dose may be increased to the highest dose tolerated, maximum 25 mg twice daily in patients less than 85 kg body-weight and 50 mg twice daily in patients over 85 kg.</p>', '<p><strong>Digoxin</strong>: In normal healthy volunteers a single dose of carvedilol taken together with a single dose of digoxin resulted in significantly increased levels of digoxin 24 hours later. Patients with congestive heart failure stabilized on digoxin have been given carvedilol concomitantly without any adverse effects. Increased monitoring of digoxin is recommended when initiating, adjusting, or discontinuing the dose of carvedilol.<br />\r\n<br />\r\n<strong>Rifampin</strong>: Pretreatment with rifampin resulted in a 60% decrease in Cmax and AUC.<br />\r\n<br />\r\n<strong>Warfarin</strong>: Carvedilol did not alter the in vitro plasma protein binding of warfarin.<br />\r\n<br />\r\n<strong>Clonidine</strong>: &beta;-receptor antagonists potentiate the pressor reaction which may follow the sudden withdrawal of treatment with clonidine although, in theory, the a-blocking action of carvedilol should modify the pressure rise.</p>', '<p>Carvedilol is contraindicated in patients with decompensated heart failure requiring intravenous inotropic therapy, bronchial asthma or related bronchospastic conditions, second or third-degree AV block, sick sinus syndrome (unless a permanent pacemaker is in place), cardiogenic shock or severe bradycardia.</p>', '<p>Postural hypotension, dizziness, headache, fatigue, gastro-intestinal disturbances, bradycardia; occasionally diminished peripheral circulation, peripheral oedema and painful extremities, dry mouth, dry eyes, eye irritation or disturbed vision, impotence, disturbances of micturition, influenza-like symptoms, rarely angina, AV block, exacerbation of intermittent claudication or Raynaud&#39;s phenomenon, allergic skin reactions, exacerbation of psoriasis, nasal stuffiness, wheezing, depressed mood, sleep disturbances, paresthesia, heart failure, changes in liver enzymes, thrombocytopenia, leukopenia are also reported.</p>', '<p>Carvedilol should not be used during breast-feeding, since no studies have been performed in lactating women and animal studies have shown that carvedilol is excreted in breast milk. Safety and efficacy in children have not been established with carvedilol. Carvedilol should not be used during pregnancy as no studies have been performed in this group. Animal studies have shown that carvedilol crosses the placental barrier. No information is available on the safety and efficacy of Carvedilol use in neonates.</p>', '<p>Take caution in hepatic impairment and in heart failure monitor clinical status for 2-3 hours after initiation and after increasing each dose. Before increasing dose ensure that the renal function and heart failure are not deteriorating</p>', NULL, '<p>Alpha adrenoceptor blocking drugs, Beta-adrenoceptor blocking drugs, Beta-blockers</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-18 19:14:52', '2022-03-23 21:49:02'),
(279, 279, '<p>This is indicated for:</p>\r\n\r\n<ul>\r\n	<li>Treatment of COVID-19 in adults and adolescents aged 12 years and older weighing at least 40 kg who do not require supplemental oxygen and who are at increased risk of progressing to severe COVID-19.</li>\r\n	<li>Prevention of COVID-19 in adults and adolescents aged 12 years and older weighing at least 40 kg.</li>\r\n</ul>', '<p>Casirivimab (IgG1&kappa;) and imdevimab (IgG1&lambda;) are two recombinant human monoclonal antibodies which are unmodified in the Fc regions. Casirivimab and imdevimab bind to non-overlapping epitopes of the spike protein receptor-binding domain (RBD) of SARS-CoV-2. This prevents RBD binding to the human ACE2 receptor, so preventing virus entry into cells.</p>', '<p>The dosage in adult patients and in adolescent patients 12 years of age and older weighing at least 40 kg is 600 mg of casirivimab and 600 mg of imdevimab administered as a single intravenous infusion or by subcutaneous injection.<br />\r\n<br />\r\n<strong>Post-exposure prophylaxis</strong>: The dosage in adult patients and in adolescent patients 12 years of age and older weighing at least 40 kg is 600 mg of casirivimab and 600 mg of imdevimab administered as a single intravenous infusion or by subcutaneous injection. Casirivimab with imdevimab should be given as soon as possible after contact with a case of COVID-19.<br />\r\n<br />\r\n<strong>Pre-exposure prophylaxis</strong>: The initial dose in adult patients and in adolescent patients 12 years of age and older weighing at least 40 kg is 600 mg of casirivimab and 600 mg of imdevimab administered as a single intravenous infusion or by subcutaneous injection. Subsequent doses of 300 mg of casirivimab and 300 mg of imdevimab administered as a single intravenous infusion or by subcutaneous injection may be given every 4 weeks until prophylaxis is no longer required. There are no data on repeat dosing beyond 24 weeks (6 doses).</p>', NULL, '<p>Hypersensitivity to the active substances or to any of the excipients.</p>', NULL, '<p><strong>Pregnancy</strong>: There are no or limited amount of data from the use of casirivimab and imdevimab in pregnant women. Animal studies have not been performed with respect to reproductive toxicity. Human immunoglobulin G1 (IgG1) antibodies are known to cross the placenta. It is unknown whether the potential transfer of casirivimab and imdevimab provides any treatment benefit or risk to the developing foetus. However, as casirivimab and imdevimab directly target the spike protein of SARS-CoV-2 and in view of lack of cross reactivity with reproductive or foetal tissues in the tissue cross reactivity studies, negative effects on developing foetus are not expected. This drug should be used during pregnancy only if the potential benefit justifies the potential risk for the mother and the foetus considering all associated health factors. If a woman becomes pregnant while taking this medicine, the individual should be informed that any potential risk to the foetus is unknown.<br />\r\n<br />\r\n<strong>Breast-feeding</strong>: It is unknown whether casirivimab and imdevimab are excreted in human milk, but maternal IgG is known to be transferred to milk during the first days after birth. As casirivimab and imdevimab directly target the spike protein of SARS-CoV-2 and in view of low systemic absorption after oral ingestion of antibodies, administration of this drug whilst breast-feeding can be considered when clinically indicated.</p>', '<p><strong>Traceability</strong>: In order to improve the traceability of biological medicinal products, the name and the batch number of the administered product should be clearly recorded.<br />\r\n<br />\r\n<strong>Subcutaneous administration for treatment of COVID-19</strong>: The clinical efficacy of this drug when administered by the subcutaneous route for treatment of COVID-19 has not been evaluated in clinical trials. The pharmacokinetics of casirivimab and imdevimab in the first 48 hours after subcutaneous administration of 600 mg of each monoclonal antibody indicate lower serum exposures compared to intravenous administration of the same dose. It is unknown whether differences in initial systemic exposure result in differences in clinical efficacy. It is recommended that the subcutaneous route of administration is used only if intravenous administration is not feasible and would lead to a delay in treatment.<br />\r\n<br />\r\n<strong>Hypersensitivity reactions including anaphylaxis</strong>: Hypersensitivity reactions, including anaphylaxis, have been reported with administration of casirivimab and imdevimab. If signs or symptoms of a clinically significant hypersensitivity reaction or anaphylaxis occur, immediately discontinue administration and initiate appropriate medications and/or supportive care.<br />\r\n<br />\r\n<strong>Infusion-related reactions</strong>: Infusion-related reactions (IRRs) have been observed with intravenous administration of casirivimab and imdevimab. IRRs observed in clinical studies were mostly moderate in severity and were typically observed during or within 24 hours of infusion. The frequently reported signs and symptoms for these reactions included nausea, chills, dizziness (or syncope), rash, urticaria and flushing. However, infusion-related reactions may present as severe or life threatening events and may include other signs and symptoms. If an IRR occurs, the infusion may be interrupted, slowed or stopped.</p>', '<p>Doses up to 4 000 mg each of casirivimab and imdevimab (approximately 7-times the recommended dose) have been administered in clinical trials. The safety profile for 8 000 mg intravenous was not substantially different to that for the recommended dose. There is no known specific antidote for casirivimab and imdevimab overdose. Treatment of overdose should consist of general supportive measures including monitoring of vital signs and observation of the clinical status of the patient.</p>', NULL, '<p>Store in a refrigerator (2&deg;C-8&deg;C). Do not freeze. Do not shake. Keep the vials in the original carton in order to protect from light.</p>', '<ul>\r\n	<li><strong>Elderly</strong>: No dosage adjustment is required.</li>\r\n	<li><strong>Renal impairment</strong>: No dosage adjustment is required.</li>\r\n	<li><strong>Hepatic impairment</strong>: No dosage adjustment is required (see section 5.2).</li>\r\n	<li><strong>Pediatric population</strong>: The safety and efficacy of casirivimab and imdevimab in children &lt;12 years of age has not yet been established. No data are available.</li>\r\n</ul>', '2022-02-18 19:15:22', '2022-03-23 21:53:04'),
(280, 280, '<p>Cefaclor is indicated in the treatment of the following infections: Otitis media, Lower respiratory tract infections, including pneumonia, bronchitis and acute exacerbation of chronic bronchitis, Upper respiratory tract infections, including pharyngitis and tonsillitis, Urinary tract infections, including pyelonephritis and cystitis, Skin and soft tissue infections, Sinusitis</p>', '<p>Cefaclor is a second generation cephalosporin antibiotic which has stability against b-lactamase inactivation and possesses a broad spectrum of activity. Cefaclor is active against the following organisms in vitro: Alpha and beta haemolytic Streptococci, Staphylococci; including coagulase-positive, coagulase negative and penicillinase-producing strains, Streptococcus pneumoniae, Streptococcus pyogenes (Group A b-haemolytic Streptococci), Branhamella catarrhalis, Escherichia coli, Proteus mirabilis, Klebsiella species Haemophilus influenzae, including ampicillin-resistant strains. Cefaclor is generally effective in the eradication of Streptococci from the nasopharynx.</p>', '<p>Adult-</p>\r\n\r\n<ul>\r\n	<li>Usual dose: 250 mg 8 hrly.</li>\r\n	<li>Bronchitis &amp; pneumonia: 250 mg tid.</li>\r\n	<li>Sinusitis: 500 mg tid for 10 days.</li>\r\n	<li>Pneumonia &amp; other more severe infections: Max: 4 gm/day for 28 days.</li>\r\n	<li>Acute gonococcal urethritis: 3 gm as a single dose combined with probenecid 1 gm.</li>\r\n</ul>\r\n\r\n<p>Children-&nbsp;</p>\r\n\r\n<ul>\r\n	<li>Recommended dose: 20 mg/kg/day in divided doses 8 hrly.</li>\r\n	<li>Bronchitis &amp; pneumonia: 20 mg/kg/day in divided doses tid.</li>\r\n	<li>Serious infections, sinusitis, otitis media &amp; infections: caused by less susceptible organisms 40 mg/kg/day in divided doses. Max: 1 gm/day.</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>The nephrotoxicity of aminoglycoside antibiotics such as gentamicin and tobramicin may be enhanced by any cephalosporin. Therefore, one should be cautious in concomitant use of these categories of drugs.</p>', '<p>Cefaclor is contraindicated in patients with known allergy to the Cephalosporin group of antibiotics.</p>', '<p><strong>Gastro-intestinal</strong>: Diarrhoea, nausea and vomiting have been reported. Hypersensitivity: Allergic reactions such as eruptions, pruritis and urticaria have been observed. These reactions usually subside upon discontinuation of therapy. Serum sickness like reactions have been reported.<br />\r\n<br />\r\n<strong>Haematological</strong>: Eosinophilia, thrombocytopenia, transient lymphocytosis and leucopenia may occur rarely. Hepatic: Transient hepatitis and cholestatic jaundice, slight elevation in AST, ALT or alkaline phosphate values have been reported rarely.<br />\r\n<br />\r\n<strong>Renal</strong>: Reversible interstitial nephritis has occurred rarely, also slight elevations in blood urea or serum creatinine or abnormal urinalysis.<br />\r\n<br />\r\n<strong>Central Nervous System</strong>: Reversible hyperactivity, nervousness, confusion, hypertonia, dizziness, hallucinations and somnolence have been reported rarely.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. This drug should be used during pregnancy only if clearly needed. Small amounts of Cefaclor have been detected in mother&#39;s milk. The effect on nursing infants is not known. Caution should be exercised when Cefaclor is administered to a nursing woman.</p>', '<p>Cefaclor should be administered with caution in the presence of markedly impaired renal function. Dosage adjustments for patients with moderate or severe renal impairment are not usually required.</p>', '<p><strong>Symptoms</strong>: Nausea, vomiting, epigastric distress and diarrhoea would be anticipated.<br />\r\n<br />\r\n<strong>Treatment</strong>: Unless 5 times the normal total daily dose has been ingested, gastrointestinal decontamination will not be necessary. General management may consist of supportive therapy.</p>', '<p>Second generation Cephalosporins</p>', '<p>Store in a cool and dry place. Protect from light.</p>', NULL, '2022-02-18 19:15:51', '2022-03-23 21:56:41'),
(281, 281, '<p>It is indicated for the treatment of upper respiratory tract infections (pharyngitis and tonsillitis) caused by Streptococcus pyogenes (group-A beta-hemolytic Streptococci) and Streptococcus pneumoniae; urinary tract infections caused by E. coli, Proteus mirabilis, and Klebsiella species and skin &amp; soft tissue infections caused by Staphylococci (including penicillinase producing bacteria) and Streptococci.</p>', '<p>Cefadroxil inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis and arresting cell wall assembly resulting in bacterial cell death.</p>', '<p>Adult:</p>\r\n\r\n<ul>\r\n	<li>Pharyngitis and Tonsillitis: 1 g per day in one or two divided doses.</li>\r\n	<li>Urinary Tract Infections: 1 or 2 g per day in one or two divided doses.</li>\r\n	<li>Skin and Skin Structure Infections: 1 g per day in one or two divided doses.</li>\r\n</ul>\r\n\r\n<p>Children: 30 mg/kg daily in divided doses every 12 hours.<br />\r\n<br />\r\nIt may be taken with meals or on empty stomach. Administration with food may be helpful in diminishing potential gastrointestinal complaints.</p>', '<p>There is no significant drug interaction with other drugs.</p>', '<p>Cefadroxil is contraindicated in patients with a history of hypersensitivity to Cefadroxil or any of the ingredients of it.</p>', '<p>Generally Cefadroxil is well tolerated. However, the most commonly reported side effects are gastrointestinal disturbances and hypersensitivity phenomena.</p>', '<p>US FDA pregnancy category of Cefadroxil is B. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Cefadroxil have been shown to be excreted in human milk. So, caution should be exercised when Cefadroxil is administered during lactation.</p>', '<p>Use of this antibiotic may cause pseudomembranous colitis; so caution should be taken during diagnosis in patients who develop diarrhea in association with Cefadroxil therapy.</p>', NULL, '<p>First generation Cephalosporins</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-02-18 19:20:44', '2022-03-23 21:59:12'),
(282, 282, '<p><strong>Cefazolin is indicated in the treatment of the following serious infections due to susceptible organisms</strong>: Respiratory Tract Infections, Urinary Tract Infections, Skin and Skin Structure Infections, Biliary Tract Infections, Bone and Joint Infections, Genital Infections, Septicemia, Endocarditis and Perioperative Prophylaxis.</p>', '<p>Cefazolin is a 1st generation broad spectrum parenteral Cephalosporin antibiotic.It interferes with the synthesis of bacterial cell wall by inhibiting transpeptidase enzyme. As a result the bacterial cell wall is weakened,the cell swells and then ruptures.</p>', '<p>Adult Dose</p>\r\n\r\n<ul>\r\n	<li><strong>Moderate to severe infection</strong>: 500 mg to 1 gm for every 6 to 8 hours</li>\r\n	<li><strong>Mild infections caused by susceptible Gram-positive cocci</strong>: 250 mg to 500 mg for every 8 hours</li>\r\n	<li><strong>Acute uncomplicated urinary tract infections</strong>: 1 gm for every 12 hours</li>\r\n	<li><strong>Pneumococcal pneumonia</strong>: 500 mg for every 12 hours</li>\r\n	<li><strong>Severe life-threatening infections (e.g. Endocarditis, Septicemia)</strong>: 1 gm to 1.5 gm for every 6 hours. In rare instances, doses up to 12 gm per day can be used</li>\r\n</ul>\r\n\r\n<p><strong>Perioperative Prophylactic Use</strong>: To prevent postoperative infection in contaminated or potentially contaminated surgery, recommended doses are:</p>\r\n\r\n<ul>\r\n	<li>1 gm IM or IV administered half hour to 1 hour prior to the start of surgery.</li>\r\n	<li>For lengthy operative procedures (e.g. 2 hours or more), 500 mg to 1 gm IM or IV during surgery.</li>\r\n	<li>500 mg to 1 gm IM or IV every 6 to 8 hours for 24 hours postoperatively.</li>\r\n</ul>\r\n\r\n<p>In surgery where the occurrence of infection may be particularly devastating (e.g. open-heart surgery and prosthetic arthroplasty), the prophylactic administration may be continued for 3 to 5 days following the completion of surgery.</p>', '<p>Probenecid may decrease renal tubular secretion of Cephalosporins when used concurrently, resulting in increased and more prolonged Cephalosporin blood levels.</p>', '<p>Cefazolin is contraindicated in patients with known allergy to the Cephalosporin group of Antibiotics.</p>', '<p>Common side effects include:Injection site reactions (pain, swelling, skin rash, or a hard lump), diarrhea, stomach pain, stomach cramps, nausea, vomiting, loss of appetite, skin rash or itching, hives, white patches or sores inside the mouth or on the lips, vaginal itching or discharge,heartburn, gas,rectal itching,confusion, weakness, hypotension, drowsiness, headache and allergic reactions.</p>', '<p>Pregnancy Category B. Cefazolin is present in very low concentrations in the milk of nursing mothers.Caution should be exercised when Cefazolin is administered to a nursing woman.</p>', '<ul>\r\n	<li>As with all Cephalosporins, Cefazolin should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly Colitis.</li>\r\n	<li>As with other &beta;-lactam antibiotics, seizures may occur if inappropriately high doses are administered to patients with impaired renal function.</li>\r\n</ul>', NULL, '<p>First generation Cephalosporins</p>', '<p>After reconstitution, Cefazolin is stable for 24 hours at room temperature or for 10 days if stored under refrigeration (5&deg;C). Reconstituted solution may range in color from pale yellow to yellow without a change in potency.</p>', '<p><strong>Patients with Impaired Renal Function</strong>:</p>\r\n\r\n<ul>\r\n	<li>Creatinine clearance 35 to 54 ml/min: 1 unit dose (based on unit doses of 500 mg &amp; 1 gm) Every 8 hours</li>\r\n	<li>Creatinine clearance 11 to 34 ml/min: &frac12; unit dose (based on unit doses of 500 mg &amp; 1 gm) Every 12 hours</li>\r\n	<li>Creatinine clearance 10 ml/min: &frac12; unit dose (based on unit doses of 500 mg &amp; 1 gm) Every 18 to 24 hours</li>\r\n</ul>\r\n\r\n<p><strong>Patients with Hepatic Insufficiency</strong>: No dosage adjustment is necessary in patients with hepatic insufficiency.<br />\r\n<br />\r\n<strong>Pediatric Dose</strong>: In pediatric patients, a total daily dosage of 25 to 50 mg per kg of body weight, divided into 3 or 4 equal doses, is effective for most mild to moderate infections. Total daily dosage may be increased to 100 mg per kg of body weight for severe infections. Safety for use in premature infants and in neonates has not been established.</p>', '2022-02-18 19:21:01', '2022-03-23 22:17:24'),
(283, 283, '<p>Cefdinir is indicated for the treatment of Community Acquired Pneumonia, Acute Exacerbation of Chronic Bronchitis, Acute Maxillary Sinusitis, Pharyngitis, Tonsillitis, Uncomplicated Skin and Skin Structure, Infections</p>', '<p>Cefdinir binds to 1 or more of the penicillin-binding proteins (PBPs) which inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.</p>', '<p><strong>Adult:</strong>&nbsp;600 mg daily as a single or in 2 divided doses for 5-10 days.<br />\r\n<strong>Child:</strong>&nbsp;<strong>&ge;6 months:</strong>&nbsp;14 mg/kg daily as a single or in 2 divided doses. Max: 600 mg daily.</p>', '<p><strong>Antacids</strong>: Cefdinir should be taken at least 2 hours interval of antacid administration.<br />\r\n<br />\r\n<strong>Iron supplement</strong>: Cefdinir should be taken at least 2 hours interval of iron supplement administration.<br />\r\n<br />\r\n<strong>Probencid</strong>: It inhibits the renal excretion of cefdinir.</p>', '<p>Cefdinir is contraindicated in patients with known allergy to the cephalosporin class of antibiotics.</p>', '<p>Common side effects are Diarrhea, Vaginal moniliasis, Nausea &amp; Vomiting, Headache, Rash etc.</p>', '<p>Pregnancy Category B. There are no adequate and well-controlled studies in pregnant women. This drug should be used during pregnancy only if clearly needed. Following administration of single 600 mg doses, Cefdinir was not detected in human breast milk.</p>', '<p>Cefdinir, as with other broad-spectrum antibiotics, should be prescribed with caution in individuals with a history of colitis. In patients with transient or persistent renal insufficiency (creatinine clearance &lt;30 ml/min), the total daily dose of Cefdinir should be reduced.</p>', '<p><strong>Symptoms</strong>: Nausea, vomiting, epigastric distress, diarrhoea, convulsions.<br />\r\n<br />\r\n<strong>Management</strong>: Haemodialysis may be useful in the event of a serious toxic reaction particularly if renal function is compromised.</p>', '<p>Third generation Cephalosporins</p>', '<p>Store between 20-25&deg; C.</p>', NULL, '2022-02-18 19:21:17', '2022-03-23 22:24:11'),
(284, 284, '<p>Cefditoren is indicated for the treatment of mild to moderate infections in adults and adolescents (12 years of age or older) which are caused by susceptible strains of the designated microorganisms in the conditions listed below:</p>\r\n\r\n<ul>\r\n	<li>Acute Bacterial Exacerbation of Chronic Bronchitis</li>\r\n	<li>Community Acquired Pneumonia</li>\r\n	<li>Pharyngitis</li>\r\n	<li>Tonsillitis</li>\r\n	<li>Uncomplicated Skin and Skin-Structure Infections</li>\r\n</ul>', '<p>Cefditoren inhibits the synthesis of bacterial cell wall. It has high affinity to penicillin-binding proteins (PBPs) in various bacteria, showing a bactericidal effect.</p>', '<p><strong>Community-Acquired Pneumonia</strong>: 400 mg twice daily for 14 days.<br />\r\n<strong>Acute Exacerbation of Chronic Bronchitis</strong>: 400 mg twice daily for 10 days.<br />\r\n<strong>Pharyngotonsillitis and Acute Sinusitis</strong>: 200 mg twice daily for 10 days.<br />\r\n<strong>Uncomplicated Skin and Soft Structure Infections</strong>: 200 mg twice daily for 10 days.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Cefditoren should be taken after meals.</p>', '<p>Co-administration of a single dose of an antacid and H2 receptor antagonists may reduce the oral absorption of cefditoren pivoxil. As with other beta-lactam antibiotics, co-administration of probenecid with cefditoren pivoxil resulted in an increase in the plasma exposure of cefditoren.</p>', '<p>Contraindicated in patients hypersensitive to drug or other cephalosporins. Also contraindicated in patients with carnitine deficiency or inborn errors of metabolism that may result in clinically significant carnitine deficiency. Because cefditoren tablets contain sodium caseinate, a milk protein, don&#39;t give to patients hypersensitive to milk protein (as distinct from those with lactose intolerance).</p>', '<p>The most common side effects of Cefditoren are diarrhea, nausea, headache, abdominal pain, vaginal moniliasis, dyspepsia, vomiting, abnormal dreams, allergic reaction, anorexia, constipation, dizziness, dry mouth and fever.</p>', '<p><strong>Pregnancy&nbsp;</strong>category B. There are no adequate and well-controlled studies in pregnant women. Cefditoren should be used during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Lactation</strong>: Animal studies show that Cefditoren excreted in breast milk. Caution should be exercised when Cefditoren is administered to nursing women.</p>', '<p>Cefditor should be prescribed with caution in individuals with a history of gastrointestinal diseases, particularly colitis. Dosage adjustment is only necessary in severe renal failure (creatinine clearance&lt; 30 ml/min)</p>', '<p>Information on Cefditoren overdosage in humans is not available. However, with other &szlig;-lactam antibiotics, adverse effects following overdosage have included nausea, vomiting, epigastric distress, diarrhea, and convulsions. Hemodialysis may aid in the removal of Cefditoren from the body, particularly if renal function is compromised.</p>', '<p>Third generation Cephalosporins</p>', '<p>Store in a cool (below 25&deg; C) and dry place protected from light.</p>', NULL, '2022-02-18 19:21:32', '2022-03-23 22:28:11'),
(285, 285, '<p>Cefepime is indicated for the treatment of the following infections caused by susceptible strains of the microorganisms:</p>\r\n\r\n<ul>\r\n	<li><strong>Pneumonia (moderate to severe)</strong>: caused by Streptococcus pneumoniae, including cases associated with concurrent bacteremia, Pseudomonas aeruginosa, Klebsiella pneumoniae, or Enterobacter species.</li>\r\n	<li><strong>Febrile Neutropenia</strong>: Cefepime as monotherapy is indicated for empiric treatment of febrile neutropenic patients. In patients at high risk for severe infection (including patients with a history of recent bone marrow transplantation, with hypotension at presentation, with an underlying hematologic malignancy, or with severe or prolonged neutropenia), antimicrobial monotherapy may not be appropriate. Insufficient data exist to support the efficacy of cefepime monotherapy in such patients.</li>\r\n	<li><strong>Uncomplicated and Complicated Urinary Tract Infections (including pyelonephritis)</strong>: caused by Escherichia coli or Klebsiella pneumoniae, when the infection is severe, or caused by Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis, when the infection is mild to moderate, including cases associated with concurrent bacteremia with these microorganisms.</li>\r\n	<li><strong>Uncomplicated Skin and Skin Structure Infections</strong>: caused by Staphylococcus aureus (methicillin- susceptible strains only) or Streptococcus pyogenes.</li>\r\n	<li><strong>Complicated Intra-abdominal Infections (used in combination with metronidazole)</strong>: caused by Escherichia coli, viridians group streptococci, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter species, or Bacteroides fragilis.</li>\r\n</ul>', '<p>Cephalosporins are bactericidal and have the same mode of action as other beta-lactam antibiotics (such as penicillins). Cephalosporins disrupt the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The final transpeptidation step in the synthesis of the peptidoglycan is facilitated by transpeptidases known as penicillin binding proteins (PBPs).</p>', '<p>Cefepime should be administered intravenously over approximately 30 minutes.</p>\r\n\r\n<ul>\r\n	<li>Moderate to Severe Pneumonia due to S. pneumoniae, *P. aeruginosa, K. pneumoniae, or Enterobacter species: 1-2 gm IV 12 hourly for 10 days.</li>\r\n	<li>Empiric therapy for febrile neutropenic patients: 2 gm IV 8 hourly for 7** days.</li>\r\n	<li>Mild to Moderate Uncomplicated or Complicated Urinary Tract Infections, including pyelonephritis, due to E. coli, K. pneumoniae, or P. mirabilis*: 0.5-1 gm IV/IM*** 12 hourly for 7-10 days.</li>\r\n	<li>Severe Uncomplicated or Complicated Urinary Tract Infections, including pyelonephritis, due to E. coli or K. pneumoniae*: 2 gm IV 12 hourly for 10 days.</li>\r\n	<li>Moderate to Severe Uncomplicated Skin and Skin Structure Infections due to S. aureus or S. pyogenes: 2 gm IV 12 hourly for 10 days.</li>\r\n	<li>Complicated Intra-abdominal Infections (used in combination with metronidazole) caused by E. coli, viridans group streptococci, P. aeruginosa, K. pneumoniae, Enterobacter species, or B. fragilis: 2 gm IV 12 hourly for 7-10 days.</li>\r\n</ul>\r\n\r\n<p><strong>Note:</strong><br />\r\n*including cases associated with concurrent bacteremia.<br />\r\n**or until resolution of neutropenia. In patients whose fever resolves but who remain neutropenic for more than 7 days, the need for continued antimicrobial therapy should be re evaluated frequently.<br />\r\n*** IM route of administration is indicated only for mild to moderate, uncomplicated or complicated UTls due to E. coli when the IM route is considered to be a more appropriate route of drug administration.</p>', '<p>Renal function should be monitored carefully if high doses of aminoglycosides are to be administered with Cefepime because of the increased potential of nephrotoxicity and ototoxicity of aminoglycoside antibiotics. Nephrotoxicity has been reported following concomitant administration of other cephalosporins with potent diuretics such as furosemide.</p>', '<p>Cefepime is contraindicated in patients who have shown immediate hypersensitivity reactions to cefepime or the cephalosporin class of antibiotics, penicillin, or other betalactum antibiotics.</p>', '<p>Cefepime is contraindicated in patients who have shown immediate hypersensitivity reactions to cefepime or the cephalosporin class of antibiotics, penicillin, or other betalactum antibiotics.</p>', '<p>Pregnancy Category B. There are, however, no adequate and well-controlled studies of cefepime use in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Cefepime is excreted in human breast milk in very low concentrations (0.5 pg/ml). Caution should be exercised when cefepime is administered to a nursing woman.</p>', '<ul>\r\n	<li>Prescribing Cefepime in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.</li>\r\n	<li>As with other antimicrobials, prolonged use of Cefepime may result in overgrowth of non susceptible microorganisms. Repeated evaluation of the patient&#39;s condition is essential.</li>\r\n	<li>Many cephalosporins, including cefepime, have been associated with a fall in prothrombin activity. Those at risk include patients with renal or hepatic impairment, or poor nutritional state, as well as patients receiving a protracted course of antimicrobial therapy. Prothrombin time should be monitored in patients at risk.</li>\r\n	<li>Cefepime should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis.</li>\r\n	<li>Arginine has been shown to alter glucose metabolism and elevate serum potassium transiently when administered at 33 times the amount provided by the maximum recommended human dose of Cefepime. The effect of lower doses is not presently known.</li>\r\n</ul>', '<p>Patients who receive an overdose should be carefully observed and given supportive treatment. In the presence of renal insufficiency, hemodialysis, not peritoneal dialysis, is recommended to aid the removal of cefepime from the body. Accidental overdosing has occurred when large doses were given to patients with impaired renal function. Symptoms of overdose include encephalopathy (disturbance of consciousness including confusion, hallucinations, stupor, and coma), myoclonus, seizures, and neuromuscular excitability.</p>', '<p>Fourth generation Cephalosporins</p>', '<p>Do not use later than the date of expiry. Keep all medicines out of the reach of children. To be dispensed only on the prescription of a registered physician.</p>', '<p><strong>Pediatric Use (2 months up to 16 years)</strong>: The maximum dose for pediatric patients should not exceed the recommended adult dose. The usual recommended dosage in pediatric patients up to 40 kg in weight for uncomplicated and complicated urinary tract infections (including pyelonephritis), uncomplicated skin and skin structure infections, and pneumonia is 50 mg/kg/dose, administered every 12 hours (50 mg/kg/dose, every 8 hours for febrile neutropenic patients), for durations as given above.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Serious adverse events have occurred in geriatric patients with renal insufficiency given unadjusted doses of cefepime, including life-threatening or fatal occurrences of the following: encephalopathy, myoclonus, and seizures. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and renal function should be monitored.<br />\r\n<br />\r\n<strong>Impaired Hepatic Function</strong>: No adjustment is necessary for patients with impaired hepatic function.<br />\r\n<br />\r\n<strong>Impaired Renal Function</strong>: In patients with impaired renal function (creatinine clearance&lt;60 ml/min), the dose of Cefepime should be adjusted to compensate for the slower rate of renal elimination.</p>', '2022-02-18 19:21:55', '2022-03-23 22:31:13'),
(286, 286, '<p>Cefixime is indicated in the treatment of the following infections when caused by the susceptible strains of the designated microorganisms:</p>\r\n\r\n<ul>\r\n	<li>Uncomplicated urinary tract infections caused by Escherichia coli and Proteus mirabilis.</li>\r\n	<li>Otitis Media caused by Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes.</li>\r\n	<li>Pharyngitis and tonsillitis caused by Streptococcus pyogenes.</li>\r\n	<li>Acute bronchitis and acute exacerbations of chronic bronchitis caused by Streptococcus pneumoniae and Haemophilus influenzae.</li>\r\n	<li>Uncomplicated gonorrhoea (cervical/urethral) caused by Neisseria gonorrhoeae.</li>\r\n</ul>', '<p>Cefixime is a third generation semisynthetic cephalosporin antibiotic for oral administration. It is bactericidal against a broad spectrum of gram positive and gram negative bacteria at easily achievable plasma concentrations. It kills bacteria by interfering in the synthesis of bacterial cell wall. It is highly stable in the presence of Beta-lactamase enzyme. As a result, many organisms resistant to penicillins and some cephalsporins due to the presence of beta-lactamases, may be susceptible to Cefixime. Absorption of it is about 40% to 50% whether administered with or without food.</p>', '<p>The usual course of treatment is 7 days. This may be continued for up to 14 days depending on the severity of the infection.<br />\r\n<br />\r\n<strong>Adult and children over 12 years</strong>: The recommended adult dose is 200-400 mg (1 to 2 capsules) daily, given either as a single dose or in two divided doses. For the treatment of uncomplicated cervical/urethral gonococcal infections, a single oral dose of Cefixime 400 mg is recommended.<br />\r\n<br />\r\n<strong>Children (6 month or older)</strong>: Usually 8 mg/kg/day given as a single dose or in two divided doses or may be given as following</p>\r\n\r\n<ul>\r\n	<li>&frac12;-1 year: 75 mg daily.</li>\r\n	<li>1-4 years: 100 mg daily.</li>\r\n	<li>5-10 years: 200 mg daily.</li>\r\n	<li>11-12 years: 300 mg daily</li>\r\n	<li>In typhoid fever, dosage should be 10 mg/kg/day for 14 days.</li>\r\n</ul>\r\n\r\n<p><strong>Children (under 6 month)</strong>: The safety and efficacy of Cefixime has not been established in children aged less than 6 months.</p>', '<p>Carbamazepine: Concomitant use elevates the carbamazepine level. Warfarin and other anticoagulants: Concomitant use increases prothrombin time.</p>', '<p>It is contraindicated in hypersensitivity to Cefixime or other cephalosporins.</p>', '<p>The drug is generally well tolerated. The most frequent side effects are diarrhoea and stool changes; that have been more commonly associated with higher doses. Other side effects are nausea, abdominal pain, dyspepsia, vomiting, flatulence, headache and dizziness. Allergies in the form of rash, pruritus, urticaria, drug fever and arthralgia have been reported. These reactions usually subsided upon dicontinuation of therapy.</p>', '<p>There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. It is not known that Cefixime is excreted in human milk. So, caution should be exercised when Cefixime is administered to a nursing woman.</p>', '<p>The drug should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis. The drug should be given with caution in patients with marked impaired renal function as well as those undergoing continuous ambulatory peritoneal dialysis and hemodialysis. Dosage adjustment is only necessary in severe renal failure (creatinine clearance &lt; 20 ml/min), in that case a dose of 200 mg once daily should not be exceeded.</p>', '<p>Gastric Lavage may be indicated; otherwise, no specific antidote exists. Cefixime is not removed in significant quantities from the circulation by hemodialysis or peritoneal dialysis. Adverse reactions in small numbers of healthy adult volunteers receiving single doses up to 2 g of Cefixime did not differ from the profile seen in patients treated at the recommended doses.</p>', '<p>Third generation Cephalosporins</p>', '<p>Keep below 30&ordm;C temperature, protected from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-18 19:22:11', '2022-03-23 22:34:04'),
(287, 287, '<p>Cefoperazone is indicated for the treatment of the following infections when caused by susceptible organisms: Respiratory Tract Infections, Peritonitis &amp; Other Intra-abdominal Infections, Bacterial Septicemia, Skin and Skin Structures Infections, Pelvic Inflammatory Disease, Endometritis &amp; Other Infections of the Female Genital Tract, Urinary Tract Infections, Enterococcal Infections etc.</p>', '<p>Cefoperazone is a bactericidal Cephalosporin antibiotic which is resistant to most beta-lactamases and active against a wide range of aerobic &amp; anaerobic, Gram positive &amp; Gram negative bacteria. The bactericidal action of Cefoperazone results from the inhibition of bacterial cell wall synthesis. Cefoperazone has a high degree of stability in the presence of beta-lactamases produced by most Gram negative pathogens. Cefoperazone is usually active against organisms which are resistant to other beta-lactam antibiotics because of beta-lactamase production.</p>', '<p>Sterile Cefoperazone Sodium can be administered by IM or IV injection (following dilution).<br />\r\n<br />\r\n<strong>Adult</strong>: 2 to 4 grams per day administered in equally divided doses every 12 hours. In severe infections or infections caused by less sensitive organisms, the total daily dose and/or frequency may be increased. Patients have been successfully treated with a total daily dosage of 6-12 grams divided into 2,3, or 4 administrations ranging from 1.5 to 4 grams per dose. When treating infections caused by Streptococcus pyogenes, therapy should be continued for at least 10 days.</p>', NULL, '<p>Cefoperazone is contraindicated in patients with known allergy to the Cephalosporin-class of antibiotics.</p>', '<p>Hypersensitivity: As with all Cephalosporins, hypersensitivity manifested by skin reactions (1 patient in 45), drug fever (1 in 260), or a change in Coombs&rsquo; test (1 in 60) has been reported. These reactions are more likely to occur in patients with a history of allergies, particularly to Penicillin.</p>', '<p>Pregnancy Category B.This drug should be used during pregnancy only if clearly needed. Only low concentrations of Cefoperazone is excreted in human milk. Although Cefoperazone passes poorly into breast milk of nursing mothers, caution should be exercised when Cefoperazone is administered to a nursing woman.</p>', '<p>Cefoperazone is extensively excreted in bile. The serum half-life of Cefoperazone is increased 2-4 fold in patients with hepatic disease and/or biliary obstruction. In general, total daily dosage above 4 gm should not be necessary in such patients. If higher dosages are used, serum concentrations should be monitored.</p>', NULL, '<p>Third generation Cephalosporins</p>', '<p>Cefoperazone is to be stored in a dry place, below 25&deg;C and protected from light prior to reconstitution. The reconstituted solution may be stored for 24 hours if kept in room temperature (below 25&deg;C).</p>', '<p><strong>Children use</strong>: Safety and effectiveness in children have not been established.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: 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>', '2022-02-18 19:22:33', '2022-03-23 22:36:32');
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
(288, 288, '<p>Cefotaxime is indicated for the treatment of the following infections either before the infecting organism has been identified or when caused by bacteria of established sensitivity: Septicaemia Respiratory Tract Infections such as acute or chronic bronchitis, bacterial pneumonia, infected bronchiectasis, lung abscess and postoperative chest infections Urinary Tract Infections such as acute and chronic pyelonephritis, cystitis and asymptomatic bacteriuria Soft-tissue Infection such as cellulitis, peritonitis and wound infections Bone and Joint Infections such as osteomyelitis, septic arthritis Obstetric and gynaecological infections: such as pelvic inflammatory disease Gonorrhoea particularly when penicillin has failed or is unsuitable Other Bacterial Infections: meningitis and other sensitive infections suitable for parenteral antibiotic therapy Prophylaxis: The administration of Cefotaxime prophylactically may reduce the incidence of certain post operative infections in patients undergoing surgical procedures that are classified as contaminated or potentially contaminated or in clean operation where infection would have serious effects.</p>', '<p>Cefotaxime binds to 1 or more of the penicillin binding proteins (PBPs) which inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death. Cefotaxime is a broad spectrum bactericidal 3rd generation parenteral cephalosporin antibiotic. Cefotaxime is exceptionally active against gram-negative organisms sensitive or resistant to first or second generation cephalosporins. It is similar to other cephalosporins in activity against gram-positive bacteria.</p>', '<p><strong>Adults</strong>: The recommended dosage for mild to moderate infections is 1 gm every 12 hourly. However, dosage may be varied according to the severity of infection, sensitivity of causative organisms and condition of the patient. In severe infections dosage may be increased up to 12 gm daily given in 3 or 4 divided doses. For infections caused by sensitive Pseudomonas spp. daily doses of greater than 6 gm will usually be required<br />\r\n<br />\r\n<strong>Children</strong>: The usual dosage range is 100-150 mg/kg/day in 2 to 4 divided doses. However, in very severe infections doses of up to 200 mg/kg/day may be required.<br />\r\n<br />\r\n<strong>Neonates</strong>: The recommended dosage is 50 mg/kg/day in 2 to 4 divided doses. In severe infections 150-200 mg/kg/day, in divided doses, have been given.<br />\r\n<br />\r\n<strong>Dosage in gonorrhoea</strong>: 500 mg as a single dose.</p>', '<p>Increased nephrotoxicity has been reported following concomitant administration of cephalosporins and aminoglycoside antibiotics.</p>', '<p>Cefotaxime is contraindicated in patients who have shown hypersensitivity to cefotaxime or the cephalosporin group of antibiotics.</p>', '<p>Adverse reactions to Cefotaxime have occurred relatively infrequently and have generally been mild and transient. Effects reported include candidiasis, rashes, fever, transient rises in liver transaminase and/or alkaline phosphatase and diarrhoea. As with all cephalosporins, pseudomembranous colitis may rarely occur during treatment. If this occurs the drug should be stopped and specific treatment instituted.As with other cephalosporins, changes in renal function have been rarely observed with high doses of Cefotaxime. Administration of high doses of cephalosporins particularly in patients with renal insufficiency may result in encephalopathy. Hypersensitivity reactions have been reported, these include skin rashes, drug fever and very rarely anaphylaxis.</p>', '<p>Although studies in animals have not shown any adverse effect on the developing foetus, the safety of Cefotaxime in human pregnancy has not been established. Consequently, Cefotaxime should not be administered during pregnancy especially during first trimester, without carefully weighing the expected benefit against possible risks. Cefotaxime is excreted in the milk.</p>', '<p>Cefotaxime should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis. Because high and prolonged antibiotic concentrations can occur from usual doses in patients with transient or persistent reduction of urinary output because of renal insufficiency, the total daily dosage should be reduced when Cefotaxime is administered to such patients. Continued dosage should be determined by degree of renal impairment, severity of infection, and susceptibility of the causative organism. There is no clinical evidence supporting the necessity of changing the dosage of Cefotaxime in patients with even profound renal dysfunction.</p>', NULL, '<p>Third generation Cephalosporins</p>', '<p>Store below 25&deg;C, protected from light and moisture. Use reconstituted solution immediately. Reconstituted solution is stable for up to 24 h if stored between 2&deg; to 8&deg;C.</p>', '<p><strong>Dosage in renal impairment</strong>: Because of extra-renal elimination, it is only necessary to reduce the dosage of Cefotaxime in severe renal failure (GFR&lt;5 ml/min = serum creatinine approximately 751 micromol/litre). After an initial loading dose of 1 gm, daily dose should be halved without change in the frequency of dosing. In all other patients, dosage may require further adjustment according to the course of infection and the general condition of the patient.</p>', '2022-02-18 19:22:50', '2022-03-26 07:36:24'),
(289, 289, '<p>Cefoxitin is indicated for the treatment of serious infections caused by susceptible strains of the designated microorganisms in the diseases listed below.<br />\r\n<br />\r\n<strong>Lower respiratory tract infections</strong>,&nbsp;including&nbsp;pneumonia&nbsp;and lung abscess, caused by&nbsp;Streptococcus pneumoniae, other streptococci (excluding enterococci, e.g., Enterococcus faecalis), Staphylococcus aureus(including penicillinaseproducing strains),&nbsp;Escherichia coli, Klebsiella&nbsp;species,&nbsp;Haemophilus influenzae, and&nbsp;Bacteroides species.<br />\r\n<br />\r\n<strong>Urinary tract infections</strong>&nbsp;caused by&nbsp;Escherichia coli, Klebsiella species, Proteus mirabilis, Morganella morganii, Proteus vulgarisand Providencia species&nbsp;(including P. rettgeri).<br />\r\n<br />\r\n<strong>Intra-abdominal infections</strong>, including&nbsp;peritonitis&nbsp;and intra-abdominal abscess, caused by&nbsp;Escherichia coli, Klebsiella species, Bacteroides species including Bacteroides fragilis, and Clostridium species.<br />\r\n<br />\r\n<strong>Gynecological infections</strong>, including&nbsp;endometritis,&nbsp;pelvic&nbsp;cellulitis, and pelvic inflammatory disease&nbsp;caused by&nbsp;Escherichia coli, Neisseria gonorrhoeae (including penicillinase-producing strains), Bacteroides species including&nbsp;B. fragilis, Clostridium species, Peptococcus niger, Peptostreptococcus species, and&nbsp;Streptococcus agalactiae. Cefoxitin, like cephalosporins, has no activity against&nbsp;Chlamydia trachomatis. Therefore, when Cefoxitin is used in the treatment of patients with pelvic inflammatory disease and C.&nbsp;trachomatis&nbsp;is one of the suspected pathogens, appropriate anti-chlamydial coverage should be added.<br />\r\n<br />\r\n<strong>Septicemia&nbsp;</strong>caused by&nbsp;Streptococcus pneumoniae, Staphylococcus aureus (including penicillinase-producing strains),&nbsp;Escherichia coli, Klebsiella species,&nbsp;and&nbsp;Bacteroides species&nbsp;including&nbsp;B. fragilis.<br />\r\n<br />\r\n<strong>Bone and joint infections</strong>&nbsp;caused by&nbsp;Staphylococcus aureus (including Penicillinaseproducing strains).<br />\r\n<br />\r\n<strong>Skin and skin structure infections</strong>&nbsp;caused by&nbsp;Staphylococcus aureus&nbsp;(including penicillinase-producing strains),&nbsp;Staphylococcus epidermidis, Streptococcus pyogenes&nbsp;and other streptococci (excluding enterococci e.g.,&nbsp;Enterococcus faecalis), Escherichia coli, Proteus mirabilis, Klebsiella&nbsp;species,&nbsp;Bacteroides species&nbsp;includingB. fragilis, Clostridium species, Peptococcus niger, and Peptostreptococcus&nbsp;species.</p>', '<p>Cefoxitin inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis and arresting cell wall assembly resulting in bacterial cell death.</p>', '<p><strong>Intravenous:</strong><br />\r\n<br />\r\nAbdominal infections, Bone and joint infections, Gynaecological infections, Respiratory tract infections, Skin and skin structure infections, Urinary tract infections:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;1-2 g 6-8 hrly, up to 12 g daily given in 4-6 divided doses in severe infections. Doses are given by slow inj over 3-5 min or, by intermittent or continuous infusion.</li>\r\n	<li><strong>Child</strong>:&nbsp;&ge;3 mth&nbsp;80-160 mg/kg daily in 4-6 equally divided doses. Max: 12 g daily.</li>\r\n</ul>\r\n\r\n<p>Prophylaxis of surgical infections:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;2 g 30-60 min prior to surgery, then 6 hrly for not more than 24 hr. For caesarean section: 2 g as a single dose as soon as the umbilical cord is clamped; a further 2 g dose 4 hr and 8 hr after the initial dose may be given if necessary.</li>\r\n	<li><strong>Child</strong>:&nbsp;&ge;3 mth&nbsp;30-40 mg/kg 30-60 min prior to surgery, then 6 hrly for not more than 24 hr.</li>\r\n</ul>', '<p>Reduces renal clearance with probenecid. Concurrent use of nephrotoxic agents (e.g. aminoglycosides, colistin, polymyxin B, vancomycin) may increase the risk of nephrotoxicity.</p>', '<p>Hypersensitivity to cefoxitin and other cephalosporins.</p>', '<p>Hypersensitivity reactions (e.g. maculopapular or erythematous rash, exfoliative dermatitis, pruritus, urticaria, eosinophilia, fever, angioedema); elevated serum creatinine and/or BUN concentrations, anaemia; transient increase in serum AST (SGOT), ALT (SGPT), LDH and alkaline phosphatase levels; jaundice; thrombophlebitis. Rarely, oliguria, renal toxicity, neutropenia, transient leucopenia, granulocytopenia, thrombocytopenia, bone marrow depression; GI effects (e.g. nausea, vomiting, diarrhoea).</p>', '<p>Hypersensitivity reactions (e.g. maculopapular or erythematous rash, exfoliative dermatitis, pruritus, urticaria, eosinophilia, fever, angioedema); elevated serum creatinine and/or BUN concentrations, anaemia; transient increase in serum AST (SGOT), ALT (SGPT), LDH and alkaline phosphatase levels; jaundice; thrombophlebitis. Rarely, oliguria, renal toxicity, neutropenia, transient leucopenia, granulocytopenia, thrombocytopenia, bone marrow depression; GI effects (e.g. nausea, vomiting, diarrhoea).</p>', '<p>Patient with history of penicillin allergy, GI disease (particularly colitis) and seizure disorder. Renal impairment. Pregnancy and lactation.</p>', NULL, '<p>Second generation Cephalosporins</p>', '<p>Store between 2-25&deg; C.</p>', '<p><strong>Haemodialysis patient</strong>: Repeat loading dose after each dialysis session.</p>\r\n\r\n<ul>\r\n	<li>CrCl &lt;5 ml/min: 0.5-1 g 24-48 hrly.&nbsp;</li>\r\n	<li>CrCl 5-9 ml/min: 0.5-1 g 12-24 hrly.</li>\r\n	<li>CrCl 10-29 ml/min: 1-2 g 12-24 hrly.</li>\r\n	<li>CrCl 30-50 ml/min: 1-2 g 8-12 hrly.</li>\r\n</ul>', '2022-02-18 19:23:10', '2022-03-26 07:39:44'),
(290, 290, '<p>Cefpirome is indicated in:</p>\r\n\r\n<ul>\r\n	<li>Severe infections, such as septicemia, bacteremia and infections in immunosuppressed neutropenic patients with hematological malignancies</li>\r\n	<li>Lower respiratory infections including pneumonia</li>\r\n	<li>Severe urinary tract infections including pyelonephritis</li>\r\n	<li>Skin and soft tissue infections</li>\r\n	<li>Bone and joint infections</li>\r\n	<li>Infections in immunocompromised patients</li>\r\n	<li>Other infections</li>\r\n</ul>', '<p>Cefpirome binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.</p>', '<p><strong>Adult:</strong>&nbsp;1-2 gm every 12 hour via IV injection over 3-5 minutes or infuse over 20-30 minutes.<br />\r\n<br />\r\n<strong>Elderly</strong>:&nbsp;There are no special precautions for its use in the elderly provided dosage is adjusted accordingly to renal function.<br />\r\n<br />\r\nCefpirome is administered only through the parenteral route. The dosage is dependent upon the severity and site of infection, the susceptibility of the infecting microorganisms and age, weight and renal function of the patient. The drug is administered through intravenous injection or infusion. The following dosages are recommended for moderate to severe infections in adult patients with normal renal function:</p>\r\n\r\n<ul>\r\n	<li><strong>Complicated upper &amp; lower urinary tract infections</strong>: 1 gm 12 hourly.&nbsp;Total daily dose not more then 2 gm</li>\r\n	<li><strong>Skin &amp; soft tissue infections</strong>:&nbsp;1 gm 12 hourly.&nbsp;Total daily dose not more then 2 gm</li>\r\n	<li><strong>Lower respiratory tract infections</strong>:&nbsp;1 to 2 gm 12 hourly.&nbsp;Total daily dose not more then 2 to 4 gm</li>\r\n	<li><strong>Bacteraemia or septicaemia and severe infections</strong>: 2&nbsp;gm 12 hourly.&nbsp;Total daily dose not more then 4 gm</li>\r\n	<li><strong>Infections in neutropenic patients</strong>:&nbsp;2&nbsp;gm 12 hourly.&nbsp;Total daily dose not more then 4 gm</li>\r\n</ul>\r\n\r\n<p>Dose reduction is necessary in patients with markedly reduced renal function. After an initial dose of 0.5 -2 gm to establish a high serum concentration, the dose should be reduced by 50% for clearances of 49-21 ml/min or 75% for clearances of 20 ml/min. In end-stage renal disease, a supplementary dose equal to 50% of the recommended daily dose should be administered after each hemodialysis<br />\r\ntreatment.</p>', '<p>Drug interactions have not been observed with Cefpirome.</p>', '<p>Cefpirome is contraindicated in patients with known allergy to the cephalosporin group of antibiotics.</p>', '<p>Cefpirome is generally well tolerated. There are no predictable life threatening effects of Cefpirome. Adverse gastrointestinal reactions include diarrhea, nausea, vomiting, pseudomembraneous colitis, abdominal pain and have been noted 3.86% of the patients. Superficial phlebitis, thrombophlebitis and infection site reaction have been reported in 2.31% of patients receiving intravenous Cefpirome.</p>', '<p>The safety of Cefpirome has not been established in pregnancy and as with all agents it should be administered with caution, especially during the early months of pregnancy. As Cefpirome is excreted in human breast milk, either Cefpirome treatment should be discontinued or breast feeding ceased.</p>', '<p>Allergy to penicillin or to cephalosporins; renal impairment, monitor renal and haematological status; pregnancy and lactation.</p>', '<p>No cases of over dosage are known. However, general supportive care with monitoring of renal, hematological and hepatic function and coagulation status is recommended.</p>', '<p>Fourth generation Cephalosporins</p>', '<p>Cefpirome vial should be stored below 25&deg; C, protected from light and moisture. Reconstituted solution can be stored for up to 6 hours at room temperature and 24 hours in refrigerator (at 2-8&deg; C) when prepared in water for injection.</p>', NULL, '2022-02-18 19:23:37', '2022-03-26 07:43:05'),
(291, 291, '<p>Cefpodoxime is indicated for the treatment of infections caused by susceptible microorganism, listed below:</p>\r\n\r\n<ul>\r\n	<li>Acute otitis media caused by Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenza, Moraxella catarrhalis (including beta-lactamase producing strains).</li>\r\n	<li>Pharyngitis/tonsillitis caused by Streptococcus pyogenes.</li>\r\n	<li>Acute maxillary sinusitis caused by Haemophilus influenzae (including beta-lactamase producing strains), Streptococcus pneumoniae and Moraxella catarrhalis.</li>\r\n	<li>Community acquired pneumonia caused by S. pneumoniae or H. influenza (including beta-lactamase-producing strains).</li>\r\n	<li>Acute bacterial exacerbation of chronic bronchitis caused by S. pneumoniae, H. influenzae (non-beta-lactamase-producing strains only), or M. catarrhalis.</li>\r\n	<li>Skin and skin structure infections caused by Staphylococcus aureus, Streptococcus pyogenes.</li>\r\n	<li>Uncomplicated urinary tract infections caused by E. coli, Klebsiella pneumoniae, Proteus mirabilis or Staphylococcus saprophyticus.</li>\r\n	<li>Uncomplicated gonorrhea caused by Neisseria gonorrhoeae (including penicillinase-producing strains).</li>\r\n	<li>Rectal gonococcal infections in women due to Neisseria gonorrhoeae (including penicillinase-producing strains).</li>\r\n</ul>', '<p>Cefpodoxime is an oral 3rd generation cephalosporin, which has good stability to beta lactamases and activity against Gram negative and Gram positive bacteria. It is indicated for the treatment of infections either before the infecting organism has been identified. It is a prodrug its active metabolite is Cefpodoxime. Approximately 29 to 33% of Cefpodoxime excreted unchanged in the urine in 12 hours.</p>', '<p>Adults and Adolescents (13 years and older)</p>\r\n\r\n<ul>\r\n	<li><strong>Pharyngitis/tonsillitis</strong>: 100 mg 12 hourly, 5 to 10 days</li>\r\n	<li><strong>Acute maxillary sinusitis</strong>: 200 mg 12 hourly, 10 day</li>\r\n	<li><strong>Community acquired pneumonia</strong>: 200 mg 12 hourly, 14 days</li>\r\n	<li><strong>Acute bacterial exacerbations of chronic bronchitis</strong>: 200 mg 12 hourly, 10 days</li>\r\n	<li><strong>Skin and skin structure</strong>: 400 mg 12 hourly, 7 to 14 days</li>\r\n	<li><strong>Uncomplicated urinary tract infection</strong>: 100 mg 12 hourly, 7 days</li>\r\n	<li><strong>Uncomplicated gonorrhea</strong>: single dose of 200 mg</li>\r\n	<li>Rectal gonococcal infections in women: single dose of 200 mg</li>\r\n</ul>\r\n\r\n<p>Infants and Pediatric Patients (2 months to 12 years)</p>\r\n\r\n<ul>\r\n	<li><strong>Acute otitis media</strong>: 5 mg/kg body weight 12 hourly, 5 days</li>\r\n	<li><strong>Pharyngitis /tonsillitis</strong>: 5 mg/kg body weight 12 hourly, 5 to 10 days</li>\r\n	<li><strong>Acute maxillary sinusitis</strong>: 5 mg/kg body weight 12 hourly, 10 days</li>\r\n</ul>', '<p>Cefpodoxime concomitant administration of high doses of antacids (sodium bicarbonate and aluminum hydroxide) or H2 blockers reduces peak plasma levels and the extent of absorption respectively. Renal excretion of Cefpodoxime is inhibit by probenecid.</p>', '<p>Cefpodoxime is contraindicated in patients with known allergy to cephalosporins.</p>', '<p>Cefpodoxime has very few side effects. Possible side effects include gastrointestinal disorders (such as- diarrhea, nausea, vomiting and abdominal pain), rash, urticaria and itching.</p>', '<p>US FDA pregnancy category of Cefpodoxime is B. There is, however, no adequate and well-controlled study in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Cefpodoxime have been shown to be excreted in human milk. So, caution should be exercised when Cefpodoxime is administered to a nursing woman.</p>', '<p>In patients with transient or persistent reduction in urinary output due to renal insufficiency, the total daily dose of Cefpodoxime should be reduced. Cefpodoxime should be administered with caution to patients receiving concurrent treatment with potent diuretics. As with other antibiotics, prolonged use of Cefpodoxime may result in overgrowth of non-susceptible organisms.</p>', NULL, '<p>Third generation Cephalosporins</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', '<p>Patients with severe renal impairment (creatinin clearance &lt;30 ml/min) the dosing intervals should be increased to 24 hourly. The dosage adjustment is not require in cases of hepatic impairment.</p>', '2022-02-18 19:23:57', '2022-03-26 07:46:52'),
(292, 292, '<p>It is indicated in the following infections -</p>\r\n\r\n<ul>\r\n	<li>Acute bacterial exacerbation of chronic bronchitis</li>\r\n	<li>Acute community acquired pneumonia</li>\r\n	<li>Pharyngitis or tonsillitis</li>\r\n	<li>Skin and soft tissue infections</li>\r\n	<li>Urinary tract infections</li>\r\n	<li>Uncomplicated gonorrhea</li>\r\n	<li>Acute maxillary sinusitis</li>\r\n</ul>', '<p>Cefpodoxime is a third generation semi-synthetic Cephalosporin, exhibits activity against several Gram positive as well as Gram negative microorganisms. This compound is also stable in beta lactamase environment. Cefpodoxime exhibits exceptional activity against methicillin susceptible Staphylococci, Streptococcus pneumoniae, Haemophilus influenzae, Neisseria spp. and Moraxella catarrhalis.<br />\r\n<br />\r\nClavulanic acid is a natural inhibitor of beta lactamase which are produced by Streptomyces clavuligerus. It binds to beta lactamase moieties and inactivates them, thus restricting the Cefpodoxime destruction.</p>', '<p>For adults (Age 12 years and older):</p>\r\n\r\n<ul>\r\n	<li><strong>Acute bacterial exacerbation of chronic bronchitis</strong>: 1 tablet 12 hourly for 10 days</li>\r\n	<li><strong>Acute community acquired pneumonia</strong>: 1 tablet 12 hourly for 14 days</li>\r\n	<li><strong>Pharyngitis or tonsillitis</strong>: &frac12; tablet 12 hourly for 5 to 10 days</li>\r\n	<li><strong>Skin and soft tissue infections</strong>: 2 tablet 12 hourly for 7 to 14 days</li>\r\n	<li><strong>Urinary tract infections</strong>: &frac12; tablet 12 hourly for 7 days</li>\r\n	<li><strong>Uncomplicated gonorrhea</strong>: Single dose</li>\r\n	<li><strong>Acute maxillary sinusitis</strong>: 1 tablet 12 hourly for 10 days</li>\r\n</ul>\r\n\r\n<p>For children: Children 2 months to 12 years- 10 mg/kg/day in divided dose, every 12 hours.</p>', '<p>Concomitant administration of Cefpodoxime at high doses with antacids or H2 blockers reduces peak plasma levels of Cefpodoxime.</p>', '<p>Cefpodoxime is contraindicated in patients with known hypersensitivity to Cephalosporins.</p>', '<p>Cefpodoxime is well tolerated. Most common gastrointestinal adverse effects are diarrhea, vomiting and abdominal pain.</p>', '<p>US FDA pregnancy category of Cefpodoxime &amp; Clavulanic Acid is B. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Cefpodoxime have been shown to be excreted in human milk. So, caution should be exercised when Cefpodoxime is administered to a nursing woman.</p>', '<p>Cefpodoxime should be administered with caution to patients receiving concurrent treatment with diuretics.</p>', NULL, '<p>Third generation Cephalosporins</p>', '<p>It is indicated in the following infections -</p>\r\n\r\n<ul>\r\n	<li>Acute bacterial exacerbation of chronic bronchitis</li>\r\n	<li>Acute community acquired pneumonia</li>\r\n	<li>Pharyngitis or tonsillitis</li>\r\n	<li>Skin and soft tissue infections</li>\r\n	<li>Urinary tract infections</li>\r\n	<li>Uncomplicated gonorrhea</li>\r\n	<li>Acute maxillary sinusitis</li>\r\n</ul>', NULL, '2022-02-18 19:24:24', '2022-03-26 07:51:38'),
(293, 293, '<p>Cefprozil is indicated for the treatment of patients with mild to moderate infections caused by susceptible strains. Infections include:</p>\r\n\r\n<ul>\r\n	<li>Lower respiratory tract infections: acute bronchitis, acute exacerbations of chronic bronchitis, community acquired pneumonia.</li>\r\n	<li>Upper respiratory tract and ear infections: otitis media, sinusitis, tonsillitis and pharyngitis.</li>\r\n	<li>Uncomplicated skin and soft tissue infections.</li>\r\n</ul>', '<p>Cefprozil is a preparation of Cefprozil, which is a semi synthetic, second-generation cephalosporin antibiotic indicated for the treatment of patients with mild to moderate infections caused by susceptible strains.</p>\r\n\r\n<ul>\r\n	<li>Ensures treatment success in pediatric GAS pharyngitis/tonsillitis</li>\r\n	<li>A drug of choice for pediatric patients with tonsilopharyngitis</li>\r\n	<li>Guarantees treatment success in SSTI</li>\r\n</ul>\r\n\r\n<p>Cefprozil is a semi synthetic, second-generation cephalosporin antibiotic. Cefprozil is active in vitro against both gram positive and gram negative bacteria. The bactericidal activity of cefprozil results from the inhibition of cell wall synthesis via affinity for penicillin-binding proteins (PBPs).</p>', '<p><strong>Adults (13 years and older)-</strong><br />\r\nUpper Respiratory Tract:</p>\r\n\r\n<ul>\r\n	<li>Pharyngitis/Tonsillitis: 500 q24h for 10 days</li>\r\n	<li>Acute Sinusitis (For moderate to severe infections, the higher dose should be used): 250 q12h or 500 q12h for 10 days</li>\r\n</ul>\r\n\r\n<p>Lower Respiratory Tract:</p>\r\n\r\n<ul>\r\n	<li>Secondary Bacterial Infection of Acute Bronchitis and Acute Bacterial Exacerbation of Chronic Bronchitis: 500 q12h for 10 days.</li>\r\n</ul>\r\n\r\n<p>Skin And Skin Structure:</p>\r\n\r\n<ul>\r\n	<li>Uncomplicated Skin and Skin Structure Infections 250 q12h or 500 q24h or 500 q12h for 10 days.</li>\r\n</ul>\r\n\r\n<p><br />\r\n<strong>Children (2 years&ndash;12 years)-</strong><br />\r\nUpper Respiratory Tract:</p>\r\n\r\n<ul>\r\n	<li>Pharyngitis/Tonsillitis: 7.5 mg/kg q12h for 10 days</li>\r\n</ul>\r\n\r\n<p>Skin And Skin Structure:</p>\r\n\r\n<ul>\r\n	<li>Uncomplicated Skin and Skin Structure Infections 20 mg/kg q24h for 10 days.</li>\r\n</ul>\r\n\r\n<p><br />\r\n<strong>Infants &amp; Children (6 months&ndash;12 years)-</strong><br />\r\nUpper Respiratory Tract:</p>\r\n\r\n<ul>\r\n	<li>Otitis Media: 15 mg/kg q12h for 10 days</li>\r\n	<li>Acute Sinusitis (For moderate to severe infections, the higher dose should be used): 7.5 mg/kg q12h or 15 mg/kg q12h for 10 days.</li>\r\n</ul>', '<p>Nephrotoxicity has been reported following concomitant administration of aminoglycoside antibiotics and cephalosporin antibiotics. Concomitant administration of probenecid doubled the AUC for cefprozil.</p>', '<p>Hypersensitivity to cephalosporin antibiotics.</p>', '<p>The adverse reactions to cefprozil are similar to those observed with other orally administered cephalosporins. Cefprozil was usually well tolerated in controlled clinical trials. The most common adverse effects of cefprozil are diarrhea, nausea, vomiting, abdominal pain, rash, urticaria, dizziness, hyperactivity, insomnia, confusion etc.</p>', '<p>Pregnancy category B. There are no adequate and well-controlled studies in pregnant women. This drug should be used during pregnancy only if clearly needed. Small amounts of cefprozil (&lt;0.3% of dose) have been detected in human milk following administration of a single 1 gram dose to lactating women. Caution should be exercised when cefprozil is administered to a nursing woman, since the effect of cefprozil on nursing infants is unknown.</p>', '<p>In patients with known or suspected renal impairment, careful clinical observation and appropriate laboratory studies should be done prior to and during therapy. Prolonged use of cefprozil may result in the overgrowth of&nbsp; nonsusceptible organisms. Cefprozil should be prescribed with caution in individuals with a history of gastrointestinal disease particularly colitis.</p>', NULL, '<p>Second generation Cephalosporins</p>', '<p>Cefprozil powder for suspension should be stored in a cool, dry place (preferably below 30&deg;C) and should be protected from light. Keep out of reach of children.</p>', NULL, '2022-02-18 19:24:41', '2022-03-26 07:53:36'),
(294, 294, '<p>This is indicated in adults and paediatric patients aged 3 months and older for the treatment of the following infections:</p>\r\n\r\n<ul>\r\n	<li>Complicated intra-abdominal infection (cIAI)</li>\r\n	<li>Complicated urinary tract infection (cUTI), including pyelonephritis</li>\r\n	<li>Hospital-acquired pneumonia (HAP), including ventilator associated pneumonia (VAP)</li>\r\n</ul>\r\n\r\n<p>Treatment of adult patients with bacteraemia that occurs in association with, or is suspected to be associated with, any of the infections listed above. This is also indicated for the treatment of infections due to aerobic Gram-negative organisms in adults and paediatric patients aged 3 months and older with limited treatment options. Consideration should be given to official guidance on the appropriate use of antibacterial agents.</p>', '<p>Ceftazidime inhibits bacterial peptidoglycan cell wall synthesis following binding to penicillin binding proteins (PBPs), which leads to bacterial cell lysis and death. Avibactam is a non &beta;-lactam, &beta;-lactamase inhibitor that acts by forming a covalent adduct with the enzyme that is stable to hydrolysis. It inhibits both Ambler class A and class C &beta;-lactamases and some class D enzymes, including extended-spectrum &beta;-lactamases (ESBLs), KPC and OXA-48 carbapenemases, and AmpC enzymes. Avibactam does not inhibit class B enzymes (metallo-&beta;-lactamases) and is not able to inhibit many class D enzymes.</p>', '<p>It is recommended that this should be used to treat infections due to aerobic Gram-negative organisms in adults and paediatric patients aged 3 months and older with limited treatment options only after consultation with a physician with appropriate experience in the management of infectious diseases.</p>\r\n\r\n<ul>\r\n	<li><strong>Complicated intra-abdominal infection</strong>: 2 g/0.5 g, every 8 hours for 5-14 days.</li>\r\n	<li><strong>Complicated urinary tract infection (cUTI), including pyelonephritis</strong>: 2 g/0.5 g every 8 hours for 5-10 days.</li>\r\n	<li><strong>Hospital-acquired pneumonia (HAP), including ventilator associated pneumonia (VAP)</strong>: 2 g/0.5 g Every 8 hours for 7-14 days.</li>\r\n	<li><strong>Bacteraemia associated with, or suspected to be associated with any of the above infections</strong>: 2 g/0.5 g Every 8 hours. Duration of treatment should be in accordance with the site of infection.</li>\r\n	<li><strong>Infections due to aerobic Gram-negative organisms in patients with limited treatment options</strong>: 2 g/0.5 g Every 8 hours. Guided by the severity of the infection, the pathogen(s) and the patient&rsquo;s clinical and bacteriological progress.</li>\r\n</ul>', NULL, '<p>Hypersensitivity to the active substances or to any of the excipients. Hypersensitivity to any cephalosporin antibacterial agent. Severe hypersensitivity (e.g. anaphylactic reaction, severe skin reaction) to any other type of &beta;-lactam antibacterial agent (e.g. penicillins, monobactams or carbapenems).</p>', '<p>severe allergic reactions: signs include sudden swelling of your lips, face, throat or tongue, a severe rash or other severe skin reactions, difficulty swallowing or breathing. This reaction may be life-threatening. diarrhoea that keeps getting worse or does not go away, or stools that contains blood or mucus-this may happen during or after treatment is stopped with this combination. If this happens do not take medicines that stop or slow bowel movement.</p>', '<p>Animal studies with ceftazidime do not indicate direct or indirect harmful effects with respect to pregnancy, embryonal/foetal development, parturition or postnatal development. Animal studies with avibactam have shown reproductive toxicity without evidence of teratogenic effects. Ceftazidime/avibactam should only be used during pregnancy if the potential benefit outweighs the possible risk. Ceftazidime is excreted in human milk in small quantities. It is unknown whether avibactam is excreted in human milk. A risk to newborns/infants cannot be excluded. A decision must be made whether to discontinue breast feeding or to discontinue/abstain from ceftazidime/avibactam therapy taking into account the benefit of breast feeding for the child and the benefit of therapy for the woman.</p>', '<p>This medicinal product does not require any special storage conditions. Store in the original package in order to protect from light.</p>', NULL, NULL, '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Elderly</strong>: No dosage adjustment is required in elderly patients.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: No dosage adjustment is required in patients with mild renal impairment.</p>', '2022-02-18 19:25:51', '2022-03-26 07:56:09'),
(295, 295, '<p>Ceftazidime Injection is indicated for the treatment of patients with infections caused by susceptible strains of the designated organisms in the following diseases:<br />\r\n<br />\r\n<strong>Lower Respiratory Tract Infections</strong>, including pneumonia, caused by Pseudomonas aeruginosa and other Pseudomonas spp., Haemophilus influenzae, including ampicillin-resistant strains; Klebsiella spp.; Enterobacter spp.; Proteus mirabilis; Escherichia coli; Serratia spp.; Citrobacter spp.; Streptococcus pneumoniae; and Staphylococcus aureus (methicillin susceptible strains).<br />\r\n<br />\r\n<strong>Skin and Skin Structure Infections</strong>&nbsp;caused by Pseudomonas aeruginosa; Klebsiella spp.; Escherichia coli; Proteus spp., including Proteus mirabilis and indole-positive Proteus, Enterobacter spp.; Serratia spp.; Staphylococcus aureus (methicillin susceptible strains); and Streptococcus pyogenes (group A beta-hemolytic streptococci).<br />\r\n<br />\r\n<strong>Urinary Tract Infections</strong>, both complicated and uncomplicated, caused by Pseudomonas aeruginosa; Enterobacter spp.; Proteus spp., including Proteus mirabilis and indole-positive Proteus, Klebsiella spp.; and Escherichia coli.<br />\r\n<br />\r\n<strong>Bacterial Septicemia</strong>&nbsp;caused by Pseudomonas aeruginosa, Klebsiella spp., Haemophilus influenzae, Escherichia coli, Serratia spp., Streptococcus pneumoniae and Staphylococcus aureus (methicillin susceptible strains).<br />\r\n<br />\r\n<strong>Bone and Joint Infections</strong>&nbsp;caused by Pseudomonas aeruginosa, Klebsiella spp., Enterobacter spp., and Staphylococcus aureus (methicillin susceptible strains).<br />\r\n<br />\r\n<strong>Gynecologic Infections</strong>, including endometritis, pelvic cellulitis, and other infections of the female genital tract caused by Escherichia coli.<br />\r\n<br />\r\n<strong>Intraabdominal Infections</strong>, including peritonitis caused by Escherichia coli, Klebsiella spp., and Staphylococcus aureus (methicillin susceptible strains) and polymicrobial infections caused by aerobic and anaerobic organisms and Bacteroides spp.<br />\r\n<br />\r\n<strong>Central Nervous System Infections</strong>, including meningitis, caused by Haemophilus influenzae and Neisseria meningitidis, Pseudomonas aeruginosa and Streptococcus pneumoniae.</p>', '<p>Ceftazidime is a semisynthetic, broad-spectrum, beta-lactam antibiotic for parenteral administration. Ceftazidime is bactericidal in action exerting its effect by inhibition of enzymes responsible for cell-wall synthesis. A wide range of gram-negative organisms is susceptible to ceftazidime in vitro, including strains resistant to gentamicin and other aminoglycosides. In addition, ceftazidime has been shown to be active against gram-positive organisms. It is highly stable to most clinically important beta-lactamases, plasmid or chromosomal, which are produced by both gram-negative and gram-positive organisms and, consequently, is active against many strains resistant to ampicillin and other cephalosporins.</p>', '<p>The usual adult dosage is 1 gram administered intravenously or intramuscularly every 8 to 12 hours. The dosage and route should be determined by the susceptibility of the causative organisms, the severity of infection and the condition, and renal function of the patient.<br />\r\n<br />\r\nCeftazidime is to be used by the parenteral route, the dosage depending upon the severity, sensitivity &amp; type of infections and the age, weight &amp; renal function of the patient.<br />\r\n<br />\r\n<strong>Adults</strong>: The adult dosage range for ceftazidime is 1 to 6 gm per day 8 or 12 hourly (IM/IV) in the majority of infections, 1 gm 8 hourly or 2 gm 12 hourly should be given.</p>\r\n\r\n<ul>\r\n	<li><strong>In urinary tract infections and many less serious infections</strong>: 500 mg or 1 gm 12 hourly is usually adequate.</li>\r\n	<li><strong>In severe infections, especially immunocompromised patients, including those with neutropenia</strong>: 2 gm 8 or 12 hourly should be administered. When used as a prophylactic agent in prostatic surgery 1 gm should be given at the induction of anesthesia. A second dose should be considered at the time of catheter removal.</li>\r\n</ul>\r\n\r\n<p><strong>Elderly</strong>: In view of the reduced clearance of Ceftazidime in acutely ill elderly patients, the daily dosage should not normally exceed 3 gm, especially in those over 80 years of age.</p>\r\n\r\n<ul>\r\n	<li><strong>Cystic fibrosis</strong>: In fibrocystic adults with normal renal function who have pseudomonal lung infections, high doses of 100 to 150 mg/kg/day as three divided doses should be used.</li>\r\n</ul>\r\n\r\n<p><strong>Infants and Children</strong>: The usual dosage range for children aged over two months is 30 to 100 mg/kg/day, given as two or three divided doses. Doses up to 150 mg/kg/day (maximum 6 gm daily) in three divided doses may be given to infected immunocompromised or fibrocystic children or children with meningitis.<br />\r\n<br />\r\n<strong>Neonates and Children up to 2 months of age</strong>: The usual dosage range is 25 to 60 mg/kg/day as two divided doses.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Ceftazidime may be given intravenously or by deep IM injection into a large muscle mass such as the upper outer quadrant of the gluteus maximus or lateral proof of the thigh. Intra-arterial administration should be avoided. For IV/IM administration, Ceftazidime should be reconstituted with the supplied Sterile Water for Injection.</p>', NULL, '<p>Ceftazidime is contraindicated in patients who have shown hypersensitivity to Ceftazidime or the cephalosporin group of antibiotics.</p>', '<p>The most common side-effects are local reactions following IV injection and allergic and gastrointestinal reactions. Hypersensitivity reactions are pruritus, rash, and fever. Angioedema and anaphylaxis have been reported very rarely. Gastrointestinal symptoms are diarrhea, nausea, vomiting, and abdominal pain. Central nervous system reactions included headache, dizziness, and paresthesia.</p>', '<p><strong>Pregnancy</strong>: No adequate and well-controlled studies in pregnant women have been conducted with Ceftazidime. Because animal reproduction studies are not always predictive of human response this drug should be used during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Lactation</strong>: Ceftazidime is excreted in human milk in low concentrations. Because many drugs are excreted in human milk and because the safety of the component of the injections in nursing infants has not been established, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>The total daily dosage should be reduced when Ceftazidime is administered to patients with renal insufficiency. Ceftazidime should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis.</p>', '<p>Ceftazidime overdosage has occurred in patients with renal failure. Reactions have included seizure activity, encephalopathy, asterixis, neuromuscular excitability, and coma. Patients who receive an acute overdosage should be carefully observed and given supportive treatment.</p>', '<p>Third generation Cephalosporins</p>', '<p>Store below 25&deg;C, protected from light and moisture. Reconstituted solutions are stable for up to 24 h if stored between 2&deg;-8&deg;C.</p>', '<p><strong>Impaired Renal Function</strong>: Ceftazidime is excreted by the kidneys, almost exclusively by glomerular filtration. Therefore, in patients with impaired renal function (glomerular filtration rate &lt;50 mL/min), it is recommended that the dosage of ceftazidime be reduced to compensate for its slower excretion. In patients with suspected renal insufficiency, an initial loading dose of 1 gram of Ceftazidime may be given. An estimate of GFR should be made to determine the appropriate maintenance dosage.<br />\r\n<br />\r\n<strong>Dosage in peritoneal dialysis</strong>: Ceftazidime may also be used in peritoneal dialysis and continuous ambulatory peritoneal dialysis (CAPD). As well as using Ceftazidime intravenously, it can be incorporated into the dialysis fluid (usually 125 to 250 mg for 2L of dialysis fluid).<br />\r\n<br />\r\n<strong>Impaired Hepatic Function</strong>: No adjustment in dosage is required for patients with hepatic dysfunction.</p>', '2022-02-18 19:28:39', '2022-03-26 07:59:21'),
(296, 296, '<p>Ceftibuten is indicated for the treatment of individuals with mild-to-moderate infections caused by susceptible strains of the designated microorganisms in the specific conditions listed below.</p>\r\n\r\n<ul>\r\n	<li><strong>Acute Bacterial Exacerbations of Chronic Bronchitis</strong>: Due to Haemophilus influenzae (including &beta;-lactamase producing strains), Moraxella catarrhalis (including (&beta;-lactamase producing strains), or Streptococcus pneumoniae (penicillin-susceptible strains only).</li>\r\n	<li><strong>Acute Bacterial Otitis Media</strong>: Due to Haemophilus influenzae (including &beta;-lactamase producing strains), Moraxella catarrhalis (including &beta;-lactamase producing strains) or Streptococcus pyogenes.</li>\r\n</ul>', '<p>Ceftibuten is the dihydrate salt of Ceftibuten, is a semi-synthetic Cephalosporin antibiotic for oral administration. Ceftibuten exerts its bactericidal action by binding to essential target proteins of the bacterial cell wall. This binding leads to inhibition of cell-wall synthesis.</p>', '<p>Otitis Media-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult Dosage</strong>: 400 mg orally every 24 hours for 10 days</li>\r\n	<li><strong>Pediatric Dosage</strong>: &gt;6 months: 9 mg/kg/day (maximum 400 mg) every 24 hours for 10 days</li>\r\n</ul>\r\n\r\n<p>Tonsillitis/Pharyngitis-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult Dosage</strong>: 400 mg orally every 24 hours for 10 days</li>\r\n	<li><strong>Pediatric Dosage</strong>: &gt;6 months: 9 mg/kg/day (maximum 400 mg) every 24 hours for 10 days</li>\r\n</ul>\r\n\r\n<p>Bronchitis-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult Dosage</strong>: 400 mg orally every 24 hours for 10 days</li>\r\n	<li><strong>Pediatric Dosage</strong>: &gt;12 years: 400 mg orally every 24 hours for 10 days</li>\r\n</ul>\r\n\r\n<p>Cystitis-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult Dosage</strong>: 400 mg orally every 24 hours for 7 days</li>\r\n	<li><strong>Pediatric Dosage</strong>: &gt;12 years: 400 mg orally every 24 hours for 7 days</li>\r\n</ul>\r\n\r\n<p>Pneumonia-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult Dosage</strong>: 200 mg orally every 12 hours for 7 to 14 days</li>\r\n	<li><strong>Pediatric Dosage</strong>: &gt;12 years: 200 mg orally every 12 hours for 7 to 14 days</li>\r\n</ul>\r\n\r\n<p>Sinusitis-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult Dosage</strong>: 400 mg orally every 24 hours for 10 to 14 days</li>\r\n	<li><strong>Pediatric Dosage</strong>: &gt;12 years: 400 mg orally every 24 hours for 10 to 14 days</li>\r\n</ul>\r\n\r\n<p>Urinary tract Infection-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult Dosage</strong>: 400 mg orally every 24 hours for 10 days</li>\r\n	<li><strong>Pediatric Dosage</strong>: &gt;6 months: 9 mg/kg/day (maximum 400 mg) every 24 hours for 10 days</li>\r\n</ul>', '<p>Theophylline &amp; Antacid do not alter the pharmacokinetic profile of Ceftibuten. Ranitidine increases the Cmax &amp; AUC of Ceftibuten.</p>', '<p>Ceftibuten is contraindicated in patients with known allergy to the cephalosporin group of antibiotics.</p>', '<p>Nausea, headache, diarrhea, dyspepsia, dizziness, abdominal pain, vomiting.</p>', '<p>Pregnancy Category B. There are no controlled data on the use of Ceftibuten in pregnant women. Ceftibuten should be used in pregnancy only when the benefit clearly outweighs the risk. It is not known whether Ceftibuten (recommended dosage) is excreted in human milk. Because many drugs are excreted in human milk, caution should be excercised when Ceftibuten is administered to nursing women.</p>', '<p>As with other broad-spectrum antibiotics, prolonged treatment may result in the possible emergence and overgrowth of resistant organisms. Careful observation of the patient is essential. The dose of Ceftibuten may require adjustment in patients with varying degrees of renal insufficiency. Ceftibuten should be prescribed with caution to individuals with a history of gastrointestinal disease, particularly colitis.</p>', NULL, '<p>Third generation Cephalosporins</p>', '<p>Store below 25&deg;C, protected from light and moisture. For Suspension: After reconstitution, the suspension may be used for 14 days while stored at 2&deg; to 8&deg;C. Keep out of reach of children.</p>', '<p>Renal Impairment-</p>\r\n\r\n<ul>\r\n	<li>CrCl 5 to 29 ml/min: 2.25 mg/kg or 100 mg orally once a day</li>\r\n	<li>CrCl 30 to 49 ml/min: 4.5 mg/kg or 200 mg orally once a day</li>\r\n</ul>\r\n\r\n<p>Hepatic Impairment: Dose adjustment is not necessary.</p>', '2022-02-18 19:29:01', '2022-03-27 22:32:21');
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
(297, 297, '<p>Ceftriaxone is indicated for the treatment of the following major infections:</p>\r\n\r\n<ul>\r\n	<li>Lower respiratory tract infections</li>\r\n	<li>Acute Bacterial Otitis Media</li>\r\n	<li>Skin and skin structure infections</li>\r\n	<li>Urinary tract infections</li>\r\n	<li>Gonorrhea</li>\r\n	<li>Bacterial Septicemia</li>\r\n	<li>Bone and joint infections</li>\r\n	<li>Meningitis</li>\r\n	<li>Prevention of postoperative infections</li>\r\n	<li>Perioperative prophylaxis of infections associated with surgery</li>\r\n</ul>', '<p>Ceftriaxone is a 3rd generation broad-spectrum parenteral cephalosporin antibiotic. It has potent bactericidal activity against a wide range of Gram-positive and Gram-negative organisms. Like other cephalosporins and penicillins, Ceftriaxone kills bacteria by interfering with the synthesis of the bacterial cell wall. Ceftriaxone has a high degree of stability in the presence of beta lactamases. A remarkable feature of Ceftriaxone is its relatively long plasma elimination half-life of about 6 to 9 hours, which makes single or once-daily dosage of the drug appropriate for most patients. Ceftriaxone is not metabolized in the body. About 40-65% of a dose of Ceftriaxone is excreted unchanged in the urine; the remainder is excreted in the bile and ultimately found in the feces as unchanged drug and microbiologically inactive compound. The drug is highly protein bound (95%).</p>', '<p><strong>Adult</strong>: The usual dose is 1 to 2 gm by intravenous or intramuscular administration once a day (or in equally divided doses twice a day).</p>\r\n\r\n<ul>\r\n	<li><strong>Pneumonia, Bronchitis, Acute bacterial otitis media, Skin and skin structure infection, Urinary tract infections, Bacterial Septicemia, Bone and joint infections, Meningitis</strong>: 1 to 2 g IV or IM once a day (or in equally divided doses twice a day); Maximum dose: 4 gm/day</li>\r\n	<li><strong>Uncomplicated gonococcal infections</strong>: 250 mg IM as a single dose</li>\r\n	<li><strong>Surgical prophylaxis</strong>: 1 g IV as a single dose 30 to 120 minutes before surgery</li>\r\n</ul>\r\n\r\n<p><strong>Infants and Children (01 month or older)</strong>: The usual dose is 50 to 75 mg/kg intravenous or intramuscular administration once a day (or in equally divided doses twice a day).</p>\r\n\r\n<ul>\r\n	<li><strong>Pneumonia, Bronchitis, Skin and skin structure infection, Urinary tract infections, Bacterial Septicemia, Bone and joint infections</strong>: 50 to 75 mg/kg IV or IM once a day (or in equally divided doses twice a day); Maximum dose: 2 gm/day</li>\r\n	<li><strong>Acute bacterial otitis media</strong>: 50 mg/kg IM in single dose; Maximum dose: 1 gm/day</li>\r\n	<li><strong>Meningitis</strong>: 100 mg/kg IV or IM in single daily dose or (or in equally divided doses twice a day); Maximum dose: 4 gm/day</li>\r\n</ul>\r\n\r\n<p><strong>Duration of therapy</strong>: Continue for more than 2 days after signs and symptoms of infection have disappeared. Usual duration is 4 to 14 days; in complicated infections, longer therapy may be required.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Preparation of Solutions for Intramuscular / Intravenous Injections:</p>\r\n\r\n<ul>\r\n	<li><strong>For Intramuscular Injection</strong>: 250 mg or 500 mg Ceftriaxone should be dissolved in 2 ml Lidocaine HCI 1% injection or 1 g Ceftriaxone in 3.5 ml of Lidocaine HCI 1% injection.</li>\r\n	<li><strong>For Intravenous Injection</strong>: 250 mg or 500 mg Ceftriaxone should be dissolved in 5 ml of Water for injection or 1 g Ceftriaxone in 10 ml of Water for injection USP or 2 g Ceftriaxone in 20 ml of Water for injection.</li>\r\n</ul>\r\n\r\n<p>The injection should be administered over 2-4 minutes, by Intramuscular or Intravenous injection or by tubing infusion over a period of 30 minutes at concentration between 10 mg/mL and 40 mg/mL. Before starting treatment through Ceftriaxone injection, patient tolerance test should be checked by administration of a test dose. (The use of freshly reconstituted solution is recommended. However, it maintains potency for at least 6 hours at room temperature or 24 hours at 5&deg;C).</p>', '<p>No drug interactions have been reported.</p>', '<p>Ceftriaxone should not be given to patients with a history of hypersensitivity to cephalosporin antibiotics.</p>', '<p>Ceftriaxone is generally well tolerated. A few side effects such as gastro-intestinal effects including diarrhea, nausea and vomiting, stomatitis and glossitis; cutaneous reactions including rash, pruritus, urticaria, edema and erythema multiforme; hematologic reactions including eosinophilia, thrombocytopenia, leucopenia, anemia and neutropenia; hepatic reactions including elevations of SGOT or SGPT, bilirubinemia; CNS reactions including nervousness, confusion, sleep disturbances, headache, hyperactivity, convulsion, hypertonia and dizziness were reported. Local phlebitis occurs rarely following intravenous administration but can be minimized by slow injections over 2-4 minutes.</p>', '<p>Its safety in human pregnancy has not been established. Therefore, it should not be used in pregnancy unless absolutely indicated. Low concentrations of Ceftriaxone are excreted in human milk. Caution should be exercised when Ceftriaxone is administered to a lactating mother.</p>', '<p>As with other cephalosporins, anaphylactic shock cannot be ruled out even if a thorough patient history is taken. Anaphylactic shock requires immediate countermeasures such as intravenous epinephrine followed by a glucocorticoid. In rare cases, shadows suggesting sludge have been detected by sonograms of the gallbladder. This condition was reversible on discontinuation or completion of Ceftriaxone therapy. Even if such findings are associated with pain, conservative, nonsurgical management is recommended. During prolonged treatment the blood picture should be checked at regular intervals.</p>', '<p>There is no specific antidote. Treatment of overdosage should be symptomatic.</p>', '<p>Third generation Cephalosporins</p>', '<p>Vial store in a cool, dry place (below 30&deg; C), away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Ceftriaxone must not be given to neonates if the neonates is premature and newborn (up to 28 days of age).</p>', '2022-02-18 19:29:21', '2022-03-27 22:37:00'),
(298, 298, '<p>It is indicated for the treatment of infections caused by sensitive bacteria.</p>\r\n\r\n<ul>\r\n	<li>Pharyngitis/Tonsillitis caused by Streptococcus pyogenes.</li>\r\n	<li>Acute Bacterial Otitis Media caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis (beta-lactamase producing strains) or Streptococcus pyogenes.</li>\r\n	<li>Acute bacterial maxillary sinusitis caused by Streptococcus pneumoniae or Haemophilus influenzae (non beta-lactamase producing strains)</li>\r\n	<li>Lower respiratory tract infections including pneumoniae, caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta lactamase-producing strains), Klebsiella spp., Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains), Streptococcus pyogenes, E. coli</li>\r\n	<li>Acute bacterial exacerbation of chronic bronchitis and Secondary bacterial infections of Acute bronchitis caused by Streptococcus pneumoniae, Haemophilus influenzae (beta-lactamase negative strains) or Haemophilus parainfluenzae (beta-lactamase negative strains).</li>\r\n	<li>Skin and skin-structure infections caused by Staphylococcus aureus (including beta-lactamase producing strains) or Streptococcus pyogenes.</li>\r\n	<li>Urinary tract infections caused by E.coli or Klebsiella pneumoniae.</li>\r\n	<li>Bone and Joint Infections caused by Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains).</li>\r\n	<li>Gonorrhoea caused by penicillinase-producing and non-penicillinase producing strains of Neisseria gonorrhoeae.</li>\r\n	<li>Early Lyme Disease (erythema migrans) caused by Borrelia burgdorferi.</li>\r\n</ul>', '<p>Cefuroxime is a well-characterized and effective antibacterial agent, which has broad-spectrum bactericidal activity against a wide range of common pathogens, including &beta;-lactamase producing strains. Cefuroxime has good stability to bacterial &beta;-lactamase and consequently, is active against many ampicillin-resistant and amoxycillin-resistant strains.</p>', '<p>Tablet or Suspension-</p>\r\n\r\n<p>Adolescents and adults (13 years and older)-</p>\r\n\r\n<ul>\r\n	<li>Pharyngitis/tonsillitis: 250 mg b.i.d. for 5-10 days</li>\r\n	<li>Acute bacterial maxillary sinusitis: 250 mg b.i.d. for 10 days</li>\r\n	<li>Acute bacterial exacerbation of chronic bronchitis: 250-500 mg b.i.d. for 10 days</li>\r\n	<li>Secondary bacterial infections of acute bronchitis: 250-500 mg b.i.d. for 5-10 days</li>\r\n	<li>Uncomplicated skin and skin structure infections: 250-500 mg b.i.d. for 10 days</li>\r\n	<li>Uncomplicated urinary tract infections: 250 mg b.i.d. for 7-10 days</li>\r\n	<li>Uncomplicated Gonorrhoea: 1000 mg Single dose</li>\r\n	<li>Community acquired pneumonia: 250-500 mg b.i.d. for 5-10 days</li>\r\n	<li>MDR Typhoid Fever: 500 mg b.i.d. for 10-14 days</li>\r\n	<li>Early Lyme disease: 500 mg b.i.d. for 20 days</li>\r\n</ul>\r\n\r\n<p>Paediatric Patients (3 months to 12 years)-</p>\r\n\r\n<ul>\r\n	<li>Pharyngitis/Tonsillitis: 20 mg/kg/day b.i.d for 5-10 days</li>\r\n	<li>Acute otitis media: 30 mg/kg/day b.i.d for 10 days</li>\r\n	<li>Acute bacterial maxillary sinusitis: 30 mg/kg/day b.i.d for 10 days</li>\r\n	<li>Impetigo: 30 mg/kg/day b.i.d for 10 days</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Parenteral-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 750 mg three times daily by IM or IV injection. In severe infections, dose can be increased upto 1.5 gm three times daily by IV injection. The frequency may be increased to four times daily, if necessary, giving total daily doses of 3 to 6 gms.</li>\r\n	<li><strong>Children</strong>&nbsp;(above 3 months of age): 30 - 100 mg/kg/day given in 3 or 4 equally divided doses. A dose of 60 mg/kg/day is appropriate for most infections.</li>\r\n	<li><strong>Neonate</strong>: 30 - 100 mg/kg/day given in 2 or 3 equally divided doses.</li>\r\n	<li><strong>Surgical prophylaxis</strong>: 1.5 gm by IV injection at induction of anaesthesia; up to 3 further doses of 750 mg may be given by IV/IM injection every 8 hours for high risk procedures.</li>\r\n	<li><strong>Pneumonia</strong>: 1.5 gm IV injection twice daily for 2-3 days, followed by 500 mg twice daily (oral) for 7-10 days.</li>\r\n	<li><br />\r\n	<strong>Acute exacerbations of chronic bronchitis</strong>: 750 mg twice daily (IM or IV injection) for 2-3 days, followed by 500 mg twice daily (oral) for 5-10 days. (Duration of both parenteral and oral therapy is determined by the severity of the infection and the clinical status of the patient.)</li>\r\n	<li><strong>In Gonorrhoea</strong>: Adult: 1.5 gm as a single dose (as 2 x 750mg injections intramuscularly with different sites, e.g. each buttock).</li>\r\n</ul>\r\n\r\n<p>In Meningitis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 3 gm IV injection three times daily.</li>\r\n	<li><strong>Children</strong>&nbsp;(above 3 months of age): 200-240 mg/kg/day by IV injection in 3 or 4 divided doses reduced to 100 mg/kg/day after 3 days or on clinical improvement.</li>\r\n	<li><strong>Neonate</strong>: 100 mg/kg/day by IV injection at initial dose, reduced to 50 mg/kg/day, When clinically indicated.</li>\r\n</ul>\r\n\r\n<p>In bone and joint infections:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 1.5 gm IV injection four times daily.</li>\r\n	<li><strong>Children</strong>&nbsp;(above 3 months of age): 150 mg/kg/day (not to exceed the maximum adult dose) in equally divided doses every 8 hours.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>The use of freshly reconstituted solution is recommended. However, it maintains potency for at least 24 hours at room temperature or 48 hours at 5o&nbsp;C</p>', '<p>No potentially hazardous interactions have been reported.</p>', '<p>Cefuroxime is contraindicated in patients with known allergy to Cephalosporins.</p>', '<p>Adverse effects to Cefuroxime have occurred infrequently and have been generally mild and transient in nature. Effects reported include rashes and gastrointestinal disturbances. As with other antibiotics, prolonged use may result in the overgrowth of non susceptible organisms e.g. Candida.</p>', '<p>US FDA pregnancy category of Cefuroxime is B. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Cefuroxime have been shown to be excreted in human milk. So, caution should be exercised when Cefuroxime is administered to a nursing woman.</p>', '<p>Cefuroxime should be given with care to patients receiving concurrent treatment with potent diuretics &amp; who has history of colitis. Cephalosporin antibiotics may in general be given safely to patients who are hypersensitive to penicillin although cross reactions have reported. Cefuroxime has shown, that is not likely to be a problem at the recommended to dose levels.</p>', NULL, '<p>Second generation Cephalosporins</p>', '<p>Store in a cool, dry place (below 30o&nbsp;C), away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-18 19:29:39', '2022-03-27 22:40:18'),
(299, 299, '<p>It is indicated for the treatment of infections caused by sensitive bacteria.</p>\r\n\r\n<ul>\r\n	<li>Pharyngitis/Tonsillitis caused by Streptococcus pyogenes.</li>\r\n	<li>Acute Bacterial Otitis Media caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis (beta-lactamase producing strains) or Streptococcus pyogenes.</li>\r\n	<li>Acute bacterial maxillary sinusitis caused by Streptococcus pneumoniae or Haemophilus influenzae (non beta-lactamase producing strains)</li>\r\n	<li>Lower respiratory tract infections including pneumoniae, caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta lactamase-producing strains), Klebsiella spp., Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains), Streptococcus pyogenes, E. coli.</li>\r\n	<li>Acute bacterial exacerbation of chronic bronchitis and secondary bacterial infections of Acute bronchitis caused by Streptococcus pneumoniae, Haemophilus influenzae (beta-lactamase negative strains) or Haemophilus parainfluenzae (beta-lactamase negative strains).</li>\r\n	<li>Uncomplicated skin and skin-structure infections caused by Staphylococcus aureus (including beta-lactamase producing strains) or Streptococcus pyogenes.</li>\r\n	<li>Uncomplicated urinary tract infections caused by E.coli or Klebsiella pneumoniae.</li>\r\n	<li>Bone and Joint Infections caused by Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains).</li>\r\n	<li>Uncomplicated Gonorrhoea caused by penicillinase-producing and non-penicillinase producing strains of Neisseria gonorrhoeae.</li>\r\n	<li>Early Lyme Disease (erythema migrans) caused by Borrelia burgdorferi.</li>\r\n	<li>Septicemia caused by Staphylococcus aureus, Streptococcus pneumoniae, E.coli, Haemophilus influenzae (including ampicillin-resistant strains) &amp; Klebsiella spp.</li>\r\n	<li>Meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae (including ampicillin-resistant strains), Neisseria meningitidis &amp; Staphylococcus aureus (penicillinase and non-penicillinase producing strains)</li>\r\n	<li>Switch therapy (Injectable to oral)</li>\r\n</ul>', '<p>Cefuroxime is a bactericidal second generation cephalosporin antibiotic which is active against a wide range of Gram-positive and Gram-negative susceptible organisms including many beta-lactamase producing strains. Cefuroxime inhibits bacterial cell wall synthesis by interfering with the transpeptidation process.<br />\r\n<br />\r\nClavulanic acid is a naturally derived beta lactamase inhibitor produced by Streptomyces clavuligerus. It has similar structure to beta lactam antibiotics which binds irreversibly to beta-lactamase enzymes and inactivates them. Clavulanic acid gives protection of Cefuroxime from degradation by beta lactamase enzymes and provides a solution for the treatment of bacterial infections caused by beta lactam resistant bacteria.</p>', '<p>Adolescents and adults (13 years and older)-</p>\r\n\r\n<ul>\r\n	<li><strong>Pharyngitis/tonsillitis</strong>: 250 mg b.i.d. for 5-10 days</li>\r\n	<li><strong>Acute bacterial maxillary sinusitis</strong>: 250 mg b.i.d. for 10 days</li>\r\n	<li><strong>Acute bacterial exacerbation of chronic bronchitis</strong>: 250-500 mg b.i.d. for 10 days</li>\r\n	<li><strong>Secondary bacterial infections of acute bronchitis</strong>: 250-500 mg b.i.d. for 5-10 days&nbsp;</li>\r\n	<li><strong>Uncomplicated skin and skin structure infections</strong>: 250-500 mg b.i.d. for 10 days</li>\r\n	<li><strong>Uncomplicated urinary tract infections</strong>: 250 mg b.i.d. for 7-10 days</li>\r\n	<li><strong>Uncomplicated Gonorrhoea</strong>: 1000 mg b.i.d. Single dose</li>\r\n	<li><strong>Community acquired pneumonia</strong>: 250-500 mg b.i.d. for 5-10 days</li>\r\n	<li><strong>MDR Typhoid Fever</strong>: 500 mg b.i.d. for 10-14 days</li>\r\n	<li><strong>Early Lyme disease</strong>: 500 mg b.i.d. for 20 days</li>\r\n</ul>\r\n\r\n<p>Paediatric Patients (3 months to 12 years)-</p>\r\n\r\n<ul>\r\n	<li><strong>Pharyngitis/Tonsillitis</strong>: 20 mg/kg/day b.i.d for 5-10 days</li>\r\n	<li><strong>Acute otitis media</strong>: 30 mg/kg/day b.i.d for 10 days</li>\r\n	<li><strong>Acute bacterial maxillary sinusitis</strong>: 30 mg/kg/day b.i.d for 10 days</li>\r\n	<li><strong>Impetigo</strong>: 30 mg/kg/day b.i.d for 10 days</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>Cefuroxime-Clavulanic Acid tablet may be taken without regard of food.</p>', '<p>Concomitant administration of probenecid with Cefuroxime-Clavulanic Acid increases the area under the serum concentration versus time curve by 50%. Drug that reduces gastric acidity may result in a lower bioavailability of Cefuroxime and tend to cancel the effect of postprandial absorption.</p>', '<p>Cefuroxime-Clavulanic Acid is contraindicated in patients with known allergy to cephalosporin &amp; in patients with Pseudomembranous Colitis.</p>', '<p>Generally Cefuroxime-Clavulanic Acid is well tolerated. However, a few side effects like nausea, vomiting, diarrhea, abdominal discomfort or pain may occur. As with other broad-spectrum antibiotics, prolonged administration of Cefuroxime and Clavulanic acid combination may result in overgrowth of nonsusceptible microorganisms. Rarely (&lt;0.2%) renal dysfunction, anaphylaxis, angioedema, pruritis, rash and serum sickness like urticaria may appear.</p>', '<p>While all antibiotics should be avoided in the first trimester if possible. However, Cefuroxime-Clavulanic Acid can be safely used in later pregnancy to treat urinary and other infections. Cefuroxime-Clavulanic Acid is excreted into the breast milk in small quantities. However, the possibility of sensitizing the infant should be kept in mind.</p>', '<p>Cefuroxime should be given with care to patients receiving concurrent treatment with potent diuretics &amp; who has history of colitis.</p>', NULL, '<p>Second generation Cephalosporins</p>', '<p>Store in a cool, dry place (below 30o&nbsp;C), away from light and moisture. Keep out of the reach of children.</p>', NULL, '2022-02-18 19:30:08', '2022-03-27 22:44:06'),
(300, 300, '<p>Celecoxib is indicated-</p>\r\n\r\n<ul>\r\n	<li>For the relief of the signs and symptoms of osteoarthritis.</li>\r\n	<li>For the relief of the signs and symptoms of rheumatoid arthritis.</li>\r\n	<li>For the regression and prevention of colorectal adenomatous polyps in patients with familial adenomatous polyposis (FAP).</li>\r\n</ul>', '<p>Celecoxib is a selective cyclooxygenase-2 (COX-2) inhibitor, non-steroidal anti-inflammatory drug (NSAID). It exhibits anti-inflammatory, analgesic and antipyretic properties. The mechanism of action of Celecoxib is believed to be due to the inhibition of prostaglandin synthesis, via the inhibition of cyclooxygenase-2 (COX-2) enzyme. At therapeutic concentration, Celecoxib does not inhibit cyclooxygenase-1 (COX-1) isoenzyme.</p>', '<p><strong>Osteoarthritis</strong>: The recommended oral dose is 200 mg per day administered as a single dose or as 100 mg twice daily.<br />\r\n<br />\r\n<strong>Rheumatoid arthritis</strong>: The recommended oral dose is 100 to 200 mg twice daily.<br />\r\n<br />\r\n<strong>Familial adenomatous polyposis (FAP)</strong>: Usual medical care for FAP patients should be continued while on Celecoxib. To reduce the number of adenomatous colorectal polyps in patients with FAP, the recommended oral dose is 400 mg (2x200 mg capsules) twice daily to be taken with food.</p>', '<p><strong>ACE inhibitors</strong>: Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE inhibitors. This interaction should be given into consideration in patients taking Celecoxib concomitantly with ACE inhibitors.<br />\r\n<br />\r\n<strong>Frusemide</strong>: NSAIDs can reduce the natriuretic effect of Frusemide and thiazides in some patients.<br />\r\n<br />\r\n<strong>Aspirin</strong>: Celecoxib can be used with low dose Aspirin. However, concomitant administration of Aspirin with Celecoxib may result in an increased rate of gastrointestinal ulceration or similar complications, compared to the use of Celecoxib alone.<br />\r\n<br />\r\n<strong>Fluconazole</strong>: Concomitant administration of Fluconazole at 200 mg qid resulted in a two fold increase in Celecoxib plasma concentration. Celecoxib should be introduced at the lowest recommended dose in patients receiving Fluconazole.<br />\r\n<br />\r\n<strong>Lithium</strong>: Patients on Lithium treatment should be closely monitored when Celecoxib is introduced or withdrawn.<br />\r\n<br />\r\n<strong>Warfarin</strong>: Caution should be used when administering Celecoxib with Warfarin since these patients are at increased risk of bleeding complications.<br />\r\n<br />\r\nCo-administration of Celecoxib with aluminium and magnesium-containing&nbsp;antacid should be avoided, because they may reduce the amount of Celecoxib that the body absorbs.</p>', '<p>Celecoxib is contraindicated in patients with known hypersensitivity to Celecoxib. It should not be given to patients who have demonstrated allergic type reactions to Sulphonamides (Celecoxib contains a sulphonamide side chain). Celecoxib should not be given to patients who have demonstrated asthma, urticaria or allergic type reactions after taking Aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic like reactions to NSAIDs have been reported in such patients.</p>', '<p>Adverse events occurring in &ge;2% of patients at recommended doses - Abdominal pain 4.1%, diarrhoea 5.6%, dyspepsia 8.8%, flatulence 2.2%, nausea 3.5%, back pain 2.8%, peripheral oedema 2.1%, accidental injury 2.9%, dizziness 2.0%, headache 15.8%, insomnia 2.3%, pharyngitis 2.3%, rhinitis 2.0%, sinusitis 5.0%, upper respiratory tract infections 8.1%, rash 2.2%. The following adverse events occurred in 0.1-1.9% of patients-</p>\r\n\r\n<ul>\r\n	<li><strong>General</strong>: Allergy aggravated, allergic reaction, asthenia, chest pain, oedema generalised, face oedema, fatigue, fever, hot flushes, influenza like symptoms, pain, peripheral pain.</li>\r\n	<li><strong>Gastrointestinal</strong>: Constipation, diverticulitis, dysphagia, oesophagitis, gastritis, gastroenteritis, gastro-oesophageal reflux disease, haemorrhoids, hiatal hernia, melaena, dry mouth, stomatitis, tenesmus, tooth disorder, vomiting.</li>\r\n	<li><strong>Cardiovascular</strong>: Aggravated hypertension, angina pectoris, coronary artery disease, myocardial infarction.</li>\r\n	<li><strong>Nervous system</strong>: Leg cramps, hypertonia, hypoesthesia, migraine, neuralgia, neuropathy, paresthesia, vertigo. Female reproductive system : Breast fibroadenosis, breast neoplasm, breast pain, dysmenorrhoea, menstrual disorder, menorrhagia, vaginitis.</li>\r\n	<li><strong>Male reproductive system</strong>: Prostatic disorder.</li>\r\n	<li><strong>Resistance mechanism disorders</strong>: Herpes simplex, herpes zoster, bacterial infection, fungal infection, infection of soft tissue, viral infection, moniliasis, moniliasis genital, otitis media.</li>\r\n	<li><strong>Hearing and vestibular</strong>: Deafness, ear abnormality, earache, tinnitus.</li>\r\n	<li><strong>Heart rate and rhythm</strong>: Palpitation, tachycardia.</li>\r\n	<li><strong>Respiratory</strong>: Bronchitis, bronchospasm, bronchospasm aggravated, coughing, dyspnoea, laryngitis, pneumonia.</li>\r\n	<li><strong>Liver and biliary system</strong>: Peptic function abnormal, increased AST and ALT.</li>\r\n	<li><strong>Musculoskeletal</strong>: Arthralgia, arthrosis, accidental fracture, myalgia, neck stiffness, synovitis, tendinitis.</li>\r\n	<li><strong>Urinary system</strong>: Albuminuria, cystitis, dysuria, haematuria, micturition frequency, renal calculus, urinary incontinence, urinary tract infection.</li>\r\n	<li><strong>Metabolic and nutritiona</strong>l: Blood urea nitrogen (BUN), CPK, creatinine, alkaline phosphatase, are increased. Hypercholesterolaemia, hyperglycaemia, hypokalaemia. Bodyweight is also increased.</li>\r\n	<li><strong>Psychiatric</strong>: Anorexia, anxiety, increased appetite, depression, nervousness, somnolence.</li>\r\n	<li><strong>Haemic</strong>: Anaemia, ecchymosis, epistaxis, thrombocythaemia.</li>\r\n	<li><strong>Skin and appendages</strong>: Alopecia, dermatitis, photosensitivity reaction, pruritus, rash erythematous, rash maculopapular, skin disorder, dry skin, increased sweating, urticaria.</li>\r\n	<li><strong>Application site disorders</strong>: Cellulitis, contact dermatitis, skin nodule.</li>\r\n	<li><strong>Special sense</strong>s: Taste perversion.</li>\r\n	<li><strong>Vision</strong>: Blurred vision, cataract, conjunctivitis, eye pain, glaucoma.</li>\r\n</ul>', '<p>Celecoxib should be used during pregnancy only if the potential benefit justifies the potential risk to fetus. But in late pregnancy Celecoxib should be avoided because it may cause premature closure of ductus arteriosus. It is not known whether Celecoxib is excreted in human milk. Because many drugs are excreted in human milk and because of potential for serious adverse reactions in nursing infants from Celecoxib, 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>Celecoxib, at doses up to 200 mg bid, can be administered without regard to timing of meal. Higher doses (400 mg bid) should be administered with food.</p>', '<p>Patients should be managed by symptomatic and supportive care following an NSAID overdose. There are no specific antidotes. No information is available regarding the removal of Celecoxib by hemodialysis but based on its high degree of plasma protein binding (&gt;97%) dialysis is unlikely to be useful in overdose. Emesis and/or activated charcoal and/or osmotic cathartic may be indicated in patients seen within 4 hours of ingestion with symptoms or following a large overdose. Forced diuresis, alkalinization of urine, hemodialysis or hemoperfusion may not be useful due to high protein binding.</p>', '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Geriatric</strong>: Dose adjustment in the elderly is not generally necessary. However, for patients of less than 50 kg in body weight, initiate therapy at the lowest recommended dose.<br />\r\n<br />\r\n<strong>Paediatric</strong>: The safety and efficacy of Celecoxib is not established in pediatric patients.<br />\r\n<br />\r\n<strong>Hepatic insufficiency</strong>: Celecoxib capsules should be introduced at a reduced dose in patients with moderate hepatic impairment. The use of Celecoxib in patients with severe hepatic impairment is not recommended.</p>', '2022-02-18 19:30:26', '2022-03-27 22:47:58'),
(301, 301, '<p>Celiprolol Hydrochloride belongs to a group of medicines called beta-blockers. It works by slowing your heart rate or lowering your blood pressure. It is used to treat high blood pressure (hypertension).</p>', '<p>Celiprolol is a vasoactive beta-1 selective adrenoceptor antagonist with partial beta-2 agonist activity. The beta-2 agonist activity is thought to account for its mild vasodilating properties. It lowers blood pressure in hypertensive patients at rest and on exercise. The effects on heart rate and cardiac output are dependent on the pre-existing background level of sympathetic tone. Under conditions of stress such as exercise, celiprolol attenuates chronotropic and inotropic responses to sympathetic stimulation. However, at rest minimal impairment of cardiac function is seen.</p>', '<p><strong>Adults including the elderly</strong>: the recommended starting dose is 200 mg of Celiprolol Hydrochloride once a day. If needed after 2 to 4 weeks, your doctor will increase your dose to 400 mg once a day. The maximum dose is 400 mg once a day. If you have the impression that the effect of Celiprolol Hydrochloride tablets is too strong or too weak, talk to your doctor or pharmacist.<br />\r\n<br />\r\n<strong>Adults with liver or kidney problems</strong>: if you have kidney problems, your doctor may give you a lower dose than stated above and increase it as needed. A reduction in dosage by half may be appropriate in patients with moderate impairment of kidney function (creatinine clearance in the range of 15-40 ml per minute). Celiprolol Hydrochloride is not recommended for patients with severely impaired kidney function (creatinine clearance less than 15 ml per minute). Use of low doses of Celiprolol Hydrochloride is recommended in patients with liver problems.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Always take this medicine exactly as your doctor has told you. Swallow the tablets whole with a glass of water. Take the tablets preferably first thing in the morning, one hour before food or two hours after food. To help you remember to take your medicine, try to get into the habit of taking it at the same time each day, preferably first thing in the morning.</p>', NULL, '<p>Do not take Celiprolol Hydrochloride if you:</p>\r\n\r\n<ul>\r\n	<li>are allergic to celiprolol hydrochloride or any of the ingredients of this medicine. Signs of an allergic reaction include: a rash, swallowing or breathing problems, swelling of your lips, face, throat or tongue</li>\r\n	<li>have suffered an allergic reaction to a beta-blocker (propranolol, sotalol, timolol etc.) in the past</li>\r\n	<li>suffer from an irregular/very slow heartbeat (known as bradycardia) or low blood pressure (hypotension)</li>\r\n	<li>suffer from heart failure which is not under control (heart failure is a condition in which your heart is not pumping blood as well as it should), have an abnormal heart rhythm, difficulty breathing and swollen ankles</li>\r\n	<li>suffer from missed heart beats (heart block) or other heart problems or you suffer from hardened arteries</li>\r\n	<li>have severe kidney problems</li>\r\n	<li>have, or have had, episodes of asthma, wheezing or other severe breathing problems</li>\r\n	<li>have a rare tumour called a phaeochromocytoma that is not being treated</li>\r\n	<li>have abnormal levels of acid in your blood (metabolic acidosis), usually as a result of severe illness</li>\r\n	<li>are already taking theophylline (an anti-asthma medicine).</li>\r\n	<li>have late stage peripheral arterial occlusive disease or Raynaud&rsquo;s syndrome.</li>\r\n</ul>', '<p><strong>Serious side effects</strong>: Allergic reaction: a rash, swallowing or breathing problems, swelling of your face, lips, throat or tongue. You get flu like symptoms, swollen or painful joints, increased sensitivity to sunlight, hair loss, abdominal pain, anaemia. This may mean you have a condition called Systemic Lupus Erythematosus (SLE). These symptoms will usually go away after Celiprolol Hydrochloride has been stopped. These are very serious side effects. If you have them you may have had a serious allergic reaction to Celiprolol Hydrochloride. You may need urgent medical attention or hospitalization.<br />\r\n<br />\r\n<strong>Common side effects</strong>&nbsp;(may affect up to 1 in 10 people): Dizziness or light headedness, weakness, or fainting especially when standing up from a lying position. These could be signs of low blood pressure.&nbsp;Skin rashes, excessive itching</p>', '<p>If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advise before taking this medicine. If your doctor cannot find any safer alternative you may be given Celiprolol Hydrochloride. If you take Celiprolol Hydrochloride during pregnancy, you should tell your midwife. In the new born of the treated mother, activity of these kind of medicines remains for several days. The effects can include slow heart beat, heart failure or having trouble breathing. Therefore close monitoring of the neonate is recommended for the first 3 to 5 days of life. If you are already taking Celiprolol Hydrochloride and have just found out you are pregnant, you should talk to your doctor immediately. You should not breast-feed if you are taking Celiprolol Hydrochloride. If you are breast-feeding or planning to breast-feed you should talk to your doctor or pharmacist before taking this medicine.</p>', '<p>Take special care and consult your doctor before taking Celiprolol Hydrochloride if you:</p>\r\n\r\n<ul>\r\n	<li>have liver or kidney problems</li>\r\n	<li>have Prinzmetal&rsquo;s angina (chest pain while resting)</li>\r\n	<li>have poor blood circulation e.g. Raynaud&rsquo;s, Burger&rsquo;s Disease. Symptoms of Raynaud&rsquo;s disease include fingers and toes changing colour when cold and tingling or painful on warming up. Your doctor will closely monitor you while taking this medicine.</li>\r\n	<li>have inadequate circulation of blood through the coronary arteries.</li>\r\n	<li>have ever had a skin condition known as psoriasis. Your doctor will stop this medicine if you have.</li>\r\n	<li>have asthma or breathing problems due to long term lung problems (called bronchitis or emphysema)</li>\r\n	<li>have a thyroid problem as the effects of an overactive thyroid gland (thyrotoxicosis) may be hidden by beta blocker medicine</li>\r\n	<li>have a history of severe allergies, particularly to other medicines, including anaphylactic reactions</li>\r\n	<li>need anti-allergic treatment eg. following a wasp or bee sting; your doctor may wish to interupt your Celiprolol Hydrochloride treatment to prevent a possible allergic reaction.</li>\r\n	<li>are diabetic. Patients with diabetes should be aware that the symptoms of low blood pressure (hypoglycaemia) may be hidden by beta blocker medicines</li>\r\n	<li>have any heart failure that is under control with medication. Your doctor will give this medicine under strict medical surveillance</li>\r\n	<li>have a slow or irregular heartbeat.</li>\r\n</ul>', '<p>You may have symptoms such as slow heart beats, low blood pressure, feeling dizzy or weak, difficulty in breathing, wheezing or heart problems. Contact your doctor or go to the nearest hospital causalty department immediately. Take this leaflet or some tablets with you so your doctor will know what you have taken.</p>', '<p>Beta-blockers</p>', '<p>Keep container in the outer carton. Do not store above 25&deg;C. Do not use this medicine after the expiry date which is stated on the carton. The expiry date refers to the last day of that month. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.</p>', '<p><strong>Use in children</strong>: Celiprolol Hydrochloride is not recommended for use in children.<br />\r\n<br />\r\n<strong>Use in elderly</strong>: Your doctor may decide to lower your dose of Celiprolol Hydrochloride if necessary.</p>', '2022-02-18 19:30:46', '2022-03-28 20:49:33'),
(302, 302, '<p>Cephalexin is indicated for the treatment of the following infections when caused by susceptible organisms.</p>\r\n\r\n<ul>\r\n	<li><strong>Respiratory tract infections</strong>: Acute and chronic bronchitis and infected bronchiectasis.</li>\r\n	<li><strong>Genito-urinary tract infections</strong>: Acute and chronic nephritis, cystitis, urethritis and prostatitis, prophylaxis of recurrent urinary tract infections.</li>\r\n	<li><strong>Skin and soft tissue infections</strong>: Caused by staphylococci and/or streptococci.</li>\r\n	<li><strong>Ear, Nose and Throat infections</strong>: Otitis media, mastoiditis, sinusitis, follicular tonsillitis and pharyngitis.</li>\r\n	<li><strong>Bone infections</strong>: Caused by staphylococci and/or P. mirabilis.</li>\r\n</ul>', '<p>Cephalexin is a semisynthetic analogue of Cephalosporin C. It kills bacteria by interfering in the synthesis of the bacterial cell wall. Peptidoglycan is a heteropolymeric structure that provides the cell wall with mechanical stability. The final stage in the synthesis of peptidoglycan involves the completion of the cross-linking and the terminal glycine residue of the Pentaglycine Bridge is linked to the fourth residue of the pentapeptide (d-alanin). The transpeptidase enzyme that performs this step is inhibited by penicillins and cephalosporins. As a result the bacterial cell wall is weakened, the cell swells and then ruptures. Cephalexin is a first generation cephalosporin that is active by mouth.</p>', '<p><strong>Adult</strong>:</p>\r\n\r\n<ul>\r\n	<li>The usual dose is 250 mg to 500 mg every 6 hour.</li>\r\n	<li>For skin and soft tissue infections, streptococcal pharyngitis and uncomplicated cystitis, in patients over 15 years of age: 500 mg of the drug may be administered every 12 hour.</li>\r\n	<li>In severe or deep seated infections the dose can be increased up to 3 g to 6 g daily.</li>\r\n</ul>\r\n\r\n<p><strong>Children</strong>: The dosage range is 25-100 mg/kg/day in divided doses to a maximum of 4 g daily<br />\r\n<br />\r\nChildren&#39;s Weight Recommended Dose:</p>\r\n\r\n<ul>\r\n	<li><strong>10 kg (22 Ibs)</strong>:&nbsp;62.5 mg to 125 mg qid or 125 mg to 250 mg bid</li>\r\n	<li><strong>20 kg (44 Ibs)</strong>:&nbsp;125 mg to 250 mg qid or 250 mg to 500 mg bid</li>\r\n	<li><strong>40 kg (88 Ibs)</strong>:&nbsp;250 mg to 500 mg qid or 500 mg to 1 g bid</li>\r\n</ul>\r\n\r\n<p>For streptococcal pharyngitis, skin and soft tissue infections and in patients over 1 year of age the total daily dose may be divided and administered every 12 hour. In the therapy of otitis media 75-100 mg/kg/day in four divided doses may be required. In the treatment of &beta; haemolytic streptococcal infections a therapeutic dosage of the drug should be given at least for 10 days.</p>', NULL, '<p>Cephalen is contraindicated in patients with known hypersensitivity to the cephalosporin group of antibiotics.</p>', '<p>Side effects include nausea, vomiting, diarrhoea and abdominal discomfort. Symptoms of pseudomembranous colitis may appear either during or after antibiotic treatment. Skin rash, angio oedema, rise in serum aminotransferases, eosinophilia, neutropenia have been reported very rarely. Superinfection with resistant micro organisms, particularly candida may follow the treatment</p>', '<p>Pregnancy&nbsp;Category B.&nbsp;Cefalexin may be used during pregnancy when it is considered essential. Cefalexin is found in the milk of nursing mothers, hence caution should be taken when it is administered to nursing mothers.</p>', '<p>Cefalexin should be given with caution in patients with renal impairment. Under such condition, careful clinical observation should be made because safe dosage may be lower than the usually recommended. The urine of patients receiving Cefalexin may give a false positive reaction for glucose with copper reduction reagent. Positive results to Coombs&rsquo; test have been reported. Although there is no evidence of teratogenicity in animal tests, Cefalexin may be used during pregnancy when it is considered essential. Cefalexin is found in the milk of nursing mothers, hence caution should be taken when it is administered to nursing mothers.</p>', NULL, '<p>First generation Cephalosporins</p>', '<p>Should be stored in cool and dry place.</p>', NULL, '2022-02-18 19:30:59', '2022-03-28 20:51:27');
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
(303, 303, '<p>Cephradine is indicated for the treatment of infections caused by sensitive Gram-positive and Gram-negative bacteria. These include-</p>\r\n\r\n<ul>\r\n	<li><strong>Undesirable Upper respiratory tract infections</strong>: sinusitis, pharyngitis, tonsillitis, laryngo-tracheo bronchitis and otitis media, and also</li>\r\n	<li><strong>Lower respiratory tract infections</strong>: bronchitis (acute and chronic), lobar pneumonia and bronchopneumonia.</li>\r\n	<li><strong>Urinary tract infections</strong>: cystitis, urethritis and pyelonephritis.</li>\r\n	<li><strong>Skin and soft tissue infections</strong>: abscess, cellulitis, furunculosis and impetigo.</li>\r\n</ul>\r\n\r\n<p>The following microorganisms are susceptible, in vitro to Cephradine:</p>\r\n\r\n<ul>\r\n	<li><strong>Gram-positive</strong>: Staphylococci (both penicillin sensitive and resistant strains and penicillinase-producing species), Streptococci, Streptococci pyogenes (beta haemolytic), Streptococcus pneumonia.</li>\r\n	<li><strong>Gram-negative</strong>: Escherichia coli, Klebsiella spp, Proteus mirabilis, Haemophilus influenza, Shigella spp, Salmonella spp (including Salmonella typhi), Neisseria spp Many strains of E.coli and Staphylococcus aureus that produce the enzyme penicillinase and thus are ampicillin resistant, are susceptible to Cephradine which is unaffected by this enzyme.</li>\r\n</ul>', '<p>Cephradine is a semisynthetic broad spectrum bactericidal antibiotic, it is active against infections caused by both gram-positive and gram-negative microorganisms. Both penicillinase producing and nonproducing staphylococci are sensitive to Cephradine. The main site of action of Cephradine is the cell wall of bacteria. Cell wall of sensitive organism contains peptidoglycan. Cephradine inhibits cross-linking process and as a result cell wall with many pores are formed, thus lysis of bacteria occur due to external osmotic pressure.</p>', '<p><strong>For oral administration</strong>-<br />\r\nAdults:</p>\r\n\r\n<ul>\r\n	<li>Urinary tract infections: 500mg four times daily or 1g twice daily. Infections which are severe or chronic may necessitate the administration of higher doses. Where complications arise including prostatitis and epididymitis continued intensive treatment is required.</li>\r\n	<li>Respiratory tract infections: 250 to 500mg four times daily or 500mg to 1g twice daily, dependent on the site and severity of the infection.</li>\r\n	<li>Skin and soft tissue infections: 250 to 500mg four times daily or 500mg to 1g twice daily, again dependent on the site and severity of the infection.</li>\r\n</ul>\r\n\r\n<p>Children:</p>\r\n\r\n<ul>\r\n	<li>Total daily dose of 25 to 50mg/kg given in two or four equally divided doses.</li>\r\n	<li>Otitis media: Total daily dose of 75 to 100mg/kg given in divided doses 6 to 12 hourly.</li>\r\n	<li>Maximum daily dosage: 4 gm</li>\r\n</ul>\r\n\r\n<p>Elderly: The normal adult dose is appropriate. Patients with impaired renal or hepatic function should be monitored during treatment.<br />\r\n<br />\r\n<strong>For injectable administration</strong>-</p>\r\n\r\n<ul>\r\n	<li>Adult: The usual dose is 2-4 gm daily in four equally divided doses up to 8 gm daily. For prophylaxis a single preoperative dose of 1-2 gm intramuscularly or intravenously is given.</li>\r\n	<li>Children: The dose is 50-100 mg/kg daily in four equally divided doses, up to 300 mg/kg daily in severe infection.</li>\r\n</ul>', '<p>The concomitant use of nephrotoxic drugs such as aminoglycosides with Cefradine may increase the risk of kidney damage. Diuretics (e.g. frusemide, ethacrynic acid) and probenecid enhanced the possibility of renal toxicity.</p>', '<p>Cephradine should not be used in patients with known or suspected hypersensitivity to cephalosporins.</p>', '<p>Limited essentially to gastro-intestinal disturbances and on occasions to hypersensitivity phenomena. The latter are more likely to occur in individuals, who have previously demonstrated hypersensitivity and thos with a history of allergy, asthma, hay fever or urticaria. Skin reactions have occasionally been reported. Rare- Glossitis, heartburn, dizziness, tightness in the chest, nausea, vomiting, diarrhoea, abdominal pain, vaginitis, candida overgrowth. Skin and hypersensitivity reactions include urticaria, skin rashes, joint pains, oedema.</p>\r\n\r\n<ul>\r\n	<li>Blood and lymphatic system disorders- Unknown: blood disorders (including thrombocytopenia, leucopenia, agranulocytosis, aplastic anaemia and haemolytic anaemia)</li>\r\n	<li>Immune system disorders- Unknown: Fever, serum sickness like reactions, anaphylaxis</li>\r\n	<li>Psychiatric disorders- Unknown: Confusion, sleep disturbances</li>\r\n	<li>Nervous system disorders- Unknown: hyperactivity, hypertonia, dizziness, nervousness; Rarely: Headache</li>\r\n	<li>Hepatobiliary disorders- Frequency unknown: Liver, enzyme disturbances, transient hepatitis, cholestatic jaundice</li>\r\n	<li>Renal and urinary disorders- Unknown: Reversible interstitial nephritis</li>\r\n	<li>Investigations- Unknown: Elevation of blood urea nitrogen, serum creatinine, alanine aminotransferase, aspartate aminotransferase, total bilirubin, alkaline phosphatase.</li>\r\n</ul>', '<p>Although animal studies have not demonstrated any teratogenicity, safety in pregnancy has not been established. Cephradine is excreted in breast milk and should be used with caution in lactating mothers. Since the medicine may cause dizziness, patients should be cautioned about operating hazardous machinery, including automobiles.</p>', '<ul>\r\n	<li>Prolonged use of an anti-infective may result in the development of superinfection due to the emergence of resistant organisms.</li>\r\n	<li>Cephradine should be administered with care to patients hypersensitive to penicillins because of the risk of cross-sensitivity between beta-lactam antibiotics.</li>\r\n	<li>Cephalosporin antibiotics may cause a positive result in Coombs&rsquo; testing. When Coombs testing is performed on neonates whose mothers received cephalosporins prior to labour, it should be noted that a positive result may be due to the drug.</li>\r\n	<li>Cephradine may cause a false positive urine glucose result when Benedict&rsquo;s or Fehling&rsquo;s solutions or tablets such as Clinitest are used in the testing. This does not occur with enzyme-based&nbsp;tests (e.g. Clinistix, Diastix).</li>\r\n	<li>Dosage adjustment is necessary in renal impairment.</li>\r\n	<li>This product contains lactose. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.</li>\r\n</ul>', '<p>The symptoms of Sefrad overdose are non-specific and are generally nausea, vomiting, diarrhoea and gastric upsets. Treatment is mainly supportive although gastric lavage will be necessary if a large amount has been ingested.</p>', '<p>First generation Cephalosporins</p>', '<p>Cephradine Suspension should be freshly prepared. Reconstituted Suspension should be used within 7 days if kept at room temperature or within 14 days, if kept in a refrigerator. Cephradine Injection solutions should be used within 2 hours when kept at room temperature. When stored at 5&deg;C, solutions retain potency for 12 hours. Reconstituted solutions may vary in colour from light to straw yellow; however, this does not affect the potency. Do not use later than the date of expiry. Keep all medicines out of the reach of children. To be dispensed only on the prescription of a registered physician</p>', '<p>Renal Impairment: The following doses are recommended (based on 500 mg every 6 hours) for patients not on haemodialysis:</p>\r\n\r\n<ul>\r\n	<li>CrCl: &gt;20 ml/min: 500 mg every 6 hours</li>\r\n	<li>CrCl: 5-20 ml/min: 250 mg every 6 hours</li>\r\n	<li>CrCl: &lt;5 ml/min: 250 mg every 50-70 hours.</li>\r\n</ul>\r\n\r\n<p>Recommendations for patients on chronic, intermittent haemodialysis:</p>\r\n\r\n<ul>\r\n	<li>250 mg at the start of haemodialysis</li>\r\n	<li>250 mg 6 to 12 hours after the start</li>\r\n	<li>250 mg 36 to 48 hours after the start</li>\r\n	<li>250 mg at the start of the next haemodialysis session if more than 30 hours have elapsed since the last dose.</li>\r\n</ul>\r\n\r\n<p>Additional Information for all patients Regardless of patient age or weight, higher doses of up to 1 gm four times daily may be required for infections which are chronic or severe. Treatment should continue for at least 2 to 3 days after symptoms have resolved or bacteria have been eradicated. To reduce the possibility of rheumatic fever or glomerulonephritis resulting from infections with haemolytic streptococci, treatment should be continued for at least 10 days. Throughout treatment of chronic urinary tract infections and for several months thereafter, regular bacteriological and clinical monitoring is required.<br />\r\n<br />\r\nDoses below those recommended above should not be prescribed. Paediatric dosages should not exceed those specified for adults, regardless of severity of infection. It may be necessary to continue Cephradine therapy for several weeks in persistent infections. Patients may be transferred from intramuscular/intravenous Cephradine therapy to oral treatment at the same dosage level.</p>', '2022-02-18 19:31:14', '2022-03-28 20:55:08'),
(304, 304, '<p>Ceritinib is indicated for the treatment of adult patients with metastatic non-small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK)-positive as detected by an FDA-approved test.</p>', '<p>Ceritinib is a kinase inhibitor. Targets of Ceritinib inhibition identified in either biochemical or cellular assays at clinically relevant concentrations include ALK, insulin- like growth factor 1 receptor (IGF-1R), insulin receptor (InsR), and ROS1. Among these, Ceritinib is most active against ALK. Ceritinib inhibited autophosphorylation of ALK, ALK-mediated phosphorylation of the downstream signaling protein STAT3, and proliferation of ALK dependent cancer cells in in vitro and in vivo assays.<br />\r\n<br />\r\n<strong>Absorption</strong>: After a single oral administration of Ceritinib in patients, peak plasma levels (Cmax) of Ceritinib were achieved at approximately 4 to 6 hours, and AUC and C max increased dose proportionally over 50 to 750 mg under fasted conditions. The absolute bioavailability of Ceritinib has not been determined.<br />\r\n<br />\r\n<strong>Distribution</strong>: Ceritinib is 97% bound to human plasma proteins, independent of drug concentration. The apparent volume of distribution is 4230 L following a single 750 mg fasted Ceritinib dose in patients. Ceritinib also has a slight preferential distribution to red blood cells, relative to plasma, with a mean in vitro blood-to-plasma ratio of 1.35.<br />\r\n<br />\r\n<strong>Elimination</strong>: Following a single 750 mg fasted Ceritinib dose, the geometric mean apparent plasma terminal half life (t&frac12;) of Ceritinib was 41 hours in patients. Ceritinib demonstrates nonlinear PK over time. The geometric mean apparent clearance of Ceritinib was lower at steady-state (33.2 L/h) after 750 mg daily dosing than after a single 750 mg dose (88.5 L/h).<br />\r\n<br />\r\n<strong>Metabolism</strong>: In vitro studies demonstrated that CYP3A was the major enzyme involved in the metabolic clearance of Ceritinib. Following oral administration of a single 750 mg radiolabeled Ceritinib dose under fasted conditions, Ceritinib as the parent compound was the main circulating component (82%) in human plasma.<br />\r\n<br />\r\n<strong>Excretion</strong>: Following oral administration of a single 750 mg radiolabeled Ceritinib dose under fasted conditions, 92.3% of the administered dose was recovered in the feces (with 68% as unchanged parent compound) while 1.3% of the administered dose was recovered in the urine.</p>', '<p>Patients should be selected for treatment of metastatic NSCLC with Ceritinib based on the presence of ALK positivity in tumor specimens. The recommended dose of Ceritinib is 450 mg orally once daily with food until disease progression or unacceptable toxicity. If a dose of Ceritinib is missed, that dose should be made up unless the next dose is due within 12 hours. If vomiting occurs during the course of treatment, an additional dose should not be administered and the next scheduled dose of Ceritinib should be continued. Or, as directed by the registered physician.</p>', '<p><strong>Effect of Other Drugs on Ceritinib</strong>: Strong CYP3A Inhibitors: A strong CYP3A4/P-gp inhibitor (ketoconazole) increased the systemic exposure of Ceritinib so it should be avoided. If concomitant use of strong CYP3A inhibitors including certain antivirals (e.g., ritonavir), macrolide antibiotics (e.g., telithromycin), antifungals (e.g., ketoconazole), and nefazodone is unavoidable, the Ceritinib dose should be reduced by approximately one third, rounded to the nearest multiple of the 150 mg dosage strength. After discontinuation of a strong CYP3A inhibitor, the Ceritinib dose should be resumed that was taken prior to initiating the strong CYP3A inhibitor. Grapefruit and grapefruit juice should not be consumed as they may inhibit CYP3A.<br />\r\n<br />\r\n<strong>Strong CYP3A Inducers</strong>: A strong CYP3A4/P-gp inducer (Rifampin) decreased the systemic exposure of Ceritinib. Concurrent use of strong CYP3A inducers (e.g., Carbamazepine, Phenytoin, Rifampin, and St. John&#39;s Wort) should be avoided during treatment with Ceritinib.<br />\r\n<br />\r\n<strong>Effect of Ceritinib on Other Drugs</strong>: CYP3A Substrates: Ceritinib increased the systemic exposure of a sensitive CYP3A substrate (Midazolam) so it should be avoided. If concomitant use is unavoidable, dose reduction of the sensitive CYP3A substrates should be considered. If Ceritinib is coadministered with other CYP3A substrates, it should be referred to the CYP3A substrate labeling for dosage recommendation with strong CYP3A inhibitors.<br />\r\n<br />\r\n<strong>CYP2C9 Substrates</strong>: Ceritinib increased the systemic exposure of a CYP2C9 substrate (Warfarin). The frequency of INR monitoring should be increased if coadministration with warfarin is unavoidable as the anti-coagulant effect of Warfarin may be enhanced. Coadministration of Ceritinib should be avoided with CYP2C9 substrates for which minimal concentration changes may lead to serious toxicities. If concomitant use of such CYP2C9 substrates is unavoidable, dose reduction should be considered for the coadministered CYP2C9 substrates.</p>', '<p>It is contraindicated in patients with known hypersensitivity to Ceritinib or any other components of this product.</p>', '<p>&nbsp;</p>\r\n\r\n<ul>\r\n	<li>Gastrointestinal Adverse Reactions</li>\r\n	<li>Hepatotoxicity</li>\r\n	<li>Interstitial Lung Disease/Pneumonitis</li>\r\n	<li>QT Interval Prolongation</li>\r\n	<li>Hyperglycemia</li>\r\n	<li>Bradycardia</li>\r\n	<li>Pancreatitis</li>\r\n</ul>', '<p>Ceritinib can cause fetal harm when administered to a pregnant woman. If it is used during pregnancy or if the patient becomes pregnant while taking it, the patient should be apprised of the potential hazard to the fetus. There are no data regarding the presence of Ceritinib or its metabolites in human milk, the effects of Ceritinib on the breastfed infant, or its effects on milk production. Because of the potential for serious adverse reactions including gastrointestinal adverse reactions, hepatotoxicity, pneumonitis, bradycardia and pancreatitis, a woman should be advised not to breastfeed during treatment with Cerinib and for 2 weeks following completion of therapy.</p>', '<p><strong>Gastrointestinal Adverse Reactions</strong>: Severe gastrointestinal toxicity occurred in patients treated with Ceritinib 750 mg under fasted conditions. Diarrhea, nausea, vomiting, or abdominal pain occurred in 95% of 925 patients, including severe cases (Grade 3 or 4) in 14% of patients treated with Ceritinib across clinical studies. Diarrhea, nausea, vomiting, or abdominal pain leading to dose interruptions or reductions occurred in 36% of patients and leading to treatment discontinuation occurred in 1.6% of patients. Patients should be monitored and managed using standards of care, including antidiarrheals, antiemetics, or fluid replacement, as indicated. Based on the severity of the adverse drug reaction, Ceritinib should be withheld with resumption at a reduced dose.<br />\r\n<br />\r\n<strong>Hepatotoxicity</strong>: Drug-induced hepatotoxicity occurred in patients treated with Ceritinib. Elevations in alanine aminotransferase (ALT) greater than 5 times the upper limit of normal (ULN) occurred in 28% and elevations in aspartate aminotransferase (AST) greater than 5 times ULN occurred in 16% of 925 patients across clinical studies. Concurrent elevations in ALT greater than 3 times the ULN and total bilirubin greater than 2 times the ULN, with alkaline phosphatase less than 2 times the ULN occurred in 0.3% of patients across clinical studies. Approximately 1.0% of patients required permanent discontinuation due to hepatotoxicity. It should be monitor with liver laboratory tests including ALT, AST, and total bilirubin once a month and as clinically indicated, with more frequent testing in patients who develop transaminase elevations. Based on the severity of the adverse drug reaction, Ceritinib should be withheld with resumption at a reduced dose, or permanently discontinue Ceritinib.<br />\r\n<br />\r\n<strong>Interstitial Lung Disease (ILD)/Pneumonitis</strong>: Severe, life-threatening, or fatal ILD/pneumonitis occurred in patients treated with Ceritinib. Across clinical studies, ILD/pneumonitis was reported in 2.4% of 925 patients treated with Ceritinib. National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Grade 3 or 4 ILD/pneumonitis was reported in 1.3% of patients, with fatal events reported in 0.2% of patients. Ten patients (1.1%) discontinued Ceritinib across clinical studies due to ILD/pneumonitis. Patients should be monitored for pulmonary symptoms indicative of ILD/pneumonitis.<br />\r\n<br />\r\n<strong>QT Interval Prolongation</strong>: QTc interval prolongation, which may lead to an increased risk for ventricular tachyarrhythmia (e.g., torsades de pointes) or sudden death, occurred in patients treated with Ceritinib. Across clinical studies, 6% of 919 patients with at least one post-baseline ECG assessment experienced a QTc interval increase over baseline of greater than 60 msec. Approximately 1.3% of patients taking Ceritinib 750 mg fasted were found to have a QTc greater than 500 msec. When possible, use of Ceritinib should be avoided in patients with congenital long QT syndrome. Periodic monitoring should be conducted with electrocardiograms (ECGs) and electrolytes in patients with congestive heart failure, bradyarrhythmias, electrolyte abnormalities, or those who are taking medications that are known to prolong the QTc interval.<br />\r\n<br />\r\n<strong>Hyperglycemia</strong>: Hyperglycemia occurred in patients receiving Ceritinib. Across clinical studies, CTCAE Grade 3 or 4 hyperglycemia, based on laboratory values, occurred in 13% of 925 patients. Fasting serum glucose should be monitored prior to the start of Ceritinib treatment and periodically thereafter as clinically indicated. Based on the severity of the adverse drug reaction, Ceritinib should be withheld until hyperglycemia is adequately controlled, then resume Ceritinib at a reduced dose.<br />\r\n<br />\r\n<strong>Bradycardia</strong>: Bradycardia occurred in patients receiving Ceritinib. Across clinical studies, sinus bradycardia, defined as a heart rate of less than 50 beats per minute (bpm), was noted as a new finding in 1% of 925 patients. Bradycardia was reported as an adverse drug reaction in 1% of patients. No patient required discontinuation and 0.1% required interruption with subsequent dose reduction for bradycardia. Using Ceritinib should be avoided in combination with other agents known to cause bradycardia (e.g., beta-blockers, nondihydropyridine calcium channel blockers, clonidine, and digoxin) to the extent possible. Heart rate and blood pressure should be regularly monitored. In cases of symptomatic bradycardia that is not life threatening, Ceritinib should be withheld until recovery to asymptomatic bradycardia or to a heart rate of 60 bpm or above, evaluate the use of concomitant medications, and adjust the dose of Ceritinib.<br />\r\n<br />\r\n<strong>Pancreatitis</strong>: Pancreatitis occurred in patients receiving Ceritinib. Pancreatitis, including one fatality, occurred in less than 1% of patients receiving Ceritinib in clinical studies. CTCAE Grade 3 or 4 elevations of amylase occurred in 7% of patients receiving Ceritinib across clinical studies, while CTCAE Grade 3 or 4 elevations of lipase occurred in 14% of patients. Lipase and amylase should be monitored prior to the start of Ceritinib treatment and periodically thereafter as clinically indicated. Based on the severity of the laboratory abnormalities, Ceritinib should be withheld with resumption at a reduced dose.<br />\r\n<br />\r\n<strong>Embryo-Fetal Toxicity</strong>: Based on its mechanism of action and findings in animal studies, Ceritinib can cause fetal harm when administered to a pregnant woman. Pregnant women should be advised of the potential risk to a fetus. Females of reproductive potential should be advised to use effective contraception during treatment with Ceritinib and for 6 months following completion of therapy. Based on the potential for genotoxicity, males with female partners of reproductive potential should be advised to use condoms during treatment with Ceritinib and for 3 months following completion of therapy.</p>', NULL, NULL, '<p>Store below 30&deg;C in a cool and dry place, away from sunlight. Keep out of reach of children.</p>', '<p><strong>Females</strong>: Ceritinib can cause fetal harm when administered to a pregnant woman. Females of reproductive potential should be advised to use effective contraception during treatment with Ceritinib and for 6 months following completion of therapy.<br />\r\n<br />\r\n<strong>Males</strong>: Based on the potential for genotoxicity, males with female partners of reproductive potential should be advised to use condoms during treatment with Ceritinib and for 3 months following completion of therapy.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: The safety and effectiveness of Ceritinib in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Of the 925 patients in clinical studies of Ceritinib, 18% were 65 years or older, while 5% were 75 years or older. No overall differences in safety or effectiveness were observed between these subjects and younger subjects.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: For patients with severe hepatic impairment (Child-Pugh C), the dose of Ceritinib should be reduced by approximately one-third, rounded to the nearest multiple of the 150 mg dosage strength. No dose adjustment is recommended in patients with mild (Child-Pugh A) or moderate (Child-Pugh B) hepatic impairment.</p>', '2022-02-18 19:31:30', '2022-03-28 20:59:16'),
(305, 305, '<p>This is indicated for the fast relief of pain, discomfort and inflammation caused by Mouth ulcer/Aphthous ulcer/Canker sore, Cold sore/Fever blister, Denture sore, Irritation from braces, Gum swelling, and sore spots due to orthodontic device.</p>', '<p>Choline salicylate has an analgesic &amp; anti-inflammatory effect. Like salicylic acid Choline salicylate has no antithrombotic activity. The pharmacological actions of choline salicylate are thought to be primarily mediated through inhibition of prostaglandin production. Cetalkonium chloride is an antiseptic, being bactericidal towards both Gram-positive and Gram-negative organisms.<br />\r\n<br />\r\n<strong>Absorption</strong>: Choline salicylate is absorbed from the gut<br />\r\n<strong>Distribution</strong>: Throughout extracellular water and most tissues<br />\r\n<strong>Plasma Half-life</strong>: 2-4 hours<br />\r\n<strong>Excretion</strong>: Mainly in the Urine<br />\r\n<strong>Protein binding</strong>: 80-90%</p>', '<p><strong>Adult</strong>: Wash hands, apply &frac12; inch of gel on to the sore area. This can be repeated after every 3 hours.</p>', '<p>Salicylates may enhance the effect of anticoagulants and inhibit the action of uricosurics.</p>', '<p>Not to be used in:</p>\r\n\r\n<ul>\r\n	<li>If allergic to salicylates, e.g. Aspirin</li>\r\n	<li>If have an active peptic ulcer</li>\r\n</ul>', '<p>Salicylates may produce bronchospasm and induce asthma attacks in susceptible patients.</p>', '<p>There is clinical evidence of the safety of salicylates in pregnancy. This medicine may pass into breast milk in very small amounts but is unlikely to have any adverse effects on a nursing infant.</p>', '<p>Do not exceed the recommended dose.</p>', NULL, '<p>Non-steroidal Anti-inflammatory Drugs (NSAIDs), Preparations for Oral Ulceration &amp; Inflammation</p>', '<p>Store in a cool and dry place, away from light. Keep out of the reach of children.</p>', NULL, '2022-02-18 19:32:07', '2022-03-28 21:02:08'),
(306, 306, '<p>It is indicated for the relief of symptoms associated with seasonal &amp; perennial allergic rhinitis. It is also indicated for the treatment of the uncomplicated skin manifestations of chronic idiopathic urticaria and allergen induced asthma.</p>', '<p>Cetirizine Hydrochloride is a potent H1 receptor antagonist without any significant anticholinergic and antiserotonic effects. At pharmacologically active dose levels, it has almost no drowsiness effect and does not cause behavioral changes. It inhibits the histamine-mediated early phase of the allergic reaction and also reduces the migration of inflammatory cells and the release of mediators associated with the late phase of the allergic reaction.<br />\r\n<br />\r\nPharmacokinetics: Cetirizine 10 mg achieves peak plasma concentrations of 257 mcg/L within one hour of administration (980 mcg/L in children). Food does not affect the extent of absorption, but it may slightly reduce the rate. Peak blood levels 0.3 micrograms/ml are reached between thirty &amp; sixty minutes after administration of 10 mg dose of Cetirizine. Its plasma half-life is approximately 11 hours. Absorption is very consistent from one subject to the next. Its renal clearance is 30 ml/minute and the excretion half-life is approximately nine hours.</p>', '<p><strong>Adults and Children 6 years and older</strong>: 1 tablet or 2 teaspoonfuls daily (or 1 teaspoonful twice daily).<br />\r\n<br />\r\n<strong>Children 2-6 years</strong>: 1 teaspoonful once daily or 1/2 teaspoonful twice daily.<br />\r\n<br />\r\n<strong>Children 6 months to 2 years</strong>&nbsp;: 1/2 teaspoonful once daily. The dose in children 12-23 months of age can be increased to a maximum dose as 1/2 teaspoonful every 12 hours.</p>', '<p>No clinically significant drug interactions have been found with Theophylline, Azithromycin, Pseudoephedrine, Ketoconazole or Erythromycin and with other drugs.</p>', '<p>It is contraindicated in patients with a history of hypersensitivity to Cetirizine or hydroxyzine.</p>', '<p>The most common side effects that occurred more frequently on Cetirizine is somnolence.</p>', '<p>US FDA Pregnancy Category of Cetirizine Hydrochloride is B. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Cetirizine Hydrochloride has been shown to be excreted in human milk. So, caution should be exercised when Cetirizine Hydrochloride is administered to a nursing woman.</p>', '<p>Caution should be exercised when driving a car or operating a heavy machinery.</p>', NULL, '<p>Sedating Anti-histamine</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-02-18 20:22:12', '2022-03-28 21:04:50'),
(307, 307, '<p>Cetirizine 0.24% ophthalmic solution is indicated for the treatment of ocular itching associated with allergic conjunctivitis.</p>', '<p>Cetirizine, an antihistamine, is a histamine-1 (H1) receptor antagonist. Its effects are mediated via selective inhibition of H1 histamine receptors. The antihistaminic activity of cetirizine has been documented in a variety of animal and human models. In vivo and ex vivo animal models have shown negligible anticholinergic and antiserotonergic activity. In vitro receptor binding studies have shown no measurable affinity for other than H1 receptors.<br />\r\n<br />\r\nIn healthy subjects, bilateral topical ocular dosing of one drop of cetirizine ophthalmic solution 0.24% resulted in a mean cetirizine plasma Cmax of 1.7 ng/mL following a single dose and 3.1 ng/mL after twice-daily dosing for one week. The observed mean terminal half-life of cetirizine was 8.6 hours following a single dose and 8.2 hours after twice-daily dosing of Cetirizine for one week.</p>', '<p><strong>Adults and children (age 2 years and above)</strong>: The recommended dosage is to instill one drop in the affected eye(s) twice daily (approximately 8 hours apart).</p>', NULL, NULL, '<p>The most common adverse reactions are ocular hyperemia, instillation site pain and visual acuity reduction.</p>', '<p><strong>Pregnancy</strong>: There is no adequate or well-controlled study with Cetirizine 0.24% ophthalmic solution in pregnant women. It should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether the systemic absorption resulting from topical ocular administration of Cetirizine could produce detectable quantities in human breast milk. There is no adequate information regarding the effects of Cetirizine on breastfed infants, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for this drug and any potential adverse effects on the breastfed child from Cetirizine.</p>', '<p>Care should be taken not to touch the eyelids or surrounding areas with the dropper tip of the bottle to prevent contaminating the tip and solution. Keep the bottle closed when not in use. Patients should be advised not to wear a contact lens if their eye is red. Remove contact lenses prior to instillation of the drug. Lenses may be reinserted after 10 minutes following the drug administration.</p>', NULL, '<p>Ophthalmic Anti-allergic preparations</p>', '<p>Do not store above 30⁰C. Do not freeze. Protect from light. Do not use more than 4 weeks after opening.&nbsp;Keep out of the reach of children.</p>', '<p><strong>Pediatric use</strong>: The safety and effectiveness have been established in pediatric patients two years of age and older.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: No overall differences in safety or effectiveness have been observed between elderly and younger patients.</p>', '2022-02-18 20:22:41', '2022-03-28 21:07:09'),
(308, 308, '<p>Cetrorelix is indicated for assisted reproductive technologies</p>', '<p>Cetrorelix, a synthetic decapeptide analog of naturally occurring gonadorelin, is a gonadorelin antagonist. It competitively blocks gonadorelin receptors on the anterior piyuitary gonadotroph and the subsequent transduction pathway, inducing a rapid, reversible suppression of gonadotrophin secretion.</p>', '<p><strong>Adult</strong>:&nbsp;250 mcg/day, given either in the morning beginning on the day 5 or 6 of ovarian stimulation or in the evening beginning on day 5, and continued until ovulation induction.</p>', NULL, '<p>Hypersensitivity. Moderate to severe renal or hepatic impairment. Women with severe allergic conditions. Pregnancy and lactation.</p>', '<p>Mild and transient reactions at Inj site, nausea, headache, ovarian hyperstimulation syndrome, systemic hypersensitivity reactions.</p>', '<p>Pregnancy&nbsp;Category X.&nbsp;Studies in animals or human beings have demonstrated foetal abnormalities or there is evidence of foetal risk based on human experience or both, and the risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant.</p>', '<p>Women with active allergic conditions or a history of allergies; childn; elderly &gt;65 yrs</p>', NULL, '<p>Drugs affecting (inhibiting) gonadotrophin</p>', '<p>Store cetrorelix acetate at room temperature, between 15 to&nbsp;30&deg; C</p>', NULL, '2022-02-18 20:23:05', '2022-03-28 21:10:00'),
(309, 309, '<p><strong>Squamous Cell Carcinoma Of The Head And Neck (SCCHN)</strong>: Cetuximab&nbsp;is indicated in combination with&nbsp;radiation therapy&nbsp;for the initial treatment of locally or regionally advanced&nbsp;squamous cell carcinoma&nbsp;of the head and neck.<br />\r\n<br />\r\nCetuximab is indicated in combination with platinum-based therapy with 5-FU for the first-line treatment of patients with recurrent locoregional disease or metastatic squamous cell&nbsp;carcinomaof the head and neck.<br />\r\n<br />\r\nCetuximab, as a single agent, is indicated for the treatment of patients with recurrent or metastatic squamous cell carcinoma of the head and neck for whom prior platinum-based therapy has failed.<br />\r\n<br />\r\n<strong>K-Ras Wild-Type, EGFR-Expressing Colorectal Cancer</strong>: Cetuximab is indicated for the treatment of&nbsp;K-Ras&nbsp;wild-type,&nbsp;epidermal growth factor receptor&nbsp;(EGFR)- expressing, metastatic&nbsp;colorectal cancer&nbsp;(mCRC) as determined by FDA-approved tests for this use&nbsp;</p>\r\n\r\n<ul>\r\n	<li>In combination with FOLFIRI (irinotecan, 5-fluorouracil,&nbsp;leucovorin) for first-line treatment</li>\r\n	<li>In combination with irinotecan in patients who are&nbsp;refractory&nbsp;to irinotecan-based&nbsp;chemotherapy</li>\r\n	<li>As a single agent in patients who have failed oxaliplatin- and irinotecan-based chemotherapy or who are intolerant to irinotecan.</li>\r\n</ul>', '<p>Cetuximab is a recombinant human/mouse chimeric monoclonal antibody. It binds specifically to the epidermal growth factor receptor (EGFR), thus competitively inhibiting the binding of epidermal growth factor (EGF) and other ligands. This blocks phosphorylation and activation of receptor-associated kinases, thus inhibiting cell growth, inducing apoptosis and decreases matrix metalloproteinase and vascular EGF production.</p>', '<p><strong>Squamous Cell Carcinoma Of The Head And Neck:</strong></p>\r\n\r\n<p><strong>Cetuximab in combination with radiation therapy or in combination with platinum-based therapy with 5-FU</strong>:</p>\r\n\r\n<ul>\r\n	<li>The recommended initial dose is 400 mg/m2&nbsp;administered one week prior to initiation of a course of radiation therapy or on the day of initiation of platinum-based therapy with 5-FU as a 120-minute intravenous infusion (maximum infusion rate 10 mg/min). Complete Cetuximab administration 1 hour prior to platinum-based therapy with 5-FU.</li>\r\n	<li>The recommended subsequent weekly dose (all other infusions) is 250 mg/m2&nbsp;infused over 60 minutes (maximum infusion rate 10 mg/min) for the duration of radiation therapy (6&ndash;7 weeks) or until disease progression or unacceptable toxicity when administered in combination with platinum-based therapy with 5-FU. Complete Cetuximab administration 1 hour prior to radiation therapy or platinumbased therapy with 5-FU.</li>\r\n</ul>\r\n\r\n<p><strong>Cetuximab monotherapy</strong>:</p>\r\n\r\n<ul>\r\n	<li>The recommended initial dose is 400 mg/m2&nbsp;administered as a 120-minute intravenous infusion (maximum infusion rate 10 mg/min).</li>\r\n	<li>The recommended subsequent weekly dose (all other infusions) is 250 mg/m2&nbsp;infused over 60 minutes (maximum infusion rate 10 mg/min) until disease progression or unacceptable toxicity.</li>\r\n</ul>\r\n\r\n<p><strong>Colorectal Cancer:</strong></p>\r\n\r\n<ul>\r\n	<li>Determine EGFR-expression status using FDA-approved tests prior to initiating treatment. Also confirm the absence of a&nbsp;Ras&nbsp;mutation prior to initiation of treatment with Cetuximab.&nbsp;</li>\r\n	<li>The recommended initial dose, either as monotherapy or in combination with irinotecan or FOLFIRI (irinotecan, 5-fluorouracil, leucovorin), is 400 mg/m2&nbsp;administered as a 120-minute intravenous infusion (maximum infusion rate 10 mg/min). Complete Cetuximab administration 1 hour prior to FOLFIRI.</li>\r\n	<li>The recommended subsequent weekly dose, either as monotherapy or in combination with irinotecan or FOLFIRI, is 250 mg/m2&nbsp;infused over 60 minutes (maximum infusion rate 10 mg/min) until disease progression or unacceptable toxicity. Complete Cetuximab administration 1 hour prior to FOLFIRI.</li>\r\n</ul>\r\n\r\n<p><strong>Recommended Premedication</strong>: Premedicate with an H1&nbsp;antagonist&nbsp;(eg, 50 mg of&nbsp;diphenhydramine) intravenously 30&ndash;60 minutes prior to the first dose; premedication should be administered for subsequent Cetuximab doses based upon clinical judgment and presence/severity of prior infusion reactions.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Do not administer cetuximab as an intravenous push or bolus. Administer via infusion pump or syringe pump. Do not exceed an infusion rate of 10 mg/min. Administer through a low protein binding 0.22-micrometer in-line filter.<br />\r\n<br />\r\nParenteral&nbsp;drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. The solution should be clear and colorless and may contain a small amount of easily visible, white, amorphous, cetuximab particulates.&nbsp;Do not s hake or dilute.</p>', NULL, NULL, '<p>Fatigue, pain, headache, fever, confusion, anxiety, insomnia, chills, rigors, depression. Acneiform rash, rash, dry skin, pruritus, nail changes, hypomagnesaemia, abdominal pain, constipation, diarrhoea, vomiting, nausea, wt loss, weakness, bone pain.</p>', '<p><strong>Pregnancy</strong>: category C. Either studies in animals have revealed adverse effects on the fetus (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 fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether Cetuximab is secreted in human milk. IgG antibodies, such as Cetuximab, can be 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 Cetuximab, 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. If nursing is interrupted, based on the mean half-life of cetuximab, nursing should not be resumed earlier than 60 days following the last dose of Cetuximab.</p>', '<p>Infusion rate should be reduced if patient exhibits signs of toxicity. Discontinue treatment if there is severe infusion reactions. Caution when used in patients with history of coronary artery disease, heart failure and arrhythmias. Monitor serum electrolytes during and after (for at least 8 wk) cetuximab therapy. Exposure to sunlight may worsen skin reactions. Risk of interstitial lung disease in patients with preexisting lung disease. Dose should be modified if there is occurrence of severe acneiform rash, refer to product insert/SPG for dosing guidelines.</p>', '<p>The maximum single dose of cetuximab administered is 1000 mg/m2&nbsp;in one patient. No adverse events were reported for this patient.</p>', '<p>Targeted Cancer Therapy</p>', '<p>Store vials under refrigeration at 2&deg; to 8&deg; C.&nbsp;Do not freeze.</p>', '<p>Dose modification in cases of severe acneiform rash (grade 3 or 4):</p>\r\n\r\n<ul>\r\n	<li>1st occurrence: Delay infusion by 1-2 wk. If improvement, continue at 250 mg/m2; discontinue if no improvement.</li>\r\n	<li>2nd occurrence: Delay infusion by1-2 wk. If improvement, continue at reduced dose of 200 mg/m2; discontinue if no improvement.</li>\r\n	<li>3rd occurrence: Delay infusion by 1-2 wk. If improvement, continue at reduced dose of 150 mg/m2; discontinue if no improvement. 4th occurrence: Discontinue therapy.</li>\r\n</ul>', '2022-02-18 20:23:19', '2022-03-28 21:12:57'),
(310, 310, '<p>Hodgkin&#39;s disease, certain forms of non-Hodgkin&#39;s lymphoma, chronic lymphocytic leukaemia, Waldenstrom&#39;s macroglobulinaemia.</p>', '<p>Chlorambucil produces its anti-cancer effects by interfering with DNA replication and damaging the DNA in a cell. The DNA damage induces cell cycle arrest and cellular apoptosis via the accumulation of cytosolic p53 and subsequent activation of Bax, an apoptosis promoter.<br />\r\n<br />\r\nChlorambucil alkylates and cross-links DNA during all phases of the cell cycle, inducing DNA damage via three different methods of covalent adduct generation with double-helical DNA:</p>\r\n\r\n<ul>\r\n	<li>Attachment of alkyl groups to DNA bases, resulting in the DNA being fragmented by repair enzymes in their attempts to replace the alkylated bases, preventing DNA synthesis and RNA transcription from the affected DNA.</li>\r\n	<li>DNA damage via the formation of cross-links which prevents DNA from being separated for synthesis or transcription.</li>\r\n	<li>Induction of mispairing of the nucleotides leading to mutations.</li>\r\n</ul>\r\n\r\n<p>The precise mechanisms by which Chlorambucil acts to kill tumor cells are not yet completely understood.</p>', '<p><strong>Hodgkin&#39;s disease</strong>: 200 mcg/kg/day for 4-8 wk.<br />\r\n<br />\r\n<strong>Non-Hodgkin&#39;s lymphoma</strong>: 100-200 mcg/kg/day for 4-8 wk. Maintenance: Reduced daily dosage of intermittent courses of treatment.<br />\r\n<br />\r\n<strong>Chronic lymphocytic leukaemia</strong>: Initially, 150 mcg/kg/day until the total leukocyte count falls to 10,000 microliter. Treatment may be resumed 4 wk after at a dose of 100 mcg/kg/day.<br />\r\n<br />\r\n<strong>Waldenstrom&#39;s macroglobulinaemia</strong>: Starting dose of 6-12 mg daily until leucopenia occurs followed by 2-8 mg daily.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken on an empty stomach: Ensure adequate hydration. Swallow whole, do not chew/crush.</p>', NULL, '<p>Pregnancy (1st trimester) &amp; lactation.</p>', '<p>Bone marrow suppression, seizures in childn with nephrotic syndrome, nausea, vomiting, diarrhoea, oral ulceration. Rarely, irreversible bone marrow failure, allergic reactions, Stevens-Johnson syndrome, toxic epidermal necrolysis, seizures, movement disorders, interstitial pulmonary fibrosis, interstitial pneumonia, hepatotoxicity, jaundice, sterile cystitis, drug fever</p>', '<p>Pregnancy&nbsp;Category D.&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>Monitor FBC closely. Bone marrow suppression reversible only if withdrawn early enough. Should not be given to patients who have recently undergone radio- or chemotherapy. In lymphocytic infiltration of bone marrow or hypoplastic bone marrow, max daily dose is 0.1 mg/kg. Childn with nephrotic syndrome, patients on high pulse dosing regimens, history of seizure disorders. Renal or hepatic impairment. Ensure adequate contraceptive precautions. Pregnancy.</p>', NULL, '<p>Cytotoxic Chemotherapy</p>', NULL, NULL, '2022-02-18 20:23:42', '2022-03-28 21:16:39'),
(311, 311, '<p>Chloramphenicol is indicated for the treatment of ocular infections involving the conjunctiva and/or cornea caused by chloramphenicol-susceptible organisms. Such as Staphylococcus aureus, Streptococcus pneumoniae, E.coli, H. influenzae, Klebsiella/Enterobacter spp, Moraxella lacunata, and Neisseria species.</p>', '<p>Chloramphenicol is a broad-spectrum bacteriostatic antibiotic which acts through the inhibition of bacterial protein synthesis by interfering with the transfer of activated amino acids from soluble RNA to ribosomes.</p>', '<p><strong>Adult and Children</strong>: Instill 1 or 2 drops in the conjunctival sac 4-6 times per day for the first 72 hours and then every 4 hours thereafter. Treatment should be continued for approximately 7 days, but should not be continued for more than 3 weeks without re-evaluation by the physician.</p>', '<p>Chymotrypsin may be inhibited if given simultaneously with Chloramphenicol.</p>', '<p>It is contraindicated in individuals with a history of hypersensitivity to Chloramphenicol or any ingredients of the preparation.</p>', '<p>The systemic adverse reaction has not been observed within short-term topical use of Chloramphenicol. The most frequently reported adverse reactions have been burning, stinging, conjunctival hyperemia, blood dyscrasia, allergic or inflammatory reactions, vesicular and maculopapular dermatitis.</p>', '<p>Safety for use in pregnancy and lactation has not been established. Therefore, use only when considered essential by the physicians.</p>', '<p>Chloramphenicol ophthalmic solution should never be given for minor infections or for prophylaxis. Repeated course and prolonged treatment should be avoided. Blood dyscrasias (granulocytopenia, thrombocytopenia and moderate anaemia) may occur after prolonged ophthalmic use.</p>', '<p>Accidental ingestion of the medicine is unlikely to cause any toxicity due to low content of antibiotic.</p>', '<p>Ear Anti-Infectives &amp; Antiseptics, Eye Anti-Infectives &amp; Antiseptics, Macrolides</p>', '<p>Store in a cool (between 2&deg;C-8&deg;C) and dry place, protect from light, keep out of reach of children. Do not touch the dropper tip to the surface since this may contaminate the solution. Do not use after 30 days of the first opening.</p>', NULL, '2022-02-18 20:24:09', '2022-03-28 21:22:00');
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
(312, 312, '<p>Chloramphenicol is an antibiotic that is clinically useful for, and should be reserved for, serious infections caused by organisms susceptible to its antimicrobial effects when less potentially hazardous therapeutic agents are ineffective or contraindicated. However, chloramphenicol may be chosen to initiate antibiotic therapy on the clinical impression that one of the conditions below is believed to be present. In vitro sensitivity tests should be performed concurrently so that the drug may be discontinued as soon as possible if less potentially dangerous agents are indicated by such tests. The decision to continue use of chloramphenicol, rather than another antibiotic when both are suggested by in vitro studies to be effective against a specific pathogen, should be based upon severity of the infection, susceptibility of the pathogen to the various antimicrobial drugs, and the efficacy of the various drugs in the infection</p>', '<p>In vitro, chloramphenicol exerts mainly a bacteriostatic effect on a wide range of Gram-negative and Gram positive bacteria and is active against rickettsiae, the lymphogranuloma-psittacosis group and Vibrio cholerae. It is particularly active against Salmonella typhi and Haemophilus influenzae. The mode of actions is through interference or inhibition of protein synthesis in intact cells and cell-free systems. Antagonism has been demonstrated in vitro between chloramphenicol, erythromycin, clindamycin and lincomycin. Chloramphenicol is rapidly absorbed from the GI tract. Chloramphenicol palmitate is hydrolyzed in the GI tract and is absorbed as free chloramphenicol.<br />\r\n<br />\r\nFollowing oral administration of a single one gram dose of chloramphenicol base to healthy adults, average peak plasma chloramphenicol concentrations of about 11 mcg/ml were attained with 1-3 hours. Cumulative dosing gave a peak of 18 mcg/ml after the fifth dose of one gram, every 6 hours. Mean serum levels were 8-14 mcg/ml over a 48 hour period.<br />\r\n<br />\r\nMost of the drug is excreted in the urine. Despite the small proportion of unchanged drug excreted in the urine, the concentration of free chloramphenicol in the urine is relatively high. From 8% to 12% of the antibiotic is excreted as free chloramphenicol. The remainder is excreted as inert metabolites, mainly glucuronate. Small amounts of active drug are found in bile and feces. Chloramphenicol diffuses rapidly, but its distribution is not uniform. Highest concentrations are found in liver and kidney, and lowest concentrations are found in brain and cerebrospinal fluid (CSF). Chloramphenicol enters CSF even in the absence of meningeal inflammation, appearing in concentrations about half of those found in the blood.</p>', '<p>Chloramphenicol, like other potent drugs, should be prescribed at recommended doses known to have therapeutic activity. Inhibition of the majority of sensitive organisms may be expected at concentrations of 5 to 20 mcg/ml. The desired concentration of active drug in serum should fall within this range over most of the treatment period. Dosage of 50 mg/kg/day divided into 4 doses at intervals of 6 hours will usually achieve and sustain levels of this order.<br />\r\n<br />\r\nExcept in certain circumstances (e.g. premature infants and neonates and individuals with hepatic or renal impairment) lower doses may not achieve these concentrations. Close observation of the patient should be maintained and in the event of any adverse reactions, dosage should be reduced or the drug discontinued, if other factors in the clinical situation permit.<br />\r\n<br />\r\n<strong>Adults</strong>: should receive 50 mg/kg/day in divided doses [approximately one 250 mg capsule per each 4.5 kg (10 lbs) of body weight or one 500 mg capsule per each 9 kg (20 lbs) of body weight] in divided doses at 6 hour intervals. In exceptional cases, patients with infections due to moderately resistant organisms may require increased dosage up to 100 mg/kg/day to achieve serum levels inhibiting the pathogen, but these high doses should be decreased as soon as possible.<br />\r\n<br />\r\nAdults with impairment of hepatic or renal function, or both, may have reduced ability to metabolize and excrete the drug. In instances of impaired metabolic processes, dosages should be adjusted accordingly.<br />\r\n<br />\r\n<strong>Pediatric patients</strong>: Dosage of 50 mg/kg/day divided at 6 hour intervals is effective against most susceptible organisms. Severe infections (eg., bacteremia or meningitis), especially when adequate cerebrospinal fluid concentrations are desired, may require dosage up to 100 mg/kg/day; however, it is recommended that dosage be reduced to 50 mg/kg/day as soon as possible. Children with impaired hepatic or renal function may retain excessive amounts of the drug.<br />\r\n<br />\r\n<strong>Newborn infants</strong>: A total of 25 mg/kg/day in 4 equal doses at 6-hour intervals usually produces and maintains concentrations in serum and tissues adequate to control most infections for which the drug is indicated.</p>', '<p>Chloramphenicol has been shown to retard the biotransformation of tolbutamide, phenytoin, and dicoumarol in man. Chloramphenicol should be used with caution if administered concomitantly with lincomycin, clindamycin, or erythromycin. In vitro experiments have demonstrated that binding sites for erythromycin, lincomycin, clindamycin and chloramphenicol overlap and competitive inhibition may occur. Rifampin therapy can reduce Chloramphenicol concentrations.</p>', '<p>Chloramphenicol is contraindicated in individuals with a history of hypersensitivity and/or toxic reaction to the product or its components. It must not be used in the treatment of trivial infections or where it is not indicated, as in colds, viral influenza, infections of the throat or as a prophylactic agent to prevent bacterial infections.</p>', NULL, NULL, '<p>It is essential that adequate hematologic functions be closely monitored during treatment with the drug. While hematologic determinations may detect early peripheral hematologic changes, such as leukopenia, reticulocytopenia, or granulocytopenia, before they become irreversible, such determinations cannot be relied on to detect bone marrow depression prior to development of aplastic anemia</p>', '<p>Levels exceeding 25 mcg/ml are frequently considered toxic. Chloramphenicol toxicity can be evidenced by serious hemopoietic effects such as aplastic anemia, thrombocytopenia, leukopenia, as well as increasing serum iron levels, nausea, vomiting and diarrhea. In the case of serious overdosage, charcoal hemoperfusion may be effective in removing chloramphenicol from plasma. Exchange transfusion is of questionable value following massive overdosage, especially in neonates and infants.</p>', '<p>Macrolides</p>', '<p>Store in a cool dry place. Keep bottle securely closed. Protect from light.</p>', NULL, '2022-02-18 20:24:29', '2022-03-28 21:24:38'),
(313, 313, '<p>Acute bacterial ear infections</p>', '<p><strong>Chloramphenicol</strong>&nbsp;inhibits bacterial protein synthesis by binding to 50s subunit of the bacterial ribosome, thus preventing peptide bond formation by peptidyl transferase. It has both bacteriostatic and bactericidal action against H. influenzae, N. meningitidis and S. pneumoniae.<br />\r\n<br />\r\n<strong>Lidocaine</strong>&nbsp;is an amide type local anaesth. It stabilises the neuronal membrane and inhibits Na ion movements, which are necessary for conduction of impulses. In the heart, lidocaine reduces depolarisation of the ventricles during diastole and automaticity in the His-Purkinje system. Duration of action potential and effective refractory period are also reduced.</p>', '<p><strong>Otic/Aural Otitis externa</strong>: Instill 2-3 drops into the ear bid-tid.</p>', '<p>Decreased effects of iron and vitamin B12 in anaemic patients. Phenobarbitone and rifampin reduce efficacy of chloramphenicol. Impairs the action of oral contraceptives.<br />\r\n<br />\r\nPotentially Fatal: Increases the effect of oral anticoagulants, oral hypoglycaemic agents, phenytoin. Avoid concomitant administration with drugs that depress bone marrow function.</p>', '<p>History of hypersensitivity or toxic reaction to the drug; Perforated ear drum. Herpes simplex and other virul conditions of the eye or ear, mycosis.</p>', '<p>Ototoxicity.</p>', '<p>Pregnancy Category C &amp; B. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.<br />\r\n<br />\r\nAnimal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.</p>', '<p>Avoid prolonged use. Discontinue immediately if local hypersensitivity reactions occur.</p>', '<p>Aural Anti-bacterial preparations</p>', NULL, NULL, NULL, '2022-02-18 20:25:05', '2022-03-28 21:26:36'),
(314, 314, '<p>Chlorhexidine Gluconate Mouthwash is an antimicrobial solution which inhibits the formation of dental plaque. It is indicated as an aid in the treatment and prevention of gingivitis and in the maintenance of oral hygiene, particularly in situations where tooth brushing cannot be adequately employed (e.g. following oral surgery, in mentally or physically handicapped patients). It may also be used in a post-peridontal surgery or treatment regimen to promote gingival healing.</p>', '<p>Chlorhexidine is a very potent cationic chemoprophylactic agent that has a broad-spectrum of activity against gm+ve and gm-ve bacteria. It is both bacteriostatic and bactericidal depending on its concentration. The bactericidal effect, which is achieved at high concentrations, is due to the binding of the cationic to negatively charged bacterial cell walls and extramicrobial complexes. Bacteriostatic effect is achieved at low concentrations which causes an alteration of bacterial cell osmotic equilibrium and leakage of potassium and phosphorus.</p>', '<p><strong>Adults:</strong>&nbsp;Thoroughly rinse the mouth for about one minute with 10 ml twice daily. In the dental&nbsp;surgery the patient should be instructed to rinse the mouth for one minute prior to treatment.&nbsp;Chlorhexidine Gluconate is incompatible with anionic agents which are usually present in conventional dentifrices.&nbsp;These should therefore be used before Chlorhexidine Gluconate (rinsing the mouth between applications) or at a&nbsp;different time of day.<br />\r\n<br />\r\nFor the treatment of gingivitis a course of about one month is advisable although some variation&nbsp;in response is to be expected. In the case of aphthous ulceration and oral candidal infections&nbsp;treatment should be continued for 48 hours after clinical resolution. For the treatment of dental&nbsp;stomatitis the dentures should be cleansed and soaked in Chlorhexidine Gluconate mouthwash for fifteen minutes twice daily.<br />\r\n<br />\r\n<strong>Children and the Elderly:</strong>&nbsp;The normal adult dose is appropriate for elderly patients and children of&nbsp;12 years and over unless otherwise recommended by the dentist or the physician. Children under&nbsp;12 years of age should not use the product unless recommended by a healthcare professional.&nbsp;Route of administration: External (oral) use.</p>', '<p>Soaps, other anionic agents, borates, bicarbonates, carbonates, chlorides, citrates, nitrates, phosphates &amp; sulfates.</p>', '<p>Hypersensitivity.</p>', '<p>Skin sensitivity; mucosal irritation; reversible brown staining of the teeth; tongue discoloration and burning sensation; transient taste disturbance; parotid gland swelling.</p>', '<p>Pregnancy Category B. Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.</p>', '<p>Avoid contact with middle ear or sensitive tissues and eyes. Do not inject or use in body cavities.Avoid eating, drinking, or brushing your teeth just after using this medication</p>', NULL, '<p>Other antibacterial preparation</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-02-18 20:25:39', '2022-03-28 21:28:44'),
(315, 315, '<p>It is used as an antiseptic cream and lubricant by healthcare professionals when examining women during pregnancy or for gynecological problems.</p>', '<p>Chlorhexidine is a very potent cationic chemoprophylactic agent that has a broad-spectrum of activity against gm+ve and gm-ve bacteria. It is both bacteriostatic and bactericidal depending on its concentration. The bactericidal effect, which is achieved at high concentrations, is due to the binding of the cationic to negatively charged bacterial cell walls and extramicrobial complexes. Bacteriostatic effect is achieved at low concentrations which causes an alteration of bacterial cell osmotic equilibrium and leakage of potassium and phosphorus.</p>', '<p>Chlorhexidine Gluconate cream is used by healthcare professionals during a physical examination. Some will be spread onto the gloved hand of the examiner and some will be applied around the birth canal and perineum of the patient. This cream is for the use on the skin or vagina only.</p>', '<p>Advice of healthcare professional should be sought if using or have recently used any other drugs. Hypochlorite bleaches may cause brown stains to develop in fabrics which have previously been in contact with preparations containing Chlorhexidine.</p>', '<p>Chlorhexidine Gluconate cream is contraindicated for patients who are hypersensitive to Chlorhexidine.</p>', '<p>Allergic reactions like sudden wheeziness, difficulty in breathing, swelling of the eyelids, face or lips, rash or itching (specially affecting the whole body) may occur.</p>', '<p>Chlorhexidine Gluconate cream is safe during pregnancy and lactation.</p>', '<p>Avoid application to the ears and eyes, and any deep cuts involving the head or spine.Wash out with water if necessary. If mixed with soap or detergents its effectiveness may reduce. If swallowed treat symptomatically and with gastric lavage using milk, raw egg, gelatin or mild soap.</p>', NULL, '<p>Other antibacterial preparation</p>', '<p>Keep in a cool and dry place protected from light. Shake the bottle well before use.</p>', NULL, '2022-02-18 20:25:57', '2022-03-28 21:31:33'),
(316, 316, '<p>Chlorhexidine Gluconate (4%) is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Surgical hand scrub: significantly reduces the number of microorganisms on the hands and forearms prior to surgery or patient care</li>\r\n	<li>Healthcare personnel handwash: helps reduce bacteria that potentially can cause disease</li>\r\n	<li>Patient preoperative skin preparation: for the preparation of the patient&#39;s skin prior to surgery</li>\r\n	<li>Skin wound and general skin cleansing.</li>\r\n</ul>', '<p>Chlorhexidine is a very potent cationic chemoprophylactic agent that has a broad-spectrum of activity against gm+ve and gm-ve bacteria. It is both bacteriostatic and bactericidal depending on its concentration. The bactericidal effect, which is achieved at high concentrations, is due to the binding of the cationic to negatively charged bacterial cell walls and extramicrobial complexes. Bacteriostatic effect is achieved at low concentrations which causes an alteration of bacterial cell osmotic equilibrium and leakage of potassium and phosphorus.</p>', '<p><strong>হাত ধোয়ায়</strong>: পানিতে হাত ভিজিয়ে নিন। প্রায় ৫ মিলি Chlorhexidine নিয়ে ১ মিনিট ধরে হাত ধুতে থাকুন ; নখের প্রতি বিশেষ মনযোগ দিন। পরিষ্কার পানিতে হাত ধুয়ে ফেলুন ও শুকিয়ে নিন। দ্রুত ব্যাকটেরিয়া বিনাশী ত্বক পরিষ্কারক দ্রবণ, যা শল্য চিকিৎসার পূর্বে হাতকে সংক্রামক জীবাণুমুক্ত করে এবং হাসপাতালের ওয়ার্ডসমূহে নিয়মিত ব্যবহারে বহুমুখী সংক্রামণের ঝুঁকি কমায়।<br />\r\n<br />\r\n<strong>শল্য চিকিৎসায় অস্ত্রপচার এর পূর্বে হাত ধোয়ায়</strong>: পানিতে হাতের কুনুই পর্যন্ত ভিজিয়ে নিন। প্রায় ৫ মিলি Chlorhexidine নিয়ে ১ মিনিট ধরে হাত ধুতে থাকুন; নখ পরিষ্কারের জন্য ব্রাশ বা র্স্ক্যাপার ব্যাবহার করুন। পরিষ্কার পানিতে হাত ধুয়ে ফেলুন। একই পদ্ধতিতে ২ মিনিট ধরে পুনরায় হেক্সিস্ক্রাব ব্যাবহার করুন।</p>', NULL, '<p>Do not use</p>\r\n\r\n<ul>\r\n	<li>if you are allergic to chlorhexidine gluconate or any other ingredients</li>\r\n	<li>in contact with meninges</li>\r\n	<li>in the genital area</li>\r\n	<li>as a preoperative skin preparation of the head or face.</li>\r\n</ul>', NULL, NULL, '<p>শিশুদের নাগালের বাইরে রাখুন। চোখ, মস্তিষ্ক, মেনিঞ্জেস ও মধ্যকর্ণ হতে দূরে রাখুন । চোখের সংপর্শে এলে তাৎক্ষনিকভাবে পর্যাপ্ত পানি দিয়ে চোখ ধুয়ে ফেলুন । আলো থেকে দূরে, ঘরে স্বাভাবিক তাপমাত্রায় রাখুন। ক্লোরহেক্সিডিন সাবান ও অন্যান্য অ্যানায়নিক এর সাথে ইনকমপিটেবল । কেবলমাত্র দেহের বহিরাংশে ব্যাবহারের জন্য ।</p>', NULL, '<p>Other antibacterial preparation</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-02-18 20:26:13', '2022-03-28 21:33:51'),
(317, 317, '<p>Chlorhexidine Gluconate 7.1% Solution is indicated for prophylaxis of omphalitis (infection of the umbilical cord) in newborn.</p>', '<p>Chlorhexidine is a broad-spectrum biocide effective against Gram-positive bacteria, Gramnegative bacteria and fungi. It has both bacteriostatic and bactericidal action, depending on its concentration. Chlorhexidine kills by disrupting the cell membrane. Upon application in vitro, Chlorhexidine can kill nearly 100% of Gram-positive and Gram-negative bacteria within 30 seconds. Since Chlorhexidine formulations can destroy the majority of categories of microbes, there is limited risk for the development of opportunistic infections.<br />\r\n<br />\r\nChlorhexidine is cationic in nature and binds strongly to skin. Data relating to topical administration in neonates are limited. There are no data on metabolism of Chlorhexidine following topical administration.</p>', '<p>Immediately after cutting the cord, 7.1% Chlorhexidine Gluconate should be applied to the tip of the cord, the stump and around the base of the stump.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Chlorhexidine ব্যবহারের পূর্বে ও পরে হাত ভালো করে সাবান ও পানি দিয়ে ধুয়ে ফেলুন। Chlorhexidine এর ড্রপার বোতল চেপে সলিউশনটি নবজাতকের জন্মের পরপর কাটা নাড়ীর অগ্রভাগ, চারপাশ ও গোড়ায় এমনভাবে লাগান যেন সম্পূর্ণ নাড়ীটি ভালো ভাবে ভিজে যায়। Chlorhexidine লাগানোর পর নাড়ী কোন কিছু দিয়ে মুছবেন না। একবার Chlorhexidine লাগানোর পর নাড়ী শুষ্ক রাখুন ও নাড়ীতে অন্য কোন কিছুই লাগাবেন না। চোখে লাগাবেন না।</p>', NULL, NULL, NULL, '<p>Not applicable for the intended patient population.</p>', '<p>For external use only. Do not inject or swallow. Keep out of the eyes and ears and do not use over large areas of the body. If the product comes into contact with the eyes, wash out promptly and thoroughly with clean water. There have been reports of hypersensitivity and skin irritation after topical administration of Chlorhexidine, including generalized allergic reactions and anaphylactic shock. The prevalence of Chlorhexidine hypersensitivity is not known, but available literature suggests this is likely to be very rare. The application of this product should be discontinued and immediate medical help should be sought in case of any symptoms which may indicate an allergic reaction. If skin irritation or redness occurs, prompt medical advice should be sought.</p>', NULL, '<p>Bleaching and Disinfectants</p>', '<p>শিশুদের নাগালের বাইরে রাখুন। আলো থেকে দূরে, ঠাণ্ডা (৩০&deg; সে. এর নিচে) ও শুষ্ক স্থানে রাখুন। কেবলমাত্র রেজিস্টার্ড চিকিৎসকের ব্যবস্থাপত্র অনুযায়ী&nbsp; ব্যবহার্য ও বিক্রয়যোগ্য।</p>', NULL, '2022-02-18 20:26:26', '2022-03-28 21:36:00'),
(318, 318, '<p>For cleansing and irrigating the skin and dirty wounds where an added surfactant effect is required.</p>', '<p><strong>Chlorhexidine</strong>: Chlorhexidine is an antiseptic and disinfectant which is effective against a wide range of vegetative Gram-positive and Gram-negative organisms, some viruses and some fungi. It is ineffective against bacterial spores at room temperature, and acid-fast bacteria are inhibited but not killed. It is more active against Gram-positive than Gram-negative bacteria and some species of Pseudomonas and Proteus are relatively less susceptible. Chlorhexidine is most active at a neutral or slightly acid pH and its activity may be reduced by blood and other organic matter.<br />\r\n<br />\r\n<strong>Cetrimide</strong>: Cetrimide is a quaternary ammonium disinfectant with properties typical of cationic surfactants. Solutions of these surfactants have emulsifying and detergent properties and bactericidal activity against both Gram-positive and Gram-negative organisms but higher concentrations are necessary to kill the latter. The combined detergent and antibacterial properties of cetrimide make it useful in cleansing dirty or infected wounds. It is however, relatively ineffective against bacterial spores, acid-fast bacteria, viruses and fungi.</p>', '<p>Rinse the area to be cleaned with water, apply the minimum amount of irrigation necessary to cover the wound area and wash gently. Rinse again thoroughly. Apply to wound as necessary. Discard remaining solution after use.<br />\r\n<br />\r\nPaediatric Use: Use with care in neonates, particularly in premature infants. Chlorhexidine may cause irritation or chemical burns.</p>', NULL, '<p>Known hypersensitivity to either chlorhexidine or cetrimide. Do not use to irrigate the brain, meninges, eyes or perforated eardrum.</p>', '<p>Irritative skin reactions and hypersensitivity reactions to chlorhexidine have been reported. In the event that these reactions occur, discontinue use. Cetrimide may have a prolonging effect on the wound healing process.</p>', '<p><strong>Pregnancy</strong>: There are no adequate data from the use of chlorhexidine and cetrimide in pregnant women. The potential risk for humans is unknown but is most likely very low since chlorhexidine and cetrimide are poorly absorbed following topical application.<br />\r\n<br />\r\n<strong>Breastfeeding</strong>: It is not known whether chlorhexidine and cetrimide are excreted in breast milk. There are no adequate data from the use of chlorhexidine and cetrimide in breast-feeding women. However, it is unlikely that the products are excreted in breast milk, since the products are poorly absorbed. After topical usage of the product, as a general precaution, rinse nipples thoroughly with water before breastfeeding.</p>', '<p>For external use only. Not for injection, for irrigation only. Not isotonic and is haemolytic. Cetrimide may have a prolonging effect on the wound healing process. Use of this antiseptic should be restricted to infection control and cleansing of wounds rather than general wound management.</p>', '<p>While accidental ingestion is unlikely to cause any systemic effects due to poor absorption of chlorhexidine and cetrimide, ingestion of high concentrations could cause irritation of the gastrointestinal mucosa/gastritis. Gastric lavage might be needed. Symptomatic treatment should be employed. If swallowed, wash out mouth, drink plenty of milk or water and seek medical advice. In case of overdose, seek medical attention or contact a poison control centre.</p>', '<p>Chlorhexidine &amp; Chloroxylenol preparations</p>', '<p>Store below 25&deg;C. Protect from light. Single use only. Discard unused portion.</p>', NULL, '2022-02-18 20:26:55', '2022-03-28 21:37:57'),
(319, 319, '<p>For the disinfection of clean and intact skin. For pre-operative surgical hand disinfection, hand disinfection on the ward prior to aseptic procedures or after handling contaminated materials. For disinfection of the patients&rsquo; skin prior to surgery or other invasive procedures</p>', '<p>Chlorhexidine is a very potent cationic chemoprophylactic agent that has a broad-spectrum of activity against gm+ve and gm-ve bacteria. It is both bacteriostatic and bactericidal depending on its concentration. The bactericidal effect, which is achieved at high concentrations, is due to the binding of the cationic to negatively charged bacterial cell walls and extramicrobial complexes. Bacteriostatic effect is achieved at low concentrations which causes an alteration of bacterial cell osmotic equilibrium and leakage of potassium and phosphorus.</p>', '<p><strong>Pre-operative surgical hand disinfection</strong>: Dispense 5 ml of solution and spread thoroughly over both hands and forearms, rubbing vigorously. When dry apply a further 5 ml and repeat the procedure.<br />\r\n<br />\r\n<strong>Antiseptic hand disinfection on the ward</strong>: Dispense 3 ml of solution and spread thoroughly over the hands and wrists rubbing vigorously until dry.<br />\r\n<br />\r\n<strong>Disinfection of patients skin</strong>: Prior to surgery apply the solution to a sterile swab and rub vigorously over the operation site for a minimum of 2 minutes. Chlorhexidine Gluconate is also used for preparation of the skin prior to invasive procedures such as venepuncture.</p>', '<p>Chlorhexidine is incompatible with soaps and other anionic agents. Hypochlorite bleaches may cause brown stains to develop in fabrics which have previously been in contact with chlorhexidine solutions.</p>', '<p>Chlorhexidine Gluconate is contraindicated for persons who have previously shown a hypersensitivity reaction to chlorhexidine. However, such reactions are extremely rare.</p>', '<p>Irritative skin reactions can occasionally occur. Generalised allergic reactions have also been reported but are extremely rare</p>', '<p>No untoward effects are known</p>', '<p>Avoid contact with brain, meninges, middle ear or sensitive tissues and eyes. Do not inject or use in body cavities.</p>', '<p><strong>Symptoms</strong>: Pharyngeal oedema, necrotic lesions of the esophagus and elevated serum aminotransferase concentrations.<br />\r\n<br />\r\n<strong>Management</strong>: Gastric lavage using milk, raw egg, gelatin or mild soap, or employ appropriate supportive measures.</p>', '<p>Chlorhexidine &amp; Chloroxylenol preparations</p>', '<p>Do not store above 25&deg; C.</p>', NULL, '2022-02-18 20:27:21', '2022-03-28 21:40:56'),
(320, 320, '<p>Cetrimide &amp; Chlorhexidine Hydrochloride is indicated in Insect bites, Sunburn, Disinfection, Cuts, Scratches, Blisters, Grazes, Nappy rash, Cracked and itchy skin, Cleansing and irrigating the skin or dirty wounds</p>', '<p>Cetrimide is a quaternary ammonium antiseptic; it has bactericidal activity against both gram-positive and gram-negative organisms. Chlorhexidine is an antimicrobial agent; it is active against a wide range of gram-negative and gram-positive vegetative bacteria, yeasts, dermatophyte fungi and lipophilic viruses.</p>', '<p>Adult and children: Apply 2-3 times daily or as directed</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Not to be used in the eye, ear, mucous membrane or body cavities.</p>', '<p>Repeated application may lead to skin irritation.</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>Prolonged and repeated use may increase risk of hypersensitivity reactions. Blood, soap, cotton or other organic matter may decrease antibacterial efficacy.</p>', NULL, '<p>Chlorhexidine &amp; Chloroxylenol preparations</p>', NULL, NULL, '2022-02-18 20:27:51', '2022-03-28 21:43:23'),
(321, 321, '<p>It is used to treat skin infections caused by either fungi and/or bacteria, such as-</p>\r\n\r\n<ul>\r\n	<li>Ringworm</li>\r\n	<li>Athlete&#39;s foot and</li>\r\n	<li>Infected nappy rash</li>\r\n</ul>', '<p>Nystatin is a fungistatic and fungicidal antibiotic primarily effective against Candida albicans. Chlorhexidine has activity against a wide range of bacteria. Nystatin is poorly absorbed from the gastrointestinal tract. It is not absorbed through the skin or mucous membranes when applied topically</p>', '<p>Route of administration: Topically<br />\r\n<strong>Child</strong>: Apply 2-3 times a day, continuing for 7 days after lesions have healed.<br />\r\n<strong>Adult</strong>: Apply 2-3 times a day, continuing for 7 days after lesions have healed. Or as directed by the physician.</p>', '<p>There are no known drug interactions.</p>', '<p>Known hypersensitivity to the active substances, especially in those with a history of possible chlorhexidine-related allergic reactions.</p>', '<p>Common side effects: Allergic skin reactions such as dermatitis, pruritus, erythema, eczema, rash and skin irritation. Rare side effects: Severe allergic reactions, leading to a drop in blood pressure and even to unconsciousness.</p>', '<p>This cream should be administered with caution during the early months of pregnancy.</p>', '<p>For external use only. Avoid contact with eyes. If sensitivity occurs, or if new infection appears, discontinue use and institute alternative therapy. This cream contains chlorhexidine. Chlorhexidine is known to induce hypersensitivity, including generalized allergic reactions and anaphylactic shock. This cream should not be administered to Anyone with a potential history of an allergic reaction to a chlorhexidine-containing compound.</p>', '<p>This is poorly absorbed from the gastrointestinal tract. In the event of accidental oral ingestion, routine measures such as gastric lavage should be performed as soon as possible after ingestion.</p>', '<p>Chlorhexidine &amp; Chloroxylenol preparations</p>', '<p>Store below 30&deg;C temperature &amp; dry place, protected from light. Keep out of the reach of children.</p>', NULL, '2022-02-18 20:28:20', '2022-03-28 21:47:38'),
(322, 322, '<p>hloroquine Phosphate is indicated in the following cases:</p>\r\n\r\n<ul>\r\n	<li>Treatment of malaria</li>\r\n	<li>Prophylaxis and suppression of malaria</li>\r\n	<li>Treatment of amoebic hepatitis and abscess</li>\r\n	<li>Treatment of discoid and systemic and systemic lupus erythematosus</li>\r\n	<li>Treatment of rheumatoid arthritis</li>\r\n</ul>', '<p>Chloroquine is used for malarial prophylaxis (as a suppressive) and in managing acute attacks of malaria. It is highly active against erythrocytic forms of P. vivax, P. malariae and P. falciparum. It influences Hb digestion by increasing intravesicular pH in malaria parasite cells and interferes with the nucleoprotein synthesis of the patient. It is also effective in extra intestinal amoebiasis. In RA chloroquine and more effectively hydroxychloroquine have a disease-modifying effect.</p>', '<p><strong>Treatment of Malaria-</strong><br />\r\n<br />\r\nPartially immune adults:</p>\r\n\r\n<p>A single dose of 4 tablets. In severe attacks, the dosage schedule for non-immune adults should be adopted.</p>\r\n\r\n<p>Partially immune children:</p>\r\n\r\n<ul>\r\n	<li><strong>Under 1 year</strong>: 1-2 single dose (in 5 ml spoonful)</li>\r\n	<li><strong>1-3 years</strong>: 3-4 single dose (in 5 ml spoonful)</li>\r\n	<li><strong>3-6 years</strong>: 4-6 single dose (in 5 ml spoonful)</li>\r\n	<li><strong>6-9 years</strong>: 6-9 single dose (in 5 ml spoonful)</li>\r\n</ul>\r\n\r\n<p>In severe attacks, the dosage schedule for non-immune children should be adopted.</p>\r\n\r\n<p>Non-immune adults:</p>\r\n\r\n<ul>\r\n	<li><strong>P. falciparum infections</strong>: 4 tablets initially, 2 tablets after 6 to 8 hours and then 2 tablets per day for 2 days</li>\r\n	<li><strong>P. vivax group infections</strong>: A single dose of four tablets followed by a course of treatment with primaquine phosphate (15 mg base daily for fourteen days)</li>\r\n</ul>\r\n\r\n<p>Non-immune Children:</p>\r\n\r\n<p>Under 1 year:</p>\r\n\r\n<ul>\r\n	<li>1-2 initial dose (in 5 ml spoonful)</li>\r\n	<li>1 dose to be taken 6 hours later and then daily for 2 days (in 5 ml spoonful)</li>\r\n</ul>\r\n\r\n<p>1-3 years:</p>\r\n\r\n<ul>\r\n	<li>3-4 initial dose (in 5 ml spoonful)</li>\r\n	<li>1-2 dose to be taken 6 hours later and then daily for 2 days (in 5 ml spoonful)</li>\r\n</ul>\r\n\r\n<p>3-6 years:</p>\r\n\r\n<ul>\r\n	<li>4-6 initial dose (in 5 ml spoonful)</li>\r\n	<li>2-3 dose to be taken 6 hours later and then daily for 2 days (in 5 ml spoonful)</li>\r\n</ul>\r\n\r\n<p>6-9 years :</p>\r\n\r\n<ul>\r\n	<li>6-9 initial dose (in 5 ml spoonful)</li>\r\n	<li>3-5 dose to be taken 6 hours later and then daily for 2 days (in 5 ml spoonful)</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Prophylaxis and suppression of Malaria-</strong></p>\r\n\r\n<p><strong>Adults</strong>: 2 tablets taken once a week, on the same day each week, during exposure to risk and continued for 6 weeks after leaving the malarious area.<br />\r\n<br />\r\n<strong>Children (Syrup)</strong>: The following doses should be taken once a week, on the same day each week, during exposure to risk and continued for 6 weeks after leaving the malarious area.</p>\r\n\r\n<ul>\r\n	<li><strong>Under 1 year</strong>: 1 single dose (in 5 ml spoonful)</li>\r\n	<li><strong>1-3 years</strong>: 2 single dose (in 5 ml spoonful)</li>\r\n	<li><strong>3-6 years</strong>: 2-3 single dose (in 5 ml spoonful)</li>\r\n	<li><strong>6-9 years</strong>: 3-5 single dose (in 5 ml spoonful)</li>\r\n</ul>\r\n\r\n<p><strong>Children (Tablets)</strong>: For practical purpose, children over 12 years may be treated as adults and for those below this age, the following proportions may be applied.</p>\r\n\r\n<ul>\r\n	<li><strong>Under 1 year</strong>: ⅛ adult dose (&frac14; tablet)</li>\r\n	<li><strong>1-4 years</strong>: &frac14; adult dose (&frac12; tablet)</li>\r\n	<li><strong>4-8 years</strong>: &frac12; adult dose (1 tablet)</li>\r\n	<li><strong>8-12 years</strong>: &frac34; adult dose (1.5 tablet)</li>\r\n</ul>', '<p>Concomitant therapy with phenylbutazone predisposes to dermatitis, antagonises effect of neostigmine and pyridostigmine, reduces bioavailability of ampicillin. Cimetidine inhibits metabolism of chloroquine raising plasma levels.</p>', '<p>There is no absolute contraindication to the use of chloroquine.</p>', '<p>Choroquine is well tolerated at the standard dosage regimens, side effects such as headache and gastrointestinal disturbances which may occur are not of a serious nature. Where prolonged high dose is required side effects can be of greater severity and patients may develop skin eruptions, occasional depigmentation or loss of hair, difficulty in accommodation, blurring of vision. Corneal opacities disappear completely when the drug is stopped. Rarely thrombocytopenia, agranulocytosis and aplastic anemia have been reported.<br />\r\n<br />\r\nThe most serious toxic hazard of prolonged therapy with doses is the occasional development of irreversible retinal damage. For this reason considerable caution is needed in the use of choroquine for long-term high dosage therapy and such use should only be considered when no other drug is available. Defects in visual accommodation may occur on first taking choloquine and patients should be warned regarding driving or operating machinery.</p>', '<p>As with all other drugs, the use of choroquine during pregnancy should be avoided if possible, unless in the case of threatening infections, in the judgment of the physician, when the potential benefit outweighs the risk.</p>', '<p>Caution is necessary when giving choroquine to patients with porphyria who also have hepatic dysfunction or cirrhosis as the drug may precipitate severe constitutional symptoms and an increase in the amount of porphyrins excreted in the urine. This reaction is especially apparent in alcoholics. Patients receiving choloquine continuously at higher dose levels for a period longer than 12 months or at weekly intervals for a period of more than 3 years as prophylactic against malaria (or the consumption exceeds 1.6 g/Kg) should undergo ophthalmic examination at three months interval.</p>', NULL, '<p>Anti-malarial drugs</p>', '<p>Store at room temperature in a dry place, away from light.</p>', '<p><strong>Amoebic hepatitis</strong>: Four tablets daily for two days followed by one tablet twice daily for two or three weeks.<br />\r\n<br />\r\n<strong>Lupus erythomatosus</strong>: One tablet twice daily for one to two weeks followed by a maintenance dose of one tablet daily.</p>', '2022-02-18 20:28:41', '2022-03-28 21:51:19'),
(323, 323, '<p>Disinfectant for skin and gloved hands; obstetrics, antiseptic lubricant for vaginal examinations and on forceps; for hand antisepsis .</p>', '<p>Chloroxylenol is used in hospitals and households for disinfection and sanitation. It is also commonly used in&nbsp;antibacterial soaps, wound-cleansing applications and household antiseptics such as liquid (to which it contributes its distinctive odor), cream and ointments.</p>', '<p>Wash with one table spoonful of Chloroxylenol to a tumbler of water (1 in 13) for urgent application, undiluted Chloroxylenol may be used but not in a sensitive skin.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity</p>', '<p>Skin sensitivity; irritation of conjunctiva, mucosal irritation; reversible brown staining of the teeth; tongue discoloration and burning sensation; transient taste disturbance; parotid gland swelling.</p>', '<p>Pregnancy Category-Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Condition worsens or symptoms persist for more than 7 days or clear up and occur again within a few days</p>', NULL, '<p>Chlorhexidine &amp; Chloroxylenol preparations</p>', NULL, NULL, '2022-02-18 20:29:05', '2022-03-28 21:54:39'),
(324, 324, '<p>Chloroxylenol &amp; Triclosan is indicated in Insect bites, Sunburn, Cuts, Scratches, Abrasions, Disinfection of the skin, Minor burns, Sore lips, Minor skin infections, Chapped roughened hands, Cracked itchy skin</p>', '<p>It is bactericidal against most gram-positive bacteria. Chloroxylenol is used in hospitals and households for disinfection and sanitation. It is also commonly used in&nbsp;antibacterial soaps, wound-cleansing applications and household antiseptics such as Dettol liquid (to which it contributes its distinctive odor), cream and ointments.&nbsp;<br />\r\n<br />\r\nTriclosan, a chlorinated bisphenol antiseptic, is active against fungi, gram-positive and gram-negative bacteria.</p>', '<p><strong>Adults and children 2 years of age and older</strong>: apply to the affected area no more than 3 to 4 times daily.<br />\r\n<br />\r\n<strong>children under 2 years of age</strong>: consult a doctor</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity</p>', '<p>Skin sensitivity; irritation of conjunctiva, mucosal irritation; reversible brown staining of the teeth; tongue discoloration and burning sensation; transient taste disturbance; parotid gland swelling.</p>', '<p>Pregnancy Category: Not Classified<br />\r\nFDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Condition worsens or symptoms persist for more than 7 days or clear up and occur again within a few days</p>', NULL, '<p>Chlorhexidine &amp; Chloroxylenol preparations</p>', NULL, NULL, '2022-02-18 20:29:46', '2022-03-28 22:09:05'),
(325, 325, '<p>Chlorpheniramine Maleate is indicated in the following indications-</p>\r\n\r\n<ul>\r\n	<li>Urticaria</li>\r\n	<li>Sensitivity reactions</li>\r\n	<li>Angioneurotic edema</li>\r\n	<li>Vasomotor rhinitis</li>\r\n	<li>Cough</li>\r\n	<li>Common cold</li>\r\n	<li>Motion sickness and</li>\r\n	<li>Other allergic conditions.</li>\r\n</ul>', '<p>Chlorpheniramine Maleate is an alkylamine antihistamine. It is one of the most potent histamine H1-receptor blocking agents which is used as a potent antihistamine. This generally causes less sedation than promethazine. Chlorpheniramine Maleate exerts its effects by blocking H1-receptor competitively.</p>', '<p>Adult- Usual adult dose is 4 mg every 4-6 hours, maximum 24 mg daily.<br />\r\n<br />\r\nChild-</p>\r\n\r\n<ul>\r\n	<li>6-12 years: 2 mg every 4-6 hours, maximum 12 mg daily.</li>\r\n	<li>2-5 years: 1 mg every 4-6 hours, maximum 6 mg daily.</li>\r\n	<li>1-2 years: 1 mg twice daily.</li>\r\n</ul>\r\n\r\n<p>Below 1 year the use of Chlorpheniramine Maleate is not recommended.</p>', '<p>Chlorphenamine maleate has been reported to be incompatible with calcium chloride, kanamycin sulfate, noradrenaline acid tartrate, pentobarbital sodium, and meglumine adipiodone.</p>', '<p>Chlorpheniramine is contraindicated in patients hypersensitive to this agent, in newborn or premature infants.</p>', '<p>Chlorpheniramine is well-tolerated, but sometimes drowsiness, dizziness, muscular weakness, and gastrointestinal upset may occur.</p>', '<p>This drug should not be used in lactating mother and in pregnancy especially during the first trimester of pregnancy.</p>', '<p>Chlorpheniramine should be used with caution in patients with glaucoma and prostatic hypertrophy. During therapy with chlorpheniramine, caution should be taken in driving vehicles and operating machinery.</p>', '<p>CNS depression (including sedation, apnea, CV collapse), CNS stimulation (including insomnia, hallucination, tremors, convulsions), tinnitus, blurred vision, dizziness, ataxia, hypotension. Stimulation and atropine-like signs and symptoms (including dry mouth, fixed dilated pupils, flushing, hyperthermia, Gl symptoms) are more likely in children.</p>', '<p>Sedating Anti-histamine</p>', '<p>Store in a cool (Below 25&deg;C temperature) and dry place protected from light. Keep out of the reach of children.</p>', NULL, '2022-02-18 20:30:13', '2022-03-28 22:11:38');
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
(326, 326, '<p>Chlorpromazine is indicated in the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Schizophrenia and other psychoses (especially paranoid), mania and hypomania.</li>\r\n	<li>In anxiety psychomotor agitation excitement, violent or dangerously impulsive behaviour. Chlorpromazine is used as an adjunct in the short-term management of these conditions.</li>\r\n	<li>Intractable hiccup.</li>\r\n	<li>Nausea and vomiting of terminal illness (where other medicines have failed or are not available).</li>\r\n	<li>Childhood schizophrenia and autism.</li>\r\n</ul>', '<p>Chlorpromazine is a neuroleptic that acts by blocking the postsynaptic dopamine receptor in the mesolimbic dopaminergic system and inhibits the release of hypothalamic and hypophyseal hormones. It has antiemetic, serotonin-blocking, and weak antihistaminic properties and slight ganglion-blocking activity.</p>', '<p>Schizophrenia, Psychoses, Anxiety and Agitation</p>\r\n\r\n<p>Oral-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Initially 25 mg three times daily or 75 mg at bedtime increasing by daily amounts of 25 mg to an effective maintenance dose. This is usually in the range 75 to 300 mg daily, but some patients may require up to 1 g daily.</li>\r\n	<li><strong>Children</strong>: Under 1 Year: Do not use unless need is life saving. 1-5 Years: 0.5 mg/kg bodyweight every 4 - 6 hours to a maximum recommended dose of 40 mg daily. 6-12 Years: A third to half the adult dose, to a maximum recommended dose of 75 mg daily.</li>\r\n	<li><strong>Elderly</strong>: Start with a third to a half the usual adult dose with a more gradual increase in dosage.</li>\r\n</ul>\r\n\r\n<p>Intramuscular-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: For acute relief of symptoms 25 - 50 mg every 6-8 hours.</li>\r\n	<li><strong>Children</strong>: Under 1 Year: Do not use unless need is life saving. 1-5 Years: 0.5 mg/kg bodyweight every 6 - 8 hours. Dosage is not advised to exceed 40 mg daily. 6-12 Years: 0.5 mg/kg bodyweight every 6-8 hours. Not to exceed 75 mg daily.</li>\r\n	<li><strong>Elderly</strong>: Doses in the lower range for adults should be sufficient to control symptoms, i.e. 25 mg, 8 hourly.</li>\r\n</ul>\r\n\r\n<p><br />\r\nIntractable Hiccup (Adult)</p>\r\n\r\n<ul>\r\n	<li><strong>Oral</strong>: 25-50 mg three or four times daily.</li>\r\n	<li><strong>Intramuscular</strong>: 25-50 mg every 6-8 hours.</li>\r\n	<li><strong>Intravenous Infusion</strong>: If other routes of administration are inappropriate, give 25-50 mg in 500-1000 ml sodium chloride by slow intravenous infusion every 6-8 hours.</li>\r\n</ul>\r\n\r\n<p><br />\r\nNausea and Vomiting of Terminal Illness</p>\r\n\r\n<p>Oral-</p>\r\n\r\n<ul>\r\n	<li>Adults: 10-25 mg every 4-6 hours.</li>\r\n	<li>Children: Under 1 Year: Do not use unless need is life saving. 1-5 Years: 0.5 mg/kg every 4 - 6 hours. Maximum daily dosage should not exceed 40 mg. 6-12 Years: 0.5 mg/kg every 4 - 6 hours. Maximum daily dosage should not exceed 75 mg.</li>\r\n	<li>Elderly: Initially a third to half the adult dose. The physician should then use their clinical judgement to obtain control.</li>\r\n</ul>\r\n\r\n<p>Intramuscular-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 25 mg initially, then 25 - 50 mg every 3 - 4 hours until vomiting stops, then drug to be taken orally.</li>\r\n	<li><strong>Children</strong>: Under 1 Year: Do not use unless need is life saving. 1-5 Years: 0.5 mg/kg 6 - 8 hourly. It is advised that maximum daily dosage should not exceed 40 mg. 6-12 Years: 0.5 mg/kg every 6 - 8 hours. It is advised that maximum daily dosage should not exceed 75 mg.</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.</p>', '<p>Interactions resulting in decreased chlorpromazine levels: Food, alcohol and benztropine can reduce the absorption of chlorpromazine. Antacids can slow the absorption of chlorpromazine. Lithium and chronic administration of barbiturates can lead to increased clearance of chlorpromazine.<br />\r\n<br />\r\nInteractions resulting in increased chlorpromazine levels: Tricyclic antidepressants decrease the clearance of chlorpromazine and may lead to increased serum levels. Administration of chlorpromazine with CYP1A2 inhibitors, in particular strong (such as ciprofloxacin and fluvoxamine) or moderate (such as oral contraceptives and vemurafenib) inhibitors leads to an increase in chlorpromazine plasma concentrations. Therefore, patients may experience any chlorpromazine dose-dependent adverse drug reaction.</p>', '<p>Chlorpromazine should never be used in the following circumstances:</p>\r\n\r\n<ul>\r\n	<li>Circulatory collapse.</li>\r\n	<li>CNS depression, e.g. coma or drug intoxication.</li>\r\n	<li>Previous history of a hypersensitivity reaction (e.g. jaundice or blood dyscrasia) to phenothiazines, especially chlorpromazine itself, or to any of the excipients contained in the tablets or injection.</li>\r\n	<li>Bone marrow depression.</li>\r\n	<li>Phaeochromocytoma.</li>\r\n	<li>Hepatic failure or active hepatic disease.</li>\r\n	<li>Chlorpromazine Injection contains sodium metabisulfite and sodium sulfite and may cause allergic-type reactions including anaphylactic symptoms and asthmatic episodes in susceptible people.</li>\r\n</ul>', '<p>The following adverse effects have been reported for chlorpromazine or phenothiazines in<br />\r\ngeneral.</p>\r\n\r\n<ul>\r\n	<li>Cardiovascular: Postural hypotension, ECG Changes.</li>\r\n	<li>Dermatological</li>\r\n	<li>Contact dermatitis, photosensitivity, urticarial, maculopapular, petechial or oedematous reactions.</li>\r\n	<li>Endocrine: Elevated prolactin levels, impaired thermoregulation, hyperglycaemia, other hypothalamic effects.</li>\r\n	<li>Gastrointestinal: Dry mouth, constipation.</li>\r\n	<li>Immunological: Raised ANA titre, positive SLE cells.</li>\r\n	<li>Genitourinary: Urinary retention.</li>\r\n	<li>Haematological: Leucopenia, agranulocytosis, eosinophilia, hemolytic anaemia, aplastic anaemia, thrombocytopenic purpura and pancytopenia have been reported.</li>\r\n</ul>', '<p>Pregnancy category C. Studies in animals by oral route have shown reproductive toxicity (dose-related embryo fetotoxicity: increased resorptions and dead foetuses). Increased incidence of malformations was observed in mice but only at doses inducing maternal mortality. There is inadequate animal data regarding reproductive toxicity with chlorpromazine by parenteral route. In humans, the teratogenic risk of chlorpromazine has not been evaluated. Different prospective epidemiological studies conducted with other phenothiazines have yielded contradictory results regarding teratogenic risk. Chlorpromazine has been found to be excreted in breast milk in variable amounts, therefore it is not recommended for nursing mothers unless the expected benefits outweigh any potential risk.</p>', '<p>Chlorpromazine generally should not be used in epilepsy, Parkinson&rsquo;s disease, hypoparathyroidism, myasthenia gravis and prostatic hypertrophy.</p>', NULL, '<p>Anti-emetic drugs, Phenothiazine drugs, Phenothiazine related drugs</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Elderly: The elderly are relatively more susceptible to the adverse effects of chlorpromazine. The starting dose should be about half the usual adult dose and dosage increments should be gradual and reviewed regularly.</p>', '2022-02-18 20:30:38', '2022-03-28 22:14:13'),
(327, 327, '<p>Chlorthalidone is indicated in the management of hypertension. Chlorthalidone is indicated as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis and corticosteroid and estrogen therapy.</p>', '<p>Chlortalidone prevents reabsorption of sodium and chloride by inhibiting the Na+/Cl&minus;&nbsp;symporter in the distal convoluted tubule. Thiazides and related compounds also decrease the glomerular filtration rate, which further reduces the drug&#39;s efficacy in patients with kidney impairment (e.g. kidney insufficiency). By increasing the delivery of sodium to the distal renal tubule, chlortalidone indirectly increases potassium excretion via the sodium-potassium exchange mechanism (i.e. apical ROMK/Na channels coupled with basolateral NKATPases). This can result in hypokalemia and hypochloremia as well as a mild metabolic alkalosis; however, the diuretic efficacy of chlortalidone is not affected by the acid-base balance of the patient being treated.<br />\r\n<br />\r\nInitially, diuretics lower blood pressure by decreasing cardiac output and reducing plasma and extracellular fluid volume. Eventually, cardiac output returns to normal, and plasma and extracellular fluid volume return to slightly less than normal, but a reduction in peripheral vascular resistance is maintained, thus resulting in an overall lower blood pressure. The reduction in intravascular volume induces an elevation in plasma renin activity and aldosterone secretion, further contributing to the potassium loss associated with thiazide diuretic therapy.</p>', '<p>Therapy should be initiated with the lowest possible dose and then titrated according to individual patient response. A single dose given in the morning with food is recommended; divided doses are unnecessary.<br />\r\n<br />\r\n<strong>Edema</strong>: Up to 50 mg daily.<br />\r\n<br />\r\n<strong>Hypertension</strong>: 25 mg daily in the morning, increased to 50 mg daily if necessary.<br />\r\n<br />\r\n<strong>Heart failure</strong>: 25-50 mg daily in the morning, increased if necessary to 100-200 mg daily (reduce to lowest effective dose for maintenance).<br />\r\n<br />\r\nMaintenance doses may often be lower than initial doses and should be adjusted according to the individual patient.</p>', '<p>Chlorthalidone may add to or potentiate the action of other antihypertensive drugs. Potentiation occurs with ganglionic peripheral adrenergic blocking drugs.</p>', '<p>Patients with anuria and known hypersensitivity to Chlorthalidone or other sulfonamide-derived drugs.</p>', '<p>Dry mouth, thirst, nausea, vomiting, feeling weak, drowsy, restless, or light-headed, fast or uneven heartbeat, muscle pain or weakness, urinating less than usual or not at all, easy bruising or bleeding, unusual weakness, red or purple spots on skin, numbness or tingly feeling, nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools.</p>', '<p>Pregnancy&nbsp;category B.&nbsp;Thiazides are excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from chlorthalidone, 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>Renal impairment</strong>: Chlorthalidone dosage should be reduced in moderate renal failure - every 24 or 48 h - and should not be used in advanced renal failure.<br />\r\n<br />\r\n<strong>Liver disease</strong>: There is a risk of precipitating hepatic encephalopathy in patients with liver cirrhosis and ascites.<br />\r\n<br />\r\n<strong>Use in pregnancy</strong>: It is better to avoid Chlorthalidone as it crosses the placenta.<br />\r\n<br />\r\n<strong>Use in Lactation</strong>: In lactating mother, significant amount of Chlorthalidone enter breast milk; like other long-acting thiazides, it can suppress lactation. Chlorthalidone should not be prescribed for lactating mother.</p>', '<p>Symptoms of acute overdosage include nausea, weakness, dizziness, and disturbances of electrolyte balance. The oral LD50 of the drug in the mouse and the rat is more than 25,000 mg/kg body weight. The minimum lethal dose (MLD) in humans has not been established. There is no specific antidote, but gastric lavage is recommended, followed by supportive treatment. Where necessary, this may include intravenous dextrose-saline with potassium, administered with caution.</p>', '<p>Thiazide diuretics &amp; related drugs</p>', '<p>Store in a cool &amp; dry place, away from children</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of Chlorthalidone tablets in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: 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>', '2022-02-18 20:30:55', '2022-03-28 22:16:30'),
(328, 328, '<p>Cholera Saline contains different electrolytes which are usually depleted in various conditions e.g. diarrhoea, vomiting, profuse sweating etc. So, this saline is indicated in cholera, also in diarrhoea, vomiting, fluid loss, to replenish and restore the normal electrolyte balance of the body.</p>', NULL, '<p>The volume and rate of infusion of Cholera Saline depends upon the requirements of the patient and the judgement of the physician. It usually varies with age, weight and clinical condition of the patient.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Administration Procedure:</p>\r\n\r\n<ul>\r\n	<li>Check infusion set and infusion solution prior to use</li>\r\n	<li>Pull moderately to tear off the protective cover of the Eurohead</li>\r\n	<li>Hold lightly the Eurohead but not the bag</li>\r\n	<li>Open the flow regulator fully and hold the giving set on the top white area, but not the membrane venting region</li>\r\n	<li>Insert the spike of the administration set to the Eurohead and fit the connector of the administration set firmly to the needle</li>\r\n	<li>Gradually allow the fluid to flow down to the needle tip and close</li>\r\n	<li>Remove the protective cover of the needle</li>\r\n	<li>Locate the venipuncture site and clean the site with an antiseptic solution, and then insert the needle</li>\r\n	<li>Securely tape the puncture site</li>\r\n	<li>Securely tape the wings and tubing</li>\r\n	<li>Start infusion while adjusting drip speed</li>\r\n</ul>', NULL, NULL, '<ul>\r\n	<li>Severe burning, pain, or swelling around the IV needle;</li>\r\n	<li>Warmth, redness, oozing, or bleeding where the IV was placed;</li>\r\n	<li>fever, ongoing cough.</li>\r\n</ul>', NULL, '<p>Since Cholera Saline contains different electrolytes, it should be infused with caution in patients where electrolyte imbalance may cause detrimental effects, e.g. in pregnancy, renal impairment, heart failure, pulmonary congestion, head injury etc. or in patients receiving potassium sparing diuretics.</p>', NULL, '<p>Intravenous fluid preparations</p>', '<p>Should be stored at controlled room temperature.</p>', NULL, '2022-02-18 20:31:11', '2022-03-28 22:18:17'),
(329, 329, '<p>Choriogonadotropin alfa injection is indicated for the induction of final follicular maturation and early luteinization in&nbsp;infertile&nbsp;women who have undergone pituitary&nbsp;desensitization and who have been appropriately pretreated with follicle stimulating hormones as part of an Assisted Reproductive Technology (ART) program such as&nbsp;in vitro&nbsp;fertilization&nbsp;and embryo transfer. Choriogonadotropin alfa PreFilled Syringe is also indicated for the induction of&nbsp;ovulation&nbsp;(OI) and pregnancy in anovulatory infertile patients in whom the cause of&nbsp;infertility&nbsp;is functional and not due to primary&nbsp;ovarian&nbsp;failure.<br />\r\n<br />\r\nSelection Of Patients:</p>\r\n\r\n<ul>\r\n	<li>Before treatment with gonadotropins is instituted, a thorough gynecologic and endocrinologic evaluation must be performed. This should include an assessment of&nbsp;pelvic&nbsp;anatomy. Patients with tubal obstruction should receive Choriogonadotropin Alfa PreFilled Syringe only if enrolled in an&nbsp;in vitro&nbsp;fertilization program.</li>\r\n	<li>Primary ovarian failure should be excluded by the determination of gonadotropin levels.</li>\r\n	<li>Appropriate evaluation should be performed to exclude pregnancy.</li>\r\n	<li>Patients in later reproductive life have a greater predisposition to endometrial carcinoma as well as a higher incidence of anovulatory disorders. A thorough diagnostic evaluation should always be performed in patients who demonstrate abnormal&nbsp;uterine bleeding&nbsp;or other signs of endometrial abnormalities before starting FSH and Choriogonadotropin Alfa PreFilled Syringe therapy.</li>\r\n	<li>Evaluation of the partner&#39;s fertility potential should be included in the initial evaluation.</li>\r\n</ul>', '<p>The physicochemical, immunological, and biological activities of&nbsp;recombinant&nbsp;hCG are comparable to those of placental and human pregnancy urine-derived hCG. Choriogonadotropin alfa stimulates late follicular maturation and resumption of&nbsp;oocyte&nbsp;meiosis, and initiates&nbsp;rupture&nbsp;of the pre-ovulatory&nbsp;ovarian&nbsp;follicle. Choriogonadotropin alfa, the active component of Choriogonadotropin Alpha PreFilled Syringe, is an analogue of&nbsp;Luteinizing Hormone&nbsp;(LH) and binds to the LH/hCG receptor of the granulosa and theca cells of the ovary to effect these changes in the absence of an&nbsp;endogenous&nbsp;LH surge. In pregnancy, hCG, secreted by the placenta, maintains the viability of the corpus&nbsp;luteum to provide the continued secretion of&nbsp;estrogen&nbsp;and&nbsp;progesterone&nbsp;necessary to support the first trimester of pregnancy. Choriogonadotropin Alpha PreFilled Syringe is administered when monitoring of the patient indicates that sufficient follicular development has occurred in response to FSH treatment for&nbsp;ovulation&nbsp;induction.</p>', '<p><strong>Infertile Women Undergoing Assisted Reproductive Technologies (ART)</strong>: Choriogonadotropin Alfa PreFilled Syringe 250 &mu;g should be administered one day following the last dose of the follicle stimulating agent. Choriogonadotropin Alfa PreFilled Syringe should not be administered until adequate follicular development is indicated by serum&nbsp;estradioland vaginal ultrasonography. Administration should be withheld in situations where there is an excessive ovarian response, as evidenced by clinically significant ovarian enlargement or excessive estradiol production.<br />\r\n<br />\r\n<strong>Infertile Women Undergoing Ovulation Induction (OI)</strong>: Choriogonadotropin Alfa PreFilled Syringe should not be administered until adequate follicular development is indicated by serum estradiol and vaginal ultrasonography. Choriogonadotropin Alfa PreFilled Syringe 250 &mu;g should be administered one day following the last dose of the follicle stimulating agent. Choriogonadotropin Alfa PreFilled Syringe administration should be withheld in situations where there is an excessive ovarian response, as evidenced by multiple follicular development, clinically significant ovarian enlargement or excessive estradiol production.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>For Subcutaneous Use Only. Directions For Administration Of Choriogonadotropin Alfa Prefilled Syringe is intended for a single subcutaneous injection. Any unused material should be discarded. Choriogonadotropin Alfa PreFilled Syringe may be self-administered by the patient. Follow the directions below for injecting Choriogonadotropin Alfa PreFilled Syringe.<br />\r\n<br />\r\n<strong>Step 1</strong>: Wash your hands thoroughly with soap and water.<br />\r\n<br />\r\n<strong>Step 2</strong>: Carefully clean the injection site: Make yourself comfortable by sitting or lying down. Carefully clean the injection site on the stomach with an alcohol wipe and allow it to air-dry.<br />\r\n<br />\r\n<strong>Step 3</strong>: Administer your injection: Carefully remove the needle cap from the syringe. Do not touch the needle or allow the needle to touch any surface. Inject the prescribed dose as directed by your doctor, nurse or pharmacist.<br />\r\n&nbsp;<br />\r\n<strong>Step 4</strong>: Gently withdraw the needle: Discard the needle and syringe into your safety container. Place gauze over the injection site. If any bleeding occurs, apply gentle pressure. If bleeding does not stop within a few minutes, place a clean piece of gauze over the injection site and cover it with an adhesive bandage.<br />\r\n<br />\r\n<strong>Step 5</strong>: Storage and clean up: Remember that your injection materials must be kept sterile and cannot be reused.</p>', '<p><strong>Drng &amp; other interactions:</strong>&nbsp;No clinically significant drug interactions have been reported during hCG therapy. Following administration, Ovidrel (choriogonadotrophin alfa) may interfere for up to ten days with the immunological determination of serum/urinary hCG, leading to a false positive pregnancy test. During Ovidrel therapy, a minor thyroid stimulation is possible of which the clinical relevance is unknown.</p>', '<p>Choriogonadotropin Alpha PreFilled Syringe is contraindicated in women who exhibit:</p>\r\n\r\n<ul>\r\n	<li>Prior hypersensitivity to hCG preparations or one of their excipients.</li>\r\n	<li>Primary&nbsp;ovarian&nbsp;failure.</li>\r\n	<li>Uncontrolled&nbsp;thyroid&nbsp;or adrenal dysfunction.</li>\r\n	<li>An uncontrolled organic intracranial&nbsp;lesion&nbsp;such as a&nbsp;pituitary&nbsp;tumor.</li>\r\n	<li>Abnormal&nbsp;uterine bleeding&nbsp;of undetermined origin&nbsp;</li>\r\n	<li>Ovarian cyst&nbsp;or enlargement of undetermined origin</li>\r\n	<li>Sex hormone dependent tumors of the reproductive tract and&nbsp;accessoryorgans.</li>\r\n	<li>Pregnancy.</li>\r\n</ul>', '<p>Injection site inflammation and reaction,&nbsp;flatulence, diarrhea, hiccup,&nbsp;ectopic pregnancy,&nbsp;breast pain, intermenstrual bleeding, vaginal hemorrhage, cervical&nbsp;lesion, leukorrhea, ovarian hyperstimulation, uterine disorders,&nbsp;vaginitis, vaginal discomfort, body pain,&nbsp;back pain, fever, dizziness, headache, hot flashes,&nbsp;malaise, paraesthesias, rash, emotional&nbsp;lability, insomnia, upper respiratory tract infection, cough, dysuria, urinary tract infection,&nbsp;urinary incontinence, albuminuria, cardiac arrhythmia, genital moniliasis, genital herpes,&nbsp;leukocytosis,&nbsp;heart murmurand cervical carcinoma.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category X. Intrauterine&nbsp;death and impaired&nbsp;parturition&nbsp;were observed in pregnant rats given a dose of urinary-hCG (500 IU) equivalent to three times the maximum human dose of 10,000, based on body surface area.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised if hCG is administered to a nursing woman.</p>', '<p>Gonadotropins, including Choriogonadotropin Alpha&nbsp;PreFilled Syringe (choriogonado-tropin alfa injection), should only be used by physicians who are thoroughly familiar with&nbsp;infertility&nbsp;problems and their management. Like other hCG products, Choriogonadotropin Alpha&nbsp;PreFilled Syringe is a potent gonadotropic substance capable of causing OvarianHyperstimulation Syndrome (OHSS) in women with or without pulmonary or vascularcomplications. The risks of gonadoptropin treatment should be considered for women with risk factors of thromboembolic events such as prior medical or&nbsp;family history.&nbsp;Gonadotropin&nbsp;therapy requires a certain time commitment by physicians and supportive health professionals, and requires the availability of appropriate monitoring facilities. Safe and effective induction of&nbsp;ovulation&nbsp;and use of Choriogonadotropin Alpha&nbsp;PreFilled Syringe in women requires monitoring of ovarian response with serum&nbsp;estradiol&nbsp;and&nbsp;transvaginal ultrasound on a regular basis.</p>', NULL, '<p>Female Sex hormones</p>', '<p>The Choriogonadotropin Alfa PreFilled Syringe must be stored refrigerated between 2-8&deg; C before being dispensed to the patient. Patients should store the pre-filled syringe refrigerated to allow the product to be used until the expiry date shown on the syringe or carton. The Choriogonadotropin Alfa PreFilled Syringe may be stored by the patient for no more than 30 days at room temperature up to 25&deg; C but must be used within those 30 days. Protect from light. Store in original package. Discard unused material.</p>', '<p><strong>Pediatric Patients</strong>: Safety and effectiveness in pediatric patients has not been established.<br />\r\n<br />\r\n<strong>Geriatric Patients</strong>: Safety and effectiveness in geriatric patients has not been established.</p>', '2022-02-18 20:31:37', '2022-03-28 22:21:09'),
(330, 330, '<p>Ciclesonide inhalation aerosol is indicated for treatment to control persistent asthma in adults (18 years and older).</p>', '<p>Ciclesonide, which is a new once daily inhaled corticosteroid, is an ester prodrug that requires hydrolyzation by endogenous esterases in the lung to form its active metabolite (B-9207-021). The activated ciclesonide has an approximately 100-fold greater affinity for glucocorticoid receptors compared with the parent compound and produces high local anti-inflammatory activity.</p>', '<p>Ciclesonide is for inhalation use only. The recommended starting dose of Ciclesonide is 160 micrograms once daily which is usually also the maximum dose. Dose reduction to 80 micrograms once daily may be an effective maintenance dose for some patients. Ciclesonide should preferably be administered in the evening although morning dosing of Ciclesonide has also been shown to be effective. There is no need to adjust the dose in elderly patients or those with hepatic or renal impairment. Patients with severe asthma are at risk of acute attacks and should have regular assessments of their asthma control including pulmonary function tests. Increasing use of short-acting bronchodilators to relieve asthma symptoms indicates deterioration of asthma control. If patients find that short-acting relief bronchodilator treatment becomes less effective, or they need more inhalations than usual, medical attention must be sought. In this situation, patients should be reassessed and consideration given to the need for increased anti-inflammatory treatment therapy (e.g. higher doses of Ciclesonide or a course of oral corticosteroids). Severe asthma exacerbations should be managed in the usual way.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Before using your inhaler for the first time, or if it has not been used for a week or more, &quot;test fire&quot; it, i.e. release one puff into the air.<br />\r\n<br />\r\n<strong>How to use your inhaler correctly</strong>:</p>\r\n\r\n<ul>\r\n	<li>Remove the mouthpiece cover, and check the mouthpiece thoroughly to see that it is clean. Shake the inhaler vigorously.</li>\r\n	<li>Hold the inhaler as shown between index finger and thumb. Breathe out gently through your mouth and immediately place the mouthpiece in your mouth between your teeth (Do not bite it).</li>\r\n	<li>Grip the mouthpiece firmly with your lips. Tilt your head slightly backwards. Start breathing in slowly through your mouth. At the same time press the canister as shown, to release one dose while continuing to breathe in steadily and deeply.</li>\r\n	<li>Remove the inhaler from your mouth. Hold the breath at least for 10 seconds, or as long as it is comfortable. Breathe out slowly.</li>\r\n	<li>If another dose is required, wait for at least 1 minute and repeat the whole process. After use, place the cover to close the mouthpiece.</li>\r\n	<li>Shake well before each use.</li>\r\n</ul>\r\n\r\n<p><strong>How to clean your inhaler</strong>:</p>\r\n\r\n<ul>\r\n	<li>Gently pull the metal canister out of the plastic body of the inhaler, remove the mouthpiece cover.</li>\r\n	<li>Rinse the plastic body and the mouthpiece cover in warm water but do not put the metal canister into water.</li>\r\n	<li>Leave to dry in warm place, avoid excessive heat.</li>\r\n	<li>Replace the canister and the mouthpiece cover correctly.</li>\r\n	<li>Clean your inhaler at least once a week.</li>\r\n</ul>', '<p>Co-administration with a potent inhibitor of the cytochrome P450 3A4 system (e.g. ketoconazole, itraconazole and ritonavir or nelfinavir) should be considered with caution. The risk of clinical adverse effect (eg cushingoid syndrome) cannot be excluded.</p>', '<p>Hypersensitivity to Ciclesonide or any of the excipients.</p>', '<p>Common (1-10%): Paradoxical bronchospasm; uncommon (0.1-1%): Bad taste, application site reactions, application site dryness, hoarseness, cough after inhalation, rash and eczema.<br />\r\n<br />\r\nSystemic effects of inhaled corticosteroids may occur, particularly at high doses prescribed for prolonged periods. These effects are much less likely to occur than with oral corticosteroids. Possible systemic effects include adrenal suppression, growth retardation in children and adolescents, decrease in bone mineral density, cataract and glaucoma. Patients with severe hepatic impairment should be monitored for potential systemic effects.</p>', '<p>As with other inhaled glucocorticoids, Ciclesonide should only be used during pregnancy or lactation if the potential benefit to the mother justifies the potential risk to the mother, foetus or child. The lowest effective dose of Ciclesonide needed to maintain adequate asthma control should be used.</p>', '<p>As with all inhaled corticosteroids, Ciclesonide should be administered with caution in patients with active or quiescent pulmonary tuberculosis, fungal, viral, or bacterial infections, and only if these patients are adequately treated. As with all inhaled corticosteroids, Ciclesonide is not indicated in the treatment of status asthmaticus where intensive measures are required, or to relieve acute asthma symptoms for which an inhaled short-acting bronchodilator is required. Patients should be advised to have such rescue medication available. Patients transferred from oral steroids should be monitored regularly and their dose of systemic steroid reduced cautiously. Treatment with Ciclesonide should not be stopped abruptly.</p>', NULL, '<p>Respiratory corticosteroids</p>', '<p>The inhaler should be stored below 30&deg;C, protected from direct sunlight and heat. The canister should not be broken, punctured or burnt, even when apparently empty. Keep away from eyes. Keep out of reach of children.</p>', NULL, '2022-02-18 20:32:12', '2022-03-28 22:23:59'),
(331, 331, '<p>Ciclesonide nasal spray is indicated for the treatment of the symptoms of seasonal allergic rhinitis in patients aged 6 years and older and perennial allergic rhinitis in patients aged 12 years and older.</p>', '<p>Ciclesonide nasal spray is a corticosteroid with anti-inflammatory activity. It is an aqueous suspension of ciclesonide for topical administration to the nasal mucosa by means of a metering and atomizing spray pump. It is necessary to prime the pump before first use or after a period of non-use (4 days or more).</p>', '<p>1 spray (50 micrograms/spray) in each nostril once a day. The maximum total daily dosage should not exceed 2 sprays in each nostril (200 micrograms/day).<br />\r\n<br />\r\nPriming information: Gently shake the bottle and prime Ciclesonide nasal spray by actuating eight times before using for the first time or when not used for 4 consecutive days.</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>', NULL, NULL, '<p>Ciclesonide nasal spray is absorbed less into rest of the body; therefore fewer side effects are seen. However, few side-effects like headache, dizziness, nosebleed, stuffy nose, earache may occur.</p>', '<p>Pregnancy category C. Ciclesonide nasal spray should be used during pregnancy only if the potential benefit justifies the potential risk of the fetus. It is not known if Ciclesonide is excreted in human milk. Because other corticosteroids are excreted in human milk, caution should be used when administered to nursing women.</p>', '<p>Ciclesonide nasal spray should be used with caution in patients with active or quiescent tuberculosis infection of the respiratory tract or in patients with untreated fungal, bacterial or systemic viral infections or ocular herpes simplex. Rare instances of nasal septal perforation, cataract, and glaucoma have been reported following intranasal application. Development of localized infections of the nose and pharynx with Candida albicans has rarely occurred. Although systemic effects have been minimal with recommended doses of Ciclesonide nasal spray, potential risk increases with larger doses. Therefore, larger than recommended doses of Ciclesonide nasal spray should be avoided.</p>', NULL, '<p>Respiratory corticosteroids</p>', '<p>Store at a temperature not exceeding 30&deg;C. Do not refrigerate. Protect from light and moisture. Keep away from eyes. Keep out of the reach of children. The bottle should be discarded after 120 actuations or 4 months after opening the pouch.</p>', NULL, '2022-02-18 20:39:55', '2022-03-28 22:31:02'),
(332, 332, '<p>Ciclopirox Cream is indicated for the topical treatment of the following dermal infections: Tinea pedis, Tinea cruris and Tinea corporis due to Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum and Microsporum canis, candidiasis (moniliasis) due to Candida albicans, and Tinea (pityriasis) versicolor due to Malassezia furfur. Ciclopirox Cream is also highly effective against some gram negative &amp; some gram-positive bacteria. Owing to its anti-inflammatory effects, Ciclopirox Olamine alone is sufficient to treat mild to moderate inflammatory fungal infections</p>', '<p>Ciclopirox Olamine is a synthetic broad spectrum antifungal agent that inhibits the growth of pathogenic dermatophytes, yeasts, and Malassezia furfur. Ciclopirox Olamine exhibits fungicidal activity in vitro against isolates of Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, Microsporum canis, and Candida albicans. The mode of action of Ciclopirox Olamine was studied mainly in Candida albicans. It is presumed that Ciclopirox Olamine mediated growth inhibition or death of fungal cells is primarily caused by in vitro cellular depletion of some essential substrates and/or ions and that such effects are brought about through blockage of their uptake from the medium.In addition to its broad spectrum of antifungal action, Ciclopirox also exerts antibacterial activity against many Gram-positive and Gram-negative bacteria. Theanti-inflammatory effects of Ciclopirox have been demonstratedin human polymorphonuclear cells, where Ciclopirox has inhibited the synthesis of prostaglandin and leukotriene. Ciclopirox can also exhibit its anti-inflammatory effects by inhibiting the formation of 5-lipoxygenase and cyclooxygenase.</p>', '<p>Ciclopirox Cream should be gently massaged onto the affected and surrounding skin areas twice daily for four weeks. Clinical improvement with relief of pruritus and other symptoms usually occurs within the first week of treatment. If a patient shows no clinical improvement after four weeks of treatment with Ciclopirox cream, the diagnosis should be redetermined. Patients with Tinea versicolor usually exhibit clinical and mycological clearing after two weeks of treatment.<br />\r\n<br />\r\nUse in children: Safety and effectiveness in children below the age of 10 years have not been established.</p>', NULL, '<p>Ciclopirox Olamine cream is contraindicated in individuals who have shown hypersensitivity to any of its components.</p>', '<p>Ciclopirox Olamine cream is well tolerated with a low incidence of adverse reactions reported in clinical trials.</p>', '<p>Pregnancy category B. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Ciclopirox Olamine cream or is administered to nursing women.</p>', '<p>Ciclopirox Olamine cream is not for ophthalmic use.</p>', NULL, '<p>Topical Antifungal preparations</p>', '<p>Store below 25&deg;C, protect from light.Keep out of the reach of children.</p>', NULL, '2022-02-18 20:40:16', '2022-03-28 22:33:09'),
(333, 333, '<p>Shampoo is indicated in the treatment of Seborrheic dermatitis, Dandruff, Inflammation and Swelling of the scalp.</p>', '<p>Ciclopirox Olamine is a synthetic broad spectrum antifungal agent that inhibits the growth of pathogenic dermatophytes, yeasts, and Malassezia furfur. Ciclopirox Olamine exhibits fungicidal activity in-vitro against isolates of Trichophyton rubrum,&nbsp;&nbsp; Trichophyton&nbsp;&nbsp;&nbsp; mentagrophytes,&nbsp;&nbsp; Epidermophyton floccosum, Microsporum canis, and Candida albicans. The mode of action of Ciclopirox Olamine was studied mainly in Candida albicans. It is presumed that Ciclopirox Olamine mediated growth inhibition or death of fungal cells is primarily caused by in-vitro cellular depletion of some essential substrates and/or ions and that such effects are brought about through blockage of their uptake from the medium. In addition to its broad spectrum of antifungal action, Ciclopirox also exerts antibacterial activity against many Gram-positive and Gram-negative bacteria. The anti-inflammatory effects of Ciclopirox have been demonstrated in human polymorphonuclear cells, where Ciclopirox has inhibited the synthesis of prostaglandin and leukotriene. Ciclopirox can also exhibit its anti-inflammatory effects by inhibiting the formation of 5-lipoxygenase and cyclooxygenase.</p>', '<p>Wet hair and apply approximately 1 teaspoon (5 ml) of Ciclopirox Olamine Shampoo to the scalp. Up to 2 teaspoons (10 ml) may be used for long hair. Lather and leave on hair and scalp for 3 minutes. A timer may be used. Avoid contact with eyes. Treatment should be repeated twice per week for 4 weeks, with a minimum of 3 days between applications.</p>', NULL, '<p>This Shampoo is contraindicated in individuals who have shown hypersensitivity to any of its components.</p>', '<p>Ciclopirox Olamine Shampoo is well tolerated with a low incidence of adverse reactions reported in clinical trials.</p>', '<p>Pregnancy category B. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Ciclopirox Olamine Shampoo or is administered to nursing women.</p>', '<p>Ciclopirox Olamine Shampoo is not for ophthalmic, oral, or intravaginal use.</p>', NULL, '<p>Topical Antifungal preparations</p>', '<p>Keep away from light and moisture. Store below 30&deg;C. Keep out of the reach of children.</p>', '<p>No clinical trials have been conducted in subjects younger than 16 years.</p>', '2022-02-18 20:40:54', '2022-03-28 22:40:51'),
(334, 334, '<p>Cilnidipine is indicated for the management of hypertension for end-organ protection. It is reported to be useful in elderly patients and in those with diabetes and albuminuria. Cilnidipine has been increasingly used in patients with chronic kidney disease<br />\r\n<br />\r\nHypertension is the term used to describe the presence of high blood pressure. The blood pressure is generated by the force of the blood pumped from the heart against the blood vessels. Thus hypertension is caused when there is too much pressure on the blood vessels and this effect can damage the blood vessel</p>', '<p>Cilnidipine is a dihydropyridine calcium-channel blocker. Cilnidipine binds to the dihydropy-ridine binding sites of the L-type voltage dependent calcium channel and inhibits Ca2+&nbsp;influx across the cell membranes of vascular smooth muscle cells via this channel, consequently vascular smooth muscle is relaxed, causing vasodilation. Cilnidipine inhibits Ca2+&nbsp;influx via N-type voltage dependent calcium channels in the sympathetic nerve cell membrane. The inhibition of Ca2+&nbsp;influx via N-type voltage dependent calcium channel was observed over a similar range of drug concentrations to those inhibiting L-type voltage dependent Ca2+&nbsp;channels. Consequently, release of norepinephrine from sympathetic nerve terminals would be inhibited. Cilnidipine is considered to suppress the reflex increase in heart rate after blood pressure reduction.</p>', '<p><strong>Adults</strong>: 5-10 mg once daily after breakfast. Maximum dose: 20 mg once daily.<br />\r\n<br />\r\n<strong>Pediatric use</strong>: The safety of Cilnidipine in pediatric patients has not been established.<br />\r\n<br />\r\n<strong>Elderly use</strong>: Since the elderly may be more susceptible to hypotension, therapy should be initiated with the lowest possible dose (5 mg).</p>', '<p>Other anti-hypertensive, antipsychotics that cause hypotension, quinidine, carbamazepine, phenytoin, rifampicin, cimetidine, erythromycin.</p>', '<p>Cilnidipine is contraindicated in patients with known sensitivity to Cilnidipine or any of the excipients or patients having cardiogenic shock, recent MI or acute unstable angina and severe aortic stenosis.</p>', '<p>The most common side effects of Cilnidipine are: Dizziness; flushing; headache; hypotension; peripheral oedema; palpitations; GI disturbances; increased micturition frequency; lethargy; eye pain; depression.</p>', '<p>Cilnidipine should not be administered in pregnant woman or woman having possibilities of being pregnant. It is also advisable to avoid the administration of Cilnidipine to nursing mothers. However, if the administration is indispensable, the patient should be instructed to discontinue lactation.</p>', '<p>Cilnidipine should be administered with care in the following patients: patients with serious hepatic dysfunction, patients with a history of serious adverse reactions to calcium antagonists. During the discontinuation, the dosage should be gradually decreased under close observation.</p>', NULL, '<p>Calcium-channel blockers</p>', '<p>Store below 30&deg;C, protected from light and moisture. Keep away from reach out of the children.</p>', NULL, '2022-02-18 20:41:20', '2022-03-28 22:42:58'),
(335, 335, '<p>Cilostazol is indicated for the reduction of symptoms of intermittent claudication, as indicated by an increased walking distance.</p>', '<p>Cilostazol is a preparation of Cilostazol which is a quinolinone derivative. The mechanism of action is to specifically inhibit cellular phosphodiesterase III (PDE III) and suppress cAMP degradation with a resultant increase in cAMP in platelets and blood vessels, leading to inhibition of platelet aggregation and vasodilation.</p>', '<p>The recommended dosage of Cilostazol is 100 mg bid, taken at least half an hour before or two hours after breakfast and dinner. A dose of 50 mg bid should be considered during coadministration of Fluconazole, Ketoconazole, Itraconazole, Erythromycin, Clarithromycin, Fluvoxamine, Fluoxetine, Nefazodone, Sertraline and Diltiazem.<br />\r\n<br />\r\nPediatric use: The safety and effectiveness of Cilostazol in pediatric patients have not been established.</p>', '<p>Pharmacokinetic studies have demonstrated that Omeprazole and Erythromycin significantly increased the systemic exposure of Cilostazol and/or its major metabolites. Population pharmacokinetic studies showed higher concentrations of Cilostazol among patients concurrently treated with Diltiazem.</p>', '<p>Cilostazol is contraindicated in patients with congestive heart failure of any severity. Cilostazol is also contraindicated in patients with known or suspected hypersensitivity to any of its components.</p>', '<p>The most common side effects are headache, diarrhoea, vomiting, leg cramps, rash etc. The less frequent side effects are anorexia and edema.</p>', '<p>There are no adequate and well controlled studies in pregnant women.&nbsp;Transfer of Cilostazol into milk has been reported in experimental animals. Because of the potential risk to nursing infants, a decision should be made to discontinue nursing or to discontinue Cilostazol.</p>', '<p>Cilostazol should be used with caution in patients with any degree of heart failure. There is no information with respect to the efficacy or safety of the concurrent use of Cilostazol and Clopidogrel.</p>', NULL, '<p>Peripheral Vasodilator drugs: Intermittent Claudication</p>', '<p>Store in a cool &amp; dry place, protected from light and moisture.</p>', NULL, '2022-02-18 20:41:40', '2022-04-02 20:56:09');
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
(336, 336, '<p>Cinacalcet is indicated in-</p>\r\n\r\n<ul>\r\n	<li>For the treatment of secondary hyperparathyroidism in patients with chronic kidney disease on dialysis</li>\r\n	<li>For the treatment of hypercalcemia in patients with parathyroid carcinoma</li>\r\n	<li>For the treatment of hypercalcaemia in patients with primary hyperparathyroidism who still have high calcium level after removal of the parathyroid gland</li>\r\n</ul>', '<p>Cinacalcet is a calcimimetic agent. It lowers parathyroid hormone (PTH) secretion by increasing the sensitivity of the calcium-sensing receptor of the parathyroid gland to activation by extracellular calcium. PTH reduction leads to concomitant decrease in serum calcium and phosphorus concentrations.</p>', '<p>Hypercalcaemia associated with parathyroid carcinoma or primary hyperparathyroidism:&nbsp;&ge;18 yr, initial: 30 mg bid. Titrate dose every 2-4 wk in sequential doses of 60 mg bid, 90 mg bid, and 90 mg 3-4 times daily as needed until serum calcium levels normalised. Max: 90 mg 4 times/day.<br />\r\n<br />\r\nSecondary hyperparathyroisim in patients with chronic kidney disease on dialysis: &ge;18 yr, initial: 30 mg once daily. Titrate dose every 2-4 wk in steps of 30 mg as necessary to achieve intact parathyroid hormone (iPTH) levels of 150-300 pg/mL. Max: 180 mg once daily. May be used alone or in combination with vitamin D sterols and/or phosphate binders.</p>', '<p>Cinacalcet is a strong CYP2D6 inhibitor and may increase serum concentrations of amitriptyline, nortriptyline and desipramine. Cinacalcet may decrease serum concentrations of tacrolimus. CYP3A4 inhibitors such as ketoconazole, erythromycin may increase plasma concentrations of Cinacalcet.</p>', '<p>Cinacalcet is contraindicated in patients with hypersensitivity to any components of this product.</p>', '<p>The common side effects of Cinacalcet are nausea, vomiting, anorexia; dizziness, paraesthesia, asthenia; reduced testosterone concentrations; myalgia; rash; less commonly dyspepsia, diarrhoea, and seizures; hypotension and heart failure also reported.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. Cinacalcet should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It Only for the use of Medical Professionals is not known whether this drug is excreted in human milk. Considering the potential for clinically significant adverse reactions in infants from Cinacalcet; it is recommended that breast-feeding be discontinued during treatment with Cinacalcet.</p>', '<p>Cinacalcet treatment should not be initiated if serum calcium is less than the lower limit of the normal range (8.4 mg/dL). Serum-calcium concentration should be measured before initiation of treatment and within 1 week after starting treatment or adjusting dose, then monthly for secondary hyperparathyroidism and every 2&ndash;3 months for primary hyperparathyroidism and parathyroid carcinoma; treatment should not be initiated in patients with hypocalcaemia; in secondary hyperparathyroidism PTH concentration should be measured 1&ndash;4 weeks after starting treatment or adjusting dose, then every 1&ndash;3 months; dose adjustment may be necessary if smoking started or stopped during treatment; hepatic impairment; pregnancy.</p>', '<p>Overdosage may lead to hypocalcaemia. Provide treatment to correct serum calcium levels. Haemodialysis are unlikely to be useful.</p>', '<p>Calcium Regulator</p>', '<p>Store in a cool dry place below 30&ordm;C. Protect from light</p>', '<p><strong>Pediatric use</strong>: The safety and efficacy of Cinacalcet in pediatric patients have not been established<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No dosage adjustment is required for geriatric patients over 65 years of age.<br />\r\n<br />\r\n<strong>Patients with renal impairment</strong>: No dosage adjustment is necessary for renal impaired patients<br />\r\n<br />\r\n<strong>Patients with hepatic impairment</strong>: In patients with moderate and severe hepatic impairment, PTH and serum calcium concentrations should be closely monitored throughout treatment with Cinacalcet.</p>', '2022-02-18 20:42:01', '2022-04-02 20:59:49'),
(337, 337, '<p>This is indicated for the treatment of-</p>\r\n\r\n<ul>\r\n	<li>Internal and external haemorrhoids</li>\r\n	<li>Haemorrhoids post-partum</li>\r\n	<li>Anal pruritus, peri-anal eczema, anal fissures and proctitis</li>\r\n	<li>Post-haemorrhoidectomy application to relieve pain and discomfort</li>\r\n</ul>', '<p>The local anaesthetic Cinchocaine Hydrochloride prevents or relieves the severe pain sometimes encountered in strangulated haemorrhoids, fissures and perianal haematomata, whilst the corticosteroid (Hydrocortisone) acts as a decongestant, anti-inflammatory and anti-pruritic agent and by so doing eliminates itching, inflammation and mucous discharge. The broad spectrum antibiotic, Framycetin Sulphate, will eradicate most infections which may already be present or arise in lesions of the anorectal area and Esculin has a skin protective action.</p>', '<p><strong>Ointment</strong>: Apply the ointment in a small quantity with the finger, on the painful or pruritic area, morning and evening and after each stool. For deep application,&nbsp;insert the cannula or applicator&nbsp;to full extent and squeeze tube gently from lower end whilst withdrawing.<br />\r\n<br />\r\n<strong>Suppository</strong>: A suppository is inserted morning and evening, and after each stool.</p>', NULL, '<p>Known hypersensitivity to any of the four ingredients. Corticosteroids have been shown to be teratogenic in animals following dermal application. As these agents are absorbed percutaneously, teratogenicity following topical application cannot be excluded. Therefore this product should not be used during pregnancy. Topical corticosteroid preparations are contraindicated in the treatment of herpes simplex, vaccinia or varicella, or tuberculous infection of the anal region.</p>', '<p>Long-term continuous treatment with topical corticosteroids should be avoided as far as possible as this may cause atrophic changes in the skin leading to thinning, loss of elasticity, dilatation of superficial blood vessels, telangiectasia and ecchymoses. These changes are particularly likely to occur when occlusive dressings are used. Systemic absorption of topically applied corticosteroids may occur, particularly under the following conditions: when large quantities are used or when application is made to wide areas of the body, or to damaged skin; when potent topical corticosteroids are used, and when the occlusive dressing technique is applied. Depression of the hypothalamic-pituitary-adrenal axis with consequent suppression of the adrenal gland may occur. These effects are most likely to be severe in children. Growth may be retarded and a Cushingoid state may be produced. Benign intracranial hypertension has been rarely reported.</p>', '<p>The safe use of topical corticosteroids during pregnancy has not been fully established. Therefore, during pregnancy, they should not be used unnecessarily on extended areas, in large amounts or for prolonged periods of time.</p>', '<p>Discontinue use if sensitization occurs. Other specific measures against infections, allergy, and other causal factors must not be neglected. The possibility, however rare, that prolonged use of this preparation might produce systemic corticosteroid effects, should be borne in mind. Patients should be advised to inform subsequent physicians of the previous use of hydrocortisone.</p>', NULL, '<p>Compound steroidal preparations, Drugs used in Ano-rectal region</p>', '<p>Store at a cool and dry place, protected from light. Store below 25&deg; C. Do not freeze.</p>', '<p>Not recommended for use in children.</p>', '2022-02-18 20:42:19', '2022-04-02 21:02:53'),
(338, 338, '<p>This is indicated for-</p>\r\n\r\n<ul>\r\n	<li>Internal and external hemorrhoids</li>\r\n	<li>\r\n	<p>Post-partum hemorrhoidal condition</p>\r\n	</li>\r\n	<li>Anal pruritus, peri-anal eczema, anal fissures and proctitis&nbsp;</li>\r\n	<li>Post-hemorrhoidectomy application to relieve pain and discomfort</li>\r\n</ul>', '<p>Cinchocaine is a local anesthetic which relieves severe pain and relaxes sphincteric spasm. Hydrocortisone acts as an anti-inflammatory and anti-pruritic agent and thereby eliminates itching and inflammation. Neomycin is a broad-spectrum antibiotic which eradicates most infections which may already be present or arise in lesions of the anorectal area. Esculin improves skin vasculature and is effective in management of cellulitis.</p>', '<p><strong>Ointment</strong>: A small quantity of the ointment should be applied with finger in the painful pruritic area in the morning and evening and after each stool. For deep application nozzle should be attached to the tube and inserted to full extent and should be squeezed gently from the lower end while withdrawing.<br />\r\n<br />\r\n<strong>Suppository</strong>: One suppository in the morning and one in the evening, and one after each stool.<br />\r\n<br />\r\n<strong>Use in children</strong>: Not recommended for children.</p>', NULL, '<p>Contraindicated in patients hypersensitive to any component of the product.</p>', '<p>Side effects which have been reported for individual constituents may occur and appropriate precautions should be taken when using this preparation.</p>', '<p>Use in pregnancy: The safe use of topical corticosteroids during pregnancy has not been fully established.</p>', '<p>Like most of the steroids under certain circumstances hydrocortisone may be absorbed in sufficient amount to produce systemic effects. So, long term use should be avoided. Adrenal suppression may occur even without occlusion. When used for prolonged period striae may occur. Skin sensitisation may occur due to Neomycin. Absorption of the antibiotic from wound or inflamed skin may occur and this may affect the hearing irreversibly. Hence this preparation should not be given to extensively damaged skin.</p>', NULL, '<p>Compound steroidal preparations, Drugs used in Ano-rectal region</p>', '<p>Keep in a cool dry place protected from light. Keep out of reach of children.</p>', NULL, '2022-02-18 20:42:34', '2022-04-02 21:07:02'),
(339, 339, '<p>Cinchocaine is indicated for Surface anaesthesia, Haemorrhoids</p>', '<p>Cinchocaine prevents or diminishes nerve impulse conduction near to the site of admin. It also has membrane-stabilising effect owing to decrease of permeability of the nerve cell to sodium ions.</p>', '<p><strong>Surface anesthesia</strong>: Use up to 1% cream or ointment topically for adult or as directed by physician</p>', NULL, '<p>Complete heart block; pyogenic infection at or near the skin. Application to inflamed or infected tissues or to damaged skin mucosa; instillation into the middle ear.</p>', '<p>Restlessness; excitement; nervousness; paraesthesias; dizziness; tinnitus; blurred vision; nausea; vomiting; muscle twitching; tremors; convulsions; hypotension; bradycardia; arrhythmias; cardiac arrest.</p>', '<p>Pregnancy Category A. A number of epidemiological studies suggest that there could possibly be an increased risk of oral clefts among newborns of women who were treated with systemic glucocorticosteroids during the first trimester of pregnancy. As a general rule, topical preparations containing corticoids should not be applied during the first trimester of pregnancy.<br />\r\n<br />\r\nLactation:&nbsp;The excretion of effective amounts of glucocorticoid with the breast milk is improbable.</p>', '<p>Elderly; debilitated patients; child; epilepsy; impaired cardiac conduction or respiratory function; shock; hepatic impairment; myasthenia gravis. Do not to rub or touch the eye while anaesthesia persists. Avoid application for prolonged periods and to extensive areas. Pregnancy, lactation.</p>', NULL, '<p>Local &amp; Surface anesthesia</p>', '<p>Store below 25&deg;C.</p>', NULL, '2022-02-18 20:43:06', '2022-04-02 21:09:16'),
(340, 340, '<p>It is mainly used for the symptomatic treatment of nausea and vertigo due to Meniere&#39;s disease and other labyrinthine disturbances and for the prevention and treatment of motion sickness. It is also used in the management of various vascular disorders.<br />\r\n<br />\r\n<strong>Cerebral circulatory disorders</strong>:</p>\r\n\r\n<ul>\r\n	<li>Prophylaxis and maintenance therapy for symptoms of cerebral vascular spasms and arteriosclerosis such as dizziness, ear buzzing (tinnitus), vascular headache, unsociability and irritability, fatigue, sleep rhythm disorders such as premature awakening, involutional depressions, loss of memory and lack of concentration, incontinence and other disorders due to aging.</li>\r\n	<li>Sequel of cerebral and cranial trauma.</li>\r\n	<li>Post-apoplectic disorders.</li>\r\n	<li>Migraine.</li>\r\n</ul>\r\n\r\n<p><strong>Peripheral circulatory disorders</strong>: Prophylaxis and maintenance therapy for symptoms of vascular spasms and arteriosclerosis (obliterating arteritis, thromboangitis obliterans, Raynaud&#39;s disease, diabetes, acrocyanosis, perrio, etc.) such as: intermittent claudication, trophic disturbances, pregangrene, trophic and varicose ulcers, paraesthesia, nocturnal cramps, cold extremities.<br />\r\n<br />\r\n<strong>Disorders of balance</strong>:</p>\r\n\r\n<ul>\r\n	<li>Prophylaxis and maintenance therapy for symptoms of labyrinthine arteriosclerosis, vestibular irritability, Meniere&#39;s syndrome, such as vertigo, dizziness, giddiness, syncopal attacks, tinnitus, nystagmus, nausea and vomiting.</li>\r\n	<li>Prophylaxis of motion sickness.</li>\r\n</ul>', '<p>Cinnarizine acts as an antihistamine, labyrinthine sedative and a peripheral antivasoconstrictor. Cinnarizine is a selective calcium antagonist, inhibiting the influx of Ca2+&nbsp;intracellularly. It prevents the Ca2+&nbsp;dependent contraction of arterial smooth muscle by inhibiting Ca2+&nbsp;influx through smooth muscle calcium channels and thereby, improves vestibular symptoms and prevents peripheral arterial disease</p>', '<p><strong>Usual adult dose</strong>: 15 to 30 mg three times daily.<br />\r\n<strong>Children (5 to 12 years)</strong>: Half of the adult dose.<br />\r\n<strong>Motion sickness</strong>: A dose of 30 mg two hours before the start of the journey and 15 mg every 8 hours during the journey.<br />\r\n<strong>Peripheral arterial diseases</strong>: 75 mg two or three times daily.</p>', '<p>No drug interactions have been seen with Cinnarizine when administered concomitantly with antihypertensives, diuretics, anticoagulants or hypoglycaemics.</p>', '<p>There are no specific contraindications. It has been found to decrease blood pressure significantly. However, the drug should be used with reasonable caution in hypotensive patients.</p>', '<p>Side effects such as somnolence and gastrointestinal disturbances are extremely rare. They are transient and may be readily prevented by achieving the optimal dosage gradually. Allergic skin reactions and fatigue have been reported on rare occasions. An aggravation or appearance of extrapyramidal symptoms has been reported extremely rarely in elderly people during prolonged therapy. The treatment should be reduced or stopped in such cases.</p>', '<p>The safety of Cinnarizine in human pregnancy has not been established although studies in animals have not demonstrated teratogenic effects. Therefore, it is not advisable to administer Cinnarizine in pregnancy</p>', '<p>Cinnarizine may cause drowsiness; patients affected in this way should not drive or operate machinery. Avoid alcoholic drink.</p>', NULL, '<p>Anti vertigo drugs</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-18 20:43:19', '2022-04-02 21:12:58'),
(341, 341, '<p><strong>Cerebral circulatory disorders</strong>:</p>\r\n\r\n<ul>\r\n	<li>Prophylaxis and maintenance therapy for symptoms of cerebral vascular spasms and arteriosclerosis such as: dizziness, ear buzzing (tinnitus), vascular headache, unsociability and irritability, fatigue, sleep rhythm disorders such as premature awakening, involutional depressions, loss of memory and lack of concentration, incontinence and other disorders due to aging.</li>\r\n	<li>Sequelae of cerebral and cranial trauma.</li>\r\n	<li>Postapoplectic disorders.</li>\r\n	<li>Migraine.</li>\r\n</ul>\r\n\r\n<p><strong>Peripheral circulatory disorders</strong>: Prophylaxis and maintenance therapy for symptoms of vascular spasms and arteriosclerosis (obliterating arteritis, thromboangitis obliterans, Raynaud&#39;s disease, diabetes, acrocyanosis pernio, etc.) such as intermittent claudication, trophic disturbances, pregangrene, trophic and varicose ulcers, paraesthesia, nocturnal cramps, cold extremities.<br />\r\n<br />\r\n<strong>Disorders of balance</strong>:</p>\r\n\r\n<ul>\r\n	<li>Prophylaxis and maintenance therapy for symptoms of labyrinthine arteriosclerosis; vestibular irritability; Meniere&#39;s syndrome such as vertigo, dizziness, giddiness, syncopal attacks, tinnitus, nystagmus, nausea and vomiting.</li>\r\n	<li>Prophylaxis of motion sickness.</li>\r\n</ul>', '<p>This contains two active ingredients Cinnarizine and Dimenhydrinate. The two substances belong to different groups of medicines. Cinnarizine is part of a group called calcium antagonists. Dimenhydrinate belongs to a group called antihistamines. Both substances work by reducing symptoms of vertigo (a feeling of dizziness or spinning) and nausea (feeling sick). The combination product is more effective than the individual compounds.</p>', '<p><strong>Adults</strong>: 1 tablet three times daily, to be taken after meals. Children and<br />\r\n<strong>adolescents under the age of 18 years</strong>: Not recommended<br />\r\n<strong>Elderly</strong>: Dosage as for adults.</p>', '<p>Concurrent use of alcohol, CNS depressants or tricyclic antidepressants may potentiate the sedative effects of either these drugs or of Cinnarizine and Dimenhydrinate. Therefore, it is advisable to avoid these drugs while taking Cinnarizine and Dimenhydrinate.</p>', '<p>Cinnarizine and Dimenhydrinate should not be used by patients with severe hepatic impairment. Cinnarizine and Dimenhydrinate is contra-indicated in patients with known hypersensitivity to the active substances or to any of the excipients. Cinnarizine and Dimenhydrinate should not be used in patients with angle-closure glaucoma, convulsions, suspicion of raised intracranial pressure, and alcohol abuse or urine retention due to urethroprostatic disorders.</p>', '<p>Drowsiness, dry mouth, headache, and stomach pain may occur. Rare side effects are impaired vision, allergic reactions, light sensitivity, and difficulty in urinating. Other possible reactions which may occur: weight gain, constipation, tightness of the chest, jaundice, worsening of angle-closure glaucoma, uncontrollable movements, unusual excitement and restlessness, severe skin reactions.</p>', '<p>Dimenhydrinate and cinnarizine should not be used during pregnancy and lactation.</p>', '<p>Cinnarizine and Dimenhydrinate do not reduce blood pressure significantly; however, it should be used with caution in hypotensive patients. Cinnarizine and Dimenhydrinate should be taken after meals to minimize any gastric irritation. Caution should be exercised when administering Cinnarizine and Dimenhydrinate to patients with Parkinson&rsquo;s disease.</p>', '<p>Drowsiness, dizziness and ataxia with anticholinergic effects such as dry mouth, flushing of the face, dilated pupils, tachycardia, pyrexia, headache and urinary retention. General supportive measures should be used to treat respiratory insufficiency or circulatory failure. Gastric lavage with isotonic sodium chloride solution is recommended.</p>', '<p>Anti vertigo drugs</p>', '<p>Store in a cool (below 30&deg;C) and dry place. Keep away from light and out of reach of children.</p>', NULL, '2022-02-18 20:43:45', '2022-04-02 21:15:48'),
(342, 342, '<p>Ciprofbrate is indicated as an adjunct to diet, exercise and weight reduction for the following:</p>\r\n\r\n<ul>\r\n	<li>Treatment of severe hypertriglyceridemia with or without low HDL cholesterol.</li>\r\n	<li>Mixed hyperlipidemia when a statin is contraindicated or not tolerated.</li>\r\n</ul>', '<p>Ciprofbrate reduces both LDL &amp; VLDL and hence the levels of triglyceride and cholesterol associated with these lipoprotein fractions. It also increases levels of HDL cholesterol. Ciprofbrate is effective in the treatment of hyperlipidemia associated with high plasma concentrations of LDL and VLDL. There is evidence that treatment with fibrates may reduce coronary heart disease events.</p>', '<p><strong>Adults</strong>: The recommended dose is Ciprofbrate 100 mg per day. This dose should not be exceeded.<br />\r\n<br />\r\n<strong>Patients with renal insufficiency</strong>: In moderate renal impairment (creatinine clearance 30-80 ml/min/1.73 m2) it is recommended that dosage be reduced to one tablet every other day. Patients should be carefully monitored. Ciprofbrate should not be used in severe renal impairment (creatinine clearance &lt;30 ml/min/1.73 m2).<br />\r\n<br />\r\n<strong>Patients with hepatic insufficiency</strong>: Use with caution in patients with impaired hepatic function. Ciprofbrate treatment should be discontinued in case of increased AST and ALT levels to more than 3 times the upper limit of normal or if cholestatic liver injury is evidenced.<br />\r\n<br />\r\n<strong>Elderly</strong>: As for adults but precautions should be taken for Age more than 70 years.<br />\r\n<br />\r\n<strong>Paediatric population</strong>: Not recommended since safety and efficacy in children has not been established.</p>', '<p><strong>Other fibrates &amp; HMG CoA reductase inhibitors</strong>: As Risk of myopathy, rhabdomyolysis and myoglobinuria may be increased if Ciprofbrate is used in combination with other fibrates and HMG CoA reductase inhibitors.<br />\r\n<br />\r\n<strong>Oral anticoagulant therapy</strong>: Caution should be exercised when Ciprofbrate is taken with oral anticoagulants. Concomitant oral anticoagulant therapy should be given at a reduced dosage and adjusted according to INR.</p>', '<ul>\r\n	<li>Hypersensitivity to the active substance or to any of the excipients</li>\r\n	<li>Severe hepatic impairment</li>\r\n	<li>Severe renal impairment (creatinine clearance &lt;30 ml/min/1.73 m2)</li>\r\n	<li>Pregnancy and lactation or when pregnancy is suspected</li>\r\n	<li>Concurrent use with another fibrate</li>\r\n</ul>', '<p>Headache, Dizziness, Somnolence, Vertigo, Nausea, Vomiting, Diarrhoea, Dyspepsia, Abdominal pain, Rash, Alopecia, Myalgia, Fatigue.</p>', '<p>There is no evidence that Ciprofbrate is teratogenic but signs of toxicity at high doses were observed in teratogenicity tests in animals. As there are no data on its use in human pregnancy, Ciprofbrate is contraindicated during pregnancy. As there are no data on its use in lactation, Ciprofbrate is contraindicated in nursing mothers.</p>', '<p><strong>Special warnings</strong>: Patients with rare hereditary problems of galactose intolerance, lactose deficiency or glucose-galactose malabsorption should not take this medicine.<br />\r\n<br />\r\n<strong>Myalgia/myopathy</strong>: Patients should be advised to report unexplained muscle pain, tenderness or weakness immediately.<br />\r\n<br />\r\n<strong>Patients with impaired hepatic function</strong>: Periodic hepatic function tests are recommended (every 3 months for the first 12 months of treatment). Ciprofbrate treatment should be discontinued in case of increased AST and ALT levels to more than 3 times the upper limit of normal or if cholestatic liver injury is evidenced.</p>', NULL, NULL, '<p>Store below 30&deg;C. Protect from light and moisture. Keep the medicine out of reach of children.</p>', NULL, '2022-02-18 20:44:02', '2022-04-02 21:28:48'),
(343, 343, '<p>Ciprofloxacin is indicated for the treatment of Respiratory Tract Infections,Urinary tract infections, Pelvic Inflammatory Diseases, Infectious Diarrhea (Shigella dysenteriae, Vibrio cholera), Typhoid fever, Intra-abdominal infections, Prostatitis, Skin and Soft Tissue Infections, Bone and Joint Infections, Gonorrhea, Neutropenic patients with fever due to bacterial infection, Meningitis, Surgical prophylaxis.</p>', '<p>Ciprofloxacin is a synthetic fluoroquinolone. It has bactericidal activity against a wide range of gram-positive and gram-negative organisms. It inhibits bacterial DNA synthesis by binding with the bacterial enzyme-DNA gyrase and topoisomerase IV which are responsible for DNA supercoiling.</p>', '<p><strong>Tablet</strong>: Adult:</p>\r\n\r\n<ul>\r\n	<li><strong>Respiratory Tract Infections</strong>: 500 to 750 mg twice daily (7 to 14 days)</li>\r\n	<li><strong>Urinary tract infections</strong>: 250 to 750 mg twice daily (3 to 10 days)</li>\r\n	<li><strong>Pelvic Inflammatory Diseases</strong>: 500 to 750 mg twice daily (14 days)</li>\r\n	<li><strong>Infectious Diarrhea (Shigella dysenteriae, Vibrio cholera)</strong>: 500 mg twice daily (1 to 5 days)</li>\r\n	<li>Typhoid fever: 500 mg twice daily (7 days)</li>\r\n	<li><strong>Intra-abdominal infections</strong>: 500 to 750 mg twice daily (5 to 14 days)</li>\r\n	<li><strong>Prostatitis</strong>: 500 to 750 mg twice daily (2 to 6 weeks)</li>\r\n	<li><strong>Skin and Soft Tissue Infections</strong>: 500 to 750 mg twice daily (7 to 14 days)</li>\r\n	<li><strong>Bone and Joint Infections</strong>: 500 to 750 mg twice daily (max. 3 months)</li>\r\n	<li><strong>Gonorrhea</strong>: 500 mg as a single dose</li>\r\n	<li><strong>Neutropenic patients with fever due to bacterial infection</strong>: 500 to 750 mg twice daily co-administered with appropriate antibacterials.</li>\r\n	<li><strong>Meningitis</strong>: 500 mg as a single dose.</li>\r\n	<li><strong>Surgical prophylaxis</strong>: 500 mg as a single dose, 60 minutes before the procedure.</li>\r\n</ul>\r\n\r\n<p><strong>Suspension</strong>: Pediatric: 10-20 mg/kg (max. 750 mg) twice daily (10 to 21 days). The duration of therapy depends on the type and severity of the infection.<br />\r\n<br />\r\n<strong>Extended-release tablet</strong>: In uncomplicated urinary tract infection (acute cystitis), the recommended dose of extended-release tablet is 1000 mg tablet once daily for three days.<br />\r\n<br />\r\nFor IV infusion:</p>\r\n\r\n<ul>\r\n	<li><strong>Urinary Tract Infection</strong>: Mild to Moderate: 200 mg 12 hourly for 7-14 days; Severe or Complicated: 400 mg 12 hourly for 7-14 days</li>\r\n	<li><strong>Lower Respiratory Tract infection</strong>: Mild to Moderate: 400 mg 12 hourly for 7-14 days; Severe or Complicated: 400 mg 8 hourly for 7-14 days</li>\r\n	<li><strong>Nosocomial Pneumonia</strong>: Mild/Moderate/Severe: 400 mg 8 hourly for 10-14 days</li>\r\n	<li><strong>Skin and Skin Structure</strong>: Mild to Moderate: 400 mg 12 hourly for 7-14 days; Severe or Complicated: 400 mg 8 hourly for 7-14 days</li>\r\n	<li><strong>Bone and Joint Infection</strong>: Mild to Moderate: 400 mg 12 hourly for more than 4-6 weeks; Severe/Complicated: 400 mg 8 hourly for more than 4-6weeks</li>\r\n	<li><strong>Intraabdominal (Acute abdomen)</strong>: Complicated: 400 mg 12 hourly for 7-14 days</li>\r\n	<li><strong>Acute Sinusitis</strong>: Mild/Moderate: 400 mg 12 hourly for 10 days</li>\r\n	<li><strong>Chronic Bacterial Prostatitis</strong>: Mild/Moderate: 400 mg 12 hourly for 28 Days.</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>Instruction for the use of Ciprofloxacin IV infusion-</p>\r\n\r\n<ul>\r\n	<li>Check the bag for minute leaks by squeezing the inner bag firmly. If leaks are found, or if seal is not intact, discard the solution.</li>\r\n	<li>Do not use if the solution is cloudy or a precipitate is present.</li>\r\n	<li>Do not use flexible bags in series connections.</li>\r\n	<li>Close flow control clamp of administration set.</li>\r\n	<li>Remove cover from port at bottom of bag.</li>\r\n	<li>Insert piercing pin of administration set into port with a twisting motion until the pin is firmly seated.</li>\r\n	<li>Suspend bag from hanger.</li>\r\n	<li>Squeeze and release drip chamber to establish proper fluid level in chamber during infusion of Ciprofloxacin IV infusion.</li>\r\n	<li>Open flow control clamp to expel air from set.Close clamp.</li>\r\n	<li>Regulate rate of administration with flow control clamp</li>\r\n</ul>\r\n\r\n<p><strong>Duration of treatment</strong>: The duration of treatment depends upon the severity of infection, clinical response and bacteriological findings. For acute infections the usual treatment period is 5 to 10 days. Generally treatment should be continued for 3 days after the signs and symptoms of the infection have been disappeared.</p>', '<p>Concurrent administration of Ciprofloxacin should be avoided with Magnesium or Aluminum containing antacids or sucralfate or with other products containing Calcium, Iron or Zinc. These products may be taken two hours after or six hours before Ciprofloxacin. Ciprofloxacin should not be taken concurrently with milk or other dairy products, since absorption of Ciprofloxacin may be significantly reduced. Dietary calcium is a part of a meal, however, does not significantly affect the absorption of Ciprofloxacin.</p>', '<p>It is contraindicated in patients who have known hypersensitivity to Ciprofloxacin or other quinolones.</p>', '<p>Side effects include- nausea and other gastrointestinal disturbances, headache, dizziness, joint pain and skin rashes.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. Ciprofloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus and mother. Ciprofloxacin is excreted in human milk. Due to the potential risk of articular damage, Ciprofloxacin should not be used during lactation.</p>', '<p>Patients receiving Ciprofloxacin should be instructed to drink fluids liberally. It should be used with caution in patients with suspected or known CNS disorders such as epilepsy or other factors which predispose to seizures and convulsion. Avoid in patients with known QT prolongation, hypokalemia.</p>', '<p>Overdose following Ciprofloxacin administration may lead to seizures, hallucinations, confusion, abdominal discomfort, renal and hepatic impairment as well as crystalluria, haematuria, &amp; reversible renal toxicity.</p>', '<p>4-Quinolone preparations, Anti-diarrhoeal Antimicrobial drugs</p>', '<p>Keep below 30&deg;C temperature, protected from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Although effective in clinical trials, Ciprofloxacin is not a drug of first choice in pediatric population.</p>', '2022-02-18 20:44:23', '2022-04-04 04:53:47'),
(344, 344, '<p>Ciprofloxacin 0.3% Eye/Ear Drops is indicated for the treatment of infections caused by susceptible strains of the designated microorganisms in the conditions listed below:</p>\r\n\r\n<ul>\r\n	<li><strong>Corneal Ulcers:</strong>&nbsp;Pseudomonas aeruginosa, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae.</li>\r\n	<li><strong>Bacterial Conjunctivitis:</strong>&nbsp;Haemophilus influenzae, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae. It is also indicated in the treatment of keratitis, kerato-conjunctivitis, blepharitis, blepharo-conjunctivitis, dacryocistitis, prophylaxis of ocular infections due to Neisseria gonorrhea or Chlamydia trachomatis, prevention of ocular infections after removal of a corneal or physical agent before or after ocular surgery.</li>\r\n	<li><strong>Ear:</strong>&nbsp;Otitis externa, acute otitis media, chronic suppurative otitis media. Prophylaxis in otic surgeries such as mastoid surgery.</li>\r\n</ul>', '<p>Ciprofloxacin is a synthetic broad-spectrum antimicrobial agent for intravenous administration. The bactericidal action of Ciprofloxacin results from inhibition of the enzymes topoisomerase II (DNA gyrase) and topoisomerase IV, which are required for bacterial DNA replication, transcription, repair, and recombination.</p>', '<p><strong>Corneal ulcers:</strong>&nbsp;The recommended dosage regimen for the treatment of corneal ulcers is two drops into the affected eye every 15 minutes for the first 6 hours and then two drops into the affected eye every 30 minutes for the remainder of the first day. On the second day, instill 2 drops in the affected eye hourly. On the third through the fourteenth day, place two drops in the affected eye every four hours. Treatment may be continued after 14 days if corneal re-epithelization has not been occurred.<br />\r\n<br />\r\n<strong>Bacterial conjunctivitis:</strong>&nbsp;The recommended dosage regimen for the treatment of bacterial conjunctivitis is one or two drops instilled into the conjunctival sac(s) every two hours while awake for two days and one or two drops every four hours while awake for the next five days.<br />\r\n<br />\r\n<strong>Ear infections</strong>: For all infections, 2-3 drops every 2-3 hours initially, reducing the frequency of the instillation with control of infection. Treatment should be continued at least 7 days.</p>', '<p>Specific drug interaction studies have not been observed with ophthalmic Ciprofloxacin.</p>', '<p>Hypersensitivity to quinolone group of antibacterials or any of the components of the formulation.</p>', '<p>Local burning or discomfort, itching, foreign body sensation, crystalline precipitates, lid margin crusting, conjunctival hyperemia and a bad taste following administration. Photophobia and nausea may be reported.</p>', '<p>Do not use unless the potential benefits outweigh the potential risk during pregnancy. It is not known whether excretion in human milk occurs following topical ophthalmic administration.&nbsp;Caution should be exercised in the nursing mothers.</p>', '<p>Prolonged ocular use of Ciprofloxacin may result in overgrowth of non-susceptible organisms, including fungi. Ciprofloxacin should be discontinued at the first appearance of a skin rash or any other sign of hypersensitivity reaction.</p>', '<p>A topical overdose may be flushed from the eye/s with warm tap water.</p>', '<p>Aural Anti-bacterial preparations, Ophthalmic antibacterial 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>Pediatric&nbsp;use</strong>:&nbsp;Safety and effectiveness in children under 1 year of age have not been established.</p>', '2022-02-18 20:44:48', '2022-04-04 05:01:01'),
(345, 345, '<p><strong>Eye:</strong>&nbsp;This combination eye drop is indicated for the treatment of steroid responsive inflammatory ocular conditions where bacterial infections or risk of bacterial infections co-exist. The use of a combination drug with an anti-infective component is indicated where the risk of infection is high or where is an expectation that potentially dangerous numbers of bacteria will be present in the eye. The combination can also be used for post-operative inflammation and any other ocular inflammation associated with infection.<br />\r\n<br />\r\n<strong>Ear:</strong>&nbsp;It is indicated for the treatment of ear infections accompanied by inflammation such as otitis externa, otitis media and chronic suppurative otitis media etc. The combination can also be used for post-operative inflammation of ear.</p>', '<p><strong>Dexamethasone</strong>&nbsp;is glucocorticoid. It has an anti-inflammatory and anti-allergic action. It is used topically in the treatment of inflammatory conditions of the anterior segment of the eye.&nbsp;It reduces prostaglandin synthesis by inhibiting the enzyme phospholipase A2. Also, Dexamethasone inhibits the chemotactic infiltration of neutrophils into the site of inflammation.<br />\r\n<br />\r\n<strong>Ciprofloxacin</strong>&nbsp;has in vitro activity against a wide range of gram-negative and gram-positive organisms, possessing the greatest antibacterial activity of all quinolones. The bactericidal action of Ciprofloxacin results from interference with the enzyme DNA gyrase which is needed for the synthesis of bacterial DNA.</p>', '<p><strong>For Eye:</strong>&nbsp;1 drop to be instilled into conjunctival sac(s) every four to six hours. During the initial 24 to 48 hours, the dosage may be increased to 1 drop every two hours.<br />\r\n<br />\r\n<strong>For Ear:</strong></p>\r\n\r\n<ul>\r\n	<li><strong>Acute otitis media in pediatric patients with typanastomy tube</strong>: 4 drops instilled into the affected ear 2 times daily for 7 days.</li>\r\n	<li><strong>Acute otitis externa</strong>: 4 drops instilled into the affected ear 2 times daily for 7 days.</li>\r\n</ul>\r\n\r\n<p>Frequency should be decreased gradually or warranted in clinical signs. Care should be taken not to discontinue therapy prematurely.</p>', '<p>Specific drug interaction studies have not been conducted with ophthalmic Ciprofloxacin and Dexamethasone. However, the systemic administration of some quinolones has been shown to elevate plasma concentrations of theophylline, interfere with the metabolism of caffeine, enhance the effects of the oral anticoagulant warfarin and its derivatives and have been associated with transient elevations in serum creatinine in patients receiving cyclosporin concomitantly.</p>', '<p>Known hypersensitivity to any ingredient of the product. Herpes simplex and other viral conditions, mycosis, glaucoma, newborn babies, fungal diseases of ocular or auricular structures.</p>', '<p>Frequently reported adverse reactions are transient ocular burning or discomfort. Other reported reactions include stinging, redness, itching, photophobia, conjunctivitis/ keratitis, Periocular/ facial edema, foreign body sensation, blurred vision, tearing, dryness, and eye pain. Elevation of IOP with development of glaucoma, and delayed wound healing may rarely occur.</p>', '<p><strong>Use in pregnancy</strong>:&nbsp;This&nbsp;should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: It is not known whether topical administration of corticosteroids would result in sufficient systemic absorption to produce detectable quantities in human milk. It is also not known whether ciprofloxacin is excreted in human milk following topical administration. Because many drugs are excreted in human milk, caution should be exercised when the combination is administered to a nursing woman.</p>', '<p>Prolonged use may result in overgrowth of nonsusceptible organisms including fungi; in ocular hypertension and/or glaucoma, with damage to the optic nerve, defects in visual acuity and fields of vision and posterior sub capsular cataract formation. Patients wearing contact lenses must not use the drops during the time the lenses are worn.</p>', NULL, '<p>Aural steroid &amp; antibiotic combined preparations</p>', '<p>Store in a cool and dry place, away from light. Keep out of reach of children. Shake well before each use.</p>', '<p><strong>Use in children</strong>: Safety &amp; effectiveness for the use of this eye drops in children below the age of one year have not been established.</p>', '2022-02-18 20:45:15', '2022-04-04 05:03:34'),
(346, 346, '<p>This is indicated in Steroid responsive inflammatory ocular conditions, Otitis media, Otitis externa, Ocular inflammation associated with infection, Post-operative inflammation of ear and eye, Corneal Ulcers, Bacterial Conjunctivitis</p>', '<p>Ciprofloxacin promotes breakage of double-stranded DNA in susceptible organisms and inhibits DNA gyrase, which is essential in reproduction of bacterial DNA.<br />\r\n<br />\r\nHydrocortisone is a corticosteroid used for its anti-inflammatory and immunosuppressive effects. Its anti-inflammatory action is due to the suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It may also be used as replacement therapy in adrenocortical insufficiency.</p>', '<p><strong>Eye:&nbsp;</strong><strong>Corneal Ulcers:</strong>&nbsp;The recommended dosage regimen for the treatment of corneal ulcer is two drops into the affected eye every 15 minutes for the first six hours and then two drops into the affected eye every 30 minutes for the remainder of the first day. On the second day, instill two drops in the affected eye hourly. On the third through the fourteenth day, place two drops in the affected eye every four hours. Treatment may be continued after 14 days if corneal re-epithelialization has not occurred.<br />\r\n<br />\r\n<strong>Eye:&nbsp;Bacterial Conjunctivitis:</strong>&nbsp;The recommended dosage regimen for the treatment of bacterial conjunctivitis is one or two drops instilled into the conjunctival sac(s) every two hours while awake for two days and one or two drops every four hours while awake for the next five days.<br />\r\n<br />\r\n<strong>Ear:&nbsp;</strong>Four drops instilled into the affected ear twice daily for seven days. The suspension should be warmed by holding the bottle in the hand for one or two minutes to avoid dizziness, which may result from the instillation of a cold suspension. The patient should lie with the affected ear upward, and then the suspension should be instilled. This position should be maintained for 60 seconds. Repeat, if necessary, for the opposite ear.</p>', '<p>May increase plasma concentrations of CYP1A2 substrates (e.g. clozapine, ropinirole, theophylline). Enhances effect of oral anticoagulants (e.g. warfarin) and glibenclamide. Increased toxicity of methotrexate. Plasma concentrations may be increased by probenecid. Reduced absorption with oral multivitamins and mineral supplements containing divalent or trivalent cations (e.g. Fe, Zn, Ca) and antacids containing Al, Ca or Mg. Concomitant use with class IA antiarrhythmics (e.g. quinidine, procainamide), class III antiarrhythmics (e.g. amiodarone, sotalol), TCAs, macrolides and antipsychotics may result in additive effects on QT interval prolongation. Concurrent use with corticosteroids may increase risk of severe tendon disorders. Increased risk of CNS stimulation with NSAIDs. Altered serum concentrations of phenytoin.<br />\r\n<br />\r\nPotentially Fatal: Marked elevation in serum levels of tizanidine which is associated with potentiated hypotensive and sedative effect.<br />\r\n<br />\r\nThiazides may enhance hyperglycaemia and hypokalaemia caused by corticosteroids. Increased incidence of peptic ulcer or Gl bleeding with concurrent NSAIDs admin. Response to anticoagulants altered. Dose of antidiabetics and antihypertensives needs to be increased. Decreases serum cone of salicylates and antimuscarinic agents. Ethanol may enhance gastric mucosal irritation. Reduced efficacy with concurrent use of carbamazepine, phenytoin, primidone, barbiturates and rifampicin. Mutual inhibition of metabolism between ciclosporin and corticosteroids increase plasma cone of both drugs. Enhanced effect in women taking oestrogens or oral contraceptives.</p>', '<p>Known hypersensitivity to any ingredient of the product. Herpes simplex and other viral conditions, mycosis, glaucoma, newborn babies, fungal diseases of ocular or auricular structures.</p>', '<p>The most frequently reported drug-related adverse reactions seen with Ciprofloxacin are transient ocular burning or discomfort. Other reported reactions include stinging, redness, itching, periocular/facial edema, foreign body sensation, photophobia, blurred vision, tearing, dryness and eye pain. Rare reports of dizziness have been received.<br />\r\n<br />\r\nThe reactions due to the steroid component are elevation of intraocular pressure (IOP) with possible development of glaucoma and infrequent optic nerve damage, posterior sub-capsular cataract formation and delayed wound healing.</p>', '<p>Pregnancy&nbsp;Category C+D.Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.<br />\r\n<br />\r\nThere is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.<br />\r\n<br />\r\nLactation: Excretion in breast milk unknown; not recommended.</p>', '<p>Prolonged use may result in overgrowth of nonsusceptible organisms including fungi; in ocular hypertension and/or glaucoma, with damage to the optic nerve, defects in visual acuity and fields of vision and posterior sub capsular cataract formation. Patients wearing contact lenses must not use the drops during the time the lenses are worn.</p>', NULL, '<p>Aural steroid &amp; antibiotic combined preparations</p>', '<p>Should be stored in cool and dry place.</p>', '<p>Paediatric Use:</p>\r\n\r\n<ul>\r\n	<li><strong>Ear:</strong>&nbsp;Safety and effectiveness of this suspension in pediatric (6 months of age and older) patients for ear application have been established.</li>\r\n	<li><strong>Eye:</strong>&nbsp;Safety and effectiveness of this suspension in pediatric patients for eye application have not been established.</li>\r\n</ul>', '2022-02-18 20:45:41', '2022-04-04 05:09:23'),
(347, 347, '<p>Cisplatin is indicated as first line therapy for lung cancer, head &amp; neck cancer and for the treatment of advanced and metastatic ovarian carcinoma, bladder carcinoma and testis carcinoma.</p>', '<p>Cisplatin modifies cell cycle by interfering with DNA structure and function. Effects are most prominent during the S phase but cells are killed at all stages. Cisplatin synergises with other anticancer drugs e.g. fluorouracil. It has a narrow therapeutic margin and is highly toxic.</p>', '<p><strong>Metastatic ovarian cancer:</strong>&nbsp;As monotherapy: 100 mg/m2&nbsp;per cycle, given as a single dose infused in 0.9% sodium chloride or glucose once every 4 wk. For combination therapy with cyclophosphamide: 75-100 mg/m2&nbsp;on day 1 of every 4-wk cycle.<br />\r\n<br />\r\n<strong>Metastatic testicular tumours:</strong>&nbsp;20 mg/m2&nbsp;BSA daily for 5 days per cycle.<br />\r\n<br />\r\n<strong>Advanced bladder cancer:</strong>&nbsp;50-70 mg/m2&nbsp;per cycle once every 3-4 wk, depending on the extent of prior exposure to radiation and/or chemotherapy treatment. An initial dose of 50 mg/m2&nbsp;every 4 wk may be used in heavily pre-treated patients.<br />\r\n<br />\r\n<strong>Usual dosage and schedule:</strong>&nbsp;40 to 120 mg/m2&nbsp;I.V. on day 1 as infusion every 3 weeks. 15 to 20 mg/m2&nbsp;I.V. on days 1 to 5 as infusion every 3 to 4 weeks. The usual dose in adults and children when used as single agent therapy is 50-100 mg/m2.</p>', '<p>Synergistic with 5-fluorouracil and etoposide. Efficacy increased and toxicity reduced when combined with radioprotecting agent WR 2721. At doses &le;100 mg, cisplatin is an ideal drug to combine with other cytotoxic drugs; unlike other antineoplastic drugs, it causes little myelosuppression.</p>', '<p>Cisplatin is contraindicated in patients with pre-existing renal impairment. Cisplatin should not be employed in myelosuppressed patients, or patients with hearing impairment. It is also contraindicated in patients with a history of allergic reactions to cisplatin or other platinum-containing compounds.</p>', '<p>Severe nausea and vomiting. Serious toxic effects on the kidneys, bone marrows and ears. Hypomagnesaemia, hypocalcaemia, hyperuricaemia. Peripheral neuropathies, papilloedema, optic neuritis, seizures. Ototoxicity (children) manifested as tinnitus, loss of hearing, deafness or vestibular toxicity.</p>', '<p>Pregnancy&nbsp;Category D.&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>Patients with renal or hepatic disorder, myelosuppression. Monitor renal, neurological and auditory function. Perform blood counts regularly. Maintain adequate hydration before and 24 hr after admin to minimise nephrotoxicity.</p>', '<p>Acute overdosage may result in kidney failure, liver failure, deafness, ocular toxicity, significant myelosuppression, intractable nausea and vomiting and/or neuritis. Death may also occur following overdosage. Treatment should include general supportive measures.</p>', '<p>Cytotoxic Chemotherapy</p>', '<p>Stability: The cisplatin remaining in vial following initial entry is stable for 28 days protected from light or for 7 days under fluorescent room light.<br />\r\n<br />\r\nStorage: Product should be stored at controlled room temperature 25&deg; C and protected from light.</p>', NULL, '2022-02-18 20:45:53', '2022-04-04 05:12:14');
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
(348, 348, '<p>Citalopram is indicated for depressive illness and panic disorder. It is also indicated in substance abuse disorders and alcohol dependence. Citalopram has also been given in variety of anxiety disorders including obsessive-compulsive disorder and social phobia. It is also effective in generalized anxiety disorder, post-traumatic stress disorder, premenstrual syndrome, idiopathic Parkinson&#39;s disease and eating disorder.</p>', '<p>Citalopram is bicyclic phthalane derivative and a selective serotonin re-uptake inhibitor, with little or no effect on noradrenaline, dopamine and GABA re-uptake. The inhibitory activity explains the antidepressant property of citalopram. It has no or very low affinity for 5-HT1AA, 5-HT2A, D1&nbsp;and D2&nbsp;receptors, &alpha;1, &alpha;2, &beta;-adrenergic, histamine H1, muscarinic, cholinergic, benzodiazepine and opioid receptors.</p>', '<p>Depression, Depressive phase of bipolar disorder:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Initially, 20 mg/day, increased to max 40 mg/day after at least 1 wk.</li>\r\n	<li><strong>Child</strong>: Contraindicated.</li>\r\n	<li><strong>Elderly</strong>: 10 mg/day. Max: 20 mg/day.</li>\r\n</ul>\r\n\r\n<p>Panic disorder with or without agoraphobia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Initially, 10 mg/day, increased to 20 mg/day after 1 wk.</li>\r\n	<li><strong>Child</strong>: Contraindicated.</li>\r\n	<li><strong>Elderly</strong>: 10 mg/day. Max: 20 mg/day.</li>\r\n</ul>', '<p>Ketoconazole, Itraconazole or Macrolide antibiotics and Citalopram co-administration decreases the metabolism of Citalopram. Omeprazole and Citalopram co-administration might decrease the clearance of Citalopram.</p>', '<p>Citalopram should not be used if the patient enters a manic phase. Concomitant use in patients taking MAO inhibitor is contraindicated. Citalopram is contraindicated in patients with a hypersensitivity to this drug or any of its ingredients.</p>', '<p>SSRIs are less sedating and have fewer antimuscarinic and cardiotoxic effects than tricyclic antidepressants. However, side-effects may be seen, includes gastro-intestinal effects (nausea, vomiting, dyspepsia, abdominal pain, diarrhoea, constipation), anorexia with weight loss, palpitations, tachycardia, postural hypotension, cough, confusion, impaired concentration, amnesia, urinary retention, sweating, movement disorders, urticaria, anaphylaxis, arthralgia, myalgia and photosensitivity.</p>', '<p><strong>Pregnancy</strong>: There are no adequate and well-controlled studies in pregnant women; therefore, Citalopram should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Lactation</strong>: Citalopram is excreted in human breast milk. So, the decision whether to continue or discontinue either nursing or Citalopram therapy should take into account the risks of Citalopram exposure for the infants and the benefits of Citalopram treatment for the mother.</p>', '<p>Caution should be taken in patients with epilepsy, concurrent electroconvulsive therapy, history of mania, cardiac disease, diabetes mellitus, angle-closure glaucoma, history of bleeding disorders, hepatic and renal impairment. Abrupt withdrawal of Citalopram should be avoided.</p>', '<p><strong>Symptoms</strong>: Dizziness, sweating, nausea, vomiting, tremor, somnolence and sinus tachycardia. Rarely, amnesia, confusion, coma, seizures, hyperventilation, cyanosis, rhabdomyolysis and ECG changes (e.g. QT prolongation, sinus bradycardia, ventricular arrhythmias, nodal rhythm, torsade de pointes and left bundle branch block).<br />\r\n<br />\r\n<strong>Management</strong>: Symptomatic and supportive treatment. Maintain and ensure adequate ventilation and oxygenation. Gastric evacuation by lavage and use of activated charcoal should be considered. Frequently monitor cardiac function and vital signs.</p>', '<p>SSRIs &amp; related anti-depressant drugs</p>', '<p>Store at 25&deg; C.</p>', NULL, '2022-02-18 20:46:19', '2022-04-04 05:20:46'),
(349, 349, '<p>Citicoline Sodium is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Cerebrovascular disease e.g. ischemia due to stroke, where Citicoline accelerates the recovery of consciousness &amp; overcoming motor deficit. Treatment within the first 24 hours after onset in patients with moderate to severe stroke increases the probability of complete recovery in 3 months.</li>\r\n	<li>Cerebral insufficiency (e.g. dizziness, memory loss, poor concentration &amp; disorientation) due to head trauma or brain injury.</li>\r\n	<li>Cognitive dysfunction due to degenerative disease (Alzheimer&#39;s disease)</li>\r\n	<li>Parkinson&#39;s disease: Citicoline has been shown to be effective as co-therapy for Parkinson&#39;s disease.</li>\r\n</ul>', '<p>Citicoline is a naturally occurring substance that is an essential intermediate in the synthesis of structural phospholipids of cell membrane. Oral dose of Citicoline is metabolized to choline &amp; cytidine. These then enter into the systemic circulation, cross the blood-brain barrier and recombine to form Citicoline within the central nervous system. Citicoline activates the biosynthesis of structural phospholipids in the neuronal membrane, promotes rapid repair of injured cell surface &amp; mitochondrial membrane &amp; increases the level of various neurotransmitters like acetylcholine &amp; dopamine. Citicoline has neuroprotective effects in situations of hypoxia &amp; ischemia, as well as improved learning &amp; memory performance in animal models for the aging brain. Citicoline inhibits the activation of Phospholipase A2 to prevent apoptotic &amp; necrotic cell death.</p>', '<p>Oral:</p>\r\n\r\n<ul>\r\n	<li>Immediate treatment of stroke due to a clot (ischemic stroke): 500-2000 mg of Citicoline per day, start within 24 hours of stroke.</li>\r\n	<li>For decline in thinking skills due to stroke: 1000-2000 mg of Citicoline per day.</li>\r\n	<li>Chronic cerebrovascular disease: 1000 mg daily in divided dose with or between meals for ongoing disease of the blood vessels that serve the brain.</li>\r\n</ul>\r\n\r\n<p>Injection:</p>\r\n\r\n<ul>\r\n	<li>1 to 2 injections daily.</li>\r\n	<li>Adjust dosage according to the severity.</li>\r\n	<li>Can be administered through intramuscular (IM), or intravenous (IV) [ 3 to 5 minutes] route.</li>\r\n</ul>', '<p>Citicoline may enhance the effects of levodopa, carbidopa &amp; entacapone. Citicoline must not be administered with products containing meclophenoxate.</p>', '<p>Patients with hypertonic of the parasympathetic nervous system.</p>', '<p>Occasionally Citicoline may exert stimulating action of the parasympathetic system as well as a fleeting &amp; discrete hypotensive effect.</p>', '<p>There are no adequate &amp; well controlled studies of Citicoline during pregnancy &amp; lactation. Citicoline should be used during pregnancy &amp; lactation only if the potential benefits justify the potential risks.</p>', '<p>In case of persistent intracranial hemorrhage, it is recommended not to exceed the dose of 1000 mg of Citicoline daily.</p>', NULL, '<p>CNS stimulant drugs</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Geriatric use: No dosage adjustment is required &amp; the usual dose can be administered.</p>', '2022-02-18 20:46:51', '2022-04-04 05:24:13'),
(350, 350, '<p>Citric Acid Monohydrate is indicated for the management of dry cough.</p>', '<p>Citric Acid Monohydrate helps to reduce the dry cough and soothes the throat from any related discomfort and pain. Citric Acid is a demulcent which relieves irritation of the mucous membrane in the throat by forming a protective film. Citric Acid is absorbed after oral administration. It is found naturally in the body and is widely distributed.</p>', '<p><strong>1-5 years:</strong>&nbsp;5 ml upto 4 times daily<br />\r\n<strong>6-12 years:</strong>&nbsp;10 ml upto 4 times daily<br />\r\n<strong>&gt;12 years &amp; Adults:</strong>&nbsp;20 ml upto 3-4 times daily</p>', '<p>No drug-drug interaction has been found.</p>', '<p>It is contraindicated for the hypersensitivity to any of the ingredients of this medicine.</p>', '<p>There are no known side effects from using this medicine when used as directed. If taken excessively above the stated dose, glycerol present in the medicine may cause headache, stomach upset and diarrhea.</p>', '<p>There are no or limited amount of data from the use of Citric Acid Monohydrate in pregnant women. There is insufficient information on the excretion of Citric Acid Monohydrate &amp; its metabolites in human milk.</p>', '<p>Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine.</p>', NULL, '<p>Cough suppressant</p>', '<p>Keep in a cool and dry place, away from light. Keep out of the reach of children.</p>', NULL, '2022-02-18 20:47:13', '2022-04-04 05:27:02'),
(351, 351, '<p>Clarithromycin is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Streptococcal pharyngitis</li>\r\n	<li>Sinusitis</li>\r\n	<li>Infective exacerbations of chronic bronchitis</li>\r\n	<li>Community-acquired pneumonia</li>\r\n	<li>Atypical pneumonia</li>\r\n	<li>Skin and soft tissue infection</li>\r\n	<li>Adjunct in the treatment of duodenal ulcers by eradication of H.pylori.</li>\r\n</ul>', '<p>Clarithromycin 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. Clarithromycin is active against most Gram-positive bacteria and Chlamydia, some Gram-negative bacteria and Mycoplasmas. Clarithromycin&#39;s activity is the same as, or greater than, that of Erythromycin in vitro against most Gram-positive bacteria. Clarithromycin is more acid-stable than Erythromycin and therefore, is better tolerated. Clarithromycin has twice the activity of Erythromycin against H. influenzae. Most species of Gram-negative bacteria are resistant to Clarithromycin because of failure to penetrate the target.</p>', '<p>Adults:</p>\r\n\r\n<ul>\r\n	<li>Pharyngitis / Tonsillitis 250 mg every 12 hours for 10 days.</li>\r\n	<li>Acute maxillary sinusitis 500 mg every 12 hours for 14 days.</li>\r\n	<li>Chronic bronchitis 250-500 mg every 12 hours for 7-14 days.</li>\r\n	<li>Pneumonia 250 mg every 12 hours for 7-14 days.</li>\r\n	<li>Uncomplicated skin &amp; skin structure infections 250 mg every 12 hours for 7-14 days.</li>\r\n	<li>Community-acquired upper and lower respiratory tract infections 250-500 mg every 12 hours for 5-14 days.</li>\r\n</ul>\r\n\r\n<p>Children:</p>\r\n\r\n<ul>\r\n	<li>Bodyweight under 8 kg: 7.5 mg/kg twice daily.</li>\r\n	<li>Bodyweight of 8-11 kg (1-2 years): 2.5 ml (Half teaspoonful) twice daily.</li>\r\n	<li>Bodyweight of 12-19 kg (3-6 years): 5 ml (One teaspoonful) twice daily.</li>\r\n	<li>Bodyweight of 20-29 kg (7-9 years): 7.5 ml (One &amp; half teaspoonfuls) twice daily.</li>\r\n	<li>Bodyweight of 30-40 kg (10-12 years): 10 ml (Two teaspoonfuls) 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>Clarithromycin may be given with or without meals.</p>', '<p>Theophylline: Concomitant use of Clarithromycin who are receiving Theophylline may be associated with an increase in serum Theophylline concentrations. Terfenadine: Clarithromycin may alter the metabolism of Terfenadine.</p>', '<p>Hypersensitivity to Clarithromycin, Erythromycin, or any of the macrolide antibiotics. Patients receiving Terfenadine who have pre-existing cardiac abnormalities or electrolyte disturbances.</p>', '<p>Clarithromycin is generally well tolerated. Side effects include nausea, vomiting, diarrhoea and abdominal pain. Stomatitis and glossitis have also been reported. Other side effects include headache, allergic reactions ranging from urticaria and mild skin reactions to anaphylaxis. Taste perversion may occur. There have been reports of transient central nervous system side effects including anxiety, dizziness, insomnia and hallucination.</p>', '<p>The drug may be used in neonates and children in appropriate doses. Breast milk from mothers receiving Clarithromycin should not be given to infants until treatment is completed. There is as yet little experience in the treatment of pregnant patients and Clarithromycin is not recommended.</p>', '<p>Clarithromycin is principally excreted by the liver and kidney. Caution should be taken in administering this antibiotic to patients with impaired hepatic and renal function. Prolonged or repeated use of Clarithromycin may result in an overgrowth of non-susceptible bacteria or fungi. If superinfection occurs, Clarithromycin should be discontinued and appropriate therapy should be instituted.</p>', '<p>Reports indicate that the ingestion of large amounts of clarithromycin can be expected to produce gastro-intestinal symptoms. One patient who had a history of bipolar disorder ingested 8 grams of clarithromycin and showed altered mental status, paranoid behaviour, hypokalemia and hypoxemia. Adverse reactions accompanying overdosage should be treated by the prompt elimination of unabsorbed drug and supportive measures. As with other macrolides, clarithromycin serum levels are not expected to be appreciably affected by haemodialysis or peritoneal dialysis.</p>', '<p>Macrolides</p>', '<p>Store in a cool and dry place, protected from light &amp; moisture. The reconstituted suspension must be used within 7 days if kept at room temperature and within 14 days when stored in a refrigerator. Keep out of reach of children.</p>', NULL, '2022-02-18 20:47:54', '2022-04-04 05:29:49'),
(352, 352, '<p>Clascoterone cream is an androgen receptor inhibitor indicated for the topical treatment of acne vulgaris in patients 12 years of age and older.</p>', '<p>Acne is a multifactorial skin condition characterized by excess sebum production, epithelial hyperkeratinization, proliferation of the skin commensal bacteria, and inflammation. Circulating and locally synthesized natural ligands, testosterone and dihydrotestosterone (DHT), serve as causative factors in both males and females. Upon binding of DHT, the DHT-androgen receptor complex dimerizes and translocates to the nucleus where it promotes the transcription of genes involved in acne pathogenesis, including proliferation and differentiation of sebocytes, excess sebum production, and inflammatory cytokine production. Clascoterone is a potent antagonist at ARs and competes for androgens in binding to the receptor, thereby inhibiting downstream signalling of ARs that promote acne.<br />\r\n<br />\r\nAndrogenetic alopecia is also an androgen-dependent and highly genetic condition. Dihydrotestosterone (DHT) binds to ARs expressed on dermal papilla cells (DPC) in the scalp to induce AR-mediated transcription of genes that contribute to androgenic alopecia. By blocking the interaction between DHT and aARs, clascoterone inhibits AR-regulated transcription and DHT-induced IL-6 synthesis.</p>', '<p>Cleanse the affected area gently. After the skin is dry, apply a thin uniform layer of Clascoterone cream twice per day, in the morning and the evening, to the affected area. Avoid accidental transfer of Clascoterone cream into eyes, mouth or other mucous membranes. If contact with mucous membranes occurs, rinse thoroughly with water. Clascoterone cream is for topical use only. This cream is not for ophthalmic, oral or vaginal use.</p>', NULL, NULL, '<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.<br />\r\n<br />\r\nIn two identical multicenter, randomized, double-blind, vehicle-controlled trials, 1421 subjects 12 years and older with facial acne vulgaris applied Clascoterone cream or vehicle twice daily for 12 weeks. Overall, 62% of the subjects were female, and 38% were male, 91% of the patients were Caucasian, and the mean age was 19.7 years.<br />\r\n<br />\r\nLocal skin reactions (edema, erythema/redness, pruritus, scaling/dryness, skin atrophy, stinging/burning, striae rubrea, telangiectasia) were observed during the 12-week treatment and occurred in a similar percentage of subjects treated with vehicle.</p>', '<p><strong>Pregnancy</strong>: There are no available data on Clascoterone cream use in pregnant women to evaluate for a drug associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. In animal reproduction studies, subcutaneous administration of clascoterone to pregnant rats and rabbits during organogenesis at doses 8 or 39 times the maximum recommended human dose (MRHD), respectively, increased malformations in rats and post-implantation loss and resorptions in rabbits. The background risk of major birth defects and miscarriage for the indicated population is unknown. Adverse outcomes in pregnancy occur regardless of the health of the mother or the use of medications. 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>: There are no data regarding the presence of clascoterone or metabolite in human milk, the effects on the breastfed infant or the effects on milk production. The lack of clinical data during lactation precludes a clear determination of the risk of clascoterone to an infant during lactation; therefore, the developmental and health benefits of breastfeeding should be considered along with the mother&#39;s clinical need for clascoterone and any potential adverse effects on the breastfed child from clascoterone or from the underlying maternal condition.</p>', '<p><strong>Local Skin Reactions</strong>: Clascoterone cream may induce local irritation (erythema/redness, pruritus, scaling/ dryness). Concomitant use with other potentially irritating topical products (medicated or abrasive soaps and cleansers, soaps and cosmetics that have a strong drying effect and products with high concentrations of alcohol, astringents, spices or lime) should be limited. The product should not be applied to cuts, abrasions, eczematous or sunburned skin.<br />\r\n<br />\r\n<strong>Hypothalamic-pituitary-adrenal (HPA) Axis Suppression</strong>: Hypothalamic-pituitary-adrenal (HPA) axis suppression was observed and may occur during or after treatment with clascoterone. In the PK trial, all subjects returned to normal HPA axis function at follow-up 4 weeks after stopping treatment. Conditions which augment systemic absorption include use over large surface areas, prolonged use, and the use of occlusive dressings. If HPA axis suppression develops, an attempt should be made to withdraw the drug. Pediatric patients may be more susceptible to systemic toxicity.</p>', NULL, '<p>Acne treatment preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of Clascoterone cream for the topical treatment of acne vulgaris have been established in 641 pediatric patients, aged 12 to 18 years in two identical multicenter, randomized, double-blind, vehicle-controlled, 12-week trials and 2 open-label pharmacokinetic studies. Safety and effectiveness of Clascoterone cream for the topical treatment of acne vulgaris has not been established in pediatric patients under 12 years of age.&nbsp;<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of Clascoterone cream did not include sufficient numbers of subjects aged 65 years of age 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>', '2022-02-18 20:48:18', '2022-04-04 05:31:56'),
(353, 353, '<p>Clindamycin has been shown to be effective in the treatment of the following infections when caused by susceptible anaerobic bacteria or susceptible strains of gram positive bacteria such as Streptococci, Staphylococci and Pneumococci; Upper respiratory infections, Lower respiratory infections, Skin and soft tissue infections, Bone and joint infections, Pelvic infections, Intra-abdominal infections, Septicemia and endocarditis, Dental infections. As an alternative therapy when used in combination with quinine or amodiaquine for the treatment of multi-drug resistant Plasmodium falciporum infection.</p>', NULL, '<p><strong>Dosage of Clindamycin Capsule</strong>:</p>\r\n\r\n<ul>\r\n	<li>Serious Infections: 150 mg-300 mg every six hours.</li>\r\n	<li>More severe infections: 300 mg-450 mg every six hours.</li>\r\n</ul>\r\n\r\n<p>To avoid the possibility of oesophageal irritation, Clindacin capsules should be taken with a full glass of water.<br />\r\n<br />\r\nSeveral researches has found that Clindamycin 300 mg capsule provides plasma concentration over MIC90&nbsp;for more than 12 hours. This finding supports the twice-daily dosing of Clindacin 300 mg capsule, particularly in SSTIs &amp; RTIs. However, in case of bone &amp; joint infections, diabetic foot infections dose of Clindamycin should be 300 mg capsule 3-4 times daily.<br />\r\n<br />\r\n<strong>Dosage of Clindamycin Powder for oral solution</strong>:</p>\r\n\r\n<ul>\r\n	<li>Serious infections: 8-12 mg/kg/day divided into 3 or 4 equal doses.</li>\r\n	<li>Severe infections: 13-16 mg/kg/day divided into 3 or 4 equal doses.</li>\r\n	<li>More severe infections: 17-25 mg/kg/day divided into 3 or 4 equal doses.</li>\r\n</ul>\r\n\r\n<p>In pediatric patients weighing 10 kg or less, 1/2 teaspoon (37.5 mg) three times a day should be considered the minimum recommended dose.<br />\r\n<br />\r\n<strong>Dosage of Clindamycin IV/IM Injection</strong>:<br />\r\nAdults-</p>\r\n\r\n<ul>\r\n	<li>Serious infections due to aerobic gram-positive cocci and the more susceptible anaerobes: 600-1200 mg/day in 2- 4 equal doses.</li>\r\n	<li>More severe infections: 1200-2700 mg/day in 2-4 equal doses.</li>\r\n	<li>For more serious infections: these doses may have to be increased. In life-threatening situations due to either aerobes or anaerobes, these doses may be increased.</li>\r\n	<li>Doses of as much as 4800 mg daily have been given intravenously to adults. Single intramuscular injections of greater than 600 mg are not recommended.</li>\r\n</ul>\r\n\r\n<p>Neonates (less than 1 month): 15 to 20 mg/kg/day in 3 to 4 equal doses. The lower effective dosage may be adequate for small prematures.<br />\r\n<br />\r\nPediatric patients (1 month of age to 16 years):</p>\r\n\r\n<ul>\r\n	<li>20 to 40 mg/kg/day in 3 or 4 equal doses. The higher doses would be used for more severe infections.</li>\r\n	<li>Parenteral therapy may be changed to Capsules (clindamycin hydrochloride) when the condition warrants and at the discretion of the physician.</li>\r\n	<li>In cases of (3-hemolytic streptococcal infections, treatment should be continued for at least 10 days.</li>\r\n</ul>', '<p>Clindamycin enhances the action of other neuromuscular blocking agents. Therefore, it should be used with caution in patients receiving such agents. Antagonism has been demonstrated between clindamycin and erythromycin in vitro. Because of possible clinical significance, these two drugs should not be administered concurrently.</p>', '<p>Clindamycin is contraindicated in patients previously found to be sensitive to clindamycin or any of the ingredients of this medicine.</p>', '<p>The adverse effects have been reported with the use of clindamycin are- abdominal pain, oesophagitis and oesophagial ulcer, nausea, vomiting and diarrhoea, pruritus, skin rashes, urticaria.</p>', '<p>Pregnancy Category B. Clindamycin crosses the placenta in humans. After multiple doses, amniotic fluid concentrations were approximately 30% of maternal concentrations. Clindamycin should be used in pregnancy only if clearly needed. Clindamycin has been reported to appear in breast milk. Therefore, it is not recommended for nursing mothers if not clearly needed.</p>', '<p>Clindamycin should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis.</p>', '<p>Overdosage with orally administered clindamycin has been rare. Adverse reactions similar to those seen with normal doses can be expected, however, unexpected reactions could occur. Haemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum. Overdosage should be treated with simple gastric lavage. No specific antidote is known.</p>', '<p>Macrolides</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Use in newborns and infants</strong>: When Clindamycin is administered to newborns and infants (birth to 16 years), appropriate monitoring of organ system functions is desirable.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: Dose adjustment of Clindamycin is not necessary.</p>', '2022-02-18 20:48:50', '2022-04-04 05:34:37'),
(354, 354, '<p>Clindamycin lotion is indicated in the treatment of acne vulgaris. Other uses of topical Clindamycin lotion are:</p>\r\n\r\n<ul>\r\n	<li>Skin infections such as erythrasma caused by Corynebacterium minutissimum; rosacea, periorificial dermatitis, folliculitis, stasis, chronic lymphaedema and familial pemphigus.</li>\r\n	<li>Dermal ulcers.</li>\r\n</ul>', '<p>Clindamycin is a lincosamide antibiotic used in the treatment of infections caused by susceptible microorganisms. Clindamycin is a semisynthetic antibiotic derived from lincomycin. It has antiacne and antibacterial activity. It binds with the 50s subunit of the bacterial ribosome and inhibits the early stage of protein synthesis. It is highly potent against gram positive and anaerobic bacteria.<br />\r\n<br />\r\nMicrobiology: Aerobic gram-positive cocci, including: Staphylococcus aureus, Staphylococcus epidermidis (penicillinase and non-penicillinase producing strains), Streptococci, Pneumococci. Anaerobic gram-negative bacilli, including: Bacteroides species, Fusobacterium species. Anaerobic gram-positive non-spore forming bacilli, including: Propionibacterium species, Eubacterium species, Actinomyces species. Anaerobic and microaerophilic gram-positive cocci, including: Peptococcus species, Peptostreptococcus species, Microaerophilic streptococci, C. perfringes</p>', '<p>At first, wash the face or affected area gently with warm water or soap. When the skin is completely dried (about 30 minutes later) apply a thin film of Clindamycin&nbsp;lotion to the entire affected area twice daily. The Applied area should not be washed within 3 hours. Noticeable improvement is usually seen after about 6 weeks. However, 8 to 12 weeks of treatment may be required for maximum benefit. Eye, lip or nose contact should be avoided while applying Clindamycin&nbsp;lotion.</p>', '<p>Clindamycin enhances the action of other neuromuscular blocking agents. Therefore, it should be used with caution in patients receiving such agents. Antagonism has been demonstrated between clindamycin and erythromycin in vitro. Because of possible clinical significance, these two drugs should not be administered concurrently.</p>', NULL, '<p>Side effects are usually rare. Possible side-effects may includes skin rash, itching, oily skin, dryness, erythema, burning, change in skin color, diarrhea, colitis, GI disturbance etc.</p>', '<p>There is no adequate data for safe use in pregnancy. Animal studies showed no adverse effects on the fetus. It is not known that whether Clindamycin is excreted through breast milk following topical administration. However, Clindamycin&nbsp;lotion can be used during lactation with caution.</p>', '<p>Clindamycin lotion is not for oral, ophthalmic, or Intravaginal use. Avoid exposure to sunlight and sunlamps. Wear sunscreen daily.</p>', '<p>Intravaginal overdose is not possible. Accidental ingestion of the product could be accompanied by effects related to therapeutic levels of oral clindamycin.</p>', '<p>Macrolides</p>', '<p>Store the tube below 25 &deg;C, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-18 20:49:15', '2022-04-10 19:51:17'),
(355, 355, '<p>Clindamycin cream is indicated in the treatment of bacterial vaginosis. Clindamycin cream can be used to treat non pregnant women and pregnant women during the second and third trimester.</p>', '<p>Clindamycin Phosphate is a water soluble ester that derived from the parent antibiotic Lincomycin. Clindamycin inhibits bacterial protein synthesis by binding preferentially to the 50s ribosomal subunit and affects the process of peptide chain initiation. In vitro Clindamycin is active against most strains of the following organisms that have been reported to be associated with bacterial vaginosis:</p>\r\n\r\n<ul>\r\n	<li>Bacteroides spp.</li>\r\n	<li>Gardnerella vaginalism</li>\r\n	<li>Mobiluncus spp.</li>\r\n	<li>Mycoplasma hominis</li>\r\n	<li>Peptostreptococcus spp.</li>\r\n</ul>', '<p>One applicator full (approximately 5 gram) intravaginally at bedtime for 7 consecutive days. In patients in whom a shorter treatment course is desirable, a 3-day regimen has been shown to be effective.</p>', NULL, '<p>Clindamycin cream is not recommended in children under 12 years of age</p>', '<p>Clindamycin may results the following side effects. Genital tract: vaginitis, vulvo-vaginal irritation Central nervous system: dizziness, headache, vertigo.Gastro-intestinal: heartburn, nausea, vomiting, diarrhea, constipation, abdominal pain. Dermatological: rash, exanthema. Hypersensitivity: urticaria.</p>', '<p>There are no adequate and well-controlled studies in pregnant women during the first trimester of pregnancy. This drug should be used during the first trimester of pregnancy only if clearly needed. There is no restriction to use Clindamycin cream during the second and third trimester. It is not known if clindamycin is excreted in breast milk following the use of vaginally administered Clindamycin phosphate. However, orally and parenterally administered Clindamycin has been reported to appear in breast milk.</p>', '<p>The patient should be instructed not to engage in vaginal intercourse, or use other vaginal products during treatment with this product. This cream contains mineral oil that may weaken latex or rubber products such as condoms or vaginal contraceptive diaphragms. Therefore, use of such products within 72 hours following treatment with Clindamycin cream is not recommended.</p>', '<p>Intravaginal overdose is not possible. Accidental ingestion of the product could be accompanied by effects related to therapeutic levels of oral clindamycin.</p>', '<p>Macrolides</p>', '<p>Store the tube below 25 &deg;C, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-18 20:54:52', '2022-04-10 19:53:46'),
(356, 356, '<p>Indicated in acne vulgaris.</p>', '<p><strong>Clindamycin</strong>&nbsp;is a semi-synthetic derivative of lincomycin. It inhibits bacterial protein synthesis by reversibly binding to the 50S ribosomal subunits thus blocking the transpeptidation or translocation reactions of susceptible organisms.<br />\r\n<br />\r\n<strong>Benzoyl peroxide</strong>&nbsp;has mild keratolytic effect and antimicrobial activity which is attributed to its potent oxidizing activity. Clindamycin and Benzoyl peroxide are both active against Propionibacterium acnes, an organism associated with acne vulgaris.</p>', '<p>Apply to the affected areas once or twice daily (morning and evening) after the skin is gently washed and patted dry.</p>', '<p>May enhance the action of neuromuscular blocking agents (e.g. atracurium). May antagonise the effects of parasympathomimetics. May competitively inhibit the effects of macrolides, ketolides, streptogramins, linezolid and chloramphenicol. Increased coagulation tests (prothrombin time/INR) and/or bleeding with vit K antagonists (e.g. warfarin, acenocoumarol, fluindione). PABA sunscreens may transiently discolour fabric.</p>', '<p>Hypersensitivity to Clindamycin, lincomycin, benzoyl peroxide, or any component of the formulation; history of regional enteritis, ulcerative colitis, pseudomembranous colitis or antibiotic-associated colitis.</p>', '<p>Application site pain, Application site exfoliation, Application site irritation, Erythema, Burning, Pruritus, Sunburn, Scaling, Drynes, Colitis, Peelin.</p>', '<p><strong>Pregnancy&nbsp;</strong>Category- C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks<br />\r\n<br />\r\n<strong>Lactation</strong>: Excretion in milk is unknown/ not recommended</p>', '<p>Avoid contact with mouth, eyes, lips &amp; mucous membranes; abraded or eczematous skin. May discolor hair &amp; dyed fabrics. Pregnancy &amp; lactation.</p>', NULL, '<p>Benzoyl peroxide, Azelaic acid &amp; other preparations</p>', NULL, NULL, '2022-02-18 20:55:19', '2022-04-10 19:56:17'),
(357, 357, '<p>Clindamycin and Tretinoin gel is indicated for the topical treatment of Acne vulgaris.</p>', '<p>This is a combination of lincosamide antibiotic Clindamycin phosphate and retinoid Tretinoin. Clindamycin binds with the 50s ribosomal subunit of susceptible bacteria and prevents elongation of peptide chain by interfering with the peptidyl transfer, thereby suppressing bacterial protein synthesis. Clindamycin inhibits the activity of Propionibacterium acne as reduces the occurrence of acne. Tretinoin decreases the cohesiveness of follicular epithelial cells and increases the turn over thereby brings the comedones out.</p>', '<p><strong>Before sleep</strong>: Wash the face gently with a mild soap and water, then pat the skin dry. Apply the Gel with finger tips through the face gently.<br />\r\n<br />\r\n<strong>In the morning</strong>: Apply a sunscreen after the application of Gel. Do not wash your face more than 2 or 3 times a day. Apply the sunscreen cream as needed.<br />\r\n<br />\r\nSafety and effectiveness in children below 12 years of age have not been established.</p>', '<ul>\r\n	<li>Concomitant use of other potentially irritating topical products (medicated or abrasive soaps and cleansers, soaps and cosmetics that have a strong drying effect, products with high concentrations of alcohol, astringents, spices or lime) should be approached with caution.</li>\r\n	<li>While using concomitantly with Erythromycin, the activity of both Clindamycin and Erythromycin are decreased. So, Clindamycin should not be used with Erythromycin concomitantly.</li>\r\n	<li>While using concomitantly with neuromuscular medicine, the activity of the neuromuscular medicine is increased. So, care should be taken during these concomitant uses.</li>\r\n</ul>', '<p>Clindamycin and Tretinoin should not be administered to individuals who are hypersensitive to Clindamycin or Tretinoin or any other component of the Gel.</p>', '<p>Erythema, scaling, nasopharyngitis, dry skin, cough, sinusitis and diarrhea are the common side effects.</p>', '<p>It is not known whether Clindamycin or Tretinoin is excreted in human milk. Exercise special caution while applying Clindamycin or Tretinoin to a nursing mother.</p>', '<p>Clindamycin and Tretinoin should not be applied to eyes, nose, ear, lips, cut, burn and other infections. After the application of the Gel, keep away from sunlight</p>', NULL, '<p>Topical antibiotic &amp; retinoid preparations</p>', '<p>Keep below 25&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-18 20:56:26', '2022-04-10 19:58:15'),
(358, 358, '<p>This combination is indicated for the treatment of external ear inflammation and infections (otitis externa) and fungal infections of the outer ear (otomycosis).</p>', '<p><strong>Flumetasone</strong>&nbsp;Pivalate is a potent difluorinated glucocorticoid designed for local application. It exerts an anti-inflammatory, anti-allergic, vasoconstrictive and anti-proliferative effect. In inflammatory skin diseases of the external auditory meatus it affords prompt relief and eliminates symptoms such as pruritus and also reduces swelling.<br />\r\n<br />\r\n<strong>Clioquinol</strong>&nbsp;is a halogenated hydroxyquinoline derivative which exerts bacteriostatic action. It is active against a broad spectrum of microorganisms including fungi (e.g., Candida, Microsporum, Trichophyton) and Gram-positive bacteria (e.g. Staphylococci). It is also effective against Gram-negative bacteria.</p>', '<p><strong>For adults and children (aged 2 years and over)</strong>: The recommended dose is 2 to 3 drops twice daily for the prescribed period of time (usually not longer than 10 days). Before you apply the medication, you should warm the ear drops to body temperature by holding the bottle in the palm of your hands. Do not heat it above body temperature.</p>', '<p>Topical use of Clioquinol-containing preparations may lead to a marked increase in protein-bound iodine (PBI).</p>', '<p>This medication is contraindicated in patients with: Punctured eardrum, Pre-existing tuberculosis of the skin, Fungal or viral infections of the skin(Chickenpox, Herpes simplex, Herpes zoster), Known hypersensitivity to corticosteroids, Iodine, Clioquinol, Flumetasone pivalate, Hydroxyquinolones or Quinolone derivatives or any of the ingredients of this formulation.</p>', '<p>Occasionally burning sensation, itching or skin rash may occur. Treatment should be discontinued if severe irritation or sensitization develops.</p>', '<p><strong>Pregnancy</strong>: No reports of adverse effects in human pregnancy have been received to date. However, when using this product in pregnancy, the risk-benefit relationship should be carefully considered.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether Flumetasone Pivalate or Clioquinol passes into breast milk. Caution should be exercised when Flumetanol is administered to a nursing mother.</p>', '<p>Prior to the beginning of therapy, the ear-drum should be checked by the physician. If there is a risk that perforation of the ear-drum may occur, this ear drops should not be used. If no improvement occurs within about 1 week, the therapy should be discontinued. It is then advisable to identify the pathogens and to institute an appropriate treatment. This ear drop should not be allowed to come in contact with the conjunctiva.</p>', '<p>Application to extensive or eroded areas of skin may lead to increased PBI values within 1 week. If signs and symptoms resembling those of thyrotoxicosis occur, the preparation should be withdrawn at once</p>', '<p>Aural steroid &amp; antibiotic combined preparations, Ophthalmic steroid - antibiotic combined preparations</p>', '<p>Keep out of the reach of children. Store in a cool, dry place, away from heat and direct light. Do not use more than 4 weeks after opening.</p>', '<p>Children under 2 years of age is contraindicated.</p>', '2022-02-18 20:58:45', '2022-04-10 20:00:57');
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
(359, 359, '<p>Acute and chronic anxiety states which may produce the following symptoms in particular: anxiety, tension, restlessness, excitement, irritability, sleep disturbances from emotional causes, psychovegetative and psychosomatic disorders (for example, in the cardiovascular or gastrointestinal area), and emotional instability.<br />\r\n<br />\r\nIn patients with depression or anxiety associated with depression, Clobazam must be used only in conjunction with adequate concomitant treatment. Use of benzodiazepines alone, can precipitate suicide in such patients. Before treatment of anxiety states associated with emotional instability, it must first be determined whether the patient suffers from a depressive disorder requiring adjunctive or different treatment.<br />\r\n<br />\r\nIn patients with schizophrenic or other psychotic illnesses, use of benzodiazepines is recommended only for adjunctive, i.e. not for primary treatment.<br />\r\n<br />\r\nAs adjunctive therapy in patients with epilepsy who are not adequately stabilized with their anticonvulsant monotherapy.</p>', '<p>Clobazam binds at distinct binding sites associated with the chloride ionopore at the post-synaptic GABA receptor. These GABA receptors are in various locations in the CNS (limbic, reticular formation) and clobazam increases the duration of time for which the chloride ionopore is open. As a result, hyper polarization and stabilization of the membrane occur as the post-synaptic inhibitory effect of GABA is enhanced.</p>', '<p>General Dosage: Dosage and duration of treatment must be adjusted to the indication, the severity of the condition and the individual clinical response. Due regard must be paid to the possibility of interference with alertness and reaction time. The fundamental principle is to keep the dose as low as possible.</p>\r\n\r\n<p>Treatment of anxiety states-</p>\r\n\r\n<p><strong>Adults and adolescents over 15 years of age</strong>: The initial dose is usually 20 mg clobazam daily. If necessary, the daily dose may be increased. Generally, it is recommended that a total daily dose of 30 mg is not exceeded.<br />\r\n<br />\r\n<strong>Elderly</strong>: Increased responsiveness and higher susceptibility to adverse effects may be present in elderly patients and require low initial doses and gradual dose increments under careful observation. A maintenance dose of 10 to 15 mg clobazam daily is frequently sufficient.<br />\r\n<br />\r\n<strong>Children from 3 to 15 years of age</strong>: Increased responsiveness and higher susceptibility to adverse effects may be present in children and require low initial doses and gradual dose increments under careful observation. A daily dose of 5 to 10 mg clobazam is frequently sufficient. Benzodiazepines must not be given to children without careful assessment of the need for their use.<br />\r\n<br />\r\n<strong>Secondary dosage adjustment</strong>: After the improvement of the symptoms, the dose may be reduced.<br />\r\n<br />\r\n<strong>Timing of doses</strong>: If the dose is to be spread throughout the day, it is recommended that the larger portion be taken in the evening.<br />\r\n<br />\r\n<strong>Duration of treatment</strong>: The duration of treatment must be as short as possible. The patient must be reassessed after a period not exceeding 4 weeks and regularly thereafter in order to evaluate the need for continued treatment, especially where the patient is free of symptoms. Generally, the overall duration of treatment (i.e. including tapering-of process) must not exceed 8 to 12 weeks. In certain cases, extension beyond the maximum treatment period may be necessary; treatment must not be extended without a re-evaluation of the patient&#39;s status using special expertise. It is strongly recommended that prolonged periods of uninterrupted treatment be avoided, since they may lead to dependence.<br />\r\n<br />\r\n<strong>Discontinuation of treatment</strong>: It is strongly recommended that after prolonged treatment clobazam is not withdrawn suddenly but rather that the dose is reduced gradually under medical supervision; otherwise, withdrawal symptoms may occur.<br />\r\n&nbsp;</p>\r\n\r\n<p>Treatment of epilepsy in combination with one or more other anticonvulsants-</p>\r\n\r\n<p><strong>Adults and adolescents over 15 years of age</strong>: It is recommended that administration be started at small doses (5 to 15 mg daily), if necessary, increasing the dose gradually to a maximum daily dose of about 80 mg.<br />\r\n<br />\r\n<strong>Children from 3 to 15 years of age</strong>: It is recommended that normally treatment be started at 5 mg daily. A maintenance dose of 0.3 to 1.0 mg/kg body weight daily is usually sufficient. Higher susceptibility to adverse effects may be present in children and require gradual dose increments under careful observation; Benzodiazepines must not be given to children without careful assessment of the need for their use.<br />\r\n<br />\r\n<strong>Elderly</strong>: Higher susceptibility to adverse effects may be present in elderly patients and require low initial doses and gradual dose increments under careful observation.<br />\r\n<br />\r\n<strong>Timing of doses</strong>: If the dose is spread throughout the day, it is recommended that the larger portion be taken in the evening. Doses of up to 30 mg clobazam can also be administered as a single evening dose.<br />\r\n<br />\r\n<strong>Duration of treatment</strong>: The patient must be re-assessed after a period not exceeding 4 weeks and regularly thereafter in order to evaluate the need for continued treatment.<br />\r\n<br />\r\n<strong>Discontinuation of treatment</strong>: At the end of treatment- to include cases in which response to therapy has been poor- it is strongly recommended that clobazam is not withdrawn suddenly but rather that the dose is reduced gradually; otherwise an increased susceptibility to seizures as well as other withdrawal symptoms may occur.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>The tablets can be administered whole, or crushed and mixed in applesauce. The 10 mg tablets can be divided into equal halves of 5 mg. Clobazam can be given with or without food.</p>', '<p><strong>Alcohol</strong>: Concomitant consumption of alcohol can increase the bioavailability of clobazam by 50% and therefore lead to increased clobazam effects.<br />\r\n<br />\r\n<strong>Central nervous system depressant drugs</strong>: Especially when clobazam is administered in higher doses, a mutually potentiating effect is to be expected if other central nervous system depressant drugs (such as antipsychotics, anxiolytics, certain antidepressant agents, anticonvulsant drugs, sedative antihistamines, anaesthetics, hypnotics or narcotic analgesics, or other sedatives) are taken at the same time. Special caution is also necessary when clobazam is administered in cases of intoxication with such substances or with lithium.<br />\r\n<br />\r\n<strong>Opioids</strong>: The concomitant use of benzodiazepines, including clobazam, and opioids increases the risk of sedation, respiratory depression, coma, and death because of the additive CNS depressant effect. Limit dosage and duration of concomitant use of benzodiazepines and opioids.<br />\r\n<br />\r\n<strong>Anticonvulsants</strong>: If clobazam is administered simultaneously with anticonvulsants in the treatment of epilepsy, the dosage must be adjusted under regular medical supervision (EEG monitoring), as there may be interactions with the patient&#39;s basic anticonvulsant medication. In patients receiving concomitant treatment with valproic acid, there may be a slight to moderate rise in plasma valproic acid concentration. Phenytoin plasma levels may rise if patients receive concomitant treatment with clobazam. Where possible, it is recommended that blood levels of concomitantly administered valproic acid or phenytoin be monitored. Carbamazepine and phenytoin may cause an increase in the metabolic conversion of clobazam to the active metabolite N-desmethyl clobazam. Stiripentol increases plasma levels of clobazam and its active metabolite N-desmethylclobazam, through inhibition of CYP3A and CYP2C19. Monitoring of blood levels is recommended, prior to initiation of stiripentol, and then once new steady-state concentration has been reached, i.e. after 2 weeks approximately.<br />\r\n<br />\r\n<strong>Narcotic analgesics</strong>: If clobazam is used concomitantly with narcotic analgesics, possible euphoria may be enhanced; this may lead to increased psychological dependence.<br />\r\n<br />\r\n<strong>Muscle relaxants</strong>: The effects of muscle relaxants and nitrous oxide may be enhanced.<br />\r\n<br />\r\n<strong>CYP 2C19 inhibitors</strong>: Strong and moderate inhibitors of CYP2C19 may result in increased exposure to N-desmethylclobazam (N-CLB), the active metabolite of clobazam. Dosage adjustment of clobazam may be necessary when co-administered with strong CYP2C19 inhibitors (e.g., cannabidiol containing medicinal products, fuconazole, fuvoxamine, ticlopidine) or moderate CYP2C19 inhibitors (e.g. omeprazole).<br />\r\n<br />\r\n<strong>CYP 2D6 substrates</strong>: Clobazam is a weak CYP2D6 inhibitor. Dose adjustment of drugs metabolized by CYP2D6 (e.g. dextromethorphan, pimozide, paroxetine, nebivolol) may be necessary.</p>', '<p>Clobazam must not be used-</p>\r\n\r\n<ul>\r\n	<li>In patients with hypersensitivity to clobazam or any of the excipients of Clobazam.</li>\r\n	<li>In patients with myasthenia gravis (risk of aggravation of muscle weakness).</li>\r\n	<li>In patients with severe respiratory insufciency (risk of deterioration).</li>\r\n	<li>In patients with sleep apnoea syndrome (risk of deterioration).</li>\r\n	<li>In patients with severe impairment of liver function (risk of precipitating encephalopathy).</li>\r\n	<li>In breast-feeding women Benzodiazepines must not be given to children without careful assessment of the need for their use.</li>\r\n	<li>Clobazam must not be used in children between the ages of 6 months and 3 years, other than in exceptional cases for anticonvulsant treatment where there is a compelling indication.</li>\r\n</ul>', '<p><strong>Metabolism and nutrition disorders</strong>: Common: decreased appetite<br />\r\n<br />\r\n<strong>Psychiatric disorders</strong>: Common: irritability, aggression, restlessness, depression (pre-existing depression may be unmasked), drug tolerance (especially during prolonged use), agitation.<br />\r\n<br />\r\n<strong>Nervous system disorders</strong>: Very common: somnolence, especially at the beginning of treatment and when higher doses are used; Common: sedation, dizziness, disturbance in attention, slow speech/dysarthria/ speech disorder (particularly with high doses or in long-term treatment, and are reversible), headache, tremor, ataxia.<br />\r\n<br />\r\n<strong>Eye Disorders</strong>: Uncommon: diplopia (particularly with high doses or in long-term treatment and is reversible)<br />\r\n<br />\r\n<strong>Respiratory, thoracic and mediastinal disorders</strong>: Not known: respiratory depression respiratory failure (particularly in patients with pre-existing compromised respiratory function e.g. in patients with bronchial asthma or brain damage)<br />\r\n<br />\r\n<strong>Gastrointestinal disorders</strong>: Common: dry mouth, nausea, constipation<br />\r\n<br />\r\n<strong>Skin and subcutaneous disorders</strong>: Uncommon: rash; Not known: photosensitivity reaction urticaria; Steven Johnson syndrome, toxic epidermal necrolysis (including some cases with fatal outcome);<br />\r\n<br />\r\n<strong>Musculoskeleteal and connective tissue disorders</strong>: Not known: muscle spasms, muscle weakness<br />\r\n<br />\r\n<strong>General disorders and administration site conditions</strong>: Very common: fatigue, especially at the beginning of treatment and when higher doses are used. Not known: slow response to stimuli, hypothermia<br />\r\n<br />\r\n<strong>Investigations</strong>: Uncommon: weight increased (particularly with high doses or in long-term treatment).</p>', '<p><strong>Pregnancy</strong>: Clobazam is not recommended during the first trimester of pregnancy and in women of childbearing potential not using contraception. Clobazam should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies have demonstrated reproductive toxicity. Clobazam crosses the placenta. In the post-marketing safety database, limited data on exposed pregnancies are available with clobazam. A large amount of data collected from cohort studies has not demonstrated evidence of the occurrence of malformations following exposure to benzodiazepines during the first trimester of pregnancy. However, in certain epidemiological case-control studies, an increased incidence of cleft lip and palate was observed with benzodiazepines. Cases of reduced fetal movement and fetal heart rate variability have been described after administration of benzodiazepines during the second and/or third trimester of pregnancy. Administration of clobazam during the late phase of pregnancy or during childbirth can result in the occurrence of neonatal respiratory depression (including respiratory distress and apnea), which may be associated with other disorders such as sedation signs, hypothermia, hypotonia, and feeding difficulties (which may result in poor weight gain) in the newborn (signs and symptoms of the so-called &quot;floppy infant syndrome&quot;). Moreover, infants born to mothers who have taken benzodiazepines over longer periods during the later stages of pregnancy may have developed physical dependence and may be at risk of developing a withdrawal syndrome in the postnatal period. Appropriate monitoring of the newborn in the postnatal period is recommended. Women of childbearing potential should be informed of the risks and benefits of the use of Clobazam during pregnancy. If a woman plans a pregnancy or becomes pregnant, carefully evaluate the risks and benefits and whether treatment with Clobazam should be discontinued. If Clobazam treatment is to be continued, use Clobazam at the lowest effective dose.<br />\r\n<br />\r\n<strong>Lactation</strong>: Clobazam must not be used in breastfeeding women, since clobazam passes into breast milk.</p>', '<p><strong>Serious Skin Reactions</strong>: Serious skin reactions, including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), have been reported with clobazam in both children and adults during the post-marketing experience. A majority of the reported cases involved the concomitant use of other drugs, including antiepileptic drugs that are associated with serious skin reactions. SJS/TEN could be associated with a fatal outcome. Patients should be closely monitored for signs or symptoms of SJS/TEN, especially during the first 8 weeks of treatment. Clobazam should be immediately discontinued when SJS/TEN is suspected. If signs or symptoms suggest SJS/TEN, use of this drug should not be resumed and alternative therapy should be considered.<br />\r\n<br />\r\n<strong>Respiratory depression</strong>: Clobazam can cause respiratory depression, especially if administered in high doses. Therefore in patients with chronic or acute respiratory insufficiency, respiratory function must be monitored and a dose reduction may be necessary. Clobazam is contraindicated in patients with severe respiratory insufficiency.<br />\r\n<br />\r\n<strong>Muscle weakness</strong>: Clobazam can cause muscle weakness. Clobazam is contraindicated in patients with myasthenia gravis.<br />\r\n<br />\r\n<strong>Renal and hepatic impairment</strong>: In patients with impairment of renal or hepatic function, responsiveness to clobazam and susceptibility to adverse effects are increased, and a dose reduction may be necessary. In long-term treatment, renal and hepatic function must be checked regularly.<br />\r\n<br />\r\n<strong>Elderly patients</strong>: In the elderly, due to the increased sensitivity to adverse reactions such as drowsiness, dizziness, muscle weakness, there is an increased risk of fall that may result in serious injury. A dose reduction is recommended.<br />\r\n<br />\r\n<strong>Tolerance in epilepsy</strong>: In the treatment of epilepsy with benzodiazepines- including Clobazam, consideration must be given to the possibility of a decrease in anticonvulsant efficacy (development of tolerance) in the course of treatment.<br />\r\n<br />\r\n<strong>CYP2C19 poor metabolizers</strong>: In patients who are CYP2C19 poor metabolizers, levels of the active metabolite N-desmethylclobazam are expected to be increased as compared to extensive metabolizers. Dosage adjustment of clobazam may be necessary (e.g. low starting dose with careful dose titration).<br />\r\n<br />\r\n<strong>Suicidality</strong>: Several epidemiological studies show an increased incidence of suicide and suicide attempt in patients with or without depression, treated with other benzodiazepines and hypnotics. There are very limited data available for clobazam in these studies. Cases of suicidal behavior have been reported with clobazam in post-marketing surveillance. All of these cases had confounding factors.<br />\r\n<br />\r\n<strong>Concomitant use of CYP2C19 inhibitors</strong>: The concomitant use of clobazam with CYP2C19 inhibitors, including cannabidiol containing medicinal products, dietary supplements and recreational products may result in increased exposure to N-desmethylclobazam (NCLB). Such increases might lead to increased adverse effects, such as somnolence and sedation. When used with medicinal products that are CYP2C19 inhibitors dosage adjustment of clobazam may be necessary. Dietary supplements and recreational products containing cannabidiol must not be taken in combination with clobazam as they contain unknown quantities of cannabidiol and are of variable quality</p>', NULL, '<p>Benzodiazepine hypnotics</p>', '<p>Do not use the medicine later than the date of expiry. Store below 30&deg; and protect from light. Keep out of the reach of children.</p>', NULL, '2022-02-18 20:58:58', '2022-04-10 20:04:32'),
(360, 360, '<p>Clobetasol Propionate scalp solution is indicated in the topical therapy of recalcitrant corticosteroid-responsive dermatoses of the scalp, including recalcitrant cases of psoriasis and seborrheic dermatitis.</p>', '<p>Clobetasol Propionate is a very potent topical corticosteroid. It has anti-inflammatory, antipruritic and vasoconstrictive properties. It shows anti-inflammatory activity via multiple mechanisms to inhibit late phase allergic reactions. It decreases the density of mast cells, chemotaxis and activation of eosinophils. It also reduces cytokine production and inhibits the metabolism of arachidonic acid.</p>', '<p><strong>Clobetasol Propionate spray</strong>: Apply required quantity of spray of once or twice daily to the affected areas of the scalp and gently rub in. The total dose applied should not exceed 50 ml weekly. If necessary, Clobetasol Propionate scalp solution may be massaged into the scalp using the tips of the fingers. Therapy should be discontinued if no response is noted after one week or as soon as the lesion heals. It is advisable to use Clobetasol Propionate scalp solution for brief periods only.<br />\r\n<br />\r\n<strong>Clobetasol Propionate shampoo</strong>: It should be applied to the dry (not wet) scalp once a day to the affected areas only. It should be massaged gently into the lesions and left in place for 15 minutes before lathering and rinsing. Treatment should be limited to 4 consecutive weeks. Total dosage of shampoo should not exceed 50 g per week. Under 18 years this preparation is not recommended.<br />\r\n<br />\r\n<strong>Scalp Solution</strong>: Apply required quantity of spray of Clobetasol Scalp Solution once or twice daily to the affected areas of the scalp and gently rub in. The total dose applied should not exceed 50 ml weekly. If necessary, Clobetasol Scalp Solution may be massaged into the scalp using the tips of the fingers. Therapy should be discontinued if no response is noted after one week or as soon as the lesion heals. It is advisable to use Clobetasol Scalp Solution for brief periods only.</p>', NULL, '<ul>\r\n	<li>Infections of the scalp</li>\r\n	<li>Hypersensitivity to the preparation</li>\r\n	<li>Use is not indicated in dermatoses in children under one year of age</li>\r\n</ul>', '<p>As with other corticosteroids, prolonged use of large amounts or treatment of extensive areas, can result in sufficient systemic absorption to produce the features of hypercortisolism. This effect is more likely to occur in infants and children, and if occlusive dressings are used. Local atrophy may occur after prolonged treatment. In rare instances, treatment of psoriasis with corticosteroids (or its withdrawal) is thought to have provoked the pustular form of the disease. If signs of hypersensitivity appear with the use of Clobetasol Propionate Scalp Solution then application should be stopped immediately.</p>', '<p>Topical administration of corticosteroids to pregnant animals can cause abnormalities of foetal development. The relevance of this finding to human beings has not been established; however, topical steroids should not used extensively in pregnancy, i.e. in large amounts for prolonged periods. The safe use of Clobetasol Propionate during lactation has not been established.</p>', '<p>Care must be taken to keep the preparation away from the eyes. Long-term continuous therapy with Clobetasol Propionate scalp solution should be avoided where possible, particularly in infants and children, as adrenal suppression can occur even without occlusion. Topical corticosteroids may be hazardous in psoriasis for a number of reasons including rebound relapses, development of tolerance, risk of generalized pustular psoriasis and development of local or systemic toxicity due to impaired barrier function of the skin. If used on psoriasis, careful patient supervision is important. Appropriate antimicrobial therapy should be used whenever treating inflammatory lesions which have become infected. Any spread of infection requires withdrawal of topical corticosteroid therapy and systemic administration of antimicrobial agents. Bacterial infection is encouraged by the warm, moist conditions induced by occlusive dressings, and so the skin should be cleansed before a fresh dressing is applied.</p>', NULL, '<p>Other Topical corticosteroids</p>', '<p>Keep below 30&deg;C temperature, protected from light and moisture. Do not freeze. Keep out of the reach of children.</p>', NULL, '2022-02-18 20:59:16', '2022-04-10 20:07:01'),
(361, 361, '<p>Clobetasol Propionate is indicated for adults, elderly and children over 1 year in following dermatoses.</p>\r\n\r\n<ul>\r\n	<li>Psoriasis (excluding widespread plaque psoriasis)</li>\r\n	<li>Recalcitrant dermatoses</li>\r\n	<li>Lichen planus</li>\r\n	<li>Discoid lupus erythematosus</li>\r\n	<li>Other skin conditions which do not respond satisfactorily to less potent steroids</li>\r\n</ul>', '<p>Clobetasol Propionate is a very potent topical corticosteroid. It has anti-inflammatory, antipruritic and vasoconstrictive properties. It shows anti-inflammatory activity via multiple mechanisms to inhibit late phase allergic reactions. It decreases the density of mast cells, chemotaxis and activation of eosinophils. It also reduces cytokine production and inhibits the metabolism of arachidonic acid.</p>', '<p><strong>Adults, elderly and children over 1 year</strong>: Apply a thin layer of Clobetasol Propionate Cream or Ointment to the affected skin areas twice daily and rub in gently and completely. Repeated short courses of Clobetasol Propionate may be used to control exacerbations. In more resistant lesions, especially where there is hyperkeratosis, the effect of Clobetasol can be enhanced, if necessary, by occluding the treatment area with polythene film. Overnight occlusion only is usually adequate to bring about a satisfactory response. Clobetasol Propionate is super-high potency topical corticosteroids; therefore, treatment should be limited to 2 consecutive weeks. The maximum weekly dose should not be exceeded 50 gm/week. In case of children, courses should be limited if possible to five days and reviewed weekly.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Route of administration: Cutaneous. Creams are especially appropriate for moist or weeping surfaces. Ointments are especially appropriate for dry, lichenified or scaly lesions.</p>', '<p>Co-administered drugs that can inhibit CYP3A4 (eg ritonavir, itraconazole) have been shown to inhibit the metabolism of corticosteroids leading to increased systemic exposure.</p>', '<p>It is contraindicated in patient with hypersensitivity to any component of the preparation. It should not be used in rosacea, acne vulgaris, perioral dermatitis, perianal and genital pruritus, pruritus without inflammation, untreated cutaneous infections.</p>', '<p>The most reported side effects are burning and stinging sensation. Less frequent adverse reactions are itching, skin atrophy, cracking and fissuring of the skin. Cushing syndrome has been reported in infants and adults as a result of prolonged use of topical Clobetasol Propionate formulations.</p>', '<p>There are limited data from the use of Clobetasol Propionate cream in pregnant women. Topical administration of corticosteroids to pregnant animals can cause abnormalities of foetal development. The relevance of this finding to humans has not been established. However, the administration of Clobetasol Propionate Cream during pregnancy and lactation should only be considered if the expected benefit to the mother outweighs the possible risks of treatment.<br />\r\n<br />\r\nIt is unknown whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Clobetasol Propionate Cream is administered to a nursing woman.</p>', '<p>In case of using occlusive dressings, the skin should be cleansed before a fresh dressing is applied. Topical corticosteroids should be used with caution in psoriasis as rebound relapses, and development of local or systemic toxicity due to impaired barrier function of the skin may occur. If used on the face, treatment should be limited to 5 days. When Clobetasol Propionate used on eyelids, care should be taken to avoid the eyes as cataract and glaucoma might result from repeated exposure.</p>', '<p>Acute overdosage is very unlikely to occur, however, in the case of chronic over-dosage or misuse the features of hypercortisolism may occur and in this situation topical steroid should be discontinued.</p>', '<p>Other Topical corticosteroids</p>', '<p>Keep below 30&deg;C temperature, protected from light and moisture. Do not freeze. Keep out of the reach of children.</p>', '<p>In infants and children under 12 years of age, long-term continuous topical corticosteroid therapy should be avoided where possible, as adrenal suppression can occur. Children are more susceptible to the use of topical corticosteroids which develops atrophic changes.</p>', '2022-02-18 20:59:39', '2022-04-10 20:11:44'),
(362, 362, '<p>This preparation is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Short courses treatment of recalcitrant eczemas.</li>\r\n	<li>Neurodermatoses.</li>\r\n	<li>Psoriasis (excluding widespread plaque psoriasis) where secondary bacterial infection or fungal infection is present, suspected or likely to occur.</li>\r\n	<li>Other inflammatory conditions which do not respond satisfactorily to less active steroids.</li>\r\n</ul>', '<p>Clobetasol Propionate is a very potent corticosteroid. It is prescribed to treat severe inflammatory skin disorders such as eczema and psoriasis that have not responded to weaker corticosteroids. Neomycin Sulphate is an antibiotic of the aminoglycoside type and is used to treat infections with bacteria. Nystatin is an antifungal that kills fungi and yeasts by interfering with their cell membranes. The mechanism of the topical steroids like Clobetasol, in general, is unclear. However, Clobetasol Propionate is highly active corticosteroid with topical anti-inflammatory activity. The major effect of Clobetasol Propionate on skin is a nonspecific anti-inflammatory response, partially due to vasoconstriction and decrease in collagen synthesis. Neomycin binds to the ribosomal 30s and 50s sub-units of susceptible bacteria and inhibits protein synthesis. Neomycin also causes a misreading of the genetic codes of the mRNA template and this causes incorrect amino acids to be incorporated into the growing polypeptide chain. Nystatin acts by binding to sterols in the cell membrane of the fungus with a resultant change in membrane permeability allowing leakage of intracellular components.</p>', '<p><strong>Adults</strong>: Apply sparingly to the affected area once or twice daily until improvement occurs. In very resistant lesion, especially where there is hyperkeratosis, the anti-inflammatory effect of this preparation can be enhanced (if necessary) by occluding the treatment area with polythene. Treatment should not be continued for more than 7 days without medical supervision. If a longer course is necessary, it is recommended that treatment should not be continued for more than 4 weeks without the patient&#39;s condition being reviewed.<br />\r\n<br />\r\n<strong>Elderly</strong>: This preparation is suitable for use in elderly. Caution should be exercised in cases where a decrease in renal function exists and significant systemic absorption of Neomycin Sulphate may occur.<br />\r\n<br />\r\n<strong>Children</strong>: This preparation is suitable for use in children (2 years and over) at the same dose as adults. A possibility of increased absorption exists in very young children, thus this cream/ointment is not recommended for use in neonates and infants (younger than 2 years).</p>', '<p>Neomycin Sulphate can intensify and prolong the respiratory depressant effects of neuromuscular blocking agents following significant systemic absorption. However, if used in accordance with the recommendations, systemic exposure to Neomycin Sulphate is expected to be minimal and drug interactions are unlikely to be significant. No hazardous interactions have been reported with use of Clobetasol Propionate or Nystatin.</p>', '<p>This medication is contraindicated in rosacea, acne vulgaris and perioral dermatitis, primary cutaneous viral infection (eg-Herpes simplex, chicken pox) and hypersensitivity to the preparation.</p>', '<p>As with other topical corticosteroids, prolonged use of large amount or treatment of extensive areas can result in sufficient systemic absorption to produce the features of hypercortisolism. The effect is more likely to occur in infants and children and if occlusive dressings are used. Prolonged and intensive treatment with highly active corticosteroid preparations may cause local atrophic changes in the skin such as thinning, striae, and dilatation of the superficial blood vessels, particularly when occlusive dressings are used, or when skin folds are involved. There are reports of pigmentation changes and hypertrichosis with topical steroids.</p>', '<p>There is little information to demonstrate the possible effect of topically applied Neomycin in pregnancy and lactation. However, Neomycin present in the maternal blood can cross the placenta and may give rise to a theoretical risk of foetal toxicity, thus the use of the preparation is not recommended in pregnancy and lactation. The safety of Clobetasol Propionate has not been established in lactating mothers.</p>', '<p>Long-term continuous topical therapy should be avoided where possible, particularly in infants and children, as adrenal suppression can occur readily even without occlusion. If applied to the eyelids, care is needed to ensure that the preparation does not enter the eye, as glaucoma might result. If this medication does enter the eye, the affected eye should be thoroughly washed with copious amount of water.</p>', '<p>Acute overdosage is very unlikely to occur. No overdose-related problem yet reported. However, in the case of chronic overdosage or misuse, the features of hypercortisolism may appear and in this situation, topical steroids should be discontinued gradually.</p>', '<p>Clobetasol / Clobetasone &amp; Combined Preparations</p>', '<p>Store below 25&deg;C temperature. Do not freeze. Keep out of reach of children.</p>', NULL, '2022-02-18 21:00:39', '2022-04-10 20:14:14'),
(363, 363, '<p>This cream is indicated in the treatment of-</p>\r\n\r\n<ul>\r\n	<li>Mixed and complicated Fungal, Protozoal &amp; Bacterial infections,</li>\r\n	<li>Mild to moderate vaginitis,</li>\r\n	<li>Candidiasis and trichomoniasis,</li>\r\n	<li>Pruritus vulvae,</li>\r\n	<li>Dermatitis,</li>\r\n	<li>Eczema,</li>\r\n	<li>Genito-urinary infections.</li>\r\n</ul>', '<p>This cream is a combination cream which exhibits anti-bacterial, anti-fungal, anti-protozoal &amp; anti-inflammatory actions. Ofloxacin is a broad-spectrum antibiotic that acts against many gram-positive &amp; gram-negative bacteria. Ornidazole belongs to the nitroimidazole group of antibiotics and is used to treat amoeba and trichomonas infections. Terbinafine is an Allylamine antifungal that inhibits biosynthesis of Ergosterol (an essential components if fungal cell membrane) via inhibition of Squalene Epoxidase enzyme causing fungal cell death. Clobetasol is a potent corticosteroid which exhibits anti-inflammatory, anti-pruritic and vasoconstrictive properties.</p>', '<p>Apply by gently rubbing onto the affected area twice daily.</p>', '<p>No hazardous interactions have been reported.</p>', '<p>Contraindicated in patients hypersensitive to any of the components of the formulation.</p>', '<p>Burning, itching, irritation, dry skin</p>', '<p>The safe use of this preparation during pregnancy &amp; lactation has not been established.</p>', '<p>Do not shallow. For external use only</p>', NULL, '<p>Clobetasol / Clobetasone &amp; Combined Preparations</p>', '<p>Store below 30&deg;C. keep away from light and out of the reach of children. Do not freeze.</p>', NULL, '2022-02-18 21:01:11', '2022-04-10 20:17:52'),
(364, 364, '<p>This ointment is indicated for the relief of the inflammatory manifestations of hyperkeratotic and dry corticosteroid responsive dermatoses such as, psoriasis, chronic atopic dermatitis, neurodermatitis (licehen Simplex, Chronicus), lichen planus, eczema (including nummular eczema, hand eczema, eczematous dermatitis), seborrheic dermatitis of the scalp, ichthyosis vulgaris and other ichthyotic conditions.</p>', '<p><strong>Clobetasol Propionate</strong>&nbsp;high potency corticosteroid. Corticosteroids decrease inflammation by stabilizing leukocyte lysosomal membranes, preventing release of destructive acid hydrolases from leukocytes; inhibiting macrophage accumulation in inflamed areas; reducing leukocyte adhesion to capillary endothelium; reducing capillary wall permeability and edema formation; decreasing complement components; antagonizing histamine activity and release of kinin from substrates; and reducing fibroblast proliferation, collagen deposition, and subsequent scar tissue formation.<br />\r\n<br />\r\n<strong>Salicylic acid</strong>&nbsp;has a potent keratolytic action and a slight antiseptic action when applied topically. It softens and destroys the stratum corneum by increasing endogenous hydration which causes the horny layer of the skin to swell, soften, and then desquamate. At high concentrations, salicylic acid has a caustic effect. It also possesses weak antifungal and antibacterial activity.</p>', '<p><strong>Adult</strong>: Apply a thin layer of this ointment to the affected skin areas twice daily and rub in gently &amp; completely. For some patients, adequate maintenance therapy may be achieved with less frequent application. As with other higher active corticosteroids, therapy should be discontinued when control has been achieved. If no improvement is seen within 2 weeks, reassessment of diagnosis may be necessary. It should not be used with occlusive dressing. Treatment beyond 2 consecutive weeks is not exceeding 50 gm/week because of the potential for the drug to suppress the hypothalamic pituitary adrenal axis.<br />\r\n<br />\r\n<strong>Children</strong>: Use in pediatric patients under 12 years of age is not recommended.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>For external use only.</p>', '<p>There has been no report of interaction with Clobetasol Propionate ointment and cream. There are no known interactions of Salicylic Acid when used as indicated. However, topical salicylic acid may increase the absorption of other topically applied medicines. Concomitant use of Salicylic Acid Ointment and other topical medicines on the same area of skin should therefore be avoided.</p>', '<p>ClobetasolPropionatev is contraindicated in patients with hypersensitivity to Clobetasol Propionate. This preparation is contraindicated also in the treatment of primary infected bacterial or fungal skin lesions if no anti-infective agent is used simultaneously, in primary cutaneous viral infections (i.e., herpes simplex, vaccinia and varicella) and in tuberculous skin lesions. Clobetasol Propionate is also contraindicated in dermatoses in children under one year of age, including dermatitis and diaper eruptions. Salicylic Acid is contraindicated in patients displaying salicylate hyersensitivity, or sensitivity to any other ingredient in the preparation.</p>', '<p>As with other topical corticosteroids, prolonged use of large amounts of Clobetasol Propionate or treatment of extensive areas can result in sufficient systemic absorption to produce the features of hypercortisolism. This effect is more likely to occur in infants and children, and if occlusive dressings are used. Local atrophy may occur after prolonged treatment. In rare instances, treatment of psoriasis with corticosteroids (or its withdrawal) is thought to have provoked the pustular form of the diseases. Clobetasol Propionate is usually well tolerated, but if signs of hypersensitivity appear, application should be stopped immediately. Possible sensitivity reactions, drying and irritation when using Salicylic Acid.</p>', '<p>Topical administration of corticosteroids to pregnant animals can cause abnormalities of fetal development. The relevance of this finding to human beings has not been established. The safe use of Clobetasol Propionate during lactation has not been established. However, the administration of Clobetasol Propionate during pregnancy and lactation should only be considered if the expected benefit to the mother is greater than any possible risk to the fetus. Drugs of this class should not be used extensively in pregnant patients in large amounts or for prolonged periods of time. Whilst there are no known contra-indications to the use of Salicylic Acid ointment during pregnancy and lactation, the safety has not been established. Salicylic Acid ointment shold therefore be used with caution.</p>', '<p>Not for prolonged use in high concentrations and on large areas of the body. Impaired peripheral circulation or diabetes. Avoid broken skin, mouth, eyes, mucous membranes and anogenital region.</p>', '<p>Acute overdosage is very unlikely to occur, however, in the case of chronic overdosage or misuse, the features of hypercortisolism may appear and in this situation topical steroids should be discontinued gradually. However, because of the risk of acute adrenal suppression this should be done under medical supervision. Symptoms osslystemic salicylate poisoning (tinnitus, dizziness and deafness) have been reported after the application of Salicylic Acid to large areas of skin and for prolonged periods. Salicylism may also occur in the unlikely event of large quantities being ingested. Salicylism is ullikely to occur if Salicylic Acid ointment is used as indicated. Salicylate poisoining is usually associated with plasma concentrations &gt;350 mg/L. Most adult deaths occur in patients whose concentrations exceed 700 ml/L. Single doses less than 100 mg/kg are unlikely to cause serious poisoning.</p>', '<p>Clobetasol / Clobetasone &amp; Combined Preparations</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-02-18 21:01:28', '2022-04-10 20:20:21'),
(365, 365, '<p>Clobetasone preparations are indicated for the treatment of eczema and dermatitis of all types including atopic eczema, photodermatitis, otitis externa, primary irritant allergic dermatitis (including napkin rash), intertrigo, prurigo nodularis, seborrhoeic dermatitis and insect bite reactions. Clobetasone may be used as a maintenance therapy between courses of one of the more active topical steroids.</p>', '<p>Clobetasone Butyrate is a topically active corticosteroid, which provides an exceptional combination of activity and safety. It is more effective in the treatment of eczemas than 1% Hydrocortisone, or the less active synthetic steroid preparations that are in common use. It has little effect on hypothalamic-pituitary-adrenal function. All topical corticosteroids can cause cutaneous atrophy if grossly misused. However, study in animal and human models indicates that Clobetasone Butyrate causes less thinning of the epidermis than the other topical steroid tested.</p>', '<p>Apply to the affected area up to four times a day until improvement occurs, when the frequency of application may be reduced.</p>', '<p>Potentially hazardous interactions- none has been reported. Potentially useful interactions- none has been reported.</p>', '<p>Pregnancy (in high doses), Presence of acute infections, Treatment of rosacea, Leg ulcers, Acne vulgaris, Widespread plaque psoriasis. Child &lt;1 yr.</p>', '<p>Local atrophic changes; pigmentation changes &amp; hypertrichosis. Increased liability to infection. Infections may be masked. Acute adrenal insufficiency. Growth retardation in child. Cushingoid symptoms. Amenorrhoea, hyperhidrosis, skin thinning</p>', '<p>There is inadequate evidence of safety in human pregnancy. Topical administration of corticosteroids to pregnant animals can cause abnormalities of fetal development including cleft palate and intrauterine growth retardation. There may therefore be a very small risk of such effects in the human fetus.</p>', '<p>May be absorbed in sufficient amounts to cause systemic effects when applied topically to large areas, broken skin or under occlusive dressings. Peptic ulcer, osteoporosis, psychoses or severe psychoneuroses. Not to be used indiscriminately for pruritus. CHF or hypertension. Diabetes mellitus, epilepsy, glaucoma, infectious diseases, ocular herpes simplex, chronic renal failure and uraemia. Active or doubtfully quiescent tuberculosis. Local treatment of eye disorders. Elderly. Prolonged use on the face.</p>', '<p>Acute overdosage is very unlikely to occur, in the case of chronic overdosage or misuse the features of hypercorticism may appear and in this situation topical steroids should be discontinued.</p>', '<p>Clobetasol / Clobetasone &amp; Combined Preparations</p>', '<p>Store below 30˚ C. Do not freeze. Protect from light.</p>', NULL, '2022-02-18 21:02:01', '2022-04-10 20:22:28'),
(366, 366, '<p>Clomiphene citrate is chiefly indicated for the treatment of ovulatory failure in female patients who wish to become pregnant. This therapy will not be successful unless the patient though unovulatory, is capable of ovulation &amp; her partner is fertile.<br />\r\n<br />\r\nClomiphene citrate is also indicated for the Polycystic ovary syndrome, Menorrhagia caused by hyperplastic endometrium, Amenorrhea with galactorrhea syndrome, Psychogenic amenorrhea syndrome, Secondary amenorrhea of unknown cause, Amenorrhea during post oral contraceptive period</p>', '<p>Clomiphene has mainly antiestrogenic effects and some estrogenic effects. The mechanism in stimulating ovulation is unknown but is believed to be related to its antiestrogenic properties. By clomiphene competing with estrogen for binding sites at the hypothalamic level, the gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH), secretion is increased, which results in ovarian follicle maturation, followed by the preovulatory LH surge, ovulation, and the subsequent development of the corpus luteum. Usefulness in male infertility is also likely related to the increases in FSH and LH secretion.</p>', '<p>The usual dose for the first course of Clomiphene is 50 mg (1 tablet) a day for 5 days in the early follicular phase of the cycle, following normal menstruation or a progestagen-induced withdrawal bleeding. Many regimes have been used, but most common begin either on day 2 or day 5. If this dose induces ovulation, there is no need to increase the dose in the following courses. If this dose induces ovulation, but pregnancy does &nbsp;not occur, stimulation with Clomiphene Citrate is to be continued, but up to 6 stimulative courses. If the first course does not induce ovulation, the second course should be started with 100 mg a day (2 tablets of 50 mg taken in a single dose) for 5 days. If ovulation is not induced, 2 more stimulative courses of the same dose should be given. If the next three stimulative courses do not produce a successful result, the therapeutic trial is considered to be finished. If ovulation is induced, but pregnancy does not occur, maximum 6 courses with Clomiphene are recommended. However, if menstrual bleeding does not occur, the patient should be examined carefully for the possible pregnancy, and the next course of therapy should be delayed until the correct diagnosis has been determined.</p>', '<p>No drug interaction has been reported during the administration of Clomiphene citrate.</p>', '<p>Clomiphene citrate is contraindicated during pregnancy, in patients with liver diseases, ovarian cysts, bleeding of undetermined origin, patients with neoplasm of endometrium.</p>', '<p>Clomiphene Citrate is well tolerated. However a few side effects like dizziness, headache, nausea, vomiting, depression, fatigue, insomnia, vasomotor flushing, and allergic reaction may occur. Rarely ovarian enlargement and cyst formation may occur. All these effects disappear promptly after the treatment is discontinued.</p>', '<p>This is not recommended in pregnancy.&nbsp;In some cases Clomiphene citrate may reduce lactation, if it is administered to a woman during lactating period. So it should be avoided during lactational period.</p>', '<p>Clomiphene citrate should be used with caution in longer maintenance therapy, with alcoholic drinks &amp; antidepressants.</p>', '<p>No such effects of acute over dosage of Clomiphene citrate have been reported. However, in case of over dosage, a few sign symptoms of nausea, vomiting, vasomotor flushes, scotoma, and ovarian enlargement with pelvic or abdominal pain may occur. In the event of over dosage appropriate supportive measures should be employed.</p>', '<p>Drugs for Infertility</p>', '<p>Clomiphene Citrate tablet should be stored below 25&deg; C and protected from light &amp; moisture.</p>', NULL, '2022-02-18 21:02:23', '2022-04-10 20:25:03');
