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
(1458, 1458, '<p><strong>Chronic Hepatitis B</strong>: Telbivudine is indicated for the treatment of chronic hepatitis B in adult patients with evidence of viral replication and either evidence of persistent elevations in serum aminotransferases (ALT or AST) or histologically active disease. The following points should be considered when initiating therapy with Telbivudine:<br />\r\n&nbsp;</p>\r\n\r\n<ul>\r\n	<li>This indication is based on virologic, serologic,&nbsp;biochemical&nbsp;and histologic responses in nucleoside treatment na&iuml;ve adult patients with HBeAg positive and HBeAg negative chronic hepatitis B with compensated liver disease&nbsp;</li>\r\n	<li>For HBeAg-positive patients, Telbivudine should only be initiated in patients with HBV DNA less than 9 log10&nbsp;copies per mL and ALT greater than or equal to 2x Upper Limit of Normal (ULN) prior to treatment.</li>\r\n	<li>For HBeAg-negative patients, Telbivudine should only be initiated in patients with HBV DNA less than 7 log10&nbsp;copies per mL prior to treatment.</li>\r\n	<li>On-treatment response should guide continued therapy&nbsp;</li>\r\n	<li>Telbivudine has not been evaluated in patients co-infected with&nbsp;HIV, HCV or&nbsp;HDV.</li>\r\n	<li>Telbivudine has not been evaluated in&nbsp;liver transplant&nbsp;recipients or in patients with decompensated liver disease.</li>\r\n	<li>Telbivudine has not been studied in well-controlled trials for the treatment of patients with established nucleoside analog reverse transcriptase inhibitor-resistant hepatitis B virus infection, but is expected to be cross-resistant to lamivudine.</li>\r\n	<li>The safety and efficacy of Telbivudine have not been evaluated in Black/African American or Hispanic patients</li>\r\n</ul>', '<p>Telbivudine is a synthetic thymidine nucleoside analogue with activity against hepatitis B virus (HBV). Telbivudine is the unmodified &beta;&ndash;L enantiomer of the naturally occurring nucleoside, thymidine. It undergoes phosphorylation via interaction with cellular kinases to form the active metabolite, telbivudine 5&#39;-triphosphate.<br />\r\n<br />\r\nTelbivudine 5&#39;&ndash;triphosphate inhibits HBV DNA polymerase (reverse transcriptase) by competing with the natural substrate, thymidine 5&#39;&ndash;triphosphate. This leads to the chain termination of DNA synthesis, thereby inhibiting viral replication. Incorporation of telbivudine 5&#39;&ndash;triphosphate into viral DNA also causes DNA chain termination, resulting in inhibition of HBV replication. Telbivudine inhibits anticompliment or second-strand DNA.</p>', '<p><strong>Adults and Adolescents (16 years of age and older)</strong>: Due to higher rates of resistance that may develop with longer term treatment among patients with incomplete viral suppression, treatment should only be initiated, if pre-treatment HBV DNA and ALT measurements are known, in the following patient populations-<br />\r\n<br />\r\nFor HBeAg-positive patients, HBV DNA should be less than 9 log10&nbsp;copies per mL and ALT should be greater than or equal to 2x ULN prior to treatment with Telbivudine.<br />\r\n<br />\r\nFor HBeAg-negative patients, HBV DNA should be less than 7 log10&nbsp;copies per mL prior to treatment with Telbivudine.<br />\r\n<br />\r\nHBV DNA levels should be monitored at 24 weeks of treatment to assure complete viral suppression (HBV DNA less than 300 copies per mL). Alternate therapy should be initiated for patients who have detectable HBV DNA after 24 weeks of treatment. Optimal therapy should be guided by further resistance testing.<br />\r\n<br />\r\n<strong>The recommended dose of Telbivudine for the treatment of chronic hepatitis B:</strong>&nbsp;600 mg once daily, taken orally, with or without food. Telbivudine Oral Solution (30 mL) may be considered for patients who have difficulty with swallowing tablets.</p>', '<p>Altered plasma concentration with drugs that affect renal function (e.g. aminoglycosides, loop diuretics, platinum compounds, vancomycin, amphotericin B). May increase risk of myopathy with other drugs associated with myopathy (e.g. azole antifungals, ciclosporin, corticosteroids, erythromycin, fibrates, HMG-CoA reductase inhibitors, penicillamine, zidovudine).</p>', '<p>Hypersensitivity. Combination of Telbivudine with pegylated interferon alfa-2a is contraindicated because of increased risk of&nbsp;peripheral neuropathy.</p>', '<p>Cough, dizziness, fatigue, GI effects (e.g. abdominal pain, diarrhoea, nausea, vomiting, dyspepsia), rash, arthralgia, myalgia, myopathy, malaise, back pain, nasopharyngitis, headache, flu or flu-like symptoms, insomnia; increased serum amylase, lipase, creatine phosphokinase, alanine aminotransferase levels; peripheral neuropathy, rhabdomyolysis.</p>', '<p>Pregnancy Category B. Telbivudine is not&nbsp;teratogenic&nbsp;and has shown no adverse effects in developing embryos and fetuses in preclinical studies. Studies in pregnant rats and rabbits showed that telbivudine crosses the placenta. Developmental toxicity studies revealed no evidence of harm to the fetus in rats and rabbits at doses up to 1000 mg per kg per day, providing exposure levels 6- and 37-times higher, respectively, than those observed with the 600 mg per day dose in humans.<br />\r\n<br />\r\nThere are no adequate and well-controlled trials of Tyzeka in pregnant women. Because animal reproductive toxicity studies are not always predictive of human response, Tyzeka should be used during pregnancy only if potential benefits outweigh the risks.</p>', '<p>Severe acute exacerbations of hepatitis B. Monitor hepatic function in discontinued therapy. Lactic acidosis, severe hepatomegaly with steatosis, myopathy, rhabdomyolysis, uncomplicated myalgia. Discontinue if myopathy is diagnosed. Increased risk of peripheral neuropathy when combined with pegylated interferon &alpha;-2a. Decompensated cirrhosis, renal impairment or on hemodialysis; liver transplant recipients or under immunosuppressant therapy. May impair the ability to drive or operate machinery. Pregnancy. Childn &lt;16 yr. Elderly.</p>', NULL, '<p>Hepatic viral infections (Hepatitis B).</p>', '<p>Store Telbivudine Tablets and Oral Solution in the original bottle at room temperature (15&deg; to 30&deg;C).</p>', NULL, '2022-03-21 05:19:51', '2022-03-21 05:19:51'),
(1459, 1459, '<p>Telmisartan is indicated in-<br />\r\n<br />\r\n<strong>Hypertension</strong>: Treatment of essential hypertension in adults.<br />\r\n<strong>Cardiovascular prevention</strong>: Reduction of cardiovascular morbidity in adults with:</p>\r\n\r\n<ul>\r\n	<li>Atherothrombotic cardiovascular disease (history of coronary heart disease, stroke, or peripheral arterial disease) or</li>\r\n	<li>Type 2 diabetes mellitus with documented target organ damage.</li>\r\n</ul>', '<p>Telmisartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Its action is therefore independent of the pathways for angiotensin II synthesis. Telmisartan has much greater affinity (&gt;3,000 fold) for the AT1 receptor than for the AT2 receptor. Because telmisartan does not inhibit ACE (kininase II), it does not affect the response to bradykinin. Telmisartan does not bind to or block other hormone receptors or ion channels known to be important in cardiovascular regulation.</p>', '<p>Dosage must be individualized. The usual starting dose of Telmisartan tablets is 40 mg once a day. Blood pressure response is dose-related over the range of 20 to 80 mg. Most of the antihypertensive effect is apparent within 2 weeks and maximal reduction is generally attained after 4 weeks. When additional blood pressure reduction beyond that achieved with 80 mg Telmisartan is required, may switch to the combination. No initial dosage adjustment is necessary for elderly patients or patients with renal impairment, including those on hemodialysis. Patients on dialysis may develop orthostatic hypotension; their blood pressure should be closely monitored. Telmisartan tablets may be administered with other antihypertensive agents. Telmisartan tablets may be administered with or without food. Initial therapy with Telmisartan is not recommended in patients &ge;75 years old or with hepatic impairment.</p>', '<ul>\r\n	<li>NSAIDS: Increased risk of renal impairment and loss of antihypertensive effect.</li>\r\n	<li>Co-administration with aliskiren with Telmisartan: in patients with diabetes should be avoided.</li>\r\n</ul>', '<p>Known hypersensitivity to this product or any of its components.</p>', '<p><strong>In hypertensive patients</strong>: The most common side effects of Telmisartan tablets include sinus pain and congestion (sinusitis), back pain, diarrhea etc.<br />\r\n<br />\r\n<strong>For patients of cardiovascular risk reduction</strong>: The most common side effects of Telmisartan tablets in CV risk reduction include intermittent claudication and skin ulcer.</p>', '<p>Pregnancy Category C (first trimester) and D (second and third trimester). Because of the potential for adverse effects on the nursing infant, decide whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<ul>\r\n	<li>Avoid fetal or neonatal exposure.</li>\r\n	<li>Hypotension.</li>\r\n	<li>Monitor carefully in patients with impaired hepatic or renal function.</li>\r\n	<li>Avoid concomitant use of an ACE inhibitor and angiotensin receptor blocker.</li>\r\n</ul>', '<p>The most likely manifestation of overdosage with Telmisartan tablets would be hypotension, dizziness and tachycardia; bradycardia, increase in serum creatinine and acute renal failure could occur from parasympathetic (vagal) stimulation.</p>', '<p>Angiotensin-ll receptor blocker.</p>', '<p>Do not store above 30&deg;C. Protect from light and high humidity. Keep out of the reach of children.</p>', '<p><strong>Pediatric use</strong>: The safety and effectiveness of Telmisartan in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: No overall differences in effectiveness and safety were observed in these patients compared to younger patients.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Monitor carefully and up titrate slowly in patients with biliary obstructive disorders or hepatic insufficiency.</p>', '2022-03-21 05:21:43', '2022-03-21 05:21:43'),
(1460, 1460, '<p>Telmisartan and Hydrochlorothiazide is indicated for the treatment of hypertension, to lower blood pressure. This combination can be used alone or with other antihypertensive agents. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions.</p>', '<p><strong>Telmisartan</strong>: Angiotensin II is formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE, kininase II). Angiotensin II is the principal&nbsp;pressor&nbsp;agent of the renin-angiotensin system, with effects that include&nbsp;vasoconstriction, stimulation of synthesis and release of&nbsp;aldosterone, cardiac stimulation, and renal reabsorption of sodium. Telmisartan blocks the vasoconstrictor and aldosteronesecreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as&nbsp;vascular&nbsp;smooth muscle&nbsp;and the&nbsp;adrenal gland. Its action is therefore independent of the pathways for angiotensin II synthesis.<br />\r\n<br />\r\nThere is also an AT2 receptor found in many tissues, but AT2 is not known to be associated with cardiovascular homeostasis. Telmisartan has much greater affinity (&gt;3,000-fold) for the AT1 receptor than for the AT2 receptor.<br />\r\n<br />\r\nTelmisartan does not inhibit ACE (kininase II) nor does it bind to or block other hormone receptors or ion channels known to be important in cardiovascular regulation.<br />\r\n<br />\r\nBlockade of the angiotensin II receptor inhibits the negative regulatory feedback of angiotensin II on renin secretion, but the resulting increased plasma renin activity and angiotensin II circulating levels do not overcome the effect of telmisartan on blood pressure.<br />\r\n<br />\r\n<strong>Hydrochlorothiazide</strong>: Hydrochlorothiazide is a thiazide diuretic. Thiazides affect the renal tubular mechanisms of&nbsp;electrolyte&nbsp;reabsorption, directly increasing excretion of sodium salt and chloride in approximately equivalent amounts. Indirectly, the diuretic action of hydrochlorothiazide reduces plasma volume, with consequent increases in plasma renin activity, increases in aldosterone secretion, increases in urinary&nbsp;potassium&nbsp;loss, and decreases in serum potassium. The renin-aldosterone link is mediated by angiotensin II, so coadministration of an ARB tends to reverse the potassium loss associated with these&nbsp;diuretics. The mechanism of the antihypertensive effect of thiazides is not fully understood.</p>', '<p>Initiate a patient whose blood pressure is not adequately controlled with-</p>\r\n\r\n<ul>\r\n	<li><strong>Telmisartan monotherapy 80 mg</strong>: Telmisartan and Hydrochlorothiazide 80 mg/12.5 mg once daily. Dose can be titrated up to 160 mg/25 mg after 2 to 4 weeks, if necessary.</li>\r\n	<li><strong>Hydrochlorothiazide 25 mg once daily, or is controlled but who experiences hypokalemia with this regimen</strong>: Telmisartan and Hydrochlorothiazide 80 mg/12.5 mg once daily. Dose can be titrated up to 160 mg/25 mg after 2 to 4 weeks, if necessary.</li>\r\n</ul>\r\n\r\n<p>Telmisartan and Hydrochlorothiazide may be administered with other antihypertensive drugs.</p>', '<p>Caution should be exercised before taking this drug if you are taking aliskiren, digoxin, lithium, other medicines for high blood pressure, NSAIDs (such as aspirin, ibuprofen, naproxen, others), corticosteroids (such as prednisone, hydrocortisone, others), angiotensin-converting enzyme (ACE) blockers (such as benazepril, enalapril, lisinopril) angiotensin II receptor blockers (such as losartan, olmesartan, valsartan). This product may interfere with certain laboratory tests (including parathyroid test, protein-bound iodide test), possibly causing false test results.</p>', '<p>This is contraindicated in patients with known hypersensitivity (e.g., anaphylaxis or angioedema) to Telmisartan, Hydrochlorothiazide or any other component of this product. Do not co-administer Aliskiren with this tablet in patients with Diabetes.</p>', '<p>Common side effects include dizziness, drowsiness, tired feeling, flushing (warmth, redness, or tingly feeling), back pain, nausea, diarrhea, stomach pain. Other adverse events include allergy, fever, leg pain, chest pain, insomnia, somnolence, and dry mouth, elevations of liver enzymes or serum bilirubin, leg cramps, myalgia, dermatitis. Other adverse events that have been reported includes weakness, gastric irritation, photosensitivity, urticaria, muscle spasm, restlessness.</p>', '<p>Pregnancy Category D. Use of drugs that act on the renin-angiotensin&nbsp;system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and&nbsp;neonatal&nbsp;morbidity and death. Resulting&nbsp;oligohydramnios&nbsp;can be associated with fetal lung&nbsp;hypoplasia&nbsp;and skeletal deformations. Potential neonatal adverse effects include skull hypoplasia, anuria,&nbsp;hypotension, renal failure, and death. When pregnancy is detected, discontinue Telmisartan and hydrochlorothiazide as soon as possible.<br />\r\n<br />\r\nNursing Mothers: It is not known whether telmisartan is excreted in human milk, but telmisartan was shown to be present in the milk of lactating rats. Thiazides appear in human milk. Because of the potential for adverse effects on the nursing infant, decide whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>Before using this medication, tell your doctor about your medical history, especially of kidney disease, liver disease, bile duct blockage, loss of too much body water and/or minerals (dehydration), untreated mineral imbalance (such as low or high potassium), gout, lupus. If you have diabetes, this medication may affect your blood sugar. Check your blood sugar regularly as directed by your doctor. This product may affect your body potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor. This drug may make you dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Report prolonged diarrhea or vomiting to your doctor. Be sure to drink enough fluids to prevent dehydration unless your doctor directs you otherwise.</p>', '<p>The most likely manifestations of overdosage are hypertension, dizziness, tachycardia, bradycardia, hypokalemia, hypochloremia, hyponatremia and dehydration etc. Telmisartan is not removed by hemodialysis and the degree to which hydrochlorothiazide is removed by hemodialysis has not been established.</p>', '<p>Combined antihypertensive preparations.</p>', '<p>Keep out of the reach of children. Keep in a cool and dry place. Protect from light.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of Telmisartan and Hydrochlorothiazide in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function and of concomitant diseases or other drug therapy.<br />\r\n<br />\r\n<strong>Use in Patients with Hepatic Impairment</strong>: Patients with biliary obstructive disorders or hepatic insufficiency should initiate treatment under close medical supervision.<br />\r\n<br />\r\n<strong>Use in Patients with Renal Impairment</strong>: Safety and effectiveness of Telmisartan and Hydrochlorothiazide in patients with severe renal impairment (Cr.Cl. &lt;30 ml/min) have not been established. In patients with severe renal impairment, Telmisartan and Hydrochlorothiazide tablets are not recommended. No dose adjustment is required in patients with mild (Cr.Cl. 60 to 90 ml/min) or moderate (Cr.Cl. 30 to 60 ml/min) renal impairment.</p>', '2022-03-21 05:23:35', '2022-03-21 05:23:35'),
(1461, 1461, '<p>Temazepam is indicated for the short-term treatment of insomnia (generally 7 to 10 days). For patients with short-term insomnia, instructions in the prescription should indicate that Temazepam should be used for short periods of time (7 to 10 days). The clinical trials performed in support of efficacy were 2 weeks in duration with the final formal assessment of sleep latency performed at the end of treatment.</p>', '<p>Gamma-Aminobutyric acid (GABA) is considered the principal inhibitory neurotransmitter in the human body. When GABA binds to GABA(a) receptors found in neuron synapses, chloride ions are conducted across neuron cell membranes via an ion channel in the receptors. With enough chloride ions conducted, the local, associated neuron membrane potentials are hyperpolarized - making it more difficult or less likely for action potentials to fire, ultimately resulting in less excitation of the neurons.<br />\r\n<br />\r\nSubsequently, benzodiazepines like temazepam can bind to benzodiazepine receptors that are components of various varieties of GABA(a) receptors. This binding acts to enhance the effects of GABA by increasing GABA affinity for the GABA(a) receptor, which ultimately enhances GABA ligand binding at the receptors. This enhanced ligand binding of the inhibitory neurotransmitter GABA to the receptors increases the aforementioned chloride ion conduction (perhaps reportedly via an increase in the frequency of the chloride channel opening), resulting in a hyperpolarized cell membrane that prevents further excitation of the associated neuron cells. Combined with the notion that such benzodiazepine receptor associated GABA(a) receptors exist both peripherally and in the CNS, this activity consequently facilitates various effects like sedation, hypnosis, skeletal muscle relaxation, anticonvulsant activity, and anxiolytic action</p>', '<p>While the recommended usual adult dose is 15 mg before retiring, 7.5 mg may be sufficient for some patients, and others may need 30 mg. In&nbsp;transient insomnia, a 7.5 mg dose may be sufficient to improve sleep latency. In elderly or debilitated patients, it is recommended that&nbsp;therapy&nbsp;be initiated with 7.5 mg until individual responses are determined.<br />\r\n<br />\r\nPediatric Use: Safety and effectiveness in pediatric patients have not been established.</p>', NULL, '<p>Benzodiazepines may cause fetal harm when administered to a&nbsp;pregnant&nbsp;woman. An increased risk of congenital malformations associated with the use of diazepam and chlordiazepoxide during the first&nbsp;trimester&nbsp;of&nbsp;pregnancy&nbsp;has been suggested in several studies. Transplacental distribution has resulted in&nbsp;neonatal&nbsp;CNS depression following the ingestion of&nbsp;therapeutic&nbsp;doses of a benzodiazepine hypnotic during the last weeks of pregnancy.<br />\r\n<br />\r\nReproduction&nbsp;studies in animals with temazepam were performed in rats and rabbits. In a&nbsp;perinatal-postnatal study in rats, oral doses of 60 mg/kg/day resulted in increasing nursling&nbsp;mortality. Teratology studies in rats demonstrated increased fetal resorptions at doses of 30 and 120 mg/kg in one study and increased occurrence of rudimentary ribs, which are considered&nbsp;skeletal&nbsp;variants, in a second study at doses of 240 mg/kg or higher. In rabbits, occasional abnormalities such as exencephaly and fusion or asymmetry of ribs were reported without dose relationship. Although these abnormalities were not found in the concurrent control group, they have been reported to occur randomly in historical controls. At doses of 40 mg/kg or higher, there was an increased&nbsp;incidence&nbsp;of the 13th&nbsp;rib&nbsp;variant when compared to the incidence in concurrent and historical controls.<br />\r\n<br />\r\nTemazepam is contraindicated in women who are or may become pregnant. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the&nbsp;fetus. Patients should be instructed to discontinue the drug prior to becoming pregnant. The possibility that a woman of childbearing potential may be pregnant at the time of institution of&nbsp;therapy&nbsp;should be considered.</p>', '<p>The most common side effects of temazepam are:</p>\r\n\r\n<ul>\r\n	<li>drowsiness</li>\r\n	<li>headache</li>\r\n	<li>tiredness</li>\r\n	<li>nervousness</li>\r\n	<li>dizziness</li>\r\n	<li>nausea</li>\r\n</ul>', '<p>Pregnancy Category X. 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 temazepam is administered to a nursing woman.</p>', '<p>Since the risk of the development of oversedation, dizziness, confusion, and/or ataxia increases substantially with larger doses of benzodiazepines in elderly and debilitated patients, 7.5 mg of temazepam is recommended as the initial dosage for such patients. Temazepam should be administered with caution in severely depressed patients or those in whom there is any evidence of latent depression; it should be recognized that suicidal tendencies may be present and protective measures may be necessary. The usual precautions should be observed in patients with impaired renal or hepatic function and in patients with chronic pulmonary insufficiency. If temazepam is to be combined with other drugs having known hypnotic properties or CNS-depressant effects, consideration should be given to potential additive effects. The possibility of a synergistic effect exists with the co-administration of temazepam and diphenhydramine. One case of stillbirth at term has been reported 8 hours after a pregnant patient received temazepam and diphenhydramine. A cause and effect relationship has not yet been determined.</p>', NULL, '<p>Benzodiazepine antagonist, Benzodiazepine hypnotics, Benzodiazepine sedatives.</p>', '<p>Store temazepam at room temperature, 20&deg; to 25&deg;C. Keep temazepam and all medicines out of reach of children.</p>', NULL, '2022-03-21 05:25:02', '2022-03-21 05:25:02'),
(1462, 1462, '<p><strong>Newly Diagnosed Glioblastoma Multiforme</strong>: Temozolomide is indicated for the treatment of adult patients with newly diagnosed glioblastoma multiforme concomitantly with&nbsp;radiotherapy&nbsp;and then as maintenance treatment.<br />\r\n<br />\r\n<strong>Refractory Anaplastic Astrocytoma</strong>: Temozolomide is indicated for the treatment of adult patients with refractory anaplastic astrocytoma, i.e., patients who have experienced disease progression on a drug regimen containing nitrosourea and procarbazine.</p>', '<p>Temozolomide, a triazene, is an inactive prodrug. It is chemically hydrolysed to 3-methyl-(triazen-1-yl) imidazole-4-carboxamide (MTIC), the active metabolite of dacarbazine. The cytotoxicity of MTIC is believed to be due alkylation of DNA, mainly at the O6&nbsp;and N7&nbsp;positions of guanine.</p>', '<p><strong>Newly diagnosed glioblastoma multiforme</strong>: 75 mg/m&lt;sup&gt;2&lt;/sup&gt; for 42 days concomitant with focal radiotherapy followed by initial maintenance dose of 150 mg/m&lt;sup&gt;2&lt;/sup&gt; once daily for Days 1-5 of a 28-day cycle of Temozolomide for 6 cycles<br />\r\n<br />\r\n<strong>Refractory Anaplastic Astrocytoma</strong>: Initial dose 150 mg/m&lt;sup&gt;2&lt;/sup&gt; once daily for 5 consecutive days per 28-day treatment cycle.&nbsp;<br />\r\n<br />\r\nThe recommended dose for Temozolomide as an intravenous infusion over 90 minutes is the same as the dose for the oral capsule formulation. Bioequivalence has been established only when Temozolomide for Injection was given over 90 minutes</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. Take at least 1 hr before meals.</p>', '<p>Reduced effectiveness of vaccines and generalised infection may occur in patients immunised with live vaccines. Decreased temozolomide clearance with valproic acid.</p>', '<p>Hypersensitivity to dacarbazine. Severe myelosupression. Pregnancy.</p>', '<p>Nausea, vomiting, taste perversion, constipation, diarrhoea, abdominal pain, stomatitis, anorexia, headache, fatigue, convulsions, dizziness, memory impairment, impaired concentration, tremors, blurred vision, hearing impairment, speech disorder, rash, infection, oral candidiasis, dyspnoea, coughing, neutropenia, thrombocytopenia, leucopenia, anaemia, hyperglycemia, decreased wt, insomnia, anxiety, alopecia, muscle weakness, urinary incontinence, increased alanine aminotransferase. Rarely, myelodysplastic syndrome and secondary malignancies.</p>', '<p>Pregnancy Category D. There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).<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 and because of the potential for serious adverse reactions in nursing infants and tumorigenicity shown for temozolomide in animal studies, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of Temozolomide&nbsp;to the mother.</p>', '<p>Severe hepatic and renal impairment. Elderly &gt;70 yr, children. Women of child bearing potential should avoid becoming pregnant during therapy. Males should be advised not to father a child up to 6 mth after treatment and to consider cryoconservation of sperms due to possibility of irreversible infertility. Unknown if distributed into breastmilk, discontinue nursing due to potential risk. May impair ability to drive or operate machinery. Swallow capsules whole with a full glass of water on an empty stomach or at bedtime. Do not take a 2nd dose if capsules are vomited. Monitor CBC wkly during concomitant therapy and on day 22 of each 28 day treatment cycle, followed by wkly blood count until recovery. Hepatitis screening and prophylactic therapy with antiviral agents as clinically indicated to be considered. Prophylaxis for Pneumocystis jiroveci (or Pneumocystis carinii) pneumonia (PCP) needed for all patients receiving concomitant temozolomide and radiation therapy for the 42-day regimen; if patients experience lymphocytopenia during the concomitant phase of therapy, PCP prophylaxis should be continued until recovery from lymphocytopenia. Monitor closely for PCP development in all patients. Anti-emetic prophylaxis recommended.</p>', '<p>Doses of 500, 750, 1000, and 1250 mg/m2&nbsp;(total dose per cycle over 5 days) have been evaluated clinically in patients. Dose-limiting toxicity was hematologic and was reported with any dose but is expected to be more severe at higher doses. An overdose of 2000 mg per day for 5 days was taken by one patient and the adverse reactions reported were&nbsp;pancytopenia, pyrexia, multi-organ failure, and death. There are reports of patients who have taken more than 5 days of treatment (up to 64 days), with adverse reactions reported including&nbsp;bone marrow&nbsp;suppression, which in some cases was severe and prolonged, and infections and resulted in death. In the event of an overdose, hematologic evaluation is needed. Supportive measures should be provided as necessary.</p>', '<p>Cytotoxic Chemotherapy.</p>', '<p>Store at 15-30&deg; C.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of temozolomide did not include sufficient numbers of subjects aged 65 and over to determine whether they responded 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, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: Caution should be exercised when temozolomide is administered to patients with severe renal impairment<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Caution should be exercised when temozolomide is administered to patients with severe hepatic impairment</p>', '2022-03-21 05:32:24', '2022-03-21 05:32:24'),
(1463, 1463, '<p>Tenecteplase is indicated for use in the reduction of mortality associated with acute myocardial infarction (AMI). Treatment should be initiated as soon as possible after the onset of acute myocardial infarction symptoms.</p>', '<p>Tenecteplase is a modified form of human tissue plasminogen activator (tPA) that binds to fibrin and converts plasminogen to plasmin. In the presence of fibrin, in vitro studies demonstrate that Tenecteplase conversion of plasminogen to plasmin is increased relative to its conversion in the absence of fibrin. This fibrin specificity decreases systemic activation of plasminogen and the resulting degradation of circulating fibrinogen as compared to a molecule lacking this property. Following administration of 30, 40, or 50 mg of Tenecteplase, there are decreases in circulating fibrinogen (4%-15%) and plasminogen (11%-24%). The clinical significance of fibrinspecificity on safety (e.g., bleeding) or efficacy has not been established. Biological potency is determined by an in vitro clot lysis assay and is expressed in Tenecteplase-specific units. The specific activity of Tenecteplase has been defined as 200 units/mg.</p>', '<p>Tenecteplase is for intravenous administration only. The recommended total dose should not exceed 50 mg and is based upon patient weight. A single bolus dose should be administered over 5 seconds based on patient weight. Treatment should be initiated as soon as possible after the onset of AMI symptoms.</p>\r\n\r\n<ul>\r\n	<li>Patient Weight &lt;60 kg: 30 mg Tenecteplase&nbsp;</li>\r\n	<li>Patient Weight &ge;60 to &lt;70 kg: 35 mg Tenecteplase&nbsp;</li>\r\n	<li>Patient Weight &ge;70 to &lt;80 kg: 40 mg Tenecteplase&nbsp;</li>\r\n	<li>Patient Weight &ge;80 to &lt;90 kg: 45 mg Tenecteplase&nbsp;</li>\r\n	<li>Patient Weight &ge;90 kg: 50 mg Tenecteplase</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ol>\r\n	<li>The product should be visually inspected prior to administration for particulate matter and discoloration. Tenecteplase may be administered as reconstituted at 5 mg/mL.</li>\r\n	<li>Precipitation may occur when Tenecteplase is administered in an IV line containing dextrose. Dextrose-containing lines should be flushed with a saline-containing solution prior to and following single bolus administration of Tenecteplase.</li>\r\n	<li>Reconstituted Tenecteplase should be administered as a single IV bolus over 5 seconds.</li>\r\n	<li>Because Tenecteplase contains no antibacterial preservatives, it should be reconstituted immediately before use. If the reconstituted Tenecteplase is not used immediately, refrigerate the Tenecteplase vial at 2-8&deg;C and use within 8 hours.</li>\r\n	<li>Although the supplied syringe is compatible with a conventional needle, this syringe is designed to be used with needleless IV systems. From the information below, follow the instructions applicable to the IV system in use.</li>\r\n</ol>', '<p>Formal interaction studies of Tenectaplase with other drugs have not been performed. Patients studied in clinical trials of Tenecteplase were routinely treated with heparin and aspirin. Anticoagulants (such as heparin and vitamin K antagonists) and drugs that alter platelet function. (such as acetylsalicylic acid, dipyridamole, and GP IIb/IIIa inhibitors) may increase the risk of bleeding if administered prior to, during, or after Tenectaplase therapy.</p>', '<p>Tenecteplase therapy in patients with acute myocardial infarction is contraindicated in the following situations because of an increased risk of bleeding:</p>\r\n\r\n<ul>\r\n	<li>Active internal bleeding</li>\r\n	<li>History of cerebrovascular accident</li>\r\n	<li>Intracranial or intraspinal surgery or trauma within 2 months</li>\r\n	<li>Intracranial neoplasm, arteriovenous malformation, or aneurysm</li>\r\n	<li>Known bleeding diathesis</li>\r\n	<li>Severe uncontrolled hypertension</li>\r\n</ul>', '<p>The most frequent adverse reaction associated with Tenecteplase is bleeding. Should serious bleeding occur, concomitant heparin and antiplatelet therapy should be discontinued. Death or permanent disability can occur in patients who experience stroke or serious bleeding episodes. For Tenecteplase-treated patients in ASSENT-2, the incidence of intracranial hemorrhage was 0.9% and any stroke was 1.8%. The incidence of all strokes, including intracranial bleeding, increases with increasing age.</p>', '<p><strong>Pregnancy</strong>: Tenectaplase has been shown to elicit maternal and embryo toxicity in rabbits given multiple IV administrations. In rabbits administered 0.5, 1.5, and 5.0 mg/kg/day during organogenesis, vaginal hemorrhage resulted in maternal deaths. Subsequent embryonic deaths were secondary to maternal hemorrhage and no fetal anomalies were observed. Tenectaplase does not elicit maternal and embryo toxicity in rabbits following a single IV administration. Thus, in developmental toxicity studies conducted in rabbits, the no observable effect level (NOEL) of a single IV administration of Tenectaplase on maternal or developmental toxicity (5 mg/kg) was approximately 7 times human exposure (based on AUC) at the dose for AMI. There are no adequate and well controlled studies in pregnant women. Tenectaplase should be given to pregnant women only if the potential benefits justify the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known if Tenectaplase is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Tenectaplase is administered to a nursing woman.</p>', '<p><strong>General</strong>: Standard management of myocardial infarction should be implemented concomitantly with Tenecteplase treatment. Arterial and venous punctures should be minimized. Noncompressible arterial puncture must be avoided and internal jugular and subclavian venous punctures should be avoided to minimize bleeding from the noncompressible sites. In the event of serious bleeding, heparin and antiplatelet agents should be discontinued immediately. Heparin effects can be reversed by protamine.<br />\r\n<br />\r\n<strong>Readministration</strong>: Readministration of plasminogen activators, including Tenecteplase, to patients who have received prior plasminogen activator therapy has not been systematically studied. Three of 487 patients tested for antibody formation to Tenecteplase had a positive antibody titer at 30 days. The data reflect the percentage of patients whose test results were considered positive for antibodies to Tenecteplase in a radioimmunoprecipitation assay, and are highly dependent on the sensitivity and specificity of the assay. Additionally, the observed incidence of antibody positivity in an assay may be influenced by several factors including sample handling, concomitant medications, and underlying disease. For these reasons, comparison of the incidence of antibodies to Tenecteplase with the incidence of antibodies to other products may be misleading. Although sustained antibody formation in patients receiving one dose of Tenecteplase has not been documented, readministration should be undertaken with caution.<br />\r\n<br />\r\n<strong>Hypersensitivity</strong>: Hypersensitivity, including urticarial / anaphylactic reactions, have been reported after administration of Tenecteplase (e.g., anaphylaxis, angioedema, laryngeal edema, rash, and urticaria). Monitor patients treated with Tenecteplase during and for several hours after infusion. If symptoms of hypersensitivity occur, appropriate therapy should be initiated.</p>', NULL, '<p>Fibrinolytics (Thrombolytics)</p>', '<p>Store lyophilized Tenecteplase at controlled room temperature not to exceed 30&deg;C or under refrigeration 2-8&deg;C. Do not use beyond the expiration date stamped on the vial.</p>', '<p>Pediatric Use: The safety and effectiveness of Tenecteplase in pediatric patients have not been established.<br />\r\n<br />\r\nIn elderly patients: The benefits of Tenecteplase on mortality should be carefully weighed against the risk of increased adverse events, including bleeding.</p>', '2022-03-21 05:34:19', '2022-03-21 05:34:19'),
(1464, 1464, '<p>Tenofovir Alafenamide is a hepatitis B virus (HBV) nucleoside analog reverse transcriptase inhibitor and is indicated for the treatment of chronic hepatitis B virus infection in adults with compensated liver disease.</p>', '<p>Tenofovir alafenamide is a phosphonamidate&nbsp;prodrug&nbsp;of tenofovir (2&#39;-deoxyadenosine monophosphate analog). Tenofovir alafenamide as a lipophilic cell-permeant compound enters primary hepatocytes by passive diffusion and by the hepatic uptake transporters OATP1B1 and OATP1B3. Tenofovir alafenamide is then converted to tenofovir through hydrolysis primarily by carboxylesterase 1 (CES1) in primary hepatocytes. Intracellular tenofovir is subsequently phosphorylated by cellular kinases to the pharmacologically active metabolite tenofovir diphosphate. Tenofovir diphosphate inhibits&nbsp;HBV&nbsp;replication through incorporation into viral DNA by the HBV reverse transcriptase, which results in DNA chain-termination.<br />\r\n<br />\r\nTenofovir diphosphate is a weak inhibitor of mammalian DNA polymerases that include&nbsp;mitochondrial DNA polymerase &gamma; and there is no evidence of toxicity to&nbsp;mitochondria&nbsp;in cell culture.</p>', '<p><strong>Testing Prior To Initiation Of Tenofovir Alafenamide</strong>: Prior to initiation of Tenofovir Alafenamide, patients should be tested for&nbsp;HIV-1 infection. Tenofovir Alafenamide alone should not be used in patients with HIV infection<br />\r\n<br />\r\nIt is recommended that serum creatinine, serum phosphorous, estimated creatinine clearance, urine glucose, and urine protein be assessed before initiating Tenofovir Alafenamide and during therapy in all patients as clinically appropriate<br />\r\n<br />\r\n<strong>Recommended Dosage In Adults</strong>: The recommended dosage of Tenofovir Alafenamide is 25 mg (one tablet) taken orally once daily with food</p>', '<p>Tenofovir is a substrate of P-glycoprotein (P-gp) and BCRP. Drugs that strongly affect P-gp and BCRP activity may lead to changes in Tenofovir absorption. Consult the full prescribing information prior to and during treatment for potential drug drug interactions.</p>', '<p>None</p>', '<p>The following adverse reactions are discussed in other sections of the labeling:</p>\r\n\r\n<ul>\r\n	<li>Lactic Acidosis/Severe&nbsp;Hepatomegaly&nbsp;with Steatosis&nbsp;</li>\r\n	<li>Severe Acute Exacerbation of&nbsp;Hepatitis B</li>\r\n	<li>New Onset or Worsening of Renal Impairment</li>\r\n</ul>\r\n\r\n<p>The most common side effects are headache, stomach pain, tiredness, cough, nausea, back pain</p>', '<p>Before you take Tenofovir Alafenamide, tell your healthcare provider about all of your medical conditions, including if you are pregnant or plan to become pregnant. It is not known if Tenofovir Alafenamide will harm your unborn baby. Tell your healthcare provider if you become pregnant during treatment with Tenofovir Alafenamide.&nbsp;<br />\r\n<br />\r\nPregnancy Registry:&nbsp;There is a pregnancy registry for women who take antiviral medicines during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk with your healthcare provider about how you can take part in this registry.</p>', NULL, '<p>If overdose occurs, monitor patient for evidence of toxicity. Treatment of overdosage with Tenofovir Alafenamide consists of general supportive measures including monitoring of vital signs as well as observation of the clinical status of the patient. Tenofovir is efficiently removed by&nbsp;hemodialysiswith an extraction coefficient of approximately 54%.</p>', '<p>Hepatic viral infections (Hepatitis B).</p>', '<p>Store below 86&deg;F (30&deg;C). Keep in its original container. Keep the container tightly closed.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of Tenofovir Alafenamide in pediatric patients less than 18 years of age have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical trials of Tenofovir Alafenamide did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No dosage adjustment of Tenofovir Alafenamide is required in patients with mild, moderate, or severe renal impairment. Tenofovir Alafenamide is not recommended in patients with end stage renal disease (estimated creatinine clearance below 15 mL per minute)&nbsp;<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No dosage adjustment of Tenofovir Alafenamide is required in patients with mild hepatic impairment (Child-Pugh A). The safety and efficacy of Tenofovir Alafenamide in patients with decompensated cirrhosis (Child-Pugh B or C) have not been established; therefore Tenofovir Alafenamide is not recommended in patients with decompensated (Child-Pugh B or C) hepatic impairment</p>', '2022-03-21 05:36:04', '2022-03-21 05:36:04'),
(1465, 1465, '<p>This is indicated for the treatment of:</p>\r\n\r\n<ul>\r\n	<li>Chronic hepatitis B virus infection in adults</li>\r\n	<li>HIV infected adults in combination with other anti retroviral agents</li>\r\n</ul>', '<p>Tenofovir Disoproxil Fumarate, an acyclic nucleotide analogue of adenosine monophosphate, is a pro-drug of Tenofovir. It shows activity against hepatitis B virus polymerase and HIV reverse transcriptase after phosphorylation to the active diphosphate form. Tenofovir diphosphate inhibits viral polymerase (reverse transcriptase) by directly competing with the natural substrate deoxyribonucleotide and by causing DNA chain termination after its incorporation into viral DNA.</p>', '<p>The recommended dose of Tenofovir in chronic hepatitis B virus infection in adults 18 years of age and older with adequate renal function is 300 mg once daily with or without food.</p>', '<p>Co-administration of Tenofovir with anti-retroviral, entecavir, lamivudine, methadone, oral contraceptives, ribavirin and tacrolimus did not result in significant drug interactions. The effects of co-administration of Tenofovir with other drugs that are renally eliminated or are known to affect renal function have not been evaluated.</p>', '<p>Tenofovir is contraindicated in patients with known hypersensitivity to Tenofovir or any component of the product.</p>', '<p>The most common side effects are nausea, vomiting, diarrhea and flatulence.</p>', '<p><strong>Pregnancy:</strong>&nbsp;Pregnancy category B. It should be used during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Lactation:</strong>&nbsp;It is not known whether it is excreted in human milk. Mothers should be instructed not to breast feed if they are taking Tenofovir.</p>', '<p><strong>Co-administration with other drugs:</strong>&nbsp;Tenofovir should not be administered concurrently with Emtricitabine &amp; Tenofovir combination or Adefovir Dipivoxil.<br />\r\n<br />\r\n<strong>Lactic Acidosis &amp; Severe Hepatomegaly with Steatosis:</strong>&nbsp;Though the risk of occurrence of lactic acidosis is low for Tenofovir, treatment should be suspended in any patient who develops lactic acidosis or hepatotoxicity.<br />\r\n<br />\r\n<strong>Exacerbation of hepatitis after discontinuation of treatment:</strong>&nbsp;Discontinuation of Tenofovir<br />\r\ntherapy may be associated with severe acute exacerbation of hepatitis.</p>', '<p>There is no experience of Tenofovir overdose reported in patients.</p>', '<p>Drugs for HIV / Anti-retroviral drugs, Hepatic viral infections (Hepatitis B).</p>', '<p>Store in a cool and dry place, protected from light and moisture. Keep the medicine out of the reach of children.</p>', '<p><strong>Pediatric use:</strong>&nbsp;Safety and effectiveness of Tenofovir in pediatric patients below the age of 18 years have not been established.<br />\r\n<br />\r\n<strong>Geriatrics use</strong>: Clinical studies of Tenofovir did not include sufficient numbers of subjects aged 65 years and over to determine whether they respond differently from younger subjects. But care should be taken in dose selection, and it may be useful to monitor renal function.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: Haemodialysis patients: 300 mg once every 7 days or after a cumulative total of 12 hr of dialysis.</p>\r\n\r\n<ul>\r\n	<li><strong>CrCl (10-29 mL/min)</strong>: 300 mg 72-96 hrly.</li>\r\n	<li><strong>CrCl (30-49 mL/min)</strong>: 300 mg 48 hrly.</li>\r\n</ul>\r\n\r\n<p><strong>Hepatic impairment</strong>: No dose adjustment is required in patients with hepatic impairment.</p>', '2022-03-21 05:37:43', '2022-03-21 05:37:43');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1466, 1466, '<p>Tenoxicam is indicated for the symptomatic treatment of the following painful inflammatory and degenerative disorders of the musculoskeletal system:</p>\r\n\r\n<ul>\r\n	<li>Rheumatoid arthritis.</li>\r\n	<li>Osteoarthritis.</li>\r\n	<li>Arthrosis.</li>\r\n	<li>Ankylosing spondylitis.</li>\r\n	<li>Extra-articular disorders, e.g. tendinitis, bursitis, periarthritis of the shoulders (shoulder-hand syndrome) or hips, strains, and sprains.</li>\r\n	<li>Acute gout.</li>\r\n</ul>', '<p>Tenoxicam is a non-steroidal anti-inflammatory drug (NSAID) with anti-inflammatory, analgesic and antipyretic properties and it also inhibits platelet aggregation. Tenoxicam inhibits prostaglandin biosynthesis. In-vitro tests of leukocyte peroxidase suggest that tenoxicam may act as a scavenger for active oxygen at the site of inflammation. Tenoxicam is a potent in-vitro inhibitor of human metalloproteinases (stromelysin and collagenase), which induce cartilage breakdown. These pharmacological effects explain, at least in part, the therapeutic benefit of Tenoxicam in the treatment of painful inflammatory and degenerative disorders of the musculoskeletal system. Tenoxicam showed no mutagenic, carcinogenic or teratogenic effects in animals. As with other prostaglandin inhibitors, renal and gastrointestinal effects, increased incidence of dystocia and delayed parturition were observed in animal safety studies.</p>', '<p><strong>Standard dosage</strong>: For all indications except acute gout, a daily dosage of 20 mg should be given at the same time of day.<br />\r\n<br />\r\n<strong>In acute attacks of gout</strong>: The recommended dose for acute attacks of gout is 40 mg once daily for two days followed by 20 mg once daily for a further five days.<br />\r\n<br />\r\n<strong>In the treatment of chronic disorders</strong>: The therapeutic effect of tenoxicam is evident early in treatment but there is a progressive increase in response over time. In chronic disorders, daily doses higher than 20 mg should be avoided since this would increase the frequency and intensity of unwanted reactions without significantly increasing efficacy. For patients needing long-term treatment, a reduction to a daily oral dose of 10 mg may be tried for maintenance.<br />\r\n<br />\r\n<strong>Special dosage instructions</strong>: In principle, the above dosage recommendations also apply to elderly patients and to patients suffering from kidney or liver disease. Because of lack of clinical experience, no dosage recommendations have so far been established for children and adolescents.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>The tablets should be taken with a glass of water. It is preferable to take this medicine during or immediately after a meal.</p>', '<p>As in the case of other NSAIDs, salicylate displaces tenoxicam from protein-binding sites and increases clearance and volume of distribution of tenoxicam. Concurrent treatment with salicylate or other NSAIDs should be avoided because of increased risk of gastrointestinal undesirable reactions. The co-administration of some NSAIDs and methotrexate has been associated with reduced renal tubular secretion of methotrexate, higher plasma concentrations of methotrexate, and severe methotrexate toxicity. Therefore, caution should be exercised when Tenoxicam is administered concurrently with methotrexate. No clinically relevant interaction was found in the small number of patients receiving concomitant treatment with gold, penicillamine or probenecid. As Tenoxicam may decrease the renal clearance of lithium, their concomitant administration may lead to increased plasma levels and toxicity of lithium. The plasma levels of lithium should be closely monitored. As with NSAIDs in general, Tenoxicam should not be administered concurrently with K-sparing diuretics. There is a known interaction between these two classes of compounds, which may cause hyperkalemia and renal failure. No clinically significant interaction between Tenoxicam and furosemide was noted, but Tenoxicam attenuates the blood pressure-lowering effect of hydrochlorothiazide. As known from other NSAIDs, Tenoxicam might attenuate the antihypertensive effects of alpha-adrenergic blockers and ACE-inhibitors. No interactions have been reported between NSAIDs and centrally-acting alpha agonists or calcium channel blockers. There was no clinically relevant interaction when Tenoxicam was administered together with atenolol. During clinical trials no interaction was reported for patients treated concomitantly with digitalis products. Thus concurrent dosing of Tenoxicam and digoxin appears to be without major risk. No interaction has been found with concomitantly administered antacids, cimetidine, warfarin and phenprocoumon at the recommended dosages. The clinical effect of oral antidiabetic drugs (glibornuride, glibenclamide, tolbutamide) was likewise not modified by Tenoxicam. Nevertheless, careful monitoring is recommended when patients concomitantly receive anticoagulants or oral antidiabetic drugs. No clinically relevant interaction has been found between Tenoxicam and low molecular weight heparin.</p>', '<p>Tenoxicam must not be administered to patients:</p>\r\n\r\n<ul>\r\n	<li>known to be hypersensitive to the drug;</li>\r\n	<li>in whom salicylates or other non-steroidal anti-inflammatory drugs (NSAIDs) induce symptoms of asthma, rhinitis, or urticaria;</li>\r\n	<li>suffering or having suffered from the disease of the upper gastrointestinal tract, such as gastritis, gastric and duodenal ulcer.</li>\r\n</ul>', '<p>Based on clinical trials including large numbers of patients, Tenoxicam proved to be well tolerated in the recommended dose. Usually, the undesirable effects reported were mild and transient. In a small proportion of patients, the interruption of treatment due to undesirable effects was necessary. Local tolerance of Tenoxicam given parenterally was good. The following undesirable effects have been reported:<br />\r\n<br />\r\nFrequency is greater than 1%-</p>\r\n\r\n<ul>\r\n	<li>Gastrointestinal tract: gastric, epigastric and abdominal discomfort, dyspepsia, heartburn, nausea.</li>\r\n	<li>Central nervous system: dizziness, headache.</li>\r\n</ul>\r\n\r\n<p>Frequency less than 1%-</p>\r\n\r\n<ul>\r\n	<li>Gastrointestinal tract: constipation, diarrhea, stomatitis, gastritis, vomiting, ulcers, Gl-bleeding including hematemesis and melena.</li>\r\n	<li>Central nervous system: fatigue, sleep disturbances, appetite loss, dry mouth, vertigo.</li>\r\n	<li>Skin: itching (also in the anal region after rectal administration), erythema, exanthema, rash, urticaria.</li>\r\n	<li>Urinary tract and kidneys: increase in BUN or creatinine, edema.</li>\r\n	<li>Liver and biliary tract: increased liver enzyme activity.</li>\r\n	<li>Cardiovascular system: palpitations.</li>\r\n</ul>\r\n\r\n<p>Isolated cases (frequency less than 0.01%)-</p>\r\n\r\n<ul>\r\n	<li>Gastrointestinal tract: Gl-perforation.</li>\r\n	<li>Central nervous system: visual disturbances.</li>\r\n	<li>Skin: Stevens-Johnson and Lyell&#39;s syndrome, photosensitivity reaction, vasculitis.</li>\r\n	<li>Blood: anemia, agranulocytosis, leukopenia, thrombocytopenia.</li>\r\n	<li>Hypersensitivity reactions: dyspnea, asthma, anaphylaxis, angioedema.</li>\r\n	<li>Cardiovascular system: elevated blood pressure, mainly in patients treated with cardiovascular drugs.</li>\r\n	<li>Liver/Biliary tract: hepatitis.</li>\r\n</ul>', '<p>NSAIDs have an inhibitory effect on prostaglandin synthesis and, when given during late pregnancy, may cause the closure of the fetal ductus arteriosus, prolong labor and delay parturition. Treatment during the third trimester of pregnancy should be avoided. Based on findings from single-dose administration, a very small amount (approximately 0.2%) of tenoxicam passes into breast milk. There is no evidence of adverse reactions in breast-fed infants of mothers taking Tenoxicam. Nevertheless, infants should be weaned or the drug discontinued.</p>', '<p>NSAIDs inhibit renal prostaglandin synthesis and consequently may have an undesirable effect on renal hemodynamics and on salt and water balance. It is necessary to adequately monitor the patient with a special emphasis on cardiac and renal function (BUN, creatinine, development of edema, weight gain, etc.) when giving Tenoxicam to patients with conditions that could increase their risk of developing renal failure, such as pre-existing renal disease, impaired renal function in diabetics, hepatic cirrhosis, congestive heart failure, volume depletion or concomitant treatment with potentially nephrotoxic drugs, diuretics and corticosteroids. Tenoxicam inhibits platelet aggregation and may affect hemostasis. Tenoxicam has no significant influence on blood coagulation factors, coagulation time, prothrombin time or activated thromboplastin time. Patients having coagulation disorders or receiving drug therapy that interferes with hemostasis should, however, be carefully observed when Tenoxicam is administered. Any patient being treated with Tenoxicam who presents with symptoms of gastrointestinal disease should be closely monitored. If peptic ulceration or gastrointestinal bleeding occurs, Tenoxicam should be immediately withdrawn. If severe skin reactions (e.g. Lyell&#39;s or Stevens-Johnson syndrome) occur, the treatment should be discontinued immediately. Adverse eye findings have been reported with Tenoxicam. Thus ophthalmic evaluation is recommended for patients who develop visual disturbances. Because of the high plasma protein binding of tenoxicam, caution is required when plasma albumin levels are markedly reduced. In common with anti-inflammatory drugs, Tenoxicam may mask the usual signs of infection. Tenoxicam Tablets should not be given to patients who either dislike or do not tolerate milk products.</p>', '<p>Although there is no experience of acute overdosage with Tenoxicam, it may be expected that the signs and symptoms mentioned under Undesirable effects would be more pronounced. Overdose should be countered by conventional measures to reduce absorption (e.g. gastrolavage and charcoal) and speed up elimination (e.g. cholestyramine).</p>', '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs).</p>', '<p>Do not store above 30&deg;C, protect from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Use in Children &amp; adolescent: Tenoxicam is not recommended for use in patients under 16 years of age, as the dose and indications in this population have not been established.<br />\r\n<br />\r\nEffects on ability to drive and use machines: Patients experiencing adverse events that might affect driving or using machines, such as vertigo, dizziness or visual disturbances should refrain from driving a car or using machines.</p>', '2022-03-21 05:39:55', '2022-03-21 05:39:55'),
(1467, 1467, '<p>Terazosin Hydrochloride is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Single therapy is used to relieve from signs and symptoms of benign prostatic hyperplasia (BPH).</li>\r\n	<li>For the treatment of hypertension.</li>\r\n</ul>', '<p>Terazosin is selective for alpha-1-adrenoceptors but not their individual subtypes. Inhibition of these alpha-1-adrenoceptors results in relaxation of smooth muscle in blood vessels and the prostate, lowering blood pressure and improving urinary flow. Smooth muscle cells accounts for roughly 40% of the volume of the prostate and so their relaxation reduces pressure on the urethra.<br />\r\n<br />\r\nIt has also been shown that catecholamines induce factors responsible for mitogenesis and alpha-1-adrenergic receptor blockers inhibit this effect. A final long term mechanism of terazosin and other alpha-1-adrenergic receptor blockers is the induction of apoptosis of prostate cells. Treatment with terazosin enhances the expression of transforming growth factor beta-1 (TGF-beta1), which upregulates p27kip1, and the caspase cascade.</p>', '<p>Benign Prostatic Hyperplasia-</p>\r\n\r\n<ul>\r\n	<li><strong>Initial dose</strong>: 1 mg at bedtime is starting dose of all patients and this dose should not be exceeded.</li>\r\n	<li><strong>Subsequent dose</strong>: The dose slowly increases to achieve the desired response. The usual recommended dose range is 5-10 mg administered once a day.</li>\r\n</ul>\r\n\r\n<p>Hypertension-</p>\r\n\r\n<ul>\r\n	<li><strong>Initial dose</strong>: 1 mg at bedtime is starting dose of all patients and this dose should not be exceeded.</li>\r\n	<li><strong>Subsequent dose</strong>: The dose slowly increases to achieve the desired response. The usual recommended dose range is 2-10 mg administered once a day.</li>\r\n</ul>', '<ul>\r\n	<li>In patients receiving Terazosin plus ACE inhibitors or diuretics the proportion reporting dizziness or related side effects was greater than in the total population of Terazosin treated patients from clinical trials.</li>\r\n	<li>Terazosin has been given without interaction with analgesics/anti-inflammatory, cardiac glycosides, hypoglycemic, antiarrhythmic, anxiolytics/sedatives, antibacterial, hormones/steroids and drugs used for gout.</li>\r\n</ul>', '<p>Terazosin is contraindicated in patients known to be hypersensitive to Terazosin or its analogues.</p>', '<p>Postural hypotension is more commonly reported side effect. Dizziness, lack of energy, peripheral oedema; urinary frequency and priapism reported.</p>', '<p>The safety of Terazosin during pregnancy has not been established. So Terazosin is not recommended during pregnancy unless the potential benefit justifies the potential risk to mother and fetus. It is not known whether Terazosin is excreted in breast milk. As many drugs are excreted in breast milk, caution should be exercised when Terazosin is administered to a nursing mother.</p>', '<ul>\r\n	<li>First dose may cause hypotension (within 30-90 minutes). Therefore should be taken on retiring to bed.</li>\r\n	<li>Caution should be observed when Terazosin is administered with other antihypertensive agents, avoid the possibility of significant hypotension. When adding Terazosin to a diuretic or other antihypertensive agent, dosage reduction and retitration may be necessary.</li>\r\n	<li>The patients should be cautioned to avoid situation such as driving and hazardous tasks where injury could result due to syncope after initiation of Terazosin therapy.</li>\r\n</ul>', '<p>Acute overdose may lead to acute hypotension, cardiovascular support is of first importance. Restoration of blood pressure and normalization of heart rate may be accomplished by keeping the patient in a supine position. At the same time expansion of plasma volume and noradrenergic vasopressor may also be needed.</p>', '<p>Alpha adrenoceptor blocking drugs, BPH/ Urinary retention/ Urinary incontinence.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-21 05:41:35', '2022-03-21 05:41:35'),
(1468, 1468, '<p><strong>Terbinafine tablet</strong>: This tablet is indicated for the treatment of onychomycosis of the toenail or fingernail due to dermatophytes (tinea unguium).<br />\r\n<br />\r\n<strong>Terbinafine granules</strong>: This is indicated in Tinea Capitis.<br />\r\n<br />\r\n<strong>Terbinafine cream</strong>: Fungal infection of the skin caused by Trichophyton (e.g. T. rubrum, T. mentagrophytes, T. verrucosum, T. violaceum), Microsporum canis and Epidermophyton floccosum. Yeast infections of the skin, principally those caused by the genus Candida (e.g. C. albicans). Pityriasis (tinea) versicolor due to Pityrosporum orbiculare (also known as Malassezia furfur).</p>', '<p>Terbinafine, an Allylamine antifungal, inhibits biosynthesis of Ergosterol (an essential component of fungai cell membrane) via inhibition of Squalene Epoxidase enzyme. This results in fungal cell death primarily due to the increased membrane permeability mediated by the accumulation of high concentrations of Squalene but not due to Ergosterol deficiency. Depending on the concentration of the drug and the fungal species test in vitro, Terbinafine hydrochloride may be fungicidal. However, the clinical significance of in vitro data is unknown. Terbinafine has been shown to be active against most strains of the following microorganisms both in vitro and in clinical infections: Tricophyton Mentagrophyte, Trichophyton Rubrum.</p>', '<p><strong>Terbinafine tablet</strong>:</p>\r\n\r\n<ul>\r\n	<li>For the treatment of finger nail onychomycosis: Terbinafine 250 mg (one tablet), once daily for 6 weeks.</li>\r\n	<li>For the treatment of toenail onychomycosis: Terbinafine 250 mg (one tablet), once daily for 12 weeks.</li>\r\n	<li>The optimal clinical effect is seen some months after mycological cure and cessation of treatment. This is related to the period required for outgrowth of healthy nail.</li>\r\n</ul>\r\n\r\n<p><strong>Terbinafine granules</strong>:</p>\r\n\r\n<ul>\r\n	<li>Body Weight: &lt;25 kg: 125 mg/day up to 6 weeks</li>\r\n	<li>Body Weight: 25-35 kg: 187.5 mg/day up to 6 weeks</li>\r\n	<li>Body Weight: &gt;35 kg: 250 mg/day up to 6 weeks</li>\r\n</ul>\r\n\r\n<p><strong>Terbinafine cream</strong>: Terbinafine cream can be applied once or twice daily. Cleanse and dry the affected areas thoroughly before application of the terbinafine cream. Apply the cream to the affected skin and the surrounding area in a thin layer and rub in lightly. In the case of intertriginous infections (submammary, interdigital, intergluteal, inguinal) the application may be covered with a gauze strip, especially at night. The likely durations of treatment are as follows:</p>\r\n\r\n<ul>\r\n	<li>Tinea corporis, cruris: 1 to 2 weeks</li>\r\n	<li>Tinea pedis: 1 week</li>\r\n	<li>Cutaneous candidiasis: 2 weeks</li>\r\n	<li>Pityriasis versicolor: 2 weeks</li>\r\n</ul>\r\n\r\n<p>Relief of the clinical symptoms usually occurs within a few days. Irregular use or premature discontinuation of treatment carries the risk of recurrence. If there are no signs of improvement after two weeks, the diagnosis should be verified.</p>', '<p>In vivo studies have shown that terbinafine is an inhibitor of the CYP450 2D6 isozyme. Drugs predominantly metabolized by the CYP450 2D6 isozyme include the following drug classes: tricyclic antidepressants, selective serotonin reuptake inhibitors, beta-blockers, antiarrhythmics class 1C (e.g., flecainide and propafenone) and monoamine oxidase inhibitors Type B. Co-administration of terbinafine should be done with careful monitoring and may require a reduction in dose of the 2D6-metabolized drug.</p>', '<p>Terbinafine tablet and cream are contra-indicated in individuals with hypersensitive to terbinafine.</p>', '<p>The adverse events reported encompass gastrointestinal symptoms (including diarrhea, dyspepsia and abdominal pain), liver test abnormalities, rashes, urticaria, pruritus, and taste disturbances. In general, the adverse events were mild, transient, and did not lead to discontinuation. Adverse events, based on worldwide experience with terbinafine use, include: idiosyncratic and symptomatic hepatic injury and more rarely, cases of liver failure, some leading to death or liver transplant, serious skin reactions, severe neutropenia, thrombocytopenia, angioedema and allergic reactions (including anaphylaxis). Other adverse reactions that have been reported include malaise, fatigue, vomiting, arthralgia, myalgia, and hair loss.</p>', '<p><strong>Terbinafine tablet</strong>: There are no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, and because treatment of onychomycosis can be postponed until after pregnancy is completed, it is recommended that terbinafine not be initiated during pregnancy. After oral administration, terbinafine is present in the breast milk of nursing mothers. Treatment with terbinafine is not recommended in nursing mothers.<br />\r\n<br />\r\n<strong>Terbinafine cream</strong>: Foetal toxicity and fertility studies in animals suggest no adverse effects. There is no clinical experience with terbinafine in pregnant women; therefore, unless the potential benefits outweigh any potential risk, terbinafine should not be administered. Terbinafine is excreted in breast milk and therefore mothers should not receive terbinafine treatment whilst breast-feeding.</p>', '<p><strong>Warnings</strong>-</p>\r\n\r\n<ul>\r\n	<li>Terbinafine tablets: Rare cases of liver failure, some leading to death or liver transplant, have occurred with the use of terbinafine tablets for the treatment of onychomycosis in individuals with and without preexisting liver disease. In the majority of liver cases reported in association with terbinafine use, the patients had serious underlying systemic conditions and an uncertain causal association with terbinafine. The severity of hepatic events and/or their outcome may be worse in patients with active or chronic liver disease. Treatment with terbinafine tablets should be discontinued if there is biochemical or clinical evidence of liver injury. There have been isolated reports of serious skin reaction (e.g., Stevens-Johnson Syndrome and toxic epidermal necrolysis). If progressive skin rash occurs, treatment with terbinafine should be discontinued.</li>\r\n	<li>Terbinafine cream: Terbinafine cream is for external use only. Contact with the eyes should be avoided.</li>\r\n</ul>\r\n\r\n<p><strong>Precautions</strong>: Terbinafine are not recommended for patients with chronic or active liver disease. Before prescribing Terbinafine, pre-existing liver disease should be assessed. Hepatotoxicity may occur in patients with and without pre-existing liver disease. Pretreatment serum transaminase (ALT and AST) teste are advised for all patients before taking terbinafine tablets.</p>', '<p>Clinical experience regarding overdose with terbinafine tablets is limited. Doses up to 5 gm (20 times the therapeutic daily dose) have been taken without inducing serious adverse reactions. The symptoms of overdose included nausea, vomiting, abdominal pain, dizziness, rash, frequent urination, and headache.</p>', '<p>Drugs for subcutaneous and mycoses, Topical Antifungal preparations.</p>', '<p>Store in a cool and dry place, below 30&deg;C, protect from light.</p>', '<p><strong>Pediatric use</strong>: The safety and efficacy of terbinafine have not been established in pediatric patients.<br />\r\n<br />\r\n<strong>Use in the elderly</strong>: There is no evidence to suggest that elderly patients require different dosages or experience side-effects different to those of younger patients.</p>', '2022-03-21 05:43:23', '2022-03-21 05:43:23'),
(1469, 1469, '<p>Terbutaline sulfate is indicated for the prevention and reversal of bronchospasm in patients 12 years of age and older with asthma and reversible bronchospasm associated with bronchitis and emphysema.</p>', '<p>Terbutaline is a relatively selective &beta;2-adrenergic bronchodilator that has little or no effect on alpha-adrenergic receptors. The drug has exerts a preferential effect on &beta;2-adrenergic receptors but stimulates beta-adrenergic receptors less selectively than relatively selective &beta;2-agonists. Terbutaline appears to have a greater stimulating effect on beta-receptors of the bronchial, vascular, and uterine smooth muscles (&beta;2 receptors) than on the beta-receptors of the heart (&beta;1 receptors). This drug relaxes smooth muscle and inhibits uterine contractions, but may also cause some cardiostimulatory effects and CNS stimulation.<br />\r\n<br />\r\nThe pharmacologic effects of terbutaline are at least in part attributable to stimulation through beta-adrenergic receptors of intracellular adenyl cyclase, the enzyme that catalyzes the conversion of adenosine triphosphate (ATP) to cyclic- 3&#39;,5&#39;- adenosine monophosphate (c-AMP). Increased c-AMP levels are associated with relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from cells, especially from mast cells.</p>', '<p><strong>Use in bronchospasm</strong>: Terbutaline tablets and syrup have a duration of action of 7 to 8 hours. The minimum recommended dosage interval is therefore 7 hours.<br />\r\n<br />\r\nAdults/Elderly:</p>\r\n\r\n<ul>\r\n	<li><strong>Tablets</strong>:&nbsp;During the first 1-2 weeks 2.5 mg (1 tablet) 3 times in a 24 hour period is recommended. The dose may then be increased to 5 mg (2 tablets) 3 times in 24 hours to achieve adequate bronchodilation.</li>\r\n	<li><strong>Syrup</strong>:&nbsp;The starting dose should be 2&times;5 ml spoonfuls (3 mg) 3 times in 24 hours. The dose may then be increased to 3&times;5 ml spoonfuls (4.5 mg) 3 times in 24 hours if necessary.</li>\r\n</ul>\r\n\r\n<p>Children:&nbsp;</p>\r\n\r\n<ul>\r\n	<li><strong>Tablets</strong>: 7-15 years, the starting dose should normally be 2.5 mg (1 tablet) 2 times in 24 hours. However, in some patients, the dose may need to be increased to 2.5 mg (1 tablet) 3 times in 24 hours.</li>\r\n	<li><strong>Syrup</strong>:&nbsp;0.25 ml (0.075 mg)/kg body weight 3 times in a 24 hour period.</li>\r\n</ul>', '<p>&beta;-blocking agents, especially the non-selective ones such as propranolol may partially or totally inhibit the effect of &beta;-stimulants. Therefore Terbutaline preparations and non-selective &beta;-blockers should not normally be administered concurrently. Terbutaline should be used with caution in patients receiving other sympathomimetics.</p>', '<p>Patients with known hypersensitivity to Terbutaline.</p>', '<p>The frequency of side-effects is low at the recommended doses. Side-effects which have been recorded such as tremor, headache, tonic cramp and palpitations are all characteristic of sympathomimetic amines. A few patients feel tense; this is also due to the effects on skeletal muscle and not to direct CNS stimulation. Whenever these side-effects have occurred the majority have usually been spontaneously reversible within the first week of treatment. Urticaria and exanthema may occur. In children sleep disturbances and disturbances of behavioural effects have been observed. Potentially serious hypokalaemia may result from &beta;2-agonist therapy.</p>', '<p>Although no teratogenic effects have been observed in animals or in patients, Terbutaline should only be administered with caution during the first trimester of pregnancy. Terbutaline is secreted via breast milk, but effect on the infant is unlikely at therapeutic doses.</p>', '<p>Care should be taken with patients suffering from myocardial insufficiency or thyrotoxicosis. Due to the hyperglycaemic effects of &beta;2-stimulants, additional blood glucose measurements are initially recommended when Terbutaline therapy is commenced in diabetic patients. If a previously effective dosage regimen no longer gives the same symptomatic relief the patient should seek further medical advice, for reassessment of asthma therapy, as soon as possible. Potentially serious hypokalaemia may result from &beta;2-agonist therapy. Particular caution is advised in severe asthma as this effect may be potentiated by concomitant treatment with xanthine derivatives, steroids, diuretics and by hypoxia. It is recommended that serum potassium levels are monitored in such situations. Due to the positive inotropic effect of &beta;2-agonists, these drugs should not be used in patients with hypertophic cardiomyopathy.</p>', '<p><strong>Possible symptoms</strong>: Headache, anxiety, tremor, tonic cramp, palpitations,&nbsp;arrhythmia. A fall in blood pressure sometimes occurs.<br />\r\n<br />\r\nTreatment:</p>\r\n\r\n<ul>\r\n	<li><strong>Mild and moderate cases</strong>: Reduce the dose.</li>\r\n	<li><strong>Severe cases</strong>: Gastric lavage, administration of activated charcoal.</li>\r\n</ul>', '<p>Short-acting selective &amp; &beta;2-adrenoceptor stimulants.</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-21 05:45:04', '2022-03-21 05:45:04'),
(1470, 1470, '<p>Terconazole Vaginal Cream and Vaginal Suppositories are indicated for the&nbsp;local treatment&nbsp;of vulvovaginal candidiasis (moniliasis). As these products are effective only for vulvovaginitis caused by the genus Candida, the diagnosis should be confirmed by KOH smears and/or cultures.</p>', '<p>Terconazole disrupts ergosterol synthesis by binding to fungal cytochrome P450. It is active in vitro against Candida spp. and other fungi. It has some antibacterial activity in vitro but not against usual vag flora e.g, lactobacilli.</p>', '<p><strong>Terconazole Vaginal Cream 0.4%</strong>: One full applicator (5 g) of 7 Vaginal Cream (20 mg terconazole) should be administered intravaginally once daily at bedtime for seven consecutive days.<br />\r\n<br />\r\n<strong>Terconazole Vaginal Cream 0.8%</strong>: One full applicator (5 g) of Vaginal Cream (40 mg terconazole) should be administered intravaginally once daily at bedtime for three consecutive days.<br />\r\n<br />\r\n<strong>Terconazole Vaginal Suppositories 80 mg</strong>: One Vaginal Suppository (80 mg terconazole) should be administered intravaginally once daily at bedtime for three consecutive days.<br />\r\n<br />\r\nBefore prescribing another course of therapy, the diagnosis should be reconfirmed by smears and/or cultures and other pathogens commonly associated with vulvovaginitis ruled out. The therapeutic effect of these products is not affected by menstruation.</p>', '<p>May decrease absorption of ciprofloxacin, ciclosporin, mycophenolate, tacrolimus and levothyroxine. Sevelamer should be given 3 hr before or 1 hr after taking other drugs to minimise potential pharmacokinetic interaction.</p>', '<p>Patients known to be hypersensitive to terconazole or to any of the components of the cream or suppositories.</p>', '<p>Vulvovaginal burning, vulvar itching, dysmenorrhoea, genital, body and abdominal pain. Flu-like syndrome with headache, fever, chills and hypotension with doses &gt;80 mg.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C. There was no evidence of teratogenicity when terconazole was administered orally up to 40 mg/kg/day (25x the recommended intravaginal human dose of the suppository formulation, 50x the recommended intravaginal human dose of the 0.8% vaginal cream formulation, and 100x the intravaginal human dose of the 0.4% vaginal cream formulation) in rats, or 20 mg/kg/day in rabbits, or subcutaneously up to 20 mg/kg/day in rats.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether this drug is excreted in human milk. Animal studies have shown that rat offspring exposed via the milk of treated (40 mg/kg/orally) dams showed decreased survival during the first few post-partum days, but overall pup weight and weight gain were comparable to or greater than controls throughout lactation. Because many drugs are excreted in human milk, and because of the potential for&nbsp;adverse reaction&nbsp;in nursing infants from terconazole, 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>Discontinue use and do not retreat with terconazole if sensitization, irritation, fever, chills or flu-like symptoms are reported during use. The base contained in the suppository formulation may interact with certain rubber or latex products, such as those used in vaginal contraceptive diaphragms; therefore concurrent use is not recommended.</p>', '<p>Overdose of terconazole in humans has not been reported to date. In the rat, the oral LD 50 values were found to be 1741 and 849 mg/kg for the male and female, respectively. The oral LD 50 values for the male and female dog were&nbsp;@&nbsp;1280 and &ge; 640 mg/kg, respectively.</p>', '<p>Drugs used in Vaginal and Vulval condition.</p>', '<p>Store at Controlled Room Temperature 15&ndash;30&deg;C</p>', '<p><strong>Pediatric Use</strong>: Safety and efficacy in children have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of terconazole did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients.</p>', '2022-03-21 05:46:49', '2022-03-21 05:46:49'),
(1471, 1471, '<p>Terfenadine is indicated for the treatment of allergic rhinitis, hay fever, and allergic skin disorders.</p>', '<p>Terfenadine competes with histamine for binding at H1-receptor sites in the GI tract, uterus, large blood vessels, and bronchial muscle. This reversible binding of terfenadine to H1-receptors suppresses the formation of edema, flare, and pruritus resulting from histaminic activity. As the drug does not readily cross the blood-brain barrier, CNS depression is minimal.</p>', '<p><strong>Adult (&gt;12 year and &gt;50 kg)</strong>: 60-120 mg in the morning or 60 mg bid. Max: 120 mg daily.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: CrCl &lt;40: Half the usual daily dose</p>', '<p>Increased risk of ventricular arrhythmia with triazole and imidazole antifungals, macrolide antibacterials, streptogramin antibacterials, SSRI, HIV-protease inhibitors and non-nucleoside reverse transcriptase inhibitors, arrhythmogenic drugs, diuretics, astemizole and zileutron.</p>', '<p>Porphyria.</p>', '<p>Anxiety, palpitations, insomnia, mild GI distubances, erythema multiforme and galactorrhoea.</p>', '<p>Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Child and elderly. Avoid in patients with cardiac or significant hepatic disease, electrolyte imbalance, or known or suspected prolongation of the QT interval. Lactation, pregnancy.</p>', NULL, '<p>Non-sedating antihistamines.</p>', NULL, NULL, '2022-03-21 05:48:17', '2022-03-21 05:48:17'),
(1472, 1472, '<p>Teriparatide is a parathyroid hormone analog, (PTH 1-34), indicated for:</p>\r\n\r\n<ul>\r\n	<li>Treatment of postmenopausal women with osteoporosis at high risk for fracture.</li>\r\n	<li>Increase of bone mass in men with primary or hypogonadal osteoporosis at high risk for fracture.</li>\r\n	<li>Treatment of men and women with osteoporosis associated with sustained systemic glucocorticoid therapy at high risk for fracture.</li>\r\n</ul>', '<p>Endogenous 84-amino acid parathyroid hormone (PTH) is the primary regulator of calcium and phosphate metabolism in bone and kidney. Physiological actions of PTH include regulation of bone metabolism, renal tubular reabsorption of calcium and phosphate, and intestinal calcium absorption. The biological actions of PTH and teriparatide are mediated through binding to specific high-affinity cell-surface receptors. Teriparatide and the 34 N-terminal amino acids of PTH bind to these receptors with the same affinity and have the same physiological actions on bone and kidney. Teriparatide is not expected to accumulate in bone or other tissues. The skeletal effects of teriparatide depend upon the pattern of systemic exposure. Once-daily administration of teriparatide stimulates new bone formation on trabecular and cortical (periosteal and/or endosteal) bone surfaces by preferential stimulation of osteoblastic activity over osteoclastic activity. In monkey studies, teriparatide improved trabecular microarchitecture and increased bone mass and strength by stimulating new bone formation in both cancellous and cortical bone. In humans, the anabolic effects of teriparatide manifest as an increase in skeletal mass, an increase in markers of bone formation and resorption, and an increase in bone strength. By contrast, continuous excess of endogenous PTH, as occurs in hyperparathyroidism, may be detrimental to the skeleton because bone resorption may be stimulated more than bone formation.</p>', '<ul>\r\n	<li>Treatment of Postmenopausal Women with Osteoporosis at High Risk for Fracture: The recommended dose is 20 mcg subcutaneously once a day.</li>\r\n	<li>Increase of Bone Mass in Men with Primary or Hypogonadal Osteoporosis at High Risk for Fracture: The recommended dose is 20 mcg subcutaneously once a day.</li>\r\n	<li>Treatment of Men and Women with Glucocorticoid-Induced Osteoporosis at High Risk for Fracture: The recommended dose is 20 mcg subcutaneously once a day.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<ul>\r\n</ul>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Teriparatide should be administered as a subcutaneous injection into the thigh or abdominal wall. There are no data available on the safety or efficacy of intravenous or intramuscular injection of Teriparatide.</p>\r\n\r\n<ul>\r\n	<li>Teriparatide should be administered initially under circumstances in which the patient can sit or lie down if symptoms of orthostatic hypotension occur</li>\r\n	<li>Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Teriparatide is a clear and colorless liquid. Do not use if solid particles appear or if the solution is cloudy or colored.</li>\r\n	<li>Patients and caregivers who administer Teriparatide should receive appropriate training and instruction on the proper use of the Teriparatide delivery device from a qualified health professional</li>\r\n</ul>', '<p>Digoxin: A single Teriparatide dose did not alter the effect of digoxin on the systolic time interval (from electrocardiographic Q-wave onset to aortic valve closure, a measure of digoxin&rsquo;s calcium-mediated cardiac effect). However, because Teriparatide may transiently increase serum calcium, Teriparatide should be used with caution in patients taking digoxin<br />\r\n<br />\r\nHydrochlorothiazide: The coadministration of hydrochlorothiazide 25 mg with teriparatide did not affect the serum calcium response to teriparatide 40 mcg. The effect of coadministration of a higher dose of hydrochlorothiazide with teriparatide on serum calcium levels has not been studied<br />\r\n<br />\r\nFurosemide: Coadministration of intravenous furosemide (20 to 100 mg) with teriparatide 40 mcg in healthy people and patients with mild, moderate, or severe renal impairment (CrCl 13 to 72 mL/min) resulted in small increases in the serum calcium (2%) and 24-hour urine calcium (37%) responses to teriparatide that did not appear to be clinically important</p>', '<p>Do not use Teriparatide in patients with hypersensitivity to teriparatide or to any of its excipients. Reactions have included angioedema and anaphylaxis.</p>', '<p>Most common adverse reactions include: arthralgia, pain, and nausea.</p>', '<p>There are no available data on Teriparatide use in pregnant women to evaluate for drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Consider discontinuing Teriparatide when pregnancy is recognized. It is not known whether teriparatide is excreted in human milk, affects human milk production, or has effects on the breastfed infant.</p>', '<ul>\r\n	<li>Patients with Paget&rsquo;s disease of bone, pediatric and young adult patients with open epiphyses, and patients with prior external beam or implant radiation involving the skeleton: Should not be treated with Teriparatide</li>\r\n	<li>Treatment duration: Use of Teriparatide for more than 2 years during a patient&rsquo;s lifetime is not recommended.</li>\r\n	<li>Patients with bone metastases, history of skeletal malignancies, metabolic bone diseases other than osteoporosis, or hypercalcemic disorders: Should not be treated with Teriparatide</li>\r\n	<li>Laboratory alterations: Teriparatide may increase serum calcium, urinary calcium, and serum uric acid</li>\r\n	<li>Urolithiasis: Use with caution in patients with active or recent urolithiasis because of risk of exacerbation</li>\r\n	<li>Orthostatic hypotension: Transient orthostatic hypotension may occur with initial doses of Teriparatide.</li>\r\n</ul>', NULL, '<p>Thyroid drugs &amp; hormone.</p>', '<p>The Teriparatide delivery device should be stored under refrigeration at 2 to 8&deg;C at all times. Do not freeze. Do not use Teriparatide if it has been frozen.</p>', '<ul>\r\n	<li>Pediatric Use: The safety and efficacy of Teriparatide have not been established in any pediatric population.</li>\r\n	<li>Hepatic Impairment: No studies have been performed in patients with hepatic impairment.</li>\r\n</ul>', '2022-03-21 05:50:24', '2022-03-21 05:50:24'),
(1473, 1473, '<p>For use in the short term management of bleeding oesophageal varices. &quot;Emergency treatment of type 1 hepatorenal syndrome, as defined by IAC (International Ascites Club) criteria&quot;.</p>', NULL, '<p><strong>Short term management of bleeding oesophageal varices</strong>: Initially an i.v. injection of 2 mg (2x8.5 ml) terlipressin acetate is given every 4 hours. The treatment should be maintained until bleeding has been controlled for 24 hours, but up to a maximum of 48 hours. After the initial dose, the dose can be adjusted to 1 mg (8.5 ml) terlipressin acetate i.v. every 4 hours in patients with body weight &lt;50 kg or if adverse effects<br />\r\noccur.<br />\r\n<br />\r\n<strong>In type 1 hepatorenal syndrome</strong>: An i.v. injection 3 to 4 mg (3x8.5ml to 4x8.5ml) terlipressin acetate every 24 hours as 3 or 4 administrations. In the absence of any reduction of the serum creatinine after 3 days of treatment, cessation of Terlipressin Acetate treatment is advised. In other cases, Terlipressin Acetate treatment is to be pursued until the obtaining either of a serum creatinine less than 130 &micro;mol/litre or of a drop of at least 30% in the serum creatinine with respect to the value measured at the time of diagnosis of hepatorenal syndrome. The standard average duration of treatment is 10 days.</p>', '<p>The hypotensive effect of non-selective beta-blockers on the portal vein is increased with terlipressin. Concomitant treatment with medicinal products with a known bradycardiac effect (e.g. propofol, sufentanil) may lower the heart rate and cardiac output. These effects are due to reflexofenic inhibition of the cardiac activity via the vagus nerve due to elevated blood pressure. Terlipressin can trigger &quot;torsade de pointes&quot;. Therefore, extreme caution should be exercised in the use of terlipressin in patients with concomitant medications that can prolong the QT interval, such as class IA and III antiarrhythmics, erythromycin, certain antihistamines and tricyclic antidepressants or medications that may cause hypokalaemia or hypomagnesemia (e.g. some diuretics).</p>', '<p>Hypersensitivity to the active substance or to any of the excipients of this preparation. Contraindicated in pregnancy.</p>', '<p>The most frequently reported undesired effects in clinical trials are paleness, increased blood pressure, abdominal pain, nausea, diarrhoea, and headache.</p>', '<p>Treatment with Terlipressin Acetate during pregnancy is contraindicated. Terlipressin Acetate has been shown to cause uterine contractions and increased intrauterine pressure in early pregnancy and may decrease the uterine blood flow. Terlipressin Acetate may have harmful effects on pregnancy and foetus. Spontaneous abortion and malformation of the foetus have been shown in rabbits after treatment with Terlipressin Acetate.<br />\r\n<br />\r\nIt is not known whether Terlipressin Acetate is excreted in human breast milk. The excretion of Terlipressin Acetate in milk has not been studied in animals. A risk to the suckling child cannot be excluded. A decision on whether to continue/discontinue breast-feeding or to continue/discontinue therapy with Terlipressin Acetate should be made taking into account the benefit of breast-feeding to the child and the benefit of Terlipressin Acetate therapy to the woman.</p>', '<p><strong>Cardiac, pulmonary and vascular disease</strong>: During treatment regular monitoring and control of blood pressure, ECG, heart rate, serum levels of sodium and potassium, as well as fluid balance are required. Caution should be exercised in treating patients with hypertension, recognised heart disease, renal dysfunction, cerebral or peripheral vascular disease, asthma or respiratory failure.<br />\r\n<br />\r\n<strong>Septic shock</strong>: In patients with septic shock with a low cardiac output terlipressin should not be used.<br />\r\n<br />\r\n<strong>Injection site reaction</strong>: To avoid local necrosis at the injection site, the injection must be administered intravenously.<br />\r\n<br />\r\n<strong>Torsade de pointes</strong>: During clinical trials and post-marketing experience, several cases of QT interval prolongation and ventricular arrhythmias including &ldquo;Torsade de pointes&rdquo; have been reported. In most cases, patients had predisposing factors such as basal prolongation of the QT interval, electrolyte abnormalities (hypokalemia, hypomagnesemia) or medications with concomitant effect on QT prolongation. Therefore, extreme caution should be exercised in the use of terlipressin in patients with a history of QT interval prolongation, electrolyte abnormalities, or concomitant medications that can prolong the QT interval.<br />\r\n<br />\r\nPrior to use of terlipressin for hepatorenal syndrome, it must be ascertained that the patient has an acute functional renal failure and this functional renal failure does not respond to a suitable plasma expansion therapy.<br />\r\n<br />\r\n<strong>Paediatric population and elderly patients</strong>: Particular caution should be exercised in the treatment of children and elderly patients, as experience is limited in these groups. There is no data available regarding dosage recommendation in these special patient categories.<br />\r\n<br />\r\nExcipients: This medicinal product contains 1.33 mmol (30.7 mg) of sodium per ampoule, equivalent to 1.5% of the WHO recommended maximum daily intake of 2 g sodium for an adult.</p>', '<p>The recommended dose in the specific patient population should not be exceeded as the risk of severe circulatory adverse effects is dose-dependent. Elevated blood pressure in patients with recognised hypertension can be controlled with 150 mcg clonidine i.v. Bradycardia requiring treatment should be treated with atropine.</p>', '<p>Other preparations.</p>', '<p>Store in a refrigerator (2-8&deg;C). Keep the ampoules in the outer carton in order to protect from light.</p>', '<p>Elderly patients: There is no data available regarding dosage recommendation in the elderly.<br />\r\n<br />\r\nPaediatric population: There is no data available regarding dosage recommendation in the paediatric population.</p>', '2022-03-21 05:53:15', '2022-03-21 05:53:15');
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
(1474, 1474, '<p><strong>Males</strong>: Testosterone is indicated for Testosterone replacement therapy for primary and secondary hypogonadal disorders, which include:</p>\r\n\r\n<ul>\r\n	<li>After castration</li>\r\n	<li>Eunuchoidism</li>\r\n	<li>Hypopituitarism</li>\r\n	<li>Endocrine impotence</li>\r\n	<li>Certain types of infertility due to spermatogenic disorders</li>\r\n	<li>Male climacteric symptoms as decreased libido and decreased feeling of general wellbeing and fitness</li>\r\n	<li>Osteoporosis caused by androgen deficiency</li>\r\n</ul>\r\n\r\n<p><strong>Female to male transsexuals</strong>: Testosterone is indicated for masculinization.</p>', '<p>Testosterone is the principal endogenous hormone essential for normal growth and development of the male sex organs and male secondary sex characteristics. During adult life testosterone is essential for the functioning of the testes and accessory structures and for the maintenance of libido, sense of well-being, erectile potency, prostate and seminal vesicle function.<br />\r\n<br />\r\nTreatment of hypogonadal men with Testanon results in a clinically significant rise of plasma concentrations of testosterone, dihydrotestosterone and androstenedione, as well as a decrease of SHBG (sex hormone binding globulin). In males with primary (hypergonadotropic) hypogonadism treatment with Testosterone Decanoate results in a normalization of gonadotropin levels. Treatment of female-to-male transsexuals with Testosterone Decanoate results in a clinically significant rise of plasma testosterone levels, a decrease of LH and FSH levels and a decrease in SHBG level.</p>', '<p>In general, the dose should be adjusted according to the response of the individual patient.<br />\r\n<br />\r\n<strong>Adults</strong>: Usually, one injection of 1 ml per three weeks is adequate. Testosterone should be administered by deep intramuscular injection.<br />\r\n<br />\r\n<strong>Children</strong>: Safety and efficacy have not been adequately determined in children and adolescents.<br />\r\n<br />\r\nTestosterone contains benzyl alcohol and should not be given to children under 3 years of age.</p>', '<p>Enzyme inducing agents may exert increasing or decreasing effects on Testosterone levels. Therefore, adjustment of dose or intervals between injections may be required.</p>', '<p>Testosterone is contraindicated in case of known hypersensitivity to Testosterone or any of its components. It is also contraindicated in patient with known and suspected prostatic carcinoma or breast carcinoma in male.</p>', '<p>The most common side effects of Testosterone therapy are precocious sexual development, increased frequency of erections, phallic enlargement and premature epiphyseal closure, priapism, oligospermia, decreased ejaculatory volume and fluid &amp; sodium retention.</p>', '<p><strong>Pregnancy</strong>: There are no adequate data for the use of Testosterone in pregnant women. In view of the risk of virilization of the foetus, Testosterone should not be used during pregnancy. Treatment with Testosterone should be discontinued when pregnancy occurs.<br />\r\n<br />\r\n<strong>Lactation</strong>: There are no adequate data for the use of Testosterone during lactation. Therefore, Testosterone should not be used during lactation.</p>', '<p>Androgens should be used with caution in pre (pubertal) boys to avoid premature epiphyseal closure or precocious sexual development. Skeletal maturation should be monitored regularly. Patients with latent or overt cardiac failure, renal dysfunction, hypertension, epilepsy or migraine (or a history of these conditions) should be kept under close medical supervision, since aggravation or recurrence may occasionally be induced. Androgens should be used with caution in men suffering from benign prostatic hyperplasia. The use of steroids may influence the results of certain laboratory tests. The misuse of androgens to enhance ability in sports carries serious health risks and is to be discouraged.</p>', '<p>The acute intramuscular toxicity of Testosterone is very low. Priapism in men is a symptom of chronic over dosage. If this occurs, treatment should be interrupted and after disappearance of the symptom, be resumed at a lower dosage.</p>', '<p>Male Sex hormones (Androgens).</p>', '<p>Store in a cool (between 8&ordm; C to 30&ordm; C) and dry place protected from light. Keep out of the reach of children.</p>', NULL, '2022-03-21 05:55:11', '2022-03-21 05:55:11'),
(1475, 1475, '<p>The active substance of this preparation is turned into testosterone by your body. Testosterone is the natural male hormone, necessary for the normal growth, development and function of the male sex organs and for secondary male sex characteristics. Preparations containing Testosterone are usually prescribed to replace the hormone if the body is unable to produce enough on its own. Testosterone are soft oval glossy capsules, transparent, orange-red colour, with an oily fill.</p>', '<p>Testosterone plays a key role in male sexual differentiation and is involved in regulation of hematopoiesis, body composition, and bone metabolism. As a result, testosterone replacement therapy in males with hypogonadism can result in improved sexual function, increased lean body mass, bone density, erythropoiesis, prostate size, and changes in lipid profiles.<br />\r\n<br />\r\nTestosterone is produced by Leydig cells and exerts it&#39;s effects by binding to androgen receptors throughout the body. Testosterone affects the voice, genitalia, mood, and influences muscle growth and protein expression. Accordingly, males with low levels of testosterone often experience decreased libido, fatigue, mood changes and dysphoria. Exogenous sources of testosterone are designed to mimic the effects of endogenous testosterone.</p>', '<p>Usually, the dosage is 3-4 capsules daily during the first 2-3 weeks, followed by a gradual decrease to 1-3 capsules daily. You must take Testosterone with a meal. Swallow the capsules whole without chewing, using some water or other fluid. Take half of the daily dose in the morning and the other half in the evening. If the daily dose is an uneven number of capsules, take the larger number in the morning. If you have the impression that the effect of Testosterone is too strong or too weak, inform your doctor immediately.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>If you forget to take Testosterone, do not take a double dose to make up for the forgotten individual dose. When treatment with Testosterone is stopped, complaints as those before treatment may re-occur within a few weeks.</p>', '<p>Food allows Testosterone Undecanoate to be taken up by your body. Therefore, Testosterone must be taken with a meal. Other medicines may influence the effects of Testosterone or Testosterone may affect other medicines. You must tell your doctor or pharmacist if you are using (or intend to use) rifampicin (an antibiotic) or medicines for epilepsy or sleeplessness.</p>', '<p>Do not take Testosterone</p>\r\n\r\n<ul>\r\n	<li>If you have a tumour of the prostate or the breast.</li>\r\n	<li>If you are hypersensitive (allergic) to Testosterone Undecanoate or any of the other ingredients of Testosterone.</li>\r\n</ul>', '<p>In general:</p>\r\n\r\n<ul>\r\n	<li>increased sexual desire</li>\r\n	<li>fluid retention in the tissues, usually marked by swelling of ankles or feet</li>\r\n</ul>\r\n\r\n<p>In men:</p>\r\n\r\n<ul>\r\n	<li>prolonged abnormal, painful erection of the penis</li>\r\n	<li>disturbed formation of sperm</li>\r\n	<li>decreased amount of sperm with seminal discharge</li>\r\n</ul>\r\n\r\n<p>In elderly men:</p>\r\n\r\n<ul>\r\n	<li>problems with passing urine</li>\r\n</ul>\r\n\r\n<p>In young boys:</p>\r\n\r\n<ul>\r\n	<li>early sexual development</li>\r\n	<li>erections occurring more often than normal</li>\r\n	<li>enlarged penis</li>\r\n	<li>disturbed growth</li>\r\n</ul>\r\n\r\n<p>Tell your doctor as soon as possible if any side-effect becomes troublesome or continues.</p>', NULL, '<p>Extra supervision by a doctor is necessary in the treatment of young boys, since Testosterone suppletion may cause early sexual development and disturb growth. Extra supervision by a doctor is also necessary in the treatment of elderly men, since male hormones may increase the size of the prostate gland. Medical checks may also be necessary for some other conditions.<br />\r\n<br />\r\nTherefore, tell your doctor if you have or have ever had:</p>\r\n\r\n<ul>\r\n	<li>heart disease</li>\r\n	<li>kidney disease</li>\r\n	<li>high blood pressure</li>\r\n	<li>epilepsy</li>\r\n	<li>migraine headaches</li>\r\n	<li>prostatic complaints, such as problems with passing urine.</li>\r\n</ul>', '<p>If you have taken several capsules at once, there is no need for great concern. However, you should consult your doctor. The oily substance in the capsule may cause diarrhoea.</p>', '<p>Male Sex hormones (Androgens).</p>', '<p>Keep Testosterone out of reach and sight of children. Store at 8&deg;C-30&deg;C. Store in the original package in order to protect from light. Do not use Testosterone after the expiry date stated on the package, sachet and blister.</p>', NULL, '2022-03-21 05:57:15', '2022-03-21 05:57:15'),
(1476, 1476, '<p>To provide temporary passive immunity in the prevention and treatment of tetanus.</p>', '<p>This is a sterile clear, faintly yellow or brown liquid of tetanus antitoxin (equine) for human use. It is a preparation containing antitoxic globulins that have the power of specifically neutralizing the toxin formed by Clostridium tetani. It is obtained by fractionation from the serum of horses that have been hyperimmunized against tetanus toxin.</p>', '<p><strong>Prophylaxis of tetanus</strong>: Tetanus Antitoxin (equine) should not be used in the routine treatment of traumatic wounds. It is given prophylactically to persons at the risk of tetanus infection by infected wounds or severe wounds. For prophylaxis after injury, non-immune or partially immune persons may be given 3,000 to 5,000 units of tetanus antitoxin subcutaneously or intramuscularly. If 24 hours have passed since the wound occurred, the dose is 3,000 III. In crush wounds or wounds contaminated with soil or other foreign bodies, the dose is 10,000 to 20,000 III. For persons below 30 kg the dosage is 1,500 IU. Active immunization with Adsorbed Tetanus vaccine should be given simultaneously with the use of this preparation or a booster injection of Adsorbed Tetanus vaccine should be given if the patient has previously been immunized.<br />\r\n<br />\r\n<strong>Treatment</strong>: Therapy should be given as soon as possible after the appearance of symptoms of the disease. Therapeutic dose not less than 3000 IU. Depending on the severity, the dose may vary from 50,000 to 100,000 IU of tetanus antitoxin for hospitalized patients given partially by intravenous route and the rest of the dose intramuscularly.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>The solution should be shaken well before use. Please do not shake vigorously. The solution should be inspected visually for particulate matter and discoloration prior to administration. If either of these conditions exists, the solution should not be administered. The solution should be used as supplied; no dilution is necessary. Once the vial is opened, the preperation must be used immediately.<br />\r\n<br />\r\nCo-administration: Immunosuppressive therapy should be interrupted when immunization is required because of a tetanus-prone wound.</p>', NULL, '<p>Injection of the antitoxin to persons with a history of allergic reactions to equine protein and to allergic individuals is contraindicated.</p>', '<p>Hypersensitive reactions may occur after the injection of any serum of animal origin. In rare cases hypotension, dyspnoea, urticaria may occur. It should be treated with adrenalin, possibly in association with antihistamine and corticosteroid therapy. Serum sickness may occur 7 to 10 days after injection of serum of animal origin; symptoms include fever, vomiting, diarrhoea, bronchospasm and urticaria.</p>', '<p>Tetanus antitoxin (equine) must not be administered during pregnancy.</p>', '<p>If there is no history of previous serum injection or allergic reaction, the dose of serum may be given intramuscularly. If the patient is subject to allergic diseases, a trial dose of 0,2 ml (diluted 1:10 if preferred) of the serum should be given subcutaneously; if no general reaction develops during an interval of 30 minutes, the main dose may be given intramuscularly. The patient must be kept under observation for at least 30 minutes after the injection and adrenaline kept in readiness for emergency use. In all urgent cases, the intravenous route is indicated, but should never be used unless a preliminary intramuscular injection, given at least 30 minutes beforehand, has been tolerated. For intravenous use, the serum should be at room temperature, the injection should be given very slowly, and the patient should be recumbent during the injection, and for at least an hour afterwards.</p>', '<p>Not applicable..</p>', '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', '<p>Keep out of the reach and sight of children. Store at +2&deg;C to +8&deg;C. Transportation should also be at +2&deg;C to +8 &deg;C. Do not freeze. Discard solution if frozen. Protect from light.</p>', NULL, '2022-03-21 05:59:14', '2022-03-21 05:59:14'),
(1477, 1477, '<p>Tetrabenazine is indicated for the treatment of&nbsp;chorea&nbsp;associated with&nbsp;Huntington&#39;s disease.</p>', '<p>Prolongation of the QTc interval has been observed at doses of 50 mg. In rats, it has been observed that tetrabenazine or its metabolites bind to melanin-containing tissues such as the eyes and skin. After a single oral dose of radiolabeled tetrabenazine, radioactivity was still detected in eye and fur at 21 days post dosing.<br />\r\n<br />\r\nTetrabenazine is a reversible human vesicular monoamine transporter type 2 inhibitor (Ki = 100 nM). It acts within the basal ganglia and promotes depletion of monoamine neurotransmitters serotonin, norepinephrine, and dopamine from stores. It also decreases uptake into synaptic vesicles. Dopamine is required for fine motor movement, so the inhibition of its transmission is efficacious for hyperkinetic movement. Tetrabenazine exhibits weak in vitro binding affinity at the dopamine D2 receptor (Ki = 2100 nM).</p>', '<p>General Dosing Considerations:</p>\r\n\r\n<p>The chronic daily dose of Tetrabenazine used to treat chorea associated with Huntington&#39;s disease (HD) is determined individually for each patient. When first prescribed, Tetrabenazine therapy should be titrated slowly over several weeks to identify a dose of XENAXINE that reduces chorea and is tolerated. Tetrabenazine can be administered without regard to food.<br />\r\n&nbsp;</p>\r\n\r\n<p>Individualization Of Dose:</p>\r\n\r\n<p><strong>Dosing Recommendations Up to 50 mg per day</strong>: The starting dose should be 12.5 mg per day given once in the morning. After one week, the dose should be increased to 25 mg per day given as 12.5 mg twice a day. Tetrabenazine should be titrated up slowly at weekly intervals by 12.5 mg daily, to allow the identification of a tolerated dose that reduces chorea. If a dose of 37.5 to 50 mg per day is needed, it should be given in a three times a day regimen. The maximum recommended single dose is 25 mg. If adverse reactions such as&nbsp;akathisia, restlessness,&nbsp;parkinsonism, depression, insomnia, anxiety or sedation occur, titration should be stopped and the dose should be reduced. If the adverse reaction does not resolve, consideration should be given to withdrawing Tetrabenazine treatment or initiating other specific treatment (e.g.,&nbsp;antidepressants).<br />\r\n<br />\r\n<strong>Dosing Recommendations Above 50 mg per day</strong>: Patients who require doses of Tetrabenazine greater than 50 mg per day should be first tested and genotyped to determine if they are poor metabolizers (PMs) or extensive metabolizers (EMs) by their ability to express the drug metabolizing enzyme, CYP2D6. The dose of Tetrabenazine should then be individualized accordingly to their status as PMs or EMs<br />\r\n&nbsp;</p>\r\n\r\n<p>Extensive and Intermediate CYP2D6 Metabolizers:</p>\r\n\r\n<p>Genotyped patients who are identified as extensive (EMs) or intermediate metabolizers (IMs) of CYP2D6, who need doses of Tetrabenazine above 50 mg per day, should be titrated up slowly at weekly intervals by 12.5 mg daily, to allow the identification of a tolerated dose that reduces chorea. Doses above 50 mg per day should be given in a three times a day regimen. The maximum recommended daily dose is 100 mg and the maximum recommended single dose is 37.5 mg. If adverse reactions such as akathisia, parkinsonism, depression, insomnia, anxiety or sedation occur, titration should be stopped and the dose should be reduced. If the adverse reaction does not resolve, consideration should be given to withdrawing Tetrabenazine treatment or initiating other specific treatment (e.g., antidepressants)</p>', '<p>Tetrabenazine should not be given with or within 14 days of discontinuation of MAOI therapy. Blocks action of reserpine. Decreases effects of levodopa and worsen parkinsonism. Increased risk of extrapyramidal side effects when given with amantadine, metoclopramide, antipsychotics.</p>', '<p>Tetrabenazine is contraindicated in patients:</p>\r\n\r\n<ul>\r\n	<li>Who are actively suicidal, or in patients with untreated or inadequately treated depression&nbsp;</li>\r\n	<li>With hepatic impairment&nbsp;</li>\r\n	<li>Taking monoamine oxidase inhibitors (MAOIs). XENAZINE should not be used in combination with an&nbsp;MAOI, or within a minimum of 14 days of discontinuing therapy with an MAOI&nbsp;</li>\r\n</ul>', '<p>The following serious adverse reactions are Depression, Suicidality Akathisia, restlessness, and agitation, Parkinsonism, Dysphagia, Sedation and&nbsp;somnolence.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C. There are no adequate and well-controlled studies in pregnant women. Tetrabenazine should be used during pregnancy 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 Tetrabenazine or its metabolites are excreted in human milk. Since many drugs are excreted into human milk and because of the potential for serious adverse reactions in nursing infants from Tetrabenazine, a decision should be made whether to discontinue nursing or to discontinue Tetrabenazine, taking into account the importance of the drug to the mother.</p>', '<p>May exacerbate symptoms of parkinsonism. Caution to be exercised when driving or performing skilled tasks. Pregnancy.</p>', '<p>Three episodes of overdose occurred in the open-label trials performed in support of registration. Eight cases of overdose with Tetrabenazine have been reported in the literature. The dose of Tetrabenazine in these patients ranged from 100 mg to 1g. Adverse reactions associated with Tetrabenazine overdose include acute&nbsp;dystonia, oculogyric crisis,&nbsp;nausea and vomiting, sweating, sedation, hypotension, confusion, diarrhea, hallucinations,&nbsp;rubor, and&nbsp;tremor.<br />\r\n<br />\r\nTreatment should consist of those general measures employed in the management of overdosage with any CNS-active drug. General supportive and symptomatic measures are recommended. Cardiac rhythm and vital signs should be monitored. In managing overdosage, the possibility of multiple drug involvement should always be considered. The physician should consider contacting a poison control center on the treatment of any overdose.</p>', '<p>Atypical neuroleptic drugs.</p>', NULL, '<p><strong>Pediatric Use</strong>: The safety and efficacy of Tetrabenazine in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: The pharmacokinetics of Tetrabenazine and its primary metabolites have not been formally studied in geriatric subjects.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Because the safety and efficacy of the increased exposure to Tetrabenazine and other circulating metabolites are unknown, it is not possible to adjust the dosage of Tetrabenazine in hepatic impairment to ensure safe use. The use of Tetrabenazine in patients with hepatic impairment is contraindicated.</p>', '2022-03-21 06:01:08', '2022-03-21 06:01:08'),
(1478, 1478, '<p>Tetracycline ointment is indicated as followings-</p>\r\n\r\n<ul>\r\n	<li>Treatment of bacterial conjunctivitis</li>\r\n	<li>Treatment of trachoma (by preference use oral azithromycin for this indication)</li>\r\n	<li>Prevention of chlamydial and gonococcal neonatal conjunctivitis</li>\r\n</ul>', '<p>Tetracycline exhibits its bacteriostatic action by reversibly binding to the 30S subunits of the ribosome, thus preventing protein synthesis and arresting cell growth. It has a broad spectrum of antimicrobial activity including Chlamydiaceae, Mycoplasma spp., Rickettsia spp., spirochaetes, many aerobic and anaerobic gm+ve and gm-ve pathogenic bacteria and some protozoa.</p>', '<p>Wash the eyes with boiled and cooled water before each application. Use sterile sodium chloride 0.9% for newborns. Apply tetracycline 1% into the conjunctival sac of both eyes:</p>\r\n\r\n<ul>\r\n	<li><strong>Conjunctivitis</strong>: one application 2 times daily for 7 days</li>\r\n	<li><strong>Trachoma</strong>: one application 2 times daily&nbsp;for 6 weeks</li>\r\n	<li><strong>Prevention of neonatal conjunctivitis</strong>: one single application immediately after birth</li>\r\n</ul>', '<p>Impaired absorption with antacids containing divalent and trivalent cations (e.g. Al, Ca, Mg), Fe, Zn and Na bicarbonate preparations, kaolin-pectin, bismuth subsalicylate, sucralfate, strontium ranelate, colestipol and colestyramine. May interfere with the bactericidal action of penicillin. May potentiate the effect of anticoagulants. May decrease efficacy of oral contraceptives. Nephrotoxic effects may be exacerbated by diuretics or other nephrotoxic drugs. May increase the hypoglycaemic effect of insulin and sulfonylureas in patients with DM. May increase toxic effects of ergot alkaloids and methotrexate.</p>', '<p>Do not use in patients with hypersensitivity to tetracyclines. May cause allergic reactions; stop treatment in the event of a serious reaction.</p>', '<p>Burning, irritation, visual disturbances, superinfections, photosensitivity, hypersensitivity.</p>', '<p>Pregnancy Category- D. There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.</p>', '<p>Hepatic impairment. Avoid exposure to sunlight. Periodic evaluation of renal, hepatic and haematological system during prolonged therapy.</p>', NULL, '<p>Ophthalmic antibacterial drugs.</p>', '<p>Store below 25&deg;C.&nbsp;Keep out of the reach of children. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Do not keep outdated medicine or medicine no longer needed.</p>', NULL, '2022-03-21 06:03:00', '2022-03-21 06:03:00'),
(1479, 1479, '<p>Tetracycline is the drug of choice in the following infections :</p>\r\n\r\n<ul>\r\n	<li>Ricketsial infection (Rocky Mountain spotted fever, endemic and scrub typhus fever and human ehrlichiosis).</li>\r\n	<li>Mycoplasma pneumoniae infections in adults. Outbreaks of pneumonia caused by this organism are common in barracks and institutions. Most cases occur in children and young adults. Maculopapular rashes, haemolytic anaemia and meningo-encephalitis occur rarely.</li>\r\n	<li>Chlamydial Infections: Chlamydia psittaci: This organism is the cause of psittacosis (ornithosis), a systemic illness contracted from infected birds. The pneumonia associated with it may be extensive, and severe systemic upset and death are common.Headache is a prominent early symptom.</li>\r\n	<li>Non-gonococcal or non specific urethritis: Inflammation of the urethra not resulting from gonococcal, chlamydial, or other specific infectious agents.</li>\r\n	<li>Lyme disease</li>\r\n	<li>Brucellosis</li>\r\n	<li>Miscellaneous infections, including granuloma inguinale, cholera, glanders, relapsing fever and V. vulnifians.</li>\r\n</ul>\r\n\r\n<p>Other common uses of tetracycline include the following:</p>\r\n\r\n<ul>\r\n	<li>Urinary Tract Infections with susceptible organisms (including the acute urethral syndrome in women).</li>\r\n	<li>Bronchitis in patients with known underlying chronic lung diseases.</li>\r\n	<li>Pelvic inflammatory disease and other sexually transmitted diseases (STDs) regimen.</li>\r\n	<li>Travelers diarrhoea.</li>\r\n	<li>Acne vulgaris</li>\r\n	<li>Prostatitis.</li>\r\n	<li>As an alternative agent in the penicillin allergic patient with syphilis.</li>\r\n	<li>Anaerobic infections with susceptible organisms.</li>\r\n</ul>', '<p>Tetracycline has its main mechanism of action on protein synthesis, and an energy-dependent active transport system pumps the drug through the inner cytoplasmic membrane of bacteria. Once inside the bacterial cell, Tetracycline binds specifically to the 30s ribosomes and inhibit bacterial protein synthesis.<br />\r\n<br />\r\nMany Gram positive aerobic Cocci are susceptible, but many strains of staphylococci, streptococci and even some pneumococci are resistant to Tetracycline. Thus, tetracycline is not the drug of choice in infections due to gram positive aerobes.<br />\r\n<br />\r\nPseudomonas and many Enterobacteriaceae are resistant. Urinary concentrations are adequate for some community - acquired E. coli and consequently, Tetracycline is still used in uncomplicated initial UTIs. Tetracycline is also active against and is the drug of choice for Brucella species, Calymmatobacterium granulomatis, Vibrio cholerae and V. vulnificus.<br />\r\n<br />\r\nTetracycline is also active against anaerobic species of bacteria and since concentrations of the drug are quite high in the gastrointestinal contents, the enteric flora are usually altered by the drug.<br />\r\n<br />\r\nTetracycline&nbsp;is incompletely absorbed from the gastro-intestinal tract, about 60 to 80% of a dose of tetracycline usually being available. It is widely distributed through the body tissues and fluids.<br />\r\n<br />\r\nTetracycline has a half-life of about 12 hours. It is excreted in the urine and in the faeces.</p>', '<p>The usual adult oral dosage of Tetracycline is 1-2 g daily given in 2-4 divided doses. The usual oral dosage of Tetracycline for children older than 8 years of age in 25-50 mg/kg daily given in 2-4 divided doses. Alternatively some clinicians recommended that children should receive 0.6-1.2 g/m2 daily.<br />\r\n<br />\r\nTetracycline should be taken preferably one hour before or 2 hours after meals.<br />\r\n<br />\r\nSome specific indications along with some information on dosage is given below:<br />\r\n<br />\r\n<strong>Acne vulgaris</strong>: 250 mg four times daily or 500 mg 12 hourly for 1 week; 125-250 mg for several weeks or months.&nbsp;Duration of therapy is determined by individual progress<br />\r\n<br />\r\n<strong>Acute&nbsp;staphylococcal infections</strong>: 1-2 g daily in divided&nbsp;doses for 10-14 days<br />\r\n<br />\r\n<strong>Acute streptococcal infections</strong>:&nbsp;1-2 g daily in divided doses for 10 days.&nbsp;Prolonged therapy is needed to avoid risk of rheumatic fever or glomerulonephritis<br />\r\n<br />\r\n<strong>Amoebiasis</strong>:&nbsp;1 g daily in four divided doses or 500 mg 12 hourly for 7 days.&nbsp;Given in association with amoebicidal agents<br />\r\n<br />\r\n<strong>Brucellosis</strong>: 500 mg four times daily plus 1 g streptomycin twice daily for 1 week ; then 500 mg four times daily (no streptomycin) for 1 week.&nbsp;Prolonged therapy is necessary to avoid relapse<br />\r\n<br />\r\n<strong>Subacute bacterial endocarditis</strong>:&nbsp;1-2 g daily in divided doses for 6 weeks.&nbsp;Usually given in combination with a bactericidal agent<br />\r\n<br />\r\n<strong>Syphilis</strong>:&nbsp;Total 30-40 g given in divided doses over 10-15 days.&nbsp;Serology and spinal fluid examination should follow the administration of tetracycline</p>', '<p>Impaired absorption with antacids containing divalent and trivalent cations (e.g. Al, Ca, Mg), Fe, Zn and Na bicarbonate preparations, kaolin-pectin, bismuth subsalicylate, sucralfate, strontium ranelate, colestipol and colestyramine. May interfere with the bactericidal action of penicillin. May potentiate the effect of anticoagulants. May decrease efficacy of oral contraceptives. Nephrotoxic effects may be exacerbated by diuretics or other nephrotoxic drugs. May increase the hypoglycaemic effect of insulin and sulfonylureas in patients with DM. May increase toxic effects of ergot alkaloids and methotrexate.</p>', '<p>Tetracycline Hydrochloride is contraindicated in patients hypersensitive to any of the member of tetracycline groups, since cross-sensitivity may occur Tetracycline Hydrochloride should be avoided in patients with systemic lupus erythematosus. Tetracycline Hydrochloride is considered to be contraindicated in renal impairment, particularly if severe ; if it must be given, doses should be reduced.</p>', '<p><strong>Teeth and bone</strong>: Tetracycline can cause depression of bone growth, permanent graybrown discoloration of the teeth and enamel hypoplasia when given during tooth development (i.e. during the later half of pregnancy, during infancy and in childhood).<br />\r\n<br />\r\nHypersensitivity reactions such as anaphylaxis, urticaria and rashes are uncommon. Photosensitivity reactions consisting of a red rash on areas exposed to intense sunlight can occur with Tetracycline.<br />\r\n<br />\r\n<strong>Gastrointestinal effects</strong>: Epigastric distress and nausea are commonly seen after oral administration, and these symptoms are somewhat dose related. Vomiting can occur.<br />\r\n<br />\r\n<strong>Accentuated prerenal azotemia</strong>: Tetracycline appears to aggravate pre-existing renal failure by inhibiting protein synthesis, which increases the azotemia from amino acid metabolism.<br />\r\n<br />\r\nSuperinfections with oral and anogenital candidiasis are relatively common in patients taking Tetracycline.<br />\r\n<br />\r\n<strong>Esophageal ulcerations</strong>: In most cases, the patients were taking the capsules with little or no fluid before going to bed. To help minimize this, oral doses should be given with adequate amounts of fluid.</p>', '<p>Tetracycline should not be used during pregnancy because of the risk of hypertoxicity in the mother as well as the effects on the developing foetus. Use in pregnancy potentially during breast-feeding and in children up to the age of 8, or some authorise say 12 years, may result in impaired bone growth and permanent discoloration of the child&#39;s teeth.</p>', '<p>Care should be taken if Tetracycline Hydrochloride is given to patients with impaired liver function and high doses should be avoided. Potentiality hepatotoxic drugs (including erythromycin, chloramphenicol, isoniazide and sulphonamides) should not be given concomitantly.</p>', NULL, '<p>Tetracycline group of drugs.</p>', '<p>Store between 20-25&deg; C.</p>', NULL, '2022-03-21 06:04:52', '2022-03-21 06:04:52'),
(1480, 1480, '<p>First aid to help prevent skin infection in minor cuts, scrapes, and burns.</p>', '<p>Tetracycline passively diffuses through porin channels in the bacterial membrane and reversibly binds to the 30S ribosomal subunit, preventing binding of tRNA to the mRNA-ribosome complex, and thus interfering with protein synthesis.</p>', '<p>Clean the affected area. Apply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times daily. May be covered with a sterile bandage.</p>', '<p>Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription medicine.</p>', '<p>Do not use</p>\r\n\r\n<ul>\r\n	<li>in eyes</li>\r\n	<li>over large areas of the body</li>\r\n	<li>longer than 1 week unless directed by doctor</li>\r\n</ul>', '<p>Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.</p>', '<p><strong>Pregnancy</strong>: Studies have not been done in humans. In studies in rats and rabbits, chlortetracycline and tetracycline topical preparations have not been shown to cause birth defects or other problems. However, studies in rabbits have shown meclocycline to cause a slight delay in bone formation.<br />\r\n<br />\r\n<strong>Breast feeding</strong>: It is not known whether tetracycline topical preparations pass into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are using any of these medicines and who wish to breast-feed should discuss this with their doctor.</p>', '<p>May be harmful is swallowed. Do not use if allergic to any ingredient listed on this label.</p>', NULL, '<p>Topical Antibiotic preparations.</p>', '<p>Keep our of reach of children. If swallowed, get medical help or contact a Poison control Center right away. Keep product refrigerated to preserve its effectiveness and color.</p>', '<p><strong>Pediatric</strong>: Tetracycline topical solution has been tested on a limited number of children 11 years of age or older and has not been shown to cause different side effects or problems in children than it does in adults. Although there is no specific information about the use of topical chlortetracycline or topical meclocycline in children, they are not expected to cause different side effects or problems in children than they do in adults.<br />\r\n<br />\r\n<strong>Geriatric</strong>: Many medicines have not been tested in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information about the use of topical tetracyclines in the elderly.</p>', '2022-03-21 06:06:34', '2022-03-21 06:06:34'),
(1481, 1481, '<p><strong>Multiple Myeloma</strong>: Thalidomide in combination with&nbsp;dexamethasone&nbsp;is indicated for the treatment of patients with newly diagnosed&nbsp;multiple myeloma&nbsp;(MM).<br />\r\n<br />\r\n<strong>Erythema Nodosum Leprosum</strong>: Thalidomide is indicated for the acute treatment of the cutaneous manifestations of moderate to severe&nbsp;erythema&nbsp;nodosum leprosum (ENL). Thalidomide is not indicated as monotherapy for such ENL treatment in the presence of moderate to severe neuritis. Thalidomide is also indicated as&nbsp;maintenance therapy&nbsp;for prevention and suppression of the cutaneous manifestations of ENL recurrence</p>', '<p>Thalidomide is a synthetic glutamic acid derivative immunomodulator with anti-inflammatory, antiangiogenetic, sedative and hypnotic activity.<br />\r\n<br />\r\nIn patients with erythema nodosum leprosum (ENL) the mechanism of action is not fully understood. Available data from in vitro studies and preliminary clinical trials suggest that the immunologic effects of this compound can vary substantially under different conditions, but may be related to suppression of excessive tumor necrosis factor-alpha (TNF-a) production and down-modulation of selected cell surface adhesion molecules involved in leukocyte migration. For example, administration of thalidomide has been reported to decrease circulating levels of TNF-a in patients with ENL, however, it has also been shown to increase plasma TNF-a levels in HIV-seropositive patients. As a cancer treatment, the drug may act as a VEGF inhibitor.</p>', '<p><strong>Multiple Myeloma</strong>: Thalidomide is administered in combination with dexamethasone in 28-day treatment cycles. The dose of Thalidomide is 200 mg administered orally once daily with water, preferably at bedtime and at least 1 hour after the evening meal. The dose of dexamethasone is 40 mg daily administered orally on days 1-4, 9-12, and 17-20 every 28 days.<br />\r\n<br />\r\nPatients who develop adverse reactions such as constipation,&nbsp;somnolence, or&nbsp;peripheral neuropathy&nbsp;may benefit by either temporarily discontinuing the drug or continuing at a lower dose. With the&nbsp;abatement&nbsp;of these adverse reactions, the drug may be started at a lower dose or at the previous dose based on clinical judgment.<br />\r\n<br />\r\n<strong>Erythema Nodosum Leprosum</strong>: For an episode of cutaneous ENL, Thalidomide dosing should be initiated at 100 to 300 mg/day, administered once daily with water, preferably at bedtime and at least 1 hour after the evening meal. Patients weighing less than 50 kilograms should be started at the low end of the dose range.<br />\r\n<br />\r\nIn patients with a severe cutaneous ENL reaction, or in those who have previously required higher doses to control the reaction, Thalidomide dosing may be initiated at higher doses up to 400 mg/day once daily at bedtime or in divided doses with water, at least 1 hour after meals.<br />\r\n<br />\r\nIn patients with moderate to severe neuritis associated with a severe ENL reaction, corticosteroids may be started concomitantly with Thalidomide.&nbsp;Steroid&nbsp;usage can be tapered and discontinued when the neuritis has ameliorated.<br />\r\n<br />\r\nDosing with Thalidomide should usually continue until signs and symptoms of active reaction have subsided, usually a period of at least 2 weeks. Patients may then be tapered off medication in 50 mg decrements every 2 to 4 weeks.<br />\r\n<br />\r\nPatients who have a documented history of requiring prolonged maintenance treatment to prevent the recurrence of cutaneous ENL or who flare during tapering should be maintained on the minimum dose necessary to control the reaction. Tapering off medication should be attempted every 3 to 6 months, in decrements of 50 mg every 2 to 4 weeks.</p>', '<p>Thalidomide enhances sedative activity of barbiturates, alcohol, chlorpromazine and reserpine. Avoid use of other drugs that have the potential to cause peripheral neuropathy. Increased risk of thromboembolic events with darbepoetin-alfa and doxorubicin.</p>', '<p>Pregnancy and lactation.</p>', '<p>Severe and irreversible peripheral neuropathy, constipation, dizziness, orthostatic hypotension, drowsiness, somnolence, bradycardia, increase of viral load in HIV-infected patients, hypersensitivity reaction.</p>', '<p>Pregnancy Category X. Studies in animals or human beings have demonstrated foetal abnormalities or there is evidence of foetal risk based on human experience or both, and the risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant.</p>', '<p>All females of childbearing potential must use 2 reliable forms of contraception simultaneously 4 wk before starting therapy, during and 4 wk after therapy is discontinued. Therapy to be stopped immediately if pregnancy occurs. Male: Use of barrier methods of contraception if partner is of child-bearing potential. Do not donate blood or sperm during therapy. Patient should not drive or operate machinery. Discontinue therapy if any skin rash develops. Do not resume therapy if the rash is exfoliative, purpuric, or bullous, or if Stevens-Johnson syndrome or toxic epidermal necrolysis suspected.</p>', NULL, '<p>Anti-Leprotic drugs, Immunosuppressant.</p>', NULL, NULL, '2022-03-21 06:08:14', '2022-03-21 06:08:14'),
(1482, 1482, '<p>Theophylline is indicated for the-</p>\r\n\r\n<ul>\r\n	<li>Control of acute asthma.</li>\r\n	<li>Management of chronic asthma (For both Symptomatic and prophylactic treatment).</li>\r\n	<li>For controlling nocturnal asthma and early morning wheezing.</li>\r\n	<li>Management of chronic obstructive lung disease (Chronic bronchitis and emphysema) and acute exacerbation of chronic obstructive lung disease.</li>\r\n	<li>Control of apnea of pre-maturity.</li>\r\n</ul>', '<p>Theophylline is a bronchodilator, structurally classified as a Methylxanthine. Theophylline has two distinct actions in the airways of patients with reversible obstruction; smooth muscle relaxation and suppression of the response of the airways to stimuli. Theophylline also increases the force of contraction of diaphragmatic muscles. The half-life of Theophylline is influenced by a number of known variables. In adult nonsmokers with uncomplicated asthma the half-life ranges from 3 to 9 hours</p>', '<p>The dose of theophylline must be individualized on the basis of peak serum theophylline concentration measurements in order to achieve a dose that will provide maximum potential benefit with minimal risk of adverse effects. Most of the sustained release preparations may be administered every 12 hours in adults while administration every 8 hours may be necessary in some children with markedly rapid hepatic<br />\r\nmetabolism of theophylline. The recommended maintenance dose within accepted therapeutic range is as follows :</p>\r\n\r\n<ul>\r\n	<li>16 years or older: 10 mg/Kg/day (Do not exceed 900 mg/day)</li>\r\n	<li>12 years-15 years: 13 mg/Kg/day</li>\r\n	<li>9-11 years: 16 mg/Kg/day</li>\r\n	<li>1 year-8 years: 24-24 mg/Kg/day</li>\r\n	<li>6 months-1 year: 12-18 mg/Kg/day</li>\r\n	<li>1-6 months: 10 mg/Kg/day.</li>\r\n</ul>', '<p>Theophylline should not be used concurrently with other preparations containing xanthine derivatives. The clearance of theophylline is increased by barbiturates, carbamazepine, lithium, phenytoin, rifampicin and sulphinpyrazone and it may therefore be necessary to increase dosage. On the other hand, the clearance of the drug is reduced by allopurinol, cimetidine, ciprofloxacin, corticosteroids, erythromycin, frusemide, isoprenaline, oral contraceptive and thiabendazole and a reduced dosage may therefore be needed to avoid side effects. Theophylline can potentiate hypokalemia resulting from beta-2-agonist therapy, steroids, diuretics and hypoxia, so serum potassium levels should be monitored in such instances.</p>', '<p>Theophylline is contraindicated in patients with hypersensitivity to Theophylline or any other component of the product.</p>', '<p>Generally side effects are rare at normal dosage. It may include gastrointestinal discomfort, headache, nausea, insomnia and hypotension. CNS stimulation and diuresis may also occur, especially in children.</p>', '<p>It is not known whether Theophylline can cause foetal harm when administered to pregnant woman. Xanthines should be given to a pregnant woman only if clearly needed. Theophylline is excreted into breast milk and may cause irritability or other signs of mild toxicity in nursing human infants. Serious adverse effects in the infant are unlikely unless the mother has toxic serum Theophylline concentrations.</p>', '<p>Careful consideration is needed for various interacting drugs and physiologic conditions that can alter Theophylline clearance. Dosage adjustment is required prior to initiation of Theophylline therapy, prior to increases in Theophylline dose, and during follow up. The dose of Theophylline selected for initiation of therapy should be low and, if tolerated, increased slowly over a period of time.</p>', NULL, '<p>Bronchodilator, Theophylline &amp; related drugs.</p>', '<p>Keep all medicines out of reach of children. Store in a cool and dry place, protected from light.</p>', '<p><strong>Pediatrics use</strong>: The clearance of Theophylline is very low in neonates. Careful attention to dosage selection and monitoring of serum Theophylline concentrations are required in pediatric patients.</p>', '2022-03-21 06:15:16', '2022-03-21 06:15:16'),
(1483, 1483, '<p>Thiamine is specifically used in the treatment of the various manifestations of thiamine deficiency such as Beriberi and Wernick&#39;s encephalopathy, neuritis associated with pregnancy and pellagra. Supplementary Thiamine may be indicated prophylactically in conditions where there is low dietary intake or impaired gastro intestinal absorption of thiamine (e.g. alcohol) or where requirements are increased (pregnancy, carbohydrate rich diet).</p>', '<p>Thiamine, in the form of thiamine pyrophosphate, is the coenzyme for decarboxylation of &alpha;-ketoglutaric acid. Thiamine deficiency affects the peripheral nervous system, the gastrointestinal tract, and the cardiovascular system. This vitamin is necessary for the optimal growth of infants and children. Thiamine is not stored in the body, and is regularly lost from tissues during short periods of deficiency. In order to maintain normal health, an adequate amount of thiamine is required every day. Deficiency of thiamine leads to fatigue, anorexia, gastrointestinal disturbance, tachycardia, irritability and neurological symptoms. Beriberi, a disease due to vitamin B1 deficiency, is common in alcoholics, in pregnant women receiving an inadequate diet, and in people with malabsorption syndrome, prolonged diarrhoea and hepatic disease.<br />\r\n<br />\r\nThiamine is well absorbed from the gastrointestinal tract and widely distributed throughout the body. Thiamine is rapidly absorbed from the upper small intestine. Thiamine is not stored in the body to any appreciable extent. Excess ingested thiamine appears in urine as intact thiamine or as pyrimidine, which arises from degradation of the thiamine molecule. The plasma half life of thiamine is 24 hours.</p>', '<p><strong>Prophylaxis</strong>: 3 to 10 mg daily.<br />\r\n<strong>Mild chronic deficiency</strong>: 10 to 25 mg daily.<br />\r\n<strong>Severe deficiency</strong>: 200 to 300 mg daily.</p>', '<p>No hazardous drug interactions have been reported. Vitamin B1 acts synergistically with other vitamins of the B-complex group and its potential for causing adverse effects is considerably reduced.</p>', '<p>There is no absolute contraindication but the risk of anaphylaxis is increased by repeated parenteral administration.&nbsp;Mild allergic phenomena, such as sneezing or mild asthma are warning signs that further may give rise to anaphylactic shock. To avoid this possibility it is advisable to start a second course of injection with a dose considerably lower than that previously used. Because of the above, vitamin B1 injection should not be given intravenously except in the case of comatose patients. Once thiamine deficiency is corrected there is no need for parenteral administration or for the administration of amounts in excess of daily requirement.</p>', '<p>Vitamin B1 does not have adverse effects when given orally, but in a few fatal cases anaphylactic reactions have occurred after intravenous administration of large doses (400 mg) in sensitive patients, especially children, and in one case following an intramuscular dose of 125 mg. The risk of such reactions increases with repeated administration of the drug by parenteral route. Transient mild soreness may occur at the site of intramuscular administration.</p>', '<p>The drug may be given safely to neonates, children, pregnant and lactating women and elderly patients.</p>', NULL, NULL, '<p>Vitamin-B preparations.</p>', '<p>Thiamine injection should be protected from light and moisture.</p>', NULL, '2022-03-21 06:16:38', '2022-03-21 06:16:38');
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
(1484, 1484, '<p>Thiopental Sodium for Injection is indicated-&nbsp;</p>\r\n\r\n<ul>\r\n	<li>As the sole anesthetic agent for brief (15 minutes) procedures,</li>\r\n	<li>For induction of anesthesia prior to administration of other anesthetic agents,</li>\r\n	<li>To supplement regional anesthesia,</li>\r\n	<li>To provide hypnosis during balanced anesthesia with other agents for analgesia or muscle relaxation,</li>\r\n	<li>For the control of convulsive states during or following inhalation anesthesia, local anesthesia, or other causes,</li>\r\n	<li>In neurosurgical patients with increased intracranial pressure, if adequate ventilation is provided, and</li>\r\n	<li>For narcoanalysis and narcosynthesis in psychiatric disorders.</li>\r\n</ul>', '<p>Thiopental, a barbiturate, is used for the induction of anesthesia prior to the use of other general anesthetic agents and for induction of anesthesia for short surgical, diagnostic, or therapeutic procedures associated with minimal painful stimuli. Thiopental is an ultrashort-acting depressant of the central nervous system which induces hypnosis and anesthesia, but not analgesia. It produces hypnosis within 30 to 40 seconds of intravenous injection. Recovery after a small dose is rapid, with some somnolence and retrograde amnesia. Repeated intravenous doses lead to prolonged anesthesia because fatty tissues act as a reservoir; they accumulate Pentothal in concentrations 6 to 12 times greater than the plasma concentration, and then release the drug slowly to cause prolonged anesthesia<br />\r\n<br />\r\nThiopental binds at a distinct binding site associated with a Cl-&nbsp;ionopore at the GABAA&nbsp;receptor, increasing the duration of time for which the Cl-&nbsp;ionopore is open. The post-synaptic inhibitory effect of GABA in the thalamus is, therefore, prolonged.</p>', '<p>Thiopental Injection is administered intravenously normally as a 2.5% w/v solution. On occasions it may be administered as a 5% w/v solution (500 mg in 10 ml). The intravenous injection preparation should be used after reconstitution of the sterile powder with Water for Injections, usually to produce a 2.5% w/v solution.<br />\r\n<br />\r\n<strong>Premedication</strong>: Premedication usually consists of atropine or scopolamine to suppress vagal reflexes and inhibit secretions. In addition, a barbiturate or an opiate is often given. Ideally, the peak effect of these medications should be reached shortly before the time of induction.<br />\r\n<br />\r\n<strong>Test dose</strong>: It is advisable to inject a small &quot;test&quot; dose of 25 mg to 75 mg of Thiopental Sodium for Injection to assess tolerance or unusual sensitivity to Thiopental Sodium for Injection, and pausing to observe patient reaction for at least 60 seconds. If unexpectedly deep anesthesia develops or if respiratory depression occurs, consider these possibilities: (1) the patient may be unusually sensitive to Thiopental Sodium for Injection, (2) the solution may be more concentrated than had been assumed, or (3) the patient may have received too much.<br />\r\n<br />\r\n<strong>Use in anaesthesia</strong>: Normal dosage for the induction of anesthesia is 100 mg to 150 mg injected over 10 to 15 seconds. If necessary, a repeat dose of 100 mg to 150 mg may be given after one minute. No fixed dosage recommendations for the intravenous injection can be given, since the dosage will need to be carefully adjusted according to the patient&#39;s response. Factors such as age, sex, and weight of the patient should be taken into consideration. Thiopental Sodium reaches effective concentrations in the brain within 30 seconds and anesthesia is normally produced within one minute of an intravenous dose.</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 100 mg to 150 mg intravenously over 10 to 15 seconds, normally as a 2.5% w/v solution. A repeat dose of 100 mg to 150 mg may be given after one minute. The intravenous injection should be given slowly and the amount given titrated against the patient&#39;s response to minimize the risk of respiratory depression or the possibility of over dosage. The average dose for an adult of 70 kg is roughly 200 mg to 300 mg (8 mls to 12 mls of a 2.5% w/v solution) with a maximum of 500 mg.</li>\r\n	<li><strong>Children</strong>: 2 mg/kg to 7 mg/kg bodyweight, intravenously over 10 to 15 seconds, normally as a 2.5% w/v solution. A repeat dose of 2 mg/kg to 7 mg/kg may be given after one minute. The dose is 2 mg/kg to 7 mg/kg based on the patient&#39;s response. The dose for children should not exceed 7 mg/kg.</li>\r\n	<li><strong>Elderly</strong>: Smaller adult doses are advisable.</li>\r\n</ul>\r\n\r\n<p><strong>Use in convulsive states</strong>: 75 mg to 125 mg (3 mls to 5 mls of a 2.5% w/v solution) should be given as soon as possible after the convulsion begins. Further doses may be required to control convulsion following the use of a local anesthetic. Other regimens, such as the use of intravenous or rectal diazepam, may be used to control convulsive states.</p>', '<p>Possible increase in difficulty in producing anaesthesia in patients taking alcohol or CNS depressants. Additive action with other CNS depressants including sedatives, hypnotics, nitrous oxide or alcohol. Increased hypotension and excitatory effects with phenothiazine antipsychotics. Increased hypnotic effect with antipsychotic. Decreased requirement of thiopental sodium with metoclopramide, sulfisoxazole, aspirin, meprobamate, probenecid and other highly protein bound drugs.</p>', '<p>Absolute Contraindication:</p>\r\n\r\n<ul>\r\n	<li>Absence of suitable veins for intravenous administration</li>\r\n	<li>Hypersensitivity (allergy) to barbiturates</li>\r\n	<li>Variegate porphyria (South African) or acute intermittent porphyria</li>\r\n	<li>Status asthmaticus</li>\r\n</ul>\r\n\r\n<p>Relative Contraindication:</p>\r\n\r\n<ul>\r\n	<li>Severe cardiovascular disease</li>\r\n	<li>Hypotension or shock</li>\r\n	<li>Conditions in which the hypnotic effect may be prolonged or potentiated, eg, excessive premedication, Addison&#39;s disease, hepatic or renal dysfunction, myxedema, increased blood urea, severe anemia, asthma, myasthenia gravis</li>\r\n</ul>', '<p>Hypersensitivity reactions have been reported. Other adverse reactions to thiopental sodium include the followings: respiratory depression, myocardial depression, cardiac arrhythmias, prolonged somnolence and recovery, hypotension, tachycardia, sneezing, coughing, bronchospasm, laryngospasm and shivering. Anaphylactic reactions have been reported. Symptoms, e.g., urticaria, bronchospasm, vasodilation and edema.</p>', '<p>Pregnancy Category C. Animal reproduction studies have not been conducted with Thiopental. It is also not known whether Thiopental can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Thiopental should be given to a pregnant woman only if clearly needed. Thiopental sodium readily crosses the placental barrier and small amounts may appear in the milk of nursing mothers following administration of large doses.</p>', '<p>A person competent in anesthesia management should be in constant attendance and adequate facilities for support of respiration and circulation should be available when Thiopental Sodium for injection is being used. Thiopental Sodium for Injection should be administered with caution to patients with preexisting hypotension or in conditions where the hypnotic effect may be prolonged or intensified, such as in the presence of liver disease and renal disease.<br />\r\n<br />\r\nThis product may be habit forming. Keep resuscitative and endotracheal intubation equipment and oxygen readily available. Maintain patency of the airway at all times. Only persons qualified in the use of anesthetics should administer this drug. Avoid extravasations or intra-arterial injection.</p>', '<p>Overdosage may occur from too rapid or repeated administration. Too rapid injection may be followed by an alarming fall in blood pressure even to shock levels. Apnoea, occasional laryngospasm, coughing and other respiratory difficulties with excessive or too rapid injections may occur. In the event of suspected or apparent overdosage, the agent should be discontinued.</p>', '<p>General (Intravenous) anesthetics.</p>', '<p>Store at controlled room temperature of 15&deg;&nbsp;C to 30&deg;&nbsp;C. Solutions should be freshly prepared and used immediately. Any portion of the contents remaining should be discarded.</p>', NULL, '2022-03-21 20:07:46', '2022-03-21 20:07:46'),
(1485, 1485, '<p>Thioridazine is indicated for the management of schizophrenic patients who fail to respond adequately to treatment with other antipsychotic&nbsp;drugs. Due to the risk of significant, potentially life-threatening, proarrhythmic effects with thioridazine treatment, thioridazine should be used only in patients who have failed to respond adequately to treatment with appropriate courses of other antipsychotic drugs, either because of insufficient effectiveness or the inability to achieve an&nbsp;effective dose&nbsp;due to intolerable adverse effects from those drugs. Consequently, before initiating treatment with thioridazine, it is strongly recommended that a patient be given at least 2 trials, each with a different antipsychotic drug product, at an adequate dose, and for an adequate duration.<br />\r\n<br />\r\nHowever, the prescriber should be aware that thioridazine has not been systematically evaluated in controlled trials in treatment refractory&nbsp;schizophrenic patients and its efficacy in such patients is unknown.</p>', '<p>Thioridazine is a piperidine phenothiazine which blocks postsynaptic mesolimbic dopaminergic receptors in the brain. It exhibits a strong &alpha;-adrenergic blocking effect and depresses the release of hypothalamic and hypophyseal hormones.</p>', '<p>Since thioridazine is associated with a dose-related prolongation of the QTc interval, which is a potentially life-threatening event, its use should be reserved for schizophrenic patients who fail to respond adequately to treatment with other antipsychotic drugs. Dosage must be individualized and the smallest effective dosage should be determined for each patient&nbsp;<br />\r\n<br />\r\n<strong>Adults</strong>: The usual starting dose for adult schizophrenic patients is 50 to 100 mg three times a day, with a gradual increment to a maximum of 800 mg daily if necessary. Once effective control of symptoms has been achieved, the dosage may be reduced gradually to determine the minimum maintenance dose. The total daily dosage ranges from 200 to 800 mg, divided into two to four doses.<br />\r\n<br />\r\n<strong>Pediatric</strong>: For pediatric patients with schizophrenia who are unresponsive to other agents, the recommended initial dose is 0.5 mg/kg/day given in divided doses. Dosage may be increased gradually until optimum&nbsp;therapeutic&nbsp;effect is obtained or the maximum dose of 3 mg/kg/day has been reached.</p>', '<p>May potentiate the effects of CNS depressants (e.g. anaesth, barbiturates, narcotics, opiates, other psychoactive drugs).</p>', '<p>Patients with reduced levels of CYP2D6 isoenzyme, congenital long QT syndrome or history of cardiac arrhythmias; severe CNS depression or comatose states of any cause; hypertensive or hypotensive heart disease of extreme degree. Concomitant use with drugs that prolong QTc interval, CYP2D6 isoenzyme inhibitors and drugs which reduce thioridazine clearance by other mechanisms.</p>', '<p>Tardive dyskinesia; leucopenia, neutropenia, agranulocytosis; drowsiness, pseudoparkinsonism and other extrapyramidal symptoms; dry mouth, blurred vision, constipation, nausea, vomiting, diarrhoea, nasal stuffiness, pallor; galactorrhoea, breast engorgement, amenorrhoea, inhibition of ejaculation, peripheral oedema; dermatitis, skin eruptions. Rarely, nocturnal confusion, hyperactivity, lethargy, psychotic reactions, restlessness, headache, photosensitivity, parotid swelling.</p>', '<p>Pregnancy Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Patient with severe CV disease, narrow-angle glaucoma, Parkinson&#39;s disease, seizure disorder. Avoid abrupt withdrawal. Hepatic and renal impairment. Elderly with dementia-related psychosis. Pregnancy and lactation.</p>', '<p>Symptoms: Cardiotoxicity (e.g. prolongation of QT interval and QRS complex).<br />\r\n<br />\r\nManagement: Symptomatic and supportive treatment with CV (e.g. ECG) monitoring. Establish a patent airway and ensure adequate oxygenation and ventilation. Employ gastric lavage and administer repeated doses of activated charcoal. May include ventricular pacing, defibrillation, admin of IV Mg sulfate, lidocaine, phenytoin or isoproterenol, correction of electrolyte abnormalities and/or acid-base balance to manage arrhythmias. Administer lidocaine with caution as it may increase the risk of developing seizures.</p>', '<p>Phenothiazine drugs, Phenothiazine related drugs.</p>', '<p>Store between 15-30&deg; C. Protect from light.</p>', '<p>Renal Impairment: Lower initial doses and more gradual dosage increase.<br />\r\nHepatic Impairment: Lower initial doses and more gradual dosage increase.</p>', '2022-03-21 20:09:38', '2022-03-21 20:09:38'),
(1486, 1486, '<p>Thiotepa is indicated, in combination with other chemotherapy medicinal products:</p>\r\n\r\n<ul>\r\n	<li>With or without total body irradiation (TBI), as conditioning treatment prior to allogeneic or autologous haematopoietic progenitor cell transplantation (HPCT) in haematological diseases in adult and paediatric patients;</li>\r\n	<li>When high dose chemotherapy with HPCT support is appropriate for the treatment of solid tumours in adult and paediatric patients.</li>\r\n</ul>', '<p>Thiotepa is a polyfunctional cytotoxic agent related chemically and pharmacologically to the nitrogen mustard. The radiomimetic action of thiotepa is believed to occur through the release of ethylene imine radicals that, as in the case of irradiation therapy, disrupt the bonds of DNA, e.g. by alkylation of guanine at the N-7, breaking the linkage between the purine base and the sugar and liberating alkylated guanine.</p>', '<p>Adults-<br />\r\n<br />\r\nAutologous HPCT:</p>\r\n\r\n<ul>\r\n	<li><strong>Haematological diseases</strong>: The recommended dose in haematological diseases ranges from 125 mg/m2/day (3.38 mg/kg/day) to 300 mg/m2/day (8.10 mg/kg/day) as a single daily infusion, administered from2up to 4 consecutive days before autologous HPCT depending on the combination with other chemotherapeutic medicinal products, without exceeding the total maximum cumulative dose of 900 mg/m2(24.32 mg/kg), during the time of the entire conditioning treatment.</li>\r\n	<li><strong>Lymphoma</strong>: The recommended dose ranges from 125 mg/m2/day (3.38 mg/kg/day) to 300 mg/m2/day (8.10 mg/kg/day) as a single daily infusion, administered from2up to 4 consecutive days before autologous HPCT depending on the combination with other chemotherapeutic medicinal products, without exceeding the total maximum cumulative dose of 900 mg/m2(24.32 mg/kg), during the time of the entire conditioning treatment.</li>\r\n	<li><strong>Central nervous system lymphoma</strong>: The recommended dose is 185 mg/m2/day (5 mg/kg/day) as a single daily infusion, administered for 2 consecutive days before autologous HPCT, without exceeding the total maximum cumulative dose of 370 mg/m2(10 mg/kg), during the time of the entire conditioning treatment.</li>\r\n	<li><strong>Multiple myeloma</strong>: The recommended dose ranges from 150 mg/m2/day (4.05 mg/kg/day) to 250 mg/m2/day (6.76 mg/kg/day) as a single daily infusion, administered for 3 consecutive days before autologous HPCT depending on the combination with other chemotherapeutic medicinal products, without exceeding the total maximum cumulative dose of 750 mg/m2(20.27 mg/kg), during the time of the entire conditioning treatment.</li>\r\n</ul>\r\n\r\n<p><strong>Solid tumours</strong>: The recommended dose in solid tumours ranges from 120 mg/m2/day (3.24 mg/kg/day) to 250 mg/m2/day (6.76 mg/kg/day) divided in one or two daily infusions, administered from2up to 5 consecutive days before autologous HPCT depending on the combination with other chemotherapeutic medicinal products, without exceeding the total maximum cumulative dose of 800 mg/m2(21.62 mg/kg), during the time of the entire conditioning treatment.</p>\r\n\r\n<ul>\r\n	<li><strong>Breast cancer</strong>: The recommended dose ranges from 120 mg/m2/day (3.24 mg/kg/day) to 250 mg/m2/day (6.76 mg/kg/day) as a single daily infusion, administered from 3 up to 5 consecutive days before autologous HPCT depending on the combination with other chemotherapeutic medicinal products, without exceeding the total maximum cumulative dose of 800 mg/m2(21.62 mg/kg), during the time of the entire conditioning treatment.</li>\r\n	<li><strong>CNS tumours</strong>: The recommended dose ranges from 125 mg/m2/day (3.38 mg/kg/day) to 250 mg/m2/day (6.76 mg/kg/day) divided in one or two daily infusions, administered from 3 up to 4 consecutive days before autologous HPCT depending on the combination with other chemotherapeutic medicinal products, without exceeding the total maximum cumulative dose of 750 mg/m2(20.27 mg/kg), during the time of the entire conditioning treatment.</li>\r\n	<li><strong>Ovarian cancer</strong>: The recommended dose is 250 mg/m2/day (6.76 mg/kg/day) as a single daily infusion, administered in 2 consecutive days before autologous HPCT, without exceeding the total maximum cumulative dose of 500 mg/m2(13.51 mg/kg), during the time of the entire conditioning treatment.</li>\r\n	<li><strong>Germ cell tumours</strong>: The recommended dose ranges from 150 mg/m2/day (4.05 mg/kg/day) to 250 mg/m2/day (6.76 mg/kg/day) as a single daily infusion, administered for 3 consecutive days before autologous HPCT depending on the combination with other chemotherapeutic medicinal products, without exceeding the total maximum cumulative dose of 750 mg/m2(20.27 mg/kg), during the time of the entire conditioning treatment.</li>\r\n</ul>\r\n\r\n<p>Allogeneic HPCT:</p>\r\n\r\n<ul>\r\n	<li><strong>Haematological diseases</strong>: The recommended dose in haematological diseases ranges from 185 mg/m2/day (5 mg/kg/day) to 481 mg/m2/day (13 mg/kg/day) divided in one or two daily infusions, administered from 1 up to 3 consecutive days before allogeneic HPCT depending on the combination with other chemotherapeutic medicinal products, without exceeding the total maximum cumulative dose of 555 mg/m2(15 mg/kg), during the time of the entire conditioning treatment.</li>\r\n	<li><strong>Lymphoma</strong>: The recommended dose in lymphoma is 370 mg/m2/day (10 mg/kg/day) divided in two daily infusions before allogeneic HPCT, without exceeding the total maximum cumulative dose of 370 mg/m2(10 mg/kg), during the time of the entire conditioning treatment.</li>\r\n	<li><strong>Multiple myeloma</strong>: The recommended dose is 185 mg/m2/day (5 mg/kg/day) as a single daily infusion before allogeneic HPCT, without exceeding the total maximum cumulative dose of 185 mg/m2(5 mg/kg), during the time of the entire conditioning treatment.</li>\r\n	<li><strong>Leukaemia</strong>: The recommended dose ranges from 185 mg/m2/day (5 mg/kg/day) to 481 mg/m2/day (13 mg/kg/day) divided in one or two daily infusions, administered from 1 up to 2 consecutive days before allogeneic HPCT depending on the combination with other chemotherapeutic medicinal products, without exceeding the total maximum cumulative dose of 555 mg/m2(15 mg/kg), during the time of the entire conditioning treatment.</li>\r\n	<li><strong>Thalassemia</strong>: The recommended dose is 370 mg/m2/day (10 mg/kg/day) divided in two daily infusions, administered before allogeneic HPCT, without exceeding the total maximum cumulative dose of 370 mg/m2(10 mg/kg), during the time of the entire conditioning treatment.</li>\r\n</ul>', '<p>Live virus and bacterial vaccines must not be administered to a patient receiving an immunosuppressive chemotherapeutic agent and at least three months must elapse between discontinuation of therapy and vaccination.<br />\r\n<br />\r\nThiotepa appears to be metabolised via CYP2B6 and CYP3A4. Co-administration with inhibitors of CYP2B6 (for example clopidogrel and ticlopidine) or CYP3A4 (for example azole antifungals, macrolides like erythromycin, clarithromycin, telithromycin, and protease inhibitors) may increase the plasma concentrations of thiotepa and potentially decrease the concentrations of the active metabolite TEPA. Co-administration of inducers of cytochrome P450 (such as rifampicin, carbamazepine, phenobarbital) may increase the metabolism of thiotepa leading to increased plasma concentrations of the active metabolite. Therefore, during the concomitant use of thiotepa and these medicinal products, patients should be carefully monitored clinically.<br />\r\n<br />\r\nThiotepa is a weak inhibitor for CYP2B6, and may thereby potentially increase plasma concentrations of substances metabolised via CYP2B6, such as ifosfamide, tamoxifen, bupropion, efavirenz and cyclophosphamide. CYP2B6 catalyzes the metabolic conversion of cyclophosphamide to its active form 4-hydroxycyclophosphamide (4-OHCP) and co-administration of thiotepa may therefore lead to decreased concentrations of the active 4 OHCP. Therefore, a clinical monitoring should be exercised during the concomitant use of thiotepa and these medicinal products.</p>', '<p>Hypersensitivity to the active substance. Pregnancy and lactation. Concomitant use with yellow fever vaccine and with live virus and bacterial vaccines.</p>', NULL, '<p>There are no data on the use of thiotepa during pregnancy. In pre-clinical studies thiotepa, as most alkylating agents, has been shown to cause embryofoetal lethality and teratogenicity. Therefore, thiotepa is contraindicated during pregnancy. It is unknown whether thiotepa is excreted in human milk. Due to its pharmacological properties and its potential toxicity for breast-fed newborns/infants, breastfeeding is contraindicated during treatment with thiotepa.</p>', '<p>The consequence of treatment with thiotepa at the recommended dose and schedule is profound myelosuppression, occurring in all patients. Severe granulocytopenia, thrombocytopenia, anaemia or any combination thereof may develop. Frequent complete blood counts, including differential white blood cell counts, and platelet counts need to be performed during the treatment and until recovery is achieved. Platelet and red blood cell support, as well as the use of growth factors such as Granulocyte- colony stimulating factor (G-CSF), should be employed as medically indicated. Daily white blood cell counts and platelet counts are recommended during therapy with thiotepa and after transplant for at least 30 days.</p>', '<p>There is no experience with overdoses of thiotepa. The most important adverse reactions expected in case of overdose is myeloablation and pancytopenia. There is no known antidote for thiotepa. The haematological status needs to be closely monitored and vigorous supportive measures instituted as medically indicated.</p>', '<p>Haematopoietic Agents</p>', '<p>Store and transport refrigerated (2&deg;C-8&deg;C). Do not freeze.</p>', '<p><strong>Renal impairment</strong>: Studies in renally impaired patients have not been conducted. As thiotepa and its metabolites are poorly excreted in the urine, dose modification is not recommended in patients with mild or moderate renal insufficiency. However, caution is recommended.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Thiotepa has not been studied in patients with hepatic impairment. Since thiotepa is mainly metabolized through the liver, caution needs to be exercised when thiotepa is used in patients with pre-existing impairment of liver function, especially in those with severe hepatic impairment. Dose modification is not recommended for transient alterations of hepatic parameters.<br />\r\n<br />\r\n<strong>Elderly</strong>: The administration of thiotepa has not been specifically investigated in elderly patients. However, in clinical studies, a proportion of patients over the age of 65 received the same cumulative dose as the other patients. No dose adjustment was deemed necessary.</p>', '2022-03-21 20:11:42', '2022-03-21 20:11:42'),
(1487, 1487, '<p>Active protection for high-risk moments. Intimate hygiene wash with Thymus vulgaris extracts for a natural antibacterial and antifungal action.<br />\r\n<br />\r\nWho should use it?</p>\r\n\r\n<ul>\r\n	<li>Women having periods</li>\r\n	<li>Expectant Mothers</li>\r\n	<li>New Mothers</li>\r\n	<li>In situations where there is a risk of infections (swimming-pools, gyms, beaches and surgical procedures)</li>\r\n</ul>', '<p>It ensures the natural antibacterial and antifungal action of Thymus vulgaris, a plant extracts with marked selective antibacterial properties. Its pH 3.5 is the way to restore the acid environment that might have been altered in the vagina and protect the good vaginal flora.</p>', NULL, NULL, '<p>Hypersensitivity to the active substance or to any of the excipients.</p>', NULL, NULL, NULL, NULL, '<p>Miscellaneous topical agents</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-21 20:13:31', '2022-03-21 20:13:31'),
(1488, 1488, '<p>Treatment of symptoms resulting from the natural or surgical menopause in post menopausal women. Prevention of osteoporosis in women who have gone through the menopause and are at high risk of fractures, but cannot take other medicines used to prevent osteoporosis.</p>', '<p>Tibolone is a synthetic steroid that has estrogenic, androgenic and progestagenic properties. After oral administration, Tibolone is rapidly metabolized into three compounds which contribute to the pharmacological effects of Tibolone. Two of these metabolites (the 3&alpha;&minus;OH and 3&beta;&minus;OH metabolite) have predominantly estrogenic activity; a third metabolite (&delta;4-isomer of Tibolone) and the parent compound have predominantly progestagenic and androgenic activities. Tibolone substitutes for the loss of estrogen production in postmenopausal women and alleviates menopausal symptoms. It prevents bone loss following menopause or ovariectomy. It has estrogenic effects on the vagina, on bone and on the thermoregulatory centers in the brain (hot flushes). It improves vaginal dryness and vaginal atrophy. Tibolone has also effects on mood and libido.</p>', '<p>The dose is one Tibolone tablet per day (2.5 mg daily). The tablet should be swallowed with some water or other drink, preferably at the same time in each day. Improvement of symptoms generally occurs within a few weeks, but optimal results are obtained when therapy is continued for at least 3 months.<br />\r\n<br />\r\n<strong>Starting Tibolone Tablet</strong>: Women experiencing a natural menopause should commence treatment with Tibolone tablet at least 12 months after their last natural bleed. In case of a surgical menopause, treatment with Tibolone tablet may commence immediately.<br />\r\n<br />\r\n<strong>Switching from a sequential or continuous combined HRT (Hormone Replacement Therapy) preparation</strong>: If changing from a sequential HRT preparation, treatment with Tibolone should start the day following completion of the prior regimen. If changing from a continuous-combined HRT preparation, treatment can start at any time.<br />\r\n<br />\r\n<strong>Missed dose</strong>: A missed dose should be taken as soon as remembered, unless it is more than 12 hours overdue. In the later case, the missed dose should be skipped and the next dose should be taken at the normal time. Missing a dose may increase the likelihood of breakthrough bleeding and spotting</p>', '<p>No examples of interactions between Tibolone and other medicines have been reported in clinical practice. However, the following potential interactions should be considered on a theoretical basis: Enzyme-inducing compounds such as barbiturates, carbamazepine, hydantoins, and rifampicin may enhance the metabolism of Tibolone and thus decrease its therapeutic effect. Since Tibolone may increase blood or fibrinolytic activity (lower fibrinogen levels; higher AT III, plasminogen, and fibrinolytic activity values), it may enhance the effect of anticoagulants.</p>', '<p>Contraindicated in pregnancy and lactation, known or suspected hormone-dependent tumours, cardiovascular or cerebrovascular disorders, active deep vein thrombosis, thromboembolic disorders, vaginal bleeding of unknown etiology and severe liver disorders.</p>', '<p>Occasionally, vaginal bleeding or spotting may occur, mainly during the first months of treatment. Other adverse effects are headache and migraine, oedema, dizziness, pruritus, increase in body weight, nausea, abdominal pain, rash, and depression.</p>', '<p>Tibolone tablet is contraindicated during pregnancy. If pregnancy occurs during medication with this tablet, treatment should be withdrawn immediately. For this tablet no clinical data on exposed pregnancies are available. Tibolone tablet is contraindicated in lactating women.</p>', '<p>In patients with renal dysfunction, history of liver disease, epilepsy, migraine, hypercholesterolemia, impaired carbohydrate metabolism, diabetes mellitus and cholestatic jaundice.</p>', '<p>The acute toxicity of Tibolone in animals is very low. Therefore, toxic symptoms are not expected to occur if several tablets are taken simultaneously. In cases of acute overdose - nausea, vomiting, and withdrawal bleeding in females may develop. Symptomatic treatment can be given if necessary.</p>', '<p>Drugs for menopausal symptoms: Hormone replacement therapy.</p>', '<p>Keep in a cool &amp; dry place. Protect from light. Keep out of the reach of children.</p>', NULL, '2022-03-21 20:15:09', '2022-03-21 20:15:09'),
(1489, 1489, '<p>Ticagrelor is indicated for the prevention of atherothrombotic events in adult patients with Acute Coronary Syndromes (unstable angina, non ST elevation Myocardial Infarction [NSTEMI] or ST elevation Myocardial Infarction [STEMI]); including patients managed medically, and those who are managed with percutaneous coronary intervention (PCI) or coronary artery by-pass grafting (CABG).</p>', '<p>Ticagrelor is a selective adenosine diphosphate (ADP) receptor antagonist acting on the P2Y12 ADP-receptor that can prevent ADP-mediated platelet activation and aggregation. Ticagrelor reversibly interacts with the platelet P2Y12 ADP-receptor.Ticagrelor does not interact with the ADP binding site itself, but interacts with platelet P2Y12 ADP-receptor to prevent signal transduction.Thus it prevents platelet activation &amp; aggregation.</p>', '<p>Ticagrelor treatment should be initiated with a single 180 mg loading dose (two tablets of 90 mg) and then continued at 90 mg twice daily. Patients taking Ticagrelor should also take aspirin daily, unless specifically contraindicated. Following an initial dose of aspirin (usually 325 mg), Ticagrelor should be used with a maintenance dose of aspirin of 75-100 mg. Maintenance dose of Aspirin above 100 mg decreased the efficacy of Ticagrelor. So, maintenance dose of aspirin above 100 mg should be avoided.<br />\r\n<br />\r\nA patient who misses a dose of Ticagrelor should take only one 90 mg tablet (the next dose) at its scheduled time. Patients treated with Clopidogrel can be directly switched to Ticagrelor if needed. Switching from prasugrel to ticagrelor has not been investigated.<br />\r\n<br />\r\nTreatment is recommended for up to 12 months unless discontinuation of Ticagrelor is clinically indicated. Ticagrelor can be administered with or without food.</p>', '<p><strong>CYP3A inhibitors</strong>: Avoid use of strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, voriconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir and telithromycin).<br />\r\n<br />\r\n<strong>CYP3A inducers</strong>: Avoid use with potent inducers of CYP3A (e.g., rifampin, dexamethasone, phenytoin,carbamazepine and phenobarbital).<br />\r\n<br />\r\n<strong>Aspirin</strong>: Use of Ticagrelor with aspirin maintenance doses above 100 mg reduced the effectiveness ofTicagrelor.<br />\r\n<br />\r\n<strong>Simvastatin, Lovastatin</strong>: Ticagrelor will result in higher serum concentrations of simvastatin and lovastatin because these drugs are metabolized by CYP3A4. Avoid simvastatin and lovastatin doses greater than 40 mg.<br />\r\n<br />\r\n<strong>Digoxin</strong>: Because of inhibition of the P-glycoprotein transporter, monitor digoxin levels with initiation of or any change in ticagrelor therapy.<br />\r\n<br />\r\n<strong>Other Concomitant Therapy</strong>: Ticagrelor can be administered with unfractionated or low-molecular-weight heparin, GPIIb/llla inhibitors, proton pump inhibitors, beta-blockers, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers.</p>', '<p>Ticagrelor is contraindicated in case of-</p>\r\n\r\n<ul>\r\n	<li>Hypersensitivity to Ticagrelor or to any of the excipients</li>\r\n	<li>Active pathological bleeding (peptic ulcer)</li>\r\n	<li>History of intracranial haemorrhage</li>\r\n	<li>Moderate to severe hepatic impairment</li>\r\n	<li>Co-administration of Ticagrelor with strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, nefazodone, ritonavir, and atazanavir)</li>\r\n</ul>', '<p>Dyspnea,bleeding,headache,cough,dizziness,nausea,atrial fibrillation, hypertension, non-cardiac chest pain, diarrhea, back pain, hypotension, fatigue, chest pain.</p>', '<p><strong>Pregnancy</strong>&nbsp;category C. There are no or limited amount of data from the use of Ticagrelor in pregnant women.Ticagrelor is not recommended during pregnancy.<br />\r\n<br />\r\n<strong>Nursing mothers</strong>: Available pharmacodynamic/toxicological data in animals have shown excretion of Ticagrelor and its active metabolites in milk. A risk to newborns/infants cannot be excluded. A decision must be made whether to discontinue breastfeeding or to discontinue/abstain from ticagrelor therapy taking into account the benefit of breastfeeding for the child and the benefit of therapy for the women.</p>', '<p>General Risk of Bleeding: Drugs that inhibit platelet function including Ticagrelor increase the risk of bleeding.<br />\r\n<br />\r\nConcomitant Aspirin Maintenance Dose: Use of Ticagrelor with maintenance doses of aspirin above 100 mg decreased the effectiveness of Ticagrelor. Therefore, after the initial loading dose of aspirin (usually 325 mg), use Ticagrelor with a maintenance dose of aspirin of 75-100 mg.<br />\r\n<br />\r\nModerate Hepatic Impairment: Ticagrelor has not been studied in patients with moderate hepatic impairment.<br />\r\n<br />\r\nDiscontinuation of Ticagrelor: Discontinuation of Ticagrelor will increase the risk of myocardial infarction, stent thrombosis, and death.</p>', '<p>There is currently no known antidote to reverse the effects ofTicagrelor and it is not expected to be dialysable.Treatment of overdose should follow local standard medical practice.The expected effect of excessive ticagrelor dosing is prolonged duration of bleeding risk associated with platelet inhibition. If bleeding occurs appropriate supportive measures should be taken.</p>', '<p>Anti-platelet drugs</p>', '<p>Protect from light &amp; moisture. Store below 25&deg; C. Keep out of reach of children.</p>', '<p><strong>Pediatric Use</strong>: The safety and effectiveness of Ticagrelor in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No overall differences in safety or effectiveness were observed in geriatric patients.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Ticagrelor has not been studied in the patients with moderate or severe hepatic impairment. Ticagrelor is metabolized by the liver and impaired hepatic function can increase risks for bleeding and other adverse events. Hence,<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No dosage adjustment is needed in patients with renal impairment. Patients receiving dialysis have not been studied.</p>', '2022-03-21 20:17:02', '2022-03-21 20:17:02'),
(1490, 1490, '<p>Ticlopidine is indicated to reduce the risk of thrombotic stroke (fatal or nonfatal) in patients who have experienced stroke precursors, and in patients who have had a completed thrombotic stroke. Because Ticlopidine&nbsp;is associated with a risk of life-threatening blood dyscrasias including&nbsp;thrombotic thrombocytopenic purpura&nbsp;(TTP), neutropenia/ agranulocytosis and&nbsp;aplastic anemia. Ticlopidine should be reserved for patients who are intolerant or allergic to&nbsp;aspirin&nbsp;therapy&nbsp;or who have failed aspirin therapy.<br />\r\n<br />\r\nTiclopidine is also indicated as an adjunctive therapy with aspirin to reduce the incidence of subacute stent&nbsp;thrombosis&nbsp;in patients undergoing successful coronary stent&nbsp;implantation</p>', '<p>When taken orally, Ticlopidine hydrochloride causes a time- and dose-dependent inhibition of both&nbsp;platelet aggregation and release of&nbsp;platelet&nbsp;granule constituents, as well as a prolongation of bleeding time. The intact drug has no significant&nbsp;in vitro&nbsp;activity at the concentrations attained&nbsp;in vivo; and, although&nbsp;analysis&nbsp;of&nbsp;urine&nbsp;and&nbsp;plasma&nbsp;indicates at least 20 metabolites, no metabolite which accounts for the activity of ticlopidine has been isolated.<br />\r\n<br />\r\nTiclopidine hydrochloride, after oral ingestion, interferes with platelet&nbsp;membrane&nbsp;function by inhibiting ADP-induced platelet-fibrinogen binding and subsequent platelet-platelet interactions. The effect on platelet function is irreversible for the life of the platelet, as shown both by persistent inhibition of&nbsp;fibrinogen&nbsp;binding after washing platelets ex vivo and by inhibition of platelet aggregation after resuspension of platelets in buffered medium.</p>', '<p><strong>Stroke</strong>:&nbsp;The recommended dose of Ticlopidine is 250 mg bid taken with food. Other doses have not been studied in controlled trials for these indications.<br />\r\n<br />\r\n<strong>Coronary Artery Stenting</strong>:&nbsp;The recommended dose of Ticlopidine is 250 mg bid taken with food together with antiplatelet doses of aspirin for up to 30 days of therapy following successful stent implantation.</p>', '<p>Reduced clearance with cimetidine; corticosteroid may antagonise effects on bleeding time. Avoid concurrent use with clopidogrel.</p>', '<p>The use of Ticlopidine is contraindicated in the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Hypersensitivity to the drug</li>\r\n	<li>Presence of&nbsp;hematopoietic&nbsp;disorders such as&nbsp;neutropenia&nbsp;and thrombocytopenia or a past history of either&nbsp;TTP&nbsp;or&nbsp;aplastic anemia</li>\r\n	<li>Presence of a hemostatic disorder or active pathological bleeding (such as bleeding&nbsp;peptic ulcer&nbsp;or&nbsp;intracranial&nbsp;bleeding)</li>\r\n	<li>Patients with severe&nbsp;liver&nbsp;impairment</li>\r\n</ul>', '<p>Diarrhoea, nausea, dyspepsia, bleeding, pupura, skin rash, increase in serum cholesterol concentration, elevation of LFTs, hepatitis, cholestatic jaundice.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category B. Teratology studies have been conducted in mice (doses up to 200 mg/kg/day), rats (doses up to 400 mg/kg/day) and rabbits (doses up to 200 mg/kg/day). Doses of 400 mg/kg in rats, 200 mg/kg/day in mice and 100 mg/kg in rabbits produced&nbsp;maternal&nbsp;toxicity, as well as fetal toxicity, but there was no evidence of a teratogenic potential of ticlopidine. There are, however, no adequate and well-controlled studies in&nbsp;pregnant&nbsp;women. Because animal&nbsp;reproduction&nbsp;studies are not always predictive of a human response, this drug should be used during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>:&nbsp;Studies in rats have shown ticlopidine is excreted in the milk. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from ticlopidine, 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>Patients with increased risk of bleeding from trauma, surgery or pathological disorder. Moderate to severe renal impairment. May need to stop therapy 10-14 days before elective surgery. Full blood counts should be performed prior to therapy and every 2 wk during the first 3 mth of treatment. Pregnancy.</p>', '<p>One case of deliberate overdosage with Ticlopidine has been reported by a foreign postmarketing surveillance program. A 38-year-old male took a single 6000-mg dose of Ticlopidine (equivalent to 24 standard 250-mg tablets). The only abnormalities reported were increased bleeding time and increased&nbsp;SGPT. No special&nbsp;therapy&nbsp;was instituted and the patient recovered without&nbsp;sequelae.<br />\r\n<br />\r\nSingle oral doses of ticlopidine at 1600 mg/kg and 500 mg/kg were&nbsp;lethal&nbsp;to rats and mice, respectively. Symptoms of&nbsp;acute&nbsp;toxicity&nbsp;were GI&nbsp;hemorrhage, convulsions, hypothermia, dyspnea, loss of equilibrium and&nbsp;abnormal&nbsp;gait.</p>', '<p>Anti-platelet drugs, Fibrinolytics (Thrombolytics)</p>', '<p>Store at 15&deg; to 30&deg; C</p>', '<p><strong>Pediatric Use</strong>:&nbsp;Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>:&nbsp;Clearance of ticlopidine is somewhat lower in elderly patients and trough levels are increased. The major clinical trials with Ticlopidine in stroke patients were conducted in an elderly population with an average age of 64 years. Of the total number of patients in the therapeutic trials, 45% of patients were over 65 years old and 12% were over 75 years old. No overall differences in effectiveness or safety were observed between these patients and younger patients, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: Dose reduction or discontinuance if haemorrhagic or haematopoietic complications occur.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Severe: contraindicated.</p>', '2022-03-21 20:21:18', '2022-03-21 20:21:18'),
(1491, 1491, '<p>Tiemonium Methylsulphate is an antispasmodic drug that reduces muscles spasm of the intestine, biliary system, bladder and uterus. It is used in symptomatic treatment of pain related to functional disorders of the digestive tract and biliary system. It is also indicated for the treatment of spasm and pain in urological and gynaecological diseases.</p>', '<p>Tiemonium Methylsulphate a competitive antagonist of Acetylcholine, Histamine and strengthens of calcium bond with membrane phospholipids and proteins. Thus inhibits intracellular contractile protein of visceral cell which causes inhibition of visceral spasm and pain.</p>', '<p>Tablet/Syrup-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: usual dose is 2-6 tablets or 3-9 teaspoonfuls syrup daily in divided doses.</li>\r\n	<li><strong>Children</strong>: 3 ml/kg or 6 mg/kg body weight daily in divided doses.</li>\r\n</ul>\r\n\r\n<p><strong>Injection</strong>: 1 Tiemonium Methylsulphate Injection 3 times daily, through Intravenous route slowly or Intramuscular route.<br />\r\n<br />\r\n<strong>Suppository</strong>: 20 mg Tiemonium Methylsulphate suppository two or three times daily, through rectal route.</p>', '<p>Tiemonium methylsulphate tablet should not be used with other drugs without prior consult of a registered physician to avoid possible drug interaction.</p>', '<p>It should not be used in urethroprostatic disorder involving a risk of urine retension. It is contraindicated in patient with having risk of angle closure glaucoma.</p>', '<p>Tiemonium Methylsulphate may have the risk of hypotension &amp; tachycardia in certain individuals.</p>', '<p>The results of animal studies of Tiemonium Methylsulphate did not reveal any teratogenic effects; no deformities have been reported up till now with normal use. In absence of sufficient data, prudence should be the rule for nursing mothers although no problems have been reported with normal use.</p>', '<p>Caution should be taken during treatment of patients with disorders of the prostate. Caution should also be taken in case of chronic bronchitis, coronary insufficiency, ambient hyperthermia, renal &amp; hepatic insufficiency. The risks of visual disturbances can make it dangerous to drive or use machines.</p>', '<p>There is not available data regarding the overdose of Tiemonium methylsulphate tablet.</p>', '<p>Anticholinergics.</p>', '<p>Keep in a dry place, away from light and heat. Keep out of the reach of children.</p>', '<p><strong>Paediatric use:</strong>&nbsp;safety and effectiveness of Tiemonium methylsulphate in paediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric use:</strong>&nbsp;Efficacy and safety were maintained with increasing age.</p>', '2022-03-21 20:23:22', '2022-03-21 20:23:22');

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
(1500, 1500, '<p>Tobramycin is a topical antibiotic indicated in the treatment of external bacterial infections of the eye caused by susceptible organisms. Such as,<br />\r\n<br />\r\n<strong>Gram-positive bacteria</strong>: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus spp. of group A beta-hemolytic and some nonhemolytic species.<br />\r\n<br />\r\n<strong>Gram-negative bacteria</strong>: E.coli, Pseudomonas aeruginosa, Enterobacter aerogenes, Klebsiella spp., Proteusmirabillis, Proteus vulgaris, Haemophilus influenzae, Morganella morganii, Acinetobacter calcoaceticus, Providentia, Serratia, Salmonella spp and some strains of Neisseria.</p>', '<p>Like other aminoglycosides, the bactericidal activity of Tobramycin is taken up into sensitive bacterial cells by an active transport process. Within the cell Tobramycin bind to the 30s, and to some extent to the 50s subunits of the bacterial ribosome, inhibiting protein synthesis and generating errors in the transcription of the genetic code. The manner in which cell death is brought about is imperfectly understood, and other mechanisms may contribute, including effects on membrane permeability.</p>', '<p><strong>Ophthalmic ointment</strong>:</p>\r\n\r\n<ul>\r\n	<li>In mild to moderate infection, apply a small amount 2-3 times daily into the conjunctival sac(s).</li>\r\n	<li>In severe cases of infection, apply a small amount 3-4 times daily into the conjunctival sac(s) until improvement is obtained, then reduce the dose gradually.</li>\r\n</ul>\r\n\r\n<p><strong>Ophthalmic solution</strong>:</p>\r\n\r\n<ul>\r\n	<li>In mild to moderate infections: Instill 1or 2 drops into the affected eye(s) every 4 hours.</li>\r\n	<li>In severe infections: Instill 2 drops into the affected eye(s) every hour until improvement is observed.</li>\r\n</ul>\r\n\r\n<p><strong>Pediatric use</strong>: Safety and effectiveness in children below the age of 1 year have not been established.</p>', '<p>Care should be exercised when tobramycin is given to patients receiving other drugs with neuromauscular blocking agents or ototoxic.</p>', '<p>It is contraindicated in patients who are hypersensitive to Tobramycin or any of the ingredients of the preparation.</p>', '<p>The most frequent side effect of Tobramycin ophthalmic solution is localized ocular toxicity, conjunctival erythema, hypersensitivity including lid itching and swelling.</p>', '<p>Pregnancy Category B. There are no adequate and well-controlled studies in pregnant women. This drug should only be used during pregnancy, if the potential benefits outweigh the possible risk to the fetus. Drug may excreted into human milk. A decision should be made whether to discontinue nursing or to taking the drug.</p>', '<p>Minor sensitivity may occur to topically applied aminoglycosides in some patients. If a sensitivity reaction occurs, discontinue use. Prolonged use may result in overgrowth of nonsusceptible organisms and fungi.</p>', '<p>Sign and symptoms of overdose may be similar to side effects as described above.</p>', '<p>Ophthalmic antibacterial drugs</p>', '<p>Protect from light, store in cool (below 25&deg;C) &amp; dry place. Keep out of reach of children. Used within 4 weeks after first opening.</p>', NULL, '2022-03-21 20:43:59', '2022-03-21 20:43:59'),
(1501, 1501, '<p>Tocilizumab is an interleukin-6 (IL-6) receptor antagonist indicated for treatment of:</p>\r\n\r\n<ul>\r\n	<li><strong>Rheumatoid Arthritis (RA)</strong>: Adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response to one or more Disease-Modifying Anti-Rheumatic Drugs (DMARDs).</li>\r\n	<li><strong>Giant Cell Arteritis (GCA)</strong>:&nbsp;Adult patients with giant cell arteritis.</li>\r\n	<li><strong>Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD)</strong>: Slowing the rate of decline in pulmonary function in adult patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD)</li>\r\n	<li><strong>Polyarticular Juvenile Idiopathic Arthritis (PJIA)</strong>: Patients 2 years of age and older with active polyarticular juvenile idiopathic arthritis.</li>\r\n	<li><strong>Systemic Juvenile Idiopathic Arthritis (SJIA)</strong>: Patients 2 years of age and older with active systemic juvenile idiopathic arthritis.</li>\r\n	<li><strong>Cytokine Release Syndrome (CRS)</strong>: Adults and pediatric patients 2 years of age and older with chimeric antigen receptor (CAR) T cell-induced severe or life-threatening cytokine release syndrome.</li>\r\n</ul>', '<p>Tocilizumab binds to both soluble and membrane-bound IL-6 receptors (sIL-6R and mIL-6R), and has been shown to inhibit IL-6-mediated signaling through these receptors. IL-6 is a pleiotropic pro-inflammatory cytokine produced by a variety of cell types including T- and B-cells, lymphocytes, monocytes and fibroblasts. IL-6 has been shown to be involved in diverse physiological processes such as T-cell activation, induction of immunoglobulin secretion, initiation of hepatic acute phase protein synthesis, and stimulation of hematopoietic precursor cell proliferation and differentiation. IL-6 is also produced by synovial and endothelial cells leading to local production of IL-6 in joints affected by inflammatory processes such as rheumatoid arthritis.</p>', '<p><strong>Rheumatoid Arthritis</strong>: Recommended Adult Intravenous Dosage: When used in combination with DMARDs or as monotherapy the recommended starting dose is 4 mg per kg every 4 weeks followed by an increase to 8 mg per kg every 4 weeks based on clinical response.</p>\r\n\r\n<ul>\r\n	<li><strong>Patients less than 100 kg weight</strong>: 162 mg administered subcutaneously every other week, followed by an increase to every week based on clinical response</li>\r\n	<li><strong>Patients at or above 100 kg weight</strong>: 162 mg administered subcutaneously every week.</li>\r\n</ul>\r\n\r\n<p><strong>Giant Cell Arteritis</strong>: Recommended Adult Subcutaneous Dosage: The recommended dose of tocilizumab for adult patients with GCA is 162 mg given once every week as a subcutaneous injection, in combination with a tapering course of glucocorticoids. A dose of 162 mg given once every other week as a subcutaneous injection, in combination with a tapering course of glucocorticoids, may be prescribed based on clinical considerations. tocilizumab can be used alone following discontinuation of glucocorticoids. tocilizumab subcutaneous formulation is not intended for intravenous administration.<br />\r\n<br />\r\n<strong>Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD)</strong>: Recommended Adult Subcutaneous Dosage: The recommended dose of tocilizumab for adult patients with SSc-ILD is 162 mg given once every week as a subcutaneous injection.<br />\r\n<br />\r\n<strong>Polyarticular Juvenile Idiopathic Arthritis</strong><br />\r\nRecommended Intravenous PJIA Dosage Every 4 Weeks-</p>\r\n\r\n<ul>\r\n	<li>Patients less than 30 kg weight: 10 mg per kg</li>\r\n	<li>Patients at or above 30 kg weight: 8 mg per kg</li>\r\n</ul>\r\n\r\n<p>Recommended Subcutaneous PJIA Dosage-</p>\r\n\r\n<ul>\r\n	<li>Patients less than 30 kg weight: 162 mg once every three weeks</li>\r\n	<li>Patients at or above 30 kg weight: 162 mg once every two weeks</li>\r\n</ul>\r\n\r\n<p><strong>Systemic Juvenile Idiopathic Arthritis</strong><br />\r\nRecommended Intravenous SJIA Dosage Every 2 Weeks-</p>\r\n\r\n<ul>\r\n	<li>Patients less than 30 kg weight: 12 mg per kg</li>\r\n	<li>Patients at or above 30 kg weight: 8 mg per kg</li>\r\n</ul>\r\n\r\n<p>Recommended Subcutaneous SJIA Dosage-</p>\r\n\r\n<ul>\r\n	<li>Patients less than 30 kg weight 162 mg every two weeks</li>\r\n	<li>Patients at or above 30 kg weight 162 mg every week</li>\r\n</ul>\r\n\r\n<p><strong>Cytokine Release Syndrome</strong><br />\r\nRecommended Intravenous CRS Dosage-</p>\r\n\r\n<ul>\r\n	<li>Patients less than 30 kg weight: 12 mg per kg</li>\r\n	<li>Patients at or above 30 kg weight: 8 mg per kg</li>\r\n</ul>\r\n\r\n<p>Alone or in combination with corticosteroids.<br />\r\n<br />\r\n<strong>General Dosing Information</strong>:</p>\r\n\r\n<ul>\r\n	<li>It is recommended that tocilizumab not be initiated in patients with an absolute neutrophil count (ANC) below 2000 per mm3, platelet count below 100,000 per mm3, or who have ALT or AST above 1.5 times the upper limit of normal (ULN).</li>\r\n	<li>tocilizumab doses exceeding 800 mg per infusion are not recommended in RA or CRS patients.</li>\r\n</ul>', '<p><strong>Interactions with CYP450 Substrates</strong>: Cytochrome P450s in the liver are down-regulated by infection and inflammation stimuli including cytokines such as IL-6. Inhibition of IL-6 signaling in RA patients treated with tocilizumab may restore CYP450 activities to higher levels than those in the absence of tocilizumab leading to increased metabolism of drugs that are CYP450 substrates. In vitro studies showed that tocilizumab has the potential to affect expression of multiple CYP enzymes including CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP2D6 and CYP3A4. Its effect on CYP2C8 or transporters is unknown. In vivo studies with omeprazole, metabolized by CYP2C19 and CYP3A4, and simvastatin, metabolized by CYP3A4, showed up to a 28% and 57% decrease in exposure one week following a single dose of tocilizumab, respectively. The effect of tocilizumab on CYP enzymes may be clinically relevant for CYP450 substrates with narrow therapeutic index, where the dose is individually adjusted. Upon initiation or discontinuation of tocilizumab, in patients being treated with these types of medicinal products, perform therapeutic monitoring of effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) and the individual dose of the medicinal product adjusted as needed. Exercise caution when coadministering tocilizumab with CYP3A4 substrate drugs where decrease in effectiveness is undesirable, e.g., oral contraceptives, lovastatin, atorvastatin, etc. The effect of tocilizumab on CYP450 enzyme activity may persist for several weeks after stopping therapy.</p>', '<p>Hypersensitivity to tocilizumab or to any of the excipients.</p>', '<p>Most common adverse reactions (incidence of at least 5%): upper respiratory tract infections, nasopharyngitis, headache, hypertension, increased ALT, injection site reactions.</p>', '<p>Based on animal data, may cause fetal harm. Discontinue drug or nursing taking into consideration importance of drug to mother.</p>', '<ul>\r\n	<li>Serious Infections- do not administer tocilizumab during an active infection, including localized infections. If a serious infection develops, interrupt tocilizumab until the infection is controlled.</li>\r\n	<li>Gastrointestinal (GI) perforation- use with caution in patients who may be at increased risk.</li>\r\n	<li>Hepatotoxicity- Monitor patients for signs and symptoms of hepatic injury. Modify or discontinue tocilizumab if abnormal liver tests persist or worsen or if clinical signs and symptoms of liver disease develop.</li>\r\n	<li>Laboratory monitoring- recommended due to potential consequences of treatment-related changes in neutrophils, platelets, lipids, and liver function tests.</li>\r\n	<li>Hypersensitivity reactions, including anaphylaxis and death have occurred.</li>\r\n	<li>Live vaccines- Avoid use with tocilizumab.</li>\r\n</ul>', '<p>There are limited data available on overdoses with tocilizumab. One case of accidental overdose was reported with intravenous tocilizumab in which a patient with multiple myeloma received a dose of 40 mg per kg. No adverse drug reactions were observed. No serious adverse drug reactions were observed in healthy volunteers who received single doses of up to 28 mg per kg, although all 5 patients at the highest dose of 28 mg per kg developed dose-limiting neutropenia. In case of an overdose, it is recommended that the patient be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate symptomatic treatment.</p>', '<p>Drugs used for Rheumatoid Arthritis.</p>', '<p>Tocilizumab must be refrigerated at 2&ordm;C to 8&ordm;C. Do not freeze. Protect the vials, syringes, and autoinjectors from light by storage in the original package until time of use, and keep syringes and autoinjectors dry.</p>', NULL, '2022-03-21 20:46:05', '2022-03-21 20:46:05'),
(1502, 1502, '<p><strong>Rheumatoid Arthritis</strong>: Tofacitinib is indicated for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to methotrexate. It may be used as monotherapy or in combination with methotrexate or other nonbiologic disease-modifying antirheumatic drugs (DMARDs).<br />\r\n<br />\r\n<strong>Psoriatic Arthritis</strong>: Tofacitinib is indicated for the treatment of adult patients with active psoriatic arthritis who have had an inadequate response or intolerance to methotrexate or other disease-modifying antirheumatic drugs (DMARDs).<br />\r\n<br />\r\n<strong>Ulcerative Colitis</strong>: Tofacitinib is indicated for the treatment of adult patients with moderately to severely active ulcerative colitis (UC).</p>', '<p>Rheumatoid arthritis is an autoimmune disease characterized by a dysregulation of pro-inflammatory cytokines including IL7, IL15, IL21, IL6, IFN-alpha, and IFN-beta. (3) Cytokines signalling results in tissue inflammation and joint damage by stimulating the recruitment and activation of immune cells via the janus kinase signalling pathway.<br />\r\n<br />\r\nTofacitinib is a partial and reversible janus kinase (JAK) inihibitor that will prevent the body from responding to cytokine signals. By inhibiting JAKs, tofacitinib prevents the phosphorylation and activation of STATs. The JAK-STAT signalling pathway is involved in the transcription of cells involved in hematopoiesis, and immune cell function. Tofacitinib works therapeutically by inhibiting the JAK-STAT pathway to decrease the inflammatory response. However, there is evidence to suggest that it may also achieve efficacy via other pathways as well.</p>', '<p><strong>Rheumatoid Arthritis</strong>: Tofacitinib 5 mg twice daily or Tofacitinib 11 mg once daily.&nbsp;Recommended dosage in patients with moderate and severe renal impairment or moderate hepatic impairment is Tofacitinib 5 mg once daily.<br />\r\n<br />\r\n<strong>Psoriatic Arthritis&nbsp;</strong>(in combination with nonbiologic DMARDs): Tofacitinib 5 mg twice daily or Tofacitinib 11 mg once daily.&nbsp; Recommended dosage in patients with moderate and severe renal impairment or moderate hepatic impairment is Tofacitinib 5 mg once daily.<br />\r\n<br />\r\n<strong>Ulcerative Colitis</strong>: Tofacitinib 10 mg twice daily for at least 8 weeks; then 5 or 10 mg twice daily. Discontinue after 16 weeks of 10 mg twice daily, if adequate therapeutic benefit is not achieved. Use the lowest effective dose to maintain response.</p>', '<ul>\r\n	<li>Potent inhibitors of Cytochrome P450 3A4 (CYP3A4) (e.g., Ketoconazole)</li>\r\n	<li>Recommended dose is Tofacitinib 5 mg once daily: One or more concomitant medications that result in both moderate inhibition of CYP3A4 and potent inhibition of CYP2C19 (e.g., fluconazole)</li>\r\n	<li>Recommended dose is Tofacitinib 5 mg once daily Potent CYP inducers (e.g.Rifampin): May result in loss of or reduced clinical response.</li>\r\n</ul>', NULL, '<p>The most commonly reported adverse reactions during the first 3 months in controlled clinical trials (occurring in greater than or equal to 2% of patients treated with Tofacitinib monotherapy or in combination with DMARDs) were upper respiratory tract infections, headache, diarrhea and nasopharyngitis.</p>', '<p>Pregnancy Category C. There are no adequate and well controlled studies in pregnant women. Tofacitinib should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\nIt is not known whether Tofacitinib is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Tofacitinib, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug for the mother</p>', '<ul>\r\n	<li>Serious Infections: Avoid use of Tofacitinib during an active serious infection, including localized infections.&nbsp;</li>\r\n	<li>Gastrointestinal Perforations: Use with caution in patients that may be at increased risk.</li>\r\n	<li>Laboratory Monitoring: Recommended due to potential changes in lymphocytes, neutrophils, hemoglobin, liver enzymes and lipids.</li>\r\n	<li>Immunizations: Live vaccines: Avoid use with Tofacitinib.</li>\r\n	<li>Do not initiate Tofacitinib&nbsp;if absolute lymphocyte count &lt;500 cells/mm3, an absolute neutrophil count (ANC) &lt;1000 cells/mm3 or hemoglobin &lt;9 gm/dL.</li>\r\n</ul>', NULL, '<p>Immunosuppressant</p>', '<p>Store below 30&deg;C. Protect from light &amp; moisture. Keep all medicines out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: The safety and effectiveness of Tofacitinib in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: The frequency of serious infection among Tofacitinib-treated subjects 65 years of age and older was higher than among those under the age of 65. As there is a higher incidence of infections in the elderly population in general, caution should be used when treating the elderly.<br />\r\n<br />\r\n<strong>Moderate and severe renal impairment or moderate hepatic impairment</strong>: half the total daily dosage recommended for patients with normal renal and hepatic function.</p>', '2022-03-21 23:33:13', '2022-03-21 23:33:13'),
(1503, 1503, '<p>Tolfenamic acid is used specifically for relieving the pain of migraine headache and also recommended for use as an analgesic in post-operative pain and fever.</p>', '<p>Tolfenamic acid (N-(2-methyl-3-chlorophenyl) anthranilic acid) belongs to the fenamate group and is a potent inhibitor of cyclooxygenase enzyme, thus it inhibits the synthesis of important inflammatory mediators such as thromboxane (TX) B2 and prostaglandin (PG) E2. Prostaglandins are responsible for causing swelling pain and inflammation associated with these conditions. It acts not only by inhibiting prostaglandin synthesis, but it also has direct antagonistic action on its receptors.<br />\r\n<br />\r\nPharmacokinetic properties: Absorption Readily absorbed from GI tract. Peak plasma concentration: 60-90 min. Bioavailability 85%. Distribution: Protein-binding: 99% Plasma half-life 2 hours. Metabolism: Metabolised in the liver. Tolfenamic acid undergoes enterohepatic circulation. Excretion: Excreted in urine (90%) and faces.</p>', '<p>Adult:</p>\r\n\r\n<ul>\r\n	<li><strong>Acute migraine attacks</strong>: 200 mg when symptoms appear may be repeated once after 1-2 hour.</li>\r\n	<li><strong>Mild to moderate pain</strong>: 100-200 mg tid</li>\r\n	<li><strong>Renal impairment</strong>: Dose adjustments may be needed.</li>\r\n	<li><strong>Severe renal impairment</strong>: Avoid.</li>\r\n</ul>\r\n\r\n<p>Children: A pediatric dosage regimen has not yet been established.<br />\r\n<br />\r\nTolfenamic acid should be taken with food. Take water during or immediately after meals.</p>', '<p>The rate of absorption of Tolfenamic acid increases with Metoclopramide and Magnesium hydroxide but decreases with Aluminium hydroxide. Risk of bleeding with anticoagulants and other NSAIDS increases when use with Tolfenamic acid. It decreases antihypertensive response to loop diuretics, B-blockers and ACE Inhibitors. Co-administration increases plasma concentration of Lithium Methotrexate and cardiac glycosides. It also increases the risk of nephrotoxicity with ACE inhibitors, Ciclosporin, Tacrolimus or diuretics</p>', '<p>Active peptic ulcer or bleeding in the gut. Severe heart, kidney or liver failure.</p>', '<p>Dysuria especially in males, diarrhoea, nausea epigastric pain, vomiting, dyspepsia, erythema, headache, tremor, euphoria, fatigue, pulmonary infiltration &amp; haematuria. Potentially fatal: Blood dyscrasias and hepatitis.</p>', '<p>This medicine is not recommended for using during pregnancy unless considered essential by doctor Not to be given during the third trimester of pregnancy. NSAID&#39;s can appear in breast milk in very low concentrations NSAID&#39;s should, if possible, be avoided when breastfeeding.</p>', '<p>Precaution should be needed for patients with asthma bronchospasm, bleeding disorders, cardiovascular diseases, peptic ulceration, hypertension, liver infection, cardiac or renal function impairment and elderly. Increase water intake or dose reduction to reduce dysuria.</p>', '<p>Symptoms include headache, nausea, vomiting, epigastric pain. gastrointestinal bleeding, diarrhoea excitation, coma, drowsiness dizziness, tinnitus, fainting and convulsions. In cases of significant poisoning, acute renal failure and liver damage are possible. Patients should be treated symptomatically as required.</p>', '<p>Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs), Other drugs for migraine.</p>', '<p>Store in a cool and dry place, away from light Keep out of the reach of children.</p>', NULL, '2022-03-21 23:34:42', '2022-03-21 23:34:42'),
(1504, 1504, '<p>Tolnaftate is used to treat&nbsp;skin&nbsp;infections such as&nbsp;athlete&#39;s foot,&nbsp;jock itch, and&nbsp;ringworm. It is an&nbsp;antifungal&nbsp;that works by preventing the growth of&nbsp;fungus.</p>', '<p>Tolnaftate is an antifungal which inhibits growth of dermatophytes e.g. Epidermophyton, Microsporum, trichophyton spp, and Malassezia furfur by distorting the hyphae and stopping mycelial growth. It is inactive against Candida spp or bacteria.</p>', '<p>Use this&nbsp;medication&nbsp;on the&nbsp;skin&nbsp;only. Clean and thoroughly dry the area to be treated. Apply this medication to the affected skin, usually twice a day or as directed on the product package or by your doctor. Dosage and length of treatment depends on the type of infection being treated.<br />\r\n<br />\r\nSome forms of tolnaftate (e.g., powder) need to be shaken before applying. Check your product package to see if your form of this medication needs to be shaken. Apply enough medication to cover the affected area and some of the surrounding skin. After applying this medication,&nbsp;wash your hands. Do not wrap, cover, or bandage the area unless directed to do so by your doctor.<br />\r\n<br />\r\nUse this medication regularly in order to get the most benefit from it. Remember to use it at the same time(s) each day.<br />\r\n<br />\r\nContinue to use this medication until the full prescribed amount is finished, even if symptoms disappear after starting tolnaftate. Stopping the medication too early may allow the&nbsp;fungus&nbsp;to continue to grow, which may result in a relapse of the infection.<br />\r\n<br />\r\nInform your doctor if your condition persists after 2 weeks of treatment for&nbsp;jock itch, after 4 weeks of treatment for&nbsp;athlete&#39;s foot&nbsp;or&nbsp;ringworm, or if your condition worsens at any time.</p>', NULL, '<p>Hypersensitivity. Nail and scalp infections.&nbsp;Do not apply this medication in the&nbsp;eyes, nose,&nbsp;mouth, or&nbsp;vagina.</p>', '<p>Irritation of the treated&nbsp;skin&nbsp;may occur. If this effect persists or worsens, notify your doctor or&nbsp;pharmacist&nbsp;promptly.<br />\r\n<br />\r\nIf your doctor has directed you to use this&nbsp;medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.<br />\r\n<br />\r\nA very serious&nbsp;allergic reaction&nbsp;to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious&nbsp;allergic reaction&nbsp;may include:&nbsp;rash,&nbsp;itching/swelling (especially of the face/tongue/throat), severe&nbsp;dizziness,&nbsp;trouble breathing.<br />\r\n<br />\r\nThis is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.</p>', '<p>Tolnaftate topical has not been formally assigned to a pregnancy category by the FDA. Animal studies have not been reported. There are no controlled data in human pregnancy. Tolnaftate topical is only recommended for use during pregnancy when benefit outweighs risk.&nbsp;There are no data on the excretion of tolnaftate topical into human milk.</p>', '<p>Before using tolnaftate, tell your doctor or&nbsp;pharmacist&nbsp;if you are allergic to it; or if you have any other&nbsp;allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.<br />\r\n<br />\r\nBefore using this&nbsp;medication, tell your doctor or pharmacist your medical history, especially of:&nbsp;immune system&nbsp;problems (e.g.,&nbsp;organ transplant,&nbsp;HIV&nbsp;disease),&nbsp;diabetes.<br />\r\n<br />\r\nThis medication should be used only if clearly needed during&nbsp;pregnancy. Discuss the risks and benefits with your doctor.<br />\r\n<br />\r\nIt is not known whether this drug passes into&nbsp;breast&nbsp;milk. Consult your doctor before&nbsp;breast-feeding.</p>', NULL, '<p>Other Antifungal preparations</p>', '<p>Store at 15-30&deg; C.</p>', NULL, '2022-03-21 23:36:14', '2022-03-21 23:36:14'),
(1505, 1505, '<p>Increased tone of skeletal muscles due to organic neurological disorders (e.g. injury of the pyramidal tract, multiple sclerosis, myelopathy, encephalomyelitis etc.), muscular hypertension, muscular spasm, muscular contracture, rigidity, spinal automatism and discopathy, obliterative vascular diseases (obliterative arteriosclerosis, diabetic angiopathy, obliterative thromboangitis, Raynaud&#39;s disease, diffuse scleroderma) and disorders due to injured innervation of the vessels (acrocyanosis, intermittent angioneurotic dysbasia). In individual cases, post-thrombotic venous and lymphatic circulation disorders, crural ulcer.</p>', '<p>Tolperisone Hydrochloride is a centrally acting muscle relaxant. It effectively reduces muscular hypertonicity, improves peripheral blood flow by vasodilatation and reduces pain. Lidocaine stabilizes the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby effecting local anesthetic action.</p>', '<p>The usual dose is one ampoule twice daily by intramuscularly. Injection should be given slowly. Accordingly to age and symptom, the dosage may be changed.</p>', NULL, '<p>Hypersensitivity to any component of the product, Myasthenia gravis, Nursing mother.</p>', '<p>Sometimes, muscular weakness, headache, nausea, vomiting and rarely hypersensitivity reactions may occur as side effects.</p>', '<p>Tolperisone hydrochloride should be used in pregnancy according to physician&#39;s advice. Tolperisone hydrochloride should not be used during breast feeding.</p>', '<p>In case of children, the prescribed dose and duration of treatment should closely be observed.</p>', '<p>In the event of over dosage, supportive therapy may be substituted.</p>', '<p>Centrally acting Skeletal Muscle Relaxants, Locally acting Skeletal Muscle Relaxants.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-21 23:37:44', '2022-03-21 23:37:44'),
(1506, 1506, '<p>Tolperisone Hydrochloride is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Treatment of increased tone of skeletal muscles due to organic neurological disorders (injury of the pyramidal tract, multiple sclerosis, myelopathy, encephalomyelitis).</li>\r\n	<li>Treatment of muscular spasm, muscular contracture, rigidity, spinal automatism.</li>\r\n	<li>In the treatment of vascular diseases (Obliterative arteriosclerosis, diabetic angiopathy, obliterative thromboangitis, Raynaud&#39;s disease, diffuse scleroderma).</li>\r\n	<li>In individual cases, post-thrombotic venous and lymphatic circulation disorders and crural ulcer.</li>\r\n</ul>', '<p>Tolperisone Hydrochloride is a centrally acting muscle relaxant, which acts on the central nervous system and used mainly for the treatment of elevated muscle tone and tension as well as for certain circulation problems in the extremities.</p>', '<p>The recommended dose is as follows:</p>\r\n\r\n<ul>\r\n	<li>Adult: 50-150 mg three times daily according to the individual requirement and tolerance of the patient.</li>\r\n	<li>Children (from 3 months to 6 years): 5 mg/kg/day in three divided doses.</li>\r\n	<li>Children (from 6 to 14 years): 2-4 mg/kg/day in three divided doses. or, as directed by the registered physician.</li>\r\n</ul>', '<p>Concomitant use of methocarbamol with Tolperisone Hydrochloride has been reported to cause disturbance of visual accommodation.</p>', '<p>It is contraindicated in patients with a history of hypersensitivity to any component of the product, myasthenia gravis and nursing mother.</p>', '<p>Possible side-effects include sometimes muscular weakness, headache, nausea, vomiting and rarely hypersensitivity reactions (itching, redness of the skin, skin rash) may occur.</p>', '<p>Tolperisone Hydrochloride should be used in pregnancy according to the physician&#39;s advice. It should not be used during breast feeding.</p>', '<p>In case of children, the prescribed dose and duration of treatment should closely be observed.</p>', NULL, '<p>Central Depolarizing muscle relaxants, Centrally acting Skeletal Muscle Relaxants.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-21 23:42:29', '2022-03-21 23:42:29'),
(1507, 1507, '<p>Tolterodine Tartrate is indicated for the treatment of overactive bladder with symptoms of urinary urgency, frequency, and/or urge incontinence.</p>', '<p>Tolterodine is a competitive, specific muscarinic receptor antagonist which exhibits a selectivity for the urinary bladder over salivary glands, which have been demonstrated in non clinical pharmacological in vivo studies. Tolterodine has a high specificity for muscarinic receptors. A major active metabolite (5-hydroxymethyl derivative) of tolterodine exhibits a pharmacological profile which is similar to that of the parent compound. In extensive metabolisers this metabolite contributes significantly to the therapeutic effect of tolterodine. The effect of treatment can be expected within 4 weeks.</p>', '<p>The recommended dose for tolterodine is 2 mg twice daily. In case of troublesome side effects the dose may be reduced from 2 mg to 1 mg twice daily.<br />\r\n<br />\r\nThe recommended total daily dose of tolterodine is 2 mg (1 mg b.i.d.) for patients with impaired renal function, impaired liver function, or receiving concomitant medication with potent CYP3A inhibitors, such as macrolide antibiotics (e.g. erythromycin and clarithromycin) or azole antifungal agents (e.g. ketoconazole, itraconazole and miconazole). After six months the need for further treatment should be considered.</p>', '<p>Pharmacokinetic interactions are possible with other drugs metabolised by or inhibiting cytochrome P450 2D6 (CYP2D6) or CYP3A4. Concomitant treatment with fluoxetine does not result in a clinically significant interaction.<br />\r\n<br />\r\nKetoconazole, a potent inhibitor of CYP3A, significantly increased plasma concentrations of tolterodine when coadministered to poor metabolisers (i.e. persons devoid of CYP2D6 metabolic pathway).<br />\r\n<br />\r\nClinical studies have shown no interactions with warfarin or combined oral contraceptives (ethinyloestradiol or levonorgestrel).</p>', '<p>Tolterodine is contraindicated in those patients with urinary retention, uncontrolled narrow angle glaucoma, known hypersensitivity to tolterodine or any other component of the drug.</p>', '<p>Tolterodine may cause mild to moderate antimuscarinic effects, like dryness of mouth, dyspepsia and/or reduced lacrimation.</p>', '<p>There are no studies in pregnant women. Therefore, tolterodine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\nUse of tolterodine during lactation should be avoided since no data on excretion of the drug into breast milk in humans is available.</p>', '<p>Tolterodine should be used with caution in the following patients:</p>\r\n\r\n<ul>\r\n	<li>at risk for urinary retention</li>\r\n	<li>at risk for decreased gastrointestinal motility</li>\r\n	<li>with impaired renal function</li>\r\n	<li>with impaired hepatic function</li>\r\n</ul>\r\n\r\n<p>Organic reasons for urge and frequency should be considered before treatment.</p>', '<p>Overdosage with Tolterodine Tartrate capsules can potentially result in severe central anticholinergic effects and should be treated accordingly. ECG monitoring is recommended in the event of overdosage.</p>', '<p>BPH/ Urinary retention/ Urinary incontinence.</p>', '<p>Store in a cool and dry place. Protect from light. Keep out of the reach of children.</p>', '<p><strong>Pediatric use:</strong>&nbsp;Safety and effectiveness of tolterodine in children have not been established.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: No overall differences in safety were observed between the older and younger&nbsp;patients treated with Tolterodine.</p>', '2022-03-21 23:44:15', '2022-03-21 23:44:15'),
(1508, 1508, '<p>Tolvaptan is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Hypervolemic or euvolemic hyponatremia.</li>\r\n	<li>Autosomal dominant polycystic kidney disease.</li>\r\n</ul>', '<p>Tolvaptan is a selective vasopressin V2-receptor antagonist. Tolvaptan affinity for the V2-receptor is 29 times greater than for the V1a-receptor. When taken orally, 15 to 60 mg doses of Tolvaptan antagonize the effect of vasopressin and cause an increase in urine water excretion that results in an increase in free water clearance (aquaresis), a decrease in urine osmolality, and a resulting increase in serum sodium concentrations. Urinary excretion of sodium and potassium and plasma potassium concentrations are not significantly changed.</p>', '<p><strong>Hypervolemic or euvolemic hyponatremia</strong>: The usual starting dose for Tolvaptan is 15 mg administered once daily without regard to meals. Increase the dose to 30 mg once daily, after at least 24 hours, to a maximum of 60 mg once daily, as needed to achieve the desired level of serum sodium. Do not use for more than 30 days due to the risk of hepatotoxicity.<br />\r\n<br />\r\n<strong>Autosomal dominant polycystic kidney disease (ADPKD)</strong>:</p>\r\n\r\n<ul>\r\n	<li>Initially: 60 mg/day in divided doses (given as 45 mg upon wakening and 15 mg 8 hours later);</li>\r\n	<li>Titrate per response and tolerability at intervals of at least 7 days between titrations to 90 mg/day in divided doses (given as 60 mg upon wakening and 30 mg 8 hours later) followed by 120 mg/day in divided doses (given as 90 mg upon wakening and 30 mg 8 hours later).</li>\r\n	<li>Maintain urine osmolality of &lt;300 mOsm/kg if possible; if the maximum dose is not tolerated, administration of a lower dose with the goal of achieving urine osmolality of 250 to 300 mOsm/kg is reasonable.</li>\r\n</ul>', '<p>Other Drugs Affecting Exposure to Tolvaptan:</p>\r\n\r\n<ul>\r\n	<li><strong>CYP 3A Inhibitors</strong>: Tolvaptan is a substrate of CYP 3A. CYP 3A inhibitors can lead to a marked increase in Tolvaptan concentrations. Do not use Tolvaptan with strong inhibitors of CYP 3A and avoid concomitant use with moderate CYP 3A inhibitors.</li>\r\n	<li><strong>CYP 3A Inducers</strong>: Avoid co-administration of CYP 3A inducers (e.g., Rifampin, Rifabutin, Rifapentin, Barbiturates, Phenytoin, Carbamazepine) with Tolvaptan, as this can lead to a reduction in the plasma concentration of Tolvaptan and decreased effectiveness of Tolvaptan treatment. If co-administered with CYP 3A inducers, the dose of Tolvaptan may need to be increased.</li>\r\n	<li><strong>P-gp Inhibitors</strong>: The dose of Tolvaptan may have to be reduced when Tolvaptan is co-administered with P-gp inhibitors, e.g., Cyclosporine.</li>\r\n</ul>', '<p>Hypersensitivity to the active substance or to any of the excipients, anuria, volume depletion, hypovolemic hyponatremia, hypernatremia, Patients who cannot perceive thirst, pregnancy, breast-feeding.</p>', '<p>The most common side effects of Tolvaptan are: thirst, dry mouth, weakness, constipation, making large amounts of urine and urinating often &amp; increased blood sugar levels.</p>', '<p>There are no or limited amount of data from the use of Tolvaptan in pregnant women. Studies in animals have shown reproductive toxicity. The potential risk for humans is unknown. Tolvaptan is contraindicated during pregnancy. Women of childbearing potential have to use effective contraception during Tolvaptan treatment. It is unknown whether Tolvaptan is excreted in human milk.</p>', '<p>Too rapid correction of serum sodium can cause serious neurologic sequelae.</p>', '<p>Single doses up to 480 mg and multiple doses up to 300 mg per day for 5 days have been well tolerated in clinical trials in healthy volunteers. There is no specific antidote for Tolvaptan intoxication. The signs and symptoms of an acute overdose can be anticipated to be those of excessive pharmacologic effect: a rise in serum sodium concentration, polyuria, thirst and dehydration/ hypovolemia (profuse and prolonged aquaresis). In patients with suspected Tolvaptan overdose, assessment of vital signs, electrolyte concentrations, ECG and fluid status is recommended. Appropriate replacement of water and/or electrolytes must continue until aquaresis abates. Dialysis may not be effective in removing Tolvaptan because of its high binding affinity for human plasma protein (&gt;98%).</p>', '<p>Selective vasopressin V2-receptor antagonist.</p>', '<p>Store at below 25&deg;C in a dry place, protected from light. Keep out of reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of Tolvaptan in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Of the total number of hyponatremic subjects treated with Tolvaptan in clinical studies, 42% were 65 and over, while 19% were 75 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Increasing age has no effect on Tolvaptan plasma concentrations.<br />\r\n<br />\r\n<strong>Use in Patients with Hepatic Impairment</strong>: Moderate and severe hepatic impairment do not affect exposure to Tolvaptan to a clinically relevant extent. Avoid use of Tolvaptan in patients with underlying liver disease.<br />\r\n<br />\r\n<strong>Use in Patients with Renal Impairment</strong>: No dose adjustment is necessary based on renal function. There are no clinical trial data in patients with CrCl&lt;10 ml/min, and, because drug effects on serum sodium levels are likely lost at very low levels of renal function, use in patients with a CrCl&lt;10 ml/min is not recommended. No benefit can be expected in patients who are anuric.<br />\r\n<br />\r\n<strong>Use in Patients with Congestive Heart Failure</strong>: The exposure to Tolvaptan in patients with congestive heart failure is not clinically relevantly increased. No dose adjustment is necessary.</p>', '2022-03-21 23:46:25', '2022-03-21 23:46:25');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1509, 1509, '<p><strong>Epilepsy</strong>: Topiramate is indicated as monotherapy in adults and children aged 6 years and above with newly diagnosed epilepsy who have generalised tonic-clonic seizures or partial seizures with or without secondarily generalised seizures. Topiramate is indicated as adjunctive therapy for adults and children over 2 years of age who are inadequately controlled on conventional first line antiepileptic drugs for partial seizures with or without secondarily generalised seizures; seizures associated with Lennox Gastaut Syndrome and primary generalised tonic-clonic seizures.<br />\r\n<br />\r\n<strong>Migraine</strong>: Topiramate is indicated in adults for the prophylaxis of migraine headache. Prophylactic treatment of migraine may be considered in situations such as: adults experiencing three or more migraine attacks per month; frequent migraine attacks that significantly interfere with the patient&#39;s daily routine. Continuing therapy should be reviewed every six months.</p>', '<p>A seizure is an abnormal and unregulated electrical discharge occurring in the brain. This leads to a transient interruption in brain function, manifested by reduced alertness, abnormal sensations, and focal involuntary movements or convulsions. Several types of seizures exist, with common types including tonic-clonic seizures and partial onset seizures.<br />\r\n<br />\r\nThe exact mechanisms by which topiramate exerts pharmacological actions on seizures and migraines are currently not fully characterized. Several properties of this drug, however, are likely to contribute to its therapeutic effects. Topiramate has been observed to exert actions on voltage-dependent sodium channels, GABA receptors, and glutamate receptors.<br />\r\n<br />\r\nTopiramate stimulates GABA-A receptor activity at brain non-benzodiazepine receptor sites and reduces glutamate activity at both AMPA and kainate receptors. Normally, GABA-A receptors are inhibitory and glutaminergic receptors are stimulatory for neuronal activity. By increasing GABA activity and inhibiting glutamate activity, topiramate blocks neuronal excitability, preventing seizures and migraines. Additionally, it blocks the voltage-dependent sodium channels, further blocking seizure activity. Topiramate has been shown to inhibit various carbonic anhydrase isozymes, but the clinical significance of this is unknown at this time.</p>', '<p>Epilepsy: Monotherapy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children over 16 year</strong>s: Titration should begin at 25 mg nightly for 1 week. The dosage should then be increased at 1- or 2-week intervals by increments of 25 or 59 mg/day, administered in two divided doses. The recommended initial target dose for topiramate monotherapy in adults with newly diagnosed epilepsy is 100 mg/day and the maximum recommended daily dose is 400 mg.</li>\r\n	<li><strong>Children aged 6-16 years</strong>: Treatment of children aged 6 years and above should begin at 0.5 to 1 mg/kg nightly for the first week. The dosage should then be increased at 1- or 2-week intervals by increments of 0.5 to 1 mg/kg/day, administered in two divided doses. The recommended initial target dose range for topiramate monotherapy in children with newly diagnosed epilepsy aged 6 years and above is 3 to 6 mg/kg/day. Higher doses have been tolerated and rarely doses up to 16 mg/kg/day have been given.</li>\r\n</ul>\r\n\r\n<p>Epilepsy: Adjunctive therapy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children over 16 years</strong>: The minimal effective dose as adjunctive therapy is 200 mg per day. The usual total daily dose is 200 mg to 400 mg in two divided doses. Some patients may require doses up to 800 mg per day, which is the maximum recommended dose.</li>\r\n	<li><strong>Children aged 2-16 years</strong>: The recommended total daily dose of Topiramate as adjunctive therapy is approximately 5 to 9 mg/kg/day in two divided doses. Titration should begin at 25 mg nightly for the first week. The dosage should then be increased at 1- or 2-week intervals by increments of 1 to 3 mg/kg/day (administered in two divided doses), to achieve optimal clinical response. Dose titration should be guided by clinical outcome. Daily doses up to 30 mg/kg/day have been studied and were generally well tolerated.</li>\r\n</ul>\r\n\r\n<p>Migraine:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children over 16 years</strong>: Titration should begin at 25 mg nightly for 1-week. The dosage should then be increased in increments of 25 mg/day administered at 1-week intervals. The recommended total daily dose of topiramate as treatment for the prophylaxis of migraine headache is 100 mg/day administered in two divided doses. Some patients may experience a benefit at a total daily dose of 50 mg/day.</li>\r\n	<li><strong>Children</strong>: Topiramate in migraine prophylaxis has not been studied in children under 16 years.</li>\r\n</ul>', '<p>The addition of topiramate to other antiepileptic drugs (phenytoin, carbamazepine, valproic add, phenobarbitai, primidone) has no clinically significant effect on their steady-state plasma concentrations, except in some patients where the addition of topiramate to phenytoin may result in an increase of plasma concentrations of phenytoin.<br />\r\n<br />\r\n<strong>CNS Depressants</strong>: Topiramate should be used with caution if used in combination with alcohol and other CNS depressants.<br />\r\n<br />\r\n<strong>Oral Contraceptives</strong>: In an interaction study with a combined oral contraceptive, Topiramate increased plasma clearance of the oestrogenic component significantly. Consequently, and bearing in mind the potential risk of teratogenicity, patients should receive a preparation containing not less than 50 &mu;g of oestrogen or use some alternative non-hormonal method of contraception. Patients taking oral contraceptives should be asked to report any change in their bleeding patterns.<br />\r\n<br />\r\n<strong>Lithium</strong>: In patients with bipolar disorder, the pharmacokinetics of lithium were unaffected during treatment with Topiramate at doses of 200 mg/day; however, there was an observed increase in systemic exposure (26% for AUC) following Topiramate doses of up to 600 mg/day. Lithium levels should be monitored when co-administered with Topiramate.<br />\r\n<br />\r\n<strong>Hydrochlorothiazide</strong>&nbsp;(HCTZ): The steady-state pharmacokinetics of HCTZ were not significantly influenced by the concomitant administration of Topiramate. Clinical laboratory results indicated decreases in serum potassium after Topiramate or HCTZ administration, which were greater when HCTZ and Topiramate were administered in combination.<br />\r\n<br />\r\n<strong>Metformin</strong>: Topiramate did not affect metformin tmax. The clinical significance of the effect of topiramate on metformin pharmacokinetics is unclear. Oral plasma clearance of topiramate appears to be reduced when administered with metformin. The clinical significance of the effect of metformin on topiramate pharmacokinetics is unclear. When Topiramate is added or withdrawn in patients on metformin therapy, careful attention should be given to the routine monitoring for adequate control of their diabetic disease state.<br />\r\n<br />\r\n<strong>Pioglitazone</strong>: When Topiramate is added to pioglitazone therapy or pioglitazone is added to Topiramate therapy, careful attention should be given to the routine monitoring of patients for adequate control of their diabetic disease state.<br />\r\n<br />\r\n<strong>Glibenclamide</strong>: The steady-state pharmacokinetics of Topiramate were unaffected by concomitant administration of glibenclamide. When Topiramate is added to glibenclamide therapy or glibenclamide is added to Topiramate therapy, careful attention should be given to the routine monitoring of patients for adequate control of their diabetic disease state.<br />\r\n<br />\r\n<strong>Others</strong>: Topiramate, when used concomitantly with other agents predisposing to nephrolithiasis, may increase the risk of nephrolithiasis. While using Topiramate, agents like these should be avoided since they may create a physiological environment that increases the risk of renal stone formation. The interaction with benzodiazepines has not been studied.&nbsp;<br />\r\n<br />\r\n<strong>Valproic Acid</strong>: Concomitant administration of Topiramate and valproic acid has been associated with hyperammonemia with or without encephalopathy in patients who have tolerated either drug alone. An association of hyperammonemia with Topiramate monotherapy or concomitant treatment with other anti epileptics has not been established.</p>', '<p>Hypersensitivity to any component of this product.</p>', '<p>Nausea, abdominal pain, dyspepsia, diarrhoea, dry mouth, taste disturbance, weight loss, anorexia, paraesthesia, hypoaesthesia, headache, fatigue, dizziness, speech disorder, drowsiness, insomnia, impaired memory &amp; concentration, anxiety, depression, visual disturbance, lesscommonly: sucidal ideation, rarely: reduced sweetening mainly children, metabolic acidosis and alopecia, very rarely: Leucopenia, thrombocytopenia and serious skin reaction.</p>', '<p>Topiramate should not be used during pregnancy unless, in the opinion of the physician, the potential benefit outweighs the potential risk to the foetus. Topiramate should not be used during breastfeeding.</p>', '<p>In patients with or without a history of seizures or epilepsy, antiepileptic drugs, including topiramate, should be gradually withdrawn to minimize the potential for seizures or increased seizure frequency. Topiramate can produce central nervous system-related adverse events and may be more sedative than other antiepileptic drugs. Drowsiness is a likelihood. In addition, there have been reports of visual disturbances/blurred vision. Patients should be warned of these and advised that if affected, they should not drive, operate machinery and/or take part in activities where such reactions could put themselves or others at risk.</p>', '<p>Topiramate overdose can result in severe metabolic acidosis. In acute topiramate overdose, if the ingestion is recent, the stomach should be emptied immediately by lavage or by induction of emesis. Activated charcoal has been shown to adsorb topiramate in vitro. Treatment should be appropriately supportive. Haemodialysis has been shown to be an effective means of removing topiramate from the body. The patient should be well hydrated.</p>', '<p>Adjunct anti-epileptic drugs.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-21 23:48:30', '2022-03-21 23:48:30'),
(1510, 1510, '<p><strong>Ovarian Cancer</strong>: Topotecan for injection, as a single agent, is indicated for the treatment of patients with metastatic&nbsp;carcinoma&nbsp;of the ovary after disease progression on or after initial or subsequent&nbsp;chemotherapy.<br />\r\n<br />\r\n<strong>Small Cell Lung Cancer</strong>: Topotecan for injection, as a single agent, is indicated for the treatment of patients with small cell&nbsp;lung cancer&nbsp;with platinum-sensitive disease who progressed at least 60 days after initiation of first-line chemotherapy.<br />\r\n<br />\r\n<strong>Cervical Cancer</strong>: Topotecan for injection in combination with&nbsp;cisplatin&nbsp;is indicated for the treatment of patients with Stage IV-B,&nbsp;recurrent, or persistent carcinoma of the&nbsp;cervix&nbsp;not amenable to curative treatment.</p>', '<p>Topotecan has the same mechanism of action as irinotecan and is believed to exert its cytotoxic effects during the S-phase of DNA synthesis. Topoisomerase I relieves torsional strain in DNA by inducing reversible single strand breaks. Topotecan binds to the topoisomerase I-DNA complex and prevents religation of these single strand breaks. This ternary complex interferes with the moving replication fork, which leads to the induction of replication arrest and lethal double-stranded breaks in DNA. As mammalian cells cannot efficiently repair these double strand breaks, the formation of this ternary complex eventually leads to apoptosis (programmed cell death).<br />\r\n<br />\r\nTopotecan mimics a DNA base pair and binds at the site of DNA cleavage by intercalating between the upstream (-1) and downstream (+1) base pairs. Intercalation displaces the downstream DNA, thus preventing religation of the cleaved strand. By specifically binding to the enzyme&ndash;substrate complex, Topotecan acts as an uncompetitive inhibitor.</p>', '<p>Verify dose using&nbsp;body surface area&nbsp;prior to dispensing. Recommended dosage should generally not exceed 4 mg intravenously&nbsp;<br />\r\n<br />\r\n<strong>Ovarian Cancer</strong>: The recommended dose of Topotecan is 1.5 mg/m&sup2; by intravenous infusion over 30 minutes daily for 5 consecutive days, starting on Day 1 of a 21-day course.<br />\r\n<br />\r\n<strong>Small Cell Lung Cancer</strong>: The recommended dose of Topotecan is 1.5 mg/m&sup2; by intravenous infusion over 30 minutes daily for 5 consecutive days, starting on Day 1 of a 21-day course.<br />\r\n<br />\r\n<strong>Cervical Cancer</strong>: The recommended dose of Topotecan is 0.75 mg/m&sup2; by intravenous infusion over 30 minutes daily on Days 1, 2, and 3 in combination with cisplatin 50 mg/m&sup2; on Day 1, repeated every 21 days.</p>', '<p>Increased clearance with phenytoin. G-CGF to be given 24 hr after completion of treatment with topotecan as concurrent admin may prolong duration of neutropenia. Increased bone marrow supression with other cytotoxic drugs (e.g. cisplatin) so dose reduction may be needed.</p>', '<p>Severe bone marrow depression (e.g. baseline neutrophil count of &lt;1500 cells/mm3&nbsp;and platelet count &lt;100,000/mm3). Pregnancy, lactation, severe renal or hepatic impairment.</p>', '<p>Neutropenia (nadir of white cell count occurs about 9-12 days after admin), thrombocytopenia and anaemia. GI upset, total alopecia, headache, dyspnoea. Fatigue, weakness, malaise, pruritus and hyperbilirubinaemia.</p>', '<p>Pregnancy category D. There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Preexisting bone marrow depression. Frequent monitoring of peripheral blood cell counts during treatment. Do not continue subsequent courses until neutrophils recover to &gt;1000 cells/mm3, platelets recover to &gt;100,000 cells/mm3&nbsp;and haemoglobin levels recover to 9.0 g/dl (with transfusion if needed). May impair ability to drive or operate machinery.</p>', '<p>Symptoms: Bone marrow supression.</p>', '<p>Cytotoxic Chemotherapy.</p>', '<p>Unopened vial: Store at 20-25&deg;C; protect from light. Reconstituted solution: Stable for 24 hr at 20-25&deg;C in ambient light.</p>', '<p><strong>Renal Impairment:</strong></p>\r\n\r\n<ul>\r\n	<li>Ovarian carcinoma, Small cell lung cancer: CrCl 20-30: Initial dose 0.75 mg/m2.</li>\r\n	<li>Cervical cancer:&nbsp;Treatment to be initiated only if serum creatinine &le;1.5 mg/dl.</li>\r\n</ul>\r\n\r\n<p><strong>Hepatic Impairment</strong>: Avoid</p>', '2022-03-21 23:50:52', '2022-03-21 23:50:52'),
(1511, 1511, '<p>Torasemide is indicated for the management of edema of cardiac, renal and hepatic origin.The management of hypertension, as a sole therapeutic agent or in combination with other classes of antihypertensive agents.</p>', '<p>Torasemide inhibits the Na+/K+/2CI-&nbsp;carrier system (via interference of the chloride binding site) in the lumen of the thick ascending portion of the loop of Henle, resulting in a decrease in reabsorption of sodium and chloride. This results in an increase in the rate of delivery of tubular fluid and electrolytes to the distal sites of hydrogen and potassium ion secretion, while plasma volume contraction increases aldosterone production. The increased delivery and high aldosterone levels promote sodium reabsorption at the distal tubules, and By increasing the delivery of sodium to the distal renal tubule, torasemide indirectly increases potassium excretion via the sodium-potassium exchange mechanism. Torasemide&#39;s effects in other segments of the nephron have not been demonstrated. Thus torasemide increases the urinary excretion of sodium, chloride, and water, but it does not significantly alter glomerular filtration rate, renal plasma flow, or acid-base balance. Torasemide&#39;s effects as a antihypertensive are due to its diuretic actions. By reducing extracellular and plasma fluid volume, blood pressure is reduced temporarily, and cardiac output also decreases.</p>', '<p><strong>Congestive heart failure:</strong>&nbsp;The usual initial oral dose is 10 mg or 20 mg once daily. If the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Single doses higher than 200 mg have not been adequately studied.<br />\r\n<br />\r\n<strong>Chronic renal failure</strong>: The usual initial oral dose is 20 mg once daily. lf the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Single doses higher than 200mg have not been adequately studied.<br />\r\n<br />\r\n<strong>Hepatic cirrhosis</strong>: The usual initial oral dose is 5 mg or 10 mg once daily, administered together with an aldosterone antagonist or a potassium sparing diuretic. If the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Single doses higher than 40 mg have not been adequately studied. Chronic use of any diuretic in hepatic disease has not been studied in adequate and well-controlled trials.<br />\r\n<br />\r\n<strong>Hypertension</strong>: The usual initial oral dose is 2.5-5 mg once daily. If the 5 mg dose does not provide adequate reduction of blood pressure within 4 to 6 weeks, the dose may be increased to 10 mg once daily. If the response to 10 mg is insufficient, an additional antihypertensive should be added to the treatment regimen.</p>', '<p>Increased risk of severe hypokalaemia with amphotercin B, corticosteroids, carbenoxolone, hypokalaemia-causing medications. Increased risk of lithium toxicity. Increased potential for ototoxicity and nephrotoxicity with nephrotoxic or ototoxic medications e.g. aminoglycosides. High dose salicylates may increase the risk of salicylate toxicity. Increased risk of toxicity with digoxin. Reduced diuretic effect with NSAIDs. Increased risk of hypotension with antihypertensives.</p>', '<p>Torasemide is contraindicated in patients with known hypersensitivity to torasemide and other sulfonyl ureas. It is also contraindicated in patients who are anuric.</p>', '<p>Usually torasemide is well tolerated. However, a few side effects like dry mouth, dizziness, tiredness, skin rash, diarrhea, constipation, nausea, vomiting, orthostatic hypotention and muscle cramp may occur. All side effects usually are mild and transient.</p>', '<p><strong>Pregnancy</strong>: Adequate and well controlled studies of torasemide have not been carried out in pregnant woman. Because animal reproduction studies are not always predictive of human response, torasemide can be used during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Nursing Mother:</strong>&nbsp;lt is not known whether torasemide is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when torasemide is administered to a nursing mother.</p>', '<p>Precautions should be taken while torasemide is administered in the conditions like diabetes, gout, hypotension and liver failure.</p>', '<p>There is no human experience of overdoses of torasemide, but the signs and symptoms of overdosage can be anticipated to be those of excessive pharmacological effect: dehydration, hypovolemia, hypotension and hypokalemia. Treatment of overdose should consist of fluid and electrolyte supplement.</p>', '<p>Loop diuretics</p>', '<p>Store Torasemide at room temperature less than 30&deg; C and keep in cool and dry place, away from moisture and sunlight. Keep the medicine out of the reach of children.</p>', '<p><strong>Use in children</strong>: Safety and efficacy of torasemide in children have not been established.</p>', '2022-03-21 23:52:35', '2022-03-21 23:52:35'),
(1512, 1512, '<p>Torsemide is indicated for the treatment of edema associated with congestive heart failure, renal disease, or hepatic disease. Torsemide is indicated for the treatment of hypertension alone or in combination with other antihypertensive agents.</p>', '<p>Torsemide acts within the lumen of the thick ascending portion of the loop of Henle, where it inhibits the Na+/K+/2CI carrier system. Torsemide increases the urinary excretion of sodium, chloride and water, but it does not significantly alter glomerular filtration rate, renal plasma flow or acid-base balance.</p>', '<p><strong>Edema associated with heart failure</strong>: The recommended initial dose is Torsemide 10 mg or 20 mg once daily. If the diuretic response is inadequate, titrate upward by approximately doubling until the desired diuretic response is obtained.<br />\r\n<br />\r\n<strong>Edema associated with chronic renal failure</strong>: The recommended initial dose is Torsemide 20 mg once daily. If the diuretic response is inadequate, titrate upward by approximately doubling until the desired diuretic response is obtained.<br />\r\n<br />\r\n<strong>Edema associated with hepatic cirrhosis</strong>: The recommended initial dose is Torsemide 5 mg or 10 mg once daily, administered together with an aldosterone antagonist or a potassium-sparing diuretic. If the diuretic response is inadequate, titrate upward by approximately doubling until<br />\r\nthe desired diuretic response is obtained.<br />\r\n<br />\r\n<strong>Treatment of Hypertension</strong>: The recommended initial dose is 5 mg once daily. If the 5 mg dose does not provide adequate reduction in blood pressure within 4 to 6 weeks, increase to 10 mg once daily. If the response to 10 mg is insufficient, add another antihypertensive agent to the treatment regimen.</p>', '<p>Patients receiving high doses of salicylates may experience salicylate toxicity when Torsemide is concomitantly administered. If Torsemide and cholestyramine should be co-administered, administer Torsemide at least one hour before or 4 to 6 h after cholestyramine administration. Also, coadministration of Torsemide with ACE inhibitors or Angiotensin receptor blockers can increase the risk of hypotension and renal impairment.</p>', '<p>Torsemide is contraindicated in patients with known hypersensitivity to Torsemide. It is contraindicated in patients who are anuric or with hepatic coma.</p>', NULL, '<p>Pregnancy Category: B<br />\r\n<br />\r\nUse in Lactation: It is not known whether Torsemide is excreted in human milk. Caution should be exercised when Torsemide is administered to a nursing woman.</p>', '<p><strong>Hypotension</strong>: Excessive diuresis may cause potentially symptomatic dehydration, blood volume reduction and hypotension.<br />\r\n<br />\r\n<strong>Electrolyte and Metabolic Abnormalities</strong>: Torsemide can cause symptomatic hypokalemia, hyponatremia and hypochloremic alkalosis.</p>', NULL, '<p>Loop diuretics</p>', '<p>Protect from light and moisture. Store below 30&deg;C. Keep the medicine out of reach of children.</p>', NULL, '2022-03-21 23:54:05', '2022-03-21 23:54:05'),
(1513, 1513, '<p>Tramadol is used for the treatment of moderate to severe painful conditions. These include:</p>\r\n\r\n<ul>\r\n	<li>Postoperative pain</li>\r\n	<li>Colic and spastic pain</li>\r\n	<li>Cancer pain</li>\r\n	<li>Joint pain</li>\r\n	<li>Neck and back pain</li>\r\n	<li>Pain associated with osteoporosis.</li>\r\n</ul>', '<p>Tramadol is a centrally acting synthetic analgesic compound. It inhibits the re uptake of neurotransmitters- serotonin and noradrenaline. Thus it modifies the transmission of pain impulses by activating both descending serotonergic pathways and noradrenergic pathways involved in analgesia. The analgesic effects of Tramadol are mediated via stimulation of mu-opioid receptors and indirect modulation of central monoaminergic inhibitory pathways.</p>', '<p><strong>Capsule or Tablet</strong>: Usual doses are 50 to 100 mg every four to six hours. For acute pain an initial dose of 100 mg is required. For chronic painful conditions an initial dose of 50 mg is recommended. Subsequent doses should be 50 to 100 mg administered 4-6 hourly. The dose level and frequency of dosing will depend on the severity of the pain.The total daily dosage by mouth should not exceed 400 mg.<br />\r\n<br />\r\n<strong>Sustained Release Capsule&nbsp;or Tablet</strong>: One SR capsule&nbsp;or tablet every 12 hours, for example first one in the morning and then at the same time in the evening. The number of capsules taken at a time will depend upon severity of pain, but it should not be taken more frequently than every 12 hours.The total daily dosage by mouth should not exceed 400 mg.<br />\r\n<br />\r\n<strong>Injection</strong>: A dose of 50-100 mg may be given every 4 to 6 hours by intramuscular or by intravenous infusion. For the treatment of postoperative pain,the initial dose is 100 mg followed by 50 mg every 10 to 20 minutes if necessary to a maximum of 250 mg in the first hour. Thereafter, doses are 50 to 100 mg every 4 to 6 hours up to a total daily dose of 600 mg.<br />\r\n<br />\r\n<strong>Suppository</strong>: Tramadol suppository should be administered rectally. For adults usual dose is 100 mg Tramadol Hydrochloride 6 hourly. In general, 400 mg Tramadol Hydrochloride (4 Tramadol suppository) per day sufficient. However, for the treatment of Cancer pain and severe pain after operations much higher daily doses can be used.</p>', '<p>In general, physician need not be concerned about drugs interacting with Tramadol. The monoamine oxidase (MAO) inhibitors represent the only drug class not recommended for combination with Tramadol. Concomitant administration of carbamazepine with Tramadol causes a significant increase in Tramadol metabolism and it requires to increase the dose of Tramadol.</p>', '<p>Tramadol is contraindicated in persons having hypersensitivity to this drug. It is also contraindicated in acute intoxication with alcohol, hypnotics, centrally acting analgesics, opioids or psychotropic drugs.</p>', '<p>Commonly occurring side-effects are dizziness/vertigo, nausea, constipation, headache, somnolence, vomiting, pruritus, CNS stimulation, asthenia, sweating, dyspepsia, dry mouth, diarrhoea. Less commonly occurring side-effects include malaise, allergic reaction, weight loss, vasodilatation, palpitations, abdominal pain, anorexia, flatulence, GI bleeding, hepatitis, stomatitis etc.</p>', '<p>Safe use of Tramadol in pregnancy has not been established. Tramadol has been shown to cross the placenta. There are no adequate and well-controlled studies in pregnant women. Therefore, Tramadol should be used during pregnancy only if the potential benefit justifies the risk to the foetus. Tramadol Hydrochloride should not be administered during breast feeding as Tramadol and its metabolites have been detected in breast milk.</p>', '<p><strong>Respiratory depression:</strong>&nbsp;When large doses of tramadol are administered with anaesthetic with anaesthetic medications or alcohol, respiratory depression may result. Therefore, tramadol should be administered cautiously in patients at risk for respiratory depression.<br />\r\n<br />\r\n<strong>Opioid dependence</strong>: Tramadol is not recommended for patients who are dependent on opioids.<br />\r\n<br />\r\n<strong>Concomitant CNS depressants:</strong>&nbsp;Tramadol should be used with caution and in reduced dosages when administering to patients receiving CNS depressants such as alcohol, opioids, anesthetic agents, phenothiazines, tranquilizers or sedative hypnotics.<br />\r\n<br />\r\n<strong>Concomitant MAO inhibitors</strong>: Tramadol should be used with great caution in patients taking MAO inhibitors, since tramadol inhibits the uptake of norepinephrine and serotonin.<br />\r\n<br />\r\nTramadol should be used with caution in patients with increased intracranial pressure or head injury and patients with acute abdominal conditions.</p>', NULL, '<p>Opioid analgesics</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>In children from the age of 1 year Tramadol Hydrochloride can be given in a dose of 1-2 mg/kg body weight. However,suppository (100 mg Tramadol Hydrochloride) should not be administered in children and adolescents below the age of 14 years. Tramadol Hydrochloride 100 mg SR Capsules have not been studied in children. Therefore, safety and efficacy have not been established and the product should not be used in children.</p>', '2022-03-21 23:55:44', '2022-03-21 23:55:44'),
(1514, 1514, '<p><strong>In medicine</strong>: Prophylaxis and therapy of hemophtoes, digestive hemorrhages, hemorrhagic syndromes in leukaemia, cirrhosis and hemophilia, thrombocytopenic purpura, accidents during thrombolytic therapy and transfusion.<br />\r\n<br />\r\n<strong>In surgery</strong>: Prophylaxis and antihemorrhagic therapy during operations of any type and nature and particularly in pulmonary, cardiovascular and abdominal surgery and post-operative and traumatic shock.<br />\r\n<br />\r\n<strong>In urology</strong>: Prophylaxis and antihemorrhagic therapy of prostatic, vesical and renal surgery. Hematurias.<br />\r\n<br />\r\n<strong>In obstetrics</strong>: Prophylaxis and therapy of post-partum and puerperium hemorrhages, hemorrhagic metrophathies, functional menometrorrhagias, idiopathic or IUD(lntra uterine Device) induced menorrhagias, primitive hyperfibrinolysis (abruptio placentae, premature placenta detachment) and in cervical conization.<br />\r\n<br />\r\n<strong>In otorhinolaryngology</strong>: Prophylaxis and antihemorrhagic therapy during a tonsillectomy, specialist surgery generally, epistaxis.<br />\r\n<br />\r\n<strong>In stomatology</strong>: Prophylaxis and antihemorrhagic therapy during maxillofacial operations, tooth extractions.<br />\r\n<br />\r\n<strong>In oncology (as supportive therapy)</strong>: To promote the formation of a fibrin capsule to wall off and thereby inhibit the growth of ovarian tumors. To cause regression of ascites secondary to carcinoma. To reduce bleeding during surgical interventions.</p>', '<p>This is a preparation of tranexamic acid (trans-4 aminomethyl-cyclohexanecarboxylic acid). Tranexamic acid is a substance endowed with a strong antifibrinolytic action and both in vivo and in vitro it has proved to be 10 times more active than conventional hemostatics, depending on the test. The antihemorrhagic action of tranexamic acid is essentially due to an inhibition of the plasminogen activation of both exogenous activators like streptokinase and endogenous ones like urokinase and the plasminogen tissue activator. This fact is particularly important for the clinical use of Tranexamic Acid, because it ensures an antihemorrhagic activity with an antifibrinolytic mechanism under a variety of conditions.<br />\r\n<br />\r\nThe acute toxicity of Tranexamic Acid is extremely low and chronic toxicity almost non-existent. Tranexamic Acid is well absorbed by oral route and the effect is already seen 15-30 minutes after administration. It is excreted mainly by renal route but more slowly than conventional hemostatics. These features make the Tranexamic Acid effect more lasting than those conventional hemostatics. Considerably lower single doses of Tranexamic Acid can thus be administered at greater intervals without the drug plasma levels dropping to inefficient levels of antifibrinolytic activity between one dose and the other.<br />\r\n<br />\r\nTranexamic Acid at therapeutic doses does not interfere with clotting processes and even a prolonged administration has not been seen to be accompanied by any tendency to thrombophilia.</p>', '<p>Adults-</p>\r\n\r\n<ul>\r\n	<li><strong>The usual dose</strong>: 500-1000 mg 3 times daily.</li>\r\n	<li><strong>For prophylaxis</strong>: The mean recommended daily doses are 0.5-1 gm orally, 500 mg by the parenteral (intravenous or intramuscular) route.</li>\r\n	<li><strong>For therapy of hemorrhagic manifestations</strong>: the oral dose increases to 1-3 gm given in divided doses: in cases of particular seriousness and urgency, begin by injecting an ampoule (500 mg) slowly by intravenous route and administer the necessary subsequent oral doses.</li>\r\n</ul>\r\n\r\n<p>Children-</p>\r\n\r\n<ul>\r\n	<li><strong>For prophylaxis</strong>: For every kg of body weight from 5-10 mg are orally administered daily in divided doses.</li>\r\n	<li><strong>For therapeutic purposes</strong>: The oral doses are doubled (from 10 to 20 mg/kg), while the intravenous and intramuscular treatment is begun with 10 mg/kg (=0.5 ml every 5 kg) by the slow intravenous route, continuing the oral administration up to the required dose. Where it is more convenient (e.g. in small babies) the ampoules, diluted in a little sweetened water, maybe orally administered instead of the Capsules.</li>\r\n</ul>\r\n\r\n<p>Elderly patients: No reduction in dosage is necessary unless there is evidence of renal failure.</p>', '<p>Tranexamic Acid is a synthetic Amino Acid that is incompatible with solutions containing penicillins (eg: Benzyl penicillin). Thrombolytic drugs like Streptokinase &amp; Urokinase antagonise the antifibrinolytic action of Tranexamic Acid. The potential for thrombus formation may be increased by concomitant administration of estrogen containing drugs, like oral contraceptives. Direct admixture of Tranexamic Acid with whole blood should be avoided during Transfusion.</p>', '<p>Known individual hypersensitivity to the product. Thromboembolic disease, arterial and venous thrombosis, endocavitary hemorrhages, serious kidney failure.</p>', '<ul>\r\n	<li>Tranexamic Acid is generally well tolerated; there may be infrequent cases of sense of fatigue, conjunctival irritation, nasal blockage, itching, skin reddening, exanthems.</li>\r\n	<li>After oral administration there may be sign of nausea, diarrhea, gastric pyrosis.</li>\r\n	<li>There are rare cases of postural hypotension.</li>\r\n	<li>In the case of hypersensitivity to tranexamic acid, avoid or suspend treatment and start a suitable therapy.</li>\r\n</ul>', '<p>Since the transplacental passage of the drug and its possible effects on the fetus are unknown, Tranexamic Acid should not be administered during known and presumed pregnancy. Tranexamic Acid passes into breast milk to a concentration of approximately one hundredth of the concentration in the maternal blood. An antifibrinolytic effect in the infant is unlikely.</p>', '<ul>\r\n	<li>Tranexamic Acid should be used in cases where there is hyperfibrinolysis. The prophylactic treatment must begin 24 hours before the operation and continue until 3-4 days after it.</li>\r\n	<li>The therapy of hemorrhages must be prolonged for at least 24 hours after manifestations have disappeared.</li>\r\n	<li>In hematuria, especially when this is not accompanied by any other hemorrhagic manifestations, reduce the doses to prevent formation of clots in the urinary tract.</li>\r\n	<li>Tranexamic Acid must not be used in serious renal insufficiency or anuric syndromes and must only be used with caution in less serious renal dysfunctions.</li>\r\n	<li>The administration of product requires particular care in cardiopathic and hepatopathic subjects.</li>\r\n</ul>', NULL, '<p>Anti-fibrinolytic drugs, Haemostatic drugs.</p>', '<p>Store in a dry place at 15-30&deg;C, away from light and keep out of children&#39;s reach.</p>', NULL, '2022-03-21 23:57:30', '2022-03-21 23:57:30'),
(1515, 1515, '<p><strong>Adjuvant Breast Cancer</strong>: Trastuzumab is indicated for adjuvant treatment of HER2 overexpressing node-positive or node-negative ER/PR negative or with one high-risk feature breast cancer</p>\r\n\r\n<ul>\r\n	<li>as part of a treatment regimen consisting of doxorubicin, cyclophosphamide, and either paclitaxel or docetaxel</li>\r\n	<li>as part of a treatment regimen with docetaxel and carboplatin</li>\r\n	<li>as a single agent following multi-modality anthracycline-based therapy.</li>\r\n</ul>\r\n\r\n<p><strong>Metastatic Breast Cancer</strong>: Trastuzumab is indicated:</p>\r\n\r\n<ul>\r\n	<li>In combination with paclitaxel for first-line treatment of HER2-overexpressing metastatic breast cancer</li>\r\n	<li>As a single agent for treatment of HER2-overexpressing breast cancer in a patient who has received one or more chemotherapy regimens for metastatic disease. overexpressing breast cancer in patient.</li>\r\n</ul>\r\n\r\n<p><strong>Metastatic Gastric Cancer</strong>: Trastuzumab is indicated, in combination with cisplatin and<br />\r\ncapecitabine or 5-fluorouracil, for the treatment of patients with HER2-overexpressing<br />\r\nmetastatic gastric or gastroesophageal junction adenocarcinoma who have not received<br />\r\nprior treatment for metastatic disease.</p>', '<p>The HER2 (or c-erbB2) proto-oncogene encodes a transmembrane receptor protein of 185 kDa, which is structurally related to the epidermal growth factor receptor. Trastuzumab has been shown, in both in vitro assays and in animals, to inhibit the proliferation of human tumor cells that overexpress HER2. Trastuzumab is a mediator of antibody-dependent cellular cytotoxicity (ADCC). In vitro, Trastuzumab-mediated ADCC has been shown to be preferentially exerted on HER2 overexpressing cancer cells compared with cancer cells that do not overexpress HER2.</p>', '<p><strong>Recommended Doses and Schedules</strong>: Do not administer as an intravenous push or bolus. Do not mix Trastuzumab with other drugs.<br />\r\n<br />\r\n<strong>Adjuvant Treatment, Breast Cancer</strong>: Administer according to one of the following doses and schedules for a total of 52 weeks of Trastuzumab therapy:<br />\r\n<br />\r\n<strong>During and following paclitaxel, docetaxel, or docetaxel/carboplatin</strong>:</p>\r\n\r\n<ul>\r\n	<li>Initial dose of 4 mg/kg as an intravenous infusion over 90 minutes then at 2 mg/kg as an intravenous infusion over 30 minutes weekly during chemotherapy for the first 12 weeks (paclitaxel or docetaxel) or 18 weeks (docetaxel/carboplatin).</li>\r\n	<li>One week following the last weekly dose of Trastuzumab, administer Trastuzumab at 6 mg/kg as an intravenous infusion over 30&minus;90 minutes every three weeks.</li>\r\n</ul>\r\n\r\n<p><strong>As a single agent within three weeks following completion of multi-modality, anthracycline-based chemotherapy regimens</strong>:</p>\r\n\r\n<ul>\r\n	<li>Initial dose at 8 mg/kg as an intravenous infusion over 90 minutes</li>\r\n	<li>Subsequent doses at 6 mg/kg as an intravenous infusion over 30&minus;90 minutes every three weeks.</li>\r\n	<li>Extending adjuvant treatment beyond one year is not recommended</li>\r\n</ul>\r\n\r\n<p><strong>Metastatic Treatment, Breast Cancer</strong>: Administer Trastuzumab, alone or in combination with paclitaxel, at an initial dose of 4 mg/kg as a 90 minute intravenous infusion followed by subsequent once-weekly doses of 2 mg/kg as 30-minute intravenous infusions until disease progression.<br />\r\n<br />\r\n<strong>Metastatic Gastric Cancer</strong>: Administer Trastuzumab at an initial dose of 8 mg/kg as a 90-minute intravenous infusion followed by subsequent doses of 6 mg/kg as an intravenous infusion over 30&ndash;90 minutes every three weeks until disease progression. Or, as directed by the registered physician.</p>\r\n\r\n<p><a href=\"https://medex.com.bd/news/104/danger-of-taking-medication-without-doctors-advice\" target=\"_blank\"><em>* চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন</em></a>&#39;</p>\r\n\r\n<p>Administration</p>\r\n\r\n<ul>\r\n	<li>Using a sterile syringe, slowly inject the 20 ml of diluent into the vial containing the lyophilized powder of Trastuzumab, which has a cake-like appearance. The stream of diluent should be directed into the cake. The reconstituted vial yields a solution for multiple-dose use, containing 21 mg/ml Trastuzumab.</li>\r\n	<li>Swirl the vial gently to aid reconstitution. DO NOT SHAKE.</li>\r\n	<li>Slight foaming of the product may be present upon reconstitution. Allow the vial to stand undisturbed for approximately 5 minutes.</li>\r\n	<li>Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Inspect visually for particulates and discoloration. The solution should be free of visible particulates, clear to slightly opalescent and colorless to pale yellow.</li>\r\n	<li>Store reconstituted Trastuzumab in the refrigerator at 2&deg;C to 8&deg;C, discard unused Trastuzumab after 28 days. If Trastuzumab is reconstituted with SWFI without preservative, use immediately and discard any unused portion.</li>\r\n</ul>', '<p>Patients who receive anthracycline after stopping Trastuzumab may be at increased risk of cardiac dysfunction because of Trastuzumab&rsquo;s long washout period based on population PK analysis. If possible, physicians should avoid anthracycline-based therapy for up to 7 months after stopping Trastuzumab. If anthracyclines are used, the patient&rsquo;s cardiac function should be monitored carefully.</p>', NULL, '<p>The most serious adverse reactions caused by Trastuzumab includes Cardiomyopathy, Infusion Reactions, Embryo-Fetal Toxicity, Pulmonary Toxicity, Exacerbation of Chemotherapy-Induced Neutropenia. The most common adverse reactions in patients receiving Trastuzumab in the adjuvant and metastatic breast cancer setting are fever, nausea, vomiting, infusion reactions, diarrhea, infections, increased cough, headache, fatigue, dyspnea, rash, neutropenia, anemia, and myalgia.</p>', '<p>It can cause fetal harm when administered to a pregnant woman. Verify the pregnancy status of females of reproductive potential prior to the initiation of Trastuzumab. Advise pregnant women and females of reproductive potential that exposure to Trastuzumab during pregnancy or within 7 months prior to conception can result in fetal harm. Advise females of reproductive potential to use effective contraception during treatment and for 7 months following the last dose of Trastuzumab. There is no information regarding the presence of Trastuzumab in human milk, the effects on the breastfed infant, or the effects on milk production.</p>', '<p><strong>Cardiomyopathy</strong>: Trastuzumab can cause left ventricular cardiac dysfunction, arrhythmias, hypertension, disabling cardiac failure, cardiomyopathy, and cardiac death. Trastuzumab can also cause asymptomatic decline in left ventricular ejection fraction (LVEF). There is a 4-6 fold increase in the incidence of symptomatic myocardial dysfunction among patients receiving Trastuzumab as a single agent or in combination therapy compared with those not receiving Trastuzumab. The highest absolute incidence occurs when Trastuzumab is administered with an anthracycline. Withhold Trastuzumab for &ge; 16% absolute decrease in LVEF from pre treatment values or an LVEF value below institutional limits of normal and &ge; 10% absolute decrease in LVEF from pretreatment values. The safety of continuation or resumption of Trastuzumab in patients with Trastuzumab-induced left ventricular cardiac dysfunction has not been studied.<br />\r\n<br />\r\n<strong>Cardiac Monitoring</strong>: Conduct thorough cardiac assessment, including history, physical examination, and determination of LVEF by echocardiogram or MUGA scan. The following schedule is recommended:</p>\r\n\r\n<ul>\r\n	<li>Baseline LVEF measurement immediately prior to initiation of Trastuzumab</li>\r\n	<li>LVEF measurements every 3 months during and upon completion of Trastuzumab</li>\r\n	<li>Repeat LVEF measurement at 4 week intervals if Trastuzumab is withheld for significant left ventricular cardiac dysfunction.</li>\r\n	<li>LVEF measurements every 6 months for at least 2 years following completion of Trastuzumab as a component of adjuvant therapy.</li>\r\n</ul>\r\n\r\n<p><strong>Infusion Reactions</strong>: Infusion reactions consist of a symptom complex characterized by fever and chills, and on occasion included nausea, vomiting, pain (in some cases at tumor sites), headache, dizziness, dyspnea, hypotension, rash, and asthenia. Serious and fatal infusion reactions have been reported. Severe reactions, which include bronchospasm, anaphylaxis, angioedema, hypoxia, and severe hypotension, were usually reported during or immediately following the initial infusion. However, the onset and clinical course were variable, including progressive worsening, initial improvement followed by clinical deterioration, or delayed post-infusion events with rapid clinical deterioration. For fatal events, death occurred within hours to days following a serious infusion reaction. Interrupt Trastuzumab infusion in all patients experiencing dyspnea, clinically significant hypotension, and intervention of medical therapy administered (which may include epinephrine, corticosteroids, diphenhydramine, bronchodilators, and oxygen). Patients should be evaluated and carefully monitored until complete resolution of signs and symptoms. Permanent discontinuation should be strongly considered in all patients with severe infusion reactions. There are no data regarding the most appropriate method of identification of patients who may safely be retreated with Trastuzumab after experiencing a severe infusion reaction. Prior to resumption of Trastuzumab infusion, the majority of patients who experienced a severe infusion reaction were pre-medicated with antihistamines and/or corticosteroids. While some patients tolerated Trastuzumab infusions, others had recurrent severe infusion reactions despite pre-medications.<br />\r\n<br />\r\n<strong>Embryo-Fetal Toxicity</strong>: Trastuzumab can cause fetal harm when administered to a pregnant woman. Use of Trastuzumab during pregnancy resulted in cases of oligohydramnios and oligohydramnios sequence manifesting as pulmonary hypoplasia, skeletal abnormalities, and neonatal death. Advise females of reproductive potential to use effective contraception during treatment and for 7 months following the last dose of Trastuzumab.<br />\r\n<br />\r\n<strong>Pulmonary Toxicity</strong>: Trastuzumab use can result in serious and fatal pulmonary toxicity. Pulmonary toxicity includes dyspnea, interstitial pneumonitis, pulmonary infiltrates, pleural effusions, non-cardiogenic pulmonary edema, pulmonary insufficiency and hypoxia, acute respiratory distress syndrome, and pulmonary fibrosis. Such events can occur as sequelae of infusion reactions. Patients with symptomatic intrinsic lung disease or with extensive tumor involvement of the lungs, resulting in dyspnea at rest, appear to have more severe toxicity.<br />\r\n<br />\r\n<strong>Exacerbation of Chemotherapy-Induced Neutropenia</strong>: In randomized, controlled clinical trials, the per-patient incidences of NCI-CTC Grade 3-4 neutropenia and of febrile neutropenia were higher in patients receiving Trastuzumab in combination with myelosuppressive chemotherapy as compared to those who received chemotherapy alone. The incidence of septic death was similar among patients who received Trastuzumab and those who did not.</p>', '<p>Store the vial in original carton at 2 o -8 o C. Protect from light. Keep out of the reach of children. Store reconstituted Trastuzumab in the refrigerator at 2&deg;C to 8&deg;C, discard unused Trastuzumab after 28 days. If Trastuzumab is reconstituted with SWFI without preservative, use immediately and discard any unused portion. Do not freeze. The solution of Trastuzumab for infusion diluted in 0.9% Sodium Chloride Injection, USP, should be stored at 2&deg;C to 8&deg;C for no more than 24 hours prior to use. Do not freeze.</p>', NULL, NULL, '<p>Pediatric Use: The safety and effectiveness in pediatric patients have not been established.</p>', '2022-03-21 23:59:39', '2022-03-21 23:59:39');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1516, 1516, '<p><strong>Metastatic Breast Cancer (MBC)</strong>: Trastuzumab Emtansine, as a single agent, is indicated for the treatment of patients with HER2-positive, unresectable locally advanced or metastatic breast cancer who have received prior treatment with trastuzumab and a taxane.</p>', '<p>Trastuzumab Emtansine is a HER2-targeted antibody-drug conjugate which contains the humanized anti-HER2 IgG1, trastuzumab, covalently linked to the microtubule inhibitory drug DM1 (a maytansine derivative) via the stable thioether linker MCC (4-[N-maleimidomethyl] cyclohexane-1-carboxylate). Emtansine refers to the MCC-DM1 complex. An average of 3.5 DM1 molecules are conjugated to each molecule of trastuzumab.<br />\r\n<br />\r\nConjugation of DM1 to trastuzumab confers selectivity of the cytotoxic agent for HER2-overexpressing tumor cells, thereby increasing intracellular delivery of DM1 directly to malignant cells. Upon binding to HER2, trastuzumab emtansine undergoes receptor-mediated internalization and subsequent lysosomal degradation, resulting in release of DM1-containing cytotoxic catabolites (primarily lysine-MCC-DM1).<br />\r\n<br />\r\nTrastuzumab Emtansine has the mechanisms of action of both trastuzumab and DM1.<br />\r\n<br />\r\nTrastuzumab emtansine, like trastuzumab, binds to domain IV of the HER2 extracellular domain (ECD), as well as to Fc&gamma; receptors and complement C1q. In addition, Trastuzumab Emtansine, like trastuzumab, inhibits shedding of the HER2 ECD, inhibits signaling through the phosphatidylinositol 3-kinase (PI3-K) pathway, and mediates antibody-dependent cell-mediated cytotoxicity (ADCC) in human breast cancer cells that overexpress HER2.<br />\r\n<br />\r\nDM1, the cytotoxic drug component of Trastuzumab Emtansine, binds to tubulin. By inhibiting tubulin polymerization, both DM1 and Trastuzumab Emtansine cause cells to arrest in the G2/M phase of the cell cycle, ultimately leading to apoptotic cell death. Results from in vitro cytotoxicity assays show that DM1 is 20&ndash;200 times more potent than taxanes and vinca alkaloids.<br />\r\n<br />\r\nThe MCC linker is designed to limit systemic release and increase targeted delivery of DM1, as demonstrated by detection of very low levels of free DM1 in plasma.</p>', '<p><strong>Recommended Doses And Schedules</strong>: The recommended dose of Trastuzumab Emtansine is 3.6 mg/kg given as an intravenous infusion every 3 weeks (21-day cycle) until disease progression or unacceptable toxicity.&nbsp;Do not administer Trastuzumab Emtansine at doses greater than 3.6 mg/kg.&nbsp;Do not substitute Trastuzumab Emtansine for or with trastuzumab. Closely monitor the infusion site for possible subcutaneous infiltration during drug administration<br />\r\n<br />\r\n<strong>First Infusion</strong>: Administer infusion over 90 minutes. Patients should be observed during the infusion and for at least 90 minutes following the initial dose for fever, chills, or other infusionrelated reactions&nbsp;<br />\r\n<br />\r\n<strong>Subsequent Infusions</strong>: Administer over 30 minutes if prior infusions were well tolerated. Patients should be observed during the infusion and for at least 30 minutes after infusion.</p>', '<p>No formal drug-drug interaction studies with trastuzumab emtansine in humans have been conducted. In vitro metabolism studies in human liver microsomes suggest that DM1, a component of trastuzumab emtansine, is metabolized mainly by CYP3A4 and, to a lesser extent, by CYP3A5. DM1 does not induce or inhibit P450-mediated metabolism in vitro. Caution should be taken when trastuzumab emtansine is co-administered with potent CYP3A inhibitors.</p>', '<p>Trastuzumab Emtansine is contraindicated in patients with a known hypersensitivity to Trastuzumab Emtansine or any of its excipients.</p>', NULL, '<p><strong>Pregnancy</strong>: There are no clinical studies of trastuzumab emtansine in pregnant women. No reproductive and developmental toxicology studies have been conducted with trastuzumab emtansine.<br />\r\n<br />\r\nTrastuzumab, a component of trastuzumab emtansine, can cause fetal harm or death when administered to a pregnant woman. In the postmarketing setting, cases of oligohydramnios, some associated with fatal pulmonary hypoplasia, have been reported in pregnant women receiving trastuzumab. Animal studies of maytansine, a closely related chemical entity of the same maytansinoid class as DM1, suggest that DM1, the microtubule inhibiting cytotoxic drug component of trastuzumab emtansine, is expected to be teratogenic and potentially embryotoxic.<br />\r\n<br />\r\nAdministration of trastuzumab emtansine to pregnant women is not recommended. Women who become pregnant must contact their doctor and should be advised of the possibility of harm to the fetus. If a pregnant woman is treated with trastuzumab emtansine, close monitoring by a multidisciplinary team is recommended.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether trastuzumab emtansine is excreted in human milk. Since many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Kadcyla, women should discontinue nursing prior to initiating treatment with trastuzumab emtansine. Women may begin nursing 7 months after concluding treatment.</p>', '<p>Patients treated with Trastuzumab Emtansine must have confirmed HER2-positive tumor status as assessed by either HER2 protein overexpression or gene amplification.</p>', NULL, '<p>Anti neoplastic preparations.</p>', '<p>Store vials at 2&deg;C-8&deg;C.</p>', '<p><strong>Pediatric Use</strong>: The safety and efficacy of Trastuzumab Emtansine in children below 18 years of age have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: There are insufficient data to establish the safety and efficacy of Trastuzumab Emtansine in patients 75 years of age or older.</p>', '2022-03-22 00:01:35', '2022-03-22 00:01:35'),
(1517, 1517, '<p>Travoprost Eye Drops is indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension who are intolerant of or insufficiently responsive to another intraocular pressure lowering medication, as monotherapy or as adjunctive therapy.</p>', '<p>Travoprost, an isopropyl ester prodrug, is a synthetic prostaglandin F2 alpha analogue that is rapidly hydrolyzed by esterases in the cornea to its biologically active free acid. The travoporst free acid is potent and highly selective for the FP prostanoid receptor.<br />\r\n<br />\r\nTravoprost free acid is a selective FP prostanoid receptor agonist and is believed to reduce intraocular pressure by increasing the drainage of aqueous humor, which is done primarily through increased uveoscleral outflow and to a lesser extent, trabecular outflow facility.</p>', '<p><strong>Use in adults</strong>: The recommended dose is one drops of Travoprost in the conjunctival sac of the affected eye (s) once daily in the evening, If more than one topical ophthalmic product is being used, the medicines must be administered at least 5 minutes apart. When substituting another ophthalmic antiglaucoma agent with Travoprost, discontinue the other agent and start the following day with Travoprost.<br />\r\n<br />\r\n<strong>Pediatric patients</strong>: The efficacy and safety of travoprost eye drops in patients below the age of 18 years have not been established.</p>', '<p>Reduced therapeutic effect with NSAIDs.</p>', '<p>Travoprost eye drops is contraindicated in patients with hypersensitive to travoprost or any excipients of this preparation.</p>', '<p>The most frequently reported treatment-related side-effect is ocular hyperaemia.</p>', '<p>There are no adequate and well-controlled clinical study En pregnant women. Travoprost should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\nIt is not known whether the drug or its metabolites are excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when travoprost is administered to a lactating woman.</p>', '<p>Travoprost should be used with caution in patients with active intraocular inflammation (iritis/uveitis). Travoprost should not be administered while wearing contact lenses. Contact lenses should be removed prior to the administration of the solution. Lenses may be reinserted 15 minutes following administration of Travoprost.</p>', NULL, '<p>Drugs for miotics and glaucoma</p>', '<p>Store in a cool, dry place and protected from light. Keep out of reach of children. Discard the container 4 weeks after opening.</p>', NULL, '2022-03-22 00:03:58', '2022-03-22 00:03:58'),
(1518, 1518, '<p>This Sterile Ophthalmic Solution is indicated for the treatment of elevated intraocular pressure in patients with open angle glaucoma or ocular hypertension who are insufficiently responsive to single therapy with prostaglandin analogue or topical beta blocker.</p>', '<p>Travoprost and Timolol reduce intraocular pressure (IOP) by complementary mechanisms of action. Travoprost is a prostaglandin analogue which reduces IOP by increasing trabecular outflow &amp; uveoscleral outflow. Timolol is a non-selective beta adrenergic receptor blocker that does not have significant intrinsic sympathomimetic, direct myocardial depressant, or local anesthetic (membrane stabilizing) activity. It lowers IOP by decreasing the formation of aqueous humor in the ciliary epithelium.</p>', '<p>Instill one drop in the conjunctival sac of the affected eye(s) once daily at about the same time each day, preferably in the evening.</p>', NULL, '<p>Contraindicated in patients who are hypersensitive to Travoprost, Timolol or any of the components of this preparation.</p>', '<p>No serious adverse reactions are reported. Most frequently reported side effects are ocular hyperemia.</p>', '<p><strong>Use in pregnancy</strong>: There are no adequate and well-controlled studies in pregnant women. It should not be used during pregnancy.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: Caution should be exercised when Travoprost + Timolol Maleate is administered to a nursing mother.</p>', '<p>For ophthalmic use only. Patients should remove their contact lenses prior to instilling this preparation and should not insert their lenses until 15 minutes after instillation of the preparation.</p>', NULL, '<p>Drugs for miotics and glaucoma.</p>', '<p>Store in a cool, dry place, away from heat and direct light. Keep out of the reach of children. Do not use more than 4 weeks after opening the bottle.</p>', '<p><strong>Use in children:</strong>&nbsp;Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Use in elderly patients:</strong>&nbsp;No overall differences in safety and effectiveness have been observed between elderly and other adult patients.</p>', '2022-03-22 00:06:20', '2022-03-22 00:06:20'),
(1519, 1519, '<p>Trelagliptin&nbsp;is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is a highly selective dipeptidyl peptidase-4 inhibitor that is typically used as an add on treatment when the first line treatment of metformin is not achieving the expected glycemic goals; though it has been approved for use as a first line treatment when metformin cannot be used.</p>', '<p>It controls blood glucose levels by selectively and continually inhibiting DPP-4, an enzyme that causes the inactivation of glucagon-like peptide-1 and glucagon-dependent insulinotropic polypeptide, incretin hormones that play an important role in blood glucose regulation. The inhibition of DPP-4 increases insulin secretion depending on blood glucose concentration, thereby controlling blood glucose levels. It is indicated for the treatment of type 2 diabetes.</p>', '<p>100 mg of Trelagliptin is administered to adults once weekly by mouth. This has lesser hypoglycemic events and 4 and 12-fold more potent than Alogliptin and Sitagliptin.</p>', NULL, '<p>Study subjects meeting any of the following criteria will not be included in this study:</p>\r\n\r\n<ul>\r\n	<li>Patients under treatment with trelagliptin for type 2 diabetes at the start of screening.</li>\r\n	<li>Patients with a diagnosis of type 1 diabetes.</li>\r\n	<li>Patients with severe renal impairment or renal failure (e.g., eGFR&nbsp;&lt;&nbsp;30&nbsp;mL/min/1.73&nbsp;m2&nbsp;or on dialysis).</li>\r\n	<li>Patients with serious heart disease or a cerebrovascular disorder, or a serious pancreatic, blood, or other disease.</li>\r\n	<li>Patients with a history of gastrointestinal resection.</li>\r\n	<li>Patients with a proliferative diabetic retinopathy.</li>\r\n	<li>Patients with malignancy.</li>\r\n	<li>Patients with a history of hypersensitivity or allergy to DPP-4 inhibitors.</li>\r\n	<li>Patients who are pregnant, breast-feeding, possibly pregnant, or planning to become pregnant.</li>\r\n	<li>Patients who may need to add or discontinue concomitant medication or change the dose during the study period.</li>\r\n	<li>Patients who will require treatment with a prohibited concomitant medication during the study period.</li>\r\n	<li>Patients participating in other clinical studies.</li>\r\n	<li>Patients assessed as ineligible for any other reason by the investigators.</li>\r\n</ul>', '<p>Among 901 domestic clinical trial cases up to the time of approval, 103 cases ( 11.4%) showed clinical results that included abnormalities and side effects. These mainly included hypoglycemia, nasopharyngitis, and elevated lipase.<br />\r\n<br />\r\nGiven the appearance of serious side effects such as hypoglycemia (0.1~5%) , administer medication in conjunction with close observation of patient status. Other DPP-4 inhibitors have been reported to present serious hypoglycemia in combination with Sulfonylurea medications as well as some cases of loss of consciousness. Moreover, decreased blood sugar from the use of this medication, once confirmed, can be remedied by giving sucrose. However, hypoglycemia resulting from a combination with glucosidase inhibitors should be treated with fructose.</p>', '<p>No study has performed in patients who are pregnant, breast-feeding, possibly pregnant, or planning to become pregnant.</p>', '<p>(provide cautious dosage to the following patients): The following patients or circumstances</p>\r\n\r\n<ul>\r\n	<li>Patients with moderate kidney function disorder</li>\r\n	<li>Patients undergoing treatment with sulfonylurea drugs or insulin medication [there are reports of severe hypotension with use in combination with other DPP-4 inhibitors]</li>\r\n	<li>Hypopituitarism or hypoadrenalism</li>\r\n	<li>Malnutrition, starvation, irregular eating patterns, insufficient eating, or hyposthenia</li>\r\n	<li>Vigorous exercise</li>\r\n	<li>Patients who consume excessive alcohol</li>\r\n</ul>', NULL, '<p>Dipeptidyl Peptidase-4 (DPP-4) inhibitor.</p>', '<p>Store at 25&deg;C; excursions permitted to 15&deg;-30&deg;C. Dispense medication in the original container to protect from exposure to high humidity and light. Keep out of the reach of children.</p>', NULL, '2022-03-22 00:08:46', '2022-03-22 00:08:46'),
(1520, 1520, '<p>Tretinoin capsules are indicated for the induction of remission in patients with acute promyelocytic leukemia (APL), French-American-British (FAB) classification M3 (including the M3 variant), characterized by the presence of the t(15;17) translocation and/or the presence of the PML/RAR&alpha; gene who are refractory to, or who have relapsed from, anthracycline chemotherapy, or for whom anthracycline-based chemotherapy is contraindicated. Tretinoin is for the induction of remission only. The optimal consolidation or maintenance regimens have not been defined, but all patients should receive an accepted form of remission consolidation and/or maintenance therapy for APL after completion of induction therapy with Tretinoin.</p>', '<p>Tretinoin is not a cytolytic agent but instead induces cytodifferentiation and decreased proliferation of APL cells in culture and in vivo. In APL patients, tretinoin treatment produces an initial maturation of the primitive promyelocytes derived from the leukemic clone, followed by a repopulation of the bone marrow and peripheral blood by normal, polyclonal hematopoietic cells in patients achieving complete remission (CR). The exact mechanism of action of tretinoin in APL is unknown.</p>', '<p>The recommended dose is 45 mg/m2/day administered as two evenly divided doses until complete remission is documented. Therapy should be discontinued 30 days after achievement of complete remission or after 90 days of treatment, whichever occurs first. If after initiation of treatment of Tretinoin the presence of the t(15;17) translocation is not confirmed by cytogenetics and/or by polymerase chain reaction studies and the patient has not responded to Tretinoin, alternative therapy appropriate for acute myelogenous leukemia should be considered. Tretinoin is for the induction of remission only. Optimal consolidation or maintenance regimens have not been determined. All patients should, therefore, receive a standard consolidation and/or maintenance chemotherapy regimen for APL after induction therapy with Tretinoin, unless otherwise contraindicated.</p>', '<p>As Tretinoin is metabolized by the hepatic P450 system, there is a potential for alteration of pharmacokinetics parameters in patients administered concomitant medications that are also inducers or inhibitors of this system. Medications that generally induce hepatic P450 enzymes include rifampicin, glucocorticoids, phenobarbital and pentobarbital. Medications that generally inhibit hepatic P450 enzymes include ketoconazole, cimetidine, erythromycin, verapamil, diltiazem and cyclosporine. To date there are no data to suggest that co-use with these medications increases or decreases either efficacy or toxicity of Tretinoin.</p>', '<p>Tretinoin is contraindicated in patients with a known hypersensitivity to Tretinoin, any of its components, or other retinoids. Tretinoin should not be given to patients who are sensitive to parabens, which are used as preservatives in the gelatin capsule.</p>', '<p>Virtually all patients experience some drug-related toxicity, especially headache, fever, weakness, and fatigue. These adverse effects are seldom permanent or irreversible nor do they usually require interruption of therapy. Some of the adverse events are common in patients with APL, including hemorrhage, infections, gastrointestinal hemorrhage, disseminated intravascular coagulation, pneumonia, septicemia, and cerebral hemorrhage. The following describes the adverse events, regardless of drug relationship, that were observed in patients treated with Tretinoin.</p>', '<p>Pregnancy Category D. Tretinoin has teratogenic and embryotoxic effects in mice, rats, hamsters, rabbits and pigtail monkeys, and may be expected to cause fetal harm when administered to a pregnant woman. Tretinoin causes fetal resorptions and a decrease in live fetuses in all animals studied. Although experience with humans administered Tretinoin is extremely limited, increased spontaneous abortions and major human fetal abnormalities related to the use of other retinoids have been documented in humans.<br />\r\n<br />\r\nNursing Mothers: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, and because of the potential for serious adverse reactions from Tretinoin in nursing infants, mothers should discontinue nursing prior to taking this drug.</p>', '<p>Tretinoin has potentially significant toxic side effects in APL patients. Patients undergoing therapy should be closely observed for signs of respiratory compromise and/or leukocytosis. Supportive care appropriate for APL patients, eg, prophylaxis for bleeding, prompt therapy for infection, should be maintained during therapy with Tretinoin.<br />\r\n<br />\r\nThere is a risk of thrombosis (both venous and arterial) which may involve any organ system, during the first month of treatment. Therefore, caution should be exercised when treating patients with the combination of Tretinoin and anti-fibrinolytic agents, such as tranexamic acid, aminocaproic acid or aprotinin.<br />\r\n<br />\r\nThe ability to drive or operate machinery might be impaired in patients treated with Tretinoin, particularly if they are experiencing dizziness or severe headache. Microdosed progesterone preparations (&quot;minipill&quot;) may be an inadequate method of contraception during treatment with Tretinoin.</p>', '<p>There has been no experience with acute overdosage in humans. The maximal tolerated dose in patients with myelodysplastic syndrome or solid tumors was 195 mg/m2 /day. The maximal tolerated dose in pediatric patients was lower at 60 mg/m2 /day. Overdosage with other retinoids has been associated with transient headache, facial flushing, cheilosis, abdominal pain, dizziness and ataxia. These symptoms have quickly resolved without apparent residual effects. There is no specific treatment in the case of an overdose, however, it is important that the patient be treated in a special hematological unit.</p>', '<p>Oral Retinoid preparations</p>', '<p>Store at 15&deg; to 30&deg;C. Protect from light.</p>', '<p><strong>Pediatric Use</strong>: There are limited clinical data on the pediatric use of Tretinoin. Of 15 pediatric patients (age range: 1 to 16 years) treated with Tretinoin, the incidence of complete remission was 67%. Safety and effectiveness in pediatric patients below the age of 1 year have not been established. Some pediatric patients experience severe headache and pseudotumor cerebri, requiring analgesic treatment and lumbar puncture for relief. Increased caution is recommended in the treatment of pediatric patients. Dose reduction may be considered for pediatric patients experiencing serious and/or intolerable toxicity; however, the efficacy and safety of Tretinoin at doses lower than 45 mg/m2 /day have not been evaluated in the pediatric population.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Of the total number of subjects in clinical studies of Tretinoin, 21.4% were 60 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.</p>', '2022-03-22 00:10:56', '2022-03-22 00:10:56'),
(1521, 1521, '<p>For topical application in the treatment of acne vulgaris in which comedones, papules and pustules predominate.</p>', '<p>Although the exact mode of action of Tretinoin is unknown, current evidence suggests that topical Tretinoin decreases cohesiveness of follicular epithelial cells with decreased microcomedo formation. Additionally Tretinoin stimulates mitotic activity and increases turnover of follicular epithelial cells, causing extrusion of the comedones, papules and pustules.</p>', '<p>This cream should be applied sparingly to the whole affected area once or twice daily. The skin should be thoroughly cleaned and dried before application. Patient should be advised that 6 to 8 weeks of treatment may be required before a therapeutic effect is observed. Moisturizers and cosmetics may be used during treatment with Tretinoin cream but should not be applied to the skin at the same time. Astringent toiletries should be avoided.</p>', '<p>Other topical acne treatments should be used with caution during treatment with Tretinoin. Particular caution should be exercised when using preparation containing a peeling agent for example benzoyl peroxide. It is also possible to apply Tretinoin and benzoyl peroxide alternately. The suggested regimens are either Tretinoin in the morning and benzoyl peroxide in the evening or the preparations should be used on alternate days.</p>', '<p>Tretinoin is contraindicated to those who are highly sensitive to any of the ingredients. This cream should not be used in patients with a personal or family history of cutaneous epithelioma (skin cancer).</p>', '<p>Initial external application of Tretinoin generally may cause burning or slight irritation, erythema and peeling at the site of application may also occur. If irritation becomes severe and persists, discontinue application and consult your physicians, if necessary.</p>', '<p>There is an inadequate evidence of the safety of topically applied Tretinoin in human pregnancy. Tretinoin has been associated with teratogenicity in human when administered systemically. So the cream should not be used during pregnancy and lactation.</p>', '<p>Avoid contact of Tretinoin with lips, mouth, eyes, eyelids, nostrils or another mucous membrane. If contact in these areas occurs, careful washing with water is recommended. Apply the cream to sensitive areas of skin, such as the neck, with caution. Do not use it on broken, eczematous or sun burned skin.</p>', NULL, '<p>Topical retinoid and related preparations.</p>', '<p>Keep out of the reach of children. Keep in a cool &amp; dry place, protect from light.</p>', NULL, '2022-03-22 00:13:54', '2022-03-22 00:13:54'),
(1522, 1522, '<p>This medication is a combination&nbsp;antibiotic&nbsp;and steroid used on the skin to treat an infection and relieve associated&nbsp;itching&nbsp;and swelling.</p>', '<p><strong>Triamcinolone</strong>&nbsp;is a fluorinated corticosteroid with anti-inflammatory, antipruritic and anti-allergic actions.<br />\r\n<br />\r\n<strong>Nystatin</strong>, a polyene antifungal antibiotic, binds to ergosterol and interferes with the permeability of cell membrane of susceptible fungi e.g Candida spp.<br />\r\n<br />\r\n<strong>Neomycin</strong>&nbsp;is an aminoglycoside, often used topically in the infections against susceptible staphylococci and other organisms.<br />\r\n<br />\r\n<strong>Gramicidin</strong>, an antibacterial substance extracted from tyrothricin, is active against many Grampositive bacteria. Used together, this combination provides a wide coverage against gram-positive, gram-negative bacteria and yeast which are responsible for most of the skin infections.</p>', '<p>This medication is for use on the skin only. Wash your hands before using. Avoid getting this product in your eyes or inside the mouth. If this occurs, wipe off the medication and rinse thoroughly with water. Do not use inside the nose unless directed by your doctor.<br />\r\n<br />\r\nClean and dry the affected area as directed. Apply a small amount of medication in a thin layer on the skin and rub in gently, usually 2 to 3 times daily or as directed by your doctor. Wash your hands after use.<br />\r\n<br />\r\nDo not bandage, wrap, or cover the treated area unless you are instructed to do so by your doctor. If this medication is applied to the groin area, do not use tight-fitting plastic pants/diapers/garments for incontinence (loss of control of your bladder or bowels). Doing so may increase the absorption of this product through the skin and increase the risk for side effects.<br />\r\n<br />\r\nDo not use large amounts of this medication, apply it more often, or use it for a longer time than directed. Your condition may not improve faster, and the risk for side effects may be increased.<br />\r\n<br />\r\nUse this medication regularly in order to get the most benefit from it. To help you remember, use it at the same times each day.<br />\r\n<br />\r\nTell your doctor if your condition does not improve or if it worsens after 1 week.</p>', '<p>Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.<br />\r\n<br />\r\nBefore using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of:</p>\r\n\r\n<ul>\r\n	<li>other products for the skin (e.g., corticosteroids/antiseptics)</li>\r\n	<li>aminoglycoside antibiotics (e.g., gentamicin, tobramycin)</li>\r\n	<li>corticosteroids taken by mouth (e.g., prednisone)</li>\r\n</ul>\r\n\r\n<p>This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.</p>', '<p>Tuberculous, viral lesions of the skin (e.g. herpes simplex and varicella); fungal lesions not susceptible to nystatin, facial rosacea, acne vulgaris or perioral dermatitis. Not to be applied to the external auditory canal in patients with perforated tympanic membranes. Do not use on extensive areas to reduce risk of systemic absorption and neomycin-induced ototoxicity. Not recommended for &lt;1 yr.</p>', '<p>Prolonged use may cause sensitivity reactions, impaired wound healing, thinning of skin, striae, telangiectasia, hirsutism, hypothalamic-pituitary-adrenal axis suppression, Cushing&#39;s syndrome.</p>', '<p>Pregnancy Category- Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Patients with established hearing loss. Avoid occlusive dressing and prolonged or recurrent use. Avoid contact with eyes or mucous membranes. If there is no clinical improvement after 7 days, discontinue use as the infection may be masked by the steroid. Limit use to 5 days if used on the face or on children &lt;1 yr. Use with caution and sparingly on inflamed or damaged skin (e.g extensive burns, trophic ulceration). Pregnancy.</p>', NULL, '<p>Triamcinolone &amp; Combined preparations.</p>', '<p>Store at room temperature between 15 and 30 degrees C, away from heat. Check the expiration date on the tube and discard any expired medication.</p>', NULL, '2022-03-22 00:17:10', '2022-03-22 00:17:10'),
(1523, 1523, '<p>Post-traumatic osteoarthritis, synovitis of osteoarthritis, rheumatoid arthritis, acute and sub-acute bursitis, epicondylitis, acute non-specific tenosynovitis, acute gouty arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile rheumatoid arthritis, pemphigus, severe erythema multiforme (Stevens-Johnson syndrome), exfoliative dermatitis, bullous dermatitis herpetiformis, severe seborrheic dermatitis, severe psoriasis, bronchial asthma, contact dermatitis, atopic dermatitis, seasonal or perennial allergic rhinitis.</p>', '<p>The antiinflammatory actions of corticosteroids are thought to involve lipocortins, phospholipase A2 inhibitory proteins which, through inhibition of arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes. Firstly, however, these glucocorticoids bind to the glucocorticoid receptors which translocate into the nucleus and bind DNA (GRE) and change genetic expression both positively and negatively. The immune system is suppressed by corticosteroids due to a decrease in the function of the lymphatic system, a reduction in immunoglobulin and complement concentrations, the precipitation of lymphocytopenia, and interference with antigen-antibody binding.</p>', '<p><strong>Adults and children over 12 years of age</strong>: Initial dose is 60 mg. Dosage is usually adjusted within the range of 40 to 80 mg. For local areas, dose for adults is up to 10 mg for smaller areas and up to 40 mg for larger areas.<br />\r\n<br />\r\n<strong>Children 6 to 12 years</strong>: Initial dose is 40 mg</p>', '<p><strong>Aminoglutethimide</strong>: Aminoglutethimide may lead to a loss of corticosteroid-induced adrenal suppression.&nbsp;<br />\r\n<br />\r\n<strong>Amphotericin B injection and potassium-depleting agents</strong>: When corticosteroids are administered concomitantly with potassium-depleting agents (ie, amphotericin B, diuretics), patients should be observed closely for development of hypokalemia. There have been cases reported in which concomitant use of amphotericin B and hydrocortisone was followed by cardiac enlargement and congestive heart failure.&nbsp;<br />\r\n<br />\r\n<strong>Antibiotics</strong>: Macrolide antibiotics have been reported to cause a significant decrease in corticosteroid clearance.&nbsp;<br />\r\n<br />\r\n<strong>Anticholinesterases</strong>: Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. If possible, anticholinesterase agents should be withdrawn at least 24 hours before initiating corticosteroid therapy.<br />\r\n&nbsp;<br />\r\n<strong>Anticoagulants, oral</strong>: Coadministration of corticosteroids and warfarin usually results in inhibition of response to warfarin, although there have been some conflicting reports. Therefore, coagulation indices should be monitored frequently to maintain the desired anticoagulant effect.<br />\r\n&nbsp;<br />\r\n<strong>Antidiabetics</strong>: Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required.&nbsp;<br />\r\n<br />\r\n<strong>Antitubercular drugs</strong>: Serum concentrations of isoniazid may be decreased.&nbsp;<br />\r\n<br />\r\n<strong>Cholestyramine</strong>: Cholestyramine may increase the clearance of corticosteroids.&nbsp;<br />\r\n<br />\r\n<strong>Cyclosporine</strong>: Increased activity of both cyclosporine and corticosteroids may occur when the two are used concurrently. Convulsions have been reported with this concurrent use.&nbsp;<br />\r\n<br />\r\n<strong>Digitalis glycosides</strong>: Patients on digitalis glycosides may be at increased risk of arrhythmias due to hypokalemia.&nbsp;<br />\r\nEstrogens, including oral contraceptives: Estrogens may decrease the hepatic metabolism of certain corticosteroids, thereby increasing their effect.&nbsp;<br />\r\n<br />\r\n<strong>Hepatic enzyme inducers (eg, barbiturates, phenytoin, carbamazepine, rifampin)</strong>: Drugs which induce hepatic microsomal drug metabolizing enzyme activity may enhance the metabolism of corticosteroids and require that the dosage of the corticosteroid be increased.&nbsp;<br />\r\n<br />\r\n<strong>Ketoconazole</strong>: Ketoconazole has been reported to decrease the metabolism of certain corticosteroids by up to 60%, leading to an increased risk of corticosteroid side effects.&nbsp;<br />\r\n<br />\r\n<strong>Nonsteroidal anti-inflammatory drugs (NSAIDs)</strong>: Concomitant use of aspirin (or other nonsteroidal anti-inflammatory drugs) and corticosteroids increases the risk of gastrointestinal side effects. Aspirin should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia. The clearance of salicylates may be increased with concurrent use of corticosteroids.&nbsp;<br />\r\n<br />\r\n<strong>Skin tests</strong>: Corticosteroids may suppress reactions to skin tests.&nbsp;<br />\r\n<br />\r\n<strong>Vaccines</strong>: Patients on prolonged corticosteroid therapy may exhibit a diminished response to toxoids and live or inactivated vaccines due to inhibition of antibody response. Corticosteroids may also potentiate the replication of some organisms contained in live attenuated vaccines. Routine administration of vaccines or toxoids should be deferred until corticosteroid therapy is discontinued if possible.</p>', '<p>Triamcinolone Acetonide injection is contraindicated in patients with a sensitivity to the active or inactive ingredients.</p>', '<p>Cushingoid syndrome, weakness, bruising or purpura, aggravation of infections, peptic ulcer, activation of latent or aggravation of existing diabetes, altered menstrual cycle, hirsutism.</p>', '<p>Triamcinolone Acetonide injection should be used during pregnancy, nursing mothers if the possible benefits of the medication justify the potential hazards to the fetus or nursing infant.</p>', '<p>Triamcinolone Acetonide injection should be used cautiously in patients with ocular herpes simplex, nonspecific ulcerative colitis, active or latent peptic ulcer, renal insufficiency, hypertension, osteoporosis, Cushing&#39;s syndrome, diabetes mellitus, congestive heart failure, chronic nephritis.</p>', '<p>Treatment of acute overdosage is by supportive and symptomatic therapy. For chronic overdosage in the face of severe disease requiring continuous steroid therapy, the dosage of the corticosteroid may be reduced only temporarily, or alternate day treatment may be introduced.</p>', '<p>Corticosteroid, Glucocorticoids, Triamcinolone &amp; Combined preparations.</p>', '<p>Store at controlled room temperature, 20-25&deg;C, avoid freezing and protect from light.</p>', '<p><strong>Use in the elderly</strong>: The common adverse effects of systemic corticosteroids such as osteoporosis or hypertension may be associated with more serious consequences in old age. Close clinical supervision is recommended.<br />\r\n<br />\r\n<strong>Use in children</strong>: As corticosteroids can suppress growth, the development of infants and children on prolonged corticosteroid therapy should be carefully observed. Caution should be taken in the event of exposure to chicken pox, measles or other communicable diseases. Children should not be vaccinated or immunized while on corticosteroid therapy. Corticosteroids may also affect endogenous steroid production.</p>', '2022-03-22 00:19:19', '2022-03-22 00:19:19'),
(1524, 1524, '<p>Triamcinolone is indicated for the treatment and prophylaxis of the nasal symptoms of seasonal and perennial allergic rhinitis in adults and children 6 years of age and older.</p>', '<p>The antiinflammatory actions of corticosteroids are thought to involve lipocortins, phospholipase A2 inhibitory proteins which, through inhibition of arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes. Firstly, however, these glucocorticoids bind to the glucocorticoid receptors which translocate into the nucleus and bind DNA (GRE) and change genetic expression both positively and negatively. The immune system is suppressed by corticosteroids due to a decrease in the function of the lymphatic system, a reduction in immunoglobulin and complement concentrations, the precipitation of lymphocytopenia, and interference with antigen-antibody binding.<br />\r\n<br />\r\nTriamcinolone Acetonide is a more potent derivative of Triamcinolone and is approximately 8 times more potent than prednisone. Corticosteroids are very effective in the treatment of allergic diseases in man. When given by intranasal spray, Triamcinolone Acetonide provides relief from allergy-induced watery nasal discharge (rhinorrhea), nasal congestion, postnasal drip, sneezing, and itching of the back of the throat.</p>', '<p><strong>Adults and children 12 years of age and older</strong>: The recommended dose is 220 &micro;gm as 2 sprays in each nostril once daily. Once symptoms are controlled patients can be maintained on 110 &micro;gm (1 spray in each nostril once daily). The minimum effective dose should be used to ensure continued control of symptoms.<br />\r\n<br />\r\n<strong>Pediatric Patients aged 6 to 12 years</strong>: The recommended dose is 110 &micro;gm as 1 spray in each nostril once daily. Triamcinolone&nbsp;spray is not recommended for children under 6 years of age.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>How to use the Nasal Spray-</p>\r\n\r\n<ul>\r\n	<li>Shake the bottle gently and remove the dust cover.</li>\r\n	<li>Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.</li>\r\n	<li>Gently blow the nose to clear the nostrils.</li>\r\n	<li>Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.</li>\r\n	<li>Breathe out through your mouth.</li>\r\n	<li>Repeat the above steps in the same/ other nostril for consecutive doses.</li>\r\n</ul>\r\n\r\n<p>Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-</p>\r\n\r\n<ul>\r\n	<li>Remove the dust cover.</li>\r\n	<li>Gently pull off the nasal applicator.</li>\r\n	<li>Wash the applicator and dust cover in warm water.</li>\r\n	<li>Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.</li>\r\n	<li>Gently push the applicator back on the top of the bottle and re-fix the dust cover.</li>\r\n</ul>', NULL, '<p>No specific contraindications but caution is required in patients with hypersensitivity to any constituents of the formulation.</p>', '<p>The most commonly reported adverse reactions in clinical trials with Triamcinolone included those involving mucous membranes of the nose &amp; throat. The most prevalent adverse reactions considered are rhinitis, headache, &amp; pharyngitis. The nasopharyngeal adverse effects included epistaxis, nasal irritation, dry mucous membrane,&nbsp;naso-sinus congestion and sneezing although these are seen as frequently with placebo. As with other nasally inhaled corticosteroids, nasal septal perforation has been reported.</p>', '<p>There are no adequate and well controlled studies in pregnant women with Triamcinolone. Because animal studies indicate a teratogenic effect, Triamcinolone should be used during pregnancy if the potential benefit justifies the potential benefit to fetus. It is not known whether Triamcinolone is excreted in human breast milk.</p>', '<p>If there is any reason to suppose that adrenal function is impaired, care must be taken while transferring patients from systemic steroid treatment to Triamcinolone. In clinical studies with Triamcinolone administered intranasally, the development of localized infections, on the nose, and pharynx with Candida albicans, has rarely occurred. When such an infection develops it may require treatment with appropriate local therapy and discontinuance of treatment with Triamcinolone. Because of the inhibitory effect of corticosteroids on wound healing in patients who have experienced recent nasal septal ulcers, nasal surgery of trauma, Triamcinolone should be used with caution until healing has occurred.</p>', '<p>Like any other nasally administered corticosteroid, acute overdosing with Triamcinolone is unlikely in view of the total amount of active ingredient present.</p>', '<p>Corticosteroid, Glucocorticoids, Nasal Steroid Preparations.</p>', '<p>Store at a temperature not exceeding 25˚C. Protect from light and moisture. Keep out of the reach of children.</p>', NULL, '2022-03-22 00:21:18', '2022-03-22 00:21:18'),
(1525, 1525, '<p>is indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid responsive dermatoses including atopic dermatitis, contact dermatitis, eczematous dermatitis, neurodermatitis, seborrheic dermatitis, insect bites, lichen simplex chronicus, exfoliative dermatitis, stasis dermatitis, nummular eczema, psoriasis and pruritus ani and vulvae.</p>', '<p>Triamcinolone Acetonide (a derivative of Triamcinolone) in a compatible base. Topical steroids are primarily effective because of their anti-inflammatory, antipruritic &amp; vasoconstrictive actions.</p>', '<p>A small amount of Triamcinolone is gently rub to the affected area 1-2 times daily. Some cases of eczematised psoriasis may be treated more effectively by the application of Triamcinolone under an occlusive dressing.<br />\r\n<br />\r\n<strong>Occlusive dressing technique</strong>: Gently rub a small amount of Triamcinolone on the lesion until it disappears. Then reapply, leaving a thin coating and cover with a pliable non porous film. For convenience apply Triamcinolone intermittently (12 hour occlusion during the night) followed by reapplication without occlusion, during the day.<br />\r\n<br />\r\n<strong>Pediatric use</strong>: Triamcinolone&nbsp;should not be used in children under 8 years. Administration of topical corticosteroids to children should be limited to the least amount compatible with an effective therapeutic regimen. Chronic corticosteroid therapy may interfere with the growth and development of children. As children are more likely to get side effects, they should not normally be treated for longer than 5 days.</p>', NULL, '<p>Triamcinolone Acetonide is contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation. It is also contraindicated in tuberculosis of the skin, fungus infections and viral diseases of the skin (Herpes simplex, chickenpox and vaccinia), perioral dermatitis, rosacea and ulcerative conditions.</p>', '<p>The following local side effects have been reported with topical corticosteroids, either with or without occlusive dressings: burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis and allergic contact dermatitis, maceration of the skin, secondary infection, skin atrophy, striae and miliaria.</p>', '<p>There are no adequate and well-controlled studies in pregnant women on teratogenic effects from topically applied corticosteroids. Therefore, topical corticosteroid should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether topical administration of corticosteroid could result in sufficient systemic absorption to produce detectable quantities in breast milk. Systemically administered corticosteroids are secreted into breast milk in quantities not likely to have a deleterious effect on the infant. Nevertheless, caution should be exercised when topical corticosteroids are administered to a nursing woman.</p>', '<p>If reactions or idiosyncrasies are encountered, Triamcinolone Acetonide should be discontinued. The use of topical steroids on infected areas should be attended with caution and careful observation, bearing in mind the potential spreading of infections by anti-inflammatory steroids and the possible advisability of discontinuing steroid therapy and/or initiating antibacterial measures.<br />\r\n<br />\r\nTriamcinolone Acetonide should not be used on healthy skin or over large areas of skin and not to be used in the eye as there is potential risk of glaucoma and cataract. When steroids are applied for long periods of time (more than 4 weeks) the occurrence of atrophic striae is likely. Prolonged use on flexures and intertriginous areas is undesirable. Children may absorb proportionately larger amounts of topical corticosteroids and thus may be more susceptible to systemic toxicity. In infants, long term continuous topical steroid therapy should be avoided. Adrenal suppression can occur even without occlusion.</p>', '<p>Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects e.g., mild, reversible suppression of adrenal function, ecchymoses of the skin, peptic ulceration, hypertension, aggravation of infection, hirsutism, acne, edema and muscle weakness.</p>', '<p>Corticosteroid, Glucocorticoids, Triamcinolone &amp; Combined preparations.</p>', '<p>Store in a cool &amp; dry place. Protect from light.</p>', NULL, '2022-03-22 00:22:52', '2022-03-22 00:22:52');
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
(1526, 1526, '<p>Trifarotene cream is a retinoid indicated for the topical treatment of acne vulgaris in patients 9 years of age and older.</p>', '<p>Trifarotene is an agonist of retinoic acid receptors (RAR), with particular activity at the gamma subtype of RAR. Stimulation of RAR results in modulation of target genes which are associated with various processes, including cell differentiation and mediation of inflammation. The exact process by which Trifarotene ameliorates acne is unknown.</p>', '<p>Apply a thin layer of Trifarotene cream to the affected areas once daily, in the evening, on clean and dry skin. The use of a moisturizer is recommended as frequently as needed from the initiation of treatment. Avoid contact with the eyes, lips, paranasal creases, mucous membranes. Trifarotene cream is intended for topical use only. Not for oral, ophthalmic or intravaginal use.</p>', '<p>Topical application of Trifarotene cream is not expected to affect the circulating concentrations of oral hormonal contraceptives containing ethinylestradiol and levonorgestrel.</p>', NULL, '<p>Most common adverse reactions (incidence &gt;1%) in patients treated with Trifarotene cream were application site irritation, application site pruritus, and sunburn.</p>', '<p>Pregnancy Category C. Available data from clinical trials with Trifarotene cream use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. The developmental and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for Trifarotene cream and any potential adverse effects on the breastfed infant from Trifarotene cream or from the underlying maternal condition.</p>', '<p><strong>Skin irritation</strong>: Patients using Trifarotene cream may experience erythema, scaling, dryness and stinging/burning. Maximum severity of these reactions typically occurred within the first 4 weeks of treatment, and severity decreased with continued use of the medication. Depending upon the severity of these adverse reactions, instruct patients to use a moisturizer, reduce the frequency of application of Trifarotene cream, or suspend use temporarily. If severe reactions persist the treatment may be discontinued. Avoid application of Trifarotene cream to cuts, abrasions, or eczematous or sunburned skin. Use of &quot;waxing&quot; as a depilatory method should be avoided on skin treated with Trifarotene cream.<br />\r\n<br />\r\n<strong>Ultraviolet Light and Environmental Exposure</strong>: Minimize unprotected exposure to ultraviolet rays (including sunlight and sunlamps) during treatment with Trifarotene cream. Warn patients who normally experience high levels of sun exposure and those with inherent sensitivity to sun to exercise caution. Use of sunscreen products and protective clothing over treated areas is recommended when exposure cannot be avoided.</p>', NULL, '<p>Topical retinoid and related preparations.</p>', '<p>Do not store above 25&deg;C. Protect from light. Keep out of reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of Trifarotene cream have not been established in pediatric patients below the age of 9 years.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical trials of Trifarotene cream did not include any subjects aged 65 years and over to determine whether they respond differently than younger subjects</p>', '2022-03-22 00:24:25', '2022-03-22 00:24:25'),
(1527, 1527, '<p><strong>Anxiety states</strong>: It controls excessive anxiety, tension, and agitation seen in neuroses or associated with somatic conditions. The treatment or prevention of nausea and vomiting of various causes. The management of psychotic disorders, such as acute or chronic catatonic, hebephrenic and paranoid schizophrenia; psychosis due to organic brain damage, toxic psychosis, and the manic&nbsp;phase of manic-depressive illness.</p>', '<p>Trifluoperazine is one of the phenothiazine class of compounds and as such has many pharmacodynamic effects which relate to its therapeutic actions and side effects. The most notable action of phenothiazines is antagonism at dopamine receptors in the CNS. It is hypothesised that this action in the limbic system and associated areas of cerebral cortex is the basis of the antipsychotic action of phenothiazines, whilst in the medullary chemoreceptor trigger zone it appears to be responsible for the antiemetic effect of these agents.</p>', '<p>Schizophrenia and other psychoses:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and child over 12 years</strong>: Recommended starting dose is 2-5 mg b.i.d, increased by 5 mg daily after 1 week then at interval of 3 days, according to response.&nbsp;</li>\r\n	<li><strong>Children (6-12 years)</strong>: Dosage should be adjusted to the weight of the child and severity of the symptoms. The starting dosage is 1 mg b.i.d. Dosage may be increased gradually until symptoms are controlled or until side effects become troublesome. While it is usually not necessary to exceed dosages of 15 mg daily.</li>\r\n	<li><strong>Elderly</strong>: Reduce initial dose by at least half</li>\r\n</ul>\r\n\r\n<p>Short-term management of severe anxiety:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult and child over 12 years</strong>: 1-2 mg b.i.d, increased if necessary to 6 mg daily.</li>\r\n	<li><strong>Child (3-5 years)</strong>: 1 mg daily</li>\r\n	<li><strong>Child (6-12 years)</strong>: Up to 4 mg daily in divided dose.</li>\r\n	<li><strong>Elderly</strong>: Reduce initial dose by at least half</li>\r\n</ul>\r\n\r\n<p>Antiemetic:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 2-4 mg daily in divided doses; max. 6 mg daily;</li>\r\n	<li><strong>Child</strong>&nbsp;3-5 years: up to 1 mg daily, 6-12 years up to 4 mg daily.</li>\r\n</ul>', '<p>Trifluoperazine may diminish the effect of oral anticoagulants. Concomitant administration of propranolol with trifluoperazine results in increased plasma levels of both drugs. Antihypertensive effects of guanethidine and related compounds may be counteracted when phenothiazines are used concurrently. Potentiation may occur if antipsychotic drugs are combined with CNS depressants such as alcohol. hypnotics and anticonvulsant.</p>', '<p>Do not use Trifluoperazine in comatose patients, or in those with existing blood dyscrasias or known liver damage, or in those hypersensitive to the active ingredient or related compounds.</p>', '<p>Common side effects are transient restlessness, dystonias or may resemble parkinsonism. Other CNS Reactions are drowsiness, dizziness, fatigue, blurred vision, seizures. Without these Peripheral oedema, blood dyscrasias, jaundice may occasionally occur. Tachycardia, constipation, urinary hesitancy and retention and hyperpyrexia have been reported very rarely.</p>', '<p><strong>Pregnancy</strong>: Safety for the use of trifluoperazine during pregnancy has not been established. Therefore, it is not recommended that the drug be given to pregnant patients except when, in the judgement of the physician, it is essential. The potential benefits should clearly outweigh possible hazards. There are reported instances of prolonged jaundices, extrapyramidal signs, hyperreflexia or hypoflexia in newborn infants whose mother received phenothiazines.<br />\r\n<br />\r\n<strong>Lactation</strong>: Adequate human data are not available in case of lactation.</p>', '<p>Care should be taken when treating elderly patients, and initial dosage should be reduced. Such patients can be specially sensitive, particularly to extra pyramidal and hypotensive effects. Patients with cardiovascular disease including arrhythmias should also be treated with caution. Care should be taken in patients with angina pectoris.</p>', '<p>Signs and symptoms will be predominantly extrapyramidal; hypotension may occur. Treatment consists of gastric lavage together with supportive and symptomatic measures. Do not induce vomiting. Extra pyramidal symptoms may be treated with an anticholinergic, antiparkinsonism drug. Treat hypotension with fluid replacement; if severe or persistent. nor adrenaline may be considered. Adrenaline is contraindicated.</p>', '<p>Phenothiazine drugs.</p>', '<p>It should be store at room temperature between 15-30&deg; C away from light and moisture.</p>', NULL, '2022-03-22 00:26:09', '2022-03-22 00:26:09'),
(1528, 1528, '<p>Trifluridine Sterile Eye Drops is indicated for the treatment of primary keratoconjunctivitis and recurrent epithelial keratitis due to herpes simplex virus, type 1 and 2.</p>', '<p>Trifluridine is a fluorinated pyrimidine nucleoside analog which interferes with DNA synthesis of herpes simplex virus, type 1 and 2 and vaccinia virus. It stops replication of herpes viral DNA in 3 ways:</p>\r\n\r\n<ol>\r\n	<li>Competitive inhibition of viral DNA polymerase,</li>\r\n	<li>Incorporation into and termination of the growing viral DNA chain and</li>\r\n	<li>Inactivation of the viral DNA polymerase.</li>\r\n</ol>', '<p><strong>Children above 6 years of age &amp; adults:</strong>&nbsp;Instill 1 drop every 2 hrs while awake; maximum 9 drops/day until the corneal ulcer has completely re-epithelialized.<br />\r\n<br />\r\n<strong>After re-epithelialization:</strong>&nbsp;Instill 1 drop every 4 hrs or at least 5 drops/day for 7 days is recommended. If there are no signs of improvement after 7 days of therapy or complete re-epithelialization has not occurred after 14 days of therapy, other forms of therapy should be considered. Continuous administration of Trifluridine&nbsp;eye drops for periods exceeding 21 days should be avoided because of potential ocular toxicity.</p>', NULL, '<p>Contraindicated in patients who develop hypersensitivity reactions or chemical intolerance to Trifluridine.</p>', '<p>Reported side effects are mild, transient burning or stinging sensation upon instillation. Other side effects are superficial punctate keratopathy, epithelial keratopathy, hypersensitivity reaction, stromal edema, irritation, keratitis sicca, hyperemia and increased intraocular pressure.</p>', '<p><strong>Pregnancy</strong>&nbsp;category C. There are no adequate and well-controlled studies in pregnant women. Trifluridine 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>&nbsp;It is unlikely that Trifluridine is excreted in human milk after instillation of Trifluridine&nbsp;eye drops because of the relatively small dosage. The drug should not be prescribed for nursing mothers unless the potential benefits outweigh the potential risks.</p>', '<p>Trifluridine should be prescribed only for patients who have a clinical diagnosis of herpetic keratitis.</p>', NULL, '<p>Ophthalmic Anti-viral Products.</p>', NULL, '<p><strong>Use in children</strong>: Safety and effectiveness in pediatric patients below 6 years of age have not been established.<br />\r\n<br />\r\n<strong>Use in elderly patients</strong>: No overall clinical differences in safety or effectiveness have been observed between elderly and other adult patients.</p>', '2022-03-22 00:27:41', '2022-03-22 00:27:41'),
(1529, 1529, '<p>Trihexyphenidyl Hydrochloride is indicated as an adjunct treatment of all forms of parkinsonism (postencephalitic, arteriosclerotic &amp; idiopathic). Additionally, it is indicated for the control of extrapyramidal disorders caused by central nervous system drugs such as dibenzoxazepines, phenothiazines, thioxanthenes &amp; butyrophenones.</p>', '<p>Trihexyphenidyl is a non-selective muscarinic acetylcholine receptor antagonist but binds with higher affinity to the M1 subtype. In vivo studies have shown that trihexyphenidyl demonstrates higher affinity for central muscarinic receptors located in the cerebral cortex and lower affinity for those located peripherally. Other studies suggest that trihexyphenidyl may modify nicotinic acetylcholine receptor neurotransmission, leading indirectly to enhanced dopamine release in the striatum. Although the anticholinergic has proven to be useful in the treatment of symptoms associated with Parkinson&rsquo;s disease or other movement disorders, its mechanism of action has yet to be fully elucidated.</p>', '<p>Dosage should be individualized. The initial dose should be low and then increased gradually, especially in patients over 60 years of age. Whether Trihexyphenidyl may best be given before or after meals should be determined by the way the patient reacts.<br />\r\n<br />\r\n<strong>Idiopathic Parkinsonism</strong>: 1 mg of Trihexyphenidyl may be administered the first day. The dose may then be increased by 2mg increments at intervals of three to five days.<br />\r\n<br />\r\n<strong>Drug-Induced Parkinsonism</strong>: Commence therapy with a single 1 mg dose increase the total daily dosage to 5-15 mg range if the extrapyramidal manifestations are not controlled.<br />\r\n<br />\r\n<strong>Concomitant Use with Levodopa</strong>: When Trihexyphenidyl is used concomitantly with levodopa, the usual dose is 3-6 mg daily.</p>', '<p>Cannabinoids, barbiturates, opiates, and alcohol may have additive effects with Trihexyphenidyl, and thus, an abuse potential exists. Concurrent use of alcohol or other CNS depressants with Trihexyphenidyl may cause increased sedative effects. It may be contraindicated in patients taking monoamine oxidase inhibitors &amp; tricycllic antidepressants.</p>', '<p>Contraindicated in patients with hypersensitivity to Trihexyphenidyl HCI or to any of the tablet or elixir ingredients. Trihexyphenidyl is also contraindicated in patients with narrow angle glaucoma. Blindness after long-term use due to narrow angle glaucoma has been reported.</p>', '<p>Minor side effects such as dryness of the mouth, blurring of vision, dizziness, mild nausea or nervousness. Patients with arteriosclerosis or with a history of idiosyncrasy to other drugs may exhibit reactions of mental confusion, agitation, disturbed behavior, or nausea and vomiting. Potential side effects are constipation, drowsiness, urinary hesitancy or retention, pupil dilation, increased intraocular tension, vomiting and headache.</p>', '<p>Pregnancy Category C. It is not known whether the drug is excreted in human milk and therefore Trihexyphenidyl should only be used if the expected benefit to the mother outweighs the potential risk to the infant.</p>', '<p>Patients with cardiac, liver, or kidney disorders, or with hypertensioon, should closely be monitored. Since Trihexyphenidyl HCI has parasympatholytic activity, it should be used with caution in patients with glaucoma, obstructive disease of the gastrointestinal or genitourinary tracts, and in elderly males with possible prostatic hypertrophy. Trihexyphenidyl is not recommended for use in patients with tardive dyskinesia unless they have concomitant Parkinson&rsquo;s disease. Abrupt withdrawal of treatment for parkinsonism may result in acute exacerbation of parkinsonism symptoms; therefore, abrupt withdrawal should be avoided.</p>', '<p>Overdosage with Trihexyphenidyl produces typical central symptoms of atropine intoxication (the central anticholinergic syndrome). Signs &amp; symptoms are: dilated and sluggish pupils, warm, dry skin, facial flushing, decreased secretions of mouth, pharynx, nose and bronchi, foul smelling breath, tachycardia etc. Neuropsychiatric signs such as delirium, disorientation, anxiety, hallucinations etc. The condition can progress to stupor, coma, paralysis, cardiac, respiratory arrest and death.</p>', '<p>Antiparkinson drugs</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-22 00:29:27', '2022-03-22 00:29:27'),
(1530, 1530, '<p>Treatment and relief of symptoms associated with irritable bowel syndrome (spastic colon). Postoperative paralytic ileus in order to accelerate the resumption of the intestinal transit following abdominal surgery.</p>', '<p>Trimebutine maleate is a noncompetitive spasmolytic agent. It possesses moderate opiate receptor affinity and has marked anti-serotonin activity especially on &#39;mu&#39; receptors. It induces regulation of spontaneous activity and increases synchronization between electrophysiological spikes and contractions in isolated guinea pig strips of colon and ileum. However, it does not alter normal motility, but regulates abnormal intestinal activity.</p>', '<p><strong>For adults</strong>: 100 mg to 200 mg, 3 times per day before meals.</p>', '<p>Trimebutine maleate increases the duration of d-tubocurarine-induced curarization. No other druginteractions have been observed during clinical trial or otherwise reported.</p>', '<p>Patients with known hypersensitivity to trimebutine maleate or any excipient.</p>', '<p>Trimebutine maleate is generally well tolerated. The infrequently reported adverse effects are as follows: dry mouth, foul taste, diarrhea, dyspepsia, epigastric pain, nausea, constipation, drowsiness, fatigue, dizziness, hot/cold sensations, headache etc.</p>', '<p>Although teratological studies have not shown any drug related adverse effects on the course and outcome of pregnancy, the use of trimebutine maleate in pregnant women is not recommended.<br />\r\n<br />\r\nIt is not known if trimebutine maleate passes into breast milk. This medication should be used while breast feeding only if the potential benefits outweigh risks to the nursing infants.</p>', '<p>Elderly, pregnancy and lactation</p>', '<p>No evidence of overdosage have been reported to date. However, if overdosage should occur following oral administration, gastric lavage is recommended. Treatment should be made according to the symptoms observed.</p>', '<p>Anticholinergics.</p>', '<p>Store in a cool and dry place, protected from light and moisture. Keep out of the reach of children.</p>', NULL, '2022-03-22 00:31:13', '2022-03-22 00:31:13'),
(1531, 1531, '<p>Trimetazidine Dihydrochloride is indicated in adults as add-on therapy for the symptomatic treatment of patients with stable angina pectoris who are inadequately controlled by or intolerant to first-line antianginal therapies.</p>', '<p>Trimetazidine Dihydrochloride is the first 3- keto acyl CoA thiolase inhibitor (KAT), a metabolic anti-ischemic agent with proven benefits for all coronary patients. Trimetazidine Dihydrochloride inhibits fatty acid pathway by inhibiting 3-keto acyl CoA thiolase enzyme and transfers oxygen to glucose pathway. Since glucose pathway is more efficient in producing energy, the same oxygen produces more energy and makes the heart more active. Moreover, the aerobic oxidation of glucose stops production of lactic acid, which prevents angina pectoris.</p>', '<p>The recommended dose of Trimetazidine is 35 mg twice daily or 20 mg tablet thrice daily during meals. The benefit of the treatment should be assessed after three months and Trimetazidine should be discontinued if there is no treatment response.</p>', '<p>No drug interaction so far has been reported. In particular, no interaction has been reported with beta-blockers, calcium antagonists, nitrates, heparin, hypolipidemic agents or digitalis preparation.</p>', '<p>Trimetazidine is contraindicated in patients who have hypersensitivity to the active substance or to any of the excipients. It is also is contraindicated in patients with Parkinson&rsquo;s disease, parkinsonian symptoms, tremors, restless legs movement disorders, severe renal impairment.</p>', '<p>Trimetazidine is safe and well tolerated. The Common side effects associated with Trimetazidine are dizziness, headache, abdominal pain, diarrhoea, dyspepsia, nausea, vomiting, rash, pruritus, urticaria and asthenia</p>', '<p>There is no data on the use of Trimetazidine in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity. As a precautionary measure, it is preferable to avoid the use of Trimetazidine during pregnancy. It is unknown whether Trimetazidine is excreted in human milk. A risk to the newborns/infants cannot be excluded. Trimetazidine should not be used during breast-feeding.</p>', '<p>Trimetazidine is not a curative treatment for angina attacks, nor an initial treatment for unstable angina pectoris. It is also not a treatment for myocardial infarction.</p>', NULL, '<p>Other Anti-anginal &amp; Anti-ischaemic drugs.</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-22 00:32:31', '2022-03-22 00:32:31'),
(1532, 1532, '<p>This&nbsp;medication&nbsp;is used to treat&nbsp;depression. It may help improve your mood and sense of well-being and allow you to enjoy everyday life more.&nbsp;Trimipramine&nbsp;is a tricyclic antidepressant. It works by restoring the balance of certain natural substances (neurotransmitters) in the&nbsp;brain.</p>', '<p>Trimipramine is a tricyclic antidepressant. It was thought that tricyclic antidepressants work by inhibiting the re-uptake of the neurotransmitters norepinephrine and serotonin by nerve cells. However, this response occurs immediately, yet mood does not lift for around two weeks. It is now thought that changes occur in receptor sensitivity in the cerebral cortex and hippocampus. The hippocampus is part of the limbic system, a part of the brain involved in emotions. Presynaptic receptors are affected: a1 and b1 receptors are sensitized, a2 receptors are desensitised (leading to increased noradrenaline production). Tricyclics are also known as effective analgesics for different types of pain, especially neuropathic or neuralgic pain. A precise mechanism for their analgesic action is unknown, but it is thought that they modulate anti-pain opioid systems in the CNS via an indirect serotonergic route. They are also effective in migraine prophylaxis, but not in abortion of acute migraine attack. The mechanism of their anti-migraine action is also thought to be serotonergic.</p>', '<p><strong>Adult:&nbsp;</strong>Initially 50-75 mg daily, increased gradually as necessary to 150-300 mg daily. May be given in divided doses during the day or as a single dose at night.<br />\r\n<br />\r\n<strong>Elderly:&nbsp;</strong>Initial 50-75 mg daily, increased gradually if necessary. Max: 100 mg daily.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>May be taken with or without food</p>', '<p>Decreased antihypertensive effects of guanethidine, guanfacine, debrisoquine, betanidine and possibly clonidine. Increased CNS depression with CNS depressants such as alcohol, sedatives, hypnotics or barbiturates. Increased trimipramine levels with protease inhibitors, SSRIs, selegiline, tramadol, quinidine, diltiazem and verapamil. Decreased trimipramine levels with barbiturates. Increased risk of arrhythmias with drugs that prolong QT intervals. Increased risk of serotonin syndrome with linezolid. Increased antimuscarinic adverse effects with nefopam. Risk of neurotoxicity and serotonin syndrome with lithium.</p>', '<p>Recent MI, cardiac arrhythmias, heart block; mania; porphyria, severe liver disease. Neonates and children. Lactation.</p>', '<p>Dry mouth, accommodation disturbances, tachycardia, constipation, hesitancy of micturation, drowsiness, sweating, postural hypotension, skin rashes, cholestatic jaundice, hypomania, convulsions, cardiac arrhythmias and peripheral neuropathy. Agitation, confusion (elderly).</p>', '<p>Pregnancy&nbsp;Category C.&nbsp;Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Narrow-angle glaucoma; prostatic hypertrophy; history of epilepsy; hyperthyroidism; patients requiring anaesthesia. Pregnancy. Withdraw gradually to decrease risk of withdrawal symptoms. Monitor liver function in long term treatment. May impair ability to drive or operate machinery.</p>', '<p><strong>Symptoms</strong>: Hypotensive collapse, convulsions, cardiac arrhythmias, acidosis and coma.<br />\r\n<br />\r\n<strong>Management</strong>: Gastric lavage should be carried out as soon as possible. Treatment is supportive and symptomatic with ECG monitoring. Intubate and ventilate the patient before convulsions develop. If convulsions occur, treat with IV diazepam. Treatment should be continued for at least 3 days even if the patient appears to have recovered, due to the long half life of trimipramine.</p>', '<p>Tricyclic &amp; related anti-depressant drugs.</p>', NULL, NULL, '2022-03-22 00:34:05', '2022-03-22 00:34:05'),
(1533, 1533, '<p>For mydriasis and cycloplegia for diagnostic procedure, for the treatment of acute and subacute iridocyclitis, chronic iridocyclitis, Adhesions and disruptions of iris and ciliary body, Sclera and iris operations</p>', '<p>Tropicamide binds to and blocks the receptors in the muscles of the eye (muscarinic receptor M4). Tropicamide acts by blocking the responses of the iris sphincter muscle to the iris and ciliary muscles to cholinergic stimulation, producing dilation of the pupil and paralysis of the ciliary muscle.</p>', '<p><strong>For refraction:</strong>&nbsp;Instill one or two drops of 1% solution in the eye(s), repeated in five minutes. If patient is not seen within 20 to 30 minutes, an additional drop may be instilled to prolong mydriatic effect.<br />\r\n<br />\r\n<strong>For examination of fundus:</strong>&nbsp;Instill one or two drops of 0.5% solution 15 to 20 minutes prior to examination. Individuals with heavily pigmented irides may require higher strength or more doses.</p>', '<p>Tropicamide may interfere with the antihypertensive action of carbachol, pilocarpine, or ophthalmic cholinesterase inhibitors.</p>', '<p>Contraindicated in persons showing hypersensitivity to any component of this preparation.</p>', '<p>Transient stinging, blurred vision, photophobia and superficial punctate keratitis have been reported with the use of tropicamide. Increased intraocular pressure has been reported following the use of mydriatics. Dryness of the mouth, tachycardia, headache, allergic reactions, nausea, vomiting, pallor, central nervous system disturbances and muscle rigidity have been reported with the use of tropicamide.</p>', '<p>Pregnancy Category C. Tropicamide should be given to a pregnant woman only if clearly needed. 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 tropicamide is administered to a nursing woman.</p>', '<p>The lacrimal sac should be compressed by digital pressure for 2-3 minutes after instillation to avoid excessive systemic absorption.</p>', NULL, '<p>Mydriatic and Cycloplegic agents.</p>', '<p>Store at 15&deg; to 25&deg;C . Do not refrigerate or store at high temperatures. Keep container tightly closed.</p>', NULL, '2022-03-22 00:35:32', '2022-03-22 00:35:32'),
(1534, 1534, '<p>This is indicated for cataract surgery to obtain mydriasis (dilation of the pupil) and intraocular anesthesia during the surgical procedure.</p>', '<p>Used only in the elderly and adults undergoing cataract surgery. The injection has to be administered by an ophthalmic surgeon, under local anesthesia, at the beginning of cataract surgery. The recommended dose is 0.2 ml of solution, in only one injection. The following procedure should be followed:</p>\r\n\r\n<ul>\r\n	<li>Five minutes before performing the preoperative antiseptic procedure and the first incision, one to two drops of anesthetic eye drops should be instilled in the eye.</li>\r\n	<li>At the beginning of surgery, 0.2 ml of the drop is slowly injected in only one injection via intracameral route, through the side port or principal port.</li>\r\n</ul>', NULL, NULL, NULL, '<p>Most serious well-known complications occurring during or after cataract surgery:<br />\r\nUncommon: may affect up to 1 in 100 people</p>\r\n\r\n<ul>\r\n	<li>Injury to the lens (posterior capsule rupture)</li>\r\n	<li>Swelling of the retina (cystoid macular edema)</li>\r\n</ul>\r\n\r\n<p>Please seek urgent medical advice in this case.<br />\r\nOther side effects:<br />\r\nUncommon: may affect up to 1 in 100 people</p>\r\n\r\n<ul>\r\n	<li>Nervous system disorder: Headache</li>\r\n	<li>Eye Disorder: Swelling of the cornea (keratitis), increased pressure in the eye, redness of the eye (ocular hyperaemia)</li>\r\n	<li>Vascular disorder: High blood pressure (hypertension)</li>\r\n</ul>', '<p>This medicine should not be used during pregnancy and lactation.</p>', '<p>Do not use if the blister is damaged or broken. Open under aseptic conditions only. The product should be used immediately after opening of the ampoule and not be reused for the other eye or any other patient. This is not recommended:</p>\r\n\r\n<ul>\r\n	<li>In combined cataract surgery with a certain type of eye surgery (vitrectomy)</li>\r\n	<li>If the ocular anterior chamber is shallow</li>\r\n	<li>If the patient has a history of acute narrow angle glaucoma</li>\r\n</ul>\r\n\r\n<p>The doctor should consider the patient&rsquo;s medical condition if he is suffering from hypertension, atherosclerosis or any kind of heart disease, hyperthyroidism, prostate gland disorders, epilepsy, any liver disease or kidney problem, breathing problem or myasthenia gravis.</p>', NULL, '<p>Other ophthalmic preparations</p>', '<p>Do not store above 30⁰C. Does not require refrigeration. Keep away from light and out of the reach of children. For single eye use only. This medicine should be used immediately after first opening of the ampoule. After use, discard the remaining solution appropriately. Do not keep it for subsequent use.</p>', NULL, '2022-03-22 00:36:40', '2022-03-22 00:36:40'),
(1535, 1535, '<p>Therapeutic purpose:</p>\r\n\r\n<ul>\r\n	<li>Inflammatory conditions of the uveal tract.</li>\r\n	<li>May be used in temporary lowering of intraocular pressure in glaucoma.</li>\r\n</ul>\r\n\r\n<p>Diagnostic purpose:</p>\r\n\r\n<ul>\r\n	<li>Retinal photography.</li>\r\n	<li>Refractive errors.</li>\r\n	<li>Fundus examination/photography.</li>\r\n	<li>Slit lamp examination.</li>\r\n</ul>\r\n\r\n<p>Pre-operative use: In order to undergo surgical procedure that requires the visualization of structures behind the iris, such as cataract extraction, vitrectomy and retinal detachment surgery.</p>', '<p>Tropicamide binds to and blocks the receptors in the muscles of the eye (muscarinic receptor M4). Tropicamide acts by blocking the responses of the iris sphincter muscle to the iris and ciliary muscles to cholinergic stimulation, producing dilation of the pupil and paralysis of the ciliary muscle.<br />\r\n<br />\r\nPhenylephrine Hydrochloride is a selective alpha-1 agonist, which causes mydriasis without cycloplegia. It tends to reduce intraocular lesion by vasoconstrictor action.</p>', '<p><strong>Uveitis</strong>: 1-2 drops bid-qid or as required.<br />\r\n<br />\r\n<strong>Diagnostic purpose/Pre-operative purpose</strong>: Instill 1-2 drops in the eye(s) 15-20 minutes before examination. If examination is not conducted within 20&ndash;30 minutes, an additional drop may be placed in the eye(s) to prolong the effect.</p>', '<p>Tropicamide may interfere with the antihypertensive action of carbachol, pilocarpine or ophthalmic cholinesterase inhibitors.</p>', '<p>This medication is contraindicated in these following cases</p>\r\n\r\n<ul>\r\n	<li>Patients with hypersensitivity to any of the components and narrow angles or narrow angle glaucoma.</li>\r\n	<li>Low birth weight infants and some elderly adults with severe arteriosclerotic cardiovascular or cerebrovascular disease.</li>\r\n	<li>During intraocular operative procedures when the corneal epithelial barrier has been disturbed.</li>\r\n</ul>', '<p>Elevated IOP (occasionally), stinging, blurred vision, tachycardia, photophobia, headache, parasympathetic stimulation and allergic reactions. Systemic effects include arrhythmias, hypertension and coronary artery spasm.</p>', '<p>The safety of this medication during pregnancy or lactation has not been established.</p>', '<p>Caution should be taken when administered with, or upto 21days after administration of monoamine oxidase (MAO) inhibitors as exaggerated adrenergic effects may result.<br />\r\n<br />\r\nThe possibility of psychotic reactions and behavioral disturbances should be considered in patients who are hypersensitive to anticholinergic drugs.<br />\r\n<br />\r\nUse with extreme caution in infants.</p>', '<p>Excessive use in children and in certain susceptible individuals may produce systemic toxic symptoms.</p>', '<p>Preparations for Ophthalmic diagnosis.</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.&nbsp;</p>', NULL, '2022-03-22 00:38:16', '2022-03-22 00:38:16'),
(1536, 1536, '<p>Trospium is a muscarinic antagonist indicated for the treatment of overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency, and urinary frequency.</p>', '<p>Trospium is a muscarinic antagonist. Trospium chloride antagonizes the effect of acetylcholine on muscarinic receptors in cholinergically innervated organs including the bladder. Its parasympatholytic action reduces the tonus of smooth muscle in the bladder. Receptor assays showed that trospium chloride has negligible affinity for nicotinic receptors as compared to muscarinic receptors at concentrations obtained from therapeutic doses.</p>', '<p>The recommended dose is 20 mg twice daily. Trospium should be dosed at least one hour before meals or given on an empty stomach. Dosage modification is recommended in the following patient populations:</p>\r\n\r\n<ul>\r\n	<li>For patients with severe renal impairment (creatinine clearance less than 30 mL/min), the recommended dose is 20 mg once daily at bedtime.</li>\r\n	<li>In geriatric patients greater than or equal to 75 years of age, dose may be titrated down to 20 mg once daily based upon tolerability.</li>\r\n	<li>Pediatric Use: The safety and effectiveness of Trospium in pediatric patients have not been established.</li>\r\n</ul>', '<p><strong>Digoxin</strong>: Concomitant use of Trospium and digoxin did not affect the pharmacokinetics of either drug.<br />\r\n<br />\r\n<strong>Drugs Eliminated by Active Tubular Secretion</strong>: Although demonstrated in a drug-drug interaction study not to affect the pharmacokinetics of digoxin, Trospium has the potential for pharmacokinetic interactions with other drugs that are eliminated by active tubular secretion (e.g., procainamide, pancuronium, morphine, vancomycin, and tenofovir). Coadministration of Trospium with these drugs may increase the serum concentration of Trospium and/or the coadministered drug due to competition for this elimination pathway. Careful patient monitoring is recommended in patients receiving such drugs.<br />\r\n<br />\r\n<strong>Antimuscarinic Agents</strong>: The concomitant use of Trospium with other antimuscarinic agents that produce dry mouth, constipation, and other anticholinergic pharmacological effects may increase the frequency and/or severity of such effects. Trospium may potentially alter the absorption of some concomitantly administered drugs due to anticholinergic effects on gastrointestinal motility.<br />\r\n<br />\r\n<strong>Metformin</strong>: Co-administration of 500 mg metformin immediate release tablets twice daily with Trospium 60 mg extended release reduced the steady-state systemic exposure of trospium by approximately 29% for mean AUC0-24&nbsp;and by 34% for mean Cmax.</p>', '<p>Trospium is contraindicated in patients with:</p>\r\n\r\n<ul>\r\n	<li>Urinary retention</li>\r\n	<li>Gastric retention</li>\r\n	<li>Uncontrolled narrow-angle glaucoma.</li>\r\n	<li>Known hypersensitivity to the drug or its ingredients. Angioedema, rash and anaphylactic reaction have been reported.</li>\r\n</ul>', '<p>The following adverse reactions have been identified during post-approval use of trospium chloride. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.</p>\r\n\r\n<ul>\r\n	<li>Gastrointestinal: gastritis</li>\r\n	<li>Cardiovascular: palpitations, supraventricular tachycardia, chest pain, syncope,</li>\r\n	<li>hypertensive crisis</li>\r\n	<li>Immunological: Stevens-Johnson syndrome, anaphylactic reaction, angioedema</li>\r\n	<li>Nervous System: dizziness, confusion, vision abnormal, hallucinations, somnolence and delirium</li>\r\n	<li>Musculoskeletal: rhabdomyolysis</li>\r\n	<li>General: rash</li>\r\n</ul>', '<p>Pregnancy Category C: There are no adequate and well-controlled studies of Trospium in pregnant women. Trospium should be used during pregnancy only if the potential benefit to the patient outweighs the risk to the patient and fetus. Women who become pregnant during Trospium treatment are encouraged to contact their physician.<br />\r\n<br />\r\nNursing Mothers: Trospium chloride (2 mg/kg orally and 50 mcg/kg intravenously) was excreted, to a limited extent (less than 1%), into the milk of lactating rats (primarily as parent compound). It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, Trospium should be used during lactation only if the potential benefit justifies the potential risk to the newborn.</p>', '<p><strong>Risk of Urin</strong>ary Retention: Trospium should be administered with caution to patients with clinically significant bladder outflow obstruction because of the risk of urinary retention.<br />\r\n<br />\r\n<strong>Angioedema</strong>: Angioedema of the face, lips, tongue, and/or larynx has been reported with trospium chloride, the active ingredient in Trospium. In one case, angioedema occurred after the first dose of trospium chloride. Angioedema associated with upper airway swelling may be life threatening. If involvement of the tongue, hypopharynx, or larynx occurs, Trospium should be promptly discontinued and appropriate therapy and/or measures necessary to ensure a patent airway should be promptly provided.<br />\r\n<br />\r\n<strong>Decreased Gastrointestinal Motility</strong>: Trospium should be administered with caution to patients with gastrointestinal obstructive disorders because of the risk of gastric retention. Trospium ,like other antimuscarinic agents, may decrease gastrointestinal motility and should be used with caution in patients with conditions such as ulcerative colitis, intestinal atony and myasthenia gravis.<br />\r\n<br />\r\n<strong>Controlled Narrow-angle Glaucoma</strong>: In patients being treated for narrow-angle glaucoma, Trospium should only be used if the potential benefits outweigh the risks and in that circumstance only with careful monitoring.<br />\r\n<br />\r\n<strong>Central Nervous System Effects</strong>: Trospium is associated with anticholinergic central nervous system (CNS) effects. A variety of CNS anticholinergic effects have been reported, including dizziness, confusion, hallucinations and somnolence. Patients should be monitored for signs of anticholinergic CNS effects, particularly after beginning treatment or increasing the dose. Advise patients not to drive or operate heavy machinery until they know how Trospium affects them. If a patient experiences anticholinergic CNS effects, dose reduction or drug discontinuation should be considered.<br />\r\n<br />\r\n<strong>Anticholinergic Adverse Reactions in Patients with Moderate Renal Impairment</strong>: Trospium is substantially excreted by the kidney. The effects of moderate renal impairment on systemic exposure are not known but systemic exposure is likely increased. Therefore, anticholinergic adverse reactions (including dry mouth, constipation, dyspepsia, urinary tract infection, and urinary retention) are expected to be greater in patients with moderate renal impairment.</p>', '<p>Overdosage with antimuscarinic agents, including Trospium, can result in severe antimuscarinic effects. Supportive treatment should be provided according to symptoms. In the event of overdosage, electrocardiographic monitoring is recommended. A 7-month-old baby experienced tachycardia and mydriasis after administration of a single dose of trospium 10 mg given by a sibling. The baby&rsquo;s weight was reported as 5 kg. Following admission into the hospital and about 1 hour after ingestion of the trospium, medicinal charcoal was administered for detoxification. While hospitalized, the baby&nbsp; experienced mydriasis and tachycardia up to 230 beats per minute. Therapeutic intervention was not deemed necessary. The baby was discharged as completely recovered the following day.</p>', '<p>Other genito-urinary preparations.</p>', '<p>Store at controlled room temperature 20&deg;-25&deg;C.</p>', NULL, '2022-03-22 00:40:01', '2022-03-22 00:40:01'),
(1537, 1537, '<p>Trypan Blue is indicated for use as an aid in ophthalmic surgery by staining the anterior capsule of the lens.</p>\r\n\r\n<p>&nbsp;</p>', '<p>Trypan Blue is a selective tissue staining agent (dye) which stains anterior lens capsule of the human crystalline lens. The dye does not penetrate the capsule, permitting visualization of the anterior capsule in contrast to the non-stained lens cortex and inner lens material.</p>', '<p>The first step to administer Trypan Blue is to inject an air bubble into the anterior chamber using a 26 gauge needle. It prevents dilution of dye by the aqueous humor. Then Trypan Blue is injected into the anterior lens capsule using a tuberculin syringe. Sufficient staining is achieved as soon as the dye has contracted the capsule. If some area is left unstained, inject one more drop till it gets stained.</p>', NULL, '<p>Trypan Blue is contraindicated when a non-hydrated (dry state), hydrophilic acrylic intraocular lens (IOL) is planned to be inserted into the eye because the dye may be absorbed by the IOL and stain the IOL.</p>', '<ul>\r\n	<li>Discoloration of high water content hydrogen intraocular lenses.</li>\r\n	<li>Inadvertent staining of the posterior lens capsule and vitreous face.</li>\r\n	<li>It is generally self limited, lasting up to one week.</li>\r\n</ul>', '<p><strong>Pregnancy</strong>&nbsp;Category C. There are no adequate and well-controlled studies in pregnant women. Trypan Blue should be given to a pregnant woman 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 this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Trypan Blue is administered to a nursing woman.</p>', '<p>It is recommended that after injection all excess Trypan Blue should be immediately removed from the eye by thorough irrigation of the anterior chamber.</p>', NULL, '<p>Preparations for Ophthalmic diagnosis.</p>', '<p>Store below 30&deg; C and keep away from lig.</p>', '<p><strong>Pediatric use:</strong>&nbsp;The safety and effectiveness of Trypan Blue have been established in pediatric patients. Use of Trypan Blue is supported by evidence from an adequate and well controlled study in pediatric patients.<br />\r\n<br />\r\n<strong>Geriatric use:</strong>&nbsp;No overall differences in safety and effectiveness have been observed between elderly and younger patients.</p>', '2022-03-22 00:41:41', '2022-03-22 00:41:41'),
(1538, 1538, '<p>This toothpaste is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Faster relief from dental hypersensitivity.</li>\r\n	<li>Sensitivity repair</li>\r\n	<li>Teeth strengthening</li>\r\n	<li>Gum protection</li>\r\n	<li>Teeth whitening</li>\r\n	<li>Total oral hygiene</li>\r\n	<li>Plaque control</li>\r\n	<li>Enamel protection</li>\r\n	<li>Extra fresh breath</li>\r\n</ul>', '<ul>\r\n	<li>Patent oral hygiene product</li>\r\n	<li>Long lasting protection with twice daily brushing</li>\r\n	<li>Prevent common dental problem</li>\r\n	<li>FDA categorized human OTC drug label</li>\r\n	<li>WHO recommended antiseptic &amp; disinfectant</li>\r\n	<li>European Medicines Agency approved as</li>\r\n	<li>herbal Medicine Product</li>\r\n</ul>', '<p>Take a small amount of toothpaste on the tooth brush and brush the tooth twice daily for at least one minutes.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Miscellaneous topical agents.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-22 00:42:43', '2022-03-22 00:42:43');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1539, 1539, '<p>Tulobuterol is indicated for prophylaxis and control of bronchospasm in bronchial asthma, chronic bronchitis, asthmatic bronchitis, pulmonary emphysema, bronchiectasis, tracheobronchitis with emphysema and other bronchospastic disorders and conditions characterized by bronchoconstriction. Because oral tulobuterol is long acting, it is ideally suited for routine maintenance therapy in chronic asthma and chronic bronchitis. Tulobuterol has been shown in controlled single and multiple-dose studies to be more effective than terbutaline and fenoterol and at least as effective as salbutamol (albuterol) in relieving bronchospasm associated with reversible obstructive airways disease such as asthma, and also chronic bronchitis and emphysema. Clinically significant improvement in pulmonary function, as demonstrated by an increase in FEV of 15% or more, occurred within 30 minutes after oral dosing with peak improvement occurring within two to three hours. In some patients, a therapeutic response was still apparent at 12 hours. Continued effectiveness was demonstrated over a one-year period.</p>', '<p>The primary pharmacological action of beta-adrenergic drugs is to stimulate adenyl cyclase, the enzyme which catalyzes the formation of cyclic-3&#39;,5&#39; adenosine monophosphate (cyclic AMP) from adenosine triphosphate (ATP). The cyclic AMP thus formed mediates the cellular response that results in bronchodilation. Tulobuterol, due to its highly selective action on beta-2 adrenoceptors, relaxes the bronchial smooth muscle and has been shown to be clinically successful in the symptomatic treatment of reversible obstructive airways disease (ROAD) such as bronchial asthma, and also in bronchitis and emphysema.<br />\r\n<br />\r\nSome bronchodilators stimulate beta-1 (cardiac) receptors in addition to beta-2 receptors and may cause tachycardia, angina, and possibly arrhythmias in susceptible patients. Animal studies and in vitro experiments indicate that tulobuterol is more selective in its beta-2 agonist activity than other agents in this class and, therefore, should produce fewer cardiac side effects.</p>', '<p>As long-term clinical studies have demonstrated, tulobuterol continues to be efficacious and does not result in cumulative or toxic side effects. Due to the variability of the disease and the need for individualized dosage requirements, flexibility in dosing is indispensable.<br />\r\n<br />\r\nThe use of Long-Acting Beta Agonists is contraindicated without the use of an asthma controller medication such as inhaled corticosteroid.<br />\r\n<br />\r\nLong-Acting Beta Agonists should be used for the shortest duration of time required to achieve control of asthma symptoms and discontinued, if possible, once asthma control is achieved. Patient should then be maintained on a long-term asthma controller medication (e.g. Corticosteroids).<br />\r\n<br />\r\n<strong>Tablets</strong>: The usual oral adult dose of tulobuterol is one 2 mg tablet twice a day. A convenient starting dose for children 12 years and over and adults is 1 mg twice a day, particularly for elderly patients and those with a history of sensitivity to beta-adrenergic agents. Unless precluded by drug-related side effects, the patient may have the dose increased after seven to ten days to 2 mg twice a day, if necessary, to achieve a greater therapeutic response.<br />\r\n<br />\r\nAlthough most patients can be maintained on a dose of 1 to 2 mg twice daily, the variability of patient response and severity of symptoms may require further adjustment of the dose, as with any bronchodilator treatment. Therefore, if necessary, the adult dose of tulobuterol may be increased to 6 mg a day in divided doses according to clinical response.<br />\r\n<br />\r\n<strong>Syrup</strong>: Based on dose-ranging studies in children, the usual dose of tulobuterol syrup (1 mg/5 mL) for children is 40 to 80 mcg/kg/day in two divided doses.<br />\r\n<br />\r\nIn clinical studies in children, the effective dose has ranged from 20 to 100 mcg/kg/day.<br />\r\n<br />\r\nThis leads to the following recommendations on the basis of age:</p>\r\n\r\n<ul>\r\n	<li>For children aged one to six years, 0.25 tsp. (1.25 mL) to 0.5 tsp. (2.5 mL) BID</li>\r\n	<li>For children aged six to twelve years, 0.5 tsp. (2.5 mL) to 1 tsp. (5 mL) BID</li>\r\n	<li>For children aged over twelve years, 1 tsp. (5 mL) to 2 tsp. (10 mL) BID</li>\r\n	<li>The above age recommended doses may have to be modified according to patient response.</li>\r\n</ul>', '<p>Increased risk of arrhythmia with digoxin. Hypokalaemia with concomitant admin of xanthines, corticosteroids and diuretics.</p>', '<p>Administration of tulobuterol is contraindicated in patients with known hypersensitivity to sympathomimetic amines or any of the formulation components.</p>', '<p>The adverse reactions of tulobuterol are similar in nature to those of other sympathomimetic agents, however the incidence of certain cardiovascular effects is less with tulobuterol. Dose-related finger tremor is common with these agents, but the effects tend to lessen with continued administration of the drug. Oral formulations of tulobuterol, like other sympathomimetic agents, can also cause less frequent adverse reactions such as hypertension, palpitations, angina, tachycardia, vomiting, vertigo, central nervous system stimulation, insomnia and headache.</p>', '<p>Safety of this product for use during pregnancy has not been established. It is not known whether tulobuterol is excreted in human breast milk nor whether it has a harmful effect on the newborn. Therefore, as with any medication, the use of the drug in pregnancy, lactation, or women of childbearing potential requires that the expected therapeutic benefit of the drug be weighed against its possible hazards to the mother and child.</p>', '<p>Long-Acting Beta Agonists should only be used long-term in patients whose asthma cannot be adequately controlled on asthma controller medications alone.<br />\r\n<br />\r\nTulobuterol should be used with caution in patients with diabetes mellitus, hypertension, hyperthyroidism, and seizure disorders.<br />\r\n<br />\r\nCaution should be observed in patients with renal failure in view of the kidney being the principle route of elimination of the drug. Dosage may also require individualization in patients with impaired liver function as normally tulobuterol is extensively metabolized by the liver.<br />\r\n<br />\r\nAs with other sympathomimetic bronchodilator agents, tulobuterol should be administered cautiously to cardiac patients, especially those with associated arrhythmias, coronary insufficiency, or myocardial ischemia.</p>', NULL, '<p>Short-acting selective &amp; &beta;2-adrenoceptor stimulants.</p>', NULL, NULL, '2022-03-22 00:44:21', '2022-03-22 00:44:21'),
(1540, 1540, '<p>Typhoid Polysaccharide Vaccine is indicated for active immunization against typhoid fever for adults and children two years of age or older. Selective immunization with typhoid vaccine is recommended for the following:</p>\r\n\r\n<ul>\r\n	<li>Travellers to high endemic areas</li>\r\n	<li>Household contact of carriers</li>\r\n	<li>Healthcare personnel</li>\r\n	<li>Police, Armed forces and such other regimented personnel</li>\r\n	<li>Laboratory workers who work with Salmonella typhi</li>\r\n</ul>', '<p><strong>Dosage</strong>: A single dose of 0.5 ml is recommended for both adults and children 2 years of age or older. Subjects who remain at risk of typhoid fever should be given a single booster dose of the vaccine with an interval of not more than 3 years.<br />\r\n<br />\r\n<strong>Administration</strong>: Typhoid Polysaccharide Vaccine is for intramuscular injection only. Do not inject intravenously. This should be given intramuscularly in the deltoid and children should be injected intramuscularly either in the deltoid or the vastus lateralis. It should not be injected into the gluteal areas where there may be a nerve trunk. Typhoid Polysaccharide Vaccine injection should be administered with caution to subjects with thrombocytopenia or bleeding disorders since bleeding may occur following an intramuscular administration to these subjects. Following injection, firm pressure should be applied to the site (without rubbing) for at least two minutes.<br />\r\n<br />\r\n<strong>Co-administration</strong>: Typhoid vaccine can be co-administered with other vaccines but should not be mixed with other vaccines or medicinal products in the same syringe.</p>', NULL, NULL, '<p>The vaccine protects against typhoid fever caused by Salmonella typhi. Protection is not conferred against paratyphoid fever or illness caused by non-invasive Salmonella. Typhoid vaccine should not be administered to subjects with known hypersensitivity to any component of the vaccine or to subjects having shown signs of hypersensitivity after previous Typhoid vaccine administration or after any other vaccine containing Vi polysaccharide Salmonella typhi antigens. It may be expected that in patients receiving immunosuppressive treatment or patients with immunodeficiency, an adequate response may not be achieved. The administration of Typhoid vaccine should be postponed in subjects suffering from acute severe febrile illness.</p>', '<p>Most recepients of Typhoid vaccine experience some reactions upon vaccination. These are generally moderate and short in duration. They mainly consist of local reactions at the injection site (erythema, induration and tenderness). Systemic reactions (malaise, headache, diarrhea, vomiting, myalgia and elevated temperature) are reported less commonly. In very rare cases allergic type reactions (pruritus, rash, urticaria) may be observed.</p>', '<p>The effect of Typhoid vaccine on foetal development or reproduction capacity has not been evaluated. Typhoid vaccine should only be used during pregnancy when there is a high risk of infection. It is not known if Typhoid vaccine is excreted in human milk. It may be administered to nursing mothers only if clearly needed.</p>', NULL, NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', '<p>Keep out of the reach of children. Store at +2&deg;C to +8&deg;C. Transportation should also be at +2&deg;C to +8&deg;C. Do not freeze. Discard vaccine if frozen. Protect from light.</p>', NULL, '2022-03-22 00:45:35', '2022-03-22 00:45:35'),
(1541, 1541, '<p>Abemaciclib is a kinase inhibitor indicated:</p>\r\n\r\n<ul>\r\n	<li>in combination with endocrine therapy (tamoxifen or an aromatase inhibitor) for the adjuvant treatment of adult patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, node-positive, early breast cancer at high risk of recurrence and a Ki-67 score &ge;20% as determined by an FDA approved test.</li>\r\n	<li>in combination with an aromatase inhibitor as initial endocrine-based&nbsp;therapy for the treatment of postmenopausal women, and men, with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer.</li>\r\n	<li>in combination with fulvestrant for the treatment of adult patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer with disease progression following endocrine therapy.</li>\r\n	<li>as monotherapy for the treatment of adult patients with HR-positive, HER2-negative advanced or metastatic breast cancer with disease progression following endocrine therapy and prior chemotherapy in the metastatic setting.</li>\r\n</ul>', '<p>Abemaciclib is an inhibitor of cyclin-dependent kinases 4 and 6 (CDK4 and CDK6). These kinases are activated upon binding to D-cyclins. In estrogen receptor-positive (ER+) breast cancer cell lines, cyclin D1 and CDK4/6 promote phosphorylation of the retinoblastoma protein (Rb), cell cycle progression, and cell proliferation. In vitro, continuous exposure to abemaciclib inhibited Rb phosphorylation and blocked progression from G1 into S phase of the cell cycle, resulting in senescence and apoptosis. In breast cancer xenograft models, abemaciclib dosed daily without interruption as a single agent or in combination with antiestrogens resulted in reduction of tumor size.</p>', '<p>Abemaciclib tablets are taken orally with or without food.</p>\r\n\r\n<ul>\r\n	<li>Recommended starting dose in combination with fulvestrant, tamoxifen, or an aromatase inhibitor: 150 mg twice daily.</li>\r\n	<li>Recommended starting dose as monotherapy: 200 mg twice daily.</li>\r\n	<li>Dosing interruption and/or dose reductions may be required based on individual safety and tolerability.</li>\r\n</ul>', '<p><strong>CYP3A Inhibitors</strong>: Avoid concomitant use of ketoconazole. Reduce the Abemaciclib dose with concomitant use of other strong and moderate CYP3A inhibitors.<br />\r\n<strong>CYP3A Inducers</strong>: Avoid concomitant use of strong and moderate CYP3A inducers.</p>', NULL, '<p>Most common adverse reactions (incidence &ge;20%) were diarrhea, neutropenia, nausea, abdominal pain, infections, fatigue, anemia, leukopenia, decreased appetite, vomiting, headache, alopecia, and thrombocytopenia.</p>', '<p>Based on findings from animal studies and the mechanism of action, Abemaciclib can cause fetal harm when administered to a pregnant woman. In animal reproduction studies, administration of abemaciclib to pregnant rats during the period of organogenesis caused teratogenicity and decreased fetal weight at maternal exposures that were similar to the human clinical exposure based on area under the curve (AUC) at the maximum recommended human dose. Advise pregnant women of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during treatment with Abemaciclib and for 3 weeks after the last dose.</p>', '<p><strong>Diarrhea</strong>: Abemaciclib can cause severe cases of diarrhea, associated with dehydration and infection. Instruct patients at the first sign of loose stools to initiate antidiarrheal therapy, increase oral fluids, and notify their healthcare provider.<br />\r\n<br />\r\n<strong>Neutropenia</strong>: Monitor complete blood counts prior to the start of Abemaciclib therapy, every 2 weeks for the first 2 months, monthly for the next 2 months, and as clinically indicated.<br />\r\n<br />\r\n<strong>Interstitial Lung Disease (ILD)/Pneumonitis</strong>: Severe and fatal cases of ILD/pneumonitis have been reported. Monitor for clinical symptoms or radiological changes indicative of ILD/pneumonitis. Permanently discontinue Abemaciclib in all patients with Grade 3 or 4 ILD or pneumonitis.<br />\r\n<br />\r\n<strong>Hepatotoxicity</strong>: Increases in serum transaminase levels have been observed. Perform liver function tests (LFTs) before initiating treatment with Abemaciclib. Monitor LFTs every two weeks for the first two months, monthly for the next 2 months, and as clinically indicated.<br />\r\n<br />\r\n<strong>Venous Thromboembolism</strong>: Monitor patients for signs and symptoms of thrombosis and pulmonary embolism and treat as medically appropriate.<br />\r\n<br />\r\n<strong>Embryo-Fetal Toxicity</strong>: Can cause fetal harm. Advise patients of potential</p>', NULL, '<p>Protein kinase inhibitor</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: The safety and effectiveness of Abemaciclib have not been established in pediatric patients.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No overall differences in safety or effectiveness of Abemaciclib were observed between these patients and younger patients.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No dosage adjustment is required for patients with mild or moderate renal impairment.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No dosage adjustments are necessary in patients with mild or moderate hepatic impairment</p>', '2022-04-03 01:34:23', '2022-04-03 01:34:23'),
(1542, 1542, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-04-03 01:50:47', '2022-04-03 01:50:47'),
(1543, 1543, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-04-03 01:52:56', '2022-04-03 01:52:56'),
(1545, 1545, '<p>This solution is used in Haemodialysis.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Composition:&nbsp;</p>\r\n\r\n<p>Each 1 liter solution contains-</p>\r\n\r\n<ul>\r\n	<li>Sodium Chloride: 161.43 gm</li>\r\n	<li>Potassium Chloride: 5.49 gm</li>\r\n	<li>Calcium Chloride: 9.75 gm</li>\r\n	<li>Magnessium Chloride: 3.74 gm</li>\r\n	<li>Glacial Acetic Acid: 8.85 gm</li>\r\n	<li>Highly purified water: q.s. to 1 liter</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>', '<p><strong>Calcium chloride</strong>&nbsp;is used to prevent or treat negative calcium balance. It also regulates action potential excitation threshold to facilitate nerve and muscle performance.<br />\r\n<br />\r\n<strong>Potassium chloride</strong>&nbsp;is a major cation of the intracellular fluid. It plays an active role in the conduction of nerve impulses in the heart, brain and skeletal muscle; contraction of cardiac skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism and gastric secretion.<br />\r\n<br />\r\n<strong>Sodium chloride</strong>&nbsp;is the major extracellular cation. It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes. It is also used as diluents for infusion of compatible drug additives.<br />\r\n<br />\r\n<strong>Magnessium Chloride</strong>&nbsp;acts as cofactor in numerous enzymatic reactions involving protein synthesis and carbohydrate metabolism; depresses CNS, blocks peripheral neuromuscular transmission, produces anticonvulsant effects.</p>', '<p><strong>Recommended dose</strong>: 5 liters concentrate per dialysis or as required.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Known hypersensitivity to any of the ingredients of this preparation.</p>', '<p>Fluid and electrolyte imbalance, hypovolemia, hypotension or muscle cramping may occur.</p>', '<p>Pregnancy Category is not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>It is used for hemodialysis purposes only. Do not use solution A or B alone. Discard container in case visible solid particles inside.</p>', NULL, '<p>Haemodialysis solutions</p>', NULL, NULL, '2022-04-15 08:19:27', '2022-04-15 08:19:27'),
(1546, 1546, '<p>This is a natural formula meant to promote the quality and quantity of milk. This is 100% safe and effective. It can be used as a tonic for physically weak nursing mothers. Breast milk production may increase within a couple of days. However, in order to ensure the best results, the mother should continue taking this preparation for at least 15 days.</p>', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', NULL, NULL, '2022-04-24 04:47:44', '2022-04-24 04:47:44'),
(1547, 1547, '<p>This is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Haemorrhoid</li>\r\n	<li>Bleeding piles</li>\r\n	<li>Constipation</li>\r\n	<li>Indigestion</li>\r\n	<li>Hyperacidity</li>\r\n	<li>Carminative</li>\r\n</ul>', '<p>This is a liquid Ayurvedic medicine. It Is a combination of several medicinal plants that are effective to cure Haemorrhoid Bleeding piles, Constipation and Indigestion. It also acts as Antacid and Carminative. It is aimed to treat male and female patients of all age groups for oral administration.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Terminalia chebula</strong>: It contains chebulinic acid, tannic acid, gallic acid, resin, tannin and glycoside. It prevents haemorrhoid, bleeding, constipation and improve digestive power.<br />\r\n<br />\r\n<strong>Vitis vinifera</strong>: It contains sugar gum, tannin, tartaric, citric, racemic and malic acids, chlondes of potassium and sodium, iron, albumin etc. It is used as demulcent, diuretic, laxative, stomachic and tonic. It is also used in dyspepsia.<br />\r\n<br />\r\n<strong>Madhuca indica</strong>: It contains glycoside saponin, sapogenin, B-sitosterol and sterol glucoside. It is used in haemorrhoids and constipation.<br />\r\n<br />\r\n<strong>Embelia ribes</strong>: It contains hydroquinone embelin alkaloid christembine, tannin, quercifol and volatile oil that have carminative, laxative, stomachic and anthelmintic activities. It is also used to improve digestive power.<br />\r\n<br />\r\n<strong>Tribulus terrestris</strong>: It contains alkaloids, pedalitin, diosmetin and dinatin. It is cooling, tonic, and carminative. It is used in piles and remove inflammation.<br />\r\n<br />\r\n<strong>Piper chaba</strong>: It contains pipperin, pippalartin, pipperleguminin, sterols, glycosides etc. It cures piles, cough and indigestion.<br />\r\n<br />\r\n<strong>Coriandrum sativum</strong>: It contains a-pinene, limonene, B-phellandrene, linalool, geraniol, linalys acetate etc. It has carminative, stomachic, refrigerant and antibacterial activity. It can help to remove dyspepsia.<br />\r\n<br />\r\n<strong>Zingiber officinale</strong>: It contains zingiberenen, zingerfone, terpenes, cineol, borneol, citrol, camphene, phelandrene, gingerol shogaol etc. It is digestive, carminative, stomachic ano stimulant. It also use in dyspepsia, flatulent, colic and constipation.<br />\r\n<br />\r\n<strong>Operculina turpethum</strong>: It contains glycosidium resin, glycoside (turoethin) and volatile oil. If is a good laxative and helpful in other abdominal troubles. It is also helpful in managing the normal body temperature.<br />\r\n<br />\r\n<strong>Salmalia malabarica</strong>: It contains minerals, starch, protein, fatty acid tannic acid and gallic acid. It is cooling, stimulant, tonic and demulcent. It is useful in haemorrhoid.</p>', '<p>Adult: 2-4 teaspoonful 2-3 times daily after meal.<br />\r\nChildren: 1-2 teaspoonful 2-3 times daily after meal.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Keep all medicines out of reach of children. Store in a cool and dry place, protected from light.</p>', NULL, '2022-04-24 04:49:32', '2022-04-24 04:49:32'),
(1548, 1548, '<p>This is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Sexual debility</li>\r\n	<li>Spermatorrhoea</li>\r\n	<li>Oligospermia</li>\r\n	<li>Gonorrhoea</li>\r\n</ul>', '<p>This is a unique formulation of Acacia (Acacia arabica), Dates (Phoenix dactylifera), Asparagus (Asparagus racemosus), Edible Pine (Pinus gerardiana), Hazel nut (Corylus avellana), Levant cotton (Gossypium herbaceum), Clove (Eugenia caryophyllus), Nutmeg (Myristica fragrans) etc. It helps to relives sparmatorrhoea, oligospermia and sexual debility. It is an ideal aphrodisiac and nervine tonic.</p>', '<p>1 teaspoonful twice daily before meal for 2-3 months or as prescribed by the physician.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Store at cool and dry place, protect from light.</p>', NULL, '2022-04-24 04:50:37', '2022-04-24 04:50:37'),
(1549, 1549, '<p>This is indicated in</p>\r\n\r\n<ul>\r\n	<li>Spermatorrhoea</li>\r\n	<li>Oligospermia</li>\r\n	<li>Sexual debility</li>\r\n	<li>Nocturnal emission</li>\r\n</ul>', '<p>This is a unique formulation of Almond (Prunus amygdalus), Coconut (Cocos nucifera), Edible Pine (Pinus gerardiana), Salep (Orchis latifolia), Mastic tree (Pistacia lentiscus), which enhances retentive power and relieves oligospermia. It also prevents sparmatorrhoea and premature ejaculation. This preparation enhances viscosity of semen &amp; prolongs the duration of coitus and ensures post coitus freshness.</p>', '<p>1-2 teaspoonful(s) twice daily with or as prescribed by the physician.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Store at cool and dry place, protect from light.</p>', NULL, '2022-04-24 04:51:35', '2022-04-24 04:51:35'),
(1550, 1550, '<p>This is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Constipation</li>\r\n	<li>Flatulence</li>\r\n	<li>Anorexia</li>\r\n	<li>Colic</li>\r\n	<li>Obesity</li>\r\n	<li>Hypercholesterolaemia</li>\r\n</ul>', '<p>This is a unique unani medicine prepared with various natural ingredients, such as Aloe (Aloe baradensis), Black pepper (Piper nigrum), Henbane (Hyoscyamus niger) and other natural medicinal ingredients. The synergistic action of these natural ingredients makes this tablet, an effective remedy for flatulence, constipation and colic. It discharges the excessive stool from the bowels and increases appetite. It also helps to reduce obesity.</p>', '<p>1-2 tablet(s) daily with milk at bed time or as prescribed by the physician.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Store at cool and dry place, protect from light.</p>', NULL, '2022-04-24 04:52:38', '2022-04-24 04:52:38'),
(1551, 1551, '<p>This is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Acid reflux</li>\r\n	<li>Gastric ulcer</li>\r\n	<li>Obesity</li>\r\n	<li>Constipation</li>\r\n	<li>Piles</li>\r\n</ul>', '<p><strong>Aloe indica royle</strong>: Aloe contains anthrone -10-C-glycosyls, including aloin A, aloin B, 7-hydroxyaloin and 1,8-dihydroxy anthraquinone, including Aloe-emodin. The 2015 study found that aloe effectively reduced the symptoms of acid reflux as well as certain traditional medication without any reported side effects. Researchers concluded that aloe may work by reducing acid production and acting as an anti-inflammatory agent. By taking Aloe regularly, ensures a better sensation of well-being, allowing energy levels to increase and also helps maintain a healthy body weight. Aloe is a best natural aid for detoxification. Aloe is colonic-specific stimulant laxatives that have a direct action on intestinal mucosa, increasing the rate of colonic motility and inhibiting water &amp; electrolyte secretion. Anthraquinones may also have stool softening properties.<br />\r\n<br />\r\n<strong>Hyoscyamus niger</strong>: It contains the alkaloids hyoscyamine and scopolamine. It is used to provide symptomatic relief of spasms caused by various lower abdominal and bladder disorders including peptic ulcers, irritable bowel syndrome, colic &amp; cystitis.<br />\r\n<br />\r\n<strong>Piper nigrum</strong>: It contains 3, 4-dihydroxy phenyl ethanol glycosides, piperine, polysac- charides, fatty oil &amp; volatile oil. It stimulates the thermal receptors and increases secretion of saliva and gastric mucus. It influences liver metabolic functions.</p>', '<p>1-2 tablets daily at bedtime.</p>', '<p>Antiarrhythmic agents, diuretic agents &amp; corticosteroids.</p>', '<p>Intestinal pathological narrow or obstruction &amp; acutely inflamed intestinal diseases, e.g, Crohn&rsquo;s disease, ulcerative colitis &amp; appendicitis.</p>', '<p>Occasionally allergic reaction may occur. Chronic use may cause loss of electrolytes (Potassium) that will reverse upon discontinuation.</p>', '<p>Should not be used during Pregnancy. There is no sufficient information for use in lactation.</p>', NULL, '<p>Overdose may alter electrolyte and water balance.</p>', '<p>Herbal and Nutraceuticals</p>', '<p>Store in a cool &amp; dry place, protected from light. Keep all medicines out of reach of children.</p>', NULL, '2022-04-24 04:58:34', '2022-04-24 04:58:34'),
(1552, 1552, '<p>This in indicated in-</p>\r\n\r\n<ul>\r\n	<li>Hyperacidity</li>\r\n	<li>Indigestion</li>\r\n	<li>Dyspepsia</li>\r\n	<li>Anorexia</li>\r\n	<li>Flatulence</li>\r\n	<li>Anaemia</li>\r\n	<li>Jaundice and</li>\r\n	<li>Increase body immunity</li>\r\n</ul>', '<p>Phyllanthus emblica-</p>\r\n\r\n<ul>\r\n	<li>Active Constituents: Phyllantidine, tannins, phyllenbic acid, gallic acid, ellagic acid and large amount of vitamin-C.</li>\r\n	<li>Actions: It is used as antacid, stomachic, carminative and antioxidant due to gallic acid. It is used in hyperacidity, anorexia, dyspepsia, jaundice, flatulence and gastrointestinal disorders.</li>\r\n</ul>\r\n\r\n<p>Piper longum-</p>\r\n\r\n<ul>\r\n	<li>Active constituents: Piperine, Piplartine, Piperlonguminine, sesamine volatile oil etc.</li>\r\n	<li>Actions: It is used as carminative, digestive, strengthen muscular system and nervine tonic. It can be used in anaemia, ascites, hemorrhoids, colic and splenic disorder.</li>\r\n</ul>', '<p><strong>Adult</strong>: 2-4 teaspoonful 2-3 times daily after meal.<br />\r\n<strong>Children</strong>: 1-2 teaspoonful 2-3 times daily after meal.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Store in a cool &amp; dry place, protected from light. Keep all medicines out of reach of children.</p>', NULL, '2022-04-24 04:59:44', '2022-04-24 04:59:44'),
(1553, 1553, '<p>Ambar Momiyaee-</p>\r\n\r\n<ul>\r\n	<li>Combats erectile dysfunction.</li>\r\n	<li>Is an ideal aphrodisiac and nervine tonic.</li>\r\n	<li>Restores sex hormone and depleted sexual power.</li>\r\n	<li>Relieves limpness and weakness after coitus.</li>\r\n	<li>Enhances retentive power.</li>\r\n	<li>Tones up the vital organ of the body.</li>\r\n	<li>Removes mental depression.</li>\r\n	<li>Its continuous use serves as a good general tonic.</li>\r\n</ul>', '<p>Ambar Momiyaee is a research product of Hamdard Laboratories and time tested aphrodisiac. Ambar Momiyaee is being used successfully to treat the patients of erectile dysfunction in different Hamdard clinics of the subcontinent for long time. It acts as nervine tonic and continuous use serves as a good general tonic.</p>', '<p>1 tablet twice daily to be taken with milk or as prescribed by the physician.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Store at cool and dry place, protect from light.</p>', NULL, '2022-04-24 05:00:51', '2022-04-24 05:00:51'),
(1554, 1554, '<ul>\r\n	<li>Strengthens vital organs.</li>\r\n	<li>Removes foul smell of mouth.</li>\r\n	<li>Acts as a powerful antioxidant.</li>\r\n	<li>Boosts up immune system.</li>\r\n	<li>Helps in regaining lost vigour &amp; vitality.</li>\r\n	<li>Strengthens the reproductive organs.</li>\r\n	<li>Prevents the symptoms of early aging &amp; senile debility.</li>\r\n</ul>', '<p>This is a versatile polypharmaceutical modern unani medicine with judicious combination of synergistically acting precious natural ingredients which restores physical strength, psychological strength, physiological strength and vital energy. This is being used successfully to treat patient of general debility, senile debility, nervine debility, paralysis, mental depression, sexual debility and foul smell of mouth. It is easily assimilable and more effective.</p>', '<p>1 capsule/tablet twice daily or as prescribed by the physician.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Store at cool and dry place, protect from light.</p>', NULL, '2022-04-24 05:02:29', '2022-04-24 05:02:29'),
(1555, 1555, '<p>Andrographis paniculata is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Viral fever</li>\r\n	<li>Flu</li>\r\n	<li>Common cold</li>\r\n	<li>Sinusitis</li>\r\n	<li>Upper respiratory tract infection</li>\r\n	<li>Viral hepatitis.</li>\r\n</ul>', '<p>Andrographis compounds have shown antiviral properties which appear to inhibit glycoproteins in the virus. This impedes the ability of viruses to invade cells and replicate. It also has a major effect activating the general defense functions of the immune system by stimulating the production of antibodies as well as non-specific immune responses such as increased macrophage phagocytosis, rather than by any direct antimicrobial activity. Andrographis has flavonoids, which always have an anti-inflammatory effect. In vitro studies have shown that the flavonoid activities suppressed the genetic expression of neutrophils. Similarly, studies have indicated that a variety of inflammatory proteins, including COX-2, are reduced by the presence of Andrographoloid.<br />\r\n<br />\r\nThe aerial parts and their constituent andrographolides have antihepato-toxic activity in vitro and in vivo. In vitro studies have shown that intraperitoneal administration of a methanol extract of the aerial parts to mice reduced hepatotoxicity induced by carbon tetrachloride CCl4, and reversed CCl4 induced histopathological changes in the liver. Intraperitoneal administration of andrographolide to mice inhibited the CCl4 induced increase in the activity of serum glutamate oxaloacetate transaminase, serum glutamate pyruvate transaminase, alkaline phosphatase, bilirubin and hepatic triglycerides. Andrographolide, the major antihepatotoxic component of the plant, exerted a pronounced protective effect in rats against hepato-toxicity induced by CCl4, Dgalactosamine, paracetamol and ethanol.<br />\r\n<br />\r\nMoreover, andrographolide and related diterpenes are choleretic, antidiarrheal, immunostimulant, antimalarial, antipyretic and active in urinary tract infections.</p>', '<p><strong>Age 18 and above</strong>: 1 capsule 3 times daily after meal for 5 to 10 days.<br />\r\n<strong>12 to 17 years</strong>: 1 capsule 2 times daily after meal for 5 to 10 days.<br />\r\n<strong>4 to 11 years</strong>: 1 capsule daily after meal for 5 to 10 days or as directed by the physician.</p>', '<p>May have a synergistic effect with isoniazid.</p>', '<p>Andrographis is contraindicated in cases of known allergy to plants of the acanthaceae family</p>', '<p>Large oral doses may cause gastric discomfort, vomiting and loss of appetite. These side-effects appear to be due to the bitter taste of andrographolide.</p>', '<p>Andrographis should not be used during pregnancy or lactation.</p>', NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-04-24 05:04:47', '2022-04-24 05:04:47'),
(1556, 1556, '<p>For digestive disorders and teething troubles, it is a palatable way to fight against griping, flatulence, convulsions, diarrhoea and indigestion, so common among infants and teething children.</p>', '<p>This is specially made for the proper growth and development of infants and children. It is totally free of alcohol and chemical that may be harmful to their delicate systems. This contains curative herbs and natural oils in a modern formulation that relieves stomach pain and gently soothes the digestive system.</p>', '<p>Up to 6 months: 1/2 teaspoonful<br />\r\n6 months to 1 year: 1 teaspoonful<br />\r\n1 year &amp; above: 2 teaspoonfuls 3-4 times daily or as prescribed by the physician.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Store in cool and dry place, protect from light.</p>', NULL, '2022-04-24 05:06:04', '2022-04-24 05:06:04'),
(1557, 1557, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-05-09 19:44:22', '2022-05-09 19:44:22'),
(1558, 1558, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-05-10 21:35:09', '2022-05-10 21:35:09'),
(1559, 1559, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-06-02 01:25:57', '2022-06-02 01:25:57'),
(1560, 1560, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-06-04 04:17:20', '2022-06-04 04:17:20'),
(1561, 1561, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-06-07 00:08:16', '2022-06-07 00:08:16'),
(1562, 1562, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-06-08 17:48:10', '2022-06-08 17:48:10'),
(1563, 1563, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-06-08 17:49:22', '2022-06-08 17:49:22');

-- --------------------------------------------------------

--
