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
(972, 972, '<p>This inhaler is used for asthma as follows:</p>\r\n\r\n<ul>\r\n	<li>This inhaler is a prescription medicine used to control symptoms of asthma and prevent symptoms such as wheezing in people 12 years of age and older.</li>\r\n	<li>This inhaler contains Formoterol which is a Long Acting &beta;2 Agonist (LABA). When it is used alone increase the risk of hospitalizations and death from asthma problems. This contains an ICS and a LABA. When an ICS and LABA are used together, there is not a significant increased risk in hospitalizations and death from asthma problems.</li>\r\n	<li>This inhaler is not for adults and adolescent patients with asthma who are well controlled with an asthma control medicine, such as a low to medium dose ICS medicine. This inhaler is for adults and adolescent patients with asthma who need both an ICS and LABA medicine.</li>\r\n</ul>', '<p>Mometasone furoate is an inhaled corticosteroid- ICS for short. Inhaled corticosteroids help to decrease inflammation in the lungs. Infammation in the lungs can lead to breathing problems. Formoterol fumarate is a long-acting beta-2 agonist- LABA for short. LABA medicines help the muscles around the airways of the lungs stay relaxed to prevent asthma symptoms, such as wheezing, cough, chest tightness, and shortness of breath. These symptoms can happen when the muscles around the airways tighten. This makes it hard to breathe.</p>', '<p><strong>Adult and adolescent patients aged 12 Years and older</strong>: Dosage is either 2 inhalations twice daily of 200 HFA inhaler or 100 HFA inhaler. When choosing the starting dosage strength of this inhaler, consider the patients&#39; disease severity, based on their previous asthma therapy, including the inhaled corticosteroid dosage, as well as the patients&#39; current control of asthma symptoms and risk of future exacerbation. The maximum recommended dosage is two inhalations of 200 HFA inhaler twice daily (maximum daily dosage 800 mcg/20 mcg). After each dose of 2 puffs, rinse your mouth with water. Spit out the water. Do not swallow it. This will help to prevent thrush in your mouth or throat.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Remove the cap and shake the inhaler vigorously before each use.</li>\r\n	<li>Holding the inhaler well away from your mouth, breathe out gently (but not fully).</li>\r\n	<li>Place the mouthpiece in your mouth and close your lips around it.</li>\r\n	<li>After starting to breathe in slowly and deeply through your mouth, press the metal canister firmly to release the powder, and continue to breathe in.</li>\r\n	<li>Remove the inhaler from your mouth and hold your breath for 10 seconds, or as long as it is comfortable, then breathe out slowly.</li>\r\n	<li>If you take a second inhalation, you should wait for at least one minute before repeating steps 2, 3 and 4. After use replace the cap on the mouthpiece.</li>\r\n	<li>Check your technique in front of a mirror from time to time, if you see a white mist during the inhalation you may not have closed your lips properly around mouthpiece, or you may not be breathing in as you press the can. This indicates failure of technique. If this happens, repeat the procedure from step 2 carefully.</li>\r\n	<li>It is very important that the plastic mouthpiece is to be cleaned regularly to prevent build-up of spare powder. Remove the metal canister and wash the plastic mouthpiece in warm water at least twice a week. Leave to dry in a warm place overnight. No harm will come with from washing the mouthpiece every day. For further assistance / information please consult with your physician.</li>\r\n</ul>', '<ul>\r\n	<li>Strong cytochrome P450 3A4 inhibitors: Use with caution. May cause increased systemic corticosteroid effects.</li>\r\n	<li>Adrenergic agents: Use with caution. Additional adrenergic drugs may potentiate sympathetic effects</li>\r\n	<li>Xanthine derivatives and diuretics: Use with caution. May potentiate ECG changes and/or hypokalemia.</li>\r\n	<li>MAO inhibitors, tricyclic antidepressants, macrolides, and drugs that prolong QTc interval: Use with extreme caution. May potentiate effect on the cardiovascular system.</li>\r\n	<li>Beta-blockers: Use with caution and only when medically necessary. May decrease effectiveness and produce severe bronchospasm.</li>\r\n	<li>Halogenated hydrocarbons: There is an elevated risk of arrhythmias in patients receiving concomitant anesthesia with halogenated hydrocarbons.</li>\r\n</ul>', '<p>This combination is contraindicated in the primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required. This combination is contraindicated in patients with known hypersensitivity to Mometasone Furoate, Formoterol Fumarate, or any of the ingredients in this combination.</p>', '<p>The most common side effects of this combination include inflammation of the nose and throat, inflammation of the sinuses, headache, flu, and upper respiratory infection. Other less common side-effects include: serious allergic reactions, thrush in the mouth &amp; throat, reduces adrenal function, increase in wheezing, lower bone mineral density in osteoporosis patient, slowed growth in children, glaucoma, blurred vision &amp; hypokalemia.</p>', '<p>The use of this combination during pregnancy and lactation should be restricted to those patients in whom the benefits clearly outweigh the risk.</p>', NULL, NULL, NULL, '<p>Keep out of the reach of children. Store below 30&deg;C protected from direct sunlight and heat. Keep away from contact of eyes. The container should not be punctured, broken or burnt even when apparently empty.</p>', '<p>Hepatic/Renal Impairment: There are no data regarding the specific use of this combination in patients with hepatic or renal impairment.<br />\r\n<br />\r\nGeriatrics: The pharmacokinetics of this combination have not been specifically studied in the elderly population.</p>', '2022-03-10 17:21:20', '2022-03-10 17:21:20'),
(973, 973, '<p>This is used for relief of occasional constipation. This product usually produces a bowel movement in 1 to 5 minutes.</p>', NULL, '<p><strong>Adults and children, 12 years and over</strong>: One Bottle per day.<br />\r\n<strong>Children between 2 and 11 years</strong>: Use this laxative preparation.<br />\r\n<strong>Children under 2 years</strong>: Do not use.<br />\r\n<br />\r\nIf no urge is felt after 5 minutes of using, try to empty bowel. Call a doctor promptly if no liquid comes out of the rectum after 30 minutes because dehydration could occur.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Remove the orange protective shield from this&nbsp;before inserting.</li>\r\n	<li>With steady pressure, gently insert this bottle tip into the rectum with a slight side-to-side movement, with the tip pointing toward the navel. Insertion may be easier if the person receiving this bears down as if having a bowel movement. This helps relax the muscles around the anus.</li>\r\n	<li>Stop using if the tip is hard to insert. Forcing the tip into the rectum can cause injury (especially if you have hemorrhoids). If this bottle tip causes rectal bleeding or pain, get immediate medical care.</li>\r\n	<li>Squeeze bottle until nearly all liquid is gone. It is not necessary to empty the bottle completely, as it contains more liquid than needed.</li>\r\n	<li>Remove the tip from the rectum and maintain position until the urge to evacuate is strong (usually 1 to 5 minutes).</li>\r\n</ul>\r\n\r\n<p>Positions for using this:</p>\r\n\r\n<ul>\r\n	<li>Left-side position: Lie on left side with knee bent, and arms resting comfortably.</li>\r\n	<li>Knee-chest position: kneel, then lower head and chest forward until left side of face is&nbsp;resting on surface with left arm folded comfortably.</li>\r\n</ul>\r\n\r\n<p>If no urge is felt after 5 minutes of using, try to empty bowel. Call a doctor promptly if no liquid comes out of the rectum after 30 minutes because dehydration could occur.</p>', NULL, '<p>Using more than one bottle in 24 hours can be harmful. Do not use without asking a doctor:</p>\r\n\r\n<ul>\r\n	<li>For more than 3 days</li>\r\n	<li>If you have kidney disease</li>\r\n	<li>If you have heart problems</li>\r\n	<li>If you are dehydrated</li>\r\n	<li>When abdominal pain, nausea, or vomiting are present.</li>\r\n</ul>', NULL, '<p>If pregnant or breastfeeding, ask a health professional before use.</p>', '<p>Ask a doctor before using this product if you:</p>\r\n\r\n<ul>\r\n	<li>Are 55 years old or older</li>\r\n	<li>Are on a sodium-restricted diet</li>\r\n	<li>Have a sudden change in bowel habits lasting more than 2 weeks</li>\r\n	<li>Already used a laxative for more than 1 week</li>\r\n</ul>\r\n\r\n<p>Stop use and ask a doctor if you have:</p>\r\n\r\n<ul>\r\n	<li>Rectal bleeding</li>\r\n	<li>No bowel movement or no liquid comes out of the rectum after 30 minutes</li>\r\n	<li>Symptoms of dehydration (feeling thirsty, dizziness, vomiting, urinating less often than normal)</li>\r\n</ul>', NULL, '<p>Other laxative preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children. If swallowed, get medical help or contact a Poison Control Center right away.</p>', NULL, '2022-03-10 17:23:13', '2022-03-10 17:23:13'),
(974, 974, '<p>Monosemicarbazone Adrenochrome is indicated in the prevention and treatment of surgical and non-surgical capillary bleedings.</p>', '<p>Adrenochrome Monosemicarbazone is a haemostatic with a rapid onset of action. It contains a water soluble form of adrenochrome monosemicarbazone, a stable derivative of adrenochrome as the active substance. Adrenochrome is an oxidation product of adrenaline; it reduces normal and pathologic bleeding time by decreasing capillary permeability. It produces capillary haemostatis without exerting any of the adrenergic actions on respiration or cardiovascular system. Thus, despite its adrenaline like action on small blood vessels, does not give rise to the general systemic effects of sympathomimetic drugs.</p>', '<p>For the prevention and treatment of capillary bleedings, accordingly to the severity of the case, 4-12 tablets divided over the day, preferably one hour before meals. Prior to surgery, medication is started on the preceding evening, either orally or by intramuscular or subcutaneous injection of usually 1.5-5 mg. In addition, an injection is given about half an hour before the surgical intervention.<br />\r\n<br />\r\nInjection solution should be administered by intramuscular or subcutaneous route; in emergency cases the injections may be given intravenously. The tablets should be taken orally.</p>', '<p>No specific drug interaction has been demonstrated.</p>', '<p>There are no known contraindications.</p>', '<p>No adverse reactions have been reported at the recommended dosages.</p>', '<p>During pregnancy, the benefits of the use of Monosemicarbazone Adrenochrome should be weighed against the possible hazards of the foetus.</p>', '<p>Because of the content of diprophylline (90 mg/ml), the dosage of the 5 mg/ml injection preparation to premature babies, infants and young children should not exceed 0.3 ml.</p>', NULL, '<p>Anti-fibrinolytic drugs.</p>', '<p>Store in a cool (in between 2&deg;-25&deg;C), dry place &amp; protect from light. Keep out of the reach of children.</p>', NULL, '2022-03-10 17:25:19', '2022-03-10 17:25:19'),
(975, 975, '<p>Monosulfiram solution is a parasiticide, active against the burrowing mite Sarcoptes scabiei. It is indicated for the treatment and prophylaxis of scabies.</p>', '<p>Monosulfiram, is an ectoparasiticide used in the treatment and prevention of scabies.</p>', '<p>Before application Monosulfiram Solution should be diluted with two to three parts of water. The patient&#39;s body should be liberally washed with soap and water and thoroughly dried. Apart from face and scalp, the entire body should be painted with the dilute solution, which is rubbed well in and left to dry. About ten minutes is allowed for the skin to dry naturally and the patient then dresses. Application is suitable for use in clinics dealing with children. In difficult cases this routine may be repeated successively for two or three days. These instructions are applicable to adults and children.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Known idiosyncratic response to its application. The solution should not be applied near a naked flame. Because of the close chemical relationship between monosulfiram and disulfiram, it is advisable to abstain from alcohol before and for at least 48 hours after the application of Monosulfiram.</p>', '<p>Very few side-effects occur with Monosulfiram Solution even in cases of undiluted application. A few cases of erythematous rash considered as idiosyncratic response have been reported.</p>', '<p>Pregnancy Category is not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', NULL, '<p>The solution contains alcohol and monosulfiram, and if ingested this combination will produce a severe reaction with flushing, dyspnoea, headache, dizziness, nausea, vomiting, drowsiness or sleep. Tachycardia and hypotension may also occur and the resultant myocardial ischaemia may be fatal. Symptomatic measures are required supply of oxygen, if dysponea is excessive, and control of the blood pressure. Other treatment which has been found useful includes application of cardiac stimulants, intravenous iron, ascorbic acid and nicotinamide, adenine and intravenous sodium thiosulphate.</p>', '<p>Parasiticidal preparations</p>', '<p>Store at room temperature (below 35&deg; C). Monosulfiram Solution should not be stored in a cold place as this causes deposition of crystals. These can be redissolved by immersing the bottle in warm water. The solution is flammable and should not be kept near naked flame. Water is a suitable diluents for Monosulfiram.</p>', NULL, '2022-03-10 17:27:39', '2022-03-10 17:27:39'),
(976, 976, '<p>Montelukast Sodium is indicated for:</p>\r\n\r\n<ul>\r\n	<li>Prophylaxis and chronic treatment of asthma</li>\r\n	<li>Acute prevention of Exercise-Induced Bronchoconstriction (EIB)</li>\r\n	<li>Relief of symptoms of Allergic Rhinitis (AR): Seasonal &amp; Perennial Allergic Rhinitis</li>\r\n</ul>', '<p>Montelukast is a selective and orally active leukotriene receptor antagonist that inhibits the cysteinyl leukotriene receptor (CysLT1). The cysteinyl leukotrienes (LTC4, LTD4, LTE4) are products of arachidonic acid metabolism and are released from various cells, including mast cells and eosinophils. Cysteinyl leukotrienes and leukotriene receptor occupation have been correlated with the pathophysiology of asthma &amp; allergic rhinitis, including airway edema, smooth muscle contraction, and altered cellular activity associated with the inflammatory process, which contribute to the signs and symptoms of asthma.</p>', '<p>Adults &amp; adolescents (15 years &amp; older)-</p>\r\n\r\n<ul>\r\n	<li><strong>Asthma &amp; Allergic Rhinitis</strong>: 10 mg/day&nbsp;</li>\r\n	<li><strong>Exercise-Induced Bronchoconstriction</strong>: 10 mg/day</li>\r\n</ul>\r\n\r\n<p>Pediatric patients (6 to 14 years)-</p>\r\n\r\n<ul>\r\n	<li><strong>Asthma &amp; Allergic Rhinitis</strong>: 5 mg/day&nbsp;</li>\r\n	<li><strong>Exercise-Induced Bronchoconstriction</strong>: 5 mg/day</li>\r\n</ul>\r\n\r\n<p>Pediatric patients (6 months to 5 years)-</p>\r\n\r\n<ul>\r\n	<li><strong>Asthma &amp; Allergic Rhinitis</strong>: 4 mg/day&nbsp;</li>\r\n	<li><strong>Exercise-Induced Bronchoconstriction</strong>: Not recommended</li>\r\n</ul>\r\n\r\n<p>Patients with both asthma and allergic rhinitis should take only one dose daily in the evening. For prevention of Acute prevention of Exercise-Induced Bronchoconstriction, a single dose should be taken at least 2 hours before exercise.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Route of administration: Oral. Montelukast may be taken with or without food or as directed by the physician.</p>', '<p><strong>With medicine</strong>: No dose adjustment is needed when montelukast is co-administered with theophylline, prednisone, prednisolone, terfenadine, digoxin, warfarin, gemfibrozil, itraconazole, thyroid hormones, sedative-hypnotics, non-steroidal anti-inflammatory agents, benzodiazepines, decongestants, oral contraceptives, and Cytochrome P450 (CYP) enzyme inducers.<br />\r\n<br />\r\n<strong>With food and others</strong>: Bioavailability and other conditions were not significantly observed with food &amp; other conditions.</p>', '<p>Montelukast is contraindicated in patients who are hypersensitive to any component of this product.</p>', '<p><strong>Common</strong>: Diarrhoea, fever, gastrointestinal discomfort, headache, nausea, vomiting, skin reactions, upper respiratory tract infection.<br />\r\n<br />\r\n<strong>Uncommon</strong>: Akathisia, anxiety, arthralgia, asthenia, abnormal behavior, depression, dizziness, drowsiness, dry mouth, haemorrhage, irritability, malaise, muscle complaints, oedema, seizure, abnormal sensation, sleep disorders.<br />\r\n<br />\r\n<strong>Rare</strong>: Angioedema, concentration impaired, disorientation, eosinophilic granulomatosis with polyangiitis, erythema nodosum, hallucination, hepatic disorders, memory loss, palpitations, pulmonary eosinophilia, suicidal tendencies, tremor.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. Montelukast should be used during pregnancy only if clearly needed. Montelukast is excreted in breast milk. So caution should be exercised when Montelukast is given to a nursing mother.</p>', '<p>Montelukast is not indicated for use in the reversal of bronchospasm in acute asthma attacks, including status asthmatic. Neuropsychiatric events including agitation, hostility, anxiousness, depression, disorientation, disturbance in attention, dream abnormalities, hallucinations, insomnia, irritability, memory impairment, restlessness, somnambulism, suicidal thinking and behavior (including suicide) and tremor.</p>', '<p>There were no adverse experiences in the majority of overdosage reports. The most frequently occurring adverse experiences were consistent with the safety profile of Montelukast and included abdominal pain, somnolence, thirst, headache, vomiting and psychomotor hyperactivity. In the event of overdose, it is reasonable to employ the usual supportive measures; e.g., remove unabsorbed material from the gastrointestinal tract, employ clinical monitoring, and institute supportive therapy, if required.</p>', '<p>Leukotriene receptor antagonists.</p>', '<p>Store in cool &amp; dry place below 30&deg;C, protect from light &amp; moisture. Keep out of reach of children.</p>', NULL, '2022-03-10 17:30:07', '2022-03-10 17:30:07'),
(977, 977, '<p>This&nbsp;medication&nbsp;is used to help relieve moderate to severe pain.&nbsp;Morphine&nbsp;belongs to a class of drugs known as&nbsp;opioid&nbsp;(narcotic) analgesics. It works in the&nbsp;brain&nbsp;to change how your body feels and responds to pain.</p>', '<p>Morphine is a phenanthrene derivative which acts mainly on the CNS and smooth muscles. It binds to opiate receptors in the CNS altering pain perception and response. Analgesia, euphoria and dependence are thought to be due to its action at the mu-1 receptors while resp depression and inhibition of intestinal movements are due to action at the mu-2 receptors. Spinal analgesia is mediated by morphine agonist action at the K receptor.</p>', '<p><strong>Oral-&nbsp;</strong>Moderate to severe pain:&nbsp;5-20 mg 4 hrly. Extended-release: 5-20 mg 12 hrly. Dosage is dependent on the severity of pain.<br />\r\n<br />\r\n<strong>Intraspinal-&nbsp;</strong>Moderate to severe pain:&nbsp;Initially, 5 mg epidural inj; after 1 hr, additional doses of 1-2 mg may be given up to a total dose of 10 mg/24 hr if pain relief is unsatisfactory. A dose of 20-30 mg daily may be required in some patients. Liposomal inj: 10-20 mg depending on the type of surgery.<br />\r\n<br />\r\n<strong>Intrathecal-&nbsp;</strong>Moderate to severe pain: 0.2-1 mg once daily or 1-10 mg daily for patients with opioid tolerance. Some patients may require a dose of up to 20 mg daily.<br />\r\n<br />\r\n<strong>Intravenous-&nbsp;</strong>Acute pulmonary oedema:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;5-10 mg via slow inj at 2 mg/min.</li>\r\n	<li><strong>Elderly:</strong>&nbsp;Half of the usual adult dose.</li>\r\n</ul>\r\n\r\n<p><strong>Intravenous-&nbsp;</strong>Pain associated with myocardial infarction:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;5-10 mg at 1-2 mg/min followed by a further 5-10 mg as necessary.</li>\r\n	<li><strong>Elderly:</strong>&nbsp;Half of the usual adult dose.</li>\r\n</ul>\r\n\r\n<p><strong>Parenteral-&nbsp;</strong></p>\r\n\r\n<ul>\r\n	<li><strong>Moderate to severe pain</strong>:&nbsp;5-20 mg; 2.5-10 mg via slow IV inj over 4-5 min with patient in recumbent position or a starting dose of 1-2 mg/hr via continuous IV infusion (max: 100 mg/day; 4 g/day in cancer patients). Doses may be adjusted according to severity of pain and patient&#39;s response.</li>\r\n	<li><strong>Premedication in surgery</strong>:&nbsp;Up to 10 mg, given 60-90 min before operation.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>May be taken with or without food. May be taken with meals to reduce GI discomfort.</p>', '<p>Additive depressant effects with other CNS depressants (e.g. sedatives, hypnotics, general anaesth, phenothiazines, other tranquilisers). May enhance the neuromuscular blocking action of skeletal muscle relaxants. Reduced analgesic effect with mixed agonist/antagonist opioid analgesics (e.g. pentazocine, nalbuphine, buprenorphine). Increased plasma concentrations with cimetidine. May reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. May delay the absorption of mexiletine. May antagonise the GI effect of cisapride, domperidone and metoclopramide. May produce hyperpyrexia and CNS toxicity with dopaminergics.</p>', '<p>Resp depression, obstructive airway disease, delayed gastric emptying, acute abdomen, heart failure secondary to chronic lung disease, known or suspected paralytic ileus, phaeochromocytoma. Concurrent admin with MAOIs or within 2 wk after treatment.</p>', '<p>Nausea, vomiting, constipation, abdominal pain, dry mouth, anorexia, taste disturbance, dyspepsia, resp depression, sedation, dizziness, confusion, insomnia, headache, somnolence, involuntary muscle contractions, hyperhidrosis, rash, pruritus, asthenic conditions, HTN, bronchospasm, seizures, amenorrhoea, rhabdomyolysis, nystagmus.</p>', '<p>Parenteral or oral: C, D (if prolonged use/high doses at term)</p>', '<p>Patient with impaired resp function, severe bronchial asthma, convulsive disorders, acute alcoholism, delirium tremens, raised intracranial pressure, hypotension with hypovolaemia, cardiac arrhythmias, severe cor pulmonale, history of substance abuse, diseases of the biliary tract, pancreatitis, inflammatory bowel disorders, prostatic hypertrophy, adrenocortical insufficiency, toxic psychoses. Opioid dependent patients. Renal and hepatic impairment. Pregnancy and lactation.</p>', '<p><strong>Symptoms:</strong>&nbsp;Resp depression, pinpoint pupils, extreme somnolence progressing to stupor and coma, skeletal muscle flaccidity, cold and clammy skin and sometimes bradycardia and hypotension. Apnoea, circulatory collapse, and cardiac arrest may occur in severe cases.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Re-establish adequate resp exchange through provision of a patent airway and institution of assisted or controlled ventilation. Oxygen, IV fluid, vasopressors and other supportive measures may be employed as necessary. Naloxone may be given as antidote.</p>', '<p>Opioid analgesics</p>', '<p>Inj/oral preparations: Store between 15-30&deg;C. Liposomal inj: Store between 2-8&deg;C. Supp: Store below 25&deg;C. Protect from light.</p>', '<p>Renal Impairment: Dosage may need to be reduced.<br />\r\nHepatic Impairment: Dosage may need to be reduced.</p>', '2022-03-10 17:32:28', '2022-03-10 17:32:28'),
(978, 978, '<p>Moxifloxacin infusion is indicated for treating following infections in adults &gt;18 years of age caused by designated, susceptible bacteria.</p>\r\n\r\n<ul>\r\n	<li>Acute Bacterial Sinusitis</li>\r\n	<li>Acute Bacterial Exacerbation of Chronic Bronchitis</li>\r\n	<li>Community Acquired Pneumonia</li>\r\n	<li>Skin and Skin Structure Infections: Uncomplicated and Complicated</li>\r\n	<li>Complicated Intra-Abdominal Infections.</li>\r\n</ul>', NULL, '<p>The dose of Moxifloxacin is 400 mg once daily. The duration of therapy depends on the type of infection as described in following:</p>\r\n\r\n<ul>\r\n	<li>Acute Bacterial Sinusitis: 400 mg once daily for 10 days.</li>\r\n	<li>Acute Bacterial Exacerbation of Chronic Bronchitis: 400 mg once daily for 5 days.</li>\r\n	<li>Community Acquired Pneumonia: 400 mg once daily for 7-14 days.</li>\r\n	<li>Uncomplicated Skin and Skin Structure Infections: 400 mg once daily for 7 days.</li>\r\n	<li>Complicated Skin and Skin Structure Infections: 400 mg once daily for 7-21 days.</li>\r\n	<li>Complicated Intra-Abdominal Infections: 400 mg once daily for 5-14 days.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Moxifloxacin injection should be administered by intravenous infusion over a period of 60 minutes. Avoid bolus or rapid infusion.</p>\r\n\r\n<ul>\r\n	<li>Check the bag for minute leaks by squeezing the inner bag firmly. If leaks are found, or if seal is not intact, discard the solution.</li>\r\n	<li>Do not use if the solution is cloudy or a precipitate is present.</li>\r\n	<li>Do not use flexible bags in series connections.</li>\r\n	<li>Close flow control clamp of administration set.</li>\r\n	<li>Remove cover from port at bottom of bag.</li>\r\n	<li>Insert piercing pin of administration set into port with a twisting motion until the pin is firmly seated.</li>\r\n	<li>Suspend bag from hanger.</li>\r\n	<li>Squeeze and release drip chamber to establish proper fluid level in chamber during infusion of Moxifloxacin 400 mg intravenous infusion.</li>\r\n	<li>Open flow control clamp to expel air from set. Close clamp.</li>\r\n	<li>Regulate the rate of administration with flow control clamp.</li>\r\n</ul>', '<p>There are no data concerning an interaction of intravenous fluoroquinolones with oral antacids, sucralfate, multivitamins, didanosine, or metal cations. However, no fluoroquinolone should be co-administered with any solution containing multivalent cations, e.g., magnesium, through the same intravenous line. Quinolones, including Moxifloxacin, have been reported to enhance the anticoagulant effects of warfarin or its derivatives in the patient population. Although not observed with Moxifloxacin in predinical and clinical trials, the concomitant administration of a nonsteroidal anti-inflammatory drug with a quinolone may increase the risks of CNS stimulation and convulsions. There is limited information available on the potential for a pharmacodynamic interaction in humans between Moxifloxacin and other drugs that prolong the QTc interval of the electrocardiogram. Sotalol, a Class III antiarrhythmic, has been shown to further increase the QTc interval when combined with high doses of intravenous (IV) Moxifloxacin in dogs. Therefore, Moxifloxacin should be avoided with Class IA and Class III antiarrhythmics.</p>', '<p>Moxifloxacin is contraindicated in persons with known hypersensitivity to Moxifloxacin or other quinolone antibacterials .</p>', '<p>Treatment with Moxifloxacin (oral, IV or sequential therapy) may cause some side effects. Common (&gt;1%) side effects include headache, nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia, dizziness, pyrexia and insomnia etc. Less common (0.1 to &lt;1%) side effects include neutropenia, palpitations, tachycardia, bradycardia, vertigo, tinnitus, dry mouth, gastritis, edema, fatigue, malaise, hyperglycemia, anorexia, hyperlipidemia, hypoglycemia, dehydration, back pain and arthralgia etc.</p>', '<p>Pregnancy Category C. Because no adequate or well controlled studies have been conducted in pregnant women, Moxifloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Moxifloxacin is excreted in the breast milk of rats. Moxifloxacin may also be excreted in human milk. Because of the potential for serious adverse reactions in infants who are nursing from mothers taking Moxifloxacin, 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>Fluoroquinolones, including Moxifloxacin, are associated with an increased risk of tendinitis and tendon rupture in all ages. The risk of developing fluoroquinolone-associated tendinitis and tendon rupture is further increased in older patients usually over 60 years of age, in patients taking corticosteroid drugs, and in patients with kidney, heart or lung transplants. Fluoroquinolones have neuromuscular blocking activity and may exacerbate muscle weakness in persons with myasthenia gravis. Clostridium difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including Moxifloxacin, and may range in severity from mild diarrhea to fatal colitis.</p>', NULL, '<p>4-Quinolone preparations</p>', '<p>Store below 25&deg;C and protect from light. Avoid extreme heat and freezing. Keep out of reach of children.</p>', '<p><strong>Pediatric patients</strong>: Safety and effectiveness in pediatric patients and adolescents less than 18 years of age have not been established.<br />\r\n<br />\r\n<strong>Geriatric patients</strong>: These patients are at increased risk for developing severe tendon disorders including tendon rupture when being treated with a fluoroquinolone such as Moxifloxacin. This risk is further increased in patients receiving concomitant corticosteroid therapy.</p>', '2022-03-10 17:34:38', '2022-03-10 17:34:38'),
(979, 979, '<p>The ophthalmic solution is indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of the following organisms:</p>\r\n\r\n<ul>\r\n	<li><strong>Aerobic Gram-positive microorganisms</strong>: Corynebacterium species, Micrococcus luteus, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus warneri, Streptococcus pneumoniae, Streptococcus viridans group.</li>\r\n	<li><strong>Aerobic Gram-negative microorganisms</strong>: Acinetobacterlwoffii, Haemophilusinfluenzae, Haemophilus parainfluenzae.</li>\r\n	<li><strong>Other microorganisms</strong>: Chlamydia trachomatis.</li>\r\n</ul>', '<p>The antimicrobial action of Moxifloxacin results from inhibition of the topoisomerase II (DNA gyrase) and topoisomerase IV. DNA gyrase is an essential enzyme that is involved in the replication, transcription and repair of bacterial DNA. Topoisomerase IV is an enzyme known to play a key role in the partitioning of the chromosomal DNA during bacterial cell division.</p>', '<p><strong>Eye Drops</strong>: One drop in the affected eye 3 times per day for 7 days.<br />\r\n<br />\r\n<strong>Eye Ointment</strong>: It should be applied thinly and evenly to the affected eye three times a day for the first two days and for the next five days apply two times a day or as advised by the registered physician.</p>', '<p>Drug-drug interaction studies have not been conducted with Moxifloxacin Hydrochloride ophthalmic solution. In vitro studies indicate that Moxifloxacin does not inhibit CYP3A4, CYP2D6, CYP2C9, CYP2C19, or CYP1A2 indicating that Moxifloxacin is unlikely to alter the pharmacokinetics of drugs metabolized by these cytochrome P450 isozymes.</p>', '<p>Moxifloxacin Hydrochloride ophthalmic solution is contraindicated in patients with a history of hypersensitivity to Moxifloxacin, to other quinolones, or to any of the components in this medication.</p>', '<p>The most frequently reported ocular adverse events were conjunctivitis, decreased visual acuity, dry eye, keratitis, ocular discomfort, ocular hyperemia, ocular pain, ocular pruritus, subconjunctival hemorrhage, and tearing. These events occurred in approximately 1-6% of patients. Nonocular adverse events reported at a rate of 1-4% were fever, increased cough, infection, otitis media, pharyngitis, rash, and rhinitis.</p>', '<p>Since there are no adequate and well-controlled studies in pregnant women, Moxifloxacin Hydrochloride ophthalmic solution should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Moxifloxacin has not been measured in human milk, although it can be presumed to be excreted in human milk. Caution should be exercised when Moxifloxacin hydrochloride ophthalmic solution is administered to a nursing mother.</p>', '<p>As with other anti-infectives, prolonged use may result in overgrowth of nonsusceptible organisms, including fungi. If superinfection occurs, discontinue use and institute alternative therapy. Whenever clinical judgment dictates, the patient should be examined with the aid of magnification, such as slit lamp biomicroscopy, and, where appropriate, fluorescein staining. Patients should be advised not to wear contact lenses if they have signs and symptoms of bacterial conjunctivitis.</p>', NULL, '<p>Ophthalmic antibacterial drugs.</p>', '<p>Store bellow 25&deg;C. Do not freeze. Store in cool and dry place, protected from light. Keep out of the reach of children. Do not touch dropper tip to any surface as this may contaminate this preparation. Do not use after one month of first opening.</p>', NULL, '2022-03-10 17:36:28', '2022-03-10 17:36:28'),
(980, 980, '<p>Moxifloxacin is indicated for the treatment of acute bacterial sinusitis, acute exacerbation of chronic bronchitis, community acquired pneumonia, uncomplicated &amp; complicated skin and skin structure infections, complicated intra-abdominal infections and pelvic inflammatory disease.</p>', '<p>Moxifloxacin is a 4th generation synthetic broad spectrum, fluoroquinolone class of antibacterial drug. It has activity against a wide range of gram-positive, gram-negative, anaerobic and atypical bacteria including Mycoplasma pneumoniae. It acts by inhibiting topoisomerase II (DNA gyrase) and topoisomerase IV which are necessary for bacterial DNA replication, transcription &amp; repair.</p>', '<p><strong>Acute bacterial sinusitis</strong>: 400 mg once daily 7-10 days.<br />\r\n<strong>Acute bacterial exacerbation of chronic bronchitis</strong>: 400 mg once daily 5-10 days.<br />\r\n<strong>Community-acquired pneumonia</strong>: 400 mg once daily 7-14 days.<br />\r\n<strong>Uncomplicated skin and skin structure infections</strong>: 400 mg once daily 7 days.<br />\r\n<strong>Complicated skin and skin structure infections</strong>: 400 mg once daily 7-21 days.<br />\r\n<strong>Complicated intra-abdominal infections</strong>: 400 mg once daily 5-14 days.<br />\r\n<strong>Pelvic inflammatory disease</strong>: 400 mg once daily 14 days.</p>', '<p>Moxifloxacin absorption is decreased when administered with antacids, sucralfate, multivitamins, and multivalent cations (e.g. iron or zinc). Moxifloxacin may enhance the risk of convulsions with NSAIDs and bleeding with warfarin. So concomitant use of Moxifloxacin with them should be avoided.</p>', '<p>It is contraindicated in patients with a history of hypersensitivity to Moxifloxacin or other quinolones.</p>', '<p>Common side effects of Moxifloxacin include nausea, vomiting, diarrhea, headache and dizziness.</p>', '<p>US FDA pregnancy category C. Moxifloxacin is not recommended during pregnancy &amp; lactation.</p>', '<p>Moxifloxacin may cause an increased risk of tendinitis and tendon rupture. It should be discontinued if pain or inflammation in a tendon occurs. It should not be used in patients with known prolongation of the QT interval, patients with uncorrected hypokalemia, and patients with receiving Class IA or Class III antiarrhythmic agents.</p>', NULL, '<p>4-Quinolone preparations.</p>', '<p>Keep in a dry place, away from light and heat. Keep out of the reach of children.</p>', '<p><strong>Renal or hepatic impaired patients</strong>: No dose adjustment is necessary for patients with renal or hepatic impairment.<br />\r\n<br />\r\n<strong>Pediatric patients</strong>: Safety and effectiveness of Moxifloxacin in pediatric patients and adolescent less than 18 years of age have not been established.</p>', '2022-03-10 17:38:29', '2022-03-10 17:38:29'),
(981, 981, '<p>Moxifloxacin &amp; Dexamethasone eye drop is indicated in the treatment of eye infections caused by susceptible microorganisms and in the prevention of inflammation and bacterial infection that may occur after eye surgery.</p>', '<p>This Eye Drops is a combination of a fourth generation fluoroquinolone Moxifloxacin and a potent corticosteroid Dexmethasone. Moxifloxacin controls infection by inhibitting the DNA gyrase &amp; Topoisomerase IV. Dexamethasone effectively controls the inflammation by inhibiting the release inflammatory mediators.</p>', '<p><strong>In the prevention of infection and post-surgical ocular inflammation</strong>: Instill 1 drop, 4 times a day, in the eye to be operated, from 1 day before surgery until 15 days after surgery.<br />\r\n<br />\r\n<strong>In patients undergoing cataract surgery</strong>: The day of surgery instill the medication immediately after eye surgery.<br />\r\n<br />\r\n<strong>In patients undergoing LASIK refractive surgery</strong>: On the day of surgery instill the medication at least 15 minutes after ocular surgery.<br />\r\n<br />\r\n<strong>In eye infections caused by susceptible microorganisms</strong>: Instill 1 drop, 4 times a day, for up to 7 days.</p>', NULL, '<p>Hypersensitivity to quinolones. Epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella &amp; other viral diseases of cornea &amp; conjunctiva. Mycobacterial infection of the eye. Fungal diseases of ocular structures. Glaucoma &amp; diseases causing thinning of cornea or sclera.</p>', '<p>Moxifloxacin: Conjunctivitis decreased visual acuity, dry eye, keratitis, Ocular discomfort, hyperemia, pain, Subconjunctival hemorrhage and tearing.<br />\r\n<br />\r\nDexamethasone: Visual acuity &amp; field defects, cataract formation, secondary ocular infection following suppression of host response &amp; perforation of the globe.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. Moxifloxacin &amp; Dexamethasone combination eye drops should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Caution is advised when Moxifloxacin &amp; Dexamethasone combination eye drops is given to nursing women.</p>', '<p>For ophthalmic use only. The solution&nbsp;should not be injected under the conjunctiva, nor introduced directly into the anterior chamber of the eye. Prolonged use of steroids may result in ocular hypertension.</p>', '<p>No information is available on overdosage with this product in humans.</p>', '<p>Ophthalmic Steroid preparations.</p>', '<p>Store in a cool place, below 30&deg;C, protected from light. Once the container is opened the contents must be used within 28 days and may be stored at room temperature up to 30&deg;C. Discard after the 28 days. Keep out of reach of children.</p>', '<p><strong>Use in the elderly</strong>: No change in dosage is required when the product is administered in elderly patients.<br />\r\n<br />\r\n<strong>Use in Children</strong>: The efficacy and safety of Moxifloxacin &amp; Dexamethasone combination eye drops in pediatric patients have not been established.</p>', '2022-03-10 17:41:50', '2022-03-10 17:41:50'),
(982, 982, '<p>This ophthalmic solution is indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of the following organisms-<br />\r\n<br />\r\n<strong>Aerobic Gram-positive microorganisms</strong>: Corynebacterium species, Micrococcus luteus, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus warneri, Streptococcus pneumonia, Streptococcus viridans group.<br />\r\n<br />\r\n<strong>Aerobic Gram-negative microorganisms</strong>: Acinetobacter iwoffii, Haemophilus influenza, Haemophilus parainfluenzae.</p>', '<p>The antimicrobial action of Moxifloxacin results from inhibition of the topoisomerase II (DNA gyrase) and topoisomerase IV. DNA gyrase is an essential enzyme that is involved in the replication, transcription and repair of bacterial DNA. Topoisomerase IV is an enzyme known to play a key role in the partitioning of the chromosomal DNA during bacterial cell division.</p>', '<p>One drop in the affected eye(s) 2 times daily for 7 days.</p>', '<p>Drug-drug interaction studies have not been conducted with Moxifloxacin Hydrochloride.</p>', NULL, '<p>In 1-6% patients the most frequently reported ocular adverse events are eye irritation, pyrexia, conjunctivitis, decreased visual acuity, dry eye, ocular discomfort, ocular hyperemia, ocular pain, ocular pruritus, subconjunctival hemorrhage and tearing.</p>', '<p>Moxifloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus as there are no adequate and well-documented studies in pregnant women. Moxifloxacin has not been measured in human milk, although it can be presumed to be excreted in human milk. Caution should be exercised when Moxifloxacin is administered to a breast feeding mother.</p>', '<p>Prolonged use may result in overgrowth of non-susceptible organisms, including fungi with other anti-infective.</p>', '<p>There is practically no risk of adverse effects due to accidental ingestion, since a bottle of 5 ml eye drops solution contains only 25 mg Moxifloxacin that is much lower than recommended daily oral dose.</p>', '<p>Ophthalmic antibacterial drugs.</p>', '<p>Store in a cool and dry place away from light. Keep out of reach of children. Do not touch the dropper tip to surfaces since this may contaminate the solution. After one month of the first opening do not use the medicine of dropper.</p>', '<p><strong>Pediatric Use</strong>: The safety and effectiveness of Moxifloxacin in infants below four months of age was not proven. However, several clinical studies show that the drug may be used safely in children even younger than one month of age.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No overall differences in safety and effectiveness have been observed between elderly and younger patients.</p>', '2022-03-10 17:44:12', '2022-03-10 17:44:12'),
(983, 983, '<p>Moxonidine belongs to a group of drugs called anti-hypertensives that lower blood pressure. Moxonidine is used to treat high blood pressure.</p>', '<p>Stimulation of central alpha 2-adrenergic receptors is associated with sympathoadrenal suppression and subsequent reduction of blood pressure. As this class was further explored it was discovered that sympathoadrenal activity can also be suppressed by a second pathway with a newly discovered drug target specific to imidazolines. Specifically, moxonidine binds the imidazoline receptor subtype 1 (I1) and to a lesser extent &alpha;lpha-2-adrenoreceptors in the RSV causing a reduction of sympathetic activity, reducing systemic vascular resistance and thus arterial blood pressure<br />\r\n<br />\r\nMoreover, since alpha-2-adrenergic receptors are considered the primary molecular target that facilitates the most common side effects of sedation and dry mouth that are elicited by most centrally acting antihypertensives, moxonidine differs from these other centrally acting antihypertensives by demonstrating only low affinity for central alpha-2-adrenoceptors compared to the aforementioned I1-imidazoline receptors.</p>', '<p><strong>Adults (including the elderly)</strong>: Your treatment will normally start with one 200 microgram tablet, taken in the morning. After three weeks, your doctor may increase this dose to 400 micrograms daily, given in a single dose in the morning, or in divided doses in the morning and evening. After another three weeks, your doctor may need to increase this dose to 600 micrograms daily, given in divided doses (morning and evening). You should not take more than 400 micrograms as a single dose, or more than 600 micrograms in any one day.<br />\r\n<br />\r\nIf you forget to take a dose, take one as soon as you remember, unless it is nearly time to take the next one. Do not take a double dose to make up for a forgotten dose.<br />\r\n<br />\r\nIf you forget to take a dose, take one as soon as you remember, unless it is nearly time to take the next one. Do not take a double dose to make up for a forgotten dose.</p>', '<p>Talk to your doctor if you are taking any of the following:</p>\r\n\r\n<ul>\r\n	<li>beta-blockers, such as propranolol or atenolol, used to treat heart problems</li>\r\n	<li>other medicines used to reduce blood pressure such as furosemide a diuretic, or captopril an angiotensin-converting enzyme inhibitor</li>\r\n	<li>antidepressants such as amitriptyline</li>\r\n	<li>sleeping tablets such as zopiclone, tranquilizers such as nitrazepam, lorazepam or phenobarbital</li>\r\n	<li>Moxonidine is removed from body by kidneys through the process called &quot;tubular excretion&quot;. Other medicines removed from the kidneys in the same way could affect how moxonidine works.</li>\r\n</ul>\r\n\r\n<p>Do not drink alcohol whilst taking Moxonidine.</p>', '<p>Do NOT take Moxonidine if you:</p>\r\n\r\n<ul>\r\n	<li>Are allergic (hypersensitive) to moxonidine or any of the other ingredients of this medicine</li>\r\n	<li>Have a slow heart rate or suffer from an abnormal heart rhythm or a change in the rate of the heart beat (called &ldquo;sick sinus syndrome&rdquo; or &ldquo;2nd or 3rd degree AV-block&rdquo;</li>\r\n	<li>Have, or have had, heart failure or other heart problems</li>\r\n</ul>', '<p>The following side effects have been reported at the approximate frequencies shown:</p>\r\n\r\n<ul>\r\n	<li><strong>Very common</strong>: dry mouth, drowsiness</li>\r\n	<li><strong>Common</strong>: headache, dizziness (vertigo), flushing (vasodilation), weakness or loss of strength, confusion, sleep disturbances, nausea (feeling sick), being sick (vomiting), stomach upsets (dyspepsia), diarrhoea, rash or itching (pruritus), back pain</li>\r\n</ul>', '<p>Moxonidine is not recommended if you are pregnant, planning on becoming pregnant or are breastfeeding. Ask your doctor or pharmacist for advice before taking any medicine if you are pregnant or breastfeeding.</p>', '<p>Tell your doctor before you start to take this medicine if you:</p>\r\n\r\n<ul>\r\n	<li>have a heart problem called &quot;1st-degree AV-block&quot;</li>\r\n	<li>have a severe coronary heart disease, or have angina (chest pain at rest)</li>\r\n	<li>have poor circulation</li>\r\n	<li>have kidney disease</li>\r\n	<li>have been told you have cerebrovascular insufficiency (poor blood supply to the brain which means you are at a greater risk of stroke)</li>\r\n	<li>are below 16 years of age</li>\r\n	<li>have a rare hereditary problem of galactose intolerance, Lapp lactase deficiency or glucosegalactose malabsorption as you should not take this medicine</li>\r\n</ul>\r\n\r\n<p>Patients who are intolerant to lactose should note that Moxonidine tablets contain a small amount of lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.</p>', '<p>If you (or someone else) swallow a lot of the tablets all together, or if you think a child has swallowed any of the tablets, contact your nearest hospital casualty department or your doctor immediately. An overdose is likely to cause headache, sleepiness, dry mouth, loss of balance, dizziness, low blood pressure, slowing of the pulse, vomiting, feeling tired, weakness and pain in your stomach. Please take this leaflet, any remaining tablets and the container with you to the hospital or doctor so that they know which tablets were consumed.</p>', '<p>Anti-hypertensive</p>', '<p>Do not store above 30&deg; C. Keep blister in the outer carton in order to protect from light.</p>', '<p><strong>Patients with kidney problems</strong>:&nbsp;If you have moderate problems with your kidneys, you should not take more than one 200 microgram tablet as a single dose or more than 400 micrograms in total, a day.<br />\r\n<br />\r\n<strong>Children under 16 years of age</strong>: Moxonidine is not recommended for use in children.</p>', '2022-03-10 17:46:24', '2022-03-10 17:46:24');


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
(1015, 1015, '<p>Nandrolone Decanoate is indicated in Established Osteoporosis, Disseminated breast cancer in women (palliative therapy), Protein deficiency states occurring after major surgery or trauma, Anemia due to chronic renal failure, Aplastic anemia, Anemia due to cytotoxic therapy, Chronic debilitating disease in elderly, Postsurgical and post traumatic catabolism, During glucocorticosteroid therap.</p>', '<p>Nandrolone Decanoate is an injectable anabolic preparation. The pharmacologically active substance is nandrolone. The decanoate ester gives the preparation duration of action of about three weeks after injection. Nandrolone Decanoate is chemically related to the male hormone. Compared to testosterone, it has an enhanced anabolic and a reduced androgenic activity. This has been demonstrated in animal bioassays and explained by receptor binding studies. The low androgenicity of nandrolone Decanoate is confirmed in clinical use.<br />\r\n<br />\r\nIn the human, Nandrolone has been shown to positively influence calcium metabolism and to increase bone mass in osteoporosis. In women with disseminated mammary carcinoma Nandrolone Decanoate has been reported to produce objective regressions for many months. Furthermore, Nandrolone Decanoate has a nitrogen-saving action. This effect on protein metabolism has been established by metabolic studies and is utilized therapeutically in conditions where a protein deficiency exists such as during chronic debilitating diseases and after major surgery and severe trauma. In these conditions, Nandrolone Decanoate serves as a supportive adjunct to specific therapies and dietary measures as well as parenteral nutrition.<br />\r\n<br />\r\nAndrogenic effects (e.g. virilisation) are relatively uncommon at the recommended dosages. Nandrolone Decanoate lacks the C 17 alpha-alkyl group which is associated with the occurrence of liver dysfunction and cholestasis.</p>', '<ul>\r\n	<li>Established Osteoporosis: 50 mg every 3 weeks</li>\r\n	<li>Disseminated breast cancer in women (palliative therapy): 50 mg every 3 weeks</li>\r\n	<li>Protein deficiency states occurring after major surgery or trauma: 50 mg every 2-3 weeks</li>\r\n	<li>Anemia due to chronic renal failure: 50-200 mg per week</li>\r\n	<li>Aplastic anemia: 50-150 mg per week</li>\r\n	<li>Anemia due to cytotoxic therapy: 200 mg per week</li>\r\n	<li>Chronic debilitating disease in elderly: 100 mg</li>\r\n	<li>Postsurgical and post-traumatic catabolism: 25-50 mg every 3 weeks</li>\r\n	<li>During glucocorticosteroid therapy: 50 mg every 2-3 week</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>should be administered by deep intramuscular injection. For an optimal therapeutic effect it is necessary to administer adequate amounts of vitamins, minerals and protein in a calorie-rich diet.</p>', '<p>Due to the nature of the drug, side effects cannot be quickly reversed by discontinuing medication. Injectables in general, may cause a local reaction at the injection site. Depending on the dose, frequency and total period of administration of Nandrolone Decanoate the following undesirable effects may occur: Virilism, Hyperlipidaemia, Increased Libido, Hypertension, Dysphonia, Nausea, Abnormal hepatic function, Peliosis hepatis, Acne, Rash, Pruritus, Hirsutism, Premature fusion of Epiphyses, Decreased urine flow, Benign prostatic hyperplasia, Priapism, Enlarged penis, clitoris, Amenorrhoea, Oligomenorrhoea, Decreased sperm count, Oedema, Injection site reaction, Decreased HDL, increased Haemoglobin.</p>', '<p>Contraindicated in Pregnancy, Male breast carcinoma, Prostatic carcinoma, The patients allergic to peanuts &amp; soya and hypersensitive to the active substance or to any of the excipients including arachis oil.</p>', NULL, '<p>This medicine is contraindicated during pregnancy because of possible masculinization of foetus. There are insufficient data on the use of this medicine in pregnant women, during breast feeding to assess potential harm to the infant or a possible influence on milk production.</p>', '<p>If signs of virilisation develop, discontinuation of the treatment should be considered, preferably in consultation with the patient.<br />\r\n<br />\r\nIt is recommended to monitor patients with any of the following conditions:</p>\r\n\r\n<ul>\r\n	<li>latent or overt cardiac failure, renal dysfunction, hypertension of migraine (or a history of these conditions), since anabolic steroids may occasionally induce fluid retention</li>\r\n	<li>incomplete statural growth, since anabolic steroids in high dosages may accelerate epiphyseal closure skeletal metastases of breast carcinoma. In these patients</li>\r\n	<li>hypercalcaemia may develop both spontaneously and as a result of anabolic steroid therapy. The later can be indicative of a positive tumour response to the hormonal treatment. Nevertheless, the hypercalcaemia should first be treated appropriately and after restoration of normal calcium levels hormone therapy can be resumed</li>\r\n	<li>liver dysfunction</li>\r\n</ul>\r\n\r\n<p>The use of anabolic steroids to enhance athletic ability may carry severe risks to the user&#39;s health and should be discouraged</p>', '<p>The acute toxicity of Nandrolone Decanoate in animals is very low. There are no reports of acute over dosage with Nandrolone Decanoate in the human.</p>', '<p>Anabolic steroid (Androgens), Hormone in bone formation by stimulation</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-10 20:48:32', '2022-03-10 20:48:32'),
(1016, 1016, '<p>Nandrolone Phenylpropionate is indicated-</p>\r\n\r\n<ul>\r\n	<li>As an adjunct to specific therapies and dietary measures in pathologic conditions characterized by a negative nitrogen balance</li>\r\n	<li>For the palliative treatment of selected cases of disseminated mammary carcinoma in women</li>\r\n	<li>Osteoporosis.</li>\r\n</ul>', '<p>Nandrolone Phenylpropionate is an injectable anabolic preparation. The pharmacologically active substance is nandrolone. The phenylpropionate ester gives the preparation a duration of action of about one week after injection. Nandrolone is chemically related to the male hormone. Compared to testosterone, it has an enhanced anabolic and a reduced androgenic activity. This has been demonstrated in animal bioassays and explained by receptor binding studies. The low androgenicity of nandrolone is confirmed in clinical use.<br />\r\n<br />\r\nIn the human, Nandrolone Phenylpropionate has a nitrogen saving action. This effect on protein metabolism has been established by metabolic studies and is utilized therapeutically in conditions where a protein deficiency exists such as during chronic debilitating diseases and after major surgery and severe trauma. In these conditions, Nandrolone Phenylpropionate serves as a supportive adjunct to specific therapies and dietary measures. In women with disseminated mammary carcinoma, in selected cases Nandrolone Phenylpropionate has been reported to produce objective regressions for many months. Furthermore, Nandrolone Phenylpropionate has been shown to produce relief of bone pain in patients with osteoporosis. The similarly acting nandrolone ester, nandrolone decanoate, has been shown to increase bone mineral content in these patients. Androgenic effects (e.g. virilisation) are relatively uncommon at the recommended dosages. Nandrolone lacks the C17alpha-alkyl group which is associated with the occurrence of liver dysfunction and cholestasis.</p>', '<p>As an adjunct to specific therapies and dietary measures in pathologic conditions characterized by a negative nitrogen balance: Recommended dose is 25-50 mg every week.<br />\r\n<br />\r\nFor the palliative treatment of selected cases of disseminated mammary carcinoma in women: Recommended dose is 50 mg every week.<br />\r\n<br />\r\nOsteoporosis: Recommended dose is 50 mg every week.<br />\r\n<br />\r\nFor an optimal therapeutic effect it is necessary to administer adequate amounts of vitamins, minerals and protein in a calorie-rich diet. Nandrolone Phenylpropionate&nbsp;should be administered by deep intramuscular injection.</p>', '<p>Anabolic steroids may improve glucose tolerance and decrease the need for insulin or other antidiabetic medicines in diabetics.</p>', '<p>Contraindicated in Pregnancy, Known or suspected carcinoma of the prostate or breast in the male.</p>', '<p>High dosages, prolonged treatment and/or too frequent administration may cause:</p>\r\n\r\n<ul>\r\n	<li>Virilisation which appears in sensitive women as hoarseness, acne hirsutism and increase of libido; in prepubertal boys as an increased frequency of erections and phallic enlargement, and in girls as an increase of pubic hair and clitoral hypertrophy. Hoarseness may be the first symptom of vocal change which may end in a long-lasting, sometimes irreversible deepening of the voice.</li>\r\n	<li>Amenorrhoea.</li>\r\n	<li>Inhibition of spermatogenesis.</li>\r\n	<li>Premature epiphyseal closure.</li>\r\n	<li>Fluid retention.</li>\r\n</ul>', '<p>This medicine is contraindicated during pregnancy because of possible masculinization of the foetus. There are insufficient data on the use of this medicine during breast-feeding to assess potential harm to the infant or a possible influence on milk production.</p>', '<p>If signs of virilisation develop, discontinuation of the treatment should be considered, Preferably in consultation with the patient.<br />\r\n<br />\r\nIt is recommended to monitor patients with any of the following conditions:</p>\r\n\r\n<ul>\r\n	<li>latent or overt cardiac failure, renal dysfunction, hypertension or migraine (or a history of these conditions), since anabolic steroids may occasioally induce fluid retention:</li>\r\n	<li>incomplete statural growth, since anabolic steroids in high dosages may accelerate epiphyseal closure;</li>\r\n	<li>skeletal metastases of breast carcinoma. In these patients</li>\r\n	<li>hypercalcaemia may develop both spontaneously and as a result of anabolic steroid therapy. The later can be indicative of a positive tumour response to the hormonal treatment. Nevertheless, the hypercalcaemia should first be treated appropriately and after restoration of normal calcium levels hormone therapy can be resumed;</li>\r\n	<li>liver dysfunction.</li>\r\n</ul>\r\n\r\n<p>The use of anabolic steroids to enhance athletic ability may carry severe risks to the user&#39;s health and should be discouraged.</p>', '<p>The acute toxicity of Nandrolone Phenylpropionate in animals is very low. There are no reports of acute overdosage with Nandrolone Phenylpropionate in the human.</p>', '<p>Anabolic steroid (Androgens), Hormone in bone formation by stimulation.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-10 20:50:42', '2022-03-10 20:50:42'),
(1017, 1017, '<p>This eye drop is indicated for the symptomatic treatment of allergic conjunctivitis.</p>', '<p>Naphazoline, an imidazoline derivative is a sympathomimetic with &alpha;-adrenergic activity. It produces vasoconstriction. When applied topically to mucous membranes, it reduces swelling and congestion. It is often used in combination with pheniramine, an alkylamine derivative antihistamine, in ophthalmic preparations.</p>', '<p><strong>Adults and children 6 years of age and older</strong>: instill 1 or 2 drops in affected eye(s) up to 4 times daily.<br />\r\n<br />\r\n<strong>Children under 6 years</strong>: ask a doctor.</p>', '<p>Increased pressor effects with maprotiline or TCA. Possibility of severe hypertensive reaction with MAOI.</p>', '<p>Angle closure glaucoma.</p>', '<p>Blurring of vision, mild stinging and/or irritation, mydriasis and increased or decreased intraocular pressure. When used in high doses in elderly, naphazoline may liberate pigment granules from the iris.</p>', '<p>Pregnancy&nbsp;Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Glaucoma, hypertension, CV abnormalities, DM, hyperthyroidism, infection, or injury. Pregnancy and lactation. Avoid in infants and young children &lt;6 yr. Rebound congestion may occur with prolonged use or overuse. Patient to seek medical advice if there is ocular pain, vision changes, worsening of redness or irritation of the eye or symptoms lasts &gt;72 hr. Remove contact lens before use.</p>', NULL, '<p>Ophthalmic Non-Steroid Combined preparations.</p>', '<p>Store at room temperature 20 degrees to 25 degrees C. Protect from light. Use before expiration date marked on the carton or bottle.</p>', NULL, '2022-03-10 20:52:44', '2022-03-10 20:52:44'),
(1018, 1018, '<p>Acute and chronic non-infectious conjunctivitis, nonspecific conjunctival irritation; also after successful treatment of bacterial and viral conjunctivitis. Irrigation of the tear ducts.</p>', '<p>Zinc ions, the active compound of zinc sulphate, have an astringent, i.e. tissue-sealing and slightly anti-septic effect. Naphazoline constricts the blood vessels and reduces the inflammation and swelling of the conjunctiva. This effect of naphazoline, a substance of the benzylimidazoline group, is due to direct binding to a-adrenergic receptor sites on unstriated muscle cells in the blood vessels.</p>', '<p><strong>Adults</strong>: 1 drop in the conjunctival sac, three to 4 times per day.<br />\r\n<br />\r\n<strong>Children</strong>: Naphazoline nitrate and Zinc sulphate drops has not been studied in children. Generally, in children the dosage of vasoconstrictors should be low and selected with caution.</p>', '<p>Naphazoline containing products should not be administered during treatment with MAO-blockers nor during 10 days after discontinuation of such treatment. The effects of Naphazoline may be increased by concomitant use of tricyclic antidepressants.</p>', '<p>Hypersensitivity to zinc sulphate, Naphazoline and other ingredients. Naphazoline &amp; Zinc is contraindicated in patients suffering from narrow-angle glaucoma, dry eye and especially keratoconjunctivits sicca Sjogren&#39;s syndrome. Naphazoline &amp; Zinc must not be used in infants.</p>', '<p>Mydriasis and a slight increase of intraocular pressure in isolated cases. A slight and transient burning sensation may occur after instillation, which does not affect the success of the treatment. Long term use may result in reactive redness of the eye (rebound effect).<br />\r\n<br />\r\nIn very rare cases systemic cardiovascular effects, such as hypertension and arrhythmia, may occur. Nonspecific fatigue has been observed in some patients.</p>', '<p><strong>Use in pregnancy</strong>: There are neither controlled animal studies nor studies in pregnant women available.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: The effects of Naphazoline &amp; Zinc treatment during lactation have not been investigated.</p>', '<p>Uncontrolled use of Naphazoline &amp; Zinc over extended periods of time should be avoided. If no improvement is seen after 2 days, treatment should be discontinued and other therapeutic measures should be considered. If ocular discomfort or visual disturbance occurs during Naphazoline &amp; Zinc treatment, the therapy must be discontinued. Caution is indicated in patients with predisposition to glaucoma and in patients suffering from hypertension, cardiovascular diseases, pheochromocytoma, aneurysm, hyperglycemia, and hyperthyroidism.</p>', NULL, '<p>Ophthalmic Non-Steroid drugs.</p>', NULL, NULL, '2022-03-10 20:54:30', '2022-03-10 20:54:30'),
(1019, 1019, '<p>Naproxen is indicated for the relief of sign and symptoms of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, juvenile arthritis, tendonitis, bursitis &amp; acute gout. It is also indicated for the management of primary dysmenorrhea &amp; pain.</p>', '<p>Naproxen is a non steroidal anti-inflammatory drug (NSAID) with anti-inflammatory, analgesic &amp; antipyretic properties. It is rapidly absorbed from the gastrointestinal tract and achieves 95% bioavailability.</p>', '<p>Naproxen Tablet-</p>\r\n\r\n<ul>\r\n	<li><strong>Rheumatoid arthritis, osteoarthritis and ankylosing spondylitis</strong>: The usual dose is 500-1000 mg daily in two divided doses after meals.</li>\r\n	<li><strong>Management of pain, primary dysmenorrhea, acute tendonitis &amp; bursitis</strong>: Recommended starting dose is 500 mg followed by 500 mg every 12 hours or 250 mg every 6-8 hours. The initial total daily dose should not exceed 1250 mg and thereafter, the total daily dose should not exceed 1000 mg.</li>\r\n	<li><strong>Acute gout</strong>: Recommended starting dose is 750 mg followed by 250 mg every 8 hours until the attack has subsided.</li>\r\n</ul>\r\n\r\n<p>Naproxen Suspension-</p>\r\n\r\n<ul>\r\n	<li><strong>For Juvenile rheumatoid arthritis</strong>: The usual dose for children over 2 years is 10 mg/kg/day given as two divided doses at 12-hours intervals. Therapy in children under 2 years of age is not recommended.</li>\r\n</ul>\r\n\r\n<p>Naproxen Gel-</p>\r\n\r\n<ul>\r\n	<li>Is to be applied 2-6 times a day as required and is not recommended for use in children.</li>\r\n</ul>', '<p><strong>ACE inhibitors</strong>: diminish the antihypertensive effect of ACE inhibitors.<br />\r\n<strong>Antacids &amp; Sucralfate</strong>: delay the absorption of Naproxen.<br />\r\n<strong>Aspirin</strong>: increase adverse effects.<br />\r\n<strong>Diuretics</strong>: reduce the natriuretic effect of Furosemide and Thiazides.<br />\r\n<strong>Methotrexate</strong>: enhance the toxicity of Methotrexate.<br />\r\n<strong>Warfarin</strong>: increase the risk of GI bleeding.<br />\r\n<strong>Selective Serotonin Reuptake Inhibitors (SSRI)</strong>: increase the risk of GI bleeding.</p>', '<p>Naproxen is contraindicated in patients with known hypersensitivity to Naproxen. It should not be given to patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. It is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.</p>', '<p>Most frequently reported side effects include following:</p>\r\n\r\n<ul>\r\n	<li><strong>Gastrointestinal</strong>: Heartburn, abdominal pain, nausea, diarrhea, dyspepsia.</li>\r\n	<li><strong>Central Nervous System</strong>: Headache, vertigo, drowsiness.</li>\r\n	<li><strong>Dermatological</strong>: Pruritus (itching), purpura.</li>\r\n	<li><strong>Cardiovascular</strong>: Edema, palpitation.</li>\r\n	<li><strong>Others</strong>: Visual disturbances, hearing disturbances.</li>\r\n</ul>', '<p>US FDA pregnancy category of Naproxen is C. So, Naproxen should be avoided in pregnancy &amp; lactation unless the potential benefits to the other outweigh the possible risks to the fetus.</p>', NULL, NULL, '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)</p>', '<p>Keep below 30&deg;C temperature, protected from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-10 20:56:09', '2022-03-10 20:56:09'),
(1020, 1020, '<p>Naproxen &amp; Esomeprazole is indicated for the relief of signs &amp; symptoms of-</p>\r\n\r\n<ul>\r\n	<li>Osteoarthritis</li>\r\n	<li>Rheumatoid arthritis</li>\r\n	<li>Ankylosing spondylitis &amp;</li>\r\n	<li>To decrease the risk of developing gastric ulcers in patients at risk of developing NSAID-associated gastric ulcers.</li>\r\n</ul>', '<p>This consists of an immediate release Esomeprazole Magnesium layer &amp; an enteric-coated Naproxen core. As a result, Esomeprazole is released first into the stomach, prior to the dissolution of Naproxen in the small intestine.<br />\r\n<br />\r\nNaproxen is a NSAID with analgesic &amp; antipyretic properties. The mechanism of action of Naproxen is to inhibit the prostaglandin synthesis. Esomeprazole is a proton pump inhibitor that suppresses gastric acid secretion by specific inhibition of the H+/k+&nbsp;-ATPase in the gastric parietal cell by acting specifically on the proton pump, Esomeprazole blocks the final step in acid production, thus reducing gastric acidity.</p>', '<p>Carefully consider the potential benefits &amp; risks of this tablet &amp; other treatment options before deciding to use this tablet. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals. If a dose of Esomeprazole lower than a total daily dose of 40 mg is more appropriate, a different treatment should be considered.<br />\r\n<br />\r\nRheumatoid Arthritis, Osteoarthritis and Ankylosing Spondylitis-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: One tablet twice daily of either: 375 mg naproxen/20 mg of esomeprazole; or 500 mg naproxen/20 mg of esomeprazole</li>\r\n</ul>\r\n\r\n<p>Juvenile Idiopathic Arthritis in Adolescent Patients 12 Years of Age &amp; Older-</p>\r\n\r\n<ul>\r\n	<li><strong>Weight greater than 50 kg</strong>: 375 mg naproxen/20 mg of esomeprazole; or 500 mg naproxen/20 mg of esomeprazole</li>\r\n	<li><strong>Weight 38 kg to less than 50 kg</strong>: One tablet twice daily of 375 mg naproxen/20 mg of esomeprazole.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Do not split, chew, crush or dissolve the tablet. This tablet is to be taken at least 30 minutes before meals.</p>', '<p>With medicine:</p>\r\n\r\n<ul>\r\n	<li>Concomitant use of NSAIDs may reduce the antihypertensive effect of ACE inhibitors, diuretics &amp; beta-blockers</li>\r\n	<li>Concomitant use of this tablet and warfarin may result in an increased risk of a bleeding complication.</li>\r\n	<li>Esomeprazole inhibits gastric acid secretion &amp; may interfere with the absorption of drugs where gastric pH is an important determinant of bioavailability (eg. Ketoconazole, iron salts and digoxin).</li>\r\n</ul>\r\n\r\n<p>With food &amp; others: Administration of Naproxen &amp; Esomeprazole together with high-fat food in healthy volunteers does not affect the extent of absorption of naproxen but significantly prolongs tmax&nbsp;by 10 hours and decreases peak plasma concentration (Cmax) by about 12%</p>', '<ul>\r\n	<li>Known hypersensitivity to any component of this tablet or substituted benzimidazoles.</li>\r\n	<li>History of asthmay urticaria or other allergic-type reactions after taking aspirin or other NSAIDs.</li>\r\n	<li>Use during the peri-operative period in the setting of coronary artery bypass graft (CABG) surgery.</li>\r\n</ul>', '<p>In general, this preparation is well tolerated. The most common adverse reactions in clinical trials (&gt;5%): erosive gastritis, dyspepsia, gastritis, diarrhea, gastric ulcer, upper abdominal pain, nausea etc.</p>', '<p>Pregnancy category C. In late pregnancy, it should be avoided because it may cause premature closure of the ductus arteriosus. This tablet should not be used in nursing mothers due to the Naproxen component.</p>', '<p>Patients with known CV disease/risk factors may be at greater risk. This tablet should be used with caution in patients with fluid retention or heart failure.</p>', '<p>There is no clinical data on overdosage with this tablet.<br />\r\n<br />\r\n<strong>Overdose of Naproxen</strong>: Significant naproxen overdosage may be characterized by lethargy, drowsiness, epigastric pain, abdominal discomfort, heartburn, indigestion, nausea, transient alteration in liver function, hypoprothrombinemia, renal dysfunction, metabolic acidosis, apnea, vomiting etc.<br />\r\n<br />\r\n<strong>Overdose of Esomeprazole</strong>: The major signs of acute toxicity were reduced motor activity, changes in respiratory frequency, tremor and intermittent clonic convulsions etc.</p>', '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)</p>', '<p>Store at temperature of below 30&deg;C, protect from light &amp; moisture. Keep out of reach of children.</p>', '<p><strong>Elderly patients</strong>: Studies indicate that although the total plasma concentration of naproxen is unchanged, the unbound plasma fraction of naproxen is increased in the elderly. Use caution when high doses are required &amp; some adjustment of dosage may be required in elderly patients. As with other drugs used in the elderly use the lowest effective dose.<br />\r\n<br />\r\n<strong>Patients with Moderate to Severe Renal impairment</strong>: Naproxen-containing&nbsp;products are not recommended for use in patients with moderate to severe or severe renal impairment (creatinine clearance &lt;30 ml/min).<br />\r\n<br />\r\n<strong>Hepatic insufficiency</strong>: Monitor patients with mild to moderate hepatic impairment closely &amp; consider a possible dose reduction based on the Naproxen component of this tablet. This is not recommended in patients with severe hepatic impairment because Esomeprazole dosage should not exceed 20 mg daily in these patients.</p>', '2022-03-10 20:58:26', '2022-03-10 20:58:26'),
(1021, 1021, '<p>Natamycin sterile ophthalmic suspension is indicated for the treatment of fungal blepharitis, conjunctivitis and keratitis caused by susceptible organisms including Fusarium solani.</p>', '<p>Natamycin is a tetraene polyene antibiotic derived from Streptomyces natalensis. Natamycin probably exerts its antifungal effects by binding to sterols in the fungal cell membrane to produce a change in membrane permeability that allows loss of essential cellular constituents. It possesses in vitro activity against a variety of yeast and filamentous fungi, including Candida, Aspergillus, Cephalosporium, Fusarium and Penicillium. Although the activity against fungi is dose-related, Natamycin is predominantly fungicidal. Topical administration appears to produce effective concentration of Natamycin within the corneal stroma but not in intraocular fluid.</p>', '<p><strong>For fungal keratitis</strong>: The preferred initial dosage is 1 drop instilled in the conjuntival sac (s) at 1-2 hours interval. The frequency of application can usually be reduced to 1 drop 6-8 times daily after the first 3-4 days. Therapy should generally be continued for 14 to 21 days or until there is resolution of active fungal keratitis. In many cases, it may be helpful to reduce the dosage gradually at 4 to 7 days intervals to assure the replicating fungus has been eliminated.<br />\r\n<br />\r\n<strong>For fungal blepharitis &amp; conjunctivitis</strong>: Less frequent initial dosage, 1 drop 4-6 times daily may be sufficient.</p>', '<p>May increase spread of fungal eye infection when used with topical corticosteroid.</p>', '<p>Natamycin ophthalmic suspension is contraindicated in individuals with a history of hypersensitivity to any of its component.</p>', '<p>Eye irritation, eye discomfort, eye edema, conjunctival chemosis and hyperemia has been reported.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C. Natamycin sterile ophthalmic suspension should be given to a pregnant woman only if clearly needed.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether this drug is excreted in human milk. Caution should be exercised when Natamycin is administered to a nursing mother.</p>', '<p>For topical eye use only. Failure of improvement of keratitis following 7-10 days of administration of the drug suggests that the infection may be caused by a microorganism not susceptible to natamycin.</p>', NULL, '<p>Ophthalmic antibacterial drugs.</p>', '<p>Store in a cool and dry place. Protect from light. Do not freeze. Do not use for longer than one month after first opening of the bottle.</p>', '<p><strong>Pediatric</strong>: Safety and effectiveness in paediatric patients have not been established.</p>', '2022-03-10 21:01:01', '2022-03-10 21:01:01'),
(1022, 1022, '<p>Nateglinide is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.</p>', '<p>Nateglinide, a nonsulfonylurea hypoglycaemic agent which stimulates insulin release from the pancreatic &beta;-cells by blocking ATP-dependent K channels, depolarising the membrane and facilitating Ca entry through Ca channels. This action depends on the amount of existing glucose levels.</p>', '<p><strong>Initial dose</strong>: 120 mg orally 3 times a day before meals<br />\r\n<br />\r\n<strong>Maintenance dose</strong>: 60 to 120 mg orally 3 times a day before meals<br />\r\n<br />\r\nFor patients who are near goal HbA1c when therapy is initiated, therapy should be initiated at 60 mg orally 3 times. May be used as monotherapy, or in combination with metformin or a thiazolidinedione. As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Take orally 1 to 30 minutes before a meal. Patients who skip a meal should be instructed to skip the dose for that meal</p>', '<p>CYP2C9 and CYP3A4 inhibitors or inducers may alter metabolism of nateglinide. Increased hypoglycaemic effects with MAOIs, nonselective &beta;-adrenergic blockers, NSAIDs, salicylates. Decreased hypoglycaemic effects with corticosteroids, sympathomimetic agents, thiazide diuretics, thyroid hormones.</p>', '<p>IDDM, diabetic ketoacidosis.</p>', '<p>Hypoglycaemia, upper respiratory tract infection, back pain, flu-like symptoms, dizziness, arthropathy, diarrhoea, accidental trauma, bronchitis, cough.</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>Patient with adrenal and/or pituitary impairment. Severe renal and moderate to severe hepatic impairment. Pregnancy and lactation.</p>', '<p>Symptoms: Hypoglycaemia.<br />\r\nManagement: Use IV glucose in severe reaction.</p>', '<p>Meglitinide Analogues</p>', '<p>Store at 25&deg; C.</p>', '<p><strong>Renal Dose Adjustments</strong>: No adjustment recommended<br />\r\n<br />\r\n<strong>Mild hepatic impairment</strong>: No adjustment recommended<br />\r\n<br />\r\n<strong>Moderate to severe hepatic impairment</strong>: Use caution<br />\r\n<br />\r\n<strong>Elderly</strong>: No adjustment recommended; however, some individuals may have a greater sensitivity to therapy.&nbsp;Insulin therapy may be temporarily needed in times of fever, infection, trauma, or surgery.<br />\r\n<br />\r\n<strong>Younger than 18 years</strong>: Safety and efficacy have not been established in patients younger than 18 years.</p>', '2022-03-10 21:03:16', '2022-03-10 21:03:16'),
(1023, 1023, '<p>Essential hypertension</p>', '<p>The Combination of these ingredients has an additive antihypertensive effect, reducing blood pressure to a greater degree than either component alone. This combination has mild vasodilating properties which reduces heart rate and blood pressure in hypertensive patients. Hydrochlorothiazide affects the renal tubular mechanisms of electrolyte reabsorption which directly increase the excretion of sodium and chloride in approximately equivalent amounts. The diuretic action of Hydrochlorothiazide reduces plasma volume, increases plasma renin activity and increases aldosterone secretion.</p>', '<p>Once daily, preferably at the same time every day.</p>', '<p>Nebivolol:</p>\r\n\r\n<ul>\r\n	<li>Class I &amp; III Antiarrhythmics, Calcium channel blocker (Verapamil/Diltiazem)</li>\r\n	<li>Centrally-acting antihypertensives, Anaesthetics</li>\r\n	<li>Antipsychotics, Antidepressants, NSAIDs</li>\r\n</ul>\r\n\r\n<p>Hydrochlorothiazide:</p>\r\n\r\n<ul>\r\n	<li>Drugs affecting Potassium &amp; Calcium level</li>\r\n	<li>Non-steroidal anti-inflammatory drugs (NSAIDs)</li>\r\n	<li>Concomitant administration of this combination with Antipsychotics, Tricyclic Antidepressants &amp; Barbiturates may enhance the hypotensive effect and lead to postural hypotension.</li>\r\n</ul>', '<p>Hypersensitivity to the active substances, Liver function impairment. Severe renal insufficiency (Creatinine clearance &lt; 30 ml/min.), Bradycardia, Hypotension.</p>', '<p><strong>Nebivolol</strong>: Headache, Dizziness, Tiredness, Diarrhoea, Constipation, Nausea etc.<br />\r\n<br />\r\n<strong>Hydrochlorothiazide</strong>: Vertigo, Itchiness, Rash, Increased sensitivity of skin to sunlight etc.</p>', '<p>This combination is not recommended during pregnancy. It is also not recommended for mothers who are breast-feeding.</p>', '<p><strong>Nebivolol</strong>: Beta-blockers should not be used in patients with untreated Congestive Heart Failure (CHF) &amp; bradycardia. In patients with Chronic Obstructive Pulmonary Diseases (COPD), beta-blockers should be used with caution as airway constriction may be aggravated.<br />\r\n<br />\r\n<strong>Hydrochlorothiazide</strong>: In patients with renal disease, thiazides may increase azotaemia. If progressive renal impairment becomes evident, careful reappraisal of therapy is necessary. Thiazides can cause fluid or electrolyte imbalance. Thiazides may decrease urinary calcium excretion and may cause slight elevation of serum calcium in the absence of known disorders of calcium metabolism.</p>', '<p>No data are available on Overdosage. Overdosage with Hydrochlorothiazide is associated with electrolyte depletion and dehydration resulting from excessive diuresis.</p>', '<p>Combined antihypertensive preparations</p>', '<p>Protect from light &amp; moisture. Store below 30&deg; C. Keep out of reach of children.</p>', '<p>Use in children is not recommended.</p>', '2022-03-10 21:05:27', '2022-03-10 21:05:27'),
(1024, 1024, '<p>Nebivolol is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Hypertension</li>\r\n	<li>Treatment of essential hypertension</li>\r\n	<li>Chronic heart failure (CHF)</li>\r\n	<li>Treatment of stable mild and moderate chronic heart failure in addition to standard therapies in elderly patients.</li>\r\n</ul>', '<p>Nebivolol is a &beta; adrenergic receptor blocking agent. Nebivolol inhibits both &beta;1 and &beta;1 adrenergic receptors. Nebivolol lacks intrinsic sympathomimetic and membrane stabilizing activity at therapeutically relevant concentrations. At clinically relevant doses, Nebivolol does not demonstrate &beta;1-adrenergic receptor blockade activity. Various metabolites, including glucuronides, contribute to beta-blocking activity.<br />\r\n<br />\r\nMode of Action of Nebivolol involved include:</p>\r\n\r\n<ul>\r\n	<li>decreased heart rate</li>\r\n	<li>decreased myocardia contractility</li>\r\n	<li>diminution of tonic sympathetic outflow to the periphery from cerebral vasomotor centers</li>\r\n	<li>suppression of renin activity and</li>\r\n	<li>vasodilation and decreased peripheral vascular resistance</li>\r\n</ul>\r\n\r\n<p><strong>Pharmacokinetics</strong>: Nebivolol is metabolized by a number of routes, including glucuronidation and hydroxylation by CYP2D6. The active isomer (d-nebivolol) has an effective half-life of about 12 hours in CYP2D6 extensive metabolizers (most people), and 19 hours in poor metabolizers and exposure to d-nebivolol is substantially increased in poor metabolizers. This has less importance than usual, however, because the metabolites, including the hydroxyl metabolite and glucuronides (the predominant circulating metabolites), contribute to b blocking activity.<br />\r\n<br />\r\n<strong>Absorption and Distribution</strong>: Absorption of Nebivolol is similar to an oral solution. Mean peak plasma nebivolol concentrations occur approximately 1.5 to 4 hours post-dosing in EMs and PMs. Food does not alter the pharmacokinetics of nebivolol. Nebivolol may be administered without regard to meals. The in vitro human plasma protein binding of nebivolol is approximately 98%, mostly to albumin, and is independent of nebivolol concentrations.<br />\r\n<br />\r\n<strong>Metabolism and Excretion</strong>: Nebivolol is predominantly metabolized via direct glucuronidation of parent and to a lesser extent via N-dealkylation and oxidation via cytochrome P450 2D6. After a single oral administration of 14C-nebivolol, 38% of the dose was recovered in urine and 44% in feces for EMs and 67% in urine and 13% in feces for PMs.<br />\r\n<br />\r\n<strong>Digoxin</strong>: Concomitant administration of Nebivolol (10 mg once daily) and digoxin (0.25 mg once daily) for 10 days in 14 healthy adult individuals resulted in no significant changes in the pharmacokinetics of digoxin or nebivolol.<br />\r\n<br />\r\n<strong>Warfarin</strong>: Administration of Nebivolol (10 mg once daily for 10 days) led to no significant changes in the pharmacokinetics of nebivolol or R- or S-warfarin following a single 10 mg dose of warfarin. Similarly, nebivolol has no significant effects on the anticoagulant activity of warfarin, as assessed by Prothrombin time and INR profiles from 0 to 144 hours after a single 10 mg warfarin dose in 12 healthy adult volunteers. The starting dose should be reduced in patients with moderate hepatic impairment. No formal studies have been performed in patients with severe hepatic impairment and nebivolol should be contraindicated for these patients.</p>', '<p>The dose of Nebivolol should be individualized to the needs of the patient. For most patients, the recommended starting dose is 5 mg once daily, with or without food, as monotherapy or in combination with other agents. For patients requiring further reduction in blood pressure, the dose can be increased at 2-week intervals up to 40 mg. A more frequent dosing regimen is unlikely to be beneficial.</p>', '<p>Nebivolol should be used with care when myocardial depressants or inhibitors of AV conduction, such as certain calcium antagonists (particularly of the phenylalkylamine [verapamil] and benzothiazepine [diltiazem] classes), or antiarrhythmic agents, such as disopyramide, are used concurrently. Both digitalis glycosides and &beta;-blockers slow atrioventricular conduction and decrease heart rate. Concomitant use can increase the risk of bradycardia.<br />\r\n<br />\r\nNebivolol should not be combined with other &beta;-blockers. Patients receiving catecholamine-depleting drugs, such as reserpine or guanethidine, should be closely monitored, because the added &beta;-blocking action of Nebivolol may produce excessive reduction of sympathetic activity. In patients who are receiving Nebivolol and clonidine, Nebivolol should be discontinued for several days before the gradual tapering of clonidine.<br />\r\n<br />\r\nCYP2D6 Inhibitors: Use caution when Nebivolol is co-administered with CYP2D6 inhibitors (quinidine, propafenone, fluoxetine, paroxetine, etc.)</p>', '<p>Nebivolol is contraindicated in patients with severe bradycardia, heart block greater than first degree, cardiogenic shock, decompensated cardiac failure, sick sinus syndrome (unless a permanent pacemaker is in place), or severe hepatic impairment (Child-Pugh &gt;B), and in patients who are hypersensitive to any component of this product.</p>', '<p>Headache, nausea and bradycardia.</p>', NULL, '<p><strong>Abrupt Cessation of Therapy</strong>: Patients with coronary artery disease treated with Nebivolol should be advised against abrupt discontinuation of therapy. Severe exacerbation of angina and the occurrence of myocardial infarction and ventricular arrhythmias have been reported in patients with coronary artery disease following the abrupt discontinuation of therapy with &beta;-blockers. Myocardial infarction and ventricular arrhythmias may occur with or without preceding exacerbation of the angina pectoris. Even patients without overt coronary artery disease should be cautioned against interruption or abrupt discontinuation of therapy. As with other &beta;-blockers, when discontinuation of Nebivolol is planned, patients should be carefully observed and advised to minimize physical activity. Nebivolol should be tapered over 1 to 2 weeks when possible. If the angina worsens or acute coronary insufficiency develops, it is recommended that Nebivolol be promptly reinstituted, at least temporarily.<br />\r\n<br />\r\n<strong>Cardiac Failure</strong>: Sympathetic stimulation is a vital component supporting circulatory function in the setting of congestive heart failure, and (&beta;-blockade may result in further depression of myocardial contractility and precipitate more severe failure. In patients who have compensated congestive heart failure, Nebivolol should be administered cautiously. If heart failure worsens, discontinuation of Nebivolol should be considered.<br />\r\n<br />\r\n<strong>Angina and Acute Myocardial Infarction</strong>: Nebivolol was not studied in patients with angina pectoris or who had a recent Ml.<br />\r\n<br />\r\n<strong>Bronchospastic Diseases</strong>: In general, patients with bronchospastic diseases should not receive (3-blockers.<br />\r\n<br />\r\n<strong>Anesthesia and Major Surgery</strong>: If Nebivolol is to be continued perioperatively, patients should be closely monitored when anesthetic agents which depress myocardial function, such as ether, cyclopropane, and trichloroethylene, are used. If &beta;-blocking therapy is withdrawn prior to major surgery, the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures. The &beta;-blocking effects of Nebivolol can be reversed by &beta;-agonists, e.g., dobutamine or isoproterenol. However, such patients may be subject to protracted severe hypotension. Additionally, difficulty in restarting and maintaining the heartbeat has been reported with (&beta;-blockers).<br />\r\n<br />\r\n<strong>Diabetes and Hypoglycemia</strong>: &beta;-blockers may mask some of the manifestations of hypoglycemia, particularly tachycardia. Nonselective &beta;-blockers may potentiate insulin-induced hypoglycemia and delay recovery of serum glucose levels. It is not known whether nebivolol has these effects. Patients subject to spontaneous hypoglycemia, or diabetic patients receiving insulin or oral hypoglycemic agents, should be advised about these possibilities and nebivolol should be used with caution.<br />\r\n<br />\r\n<strong>Thyrotoxicosis</strong>: &beta;-blockers may mask clinical signs of hyperthyroidism, such as tachycardia. Abrupt withdrawal of &beta;-blockers may be followed by an exacerbation of the symptoms of hyperthyroidism or may precipitate a thyroid storm.<br />\r\n<br />\r\n<strong>Peripheral Vascular Disease</strong>: &beta;-blockers can precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease. Caution should be exercised in these patients.<br />\r\n<br />\r\n<strong>Non-dihydropyridine Calcium Channel Blockers</strong>: Because of significant negative inotropic and chronotropic effects in patients treated with &beta;-blockers and calcium channel blockers of the verapamil and diltiazem type, caution should be used in patients treated concomitantly with these agents and ECG and blood pressure should be monitored.</p>', NULL, '<p>Beta-adrenoceptor blocking drugs, Beta-blockers.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Impaired Renal Function</strong>: Nebivolol should be used with caution in patients with severe renal impairment because of decreased renal clearance. Nebivolol has not been studied in patients receiving dialysis.<br />\r\n<br />\r\n<strong>Impaired Hepatic Function</strong>: Nebivolol should be used with caution in patients with moderate hepatic impairment because of decreased metabolism. Since Nebivolol has not been studied in patients with severe hepatic impairment, Nebivolol is contraindicated in this population.&nbsp;<br />\r\n<br />\r\n<strong>Risk of Anaphylactic Reactions</strong>: While taking &beta;-blockers, patients with a history of severe anaphylactic reactions to a variety of allergens may be more reactive to repeated challenges either accidental, diagnostic, or therapeutic. Such patients may be unresponsive to the usual doses of epinephrine used to treat allergic reactions.</p>', '2022-03-10 21:08:16', '2022-03-10 21:08:16'),
(1025, 1025, '<p>Nedocromil inhaler is indicated for&nbsp;maintenance therapy&nbsp;in the management of adult and&nbsp;pediatric&nbsp;patients 6 years and older with mild to moderate&nbsp;asthma. Nedocromil&nbsp;inhaler is not indicated for the reversal of&nbsp;acute&nbsp;bronchospasm.</p>', '<p>Nedocromil is a mast-cell stabiliser. It inhibits mediator release and bronchoconstriction induced by various stimuli and affects various inflammatory cells.</p>', '<p>The recommended dosage for adult and pediatric patients 6 years of age and older is two inhalations four times a day at regular intervals, which provides a dose of 14 mg per day. In patients whose asthma is well controlled on this dosage (e.g., patients who only need occasional inhaled or oral beta2-agonists and who are not experiencing serious exacerbations), less frequent administration may be effective.<br />\r\n<br />\r\nEach Nedocromil Inhaler canister must be primed with 3 actuations prior to the first use. If a canister remains unused for more than 7 days, then it should be reprimed with 3 actuations. Nedocromil Inhaler may be added to the patient&#39;s existing treatment&nbsp;regimen&nbsp;(e.g., bronchodilators). When a clinical response to Nedocromil Inhaler is evident and if the patient&#39;s asthma is under good control, an attempt may be made to decrease concomitant medication usage gradually. Proper inhalational technique is&nbsp;essential&nbsp;(see&nbsp;Patient Instructions&nbsp;for Use). Patients should be advised that the optimal effect of Nedocromil &nbsp;therapy&nbsp;depends upon its administration at regular intervals, even during symptom-free periods.</p>', '<p>In clinical studies, Nedocromil inhalation aerosol has been co-administered with other anti-asthma medications, including inhaled and oral bronchodilators, and inhaled corticosteroids, with no evidence of increased frequency of adverse events or laboratory abnormalities. No formal drug-drug interaction studies, however, have been conducted.</p>', '<p>Nedocromil inhalation aerosol inhaler is contraindicated in patients who have shown hypersensitivity to nedocromil sodium or other ingredients in this preparation.</p>', '<p>Unpleasant taste, headache, fatigue, nausea, vomiting, dyspepsia, diarrhoea, abdominal pain, conjunctivitis, cough, pharyngitis, rhinitis, upper respiratory infection.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category B. Reproduction studies performed in mice, rats, and rabbits using a subcutaneous dose of 100 mg/kg/day (approximately 30 times, 60 times, and 116 times, respectively, the maximum recommended human daily inhalation dose on a mg/m2&nbsp;basis) revealed no evidence of teratogenicity or harm to the&nbsp;fetus&nbsp;due to nedocromil sodium. There are, however, no adequate and well-controlled studies in&nbsp;pregnant&nbsp;women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>:&nbsp;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 Nedocromil inhalation aerosol is administered to a nursing woman.</p>', '<p>Pregnancy and lactation. Not for use in acute asthma attacks; acute bronchospasm. Children &lt;6 yr; monitor closely.</p>', NULL, '<p>Cromoglycate &amp; related drugs</p>', '<p>Store at 2-30&deg; C. Do not freeze.</p>', '<p><strong>Pediatric Use</strong>:&nbsp;The safety and effectiveness of Nedocromil inhalation aerosol in patients below the age of 6 years have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>:&nbsp;Clinical studies of Nedocromil inhalation aerosol 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>', '2022-03-10 21:10:54', '2022-03-10 21:10:54');
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
(1026, 1026, '<p>Nefopam Hydrochloride is indicated for the relief of acute pain, including post-operative, dental, musculo-skeletal and acute traumatic pain. It is also indicated in chronic pain like cancer pain.</p>', '<p>Nefopam is a non-opioid analgesic and though it acts centrally, its mechanism is not defined. It also exerts antimuscarinic and sympathomimetic actions.</p>', '<p>Tablet-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: Dosage may range from 30 to 90 mg three times daily depending on response. The recommended starting dosage is 2 tablets three times daily.&nbsp;</li>\r\n	<li><strong>Elderly</strong>: Elderly patients may require reduced dosage due to slower metabolism. It is strongly recommended that the starting dose does not exceed 1 tablet 3 times daily.</li>\r\n</ul>\r\n\r\n<p>Injection-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 20 mg by IM injection, repeated every 6 hours if necessary. It also be given by slow IV injection in similar dose.</li>\r\n	<li><strong>Children</strong>: Not recommended for children under the age of 12 years.&nbsp;</li>\r\n</ul>', NULL, '<p>Nefopam Hydrochloride is contraindicated in patients with a history of convulsive disorders and should not be given to patients taking monoamine oxidase (MAO) inhibitors. It is also should not be used in the treatment of myocardial infarction.</p>', '<p>Nefopam Hydrochloride is generally well tolerated. However the most common side-effects are nausea, nervousness, dry mouth, lightheadedness and urinary retention.The less common side-effects are vomiting, blurred vision, drowsiness, sweating, insomnia, headache, confusion, hallucinations, tachycardia and aggravation of angina.</p>', '<p><strong>Pregnancy:</strong>&nbsp;Nefopam Hydrochloride is not recommended for pregnant women.<br />\r\n<br />\r\n<strong>Lactation:</strong>&nbsp;Evidence suggests that nefopam is excreted in human milk. A decision should made whether to discontinue nursing or discontinue the medication, taking into account the potential for adverse effects for the foetus and the importance of treatment to the mother.</p>', '<p>Nefopam Hydrochloride should be used with caution in patients with glaucoma and with or at risk of urinary retention. Caution should be exercised when Nefopam is administered concurrently with tricyclic antidepressants. Caution should also be exercised in patients with a history of ischaemic heart disease.</p>', '<p>Nefopam toxicity is manifested by neurological symptoms (convulsions, hallucinations, agitation) and cardiovascular response (tachycardia with hyperdynamic circulation). Supportive treatment is suggested including gastric lavage, forced emesis and diuresis. Oral administration of activated charcoal may help prevent absorption. Convulsions and hallucinations may be controlled with diazepam. Beta-adrenergic blockers may be of use in controlling the cardiovascular complications.</p>', '<p>Non opioid analgesics, Non-Opioid Analgesics</p>', NULL, NULL, '2022-03-10 21:12:46', '2022-03-10 21:12:46'),
(1027, 1027, '<p>Nelfinavir is indicated for the treatment of HIV infection when antiretroviral therapy is warranted.</p>', '<p>Nelfinavir is a selective, competitive, reversible HIV protease inhibitor. It inhibits HIV-1 protease preventing the cleavage of the gag-pol polyprotein resulting in the production of noninfectious virus.</p>', '<p><strong>Adults</strong>: The recommended dose is 1250 mg (five 250 mg tablets) twice daily or 750 mg (three 250 mg tablets) three times daily. Nelfinavir should be taken with a meal. Antiviral activity is enhanced when Nelfinavir is administered in combination with nucleoside analogues. Therefore, it is recommended that Nelfinavir should be used in combination with nucleoside analogues.<br />\r\n<br />\r\n<strong>Paediatric patients (2-13 years)</strong>: The recommended oral dose of Nelfinavir for paediatric patients 2 to 13 years of age is 20-30 mg/kg per dose, three times daily with a meal.</p>', '<p>Reduced levels/effects with antacids, phenobarbital, carbamazepine, aminoglutethimide, phenytoin, rifampicin, nafcillin, nevirapine, omeprazole, nevirapine. Increased serum levels/effects with azole antifungal agents, cimetidine, efavirenz. Increased serum levels/effects of azithromycin, calcium channel blockers, clarithromycin, corticosteroids (e.g. fluticasone), mirtazapine, nateglinide, nefazodone, ciclosporin, sirolimus, tacrolimus, venlafaxine, eplerinone, fentanyl, atorvastatin, phosphodiesterase-5 (PDE-5) inhibitors, rifabutin, trazodone, TCAs. Reduced serum levels/effects of hormonal contraceptives, methadone, theophylline derivatives.</p>', '<p>Nelfinavir is contraindicated in patients with clinically significant hypersensitivity to any of its components. Co-administration of Avifix is contraindicated with drugs that are highly dependent on CYP3A for clearance and for which elevated plasma concentrations are associated with serious and/or life-threatening adverse events.</p>', '<p>The safety of Nelfinavir was studied in over 1500 patients who received drug either alone or in combination with nucleoside analogues. The majority of adverse events were of mild intensity. The most frequently reported adverse event among patients receiving Nelfinavir was diarrhoea, which was generally of mild to moderate intensity. Adverse events occurring in less than 2% of patients receiving Nelfinavir in all phase II/III clinical trials and considered at least possibly related or of unknown relationship to treatment and of at least moderate severity are listed below.<br />\r\n<br />\r\n<strong>General</strong>: Abdominal pain, accidental injury, allergic reaction, asthenia, back pain, fever, headache, malaise, pain and redistribution/accumulation of body fat.<br />\r\n<br />\r\n<strong>Digestive system</strong>: Anorexia, dyspepsia, epigastric pain, gastrointestinal bleeding, hepatitis, mouth ulceration, pancreatitis and vomiting.<br />\r\n<br />\r\n<strong>Haemic/Lymphatic system</strong>: Anaemia, leukopenia and thrombocytopenia.<br />\r\n<br />\r\n<strong>Metabolic/Nutritional</strong>: Increase in alkaline phosphate, amylase, creatinine phosphokinase, lactic dehydrogenase, SGOT, SGPT and g glutamyl transpeptidase, hyperlipaemia, hyperuricaemia, hyperglycaemia, hypoglycaemia, dehydration and liver function tests abnormal.<br />\r\n<br />\r\n<strong>Musculoskeletal system</strong>: Arthralgia, arthritis, cramps, myalgia, myasthenia and myopathy.<br />\r\n<br />\r\n<strong>Nervous system</strong>: Anxiety, depression, dizziness, emotional lability, hyperkinesia, insomnia, migraine, paraesthesia, seizures, sleep disorder, somnolence and suicide ideation.<br />\r\n<br />\r\n<strong>Respiratory system</strong>: Dyspnoea, pharyngitis, rhinitis and sinusitis.<br />\r\n<br />\r\n<strong>Skin/Appendages</strong>: Dermatitis, folliculitis, fungal dermatitis, maculopapular rash, pruitus, sweating, and urticaria.<br />\r\n<br />\r\n<strong>Ophthalmic</strong>: Acute iritis and eye disorder.<br />\r\n<br />\r\n<strong>Urogenital system</strong>: Kidney calculas, sexual dysfunction.</p>', '<p>Pregnancy Category B. There are no adequate and well controlled studies in pregnant women.<br />\r\n<br />\r\nLactation: The US Public Health Service Centers for Disease Control and Prevention advises HIV-infected women not to breast-feed to avoid postnatal transmission of HIV to a child.</p>', '<p>Nelfinavir should not be administered concurrently with Terfenadine, Astemizole, Cisapride, Triazolam, Midazolam, Ergot derivatives, Amiodarone or Quinidine because Nelfinavir may affect the hepatic metabolism of these drugs and create potential for serious and/or life-threatening adverse events. New onset diabetes mellitus, exacerbation of pre-existing diabetes mellitus and hyperglycaemia have been reported during post-marketing surveillance in HIV-infected patients receiving protease inhibitor therapy. Some patients required either initiation or dose adjustments of insulin or oral hypoglycaemic agents for treatment of these events. In some cases diabetic ketoacidosis has occurred. In those patients who discontinued protease inhibitor therapy, hyperglycaemia persisted in some cases.<br />\r\n<br />\r\n<strong>General:</strong>&nbsp;Nelfinavir is principally metabolised by the liver. Therefore, caution should be exercised when administering this drug to patients with hepatic impairment.<br />\r\n<br />\r\n<strong>Haemophilia:</strong>&nbsp;There have been reports of increased bleeding, including spontaneous skin haematomas and haemarthrosis, in patients with haemophilia type A and B treated with protease inhibitors. In some patients, additional factor VIII was given. In more than half of the reported cases, treatment with protease inhibitors was continued or reintroduced. A causal relationship has not been established.</p>', NULL, '<p>Drugs for HIV / Anti-retroviral drugs</p>', '<p>Store at 15-30&deg; C.</p>', '<p><strong>Paediatric use:</strong>&nbsp;The safety, effectiveness and pharmacokinetics of Nelfinavir have not been evaluated in paediatric patients below the age of 2 years.</p>', '2022-03-10 21:23:22', '2022-03-10 21:23:22'),
(1028, 1028, '<p>This is indicated in the treatment of topical bacterial infections. This is particularly effective in atopic, contact stasis and infections, eczematoid dermatitis, neurodermatitis, eczema, anogenital pruritus. It may also be useful as an adjunct in certain pyodermas, such as impetigo, during specific systemic antibiotic therapy for these infections.</p>', '<p><strong>Bacitracin</strong>&nbsp;inhibits bacterial cell wall synthesis and is active against many gram-positive bacteria (e.g. staphylococci, streptococci, corynebacteria and Clostridia) and some gram-negative species (e.g. Neisseria and Haemophilus influenzae). They are often found in combinations in topical preparations as broad spectrum antibacterial agents.<br />\r\n<br />\r\n<strong>Neomycin</strong>, an aminoglyoside with antimicrobial spectrum similar to gentamicin, binds to the 30S subunits of the bacterial ribosome, inhibiting protein synthesis and thereby disrupting DNA synthesis. It is active against many gram negative aerobes and against some strains of staphylococci.</p>', '<p><strong>Ointment:</strong>&nbsp;Before use, the area for application should be cleaned gently. Derbis such as pus or crusts should be removed from the affected area. Apply two to three times daily to the affected skin area.<br />\r\n<br />\r\n<strong>Dusting Powder:</strong>&nbsp;Antibiotic powder is a non- sterile dusting powder and used for superficial skin infections. A light dusting of the powder to be applied to the affected skin area upto 4 times daily.</p>', '<p><strong>Bacitracin Zinc:</strong>&nbsp;Increased risk of nephrotoxicity when used with other nephrotoxic drugs. May enhance the action of neuromuscular-blocking agents.<br />\r\n<br />\r\n<strong>Neomycin Sulphate:</strong>&nbsp;Additive nephrotoxic and neurotoxic effect with other aminoglycosides, bacitracin, cisplatin, vancomycin, amphotericin B, polymyxin B, colistin and viomycin. Enhanced toxicity with potent diuretics. May impair the absorption of other drugs. May enhance the effect of acarbose. May enhance the effect of non-depolarising muscle relaxants. May antagonise the parasympathomimetic effect of neostigmine and pyridostigmine. May increase the risk of hypocalcaemia in patients receiving bisphosphonates. May alter INR when givenwithanticoagulants. May inactivate oral typhoid vaccine.</p>', '<p>Hypersensitivity to any of its components.</p>', '<p>This preparation&nbsp;is usually well tolerated. In rare cases, allergic reactions may be occurred.</p>', '<p>The safe use of this preparation during pregnancy &amp; lactation has not been established. Therefore it should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.</p>', '<p>Bacitracin &amp; Neomycin antibiotic powder should not be used to large open wounds or to severely injured skin or on areas that exude large volumes of fluid as hard crusts may form. Since this&nbsp;skin ointment contains Neomycin, it should not be used for the treatment of otitis external when the eardrum is perforated because of risk of ototoxicity.<br />\r\n<br />\r\nPatients considering self-medication with a topical anti-infective for deep or puncture wounds, animal bites, or serious burns should be advised to first consult a physician. Patients using the preparations for the prevention of infection in minor skin injuries (e.g., cuts, scrapes, burns) should be advised to discontinue the topical anti-infective preparation and consult a physician if the condition persists or worsens; it should not be used for longer than 1 week unless directed by a physician.</p>', NULL, '<p>Ophthalmic and Topical antibacterial products.</p>', '<p>Keep all medicines out of reach of children. Store in a cool and dry place, protected from light.</p>', '<p><strong>Children and Infants</strong>: This ointment is suitable for use in children at the same dose as adults, but the dose should be reduced in infants. This ointment is not recommended for use in neonates.</p>', '2022-03-10 21:25:58', '2022-03-10 21:25:58'),
(1029, 1029, '<p>This is indicated in the treatment of topical bacterial infections. This is particularly effective in atopic, contact stasis and infections, eczematoid dermatitis, neurodermatitis, eczema, anogenital pruritus. It may also be useful as an adjunct in certain pyodermas, such as impetigo, during specific systemic antibiotic therapy for these infections.</p>', '<p><strong>Bacitracin</strong>&nbsp;inhibits bacterial cell wall synthesis and is active against many gram-positive bacteria (e.g. staphylococci, streptococci, corynebacteria and Clostridia) and some gram-negative species (e.g. Neisseria and Haemophilus influenzae). They are often found in combinations in topical preparations as broad spectrum antibacterial agents.<br />\r\n<br />\r\n<strong>Neomycin</strong>, an aminoglyoside with antimicrobial spectrum similar to gentamicin, binds to the 30S subunits of the bacterial ribosome, inhibiting protein synthesis and thereby disrupting DNA synthesis. It is active against many gram negative aerobes and against some strains of staphylococci.</p>', '<p><strong>Ointment:</strong>&nbsp;Before use, the area for application should be cleaned gently. Derbis such as pus or crusts should be removed from the affected area. Apply two to three times daily to the affected skin area.<br />\r\n<br />\r\n<strong>Dusting Powder:</strong>&nbsp;Antibiotic powder is a non- sterile dusting powder and used for superficial skin infections. A light dusting of the powder to be applied to the affected skin area upto 4 times daily.</p>', '<p><strong>Bacitracin Zinc:</strong>&nbsp;Increased risk of nephrotoxicity when used with other nephrotoxic drugs. May enhance the action of neuromuscular-blocking agents.<br />\r\n<br />\r\n<strong>Neomycin Sulphate:</strong>&nbsp;Additive nephrotoxic and neurotoxic effect with other aminoglycosides, bacitracin, cisplatin, vancomycin, amphotericin B, polymyxin B, colistin and viomycin. Enhanced toxicity with potent diuretics. May impair the absorption of other drugs. May enhance the effect of acarbose. May enhance the effect of non-depolarising muscle relaxants. May antagonise the parasympathomimetic effect of neostigmine and pyridostigmine. May increase the risk of hypocalcaemia in patients receiving bisphosphonates. May alter INR when givenwithanticoagulants. May inactivate oral typhoid vaccine.</p>', '<p>Hypersensitivity to any of its components.</p>', '<p>This preparation&nbsp;is usually well tolerated. In rare cases, allergic reactions may be occurred.</p>', '<p>The safe use of this preparation during pregnancy &amp; lactation has not been established. Therefore it should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.</p>', '<p>Bacitracin &amp; Neomycin antibiotic powder should not be used to large open wounds or to severely injured skin or on areas that exude large volumes of fluid as hard crusts may form. Since this&nbsp;skin ointment contains Neomycin, it should not be used for the treatment of otitis external when the eardrum is perforated because of risk of ototoxicity.<br />\r\n<br />\r\nPatients considering self-medication with a topical anti-infective for deep or puncture wounds, animal bites, or serious burns should be advised to first consult a physician. Patients using the preparations for the prevention of infection in minor skin injuries (e.g., cuts, scrapes, burns) should be advised to discontinue the topical anti-infective preparation and consult a physician if the condition persists or worsens; it should not be used for longer than 1 week unless directed by a physician.</p>', NULL, '<p>Ophthalmic and Topical antibacterial products</p>', '<p>Keep all medicines out of reach of children. Store in a cool and dry place, protected from light.</p>', '<p><strong>Children and Infants</strong>: This ointment is suitable for use in children at the same dose as adults, but the dose should be reduced in infants. This ointment is not recommended for use in neonates.</p>', '2022-03-10 21:28:17', '2022-03-10 21:28:17'),
(1030, 1030, '<p>This ophthalmic ointment or drop is indicated for the topical treatment of superficial infections of the external eye and its adnexa caused by susceptible bacteria. Such infections encompass conjunctivitis, keratitis and keratoconjunctivitis, blepharitis and blepharoconjunctivitis.</p>', '<p><strong>Neomycin</strong>, an aminoglyoside with antimicrobial spectrum similar to gentamicin, binds to the 30S subunits of the bacterial ribosome, inhibiting protein synthesis and thereby disrupting DNA synthesis. It is active against many gram-negative aerobes and against some strains of staphylococci.<br />\r\n<br />\r\n<strong>Bacitracin</strong>, on the other hand, inhibits bacterial cell wall synthesis and is active against many gram-positive bacteria (e.g. staphylococci, streptococci, corynebacteria and Clostridia) and some gram-negative species (e.g. Neisseria and Haemophilus influenzae). They are often found in combinations in topical preparations as broad spectrum antibacterial agents.<br />\r\n<br />\r\n<strong>Polymyxin B</strong>&nbsp;disrupts the bacterial cytoplasmic membrane of mostly gm-ve organisms allowing leakage of intracellular constituents by binding to membrane phospholipids.</p>', '<p><strong>Eye Drop</strong>: 1-2 drops 3-4 times daily.<br />\r\n<br />\r\n<strong>Eye ointment</strong>: Apply 1/2 inch ribbon of ointment to conjunctival sac of affected eye(s) q3-4hr for 7-10 days for acute infections</p>', NULL, '<p>Hypersensitivity</p>', '<p>Rash, itching, burning, anaphylactic reactions, swelling, conjunctival erythema.</p>', '<p>Pregnancy Category C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks<br />\r\n<br />\r\nLactation: Excretion in breast milk unknown; caution should be taken</p>', '<p>Excessive use of the topical preparation may lead to substantial systemic absorption which may lead to nephrotoxicity (polymyxin B sulfate) and neurotoxicity (bacitracin). Prolonged use of the antibacterial preparation may cause overgrowth of non-susceptible organisms, including fungi. Pregnancy and lactation.</p>', NULL, '<p>Aural Anti-bacterial preparations, Ophthalmic antibacterial drugs</p>', NULL, '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No overall differences in safety or effectiveness have been observed between elderly and younger patients.</p>', '2022-03-10 21:31:36', '2022-03-10 21:31:36'),
(1031, 1031, '<p>This is a first aid cream. It prevents infections and provides temporary relief of pain or discomfort in minor cuts, scrapes and burns.</p>', '<p>This cream is a combination of Neomycin, Polymyxin B and Pramoxine HCl.<br />\r\n<br />\r\n<strong>Neomycin</strong>&nbsp;is a bactericidal for many gram positive and gram-negative organisms. It is an aminoglycoside antibiotic which inhibits protein synthesis by binding with ribosomal RNA and causing misreading of the bacterial genetic code.<br />\r\n<br />\r\n<strong>Polymyxin B</strong>&nbsp;is bactericidal for a variety of gram-negative organisms. It increases the permeability of the bacterial cell membrane by interacting with the phospholipids components of the membrane.<br />\r\n<br />\r\n<strong>Pramoxine</strong>&nbsp;is an external analgesic that provides temporary relief of pain or discomfort.</p>', '<p>Clean the affected area. Apply a small amount of product (an amount equal to the surface area of the tip of a finger). May be covered with a sterile bandage.</p>', NULL, '<p>Neomycin, Polymyxin B and Pramoxine HCl cream should not be administered to individuals who are hypersensitive to Neomycin, Polymyxin B, Pramoxine or any other components of this product.</p>', '<p>Topical antibiotics, particularly Neomycin sulphate, may cause cutaneous sensitization. The manifestations of sensitization to topical antibiotics are usually itching and reddening. When used in small doses, no common side effects have been reported with this product.</p>', '<p>Use Neomycin, Polymyxin B and Pramoxine HCl during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether this drug is excreted in breast milk. Exercise caution when applying Nepranol to a nursing mother.</p>', '<p>Do not use this medication in the eyes or apply to large areas of the body. Do not use longer than one week unless directed by the physician.</p>', NULL, '<p>Anti-infective &amp; Anesthetic combined preparations.</p>', '<p>Store in a dry and cool place protected from light and moisture.</p>', '<p>Safety and effectiveness in children below 2 years of age have not been established.</p>', '2022-03-10 21:42:34', '2022-03-10 21:42:34'),
(1032, 1032, '<p><strong>Neostigmine Methyl Sulphate is indicated for</strong>-</p>\r\n\r\n<ul>\r\n	<li>Reversal of nondepolarising neuromuscular blockade for surgical anesthetic procedures</li>\r\n	<li>The prevention and treatment of post-operative abdominal distention and urinary retention after mechanical obstruction has been excluded.</li>\r\n	<li>Treatment of the systemic control of Myasthenia Gravis when oral therapy is impractical.</li>\r\n</ul>', '<p>Neostigmine is a parasympathomimetic, specifically, a reversible cholinesterase inhibitor. By interfering with the breakdown of acetylcholine, Neostigmine indirectly stimulates both nicotinic and muscarinic receptors. It does cross the blood-brain barrier but only poorly. Neostigmine binds to the anionic site of cholinesterase. The drug blocks the active site of acetylcholinesterase; so the enzyme can no longer break down the acetylcholine molecules before they reach the postsynaptic membrane receptors. This allows for the threshold to be reached so a new impulse can be triggered in the next neuron. In myasthenia gravis there are too few acetylcholine receptors. So with the acetylcholinesterase blocked, acetylcholine can bind to the few receptors and trigger a muscular contraction.</p>', '<p><strong>Reversal of the effects of Non-depolarizing Neurormuscular Blocking Agents</strong>: The usual dose is 0.5 to 2 mg given by slow intravenous injection over 60 seconds; repeated as required. Total dose should not exceed 5 mg (in exceptional cases). When Neostigmine is administered intravenously, it is recommended that Atropine Sulphate (0.6-1.2 mg) also be given intravenously using separate syringe.<br />\r\n<br />\r\n<strong>Prevention of post-operative abdominal distention and urinary retention:</strong>&nbsp;0.25 mg intramuscularly or subcutaneously as soon as possible after operation; repeat every 4 6 hours for 2-3 days.<br />\r\n<br />\r\n<strong>Treatment of post-operative abdominal distention</strong>: 0.5 mg intramuscularly or subcutaneously or as required.<br />\r\n<br />\r\n<strong>Treatment of urinary retention:</strong>&nbsp;0.5 mg intramuscularly or subcutaneously. If urination does not occur within an hour, the patient should be catheterized. After the patient has voided, or the bladder has been emptied, continue the 0.5 mg injection every 3 hours, for at least 5 injections.<br />\r\n<br />\r\n<strong>Symptomatic control of Myasthenia Gravis:</strong>&nbsp;0.5 mg intramuscularly or subcutaneously. Subsequent dose should be based on the individual patient&#39;s response.<br />\r\n<br />\r\n<strong>Neonates:</strong>&nbsp;50-250 micrograms (0.1 to 0.5 ml) every 4 hours.<br />\r\n<br />\r\n<strong>Children:</strong>&nbsp;200-500 micrograms (0.4 ml to 1 ml) as recommended.</p>', '<p>Anti-arrhythmic Procainamide, Quinidine and possibly Propafenone antagonise effect of Neostigmine. Antibacterials, Aminoglycosides, Clindamycin, Lincomycin and Polymyxins antagonise effect of Neostigmine.</p>', '<p>Neostigmine is contraindicated in patients with known hypersensitivity to the drug. It is also contraindicated in patients with peritonitis or mechanical obstruction of the intestinal or urinary tract.</p>', '<p>Nausea, vomiting, increased salivation, diarrhoea and abdominal cramps (more marked with high doses). Signs of overdose are increased gastrointestinal discomfort, bronchial secretions and sweating, involuntary defecation and micturition, miosis, nystagmus, bradycardia, hypotension, agitation, excessive dreaming and weakness eventually leading to fasciculation and paralysis.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C. There are no adequate or well-controlled studies of Neostigmine in either laboratory animals or in&nbsp;pregnantwomen. It is not known whether Neostigmine can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. Neostigmine should be given to a pregnant woman only if clearly needed.<br />\r\n<br />\r\n<strong>Nonteratogenic Effects</strong>: Anticholinesterase drugs may cause uterine irritability and induce premature&nbsp;labor&nbsp;when given intravenously to pregnant women near term.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether Neostigmine is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions from Neostigmine in nursing infants, 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>Asthma, bradycardia, recent myocardial infarction, epilepsy, hypotension, parkinsonism, vagotonia, peptic ulceration. Atropine or other antidote to muscarinic effccts may be necessary (particularly when Neostigmine is given by injection), but it should not be given routinely as it may mask signs of overdose.</p>', NULL, '<p>Anti-cholinesterases, Drugs used in Myasthenia Gravis</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-10 21:45:01', '2022-03-10 21:45:01'),
(1033, 1033, '<p><strong>Nepafenac 0.1% Sterile Ophthalmic Suspension</strong>: The treatment of post-operative ocular pain and inflammation including cataract surgery Inhibition of surgery induced miosis and Prevention of post-operative cystoid macular edema (CME).<br />\r\n<br />\r\n<strong>Nepafenac 0.3% Sterile Ophthalmic Suspension</strong>: Post-operative pain and inflammation associated with cataract surgery.</p>', '<p>Nepafenac is a nonsteroidal anti-inflammatory prodrug (NSAID). After instillation in the eye, it penetrates the cornea and is converted by ocular tissue hydrolase to Amfenac, a potent nonsteroidal anti-inflammatory drug. Amfenac is thought to inhibit the action of cyclooxygenase enzyme. This enzyme is required for prostaglandin synthesis.</p>', '<p>Nepafenac 0.1% Sterile Ophthalmic Suspension-</p>\r\n\r\n<ul>\r\n	<li><strong>For post-operative pain &amp; inflammation:</strong>&nbsp;Instill 1 drop 3 times daily 1 day prior to cataract surgery and continued on the day of surgery and through the first 2 weeks of the post-operative period.</li>\r\n	<li><strong>For surgery induced miosis</strong>: Instill 1 drop 3 times daily 1 day before surgery &amp; on the day of surgery.</li>\r\n	<li><strong>For prevention of post-operative CME:</strong>&nbsp;Instill 1 drop 3 times daily 1 day before surgery and continued on the day of surgery and through the first 6 weeks of the post-operative period.</li>\r\n</ul>\r\n\r\n<p>Nepafenac 0.3% Sterile Ophthalmic Suspension-</p>\r\n\r\n<ul>\r\n	<li><strong>For post-operative pain &amp; inflammation:</strong>&nbsp;Instill 1 drop once daily 1 day prior to cataract surgery and continued on the day of surgery and through the first 2 weeks of the post-operative period. An additional drop should be administered 30 to 120 minutes prior to surgery.</li>\r\n</ul>', NULL, '<p>Contraindicated in patients with previously demonstrated hypersensitivity to any of the ingredients in the formulation or to other NSAIDs.</p>', '<p>Reported side effects are foreign body sensation, lid margin crusting, ocular discomfort, ocular hyperemia etc.</p>', '<p><strong>Use in pregnancy:</strong>&nbsp;There are no adequate and well-controlled studies in pregnant women. Nepafenac 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:&nbsp;</strong>It is not known whether this drug is excreted in human milk. So, caution should be exercised when Nepafenac ophthalmic suspension is administered to a nursing mother.</p>', '<p>Nepafenac should be used with caution in patients with known bleeding tendencies or who are receiving medications which may prolong bleeding time.</p>', NULL, '<p>Ophthalmic Non-Steroid drugs.</p>', NULL, '<p><strong>Use in children</strong>: Safety and effectiveness in pediatric patients below 18 years of age have not been established.<br />\r\n<br />\r\n<strong>Use in elderly patients</strong>: No overall differences in safety or effectiveness have been observed between elderly and younger patients.</p>', '2022-03-10 21:47:09', '2022-03-10 21:47:09'),
(1034, 1034, '<p>Neratinib is a kinase inhibitor indicated for the extended adjuvant treatment of adult patients with early stage HER2-overexpressed/amplified breast cancer, to follow adjuvant trastuzumab-based therapy.</p>', '<p>Neratinib is a kinase inhibitor that irreversibly binds to Epidermal Growth Factor Receptor (EGFR), Human Epidermal Growth Factor Receptor 2 (HER2), and HER4. In vitro, neratinib reduces EGFR and HER2 autophosphorylation, downstream MAPK and AKT signaling pathways, and showed antitumor activity in EGFR and/or HER2 expressing carcinoma cell lines. Neratinib human metabolites M3, M6, M7 and M11 inhibited the activity of EGFR, HER2 and HER4 in vitro. In vivo, oral administration of neratinib inhibited tumor growth in mouse xenograft models with tumor cell lines expressing HER2 and EGFR.</p>', '<p>Antidiarrheal prophylaxis: Initiate loperamide with the first dose of Neratinib and continue during first 2 cycles (56 days) of treatment. Instruct patients to maintain 1-2 bowel movements per day and on how to use antidiarrheal treatment regimens<br />\r\n<br />\r\n<strong>Recommended dose</strong>: 240 mg (6 tablets) given orally once daily with food, continuously for one year. Dose interruptions and/or dose reductions are recommended based on individual safety and tolerability<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Reduce starting dose to 80 mg in patients with severe hepatic impairment.</p>', '<p><strong>Gastric acid reducing agents</strong>: Avoid concomitant use with proton pump inhibitors (PPI) and H2-receptor antagonists. Separate Neratinib by 3 hours after antacid dosing.<br />\r\n<br />\r\n<strong>Strong or moderate CYP3A4 inhibitors</strong>: Avoid concomitant use.<br />\r\n<br />\r\n<strong>Strong or moderate CYP3A4 inducers</strong>: Avoid concomitant use.&nbsp;<br />\r\n<br />\r\n<strong>P-glycoprotein (P-gp) substrates</strong>: Monitor for adverse reactions of narrow therapeutic agents that are P-gp substrates when used concomitantly with Neratinib.</p>', '<p>None</p>', '<p>The most common adverse reactions (&gt; 5%) were diarrhea, nausea, abdominal pain, fatigue, vomiting, rash, stomatitis, decreased appetite, muscle spasms, dyspepsia, AST or ALT increase, nail disorder, dry skin, abdominal distention, weight decreased and urinary tract infection.</p>', '<p>There are no available data in pregnant women to inform the drug-associated risk. No data are available regarding the presence of neratinib or its metabolites in human milk or its<br />\r\neffects on the breastfed infant or on milk production.</p>', '<p><strong>Diarrhea</strong>: Aggressively manage diarrhea occurring despite recommended prophylaxis with additional antidiarrheals, fluids, and electrolytes as clinically indicated. Withhold Meratinib in patients experiencing severe and/or persistent diarrhea. Permanently discontinue Meratinib in patients experiencing Grade 4 diarrhea or Grade &ge; 2 diarrhea that occurs after maximal dose reduction.<br />\r\n<br />\r\n<strong>Hepatotoxicity</strong>: Monitor liver function tests monthly for the first 3 months of treatment, then every 3 months while on treatment and as clinically indicated. Withhold Meratinib in patients experiencing Grade 3 liver abnormalities and permanently discontinue Meratinib in patients experiencing Grade 4 liver abnormalities.<br />\r\n<br />\r\n<strong>Embryo-Fetal Toxicity</strong>: Meratinib can cause fetal harm. Advise patients of potential risk to a fetus and to use effective contraception.</p>', '<p>There is no specific antidote, and the benefit of hemodialysis in the treatment of Neratinib overdose is unknown. In the event of an overdose, administration should be withheld and general supportive measures undertaken. In the clinical trial setting, a limited number of patients reported overdose. The adverse reactions experienced by these patients were diarrhea, nausea, vomiting, and dehydration. The frequency and severity of gastrointestinal disorders (diarrhea, abdominal pain, nausea and vomiting) appear to be dose related.</p>', '<p>Tyrosine Kinase Inhibitor.</p>', '<p>Store Neratinib at room temperature between 20&deg; to 25&deg;C. Keep Neratinib and all medicines out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: The safety and efficacy of Neratinib in pediatric patients has not been established.</p>', '2022-03-10 21:49:18', '2022-03-10 21:49:18'),
(1035, 1035, '<p>This is indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension.</p>', '<p>This is a fixed-dose combination of a Rho kinase inhibitor and a Prostaglandin F2 analogue. Netarsudil is a Rho kinase inhibitor, works at the cellular level within the trabecular outflow pathway to relax actin-myosin. This causes relaxation within the trabecular meshwork and the inner wall of Schlemm&#39;s canal, and decrease episcleral venous pressure (EVP).<br />\r\n<br />\r\nLatanoprost is a selective FP receptor agonist which reduces the intraocular pressure (IOP) by increasing the outflow of aqueous humor through uveoscleral outflow.</p>', '<p>The recommended dosage is one drop in the affected eye(s) once daily in the evening.</p>', NULL, '<p>This eye drops is contraindicated in patients who are hypersensitive to any component of this preparation.</p>', '<p>The most common ocular adverse reaction observed in controlled clinical studies with Netarsudil &amp; Latanoprost was conjunctival hyperemia, instillation site pain, corneal verticillata, instillation site discomfort, foreign body sensation and blurred visions were reported in few patients.</p>', '<p>There are no adequate and well-controlled studies of Netarsudil &amp; Latanoprost combination in pregnant women to inform any drug-associated risk. There are no data on the presence of Netarsudil or Latanoprost in human milk, the effects on the breastfed infant, or the effects on milk production.</p>', '<ul>\r\n	<li>For ophthalmic use only</li>\r\n	<li>To avoid possible contamination of the drops, do not touch the dropper tip or to any surface</li>\r\n	<li>Should be used with caution in patients with active intraocular inflammation (e.g., iritis/uveits)</li>\r\n	<li>May cause changes to pigmented tissues, gradually change eyelashes and vellus hair in the treated eye</li>\r\n	<li>Cystoid macular edema, has been reported during treatment with Latanoprost. Reactivation of Herpes Simplex keratitis may occur</li>\r\n	<li>Netarsudil &amp; Latanoprost combination can be used with other topical eye drug products, but they should be administered at least 5 minutes apart from each other.</li>\r\n</ul>', NULL, '<p>Drugs for miotics and glaucoma.</p>', '<p>Store at 2&deg;-8&deg;C in a dry place, protect from light until opened. After opening the product may be kept at 2&deg;-25&deg;C for upto 6 weeks. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Use in elderly patients</strong>: No overall differences in safety and effectiveness have been observed between elderly and other adult patients.</p>', '2022-03-10 21:51:03', '2022-03-10 21:51:03'),
(1036, 1036, '<p>Netarsudil ophthalmic solution is indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension.</p>', '<p>Netarsudil is a Rho kinase inhibitor, works at the cellular level within the trabecular outflow pathway to relax actin-myosin. This causes relaxation within the trabecular meshwork and the inner wall of Schlemm&#39;s canal and decreases episcleral venous pressure (EVP).</p>', '<p>The recommended dosage is one drop in the affected eye(s) once daily in the evening.</p>', '<p>This eye drops is contraindicated in patients who are hypersensitive to any component of this preparation.</p>', NULL, '<p>The most common ocular adverse reaction observed in controlled clinical studies with Netarsudil was conjunctival hyperemia, corneal verticillata, instillation site pain, corneal staining and blurred vision.</p>', '<p><strong>Pregnancy</strong>: There are no adequate and well-controlled studies of Netarsudil ophthalmic solution in pregnant women to inform any drug-associated risk. However, systemic exposure to Netarsudil from ocular administration is low.<br />\r\n<br />\r\n<strong>Lactation</strong>: There are no data on the presence of Netarsudil in human milk, the effects on the breastfed infant, or the effects on milk production.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients below the age of 18 years have not been established.<br />\r\n<br />\r\n<strong>Use in elderly patients</strong>: No overall differences in safety and effectiveness have been observed between elderly and other adult patients.</p>', '<p>For ophthalmic use only. To avoid possible contamination of the drops, do not touch the dropper tip or to any surface. Netarsudil can be used with other topical eye drug products, but they should be administered at least 5 minutes apart from each other. Contact lenses should be removed prior to instillation of Netarsudil and may be reinserted 15 minutes following its administration.</p>', NULL, '<p>Drugs for miotics and glaucoma.</p>', '<p>Store at 2&deg;-8&deg;C in a dry place, protect from light until opened. After opening the product may be kept at 2&deg;-25&deg;C for upto 6 weeks. Keep out of the reach of children.</p>', NULL, '2022-03-10 21:52:46', '2022-03-10 21:52:46'),
(1037, 1037, '<p>Nevirapine is indicated for combination&nbsp;antiretroviral&nbsp;treatment of&nbsp;HIV-1 infection in adults and in pediatric patients 15 days and older.<br />\r\n<br />\r\nAdditional important information regarding the use of Nevirapine for the treatment of HIV-1 infection:</p>\r\n\r\n<ul>\r\n	<li>Based on serious and life-threatening hepatotoxicity observed in controlled and uncontrolled trials, Nevirapine should not be initiated in adult females with CD4+&nbsp;cell counts greater than 250 cells/mm&sup3; or in adult males with CD4+&nbsp;cell counts greater than 400 cells/mm&sup3; unless the benefit outweighs the risk.</li>\r\n	<li>The 14-day lead-in period with Nevirapine 200 mg daily dosing must be strictly followed; it has been demonstrated to reduce the frequency of rash.</li>\r\n	<li>If rash persists beyond the 14-day lead-in period, do not dose escalate to 200 mg twice daily. The 200 mg once-daily dosing regimen should not be continued beyond 28 days, at which point an alternative regimen should be sought.</li>\r\n</ul>', '<p>Nevirapine is a non-nucleoside reverse transcriptase inhibitor that acts against HIV-1. It binds directly to reverse transcriptase and thereby blocks the RNA-dependent and DNA-dependent DNA polymerase activities by disrupting the enzyme&#39;s catalytic site.</p>', '<p><strong>Adult Patients</strong>: The recommended dose for Nevirapine is one 200 mg tablet daily for the first 14 days, followed by one 200 mg tablet twice daily, in combination with other antiretroviral agents. The lead-in period has been observed to decrease the incidence of rash. For concomitantly administered&nbsp;antiretroviral therapy, the manufacturer&#39;s recommended dosage and monitoring should be followed.<br />\r\n<br />\r\n<strong>Pediatric Patients</strong>: The recommended oral dose for pediatric patients 15 days and older is 150 mg/m&sup2; once daily for 14 days followed by 150 mg/m&sup2; twice daily thereafter. The total daily dose should not exceed 400 mg for any patient.</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>Mutually increased levels effects when used with drugs extensively metabolised by CYP3A. Reduced levels/effects of methadone.</p>', '<p>Hypersensitivity. Lactation. Severe hepatic impairment.</p>', '<p>Skin rash, nausea, vomiting, headache, abnormal LFT, fatigue, diarrhoea, abdominal pain.</p>', '<p><strong>Nursing Mothers</strong>: The Centers for Disease Control and Prevention recommend that HIV-1 infected mothers not breastfeed their infants to avoid risking postnatal transmission of HIV-1. Nevirapine is excreted in breast milk. Because of both the potential for HIV-1 transmission and the potential for serious adverse reactions in nursing infants, mothers should be instructed not to breastfeed if they are receiving Nevirapine.</p>', '<p>Caution should be taken during pregnancy. Interrupt treatment if severe hepatotoxicity or life-threatening skin reactions develop. Renal or hepatic insufficiency. Monitor liver function periodically.</p>', '<p>There is no known&nbsp;antidote&nbsp;for Nevirapine overdosage. Cases of Nevirapine overdose at doses ranging from 800 to 1800 mg per day for up to 15 days have been reported. Patients have experienced events including&nbsp;edema,&nbsp;erythema nodosum, fatigue, fever, headache, insomnia, nausea, pulmonary infiltrates, rash,&nbsp;vertigo, vomiting, and weight decrease. All events subsided following discontinuation of Nevirapine.</p>', '<p>Drugs for HIV / Anti-retroviral drugs.</p>', '<p>Store at 15-30&deg; C.</p>', '<p><strong>Pediatric Use</strong>: The safety, pharmacokinetic profile, and virologic and immunologic responses of Nevirapine have been evaluated in HIV-1 infected pediatric subjects age 3 months to 18 years. The safety and pharmacokinetic profile of Nevirapine has been evaluated in HIV-1 infected pediatric subjects age 15 days to less than 3 months.<br />\r\n<br />\r\nThe most frequently reported adverse events related to Nevirapine in pediatric subjects were similar to those observed in adults, with the exception of granulocytopenia, which was more commonly observed in children receiving both&nbsp;zidovudine&nbsp;and Nevirapine.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical trials of Nevirapine did not include sufficient numbers of subjects aged 65 and older to determine whether elderly subjects respond differently from younger subjects. 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>: In subjects with renal impairment (mild, moderate or severe), there were no significant changes in the pharmacokinetics of nevirapine. Nevirapine is extensively metabolized by the liver and nevirapine metabolites are extensively eliminated by the kidney. Nevirapine metabolites may accumulate in patients receiving&nbsp;dialysis; however, the clinical significance of this accumulation is not known. No adjustment in nevirapine dosing is required in patients with CrCL greater than or equal to 20 mL per min. The pharmacokinetics of nevirapine have not been evaluated in patients with CrCl less than 20 mL per min. In patients undergoing chronic&nbsp;hemodialysis, an additional 200 mg dose following each dialysis treatment is indicated.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Because increased nevirapine levels and nevirapine accumulation may be observed in patients with serious liver disease, do not administer Nevirapine to patients with moderate or severe (Child-Pugh Class B or C, respectively) hepatic impairment.</p>', '2022-03-10 21:55:01', '2022-03-10 21:55:01');
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
(1038, 1038, '<p>Nicorandil is indicated for the prevention and long-term treatment of angina pectoris.</p>', '<p>Nicorandil dilates arterioles and large coronary arteries by opening the potassium channels, and stimulates guanylate cyclase causing venous vasodilatation. It therefore reduces preload and afterload, and improves coronary blood flow.</p>', '<p><strong>Adult</strong>: The usual therapeutic range is 10 to 20 mg twice daily. The usual&nbsp;starting dose is 10 mg twice daily, in the morning and in the evening&nbsp;preferably, and should be titrated upwards in accordance with patients needs, response and&nbsp;tolerance up to 40 mg twice daily, if necessary. An even lower starting dose of 5 mg twice daily may be used in patients particularly prone to headache.<br />\r\n<br />\r\n<strong>Eldery</strong>: There are no&nbsp;special dosage requirements for elderly patients, but as with all medicines the lowest effective&nbsp;dose should be used. Nicorandil should be administered with care, using low starting&nbsp;dosages, in the elderly.<br />\r\n<br />\r\n<strong>Children</strong>: Not recommended. Nicorandil should be used with&nbsp;caution in patients with serious hepatic dysfunction.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Dose reduction may be necessary.</p>', '<p>Although no pharmacological and/or pharmacokinetic interaction has been obsen/ed in animal and human studies with Nicorandil associated with beta-blockers, calcium antagonists, digoxin, a combination of digoxin/furosemide, rifampicin, and cimetidine, it is not excluded that the drug may nevertheless potentiate the effect of other vasodilators, tricyclic antidepressants and antihypertensive drugs administered concurrently, especially in combination with alcohol.</p>', '<p>Nicorandil tablet is contra-indicated in patients who have shown&nbsp;hypersensitivity to Nicorandil. Use is contra-indicated with cardiogenic shock and acute&nbsp;myocardial infarction with acute left ventricular failure and low filling pressures, in patients with&nbsp;hypotension, and in patients taking phosphodiesterase-5 inhibitors because concurrent use of&nbsp;Nicorandil can lead to a serious drop in blood pressure. Warnings and precautions: Nicorandil&nbsp;should be used with caution in patients who may have blood volume depletion or in those who&nbsp;present with low systolic blood pressure (below 100 mm Hg). The use of the drug in patients with&nbsp;cardiogenic shock, or acute myocardial infarction with acute left ventricular failure and low filling&nbsp;pressures should be avoided. Nicorandil should be discontinued and appropriate measures taken&nbsp;if mouth ulceration, stomatitis or persistent or severe buccal ulcerations, appear. Caution is&nbsp;advised for the use of Nicorandil in patients with glaucoma. The hypotensive effect of other&nbsp;vasodilators, tricyclic antidepressants or alcohol can be increased by administration in&nbsp;combination with Nicorandil. Therapeutic doses of Nicorandil may lower the blood pressure of&nbsp;hypertensive patients and Nicorandil therefore, as with other antianginal agents, should be used&nbsp;with care when prescribed with antihypertensive drugs. Animal mutagenicify and carcinogenicity&nbsp;studies have not revealed any adverse effect of Nicorandil when used under experimental&nbsp;conditions.</p>', '<p>Headache (usually transitory), flushing, dizziness, nausea, vomiting and weakness. Hypotension and reflex tachycardia at high doses.</p>', '<p>Although animal studies have not shown any harmful&nbsp;effect of Nicorandil to the foetus, has not been studied in human pregnancy. Use in pregnant&nbsp;women requires that the anticipated benefit be weighed against possible hazard. It is not known&nbsp;whether the drug is excreted in human milk. Caution should be exercised when Nicorandil is&nbsp;administered to a nursing mother. Drug interactions: Although no pharmacological and/or&nbsp;pharmacokinetic interaction has been obsen/ed in animal and human studies with Nicorandil&nbsp;associated with beta-blockers, calcium antagonists, digoxin, a combination of digoxin/furosemide,&nbsp;rifampicin, and cimetidine, it is not excluded that the drug may nevertheless potentiate the effect&nbsp;of other vasodilators, tricyclic antidepressants and antihypertensive drugs administered&nbsp;concurrently, especially in combination with alcohol.</p>', '<p>Hypovolaemia, low systolic BP, acute pulmonary oedema, pregnancy. May impair ability to drive or operate machinery.</p>', '<p>ln the case of overdosage, the likely symptomatology may be peripheral vasodilation with a fall in blood pressure and reflex tachycardia. In such an event, monitoring of cardiac function and general supportive measures should be used. If not successful, circulating plasma volume should be increased by substitution of fluid. ln life-threatening situations, administration of vasopressors should be considered.</p>', '<p>Potassium-channel activator.</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-10 21:57:09', '2022-03-10 21:57:09'),
(1039, 1039, '<p>Niacin is indicated as an adjunct to diet for reduction of elevated TC, LDL-C, Apo B and TG level and to increase HDL-C in patients with primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia. when the response to an appropriate diet has been inadequate. In patients with a history of myocardial infarction and hypercholesterolemia, Niacin is indicated to reduce the risk of recurrent nonfatal myocardial infarction. Niacin is also indicated as adjunctive therapy for treatment of adult patients with very high serum triglyceride levels (Type IV and V hyperlipidemia) who present a risk of pancreatitis and who do not respond adequately to a determined dietary effort to control them. Prior to initiating therapy with Niacin, secondary causes for hypercholesterolemia (e.g poorly controlled diabetes mellitus, hypothyroidism, nephrotic syndrome, dysproteinemias, obstructive liver disease, other drug therapy, alcoholism) should be excluded and a lipid profile obtained to measure TC, HDL-C and TG.</p>', '<p>Niacin is a preparation of Nicotinic acid. It is proven effective at lowering VLDL, LDL, total cholesterol and triglyceride levels while raising HDL levels. So Niacin has been prescriped for the treatment of cardiovascular disease particularly the hyperlipidemias.</p>', '<p><strong>Initial Dose</strong>: 500 mg tablet at bedtime from 1 to 4 weeks.<br />\r\n<br />\r\n<strong>Maintenance Dose</strong>: the daily dosage should not be increased by more than 500 mg in any 4 week period. The recommended maintenance dose is 1000 mg (two tablet) to 2000 mg (4 tablets) once daily at bedtime. Dose greater than 2000 mg daily is not recommended. Or, as directed by the registered physician.</p>', '<p>Niacin may potentiate the effects of ganglionic blocking agents and vasoactive drugs resulting in postural hypotension. Concomitant aspirin may decrease the metabolic clearance of nicotinic acid. The clinical relevance of this finding is unclear. About 98% of available Niacin was bound to colestipol, with 10 to 30% binding to cholestyramine. These results suggest that 4 to 6 hours, or as great an interval as possible, should elapse between the ingestion of bile acid-binding resins and the administration of Niacin.</p>', '<p>Niacin is contraindicated in patients with a known hypersensitivity to Niacin or any component of this medication, significant or unexplained hepatic dysfunction, active peptic ulcer disease or arterial bleeding.</p>', '<p>Niacin is generally well tolerated; adverse reactions have been mild and transient. The most frequent advers effects were flushing, itching, pruritis, nausea and GI upset, jaundice, hypotension, tachycardia, increased serum blood glucose and uric acid levels, myalgia.</p>', '<p>Niacin cannot be used in pregnancy and lactation because of a lack of information.</p>', '<p>Before instituting therapy with Niacin, an attempt should be made to control hyperlipidemia with appropriate diet, exercise, and weight reduction in obese patients and to treat other underlying medical problems. Patients with a past history of jaundice, hepatobiliary disease, or peptic ulcer should be observed closely during Niacin therapy. Frequent monitoring of liver function tests and blood glucose should be performed to ascertain that the drug is producing no adverse effects on these organ systems. Diabetic patients may experience a dose-related rise in glucose intolerance, the clinical significance of which is unclear. Diabetic or potentially diabetic patients should be observed closely. Adjustment of diet and/or hypoglycemic therapy may be necessary.<br />\r\n<br />\r\nCaution should also be used when Niacin is used in patients with unstable angina or in the acute phase of MI, particularly when such patients are also receiving vasoactive drugs such as nitrates, calcium channel blockers or adrenergic blocking agents. Elevated uric acid levels have occurred with Niacin therapy, therefore use with caution in patients predisposed to gout. Niacin has been associated with small but statistically significant dose-related reductions in platelet count and increases in prothrombin time. Caution should be observed when Niacin is administered concomitantly with anticoagulants; prothrombin time and platelet counts should be monitored closely in such patients. Niacin has been associated with small but statistically significant, dose-related reductions in phosphorus levels (mean of -13% with 2000 mg). So phosphorus levels should be monitored periodically in patients at risk.</p>', '<p>Supportive measures should be undertaken in the event of an overdosage. Symptoms may include nausea, dizziness, itching, vomiting, upset stomach, and flushing.</p>', NULL, '<p>Store in a cool and dry place, protect from light and moisture. Keep all medicines out of the reach of the children.</p>', NULL, '2022-03-10 21:58:55', '2022-03-10 21:58:55'),
(1040, 1040, '<p>Nifedipine is indicated in the management of all types of essential &amp; renal hypertension. Also indicated in the management of hypertension during pregnancy &amp; during coronary by pass surgery.<br />\r\n<br />\r\nNifedipine is also used for prophylaxis and the treatment of unstable &amp; variant angina, myocardial infarction, and silent myocardial ischaemia. Moreover Nifedipine is also used in Raynaud&#39;s phenomenon &amp; heart failure.</p>', '<p>Nifedipine is an inhibitor of Calcium Channel Blocker that blocks the transmembrane influx of Calcium ions into muscle cells. Nifedipine has selective effects as a dilator of arterial vessels. Nifedipine dilates main coronary and systemic arteries. As a result blood pressure falls and this elicits a sympathetic reflex response causing tachycardia and an increased cardiac output. Pulmonary arterial pressure also falls. Nifedipine has direct negative inotropic effects on cardiac muscles and these effects are seen at higher doses than dose which causes arterial vasodilatation.</p>', '<p><strong>Nifedipine 10 mg:</strong></p>\r\n\r\n<ul>\r\n	<li><strong>Angina:</strong>&nbsp;Initially 10 mg 3 times daily with food increased to 20 mg 3 times daily if necessary, in elderly patients, initially 5 mg 3 times daily.</li>\r\n	<li><strong>Raynaud&#39;s Phenomenon:</strong>&nbsp;10 mg 3 times daily; maximum 60 mg daily. In urgent cases, the tablet should be dissolved under the tongue like a sublingual tablet. The effect occurs within some minutes.</li>\r\n</ul>\r\n\r\n<p><strong>Nifedipine 20 mg:&nbsp;</strong>The starting dose for patients, not previously prescribed Nifedipine products is one tablet once daily. The recommended dose in hypertension and angina prophylaxis is 20 mg twice daily during or after food. Dosage may be adjusted within the range 10 mg twice daily to 40 mg twice daily.<br />\r\n<br />\r\nPatients with liver dysfunction should commence therapy with 10 mg twice daily with careful monitoring.<br />\r\n<br />\r\nPatients with renal impairment do not require adjustment of dosage.</p>', '<p>&nbsp;</p>\r\n\r\n<ul>\r\n	<li>ACE inhibitors: Enhanced hypotensive effect.</li>\r\n	<li>Anti-arrythmics: Plasma concentration of quinidine is reduced.</li>\r\n	<li>Anti-bacterials: Rifampicin possibly increases metabolism of Nifedipine.</li>\r\n	<li>Anti-epileptics: Plasma concentration of phenytoin increases.</li>\r\n	<li>Antipsychotics: Enhanced hypotensive effect.</li>\r\n	<li>&beta;-blockers: Occasionally severe hypotension and heart failure may occur.</li>\r\n	<li>Cyclosporin: Plasma concentration of Nifedipine possibly increases.</li>\r\n	<li>Muscle relaxants: Effect of muscle relaxants e.g. tubocurarine increases.</li>\r\n	<li>Ulcer healing drugs: Metabolism of Nifedipine increases.</li>\r\n</ul>', '<p>Cardiogenic shock, advanced aortic stenosis, nursing mothers, GI obstruction, inflammatory bowel disease, hypotension.</p>', '<p>Headache, flushing, lethargy, gravitational oedema rash, nausea, increased frequency of micturation, eye pain, gum hyperplasia, depression, tremor, photosensitivity and few cases of jaundice have been reported. These reactions may regress on discontinuation of therapy. Its introduction may induce attacks of ischaemic pain in some patients with angina pectoris.</p>', '<p>There are no adequate and well controlled studies in pregnant women. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.</p>', '<p>Tablets should be swallowed whole and should not be bitten, chewed or broken up. It should be used with caution in patient whose cardiac reserve is poor. Should be withdrawn if ischaemic pain occurs or existing pain worsens shortly after initiating treatment. Use in diabetic patients requires adjustment of their control. Since the absorption of the drug could be modified by renal disease, caution should be exercised in treating such patients.</p>', NULL, '<p>Calcium-channel blockers.</p>', '<p>Protect from strong light, store in a cool place in the original pack.</p>', NULL, '2022-03-10 22:00:44', '2022-03-10 22:00:44'),
(1041, 1041, '<p>Nikethamide Injection is used for the treatment, control, prevention, &amp; improvement of the following diseases, conditions and symptoms: Central nervous system stimulant, Barbiturate overdose.</p>', '<p>Nikethamide was formerly used as a respiratory stimulant but its use for this indication is no longer recommended as the effective doses are close to those causing toxic effects (especially convulsions).</p>', '<p>1500 mg as single dose. Frequency: as recommended.</p>', '<p>Additive pressor effects with sympathomimetics or MAOIs. Increased risk of cardiac arrythmias with some anaesthetics (halothane, enflurane, isoflurane). May mask the effects of neuromuscular blockers. Increased risk of convulsions with bupropion.</p>', '<p>Porphyria, epilepsy or other convulsive disorders, cerebral oedema, cerebrovascular accident, head injury, acute severe asthma, physical obstruction of the airway, severe hypertension, ischaemic heart disease, hyperthyroidism, phaeochromocytoma.</p>', '<p>The following is a list of possible side-effects that may occur from all constituting ingredients of Nikethamide Injection: Skin irritation, Eye irritation, Respiratory irritation.</p>', NULL, '<p>Less severe degrees of hypertension or impaired cardiac reserve; liver dysfunction.</p>', NULL, '<p>Respiratory stimulants: analeptics</p>', NULL, NULL, '2022-03-10 22:02:39', '2022-03-10 22:02:39'),
(1042, 1042, '<p>Treatment of newly diagnosed adult patients with Philadelphia chromosome positive chronic myeloid leukemia (Ph+ CML) in chronic phase. The study is ongoing and further data will be required to determine long-term outcome.<br />\r\n<br />\r\nTreatment of chronic phase (CP) and accelerated phase (AP) Ph+ CML in adult patients resistant to or intolerant to prior therapy that included imatinib. Clinical benefit, such as improvement in disease-related symptoms or increased survival, has not been demonstrated.</p>', '<p>Nilotinib is a potent inhibitor of BCR-ABL tyrosine kinase. It binds to and stabilises the inactive conformation of the kinase domain of Abl protein.</p>', '<p><strong>Adult:</strong>&nbsp;400 mg bid. May continue until patient shows unacceptable toxicity or evidence of progression.<br />\r\n<br />\r\n<strong>Patient on strong CYP3A4 inhibitor:</strong>&nbsp;Reduce dose to 300 mg once daily, or to 200 mg once daily in newly-diagnosed chronic phase Philadelphia chronic myelogenous leukaemia. Dose may be adjusted to usual dose after a washout period.<br />\r\n<br />\r\n<strong>Patient on drugs that prolong QT interval</strong>&nbsp;(e.g. antiarrhythmics): Reduce dose and closely monitor for QT interval prolongation.<br />\r\n<br />\r\n<strong>Hepatic Impairment:</strong>&nbsp;Use a lower starting dose.</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. Avoid food at least 2 hr before &amp; at least 1 hr after a dose. Swallow whole, do not chew/crush. Avoid grapefruit products.</p>', '<p>Drugs that inhibit gastric acid secretion (e.g. PPIs) may reduce solubility and bioavailability of nilotinib.</p>', '<p>Patient with hypokalaemia, hypomagnesaemia or long QT syndrome. Concomitant use with potent CYP3A4 inhibitors or antiarrhythmics and other QT prolonging drugs. Concomitant use with potent CYP3A4 inducers.</p>', '<p>Rash, pruritus, hepatotoxicity, headache, fever, fatigue, GI disturbances (nausea, constipation, diarrhoea), alopecia, asthenia, muscle spasms, arthralgia, myalgia, pain (e.g. musculoskeletal or chest pain), oedema, folliculitis, papilloma, insomnia, dizziness, vertigo, anxiety, paraesthesia, hyperhidrosis, dry skin, urticaria, acne, conjunctivitis, dry eye, flushing, dyspnoea, cough, myelosuppression (e.g. thrombocytopenia, neutropenia, and anaemia), thrombotic disorders or haemorrhage, arrhythmias, heart failure, pericarditis, palpitations, HTN, angina, MI; elevated AST/ALT, serum lipase; electrolyte imbalances.</p>', '<p><strong>Category D:</strong>&nbsp;There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Patient with history of pancreatitis, with total gastrectomy. Hepatic impairment. Maintain adequate hydration and correct uric acid levels, hypomagnesaemia, hypokalaemia and other electrolyte imbalances prior to therapy. Pregnancy and lactation.</p>', '<p><strong>Symptoms:</strong>&nbsp;Neutropenia, vomiting and drowsiness.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Monitor patient and give supportive treatment.</p>', '<p>Targeted Cancer Therapy.</p>', '<p>Store below 30&deg; C.</p>', NULL, '2022-03-10 22:04:46', '2022-03-10 22:04:46'),
(1043, 1043, '<p>Nimesulide is indicated in acute pain; extra-articular disorders; osteoarthritis; post-op pain; primary dysmenorrhoea.</p>', '<p>Nimesulide is a nonsteroidal anti-inflammatory drug (NSAID) with anti-inflammatory, anti-pyretic, and analgesic properties. It inhibits prostaglandin synthetase/cyclooxygenase, which limits prostaglandin production. Its cyclooxygenase inhibiting potency is intermediate, but is relatively selective for the cyclo-oxygenase-2 (COX-2) thus the potential for gastric injury and intolerance is less. It is also a free radical scavenger, and helps protect against the tissue damage that occurs during inflammation.</p>', '<p>100 mg twice daily.&nbsp;Should be taken with food. Take after meals.</p>', '<p>Additive hepatotoxic effects with known hepatotoxins: anti-convulsants (e.g. valproic acid), anti-fungals (e.g. ketoconazole), anti-tuberculous drugs (e.g. isoniazid), tacrine, pemoline, amiodarone, methotrexate, methyldopa, amoxicillin/clavulanic acid. May decrease the oral bioavailability of furosemide and the natriuretic and diuretic response to furosemide. Increased risks of GI and hepatic adverse effects with other NSAIDs, including aspirin. May increase anti-coagulant effect of warfarin. Potentiates the action of phenytoin. May be displaced from binding sites with fenofibrate, salicylic acid, and tolbutamide. Interactions between NSAIDs and lithium, probenecid and ciclosporin, have been documented.</p>', '<p>Hypersensitivity; GI bleeding, active peptic ulcer disease; severe renal and heart failure; hepatic impairment or known liver disease; coagulation disorders; pregnancy; children &lt;12 yr.</p>', '<p>Epigastric discomfort, heartburn or abdominal cramps, nausea, vomiting and diarrhoea; skin rash, pruritus, oedema, headache, dizziness, drowsiness; hypersensitivity reactions (e.g. bronchospasm, rhinitis, angioedema urticaria); GI haemorrhage/perforation; bullous/erosive stomatitis, purpura, thrombocytopenia, toxic epidermal necrolysis, haematuria, oliguria, and renal failure; increases in liver enzymes.</p>', '<p>Category not classified</p>', '<p>History of GI tract disease, infections, oedema, hypertension, elderly, lactation.</p>', '<p>Epigastric pain, nausea, vomiting, drowsiness, lethargy, GI haemorrhage, seizures, hypertension, apnoea, coma, anaphylactic reactions and renal failure. Treatment is supportive.</p>', '<p>Non-steroidal Anti-inflammatory Drugs (NSAIDs).</p>', '<p>Protect from heat and humidity; store at &lt;25&deg;C.</p>', NULL, '2022-03-10 22:06:33', '2022-03-10 22:06:33'),
(1044, 1044, '<p>For the improvement of neurological outcome by reducing the incidence and severity of ischemic deficits in patients with subarachnoid hemorrhage from ruptured intracranial berry aneurysms regardless of their post ictus neurological condition.</p>', '<p>Nimodipine inhibits inflow of Calcium ions into cells by blocking Calcium channels or select voltage-sensitive areas resulting in relaxation of vascular smooth muscle and myocardium during depolarisation. Nimodipine has greater action on the cerebral vessels because of its high lipophilicity.</p>', '<p><strong>Adult:</strong>&nbsp;Initial dose is 60 mg in every four hours interval for 21 consecutive days, preferably not less than one hour before or two hours after meals. Oral Nimodipine therapy should be commence within 96 hours of the subarachnoid hemorrhage.<br />\r\n<br />\r\n<strong>Use in Pediatric Patients:</strong>&nbsp;While there is no specific information on use of this medication in pediatric patients.</p>', '<p>Plasma concentration and efficacy may be significantly reduced when administered with strong CYP3A4 inducers (e.g. rifampicin, carbamazepine, phenobarbital, phenytoin). May increase serum levels and toxicity of phenytoin. Increased plasma concentrations with cimetidine or sodium valproate.</p>', '<p>Use within 1 mth of MI or an episode of unstable angina. Concomitant use with potent CYP3A4 inhibitors (e.g. clarithromycin, ritonavir, ketoconazole, nefazodone).</p>', '<p>Although side effects from nimodipine are not common, the following can occur: headache, dizziness, flushing (feeling of warmth), heartburn, fast heartbeat, slow heartbeat, upset stomach, stomach pain, constipation, depression etc.</p>', '<p><strong>Use in Pregnancy:&nbsp;</strong>Large doses of nimodipine have been shown to cause birth defects in animals. Human studies have not been done. Before you take nimodipine, tell your doctor if you are pregnant or plan to become pregnant.<br />\r\n<br />\r\n<strong>Use in Nursing Mothers:&nbsp;</strong>Nimodipine may pass into breast milk but has not been reported to cause problems; caution is advised. Consult your doctor for advice.</p>', '<p>Patients with cerebral oedema or severely raised intracranial pressure. Contents of oral capsules should be given only by mouth or through a feeding tube. It must never be administered IV or by any other parenteral route. Hepatic impairment. Pregnancy and lactation.</p>', '<p><strong>Symptoms:</strong>&nbsp;Excessive peripheral vasodilation, systemic hypotension, tachycardia, bradycardia, GI complaints, nausea.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Symptomatic and supportive treatment. Admin of vasopressor may be necessary if significant hypotension occurs. IV Ca salts have been also used for hypotension.</p>', '<p>Calcium-channel blockers.</p>', '<p>Store between 15-30&deg; C. Protect from light.</p>', NULL, '2022-03-10 22:08:24', '2022-03-10 22:08:24'),
(1045, 1045, '<ul>\r\n	<li>Nintedanib is indicated in adults for the treatment of Idiopathic Pulmonary Fibrosis (IPF).</li>\r\n	<li>Nintedanib is indicated in adults for the treatment of chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype.</li>\r\n	<li>Nintedanib is indicated in adults for the treatment of systemic sclerosis-associated interstitial lung disease (SSc-ILD).</li>\r\n	<li>Nintedanib is indicated in combination with docetaxel for the treatment of adult patients with locally advanced, metastatic or locally recurrent non-small cell lung cancer (NSCLC) of adenocarcinoma tumor histology after first-line chemotherapy.</li>\r\n</ul>', '<p>Nintedanib is a small molecule, competitive, triple angiokinase inhibitor that targets multiple receptor tyrosine kinases (RTKs) and non-receptor tyrosine kinases (nRTKs). Many of these RTKs are implicated in lung fibrosis and tumour angiogenesis, so nintedanib is therefore used in the treatment of proliferative diseases such as idiopathic pulmonary fibrosis, non-small cell lung cancer, and systemic sclerosis-associated interstitial lung disease. The specific RTKs that nintedanib inhibits are platelet-derived growth factor (PDGFR) &alpha; and &beta;, fibroblast growth factor receptor (FGFR) 1-3, vascular endothelial growth factor receptor (VEGFR), and Fns-Like tyrosine kinase-3 (FLT3). Nintedanib binds to the ATP-binding pocket of these receptors and inhibits their activity, thereby blocking signalling cascades that result in the proliferation and migration of lung fibroblasts. Nintedanib also inhibits kinase signalling pathways in various cells within tumour tissues, including endothelial cells, pericytes, smooth muscle cells, and cells contributing to angiogenesis, culminating in an inhibition of cell proliferation and apoptosis of affected tumour cells.<br />\r\n<br />\r\nIn addition to RTK inhibition, nintedanib also prevents the actions of the nRTKs Lck, Lyn, and Src. The contribution of the inhibition of Lck and Lyn towards the therapeutic efficacy of nintedanib is unclear, but inhibition of the Src pathway by nintedanib has been shown to reduce lung fibrosis.</p>', '<p>Treatment with Nintedanib should be initiated by physicians experienced in the diagnosis and treatment of IPF.<br />\r\n<br />\r\nPosology: The recommended dose is 150 mg Nintedanib twice daily administered approximately 12 hours apart. The 100 mg twice daily dose is only recommended to be used in patients who do not tolerate the 150 mg twice daily dose. If a dose is missed, administration should resume at the next scheduled time at the recommended dose. If a dose is missed the patient should not take an additional dose. The recommended maximum daily dose of 300 mg should not be exceeded.<br />\r\n<br />\r\nFor NSCLC:</p>\r\n\r\n<ul>\r\n	<li>The recommended dose of nintedanib is 200 mg twice daily administered approximately 12 hours apart, on days 2 to 21 of a standard 21 day docetaxel treatment cycle.</li>\r\n	<li>Nintedanib must not be taken on the same day of docetaxel chemotherapy administration (= day 1). If a dose of nintedanib is missed, administration should resume at the next scheduled time at the recommended dose. The individual daily doses of nintedanib should not be increased beyond the recommended dose to make up for missed doses. The recommended maximum daily dose of 400 mg should not be exceeded.</li>\r\n	<li>Patients may continue therapy with nintedanib after discontinuation of docetaxel for as long as clinical benefit is observed or until unacceptable toxicity occurs.</li>\r\n	<li>Dose adjustments: In addition to symptomatic treatment if applicable, the management of adverse reactions to Nintedanib could include dose reduction and temporary interruption until the specific adverse reaction has resolved to levels that allow continuation of therapy. Nintedanib treatment may be resumed at the full dose (150 mg twice daily) or a reduced dose (100 mg twice daily). If a patient does not tolerate 100 mg twice daily, treatment with Nintedanib should be discontinued.</li>\r\n	<li>In case of interruptions due to aspartate aminotransferase (AST) or alanine aminotransferase (ALT) elevations &gt; 3x upper limit of normal (ULN), once transaminases have returned to baseline values, treatment with Nintedanib may be reintroduced at a reduced dose (100 mg twice daily) which subsequently may be increased to the full dose (150 mg twice daily).</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Nintedanib is for oral use. The capsules should be taken with food, swallowed whole with water, and should not be chewed or crushed.</p>', '<p><strong>P-glycoprotein (P-gp)</strong>: Nintedanib is a substrate of P-gp. Co-administration with the potent P-gp inhibitor ketoconazole increased exposure to Nintedanib 1.61-fold based on AUC and 1.83-fold based on Cmax in a dedicated drug-drug interaction study. In a drug-drug interaction study with the potent P-gp inducer rifampicin, exposure to Nintedanib decreased to 50.3% based on AUC and to 60.3% based on Cmax upon co-administration with rifampicin compared to administration of Nintedanib alone. If co-administered with Nintedanib, potent P-gp inhibitors (e.g. ketoconazole, erythromycin or cyclosporine) may increase exposure to Nintedanib. In such cases, patients should be monitored closely for tolerability of Nintedanib. Management of side effects may require interruption, dose reduction, or discontinuation of therapy with Nintedanib. Potent P-gp inducers (e.g. rifampicin, carbamazepine, phenytoin, and St. John&rsquo;s Wort) may decrease exposure to Nintedanib. Selection of an alternate concomitant medicinal product with no or minimal P-gp induction potential should be considered.<br />\r\n<br />\r\n<strong>Cytochrome (CYP)-enzymes</strong>: Only a minor extent of the biotransformation of Nintedanib consisted of CYP pathways. Nintedanib and its metabolites, the free acid moiety BIBF 1202 and its glucuronide BIBF 1202 glucuronide, did not inhibit or induce CYP enzymes in preclinical studies. The likelihood of drug-drug interactions with Nintedanib based on CYP metabolism is therefore considered to be low.<br />\r\n<br />\r\n<strong>Co-administration with other medicinal products</strong>: The potential for interactions of Nintedanib with hormonal contraceptives was not explored.</p>', '<p>Hypersensitivity to Nintedanib, to peanut or soya, or to any of the excipients.</p>', '<p>Summary of the safety profile: Nintedanib has been studied in clinical trials of 1,529 patients suffering from IPF. The safety data provided in the following are based on the two Phase III, randomized, double-blind, placebo-controlled studies in 1,061 patients comparing treatment with Nintedanib 150 mg twice daily to placebo for 52 weeks (INPULSIS-1 and INPULSIS-2) and based on data observed during the post-marketing period.<br />\r\n<br />\r\nThe most frequently reported adverse reactions associated with the use of Nintedanib included diarrhea, nausea and vomiting, abdominal pain, decreased appetite, weight decreased and hepatic enzyme increased.<br />\r\n<br />\r\nTabulated list of adverse reactions: The below table provides a summary of the adverse reactions by MedDRA System Organ Class (SOC) and frequency category.<br />\r\n<br />\r\nBelow table summarizes the frequencies of adverse drug reactions (ADRs) that were reported in the Nintedanib group (638 patients) pooled from the two placebo-controlled Phase III clinical trials of 52 weeks duration or from the post-marketing period.<br />\r\n<br />\r\nFrequency categories are defined using the following convention: Very common (&ge; 1/10), common (&ge; 1/100 to &lt; 1/10), uncommon (&ge; 1/1,000 to &lt; 1/100), rare (&ge; 1/10,000 to &lt; 1/1,000), very rare (&lt; 1/10,000), not known (cannot be estimated from the available data).</p>', '<p>Women of childbearing potential/Contraception: Nintedanib may cause foetalharm in humans. Women of childbearing potential should be advised to avoid becoming pregnant while receiving treatment with Nintedanib. They should be advised to use adequate contraception during and at least 3 months after the last dose of Nintedanib. Since the effect of Nintedanib on the metabolism and efficacy of hormonal contraceptives has not been investigated, barrier methods should be applied as a second form of contraception, to avoid pregnancy.<br />\r\n<br />\r\n<strong>Pregnancy</strong>: There is no information on the use of Nintedanib in pregnant women, but pre-clinical studies in animals have shown reproductive toxicity of this active substance. As Nintedanib may cause foetal harm also in humans, it must not be used during pregnancy. Female patients should be advised to notify their doctor or pharmacist if they become pregnant during therapy with Nintedanib. If the patient becomes pregnant while receiving Nintedanib, she should be apprised of the potential hazard to the foetus. Termination of the treatment with Nintedanib should be considered.<br />\r\n<br />\r\n<strong>Lactation</strong>: There is no information on the excretion of Nintedanib and its metabolites in human milk. Pre-clinical studies showed that small amounts of Nintedanib and its metabolites (&le; 0.5% of the administered dose) were secreted into milk of lactating rats. A risk to the newborns/infants cannot be excluded. Breast-feeding should be discontinued during treatment with Nintedanib.<br />\r\n<br />\r\n<strong>Fertility</strong>: Based on preclinical investigations there is no evidence for impairment of male fertility. From subchronic and chronic toxicity studies, there is no evidence that female fertility in rats is impaired at a systemic exposure level comparable with that at the maximum recommended human dose (MRHD) of 150 mg twice daily.</p>', '<p><strong>Diarrhoea</strong>: In the INPULSIS trials, diarrhoea was the most frequent gastro-intestinal adverse reaction reported in 62.4% versus 18.4% of patients treated with Nintedanib and placebo, respectively. In most patients the adverse reaction was of mild to moderate intensity and occurred within the first 3 months of treatment. Diarrhoea led to dose reduction in 10.7% of the patients and to discontinuation of Nintedanib in 4.4% of the patients in clinical trials. Serious cases of diarrhoea leading to dehydration and electrolyte disturbances have been reported in the post-marketing. Patients should be treated at first signs with adequate hydration and anti-diarrhoeal medicinal products, e.g. loperamide, and may require treatment interruption. Nintedanib treatment may be resumed at a reduced dose (100 mg twice daily) or at the full dose (150 mg twice daily). In case of persisting severe diarrhoea despite symptomatic treatment, therapy with Nintedanib should be discontinued.<br />\r\n<br />\r\n<strong>Nausea and vomiting</strong>: Nausea and vomiting were frequently reported gastrointestinal adverse reactions. In most patients with nausea and vomiting, the event was of mild to moderate intensity. Nausea led to discontinuation of Nintedanib in 2.0% of patients. Vomiting led to discontinuation in 0.8% of the patients. If symptoms persist despite appropriate supportive care (including anti-emetic therapy), dose reduction or treatment interruption may be required. The treatment may be resumed at a reduced dose (100 mg twice daily) or at the full dose (150 mg twice daily). In case of persisting severe symptoms therapy with Nintedanib should be discontinued.<br />\r\n<br />\r\n<strong>Hepatic function</strong>: The safety and efficacy of Nintedanib has not been studied&nbsp; in patients with moderate (Child Pugh B) or severe (Child Pugh C) hepatic impairment. Therefore, treatment with Nintedanib is not recommended in such patients. Based on increased exposure, the risk for adverse events may be increased in patients with mild hepatic impairment (Child Pugh A). Patients with mild hepatic impairment (Child Pugh A) should be treated with a reduced dose of Nintedanib. Cases of drug-induced liver injury have been observed with Nintedanib treatment, including severe liver injury with fatal outcome. The majority of hepatic events occur within the first three months of treatment. Therefore, hepatic transaminase and bilirubin levels should be investigated before treatment initiation and during the first month of treatment with Nintedanib. Patients should then be monitored at regular intervals during the subsequent two months of treatment and periodically thereafter, e.g. at each patient visit or as clinically indicated. Elevations of liver enzymes (ALT, AST, ALKP, gamma-glutamyl-transferase (GGT) and bilirubin were reversible upon dose reduction or interruption in the majority of cases. If transaminase (AST or ALT) elevations &gt; 3x ULN are measured, dose reduction or interruption of the therapy with Nintedanib is recommended and the patient should be monitored closely. Once transaminases have returned to baseline values, treatment with Nintedanib may be resumed at the full dose (150 mg twice daily) or reintroduced at a reduced dose (100 mg twice daily) which subsequently may be increased to the full dose. If any liver test elevations are associated with clinical signs or symptoms of liver injury, e.g. jaundice, treatment with Nintedanib should be permanently discontinued. Alternative causes of the liver enzyme elevations should be investigated.<br />\r\n<br />\r\nPatients with low body weight (&lt;65 kg), Asian and female patients have a higher risk of elevations of liver enzymes. Nintedanib exposure increased linearly with patient age, which may also result in a higher risk of developing liver enzyme elevations. Close monitoring is recommended in patients with these risk factors.<br />\r\n<br />\r\n<strong>Renal Function</strong>: Cases of renal impairment/failure, in some cases with fatal outcome, have been reported with Nintedanib use. Patients should be monitored during Nintedanib therapy, with particular attention to those patients exhibiting risk factors for renal impairment/failure. In case of renal impairment/failure, therapy adjustment should be considered.<br />\r\n<br />\r\n<strong>Haemorrhage</strong>: Vascular endothelial growth factor receptor (VEGFR) inhibition might be associated with an increased risk of bleeding. In the INPULSIS trials with Nintedanib, the frequency of patients who experienced bleeding AEs was slightly higher in the Nintedanib arm (10.3%) than in the placebo arm (7.8%). Non-serious epistaxis was the most frequent bleeding event. Serious bleeding events occurred with low and similar frequencies in the 2 treatment groups (placebo: 1.4%; Nintedanib: 1.3%). Patients at known risk for bleeding including patients with inherited predisposition to bleeding or patients receiving a full dose of anti-coagulative treatment were not included in the INPULSIS studies. Non-serious and serious bleeding events, some of which were fatal, have been reported in the post-marketing period (including patients with or without anticoagulant therapy or other drugs that could cause bleeding). Therefore, these patients should only be treated with Nintedanib if the anticipated benefit outweighs the potential risk. Post-marketing bleeding events include but are not limited to gastrointestinal, respiratory and central nervous organ systems, with the most frequent being gastrointestinal.<br />\r\n<br />\r\n<strong>Arterial thromboembolic events</strong>: Patients with a recent history of myocardial infarction or stroke were excluded from the INPULSIS trials. Arterial thromboembolic events were infrequently reported: in 0.7% of patients in the placebo and 2.5% in the Nintedanib treated group. While adverse events reflecting ischemic heart disease were balanced between the Nintedanib and placebo groups, a higher percentage of patients experienced myocardial infarctions in the Nintedanib group (1.6%) compared to the placebo group (0.5%). Caution should be used when treating patients at higher cardiovascular risk including known coronary artery disease. Treatment interruption should be considered in patients who develop signs or symptoms of acute myocardial ischemia.<br />\r\n<br />\r\n<strong>Venous thromboembolism</strong>: In the INPULSIS trials no increased risk of venous thromboembolism was observed in Nintedanib treated patients. Due to the mechanism of action of Nintedanib patients might have an increased risk of thromboembolic events.<br />\r\n<br />\r\n<strong>Gastrointestinal perforations</strong>: In the INPULSIS trials, the frequency of patients with perforation was very low in both treatment groups: 0% placebo, 0.3% Nintedanib (involving two patients). Due to the mechanism of action of Nintedanib patients might have an increased risk of gastrointestinal perforation. Cases of gastrointestinal perforations, some of which were fatal, have been reported in the post-marketing period. Particular caution should be exercised when treating patients with previous abdominal surgery, previous history of peptic ulceration, diverticular disease or receiving concomitant corticosteroids or NSAIDs. Nintedanib should only be initiated at least 4 weeks after abdominal surgery. Therapy with Nintedanib should be permanently discontinued in patients who develop gastrointestinal perforation.<br />\r\n<br />\r\n<strong>Hypertension</strong>: Administration of Nintedanib may increase blood pressure. Systemic blood pressure should be measured periodically and as clinically indicated.<br />\r\n<br />\r\n<strong>Wound healing complication</strong>: No increased frequency of impaired wound healing was observed in the INPULSIS trials. Based on the mechanism of action Nintedanib may impair wound healing. No dedicated studies investigating the effect of Nintedanib on wound healing were performed. Treatment with Nintedanib should therefore only be initiated or &ndash; in case of perioperative interruption &ndash; resumed based on clinical judgement of adequate wound healing.<br />\r\n<br />\r\n<strong>Co-administration with Pirfenidone</strong>: In a dedicated pharmacokinetic study, concomitant treatment of Nintedanib with Pirfenidone was investigated in patients with IPF. Based on these results, there is no evidence of a relevant pharmacokinetic drug-drug interaction between Nintedanib and Pirfenidone when administered in combination. In view of the limited number of patients, this study detected only the most frequent adverse events and showed an increase in gastrointestinal adverse events and a trend toward increased hepatic adverse events. Given the similarity in safety profiles for both medicinal products, additive adverse events, including gastrointestinal and hepatic adverse events, may be expected. The benefit-risk balance of concomitant treatment with Pirfenidone has not been established.<br />\r\n<br />\r\n<strong>Effect on QT interval</strong>: No evidence of QT prolongation was observed for Nintedanib in the clinical trial programme. As some other tyrosine kinase inhibitors are known to exert an effect on QT, caution should be exercised when administered Nintedanib in patients who may develop QTc prolongation.<br />\r\n<br />\r\n<strong>Allergic reaction</strong>: Dietary soya products are known to cause allergic reactions including severe anaphylaxis in persons with soya allergy. Patients with known allergy to peanut protein carry an enhanced risk for severe reactions to soya preparations.</p>', NULL, '<p>Tyrosine Kinase Inhibitor.</p>', '<p>Store in a cool and dry place, protected from light. Do not store above 25&deg;C.</p>', '<p><strong>Elderly patients (&ge;65 years)</strong>: No overall differences in safety and efficacy were observed for elderly patients. No a-priori dose adjustment is required on the basis of a patient&rsquo;s age. Patients &ge;75 years may be more likely to require dose reduction to manage adverse effects.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: Less than 1% of a single dose of Nintedanib is excreted via the kidney. Adjustment of the starting dose in patients with mild to moderate renal impairment is not required. The safety, efficacy, and pharmacokinetics of Nintedanib have not been studied in patients with severe renal impairment (&lt;30 ml/min creatinine clearance).<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Nintedanib is predominantly eliminated via biliary/faecal excretion (&gt; 90%). Exposure increased in patients with hepatic impairment (Child Pugh A, Child Pugh B). In patients with mild hepatic impairment (Child Pugh A), the recommended dose of Nintedanib is 100 mg twice daily approximately 12 hours apart. In patients with mild hepatic impairment (Child Pugh A), treatment interruption or discontinuation for management of adverse reactions should be considered. The safety and efficacy of Nintedanib have not been investigated in patients with hepatic impairment classified as Child Pugh B and C. Treatment of patients with moderate (Child Pugh B) and severe (Child Pugh C) hepatic impairment with Nintedanib is not recommended.<br />\r\n<br />\r\n<strong>Paediatric population</strong>:&nbsp;The safety and efficacy of Nintedanib in children aged 0-18 years have not been established. No data are available.</p>', '2022-03-10 22:11:14', '2022-03-10 22:11:14');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1046, 1046, '<p>Niraparib is indicated for the maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to platinum-based chemotherapy.</p>', '<p>Niraparib is an inhibitor of poly (ADP-ribose) polymerase (PARP) enzymes, PARP-1 and PARP-2, which play a role in DNA repair. In vitro studies have shown that niraparib induced cytotoxicity may involve inhibition of PARP enzymatic activity and increased formation of PARP-DNA complexes resulting in DNA damage, apoptosis and cell death. Increased Niraparib-induced cytotoxicity was observed in tumor cell lines with or without deficiencies in BRCA1/2. Niraparib decreased tumor growth in mouse xenograft models of human cancer cell lines with deficiencies in BRCA1/2 and in human patient-derived xenograft tumor models with homologous recombination deficiency that had either mutated or wild type BRCA1/2.<br />\r\n<br />\r\n<strong>Absorption</strong>: The absolute bioavailability of niraparib is approximately 73%. Following oral administration of Niraparib, peak plasma concentration, Cmax, is reached within 3 hours. Concomitant administration of a high fat meal (800-1,000 calories with approximately 50% of total caloric content of the meal from fat) did not significantly affect the pharmacokinetics of Niraparib.<br />\r\n<br />\r\n<strong>Distribution</strong>: Niraparib is 83.0% bound to human plasma proteins. The average (&plusmn;SD) apparent volume of distribution (Vd/F) was 1220 (&plusmn;1114) L. In a population pharmacokinetic analysis, the Vd/F of Niraparib was 1074 L in cancer patients.<br />\r\n<br />\r\n<strong>Elimination</strong>: Following multiple daily doses of 300 mg Niraparib, the mean half-life (t1/2) is 36 hours. In a population pharmacokinetic analysis, the apparent total clearance (CL/F) of niraparib was 16.2 L/h in cancer patients.<br />\r\n<br />\r\n<strong>Metabolism</strong>: Niraparib is metabolized primarily by carboxylesterases (CEs) to form a major inactive metabolite, which subsequently undergoes glucuronidation.<br />\r\n<br />\r\n<strong>Excretion</strong>: Following administration of a single oral 300 mg dose of radio-labeled Niraparib, the average percent recovery of the administered dose over 21 days was 47.5% (range 33.4% to 60.2%) in urine and 38.8% (range 28.3% to 47.0%) in feces. In pooled samples collected over 6 days, unchanged Niraparib accounted for 11% and 19% of the administered dose recovered in urine and feces, respectively</p>', '<p>The recommended dose of Niraparib as monotherapy is 300 mg (three 100 mg capsules) taken orally once daily. Instruct patients to take their dose of Niraparib at approximately the same time each day. Each capsule should be swallowed whole. Niraparib may be taken with or without food. Bedtime administration may be a potential method for managing nausea. Patients should start treatment with Niraparib no later than 8 weeks after their most recent platinum-containing regimen. Niraparib treatment should be continued until disease progression or unacceptable toxicity. In the case of a missed dose of Niraparib, instruct patients to take their next dose at its regularly scheduled time. If a patient vomits or misses a dose of Niraparib, an additional dose should not be taken.<br />\r\n<br />\r\nNiraparib is for oral use. The capsules should be swallowed whole with water. The capsules should not be chewed or crushed. Niraparib can be taken without regard to meals.</p>', '<p>Inhibition of CYPs (CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, and CYP3A4). Neither Niraparib nor M1 is an inhibitor of any active ubstance-metabolising CYP enzymes, namely CYP1A1/2, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6 and CYP3A4/5. Even though inhibition of CYP3A4 in the liver is not expected, the potential to inhibit CYP3A4 at the intestinal level has not been established at relevant Niraparib concentrations. Therefore, caution is recommended when Niraparib is combined with active substances the metabolism of which is CYP3A4-dependent and, notably, those having a narrow therapeutic range (e.g. ciclosporin, tacrolimus, alfentanil, ergotamine, pimozide, quetiapine and halofantrine).<br />\r\n<br />\r\nInduction of CYPs (CYP1A2 and CYP3A4): Neither Niraparib nor M1 is a CYP3A4 inducer in vitro. In vitro, Niraparib weakly induces CYP1A2 at high concentrations and the clinical relevance of this effect would not be completely ruled out. M1 is not a CYP1A2 inducer. Therefore, caution is recommended when niraparib is combined with active substances the metabolism of which is CYP1A2-dependent and, notably, those having a narrow therapeutic range (e.g. clozapine, theophylline and ropinirole).</p>', '<p>Hypersensitivity to the active substance or to any of the excipients &amp; breast-feeding.</p>', '<p>In the pivotal ENGOT-OV16 study, adverse reactions (ADRs) occurring &gt; 10% of patients receiving Niraparib monotherapy were nausea, thrombocytopenia, fatigue/asthenia, anaemia, constipation, vomiting, abdominal pain, neutropenia, insomnia, headache, decreased appetite, nasopharyngitis, diarrhoea, dyspnea, hypertension, dyspepsia, back pain, dizziness, cough, urinary tract infection, arthralgia, palpitations, and dysgeusia. The most common serious adverse reactions &gt;1% (treatment-emergent frequencies) were thrombocytopenia and anaemia.</p>', '<p>Women of childbearing potential/contraception in females Women of childbearing potential should not become pregnant while on treatment and should not be pregnant at the beginning of treatment. A pregnancy test should be performed on all women of childbearing potential prior to treatment. Women of childbearing potential must use effective contraception during therapy and for 1 month after receiving the last dose of Niraparib.<br />\r\n<br />\r\n<strong>Pregnancy</strong>: There are no or limited amount of data from the use of Niraparib in pregnant women. Animal reproductive and developmental toxicity studies have not been conducted. However, based on its mechanism of action, niraparib could cause embryonic or foetal harm, including embryo-lethal and teratogenic effects, when administered to a pregnant woman. Niraparib should not be used during pregnancy.<br />\r\n<br />\r\n<strong>Breast-feeding</strong>: It is unknown whether niraparib or its metabolites are excreted in human milk. Breast-feeding is contraindicated during administration of Niraparib and for 1 month after receiving the last dose.<br />\r\n<br />\r\n<strong>Fertility</strong>: There are no clinical data on fertility. A reversible reduction of spermatogenesis was observed in rats and dogs.</p>', '<p><strong>Myelodysplastic syndrome/acute myeloid leukaemia</strong>: Myelodysplastic syndrome/acute myeloid leukaemia (MDS/AML), including cases with fatal outcome, have been reported in a small number of patients who received Niraparib or placebo. In the pivotal Phase 3 international trial (ENGOT-OV16), the incidence of MDS/AML in patients who received niraparib (1.4%) was similar to that in patients who received placebo (1.1%). Overall, MDS/AML has been reported in 7 out of 751 (0.9%) patients treated with Niraparib in clinical studies. The duration of Niraparib treatment in patients prior to developing MDS/AML varied from 1 month to &gt; 2 years. The cases were typical of secondary, cancer therapy-related MDS/AML. All patients had received multiple platinum-containing chemotherapy regimens and many had also received other DNA damaging agents and radiotherapy. Some of the patients had a history of bone marrow dysplasia. If MDS and/or AML are confirmed while on treatment with Niraparib, treatment should be discontinued and the patient treated appropriately.<br />\r\n<br />\r\n<strong>Hypertension including hypertensive crisis</strong>: Hypertension, including hypertensive crisis, has been reported with the use of Niraparib. Pre-existing hypertension should be adequately controlled before starting Niraparib treatment. Blood pressure should be monitored monthly for the first year and periodically thereafter during treatment with Niraparib. Hypertension should be medically managed with antihypertensive medicinal products as well as adjustment of the Niraparib dose, if necessary. In the clinical programme, blood pressure measurements were obtained on Day 1 of each 28-day cycle while the patient remained on Niraparib. In most cases, hypertension was controlled adequately using standard antihypertensive treatment with or without Niraparib dose adjustment. Niraparib should be discontinued in case of hypertensive crisis or if medically significant hypertension cannot be adequately controlled with antihypertensive therapy.<br />\r\n<br />\r\n<strong>Pregnancy/contraception</strong>: Niraparib should not be used during pregnancy or in women of childbearing potential not willing to use reliable contraception during therapy and for 1 month after receiving the last dose of Niraparib. A pregnancy test should be performed on all women of childbearing potential prior to treatment.<br />\r\n<br />\r\n<strong>Lactose</strong>: Niraparib hard capsules contain lactose monohydrate. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose galactose malabsorption should not take this medicine.<br />\r\n<br />\r\n<strong>Tartrazine (E102)</strong>: This medicinal product contains tartrazine (E 102), which may cause allergic reactions.</p>', '<p>There is no specific treatment in the event of Niraparib overdose, and symptoms of overdose are not established. In the event of an overdose, physicians should follow general supportive measures and should treat symptomatically.</p>', '<p>Cytotoxic Chemotherapy.</p>', '<p>Store in a cool and dry place. Do not store above 30&deg;C. Do not take Niraparib if it is suspected of having been exposed to temperatures greater than 40&deg;C or 104&deg;F. Keep Niraparib out of the reach and sight of children.</p>', '<p><strong>Elderly</strong>: No dose adjustment is necessary for elderly patients (&gt; 65 years). There are limited clinical data in patients aged 75 or over.<br />\r\n<br />\r\n<strong>Paediatric population</strong>: The safety and efficacy of niraparib in children and adolescents below 18 years of age have not yet been established. No data are available.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: No dose adjustment is necessary for patients with mild to moderate renal impairment. There are no data in patients with severe renal impairment or end-stage renal disease undergoing hemodialysis; use with caution in these patients.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: No dose adjustment is needed in patients with mild to moderate hepatic impairment. There are no data in patients with severe hepatic impairment; use with caution in these patients.</p>', '2022-03-10 22:13:25', '2022-03-10 22:13:25'),
(1047, 1047, '<p>This is indicated in combination with other antiretrovirals or alone for the treatment of human immunodeficiency virus type 1 (HIV-1) infection.</p>', '<p>Abacavir is a carbocyclic synthetic nucleoside analogue and an antiviral agent. Intracellularly, abacavir is converted by cellular enzymes to the active metabolite carbovir triphosphate, an analogue of deoxyguanosine-5&#39;-triphosphate (dGTP). Carbovir triphosphate inhibits the activity of HIV-1 reverse transcriptase (RT) both by competing with the natural substrate dGTP and by its incorporation into viral DNA. Viral DNA growth is terminated because the incorporated nucleotide lacks a 3&#39;-OH group, which is needed to form the 5&prime; to 3&prime; phosphodiester linkage essential for DNA chain elongation.<br />\r\n<br />\r\nLamivudine is a synthetic nucleoside analogue and is phosphorylated intracellularly to its active 5&#39;-triphosphate metabolite, lamivudine triphosphate (L-TP). This nucleoside analogue is incorporated into viral DNA by HIV reverse transcriptase and HBV polymerase, resulting in DNA chain termination.<br />\r\n<br />\r\nZidovudine, a structural analog of thymidine, is a prodrug that must be phosphorylated to its active 5&prime;-triphosphate metabolite, zidovudine triphosphate (ZDV-TP). It inhibits the activity of HIV-1 reverse transcriptase (RT) via DNA chain termination after incorporation of the nucleotide analogue. It competes with the natural substrate dGTP and incorporates itself into viral DNA. It is also a weak inhibitor of cellular DNA polymerase &alpha; and &gamma;.</p>', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-03-11 01:14:16', '2022-03-11 01:14:16'),
(1048, 1048, '<p>Indicated for mild-to-moderate COVID-19 positive adult and pediatric patients (12 years of age and older weighing at least 40 kg), who are at high risk for progression to severe COVID-19, including hospitalization or death.</p>', '<p>This inhibits the main protease (Mpro) of the SARS-CoV-2. This main protease (Mpro) is also referred as 3C-like protease (3CLpro) or nsp5 protease. This inhibition of Mpro hampers the peptidomimetic activity of SARS-CoV-2. Ritonavir is an HIV-1 protease inhibitor but is not active against SARS-CoV-2 Mpro. Ritonavir inhibits the CYP3A mediated metabolism of Nirmatrelvir, resulting in increased plasma concentrations of Nirmatrelvir.</p>', '<p>Nirmatrelvir must be co-administered with Ritonavir. Initiate this treatment as soon as possible after diagnosis of COVID-19 and within 3-5 days of symptom onset. Administer orally with or without food.<br />\r\n<br />\r\n<strong>Dosage</strong>: 300 mg Nirmatrelvir (two 150 mg tablets) with 100 mg Ritonavir (one 100 mg tablet), with all three tablets taken together twice daily for 5 days.<br />\r\n<br />\r\n<strong>Missed Dose</strong>: If the patient misses a dose of this within 8 hours of the time it is usually taken, the patient should take it as soon as possible and resume the normal dosing schedule. If the patient misses a dose by more than 8 hours, the patient should not take the missed dose and instead take the next dose at the regularly scheduled time. The patient should not double the dose to make up for a missed dose.</p>', '<p>Co-administration of this tablet with drugs highly dependent on CYP3A for clearance and for which elevated plasma concentrations are associated with serious and/or life-threatening events is contraindicated. Co-administration with other CYP3A substrates may require a dose adjustment or additional monitoring. Nirmatrelvir and Ritonavir are CYP3A substrates; therefore, drugs that induce CYP3A may decrease Nirmatrelvir and Ritonavir plasma concentrations and reduce this tablet therapeutic effect.</p>', '<ul>\r\n	<li>History of clinically significant hypersensitivity reactions to the active ingredients (Nirmatrelvir or Ritonavir) or any other components.</li>\r\n	<li>Co-administration with drugs highly dependent on CYP3A for clearance and for which elevated concentrations are associated with serious and/or life-threatening reactions.</li>\r\n	<li>Co-administration with potent CYP3A inducers where significantly reduced Nirmatrelvir or Ritonavir plasma concentrations may be associated with the potential for loss of virologic response and possible resistance.</li>\r\n</ul>', '<p>Adverse events (incidence &gt;1% and subject difference) were dysgeusia, diarrhea, hypertension, and myalgia.</p>', '<p>This is not recommended during pregnancy and in people who can become pregnant and who are not using contraception. Breastfeeding should be interrupted during treatment. These recommendations are because laboratory studies in animals suggest that high doses of this may impact the growth of the fetus. This drug should be used during pregnancy only if clearly needed and the benefit outweighs the risk to the fetus; use of oral solution is not recommended.</p>', '<p>The concomitant use of this tablet and certain other drugs may result in potentially significant drug interactions. Consult the full prescribing information prior to and during treatment for potential drug interactions.<br />\r\n<br />\r\n<strong>Hepatotoxicity</strong>: Hepatic transaminase elevations, clinical hepatitis, and jaundice have occurred in patients receiving Ritonavir.<br />\r\n<br />\r\n<strong>HIV-1 Drug Resistance</strong>: This tablet use may lead to a risk of HIV-1 developing resistance to HIV protease inhibitors in individuals with uncontrolled or undiagnosed HIV-1 infection.</p>', '<p>Treatment of an overdose of this tablet should consist of general supportive measures including monitoring of vital signs and observation of the clinical status of the patient. There is no specific antidote for overdose with this tablet.</p>', NULL, '<p>Do not store above 30&deg;C. Keep in a dry place. Protect from light and keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: This tablet is not authorized for use in pediatric patients younger than 12 years of age or weighing less than 40 kg. The safety and effectiveness of this tablet have not been established in pediatric patients.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of this tablet include subjects 65 years of age and older and their data contributes to the overall assessment of safety and efficacy.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No dosage adjustment is needed in patients with mild renal impairment. In patients with moderate renal impairment (eGFR &gt;30 to &lt;60 mL/min), reduce the dose of This tablet to 150 mg Nirmatrelvir and 100 mg Ritonavir twice daily for 5 days. This tablet is not recommended in patients with severe renal impairment (eGFR &lt;30 mL/min).<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No dosage adjustment of this tablet is needed for patients with either mild (Child-Pugh Class A) or moderate (Child-Pugh Class B) hepatic impairment. This tablet is not recommended in patients with severe hepatic impairment (Child-Pugh Class C).</p>', '2022-03-11 03:37:39', '2022-03-11 03:37:39'),
(1049, 1049, '<p>Nitazoxanide is indicated for the treatment of diarrhea caused by Cryptosporidium parvum, Giardia lamblia and Entamoeba histolytica.</p>', '<p>Nitazoxanide is a synthetic antiprotozoal agent for oral administration. The antiprotozoal activity of Nitazoxanide is believed to be interference with the Pyruvate Ferredoxin Oxido Reductase (PFOR) enzyme-dependant electron transfer reaction. This reaction is essential for anaerobic energy metabolism of the protozoa. Nitazoxanide and its metabolites, tizoxanid are active in vitro in inhibiting the growth of sporozoites and oocyst of Cryptosporidium parvum and trophozoites of Giardia lamblia.</p>', '<p><strong>Age 1-3 years</strong>: 1 tea-spoonfull or 5 ml suspension every 12 hours for 3 days.<br />\r\n<strong>Age 4-11 years</strong>: 2 tea-spoonfulls or 10 ml suspension every 12 hours for 3 days.<br />\r\n<strong>Age 12 years or above</strong>: 5 tea-spoonfulls (25 ml) suspension or 1 tablet every 12 hours for 3 days.<br />\r\n<br />\r\nIt is recommended to be administered with food.</p>', '<p>It is highly bound to plasma protein. Therefore, caution should be exercised when administering Nitazoxanide concurrently with other highly plasma protein-bound drugs with narrow therapeutic index.</p>', '<p>It is contraindicated in patients with known hypersensitivity to Nitazoxanide or any components of the preparation.</p>', '<p>The most frequent side effects, reported by Nitazoxanide are abdominal pain, vomiting and headache. These side effects are typically mild and transient in nature. Very rare side effects include- nausea, anorexia, flatulence, increased appetite, enlarged salivary glands, increased creatinine &amp; SGPT level, pruritus, rhinitis, sweating, dizziness, discolored urine etc.</p>', '<p>US FDA pregnancy category of Nitazoxanide is B. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Nitazoxanide have been shown to be excreted in human milk. So, caution should be exercised when Nitazoxanide is administered during lactation.</p>', '<p>Nitazoxanide must be administered with caution to patients with hepatic &amp; biliary disease and to patients with renal disease.</p>', NULL, '<p>Anti-diarrhoeal Antiprotozoal.</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-11 03:39:52', '2022-03-11 03:39:52'),
(1050, 1050, '<p>Short-term management of insomnia,&nbsp;Infantile spasms.</p>', '<p>Nitrazepam is a benzodiazepine with a pronounced sleep-inducing activity. It depresses the reticular-activating system in the brainstem by enhancing the inhibitory effect of GABA on brain cells, thus preventing excessive brain activity.</p>', '<p>Short-term management of insomnia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;5 mg at night; increase to 10 mg if necessary.</li>\r\n	<li><strong>Elderly:</strong>&nbsp;and debilitated patients: &le;normal adult dose.</li>\r\n</ul>\r\n\r\n<p>Infantile spasms:</p>\r\n\r\n<ul>\r\n	<li><strong>Child:</strong>&nbsp;Infants: 125 mcg/kg bid; gradually increase to 250-500 mcg/kg bid.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>May be taken with or without food</p>', '<p>CNS depressant effect increased with alcohol, barbiturates, TCAs, phenothiazines, morphine derivatives. Effects may be antagonised by theophylline. Increased levels/effects with probenecid. Reduced levels/effects with rifampicin. May reduce effects of levodopa.</p>', '<p>Myasthenia gravis, narrow-angle glaucoma, severe respiratory insufficiency, sleep apnoea syndrome, severe hepatic impairment, porphyria.</p>', '<p>Hypotension, palpitation; agitation, aggressiveness, amnesia, ataxia, confusion, delusions, disorientation, dizziness, fatigue, hallucination, hangover, headache, irritability, nightmares, psychoses, rage, restlessness, sedation; rash; changes in libido; constipation, diarrhoea, excessive salivation, heartburn, nausea, vomiting; granulocytopenia, leukopenia; falling, muscle weakness; blurred or double vision; tinnitus (associated with withdrawal); aspiration, increased bronchial secretion, dyspnoea.</p>', '<p>Category not classified</p>', '<p>May induce anterograde amnesia; caution patients to have uninterrupted sleep of 7-8 hr after ingestion of dose. May impair ability to drive or operate machinery. Depression, especially if suicidal risk may be present. History of drug abuse or acute alcoholism. Hepatic and renal impairment. Respiratory disease. Debilitated patients. Patients who are at risk of falls. Children, elderly. Pregnancy and lactation.</p>', '<p><strong>Symptoms:</strong>&nbsp;Somnolence, drowsiness, confusion, ataxia, impaired reflexes, coma, dyspnoea, hypotension, respiratory and cardiovascular depression.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Supportive. Gastric lavage may be beneficial if performed soon after ingestion. Flumazenil may reverse benzodiazepine-induced CNS depression.</p>', '<p>Benzodiazepine hypnotics</p>', '<p>Store at room temperature. Protect from light and moisture.</p>', NULL, '2022-03-11 03:42:06', '2022-03-11 03:42:06'),
(1051, 1051, '<p>Nitrofurantoin is specifically indicated for the treatment &amp; prophylaxis of urinary tract infections caused by susceptible strains of Escherichia coli, Enterococci, Staphylococcus aureus, Staphylococcus saprophyticus and certain susceptible strains of Klebsiella and Enterobacter species.</p>', '<p>Nitrofurantoin is an antibacterial agent specific for urinary tract infections. Nitrofurantoin is highly soluble in urine, to which it may impart a brown color. Nitrofurantoin inactivates or alters bacterial ribosomal proteins and other macromolecules. Nitrofurantoin has been shown to be active against the following bacteria: Gram-Positive Aerobes Staphylococcus saprophyticus, Coagulase-negative staphylococci (including Staphylococcus epidermidis), Enterococcus faecalis, Staphylococcus aureus, Streptococcus agalactiae, Group D streptococci, Viridans group streptococci. Gram-Negative Aerobes- Escherichia coli, Citrobacter amalonaticus, Citrobacter diversus, Citrobacter freundii, Klebsiella oxytoca, Klebsiella ozaenae.</p>', '<p>Nitrofurantoin tablet (In adults):</p>\r\n\r\n<ul>\r\n	<li><strong>Uncomplicated urinary tract infections</strong>: 50-100 mg four times a day- the lower dosage level is recommended. Therapy should be continued for one week or for at least 3 days after sterility of the urine is obtained.</li>\r\n	<li><strong>For long-term suppressive therapy</strong>: In adults, a reduction of dosage to 50-100 mg at bedtime may be adequate.</li>\r\n</ul>\r\n\r\n<p>Nitrofurantoin capsule (In adults):</p>\r\n\r\n<ul>\r\n	<li><strong>Acute Uncomplicated Urinary Tract Infections (UTIs)</strong>: 50 mg four times daily for 7 days.</li>\r\n	<li><strong>Long term suppression</strong>: 50-100 mg once a day.</li>\r\n	<li><strong>Prophylaxis</strong>: 50 mg four times daily for the duration of procedure and for three days thereafter.</li>\r\n</ul>\r\n\r\n<p>Nitrofurantoin SR capsule:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and Children over 12 years</strong>: One 100 mg capsule every 12 hours for seven days.</li>\r\n	<li><strong>Genito-urinary surgical prophylaxis</strong>: One capsule twice daily on day of procedure and for next 3 days.</li>\r\n</ul>\r\n\r\n<p>Nitrofurantoin suspension: Children: 5-7 mg/kg/day in four divided doses (contraindicated under one month of age). The average dose of Nintoin suspension for pediatric patients are as follows-</p>\r\n\r\n<ul>\r\n	<li>7 to 11 kg: &frac12; (2.5 ml) teaspoonfuls 4 times daily.</li>\r\n	<li>12 to 21 kg: 1 (5 ml) teaspoonfuls 4 times daily.</li>\r\n	<li>22 to 30 kg: 1&frac12; (7.5 ml) teaspoonfuls 4 times daily.</li>\r\n	<li>31 to 41 kg: 2 (10 ml) teaspoonfuls 4 times daily.</li>\r\n</ul>\r\n\r\n<p>Therapy should be continued for one week or for at least 3 days after sterility of the urine is obtained. For long-term suppressive therapy in children, doses as low as 1 mg/kg per 24 hours, given in a single dose or in two divided doses, may be adequate.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Nitrofurantoin should be taken with food.</p>', '<p>Antacids containing Magnesium Trisilicate, when administered concomitantly with Nitrofurantoin, reduce both the rate and extent of absorption of Uricosuric drugs, such as Probenecid and Sulfinpyrazone, can inhibit renal tubular secretion of Nitrofurantoin.</p>', '<p>Anuria, oliguria or significant impairment of renal function are contraindications. This drug is contraindicated in pregnant patients at 38-42 weeks, during labor and delivery. Nitrofurantoin is also contraindicated in those patients with known hypersensitivity to Nitrofurantoin.</p>', '<p>The most frequent clinical adverse events are nausea, headache, and flatulence. Other less occurred adverse events are diarrhea, dyspepsia, abdominal pain, constipation, emesis, dizziness and drowsiness.</p>', '<p>Pregnancy Category B. There are no adequate and well-controlled studies in pregnant women. This drug should be used during pregnancy only if clearly needed. Nitrofurantoin has been detected in human breast milk in trace amounts. Because of the potential for serious adverse reactions from Nitrofurantoin in nursing infants under one month of age, 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>If acute, sub-acute or chronic pulmonary reactions occur, Nitrofurantoin should be discontinued. Antacid preparations containing magnesium trisilicate should not be taken while taking Nitrofurantoin.</p>', '<p>Occasional incidents of acute overdosage of Nitrofurantoin have not resulted in any specific symptoms other than vomiting. Induction of emesis is recommended.</p>', '<p>Systemic Urinary Anti- infective</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-11 03:44:16', '2022-03-11 03:44:16'),
(1052, 1052, '<p>For the treatment of and prophylaxis against acute or recurrent, uncomplicated lower urinary tract infections or pyelitis either spontaneous or following surgical procedures. Nitrofurantoin is specifically indicated for the treatment of infections when due to susceptible strains of Escherichia coli, enterococci, staphylococci, Citrobacter, Klebsiella and Enterobacter.</p>', '<p>Each capsule contains two forms of nitrofurantoin. Twenty-five percent is macrocrystalline nitrofurantoin, which has slower dissolution and absorption than nitrofurantoin monohydrate. The remaining 75% is nitrofurantoin monohydrate contained in a powder blend which, upon exposure to gastric and intestinal fluids, forms a gel matrix that releases nitrofurantoin over time. This capsule is highly soluble in urine, to which it may impart a brown color. When administered with food, the bioavailability of nitrofurantoin is increased by approximately 40%.</p>', '<p><strong>Adults and Pediatric Patients Over 12 Years</strong>: One 100 mg capsule every 12 hours for seven days. Capsules should be taken with food.<br />\r\n<br />\r\nThe administration of high doses of nitrofurantoin to rats causes temporary spermatogenic arrest; this is reversible on discontinuing the drug. Doses of 10 mg/kg/day or greater in healthy human males may, in certain unpredictable instances, produce a slight to moderate spermatogenic arrest with a decrease in sperm count.</p>', '<p>Antacids containing magnesium trisilicate, when administered concomitantly with nitrofurantoin, reduce both the rate and extent of absorption. The mechanism for this interaction probably is adsorption of nitrofurantoin onto the surface of magnesium trisilicate. Uricosuric drugs, such as probenecid and sulfinpyrazone, can inhibit renal tubular secretion of nitrofurantoin. The resulting increase in nitrofurantoin serum levels may increase toxicity, and the decreased urinary levels could lessen its efficacy as a urinary tract antibacterial.</p>', NULL, '<p>In clinical trials of Macrobid, the most frequent clinical adverse events that were reported as possibly or probably drug related were nausea (8%), headache (6%), and flatulence (1.5%).</p>', '<p>Pregnancy Category B.&nbsp;Nitrofurantoin has been detected in human breast milk in trace amounts. Because of the potential for serious adverse reactions from nitrofurantoin in nursing infants under one month of age, 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>', NULL, '<p>Occasional incidents of acute overdosage of nitrofurantoin have not resulted in any specific symptoms other than vomiting. Induction of emesis is recommended. There is no specific antidote, but a high fluid&nbsp;intake should be maintained to promote urinary excretion of the drug. Nitrofurantoin is dialyzable.</p>', '<p>Systemic Urinary Anti- infective.</p>', NULL, NULL, '2022-03-11 03:46:30', '2022-03-11 03:46:30'),
(1053, 1053, '<p>Nitrofurazone is indicated in the infectious conditions of the skin such as burns, wounds, ulcers, skin infections and skin grafting.</p>', '<p>Nitrofurazone is a broad spectrum topical antibacterial agent indicated for the treatment of mixed skin infections of superficial wounds and diseases of the skin.</p>', '<p>To be applied directly to the lesion or on gauze first; 2-3 times daily or as advised by the physician.</p>', NULL, '<p>Nitrofurazone is contraindicated to patients with known sensitivity to Nitrofurazone. It is not advisable to use Nitrofurazone after the infection is cured. It should be used with caution in patients with known or suspected renal impairment.</p>', '<p>Sensitization and generalized allergic skin reactions may be produced after few days of initial application. Cross sensitization to other Nitrofurazone derivatives may occur. Intolerance to Nitrofurazone necessitating withdrawal has been encountered.</p>', '<p>Pregnancy category- B.</p>', '<p>G6PD deficiency,&nbsp;renal impairment.</p>', NULL, '<p>Topical Antibiotic preparations</p>', NULL, NULL, '2022-03-11 03:48:02', '2022-03-11 03:48:02'),
(1054, 1054, '<p>Nitroglycerin Injection is indicated for the treatment of peri-operative hypertension; for controlling of congestive heart failure in the setting of acute myocardial infarction; for treatment of angina pectoris in patients who have not responded to sublingual nitroglycerin and beta blockers and for induction of Intraoperative hypotension.</p>', '<p>The principal pharmacological action of nitroglycerin is relaxation of vascular smooth muscle and consequent dilatation of peripheral arteries and veins. Dilatation of the veins promotes peripheral pooling of blood and decreases venous return to the heart, thereby reducing left ventricular end-diastolic pressure and pulmonary capillary wedge pressure (preload). Arteriolar relaxation reduces systemic vascular resistance,systolic arterial pressure, and mean arterial pressure (after load). Dilatation of the coronary arteries also occurs.</p>', '<p>Not for direct intravenous injection. Nitroglycerin injection is a concentrated, potent drug which must be diluted in dextrose (5%) injection or sodium chloride (0.9%) injection prior to its infusion. Nitroglycerin injection should not be mixed with other drugs.<br />\r\n<br />\r\n<strong>Initial Dilution</strong>: Aseptically transfer the contents of one nitroglycerin ampoule (containing 50 mg of nitroglycerin) into a 500 ml glass bottle of either Dextrose (5%) Injection or Sodium Chloride Injection (0.9%).This yields a final concentration of 100 mcg/ml.<br />\r\n<br />\r\n<strong>Maintenance Dilution</strong>: It is important to consider the fluid requirements of the patient as well as the expected duration of infusion in selecting the appropriate dilution of Nitroglycerin Injection. After the initial dosage titration, the concentration of the solution may be increased, if necessary, to limit fluids given to the patient. The nitroglycerin concentration should not exceed 400 mcg/ml.</p>', '<p>The vasodilating effects of nitroglycerin may be additive with those of other vasodilators. Administration of nitroglycerin infusions through the same infusion set as blood can result in pseudoagglutination and hemolysis. More generally, nitroglycerin in 5% dextrose or sodium chloride 0.9% should not be mixed with any other medication of any kind. Intravenous nitroglycerin interferes, at least in some patients, with the anticoagulant effect of heparin. In patients receiving intravenous nitroglycerin, concomitant heparin therapy should be guided by frequent measurement of the activated partial thromboplastin time.</p>', '<p>Allergic reactionsto organic nitrates are extremely rare,but they do occur. Nitroglycerin Injection is contraindicated in patients who are allergic to it. In patients with pericardial tamponade, restrictive cardiomyopathy, or constrictive pericarditis, cardiac output is dependent upon venousreturn. Intravenous nitroglycerin is contraindicated in patients with these conditions.</p>', '<p>Adverse reactions to nitroglycerin are generally dose-related and almost all of these reactions are the result of nitroglycerin&#39;s activity as a vasodilator. Headache, which may be severe, is the most commonly reported side effect. Headache may be recurrent with each daily dose, especially at higher doses. Transient episodes of lightheadedness, occasionally related to blood pressure changes, may also occur. Hypotension occurs infrequently, but in some patients it may be severe enough to warrant discontinuation of therapy. Syncope, crescendo angina, and rebound hypertension have been reported but are uncommon. Extremely rarely, ordinary doses of organic nitrates have caused methemoglobinemia in normal-seeming patients. Methemoglobinemia is so infrequent at these doses that further discussion of its diagnosis and treatment is deferred.</p>', '<p>Pregnancy category C. It is not known whether nitroglycerin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when nitroglycerin injection is administered to a nursing mother.</p>', '<p>Severe hypotension and shock may occur with even small doses of nitroglycerin. This drug should therefore be used with caution in patients who may be volume depleted or who, for whatever reason, are already hypotensive. Hypotension induced by nitroglycerin may be accompanied by paradoxical bradycardia and increased angina pectoris. Nitrate therapy may aggravate the angina caused by hypertrophic cardiomyopathy. As tolerance to other forms of nitroglycerin develops,the effect of sublingual nitroglycerin on exercise tolerance, although still observable, is somewhat blunted. In industrial workers who have had long-term exposure to unknown (presumably high) doses of organic nitrates, tolerance clearly occurs. Chest pain, acute myocardial infarction, and even sudden death have occurred during temporary withdrawal of nitratesfrom these workers, demonstrating the existence of true physical dependence.</p>', '<p>Homodynamic Effects: The ill effects of nitroglycerin overdose are generally the results of nitroglycerin&#39;s capacity to induce vasodilatation, venous pooling, reduced cardiac output, and hypotension. These hemodynamic changes may have protean manifestations, including increased intracranial pressure, with any or all of persistent throbbing headache, confusion, and moderate fever; vertigo; palpitation; visual disturbances; nausea and vomiting (possibly with colic and even bloody diarrhea); syncope (especially in the upright posture); air hunger and dyspnea, later followed by reduced ventilatory effort; diaphoresis, with the skin either flushed or cold and clammy; heart block and bradycardia; paralysis; coma; seizures; and death.</p>', '<p>Nitrates: Coronary vasodilators.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Safety and effectiveness in children have not been established.</p>', '2022-03-11 03:50:29', '2022-03-11 03:50:29'),
(1055, 1055, '<p>The ointment will help to relieve the symptom of pain caused by chronic anal fissures.</p>', '<p>The principal pharmacologic action of glyceryl trinitrate is mediated via the release of nitric oxide. When glyceryl trinitrate ointment is applied by the intra-anal route,the internal anal sphincter becomes relaxed.Hypertonicity of the internal but not the external anal sphincter is a predisposing factor in the formation of anal fissures.</p>', '<p>Nitroglycerin 0.4% ointment should be inserted into the anal cavity with an applicator.The ointment must be inserted at least 1 cm into the anus.The dose is to be applied intra-anally every twelve hours. Treatment may be continued until the pain abates,up to a maximum of 8 weeks.</p>', '<p>The following medicines may increase the blood pressure lowering effect of glyceryl trinitrate ointment-</p>\r\n\r\n<ul>\r\n	<li>Medicines for depression&nbsp;</li>\r\n	<li>Medicines for erectile dysfunction&nbsp;</li>\r\n	<li>Medicines for high blood pressure&nbsp;</li>\r\n	<li>Diuretics</li>\r\n	<li>Commonly used tranquillizers&nbsp;</li>\r\n	<li>Medicines used to treat heart problems&nbsp;</li>\r\n</ul>', '<p>Headache and dizziness is a common side effect experienced with Nitroglycerin 0.4% ointment. A possible side effect is reduced control over bowel movements and leaking of bowel motions although this is expected to be a rare event.</p>', '<p>Headache and dizziness is a common side effect experienced with Nitroglycerin 0.4% ointment. A possible side effect is reduced control over bowel movements and leaking of bowel motions although this is expected to be a rare event.</p>', '<p>There are no adequate data from the use of Nitroglycerin in pregnant women. Animal studies are inconclusive with respect to effects on pregnancy embryonal/foetal parturition and postnatal development. This ointment should not be used during pregnancy. It is not known whether Nitroglycerin is excreted in human milk. Due to the potential harmful effects on the breast fed child, the use of this ointment is not recommended during breast feeding.</p>', '<p>Nitroglycerin 0.4% ointment should be used with caution in patients who have severe hepatic or renal disease.It should not be used if patient suffers from severe anemia, glaucoma, hypotension, increased intracranial pressure.</p>', '<p>Accidental overdose may result in hypotension and reflex tachycardia. Because the hypotension associated with nitroglycerin overdose is the result of venodilation and arterial hypovolaemia, prudent therapy in this situation should be directed toward increasing central fluid volume. Excessive dosage may also give rise to methaemogiobinaemia. This should be treated with methylene blue infusion.</p>', '<p>Drugs used in Ano-rectal region.</p>', '<p>Store below 25&deg;C. Do not freeze. Keep all medicines out of reach of the children.</p>', '<p><strong>Pediatric Use</strong>: It is not recommended for use in children and adolescents below 18 years of age due to lack of data on safety and efficacy.</p>', '2022-03-11 03:52:24', '2022-03-11 03:52:24'),
(1056, 1056, '<p>Nitroglycerin is indicated for the prophylaxis of angina pectoris. The onset of action is not sufficiently rapid for this form to be useful in aborting an acute anginal episode.</p>', '<p>Nitroglycerin causes relaxation of vascular smooth muscle, producing a vasodilator effect on both peripheral arteries and veins. Dilation of veins promote peripheral pooling of blood and decreases venous return to the heart, thereby reducing left ventricular end-diastolic pressure (preload) and relaxation of arteries reduce systemic vascular resistance and arterial pressure (afterload).</p>', '<p>Dosage should always to be adjusted according to the requirement and response obtained by the individual patient and the severity of the anginal pain. For adults, one Nitroglycerin 2.6 mg sustained released tablet or capsule in morning and evening. This should be taken empty stomach.</p>', '<p>Nitroglycerin dilates peripheral blood vessels and may increase the antihypertensive properties of vasodilators, calcium antagonists, beta-adrenergic blockers. Concomitant use of nitrates with tricyclic antidepressants and alcohol may cause high blood pressure. Concomitant use of nitrates with phosphodiesterase type 5 (PDE5) inhibitors, such as sildenafil, vardenafil and tadalafil cause fall in blood pressure. Aspirin decreases the clearance and enhances the hemodynamic effects of nitroglycerin. Nitroglycerin may reduce the pharmacologic effects of heparin when used concomitantly. Nitrates increase the bioavailability of dihydroergotamine.</p>', '<p>Nitroglycerin is contraindicated in patients with a known hypersensitivity to nitroglycerin, other organic nitrates, or nitrites or to the excipients of the medicine. It is also contraindicated in patients with acute myocardial infarction, marked anaemia, head trauma, cerebral haemorrhage, or closed angle glaucoma.</p>', '<p>Headache may occur at the onset of treatment but will usually subside after a few days. If the headache persists dosage should be decreased. Other side effects include tachycardia, postural hypotension and syncope, cyanosis and methaemoglobinaemia.</p>', '<p>Nitroglycerin should not be used during pregnancy or lactation unless considered essential by the physician.</p>', '<p>Nitroglycerin should be used with caution in patients who are predisposed to closed-angle glaucoma. As with other drugs for the treatment of angina pectoris, abrupt discontinuation of therapy may lead to exacerbation of symptoms. When discontinuing long term treatment, the dosage should be reduced gradually over several days, and the patient carefully monitored. The use of nitroglycerin during the early days of acute myocardial infarction requires particular attention to hemodynamic monitoring and clinical status to avoid the hazards of hypotension and tachycardia.</p>', NULL, '<p>Nitrates: Coronary vasodilators.</p>', '<p>Store in a cool and dry place away from light and heat. Keep all medicines out of the reach of children.</p>', NULL, '2022-03-11 03:54:07', '2022-03-11 03:54:07'),
(1057, 1057, '<p>Nitroglycerin sublingual spray is indicated for acute relief of an attack or prophylaxis of angina pectoris due to coronary artery disease.</p>', '<p>The principal pharmacological action of nitroglycerin is relaxation of vascular smooth muscle, producing a vasodilator effect on both peripheral arteries and veins with more prominent effects on the latter. Dilation of the post-capillary vessels, including large veins, promotes peripheral pooling of blood and decreases venous return to the heart, thereby reducing left ventricular enddiastolic pressure (pre-load). Arteriolar relaxation reduces systemic vascular resistance and arterial pressure (after-load).</p>', '<p>At the onset of an attack, 1 or 2 metered sprays should be administered under the tongue. No more than 3 metered sprays are recommended within a 15 minute period. If the chest pain persists, prompt medical attention is recommended. Nitroglycerin spray may be used prophylactically 5 to 10 minutes prior to engaging in activities which might precipitate an acute attack.</p>', '<p>Use of alcohol with Nitroglycerin may produce severe hypotension and collapse. Oral Nitroglycerin may enhance the bioavailability of dihydroergotamine. Orthostatic hypotension may occur with the combined use of calcium channel blocker, phenothiazines and tricyclic antidepressants.</p>', '<p>Hypersensitivity to nitrates or any constituents of the formulation. Hypotension, hypovolaemia, severe anaemia, cerebral haemorrhage and brain trauma, mitral stenosis and angina caused by hypertrophic obstructive cardiomyopathy. Concomitant administration of phosphodiesterase inhibitors used for the treatment of erectile dysfunction.</p>', '<p>A number of nitrate related adverse effects may occur including headache, facial flushing, dizziness, nausea, vomiting, feelings of weakness, postural hypotension and reflex tachycardia .</p>', '<p>Pregnancy Category C. There are no adequate and well controlled studies in pregnant women. Nitroglycerin should be given to pregnant women only if clearly needed. It is not known whether nitroglycerin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Nitroglycerin spray is administered to a nursing woman.</p>', '<p>The use of Nitroglycerin during the early days of acute myocardial infarction requires particular attention to monitoring hemodynamics and clinical status. Nitroglycerin should be used with caution in patients with severely impaired renal or hepatic function, hypothyroidism, malnutrition or hypothermia.</p>', '<p>Nitrate overdosage may result in: severe hypotension, persistent throbbing headache, vertigo, palpitation, visual disturbance, flushing and perspiring skin (later becoming cold and cyanotic), nausea and vomiting (possibly with colic and even bloody diarrhea), syncope (especially in the upright posture), methemoglobinemia with cyanosis and anorexia, initial hyperpnea, dyspnea and slow breathing, slow pulse, heart block, increased intracranial pressure with cerebral symptoms of confusion and moderate fever, paralysis and coma followed by clonic convulsions and possibly death due to circulatory collapse.<br />\r\n<br />\r\nMethemoglobinemia: Case reports of clinically significant methemoglobinemia are rare at conventional doses of organic nitrates. The formation of methemoglobin is dose-related and in the case of genetic abnormalities of hemoglobin that favor methemoglobin formation, even conventional doses of organic nitrates could produce harmful concentrations of methemoglobin.<br />\r\n<br />\r\nTreatment of Overdosage: Keep the patient recumbent in a shock position and comfortably warm. Passive movement of the extremities may aid venous return. Administer oxygen and artificial ventilation, if necessary. If methemoglobinemia is present, administration of methylene blue (1% solution), 1-2 mg per kilogram of body weight intravenously, may be required. If an excessive quantity of Nitroglycerin spray has been recently swallowed, gastric lavage may be of use.</p>', '<p>Nitrates: Coronary vasodilators.</p>', '<p>Store in a cool and dry place away from light and heat. Keep all medicines out of the reach of children.</p>', '<p>Safety and effectiveness of nitroglycerin in pediatric patients have not been established.</p>', '2022-03-11 03:55:57', '2022-03-11 03:55:57');

INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1064, 1064, '<p>Norgestrel tablets are indicated for use by females of reproductive potential to prevent pregnancy. This tablet are not for use as emergency contraception.</p>', '<p>Progestin-only oral contraceptives such as Norgestrel tablets prevent conception by suppres sing ovulation in approximately half of the cycles in users, thickening the cervical mucus to inhibit sperm penetration, lowering the midcycle LH and FSH peaks, slowing the movement of the ovum through the fallopian tubes, and altering the endometrium. Serum progestin levels peak about two hours after oral administration, followed by rapid distribution and elimination. By 24 hours after drug ingestion, serum levels are near baseline, making efficacy dependent upon rigid adherence to the dosing schedule. There are large variations in serum levels among individual users. Progestin-only administration results in lower steady-state progestin levels and a shorter elimination half-life than concomitant administration with estrogens.</p>', '<p>To achieve maximum contraceptive effectiveness, Norgestrel Tablets must be taken exactly as directed. The woman should take one tablet every day, at the same time. The administration is continuous, with no interruption between pill packs.</p>', NULL, '<p>Norgestrel tablet is contraindicated for use by women who are known to have the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Known or suspected pregnancy</li>\r\n	<li>Known or suspected carcinoma of the breast, or other progestin-sensitive cancer, now or in the past</li>\r\n	<li>Undiagnosed abnormal uterine bleeding</li>\r\n	<li>Hypersensitivity to any component of this product</li>\r\n	<li>Benign or malignant liver tumors</li>\r\n</ul>', '<p>An increased risk of the following adverse reactions has been reported with the use of progestin-only oral contraceptives: Delayed follicular atresia/ovarian cysts, Menstrual irregularity, changes in menstrual flow; breakthrough bleeding/spotting; amenorrhea, prolonged bleeding. The following adverse reactions were reported in &ge;5% of subjects in the Norgestrel&nbsp;Tablet clinical studies:</p>\r\n\r\n<ul>\r\n	<li>Headache</li>\r\n	<li>Dizziness</li>\r\n	<li>Nausea</li>\r\n	<li>Increased appetite</li>\r\n	<li>Abdominal pain, cramps and bloating</li>\r\n	<li>Fatigue</li>\r\n	<li>Vaginal discharge</li>\r\n	<li>Dysmenorrhea</li>\r\n	<li>Nervousness</li>\r\n	<li>Backache</li>\r\n	<li>Breast discomfort</li>\r\n	<li>Acne</li>\r\n</ul>', '<p><strong>Pregnancy</strong>: Norgestrel Tablets are contraindicated for use in pregnant women because there is no need for pregnancy prevention in a woman who is already pregnant. Published studies report no harmful effects on fetal development associated with long-term use of contraceptive doses of oral progestins in pregnant women. Discontinue Norgestrel Tablets if pregnancy is confirmed.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: Small amounts of progestin pass into the breast milk, resulting in steroid levels in infant plasma. No adverse effects have been reported on breastfeeding performance or infant health. The developmental and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for Norgestrel Tablets and any potential adverse effects on the breastfed infant from Norgestrel Tablets or from the underlying maternal condition.</p>', '<p><strong>Migraine/Headache</strong>: The onset or exacerbation of migraine, or development of headache with a new pattern that is recurrent, persistent, or severe requires evaluation of the cause because women with migraine may be at increased risk of stroke.<br />\r\n<br />\r\nDrug Interactions:</p>\r\n\r\n<ul>\r\n	<li>The effectiveness of progestin-only pills is reduced by hepatic enzyme-inducing drugs such as phenytoin, carbamazepine, barbiturates, rifampin, efavirenz, bosentan and herbal preparations containing St. John&rsquo;s Wort (hypericum perforatum ). This could result in unintended pregnancy or breakthrough bleeding. During concomitant use of Norgestrel and substances that may affect its efficacy, it is recommended that a nonhormonal back-up method of contraception (such as condom) be used in addition to the regular intake of Norgestrel Tablets. Use of a nonhormonal back-up method is recommeded for 28 days after discontinuation of substances that have led to induction of hepatic microsomal enzymes. For women receiving long-term therapy with hepatic enzyme inducers, another method of contraception should be considered.</li>\r\n	<li>Effectiveness of progestin-containing hormonal contraceptives and emergency contraceptive ulipristal acetate may be decreased if progestin-containing hormonal contraceptives are used within five days after ulipristal acetate dosing. If a woman wishes to use Norgestrel Tablets after using ulipristal acetate, she should do so no sooner than 5 days after the intake of ulipristal acetate and she should use a reliable barrier method for subsequent acts of intercourse until her next menstrual period.</li>\r\n</ul>\r\n\r\n<p><strong>Gastrointestinal</strong>: Diarrhea and/or vomiting within 4 hours after taking a pill may reduce hormone absorption. Women should use of a nonhormonal back-up method of birth control (such as a condom or spermicide) during the next 48 hours.<br />\r\n<br />\r\n<strong>Interactions with Laboratory Tests</strong>: The following endocrine tests may be affected by Norgestrel Tablets use:</p>\r\n\r\n<ul>\r\n	<li>Sex hormone-binding globulin (SHBG) concentrations may be decreased.</li>\r\n	<li>Total thyroxine concentrations may be decreased, due to a decrease in thyroid binding globulin (TBG). However, free thyroxine level should remain unchanged.</li>\r\n</ul>', '<p>Symptoms of oral contraceptive overdosage may include nausea, vomiting, breast tenderness, dizziness, somnolence ( drowsiness/fatigue), and withdrawal bleeding in females. There is no specific antidote and further treatment of overdose, if necessary, is directed to the symptoms.</p>', '<p>Oral Contraceptive preparations</p>', '<p>Store at controlled room temperature between 20&deg; to 25&deg;C.</p>', '<p><strong>Pediatric Use</strong>: The safety and efficacy of Norgestrel tablets have been established in women of reproductive age, including adolescents as young as 15 years of age, and almost 30% of subjects in the clinical trials who were under 20 years of age. Use of this product before menarche is not indicated.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Norgestrel tablet Tablets have not been studied in postmenopausal women and is not indicated in this population.</p>', '2022-03-11 04:10:04', '2022-03-11 04:10:04'),
(1065, 1065, '<p>Oral contraceptives are indicated for the prevention of pregnancy in women who elect to use this product as a method of contraception.&nbsp;Oral contraceptives are highly effective.&nbsp;The efficacy of these contraceptive methods, except sterilization, the IUD, and implants depends upon the reliability with which they are used. Correct and consistent use of methods can result in lower failure rates.</p>', '<p>Combination oral contraceptives (COC) act by suppression of gonadotropins. Although the primary mechanism of this action is inhibition of ovulation, other alterations include changes in the cervical mucus (which increase the difficulty of sperm entry into the uterus) and the endometrium (which reduce the likelihood of implantation).</p>', '<p>To achieve maximum contraceptive effectiveness, Norgestrel &amp; Ethinyl Estradiol and ferrous fumarate must be taken exactly as directed and at intervals not exceeding 24 hours. The possibility of ovulation and conception prior to initiation of medication should be considered. The dosage of Norgestrel &amp; Ethinyl Estradiol and ferrous fumarate is one white tablet daily for 21 consecutive days, followed by one brown tablet daily for 7 consecutive days, according to prescribed schedule. It is recommended that tablets be taken at the same time each day.</p>', '<p>Reduced contraceptive effectiveness with antibiotics, anticonvulsants and drugs that may increase contraceptive steroids clearance (e.g. bosentan, rifampicin, rifabutin, barbiturates, primidone, phenytoin, carbamazepine, oxcarbazepine, topiramate, griseofulvin, aprepitant). Severe pruritus and jaundice with troleandomycin, avoid concurrent use. Decreased effectiveness of ursodeoxycholic acid by increasing the elimination of cholesterol in bile. Effects of danazol or gestrinone and hormonal contraceptives might be altered or reduced by concurrent use, avoid concomittant use.<br />\r\n<br />\r\nDecreased contraceptive effectiveness with anti-HIV protease inhibitors. Increased tacrolimus levels with ethinyl estradiol. May increase theophylline, selegiline and tizanidine levels with oral contraceptives.</p>', '<p>Pregnancy, undiagnosed vaginal bleeding, severe arterial disease (or family history of atherogenic lipid profile); liver adenoma; porphyria; after evacuation of hydatidiform mole; history of breast cancer; hepatic impairment; thrombophloebitis or thromboembolic disorders; breast carcinoma except in selected patients being treated for metastatic disease; oestrogen-dependent tumour; smoking &gt;40 cigarettes daily; &gt;50 yr; diabetes complications present; BMI &gt;39 kg/m2; migraine with typical focal aura, lasting &gt;72 hr despite treatment or migraine treated with ergot derivatives; BP &gt;160 mmHg systolic and 100 mmHg diastolic; transient ischaemic attacks without headaches; SLE; gallstones; history of haemolytic uraemic syndrome, pruritis during pregnancy; cholestatic jaundice; chorea or deterioration of otosclerosis pemphigoid; breast feeding during 1 st 6 mth after delivery.</p>', '<p>Edema, Weakness, Amenorrhea, Breakthrough bleeding, Change in menstrual flow, Spotting, Anorexia, DVT, Thrombophlebitis, Depression, Dizziness, Headache, Nervousness, Somnolence, B reast tenderness, Galactorrhea, Abdominal pain, Nausea, Vomiting, Change in weight, Cholestatic jaundice.</p>', '<p>Extensive epidemiological studies have revealed no increased risk of birth defects in infants born to women who have used oral contraceptives prior to pregnancy. Studies also do not suggest a teratogenic effect, particularly insofar as cardiac anomalies and limb-reduction defects are concerned, when taken inadvertently during early pregnancy<br />\r\n<br />\r\nThe administration of oral contraceptives to induce withdrawal bleeding should not be used as a test for pregnancy. Oral contraceptives should not be used during pregnancy to treat threatened or habitual abortion.&nbsp;<br />\r\n<br />\r\nIt is recommended that for any patient who has missed two consecutive periods, pregnancy should be ruled out before continuing oral-contraceptive use. If the patient has not adhered to the prescribed schedule, the possibility of pregnancy should be considered at the time of the first missed period. Oral-contraceptive use should be discontinued if pregnancy is confirmed.</p>', '<p>Sex-steroid dependent cancer; past ectopic pregnancy; malabsorption syndromes; functional ovarian cysts; active liver disease, recurrent cholestatic jaundice, history of jaundice in pregnancy; history of CV or renal impairment; DM; asthma; epilepsy; migraine; depression; lactation; conditions exacerbated by fluid retention; hypercalcaemia; CV and gall bladder diseases; lipid effects; familial defects of lipoprotein metabolism; patients at risk of venous thromboembolism, breast cancer, preexisting uterine leiomyomata and benign hepatic adenoma; family history of arterial disease in 1 st degree relative systolic 140 mmHg and diastolic 90 mmHg; &gt;35 yr; BMI 30-39 kg/m2; migraine without focal aura, controlled with 5HT1; Gl upset (vomiting and diarrhoea), missed pills and interaction with other drugs may require additional contraceptive precautions. Should be taken at same time each day.<br />\r\n<br />\r\nLactation: small amounts of steroids are excreted in breast milk; estrogens may reduce quality/quantity of milk; may be prudent to use other forms of birth control until full weaning.</p>', NULL, '<p>Oral Contraceptive preparations.</p>', NULL, NULL, '2022-03-11 04:11:50', '2022-03-11 04:11:50'),
(1066, 1066, '<p>Nortriptyline is indicated for the treatment of depression and nocturnal enuresis.</p>', '<p>Nortriptyline, a dibenzocycloheptadiene tricyclic antidepressant, is the primary active metabolite of amitriptyline. It increases synaptic concentration of serotonin and/or norepinephrine in the CNS by blocking the neuronal reuptake of norepinephrine and serotonin.</p>', '<p>Depression:&nbsp;</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Low dose initially increased as necessary to 75-100 mg daily in divided doses or as a single dose (max. 150 mg daily)</li>\r\n	<li><strong>Adolescent &amp; Elderly</strong>: 30-50 mg daily in divided doses; Child not recommended for depression</li>\r\n</ul>\r\n\r\n<p>Nocturnal enuresis:</p>\r\n\r\n<ul>\r\n	<li><strong>Child 7 years</strong>: 10 mg</li>\r\n	<li><strong>8-11 years</strong>: 10-20 mg</li>\r\n	<li><strong>Over 11 years</strong>: 25-35 mg, 30 minutes before bedtime; max period of treatment (including gradual withdrawal) 3 months- full physical examination and ECG before further course.</li>\r\n</ul>', '<p>Nortriptyline should not be given with adrenaline, ephedrine, isoprenaline, noradrenaline, phenylephrine, phenylpropanolamine, drugs that are metabolized by CYP4502D6, MAOIs, guanethidine, debrisoquine, bethanidine, clonidine and reserpine etc. Barbiturates may increase the rate of metabolism of nortriptyline.</p>', '<p>Nortriptyline is contraindicated in patients with hypersensitivity to nortriptyline. Concomitant administration with MAOI is contraindicated. Do not use with or within 2 weeks of stopping an MAOI. Nortriptyline is contraindicated during the acute recovery period after myocardial infarction.</p>', '<p>The most common side effects include dry mouth, sedation, constipation and increased appetite, mild blurred vision, tinnitus, often euphoria and mania. An occasional side effect is a rapid or irregular heartbeat. Alcohol may exacerbate some of its side effects and should be avoided.</p>', '<p>The safety of nortriptyline for use in pregnancy has not been established. Nortriptyline should only be given during pregnancy when there are no alternatives and benefit outweighs risk.</p>', '<p>Not intended for treatment of bipolar depression. Avoid abrupt withdrawal. Patient at risk of seizures, with DM, narrow angle glaucoma, urinary retention, prostatic hyperplasia, chronic constipation, history of CV disease. Renal and hepatic impairment. Elderly, childn. Pregnancy and lactation.</p>', '<p><strong>Symptoms:</strong>&nbsp;Severe hypotension, cardiac dysrhythmias, shock, CHF, pulmonary oedema, convulsions, and CNS depression, including coma; changes in ECG.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Symptomatic and supportive treatment. Admin IV Na bicarbonate, benzodiazepines. Admin activated charcoal to reduce absorption. Emesis is contraindicated. Initiate cardiac monitoring and observe for signs of CNS or resp depression, hypotension, cardiac dysrhythmias and/or conduction blocks, and seizures.</p>', '<p>Tricyclic &amp; related anti-depressant drugs, Tricyclic Anti-depressant.</p>', '<p>Store at 15-30&deg; C. Protect from light and moisture.</p>', NULL, '2022-03-11 04:13:45', '2022-03-11 04:13:45'),
(1067, 1067, '<p>Nystatin is an antifungal antibiotic active against a wide range of yeasts and yeast like fungi including Candida albicans. It is used for the prevention and treatment of Candida infections of oral cavity, esophagus and intestinal tract. It provides effective prophylaxis against oral candidiasis in those born of mothers with vaginal candidiasis. It is used for the prophylaxis of Candida overgrowth during courses of broadspectrum antibiotics.</p>', '<p>Nystatin is an antifungal antibiotic. Which has fungistatic or fungicidal activity against variety of pathogenic and nonpathogenic yeast and fungi, including Candida albicans. Nystatin exerts its antifungal activity by binding to sterols in the fungal cell membrane. As a result of binding, the membrane is no longer able to function as a selective barrier, and potassium and other cellular constituents are lost. It is poorly absorbed from the gastrointestinal tract.</p>', '<p>Children:</p>\r\n\r\n<ul>\r\n	<li><strong>In intestinal and oral candidiasis (thrush):</strong>&nbsp;1,00,000 units (1 ml) should be dropped into the mouth four times daily.The longer the suspension is kept in contact with the affected area in the mouth, before swallowing, the greater will be its effect.</li>\r\n	<li><strong>For prophylaxis in the newborn:</strong>&nbsp;The suggested dose is 1,00,000 units (1 ml) once daily or as prescribed by the physician.</li>\r\n</ul>\r\n\r\n<p>Adult:</p>\r\n\r\n<ul>\r\n	<li><strong>For the treatment of intestinal or esophageal candidiasis:</strong>&nbsp;5,00,000 units (5 ml) by mouth 3 or 4 times daily. The dose may be doubled, if required.</li>\r\n	<li><strong>For prophylaxis of intestinal candidiasis in adults:</strong>&nbsp;10,00,000 units (10 ml) daily.</li>\r\n	<li><strong>For prophylaxis to suppress the over growth of Candida albicans in patients receiving broad spectrum antibiotic therapy:</strong>&nbsp;10,00,000 units (10 ml) daily.</li>\r\n	<li><strong>For the treatment of dental sores and oral infection:</strong>&nbsp;1,00,000 units (1 ml) suspension should be dropped into the mouth four times daily.</li>\r\n</ul>\r\n\r\n<p>Elderly: Older people with intestinal candidiasis who are unable to swallow tablets should be given 5,00,000 units (5 ml) suspension four times daily.</p>', NULL, '<p>There is no known contraindication to the use of Nystatin.</p>', '<p>Nausea, vomiting and diarrhoea have occasionally been reported with high doses of Nystatin. No systemic effects or allergic reactions have been associated with its oral dose.</p>', '<p>Absorption of Nystatin&nbsp;from the gastrointestinal tract is negligible, therefore no special precautions apply in pregnancy.</p>', '<p>Absorption from the gastrointestinal tract is negligible, therefore no special precaution is required to apply in pregnancy and lactation.</p>', NULL, '<p>Drugs for subcutaneous and mycoses, Drugs used in Vaginal and Vulval condition</p>', '<p>Store in a cool and dry place, protect from light. Keep out of reach of children.</p>', NULL, '2022-03-11 04:15:37', '2022-03-11 04:15:37'),
(1068, 1068, '<p>Nystatin Cream is indicated in the treatment of&nbsp;cutaneous&nbsp;or mucocutaneous mycotic infections caused by&nbsp;Candida albicans&nbsp;and other susceptible&nbsp;Candida&nbsp;species. This cream is not indicated for systemic, oral, intravaginal or ophthalmic use.</p>', '<p>Nystatin has fungistatic or fungicidal activity against variety of pathogenic and nonpathogenic yeast and fungi, including Candida albicans. Nystatin exerts its antifungal activity by binding to sterols in the&nbsp;fungal cell membrane. As a result of binding, the membrane is no longer able to function as a selective barrier, and potassium and other cellular constituents are lost. It is poorly absorbed from the gastrointestinal tract.</p>', '<p><strong>Adults and Pediatric Patients (Neonates and Older)</strong>: Apply liberally to affected areas twice daily or as indicated until healing is complete.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness have been established in the pediatric population from birth to 16 years.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies with nystatin cream did not include sufficient numbers of subjects aged 65 years and older to determine whether they respond differently than younger subjects. Other reported clinical experience has not identified differences in responses between elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.</p>', NULL, '<p>Nystatin cream is contraindicated in patients with a history of hypersensitivity to any of its components.</p>', '<p>The frequency of adverse events reported in patients using nystatin cream is less than 0.1%. The more common events that were reported include allergic reactions, burning, itching, rash,&nbsp;eczema, and pain on application.</p>', '<p><strong>Pregnancy&nbsp;</strong>Category C. Animal reproduction studies have not been conducted with any nystatin cream. It also is not known whether this cream can cause fetal harm when used by a pregnant woman or can affect reproductive capacity. Nystatin cream should be prescribed for a pregnant woman only if the potential benefit to the mother outweighs the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether nystatin is excreted in human milk. Caution should be exercised when nystatin is prescribed for a nursing woman.</p>', '<p>Nystatin cream should not be used for the treatment of systemic, oral, intravaginal or ophthalmic infections. If irritation or sensitization develops, treatment should be discontinued and appropriate measures taken as indicated. It is recommended that KOH smears, cultures, or other diagnostic methods be used to confirm the diagnosis of&nbsp;cutaneous&nbsp;or mucocutaneous candidiasis and to rule out infection caused by other pathogens.</p>', NULL, '<p>Drugs for subcutaneous and mycoses, Drugs used in Vaginal and Vulval condition.</p>', '<p>Store at 20&deg; to 25&deg;C. Avoid freezing.</p>', NULL, '2022-03-11 04:17:31', '2022-03-11 04:17:31'),
(1069, 1069, '<p>Obeticholic Acid is indicated for the treatment of primary biliary cholangitis (PBC) in combination with Ursodeoxycholic Acid (UDCA) in adults with an inadequate response to UDCA, or as monotherapy in adults unable to tolerate UDCA, cholestatic liver disease &amp; non-alcoholic fatty liver disease (NAFLD) including non-alcoholic steatohepatitis (NASH).</p>', '<p>Obeticholic Acid is an agonist for FXR, a nuclear receptor expressed in the liver and intestine. FXR is a key regulator of bile acid, inflammatory, fibrotic, and metabolic pathways. FXR activation decreases the intracellular hepatocyte concentrations of bile acids by suppressing de novo synthesis from cholesterol as well as by increased transport of bile acids out of the hepatocytes. These mechanisms limit the overall size of the circulating bile acid pool while promoting choleresis, thus reducing hepatic exposure to bile acids.</p>', '<p><strong>Starting Dosage</strong>: The recommended starting dosage of Obeticholic Acid is 5 mg orally once daily in adult patients who have not achieved an adequate biochemical response to an appropriate dosage of Ursodeoxycholic Acid (UDCA) for at least 1 year or are intolerant to UDCA.<br />\r\n<br />\r\n<strong>Dosage Titration</strong>: If an adequate reduction in alkaline phosphatase (ALP) and/or total bilirubin has not been achieved after 3 months of Obeticholic Acid 5 mg once daily, and the patient is tolerating Obeticholic Acid, increase the dosage of Obeticholic Acid to 10 mg once daily.<br />\r\n<br />\r\n<strong>Maximum Dosage</strong>: The maximum recommended dosage of Obeticholic Acid is 10 mg once daily.<br />\r\n<br />\r\n<strong>Management of Patients with Intolerable Pruritus on Obeticholic Acid</strong>: For patients with intolerable pruritus on Obeticholic Acid, consider one or more of the following:<br />\r\n<br />\r\nAdd an antihistamine or bile acid binding resin. Reduce the dosage of Obeticholic Acid to:</p>\r\n\r\n<ul>\r\n	<li>5 mg every other day, for patients intolerant to 5 mg once daily</li>\r\n	<li>5 mg once daily, for patients intolerant to 10 mg once daily</li>\r\n</ul>\r\n\r\n<p>Temporarily interrupt Obeticholic Acid dosing for up to 2 weeks followed by restarting at a reduced dosage<br />\r\n<br />\r\nIncrease the dosage of Obeticholic Acid to 10 mg once daily, as tolerated, to achieve optimal response. Consider discontinuing Obeticholic Acid treatment in patients who continue to experience persistent, intolerable pruritus.</p>', '<p><strong>Bile Acid Binding Resins</strong>: Bile acid binding resins such as cholestyramine, colestipol, or colesevelam adsorb and reduce bile acid absorption and may reduce the absorption, systemic exposure, and efficacy of Obeticholic Acid. If taking a bile acid binding resin, take Obeticholic Acid at least 4 hours before or 4 hours after taking the bile acid binding resin, or at as great an interval as possible.<br />\r\n<br />\r\n<strong>Warfarin</strong>: The International Normalized Ratio (INR) decreased following co-administration of warfarin and Obeticholic Acid. Monitor INR and adjust the dosage of warfarin, as needed, to maintain the target INR range when co-administering Obeticholic Acid and warfarin.<br />\r\n<br />\r\n<strong>CYP1A2 Substrates with Narrow Therapeutic Index</strong>: Obeticholic Acid may increase the exposure to concomitant drugs that are CYP1A2 substrates. Therapeutic monitoring of CYP1A2 substrates with a narrow therapeutic index.</p>', '<p>Contraindicated in patients known to have hypersensitivity to the drug or any of its components &amp; in patients with complete biliary obstruction.</p>', '<p>The most common side effects of Obeticholic Acid include: Pruritus, Fatigue &amp; Stomach pain and discomfort. Other common side effects include rash, arthralgia (joint pain), oropharyngeal pain (pain in the middle part of the throat), dizziness, constipation, abnormal thyroid function, and eczema (inflammation of the skin).</p>', '<p>The limited available human data on the use of Obeticholic Acid during pregnancy are not sufficient to inform a drug-associated risk.There is no information on the presence of Obeticholic Acid in human milk, the effects on the breast-fed infant or the effects on milk production.</p>', '<p>The following clinically significant reactions are described:</p>\r\n\r\n<ul>\r\n	<li>Liver-Related Adverse Reactions</li>\r\n	<li>Severe Pruritus</li>\r\n	<li>Reduction in high density lipoprotein-cholesterol (HDL-C)</li>\r\n</ul>\r\n\r\n<p>Special monitoring is essential for the patient with such type of problems</p>', '<p>In PBC patients who received Obeticholic Acid 25 mg once daily (2.5 times the highestrecommended dosage) or 50 mg once daily (5 times the highest recommended dosage), a dose-dependent increase in the incidence of liver-related adverse reactions, including elevations in liver biochemical tests, ascites, jaundice, portal hypertension, and primary biliary cholangitis flare, was reported. In the case of over dosage, patients should be carefully observed and supportive care administered, as appropriate.</p>', '<p>Farnesoid X Receptor Agonists.</p>', '<p>Store at 15&deg;C to 30&deg;C in a dry place protected from light. Keep out of reach of children.</p>', '<p><strong>Geriatric Use</strong>: No dosage adjustment is recommended in elderly patientless than 65 years of age.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and efficacy have not been established in patients younger than 18 years.<br />\r\n<br />\r\n<strong>Use in Patients with Impaired Renal Function</strong>: Obeticholic Acid has not been studied in patients with moderate and severe renal impairment (estimated glomerular filtration rate [eGFR] less than 60 ml/min/1.73 m2). In the population pharmacokinetic analysis, an eGFR greater than 50 ml/min/1.73 m2 did not have a meaningful effect on the pharmacokinetics of Obeticholic Acid and its conjugated metabolites.<br />\r\n<br />\r\n<strong>Use in Patients with Impaired Hepatic Function</strong>: Obeticholic Acid is metabolized in the liver. Plasma exposure to Obeticholic Acid and its active conjugates, increases significantly in patients with moderate to severe hepatic impairment (Child-Pugh Classes B and C).The recommended starting dosage of Obeticholic Acid for moderate (Child-Pugh Class B) and severe (Child-Pugh Class C) hepatic impairment is 5 mg once weekly. If an adequate reduction in ALP and/or total bilirubin has not been achieved after 3 months of Obeticholic Acid 5 mg once weekly, and the patient is tolerating the drug, increase the dosage of Obeticholic Acid to 5 mg twice weekly (at least three days apart) and subsequently to 10 mg twice weekly (at least three days apart) depending on response and tolerability.</p>', '2022-03-11 04:44:09', '2022-03-11 04:44:09'),
(1070, 1070, '<p><strong>Chronic Lymphocytic Leukemia (CLL)</strong>: Obinutuzumab in combination with chlorambucil is indicated for the treatment of patients with previously untreated chronic lymphocytic leukemia.<br />\r\n<br />\r\n<strong>Follicular Lymphoma (FL)</strong>: Obinutuzumab in combination with chemotherapy, followed by Obinutuzumab maintenance is indicated for the treatment of patients with previously untreated follicular lymphoma. Obinutuzumab in combination with bendamustine, followed by Obinutuzumab maintenance, is indicated for the treatment of patients with FL who did not respond to, or who progressed during or after treatment with rituximab or a rituximab-containing regimen.</p>', '<p>Obinutuzumab is a monoclonal antibody that targets the CD20 antigen expressed on the surface of pre-B and mature B lymphocytes. Upon binding to CD20, obinutuzumab mediates B-cell lysisthrough (1) engagement of immune effector cells (2) by directly activating intracellular death signaling pathways (direct cell death), and/or (3) activation of the complement cascade. The immune effector cell mechanisms include antibody-dependent cellular cytotoxicity (ADCC) and antibodydependent cellular phagocytosis.<br />\r\n<br />\r\nAs an antibody with reduced fucose content, obinutuzumab induces greater ADCC activity than rituximab in vitro using human cancer cell lines. Obinutuzumab also demonstrated an increased ability to induce direct cell death when compared to rituximab. Obinutuzumab binds to Fc&gamma;RIII using purified proteins with a higher affinity than rituximab. Obinutuzumab and rituximab bind with similar affinity to overlapping epitopes on CD20.</p>', NULL, '<p>No formal drug-drug interaction studies have been performed, although limited drug interaction sub-studies have been undertaken for Obinutuzumab with bendamustine, CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone), FC (fludarabine, cyclophosphamide) and chlorambucil. Co administration with Obinutuzumab had no effect on the pharmacokinetics of bendamustine, FC or the individual components of CHOP; in addition, there were no apparent effects of bendamustine, FC, chlorambucil or CHOP on the pharmacokinetics of Obinutuzumab. A risk for interactions with concomitantly used medicinal products cannot be excluded.</p>', '<p>Obinutuzumab is contraindicated in patients with a known hypersensitivity to obinutuzumab or to any of the excipients.</p>', '<p>The following adverse reactions are discussed in greater detail in other sections of the label:</p>\r\n\r\n<ul>\r\n	<li>Hepatitis B reactivation</li>\r\n	<li>Progressive multifocal leukoencephalopathy</li>\r\n	<li>Infusion reactions&nbsp;</li>\r\n	<li>Tumor lysis syndrome</li>\r\n	<li>Infections&nbsp;</li>\r\n	<li>Neutropenia&nbsp;</li>\r\n	<li>Thrombocytopenia</li>\r\n</ul>', '<p><strong>Pregnancy</strong>: Obinutuzumab is likely to cause fetal B-cell depletion based on findings from animal studies and the drug&rsquo;s mechanism of action. There are no data with Obinutuzumab use in pregnant women to inform a drug-associated risk. Monoclonal antibodies are transferred across the placenta. In animal reproduction studies, weekly intravenous administration of obinutuzumab to pregnant cynomolgus monkeys from day 20 of pregnancy until parturition which includes the period of organogenesis at doses with exposures up to 2.4 times the exposure at the clinical dose of 1000 mg monthly produced opportunistic infections and immune complex mediated hypersensitivity reactions. No embryo-toxic or teratogenic effects were observed in the monkeys. Consider the potential risk to the fetus when prescribing Obinutuzumab to a pregnant woman.<br />\r\n<br />\r\nThe background risk of major birth defects and miscarriage for the indicated population is unknown; however, the estimated background risk in the U.S. general population of major birth defects is 2% to 4% and of miscarriage is 15% to 20% of clinically recognized pregnancies.<br />\r\n<br />\r\n<strong>Lactation</strong>: There is no information regarding the presence of Obinutuzumab in human milk, the effects on the breastfed child, or the effects on milk production. However, low levels of obinutuzumab were present in the milk of lactating cynomolgus monkeys [see Pregnancy]. Human IgG is known to be present in human milk. Published data suggest that antibodies in breast milk do not enter the neonatal and child circulations in substantial amounts. The developmental and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for Obinutuzumab and any potential adverse effects on the breastfed child from Obinutuzumab or from the underlying maternal condition.</p>', '<p>In order to improve the traceability of biological medicinal products, the trade name and batch number of the administered product should be clearly recorded (or stated) in the patient file.</p>', NULL, '<p>Anti neoplastic preparations.</p>', '<p>Store vials in a refrigerator at 2&deg;C-8&deg;C. Keep vial in the outer carton in order to protect from light. Do not freeze. Do not shake.</p>', '<p><strong>Pediatric Use</strong>: The safety and efficacy of Obinutuzumab in children below 18 years of age have not been established.<br />\r\n<br />\r\nGeriatric Use:</p>\r\n\r\n<ul>\r\n	<li><strong>Chronic Lymphocytic Leukemia (CLL)</strong>: In the pivotal study in CLL, 46% (156 out of 336) of patients treated with Obinutuzumab plus chlorambucil were 75 years old or older (median age was 74 years). These patients experienced more serious adverse events and adverse events leading to death than patients &lt;75 years of age. No significant differences in efficacy were observed between patients &ge;75 years of age and those &lt;75 years of age</li>\r\n	<li><strong>Non-Hodgkin Lymphoma (NHL)</strong>: In the pivotal studies in NHL, patients 65 years old or older experienced more serious adverse events, and adverse events leading to withdrawal or death than patients &lt;65 years of age. No clinically meaningful differences in efficacy were observed.</li>\r\n</ul>', '2022-03-11 04:46:19', '2022-03-11 04:46:19'),
(1071, 1071, '<p><strong>Acromegaly</strong>: Octreotide acetate injection is indicated to reduce blood levels of growth hormone and IGF-I (somatomedin C) in acromegaly patients who have had inadequate response to or cannot be treated with surgical resection, pituitary irradiation, and bromocriptine mesylate at maximally tolerated doses. The goal is to achieve normalization of growth hormone and IGF-I (somatomedin C) levels. In patients with acromegaly, Octreotide acetate injection reduces growth hormone to within normal ranges in 50% of patients and reduces IGF-I (somatomedin C) to within normal ranges in 50% to 60% of patients. Since the effects of pituitary irradiation may not become maximal for several years, adjunctive therapy with Octreotide acetate injection to reduce blood levels of growth hormone and IGF-I (somatomedin C) offers potential benefit before the effects of irradiation are manifested.<br />\r\n<br />\r\nImprovement in clinical signs and symptoms or reduction in tumor size or rate of growth were not shown in clinical trials performed with Octreotide acetate injection; these trials were not optimally designed to detect such effects.<br />\r\n<br />\r\n<strong>Carcinoid Tumors</strong>: Octreotide acetate injection is indicated for the symptomatic treatment of patients with metastatic carcinoid tumors where it suppresses or inhibits the severe diarrhea and flushing episodes associated with the disease.<br />\r\n<br />\r\nOctreotide acetate injection studies were not designed to show an effect on the size, rate of growth or development of metastases.<br />\r\n<br />\r\n<strong>Vasoactive Intestinal Peptide Tumors</strong>&nbsp;(VIPomas): Octreotide acetate injection is indicated for the treatment of the profuse watery diarrhea associated with VIP-secreting tumors. Octreotide acetate injection studies were not designed to show an effect on the size, rate of growth or development of metastases.</p>', '<p>Octreotide is a synthetic analogue of somatostatin which acts by suppressing basal and stimulated secretion of growth hormone (GH). It also suppresses LH response to gonadotrophin-releasing hormone and reduces the secretion of gastrin, vasoactive intestinal peptide (VIP), insulin, glucagon, secretin, motilin and pancreatic polypeptide.</p>', '<p><strong>Intramuscular-</strong><br />\r\nAcromegaly:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Following initial control with SC therapy: As a depot preparation, initially 20 mg every 4 wk. Adjust if required after 3 mth to 10-30 mg every 4 wk. Max: 40 mg every 4 wk.</li>\r\n</ul>\r\n\r\n<p><strong>Intravenous-</strong><br />\r\nVariceal haemorrhage in patients with cirrhosis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;As continuous IV infusion: 25 mcg/hr for 48 hr (up to 5 days in patients at high risk of re-bleeding).</li>\r\n	<li><strong>Child:</strong>&nbsp;&ge;1 mth: 1 mcg/kg/hr (up to 50 mcg/hr); given as continuous IV infusion. Higher doses may be needed initially, reduce dose gradually over 24 hr until bleeding has stopped.</li>\r\n</ul>\r\n\r\n<p><strong>Subcutaneous-</strong><br />\r\nProphylaxis of complications following pancreatic surgery:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;100 mcg tid of a rapid-acting preparation given for 7 consecutive days, starting at least 1 hr before operation.</li>\r\n</ul>\r\n\r\n<p><strong>Subcutaneous-</strong><br />\r\nAcromegaly:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initially 50 mcg tid, increased as necessary to usual dose 100-200 mcg tid. Max: 500 mcg tid.</li>\r\n</ul>\r\n\r\n<p><strong>Subcutaneous-</strong><br />\r\nSecretory neoplasms:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initially, 50 mcg 1-2 times daily, increased gradually to up to 600 mcg daily in 2-4 divided doses according to response. Continued treatment is not recommended if there is no benefit within a wk of starting treatment for carcinoid tumour. Initial dose may be given via IV admin of a rapid response is required.</li>\r\n</ul>\r\n\r\n<p><strong>Subcutaneous-</strong><br />\r\nHIV-associated diarrhoea:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initial dose 100 mcg tid. If symptoms are not controlled after 1 wk, increase dose to 250 mcg tid, if still not effective after 1 wk stop therapy.</li>\r\n</ul>', '<p>Dosage adjustment of concurrent therapy may be necessary with calcium channel blockers, oral hypoglycaemics, &beta;-blockers, diuretics. May increase concentration of bromocriptine.</p>', '<p>Hypersensitivity</p>', '<p>Local pain, stinging, tingling at site of inj; anorexia, nausea, vomiting, abdominal pain, bloating, flatulence, loose stools, steatorrhoea; biliary tract abnormalities. Hypoglycaemia and hyperglycaemia, hypothyroidism, cardiac conduction abnormalitles, pancreatitis.</p>', '<p><strong>Category B:</strong>&nbsp;Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).</p>', '<p>Renal disease; risk of gall bladder disease; DM; hypothyroidism. Pregnancy, lactation, children, elderly. Monitor levels of vitamin B12 during long term therapy.</p>', NULL, '<p>Growth hormone antagonist</p>', '<p>Store at 2-8&deg; C. Stable at room temperature for up to 14 days.</p>', '<p><strong>Renal Impairment:</strong>&nbsp;Dosage may need to be reduced in severe renal impairment requiring dialysis.</p>', '2022-03-11 04:48:20', '2022-03-11 04:48:20'),
(1072, 1072, '<p><strong>Eye</strong>: It is indicated for the treatment of external ocular infections such as acute &amp; sub-acute conjunctivitis, keratitis, kerato-conjunctivitis, blepharo-conjunctivitis, blepharitis, corneal ulcer and pre-operative prophylaxis in ocular surgery.<br />\r\n<br />\r\n<strong>Ear</strong>: It is indicated for the treatment of external ear infections (otitis externa) and certain middle ear infections (otitis media).</p>', '<p>Ofloxacin is a synthetic 4-fluoroquinolone antibacterial agent with bactericidal activity against a wide range of Gram-negative and Gram-positive organisms. Ofloxacin is thought to exert bactericidal effect by inhibiting DNA gyrase, an essential enzyme that is a critical catalyst in the duplication, transcription and repair of bacterial DNA.</p>', '<p><strong>Eye</strong>: Instill 1 drop in the affected eye(s) every 2 to 4 hours for the first two days and then 4 times daily. The length of treatment should not exceed ten days.<br />\r\n<br />\r\n<strong>Ear</strong>: Instill 1-2 drops in the affected ear(s) twice daily or as needed.</p>', NULL, '<p>It is contraindicated in patients who are hypersensitive to Ofloxacin or any other component of this preparation.</p>', '<p><strong>Eye</strong>: Transient ocular irritation, burning, stinging, redness, itching or photophobia have been reported.&nbsp;<br />\r\n<br />\r\n<strong>Ear</strong>: Mild irritation or mild discomfort in the ear may occur. Symptoms of an allergic reaction include rash, itching, swelling or trouble breathing.</p>', '<p><strong>Use in pregnancy</strong>: There are no adequate and well-controlled studies in pregnant women. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: It is not known whether Ofloxacin is excreted in human milk. Cautions should be taken when Ofloxacin eye &amp; ear drops is administered during lactation.</p>', '<p>Prolonged use of eye drops &amp; ear drops may result in overgrowth of non-susceptible organisms and secondary infection respectively.</p>', NULL, '<p>4-Quinolone preparations, Ophthalmic antibacterial drugs.</p>', NULL, NULL, '2022-03-11 04:49:49', '2022-03-11 04:49:49'),
(1073, 1073, '<p>Ofloxacin&nbsp;are indicated for the treatment of adults with mild to moderate infections caused by susceptible strains.</p>\r\n\r\n<ul>\r\n	<li>Lower Respiratory Tract: Acute bacterial exacerbation of chronic bronchitis lung abscess, pneumonia.</li>\r\n	<li>Gastrointestinal Tract: Enteric fever, shigellosis.</li>\r\n	<li>Multi-drug-resistant Tuberculosis.</li>\r\n	<li>Skin and skin structures: Uncomplicated skin and skin structure infections.</li>\r\n	<li>Sexually Transmitted Diseases: Acute, Uncomplicated urethral and cervical gonorrhoea. Nongonococcal urethritis and cervicitis. Mixed infections of the urethra and cervix.</li>\r\n	<li>Urinary tract: Uncomplicated Urinary Tract Infections, Complicated urinary tract infections.</li>\r\n</ul>', '<p>Ofloxacin is a synthetic 4-fluoroquinolone antibacterial agent with bactericidal activity against a wide range of Gram-negative and Gram-positive organisms. Ofloxacin is thought to exert bactericidal effect by inhibiting DNA gyrase, an essential enzyme that is a critical catalyst in the duplication, transcription and repair of bacterial DNA.</p>', '<p>Intravenous (Adult):</p>\r\n\r\n<ul>\r\n	<li><strong>Skin and soft tissue infections</strong>: 400 mg bid infused over at least 1 hr.</li>\r\n	<li><strong>Complicated urinary tract infections</strong>: 200 mg daily by infusion over at least 30 min. Max: 400 mg bid infused over at least 1 hr.</li>\r\n	<li><strong>Lower respiratory tract infections, Septicaemia</strong>: 200 mg bid by infusion over at least 30 min. Max: 400 mg bid infused over at least 1 hr.</li>\r\n</ul>\r\n\r\n<p>Oral (Adult):</p>\r\n\r\n<p><strong>General dosage recommendations</strong>: The dose of ofloxacin is determined by the type and severity of the infection. The dosage range for adults is 200 mg to 800 mg daily. Up to 400 mg may be given as a single dose, preferably in the morning, larger doses should be given as two divided doses. Ofloxacin tablets should be swallowed with liquid; they should not be taken within two hours of intake of magnesium/aluminium containing antacids or iron preparations since reduction of absorption of ofloxacin can occur.</p>\r\n\r\n<ul>\r\n	<li><strong>Enteric fever</strong>: For adults 200 mg, every 12 hours, for 5 days. For children 15 mg/kg/day in 2 divided doses for 3 days.</li>\r\n	<li><strong>Shigellosis</strong>: 400 mg single dose.</li>\r\n	<li><strong>Multi-drug-resistant tuberculosis</strong>: 400 mg twice daily along with conventional anti-tuberculosis drugs.</li>\r\n	<li><strong>Lower respiratory tract infection</strong>: 400 mg daily, increasing, if necessary, to 400 mg twice daily.</li>\r\n	<li><strong>Uncomplicated Urinary Tract Infections</strong>: A single dose of 200/400 mg.</li>\r\n	<li><strong>Uncomplicated urethral and cervical gonorrhoea</strong>: A single dose of 400 mg.</li>\r\n	<li><strong>Non-gonococcal urethral and cervicitis</strong>: 400 mg daily in single or divided doses.</li>\r\n	<li><strong>Complicated Urinary Tract Infection</strong>: 200/400 mg/day for 7 days.</li>\r\n</ul>\r\n\r\n<p><strong>Children</strong>: Ofloxacin is usually not indicated for use in children or growing adolescents.<br />\r\n<br />\r\n<strong>Elderly</strong>: No adjustment of dosage is required in the elderly.</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>May be taken with or without food. Avoid antacids or supplements containing Fe or Zn within 2 hr before or after ofloxacin. Ensure adequate hydration.</p>\r\n\r\n<p>&nbsp;</p>', '<p>Antacids containing magnesium, aluminium or calcium may decrease absorption of ofloxacin. Iron or Zinc may decrease oral absorption of ofloxacin.</p>', '<p>Ofloxacin should not be used in-patients with known hypersensitivity to 4-fluoroquinolone antibacterials. It is contraindicated in-patients with a history of epilepsy or with a lowered seizure threshold. Ofloxacin is usually contraindicated in children or growing adolescents and in pregnant or breast feeding women.</p>', '<p>Ofloxacin is generally well tolerated and clinical side-effects of ofloxacin has been quite low. Among the adverse effects gastrointestinal and central nervous systems&#39; reactions are common. Nausea, rash, vomiting, abdominal pain, diarrhoea and gastrointestinal distress are the gastrointestinal adverse effects. Common central nervous system reactions are headache, dizziness and insomnia.</p>', '<p>The safety of ofloxacin during pregnancy has not been established. Ofloxacin may enter breast milk but data are not available.</p>', '<p>Patients being treated with Ofloxacin should not expose themselves unnecessarily to strong sunlight and should avoid UV rays. Caution is recommended if the drug is to be used in psychotic patients or in-patients with a history of psychiatric disease.</p>', '<p><strong>Symptoms</strong>: Confusion, dizziness, impairment of consciousness, convulsive seizures, GI reactions (e.g. nausea, mucosal erosions).<br />\r\n<br />\r\n<strong>Management</strong>: Symptomatic and supportive treatment. Remove any unabsorbed drug by gastric lavage or admin of adsorbants and Na sulfate. Antacids are recommended for protection of gastric mucosa. Elimination may be increased by forced diuresis.</p>', '<p>4-Quinolone preparations, Aural Anti-bacterial preparations.</p>', '<p>Store between 15-30&deg; C. Protect from light.</p>', '<p>Renal Impairment:</p>\r\n\r\n<ul>\r\n	<li><strong>CrCl &lt;20 and patients on haemodialysis or peritoneal dialysis</strong>: 100 mg 24 hrly following usual initial dose.</li>\r\n	<li><strong>CrCl 20-50</strong>: Reduce dose by half 24 hrly following usual initial dose.</li>\r\n</ul>\r\n\r\n<p>Hepatic Impairment:Severe: Reduce dose. Max: 400 mg daily</p>', '2022-03-11 04:52:34', '2022-03-11 04:52:34');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1074, 1074, '<p>This ear drop is indicated for the treatment of superficial bacterial and fungal infections of the external auditory canal and the middle ear, caused by organisms susceptible to the action of Ofloxacin and Clotrimazole.</p>', '<p>It is a combination of an antibacterial, an antifungal, an anti-inflammatory and a topical local anesthetic agent. This ear drop has been specially formulated to maintain the natural environment of the external ear canal.<br />\r\n<br />\r\n<strong>Ofloxacin</strong>&nbsp;is a fluoroquinolone that has a broad spectrum of activity against otic pathogens without ototoxicity. Hence Ofloxacin is preferred to Aminoglycosides for any application within the middle ear space. Ofloxacin exerts antibacterial activity by inhibiting DNA gyrase of bacteria. Ofloxacin has been shown to be active against the following organisms responsible for otic infections: Gram-positive: Staphylococcus aureus, Streptococcus pneumoniae. Gram-negative: Escherichia coli, Haemophilus influenzae, Moraxella catarrhalis, Proteus mirabilis, Pseudomonas aeruginosa.<br />\r\n<br />\r\n<strong>Clotrimazole</strong>&nbsp;is a synthetic imidazole derivative, which is a broad-spectrum antifungal agent that exerts fungicidal activity against fungi responsible for superficial mycotic infections affecting the outer or middle ear including Candida, Microsporum &amp; Trichophyton. Clotrimazole inhibits Cytochrome P-450 synthesis of Ergosterol, which decreases fungal cell wall integrity thus inhibits fungal growth. Clotrimazole also has activity against certain bacteria such as Streptococci and Staphylococci. The antibacterial effect of Clotrimazole is advantageous to treat mixed bacterial-fungal infections.<br />\r\n<br />\r\n<strong>Beclomethasone Dipropionate</strong>&nbsp;is a potent steroid as compared with other topical corticosteroids. Beclomethasone like other topical corticosteroids, has anti-inflammatory, antipruritic, and vasoconstrictive properties. It induces phospholipase A2 and sequentially inhibits the release of arachidonic acid, thereby depressing the formation, release, and activity of prostaglandins, leukotrienes, and other inflammatory mediators.<br />\r\n<br />\r\n<strong>Lidocaine Hydrochloride</strong>&nbsp;is a topical local anesthetic which helps to reduce pain and stinging in the ear.</p>', '<ul>\r\n	<li>Adults &amp; Children: Instill 2-5 drops three to four times daily into the affected ear for 7-14 days.</li>\r\n	<li>Otitis Externa with intact tympanic membrane: From age 06 months &amp; older.</li>\r\n	<li>Chronic Suppurative Otitis Media with perforated tympanic membrane: 12 years &amp; older.</li>\r\n</ul>\r\n\r\n<p>Instruction to use: To apply, tilt head to one side so that the ear is facing up. Then gently pull the ear lobe up &amp; backward in case of adults and children older than 3 years. In case of pediatric patients gently pull the ear lobe down &amp; backward.</p>', NULL, '<p>This ear drop is contraindicated in patients with sensitive to Ofloxacin or other quinolone, or to any of the components of this medications. It is contra-indicated in viral infections of the ear.</p>', '<p>The systemic side-effects are not common with this ear drops. The following adverse reactions may be observed when using this product: itching, burning, irritation, dryness, earache, headache, vertigo, dizziness, redness, folliculitis, hypertrichosis, acne form eruptions and hypopigmentation.</p>', '<p>Safety during pregnancy or lactation has not been established. It is not known whether the active substances pass into breast milk when applied topically. Therefore, the potential benefit of this product during pregnancy or lactation, should be weighed against possible hazard to the fetus or the nursing infant.</p>', '<ul>\r\n	<li>If a favorable response does not occur in one week, discontinue the use of this preparation and obtain cultures to guide further treatment.</li>\r\n	<li>As with other anti-infective preparations, prolonged use may result in overgrowth of nonsusceptible organisms.</li>\r\n	<li>If local irritation or sensitization occurs, discontinue this preparation and institute appropriate therapy.</li>\r\n	<li>If otorrhea persists after a full course of therapy, or if two or more episodes of otorrhea occur within six months, further evaluation is recommended to exclude an underlying condition such as cholesteatoma, foreign body, or a tumor.</li>\r\n	<li>Not for Ophthalmic use. Not for injection.</li>\r\n</ul>', NULL, '<p>Anti-fungal or anti-bacterial ear drops.</p>', '<p>Keep away from light and moisture, store below 25&deg;C.</p>', NULL, '2022-03-11 04:54:14', '2022-03-11 04:54:14'),
(1075, 1075, '<p>Olanzapine is indicated for the acute and maintenance treatment of schizophrenia and related psychoses where positive symptoms (e.g. delusions, hallucinations, disordered thinking, hostility and suspiciousness) and/or negative symptoms (e.g. flattened affect, emotional and social withdrawal, poverty of speech) are prominent. Olanzapine is indicated for the treatment of acute manic or mixed episodes in bipolar disorder, with or without psychotic features and with or without a rapid cycling course.</p>', '<p>Olanzapine is an antipsychotic agent and has affinities for serotonin 5HT2A/2C, 5HT3, 5HT6; dopamine D1, D2, D3, D4, D5; cholinergic muscarinic receptors M1-M5; &alpha;1 adrenergic; and histamine H1 receptors. The mechanism of action of Olanzapine, as with other drugs having efficacy in schizophrenia, is unknown. However, it has been proposed that this drug&rsquo;s efficacy in schizophrenia is mediated through a combination of dopamine and serotonin type 2 (5HT2) antagonism. Olanzapine is well absorbed after oral administration, reaching peak plasma concentrations within 5 to 8 hours. The absorption is not affected by food. Olanzapine is not mutagenic or clastogenic as well as not carcinogenic.</p>', '<p><strong>Schizophrenia, combination therapy for Mania, Bipolar Disorder</strong>: The initial dose is 5-10 mg once daily. Daily dosage may subsequently be adjusted on the basis of individual clinical status within the range of 5-20 mg daily. Dosage greater than 10 mg daily only after reassessment. Maximum dose is 20 mg daily.<br />\r\n<br />\r\n<strong>Monotherapy for Mania</strong>: Initially 15 mg once daily. Daily dosage may subsequently be adjusted on the basis of individual clinical status within the range of 5-20 mg daily. Dosage greater than 15 mg only after reassessment. Maximum dose is 20 mg daily.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Olanzapine can be given without regard to meals. Gradual tapering of the dose should be considered while discontinuing Olanzapine.</p>', '<p>Olanzapine may antagonize the effects of levodopa and dopamine agonists. Drugs that induce CYP1A2 or glucoronyl transferase enzymes e.g, Omeprazole and Rifampicin, may increase Olanzapine clearance. Inhibitors of CYP1A2 may potentially inhibit Olanzapine elimination. Carbamazepine may increase the clearance of Olanzapine. Concomitant administration of activated charcoal reduces the oral bioavailability of Olanzapine by 50-60%. Caution should be taken when Olanzapine is administered with centrally acting drugs and alcohol.</p>', '<p>Olanzapine is contraindicated in those patients with a known hypersensitivity to any ingredient of the product as well as in patients with known risk for narrow-angle glaucoma.</p>', '<p>Very common undesirable effects are somnolence and weight gain. Besides increased appetite, elevated glucose levels, elevated triglyceride levels, dizziness, akathisia, Parkinson&#39;s disease, dyskinesia, orthostatic hypotension, mild and transient anticholinergic effects including constipation and dry mouth, asthenia, edema and photosensitivity reaction etc. may be observed.</p>', '<p>Olanzapine should be used in pregnancy only if the potential benefits justify the potential risk to the foetus. So, patients should be advised to notify their physician if they become pregnant or intend to become pregnant during treatment with Olanzapine. There is no report to show teratogenecity. Patients should not breast feed if they are taking Olanzapine.</p>', '<p>Olanzapine should be used cautiously in patients who have a history of seizures or have conditions associated with seizures.&nbsp;Olanzapine should be used cautiously in patients with low leukocyte and/or neutrophil counts for any reason, drug induced bone marrow depression/toxicity caused by radiation therapy or chemotherapy, hypereosinophilic conditions, impaired hepatic function, and patients using hepatotoxic medicines, centrally acting drug and medicines know to increase QT interval, especially in the elderly. Patients should be cautioned about operating hazardous machinery, including motor vehicles.</p>', NULL, '<p>Atypical neuroleptic drugs.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Children</strong>: Olanzapine has not been studied in subjects under 18 years of age.<br />\r\n<br />\r\n<strong>Elderly patients (age 65 and over)</strong>: starting dose 5 mg/day<br />\r\n<br />\r\n<strong>Patients with hepatic, renal impairment</strong>: starting dose 5 mg/day</p>', '2022-03-11 04:56:27', '2022-03-11 04:56:27'),
(1076, 1076, '<p><strong>Breast Cancer</strong>: Olaparib is indicated as monotherapy for the treatment of adult patients with deleterious or suspected deleterious germline BRCA-mutated (gBRCAm), human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer who have previously been treated with chemotherapy in the neoadjuvant, adjuvant or metastatic setting. Patients with hormone receptor (HR)-positive breast cancer should have progressed on or be considered inappropriate for endocrine therapy. Germline BRCA mutation must be confirmed before Olaparib treatment is initiated.<br />\r\n<br />\r\n<strong>Ovarian Cancer</strong>: Olaparib is indicated as monotherapy for the maintenance treatment of adult patients with platinum sensitive relapsed (PSR) high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer who are in response (complete response or partial response) to platinumbased chemotherapy.</p>', '<p>Olaparib is an inhibitor of poly (ADP-ribose) polymerase (PARP) enzymes, including PARP1, PARP2, and PARP3. PARP enzymes are involved in normal cellular homeostasis, such as DNA transcription, cell cycle regulation, and DNA repair. Olaparib has been shown to inhibit growth of select tumor cell lines in vitro and decrease tumor growth in mouse xenograft models of human cancer both as monotherapy or following platinum-based chemotherapy. Increased cytotoxicity and anti-tumor activity following treatment with olaparib were noted in cell lines and mouse tumor models with deficiencies in BRCA. In vitro studies have shown that olaparib-induced cytotoxicity may involve inhibition of PARP enzymatic activity and increased formation of PARP-DNA complex, resulting in disruption of cellular homeostasis and cell death.</p>', '<p>There is a risk of medication errors between Olaparib tablets and Olaparib capsules. In order to minimize this risk, check the bottle labels to ensure that the drug being prepared and dispensed is Olaparib tablets and not Olaparib capsules. Prescribers should specify the formulation and dosage of Olaparib on each prescription.<br />\r\n<br />\r\nThe recommended total daily dose of Olaparib tablets is 600 mg, taken as two 150 mg tablets twice daily. The 100 mg tablet is available for dose reduction.<br />\r\n<br />\r\n<strong>For treatment of ovarian cancer</strong>: Patients should start treatment with Olaparib no later than 8 weeks after completion of their final dose of the platinum-containing regimen. Patients should have recovered from prior hematologic toxicities prior to starting Olaparib therapy (hemoglobin, platelet, and neutrophil levels should be &le; CTCAE grade 1).<br />\r\n<br />\r\nIt is recommended that Olaparib treatment be continued until progression of the underlying disease or unacceptable toxicity. Olaparib should not be given in combination with other anti cancer therapy. Grapefruit or other similar fruit juices that are known to inhibit CYP3A should not be consumed while taking Olaparib.</p>', '<p>Clinical studies of olaparib in combination with other anti-cancer agents, including DNA damaging agents, indicate a potentiation and prolongation of myelosuppressive toxicity. The recommended Olaparib monotherapy dose is not suitable for combination with myelosuppressive anti-cancer agents. Olaparib is predominantly metabolised by CYP3A. Co-administered CYP3A inhibitors or inducers may respectively increase or decrease olaparib plasma concentration.</p>', '<p>Olaparib is contraindicated in patients who are hypersensitive to this drug or to any ingredient in the formulation.</p>', '<p>The most common serious adverse reaction reported was anemia (2.4% olaparib vs 2.2% chemotherapy). The following serious ADRs were reported in one patient each: dermatitis allergic, neutrophil count decreased and platelet count decreased. The proportion of patients who permanently discontinued Olaparib due to adverse events was 4.9% in the Olaparib arm compared with 7.7% in the chemotherapy arm. Anemia and platelet count decrease were the only adverse reactions leading to discontinuation of Olaparib in more than one patient.</p>', '<p><strong>Pregnancy</strong>: Olaparib can cause fetal harm when administered to a pregnant woman based on its mechanism of action and findings in animals. Olaparib wasteratogenic and caused embryo-fetal toxicity in rats at exposures below those in patients receiving the recommended human dose of 400 mg twice daily. If this drug is used during pregnancy, or if a patient becomes pregnant while taking this drug, apprise the patient of the potential hazard to the fetus and the potential risk for loss of the pregnancy.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether olaparib is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from olaparib, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p><strong>Myelodysplastic Syndrome/Acute Myeloid Leukemia (MDS/AML)</strong>: occurred in patients exposed to Olaparib, and the majority of reports were fatal. Monitor patients for hematological toxicity at baseline and monthly thereafter. Discontinue if MDS/AML is confirmed.<br />\r\n<br />\r\n<strong>Pneumonitis</strong>: occurred in patients exposed to Olaparib, and some cases were fatal. Interrupt treatment if pneumonitis is suspected. Discontinue if pneumonitis is confirmed.<br />\r\n<br />\r\n<strong>Embryo-Fetal Toxicity</strong>: Olaparib can cause fetal harm. Advise females of reproductive potential of the potential risk to a fetus and to use effective contraception.</p>', '<p>There is no specific treatment in the event of Olaparib overdose, and symptoms of overdose are not established. In the event of an overdose, physicians should follow general supportive measures and should treat symptomatically.</p>', '<p>Targeted Cancer Therapy.</p>', '<p>Store in a dry place below 30&deg;C, protect from light. Keep out of the reach of children.</p>', '<p>Pediatric Use: The safety and efficacy of Olaparib has not been established in pediatric patients.</p>', '2022-03-11 04:58:18', '2022-03-11 04:58:18'),
(1077, 1077, '<p>Olmesartan Medoxomil is indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive agents.</p>', '<p>Angiotensin-II formed from angiotensin-I in a reaction catalyzed by angiotensin-converting enzyme (ACE), is a potent vasoconstrictor, the primary vasoactive hormone of the renin-angiotensin system and an important component in the pathophysiology of hypertension. It also stimulates aldosterone secretion by the adrenal cortex. Olmesartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin-II by selectively blocking the binding of angiotensin-II to the AT 1 receptor found in many tissues (e.g. vascular smooth muscle, adrenal gland). In-vitro-binding studies indicate that Olmesartan is a reversible &amp; competitive inhibitor of AT 1 receptor. Olmesartan does not inhibit ACE (kinase-I, the enzyme that converts angiotensin-I to angiotensin-II and degrades bradykinin).</p>', '<p>Dosage must be individualized. The usual recommended starting dose of Olmesartan is 20 mg once daily when used as monotherapy in patients who are not volume-contracted. For patients requiring further reduction in blood pressure after 2 weeks of therapy, the dose of Olmesartan may be increased to 40 mg. Doses above 40 mg do not appear to have a greater effect. Twice-daily dosing offers no advantage over the same total dose given once daily.<br />\r\n<br />\r\nNo initial dosage adjustment is recommended for elderly patients, for patients with moderate to marked renal impairment (creatinine clearance &lt;40 ml/min) or with moderate to marked hepatic dysfunction. For patients with possible depletion of intravascular volume (e.g. patients treated with diuretics, particularly those with impaired renal function), Olmesartan should be initiated under close medical supervision and consideration should be given to use of a lower starting dose. Olmesartan may be administered with or without food.</p>', '<p><strong>With medicine</strong>: No significant drug interactions were reported in which Olmesartan was co-administered.<br />\r\n<strong>With food &amp; others</strong>: Food does not affect the bioavailability of Olmesartan.</p>', '<p>Olmesartan is contraindicated in patients who are hypersensitive to any component of this product.</p>', '<p><strong>Common</strong>: The most common side effects include Back pain, bronchitis, creatine phosphokinase increased, diarrhea, headache, hematuria, hyperglycemia, hypertriglyceridemia, influenza-like symptoms, pharyngitis, rhinitis, and sinusitis.<br />\r\n<br />\r\n<strong>Rare</strong>: Chest pain, peripheral edema, arthritis.</p>', '<p><strong>Pregnancy</strong>: When pregnancy is detected, discontinue this product as soon as possible. When used in pregnancy during the second and third trimesters, drugs that act directly on the renin-angiotensin system can cause injury and even death to the developing fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether Olmesartan is excreted in human milk, but Olmesartan is secreted at low concentration in the milk of lactating rats. Because of the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>As a consequence of inhibiting the renin-angiotensin-aldosterone system, changes in renal function may be anticipated in susceptible individuals treated with olmesartan medoxomil. In patients whose renal function may depend upon the activity of the renin-angiotensin-aldosterone system (e.g. patients with severe congestive heart failure), treatment with angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists has been associated with oliguria and/or progressive azotemia and (rarely) with acute renal failure and/or death. Similar results may be anticipated in patients treated with olmesartan medoxomil.</p>', '<p><strong>Symptoms</strong>: There is no experience of overdose with Olmesartan. The most likely effects of olmesartan medoxomil overdosage are hypotension and tachycardia; bradycardia could be encountered if parasympathetic (vagal) stimulation occurred.<br />\r\n<br />\r\n<strong>Treatment</strong>: If intake is recent, gastric lavage or induction of emesis may be considered. Clinically significant hypotension due to an overdose of Olmesartan requires the active support of the cardiovascular system, including close monitoring of heart and lung function, the elevation of the extremities, and attention to circulating fluid volume and urine output.</p>', '<p>Angiotensin-ll receptor blocker.</p>', '<p>Store in cool &amp; dry place below 30&ordm;C, protect from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Paediatric use: Safety and effectiveness in paediatric patients have not been established.</p>', '2022-03-11 05:00:20', '2022-03-11 05:00:20'),
(1078, 1078, '<p>Olmesartan Medoxomil &amp; Hydrochlorothiazide combination is indicated for the treatment of hypertension.</p>', '<p>Angiotensin-II formed from angiotensin-I in a reaction catalyzed by angiotensin-converting enzyme (ACE), is a potent vasoconstrictor, the primary vasoactive hormone of the renin-angiotensin system and an important component in the pathophysiology of hypertension. It also stimulates aldosterone secretion by the adrenal cortex. Olmesartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin-II by selectively blocking the binding of angiotensin-II to the AT 1 receptor found in many tissues (e.g. vascular smooth muscle, adrenal gland). In-vitro-binding studies indicate that Olmesartan is a reversible &amp; competitive inhibitor of AT 1 receptor. Olmesartan does not inhibit ACE (kinase-I, the enzyme that converts angiotensin-I to angiotensin-II and degrades bradykinin).<br />\r\n<br />\r\nHydrochlorothiazide is a thiazide diuretic. Thiazides affect the renal tubular mechanisms of electrolyte reabsorption, directly increasing the excretion of Sodium and Chloride in approximately equivalent amounts. Indirectly, the diuretic action of Hydrochlorothiazide reduces plasma volume with consequent increases in plasma renin activity, increases Aldosterone secretion &amp; urinary Potassium loss and decreases serum Potassium. The renin-aldosterone link is mediated by angiotensin-II. So, co-administration of an angiotensin-II receptor antagonist tends to reverse the potassium loss associated with these diuretics.</p>', '<p><strong>Hypertension</strong>: The usual starting dose is 20/12.5 mg one tablet once daily. Dosing should be individualized. Depending on the blood pressure response, the dose may be titrated at intervals of 2-4 weeks to two tablets 40/25 once daily.</p>', '<p><strong>Olmesartan</strong>: No significant drug interactions were reported in studies in which Olmesartan Medoxomil was co-administered with hydrochlorothiazide, digoxin or warfarin in healthy volunteers. Olmesartan Medoxomil is not metabolized by the cytochrome P450 system and has no effects on P450 enzymes; thus, interactions with drugs that inhibit, induce or are metabolized by those enzymes are not expected.<br />\r\n<br />\r\n<strong>Hydrochlorothiazide</strong>: When administered concurrently, the following drugs may interact with Thiazide diuretics:</p>\r\n\r\n<ul>\r\n	<li>Alcohol, Barbiturates or Narcotics: Potentiation of orthostatic hypotension may occur.</li>\r\n	<li>Antidiabetic drugs (oral agents and Insulin): Dosage adjustment of the antidiabetic drug may be required.</li>\r\n	<li>Other antihypertensive drugs: Additive effect.</li>\r\n	<li>Corticosteroids, ACTH.</li>\r\n	<li>Lithium.</li>\r\n</ul>', '<p>The combination of Olmesartan and Hydrochlorothiazide is contraindicated in patients who are hypersensitive to any component of this product. Because of the Hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs.</p>', '<p>The common side-effects are nausea, headache, dizziness, hyperuricemia, upper respiratory tract infection and urinary tract infection. Other adverse effects are chest pain, back pain, peripheral edema, abdominal pain, dyspepsia, gastroenteritis, diarrhea.</p>', '<p>Safety and effectiveness in nursing mother &amp; pregnancy have not been established. The drug should be discontinued during these conditions.</p>', '<ul>\r\n	<li>Periodic determination of serum electrolytes should be performed at appropriate intervals to detect possible electrolyte imbalance like hypokalemia, hyponatremia and hypochloremic alkalosis.</li>\r\n	<li>Hyperuricemia may occur in certain patients receiving thiazide therapy.</li>\r\n	<li>Impaired renal function.</li>\r\n</ul>', '<p><strong>Olmesartan</strong>: Limited data are available in regard to overdosage in humans. The most likely manifestation of overdosage would be hypotension and tachycardia. Supportive treatment should be instituted.<br />\r\n<br />\r\n<strong>Hydrochlorothiazide</strong>: The most common signs and symptoms observed are those caused by electrolyte depletion (hypokalemia, hypochloremia, and dehydration) resulting from excessive diuresis. If digitalis has also been administered, hypokalemia may accentuate cardiac arrhythmias.</p>', '<p>Combined antihypertensive preparations.</p>', '<p>Store in a cool and dry place, protect from light and moisture. Keep out of the reach of children.</p>', '<p><strong>Renal Impairment Patients</strong>: The usual regimens of therapy with this may be followed provided the patient&#39;s creatinine clearance is &gt;30 ml/min. In patients with more severe renal impairment, loop diuretics are preferred to thiazides. So, this preparation is not recommended.<br />\r\n<br />\r\n<strong>Hepatic Impairment Patients</strong>: No dosage adjustment is necessary with hepatic impairment.<br />\r\n<br />\r\n<strong>Paediatric use</strong>: Safety and effectiveness in paediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: Clinical studies of Olmesartan and Hydrochlorothiazide combination did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. In general, dose selection for an elderly patient should be cautious.</p>', '2022-03-11 05:02:37', '2022-03-11 05:02:37'),
(1079, 1079, '<p>Olopatadine Nasal Spray is an H1 receptor antagonist indicated for the relief of the symptoms of seasonal allergic rhinitis in adults and children 6 years of age and older.</p>', '<p>Olopatadine, an antihistamine, works by blocking the action of histamine in the body, which reduces allergy symptoms. Olopatadine Hydrochloride treats sneezing, itching, runny nose, and other nasal symptoms of allergies. Olopatadine Nasal Spray contains 0.6% w/v Olopatadine (base) in a nonsterile aqueous solution with pH of approximately 3.7. After initial priming (5 sprays), each metered spray from the nasal applicator delivers 100 microliters of the aqueous solution containing 665 mcg of olopatadine Hydrochloride, which is equivalent to 600 mcg of Olopatadine (base). Olopatadine Nasal Spray also contains benzalkonium chloride (0.01%), dibasic sodium phosphate, edetate disodium, sodium chloride, hydrochloric acid and/or sodium hydroxide (to adjust pH), and purified water.</p>', '<p><strong>Adults and Adolescents 12 years of age and older</strong>: Two sprays per nostril twice daily.<br />\r\n<br />\r\n<strong>Children 6 to 11 years of ag</strong>e: One spray per nostril twice daily.<br />\r\n<br />\r\nAdminister Olopatadine&nbsp;Nasal Spray by the intranasal route only.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>How to use the Nasal Spray-</p>\r\n\r\n<ul>\r\n	<li>Shake the bottle gently and remove the dust cover.</li>\r\n	<li>Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.</li>\r\n	<li>Gently blow the nose to clear the nostrils.</li>\r\n	<li>Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.</li>\r\n	<li>Breathe out through your mouth.</li>\r\n	<li>Repeat the above steps in the same/ other nostril for consecutive doses.</li>\r\n</ul>\r\n\r\n<p>Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-</p>\r\n\r\n<ul>\r\n	<li>Remove the dust cover.</li>\r\n	<li>Gently pull off the nasal applicator.</li>\r\n	<li>Wash the applicator and dust cover in warm water.</li>\r\n	<li>Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.</li>\r\n	<li>Gently push the applicator back on the top of the bottle and re-fix the dust cover.</li>\r\n</ul>', '<p>Interaction with other medications have not been investigated.</p>', NULL, '<p>A bitter taste in the mouth, nosebleeds, or irritation/soreness in the nose may occur. Drowsiness may rarely occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.</p>', '<p>Pregnancy Category C. No adequate and well-controlled studies in pregnant women have been conducted. Olopatadine Nasal Spray should be used in pregnant women only if the potential benefit to the mother justifies the potential risk to the embryo or fetus.<br />\r\n<br />\r\nLactation: It is not known whether topical nasal administration could result in sufficient systemic absorption to produce detectable quantities in human breast milk. Olopatadine Nasal Spray should be used by nursing mothers only if the potential benefit to the patient outweighs the potential risks to the infant.</p>', '<p>Before initial use, Olopatadine Nasal Spray by releasing 5 sprays or until a fine mist appears. When Olopatadine Nasal Spray has not been used for more than 7 days, re-prime by releasing 2 sprays. Avoid spraying Olopatadine Nasal Spray into the eyes. Patients should be informed to avoid spraying Olopatadine Nasal Spray in their eyes.</p>', '<p>There have been no reported overdoses with Olopatadine Nasal Spray.</p>', '<p>Nasal Anti-histamine preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-11 05:04:30', '2022-03-11 05:04:30'),
(1080, 1080, '<p>Olopatadine is indicated for the treatment of ocular itching associated with allergic conjunctivitis.</p>', '<p>Olopatadine is an inhibitor of the release of histamine from the mast cell and a relatively selective histamine H1‐antagonist that inhibits the in vivo and in vitro type 1 immediate hypersensitivity reaction including inhibition of histamine induced effects on human conjunctival epithelial cells. Olopatadine is devoid of effects on alpha adrenergic, dopamine and muscarinic type 1 and 2 receptors. Following topical ocular administration in human, olopatadine was shown to have low systemic exposure.</p>', '<p><strong>0.1% Sterile Eye Drops</strong>: One drop in each affected eye two times per day at an interval of 6 to 8 hours.<br />\r\n<br />\r\n<strong>0.2% Sterile Eye Drops</strong>: One drop in the affected eye once a day.<br />\r\n<br />\r\n<strong>0.7% Sterile Eye Drops</strong>: One drop in each affected eye once a day.</p>', '<p>May result in additive CNS depression with CNS depressants.</p>', '<p>Olopatadine Hydrochloride ophthalmic solution is contraindicated in persons with a known hypersensitivity to Olopatadine Hydrochloride.</p>', '<p>Headaches have been reported at an incidence of 7%. The following adverse experiences have been reported in less than 5% of patients: Asthenia, blurred vision, burning or stinging, cold syndrome, dry eye, foreign body sensation, hyperemia, hypersensitivity, keratitis, lid edema, nausea, pharyngitis, pruritus, rhinitis, sinusitis, and taste perversion</p>', '<p>There are no adequate and well controlled studies in pregnant women. Because animal studies are not always predictive of human responses, this drug should be used in pregnant women only if the potential benefit to the mother justifies the potential risk to the fetus.<br />\r\n<br />\r\nIt is not known whether topical ocular administration could result in sufficient systemic absorption to produce detectable quantities in the human breast milk. Nevertheless, caution should be exercised when Olopatadine Hydrochloride ophthalmic solution is administered to a nursing mother.</p>', '<p>Olopatadine HCl ophthalmic solution should not be used to treat contact lens related irritation. Patients who wear soft contact lenses should be instructed to wait at least ten minutes after instilling Olopatadine Hydrochloride ophthalmic solution before they insert their contact lenses.</p>', '<p><strong>Symptoms:</strong>&nbsp;Drowsiness in adults and, initially, agitation and restlessness, followed by drowsiness in childn.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Symptomatic or supportive treatment.</p>', '<p>Ophthalmic Non-Steroid drugs.</p>', '<p>Store below 30&deg; C in a cool and dry place protected from light. Keep out of reach of children. Do not touch the dropper tip to surfaces since this may contaminate the solution. Do not use after 30 days of first opening.</p>', '<p><strong>Geriatric Use</strong>: No overall differences in safety or effectiveness have been observed betweents.</p>', '2022-03-11 05:06:29', '2022-03-11 05:06:29'),
(1081, 1081, '<p><strong>Asthma</strong>: Omalizumab is indicated for patients 6 years of age and older with moderate to severe persistent&nbsp;asthma&nbsp;who have a positive skin test or in vitro reactivity to a perennial aeroallergen and whose symptoms are inadequately controlled with inhaled corticosteroids. Omalizumab has been shown to decrease the incidence of asthma exacerbations in these patients.<br />\r\n<br />\r\n<strong>Chronic Idiopathic Urticaria (CIU)</strong>: Omalizumab is indicated for the treatment of adults and adolescents 12 years of age and older with chronic&nbsp;idiopathic&nbsp;urticaria&nbsp;who remain symptomatic despite H1 antihistamine treatment.</p>', '<p><strong>Asthma</strong>: Omalizumab inhibits the binding of&nbsp;IgE&nbsp;to the high-affinity&nbsp;IgE receptor (Fc&epsilon;RI) on the surface of mast cells and basophils. Reduction in surface-bound IgE on Fc&epsilon;RI-bearing cells limits the degree of release of mediators of the allergic response. Treatment with Omalizumab also reduces the number of Fc&epsilon;RI receptors on basophils in&nbsp;atopic&nbsp;patients.<br />\r\n<br />\r\n<strong>Chronic Idiopathic Urticaria</strong>: Omalizumab binds to IgE and lowers free IgE levels. Subsequently, IgE receptors (Fc&epsilon;RI) on cells down-regulate. The mechanism by which these effects of omalizumab result in an improvement of CIU symptoms is unknown.</p>', '<p>Subcutaneous-</p>\r\n\r\n<p>Poorly controlled, moderate to severe asthma:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Doses (mg) and dosing frequency are based on pre-treatment serum IgE levels (IU/mL) and body wt (kg) as follows: &ge;30-100 IU/mL: 150 mg (30-90 kg); 300 mg (&gt;90-150 kg). &gt;100-200 IU/mL: 300 mg (30-90 kg). &gt;200-300 IU/mL: 300 mg (30-60 kg). All doses to be taken every 4 wk. &gt;100-200 IU/mL: 225 mg (&gt;90-150 kg). &gt;200-300 IU/mL: 225 mg (&gt;60-90 kg); 300 mg (&gt;90-150 kg). &gt;300-400 IU/mL: 225 mg (30-70 kg); 300 mg (&gt;70-90 kg). &gt;400-500 IU/mL: 300 mg (30-70 kg); 375 mg (&gt;70-90 kg). &gt;500-600 IU/mL: 300 mg (30-60 kg); 375 mg (&gt;60-70 kg). 375 mg (30-60 kg). All doses to be taken every 2 wk. Doses no more than 150 mg should be admin at 1 inj site.</li>\r\n	<li><strong>Child:</strong>&nbsp;&ge;12 yr Same as adult dose.</li>\r\n</ul>\r\n\r\n<p>Chronic idiopathic urticaria:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;150 or 300 mg every 4 wk.</li>\r\n	<li><strong>Child:</strong>&nbsp;&ge;12 yr Same as adult dose.</li>\r\n</ul>', NULL, '<p>Severe hypersensitivity reaction to Omalizumab or any ingredient of this preparation</p>', '<p>Generalised pain, arthralgia, myalgia, fatigue, dizziness, earache, headache, GI disturbances, fractures, pruritus, alopecia, dermatitis, upper resp tract infections, viral infections, sinusitis, pharyngitis, flu-like illness, systemic eosinophilia (e.g. Churg-Strauss syndrome).</p>', '<p><strong>Pregnancy&nbsp;</strong>Category B.&nbsp;Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).</p>', '<p>Not intended for treatment of acute asthma exacerbations, acute bronchospasm or status asthmaticus. Patient at risk of parasitic infections. May increase risk of malignancy. Delayed onset of anaphylaxis, it usually occurs 2 hr after admin but may also occur up to 4 days to &gt;1 yr after initiation of regular treatment. Avoid abrupt withdrawal of corticosteroid therapy. Renal and hepatic impairment. Childn. Pregnancy and lactation.</p>', '<p>The maximum tolerated dose of Omalizumab has not been determined. Single intravenous doses of up to 4,000 mg have been administered to patients without evidence of dose limiting toxicities. The highest cumulative dose administered to patients was 44,000 mg over a 20 week period, which was not associated with toxicities.</p>', '<p>Antihistamines anti-allergies &amp; hypo-sensitisation.</p>', '<p>Store between 2-8&deg;C. May be transferred at room temp. Do not freeze. Following reconstitution, protect from direct sunlight. Stable for up to 8 hr if refrigerated or 4 hr if at room temp.</p>', NULL, '2022-03-11 05:08:32', '2022-03-11 05:08:32'),
(1082, 1082, '<p>Omega-3 Acid Ethyl Esters is indicated as an adjunct to diet to reduce very high (&gt;500mg/dl) triglyceride (TG) levels in adult patients and as an adjunct in secondary prevention in those who have had a myocardial infarction in the preceding 3 months. It is also indicated to help reduce the joint inflammation associated with mild arthritis, mood disorders &amp; impulse control, age-related macular degeneration.</p>', '<p>Omega-3-acid ethyl esters reduce triglyceride production by the liver but this mechanism is not well understood. Omega-3-acid ethyl esters inhibit acyl-CoA: 1,2-diacylglycerol acyltransferase, reducing triglyceride synthesis and increasing paroxysmal beta-oxidation, which increases fatty aside metabolism. Omega-3-acid ethyl esters also inhibit the release of fatty acids by competing for enzymes involved in the synthesis of triglycerides, increase triglyceride clearance by increasing the activity of lipoprotein lipase, and decrease production of VLDL-C.</p>', '<p><strong>In hypertriglyceridaemia</strong>: it can be taken as a single dose of 4 capsules (4 gm) or 2 capsules (2 gm) twice daily.<br />\r\n<br />\r\n<strong>In previously myocardial infarction patients</strong>: It can be taken 1 capsule (1 gm ) daily with food. Patients should be placed on an appropriate lipid lowering diet before receiving Omega-3 Acid Ethyl Esters and should continue this diet during treatment.<br />\r\n<br />\r\n<strong>In joint inflammation associated with mild arthritis</strong>: The dose is 2.7 gm daily.<br />\r\n<br />\r\n<strong>In mood disorders &amp; impulse control and age-related macular degeneration</strong>: The dose is 1 capsule (1 gm) per day. Or, as directed by the registered physician.</p>', '<p>Patients receiving treatment with both Omega-3-acid ethyl esters and anticoagulants should be monitored periodically.</p>', '<p>It is contraindicated in patients who exhibit hypersensitivity to any component of this medication.</p>', '<p>Adverse events are rarely reported such as dyspepsia, nausea, constipation, gastritis, dizziness etc.</p>', '<p>Omega-3-acid ethyl esters should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether it is excreted in human milk. Caution should be exercised when Omega-3-acid ethyl esters are administered to a lactating mother.</p>', '<p>During therapy with omega-3-acid ethyl esters, LDL-C levels should be monitored and laboratory studies should be performed periodically to measure the patient&#39;s TG levels.</p>', NULL, '<p>Other lipid regulating drugs.</p>', '<p>Store below 25&deg;C in a dry &amp; cool place.</p>', NULL, '2022-03-11 05:10:12', '2022-03-11 05:10:12'),
(1083, 1083, '<p>Omeprazole is indicated for the treatment of-</p>\r\n\r\n<ul>\r\n	<li>Gastric and duodenal ulcer</li>\r\n	<li>NSAID-associated duodenal and gastric ulcer</li>\r\n	<li>As prophylaxis in patients with a history of NSAID-associated duodenal and gastric ulcer</li>\r\n	<li>Gastro-esophageal reflux disease</li>\r\n	<li>Long-term management of acid reflux disease</li>\r\n	<li>Acid-related dyspepsia</li>\r\n	<li>Severe ulcerating reflux esophagitis</li>\r\n	<li>Prophylaxis of acid aspiration during general anesthesia</li>\r\n	<li>Zollinger-Ellison syndrome</li>\r\n	<li>Helicobacter pylori-induced peptic ulcer.</li>\r\n</ul>', '<p>Omeprazole, a substituted benzimidazole, is an inhibitor of gastric acid secretion. It inhibits gastric acid secretion by blocking hydrogen-potassium-adenosine triphosphatase (H+/K+&nbsp;ATPase) enzyme system in the gastric parietal cell. After oral administration, the onset of the antisecretory effect occurs within one hour, with the maximum effect occurring within two hours and inhibition of secretion lasts up to 72 hours. When the drug is discontinued, secretory activity returns gradually, over 3 to 5 days.</p>', '<p>Oral-</p>\r\n\r\n<ul>\r\n	<li><strong>Benign gastric and duodenal ulcer</strong>: 20 mg once daily for 4 weeks in duodenal ulceration, 8 weeks in gastric ulceration; in severe or recurrent cases, dose to be increased to 40 mg daily; maintenance dose for recurrent duodenal ulcer, 20 mg once daily; in prevention of relapse in duodenal ulcer, 10-20 mg daily.</li>\r\n	<li><strong>NSAID-associated duodenal or gastric ulcer</strong>: 20 mg once daily for 4 weeks, continued for further 4 weeks, if not fully healed. 20 mg once daily is used as prophylaxis in patients with a history of NSAID-associated duodenal or gastric ulcers.</li>\r\n	<li><strong>Gastro-esophageal reflux disease</strong>: 20 mg once daily for 4 weeks, continued for further 4-8 weeks, if not fully healed; 40 mg once daily has been given for 8 weeks in gastro-esophageal reflux disease, refractory to other treatment; maintenance dose is 20 mg once daily.</li>\r\n	<li><strong>Long-term management of acid reflux disease</strong>: 10-20 mg daily.</li>\r\n	<li><strong>Acid-related dyspepsia</strong>: 10-20 mg once daily for 2-4 weeks.</li>\r\n	<li><strong>Prophylaxis of acid aspiration</strong>: 40 mg on the preceding evening, then 40 mg 2-6 hours before surgery.</li>\r\n	<li><strong>Zollinger-Ellison syndrome</strong>: Initially 60 mg once daily; usual range 20-120 mg daily (If daily dose is more than 80 mg, 2 divided dose should be used).</li>\r\n	<li><strong>Helicobacter pylori eradication regimen in peptic ulcer disease</strong>: Omeprazole is recommended at a dose of 20 mg twice daily in association with antimicrobial agents as detailed below: Amoxicillin 500 mg and Metronidazole 400 mg both three times a day for one week, or Clarithromycin 250 mg and Metronidazole 400 mg both twice a day for one week, or Amoxicillin 1 g and Clarithromycin 500 mg both twice a day for one week.</li>\r\n	<li><strong>Paeditaric use in severe ulcerating reflux esophagitis (Child&gt;1 year)</strong>: If body-weight 10-20 kg, 10-20 -mg once daily for 4-12 weeks; if body-weight over 20 kg, 20-40 mg once daily for 4-12 weeks.</li>\r\n</ul>\r\n\r\n<p><br />\r\nIV Injection-</p>\r\n\r\n<ul>\r\n	<li><strong>Prophylaxis of acid aspiration</strong>: Omeprazole 40 mg to be given slowly (over a period of 5 minutes) as an intravenous injection, one hour before surgery.</li>\r\n	<li><strong>Duodenal ulcer, gastric ulcer or reflux oesophagitis</strong>: In patients with duodenal ulcer, gastric ulcer or reflux oesophagitis where oral medication is inappropriate, Omeprazole IV 40 mg once daily is recommended.</li>\r\n	<li><strong>Zollinger- Ellison syndrome (ZES)</strong>: In patients with Zollinger-Ellison Syndrome the recommended initial dose of Omeprazole given intravenously is 60 mg daily. Higher daily doses may be required and the dose should be adjusted individually. When doses exceed 60 mg daily, the dose should be divided &amp; given twice daily.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p><strong>Direction for use of IV Injection</strong>: Omeprazole lyophilized powder and water for injection is for intravenous administration only and must not be given by any other route. Omeprazole IV injection should be given as a slow intravenous injection. The solution for IV injection is obtained by adding 10 ml water for injection to the vial containing powder. After&nbsp;reconstitution the injection should be given slowly over a period of at least 2 to 5 minutes at a maximum rate of 4 ml/minute. Use only freshly prepared solution. The solution should be used within 4 hours of reconstitution.<br />\r\n<br />\r\n<strong>Direction for use of IV Infusion</strong>: Omeprazole IV infusion should be given as an intravenous infusion over a period of 20-30 minutes or more. The contents of one vial must be dissolved in 100 ml saline for infusion or 100 ml 5% Dextrose for infusion. The solution should be used within 12 hours when Omeprazole is dissolved in saline and within 6 hours when dissolved in 5% Dextrose. The reconstituted solution should not be mixed or co-administered in the same infusion set with any other drug.</p>', '<p>Omeprazole can prolong the elimination of diazepam, warfarin and phenytoin. So, reduction of warfarin or phenytoin dose may be necessary when Omeprazole is added to the treatment. There is no evidence of an interaction of Omeprazole with theophylline, propranolol or antacids.</p>', '<p>Omeprazole is contraindicated in patients with known hypersensitivity to any of the components of the formulation.</p>', '<p>Omeprazole is generally well tolerated. Nausea, abdominal colic, paresthesia, dizziness and headache have been stated to be generally mild and transient and not requiring a reduction in dosage.</p>', '<p>US FDA pregnancy category of Omeprazole is C. However, results from three prospective epidemiological studies indicate no adverse effects of Omeprazole on pregnancy or on the health of the fetus/newborn child. There is no information available on the passage of Omeprazole into breast milk or its effects on the neonate. Breast-feeding should, therefore, be discontinued, if the use of Omeprazole is considered essential.</p>', '<p>When gastric ulcer is suspected, the possibility of gastric malignancy should be excluded before treatment with Omeprazole is instituted, as treatment may alleviate the symptoms and delay diagnosis.</p>', NULL, '<p>Proton Pump Inhibitor</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-11 05:12:09', '2022-03-11 05:12:09');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1084, 1084, '<p>Omeprazole MUPS tablet is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Duodenal and Gastric ulcers</li>\r\n	<li>NSAID-induced gastric and duodenal ulcers</li>\r\n	<li>Reflux Oesophagitis</li>\r\n	<li>GERD (Gastroesophageal Reflux Disease)</li>\r\n	<li>Eradication of H. pylori with appropriate antibiotics</li>\r\n	<li>Zollinger-Ellison Syndrome</li>\r\n</ul>', '<p>MUPS is abbreviation for Multiple-Unit Pellet System. However, from pharmaceutical industry and research perspective, the term in general refers to MUPS compacted into tablets. Thus, the resulting tablets prepared by compaction of modified release coated multiparticulates or pellets are called as MUPS. It is the more recent and challenging technology that combines the advantages of both tablets and pellet-filled capsules in one dosage form.<br />\r\n<br />\r\n<img src=\"https://i.imgur.com/YwkaPsO.png\" /><br />\r\n<br />\r\nClinical advantage of omeprazole MUPS tablet compared to conventional modified-release omeprazole tablets and pellet-filled omeprazole capsules:</p>\r\n\r\n<ul>\r\n	<li>Ensures greater bioavailability</li>\r\n	<li>Ensures uniform emptying of micro pellets from stomach into small intestine facilitates rapid dissolution of enteric coating and drug release resulting in early Tmax&nbsp;and Cmax&nbsp;(peak time and peak plasma concentration)</li>\r\n	<li>Ensures lesser possibility of dose dumping</li>\r\n	<li>Is a combination of fast acting and sustained action</li>\r\n	<li>Ensures uniform drug release</li>\r\n	<li>Once daily dosing</li>\r\n	<li>Ensures lesser chance of localized irritation</li>\r\n	<li>Ensures better and more uniform drug absorption</li>\r\n	<li>Better than capsules in reducing the esophageal residence time</li>\r\n	<li>Minimizes fluctuation in plasma concentration of drug.</li>\r\n</ul>\r\n\r\n<p>Pharmacodynamic advantage:</p>\r\n\r\n<ul>\r\n	<li>MUPS ensure rapid and uniform gastric emptying and subsequently uniform drug dissolution of pellets in the gastrointestinal tract due to their small size and larger surface, uniform drug absorption is facilitated which results in consistent and controlled pharmacological action.</li>\r\n	<li>A further reduction in inter-and intra-subject variability in drug absorption and clinical response is facilitated since the number of pellets per MUPS dosage form is much more than a conventional pellet-filled capsule and possibility of dose dumping(in stomach) and incomplete drug release is further minimized.</li>\r\n</ul>', '<p>Adult:</p>\r\n\r\n<ul>\r\n	<li>GERD (Gastroesophageal Reflux Disease):&nbsp;20 mg&nbsp;once daily for 4 weeks.</li>\r\n	<li>Gastric ulcer:&nbsp;20 mg&nbsp;once daily for 4-8 weeks; in severe cases Twice daily.</li>\r\n	<li>Duodenal ulcer:&nbsp;20 mg once daily for 2-4 weeks; in severe cases Twice daily.</li>\r\n	<li>NSAID-induced ulceration:&nbsp;20 mg once daily for 4-8 weeks.</li>\r\n	<li>Reflux esophagitis:&nbsp;20 mg once daily for 4-8 weeks; in severe cases Twice daily.</li>\r\n	<li>H. pylori eradication (Omeprazole MUPS tablet with Amoxicillin and Clarithromycin or Metronidazole): 20 mg twice daily for 1 week.</li>\r\n	<li>Zollinger-Ellison Syndrome:&nbsp;60 mg once daily; Usual maintenance, 20-120 mg daily.</li>\r\n</ul>\r\n\r\n<p>Children over 2 years old:</p>\r\n\r\n<ul>\r\n	<li>Acid regurgitation in GERD (Gastroesophageal Reflux Disease):&nbsp;20 mg once daily for 2-4 week.</li>\r\n	<li>Reflux esophagitis:&nbsp;20 mg once daily for 4-8 weeks.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Take the tablet before or after a meal.</li>\r\n	<li>Swallow the tablet whole with a glass of water. The tablet must not be chewed or crushed. OR</li>\r\n	<li>If the patients have trouble swallowing the tablets, put the tablet into a glass of water (Do not use other liquids). Stir the preparation until the tablets disintegrate. Then drink the liquid within 30 minutes. Stir the mixture just always before drinking.</li>\r\n</ul>', '<p>Omeprazole is metabolized through CYP2C19 . When starting or stopping treatment with Omeprazole should be taken into account potential interactions with medicines which are CYP2C19 metabolized.</p>', '<p>Omeprazole is contraindicated in those patients who have known hypersensitivity to any other components of the formulation.</p>', NULL, '<p>Not known to be harmful. Omeprazole can be used during pregnancy. Omeprazole is excreted in breast milk but is not likely to influence the child when therapeutic doses are used.</p>', '<p>Omeprazole tablet should be used carefully if the patient has severe liver dysfunction and severe renal impairment.</p>', NULL, '<p>Proton Pump Inhibitor.</p>', '<p>Store in a cool (below 25&deg;C) and dry place, protected from light and moisture.</p>', NULL, '2022-03-11 05:14:04', '2022-03-11 05:14:04'),
(1085, 1085, '<p>Ondansetron is a serotonin subtype 3 (5-HT3) receptor antagonist indicated:</p>\r\n\r\n<ul>\r\n	<li>Prevention of nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy.</li>\r\n	<li>Prevention and treatment of post-operative nausea and vomiting.</li>\r\n	<li>Prevention of radiotherapy-induced nausea and vomiting.</li>\r\n</ul>', '<p>Ondansetron is a potent, highly selective 5HT3&nbsp;receptor-antagonist. Its precise mode of action in the control of nausea and vomiting is not known. Chemotherapeutic agents and radiotherapy may cause release of 5HT in the small intestine initiating a vomiting reflex by activating vagal afferents via 5HT3&nbsp;receptors. Ondansetron blocks the initiation of this reflex. Activation of vagal afferents may also cause a release of 5HT in the area postrema, located on the floor of the fourth ventricle, and this may also promote emesis through a central mechanism. Thus, the effect of ondansetron in the management of the nausea and vomiting induced by cytotoxic chemotherapy and radiotherapy is probably due to antagonism of 5HT3&nbsp;receptors on neurons located both in the peripheral and central nervous system. The mechanisms of action in post-operative nausea and vomiting are not known but there may be common pathways with cytotoxic induced nausea and vomiting.</p>', '<p>Chemotherapy-Induced Nausea and Vomiting-<br />\r\nAdults, Pediatric patients (6 months to 18 years):</p>\r\n\r\n<ul>\r\n	<li><strong>8 mg tablet/orodispersible tablet</strong>: Three 0.15 mg/kg doses, up to a maximum of 16 mg per dose.</li>\r\n	<li><strong>4 mg orodispersible tablet</strong>: Three 0.15 mg/kg doses, up to a maximum of 16 mg per dose.</li>\r\n	<li><strong>Injection</strong>: Three 0.15 mg/kg doses, up to a maximum of 16 mg per dose, infused intravenously over 15 minutes.</li>\r\n</ul>\r\n\r\n<p>Radiotherapy-Induced Nausea and Vomiting-<br />\r\nAdults:</p>\r\n\r\n<ul>\r\n	<li><strong>8 mg tablet/orodispersible tablet</strong>: Initial Dose: 8 mg orally 1 to 2 hours before radiotherapy. Post Radiotherapy: 8 mg orally every 8 hours for up to 5 days after a course of treatment.</li>\r\n	<li><strong>4 mg orodispersible tablet</strong>: Three 0.15 mg/kg doses, up to a maximum of 16 mg per dose.</li>\r\n	<li><strong>Injection</strong>: Three 0.15 mg/kg doses, up to a maximum of 16 mg per dose, infused intravenously over 15 minutes.</li>\r\n</ul>\r\n\r\n<p>Postoperative Nausea and Vomiting-<br />\r\nAdults:</p>\r\n\r\n<ul>\r\n	<li><strong>8 mg tablet/orodispersible tablet</strong>: 16 mg given as two 8 mg tablets</li>\r\n	<li><strong>4 mg orodispersible tablet</strong>: 16 mg</li>\r\n	<li><strong>Injection</strong>: 4 mg</li>\r\n</ul>\r\n\r\n<p>Pediatrics (&gt;40 kg): Injection: 4 mg<br />\r\nPediatrics (40 kg): Injection: 0.1 mg/kg<br />\r\n<br />\r\n<strong>Oral Soluble Film:</strong><br />\r\nPrevention of nausea and vomiting associated with highly emetogenic cancer chemotherapy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult oral dose</strong>: 24 mg given successively as three 8 mg films 30 minutes before the start of chemotherapy.</li>\r\n</ul>\r\n\r\n<p>Prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and pediatric patients 12 years of age and older</strong>: One 8 mg film 30 minutes before chemotherapy followed by an 8 mg dose 8 hours later. Administer one 8 mg film twice a day (every 12 hours) for 1 to 2 days after completion of chemotherapy.</li>\r\n	<li><strong>Pediatric patients 4 through 11 years of age</strong>: One 4 mg film three times a day. Administer the first dose 30 minutes before chemotherapy, with subsequent doses 4 and 8 hours later. Administer one 4 mg film three times a day (every 8 hours) for 1 to 2 days after completion of chemotherapy.</li>\r\n	<li><strong>Prevention of nausea and vomiting associated with radiotherapy</strong>: The adult dosage is one 8 mg film three times a day.</li>\r\n	<li><strong>Postoperative nausea and vomiting</strong>: The adult dose is 16 mg given successively as two 8 mg films 1 hour before anesthesia.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Administration of Oral Soluble Film:</p>\r\n\r\n<ul>\r\n	<li>Step 1:&nbsp;Tear the pouch carefully along with the edge tear mark.</li>\r\n	<li>Step 2:&nbsp;Put the Ondansetron&nbsp;film on top of your tongue. It will dissolve within 20 seconds</li>\r\n	<li>Step 3:&nbsp;Do not chew or swallow the film whole.</li>\r\n	<li>Step 4:&nbsp;Swallow after the Onsaf oral soluble film dissolves. You may swallow the dissolved film with or without liquid.</li>\r\n	<li>Step 5:&nbsp;Wash your hands after taking Onsaf oral soluble film</li>\r\n</ul>', '<p>The potential for clinically significant drug interactions with Ondansetron appears to be low.</p>', '<p>Contraindicated in patients known to have hypersensitivity to the drug or any of its components. Concomitant use of apomorphine.</p>', '<p>The most common adverse reactions in chemotherapy-induced nausea and vomiting (incidence 7%) are diarrhea, headache and fever. The most common adverse reactions in postoperative nausea and vomiting in adults is headache (incidence 10%), and in pediatric patients aged 1 to 24 months is diarrhea (incidence 2%).</p>', '<p>Pregnancy Category B. Ondansetron is excreted in the breast milk of rats. It is not known whether ondansetron is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when ondansetron is administered to a nursing woman.</p>', '<p>Hypersensitivity reactions, including anaphylaxis and bronchospasm, have been reported with or without known hypersensitivity to other selective 5-HT3 receptor antagonists. QT prolongation occurs in a dose-dependent manner.</p>', NULL, NULL, '<p>Store at temperature not exceeding 30&ordm;C in a dry place. Protect from light and moisture.</p>', '<p><strong>Geriatric Use</strong>: Dosage adjustment is not needed in patients over the age of 65.<br />\r\n<strong>Hepatic Impairment</strong>: A total daily dose of 8mg should not be exceeded (patients with severe hepatic impairment).<br />\r\n<strong>Renal Impairment</strong>: No dosage adjustment is recommended.</p>', '2022-03-11 05:16:25', '2022-03-11 05:16:25'),
(1086, 1086, '<p>Ondansetron is indicated for the prevention and treatment of post-operative nausea and vomiting, and for the management of nausea and vomiting induced by cytotoxic chemotherapy and radiotherapy.</p>', '<p><strong>Pharmacokinetics</strong>:</p>\r\n\r\n<ul>\r\n	<li>Ondansetron is well absorbed from the gastrointestinal tract and undergoes some first-pass metabolism. Mean bioavailability in healthy subjects is approximately 56% and bioavailability is also slightly enhanced by the presence of food and at higher doses but unaffected by antacids.</li>\r\n	<li>Ondansetron is distributed with volume of distribution of 1.9-2.6 L/Kg, indicating that much of the drug is taken up by body tissues. Circulating drug also distributes into erythrocytes. Plasma protein binding is 70% and crosses membranes readily.</li>\r\n	<li>Biotransformation pathways involve the primary metabolic pathway is hydroxylation on the indole ring followed by subsequent glucuronide or sulfate conjugation.</li>\r\n	<li>Ondansetron is excreted in the urine (approximately 65%) and feces (35%) after extensive hepatic metabolism. The plasma half-life is 3.5 hours.</li>\r\n</ul>\r\n\r\n<p><strong>Pharmacodinetics</strong>: Ondansetron is a potent, highly selective 5HT3 receptor-antagonist. Its precise mode of action in the control of nausea and vomiting is not known. Chemotherapeutic agents and radiotherapy may cause release of 5HT in the small intestine initiating a vomiting reflex by activating vagal afferents via 5HT3 receptors. Ondansetron blocks the initiation of this reflex. Activation of vagal afferents may also cause a release of 5HT in the area postrema, located on the floor of the fourth ventricle, and this may also promote emesis through a central mechanism. Thus, the effect of ondansetron in the management of the nausea and vomiting induced by cytotoxic chemotherapy and radiotherapy is probably due to antagonism of 5HT3 receptors on neurons located both in the peripheral and central nervous system. The mechanisms of action in post-operative nausea and vomiting are not known but there may be common pathways with cytotoxic induced nausea and vomiting.</p>', '<p>Chemotherapy-induced Nausea and Vomiting-</p>\r\n\r\n<p>Adults/Geriatric/Child of 12 years or over:</p>\r\n\r\n<ul>\r\n	<li><strong>Highly emetogenic cancer chemotherapy</strong>: 30 ml (24 mg) Ondansetron Oral Solution administered 30 minutes before start of emetogenic chemotherapy.</li>\r\n	<li><strong>Moderate emetogenic cancer chemotherapy</strong>: 10 ml (8 mg) Ondansetron Oral Solution administered 30 minutes before start of emetogenic chemotherapy. A further 10 ml dose should be administered after 8 hours of the first dose. One 10 ml dose should be administered twice a day (every 12 hours) for 1-2 days after completion of chemotherapy.</li>\r\n</ul>\r\n\r\n<p>Pediatric (4-11 years): 5 ml (4 mg) Ondansetron Oral Solution should be taken 30 minutes before the start of chemotherapy. The other 2 doses should be taken 4 and 8 hours after the first dose. Then 5 ml oral solution should be administered 3 times a day (every 8 hours) for 1-2 days after completion of chemotherapy.</p>\r\n\r\n<p><br />\r\nRadiotherapy induced Nausea and Vomiting-</p>\r\n\r\n<p>Adults/Geriatric/Child of 12 years or over:</p>\r\n\r\n<ul>\r\n	<li><strong>The recommended oral dosage</strong>: 10 ml (8 mg) Ondansetron Oral Solution 3 times daily.</li>\r\n	<li><strong>For total body irradiation</strong>: 10 ml (8-mg) Ondansetron Oral Solution should be administered 1 to 2 hours before each fraction of radiotherapy administered each day.</li>\r\n	<li><strong>For single high-dose fraction radiotherapy to the abdomen</strong>: one 10 ml Ondansetron Oral Solution should be administered 1 to 2 hours before radiotherapy, with subsequent doses every 8 hours after the first dose for 1 to 2 days after completion of radiotherapy.</li>\r\n	<li><strong>For daily fractionated radiotherapy to the abdomen</strong>: 10 ml (8-mg) Ondansetron Oral Solution should be administered 1 to 2 hours before radiotherapy, with subsequent doses every 8 hours after the first dose for each day radiotherapy is given.</li>\r\n</ul>\r\n\r\n<p><br />\r\nPostoperative Nausea and Vomiting-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults/Geriatric/Child of 12 years or over</strong>: 20 ml (16 mg) Ondansetron Oral Solution 1 hour before induction of anesthesia</li>\r\n</ul>', '<p>Ondansetron does not itself appear to induce or inhibit the cytochrome P-450 drug-metabolizing enzyme system of the liver. Because Ondansetron is metabolized by hepatic cytochrome P-450 drug-metabolizing enzymes, inducers or inhibitors of these enzymes may change the clearance and hence, the half-life of Ondansetron. On the basis of available data, no dosage adjustment of Ondasetron is recommended for patients on these drugs.</p>', '<p>Ondansetron oral solution is contraindicated for patients known to have hypersensitivity to the drug.</p>', '<p>Frequently reported adverse events were headache, constipation and diarrhea, but the majority have been mild or moderate in nature. In chemotherapy-induced nausea and vomiting, rash has occurred in approximately 1% of patients receiving Ondansetron. There also have been reports to a sensation of flushing or warmth, hiccups and liver enzyme abnormalities. Rare cases of anaphylaxis, brochospasm, tachycardia, angina (chest pain), hypokalemia, shortness of breath have also been reported, except for bronchospasm and anaphylaxis, the relationship to Ondansetron&nbsp;is unclear. There have been no evidence to extrapyramidal reactions, in rare case oculogyric crisis appearing alone, as well as with other dystonic reactions without definitive clinical evidence. In case of PONV, with the exception of headache, rates of these events were not significantly different in the Ondansetron and placebo groups.</p>', '<p>Carcinogenic effects were not seen in 2-year studies in rats and mice with oral Ondansetron doses up to 10 and 30 mg/kg per day, respectively. Ondansetron was not mutagenic in standard tests for mutagenicity. Oral administration of Ondansetron up to 15 mg/kg per day did not affect fertility or general reproduction performance of male and female rats.<br />\r\n<br />\r\nReproduction studies have been performed in pregnant rats and rabbits at daily oral doses up to 15 and 30 mg/kg per day, respectively, and have revealed no evidence of impaired fertility or harm to the fetus due to Ondansetron. There are, however, no adequate and well-controlled studies in pregnant women. Ondansetron is excreted in the breast milk of rats. So caution should be exercised when Ondansetron is administered to a nursing women.</p>', '<p>Hypersensitivity reactions have been reported in patients who have exhibited hypersensitivity to other selective 5-HT3 receptor antagonists. Ondansetron is not a drug that stimulates gastric or intestinal peristalsis. It should not be used instead of nasogastric suction. The use of Ondansetron in patients following abdominal surgery or in patients with chemotherapy-induced nausea and vomiting may mask a progressive ileus and/or gastric distension.</p>', '<p>There is no specific antidote for Ondansetron overdose. In addition to the adverse events, hypotension (and faintness) occurred in a patient that took 60 ml of Ondansetron oral solution. In all instances, the events resolved completely.</p>', '<p>Anti-emetic drugs.</p>', '<p>Store in a cool and dry place below 30&ordm;C. Protect from light. keep out of reach of children.</p>', '<p>Dosage Adjustment for Patients With Impaired Renal Function: The dosage recommendation is the same as for the general population.<br />\r\n<br />\r\nDosage Adjustment for Patients With Impaired Hepatic Function: In patients with severe hepatic impairment, a single maximal daily dose of 8 mg to be infused over 15 minutes beginning 30 minutes before the start of the emetogenic chemotherapy is recommended.<br />\r\n<br />\r\nLittle information is available about dosage in pediatric patients 4 years of age or younger.<br />\r\n<br />\r\nDosage adjustment is not needed in patients over the age of 65.</p>', '2022-03-11 05:18:31', '2022-03-11 05:18:31'),
(1087, 1087, '<p>Oral Cholera Vaccine is indicated for active immunization against Vibrio cholerae. The vaccine can be administered to anyone above the age of 1 year. Data for the safety and efficacy of the vaccine in infants (less than 1 year of age) is not available. The earliest onset of protection can be expected 7-10 days after the completion of the primary series of the vaccine. Efficacy against Vibrio cholerae serogroup O139 was not demonstrated.</p>', NULL, '<p>The recommended dose of the vaccine (1.5 ml) is to be administered orally. The primary immunization schedule consists of two doses given at an interval of at least two weeks. Cholera vaccine should not be administered parenterally (intramuscular, subcutaneous or intravenously). The vaccine is only recommended for oral administration.<br />\r\n<br />\r\nMethod of administration: The vaccine is presented as a suspension. After vigorous shaking of the vial, 1.5 ml should be poured into the mouth of the recipient. The vaccine administration may be optionally followed by water to facilitate ingestion, if needed. The vaccine can alternatively be administered with a disposable syringe (without needle) after removing the contents from the vial and squirted into the mouth of the recipient. The vaccine should not be administered parenterally (intramuscular, subcutaneous or intravenously). The vaccine is only recommended for oral administration.</p>', NULL, '<p>Cholera vaccine should not be administered to subjects with either known hypersensitivity to any component of vaccine, or having shown signs of hypersensitivity after previous administration of the vaccine. Formaldehyde is used during the manufacturing process and trace amounts may be present in the final product. Caution should be taken in subjects with known hypersensitivity to formaldehyde. CVV V.N. 02 TM As with other vaccines, immunization with the cholera vaccine should be delayed in the presence of any acute illness, including acute gastrointestinal illness or acute febrile illness. A minor illness such as mild upper respiratory tract infection is not a reason to postpone immunization.</p>', '<p>The following adverse events are known to occur with cholera vaccine use. Acute gastroenteritis, diarrhea, fever, vomiting, abdominal pain, itching, rash, nausea, weakness, cough, vertigo, dryness of mouth, oral ulcer (rare), sore throat (rare) and yellowing of urine (rare). It has been observed that the incidence of adverse events is less after the second dose as compared to the first.</p>', '<p>No specific clinical studies have been performed to evaluate the safety and immunogenicity of cholera vaccine in pregnant women and for the fetus. However, administration of cholera vaccine to pregnant women and nursing mother may be considered after careful evaluation of the benefits and risks in case of a medical emergency or an epidemic.</p>', '<p>Vaccination should be provided by a review of the medical history (especilly with regard to previous vaccination &amp; possible occurrence of the undesirable events) and a clinical examination. As with any vaccine immunization with the cholera vaccine may not protect 100% susceptible individuals. This vaccine is also not a substitute for therapy in case of individuals suspected to be suffering from cholera or showing signs and symptoms of an acute episode of gastro intestinal disease or acute watery diarrhea. Immunocompromised persons (subsequent to a disease or immunosuppressive therapy) may not obtain the expected immune response after vaccination with the cholera vaccine. If possible, in the opinion of the medical practitioner, due consideration should be given to postpone vaccination until after the completion of the immunosuppressive treatment. As with all vaccines, appropriate medical treatment should always be available in case of a rare event of anaphylactic reactions following the administration of the vaccine. For this reason, it is recommended that the vaccinee should remain under medical supervision for at least 30 minutes after vaccination.</p>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', '<p>Keep out of the reach and sight of children. Store at +2 &ordm;C to +8 &ordm;C. Transportation should also be at +2 &ordm;C to +8 &ordm;C. Do not freeze. Discard vaccine if frozen. Protect from light.</p>', NULL, '2022-03-11 05:20:10', '2022-03-11 05:20:10'),
(1088, 1088, '<p>Polio&nbsp;vaccines are vaccines used to prevent poliomyelitis (polio)</p>', '<p>Parenteral inactivated poliovirus vaccine(IPV) chiefly induces formation of serum antibody. Infection, with oral poliovirus vaccine (OPV) or wild poliovirus, also induces development of secretory IgA antibody. In addition, infection results in virus shedding and, hence, in possible spread of virus to contacts (more likelywith wild than with vaccine virus). IPV induces a high level (90%&ndash;95%) of protection against disease, which presumably is mediated by serum antibody that prevents CNS invasion resulting from viremia. IPV induces little protection against infection but does modify the related virus shedding- chiefly that from the oropharynx. Infection, whether by OPV or wild virus, induces a high level of protection against disease. It also results in appreciable prevention or modification of infection because of the developmentof secretoryIgA antibody. This effect is directly protective for the vaccinee and also benefits the community, since the exposed vaccinee can play little or no part in the spread of wild virus. One major question remaining concerns the maintenance of immunity. Lifelong immunologic memory assures an enhanced serum antibody response to any infection that occurs, but will it be sufficiently rapid that when preinfection antibody cannot be detected newly formed antibody will block blood-borne viral invasion of the CNS? If not, booster doses of vaccineare indicated. OPV boosters might be indicated in any case to reinforce protection against infection and so maintain herd immunity.</p>', '<p>3 doses course, each dose (2-3 drops) given orally at an interval of 6-8 weeks.</p>', NULL, '<p>Diarrhoea; Hypogammaglobulinemia. Febrile illness or any active infection is present.</p>', '<p>Paralysis (very rarely reported).</p>', '<p>Data not available</p>', NULL, NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', NULL, NULL, '2022-03-11 05:21:57', '2022-03-11 05:21:57'),
(1089, 1089, '<p>Indicated for Diarrhea, Dehydration, Vomiting, Fluid and Electrolytes imbalance.</p>', '<p><strong>Potassium chloride</strong>&nbsp;is a major cation of the intracellular fluid. It plays an active role in the conduction of nerve impulses in the heart, brain and skeletal muscle; contraction of cardiac skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism and gastric secretion.<br />\r\n<br />\r\n<strong>Sodium chloride</strong>&nbsp;is the major extracellular cation. It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes.<br />\r\n<br />\r\nIt is also used as diluents for infusion of compatible drug additives.<br />\r\n<br />\r\n<strong>Dextrose</strong>&nbsp;is a monosaccharide that is used as a source of calories and water for hydration. It helps to reduce loss of body protein and nitrogen. It also promotes glycogen deposition in the liver. When used with insulin, it stimulates the uptake of potassium by cells, especially in muscle tissue, thus lowering serum potassium levels.<br />\r\n<br />\r\n<strong>Sodium bicarbonate</strong>&nbsp;raises blood and urinary pH by dissociation to provide bicarbonate ions, which neutralises the hydrogen ion concentration. It also neutralises gastric acid via production of carbon dioxide.</p>', '<p>Daily dose should be equivalent to patients fluid requirement for maintenance and replenishment of losses. During saline therapy mother should not stop breast-feeding to their child and normal food should be continued in case of adults.<br />\r\n<br />\r\n<strong>Children less than 2 years:</strong>&nbsp;After each loose stool or vomiting 10 to 20 spoonful (50-100 ml) of prepared saline.<br />\r\n<br />\r\n<strong>Children 2 to 10 years:</strong>&nbsp;After each loose stool or vomiting 100-200 ml of prepared oral saline.<br />\r\n<br />\r\n<strong>Adult and children above 10 years:</strong>&nbsp;After each loose stool or vomiting 200-400 ml of prepared saline.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Patients with known hypersensitivity.</p>', '<p>No significant side effects.</p>', '<p>Pregnancy Category- Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Depressed renal function, severe continuing diarrhoea or other critical fluid losses may need supplementation with parenteral fluids along with oral saline. Reconstitue saline should be used within 6 hours.</p>', NULL, '<p>Oral electrolytes preparations</p>', NULL, NULL, '2022-03-11 05:47:45', '2022-03-11 05:47:45'),
(1090, 1090, '<p>Oral Rehydration Salt replacement of fluid and electrolyte loss due to-</p>\r\n\r\n<ul>\r\n	<li>Acute diarrhea</li>\r\n	<li>Vomiting</li>\r\n	<li>Dehydration</li>\r\n</ul>\r\n\r\n<p>Other conditions of fluid loss or lack of intake in patients of all age groups.</p>', '<p>This is the preparation of oral rehydration salt. It is composed of anhydrous glucose, sodium chloride, potassium chloride and sodium citrate (as dihydrate). This is a single formulation of glucose based oral rehydration salt to treat or prevent dehydration from diarrhea of any etiology, including cholera and in individuals of any age. This also prevents acidosis due to electrolyte imbalance.</p>', '<p>Daily dose should be equivalent to patients&#39; fluid requirement for maintenance and replenishment of losses. During this therapy, mother should not stop breastfeeding to their child and normal food should be continued in case of adults.<br />\r\n<br />\r\n<strong>Children less than 2 years</strong>: After each loose stool or vomiting 50-100 mL (10 to 20 teaspoonful) of prepared this.<br />\r\n<br />\r\n<strong>Children 2 to 10 years</strong>: After each loose stool or vomiting 100-200 mL (1/2 to 1 glass) of prepared oral saline.<br />\r\n<br />\r\n<strong>Adult and children above 10 years</strong>: After each loose stool or vomiting 200-400 mL (1 to 2 glass) of prepared this.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Disperse the full contents of the sachet in 500 mL (1/2 liter) of pure drinking water.</li>\r\n	<li>Do not mix the oral saline with hot water or heat the prepared solution.</li>\r\n	<li>Discard the unused prepared oral saline after 12 hours of preparation.</li>\r\n</ul>', '<p>There are no known drug interactions and none well documented.</p>', NULL, NULL, NULL, '<p>Depressed renal function, severe continuing diarrhea or other critical fluid losses may need supplementation with parenteral fluids along with oral saline.</p>', NULL, '<p>Oral electrolytes preparations</p>', '<p>Do not store above 30&deg;C temperature. Keep away from light and wet places. Keep out of reach of children.</p>', NULL, '2022-03-11 05:49:12', '2022-03-11 05:49:12'),
(1091, 1091, '<p>This saline is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Acute fluid and electrolyte loss conditions such as cholera, acute diarrhea &amp; vomiting</li>\r\n	<li>Dehydration</li>\r\n	<li>Severely low concentrations of salts in the blood (severe electrolyte depletion)</li>\r\n</ul>', '<p>This saline contains essential electrolytes &amp; carbohydrate (in the form of processed rice) which are vital for a dehydrating patient in conditions such as cholera, acute diarrhoea, vomiting &amp; excessive sweating.<br />\r\n<br />\r\nIn the normal healthy intestine, there is a continuous exchange of water through the intestinal wall- up to 20 liters of water is secreted and very nearly as much is reabsorbed every 24 hours- this mechanism allows the absorption of soluble metabolites from digested food into the bloodstream.<br />\r\n<br />\r\nIn a state of diarrheal disease, the balance is upset and much more water is secreted than is reabsorbed causing a net loss to the body which can be as high as several liters a day. In addition to water, Chloride ion (CI-), extracellular sodium ion (Na+) &amp; intracellular potassium ion (K+) are also lost. This saline is effectively replenishes the lost electrolytes in the body.<br />\r\n<br />\r\nThe pharmacokinetics and therapeutic values of the substances of this saline are as follows:</p>\r\n\r\n<ul>\r\n	<li>Glucose (comes from rice) facilitates the absorption of sodium (and hence water) on a 1:1 molar basis in the small intestine</li>\r\n	<li>Sodium and potassium are needed to replace the body losses of these essential ions during diarrhoea and vomiting</li>\r\n	<li>Citrate corrects the acidosis that occurs as a result of diarrhoea and dehydration</li>\r\n</ul>\r\n\r\n<p>Rice, a carbohydrate is converted to glucose through digestion. Glucose is then absorbed through intestinal wall with salt. Addition of rice (instead of pure glucose) to this formula reduces the osmolarity of the solution,thus preventing additional loss of fluid through stools.</p>', '<p>The dose depends on the severity of the dehydrating conditions of the patients. Recommended dose after each watery stool are as follows:</p>\r\n\r\n<ul>\r\n	<li><strong>6 months to 2 years</strong>: 50 ml to 100 ml (10 to 20 Teaspoonfuls)</li>\r\n	<li><strong>2 years to 9 years</strong>: 100 ml to 200 ml (20 to 40 teaspoonfuls)</li>\r\n	<li><strong>10 years and above</strong>: 250 ml to 500 ml (1 to 2 glassfuls)</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Discard any unused reconstituted saline after 5 hours of preparation</li>\r\n	<li>After preparing the saline further heating or boiling is not necessary</li>\r\n	<li>Feeding-bottle should not be used</li>\r\n	<li>Mix the solution with a clean spoon each time before administration</li>\r\n	<li>Syringe without needle may be used to put a small amount of saline into babies&#39; mouth</li>\r\n</ul>', '<p>There is no known drug interaction reported.</p>', '<ul>\r\n	<li>Kidney failure resulting in diminished production of urine (oliguria)</li>\r\n	<li>Kidney failure, preventing the production of urine (anuria)</li>\r\n	<li>Obstruction of the stomach or intestines</li>\r\n	<li>Reduced blood flow to vital internal organs (shock)</li>\r\n	<li>Severe and continuous vomiting (intractable vomiting)</li>\r\n	<li>Severe dehydration</li>\r\n	<li>Severe diarrhea in infants.</li>\r\n</ul>', NULL, '<p>Recommended in pregnancy &amp; lactation, as there is no known harmful effects when this medicine is used.</p>', '<p>Precautions should be taken in case of significant overdose, especially for the following patients-</p>\r\n\r\n<ul>\r\n	<li>Children less than 1 year of age.</li>\r\n	<li>Patients with imbalance of salt concentrations in the blood (electrolyte imbalance).</li>\r\n	<li>Patients with severely decreased kidney and liver function.</li>\r\n</ul>', NULL, '<p>Oral electrolytes preparations.</p>', '<p>Store in a cool &amp; dry place, protected from light &amp; moisture.</p>', NULL, '2022-03-11 05:50:47', '2022-03-11 05:50:47'),
(1092, 1092, '<p><strong>Adults</strong>: Orlistat is indicated in conjunction with a mildly hypocaloric diet for the treatment of obese patients with a body mass index (BMI)&gt;30 kg/m2&nbsp;and overweight patients (BMI &gt;28 kg/m2&nbsp;) with associated risk factors such as type II diabetes, hyperlipidemia and hypertension. Treatment with Orlistat should be discontinued after 12 weeks in patients who have not lost at least 5% of their body weight as measured at the start of drug therapy.<br />\r\n<br />\r\n<strong>Adolescents (12 years &amp; older)</strong>: Obese adolescents should be treated with Orlistat only if an adequate reduction of body weight cannot be achieved by means of diet &amp; increased physical activity. Treatment with orlistat should be considered in particular if complications of obesity are present.</p>', '<p>Orlistat is a potent, specific and long-acting lipase inhibitor. It exerts its therapeutic activity in the lumen of the stomach and upper small intestine by forming a covalent bond with the active serine site of gastric and pancreatic lipases. The inactivated enzyme is thus rendered unable to hydrolyze dietary fats in the form of triglycerides into absorbable free fatty acids and monoglycerides. As undigested triglycerides can not be absorbed, a caloric deficit arises which has a positive effect on weight control. Systemic absorption of orlistat is therefore not needed for the activity. At the recommended therapeutic dose of 120 mg three times a day, orlistat inhibit dietary fat absorption by approximately 30%.</p>', '<p>The recommended dose of Orlistat is one 120 mg capsule to be taken immediately before, during or up to one hour after each main meal. If a meal is missed or contains no fat the dose of Orlistat should be omitted. Doses of Orlistat above 120 mg three times daily have not been shown to provide additional benefits. The effect of Orlistat results in an increase in fecal fat 24-48 hours after dosing. Upon discontinuation of therapy, fecal fat content usually returns to pretreatment levels within 48-72 hours.<br />\r\n<br />\r\nThe safety &amp; efficacy of Orlistat were investigated in clinical studies lasting up to 4 years. The recommended dose of Orlistat for adolescents is as same as adults.<br />\r\n<br />\r\nSpecial dosage instruction: The tolerability and efficacy of Orlistat have not been studied in elderly patients, or patients with hepatic and/ or renal impairments.</p>', '<p>No interactions with commonly prescribed medications such as alcohol, digoxin, nifedipine, oral contraceptives, phenytoin, pravastatin, warfarin, or metformin, glibenclamide, fibrates, furosemide, captopril, or atenolol have been observed in studies.</p>', '<p>Orlistat is contraindicated in patients with chronic malabsorption syndrome, in patients with cholestasis and in patients who are hypersensitive to orlistat or to any of the other ingredients of the capsules.</p>', '<p><strong>Common</strong>: Undesirable effects of Orlistat are largely gastrointestinal in nature. Common gastrointestinal side effects are oily spotting from the rectum, flatulence, fecal urgency, oily or fatty stool, abdominal discomfort etc.<br />\r\n<br />\r\n<strong>Rare</strong>: Influenza, anxiety. headache, fatigue etc may rarely occur in some patients. Rare cases of hypersensitivity have been reported. Main clinical symptoms are pruritus, exanthema, urticaria, angioedema and anaphylaxis.</p>', '<p>Use in pregnancy &amp; lactation: No clinical data are available on pregnancy exposed to Orlistat. As it is not known whether Orlistat is excreted in breast milk. Orlistat should not be used during breastfeeding.</p>', '<p>Organic causes of obesity (e.g. hypothyroidism) should be excluded before prescribing Orlistat. Orlistat and cyclosporine should not be coadministered. Cyclosporine should be taken at least 2 hours before or after Orlistat in patients taking both drugs. Cyclosporine level should be measured and frequently monitored.<br />\r\n<br />\r\nIn clinical trial, the decrease in body weight with Orlistat therapy was less in type II diabetic patients than in non-diabetic patients. Antidiabetic drug treatment should be closely monitored during Orlistat therapy. Because of the improvement in glycemic control, the dose of oral antidiabetics or of insulin may need to be adjusted.<br />\r\n<br />\r\nPatients should be advised to adhere to the dietary recommendations. The probability of occurrence of gastrointestinal side effects may increase when Orlistat is taken with a fatty meal. The daily intake of fat should be distributed between three main meals. Patients should be strongly encouraged to take a multivitamin supplement that contains fat soluble vitamins to ensure adequate nutrition because orlistat has been shown to reduce the absorption of some fat soluble vitamins &amp; beta-carotene. In addition, the levels of vitamin D &amp; beta carotene may be low in obese patients compared with non-obese patients.</p>', '<p>Single doses of 800 mg Orlistat and multiple doses of up to 400 mg three times a day for 15 days have been studied in normal weight and obese subjects without significant adverse findings.</p>', '<p>Appetite suppressant drugs/Anti-obesity drugs</p>', '<p>Store in cool &amp; dry place below 30&deg;C, protect from light &amp; moisture. Keep out of reach of children.</p>', NULL, '2022-03-11 05:53:15', '2022-03-11 05:53:15'),
(1093, 1093, '<p>Ornidazole is indicated for Amoebiasis (Intestinal and hepatic), Giardiasis, Trichomoniasis, Bacterial vaginosis, Treatment of susceptible anaerobic infections.</p>', '<p>Ornidazole is a 5-nitroimidazole derivative active against protozoa and anaerobic bacteria. It is converted to reduction products that interact with DNA to cause destruction of helical DNA structure and strand leading to a protein synthesis inhibition and cell death in susceptible organisms.</p>', '<p>Amoebiasis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 500 mg twice a day for 5 days.</li>\r\n	<li><strong>Children</strong>: 10-25 mg per kg body weight in two divided doses.</li>\r\n</ul>\r\n\r\n<p>Amoebic dysentery:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 1.5 gm once a day for 3 days.</li>\r\n	<li><strong>Children</strong>: 40 mg per kg body weight, once a day for 3 days.</li>\r\n</ul>\r\n\r\n<p>Giardiasis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 1.5 gm once daily for 1-2 days.</li>\r\n	<li><strong>Children</strong>: 40 mg per kg body weight for 2 days.</li>\r\n</ul>\r\n\r\n<p><strong>Trichomoniasis</strong>: 1.5 gm once or 500 mg twice a day for 5 days. Sexual partner should also be treated at the same time.<br />\r\n<br />\r\n<strong>Bacterial vaginosis</strong>: 3 tablets of 500 mg each as a single dose or one tablet of 500 mg once daily for 5-7 days.</p>', '<p>Like other imidazoles, Ornidazole has a mild potential to cause disulfiramlike reactions. Concomitant administration of oral anticoagulants may increase the risk of haemorrhage due to diminished hepatic metabolism. Ornidazole has been reported to decrease the clearance of 5-fluorouracil.</p>', '<p>Previous hypersensitivity to Ornidazole and to other nitroimidazoles. Ornidazole is contraindicated in central nervous system disorders, particularly in epilepsy or in peripheral neuropathy.</p>', '<p>Side effects of Ornidazole have been mainly limited to the gastrointestinal tract (nausea, vomiting, epigastric pain) and central nervous system (dizziness, headache, lassitude). Unlike other nitroimidazoles, Ornidazole does not interact with alcohol, although this requires further study.<br />\r\n<br />\r\nLeukopenia has been described occasionally during therapy. Adverse central nervous system (CNS) effects of Ornidazole have mainly included headache, dizziness, lassitude or somnolence, fatigue and weakness. Adverse CNS effects of Ornidazole may be less than that happens with metronidazole. Seizures have not been reported with Ornidazole in studies available to date.</p>', '<p>Adequate clinical trials have not been conducted. Ornidazole should be prescribed only if the potential benefit justifies the potential risk to fetus/neonate.</p>', '<p>In patient with ataxia, vertigo, and mental confusion, Ornidazole should be prescribed with caution. During prolonged treatment with Ornidazole, blood dyscrasia namely mild leukopenia have been reported rarely. In case leukopenia occurs, the decision to discontinue the therapy should depend upon the gravity of infection.</p>', NULL, '<p>Amoebicides, Anti-diarrhoeal Antiprotozoal.</p>', '<p>Store at room temperature and protect from light and moisture.</p>', '<p><strong>Renal Impairment</strong>&nbsp;Haemodialysis patients: Give a supplemental dose (50% of the usual dose) before dialysis.<br />\r\n<br />\r\n<strong>Hepatic Impairment Severe</strong>: Double the interval between doses.</p>', '2022-03-11 05:55:11', '2022-03-11 05:55:11'),
(1094, 1094, '<p>Oseltamivir is indicated for prevention of flu (influenza) in adults and adolescents aged 13 years and over who have been in contact with someone diagnosed with flu; treatment of flu (influenza) in adults and in children over one year of age when the influenza virus is circulating in the community.</p>', '<p>Oseltamivir is a prodrug of oseltamivir carboxylate. Oseltamivir carboxylate inhibits neuraminidase (sialidase), a viral surface enzyme which is responsible for the replication and infectivity of influenza virus A and B, thereby preventing the release of viruses from infected cells.</p>', '<p>Oseltamivir Phosphate may be taken with or without food. However, when taken with food, tolerability may be enhanced in some patients.<br />\r\n<br />\r\nStandard oral dose for the treatment of influenza:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and Adolescents</strong>: The recommended oral dose of Oseltamivir for treatment of influenza in adults and adolescents 13 years and older is 75 mg twice daily for 5 days. Treatment should begin within 2 days of onset of symptoms of influenza.</li>\r\n	<li><strong>Pediatric patients</strong>: The safety and efficacy of Oseltamivir for prophylaxis of influenza in pediatric patients younger than 13 years of age have not been established.</li>\r\n</ul>\r\n\r\n<p>Recommended oral dose for the treatment of influenza:</p>\r\n\r\n<ul>\r\n	<li><strong>For prophylaxis of influenza in adults and adolescents 13 years and older following close contact with an infected individual</strong>: 75 mg once daily for at least 7 days. Therapy&nbsp;should begin within 2 days of exposure.</li>\r\n	<li><strong>For prophylaxis during a community outbreak of influenza</strong>: 75 mg once daily. Safety and efficacy have been demonstrated for up to 6 weeks. The duration of protection lasts for as long as dosing is continued.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>May be taken with or without food. May be taken with meals to reduce GI discomfort. Cap may be opened &amp; mixed with sweetened food products eg chocolate syr, sweetened condensed milk, apple sauce or yogurt. Swallow mixture immediately after preparation.</p>', '<p>Information derived from pharmacology and pharmacokinetic studies of Oseltamivir suggests that clinically significant drug interactions are unlikely. Co-administration with amoxicillin does not alter plasma levels of either compound.</p>', '<p>Oseltamivir is contraindicated in patients with known hypersensitivity to any of the components of the product.</p>', '<p>The most frequently reported adverse events are nausea and vomiting. These events generally of mild to moderate degree and usually are occurred on the first 2 days of administration. Additional adverse events occurring in &lt;1% of patients receiving Oseltamivir for treatment include unstable angina, anemia, pseudomembranous colitis, humerus fracture, pneumonia, pyrexia, and peritonsillar abscess.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C: There are insufficient human data upon which to base an evaluation of risk of Oseltamivir Phosphate to the pregnant woman or developing fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers:</strong>&nbsp;It is not known whether oseltamivir or oseltamivir carboxylate is excreted in human milk. Oseltamivir Phosphate should, therefore, be used only if the potential benefit for the lactating mother justifies the potential risk to the breast-fed infant.</p>', '<p>There is no evidence for efficacy of Oseltamivir Phosphate in any illness caused by agents other than influenza viruses Types A and B. Efficacy of Oseltamivir Phosphate in patients who begin treatment after 40 hours of symptoms has not been established.</p>', '<p>At present there has been no experience of over dose. Single dose of up to 1000 mg of Oseltamivir have been associated with nausea and/or vomiting.</p>', '<p>Respiratory viral infections (Influenza).</p>', '<p>Store at 25&deg;C. Reconstituted susp: Store between 2-8&deg;C for up to 17 days or at 25&deg;C for up to 10 days. Do not freeze.</p>', '<p><strong>Hepatic Impairment:</strong>&nbsp;The safety and pharmacokinetics in patients with hepatic impairment have not been evaluated.<br />\r\n<br />\r\n<strong>Renal Impairment:</strong>&nbsp;Dose adjustment is recommended for patients with a serum creatinine clearance &lt;30 mL/min.<br />\r\n<br />\r\n<strong>Geriatric Use:</strong>&nbsp;The safety of Oseltamivir Phosphate has been established in clinical studies.<br />\r\n<br />\r\n<strong>Pediatric Use:</strong>&nbsp;The safety and efficacy of Oseltamivir Phosphate in pediatric patients younger than 1 year of age have not been studied. Oseltamivir Phosphate is not indicated for either treatment or prophylaxis of influenza in pediatric patients younger than 1 year of age.</p>', '2022-03-11 05:57:13', '2022-03-11 05:57:13');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1095, 1095, '<p>Osimertinib is indicated for the treatment of patients with metastatic&nbsp;epidermal growth factor receptor&nbsp;(EGFR) T790M mutation-positive&nbsp;non-small cell lung cancer&nbsp;(NSCLC), as detected by an FDA-approved test, whose disease has progressed on or after EGFR tyrosine kinase inhibitor (TKI) therapy.</p>', '<p>Osimertinib is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that binds to certain mutant forms of EGFR (T790M, L858R, and exon 19 deletion) that predominate in non-small cell lung cancer (NSCLC) tumours following treatment with first-line EGFR-TKIs. As a third-generation tyrosine kinase inhibitor, osimertinib is specific for the gate-keeper T790M mutation which increases ATP binding activity to EGFR and results in poor prognosis for late-stage disease. Furthermore, osimertinib has been shown to spare wild-type EGFR during therapy, thereby reducing non-specific binding and limiting toxicity.</p>', '<p>The recommended dose of Osimertinib is 80 mg once a day until disease progression or unacceptable toxicity. Osimertinib can be taken with or without food. If a dose of Osimertinib is missed, do not make up the missed dose and take the next dose as scheduled.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p><strong>Administration To Patients Who Have Difficulty Swallowing Solids:&nbsp;</strong>Disperse tablet in 60 ml (2 ounces) of non-carbonated water only. Stir until tablet is dispersed into small pieces (the tablet will not completely dissolve) and swallow immediately. Do not crush, heat, or ultrasonicate during preparation. Rinse the container with 120 ml to 240 ml (4 to 8 ounces of) water and immediately drink.<br />\r\n<br />\r\nIf administration via&nbsp;nasogastric tube&nbsp;is required, disperse the tablet as above in 15 ml of non-carbonated water, and then use an additional 15 ml of water to transfer any residues to the syringe. The resulting 30 ml liquid should be administered as per the nasogastric tube instructions with appropriate water flushes (approximately 30 ml).</p>', '<p><strong>Strong CYP3A4 Inducers</strong>: If concurrent use is unavoidable, increase Osimertinib dosage to 160 mg daily when coadministering with a strong CYP3A inducer. Resume Osimertinib at 80 mg 3 weeks after discontinuation of the strong CYP3A4 inducer.</p>', NULL, '<p>Common side effects are&nbsp;Interstitial Lung Disease or Pneumonitis,&nbsp;QTc Interval Prolongation, Cardiomyopathy, Keratitis</p>', '<p><strong>Use in Pregnancy</strong>:&nbsp;There are no or limited amount of data from the use of Osimertinib in pregnant women. Studies in animals have shown reproductive toxicity. Based on its mechanism of action and preclinical data, Osimertinib may cause foetal harm when administered to a pregnant woman. Administration of osimertinib to pregnant rats was associated with embryolethality, reduced foetal growth and neonatal death at exposures similar to what is expected in humans. Osimertinib is not recommended during pregnancy and in women of childbearing potential not using contraception.<br />\r\n<br />\r\n<strong>Use in Lactation</strong>:&nbsp;It is not known whether osimertinib or its metabolites are excreted in human milk. Administration to rats during gestation and early lactation was associated with adverse effects, including reduced growth rates and neonatal death. There is insufficient information on the excretion of osimertinib or its metabolites in animal milk. A risk to the suckling child cannot be excluded. Breast-feeding should discontinue during treatment with Osimertinib.<br />\r\n<br />\r\n<strong>Fertility</strong>:&nbsp;There are no data on the effect of Osimertinib on human fertility. Results from animal studies have shown that Osimertinib has effects on male and female reproductive organs and could impair fertility.</p>', NULL, NULL, '<p>Cytotoxic Chemotherapy.</p>', '<p>Store Osimertinib at room temperature between 20&deg;C to 25&deg;C. Safely throw away medicine that is out of date or that you no longer need. Keep Osimertinib and all medicines out of the reach of children.</p>', NULL, '2022-03-11 05:58:50', '2022-03-11 05:58:50'),
(1096, 1096, '<p>Ospemifene is indicated for:</p>\r\n\r\n<ul>\r\n	<li>The Treatment of Moderate to Severe Dyspareunia, a Symptom of Vulvar and Vaginal Atrophy, Due to Menopause.</li>\r\n	<li>The Treatment of Moderate to Severe Vaginal Dryness, a Symptom of Vulvar and Vaginal Atrophy, Due to Menopause.</li>\r\n</ul>', '<p>Ospemifene is an estrogen receptor agonist/antagonist with tissue selective effects. Its biological actions are mediated through binding to estrogen receptors. This binding results in activation of estrogenic pathways in some tissues (agonism) and blockade of estrogenic pathways in others (antagonism).</p>', '<p>Ospemifene is an estrogen agonist/antagonist which has agonistic effects on the endometrium. Use of Ospemifene should be for the shortest duration consistent with treatment goals and risks for the individual woman. Postmenopausal women should be re-evaluated periodically as clinically appropriate to determine if treatment is still necessary.</p>\r\n\r\n<ul>\r\n	<li>Treatment of Moderate to Severe Dyspareunia, a Symptom of Vulvar and Vaginal Atrophy, Due to Menopause: Take one 60 mg tablet with food once daily.</li>\r\n	<li>Treatment of Moderate to Severe Vaginal Dryness, a Symptom of Vulvar and Vaginal Atrophy, Due to Menopause: Take one 60 mg tablet with food once daily.</li>\r\n</ul>', '<ul>\r\n	<li>Do not use estrogens or estrogen agonist/antagonist concomitantly with Ospemifene.</li>\r\n	<li>Do not use fluconazole concomitantly with Ospemifene. Fluconazole increases serum concentrations of Ospemifene.</li>\r\n	<li>Do not use rifampin concomitantly with Ospemifene. Rifampin decreases serum concentration of Ospemifene.</li>\r\n</ul>', '<p>Ospemifene is contraindicated in women with any of the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Undiagnosed abnormal genital bleeding</li>\r\n	<li>Known or suspected estrogen-dependent neoplasia</li>\r\n	<li>Active DVT, pulmonary embolism (PE), or a history of these conditions</li>\r\n	<li>Active arterial thromboembolic disease [for example, stroke and myocardial infarction (MI)], or a history of these conditions</li>\r\n	<li>Hypersensitivity (for example, angioedema, urticaria, rash, pruritus) to Ospemifene or any ingredients</li>\r\n	<li>Ospemifene is contraindicated in women who are or may become pregnant. Ospemifene may cause fetal harm when administered to a pregnant woman. Ospemifene was embryo-fetal lethal with labor difficulties and increased pup deaths in rats at doses below clinical exposures, and embryo-fetal lethal in rabbits at 10 times the clinical exposure based on mg/m 2 . If this drug is used during pregnancy, or if a woman becomes pregnant while taking this drug, she should be apprised of the potential hazard to a fetus.</li>\r\n</ul>', '<p>Adverse reactions (&ge;1 percent) include hot flush, vaginal discharge, muscle spasms, headache, hyperhidrosis, vaginal hemorrhage, night sweats.</p>', '<p><strong>Pregnancy</strong>: Ospemifene is contraindicated in women who are or may become pregnant. If this drug is used during pregnancy, or if a woman becomes pregnant while taking this drug, she should be apprised of the potential hazard to a fetus. Based on animal data, Ospemifene is likely to increase the risk of adverse outcomes during pregnancy and labor. Adverse findings at maternally toxic doses included embryofetal lethality in rats and rabbits, and neonatal mortality and difficult labor in rats. The reproductive effects observed are consistent with and are considered to be related to the estrogen receptor activity of Ospemifene.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether Ospemifene is excreted in human breast milk. There are no data on the effects of Ospemifene on the breastfed child or the effects on milk production. Do not breastfeed while taking Ospemifene. Ospemifene was excreted in rat milk</p>', '<ul>\r\n	<li>Venous Thromboembolism: Risk of DVT and pulmonary embolism</li>\r\n	<li>Known, suspected, or history of breast cancer</li>\r\n	<li>Severe Hepatic Impairment</li>\r\n</ul>', NULL, '<p>Drugs used in Vaginal and Vulval condition.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: Ospemifene is not indicated in children. Clinical studies have not been conducted in the pediatric population.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Of the 2209 Ospemifene-treated women enrolled in the ten phase 2/3 trials of Ospemifene, &gt;19 percent were 65 years of age or older. No clinically meaningful differences in safety or effectiveness were observed between these women and younger women less than 65 years of age.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: The pharmacokinetics of ospemifene in women with severe renal impairment (CrCL &lt;30 mL/min) was similar to those in women with normal renal function. No dose adjustment of Ospemifene is required in women with renal impairment.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: The pharmacokinetics of ospemifene has not been studied in women with severe hepatic impairment (Child-Pugh Class C); therefore, do not use Ospemifene in women with severe hepatic impairment.</p>', '2022-03-11 06:00:35', '2022-03-11 06:00:35'),
(1097, 1097, '<p>Oxaliplatin, used in combination with infusional 5-fluorouracil/leucovorin, is indicated for:</p>\r\n\r\n<ul>\r\n	<li>Adjuvant treatment of stage III colon cancer in patients who have undergone complete&nbsp;resection&nbsp;of the primary tumor.</li>\r\n	<li>Treatment of advanced&nbsp;colorectal cancer.</li>\r\n</ul>', '<p>Oxaliplatin, a platinum-containing complex similar to cisplatin, is an alkylating agent. After intracellular hydrolysis, the platinum compound binds to DNA forming cross-links which inhibit DNA replication and transcription, resulting in cell death.</p>', '<p>Intravenous (Adult)-<br />\r\n<br />\r\n<strong>Adjuvant therapy in stage III colon cancer:</strong>&nbsp;In combination with fluorouracil/ leucovorin: 85 mg/m2&nbsp;every 2 wk for 12 cycles. Dose to be given by IV infusion over 2-6 hr, dissolved in 250-500 ml of glucose 5%, every 2 wk; given for 12 cycles. After recovery from toxicity, reduce dose to 75 mg/m2. Administer before fluoropyrimidines.<br />\r\n<br />\r\n<strong>Advanced colorectal cancer: In combination with fluorouracil/ leucovorin:</strong>&nbsp;85 mg/m2&nbsp;every 2 wk until disease progression or unacceptable toxicity. Dose to be given by IV infusion over 2-6 hr, dissolved in 250-500 ml of glucose 5%, . After recovery from toxicity, reduce dose to 65 mg/m2. Administer before fluoropyrimidines.</p>', '<p>May decrease plasma levels of digoxin. May increase risk of toxicity with nephrotoxic drugs. When administered as sequential infusions, taxane derivatives (docetaxel, paclitaxel) should be administered before oxaliplatin to limit myelosuppression and enhance efficacy.</p>', '<p>Pregnancy. Peripheral neuropathy with functional impairment. Severe renal impairment.</p>', '<p>Fatigue, fever, pain, headache, insomnia, nausea, diarrheoa, vomiting, abdominal pain, constipation, anorexia, stomatitis, anemia, thrombocytopenia, leukopenia, aspartate and alanine transaminases increased, total bilirubin increased, peripheral neuropathy, back pain, dyspnoea, cough, oedema, chest pain, peripheral oedema, flushing , thromboembolism, dizziness, rash, alopecia , hand-foot syndrome dehydration, hypokalaemia, dyspepsia, taste perversion, flatulence, mucositis, gastroesophageal reflux, dysphagia, dysuria, neutropenia, inj site reaction, rigors, arthralgia, abnormal lacrimation, serum creatinine increased, rhinitis, epistaxis, pharyngitis, pharyngolaryngeal dysesthesia, allergic reactions, hiccup.</p>', '<p><strong>Category D:</strong>&nbsp;There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Should be administered under the supervision of an experienced cancer chemotherapy physician. Use appropriate precautions for handling and disposal. Monitor neurological status and dose should be reduced if symptoms are prolonged or severe. Monitor blood counts during treatment and courses should not be repeated until blood counts have recovered. Caution in elderly, moderate degrees of renal impairment. Avoid using aluminum-containing needles or IV admin sets that may come into contact with oxaliplatin as aluminum has been reported to cause degradation of platinum compounds. Lactation.</p>', '<p>Extensions of known adverse reaction (e.g. thrombocytopenia, myelosuppression, nausea, vomiting, neurotoxicity, respiratory symptoms). Treatment is supportive.</p>', '<p>Cytotoxic Chemotherapy.</p>', '<p>Store intact vials at 15-30&deg;C; do not freeze. Reconstituted solution: May store at 2-8&deg;C for up to 24 hr. Diluted solutions: Stable up to 6 hr at 20-25&deg;C or up to 24 hr under refrigeration at 2-8&deg;C.</p>', '<p><strong>Renal Impairment:</strong>&nbsp;Dose adjustment may be needed.</p>', '2022-03-11 06:02:40', '2022-03-11 06:02:40'),
(1098, 1098, '<p>Oxaprozin is indicated:</p>\r\n\r\n<ul>\r\n	<li>For relief of the signs and symptoms of osteoarthritis</li>\r\n	<li>For relief of the signs and symptoms of rheumatoid arthritis</li>\r\n	<li>For relief of the signs and symptoms of juvenile rheumatoid arthritis</li>\r\n</ul>', '<p>Oxaprozin, the&nbsp;potassium&nbsp;salt of oxaprozin, is a nonsteroidal anti-inflammatory drug (NSAID), which dissociates into the active moiety oxaprozin&nbsp;in vivo. Oxaprozin has&nbsp;analgesic, anti-inflammatory, and&nbsp;antipyretic&nbsp;properties.<br />\r\n<br />\r\nThe mechanism of action of Oxaprozin, like that of other NSAIDs, is not completely understood but involves inhibition of&nbsp;cyclooxygenase&nbsp;(COX-1&nbsp;and&nbsp;COX-2).<br />\r\n<br />\r\nOxaprozin is a potent inhibitor of&nbsp;prostaglandin&nbsp;synthesis&nbsp;in vitro. Oxaprozin concentrations reached during therapy have produced&nbsp;in vivo&nbsp;effects. Prostaglandins sensitize afferent nerves and potentiate the action of bradykinin in inducing pain in animal models. Prostaglandins are mediators of inflammation. Because oxaprozin potassium is an inhibitor of prostaglandin synthesis, its mode of action may be due to a decrease of prostaglandins in peripheral tissues.</p>', '<p><strong>General Dosing Instructions</strong>: Carefully consider the potential benefits and risks of&nbsp;Oxaprozin and other treatment options before deciding to use Oxaprozin. Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. After observing the response to initial therapy with Oxaprozin, the dose and frequency should be adjusted to suit an individual patient&rsquo;s needs.<br />\r\n<br />\r\nDivided doses may be tried in patients unable to tolerate single doses. For osteoarthritis patients of low body weight or with milder disease, an initial dose of one 600 mg tablet once a day may be appropriate. The maximum total daily dose is 1200 mg.<br />\r\n<br />\r\n<strong>Osteoarthritis</strong>: For Osteoarthritis, the dosage is 1200 mg (two 600 mg tablets) given orally once a day.<br />\r\n<br />\r\n<strong>Rheumatoid Arthritis</strong>: For Rheumatoid Arthritis, the dosage is 1200 mg (two 600 mg tablets) given orally once a day.</p>', '<p>Increased risk of salicylate toxicity with aspirin. May increase effects of oral anticoagulants. May reduce effects of &beta;-blockers, diuretics and other antihypertensive agents. May increase risk of methotrexate and lithium toxicity.</p>', '<p>Previous or active peptic ulceration, known hypersensitivity to NSAIDs. Perioperative pain in CABG setting.</p>', '<p>Common side effects are depression, sedation, somnolence, confusion, disturbance of sleep, weakness, malaise; rash, prutitus, urticaria, photosensitivity; abdominal pain/distress, anorexia, flatulence, vomiting, constipation, diarrhoea, dyspepsia, nausea, peptic ulcer and/or GI bleeding, abnormalities in LFTs, stomatitis, haemorrhoidal or rectal bleeding; tinnitus; dysuria or frequency; oedema, BP changes; haematuria, renal insufficiency, decreased menstrual flow; anaemia, thrombocytopenia, leukopenia, ecchymoses; wt gain/loss; blurred vision, conjunctivitis.<br />\r\n<br />\r\nThe following adverse reactions may occur:</p>\r\n\r\n<ul>\r\n	<li>Cardiovascular&nbsp;Thrombotic Events&nbsp;</li>\r\n	<li>GI&nbsp;Bleeding,&nbsp;Ulceration&nbsp;and Perforation&nbsp;</li>\r\n	<li>Hepatotoxicity&nbsp;</li>\r\n	<li>Hypertension&nbsp;</li>\r\n	<li>Heart Failure&nbsp;and Edema&nbsp;</li>\r\n	<li>Renal Toxicity and&nbsp;Hyperkalemia</li>\r\n	<li>Anaphylactic Reactions</li>\r\n	<li>Serious Skin Reactions&nbsp;</li>\r\n	<li>Hematologic Toxicity&nbsp;</li>\r\n</ul>', '<p>Pregnancy categaory: C, D (in 3rd trimester or near delivery).</p>', '<p>Be alert for ulceration and bleeding in patients treated chronically. History of serious GI events, alcoholism, smoking, other factors known to be associated with peptic ulcer. Elderly or debilitated patients. Uncompensated cardiac failure, history of hypertension, cardiac decompensation, chronic diuretic therapy, conditions predisposing to fluid retention. Renal and hepatic impairment. Underlying coagulation defects or patients who are undergoing surgical procedures where a high degree of haemostasis is required. Pregnancy (avoid in 3rd trimester) and lactation.</p>', '<p><strong>Symptoms:</strong>&nbsp;Acute renal failure, vomiting, drowsiness, leukocytosis.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Supportive and symptomatic. Multiple admin of charcoal may be required to reduce potential for delayed toxicities.</p>', '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs).</p>', '<p>Store at 25&deg; C. Protect from light.</p>', '<p>Renal Impairment-<br />\r\n<br />\r\n<strong>Osteoarthritis:</strong>&nbsp;Severe or on dialysis: 600 mg once daily. Increase to 1.2 g daily if needed.<br />\r\n<strong>Rheumatoid arthritis:</strong>&nbsp;Severe or on dialysis: 600 mg once daily. Increase to 1.2 g daily if needed.</p>', '2022-03-11 06:04:56', '2022-03-11 06:04:56'),
(1099, 1099, '<p>Oxazepam is used in the treatment of anxiety disorders, including anxiety associated with depression. This drug seems to be particularly effective for anxiety, tension, agitation and irritability in older people. It is also prescribed to relieve symptoms of acute alcohol withdrawal.</p>', '<p>Oxazepam belongs to a class of drugs called &quot;Benzodiazepine&quot; which act on the brain and nerves (central nervous system) to produce a calming effect. It works by enhancing the effect of a natural chemical in the brain (GABA).</p>', '<p><strong>Adult</strong>:</p>\r\n\r\n<ul>\r\n	<li>Mild to Moderate Anxiety with Tension, Irritability and Agitation: The usual dose is 10 to 15 milligrams 3 or 4 times per day.</li>\r\n	<li>Severe Anxiety, Depression with Anxiety, or Alcohol Withdrawal: The usual dose is 15 to 30 milligrams, 3 or 4 times per day.</li>\r\n</ul>\r\n\r\n<p><strong>Children</strong>:</p>\r\n\r\n<ul>\r\n	<li>Safety and effectiveness have not been established for children less than 6 years of age,</li>\r\n	<li>Nor have dosage guidelines been established for children 6 to 12 years. The doctor will adjust the dosage to fit the child&#39;s needs.</li>\r\n</ul>\r\n\r\n<p><strong>Older adults</strong>: The usual starting dose is 10 milligrams, 3 times a day. The doctor may increase the dose to 15 milligrams 3 or 4 times a day if needed.</p>', '<p>Oxazepam may intensify the effects of alcohol. It may be best to avoid alcohol while taking this medication. If Oxazepam is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with a doctor before combining Oxazepam with the following: Antihistamines such as Diphenhydramine Narcotic painkillers such as Oxycodone and Pethidine Sedatives such as Secobarbital and Triazolam Tranquilizers such as Diazepam and Alprazolam.</p>', '<p>The drug is contraindicated in individuals who have an allergic reaction to Oxazepam or other benzodiazepines such as diazepam. Oxazepam should not be prescribed if any patient is being treated for mental disorders which are more serious than anxiety.</p>', '<p>Side effects cannot be anticipated. If any develop or change in intensity, doctor should be informed immediately. Doctor will determine if it is safe for a patient to continue taking Oxazepam. More common side effect includes drowsiness. Less common or rare side effects include: Blood disorders, change in libido, dizziness, excitement, fainting, headache, liver problems, loss or lack of muscle control, nausea, skin rashes or eruptions, sluggishness or unresponsiveness, slurred speech, swelling due to fluid retention, tremors, vertigo, yellowed eyes and skin. Side effects due to rapid decrease or abrupt withdrawal from Oxazepam: Abdominal and muscle cramps, convulsions, depressed mood, inability to fall or stay asleep, sweating, tremors, vomiting.</p>', '<p>This medication is not recommended for use during pregnancy due to the potential possible fetal harm. Based on information from related drugs, this drug may pass into breast milk and may have undesirable effects on a nursing infant. Therefore, breastfeeding while using this medication is not recommended.</p>', '<p>This drug may make dizzy, drowsy or cause blurred vision; caution should be taken while engaging in activities requiring alertness such as driving or using machinery. The limit should be maintained while taking alcoholic beverages. Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug, especially the drowsiness effect.</p>', NULL, '<p>Tricyclic Anti-depressant</p>', '<p>Store in a cool and dry place, protected from light and moisture. Keep out of reach of children.</p>', NULL, '2022-03-11 06:06:49', '2022-03-11 06:06:49'),
(1100, 1100, '<p>Oxcarbazepine is indicated for:<br />\r\n<br />\r\n<strong>Adults</strong>: Monotherapy or adjunctive therapy in the treatment of partial seizures<br />\r\n<br />\r\n<strong>Pediatrics</strong>:</p>\r\n\r\n<ul>\r\n	<li>Monotherapy in the treatment of partial seizures in children 4-16 years</li>\r\n	<li>Adjunctive therapy in the treatment of partial seizures in children 2&ndash;16 years</li>\r\n</ul>', '<p>The pharmacological activity of Oxcarbazepine is primarily exerted through the metabolite derivative (the monohydroxy derivative, MHD) of Oxcarbazepine. The mechanism of action of Oxcarbazepine and MHD is thought to be mainly based on blockade of voltage-sensitive sodium channels, thus resulting in stabilization of hyper excited neural membranes, inhibition of repetitive neuronal firing and diminishment of propagation of synaptic impulses.</p>', '<p><strong>Adults</strong>: initiate with a dose of 600 mg/day, given twice-a-day</p>\r\n\r\n<ul>\r\n	<li><strong>Adjunctive Therapy</strong>: Maximum increment of 600 mg/day at approximately weekly intervals. The recommended daily dose is 1200 mg/day</li>\r\n	<li><strong>Conversion to Monotherapy</strong>: withdrawal concomitant over 3 to 6 weeks;reach maximum dose of Oxcarbazepine in 2 to 4 weeks with increments of 600 mg/day at weekly intervals to a recommended daily dose of 2400 mg/day</li>\r\n	<li><strong>Initiation of Monotherapy</strong>: Increments of 300 mg/day every third day to a dose of 1200 mg/day.</li>\r\n	<li><strong>Creatinine Clearance &lt;30 mL/min</strong>: Initiate at one half the usual starting dose and increase slowly</li>\r\n</ul>\r\n\r\n<p><strong>Pediatrics</strong>: initiation with 8 to 10 mg/kg/day, given twice-a-day. For patients aged 2 to &lt;4 years and under 20 kg, a starting dose of 16 to 20 mg/kg/day may be considered. Recommended daily dose is dependent upon patient weight.</p>\r\n\r\n<ul>\r\n	<li><strong>Adjunctive Patients (Aged 2&ndash;16 Years)</strong>: For patients aged 4 to 16 years, target maintenance dose should be achieved over 2 weeks. For patients aged 2 to &lt;4 years, maximum maintenance dose should be achieved over 2 to 4 weeks and should not to exceed 60 mg/kg/day</li>\r\n	<li><strong>Conversion to Monotherapy for Patients (Aged 4-16 Years)</strong>: Maximum increment of 10 mg/kg/day at weekly intervals, concomitant antiepileptic drugs can be completely withdrawn over 3 to 6 weeks</li>\r\n	<li><strong>Initiation of Monotherapy for Patients (Aged 4&ndash;16 Years)</strong>: Increments of 5 mg/kg/day every third day</li>\r\n</ul>', '<p>Oxcarbazepine and its metabolite inhibit the enzyme CYP2C19 and therefore, interactions could arise when co-administering high doses of Oxazep with medicinal products that are metabolised by CYP2C19 (e.g. phenobarbital, phenytoin). Concurrent use of Oxazep with hormonal contraceptives may render few contraceptives ineffective (e.g. Ethinylestradiol and Levonorgestrel preparations). Co-administration of Oxazep lowers AUC of felodipine and Verapamil decreases bioavailability of MHD.</p>', '<p>It is contraindicated to patients with hypersensitivity to the active substance or to any of the excipients.</p>', '<p>The most commonly reported adverse reactions are somnolence, headache, dizziness, diplopia, nausea; vomiting and fatigue. Very rarely clinically significant hyponatraemia can develop during Oxazep use. Class I (immediate) hypersensitivity reactions including rash, pruritus, urticaria, angioedema and reports of anaphylaxis have been received.</p>', '<p><strong>Pregnancy</strong>: Data on a limited number of pregnancies indicate that Oxcarbazepine may cause serious birth defects (e.g. cleft palate) when administered during pregnancy. In the newborn child. Bleeding disorders in the newborn caused by antiepileptic agents have been reported. As a precaution, vitamin K1 should be administered as a preventive measure in the last few weeks of pregnancy and to the newborn. Oxcarbazepine and its active metabolite (MHD) cross the placenta. Neonatal and maternal plasma MHD concentrations were similar in one case.<br />\r\n<br />\r\n<strong>Lactation</strong>: Oxcarbazepine and its active metabolite (MHD) are excreted in human breast milk. Therefore, Oxazep should not be used during breast-feeding.</p>', '<p><strong>Alcohol</strong>: Caution should be exercised if alcohol is taken in combination with Oxazep therapy, due to a possible additive sedative effect.<br />\r\n<br />\r\n<strong>Withdrawal</strong>: As with all antiepileptic medicinal products, Oxazep should be withdrawn gradually to minimise the potential of increased seizure frequency.</p>', NULL, '<p>Adjunct anti-epileptic drugs</p>', NULL, NULL, '2022-03-11 06:14:23', '2022-03-11 06:14:23'),
(1101, 1101, '<p>Oxiconazole topical preparation is indicated for the topical treatment of the following dermal infections: tinea pedis, tinea cruris, and tinea corporis due to Trichophyton rubrum, Trichophyton mentagrophytes, or Epidermophyton floccosum. Oxiconazole Cream is indicated for the topical treatment of tinea (pityriasis) versicolor due to Malassezia furfur.</p>', '<p>This topical preparation contains the antifungal active compound Oxiconazole Nitrate. For topical dermatological use only. Oxiconazole Nitrate is an imidazole derivative whose antifungal activity is derived primarily from the inhibition of ergosterol biosynthesis, which is critical for cellular membrane integrity. It has in vitro activity against a wide range of pathogenic fungi. Oxiconazole has been shown to be active against most strains of the following organisms both in vitro and in clinical infections at indicated body sites: Epidermophyton floccosum, Trichophyton mentagrophytes, Trichophyton rubrum, Malassezia furfur. Oxiconazole exhibits satisfactory in vitro minimum inhibitory concentrations (MICs) against most strains of the following organisms: Microsporum audouini, Microsporum canis, Microsporum gypseum, Trichophyton tonsurans,Trichophyton violaceum.</p>', '<p>This topical preparation should be applied to affected and immediately surrounding areas once to twice daily in patients with tinea pedis, tinea corporis, or tinea cruris. Oxiconazole Cream should be applied once daily in the treatment of tinea (pityriasis) versicolor. Tinea corporis, tinea cruris, and tinea (pityriasis) versicolor should be treated for 2 weeks and tinea pedis for 1 month to reduce the possibility of recurrence.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Use Oxiconazole topical preparation as directed by the physician. The hands should be washed after applying the medication to the affected area(s). Avoid contact with the eyes, nose, mouth, and other mucous membranes. Oxiconazole cream isfor external use only.</li>\r\n	<li>Use the medication for the full treatment time recommended by the physician, even though symptoms may have improved. Notify the physician if there is no improvement after 2 to 4 weeks orsooner if the condition worsens.</li>\r\n	<li>Inform the physician if the area of application shows signs of increased irritation, itching, burning, blistering, swelling, or oozing.</li>\r\n	<li>Avoid the use of occlusive dressings unless otherwise directed by the physician.</li>\r\n	<li>Do not use this medication for any disorder other than that for which it was prescribed</li>\r\n</ul>', '<p>Potential drug interactions between Oxiconazole and other drugs have not been systematically evaluated.</p>', '<p>Oxiconazole topical preparation is contraindicated in individuals who have shown previous hypersensitivity to Oxiconazole.</p>', '<p>Pruritus, burning, irritation and allergic contact dermatitis, folliculitis, erythema, and papules, fissure, maceration, rash, stinging and nodules.</p>', '<p>Pregnancy category B. Because Oxiconazole Nitrate is excreted in human milk, caution should be exercised when the drug is administered to a nursing woman.</p>', '<p>Oxiconazole topical preparation is not for ophthalmic or intravaginal use.</p>', NULL, '<p>Topical Antifungal preparations.</p>', '<p>Store in a cool and dry place,protected from light. Do not freeze.</p>', NULL, '2022-03-11 06:16:30', '2022-03-11 06:16:30'),
(1102, 1102, '<p>Used to temporarily numb the front surface of the eye so that the eye pressure can be measured or a foreign body removed.</p>', '<p>Oxybuprocaine is a local anaesthetic. It may be less irritating than tetracaine, and the onset and duration of action are similar to tetracaine. Oxybuprocaine binds to sodium channel and reversibly stabilizes the neuronal membrane which decreases its permeability to sodium ions. Depolarization of the neuronal membrane is inhibited thereby blocking the initiation and conduction of nerve impulses.</p>', '<p>Use as a 0.4% solution in short ophthalmic procedures. Instil 1 drop into the conjunctival sac to allow tonometry after 60 sec; a further drop after a 90 sec interval produces sufficiReduce systemic absorption by compressing the lacrimal sac at the medial canthus for a minute during and following instillation. Heart block; epilepsy, impaired cardiac conduction, myasthenia gravis; not to be applied to inflamed, infected tissues or damaged mucosa. Protect anaesthetised eye from dust and bacterial contamination; cornea may be damaged by prolonged application. Do not drive until normal vision restored.ent anaesthesia for the fitting of contact lenses; 3 drops at 90 sec intervals produces sufficient anaesthesia after 5 min for a foreign body to be removed from the corneal epithelium or for incision of a meibomian cyst through the conjunctiva.</p>', NULL, NULL, '<p>Hypersensitivity reactions; transient stinging and blurring of vision; excitation of CNS; muscle twitching and tremors; convulsions.</p>', '<p>Pregnancy&nbsp;Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Reduce systemic absorption by compressing the lacrimal sac at the medial canthus for a minute during and following instillation. Heart block; epilepsy, impaired cardiac conduction, myasthenia gravis; not to be applied to inflamed, infected tissues or damaged mucosa. Protect anaesthetised eye from dust and bacterial contamination; cornea may be damaged by prolonged application. Do not drive until normal vision restored.</p>', NULL, '<p>Ocular perioperative drugs.</p>', NULL, NULL, '2022-03-11 06:17:52', '2022-03-11 06:17:52'),
(1103, 1103, '<p>Oxybutynin Chloride is a muscarinic antagonist indicated for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency. Oxybutynin Chloride Extended Release Tablets are also indicated for the treatment of pediatric patients aged 6 years and older with symptoms of detrusor overactivity associated with a neurological condition (e.g., spina bifida).</p>', '<p>Oxybutynin exerts direct antispasmodic effect on the smooth muscle by inhibiting the muscarinic action of acetylcholine. It exhibits moderate anticholinergic effect, but has potent antispasmodic effects on urinary smooth muscle.</p>', '<p>The recommended starting dose of Uricon is 5 mg once daily, with or without food. Dosage may be adjusted in 5 mg increments to achieve a balance of efficacy and tolerability (up to a maximum of 30 mg/day). In general, dosage adjustment may proceed at approximately weekly intervals.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>May be taken with or without food.</p>', '<p>Anticholinergic agents, cytochrome P450 enzyme inhibitors, such as antimycotic agents (e.g., Ketoconazole, Itraconazole, and Miconazole) or macrolide antibiotics (e.g., erythromycin and clarithromycin), have not been performed. No specific drug-drug interaction studies have been performed with Oxybutynin.</p>', '<p>Oxybutynin Chloride is contraindicated in patients with urinary retention, gastric retention, or uncontrolled narrow angle glaucoma and in patients who are at risk for these conditions. It is also contraindicated in patients who have demonstrated hypersensitivity to the drug substance or other components of the product.</p>', '<p>The incidence of dry mouth may occur which is dose-related. Abdominal pain, dry nasal and sinus mucous membranes, back pain, hypertension, palpitation, vasodilatation, flatulence, gastro-esophageal reflux, insomnia, nervousness, confusion, cough, sinusitis, bronchitis, dry skin, rash, impaired urination (hesitancy), urinary retention, etc. may be reported.</p>', '<p>Oxybutynin Chloride should not be given to pregnant women unless, the probable clinical benefits outweigh the possible hazards, caution should be exercised when it is administered to a nursing woman.</p>', '<p>Oxybutynin Chloride should be used with caution in patients with hepatic or renal impairment, clinically significant bladder outflow obstruction because of the risk of urinary retention, gastrointestinal obstructive disorders because of the risk of gastric retention, conditions such as ulcerative colitis, intestinal atony, and myasthenia gravis, gastro-esophageal reflux and/or who are concurrently taking drugs (such as bisphosphonates) that can cause or exacerbate esophagitis.</p>', '<p>Anticholinergic effects including CNS excitation (e.g. restlessness, tremor, irritability, convulsions, delirium, hallucinations), flushing, fever, dehydration, cardiac arrhythmia, vomiting, and urinary retention may occur after overdose. Treatment should be symptomatic and supportive. Activated charcoal may be administered.</p>', '<p>Anticholinergics (antimuscarinics)/ Anti-spasmodics.</p>', '<p>Store at 15-30&deg; C.</p>', NULL, '2022-03-11 06:19:40', '2022-03-11 06:19:40'),
(1104, 1104, '<p>Oxygen therapy, also known as&nbsp;supplemental oxygen, is the use of&nbsp;oxygen&nbsp;as a&nbsp;medical treatment. This can include for&nbsp;low blood oxygen,&nbsp;carbon monoxide toxicity,&nbsp;cluster headaches, and to maintain enough oxygen while&nbsp;inhaled anesthetics&nbsp;are given. Long term oxygen is often useful in people with chronically low oxygen such as from severe&nbsp;COPD&nbsp;or&nbsp;cystic fibrosis. Oxygen can be given in a number of ways including&nbsp;nasal cannula,&nbsp;face mask, and inside a&nbsp;hyperbaric chamber.</p>', '<p>Oxygen is required for normal cell metabolism. Excessively high concentrations can cause oxygen toxicity such as lung damage or result in respiratory failure in those who are predisposed. Higher oxygen concentrations also increase the risk of fires, particularly while smoking, and without humidification can also dry out the nose. The target oxygen saturation recommended depends on the condition being treated. In most conditions a saturation of 94-98% is recommended, while in those at risk of carbon dioxide retention saturations of 88-92% are preferred, and in those with carbon monoxide toxicity or cardiac arrest they should be as high as possible. Air is typically 21% oxygen by volume while oxygen therapy increases this by some amount up to 100%.<br />\r\n<br />\r\nThe use of oxygen in medicine become common around 1917. It is on the&nbsp;World Health Organization&#39;s List of Essential Medicines, the most effective and safe medicines needed in a&nbsp;health system.</p>', '<p><strong>Adult</strong>: Use as required<br />\r\n<strong>Child</strong>: Safety and efficacy has not been established</p>', NULL, '<p>Hypersensitivity</p>', NULL, NULL, NULL, NULL, '<p>Other preparations</p>', '<p>Oxygen should be kept as compressed gas or liquid at cryogenic temperature, in appropriate containers complying with the safety regulations of the national authority. Valves or taps should not be lubricated with oil or grease.</p>', NULL, '2022-03-11 06:20:48', '2022-03-11 06:20:48'),
(1105, 1105, '<p>Oxymetazoline Hydrochloride cream is indicated for the topical treatment of persistent facial erythema associated with rosacea in adults.</p>', '<p>Oxymetazoline is an alpha1A adrenoceptor&nbsp;agonist. Oxymetazoline acts as a vasoconstrictor.</p>', '<p>For topical use only, it is not for oral, ophthalmic or intravaginal use. Apply a little amount of the cream, once daily in a thin layer to cover the entire face (forehead, nose, each cheek and chin) avoiding eyes and lips. Wash hands immediately after applying the cream.</p>', NULL, NULL, '<p>Most common side effects are application site dermatitis, worsening inflammatory lesions of rosacea, application site pruritis, application site erythema and application site pain.</p>', '<p>The safety of oxymetazoline during pregnancy and lactation has not been established, but use during this period is not considered to constitute a hazard.</p>', '<p>Alpha-adrenergic agonists may impact blood pressure. Advise patients with ardiovascular disese, orthostatic hypotension and/or uncontolled hypertension or hypotension to seek medical care if their condition worsens. Use with caution in patients with cerebral or coronary insufficiency, Raynaud&rsquo;s phenomenon, thromboangiitis obliterans, scleroderma or Sj&ouml;gren&rsquo;s syndrome and advisepatients to seek medical care if signs and symptoms of potentiation of vascular insufficiency develop. Advise patients to seek immediate medical care if signs and symptoms of acute narrow-angle glaucoma develop.</p>', '<p>Oxymetazoline&nbsp;is not for oral use. If oral ingestion occurs, seek medical advice. Monitor patient closely and administer appropriate supportive measures as necessary.</p>', '<p>Vasoconstrictor/Venotonic</p>', '<p>Do not store above 30&deg; C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-11 06:22:26', '2022-03-11 06:22:26'),
(1106, 1106, '<p>Oxymetazoline Hydrochlorid is indicated for the treatment of nasal congestion associated with acute or chronic rhinitis, common cold, sinusitis, upper respiratory allergies, epistaxis and hay fever. It is also used as nasal decongestant in otitis media.</p>', '<p>Oxymetazoline Hydrochloride is an imidazoline derivative sympathomimetic amine. It is a direct agonist at &alpha;-adrenoceptors but has no action on &beta;- adrenoceptors. It is used as a topical agent on the nasal mucosa, produces a rapid and long acting vasoconstriction of the arterioles, thus reducing the blood flow and diminishing swelling of the mucosa. This results in improved potency of the airway and better drainage of the nasal sinus.</p>', '<p>Oxymetazoline nasal spray-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children (6 years of age and older)</strong>: 2 or 3 sprays in each nostril twice daily for 3-5 days.</li>\r\n	<li><strong>Elderly</strong>: There is no need for dosage reduction in the elderly for nasal administration.</li>\r\n	<li><strong>Children below 6 years of age</strong>: It is not suitable for children below 6 years of age.</li>\r\n</ul>\r\n\r\n<p>Oxymetazoline nasal drop-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults &amp; children 6 years of age</strong>: 2-3 drops of 0.05% Nasal Drops in each nostril twice daily in the morning and evening.</li>\r\n	<li><strong>Children 2-5 years of age</strong>: 2-3 drops of 0.025% Nasal Drops in each nostril twice daily in the morning and evening</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>How to use the Nasal Spray-</p>\r\n\r\n<ul>\r\n	<li>Shake the bottle gently and remove the dust cover.</li>\r\n	<li>Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.</li>\r\n	<li>Gently blow the nose to clear the nostrils.</li>\r\n	<li>Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.</li>\r\n	<li>Breathe out through your mouth.</li>\r\n	<li>Repeat the above steps in the same/ other nostril for consecutive doses.</li>\r\n</ul>\r\n\r\n<p>Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-</p>\r\n\r\n<ul>\r\n	<li>Remove the dust cover.</li>\r\n	<li>Gently pull off the nasal applicator.</li>\r\n	<li>Wash the applicator and dust cover in warm water.</li>\r\n	<li>Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.</li>\r\n	<li>Gently push the applicator back on the top of the bottle and re-fix the dust cover.</li>\r\n</ul>', '<p>Oxymetazoline Hydrochloride Nasal preparation should not be given to patients being treated with MAO inhibitors or within 14 days of ceasing such treatment.</p>', '<p>It is contraindicated in patients with cardiovascular disease, hyperthyroidism, prostatic enlargement, angle closure glaucoma and hypersensitivity to any of its ingredients.</p>', '<p>Occasionally it may cause local irritation and dryness of the mouth and throat. Temporarily discomfort such as burning, stinging, sneezing or increase in nasal discharge may occur.</p>', '<p>The safety of Oxymetazoline Hydrochloride Nasal Spray during pregnancy and lactation has not been established, but is not thought to constitute a hazard during those periods.</p>', '<p>Keep away from the eyes. The spray should not be used for longer than seven days without medical advice. Frequent or prolonged use may cause nasal congestion to recur or worsen.</p>', '<p>Overdose may give rise to local irritation and rebound congestion. Treatment need only be symptomatic.</p>', '<p>Nasal Anti-histamine preparations, Nasal Decongestants &amp; Other Nasal Preparations.</p>', '<p>Keep below 30&deg; C temperature in a dry place, protect from light. Do not refrigerate or freeze. Keep out of the reach of children.</p>', NULL, '2022-03-11 06:24:41', '2022-03-11 06:24:41');
