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
(886, 886, '<p>Lubiprostone is indicated in:</p>\r\n\r\n<ul>\r\n	<li>Irritable Bowel Syndrome with Constipation (IBS-C).</li>\r\n	<li>Chronic Idiopathic Constipation (CIC) in adults.</li>\r\n	<li>Opioid-Induced Constipation (OIC) in adult patients with chronic, non-cancer pain.</li>\r\n</ul>', '<p>Lubiprostone&nbsp;is a locally-acting chloride-channel activator that increases intestinal secretion. In doing so, it increases intestinal motility, thus aiding the passage of stool and relieve the symptoms associated with chronic idiopathic constipation.<br />\r\n<br />\r\nLubiprostone acts by specifically activating ClC-2 chloride channels, which is a normal constituent of the apical membrane of the human intestine, in a protein kinase A action independent fashion. Activation of ClC-2 chloride channels causes an efflux of chloride ions into the lumen, which in turn leads to an efflux of sodium ions through a paracellular pathway to maintain isoelectric neutrality. As a result, water follows sodium into the lumen in order to maintain isotonic equilibrium, thereby increasing intestinal fluid secretion. By increasing intestinal fluid secretion, lubiprostone increases motility in the intestine, thereby increasing the passage of stool and alleviating symptoms associated with chronic idiopathic constipation. Activation of ClC-2 chloride channels may also stimulate the recovery of muscosal barrier function by restoring tight junction protein complexes in the intestine. Patch clamp cell studies in human cell lines have indicated that the majority of the beneficial biological activity of lubiprostone and its metabolites is observed only on the apical (luminal) portion of the gastrointestinal epithelium.</p>', '<p><strong>Irritable Bowel Syndrome with Constipation</strong>:&nbsp;The recommended dose is 8 mcg twice daily orally with food and water.<br />\r\n<br />\r\n<strong>Dosage in patients with hepatic impairment</strong>: Dosage adjustment is not required for patients with moderately impaired hepatic function. For patients with severely impaired hepatic function, the recommended starting dose is 8 mcg once daily. If tolerated then dose can be increased to 8 mcg twice&nbsp;<br />\r\n<br />\r\n<strong>Chronic Idiopathic Constipation and Opioid-induced Constipation</strong>:&nbsp;The recommended dose is 24 mcg twice daily orally with food and water.&nbsp;<br />\r\n<br />\r\n<strong>Dosage in patients with hepatic impairment</strong>: For patients with moderately impaired hepatic function, the recommended starting dose is 16 mcg twice daily. For patients with severely impaired hepatic function, the recommended starting dose is 8 mcg twice daily.</p>', '<p>There is a possibility of a dose-dependent decrease in the efficacy of Lubiprostone in patients using diphenylheptane opioids.</p>', '<p>Lubiprostone is contraindicated in patients with known or suspected mechanical gastrointestinal obstruction.</p>', '<p>Diarrhea, full or bloated feeling or pressure in the stomach, nausea, stomach pain, swelling of abdominal or stomach area, Dyspnea.</p>', '<p>Pregnancy category C. It is not known whether lubiprostone is excreted in human milk. Because lubiprostone increases fluid secretion in the intestine and intestinal motility, human milk-fed infants should be monitored for diarrhea. Caution should be exercised when Lubiprostone is administered to a nursing woman.</p>', '<p><strong>Nausea:</strong>&nbsp;Patients taking Lubiprostone may experience nausea. Concomitant administration of food with Lubiprostone may reduce symptoms of nausea.<br />\r\n<br />\r\n<strong>Diarrhea:</strong>&nbsp;Lubistone should not be prescribed to patients that have severe diarrhea.<br />\r\n<br />\r\n<strong>Bowel Obstruction:</strong>&nbsp;In patients with symptoms suggestive of mechanical gastrointestinal obstruction, perform a thorough evaluation to confirm the absence of an obstruction prior to initiating therapy with Lubiprostone.</p>', '<p>Adverse reactions due to overdose may include: nausea, diarrhea, vomiting, dizziness, headache, abdominal pain, flushing/hot flash, retching, dyspnea, pallor, stomach discomfort, anorexia, asthenia , chest discomfort, dry mouth, hyperhidrosis , and syncope.</p>', '<p>Other laxative preparations.</p>', '<p>Store between 15-30&deg; C.</p>', NULL, '2022-03-09 02:58:28', '2022-03-09 02:58:28'),
(887, 887, '<p>Luliconazole is indicated for the topical treatment of interdigital</p>\r\n\r\n<ul>\r\n	<li>Tinea pedis (athelet&#39;s foot),</li>\r\n	<li>Tinea cruris, and</li>\r\n	<li>Tinea corporis.</li>\r\n</ul>', '<p>Luliconazole is a topical antifungal agent. It is a broad-spectrum antifungal agent that belongs to the azole group. It acts against fungus by inhibiting the enzyme lanosterol demethylase and blocks ergosterol synthesis which is an important constituent of fungal cell membrane. Thus it exerts strong fungicidal activity both in-vitro and in-vivo against dermatophytes, Candida albicans, Malassezia spp, Trichophyton and Epidermophyton spp.</p>', '<p>Adult:</p>\r\n\r\n<ul>\r\n	<li><strong>Interdigital tinea pedis</strong>: Luliconazole cream should be applied to the affected area and approximately 1 inch of the immediate surrounding area(s) once daily for two weeks.</li>\r\n	<li><strong>Tinea cruris and Tinea corporis</strong>: Luliconazole cream should be applied to the affected area and approximately 1 inch of the immediate surrounding area(s) once daily for one week.</li>\r\n</ul>\r\n\r\n<p>Geriatric: Same as adult<br />\r\nPediatric: Safety and effectiveness have not been established.</p>', NULL, '<p>None</p>', '<p>Contact dermatitis and cellulitis may occur. Application site reactions were observed in iess than 1% of subjects in clinical trial.</p>', '<p>Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Luliconazole should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether luliconazole is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Luliconazole cream is applied to women who are breastfeeding.</p>', '<p>If there is any unusual allergic reaction with the use of Luliconazole, then treatment should be discontinued and appropriate therapy should be instituted. Luliconazole is recommended for topical use only. It is not intended for ophthalmic, oral or intravaginal use.</p>', NULL, '<p>Miscellaneous topical agents.</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-09 03:00:35', '2022-03-09 03:00:35'),
(888, 888, '<p>Lurasidone Hydrochloride is an atypical antipsychotic. This is used for the treatment of: Schizophrenia, Depressive episodes associated with Bipolar I Disorder (bipolar depression), as monotherapy and as adjunctive therapy with lithium or valproate.</p>', '<p>The efficacy of Lurasidone in schizophrenia could be mediated through a combination of central Dopamine D2 and Serotonin 5HT2A receptor antagonism.</p>', '<p>Schizophrenia-</p>\r\n\r\n<ul>\r\n	<li><strong>Starting Dose</strong>: 40 mg once daily</li>\r\n	<li><strong>Recommended Dose</strong>:&nbsp;40 mg to 160 mg once daily</li>\r\n</ul>\r\n\r\n<p>Bipolar Depression-</p>\r\n\r\n<ul>\r\n	<li><strong>Starting Dose</strong>:&nbsp;20 mg once daily</li>\r\n	<li><strong>Recommended Dose</strong>:&nbsp;20 mg to 120 mg once daily</li>\r\n</ul>\r\n\r\n<p>Lurasidone &nbsp;should be taken with food. Administration with food substantially increases the absorption of Lurasidone.</p>', '<p>The Lurasidone dose should be reduced to half of the original level when used concomitantly with moderate inhibitors of CYP3A4 (e.g., Diltiazem, Atazanavir, Erythromycin, Fluconazole, Verapamil, etc.). If Lurasidone is used concomitantly with a moderate CYP3A4 inducer, it may be necessary to increase the Lurasidone dose.<br />\r\n<br />\r\nGrapefruit: Grapefruit and grapefruit juice should be avoided in patients taking Lurasidone, since these may inhibit CYP3A4 and alter Lurasidone concentrations.</p>', '<p>Hypersensitivity. Concurrent administration of strong CYP3A4 inhibitors (eg, Ketoconazole). Concurrent administration of strong CYP3A4 inducers (eg, Rifampin). Dementia-related psychosis.</p>', '<p>Somnolence, akathisia, extrapyramidal symptoms, and nausea.</p>', '<p>Pregnancy Category B. Lurasidone should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Patient should be advised not to breast-feed an infant if they are taking Lurasidone.</p>', '<p>Cerebrovascular adverse reactions in elderly patients with dementia-related psychosis: Increased incidence of cerebrovascular adverse events (e.g., stroke, transient ischemic attack).<br />\r\n<br />\r\n<strong>Neuroleptic malignant syndrome</strong>: Manage with immediate discontinuation and close monitoring.<br />\r\n<br />\r\n<strong>Tardive dyskinesia</strong>: Discontinue if clinically appropriate.<br />\r\n<br />\r\n<strong>Metabolic changes</strong>: Atypical antipsychotic drugs have been associated with metabolic changes that may increase cardiovascular/cerebrovascular risk. These metabolic changes include hyperglycemia, dyslipidemia, and weight gain.<br />\r\n<br />\r\n<strong>Hyperglycemia and diabetes mellitus</strong>: Monitor patients for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness. Monitor glucose regularly in patients with diabetes or at risk for diabetes.<br />\r\n<br />\r\n<strong>Dyslipidemia</strong>: Undesirable alterations have been observed in patients treated with atypical antipsychotics.<br />\r\n<br />\r\n<strong>Weight Gain</strong>: Gain in body weight has been observed. Monitor weight.<br />\r\n<br />\r\n<strong>Hyperprolactinemia</strong>: Prolactin elevations may occur.<br />\r\n<br />\r\n<strong>Leukopenia, neutropenia and agranulocytosis</strong>:&nbsp;Perform complete blood counts (CBC) in patients with a pre-existing low white blood cell count (WBC) or a history of leukopenia or neutropenia. Consider discontinuing Lurasidone if a clinically significant decline in WBC occurs in the absence of other causative factors.<br />\r\n<br />\r\n<strong>Orthostatic hypotension and syncope</strong>: Dizziness, tachycardia or bradycardia, and syncope may occur, especially early in treatment. In patients with known cardiovascularor cerebrovascular disease, and in antipsychotic-na&iuml;ve patients, consider a lower starting dose and slower titration.</p>', NULL, '<p>Atypical neuroleptic drugs.</p>', '<p>Protect from light and moisture, store below 30&deg; C. Keep out of the reach of children.</p>', '<p><strong>Moderate and Severe Renal Impairment</strong>: Recommended starting dose is 20 mg per day, and the maximum recommended dose is 80 mg per day .<br />\r\n<br />\r\n<strong>Moderate and Severe Hepatic Impairment</strong>: Recommended starting dose is 20 mg per day. The maximum recommended dose is 80 mg per day in moderate hepatic impairment and 40 mg per day in severe hepatic impairment.</p>', '2022-03-09 03:02:51', '2022-03-09 03:02:51'),
(889, 889, '<p>Lymecycline capsules belong to a group of medicines called tetracycline antibiotics. It is used to treat acne which appears as blackheads or whiteheads, which people often refer to as pimples or spots.<br />\r\n<br />\r\nThis medicine can also be used to treat other infections, such as:</p>\r\n\r\n<ul>\r\n	<li>Acute sinusitis</li>\r\n	<li>Bronchitis</li>\r\n	<li>Infections in the abdomen</li>\r\n	<li>Some types of eye infections called trachoma</li>\r\n	<li>Soft skin infections</li>\r\n</ul>', '<p>Lymecycline is a tetracycline derivative which blocks the access of bacterial aminoacyl-tRNA to the mRNA-ribosome complex by binding to the 30S ribosome subunit, preventing the addition of amino acids to the growing peptide chain in protein synthesis.</p>', '<p>Adults and children over 12 years:</p>\r\n\r\n<ul>\r\n	<li><strong>Acne</strong>: the normal dose is one capsule once a day, preferably in the morning. Lymecycline capsules should always be taken with a glass of water. How long you will have to take Lymecycline capsules for will depend on how quickly your condition improves. For acne this will normally be a minimum of eight weeks.</li>\r\n	<li><strong>Infections</strong>: For other infections the usual dose is one Lymecycline capsule twice a day. Your doctor may recommend a higher or lower dose; this depends upon the type and severity of the infection. Ask your doctor if you are unsure. Lymecycline capsules should always be taken with a glass of water.</li>\r\n</ul>\r\n\r\n<p><strong>Use in children and adolescents</strong>: Lymecycline capsules are not recommended for use in children under 12 years of age as they can cause permanent discolouration of tooth enamel and affect bone development.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken on an empty stomach. Take 1 hr before or 2 hr after meals.</p>', '<p>Decreased absorption with Ca, Al, Mg, bismuth and zinc salts, antacids, bismuth containing ulcer-healing drugs, Fe preparations and quinapril. Increased effects of anticoagulants. Decreased plasma levels with barbiturates, phenytoin or carbamazepine.</p>', '<p>Hypersensitivity to lymecycline or other tetracyclines. Overt renal insufficiency. Pregnancy and lactation. Concomitant use with methoxuflurane or oral retinoids.</p>', '<p>Lymecycline capsules may also cause the following<br />\r\nside effects.<br />\r\n<br />\r\nCommon (occur in less than 1 in 10 patients):</p>\r\n\r\n<ul>\r\n	<li>Feeling sick (nausea)</li>\r\n	<li>Abdominal pain</li>\r\n	<li>Diarrhoea</li>\r\n	<li>Headache</li>\r\n</ul>\r\n\r\n<p>Unknown (frequency cannot be estimated from<br />\r\navailable information):</p>\r\n\r\n<ul>\r\n	<li>Eyesight disturbances</li>\r\n	<li>Dizziness</li>\r\n	<li>Being sick (vomiting)</li>\r\n	<li>Yellowing of eyes or skin (jaundice)</li>\r\n	<li>Increased sensitivity of the skin to sunlight (real or artificial)</li>\r\n	<li>Increased pressure in the brain</li>\r\n	<li>Changes in type or number of certain blood cells</li>\r\n	<li>Pain in the upper part of the abdomen</li>\r\n	<li>Changes in some blood tests (liver function tests)</li>\r\n	<li>Fever</li>\r\n	<li>Itchiness, skin rash, or hives</li>\r\n	<li>Inflammation of the intestine</li>\r\n</ul>', '<p>If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. Lymecycline capsules must not to be taken if you are pregnant or breast feeding. Use of medicines such as Lymecycline capsules may affect the proper growth of developing teeth or bones, and lead to permanent tooth discolouration.</p>', '<p>Patient with myasthenia gravis. May exacerbate SLE. Hepatic impairment.</p>', NULL, '<p>Tetracycline group of drugs</p>', '<p>Store below 25&deg; C. Protect from light.</p>', NULL, '2022-03-09 03:05:02', '2022-03-09 03:05:02'),
(890, 890, '<p>Lynestrenol is indicated in Polymenorrhoea, Menorrhagia and metrorrhagia, Selected cases of primary and secondary amenorrhoea and oligomenorrhoea, Premenstrual syndrome, Endometriosis, Selected cases of endometrial carcinoma, Benign breast disease, Suppression of menstruation ovulation and ovulation pain dysmenorrhoea, Postponement of menstruation, As an adjunct to estrogen therapy in pre-and postmenopause in order to avoid endometrial hyperplasia.</p>', '<p>Lynestrenol is an oral preparation of the synthetic progestagen lynestrenol, which shares various activities with the natural hormone progesterone. Lynestrenol has a strong progestational influence on the endometrium. In addition, it suppresses ovulation and menstruation for as long as the preparation is taken daily without interruption. Lynestrenol can be used in conditions requiring a pronounced progestagenic effect. After oral administration lynestrenol is readily absorbed and subsequently converted into the pharmacologically active norethisterone, through which it exerts its major biological effects. Within 2-4 hours after ingestion of lynestrenol peak plasma levels of norethisterone are reached. Lynestrenol and its metabolites are predominantly excreted in the urine, and to a less extent in the faeces.</p>', '<p><strong>Polymenorrhoea</strong>: 1 tablet daily on days 14-25 of the cycle.<br />\r\n<br />\r\n<strong>Premenstrual syndrome</strong>: 1 tablet daily on days, 4-25 of the cycle.<br />\r\n<br />\r\n<strong>Endometriosis</strong>: 1-2 tablets daily for at least 6 months.<br />\r\n<br />\r\n<strong>Selected cases of endometrial carcinoma</strong>: 6-10 tablets daily for prolonged periods.<br />\r\n<br />\r\n<strong>Benign breast disease</strong>: 1 tablet daily on days 14-25 of the cycle for at least 3-4 months.<br />\r\n<br />\r\n<strong>Menorrhagia and metrorrhagia</strong>: 1 tablet daily on days 14-25 of the cycle cease within a few days after the start of the treatment. Treatment is repeated during the next 3 menstrual cycles with 1 tablet daily on days 14-25 of each cycle. Further diagnostic procedures are necessary if the complaints do not disappear during or after this treatment.<br />\r\n<br />\r\n<strong>Selected cases of primary and secondary amenorrhoea and oligomenorrhoea</strong>: Treatment should start with the administration of an estrogen, e.g. 0.02-0.05 mg ethinylestradiol per day for 25 days. In conjunction with this, 1 tablet daily of Lynestrenol is administered on days 14-25. After cessation of treatment, a withdrawal bleeding usually occurs within 3 days. Treatment is resumed (second cycle) starting on day 5 of this withdrawal bleeding with the estrogen given on days 5-25 of the cycle and again with 1 tablet daily of Lynestrenol on days 14-25. This treatment should be repeated for at least another cycle.<br />\r\n<br />\r\n<strong>Suppression of menstruation ovulation and ovulation pain dysmenorrhoea</strong>: Treatment with 1 tablet daily should start preferably on day 1, but no later than day 5 of the cycle The treatment can be continued for many months (without tablet-free days). If in spite of treatment, a breakthrough bleeding occurs, the dosage should be increased to 2 or 3 tablets daily for 3-5 days.<br />\r\n<br />\r\n<strong>Postponement of menstruation</strong>: Treatment with 1 tablet daily should start preferably 2 weeks before the expected onset of menstruation. If treatment is started less than 1 week before the expected onset of menstruation the dosage should be 2-3 tablets per day. However, in that case a delay of more than 1 week is undesirable. The risk of breakthrough bleeding increases if treatment is started later. Therefore, treatment should not be started later than 3 days before the expected onset of menstruation.<br />\r\n<br />\r\n<strong>As an adjunct to estrogen therapy in pre-and postmenopause in order to avoid endometrial hyperplasia</strong>: 1/2-1 tablet daily for 12-15 days per month, e.g. for the first 2 weeks of every calendar month; the estrogen may be administered daily without tablet-free intervals at the lowest effective dose.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Lynestrenol tablets should be taken orally with some fluid.</p>', '<p>There are some indications, mainly obtained with other progestagen-containing preparations, that activated charcoal, barbiturates (primidone included), hydantoins and rifampicin may possibly decrease the effectiveness of Lynestrenol. Conversely, Lynestrenol may possibly increase the effectiveness of certain beta-adrenergic blockers and cyclosporin and possibly decrease the effectiveness of insulins.</p>', '<ul>\r\n	<li>Pregnancy or suspected pregnancy.</li>\r\n	<li>Severe liver disease such as cholestatic jaundice or hepatitis (or a history of severe liver disease if the results of liver function tests have failed to return to normal), hepatic cell tumours,Rotor syndrome and Dubin-Johnson syndrome.</li>\r\n	<li>Undiagnosed vaginal bleeding.</li>\r\n	<li>Conditions of rare occurrence known to be affected by sex steroids, or a history of these conditions (the condition may have occurred first or worsened during pregnancy or use of sex steroids); i.e. herpes gestationis, jaundice of pregnancy otosclerosis, severe pruritus or porphyria.</li>\r\n</ul>', '<p>During continuous treatment regimens with Lynestrenol, breakthrough bleeding or spotting will occur frequently (over 10 per cent) during the first two months. Later on the frequency gradually decreases. During cyclic treatment regimens breakthrough bleeding and spotting will be seen occasionally (1-10 per cent). Temporarily increasing the dose will control the bleeding in most cases. Other adverse events which occur frequently (over 10 per cent) are : change in libido (both increase and decrease), nausea or other gastrointestinal disturbances, and weight increase. Adverse events which may be observed occasionally (1-10 per cent) or rare (less than 1 per cent) are : headache or migraine, dizziness, nervousness, depression, increased sweating, acne, hirsutism, chloasma, rash, pruritus, jaundice, change in lipoprotein profile, alterations in liver function tests, amenorrhoea, menstrual irregularity, reduced glucose tolerance, breast pain, oedema. Most of these adverse events are transient and of minor importance in many cases.</p>', '<p>This medicine is contraindicated during pregnancy. There are insufficient data on the use of this medicine during breast feeding to assess potential harm.</p>', '<ul>\r\n	<li>Chloasma is occasionally seen during the use of estrogen and/or progestagen-containing preparations, especially in women with a history of chloasma gravidarum. In women with a tendency to chloasma exposure of the skin to natural or artificial sunlight may induce or aggravate the condition.</li>\r\n	<li>Occasionally changes in parameters of liver function, carbohydrate metabolism and haemostasis may occur. If the results of relevant tests become abnormal, treatment should be discontinued. An increase in LDL-cholesterol and a decrease in HDL-cholesterol may occur during Lynestrenol therapy.</li>\r\n	<li>During prolonged treatment with progestagens, periodic medical examinations are advisable.</li>\r\n	<li>As determined by the effects on SHBG, lynestrenol has weak androgenic activity. This is confirmed by the slight signs of virilisation (such as acne and hirsutism) observed in some patients.</li>\r\n	<li>Patients with any of the following conditions should be kept under close medical supervision: circulatory disorders (or a history of this condition), since with estrogen/progestagen&nbsp; containing oral contraceptive preparations a slightly increased risk of some cardiovascular disorders has been reported; some forms of severe depression,if likely to be exacerbated by sex steroid</li>\r\n</ul>', NULL, '<p>Female Sex hormones, Oral Contraceptive preparations.</p>', '<p>Store in a cool &amp; dry place, away from light. Keep the medicine out of the reach of children.</p>', NULL, '2022-03-09 03:07:08', '2022-03-09 03:07:08'),
(891, 891, '<p>Prevention of acute, sub-acute, chronic or recurrent infections of the upper respiratory tract (Common cold, Sinusitis, Pharyngitis, Epiglottitis, Laryngotracheitis, Otitis) and lower respiratory tract (Bronchitis, Bronchiolitis, Pneumonia, Acute Exacerbations in Chronic Obstructive Pulmonary Disease).</p>', NULL, '<p><strong>Children 3 years and above, adults and elderly</strong>: One sublingual tablet daily, to be dissolved under the tongue before meal for 10 consecutive days per month, for three consecutive months.</p>', '<p>&nbsp;Interactions with other drugs is not known.</p>', '<p>Hypersensivity to the active substance or auxiliary.</p>', '<p>In rare cases, respiratory, thoracic and mediastinal violations; skin and subcutaneous violations; general disorders, digestive disorders and local sublingual disturbances caused by the drug. In any case of violation, the treatment should be discontinued.</p>', '<p>Although toxic effects were observed in animals, not controlled studies were performed in pregnant women. For that reason, it is recommended to avoid the use during the first three months of confirmed or suspected pregnancy. During the period of fertility and lactation, special observations on the effect of the drug was carried out.</p>', NULL, '<p>No cases of overdose were observed.</p>', '<p>Other antibacterial preparation.</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-09 03:09:25', '2022-03-09 03:09:25'),
(892, 892, '<p>For use in adults and children over 12 years of age for effective relief from constipation and treatment of chronic constipation. Also effective in resolving faecal impaction, defined as refractory constipation with faecal loading of the rectum and colon.</p>', '<p>Macrogol (3350) exerts an osmotic action in the gut, which induces a laxative effect. Macrogol (3350) increases the stool volume, which triggers colon motility via neuromuscular pathways. The physiological consequence is an improved propulsive colonic transportation of the soften stools and a facilitation of the defecation. Electrolytes combined with Macrogol (3350) are exchanged across the intestinal barrier (mucosa) with serum electrolytes and excreted without net gain or loss of sodium, potassium and water. Macrogol (3350) is unchanged along the gut. It is virtually unabsorbed from the gastrointestinal tract.</p>', '<p>Measure 25 ml of this oral solution with the measuring cup provided, then add this to 100 ml of water. Any unused diluted solution should be discarded within 24 hours.<br />\r\n<br />\r\nAdult:</p>\r\n\r\n<ul>\r\n	<li><strong>Constipation</strong>: 25 ml of this oral solution added to 100 ml of water once daily (to make a total&nbsp;volume of 125 ml). This may be increased to 2 - 3 doses of 25 ml daily (each 25 ml dose added to 100 ml of water), if required according to individual response.</li>\r\n	<li><strong>Fecal Impaction</strong>: 8 doses of 25 ml daily (each 25 ml dose added to 100 ml of water). A course of treatment for fecal impaction does not normally exceed 3 days.</li>\r\n</ul>\r\n\r\n<p>Children (12-18 years): 25 ml of this oral solution added to 100 ml of water once daily.</p>', '<p>There is a possibility that the absorption of other medicinal products could be transiently reduced during use with this&nbsp;oral solution. There have been isolated reports of decreased efficacy with some concomitantly administered medicinal products, e.g. anti-epileptics.</p>', '<p>Intestinal perforation or obstruction due to structural or functional disorder of the gut wall, ileus, severe inflammatory conditions of the intestinal tract, such as&nbsp;Crohn&#39;s disease and ulcerative colitis and toxic megacolon. Hypersensitivity to the active substances.</p>', '<p>In the treatment of chronic constipation, diarrhoea or loose stools normally respond to a reduction in dose. Diarrhoea, abdominal distension, anorectal discomfort and mild vomiting are more often observed during the treatment for fecal impaction. Vomiting may be resolved if the dose is reduced or delayed.</p>', '<p>Clinically, no effects during pregnancy are anticipated, since systemic exposure to Macrogol (3350) is negligible. This oral solution can be used during pregnancy. No effects on the breastfed newborn/infant are anticipated since the systemic exposure of the breast-feeding woman to Macrogol (3350) is negligible. This oral solution can be used during breast-feeding.</p>', '<p>This medicinal product contains 8.125 mmol of sodium in each dose of 125 ml. The sodium content of this&nbsp;oral solution should be taken into consideration when administering the product to patients on a controlled sodium diet.</p>', '<p>Extensive fluid loss by diarrhea or vomiting may require correction of electrolyte disturbances.</p>', '<p>Osmotic purgatives.</p>', '<p>Store below 30&deg; C and in a place protected from light. Do not refrigerate.</p>', NULL, '2022-03-09 04:00:31', '2022-03-09 04:00:31'),
(893, 893, '<p>Magaldrate is indicated to relieve symptoms of dyspepsia, heartburn, acid indigestion, sour stomach, gastroesophageal reflux, hiatal hernia and flatulence. It is also prescribed in hyperacidity associated with peptic ulcers, gastritis and esophagitis. Magaldrate may be given to children if necessary.</p>', '<p>Magaldrate is a hydroxymagnesium aluminate complex that is converted rapidly in gastric acid to Mg(OH)2&nbsp;and Al(OH)3, which are absorbed poorly and thus provide a sustained antacid effect.</p>', '<p><strong>Tablet</strong>: 1-3 tablets, after meals and at bed time or as directed by the physician.<br />\r\n<br />\r\n<strong>Syrup</strong>: 2 to 3 teaspoonful, 3 or 4 times daily, half to one hour after or before meal and at bedtime.</p>', NULL, '<p>Magaldrate is contraindicated in patients with known hypersensitivity to magnesium and aluminium. It is also contraindicated in patients with impaired renal function.</p>', '<p>Constipation and diarrhea may occur.</p>', '<p><strong>Pregnant women</strong>: Magaldrate may be used in pregnancy if indicated however one should avoid excessive dosage.<br />\r\n<br />\r\n<strong>Lactating mother</strong>: Magaldrate may pass into breast milk but has not been reported to cause problem in nursing babies.</p>', NULL, NULL, '<p>Antacids, Anti-dyspeptic/Carminatives.</p>', NULL, NULL, '2022-03-09 04:02:15', '2022-03-09 04:02:15'),
(894, 894, '<p>This is indicated to relieve symptoms of dyspepsia, heartburn, acid indigestion, sour stomach, gastroesophageal reflux and hiatal hernia. It is also prescribed in hyperacidity associated with peptic ulcers, gastritis and esophagitis. Magaldrate may be given to children if necessary. Also indicated for the relief of flatulence, abdominal distension and windy colic.</p>', '<p>This is a combination of magaldrate and simethicone. Magaldrate (magnesium aluminium compound i.e. Hydroxymagnesium Aluminate), which neutralizes gastric acid extraordinarily quickly without raising the pH above 5-6. It also decreases the activity of pepsin in gastric secretion. Besides this, simethicone, the another component of Marlox Plus, enables the gas buble to coalesce and give relief from flatulence.</p>', '<p><strong>Tablet</strong>: 1-4 chewable tablets, 20 to 60 minutes after meals and at bedtime, or as directed by the physician.<br />\r\n<strong>Suspension</strong>: 2-4 teaspoonfuls (10-20 ml) of suspension, 20 to 60 minutes after meals and at bed time, or as directed by the physician.</p>', '<p>It should not be used in patients taking any form of Tetracycline. The drug may cause reduced bio-availability or slower absorption of a number of drugs including propranolol, isoniazid, prednisolone and naproxen.</p>', '<p>Magaldrate is contraindicated in patients with known hypersensitivity to magnesium and aluminium. It is also contraindicated in patients with impaired renal functions.</p>', '<p>Gastrointestinal side-effects are uncommon. Occasionally, if excessive amount is consumed, diarrhea, constipation or regurgitation may occur.</p>', '<p>Magaldrate may be used in pregnancy if indicated however one should avoid excessive dosage. Magaldrate may pass into breast milk but has not been reported to cause problem in nursing babies.</p>', '<p>Care should be taken in decreased kidney function, hypophosphataemia and weak people.</p>', '<p>Over dosage with this formulation is a rare case.</p>', '<p>Antacids, Anti-dyspeptic/Carminatives.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-09 04:04:24', '2022-03-09 04:04:24'),
(895, 895, '<p>Magnesium Hydroxide suspension is used in constipation, heart burn, gas and nausea. It is also indicated in acute and long acting constipation due to hyper acidity and peptic ulcer or stomatitis.</p>', '<p>Magnesium Hydroxide is popularly known as Milk of Magnesia. It is a mildly acting antacid and laxative. It is poorly and slowly absorbed and acts by its osmotic properties in the luminal fluid which causes retention of fluid in the bowel. It is useful for emptying the bowel prior to surgical, radiological and colonoscopic procedures and can help to eliminate parasites following appropriate therapy and toxic material in some cases of poisoning. Magnesium Hydroxide is converted into Magnesium Chloride in the stomach without forming carbon dioxide</p>', '<p>As Laxative:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 2-4 Tablespoonful with a full glass of water.</li>\r\n	<li><strong>Children</strong>: 6-11 years: 1-2 Tablespoonful with a full glass of water. 2-5 years: 1-3 Teaspoonful with a full glass of water.</li>\r\n</ul>\r\n\r\n<p>As Antacid:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 1-3 teaspoonful (5 to 15 ml) up to 4 times daily with water.</li>\r\n	<li><strong>Children</strong>: 1-3 years: &frac14; teaspoonful. 3-6 years: &frac14;-&frac12; teaspoonful. 6-12 years: &frac12;-1 teaspoonful</li>\r\n</ul>', '<p>Magnesium hydroxide can decrease the absorption of other drugs such as, digoxin, mycophenolate, phosphate supplements (e.g., potassium phosphate), tetracycline antibiotics, certain azole antifungals (ketoconazole, itraconazole), and quinolone antibiotics (e.g., ciprofloxacin, levofloxacin).</p>', '<p>Magnesium Hydroxide should not be administered where use of laxative is contraindicated. Long term treatment of Magnesium Hydroxide is contraindicated in patients with renal failure.</p>', '<p>Magnesium Hydroxide in common with other magnesium salts may cause diarrhoea.</p>', NULL, '<p>The drug should be avoided if possible in patients with renal and hepatic failure and in those with heart block and myocardial disease. The drug may be used cautiously in pregnancy.</p>', NULL, '<p>Antacid with laxative action.</p>', '<p>Store in a cool &amp; dry place, protected from light. Keep all medicines out of reach of children.</p>', NULL, '2022-03-09 04:06:25', '2022-03-09 04:06:25'),
(896, 896, '<p>This preparation is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Constipation</li>\r\n	<li>Hyperacidity with constipation</li>\r\n	<li>Anorectal disorder</li>\r\n	<li>Post-operative constipation</li>\r\n	<li>Constipation associated with chronic cholecystitis</li>\r\n	<li>Hernia</li>\r\n</ul>', '<p>This preparation has a dual-relief formulation containing a gentle laxative ingredient and a lubricant which eases the discomfort associated with straining and bowel movement. It is recommended for the temporary relief of constipation.</p>', '<p>The recommended oral dose are as follows-<br />\r\n<strong>Adults</strong>: 15-30ml before breakfast or at bedtime.<br />\r\n<br />\r\n<strong>Children</strong>:</p>\r\n\r\n<ul>\r\n	<li>Over 7 years: 7.5 ml-15 ml at bedtime.</li>\r\n	<li>3-7 years: 5-10 ml at bedtime.</li>\r\n</ul>\r\n\r\n<p>The dose may be mixed with milk or half a glass of water if desired. Don&#39;t take for more than 1 week unless under doctor&#39;s supervision</p>', '<p>Cimetidine, Diuretics, Famotidine and Ranitidine may cause irritation of stomach or bowel.</p>', '<p>Acute Gl conditions like abdominal pain.</p>', '<p>Rectal irritation, potassium loss (thirst, weakness, nausea and diarrhea).</p>', '<p>Can be given to pregnant and lactating mother.</p>', '<p>Renal and hepatic impairment. Maintain adequate fluid intake.</p>', '<p>There are no reported cases of overdosage.</p>', '<p>Antacid with laxative action.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-09 04:08:48', '2022-03-09 04:08:48'),
(897, 897, '<p>Magnesium Oxide is indicated for the treatment of following condition:</p>\r\n\r\n<ul>\r\n	<li>Relieving the symptoms of magnesium defciency</li>\r\n	<li>Cardiovascular system: Rapid heartbeat, heart rate irregularity, heart attack, angina pectoris (chest pain caused by narrowing / obstruction of heart-feeding vessels), mild severe hypertension</li>\r\n	<li>Nervous system and muscles: Sudden and excessive contractions (tetania) in the muscles, muscle cramp, gastrointestinal cramps, increased stimulability of muscles and nerves, calf cramps, cramp conditions in newborn and young children and stress</li>\r\n	<li>Gynecological diseases, birth and pregnancy: Pre-term contraction, cervical insufciency, premature membrane rupture, contractions during pregnancy (eclampsia [Disease with seizures, blood pressure increase, protein in the urine, water retention in body during pregnancy]/preeclampsia [Disease with blood pressure increase, protein in the urine, water retention in body during pregnancy]), tocolysis requiring the use of beta mimetic (interruption of the uterine contractions), dysmenorrhea.</li>\r\n	<li>Orthopedics: Calcifcation and ossifcation</li>\r\n	<li>Prevention of kidney stone formation (prevention of recurrence of calcium oxalate urolithiasis)</li>\r\n	<li>Diabetes treatment and migraine (a kind of headache)</li>\r\n</ul>', '<p><strong>Pharmacology</strong>: Magnesium is the second most abundant intracellular divalent cation and is a cofactor for more than 300 metabolic reactions in the body. These processes include protein synthesis, cellular energy production and storage, cell growth and reproduction, DNA and RNA synthesis, and stabilization of mitochondrial membranes. Magnesium is one of the minerals responsible for managing bone metabolism, nerve transmission, cardiac excitability, neuromuscular conduction, muscular contraction, vasomotor tone, and blood pressure. Magnesium also plays a significant role in glucose and insulin metabolism, mainly through its impact on tyrosine kinase activity, phosphorylase b kinase activity, and glucose transporter protein activity. Because of these vital roles, magnesium levels may be affected by stressors to the body, such as in certain disease states. Supplementation with magnesium may have therapeutic effects in these situations.<br />\r\n<br />\r\n<strong>Pharmacokinetics</strong>: Absorption of a micronutrient as Mg is affected by other nutrients and reaches an estimated 30&ndash;50% of dietary Mg intake at basal conditions, while the absorption fraction declines with age and raising Mg intake. The drug absorption depends on both the kind of Mg salt and other food elements that may either augment or abate it. The distribution&nbsp;of Mg is mainly intracellular, &lt;1% circulates in the blood (both extracellularly and intracellularly), and total serum Mg comprises three states with roughly 60% ionized, 33% protein-bound and 7% anion complexed. Elimination of Mg is handled by renal filtration with 25% being reabsorbed in the proximal convoluted tubule and further 50&ndash;60% is reabsorbed in the loop of Henle. Around 70&ndash;80% of plasma Mg undergoes glomerular filtration, but merely 3% is eventually excreted in the urine.</p>', '<p>Magnesium supplements must be taken with meal to reduce stomach upset and diarrhea. The recommended daily dose for adults and adolescents (12-17 years) is 1-2 tablets.<br />\r\n<br />\r\nKidney failure: Should not be used in patients with severe kidney insufficiency.<br />\r\nLiver failure: There are no data on patients with liver insufficiency.<br />\r\nUsage in the elderly: There is no data on the use in elderly patients.</p>', '<p>Other medicines can affect treatment with Magnesium Oxide tablet. If you are using any of the following: medicines, tell your doctor; muscle relaxants (non-depolarizing neuromuscular blockers), aminoquinolones, nitrofurantoin, penicillamine, tetracyclines, fluoroquinolones (antibiotics), Digoxin (for the treatment of heart failure), Lithium (Control of emotional changes and depression), Sodium polystyrene sulfonate (allows potassium to be removed from the body), Cellulose sodium phosphate (used to prevent kidney stones), Other medicines containing magnesium (including magnesium enemas), Barbiturates (drugs used for the treatment of insomnia), opioids (substances that act as morphine in the body), hypnotics (soporific), Nifedipine (drugs used in high blood pressure or heart problems).</p>', '<p>Hypersensitivity and severe renal impairment.</p>', '<p>Mild side effects include-Nausea, Vomiting, Diarrhea, Cramp, Tiredness, Weakness, Confusion. These side effects disappear when the dose is reduced or treatment is discontinued. Serious side effects include low blood pressure, changes in the recording of the heart&#39;s electrical activity (ECG), depression, severe allergic reaction (e.g. swelling in mouth and throat, itching, rash, redness), respiratory depression, coma. These may require emergency medical treatment. These serious side efects occur very rarely.</p>', '<p>The recommended daily dose in pregnancy and lactation is 1-2 tablets. (During pregnancy &amp; lactation, this product should be used only when clearly needed).</p>', '<p>This product may contain inactive ingredients, which can cause allergic reactions or other problems. If anyone has the following health problem, consult with doctor before using this product: kidney disease, alcohol dependence, liver disease, phenylketonuria (PKU), or any other condition that requires limit/avoid these substances from diet.</p>', '<p>Symptoms of overdose may include slow heartbeat, severe dizziness, confusion, muscle weakness, loss of consciousness, diarrhea and hypermagnesemia.</p>', '<p>Antacids, Electrolytes preparations, Oral electrolytes preparations.</p>', '<p>Store below 25&deg;C. Protected from light and moisture. Keep all medicines out of the reach of children.</p>', NULL, '2022-03-09 04:10:46', '2022-03-09 04:10:46'),
(898, 898, '<p>Magnesium Sulfate injection is indicated mainly for the treatment of hypomagnesaemia and magnesium deficiency states. Irregular heart beats, some time it may be used as a laxative.<br />\r\n<br />\r\nMagnesium Sulfate injection is used in the treatment of magnesium deficiency. Magnesium Sulfate has anticonvulsant properties when administered parentally, it may be used to prevent or control of Seizures associated with acute uremia, hypothyroidism and eclampsia. It is also used in bronchial asthma &amp; cardiovascular disorder</p>', '<p>Magnesium&nbsp;is the second most plentiful&nbsp;cation&nbsp;of the intracellular fluids. It is&nbsp;essential&nbsp;for the activity of many enzyme systems and plays an important role with regard to neurochemical transmission and&nbsp;muscular&nbsp;excitability. Deficits are accompanied by a variety of structural and functional disturbances.</p>', '<p><strong>Intramuscular</strong>: Adults and older children: For severe hypomagnesemia, 1 to 5 gm (2 to 10 ml of 50% solution) daily in divided doses; administration is repeated daily until serum levels have returned to normal. If deficiency is not severe, 1 gm (2 ml of 50% solution) can be given once or twice daily. Serum magnesium levels should serve as a guide to continued dosage.<br />\r\n<br />\r\n<strong>Intravenous</strong>: 1 to 4 gm magnesium sulfate (magnesium sulfate (magnesium sulfate injection) injection) may be given intravenously in 10% to 20% solution, but only with great caution; the rate should not exceed 1.5 ml of 10% solution or equivalent per minute until relaxation is obtained.<br />\r\n<br />\r\n<strong>Usual Dose Range</strong>: 1 to 40 gm daily.<br />\r\n<br />\r\n<strong>Electrolyte Replenisher</strong>: Intramuscular 1 to 2 gm in 50% solution four times a day until serum magnesium is within normal limits.<br />\r\n<br />\r\n<strong>Usual Pediatric Dose</strong>:&nbsp;Intramuscular 20 to 40 mg per kg of body weight in a 20% solution repeated as necessary.<br />\r\n<br />\r\n<strong>For Eclampsia</strong>: Initially 1 to 2 gm in 25% or 50% solution is given intramuscularly. Subsequently, 1 gm is given every 30 minutes until relief is obtained. The blood pressure should be monitored after each injection.</p>', '<p><strong>Interaction with medicine</strong>: Magnesium Sulfate may cause a reduction in blood pressure when taken together with Calcium channel blockers such as nifedipine. There may be an increase in the effects of neuromuscular blocking agents when given together with Magnesium Sulfate. When Magnesium Sulfate is given together with the following medicines there may be a risk of respiratory depression on high dose barbiturates, opioids and aminoglycosides antibiotics.<br />\r\n<br />\r\n<strong>Interaction with food &amp; others</strong>:There is no interaction of Magnesium Sulfate with food &amp; others.</p>', '<p>Magnesium Sulfate contra-indicated in the case of defect of the heart&#39;s electrical message pathways resulting in decreased function of the heart (heart block), severe damage to the muscular wall of the heart (myocardium) and significantly decreased kidney function.</p>', '<p>Excessive administration of magnesium leads to the development of hypermagnesaemia. Symptoms of hypermagnesaemia may include nausea, vomiting, flushing of skin, thirst, hypotensiondue to peripheral vasodilatation, drowsiness, confusion, muscle weakness etc.</p>', '<p>Magnesium Sulfate crosses the placenta. So, as with any other drugs, caution is required when the drug is administered to pregnant women. It is not known whether the drug is excreted in human milk. As it happens with many other drugs, cautions should be taken when it is administered to a nursing mother.</p>', '<p>Magnesium Sulfate contra-indicated in the case of defect of the heart&#39;s electrical message pathways resulting in decreased function of the heart (heart block), severe damage to the muscular wall of the heart (myocardium) and significantly decreased kidney function.</p>', '<p><strong>Symptoms of hypermagnesemia are</strong>: respiratory depression and loss of deep tendon reflexes due to neuromuscular blockade, nausea, vomiting, flushing, thirst, hypotension, drowsiness, confusion, slurred speech, double vision, bradycardia and muscle weakness.</p>', '<p>Specific mineral preparations.</p>', '<p>Store in a cool &amp; dry place, keep away from light &amp; children.</p>', '<p><strong>Use in Children &amp; Adolescents</strong>: Magnesium Sulfate seems to be beneficial in the treatment of moderate to severe asthma in children as an adjuvant therapy.</p>', '2022-03-09 04:12:55', '2022-03-09 04:12:55');
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
(899, 899, '<p>Magnesium Sulphate Heptahydrateis indicated in the following conditions:</p>\r\n\r\n<ul>\r\n	<li>To prevent convulsion in patients with preeclampsia, eclampsia, tetanus and acute uraemia.</li>\r\n	<li>In acute myocardial infarction, arrythmia.</li>\r\n	<li>To arrest premature labour.</li>\r\n	<li>As an adjuvant in neurosurgery to lower the C.S.F pressure.</li>\r\n	<li>For replacement therapy in hypomagnesaemia</li>\r\n	<li>To control hypertension, encephalopathy and convulsion associated with acute nephritis in children.</li>\r\n</ul>', '<p>Magnesium is the second most plentiful cation of intracellular fluid and is involved in a wide range of activities. It is needed for activity of many enzymes and plays a role in neurochemical transmission and muscular excitability. Abnormally low concentration of magnesium in the ECF results in increased acetylcholine release and increased muscle excitability that can produce tetany. Magnesium Sulphate heptahydrate has anticonvulsant properties when administered parenterally. An increased concentration of magnesium in the ECF causes depression of the central nervous system ( CNS). Magnesium has a direct effect on skeletal muscle. Hypomagnesaemia may develop from diarrhoea, stoma or fistula, alcoholism or diuretic therapy, prolonged treatment with aminoglycosides, hypocalcaemia, hypokalaemia and hyponatraemia.<br />\r\n<br />\r\nAfter administration 25-30% of magnesium is protein bound. It is excreted mainly in the urine, over 90% of magnesium filtered by the kidney is reabsorbed. Small amounts are excreted in the faeces, breast milk and saliva. Magnesium also crosses the placenta.</p>', '<p><strong>Usual dose range</strong>: Upto 40 gm daily at a rate not exceeding 3 ml per minute<br />\r\n<br />\r\n<strong>Seizure prophylaxis in Preeclampsia and Eclampsia</strong>: A loading dose of 4 gm (100 ml) over upto 20 minutes followed by a maintenance dose of 2 gm (50 ml) per hour. Recurrence of seizure may require an additional I.V bolus of 8-16 mmol (upto 100 ml). For seizure prophylaxis, treatment should continue during labour and for atleast 24 hours after delivery.<br />\r\n<br />\r\n<strong>In Myocardial infarction</strong>: 8 mmol (50 ml) over 20 minutes, then 65 mmol (400 ml) over 24 hours.<br />\r\n<br />\r\n<strong>In Magnesium deficiency</strong>: 0.5-1 mmol/kg/day (200 ml to 400 ml) on the first day followed by 25 mmol (150 ml) daily, upto 160 mmol (1000 ml) over upto 5 days.<br />\r\n<br />\r\n<strong>In Tetanus</strong>: An infusion of Magnesium Sulphate sufficient to maintain a blood magnesium concentration of 2.5 to 4 mmol per litre has been recommended.<br />\r\n<br />\r\n<strong>In arrythmia</strong>: 8 mmol (50 ml) over 10-15 minutes (repeated once if needed)</p>', '<p>Concomitant use of magnesium salts with barbiturates, narcotics, hypnotics or other C.N.S depressants need dose adjustment because of additive effect on C.N.S.</p>', '<p>It is contraindicated in patients with heart block or myocardial damage.</p>', '<p>Excessive administration of magnesium results in hypermagnesaemia manifested by nausea, vomiting, flushing of the skin, thirst, hypotension, drowsiness, confusion, loss of tendon reflexes, respiratory depression, cardiac arrest etc.</p>', '<p>Magnesium Sulphate crosses the placenta. So, as with any other drugs, caution is required when the drug is administered to pregnant women. It is not known whether the drug is excreted in human milk. As it happens with many other drugs, cautions should be taken when it is administered to a nursing mother.</p>', '<p>Magnesium salts should be used with caution in patients with impaired renal and hepatic function. Infusion of fluid should be immediately discontinued if rigor arises from any reason during the process. Do not use if the bottle is leaking, solution is cloudy, contains particles or after expiry date.</p>', '<p>Magnesium Sulphate overdose can be treated with 10ml of 10% calcium gluconate or chloride intravenously. If the renal function is normal, adequate fluid should be given. Dialysis may be performed in renal impairment.</p>', '<p>Specific mineral preparations.</p>', '<p>Store at controlled room temperature. Protect from light. This IV infusion is not intended for multi-dose use.</p>', NULL, '2022-03-09 04:15:12', '2022-03-09 04:15:12'),
(900, 900, '<p>Mannitol is principally used by IV infusion as an osmotic diuretic to preserve renal function in acute renal failure and to reduce raised intracranial and intraocular pressure. Mannitol is also used as an irrigating solution to prevent hemolysis and hemoglobin buildup during transurethral prostatic resection. It is useful in the management of acute drug poisoning where a route of elimination is through kidney. Besides these, it is also used in symptomatic relief of edema, reperfusion injury, termination of pregnancy, and bowel preparation. So, Mannitol is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Renal insufficiency</li>\r\n	<li>Reperfusion injury</li>\r\n	<li>Raised intracranial pressure</li>\r\n	<li>Bladder irrigation</li>\r\n	<li>Raised intraocular pressure</li>\r\n	<li>Bowel preparation</li>\r\n	<li>Edematous status</li>\r\n	<li>As a prophylactic in renal failure</li>\r\n	<li>Management of poisoning</li>\r\n	<li>Termination of Pregnancy</li>\r\n</ul>', NULL, '<p>The adult dose of Mannitol ranges from 50 to 100 gm by IV infusion. The rate of administration is usually adjusted to maintain a urine flow of at least 30 to 50 ml/hr. Total dosage, concentration and the rate of administration depends on fluid requirement, urinary output and the severity of the condition being treated<br />\r\n<br />\r\nRenal insufficiency-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 50 to 100 g of Mannitol administered at a rate adjusted to maintain a urine flow of at least 30 to 50 ml/hr.</li>\r\n	<li><strong>Children</strong>: 2 gm/kg or 60 gm/m2&nbsp;of body surface area administered over a period of 2 to 6 hrs.</li>\r\n</ul>\r\n\r\n<p>Cerebral edema, elevated intracranial pressure, elevated intraocular pressure, Glaucoma-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 1.5 to 2 gm/kg&nbsp;administered over a period of 30 to 60 minutes.</li>\r\n	<li><strong>Children</strong>: 1 to 2 gm/kg body wt. or 30 to 60 gm/m2&nbsp;of body surface area administered over a period of 30 to 60 mins.</li>\r\n</ul>\r\n\r\n<p>Adjunctive therapy for removal of toxic substances-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 50 to 200 g of Mannitol administered at a rate adjust to maintain a urine flow of at least 100 to 500 ml/hr.</li>\r\n	<li><strong>Children</strong>: 2 gm/kg or 60 gm/m2&nbsp;of body surface area</li>\r\n</ul>\r\n\r\n<p>For termination of pregnancy 50 gm of Mannitol (250 ml of Mannitol) is instilled into the amniotic cavity which induces abortion in a high proportion of pregnancies.</p>', NULL, '<p>Mannitol intravenous infusion is contraindicated in patients with pulmonary edema or congestive heart failure. It is also contraindicated during inadequate urine flow, dehydration or acidosis, intracranial bleeding and in patients with renal failure unless a test dose has produced a diuretic response.</p>', '<p>The most common side effects associated with Mannitol intravenous infusion is fluid and electrolytes imbalance including circulatory overload and acidosis at high doses. Other side effects include nausea, vomiting, thirst, headache, dizziness, fever, tachycardia, chest pain, hyponatraemia, dehydration, blurred vision, urticaria, and hypertension or hypotension.</p>', '<p>Safety of Mannitol intravenous infusion in pregnancy has not been established yet. No information is available on the excretion of mannitol in breast milk and should be administered after careful consideration of risk-benefit ratio.</p>', '<p>Careful monitoring of rate of administration of Mannitol is necessary to avoid fluid and electrolyte imbalance and circulatory overloading. The infusion should be discontinued if the patient develops signs of progressive renal dysfunction, heart failure or pulmonary congestion. Mannitol should not be administered with whole blood. Infusion of fluid should be immediately discontinued if rigor arises from any reason during the process. Do not use if the solution is cloudy, contains particles or after expiry date.</p>', NULL, '<p>Osmotic diuretics.</p>', '<p>Mannitol should be stored at a temperature of 20&deg; to 30&deg;. Exposure to lower temperatures may cause deposition of crystals, which should be dissolved by warming the bottle in hot water for about 30 minutes. Cool to body temperature before using. If all crystals can not be dissolved, the solution should not be used. The content of open containers should be used promptly. Unused contents should be discarded.</p>', NULL, '2022-03-09 04:16:47', '2022-03-09 04:16:47'),
(901, 901, '<p>Maprotiline hydrochloride tablets are indicated for the treatment of depressive illness in patients with depressive neurosis (dysthymic disorder) and manic depressive illness, depressed type (major depressive disorder). Maprotiline is also effective for the relief of anxiety associated with depression.</p>', '<p>The mechanism of action of maprotiline is not precisely known. It does not act primarily by stimulation of the central nervous system and is not a monoamine oxidase inhibitor. The postulated mechanism of maprotiline is that it acts primarily by potentiation of central adrenergic synapses by blocking reuptake of norepinephrine at nerve endings. This pharmacologic action is thought to be responsible for the drug&#39;s antidepressant and anxiolytic effects.</p>', '<p><strong>Adult:</strong>&nbsp;As hydrochloride: 25-75 mg daily in 3 divided doses, gradually increased in 25 mg increments at 1-2 wk intervals to 150 mg/day if necessary. Up to 225 mg/day in severely depressed patients.<br />\r\n<br />\r\n<strong>Elderly:</strong>&nbsp;Initial: 25 mg daily. May increase slowly according to response to 50-75 mg daily if needed.</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>Close super vision and careful adjustment of dosage are required when administering maprotiline concomitantly with anticholinergic or sympathomimetic drugs because of the possibility of additive atropine like effects. Concurrent administration of maprotiline with electroshock therapy should be a voided because of the lack of experience in this area.<br />\r\n<br />\r\nCaution should be exercised when administering maprotiline to hyperthyroid patients or those on thyroid medication because of the possibility of enhanced potential for cardiovascular toxicity of maprotiline.<br />\r\n<br />\r\nMaprotiline should be used with caution in patients receiving guanethidine or similar agents since it may block the pharmacologic effects of these drugs.<br />\r\n<br />\r\nThe risk of seizures may be increased when maprotiline is taken concomitantly with phenothiazines or when the dos age of benzodiazepines is rapidly tapered in patients receiving maprotiline.<br />\r\n<br />\r\nBecause of the pharmacologic similarity of maprotiline hydrochloride to the tricyclic antidepressants, the plasma concentration of maprotiline may be increased when the drug is given concomitantly with hepatic enzyme inhibitors (e.g., cimetidine, fluoxetine) and decreased by concomitant administration with hepatic enzyme inducers (e.g., barbiturates, phenytoin), as has occur red with tricyclic antidepressants. Adjustment of the dosage of maprotiline hydrochloride may therefore be necessary in such cases.</p>', '<p>Maprotiline hydrochloride tab lets are contraindicated in patients hypersensitive to maprotiline and in patients with known or suspected seizure disorders. It should not be given concomitantly with monoamine oxidase (MAO) inhibitors. A minimum of 14 days should be allowed to elapse after discontinuation of MAO inhibitors before treatment with maprotiline is initiated. Effects should be monitored with gradual increase in dosage until optimum response is achieved. The drug is not recommended for use during the acute phase of myocardial infarction.</p>', '<p>Dry mouth, constipation, blurred vision, drowsiness, dizziness, tremor, nervousness, anxiety, insomnia, agitation, confusion, nausea, weakness and fatigue, headache, CV disorders, altered liver function, changes in blood glucose concentrations, allergic skin manifestations.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category B. Reproduction studies have been performed in female laboratory rabbits, mice, and rats at doses up to 1.3, 7, and 9 times themaximum daily human dose respectively and have revealed no evidence of impaired fertility or harm to the fetus due to maprotiline. There are, however, no adequate and well controlled studies in pregnant women. Be cause 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>Labor and Delivery</strong>: Although the effect of maprotiline on labor and delivery is unknown, caution should be exercised as with any drug with CNS depressant action<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: Maprotiline is excreted in breast milk. At steady-state, the concentrations in milk correspond closely to the concentrations in whole blood. Caution should be exercised when maprotiline hydrochloride is administered to a nursing woman.</p>', '<p>Urinary retention, prostatic hyperplasia, chronic constipation, untreated angle-closure glaucoma; hyperthyroidism; risk of suicide; may precipitate mania or psychotic symptoms; withdraw gradually; may impair ability to operate machinery. Pregnancy and lactation; elderly.</p>', '<p>Deaths may occur from overdosage with this class of drugs. Multiple drug ingestion (including alcohol) is common in deliberate overdose. As the management is complex and changing, it is recommended that the physician contact a poison control center for current information on treatment. Signs and symptoms of toxicity develop rapidly after overdose. There fore, hospital monitoring is required as soon as possible.</p>', '<p>Tricyclic Anti-depressant.</p>', '<p>Store at 20&deg; to 25&deg;C. Protect from light. Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.</p>', NULL, '2022-03-09 04:19:07', '2022-03-09 04:19:07'),
(902, 902, '<p>This is indicated for simultaneous immunization against measles and rubella in persons older than 8 months.</p>', NULL, '<p><strong>Adults and Children</strong>: A single dose of 0.5 ml of the reconstituted vaccine given by deep subcutaneous injection. Do not give intravenously.<br />\r\n<br />\r\n<strong>EPI schedule</strong>: After completion of 9 months, 1 dose of measles-rubella vaccine should be given. After completion of 15 months, 1 dose of only measles containing vaccine should be given.</p>', NULL, '<p>Allergic to any ingredient in the vaccine. Suffering from acute diseases, severe chronic diseases, acute exacerbation of chronic diseases and fever. Pregnant women. Immune deficiency, immune dysfunction or receiving immunosuppressive therapy. Suffering from encephalopathy, uncontrolled epilepsy and other progressive neurological diseases.</p>', '<p>Common side-effects:</p>\r\n\r\n<ul>\r\n	<li>Generally pain and tenderness at the injection site may occur within 24 hours after vaccination, which usually disappear by itself within 2-3 days.</li>\r\n	<li>Generally transient fever reaction may occur within 1-2 weeks after vaccination.</li>\r\n	<li>Rash: generally mild rash may occur within 12 days after vaccination, which generally lasts for no more than 2 days.</li>\r\n</ul>\r\n\r\n<p>Rare side-effects:</p>\r\n\r\n<ul>\r\n	<li>Severe fever reaction: physical methods and drugs should be used for symptomatic treatment to prevent febrile seizures.</li>\r\n</ul>\r\n\r\n<p>Very rare side-effects:</p>\r\n\r\n<ul>\r\n	<li>Allergic rash: generally urticaria may occur within 72 hours after vaccination, and if this reaction occurs, anti-allergy treatment should be timely given.</li>\r\n	<li>Anaphylactic shock: generally occurs within 1 hour after vaccination. Injection of epinephrine and other emergency measures should be timely given for treatment.</li>\r\n	<li>Anaphylactoid purpura: medical care should be timely given if anaphylactoid purpura occurs. Cortical steroids can be given for anti-allergy treatment. Improper or not timely treatment is likely to cause anaphylatic purpura nephritis.</li>\r\n	<li>Thrombocytopenia purpura.</li>\r\n	<li>Adults may develop arthritis, pain and swelling of large joints after vaccination.</li>\r\n</ul>', '<p>Pregnancy category C. Pregnancy should be avoided for 3 months following vaccination. Caution should be exercised when Measles and Rubella vaccine is administered to a nursing woman.</p>', '<p>The vaccine should not be used if vaccine bottle has cracks or unclear labels, the vaccine is beyond shelf life, and abnormal appearance (such as turbidity) is observed after reconstitution. The vaccine should be used immediately after opening. Epinephrine and other drugs should be prepared for emergency use in case of occasional severe allergic reaction. The people receiving vaccination should be observed at the site for at least 30 minutes after injection. The people receiving injection of immune globulin should be vaccinated with an interval of at least 3 months so as not to affect the immune effect. Other attenuated live vaccine should be vaccinated with an interval of at least 1 month from this vaccine, but this vaccine can be vaccinated simultaneously with attenuated live mumps vaccine. This product is an attenuated live vaccine and it is not recommended to be used in the epidemic season. Women of childbearing age should avoid pregnancy within at least 3 months after injection of this vaccine. Freezing is prohibited.</p>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', '<p>Keep out of the reach and sight of children. Store at +2&deg;C to +8&deg;C. Transportation should also be at +2&deg;C to +8&deg;C. Do not freeze. Discard vaccine if frozen. Protect from light.</p>', NULL, '2022-03-09 04:20:56', '2022-03-09 04:20:56'),
(903, 903, '<p>Mebendazole is indicated for the treatment of threadworms, whipworms, roundworms and hookworms.</p>', '<p>Mebendazole is a synthetic broad-spectrum anthelmintic that is active against most nematodes and some other worms. Mebendazole is principally used in the treatment of intestinal nematode infection. Mebendazole inhibits the formation of the worms&#39; microtubules and causes the worms&#39; glucose depletion. After oral administration about 2-10% of oral dose is absorbed from Gl tract and peak plasma concentration occurs within 30 minutes to 7 hours. Mebendazole is highly bound to plasma protein. Elimination half-life is 2.8 to 9 hours.</p>', '<p>Adult and Child over 2 years-</p>\r\n\r\n<ul>\r\n	<li><strong>Threadworms</strong>: 100 mg or 1 teaspoonful: Single dose.</li>\r\n	<li><strong>Whipworms, Roundworms, Hookworms</strong>: 100 mg or 1 teaspoonful: Twice daily for 3 days.</li>\r\n</ul>\r\n\r\n<p>If reinfection occurs the second dose may be needed after 2 weeks.</p>', '<p>Preliminary evidence suggests that cimetidine inhibits mebendazole metabolism and may result in an increase in plasma concentration.</p>', '<p>Mebendazole is contraindicated in patients with known hypersensitivity to Mebendazole, or to any component of the formulation.</p>', '<ul>\r\n	<li>Gastrointestinal: Transient symptoms of abdominal pain and diarrhoea in case of massive infection and expulsion of worms.</li>\r\n	<li>Hypersensitivity: Rash, urticaria and angioedema have been observed on rare occasions.</li>\r\n	<li>Central Nervous System: Very rare cases of convulsions have been reported.</li>\r\n	<li>Haematologic: Neutropenia and agranulocytosis.</li>\r\n</ul>', '<p>Mebendazole is not recommended in pregnant women. It is not known whether mebendazole is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when it is administered to a nursing mother.</p>', '<p><strong>General</strong>: Periodic assessment of organ system functions, including haematopoietic and hepatic, is advisable during prolonged therapy.<br />\r\n<br />\r\n<strong>Information for Patients</strong>: Patients should be informed of the potential risk to the foetus in women taking mebendazole during pregnancy, especially during the first trimester. Patients should also be informed that cleanliness is important to prevent reinfection &amp; transmission of the infection.</p>', '<p>In the event of accidental overdosage, gastrointestinal complaints lasting up to a few hours may occur. Vomiting and purging should be induced.</p>', '<p>Anthelmintic</p>', '<p>Store in a cool (Below 25&deg;C temperature) and dry place, protected from light. Keep out of the reach of children.</p>', '<p>Paediatric use: The drug has not been extensively studied in children under two years; therefore, in the treatment of children under two years the relative benefit/risk should be considered.</p>', '2022-03-09 04:23:05', '2022-03-09 04:23:05'),
(904, 904, '<p>Mebeverine is indicated for the:</p>\r\n\r\n<ul>\r\n	<li>Symptomatic treatment of irritable bowel syndrome (IBS)</li>\r\n	<li>Chronic irritable colon</li>\r\n	<li>Spastic constipation</li>\r\n	<li>Mucous colitis</li>\r\n	<li>Colicky abdominal pain</li>\r\n	<li>Persistent non-specific diarrhoea</li>\r\n</ul>', NULL, '<p>For adults, elderly and children over 10 years:</p>\r\n\r\n<ul>\r\n	<li><strong>Mebeverine Hydrochloride 135 mg tablet</strong>: 1 tablet 03 times daily.</li>\r\n	<li><strong>Mebeverine Hydrochloride 200 mg capsule</strong>: 1 capsule 02 times daily.</li>\r\n</ul>\r\n\r\n<p>This is most effective when taken 20 minutes before meals. After several weeks when the desired effect has been obtained, the dosage may be gradually reduced.<br />\r\n<br />\r\n<strong>Missed dose</strong>: If a dose of this medicine is missed, that should be taken as soon as possible. However, if it is almost time for the next dose, then skip the missed dose and the regular dosing schedule should be maintained. Dose should not be doubled at the same time to compensate the missed dose.<br />\r\n&nbsp;</p>', NULL, '<p>Hypersensitivity to the drug or any other ingredients.</p>', '<p>Generally Mebeverine is well tolerated. However, few side-effects like skin rash, urticaria and angioedema may appear.</p>', '<p>No teratogenicity has been shown in animal experiments. However, the usual precautions concerning the administration of any drug during pregnancy should be exercised. Mebeverine does not excrete in the breast milk after administering at therapeutic dose.</p>', '<p>Caution should be exercised in porphyria or allergic reaction to this or any other medicine of this group.</p>', '<p>On theoretical grounds it may be predicted that CNS excitability will occur in case of overdosage. No specific antidote is known: gastric lavage and symptomatic treatment is recommended.</p>', '<p>Anticholinergics</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-09 04:25:21', '2022-03-09 04:25:21'),
(905, 905, '<p>Mebhydrolin Napadisylate is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Allergic disease or symptoms such as urticaria</li>\r\n	<li>Pruritus of various origin</li>\r\n	<li>Eczema</li>\r\n	<li>Itching</li>\r\n	<li>Drug rash</li>\r\n	<li>Insect bites</li>\r\n	<li>Allergic conjunctivitis</li>\r\n	<li>Dermatitis of nutritional origin</li>\r\n	<li>Hay fever,</li>\r\n	<li>Vasomotor rhinitis</li>\r\n	<li>Allergic asthma.</li>\r\n</ul>', '<p>Mebhydrolin diminishes or abolishes the main actions of histamine in the body by blocking of histamine receptors.</p>', '<p>Adults and children over 10 years: 2-6 tablets daily<br />\r\n<br />\r\nChildren-</p>\r\n\r\n<ul>\r\n	<li>5-10 years: 2-4 tablets daily</li>\r\n	<li>2-5 years: 1-3 tablets daily</li>\r\n	<li>Up to 2 years: 1-2 tablets daily</li>\r\n</ul>\r\n\r\n<p>Treatment should be given in several single doses daily. Mebhydrolin may be swallowed during or shortly after meals. For children, the tablet may be crushed and mixed with food.</p>', '<p>The effects of atropine and tricyclic anti-depressants may be enhanced by Mebhydrolin. It may mask the warning symptoms of damage caused by ototoxic drugs.</p>', '<ul>\r\n	<li>Hypersensitivity to any of the ingredients of Mebhydrolin tablet or to mebhydrolin</li>\r\n	<li>Prostatic hypertrophy, narrow-angle glaucoma.</li>\r\n	<li>First trimester of pregnancy.</li>\r\n</ul>', '<p>Lassitude, dizziness, hypotension, muscular weakness, nausea, vomiting, diarrhoea or constipation, epigastric pain, headache, blurred vision, tinnitus, depression, nightmares, anorexia, dryness of the mouth, tightness of the chest, tingling, sedation, drowsiness etc. may occur.</p>', '<p>Safety in pregnancy and lactation has not been established.</p>', '<p>The substance may cause drowsiness, if affected, driving or operating machinery &amp; alcoholic drinks should be avoided.</p>', NULL, '<p>Sedating Anti-histamine</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Safety in pregnancy and lactation has not been established.</p>', '2022-03-09 04:27:12', '2022-03-09 04:27:12'),
(906, 906, '<p>Prevention and treatment of nausea, vomiting, dizziness, motion sickness, radiation sickness and vertigo associated with diseases of the vestibular system (e.g. Meniere&#39;s syndrome, labyrinthitis and other vestibular disturbances).</p>', '<p>Meclizine is a piperazine-derivative antihistamine that is used as an antiemetic. It has antiemetic, anticholinergic and antihistaminic properties. It reduces the sensitivity of the labyrinthine apparatus. The action may be mediated through nerve pathways to the vomiting center (VC) from the chemoreceptor trigger zone (CTZ), peripheral nerve pathways, the VC, or other CNS centers. Pyridoxine is vitamin B-6. It has been added to enhance the anti-emetic effects &amp; as a dietary suppliment.</p>', '<p>Adult and Children 12 years of age &amp; over:</p>\r\n\r\n<ul>\r\n	<li><strong>Nausea and vomiting</strong>: 25-50 mg daily or as directed by a physician.</li>\r\n	<li><strong>Motion sickness</strong>: Take an initial dose of 25-50 mg, 1 hour prior to travel. May repeat the dose every 24 hours for the duration of the journey.</li>\r\n	<li><strong>Radiation sickness</strong>: 50 mg administered 2-12 hours prior to radiation treatment.</li>\r\n	<li><strong>Vertigo</strong>: 25-100 mg daily in divided doses.</li>\r\n	<li><strong>Prevention of nausea and vomiting associated with emergency contraceptive pill (ECP)</strong>: 25-50 mg, 1 hour before first ECP dose; repeat if needed in 24 hours.</li>\r\n</ul>\r\n\r\n<p>The safety and efficacy for use in children less than 12 years of age have not been established.</p>', '<p>The CNS depressant effects of Meclizine can be potentiated by concurrent use of Ethanol or other CNS depressant agents such as Benzodiazepines, Barbiturates, Tricyclic antidepressants, opiate agonists, skeletal muscle relaxants and antihistamines. Concurrent use of other anticholinergics can potentiate the anticholinergic effects of Meclizine. Meclizine can increase the absorption of digoxin by decreasing gastrointestinal motility.</p>', '<p>Meclizine Hydrochloride and Pyridoxine Hydrochloride is contraindicated in patients who are hypersensitive to these ingredients.</p>', '<p>Drowsiness, dry mouth and, on rare occasions, blurred vision have been reported.</p>', '<p>Pregnancy Category B. Large-scale human studies have not demonstrated adverse fetal effects. It has been suggested that based on available data, Meclizine presents the lowest risk of teratogenicity and is the drug of first choice in treating nausea and vomiting during pregnancy. Safety for use in the nursing mother has not been established.</p>', '<p>Patients should be warned that Meclizine Hydrochloride may impair their ability to perform hazardous activities requiring mental alertness or physical coordination (e.g., operating machinery, driving a motor vehicle). Patients should avoid alcoholic beverages while taking this drug. Due to its potential anticholinergic action, this drug should be used with caution in patients with asthma, glaucoma or enlargement of the prostate gland.</p>', '<p><strong>Symptoms</strong>: Extreme excitability, seizures, drowsiness and hallucinations.<br />\r\n<strong>Treatment</strong>: Appropriate supportive and symptomatic treatment. Consider dialysis.</p>', '<p>Anti-emetic drugs.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-09 04:29:02', '2022-03-09 04:29:02'),
(907, 907, '<p>Meclizine Hydrochloride is indicated in nausea, vomiting, motion sickness, vertigo.</p>', '<p>Meclizine has antiemetic, anticholinergic and antihistaminic properties. It reduces the sensitivity of the labyrinthine apparatus. The action may be mediated through nerve pathways to the vomiting center (VC) from the chemoreceptor trigger zone (CTZ), peripheral nerve pathways, the VC, or other CNS centers. Meclizine has an onset of action of 30 to 60 minutes, depending on dosage; their duration of action is 12 to 24 hours.</p>', '<p>Adult &amp; children over 12 years of age:</p>\r\n\r\n<ul>\r\n	<li><strong>Nausea and vomiting:</strong>&nbsp;25-50 mg once daily.</li>\r\n	<li><strong>Motion sickness:</strong>&nbsp;Take an initial dose of 25 to 50 mg, 1 hour prior to travel. May repeat dose every 24 hours for the duration of the journey.&nbsp;Children: Age 6-12 years, 12.5 mg once daily. Age 2-6 years, 6.25 mg once daily.</li>\r\n	<li><strong>Vertigo:</strong>&nbsp;25 to 100 mg daily in divided doses.</li>\r\n	<li><strong>Radiotherapy induced nausea and vomiting:</strong>&nbsp;50 mg two to twelve hours prior to radiotherapy.</li>\r\n	<li><strong>Emergency contraception:</strong>&nbsp;25-50 mg, 1 hour before first ECP dose; repeat if needed in 24 hours.</li>\r\n</ul>\r\n\r\n<p><strong>Use in children</strong>: Clinical studies establishing safety and efficacy in children have not been done; therefore, its use should be determined by physician.<br />\r\n<br />\r\n<strong>Use in elderly</strong>: There is no specific information available. However older people may be especially sensitive to the anticholinergic effects of medicine.</p>', '<p>Meclizine may increase the toxicity with CNS depressants, neuroleptics and anticholinergic. Alcohol, sedatives and tranquilizers can increase the drowsiness of the patient.</p>', '<p>Meclizine is contraindicated in patients hypersensitive to Meclizine or any of its excipeints.</p>', '<p>Common side effects are Drowsiness, dry mouth, and on rare occasions, blurred vision have been reported.</p>', '<p>Meclizine shows no risk of birth defects or abnormalities when administered during pregnancy. Although Meclizine may excrete into the milk, it causes no harm in nursing babies.</p>', '<p>Patients with asthma, bronchitis, emphysema, enlarged prostate, glaucoma or urinary tract blockage should take Meclizine (like other antiemetics) with caution.</p>', '<p><strong>Symptoms</strong>: Extreme excitability, seizures, drowsiness and hallucinations.<br />\r\n<br />\r\n<strong>Treatment</strong>: Appropriate supportive and symptomatic treatment. Consider dialysis.</p>', '<p>Anti-emetic drugs.</p>', '<p>Store in a cool &amp; dry place and away from children.</p>', NULL, '2022-03-09 04:30:58', '2022-03-09 04:30:58'),
(908, 908, '<p>Mecobalamin is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Peripheral Neuropathies</li>\r\n	<li>Diabetic Neuropathy</li>\r\n	<li>Verteberal Syndrome</li>\r\n	<li>Nerve Compression Syndrome</li>\r\n	<li>Multiple sclerosis</li>\r\n	<li>Amyotrophic lateral sclerosis</li>\r\n	<li>Parkinson&rsquo;s disease</li>\r\n	<li>Alzheimer&rsquo;s disease</li>\r\n	<li>Diabetic retinopathy</li>\r\n	<li>Entrapment neuropathy</li>\r\n	<li>Drug induced neuropathy</li>\r\n	<li>Megaloblastic anemia due to Vitamin B12 deficiency</li>\r\n</ul>', '<p>Mecobalamin is the neurologically active form of vitamin B12 and occurs as a water-soluble vitamin in the body. It is a cofactor in the enzyme methionine synthase, which functions to transfer methyl groups for the regeneration of methionine from homocysteine. In anaemia, it increases erythrocyte production by promoting nucleic acid synthesis in the bone marrow and by promoting maturation and division of erythrocytes.</p>', '<p><strong>Tablet</strong>: The usual adult dosage is 500 mcg tablet three times daily. The dosage should be adjusted according to the age of patient and the severity of symptoms.&nbsp;<br />\r\n<br />\r\nInjection:</p>\r\n\r\n<ul>\r\n	<li><strong>Peripheral neuropathies</strong>: The usual adult dosage is&nbsp; 500 mcg Mecobalamin administered intramuscularly or intravenously three times a week.The dosage should be adjusted according to the age of patient and the severity of symptoms.&nbsp;</li>\r\n	<li><strong>Megaloblastic anemia</strong>: The usual adult dosage is&nbsp; 500 mcg Mecobalamin administered intramuscularly or intravenously three times a week. After about two months of administration, dosage should be changed to one ampoule equivalent to 500 mcg of Mecobalamin every one to three months as maintenance therapy.</li>\r\n</ul>', '<p>Decreased GI tract absorption with neomycin, aminosalicylic acid, H2-blockers and colchicine. Reduced serum concentrations with oral contraceptives. Reduced effects in anaemia with parenteral chloramphenicol.</p>', '<p>Hypersensitivity to any component of this product.</p>', '<p>Generally Mecobalamin is well tolerated. However, a few side effects like GI discomfort (including anorexia, nausea or diarrhea) &amp; rash may be seen after administration of Mecobalamin.</p>', '<p>Not recommended during pregnancy &amp; lactation.</p>', '<p>The medicine should not be used for months if there is no response at all after its use for a certain period of time.</p>', NULL, '<p>Drugs for Megaloblastic Anemia.</p>', '<p><strong>Oral:</strong>&nbsp;Store at room temperature. Protect from moisture and light.<br />\r\n<strong>Parenteral:</strong>&nbsp;Store at room temperature. Do not expose to direct light.</p>', '<p><strong>Use in children:</strong>&nbsp;Not recommended.</p>', '2022-03-09 04:33:10', '2022-03-09 04:33:10'),
(909, 909, '<p>Medroxyprogesterone Acetate indicated for:</p>\r\n\r\n<ul>\r\n	<li>Ovulation suppression</li>\r\n	<li>The treatment of endometriosis.</li>\r\n	<li>Adjunctive and/or pallivative treatment of recurrent and/or metastatic endometrial or renal carcinoma.</li>\r\n	<li>The treatment of hormonally-dependant recurrent breast cancer in post-menopausal women.</li>\r\n</ul>', '<p><strong>Pharmacodynamics</strong>: Medroxyprogesterone Acetate injection has prolonged progestational effects when administered by intramuscular injection. This injection suppresses the secretion of pituitary gonadotropins which, in turns, prevents follicular maturation producing long-term anovulation in the reproductive aged women. Medroxyprogesterone Acetate injection suppresses the Leydig cell function in the male. i.e. suppresses endogenous testosterone product.<br />\r\n<br />\r\n<strong>Pharmacokinetics</strong>: Parenteral Medroxyprogesterone Acetate is a long acting progestational steroid. The 150 mg/ml formulation reaches half its initial concentration in about 27 days. Its long duration of acting results from its slow absorption from the injection site. The principle metabolite of medroxyprogesterone acetate that has been identified is a 6-alpha-methyl-6 beta 17 alpha, 21 trihydroxy-4-pregnene-3, 20-dione-17 acetate which is excreted in the urine.</p>', '<p><strong>Ovulation suppression</strong>: Medroxyprogesterone Acetate injectables suspension should be gently shaken just before use to ensure that the dose being administered represents a uniform suspension. The recommended dose is 150 mg/ml of this injectable suspension every three months administered by intramuscular injection in the gluteal or deltoid muscle. The initial injection should be given during the first 5 days after the onset of a menstrual period; within the 5 days post partum if not breast feeding; if exclusively breast-feeding at or after six weeks post partum.<br />\r\n<br />\r\nBased on limited experience, some investigators favour the use of a second injection of Medroxyprogesterone Acetate before 90 days to control troublesome bleeding. The third and subsequent injections should be administered at separate 90 days intervals.<br />\r\n<br />\r\nIf abnormal bleeding persists, appropriate investigations should be instituted to rule out the possibility of organic pathology. Uterine curettage may be required on rare occations.</p>', '<p>Aminoglutethimide administered concomitantly with high doses of medroxyprogestrone acetate may significant depress the serum concentration of medroxyprogestrone acetate. User should be warned of the possibility of decreases efficacy with the use of amoniglutethimide.</p>', '<p>Known or suspected pregnancy, Undiagnosed vaginal bleeding, Known or suspected malignancy of breast ( when used for ovulation suppression or gynaecology indications), Severe liver dysfunction, Known hypersensitivity to medroxyprogesterone acetate or any component of the drug.</p>', '<ul>\r\n	<li>Weight gain, feeling heaviness and pain in the abdomen, feeling pain, anxiety</li>\r\n	<li>Amenorrhea</li>\r\n	<li>Spotting</li>\r\n	<li>Excessive bleeding</li>\r\n	<li>Infection in the injected site</li>\r\n	<li>Headache, Blurring of vision</li>\r\n	<li>Pain in the back of the leg</li>\r\n	<li>Delay in pregnancy after withdrawing injectable contraceptive.</li>\r\n</ul>', '<p>Not recommended for the first 4 months.</p>', '<p>Unexpected vaginal bleeding during therapy, patient with a pre-existing medical condition that might be adversely affected by fluid retention, patients with a history of treatment for clinical depression diabetic patient. It may decrease the level of the following endocrine biomarkers: Plasma /urinary steroid (eg: cortisol, oestrogen, pregnanediol , progesterone &amp; testosterone ) Plasma /urinary gonadotrophin (eg: LH &amp; FSH) &amp; sex&nbsp; hormonebinding- globulin (SHBG).</p>', NULL, '<p>Female Sex hormones.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-09 04:35:07', '2022-03-09 04:35:07'),
(910, 910, '<p>Medroxyprogesterone acetate tablet is a progestin indicated for the treatment of secondary amenorrhea and abnormal uterine bleeding due to hormonal imbalance in the absence of organic pathology, such as fibroids or uterine cancer. Medroxyprogesterone acetate is also indicated to reduce the incidence of endometrial hyperplasia in nonhysterectomized postmenopausal women receiving daily oral conjugated estrogens 0.625 mg tablets.</p>', '<p>Medroxyprogesterone acetate (MPA) administered orally or parenterally in the recommended doses to women with adequate endogenous estrogen, transforms proliferative into secretory endometrium. Androgenic and anabolic effects have been noted, but the drug is apparently devoid of significant estrogenic activity. While parenterally administered MPA inhibits gonadotropin production, which in turn prevents follicular maturation and ovulation, available data indicate that this does not occur when the usually recommended oral dosage is given as single daily doses.</p>', '<p><strong>Secondary Amenorrhea</strong>: Medroxyprogesterone acetate tablets may be given in dosages of 5 or 10 mg daily for 5 to 10 days. A dose for inducing an optimum secretory transformation of an endometrium that has been adequately primed with either endogenous or exogenous estrogen is 10 mg of this tablet daily for 10 days. In cases of secondary amenorrhea, therapy may be started at any time. Progestin withdrawal bleeding usually occurs within three to seven days after discontinuing this tablet therapy.<br />\r\n<br />\r\n<strong>Abnormal Uterine Bleeding Due to Hormonal Imbalance in the Absence of Organic Pathology</strong>: Beginning on the calculated 16th or 21st day of the menstrual cycle, 5 or 10 mg of this tablet may be given daily for 5 to 10 days. To produce an optimum secretory transformation of an endometrium that has been adequately primed with either endogenous or exogenous estrogen, 10 mg of this tablet daily for 10 days beginning on the&nbsp; 16th day of the cycle is suggested. Progestin withdrawal bleeding usually occurs within three to seven days after discontinuing therapy with this tablet. Patients with a past history of recurrent episodes of abnormal uterine bleeding may benefit from planned menstrual cycling with this tablet.<br />\r\n<br />\r\n<strong>Reduction of Endometrial Hyperplasia in Postmenopausal Women Receiving Daily 0.625 mg Conjugated Estrogens</strong>: When estrogen is prescribed for a postmenopausal woman with a uterus, a progestin should also be initiated to reduce the risk of endometrial cancer. A woman without a uterus does not need progestin. Use of estrogen, alone or in combination with a progestin, should be with the lowest effective dose and for the shortest duration consistent with treatment goals and risks for the individual woman. Patients should be re-evaluated periodically as clinically appropriate (for example, 3 to 6 month intervals) to determine if treatment is still necessary. For women who have a uterus, adequate diagnostic measures, such as endometrial sampling, when indicated, should be undertaken to rule out malignancy in cases of undiagnosed persistent or recurring abnormal vaginal bleeding.<br />\r\n<br />\r\nMedroxyprogesterone acetate tablet tablets may be given in dosages of 5 or 10 mg daily for 12 to 14 consecutive days per month, in postmenopausal women receiving daily 0.625 mg conjugated estrogens, either beginning on the 1st day of the cycle or the 16th day of the cycle. Patients should be started at the lowest dose. The lowest effective dose of this tablet has not been determined.</p>', NULL, '<p>Medroxyprogesterone Acetate 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, suspected, or history of breast cancer.</li>\r\n	<li>Known or suspected estrogen- or progesterone-dependent neoplasia.</li>\r\n	<li>Active DVT, PE, or a history of these conditions</li>\r\n	<li>Active arterial thromboembolic disease (for example, stroke and MI), or a history of these conditions.</li>\r\n	<li>Known anaphylactic reaction or angioedema to Medroxyprogesterone Acetate</li>\r\n	<li>Known liver impairment or disease.</li>\r\n	<li>Known or suspected pregnancy.</li>\r\n</ul>', '<p>The following adverse reactions have been reported in women taking Medroxyprogesterone Acetate tablets, without concomitant estrogens treatment:</p>\r\n\r\n<ul>\r\n	<li><strong>Genitourinary system</strong>: Abnormal uterine bleeding (irregular, increase, decrease), change in menstrual flow, breakthrough bleeding, spotting, amenorrhea, changes in cervical erosion and cervical secretions.</li>\r\n	<li><strong>Breasts</strong>: Breast tenderness, mastodynia or galactorrhea has been reported.</li>\r\n	<li><strong>Cardiovascular</strong>: Thromboembolic disorders including thrombophlebitis and pulmonary embolism have been reported.</li>\r\n	<li><strong>Gastrointestinal</strong>: Nausea, cholestatic jaundice.</li>\r\n	<li><strong>Skin</strong>: Sensitivity reactions consisting of urticaria, pruritus, edema and generalized rash have occurred. Acne, alopecia and hirsutism have been reported.</li>\r\n	<li><strong>Eyes</strong>: Neuro-ocular lesions, for example, retinal thrombosis, and optic neuritis.</li>\r\n	<li><strong>Central nervous system</strong>: Mental depression, insomnia, somnolence, dizziness, headache, nervousness.</li>\r\n</ul>', '<p>Medroxyprogesterone Acetate should not be used during pregnancy. There may be increased risks for hypospadias, clitoral enlargement and labial fusion in children whose mothers are exposed to Medroxyprogesterone Acetate during the first trimester of pregnancy. However, a clear association between these conditions with use of this tablet has not been established. This tablet should not be used during lactation. Detectable amounts of progestin have been identified in the breast milk of nursing mothers receiving progestins.</p>', '<p><strong>Addition of a progestin when a woman has not had a hysterectomy</strong>: Studies of the addition of a progestin for 10 or more days of a cycle of estrogen administration, or daily with estrogen in a continuous regimen, have reported a lowered incidence of endometrial hyperplasia than would be induced by estrogen treatment alone. Endometrial hyperplasia may be a precursor to endometrial cancer. There are, however, possible risks that may be associated with the use of progestins with estrogens compared to estrogen-alone regimens. These include an increased risk of breast cancer.<br />\r\n<br />\r\n<strong>Unexpected abnormal vaginal bleeding</strong>: In cases of unexpected abnormal vaginal bleeding, adequate diagnostic measures are indicated.<br />\r\n<br />\r\n<strong>Elevated blood pressure</strong>: Blood pressure should be monitored at regular intervals with estrogen plus progestin therapy.<br />\r\n<br />\r\n<strong>Hypertriglyceridemia</strong>: In women with pre-existing hypertriglyceridemia, estrogen plus progestin therapy may be associated with elevations of plasma triglycerides leading to pancreatitis. Consider discontinuation of treatment if pancreatitis occurs.<br />\r\n<br />\r\n<strong>Hepatic Impairment and/or past history of cholestatic jaundice</strong>: Estrogens plus progestins may be poorly metabolized in women with impaired liver function. For women with a history of cholestatic jaundice associated with past estrogen use or with pregnancy, caution should be exercised, and in the case of recurrence, medication should be discontinued.<br />\r\n<br />\r\n<strong>Fluid Retention</strong>: Progestins may cause some degree of fluid retention. Women who have conditions which might be influenced by this factor, such as cardiac or renal impairment, warrant careful observation when estrogen plus progestin are prescribed.<br />\r\n<br />\r\n<strong>Hypocalcemia</strong>: Estrogen plus progestin therapy should be used with caution in women with hypoparathyroidism as estrogen-induced hypocalcemia may occur.<br />\r\n<br />\r\n<strong>Exacerbation of other conditions</strong>: Estrogen plus progestin therapy may cause an exacerbation of asthma, diabetes mellitus, epilepsy, migraine, porphyria, systemic lupus erythematosus, and hepatic hemangiomas and should be used with caution in women with these conditions.</p>', '<p>Overdosage of estrogen plus progestin therapy may cause nausea and vomiting, breast tenderness, dizziness, abdominal pain, drowsiness/fatigue and withdrawal bleeding may occur in women. Treatment of overdose consists of discontinuation of CE plus MPA together with institution of appropriate symptomatic care.</p>', '<p>Female Sex hormones.</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>: Medroxyprogesterone Acetate tablets are not indicated in children. Clinical studies have not been conducted in the pediatric population.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: There have not been sufficient numbers of geriatric women involved in clinical studies utilizing Medroxyprogesterone Acetate alone to determine whether those over 65 years of age differ from younger subjects in their response to Medroxyprogesterone Acetate alone.</p>', '2022-03-09 04:37:50', '2022-03-09 04:37:50');
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
(911, 911, '<p>Mefenamic Acid is indicated for-</p>\r\n\r\n<ul>\r\n	<li>Fever</li>\r\n	<li>Toothache</li>\r\n	<li>Headache</li>\r\n	<li>Migraine</li>\r\n	<li>Primary dysmenorrhoea</li>\r\n	<li>Menorrhagia</li>\r\n	<li>Mild to moderate pain in rheumatoid arthritis and osteoarthritis</li>\r\n	<li>Traumatic pain</li>\r\n	<li>Low-back pain</li>\r\n	<li>Juvenile chronic arthritis in children etc.</li>\r\n</ul>', '<p>Mefenamic acid contains Mefenamic Acid which is a nonsteroidal agent with demonstrated analgesic, anti-inflammatory and antipyretic activity due to its dual action on prostaglandins. It inhibits the enzymes of prostaglandin synthetase and also antagonizes the actions of prostaglandin at the receptor sites.</p>', '<p><strong>Adult</strong>:</p>\r\n\r\n<ul>\r\n	<li>500 mg dose should be given to adults upto three times (1.5 gm total) per day with meals. The dosage may be reduced to 1 tablet (250 mg) three times daily.</li>\r\n	<li>In case of menorrhagia: 500 mg three times daily with meals and from the onset of menses and continued according to the judgement of the physician.</li>\r\n</ul>\r\n\r\n<p><strong>Children</strong>:</p>\r\n\r\n<ul>\r\n	<li>6 months to 1 year: 5 ml three times/day.</li>\r\n	<li>2-4 years: 10 ml three times/day.</li>\r\n	<li>5-8 years: 10 ml four times /day.</li>\r\n	<li>9-12 years: 15 ml four times/day.</li>\r\n</ul>\r\n\r\n<p>Treatment should not be continued for more than 7 days except on the advice of a physician.</p>', '<p><strong>Aspirin</strong>: As other NSAIDs, concomitant administration of Mefenamic Acid and Aspirin is not generally recommended because of the potential of increased adverse effects.<br />\r\n<br />\r\n<strong>Warfarin</strong>: Mefenamic Acid can inhibit platelet aggregation and may prolong the prothrombin time in patients on warfarin therapy.</p>', '<p>It is contraindicated in patients with known hypersensitivity to Mefenamic Acid. It should not be used in patients with peptic ulcer, inflammatory bowel diseases, hepatic or renal impairment. It is also contraindicated in patients, whom aspirin and/or other NSAID&#39;s have induced symptoms of bronchospasm, skin rashes etc.</p>', '<p>The most frequently reported adverse experiences occurring in approximately 1-10% of patients are gastrointestinal: abdominal pain, constipation, diarrhoea, dyspepsia, flatulence, nausea, Gl ulcers, vomiting, dizziness, abnormal renal function, pruritus, rashes.</p>', '<p>The safety of Mefenamic acid on reproductive capacity and pregnancy has not been established. Thus, mefenamic acid should be used in women of childbearing potential and during pregnancy only when the potential benefits are expected to outweigh the potential risks. Trace amounts of Mefenamic acid may be present in breast milk and transmitted to the nursing infant. Thus Mefenamic acid should not be taken by the nursing mother because of the effects of this class of drugs on the infant&#39;s cardiovascular system.</p>', '<p>It should be administered with caution in allergic diseases especially in asthma. The treatment should be withdrawn in diarrhoea, rashes, cholestatic jaundice, thrombocytopenia, haemolytic anaemia.</p>', NULL, '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs).</p>', '<p>Keep away from light, store in a cool and dry place. Keep out of reach of children.</p>', NULL, '2022-03-09 04:40:01', '2022-03-09 04:40:01'),
(912, 912, '<p>Mefloquine is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Acute Malaria Infections caused by Mefloquine-susceptible strains of Plasmodium falciparum (both chloroquine- susceptible and resistant strains) or by P. vivax</li>\r\n	<li>Prophylaxis of P. falciparum and P. vivax malaria infections</li>\r\n</ul>', '<p>Mefloquine has been found to produce swelling of the&nbsp;Plasmodium falciparum&nbsp;food vacuoles. It may act by forming toxic complexes with free heme that damage membranes and interact with other plasmodial components.<br />\r\n<br />\r\nMefloquine is an antimalarial agent which acts as a blood schizonticide. Mefloquine is active against the erythrocytic stages of Plasmodium species. However, the drug has no effect against the exoerythrocytic (hepatic) stages of the parasite. Mefloquine is effective against malaria parasites resistant to chloroquine. Mefloquine is a chiral molecule. According to some research, the (+) enantiomer is more effective in treating malaria, and the (-) enantiomer specifically binds to adenosine receptors in the central nervous system, which may explain some of its psychotropic effects.</p>', '<p>Adult:</p>\r\n\r\n<ul>\r\n	<li><strong>Malaria prevention</strong>: 1 tablet (250 mg) once per week starting 1-2 weeks before departure and continued for 4 weeks after leaving malarious area.</li>\r\n	<li><strong>Malaria treatmen</strong>t: 5 tablets (5X250 mg) in a single dose (up to max. 1.5 gm) or preferably in 2 divided doses 6 to 8 hours apart.</li>\r\n</ul>\r\n\r\n<p>In Children 6 Months and Older:</p>\r\n\r\n<ul>\r\n	<li><strong>Malaria prevention</strong>: Approximately 5 mg/kg body weight once per week (250 mg for children weighing over 45 kg, decreasing in proportion to body weight for children weighing 45 kg or less).</li>\r\n	<li><strong>Malaria treatment</strong>: 20 to 25 mg/kg body weight which may be split into two doses 6 to 8 hours apart to reduce the occurrence or severity of adverse reactions.</li>\r\n</ul>\r\n\r\n<p><strong>Geriatric Use</strong>: Experiences have not identified differences in responses between the elderly and younger patients.<br />\r\n<br />\r\nShould be taken with food. Best taken with meals &amp; a full glass of water.</p>', '<p>Increased risk of ECG abnormalities with quinine or chloroquine, antihistamines, TCAs and phenothiazines. May increase risk of seizure with quinidine or quinine. Concomitant use with valproic acid, phenobarbital, carbamazepine and phenytoin may cause loss of seizure control and lower plasma levels of anticonvulsants. Increased risk of QT prolongation and arrhythmia with ketoconazole. Concomitant use with digoxin, Ca channel blockers, antiarrhythmics and &beta;-blockers may increase the risk of cardiotoxicity. Increased risk of ventricular arrhythmias with amiodarone. Concomitant use with TCAs, SSRIs, buprion, antipsychotic, tramadol may increase the risk of convulsions. Increased plasma levels with metoclopromide. May compromise adequate immunisation by live typhoid vaccine. Vaccinations with attenuated live bacteria should be completed at least 3 days prior the 1st dose of mefloquine.</p>', '<p>Use of Mefloquine is contraindicated in patients with a known hypersensitivity to Mefloquine or related compounds (e.g. quinine and quinidine). It should not be prescribed for prophylaxis in patients with active depression, a recent history of depression, generalized anxiety disorder, psychosis, or schizophrenia or other major psychiatric disorders, or with a history of convulsions.</p>', '<p>Among subjects who received Mefloquine for prophylaxis of malaria, following side effects was observed:</p>\r\n\r\n<ul>\r\n	<li>The most frequently observed sied-effects were vomiting, dizziness, syncope, extrasystoles and other complaints affecting less than 1%. Among subjects who received Mefloquine for treatment, following side-effects was observed:</li>\r\n	<li>The most frequently observed side-effects included : dizziness, myalgia, nausea, fever, headache, vomiting, chills, diarrhoea, skin rash, abdominal pain fatigue, loss of appetite, and tinnitus.</li>\r\n</ul>', '<p><strong>Use in Pregnancy</strong>: There is no adequate and well-controlled study in pregnant women. However, clinical experience with Mefloquine has not revealed an embrytoxic or teratogenic effect. Mefloquine 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 Nursing Mothers</strong>: Mefloquine is excreted in breast milk in small amounts. the activity of which is unknown. Because of the potential for serious adverse reactions in nursing infants form Mefloquine. a decision should be made whether to discontinue the drug taking into account the importance of the drug to the mother.</p>', '<p><strong>Warnings</strong>: Mefloquine may cause psychiatric symptoms in a number of patients, ranging from anxiety, paranoia, and depression to hallucinations and psychotic behavior. Rare cases of suicidal ideation and suicide have been reported though no relationship to drug administration has been confirmed. Mefloquine should be used with caution in patients with a previous history of depression. Concomitant administration of Mefloquine and quinine or quinidine may produce electrocardiographic abnormalities and may increase risk of convulsions.<br />\r\n<br />\r\n<strong>Precautions</strong>: In patients with epilepsy, Mefloquine may increase the risk of convulsions. Caution should be exercised with regard to activities requiring alertness and fine motor coordination such as driving, piloting aircraft and operating machinery. Mefloquine should be used with caution in patients with psychiatric disturbances. In patients with impaired liver function the elimination of Mefloquine may be prolonged, leading to higher plasma levels.</p>', '<p>In cases of overdosage with Mefloquine, the symptoms may be more pronounced. The following procedure is recommended in case of overdosage:</p>\r\n\r\n<ul>\r\n	<li>Induce vomiting or perform gastric lavage, as appropriate.</li>\r\n	<li>Monitor cardiac function (if possible by ECG), neurologic and psychiatric status for at least 24 hours.</li>\r\n	<li>Provide Symptomatic and intensive supportive treatment as required, particularly of cardiovascular disturbance.</li>\r\n	<li>Treat vomiting or diarrhoea with standard fluid therapy.</li>\r\n</ul>', '<p>Anti-malarial drugs.</p>', '<p>Store in a cool dry place. Protect from light.</p>', NULL, '2022-03-09 05:55:57', '2022-03-09 05:55:57'),
(913, 913, '<p>Megestrol Oral Suspension is indicated for the treatment of anorexia, cachexia, or an unexplained, significant weight loss in patients with a diagnosis of Acquired Immunodeficiency Syndrome (AIDS) &amp; cancer.</p>', '<p>Several investigators have reported on the appetite enhancing property of Megestrol Acetate and its possible use in anorexia, cachexia. The precise mechanism by which Megestrol Acetate produces effects in anorexia and cachexia is unknown at the present time but some studies indicate there is a statistically significant negative correlation between the level of pro-inflammatory cytokines such as IL1&nbsp;IL6&nbsp;,TNF with various nutritional parameters and improvement in quality of life and wieght gain.<br />\r\n<br />\r\nPlasma concentrations of Megestrol Acetate are dependent, not only on the method used, but also on intestinal and hepatic inactivation of the drug, which may be affected by factors such as intestinal tract motility, intestinal bacteria, antibiotics administered, body weight, diet, and liver function. The effect of food on the bioavailability of Megestrol Acetate Oral Suspension has not been evaluated. The major route of drug elimination in human is urine. The mean elimination half life ranged from 20 to 50 hours in healthy subject.</p>', '<p>The recommended adult initial dosage of Megestrol Oral Suspension is 800 mg/day (20 ml/day).</p>', '<p>Pharmacokinetic studies show that there are no significant alterations in pharmacokinetic parameters of Zidovudine or Rifabutin to warrant dosage adjustment when Megestrol Acetate is administered with these drugs. The effects of Zidovudine or Rifabutin on the pharmacokinetics of Megestrol Acetate were not studied.</p>', '<p>History of hypersensitivity to Megestrol Acetate or any component of the formulation. Known or suspected pregnancy.</p>', '<p>Adverse events which occurred in at least 5% of patients in any arm of the two clinical efficacy trials and the open trial are listed below by treatment group. These adverse events should be considered by the physician when prescribing Megestrol Acetate. Those are- diarrhea, impotence, rash, flatulence, hypertension, asthenia, insomnia, nausea, anaemia, fever, libido decreased, dyspepsia, hyperglycemia, headache, vomiting, pneumonia &amp; urinary frequency.<br />\r\n<br />\r\nAdverse events which occurred in 1% to 3% of all patients enrolled in the two clinical efficacy trials with at least one follow-up visit during the first 12 weeks of the study are listed below by body system.</p>\r\n\r\n<ul>\r\n	<li>Body as a Whole: abdominal pain, chest pain, infection, candidiasis and sarcoma</li>\r\n	<li>Cardiovascular System: cardiomyopathy and palpitation</li>\r\n	<li>Digestive System: constipation, dry mouth, hepatomegaly &amp; increased salivation</li>\r\n	<li>Hemic and Lymphatic System: leukopenia</li>\r\n	<li>Metabolic and Nutritional: LDH increased, oedema and peripheral oedema</li>\r\n	<li>Nervous System: paresthesia, confusion, convulsion, depression, neuropathy, hypesthesia and abnormal thinking</li>\r\n	<li>Respiratory System: dyspnea, cough and lung disorder</li>\r\n	<li>Skin and Appendages: alopecia, herpes, pruritus, vesiculobullous rash, sweating and skin disorder</li>\r\n	<li>Urogenital System: albuminuria, urinary incontinence, urinary tract infection and gynecomastia</li>\r\n</ul>', '<p>Pregnancy Category X. There are no adequate and well-controlled studies in pregnant women. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus. Women of childbearing potential should be advised to avoid becoming pregnant. Because of the potential for adverse effects on the newborn, nursing should be discontinued if Megestrol Acetate is required.</p>', '<p>General therapy with Megestrol Acetate for weight loss should only be instituted after treatable causes of weight loss are required and addressed. These treatable causes include possible malignancies, systemic infections, gastrointestinal disorders affecting absorption, endocrine disease and renal or psychiatric diseases. Effects on HIV viral replication have not been determined. Use with caution in patients with a history of thromboembolic disease. Use in Diabetics: Exacerbation of pre-existing diabetes with increased insulin requirements have been reported in association with the use of Megestrol Acetate.</p>', '<p>No serious unexpected side effects have resulted from studies involving Megestrol Acetate administered in dosages as high as 1200 mg/day.</p>', '<p>Hormonal Chemotherapy.</p>', '<p>Store at 20&deg; to 25&deg;C. Protect from heat. Shake well immediately before use.</p>', '<p>Pediatric Use: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\nGeriatric Use: In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.</p>', '2022-03-09 05:58:05', '2022-03-09 05:58:05'),
(914, 914, '<p>Megestrol Acetate is indicated for the palliative treatment of advanced carcinoma of the breast or endometrium (i.e., recurrent, inoperable, or metastatic disease). It should not be used instead of currently accepted procedures such as surgery, radiation, or chemotherapy.</p>', '<p>Megestrol Acetate is a synthetic, antineoplastic and progestational drug. While the precise mechanism by which Megestrol Acetate produces its antineoplastic effects against endometrial carcinoma is unknown at the present time, inhibition of pituitary gonadotrophin production and resultant decrease in estrogen secretion may be factors. The antineoplastic action of megestrol acetate on carcinoma of the breast is effected by modifying the action of other steroid hormones and by exerting a direct cytotoxic effect on tumor cells. In metastatic cancer, hormone receptors may be present in some tissues but not others. The receptor mechanism is a cyclic process whereby estrogen produced by the ovaries enters the target cell, forms a complex with cytoplasmic receptor and is transported into the cell nucleus. There it induces gene transcription and leads to the alteration of normal cell functions. Pharmacologic doses of megestrol acetate not only decrease the number of hormone-dependent human breast cancer cells but also are capable of modifying and abolishing the stimulatory effects of estrogen on these cells.<br />\r\n<br />\r\nEstimates of plasma levels of Megestrol Acetate are dependent on the measurement method used. Peak plasma concentrations occur 2 to 3 hours after a single oral dose 160 mg tablets. The plasma half-life of Megestrol Acetate is 33 to 38 hours. Approximately 66% of an administered dose is excreted in the urine and approximately 20% in the faeces.</p>', '<ul>\r\n	<li>Breast cancer: 160 mg/day</li>\r\n	<li>Endometrial carcinoma: 40-320 mg/day in divided doses.</li>\r\n	<li>At least 2 months of continuous treatment is considered an adequate period for determining the efficacy of Megestrol.</li>\r\n</ul>', '<p>Pharmacokinetic studies show that there are no significant alterations in pharmacokinetics parameters of Zidovudine or Rifabutin to warrant dosage adjustment when Megestrol Acetate is administered with these drugs. The effects of Zidovudine or Rifabutin on the pharmacokinetics of Megestrol Acetate were not studied.</p>', '<p>History of hypersensitivity to Megestrol Acetate or any component of the formulation. Known or suspected pregnancy.</p>', '<p><strong>Weight Gain</strong>: Weight gain is a frequent side effect of Megestrol Acetate. This gain has been associated with increased appetite and is not necessarily associated with fluid retention.<br />\r\n<br />\r\n<strong>Thromboembolic Phenomena</strong>: Thromboembolic phenomena including thrombophlebitis and pulmonary embolism (in some cases fatal) have been reported.<br />\r\n<br />\r\n<strong>Glucocorticoid Effects</strong>: The glucocorticoid activity of Megestrol Acetate has not been fully evaluated. Clinical cases of new onset diabetes mellitus, exacerbation of preexisting diabetes mellitus, and overt Cushing&rsquo;s syndrome have been reported in association with the chronic use of Megestrol Acetate. In addition, clinical cases of adrenal insufficiency have been observed in patients receiving or being withdrawn from chronic Megestrol Acetate therapy in the stressed and non-stressed state.<br />\r\n<br />\r\n<strong>Other</strong>: Nausea, dyspnea, tumor flare, hyperglycemia, glucose intolerance, alopecia, hypertension, carpal tunnel syndrome, mood changes, hot flashes, malaise, asthenia, lethargy, sweating and rash.</p>', '<p>Pregnancy Category D. The use of progestational agents during the first four months of pregnancy is not recommended. Very small amounts (approximately 0.1%) are excreted in mother&#39;s milk. It is however, not known whether these amounts exert any harmful effect on the newborn. Because of the potential for adverse effects on the new born, nursing should be discontinued during treatment with Megestrol Acetate.</p>', '<p><strong>General</strong>: Close surveillance is indicated for any patient treated for recurrent or metastatic cancer. Use with caution in patients with a history of thromboembolic disease.<br />\r\n<br />\r\n<strong>Use in Diabetics</strong>: Exacerbation of preexisting diabetes with increased insulin requirements has been reported in association with the use of Megestrol Acetate.</p>', '<p>No serious unexpected side effects have resulted from studies involving Megestrol Acetate administered in dosages as high as 1600 mg/day.</p>', '<p>Hormonal Chemotherapy.</p>', '<p>Store at or below 25&deg;C. Protect from heat, light &amp; moisture.</p>', '<p>Pediatric Use: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\nGeriatric Use: In the dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy.</p>', '2022-03-09 06:00:14', '2022-03-09 06:00:14'),
(915, 915, '<p>Melatonin is used for numerous conditions but is showing the most promise in the short-term regulation of sleep patterns, including jet lag.<br />\r\n<br />\r\n<strong>Insomnia</strong>: Melatonin helps to induce sleep in people with-</p>\r\n\r\n<ul>\r\n	<li>Disrupted circadian rhythms (such as those suffering from jet lag or poor vision or those who work the night shift)</li>\r\n	<li>Low melatonin levels (such as some elderly and individuals with schizophrenia)</li>\r\n	<li>Children with learning disabilities who suffer from insomnia.</li>\r\n</ul>\r\n\r\n<p><strong>Osteoporosis</strong>: Melatonin stimulates cells called osteoblasts that promote bone growth.<br />\r\n<br />\r\n<strong>In Menopause</strong>: Melatonin helps peri- or postmenopausal women to regulate sleep patterns.<br />\r\n<br />\r\n<strong>Eating disorders</strong>: Melatonin levels may play a role in the symptoms of anorexia.<br />\r\n<br />\r\n<strong>Attention Deficit Hyperactivity Disorder (ADHD)</strong>: it may be effective in managing sleep disturbances in children with this condition. And<br />\r\n<br />\r\n<strong>Sarcoidosis</strong></p>', '<p>After administration, melatonin binds with its receptors. Two types of melatonin receptor subtypes - MT1 &amp; MT2 have been identified in humans. Melatonin receptors are found in the brain and some peripheral organs. The MT1 subtype is present in the pars tuberalis of the pituitary gland and the suprachiasmatic nuclei of the hypothalamus. The MT2 subtype is mainly present in the retina. Increased level of Melatonin initiates neural &amp; endocrine signals to optimize the levels of neurotransmitters e.g. increased serotonin, increased GABA &amp; decreased dopamine, which induces &amp; sustains sleep, as well as, maintains the body&#39;s circadian rhythm.</p>', '<p><strong>Adult</strong>:<br />\r\nInsomnia: 3-6 mg one hour before bedtime<br />\r\n<br />\r\nJet lag:</p>\r\n\r\n<ul>\r\n	<li>0.50 to 5 mg one hour prior to bedtime at final destination or, 1 to 5 mg 1 hour before bedtime for 2 days prior to departure and for 2 to 3 days upon arrival at final destination.</li>\r\n	<li>Eastbound travel- Take a preflight early evening treatment followed by treatment at bedtime for 4 days after arrival.</li>\r\n	<li>Westbound travel- Take for 4 days at bedtime when in the new time zone.</li>\r\n</ul>\r\n\r\n<p>Sarcoidosis: 20 mg per day for 4 to 12 months.<br />\r\n<br />\r\nDepression: 0.125 mg twice in the late afternoon, each dose 4 hours apart.<br />\r\n<br />\r\nDifficulty falling asleep: 5 mg 3 to 4 hours before an imposed sleep period over a 4-weeks period.<br />\r\n<br />\r\n<strong>Children (6 months to 14 years of age)</strong>: For sleep disorders&nbsp;0.30 mg/day</p>', '<p><strong>Antidepressant Medications</strong>: Melatonin reduces the antidepressant effects of desipramine and fluoxetine. In addition, fluoxetine leads to measurable depletion of melatonin in people.<br />\r\n<br />\r\n<strong>Antipsychotic Medications</strong>: People with schizophrenia and tardive dyskinesia taking antipsychotic medications with melatonin has significantly reduced mouth movements compared to those who did not take the supplements.<br />\r\n<br />\r\n<strong>Benzodiazepines</strong>: The combination of melatonin and triazolam improves sleep quality. In addition, there have been a few reports suggesting that melatonin supplements may help individuals stop using long-term benzodiazepine therapy.<br />\r\n<br />\r\n<strong>Blood Pressure Medications</strong>: Melatonin may reduce the effectiveness of blood pressure medications like methoxamine and clonidine. In addition, calcium channel blockers (such as nifedipine, verapamil, diltiazem, amlodipine, nimodipine, felodipine, nisoldipine, and bepridil) may decrease melatonin levels. The use of beta-blockers (propranolol, acebutolol, atenolol, labetalol, metoprolol, pindolol, nadolol, sotalol, and timolol) may reduce melatonin production in the body.<br />\r\n<br />\r\n<strong>Blood-Thinning Medications, Anticoagulants</strong>: Melatonin may increase the risk of bleeding from anticoagulant medications such as warfarin.<br />\r\n<br />\r\n<strong>Interleukin-2</strong>: In one study of 80 cancer patients, the use of melatonin in conjunction with interleukin-2 led to more tumor regression and better survival rates than treatment with interleukin-2 alone.<br />\r\n<br />\r\n<strong>Nonsteroidal Anti-inflammatory Drugs (NSAIDs)</strong>: NSAIDs such as ibuprofen may reduce the levels of melatonin in the blood.<br />\r\n<br />\r\n<strong>Steroids and Immunosuppressant Medications</strong>: People should not take melatonin with corticosteroids or other medications used to suppress the immune system because the supplement may cause them to be ineffective.<br />\r\n<br />\r\n<strong>Tamoxifen</strong>: Preliminary research suggests that the combination of tamoxifen (a chemotherapy drug) and melatonin may benefit certain patients with breast and other cancers.<br />\r\n<br />\r\n<strong>Other Substances</strong>: Caffeine, tobacco, and alcohol can all diminish levels of melatonin in the body while cocaine and amphetamines may increase melatonin production.</p>', '<p>Melatonin should not be used by patients who have autoimmune diseases.</p>', '<p>Possible adverse effects include headache and depression. Drowsiness may be experienced within 30 minutes after taking melatonin and may persist for 1 hour and thus may affect driving skills.</p>', '<p>Information regarding safety and efficacy in pregnancy and lactation is not available.</p>', '<p>Caffeine and fluvoxamine may increase the effects of melatonin, while melatonin may decrease the antihypertensive effect of nifedipine.</p>', '<p>There is little or no evidence of any major toxicities with melatonin,even at high doses.</p>', '<p>Hormone preparations for other uses, Oral nutritional preparations.</p>', '<p>Store below 30&deg;C. Keep away from light. Keep all the medicine out of reach of children.</p>', NULL, '2022-03-09 06:02:26', '2022-03-09 06:02:26'),
(916, 916, '<p>Meloxicam is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Osteoarthritis,</li>\r\n	<li>Rheumatoid arthritis,</li>\r\n	<li>Ankylosing spondylitis</li>\r\n</ul>', '<p>Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) of the oxicam family, with anti-inflammatory, analgesic and antipyretic properties. The bioavailability of Meloxicam following oral administration is 89% on the average. With the doses of 7.5 mg &amp; 15 mg plasma concentrations are proportional to dose: 0.4 to 1.0 mg/litre for 7.5 mg &amp; 0.8 to 2.0 mg/litre for 15 mg, on an average. Meloxicam is very strongly bound to plasma proteins, essentially albumin (99%). Meloxicam is extensively metabolised, chiefly by oxidation of the methyl redical attached to the thiazolyl ring. Elimination in unchanged form accounts for 3% of the dose. Half of the substance is eliminated in urine &amp; the other half in the faeces. The mean elimination half life is 20 hours.</p>', '<p>For Adults:</p>\r\n\r\n<ul>\r\n	<li><strong>Osteoarthritis</strong>: 7.5 mg/day. If necessary, in the absence of improvement, the dose may be increased to 15 mg/day.</li>\r\n	<li><strong>Rheumatoid arthritis</strong>: 15 mg/day. In elderly patients the recommended dose for long term treatment is 7.5 mg/day.</li>\r\n	<li><strong>Ankylosing spondylitis</strong>: 15 mg/day. In elderly patients the recommended dose is 7.5 mg/day.</li>\r\n</ul>\r\n\r\n<p>Do not exceed the dose of 15 mg/day. The total daily amount should be taken as a single dose. Patients with increased risks for adverse reactions should start treatment with 7.5 mg/day. In dialysis patients with severe renal failure the dose should not exceed 7.5 mg/day<br />\r\n<br />\r\n<strong>For Children</strong>: The pharmacokinetics of Meloxicam in paediatric patients under 18 years of age have not been investigated.</p>', '<ul>\r\n	<li>Other NSAIDs, including high doses of salicylates: Administration of several NSAIDs together may increase the risk of ulcers and of gastrointestinal bleeding, via a synergistic effect.</li>\r\n	<li>Oral anticoagulants, heparin and ticlopidine: Increased risk of bleeding via inhibition of platelet function and damage to the gastroduodenal mucosa. Careful monitoring of the effects of anticoagulants is thus essential if it proves impossible to avoid such combined prescription.</li>\r\n	<li>Lithium: NSAIDs increase blood lithium levels, which may then reach toxic values.</li>\r\n	<li>Methotrexate: NSAIDs may accentuate the haematologic toxicity of methotrexate.</li>\r\n	<li>Intrauterine contraceptive devices: NSAIDs appear to decrease the efficacy of intrauterine contraceptive devices.</li>\r\n</ul>', '<p>Meloxicam is contraindicated to patients hypersensitive to this drug. Meloxicam should not be given to patients who have developed signs of asthma, nasal polyps, angioneurotic oedema or urticaria following the administration of aspirin or NSAIDs. Meloxicam is contraindicated to patients with active peptic ulcer during the last six months or a history of recurrent peptic ulcer disease, severe hepatic failure, non-dialysed severe renal failure, gastrointestinal bleeding, cerebrovascular bleeding or other bleeding disorders.</p>', '<p>Nausea, vomiting, abdominal pain, dyspepsia, constipation or diarrhoea may occur. Ulcers or gastrointestinal bleeding may rarely occur. Skin rash, or urticaria may occur in some individuals. Oedema of the lower limbs may occur during treatment. Onset of an asthma attack has been reported in certain individuals allergic to aspirin or to other NSAIDs. Headache, vertigo or drowsiness may occur.</p>', '<p>It is advisable to avoid the administration of Meloxicam during pregnancy. It is unknown whether Meloxicam passes into mother&rsquo;s milk. Meloxicam should not be given to nursing mothers.</p>', '<p>Patient with known CV disease or risk factors for CV disease, fluid retention or heart failure, history of GI bleeding or ulceration. Hepatic and renal impairment. Elderly. Pregnancy and lactation.</p>', NULL, '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs).</p>', '<p>Store Meloxicam tablet in a cool &amp; dry place and away from light. Store Meloxicam suppository below 25˚C protected from light and moisture.</p>', NULL, '2022-03-09 06:04:23', '2022-03-09 06:04:23'),
(917, 917, '<p>Memantine and donepezil hydrochlorides extended-release capsules are a combination of memantine hydrochloride, an NMDA receptor antagonist, and donepezil hydrochloride, an acetylcholinesterase inhibitor, indicated for the treatment of moderate to severe dementia of the Alzheimer&rsquo;s type in patients stabilized on 10 mg of donepezil hydrochloride once daily.</p>', '<p>Memantine and donepezil hydrochlorides extended-release capsules contain two approved medications: memantine hydrochloride extended-release and donepezil hydrochloride. Each of those medications is postulated to have a different mechanism in Alzheimer&rsquo;s disease.<br />\r\n<br />\r\n<strong>Memantine</strong>: Persistent activation of central nervous system NMDA receptors by the excitatory amino acid glutamate has been hypothesized to contribute to the symptomatology of Alzheimer&rsquo;s disease. Memantine is postulated to exert its therapeutic effect through its action as a low to moderate affinity uncompetitive (open channel) NMDA receptor antagonist which binds preferentially to the NMDA receptor-operated cation channels. There is no evidence that memantine prevents or slows neurodegeneration in patients with Alzheimer&rsquo;s disease.<br />\r\n<br />\r\n<strong>Donepezil</strong>: Current theories on the pathogenesis of the cognitive signs and symptoms of Alzheimer&rsquo;s disease attribute some of them to a deficiency of cholinergic neurotransmission. Donepezil is postulated to exert its therapeutic effect by enhancing cholinergic function. This is accomplished by increasing the concentration of acetylcholine in the central nervous system through reversible inhibition of its hydrolysis by acetylcholinesterase. There is no evidence that donepezil prevents or slows neurodegeneration in patients with Alzheimer&rsquo;s disease.</p>', '<p>For patients on donepezil hydrochloride 10 mg only, the recommended starting dose of memantine and donepezil hydrochlorides extended-release capsules is 7 mg/10 mg, taken once daily in the evening. The dose should be increased in 7 mg increments to the recommended maintenance dose of 28 mg/10 mg. The minimum recommended interval between dose increases is one week.<br />\r\n<br />\r\nPatients on memantine hydrochloride (10 mg twice daily or 28 mg extended-release once daily) and donepezil hydrochloride 10 mg once daily can be switched to memantine and donepezil hydrochlorides extended- release capsules 28 mg/10 mg, taken once daily in the evening.<br />\r\n<br />\r\nMemantine and donepezil hydrochlorides extended- release capsules can be taken with or without food, whole or sprinkled on applesauce; do not divide, chew, or crush. Severe renal impairment: the recommended maintenance dose for memantine and donepezil hydrochlorides extended-release capsules is 14 mg/10 mg once daily in the evening.</p>', '<p>Combined use with NMDA antagonists: use with caution. Memantine and donepezil hydrochlorides extended-release may interfere with anticholinergic medications. Concomitant administration of succinylcholine, similar neuromuscular blocking agents, or cholinergic agonists may lead to synergistic effect.</p>', '<p>Memantine and donepezil hydrochlorides extended-release capsules are contraindicated in patients with known hypersensitivity to memantine hydrochloride, donepezil hydrochloride, piperidine derivatives, or to any excipients used in the formulation.</p>', '<p>The most common adverse reactions, occurring at a frequency of at least 5% and greater than placebo with memantine hydrochloride extended-release 28 mg/day, were headache, diarrhea, and dizziness. The most common adverse reactions occurring at a frequency of at least 5% in patients receiving donepezil and at twice or more the placebo rate, include diarrhea, anorexia, vomiting, nausea, and ecchymosis.</p>', '<p>There are no adequate data on the developmental risk associated with the use of memantine and donepezil hydrochlorides extended-release capsules or its active ingredients (memantine hydrochloride and donepezil hydrochloride) in pregnant women. There are no data on the presence of memantine or donepezil in human milk, the effects on the breastfed infant, or the effects of memantine and donepezil hydrochlorides extended-release capsules or its metabolites on milk production.</p>', '<ul>\r\n	<li>Memantine and donepezil hydrochlorides extended-release is likely to exaggerate succinylcholine-type muscle relaxation during anesthesia.</li>\r\n	<li>Memantine and donepezil hydrochlorides extended-release may have vagotonic effects on the sinoatrial and atrioventricular nodes manifesting as bradycardia or heart block.</li>\r\n	<li>Monitor patients for symptoms of active or occult gastrointestinal bleeding, especially those at increased risk for developing ulcers.</li>\r\n	<li>Memantine and donepezil hydrochlorides extended-release can cause diarrhea, nausea, and vomiting.</li>\r\n	<li>Memantine and donepezil hydrochlorides extended-release may cause bladder outflow obstructions.</li>\r\n	<li>Conditions that raise urine pH may decrease the urinary elimination of memantine, resulting in increased plasma levels of memantine.</li>\r\n</ul>', NULL, '<p>Anti-Alzheimer drugs.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Pediatric Use: Safety and effectiveness of memantine and donepezil hydrochlorides extended-release in pediatric patients have not been established.<br />\r\n<br />\r\nRenal Impairment: No dosage adjustment is needed in patients with mild or moderate renal impairment.<br />\r\n<br />\r\nHepatic Impairment: No dosage adjustment is needed in patients with mild or moderate hepatic impairment. Memantine and donepezil hydrochlorides extended-release has not been studied in patients with severe hepatic impairment.</p>', '2022-03-09 06:06:32', '2022-03-09 06:06:32'),
(918, 918, '<p>Memantine is indicated for the treatment of all froms of dementia of the Alzheimer&#39;s type. Memantine may also be indicated in other types of dementia.</p>', '<p>Persistent activation of N-methyl-D-aspartate (NMDA) receptors in Central Nervous System by the excitatory amino acid glutamate has been hypothesized to contribute to the symptomatology of Alzheimer&#39;s disease. Memantine is postulated to exert its therapeutic effect through its action as a low to moderate affinity as an uncompetitive (open-channel) NMDA receptor antagonist which binds preferentially to the NMDA receptor-operated cation channels.<br />\r\n<br />\r\nMemantine is well absorbed after oral administration and has linear pharmacokinetics over the therapeutic dose range. It is excreted predominantly unchanged in the urine and has a terminal elimination half-life of about 60-80 hours. Following oral administration, Memantine is highly absorbed with peak concentrtions reached in about 3-7 hours. Food has no effect on the absorption of Memantine. The mean volume of distribution of Memantine is 9-11 L/kg and the plasma protein binding is low (45%). emantine undergoes partial hepatic metabolism. About 48% of administered drug is excreted unchanged in urine; the remainder is converted primarily to three polar metabolites which possess minimal NMDA receptor antagonistic activity: the N-glucuronide conjugate, 6-hydroxy Memantine and 1-nitroso-deaminated Memantine. A total of 74% of the administered dose is excreted as the sum of the parent drug and the N-glucuronide conjugate. The hepatic microsomal CYP-450 enzyme system does not play a significant role in the metabolism of Memantine.</p>', '<p>The recommended maintenance dose of Memantine&nbsp;for adults and older patients is 20 mg every day. In order to lower the risk of side effects, the dose should be achieved by upward titration with 5 mg per week over 3 weeks, achieving the maintenance dose of 20 mg/day from the start of week 4 according to the following dosage guideline:<br />\r\n<br />\r\n<strong>Week 1 (Everyday)</strong>:&nbsp;Morning- 5 mg (1 tablet),&nbsp;Night- No dose<br />\r\n<strong>Week 2 (Everyday)</strong>:&nbsp;Morning- 5 mg (1 tablet),&nbsp;Night- 5 mg (1 tablet)<br />\r\n<strong>Week 3 (Everyday)</strong>:&nbsp;Morning- 10 mg (2 tablets),&nbsp;Night- 5 mg (1 tablet)<br />\r\n<strong>Week 4 and onwards (Everyday)</strong>:&nbsp;Morning- 10 mg (2 tablets),&nbsp;Night- 10 mg (2 tablets)<br />\r\n<br />\r\n<strong>Missed Dose</strong>: If any dose is missed, just wait and take the next dose at the usual time. Do not double the dose to compensate for the missed dose.<br />\r\n<br />\r\n<strong>In case renal impairment</strong>: In patients with moderate renal impairment (creatinine clearance 30-49 ml/min) daily dose should be 10 mg (1 ml solution, equivalent to two downward strokes). If tolerated well after at least 7 days of treatment, the dose could be increased up to 20 mg/day according to standard titration scheme. In patients with severe renal impairment (creatinine clearance 5-29 ml/min) daily dose should be 10 mg (1 ml solution, equivalent to two downward strokes) per day.<br />\r\n<br />\r\n<strong>In case of hepatic impairment</strong>: In patients with mild or moderate hepatic impaired function, no dosage adjustment is needed. Administration of memantine is not recommended in patients with severe hepatic impairment.<br />\r\n<br />\r\n<strong>Children under 18 years</strong>: Memantine is not recommended for use in children below 18 years due to lack of data on safety and efficacy.</p>', '<p>Due to the pharmacological effects and mechanism of action of memantine suggests that the effects of L-dopa, dopaminergic agonists, and anticholinergics may be enhanced by concomitant treatment with NMDA-antagonists such as memantine. The effects of barbiturates and neuroleptics may be reduced. Concomitant administration of mematine with the antispasmodic agents, dantrolene or baclofen, can modify their effects and a dosage adjustment may be necessary. Memantine should not be used with amantadine, ketamine, dextromethorphan, phenytoin, cimetidine, ranitidine, procainamide, quinidine, quinidine, quinine &amp; nicotine.</p>', '<p>Memantine Hydrochloride is contraindicated in patients with known hypersensitivity to Memantine Hydrochloride or to any excipients used in the formulation.</p>', '<p>Most frequent side effects (frequency of 2% or less) include hallucination, confusion, dizziness, headache and fatigue. Occasional side effects include anxiety, hypertonus (heightened muscle tension), vomiting, bladder infections and increased sexual drive. If there is a history of epileptic seizures, there is a slight chance that Memantine may increase the probability of an attack.</p>', '<p>Pregnancy Category B. Yet there are no adequate and well controlled studies of Memantine in pregnant women. Memantine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Memantine is excreted in human breast milk. Because many drugs are excreted in human milk, caution should be exercised when Memantine is administered to a nursing mother.</p>', '<p>Caregivers should be instructed in the recommended administration (twice per day for doses above 5 mg) and dose escalation (minimum interval of one week between dose increases). If the patients suffer from kidney dysfunction, the kidney function should be monitored at regular basis.<br />\r\n<br />\r\n<strong>Seizures:</strong>&nbsp;Memantine has not been systematically evaluated in patients with a seizure disorder. One clinical trial shows that seizures occurred in 0.2% of patients treated with Memantine and 0.5% of patients treated with placebo.<br />\r\n<br />\r\n<strong>Carcinogenesis, Mutagenesis and Impairment of Fertility:</strong>&nbsp;Study shows that no risk of carcinogenesis, mutagenesis and impairment of fertility are caused after Memantine use.<br />\r\n<br />\r\n<strong>Operating Vehicles or Machinery</strong>: Taking Memantine may alter the reaction time significantly; therefore safe driving and safe operation of machinery may no longer be possible.</p>', NULL, NULL, '<p>Store in a cool and dry place, protected from light. Keep this medication out of reach of children.</p>', NULL, '2022-03-09 06:08:25', '2022-03-09 06:08:25'),
(919, 919, '<p>This capsule is indicated for the treatment and prevention of-</p>\r\n\r\n<ul>\r\n	<li>Osteoporosis</li>\r\n	<li>Coronary artery calcification</li>\r\n	<li>Rheumatoid arthritis</li>\r\n</ul>', '<p>Menaquinone-7 is a fat soluble vitamin which is also known as vitamin K2. Menaquinone-7 is an especial key isomer of vitamin K2 that is produced using Bacillus subtilis. Menaquinone-7 is the active trans-isomer of natural vitamin K2 with the highest bioavailability and longest half-life in blood. This makes Menaquinone-7 also available for tissues outside the liver, namely bones, arteries and soft tissues. It is a powerful cofactor in transporting excess calcium out of the arteries and depositing it into the bones thus prevents hardening of arteries. Menaquinone-7 is very essential for healthy bone and artery.</p>', '<p>Orally 1-2 capsules daily or as advised by the physician.</p>', '<p>Menaquinone-7 may alter the effect of warfarin. Concomitant use with orlistat may decrease the absorption of Menaquinone-7.</p>', '<p>Contraindicated in patients with known hypersensitivity to Menaquinone-7. Use of Menaquinone-7 is contraindicated with warfarin.</p>', '<p>Generally well tolerated in recommended dose. From a large number of clinical trials using dosages in excess of 40 mg/day, there were no reports of side effects associated with any type of hypercoagulable state.</p>', '<p>Menaquinone-7 can be used during pregnancy. Use of Menaquinone-7 during pregnancy may help both mother and child in formation and maintaining proper bone health.</p>', NULL, NULL, '<p>Drugs for Osteoarthritis</p>', '<p>Store at temperature below 30˚C, protect from light &amp; moisture. Keep out of reach of children.</p>', NULL, '2022-03-09 06:10:10', '2022-03-09 06:10:10');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(920, 920, '<p>Meningococcal Conjugate Vaccine is indicated for active immunisation of individuals from the age of 6 weeks against invasive meningococcal diseases caused by Neisseria meningitidis group A, C, W-135, and Y.</p>', '<p>Anti-capsular meningococcal antibodies protect against meningococcal diseases via complement mediated bactericidal activity. Meningococcal Conjugate Vaccine induces the production of bactericidal antibodies against capsular polysaccharides of Neisseria meningitidis group A,C,W-135 and Y when measured by assays using either rSBA or hSBA.</p>', '<p><strong>Posology</strong>: Meningococcal Conjugate Vaccine should be used in accordance with available official recommendations. Primary immunisation:</p>\r\n\r\n<ul>\r\n	<li><strong>Infants from 6 weeks to less than 6 months of age</strong>: two doses, each of 0.5 ml, should be administered with an interval of 2 months between doses.</li>\r\n	<li><strong>Infants from 6 months of age, children, adolescents and adults</strong>: a single 0.5 mL doseshould be administered.</li>\r\n	<li>An additional primary dose of Meningococcal Conjugate Vaccine may be considered appropriate for some individuals.</li>\r\n</ul>\r\n\r\n<p><strong>Booster doses</strong>: After completion of the primary immunisation course in infants 6 weeks to less than 12 months of age, a booster dose should be given at 12 months of age with an interval of at least 2 months after the last Meningococcal Conjugate vaccination. In previously vaccinated individuals 12 months of age and older, Meningococcal Conjugate Vaccine may be given as a booster dose if they have received primary vaccination with a conjugated or plain polysaccharide meningococcal vaccine.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Immunisation should be carried out by intramuscular injection only. In infants, the recommended injection site is the anterolateral aspect of the thigh. In individuals from 1 year of age, the recommended injection site is the anterolateral aspect of the thigh or the deltoid muscle. For instructions on reconstitution of the medicinal product before administration.</p>', '<ul>\r\n	<li>In infants, Meningococcal Conjugate Vaccine can be given concomitantly with combined DTaP-HBV-IPV/Hib vaccines and with 10-valent pneumococcal conjugate vaccine.</li>\r\n	<li>From age 1 year and above, Meningococcal Conjugate Vaccine can be given concomitantly with any of the following vaccines: hepatitis A (HAV) and hepatitis B (HBV) vaccines, measles- mumps-rubella (MMR) vaccine, measles- mumps- rubella- varicella (MMRV) vaccine, 10-valent pneumococcal conjugate vaccine or unadjuvanted seasonal influenza vaccine.</li>\r\n	<li>In the second year of life, Meningococcal Conjugate Vaccine can also be given concomitantly with combined diphtheria- tetanus- acellular pertussis (DTaP) vaccines, including combination DTaP vaccines with hepatitis B, inactivated poliovirus or Haemophilus influenzae type b (HBV, IPV or Hib) such as DTaP-HBV-IPV/Hib vaccine, and 13-valent pneumococcal conjugate vaccine.</li>\r\n	<li>In individuals aged 9 to 25 years, Meningococcal Conjugate Vaccine can be given concomitantly with human papillomavirus bivalent [Type 16 and 18] vaccine, recombinant (HPV2).</li>\r\n	<li>Whenever possible, Meningococcal Conjugate Vaccine and a TT containing vaccine, such as DTaP-HBV-IPV/Hib vaccine, should be co-administered or Meningococcal Conjugate Vaccine should be administered at least one month before the TT containing vaccine.</li>\r\n	<li>One month after co-administration with a 10-valent pneumococcal conjugate vaccine, lower Geometric Mean antibody Concentrations (GMCs) and opsonophagocytic assay (OPA) antibody GMTs were observed for one pneumococcal serotype (18C conjugated to tetanus toxoid carrier protein). The clinical relevance of this observation is unknown.</li>\r\n	<li>There was no impact of co-administration on immune responses to the other nine pneumococcal serotypes.</li>\r\n	<li>One month after co-administration with a combined tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine, adsorbed (Tdap) in subjects aged 9 to 25 years, lower GMCs were observed to each pertussis antigen (pertussis toxoid [PT], filamentous haemagglutinin [FHA] and pertactin [PRN]). More than 98% of subjects had anti-PT, FHA or PRN concentrations above the assay cut-off thresholds. The clinical relevance of these observations is unknown. There was no impact of co-administration on immune responses to Meningococcal Conjugate Vaccine or the tetanus or diphtheria antigens included in Tdap.</li>\r\n	<li>If Meningococcal Conjugate Vaccine is to be given at the same time as another injectable vaccine, the vaccines should always be administered at different injection sites.</li>\r\n	<li>It may be expected that in patients receiving immunosuppressive treatment, an adequate response may not be elicited.</li>\r\n</ul>', '<p>Hypersensitivity to the active substances or to any of the excipients of this preparation.</p>', '<p>Adverse reactions are Appetite lost, Irritability, Insomnia, Crying, Drowsiness, Headache, Hypoaesthesia, Dizziness, Diarrhoea, Vomiting, Nausea, Pruritus, Rash, Myalgia, Pain in extremity, Fever, Swelling at injection site, Pain at injection site, Redness at injection site, Fatigue, Injection site haematoma, Malaise, Injection site induration, Injection site pruritus, Injection site warmth, Injection site anaesthesia.</p>', '<p><strong>Pregnancy</strong>: There is limited experience with use of Meningococcal Conjugate Vaccine in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy, embryo/foetal development, parturition or post-natal development. Meningococcal Conjugate Vaccine should be used during pregnancy only when clearly needed, and the possible advantages outweigh the potential risks for the foetus.<br />\r\n<br />\r\n<strong>Breast-feeding</strong>: It is unknown whether Meningococcal Conjugate Vaccine is excreted in human milk. Meningococcal Conjugate Vaccine should only be used during breast-feeding when the possible advantages outweigh the potential risks.</p>', NULL, '<p>No case of overdose has been reported.</p>', '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', '<p>Store in a refrigerator (2&deg;C-8&deg;C). Do not freeze. Store in the original package in order to protect from light.</p>', NULL, '2022-03-09 06:12:20', '2022-03-09 06:12:20'),
(921, 921, '<p>Meningococcal Polysaccharide Vaccine is indicated for the active immunization of children from 2 years of age, adolescents and adults against meningococcal disease caused by meningococci of serogroups A, C, W135 and Y. The vaccine may also be used for:</p>\r\n\r\n<ul>\r\n	<li>Subjects who are living in closed communities and close contacts of patients with disease caused by meningococci of serogroups A, C, W135 and Y.</li>\r\n	<li>Travellers to countries where the disease is epidemic or highly endemic</li>\r\n</ul>', '<p>Meningococcal Polysaccharide Vaccine is a freeze-dried preparation of the group-specific polysaccharide antigens from Neisseria meningitidis Group A, Group C, Group Y and Group W135. When reconstituted, the vaccine is a clear, colorless sterile solution for subcutaneous use.</p>', '<p>The immunizing dose is a single injection of 0.5 ml administered subcutaneously. Primary Immunization For both adults and children from 2 years of age, vaccine is administered subcutaneously as a single 0.5 ml dose. Protective antibody levels may be achieved within 7 to 10 days after vaccination.</p>', NULL, '<p>Hypersensitivity to the active substances or to any of the excipients.</p>', '<p>Meningococcal polysaccharide vaccine is generally well tolerated. Adverse reactions usually occur within 48 hours following vaccination.<br />\r\n<br />\r\nMetabolism and nutrition disorders-</p>\r\n\r\n<ul>\r\n	<li>Common: appetite lost Psychiatric disorders:</li>\r\n	<li>Very common: irritability</li>\r\n</ul>\r\n\r\n<p>Nervous system disorders-</p>\r\n\r\n<ul>\r\n	<li>Very common: drowsiness, headache.</li>\r\n	<li>Uncommon: dizziness</li>\r\n</ul>\r\n\r\n<p>Gastrointestinal disorders-</p>\r\n\r\n<ul>\r\n	<li>Common: gastrointestinal symptoms e.g. nausea, vomiting and diarrhea</li>\r\n</ul>\r\n\r\n<p>Musculoskeletal and connective tissue disorders-</p>\r\n\r\n<ul>\r\n	<li>Common: myalgia</li>\r\n</ul>\r\n\r\n<p>General disorders and administration site conditions-</p>\r\n\r\n<ul>\r\n	<li>Very common: pain and redness at the injection site, fatigue</li>\r\n	<li>Common: swelling at the injection site, fever</li>\r\n</ul>', '<p><strong>Pregnancy:</strong>&nbsp;Adequate human data on use during pregnancy and adequate animal reproduction studies are not available. This vaccine should be used during pregnancy only when clearly needed and when the possible advantages outweigh the possible risks for the fetus.<br />\r\n<br />\r\n<strong>Lactation</strong>: Adequate data on the administration of this vaccine to women who are breast-feeding are not available. This vaccine should be administered to women who are breast-feeding when needed and the possible advantages outweigh the possible risks.</p>', '<p>As with other vaccines, the administration of Meningococcal polysaccharide vaccine should be postponed in subjects suffering from acute severe febrile illness. The presence of a minor infection, however, is not a contraindication for immunization. This vaccine gives no protection against meningococcal meningitis caused by meningococci belonging to serogroups other than A, C, W135 and Y. If administered to subjects with impaired immune responses, the vaccine may not induce an effective response.As with all injectable vaccines, appropriate medication (e.g. adrenaline) should always be readily available for treatment in case of anaphylactic reactions following the administration of the vaccine. Vaccination should be preceded by a review of the medical history (especially with regard to previous vaccination and possible occurrence of undesirable events) and a clinical examination.</p>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', '<p>Keep out of the reach and sight of children .Store and transport at 2&deg;C to 8&deg;C. Do not freeze Protect from light .The vaccine should be used within 30 minutes after reconstitution.</p>', NULL, '2022-03-09 06:14:23', '2022-03-09 06:14:23'),
(922, 922, '<p><strong>Pain and Itching</strong>: For temporary relief of pain and itch associated with minor skin irritations, minor cuts, minor burns, minor sunburns, scrapes, or insect bites; may also be used for rashes due to poison ivy, oak, or sumac.</p>', '<p><strong>Menthol</strong>&nbsp;primarily activates the cold-sensitive TRPM8 receptors in the skin. Menthol, after topical application, causes a feeling of coolness due to stimulation of &#39;cold&#39; receptors by inhibiting Ca++&nbsp;currents of neuronal membranes. It may also yield analgesic properties via kappa-opioid receptor agonism.<br />\r\n<br />\r\n<strong>Pramocaine</strong>&nbsp;reversibly binds and inhibits voltage gated sodium channels on neurons decreasing sodium permeability into the cell. This stabilizes the membrane and prevents ionic fluctuations needed for depolarization stopping any action potential propagation.<br />\r\n<br />\r\nMenthol and pramoxine: Each of these agents elicits local anesthetic effects.</p>', '<p><strong>Adult</strong>: Apply topically to affected area up to 3-4 times daily.<br />\r\n<br />\r\n<strong>Child</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>&lt;2 years</strong>: Safety and efficacy not established</li>\r\n	<li><strong>&gt;2 years</strong>: Apply topically to affected area up to 3-4 times daily</li>\r\n</ul>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity, Deep or puncture wounds, animals bites, serious burns, large areas of the body.</p>', '<p>Redness, irritation, swelling or pain.</p>', '<p>Pregnancy Category A. Adequate and well-controlled human studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).</p>', '<p>For external use only. Avoid contact with eyes Do not use in the eyes or mucous membranes Not for prolonged use Do not apply to large areas of the body. Discontinue if symptoms persist for &gt;7 days or clear up and occur again within a few days. Discontinue if redness, irritation, swelling, or pain persists or increases.</p>', NULL, '<p>Local Antipruritic, Topical Analgesics.</p>', NULL, NULL, '2022-03-09 06:16:19', '2022-03-09 06:16:19'),
(923, 923, '<p>Bad breath, Cavities, Gingivitis, Gum disease, Oral hygiene, Plaque, Teeth cleaner &amp; brighter.</p>', '<p>This preparation&nbsp;is a clinically proven antiseptic mouthwash that provides you complete care for healthier mouth with around-the-clock protection against bacteria and plaque. Your mouth stays cleaner, fresher and healthier.</p>\r\n\r\n<ul>\r\n	<li>24 hours protection against plaque, gingivitis and gum disease</li>\r\n	<li>Fights against germs that cause bad breath</li>\r\n	<li>Kills germs between teeth and keeps teeth cleaner &amp; brighter</li>\r\n</ul>', '<p>Rinse with 20 ml Antiseptic Mouthwash for 30 seconds, twice daily (morning and evening). Then rinse with water. Do not swallow. Not indicated below 12 years of age.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity</p>', '<p>Do not rinse, eat, or smoke for thirty minutes after using a mouthwash. Doing so will diminish the effects of the mouthwash.</p>', '<p>Pregnancy Category - Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Do not swallow. It is not indicated below 12 years of age. Keep out of the reach of children. Keep in a cool and dry palace. Do not use if cap seal is broken.</p>', NULL, '<p>Oral preparations</p>', NULL, NULL, '2022-03-09 06:18:04', '2022-03-09 06:18:04'),
(924, 924, '<p>Mepyramine Maleate Cream is a type of antihistamine used for the relief of insect bites, stings and nettle rash. Mepyramine Maleate Cream works by relieving the pain, itching and inflammation from insect bites, stings and nettle rash. Your doctor or pharmacist, however, may recommend Anthisan Cream for another purpose.</p>', NULL, '<p>Apply Mepyramine Maleate Cream directly to the site of the insect bite or sting or nettle rash, two to three times a day. For best results, use as soon as possible after the bite. sting or appearance of nettle rash. Use for up to three days.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Miscellaneous topical agents.</p>', '<p>Keep the medicine in a cool, dry place where the temperature stays below 25&deg;C. Do not store Anthisan Cream or any other medicine in the bathroom or near a sink. Do not leave it on a windowsill or in the car. Heat and damp can destroy some medicines.</p>', NULL, '2022-03-09 06:19:13', '2022-03-09 06:19:13'),
(925, 925, '<p>Mercaptopurine is indicated for&nbsp;maintenance therapy&nbsp;of acute lymphatic (lymphocytic, lymphoblastic)&nbsp;leukemiaas part of a combination&nbsp;regimen. The response to this agent depends upon the particular subclassification of acute lymphatic leukemia and the age of the patient (pediatric or adult).<br />\r\n<br />\r\nMercaptopurine is not effective for&nbsp;prophylaxis&nbsp;or treatment of&nbsp;central nervous system&nbsp;leukemia. Mercaptopurine is not effective in&nbsp;acute myelogenous leukemia, chronic lymphatic leukemia, the lymphomas (including Hodgkins Disease), or solid tumors.</p>', '<p>Mercaptopurine is a purine antagonist which is converted intracellularly into its active nucleotides, including thioinosinic acid. The nucleotides inhibit several reactions which ultimately interferes with nucleic acid synthesis and prevents the formation of RNA and DNA.</p>', '<p>Crohn&#39;s disease:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initially 1-1.5 mg/kg daily, may increase to 125 mg daily.</li>\r\n	<li><strong>Child:</strong>&nbsp;Initially 1-1.5 mg/kg daily increased to a max of 75 mg daily</li>\r\n</ul>\r\n\r\n<p>Acute lymphocytic leukemia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Usual maintenance dose: Initially, 1.5-2.5 mg/kg daily as a single dose, usually used in combination with methotrexate. Dose may vary individually based on response and tolerance. Monitor blood counts at least once wkly. Withdraw treatment immedietely if there is a sharp drop in the white cell count or severe bone-marrow depression. May resume treatment slowly and carefully if white cell count remains constant for 2-3 days or rises. Reduce dose when used with allopurinol.</li>\r\n	<li><strong>Child:</strong>&nbsp;Usual maintenance dose: Initially, 1.5-2.5 mg/kg daily as a single dose, usually used in combination with methotrexate. Dose may vary individually based on response and tolerance. Monitor blood counts at least once wkly. Withdraw treatment immedietely if there is a sharp drop in the white cell count or severe bone-marrow depression. May resume treatment slowly and carefully if white cell count remains constant for 2-3 days or rises. Reduce dose when used with allopurinol.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken on an empty stomach. Best taken on an empty stomach 1 hr before or 2 hr after meals. Ensure adequate fluid intake.</p>', '<p>Anticoagulant action of warfarin may be inhibited by mercaptopurine. Enhanced toxicity with myelosuppressive drugs.</p>', '<p>Pregnancy and lactation. Prior resistance to mercaptopurine or thioguanine; severe liver disease; severe bone marrow suppression.</p>', '<p>Hyperuricaemia, bone marrow toxicity, hypoplasia, anorexia, diarrhoea, leukopenia, thrombocytopenia, intestinal ulceration, crystalluria with haematuria, immunosuppression, interstitial pneumonitis. Cutaneous hyperpigmentation, alopecia.</p>', '<p>Pregnancy category D.&nbsp;There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Hepatic or renal dysfunction; monitor hepatic function periodically. Mercaptopurine is potentially carcinogenic. Thiopurine S-methyl transferase (TPMT) deficiency; porphyria.</p>', NULL, '<p>Cytotoxic Chemotherapy.</p>', '<p>Store at 20-25&deg; C.</p>', '<p><strong>Renal Impairment:</strong>&nbsp;Dosage may need to be reduced.<br />\r\n<br />\r\n<strong>Hepatic Impairment:</strong></p>\r\n\r\n<ul>\r\n	<li><strong>Crohn&#39;s disease</strong>: Dosage may need to be reduced.</li>\r\n	<li><strong>Acute lymphocytic leukemia</strong>: Dosage may need to be reduced</li>\r\n</ul>\r\n\r\n<p>Dosage adjustment in patients with thiopurine-S-methyl transferase (TPMT) deficiency to prevent life-threatening myelotoxicity.<br />\r\n<br />\r\n<strong>For patients with homozygous TPMT deficiency</strong>: Substantial reduction is required.<br />\r\n<br />\r\n<strong>For patients with heterozygous TPMT deficiency</strong>: Some may require reduction but most will tolerate the usual dosages.</p>', '2022-03-09 06:21:34', '2022-03-09 06:21:34'),
(926, 926, '<p>Meropenem is indicated for treatment in adults and children for the following infections caused by single or multiple bacteria sensitive to Meropenem.</p>\r\n\r\n<ul>\r\n	<li>Pneumonia and Nosocomial Pneumonia</li>\r\n	<li>Urinary Tract Infections</li>\r\n	<li>Intra-abdominal Infections</li>\r\n	<li>Gynaecological Infections, such as endometritis and pelvic inflammatory disease</li>\r\n	<li>Skin and Skin Structure Infections</li>\r\n	<li>Meningitis</li>\r\n	<li>Septicaemia</li>\r\n	<li>Pulmonary infections in cystic fibrosis</li>\r\n	<li>Empiric treatment for presumed infections in patients with febrile neutropenia.</li>\r\n</ul>', '<p>Meropenem is a carbapenem antibiotic for parenteral use . It exerts its bactericidal action by interfering with bacterial cell wall synthesis. It penetrates bacterial cell walls, its high level of stability to all serine beta-lactamases and its marked affinity for the Penicillin Binding Proteins (PBPs.). It shows potent bactericidal activity against a broad spectrum of Gram-positive and Gram-negative, aerobic and anaerobic bacteria.</p>', '<p>The dosage and duration of therapy shall be established depending on type, severity of infection and the condition of the patient. The recommended daily dosage is as follows-<br />\r\n<br />\r\nAdults:</p>\r\n\r\n<ul>\r\n	<li>The usual dose is 500 mg to 1 gm by intravenous administration every 8 hours.</li>\r\n	<li>Pneumonia, urinary tract infections, gynaecological infections such as endometritis, pelvic inflammatory disease, skin and skin structure infections: 500 mg IV every 8 hours.</li>\r\n	<li>Nosocomial pneumonias, peritonitis, presumed infections in neutropenic patients and septicaemia: 1 g IV every 8 hours.</li>\r\n	<li>Intra-abdominal infections: 500 mg to 1 gm every 8 hours.</li>\r\n	<li>Cystic fibrosis: Upto 2 gm every 8 hours.</li>\r\n	<li>Meningitis: 2 gm IV every 8 hours.</li>\r\n</ul>\r\n\r\n<p>Children:</p>\r\n\r\n<ul>\r\n	<li>3 months to 12 years: 10 to 40 mg/kg intravenously every 8 hours depending on type and severity of infection, susceptibility of the pathogens and the condition of the patient.</li>\r\n	<li>Intra-abdominal infections: 20 mg/kg every 8 hours.</li>\r\n	<li>Cystic fibrosis (4-18 years): 25-40 mg/kg every 8 hours.</li>\r\n	<li>Meningitis: 40 mg/kg IV every 8 hours.</li>\r\n	<li>Febrile neutropenia: 20 mg/kg every 8 hours.</li>\r\n	<li>Children over 50 kg weight: use adult dosage.</li>\r\n	<li>There is no experience in children with hepatic or renal impairment.</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>Meropenem should be administered by intravenous Infusion over approximately 15-30 minutes or as intravenous bolus (5 to 20 ml) over approximately 3-5 minutes</p>', '<p>Probenecid competes with Meropenem for active tubular secretion and thus inhibits the renal excretion, with the effect of increasing the elimination half-life and plasma concentration of meropenem. Meropenem may reduce serum valproic acid levels. Sub therapeutic levels may be reached in some patients.</p>', '<p>Meropenem is contraindicated in patients who have demonstrated hypersensitivity to this product.</p>', '<p>Meropenem is generally well tolerated. Side effects like inflammation, thrombophlebitis, pain at the site of injection, skin reactions like rash, pruritus, urticaria, abdominal pain, nausea, vomiting, diarrhea, headache may occur.</p>', '<p>Pregnancy Category B. There are no adequate and well-controlled studies in pregnant women. So this drug should be used during pregnancy only if clearly needed. Because many drugs are excreted in human milk, caution should be exercised when Meropenem is administered to a nursing woman.</p>', '<p>If an allergic reaction to Meropenem occurs, the drug should be discontinued and appropriate measures taken. Use of Meropenem in patients with hepatic disease should be made with careful monitoring of transaminase and bilirubin levels.</p>', '<p>Accidental overdose could occur during therapy, particularly in patients with renal impairment. Treatment of overdose should be symptomatic. In normal individuals, rapid renal elimination will occur; in subjects with renal impairment, haemodialysis will remove Meropenem and its metabolite.</p>', '<p>Other beta-lactam Antibiotics.</p>', '<p>Vial store in a cool, dry place (below 30oC), away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Renal impairment</strong>: Dosage should be reduced in patients with creatinine clearance less than 51 ml/min.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: No dosage adjustments are necessary with impairment of liver function. Hemodialysis patients should receive Meropenem after dialysis has been completed.<br />\r\n<br />\r\n<strong>Elderly</strong>: No dosage adjustments are necessary in elderly patients unless creatinine clearance is &lt;51 ml/min.<br />\r\n<br />\r\n<strong>Use in Children</strong>: Efficacy and tolerability in infants under 3 months have not been established.</p>', '2022-03-09 06:24:17', '2022-03-09 06:24:17'),
(927, 927, '<p>Mesalazine is indicated for</p>\r\n\r\n<ul>\r\n	<li>Treatment of mild to moderately active Ulcerative Colitis &amp; &amp; Crohn&rsquo;s Disease</li>\r\n	<li>Maintenance of remission of Ulcerative Colitis</li>\r\n	<li>Maintenance of remission of Crohn&rsquo;s disease</li>\r\n</ul>', '<p>The mechanism of action of Mesalamine is unknown, but appears to be topical rather than systemic. Mucosal production of Arachidonic Acid metabolites, both through the cyclooxygenase pathways, that is, prostanoids, and through the lipoxygenase pathways, that is, leukotrienes and hydroxyeicosatetraenoic acids, is increased in patients with chronic infammatory bowel disease. Mesalamine diminishes infammation by blocking cyclooxygenase and inhibiting prostaglandin production in the colon.</p>', '<p>Ulcerative colitis-<br />\r\n<strong>Adults</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Active disease</strong>: Individual dosage, up to 4 gm mesalazine once daily or divided into 2-4 doses.</li>\r\n	<li><strong>Maintenance treatment</strong>: Individual dosage. Recommended dosage, 2 gm mesalazine once daily.</li>\r\n</ul>\r\n\r\n<p><strong>Pediatrics</strong>: The safety and efficacy in children below 6 years of age have not been established. There is only limited documentation for an effect in children (age 6-18 years).<br />\r\n<br />\r\nChildren 6 years of age and older:</p>\r\n\r\n<ul>\r\n	<li><strong>Active disease</strong>: To be determined individually, starting with 30-50 mg/kg/day in divided doses. Maximum dose: 75 mg/kg/day in divided doses. The total dose should not exceed 4 g/day (maximum adult dose).</li>\r\n	<li><strong>Maintenance treatment</strong>: To be determined individually, starting with 15-30 mg/kg/day in divided doses. The total dose should not exceed 2 g/day (recommended adult dose).</li>\r\n	<li>It is generally recommended that half the adult dose may be given to children up to a body weight of 40 kg; and the normal adult dose to those above 40 kg.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>The granules must not be chewed. The contents of the sachet should be emptied onto the tongue and washed down with some water or orange juice. Alternatively, the entire content of the sachet can be taken with yogurt and consumed immediately.</p>', '<p>Concurrent use of other known nephrotoxic agents such as NSAIDs and Azathioprine may increase the risk of renal reactions.</p>', '<p>Hypersensitivity to salicylates or to any other component of the formulation.</p>', '<p>The commonly reported adverse events are headache, nausea, dizziness, asthenia, dyspepsia, vomiting, pruritus etc.</p>', '<p>It should be given in pregnancy only if the potential beneft justifes the potential risk to the fetus. Caution is advised when it is administered to a nursing mother.</p>', '<p>Patients with pyloric stenosis may have prolonged gastric retention of Mesalamine tablets which could delay release of Mesalamine in the colon. Renal impairment, including minimal change nephropathy and acute and chronic interstitial nephritis has been reported in patients taking Mesalamine. Therefore, caution should be exercised when using Mesalamine in patients with known renal dysfunction or history of renal disease. Patients should have renal function monitored, prior to treatment start and then it should be monitored periodically during treatment. There have been reports of hepatic failure in patients with pre-existing liver disease who have been administered Mesalamine. Caution should be exercised when administering Mesalamine to patients with liver impairment.</p>', '<p>There is no specifc antidote for Mesalamine overdose. Treatment for suspected acute severe toxicity should be symptomatic and supportive. This may include prevention of further gastrointestinal tract absorption, correction of fuid electrolyte imbalance and maintenance of adequate renal function. This is a pH dependent delayed-release product and this factor should be considered when treating a suspected over dose.</p>', '<p>Aminosalicylates</p>', '<p>Store below 30 0 C. Protect from light and moisture. Keep all medicines out of the reach of children.</p>', '<p>Geriatrics: Patients who are 65 years or older, caution should be taken to closely monitor blood cell counts during Mesalamine therapy.<br />\r\n<br />\r\nElderly: Because elderly patients are more likely to have decreased renal function, care should be taken when prescribing this drug therapy. It is recommended that all patients have an evaluation of renal function prior to initiation of Mesalamine tablets. Monitor blood cell counts during drug therapy.<br />\r\n<br />\r\nPaediatric: Safety and effectiveness have not been established.</p>', '2022-03-09 06:26:24', '2022-03-09 06:26:24'),
(928, 928, '<p>Mesna is a cytoprotective agent indicated as a prophylactic agent in reducing the incidence of ifosfamide-induced hemorrhagic cystitis.</p>', '<p>Mesna is used to prevent urothelial toxicity associated with oxazaphosphorine, ifosfamide or cyclophosphamide. It acts in the kidney; reacting with thiol groups of urotoxic metabolites (e.g. acrolein) of ifosfamide and cyclophosphamide. It is used as a mucolytic in the management of some respiratory tract conditions e.g. cystic fibrosis where other mucolytics have failed. It acts by reducing the viscosity of pulmonary secretions; the drug&#39;s free sulfhydryl group is thought to reduce disulfide linkages of mucoproteins.</p>', '<p>Intravenous-<br />\r\nProphylaxis against urothelial toxicity:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Refer to individual and local protocol. Dose calculated according to cytotoxic dose. Normally given at a dose &ge;cytotoxic dose. Duration of treatment should be as long as cytotoxic treatment; plus the time it takes for concentration of antineoplastic metabolites in urine to fall. Administered either by short (15-30 minutes) or continuous (24 hr) infusion.</li>\r\n	<li><strong>Child:</strong>&nbsp;Refer to individual and local protocol. Has been used in children &gt;4 mth.</li>\r\n</ul>\r\n\r\n<p>Oral-<br />\r\nProphylaxis against urothelial toxicity:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Refer to individual and local protocol. Dose calculated according to cytotoxic dose. Normally given at a dose &ge;cytotoxic dose. Duration of treatment should be as long as cytotoxic treatment; plus the time it takes for concentration of antineoplastic metabolites in urine to fall.</li>\r\n	<li><strong>Child</strong>: Refer to individual and local protocol.</li>\r\n</ul>', NULL, '<p>Hypersensitivity to thiol-containing compounds.</p>', '<p>Nausea, vomiting, colic, diarrhoea, anorexia, dyspepsia, unpleasant taste, constipation; headache, malaise, fatigue, depression, irritability, somnolence, hyperaesthesia, dizziness, confusion; rash, pruritus, generalised urticaria, alopecia, inj site reactions, flushing; leucopenia, thrombocytopenia, anaemia, granulocytopenia, chest pain, oedema (peripheral, facial and periorbital), hypotension, tachycardia, hypertension, increased heart rate, ST-segment elevation; dyspnoea, coughing, pneumonia, tachypnea; fever; hypocalcaemia; increased sweating; back pain, limb pain, myalgia; increased hepatic enzyme concentrations; pharyngitis; ulceration of mucous membranes. In patients receiving oral and/or IV mesna and were specifically not treated with concurrent cytotoxic therapy: flatulence; rhinitis; rigors; back pain; rash; conjunctivitis; arthralgia. Inhalation: bronchospasm.</p>', '<p>Pregnancy&nbsp;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>Protective effect applies only to the urinary tract; pregnancy, lactation. Patients with auto-immune disorders. IV formulation may contain benzyl alcohol as a preservative; avoid in neonates or infants. Instruct patients to seek medical attention if discolouration of urine occurs. During treatment, monitor urine for erythrocytes and haematuria. Maintain adequate hydration in all patients. Patients who vomit within 2 hr of oral dose should repeat dose or receive IV dose.</p>', NULL, '<p>Antidote preparations.</p>', '<p>Should be stored at 15-30&deg; C.</p>', NULL, '2022-03-09 06:28:07', '2022-03-09 06:28:07'),
(929, 929, '<p>Metamizol is indicated in Pain and Fever.</p>', '<p>It inhibits the synthesis of prostaglandins D and E resulting in analgesic, antiinflammatory and antipyretic effects. It also has the potential for causing agranulocytosis.</p>', '<p><strong>Adults and children over 18 years</strong>: The usual dose is 1.25 gm (2.5 ml) or 2.5 gm (5 ml) once daily. The maximum daily dose is 4 g.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<ul>\r\n	<li>Hypersensitivity to any of the ingredients</li>\r\n	<li>Renal failure, pyelonephritis, glomerulonephritis and other renal diseases;</li>\r\n	<li>Inhibition of hematopoiesis functions (neutropenia cytostatic or infectious, agranulocytosis);</li>\r\n	<li>Liver failure;</li>\r\n	<li>Anemias, including hereditary hemolytic anemia;</li>\r\n	<li>Leukopenia;</li>\r\n	<li>Propensity to bronchospasm;</li>\r\n	<li>Optic neuritis;</li>\r\n	<li>Myasthenia gravis, accompanied by severe muscle weakness and fatigue;</li>\r\n</ul>', '<p>Allergic reactions that may occur are usually skin reactions: rash, redness, itching, swelling, gradually swelling of the face and tongue, and a lot more dangerous anaphylactic shock which has the following symptoms: itching, cold sweat, dizziness, lethargy, nausea, redness or paleness of skin and shortness of breath.<br />\r\n<br />\r\nMetamizole can cause damage to the bone marrow (granulocytopenia, agranulocytosis, hemolytic anemia, aplastic anemia). Cases of agranulocytosis are rare, but they are still very serious. Symptoms of agranulocytosis include: high fever, chills, sore throat, difficulty swallowing, inflammation of the mouth, nose, throat.<br />\r\n<br />\r\nMetamizole can cause digestive disorders such as nausea, vomiting, dry mouth, irritation of the digestive system. You can contact drowsiness, fatigue, weakness, headache, and hypotension, and wheezing.</p>', '<p>Category- Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<ul>\r\n	<li>Allergic reactions to aspirin and nonsteroidal anti-inflammatory drugs</li>\r\n	<li>Asthma or chronic inflammation of the airways</li>\r\n	<li>Anaemia</li>\r\n	<li>The weakness of the kidney or liver An ulcer in the stomach or duodenum</li>\r\n	<li>Heart disease and systolic blood pressure less than 100 mmHg and unstable circulation disorder (initial shock or heart attack)</li>\r\n</ul>', NULL, '<p>Non-Opioid Analgesics</p>', NULL, NULL, '2022-03-09 06:32:04', '2022-03-09 06:32:04'),
(930, 930, '<p>Treatment of type 2 diabetes mellitus, particularly in overweight patients when dietary management and exercise alone does not result in adequate glycaemic control.</p>\r\n\r\n<ul>\r\n	<li><strong>In adults</strong>: Metformin may be used as monotherapy or in combination with other oral antidiabetic agents or with insulin.</li>\r\n	<li><strong>In children from 10 years of age and adolescents</strong>: Metformin may be used as monotherapy or in combination with insulin.</li>\r\n</ul>\r\n\r\n<p>A reduction of diabetic complications has been shown in overweight type 2 diabetic adult patients treated with metformin as first-line therapy after diet failure.</p>', '<p>Metformin is a biguanide type oral antihyperglycemic drug used in the management of type 2 diabetes. It lowers both basal and postprandial plasma glucose. Its mechanism of action is different from those of sulfonylureas and it does not produce hypoglycemia. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity by an increase in peripheral glucose uptake and utilization.</p>', '<p><strong>Metformin immediate release tablet</strong>: Dosage of Metformin Hydrochloride must be individualized on the basis of both effectiveness and tolerance, while not exceeding the maximum recommended daily doses.</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: The usual starting dose of Metformin is 500 mg twice a day or 850 mg once a day, given with meals. Dosage increases should be made in increments of 500 mg weekly or 850 mg every 2 weeks, up to a total of 2000 mg per day, given in divided doses. For those patients requiring additional glycemic control, Glucomin may be given to a maximum daily dose of 2550 mg per day. Doses above 2000 mg may be better tolerated given three times a day with meals.</li>\r\n	<li><strong>Children</strong>: The usual starting dose of Metformin is 500 mg twice a day, given with meals. Dosage increases should be made in increments of 500 mg weekly up to a maximum of 2000 mg per day, given in divided doses.</li>\r\n</ul>\r\n\r\n<p><strong>Metformin extended release tablet</strong>: Swallow Metformin XR tablet whole and never crush, cut or chew.</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: The usual starting dose of Metformin XR is 500 mg once daily with the evening meal. Dose should be increased in increments of 500 mg weekly, up to a maximum of 2000 mg once daily with the evening meal, alternatively increased to 1000 mg twice daily taken with meal. Patient receiving Metformin immediate release tablet may be switched to Metformin extended release tablet up to a maximum recommended daily dose.</li>\r\n	<li><strong>Children</strong>: Metformin extended release tablet has not been studied in children.</li>\r\n	<li><strong>Renal impaired patient</strong>: Do not use Metformin in patients with eGFR below 30 mL/min/1.73 m2. Asses risk/benefit of counting if eGFR falls below 45 mL/min/1.73 m2.</li>\r\n</ul>', '<p>Co-administration with Carbonic anhydrase (Topiramate, Zonisamide) may increase risk of lactic acidosis. Drugs (Ranolazine, Dolutegravir, Cimetidine) that reduce Metformin clearance may increase the accumulation of Metformin. Alcohol can potentiate the effect of Metformin on lactate metabolism.</p>', '<ul>\r\n	<li>Hypersensitivity to the active substance or to any of the excipients.</li>\r\n	<li>Any type of acute metabolic acidosis (such as lactic acidosis, diabetic ketoacidosis).</li>\r\n	<li>Severe renal failure (GFR &lt;30 mL/min).</li>\r\n	<li>Acute conditions with the potential to alter renal function such as: dehydration, severe infection, shock.</li>\r\n	<li>Acute or chronic disease, which may cause tissue hypoxia such as: cardiac or respiratory failure, recent myocardial infarction, shock, Hepatic insufciency, acute alcohol intoxication, alcoholism.</li>\r\n</ul>', '<p><strong>Blood and lymphatic system disorders</strong>: Not known: Hemolytic anemia<br />\r\n<br />\r\n<strong>Metabolism and nutrition disorders</strong>: Very rare: Lactic acidosis. Decrease of vitamin B12 absorption with a decrease of serum levels during long-term use of metformin. Consideration of such etiology is recommended if a patient presents with megaloblastic anemia. Cases of peripheral neuropathy in patients with vitamin B12 deficiency have been reported in post-marketing experience (frequency not known)<br />\r\n<br />\r\n<strong>Nervous system disorder</strong>s: Common: Taste disturbance. Not known: Encephalopathy<br />\r\n<br />\r\n<strong>Gastrointestinal disorders</strong>: Very common: Gastrointestinal disorders, such as nausea, vomiting, diarrhea, abdominal pain, and loss of appetite. These undesirable effects occur most frequently during the initiation of therapy and resolve spontaneously in most cases. To prevent them, it is recommended that metformin be taken in 2 or 3 daily doses during or after meals. A slow increase of the dose may also improve gastrointestinal tolerability.<br />\r\n<br />\r\n<strong>Hepatobiliary disorders</strong>: Very rare: Isolated reports of liver function test abnormalities or hepatitis resolving upon metformin discontinuation.<br />\r\n<br />\r\n<strong>Skin and subcutaneous tissue disorders</strong>: Very rare: Skin reactions, such as erythema, pruritus, urticaria.</p>', '<p><strong>Pregnancy</strong>: Uncontrolled diabetes during pregnancy (gestational or permanent) is associated with an increased risk of congenital abnormalities and perinatal mortality. When the patient plans to become pregnant and during pregnancy, it is recommended that diabetes is not treated with metformin but insulin be used to maintain blood glucose levels as close to normal as possible, to reduce the risk of malformations of the foetus.<br />\r\n<br />\r\n<strong>Breastfeeding</strong>: Metformin is excreted into human breast milk. No adverse efects were observed in breastfed newborns/infants. However, as only limited data are available, breastfeeding is not recommended during metformin treatment. A decision on whether to discontinue breastfeeding should be made, taking into account the benefit of breastfeeding and the potential risk to adverse effects on the child.</p>', '<p>Metformin Hydrochloride is known to be substantially excreted by the kidney and the risk of Metformin accumulation and lactic acidosis increases with the degree of impairment of renal function. Metformin may lower vitamin B12 level. It also increases risk of hypoglycemia when use in combination with insulin or insulin secretagogue.</p>', '<p>Hypoglycemia has not been seen with Metformin doses up to 85 gm, although lactic acidosis has occurred in such circumstances. Lactic acidosis is a medical emergency and must be treated in hospital. The most effective method to remove lactate and Metformin is hemodialysis.</p>', '<p>Biguanides</p>', '<p>Treatment of type 2 diabetes mellitus, particularly in overweight patients when dietary management and exercise alone does not result in adequate glycaemic control.</p>\r\n\r\n<ul>\r\n	<li><strong>In adults</strong>: Metformin may be used as monotherapy or in combination with other oral antidiabetic agents or with insulin.</li>\r\n	<li><strong>In children from 10 years of age and adolescents</strong>: Metformin may be used as monotherapy or in combination with insulin.</li>\r\n</ul>\r\n\r\n<p>A reduction of diabetic complications has been shown in overweight type 2 diabetic adult patients treated with metformin as first-line therapy after diet failure.</p>', '<p><strong>Elderly</strong>: Due to the potential for decreased renal function in elderly subjects, the metformin dosage should be adjusted based on renal function. Regular assessment of renal function is necessary.<br />\r\n<br />\r\n<strong>Pediatric population</strong>: The diagnosis of type 2 diabetes mellitus should be confirmed before treatment with metformin is initiated. No effect of metformin on growth and puberty has been detected during controlled clinical studies of one-year duration but no long-term data on these specific points are available. Therefore, a careful follow-up of the effect of metformin on these parameters in metformin-treated children, especially prepubescent children, is recommended.<br />\r\n<br />\r\n<strong>Children aged between 10 and 12 years</strong>: Particular caution is recommended when prescribing to children aged between 10 and 12 years.<br />\r\n<br />\r\n<strong>Renal function</strong>: As metformin is excreted by the kidney, creatinine clearance (this can be estimated from serum creatinine levels by using the Cockcroft-Gault formula) should be determined before initiating treatment and regularly thereafter:</p>\r\n\r\n<ul>\r\n	<li>At least annually in patients with normal renal function,</li>\r\n	<li>At least two to four times a year in patients with creatinine clearance at the lower limit of normal and in elderly subjects.</li>\r\n</ul>\r\n\r\n<p>Decreased renal function in elderly subjects is frequent and asymptomatic. Special caution should be exercised in situations where renal function may become impaired, for example when initiating antihypertensive therapy or diuretic therapy and when starting therapy with a non-steroidal anti-inflammatory drug (NSAID). GFR should be assessed before treatment initiation and regularly thereafter. Metformin is contraindicate in patients with GFR&lt;30 ml/min and should be temporarily discontinued in the presence of conditions that alter renal function.</p>', '2022-03-09 06:34:33', '2022-06-12 04:05:35');
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
(931, 931, '<p>Methenamine is indicated for prophylactic or suppressive treatment of frequently recurring urinary tract infections when long-term therapy is considered necessary. This drug should only be used after eradication of the infection by other appropriate antimicrobial agents. To reduce the development of drug-resistant bacteria and maintain the effectiveness of Methenamine and other antibacterial drugs, Methenamine should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.</p>', '<p>Methenamine Hippurate has antibacterial activity because the methenamine component is hydrolyzed to formaldehyde in acid urine. Hippuric acid, the other component, has some antibacterial activity and also acts to keep the urine acid. The drug is generally active against E. coli, enterococci and staphylococci. Enterobacter aerogenes is generally resistant. The urine must be kept sufficiently acid for urea-splitting organisms such as Proteus and Pseudomonas to be inhibited.<br />\r\n<br />\r\n<strong>Pharmacology</strong>: Within 1/2 hour after ingestion of a single 1-gram dose of Methenamine, antibacterial activity is demonstrable in the urine. Urine has continuous antibacterial activity when HIPREX is administered at the recommended dosage schedule of 1 gram twice daily. Over 90% of methenamine moiety is excreted in the urine within 24 hours after administration of a single 1-gram dose. Similarly, the hippurate moiety is rapidly absorbed and excreted, and it reaches the urine by both tubular secretion and glomerular filtration. This action may be important in older patients or in those with some degree of renal impairment.</p>', '<p><strong>For adults and pediatric patients over 12 years of age</strong>: 1 tablet twice daily (morning and night).<br />\r\n<strong>For pediatric patients 6 to 12 years of age</strong>: &frac12; to 1 tablet twice daily (morning and night).<br />\r\n<br />\r\nSince the antibacterial activity of Methenamine is greater in acid urine, restriction of alkalinizing foods and medications is desirable. If necessary, as indicated by urinary pH and clinical response, supplemental acidification of the urine should be instituted. The efficacy of therapy should be monitored by repeated urine cultures.</p>', NULL, '<p>Methenamine Hippurate tablets USP is contraindicated in patients with renal insufficiency, severe hepatic insufficiency, or severe dehydration. Methenamine preparations should not be given to patients taking sulfonamides because some sulfonamides may form an insoluble precipitate with formaldehyde in the urine.</p>', NULL, '<p>In early pregnancy the safe use of Methenamine is not established. In the last trimester, safety is suggested, but not definitely proved. No adverse effects on the fetus were seen in studies in pregnant rats and rabbits. Methenamine taken during pregnancy can interfere with laboratory tests of urine estriol (resulting in unmeasurably low values) when acid hydrolysis is used in the laboratory procedure. This interference is due to the presence in the urine of methenamine and/or formaldehyde. Enzymatic hydrolysis, in place of acid hydrolysis, will circumvent this problem.</p>', '<p>Prescribing Methenamine in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.<br />\r\n<br />\r\nCare should be taken to maintain an acid pH of the urine, especially when treating infections due to urea-splitting organisms such as Proteus and strains of Pseudomonas.<br />\r\n<br />\r\nIn a few instances in one study, the serum transaminase levels were slightly elevated during treatment but returned to normal while the patients were still taking Methenamine. Because of this report, it is recommended that liver function studies be performed periodically on patients taking the drug, especially those with liver dysfunction.</p>', NULL, '<p>Other genito-urinary preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Geriatric Use</strong>: Clinical studies of Methenamine&nbsp;did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy.<br />\r\n<br />\r\n<strong>Renal insufficiency and severe hepatic insufficiency</strong>: Methenamine is contraindicated in patients with renal insufficiency and severe hepatic insufficiency.</p>', '2022-03-09 06:36:22', '2022-03-09 06:36:22'),
(932, 932, '<p>Methimazole is indicated:</p>\r\n\r\n<ul>\r\n	<li>In patients with Graves&#39; disease with hyperthyroidism or toxic multinodular goiter for whom surgery or radioactive iodine therapy is not an appropriate treatment option.</li>\r\n	<li>To ameliorate symptoms of hyperthyroidism in preparation for thyroidectomy or radioactive iodine therapy.</li>\r\n</ul>', '<p>Methimazole inhibits the synthesis of thyroid hormones and thus is effective in the treatment of hyperthyroidism. The drug does not inactivate existing thyroxine and triiodothyronine that are stored in the thyroid or circulating in the blood nor does it interfere with the effectiveness of thyroid hormones given by mouth or by injection. Methimazole is readily absorbed in the gastrointestinal tract, metabolized in the liver, and excreted in the urine.</p>', '<p>Methimazole is administered orally. The total daily dosage is usually given in 3 divided doses at approximately 8 hour intervals.<br />\r\n<br />\r\n<strong>Adults</strong>: The initial daily dosage is 15 mg for mild hyperthyroidism, 30 to 40 mg for moderately severe hyperthyroidism, and 60 mg for severe hyperthyroidism, divided into 3 doses at 8 hour intervals. The maintenance dosage is 5 to 15 mg daily.<br />\r\n<br />\r\n<strong>Pediatric</strong>: Initially, the daily dosage is 0.4 mg/kg of body weight divided into 3 doses and given at 8 hour intervals. The maintenance dosage is approximately 1/2 of the initial dose.<br />\r\n<br />\r\n<strong>Use in children &amp; adolescents</strong>: Because of post-marketing reports of severe liver injury in pediatric patient treated with propylthiouracil, Methimazole is the preferred choice when an antithyroid drug is required for a pediatric patient.</p>', '<p><strong>With medicine</strong>: Anticoagulants (oral)- Due to potential inhibition of vitamin K activity by methimazole, the activity of oral anticoagulants (e.g., warfarin) may be increased; additional monitoring of PT/INR should be considered, especially before surgical procedures. &beta;-adrenergic blocking agents- Hyperthyroidism may cause an increased clearance of beta-blockers with a high extraction ratio. A dose reduction of beta-adrenergic blockers may be needed when a hyperthyroid patient becomes euthyroid. Digitalis glycosides- Serum digitalis levels may be increased when hyperthyroid patients on a stable digitalis glycoside regimen become euthyroid; a reduced dosage of digitalis glycosides may be needed. Theophylline- Theophylline clearance may decrease when hyperthyroid patients on a stable theophylline regimen become euthyroid; a reduced dose of theophylline may be needed.<br />\r\n<br />\r\n<strong>With food</strong>: Always take at the same moment in regard to meals, food may affect absorption unpredictably.</p>', '<p>Methimazole is contraindicated in the presence of hypersensitivity to the drug or any of the other product components.</p>', '<p><strong>Common</strong>: Skin rash, urticaria, nausea, vomiting, epigastric distress, arthralgia, paresthesia, loss of taste, abnormal loss of hair, myalgia, headache, pruritus, drowsiness, neuritis, edema, vertigo, skin pigmentation, jaundice, sialadenopathy, and lymphadenopathy.<br />\r\n<br />\r\n<strong>Rare</strong>: Agranulocytosis, granulocytopenia, thrombocytopenia and aplastic anemia, drug fever, a lupus-like syndrome, insulin autoimmune syndrome (which can result in hypoglycemic coma), hepatitis (jaundice may persist for several weeks after discontinuation of the drug), periarteritis, and hypoprothrombinemia. Nephritis occurs very rarely.</p>', '<p>Pregnancy Category D. Due to the rare occurrence of congenital malformations associated with methimazole use, it may be appropriate to use other agents in pregnant women requiring treatment for hyperthyroidism particularly in the first trimester of pregnancy. Methimazole is excreted into breast milk. However, several studies found no effect on clinical status in nursing infants of mothers taking methimazole, particularly if thyroid function is monitored at frequent (weekly or biweekly) intervals.</p>', '<p><strong>Congenital Malformations</strong>: Methimazole readily crosses the placental membranes and can cause fetal harm, particularly when administered in the first trimester of pregnancy. If Methimazole is used during pregnancy or if the patient becomes pregnant while taking this drug, the patient should be warned of the potential hazard to the fetus. Since some congenital defects have been reported in offspring of patients treated with Methimazole, it may be appropriate to use other agents in pregnant women requiring treatment for hyperthyroidism, particularly in the first trimester of pregnancy. If Methimazole is used, the lowest possible dose to control the disease should be given.<br />\r\n<br />\r\n<strong>Agranulocytosis</strong>: Agranulocytosis is potentially a life-threatening adverse reaction of Methimazole therapy. Patients should be instructed to immediately report to their physicians if any symptoms suggestive of agranulocytosis, such as fever or sore throat occur. Leukopenia, thrombocytopenia, and aplastic anemia (pancytopenia) may also occur. The drug should be discontinued in the presence of agranulocytosis, aplastic anemia (pancytopenia), ANCA-positive vasculitis, hepatitis, or exfoliative dermatitis and the patient&rsquo;s bone marrow indices should be monitored.<br />\r\n<br />\r\n<strong>Liver Toxicity</strong>: Although there have been reports of hepatotoxicity associated with Methimazole, the risk of hepatotoxicity appears to be less with methimazole than with propylthiouracil, especially in the pediatric population. Drug treatment should be discontinued promptly in the event of clinically significant evidence of liver abnormality including hepatic transaminase values exceeding 3 times the upper limit of normal.<br />\r\n<br />\r\n<strong>Hypothyroidism</strong>: Methimazole can cause hypothyroidism necessitating routine monitoring of TSH and free T4 levels with adjustments in dosing to maintain a euthyroid state. Because the drug readily crosses placental membranes, Methimazole can cause fetal goiter and cretinism when administered to a pregnant woman. For this reason, it is important that a sufficient, but not excessive, dose be given during pregnancy. Because Methimazole may cause hypoprothrombinemia and bleeding, prothrombin time should be monitored during therapy with the drug, especially before surgical procedures. Thyroid function tests should be monitored periodically during therapy. Once clinical evidence of hyperthyroidism has resolved, the finding of a rising serum TSH indicates that a lower maintenance dose of Methimazole should be employed.</p>', '<p>Symptoms may include nausea, vomiting, epigastric distress, headache, fever, joint pain, pruritus, and edema. Aplastic anemia or agranulocytosis may be manifested in hours to days. Less frequent events are hepatitis, nephrotic syndrome, exfoliative dermatitis, neuropathies, and CNS stimulation or depression. In the event of an overdose, appropriate supportive treatment should be initiated as dictated by the patient&rsquo;s medical status.</p>', '<p>Anti-thyroid drugs.</p>', '<p>Store in a cool (below 30&deg;C) and dry place, away from light and children.</p>', NULL, '2022-03-09 06:46:29', '2022-03-09 06:46:29'),
(933, 933, '<p>Indications</p>\r\n\r\n<p>Methocarbamol is indicated as an adjunct to rest, physical therapy, and other measures for the relief of discomfort associated with acute, painful musculoskeletal conditions. The mode of action of methocarbamol has not been clearly identified, but may be related to its sedative properties. Methocarbamol does not directly relax tense skeletal muscles in man.</p>', '<p>Methocarbamol is a central muscle relaxant for skeletal muscles, used to treat spasms. It is structurally related to guaifenesin. Methocarbamol&#39;s exact mechanism of causing skeletal muscle relaxation is unknown. It is thought to work centrally, perhaps by general depressant effects. It has no direct relaxant effects on striated muscle, nerve fibers, or the motor endplate. It will not directly relax contracted skeletal muscles. The drug has a secondary sedative effect.<br />\r\n<br />\r\nThe mechanism of action of methocarbamol in humans has not been established, but may be due to general central nervous system (CNS) depression. It has no direct action on the contractile mechanism of striated muscle, the motor end plate or the nerve fiber.</p>', '<p>Methocarbamol 500 mg:</p>\r\n\r\n<ul>\r\n	<li><strong>Initial dosage</strong>: 1500 mg (3 tablets) q.i.d.</li>\r\n	<li><strong>Maintenance dosage</strong>: 2 tablets q.i.d.</li>\r\n</ul>\r\n\r\n<p>Methocarbamol 750 mg:</p>\r\n\r\n<ul>\r\n	<li><strong>Initial dosage</strong>: 1500 mg (2 tablets) q.i.d.</li>\r\n	<li><strong>Maintenance dosage</strong>: 1 tablet q.4h. or 2 tablets t.i.d.</li>\r\n</ul>\r\n\r\n<p>Six grams a day are recommended for the first 48 to 72 hours of treatment. (For severe conditions 8 grams a day may be administered). Thereafter, the dosage can usually be reduced to approximately 4 grams a day.</p>', '<p>Methocarbamol may inhibit the effect of pyridostigmine bromide. Therefore, methocarbamol should be used with caution in patients with myasthenia gravis receiving anticholinesterase agents.</p>', '<p>Methocarbamol is contraindicated in patients hypersensitive to methocarbamol or to any of the tablet components.</p>', '<p><strong>Body as a whole</strong>: Anaphylactic reaction, angioneurotic edema, fever, headache<br />\r\n<br />\r\n<strong>Cardiovascular system</strong>: Bradycardia, flushing, hypotension, syncope, thrombophlebitis<br />\r\n<br />\r\n<strong>Digestive system</strong>: Dyspepsia, jaundice (including cholestatic jaundice), nausea and vomiting<br />\r\n<br />\r\n<strong>Hemic and lymphatic system</strong>: Leukopenia<br />\r\n<br />\r\n<strong>Immune system</strong>: Hypersensitivity reactions<br />\r\n<br />\r\n<strong>Nervous system</strong>: Amnesia, confusion, diplopia, dizziness or lightheadedness, drowsiness, insomnia, mild muscular incoordination, nystagmus, sedation, seizures (including grand mal), vertigo<br />\r\n<br />\r\n<strong>Skin and special senses</strong>: Blurred vision, conjunctivitis, nasal congestion, metallic taste, pruritus, rash, urticaria</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C. Animal reproduction studies have not been conducted with methocarbamol. It is also not known whether methocarbamol can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. methocarbamol&nbsp;should be given to a pregnant woman only if clearly needed.<br />\r\n<br />\r\nSafe use of methocarbamol&nbsp;has not been established with regard to possible adverse effects upon fetal development. There have been reports of fetal and congenital abnormalities following in utero exposure to methocarbamol. Therefore, methocarbamol&nbsp;should not be used in women who are or may become pregnant and particularly during early pregnancy unless in the judgment of the physician the potential benefits outweigh the possible hazards<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: Methocarbamol and/or its metabolites are excreted in the milk of dogs; however, it is not known whether methocarbamol or its metabolites are excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Methocarbamol &nbsp;is administered to a nursing woman.</p>', '<p>Patients should be cautioned that methocarbamol may cause drowsiness or dizziness, which may impair their ability to operate motor vehicles or machinery. Because methocarbamol may possess a general CNS-depressant effect, patients should be cautioned about combined effects with alcohol and other CNS depressants.<br />\r\n<br />\r\nSince methocarbamol may possess a general CNS depressant effect, patients receiving methocarbamol&nbsp;should be cautioned about combined effects with alcohol and other CNS depressants. Safe use of methocarbamol&nbsp;has not been established with regard to possible adverse effects upon fetal development. There have been reports of fetal and congenital abnormalities following in utero exposure to methocarbamol. Therefore, methocarbamol&nbsp;should not be used in women who are or may become pregnant and particularly during early pregnancy unless in the judgment of the physician the potential benefits outweigh the possible hazards.</p>', '<p>Limited information is available on the acute toxicity of methocarbamol. Overdose of methocarbamol is frequently in conjunction with alcohol or other CNS depressants and includes the following symptoms: nausea, drowsiness, blurred vision, hypotension, seizures, and coma. In post-marketing experience, deaths have been reported with an overdose of methocarbamol alone or in the presence of other CNS depressants, alcohol or psychotropic drugs.<br />\r\n<br />\r\nManagement of overdose includes symptomatic and supportive treatment. Supportive measures include maintenance of an adequate airway, monitoring urinary output and vital signs, and administration of intravenous fluids if necessary. The usefulness of hemodialysis in managing overdose is unknown.</p>', '<p>Centrally acting Skeletal Muscle Relaxants.</p>', '<p>Store at controlled room temperature, between 20&deg;C and 25&deg;C.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of Methocarbamol&nbsp;in pediatric patients below the age of 16 have not been established.</p>', '2022-03-09 06:48:42', '2022-03-09 06:48:42'),
(934, 934, '<p><strong>Neoplastic Diseases</strong>: Methotrexate is indicated in the treatment of gestational choriocarcinoma, chorioadenoma destruens and&nbsp;hydatidiform mole. Methotrexate is used in&nbsp;maintenance therapy&nbsp;in combination with other chemotherapeutic agents. Methotrexate is used alone or in combination with other anticancer agents in the treatment of breast&nbsp; cancer, epidermoid cancers of the head and neck, advanced&nbsp;mycosis fungoides&nbsp;(cutaneous&nbsp;T cell&nbsp;lymphoma), and lung cancer, particularly squamous cell and small cell types. Methotrexate is also used in combination with other chemotherapeutic agents in the treatment of advanced stage non-Hodgkin&#39;s lymphomas.<br />\r\n<br />\r\n<strong>Psoriasis</strong>: Methotrexate is indicated in the symptomatic control of severe, recalcitrant, disabling psoriasis&nbsp;that is not adequately responsive to other forms of therapy,&nbsp;but only when the diagnosis has been established, as&nbsp;by biopsy and/or after dermatologic consultation.&nbsp;It is important to ensure that a psoriasis &ldquo;flare&rdquo; is not due to an undiagnosed concomitant disease affecting immune responses.<br />\r\n<br />\r\n<strong>Rheumatoid Arthritis Including Polyarticular-Course Juvenile Rheumatoid Arthritis:&nbsp;</strong>Methotrexate is indicated in the management of selected adults with severe, active,&nbsp;rheumatoid arthritis&nbsp;(ACR criteria), or children with active polyarticular course juvenile rheumatoid arthritis, who have had an insufficient therapeutic response to, or are intolerant of, an adequate trial of first-line therapy including full dose non-steroidal anti-inflammatory agents (NSAIDs).<br />\r\n<br />\r\nAspirin, NSAIDs, and/or low dose steroids may be continued, although the possibility of increased toxicity with concomitant use of NSAIDs including salicylates has not been fully explored. Steroids may be reduced gradually in patients who respond to methotrexate. Combined use of methotrexate with gold, penicillamine, hydroxychloroquine, sulfasalazine, or&nbsp;cytotoxic&nbsp;agents, has not been studied and may increase the incidence of adverse effects. Rest and physiotherapy as indicated should be continued.</p>', '<p>Methotrexate inhibits dihydrofolic acid reductase. Dihydrofolates must be reduced to tetrahydrofolates by this enzyme before they can be utilized as carriers of one-carbon groups in the synthesis of p.r.n. nucleotides and thymidylate. Therefore, methotrexate interferes with DNA synthesis, repair, and cellular replication. Actively proliferating tissues such as malignant cells, bone marrow, fetal cells, buccal and intestinal mucosa, and cells of the urinary bladder are in general more sensitive to this effect of methotrexate. When cellular proliferation in malignant tissues is greater than in most normal tissues, methotrexate may impair malignant growth without irreversible damage to normal tissues</p>', '<p>Oral-</p>\r\n\r\n<ul>\r\n	<li><strong>Choriocarcinoma</strong>: 15-30 mg daily for 5 days, repeat after an interval of &ge;1 wk for 3-5 courses.</li>\r\n	<li><strong>Acute lymphoblastic leukaemia</strong>: Maintenance: 15 mg/m2 once or twice wkly, with other agents.</li>\r\n	<li><strong>Burkitt&#39;s lymphoma</strong>: 10-25 mg daily for 4-8 days, repeated after 7-10 days.</li>\r\n	<li><strong>Psoriasis</strong>: 10-25 mg wkly as a single dose, adjust subsequent doses based on response.</li>\r\n	<li><strong>Rheumatoid arthritis</strong>: 7.5 mg once wkly, adjust by response. Not more than 20 mg/wk.</li>\r\n	<li><strong>Mycosis fungoides</strong>: 2.5-10 mg daily to induce remission.</li>\r\n	<li><strong>Crohn&#39;s disease</strong>: 12.5-22.5 mg once wkly for up to 1 yr.</li>\r\n</ul>\r\n\r\n<p>Parenteral-</p>\r\n\r\n<ul>\r\n	<li><strong>Psoriasis:</strong>&nbsp;10-25 mg wkly as a single dose. Adjust subsequent doses based on response. May be given via IV/IM admin.</li>\r\n</ul>\r\n\r\n<p>Intramuscular-</p>\r\n\r\n<ul>\r\n	<li><strong>Choriocarcinoma:</strong>&nbsp;15-30 mg daily for 5 days. Repeat after at least 1 wk for 3-5 courses. Alternatively, 0.25-1 mg/kg (max: 60 mg) every 48 hr for 4 doses followed by folinic acid rescue, repeat at intervals of 7 days for 4 or more courses.</li>\r\n	<li><strong>Mycosis fungoides:</strong>&nbsp;50 mg wkly as a single dose or 2 divided doses.</li>\r\n	<li><strong>Acute lymphoblastic leukaemia:</strong>&nbsp;Maintenance: 15 mg/m2&nbsp;once or twice wkly, with other agents.</li>\r\n	<li><strong>Crohn&#39;s disease:</strong>&nbsp;25 mg once wkly for 16 wk. Maintenance: 15 mg wkly.</li>\r\n</ul>\r\n\r\n<p>Intrathecal-</p>\r\n\r\n<ul>\r\n	<li><strong>Meningeal leukaemia:</strong>&nbsp;12 mg/m2&nbsp;(max 15 mg) once wkly for 2-3 wk, then once mthly. Alternatively, 200-500 mcg/kg every 2-5 day until CSF cell count is normalised.</li>\r\n</ul>\r\n\r\n<p>Intravenous-</p>\r\n\r\n<ul>\r\n	<li><strong>Osteosarcoma:</strong>&nbsp;Initial recommended dose: 12 g/m2&nbsp;as a 4-hr infusion, followed by folinic acid, as part of combined therapy. May increase dose to 15 g/m2&nbsp;in subsequent treatments if initial dosage is insufficient to achieve peak serum methotrexate levels of 454 mcg/mL at the end of the infusion. Methotrexate infusion is administered on postoperative wk 4, 5, 6, 7, 11, 12, 15, 16, 29, 30, 44 and 45; in combination with other chemotherapy agents. Folinic acid can be given orally, IM or IV inj starting 24 hr after the beginning of the methotrexate infusion. Give via parenteral routes If patient experiences GI toxicity (e.g., nausea, vomiting). Usual dosage of folinic acid: 15 mg every 6 hr for a total of 60 hr or a total of 10 doses.</li>\r\n	<li><strong>Breast cancer:</strong>&nbsp;10-60 mg/m2&nbsp;often with cyclophosphamide and fluorouracil.</li>\r\n	<li><strong>Advanced lymphosarcoma:</strong>&nbsp;Up to 30 mg/kg, followed by folinic acid rescue.</li>\r\n	<li><strong>Acute lymphoblastic leukaemia</strong>: Maintenance: 2.5 mg/kg every 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>Should be taken on an empty stomach. Best taken on an empty stomach. May be taken with meals to reduce GI discomfort. Avoid taking with milk-rich products.</p>', '<p>Decreased effectiveness with folic acid and its derivatives.</p>', '<p>Severe renal or hepatic impairment, pre-existing profound bone marrow suppression in patients with psoriasis or rheumatoid arthritis, alcoholic liver disease, AIDS, pre-existing blood dyscrasias, pregnancy (in patients with psoriasis or rheumatoid arthritis), breast-feeding.</p>', '<p>Ulceration of the mouth and GI disturbances (e.g. stomatitis and diarrhoea), bone marrow depression, hepatotoxicity, renal failure, skin reactions, alopecia, ocular irritation, arachnoiditis in intrathecal use, megaloblastic anaemia, osteoporosis, precipitation of diabetes, arthralgias, necrosis of soft tissue and bone, anaphylaxis, impaired fertility.</p>', '<p>Pregnancy category X.&nbsp;Studies in animals or human beings have demonstrated fetal abnormalities or there is evidence of fetal risk based on human experience or both, and the risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant.</p>', '<p>Hepatic or renal impairment, bone marrow depression, elderly, neonates. Ulcerative disorders of the GI tract. Monitor haematological, renal and hepatic function, and GI toxicity regularly.</p>', '<p>Nausea, vomiting, alopecia, melena, and renal failure.</p>', '<p>Antidote preparations, Immunosuppressant.</p>', '<p>Store at room temperature (15-25&deg;C).</p>', NULL, '2022-03-09 06:50:43', '2022-03-09 06:50:43'),
(935, 935, '<p>It is indicated for the repigmentation of idiopathic vitiligo. It is also indicated for the symptomatic control of severe, recalcitrant, disabling psoriasis not adequately responsive to other forms of therapy and when the diagnosis has been supported by biopsy.</p>', '<p>The combination treatment regimen of Psoralen (P) and UVA (Ultraviolet radiation of 320-400 nm wavelength) is commonly known as PUVA. Skin reactivity to UVA radiation is enhanced by the ingestion of Methoxsalen. The drug reaches its maximum bioavailability 1-3 hours after oral administration and may last for up to 8 hours. Methoxsalen is reversibly bound to serum albumin and is also preferentially taken up by epidermal cells. In both mice and man, Methoxsalen is rapidly metabolized. Approximately 95% of the drug is excreted as a series of metabolites in the urine within 24 hours.<br />\r\n<br />\r\nThe exact mechanism of action of Methoxsalen with the epidermal melanocytes and keratinocytes is not known. The best known biochemical reaction of Methoxsalen is with DNA. Methoxsalen, upon photoactivation, conjugates and forms covalent bonds with DNA (both monofunctional and bifunctional). Reactions with proteins have also been described.</p>', '<p><strong>Methoxsalen capsules:<br />\r\n<br />\r\nVitiligo therapy</strong>: Two Methoxsalen capsules (10 mg each) in one dose taken with milk or food two to four hours before ultraviolet light exposure.<br />\r\n<br />\r\n<strong>Light exposure</strong>: The exposure time to sunlight should comply with the following guide:</p>\r\n\r\n<ul>\r\n	<li>Initial exposure: Light-15 min, Medium-20&nbsp;min, Dark-25 min</li>\r\n	<li>Second exposure: Light-20 min, Medium-25 min, Dark-30 min</li>\r\n	<li>Third exposure: Light-25 min, Medium-30 min, Dark-35 min</li>\r\n	<li>Fourth exposure: Light-30 min, Medium-35 min, Dark-40 min</li>\r\n</ul>\r\n\r\n<p><strong>Subsequent exposure</strong>: Gradually increase exposure based on erythema and tenderness of the amelanotic skin. Therapy should be on alternate days and never two consecutive days.<br />\r\n<br />\r\n<strong>Psoriasis therapy</strong>: The Methoxsalen capsules should be taken 2 hours before UVA exposure with some food or milk, according to the following table:</p>\r\n\r\n<ul>\r\n	<li>&lt;30 kg body weight: 10 mg</li>\r\n	<li>30-50 kg body weight: 20 mg</li>\r\n	<li>51-65 kg body weight: 30 mg</li>\r\n	<li>66-80 kg body weight: 40 mg</li>\r\n	<li>81-90 kg body weight: 50 mg</li>\r\n	<li>91-115 kg body weight: 60 mg</li>\r\n	<li>&gt;115 kg body weight: 70 mg</li>\r\n</ul>\r\n\r\n<p><strong>Methoxsalen Lotion</strong>: is applied to a well-defined area of vitiligo by the physician and the area is then exposed to a suitable credit of UVA. Initial exposure time should be conservative and not exceed that which is predicted to be one-half the minimal erythema dose. Treatment intervals should be regulated by the erythema response; generally once a week is recommended or less often depending on results. The hands and fingers of the person applying the medication should be protected by gloves or finger cots to avoid photosensitization and possible burns.<br />\r\n<br />\r\nPigmentation may begin after a few weeks but significant repigmentation may require 6 to 9 months of treatment. Periodic re-treatment may be necessary to retain all of the new pigment. Idiopathic vitiligo is reversible but not equally reversible in every patient. Treatment must be individualized. Repigmentation will vary in completeness, time of onset, and duration. Repigmentation occurs more rapidly in fleshy areas such as face, abdomen, and buttocks and less rapidly over less fleshy areas such as the dorsum of the hands or feet.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Hands and fingers of person applying the lotion should be protected to prevent possible photosensitization and/or burns.</p>', '<p>May increase plasma concentration of drugs metabolised by CYP2A6 isoenzyme. Additive effect with other systemic or topical photosensitising agents (e.g. anthralin, coal tar, nalidixic acid).</p>', '<ul>\r\n	<li>Patient with idiosyncratic reactions to psoralen compounds</li>\r\n	<li>Patient possessing light sensitive disease including lupus erythematosus, porphyria, erythropoietic protoporphyria, variegate porphyria, xeroderma pigmentosum and albinism</li>\r\n	<li>Patient with melanoma or possessing a history of melanoma</li>\r\n	<li>Patient with invasive squamous cell carcinomas</li>\r\n	<li>Patient with aphakia</li>\r\n</ul>', '<p>The most commonly reported side effect of Methoxsalen alone is nausea, which occurs with approximately 10% of all patients. This effect may be minimized or avoided by instructing the patient to take Methoxsalen with milk or food, or to divide the dose into two portions, taken approximately one-half hour apart. Other effects include nervousness, insomnia and psychological depression.</p>', '<p>Pregnancy Category C. Methoxsalen should be given to a woman only if clearly needed. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Methoxsalen is administered to a nursing woman.</p>', '<p><strong>Skin burning</strong>: Serious burns from either UVA or sunlight (even through window glass) can result if the recommended dosage of the drug and/or exposure schedules are not maintained.<br />\r\n<br />\r\n<strong>Carcinogenicity</strong>: The increasing risk of carcinoma appears great among patients who are fair skinned or had pre PUVA exposure or prolong treatment with tar UVB, ionizing radiation or arsenic.<br />\r\n<br />\r\n<strong>Cataractogenicity</strong>: Among patients using proper eye protection, there is no evidence for a significantly increased risk of cataracts in association with PUVA therapy.<br />\r\n<br />\r\nPatients must not sunbathe during the 24 hours prior to Methoxsalen ingestion and UV exposure.</p>', '<p>In the event of Methoxsalen overdosage, induce emesis and keep the patient in a darkened room for at least 24 hours. Emesis is beneficial only within the first 2 to 3 hours after ingestion of Methoxsalen, since maximum blood levels are reached by this time.</p>', '<p>Methoxsalen preparation.</p>', '<p>Store at 25&deg;C; excursions permitted to 15&deg;C-30&deg;C.</p>', '<p><strong>Pediatric use</strong>: Safety in children has not been established.</p>', '2022-03-09 06:52:54', '2022-03-09 06:52:54'),
(936, 936, '<p>This is indicated for the treatment of anemia associated with chronic kidney disease (CKD) including patients on dialysis and patients not on dialysis.</p>', '<p>Methoxy polyethylene glycol-epoetin beta is a chemically synthesized continuous erythropoietin receptor activator. Methoxy polyethylene glycol-epoetin beta differs from erythropoietin through integration of an amide bond between either the N-terminal amino group or the &epsilon; amino group of lysine, predominantly Lys52 and Lys45 and methoxy polyethylene glycol butanoic acid. This results in a molecular weight of approximately 60,000 daltons for methoxy polyethylene glycol-epoetin beta with the PEG-moiety having an approximate molecular weight of 30,000 daltons.<br />\r\n<br />\r\nIn contrast with erythropoietin, methoxy polyethylene glycol-epoetin beta shows a different activity at the receptor level characterized by a slower association to and faster dissociation from the receptor, a reduced specific activity in vitro with an increased activity in vivo, as well as an increased half-life. These differential pharmacological properties are relevant in order to achieve a once monthly dosing regimen with methoxy polyethylene glycol-epoetin beta in patients.<br />\r\n<br />\r\nMethoxy polyethylene glycol-epoetin beta stimulates erythropoiesis by interaction with the erythropoietin receptor on progenitor cells in the bone marrow. As primary growth factor for erythroid development, the natural hormone erythropoietin is produced in the kidney and released into the bloodstream in response to hypoxia. In responding to hypoxia, the natural hormone erythropoietin interacts with erythroid progenitor cells to increase red cell production.</p>', '<p>This preparation is administered less frequently than other erythropoiesis stimulating agents (ESAs) due to the longer elimination half-life. Treatment with this preparation has to be initiated under the supervision of a healthcare professional.<br />\r\n<br />\r\nTreatment of anemic patients with chronic kidney disease:</p>\r\n\r\n<ul>\r\n	<li>The solution can be administered subcutaneously (s.c.) or intravenously (i.v.), according to clinical preference.</li>\r\n	<li>This preparation can be injected subcutaneously in the abdomen, arm or thigh. All three injection sites are equally suitable for subcutaneous injection with this preparation.</li>\r\n	<li>It is recommended that hemoglobin is monitored every two weeks until stabilized, and periodically thereafter.</li>\r\n</ul>\r\n\r\n<p>Patients currently not treated with an Erythropoiesis Stimulating Agent:</p>\r\n\r\n<ul>\r\n	<li>Patients not on dialysis- In order to increase the haemoglobin to greater than 11 g/dl (6.83 mmol/L), the recommended starting dose is 1.2 microgram/kg body weight administered once every month as a single subcutaneous injection. Alternatively, a starting dose of 0.6 microgram/kg body weight may be administered once every two weeks as a single IV or SC injection.</li>\r\n	<li>Patients on dialysis- In order to increase the haemoglobin to greater than 11 g/dl (6.83 mmol/L), the recommended starting dose of 0.6 microgram/kg body weight may be administered once every two weeks as a single IV or SC injection.</li>\r\n	<li>The dose of this preparation may be increased by approximately 25 to 50% of the previous dose if the rate of rise in hemoglobin is less than 1.0 g/dl (0.621mmol/l) over a month. Further increases of approximately 25 to 50% may be made at monthly intervals until the individual target hemoglobin level is obtained.</li>\r\n	<li>If the rate of rise in hemoglobin is greater than 2 g/dl (1.24 mmol/l) in one month, the dose is to be reduced by approximately 25 to 50%. If the hemoglobin level exceeds 13 g/dl (8.07 mmol/l), therapy is to be interrupted until the hemoglobin level falls below 13 g/dl and then restarted with approximately 50% of the previously administered dose. For regions where the upper limit of hemoglobin level has been set at 12 g/dl, dose adjustments of 25% should be considered. After dose interruption a hemoglobin decrease of approximately 0.35 g/dl per week is expected.</li>\r\n	<li>Patients treated once every two weeks whose haemoglobin concentration is above 11 g/dl (6.83 mmol/l) may receive this preparation administered once monthly using the dose equally to twice the previous once every two weeks dose. Dose adjustments should not be made more often than once a month.</li>\r\n</ul>\r\n\r\n<p>Patients currently treated with an Erythropoiesis Stimulating Agent: Patients currently treated with an ESA can be converted to This preparation administered once a month or, if desired, once every two weeks as a single i.v. or s.c. injection. The starting dose of This preparation is based on the calculated previously given weekly dose of darbepoetin alfa or epoetin at the time of substitution as described in Tables 1 and 2 below. The first injection of This preparation should be administered at the next scheduled dose of the previously administered darbepoetin alfa or epoetin.</p>', '<p>No interaction studies have been performed. The clinical results do not indicate any interaction of Methoxy Polyethylene Glycol Epoetin Beta with other medicinal products. The effect of other drugs on the pharmacokinetics and pharmacodynamics of Methoxy Polyethylene Glycol Epoetin Beta was explored using a population analysis approach. There was no indication of an effect of concomitant medications on the pharmacokinetics and pharmacodynamics of Methoxy Polyethylene Glycol Epoetin Beta.</p>', '<p>Methoxy Polyethylene Glycol Epoetin Beta is contraindicated in patients with:</p>\r\n\r\n<ul>\r\n	<li>Uncontrolled hypertension.</li>\r\n	<li>Known hypersensitivity to the active substance or any of the excipients.</li>\r\n</ul>', '<p>Adverse reactions are Hypertension, Vascular access thrombosis, Headache, Hypersensitivity, Hypertensive encephalopathy, Rash (maculo-papular, serious).</p>', '<p><strong>Pregnancy</strong>: There are no adequate data on the use of this preparation in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy, embryonal/fetal development, parturition or postnatal development. Caution should be exercised when prescribing this preparation to pregnant women.&nbsp;<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is unknown whether methoxy polyethylene glycol-epoetin beta is excreted in human breast milk. One animal study has shown excretion of methoxy polyethylene glycol-epoetin beta in maternal milk. A decision on whether to continue or discontinue breast-feeding or to continue or discontinue therapy with this preparation should be made taking into account the benefit of breast-feeding to the child and the benefit of this therapy to the woman.</p>', '<p>Supplementary iron therapy is recommended for all patients with serum ferritin values below 100 &micro;g/l or whose transferrin saturation is below 20%. To ensure effective erythropoiesis, iron status should be evaluated for all patients prior to and during treatment.<br />\r\n<br />\r\n<strong>Lack of effect</strong>: The most common reasons for incomplete response to ESAs are iron deficiency and inflammatory disorders. The following conditions may also compromise the effectiveness of ESAs therapy: chronic blood loss, bone marrow fibrosis, severe aluminium overload due to treatment of renal failure, folic acid or vitamin B12 deficiencies, and hemolysis. If all the conditions mentioned are excluded and the patient has a sudden drop of hemoglobin associated with reticulocytopenia and anti erythropoietin antibodies, examination of the bone marrow for the diagnosis of Pure Red Cell Aplasia (PRCA) should be considered. If PRCA is diagnosed, therapy with MIRCERA must be discontinued and patients should not be switched to another ESA.<br />\r\n<br />\r\n<strong>PRCA</strong>: PRCA caused by anti-erythropoietin antibodies has been reported in association with ESAs including MIRCERA. These antibodies have been shown to cross-react with all ESAs, and patients suspected or confirmed to have antibodies to erythropoietin should not be switched to MIRCERA.<br />\r\n<br />\r\n<strong>Blood pressure monitoring</strong>: As with other ESAs, blood pressure may rise during treatment of anemia with MIRCERA. Blood pressure should be adequately controlled before, at initiation of and during treatment with MIRCERA. If high blood pressure is difficult to control by drug treatment or dietary measures, the dose of MIRCERA must be reduced or withheld.</p>', '<p>The therapeutic range of Methoxy Polyethylene Glycol Epoetin Beta is wide and individual response to therapy must be considered when Methoxy Polyethylene Glycol Epoetin Beta treatment is initiated. Overdose can result in manifestations of an exaggerated pharmacodynamic effect, e.g. excessive erythropoiesis. In case of excessive hemoglobin levels, Methoxy Polyethylene Glycol Epoetin Beta should be temporarily withheld. If clinically indicated, phlebotomy may be performed.</p>', '<p>Drugs for Haemolytic Hypoplastic &amp; Renal Anemia.</p>', '<p>This medicine should not be used after the expiry date (EXP) shown on the pack. Store in the refrigerator at 2&deg;C to 8&deg;C. Keep the pre-filled syringe in the outer carton in order to protect from light. Do not freeze. The patient may remove the product from refrigeration for storage at room temperature (not above 30&deg;C) for one single period of 1 month. Once removed from the refrigerator the product must be used within this period.</p>', '<p><strong>Pediatric use</strong>: Methoxy Polyethylene Glycol Epoetin Beta is not recommended for use in patients aged less than 18 years due to a lack of data on safety and efficacy.<br />\r\n<br />\r\n<strong>Elderly</strong>: no adjustment of the starting dose is required in patients aged 65 years or older.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: no adjustments of the starting dose nor dose modification rules are required in patients with any degree of hepatic impairment.</p>', '2022-03-09 06:55:35', '2022-03-09 06:55:35'),
(937, 937, '<p>This cream is indicated for the fast relief of minor aches and pains of muscles &amp; joints associated with-</p>\r\n\r\n<ul>\r\n	<li>Joint Pain</li>\r\n	<li>Back Pain</li>\r\n	<li>Arthritic Pain</li>\r\n	<li>Neck &amp; Shoulder Pain</li>\r\n	<li>Sprains</li>\r\n	<li>Strain</li>\r\n</ul>', '<p>This cream is a specially formulated Methyl salicylate and Menthol cream. It penetrates into skin to provide fast relief from pain and stiffness of minor arthritis and muscle aches. This cream is fast-acting, strong medicine that penetrates deep down to provide long-lasting and effective relief. Methyl salicylate has been shown that first-pass metabolism exists in the skin and rapidly hydrolyzing salicylate ester to release the active salicylate in both epidermis and dermis. It alleviates pain and inflammation by inhibiting the synthesis of prostaglandins that occur in inflamed tissues. Menthol increases the penetration of drugs when applied on the skin to give a faster onset of action. It dilates the blood vessels causing a sensation of coldness followed by an analgesic effect.</p>', '<p><strong>Adult and children 2 years of age and older</strong>: Apply a thin layer to the affected area and gently massage until this cream disappears. Apply to the affected area not more than 3 to 4 times daily.</p>', '<p>Methyl Salicylate is systemically absorbed through the skin in measurable amounts and may increase Warfarin action by affecting Vitamin K metabolism or by displacing warfarin from protein-binding sites.</p>', '<p>Allergy to salicylate or sensitivity to any of the components. Application to broken skin or raw surfaces is contraindicated.</p>', '<p>Redness or irritation may occur, especially in persons with sensitive skin. Adverse reactions possibly involved are mild to moderate local irritation, erythema, rash, desquamation, pruritis and relative local reaction at the application site.</p>', '<p>This medication should be used only if clearly needed during pregnancy or while breast-feeding.</p>', '<p>For external use only. Use only as directed. Do not use with a heating pad. Keep away from children to avoid accidental ingestion. Do not swallow. If swallowed, get medical help or contact a poison control centre immediately. Do not bandage tightly. Keep away from eyes, mucous membranes, broken or irritated skin. If skin redness or excessive irritation develops, pain lasts for more than 10 days or with arthritis-like conditions in children under 12, do not use and call a physician.</p>', '<p>Large amount of topical application may cause absorption through the skin and may cause salicylism. Symptoms of salicylism include tinnitus,hearing loss, nausea, vomiting etc.</p>', '<p>Local Antipruritic, Topical Analgesics, Topical anti-inflammatory preparations.</p>', '<p>It should be stored in a cool and dry place, away from light, temperature not exceeding 30&deg;C. Keep out of reach of children.</p>', NULL, '2022-03-09 06:58:43', '2022-03-09 06:58:43'),
(938, 938, '<p>This cream is indicated for the fast relief of minor aches and pains of muscles and joints e.g., Simple Backache, Arthritis, Strains, Bruises and Sprains.</p>', '<p>This cream is a specially formulated Methyl salicylate, Menthol and Camphor cream. It penetrates into skin to provide fast relief from pain and stiffness of minor arthritis and muscle aches. It alleviates pain and inflammation by inhibiting the synthesis of prostaglandins that occur in inflamed tissues. Methyl salicylate has been shown that first pass metabolism exists in the skin and rapidly hydrolyzing salicylate ester to release the active salicylate in both epidermis and dermis. Menthol increases the penetration of drugs when applied on the skin to give a faster onset of action. It dilates the blood vessels causing a sensation of coldness followed by an analgesic effect. Camphor is a stimulant, used topically to increase local blood flow and as a &#39;counterirritant&#39;, which reduces pain &amp; swelling. When in combination with other ingredients like menthol, methyl salicylate, it becomes ideal for neuralgia and other painful areas.</p>', '<p><strong>Adults and children (12 years of age and older)</strong>: Apply to affected area not more than 3 to 4 times daily.<br />\r\n<br />\r\n<strong>Children under 12 years of age</strong>: Use on advice of a physician.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity to salicylate or any of its ingredients.</p>', '<p>Redness or irritation may occur, especially in persons with sensitive skin.</p>', '<p>This medication should be used only if clearly needed during pregnancy or while breast-feeding.</p>', '<p>For external use only. Do not use-</p>\r\n\r\n<ul>\r\n	<li>on wounds or damaged skin</li>\r\n	<li>with a heating pad</li>\r\n	<li>on a child under 12 years of age with arthritis-like conditions.</li>\r\n</ul>', NULL, '<p>Topical anti-inflammatory preparations.</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-09 07:00:38', '2022-03-09 07:00:38');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(939, 939, '<p>Methyldopa is indicated in Hypertension.</p>', '<p>Methyldopa, or &alpha;-methyldopa, is a centrally acting sympatholytic agent and an antihypertensive agent. It is an analog of DOPA (3,4‐hydroxyphenylanine), and it is a prodrug, meaning that the drug requires biotransformation to an active metabolite for therapeutic effects. Methyldopa works by binding to alpha(&alpha;)-2 adrenergic receptors as an agonist, leading to the inhibition of adrenergic neuronal outflow and reduction of vasoconstrictor adrenergic signals. Methyldopa exists in two isomers D-&alpha;-methyldopa and L-&alpha;-methyldopa, which is the active form.<br />\r\n<br />\r\nFirst introduced in 1960 as an antihypertensive agent, methyldopa was considered to be useful in certain patient populations, such as pregnant women and patients with renal insufficiency. Since then, methyldopa was largely replaced by newer, better-tolerated antihypertensive agents; however, it is still used as monotherapy or in combination with hydrochlorothiazide. Methyldopa is also available as intravenous injection, which is used to manage hypertension when oral therapy is unfeasible and to treat hypertensive crisis.</p>', '<p>Adults-</p>\r\n\r\n<ul>\r\n	<li><strong>Initiation of Therapy</strong>: The usual starting dosage of Methyldopa is 250 mg two or three times a day in the first 48 hours. The daily dosage then may be increased or decreased, preferably at intervals of not less than two days, until an adequate response is achieved. To minimize the sedation, start dosage increases in the evening. When Methyldopa is given to patients on other antihypertensives, the dose of these agents may need to be adjusted to effect a smooth transition. When Methyldopa is given with antihypertensives other than thiazides, the initial dosage of Methyldopa should be limited to 500 mg daily in divided doses; when Methyldopa is added to a thiazide, the dosage of thiazide need not to be changed.</li>\r\n	<li><strong>Maintenance Therapy</strong>: The usual daily dosage of Methyldopa is 500 mg to 2 g in two to four doses. Although occasional patients have responded to higher doses, the maximum recommended daily dosage is 3 gm. Occasionally tolerance may occur, usually between the second and third month of therapy. Adding a diuretic or increasing the dosage of Methyldopa frequently will restore effective control of blood pressure. A thiazide may be added at any time during Methyldopa therapy and is recommended if therapy&#39;has not been started with a thiazide or if effective control of blood pressure cannot be maintained on 2 gm of Methyldopa daily. Methyldopa is largely excreted by the kidney and patients with impaired renal function may respond to smaller doses. Syncope in older patients may be related to an increased sensitivity and advanced arteriosclerotic vascular disease. This may be avoided by lower doses.</li>\r\n</ul>\r\n\r\n<p><strong>Pediatric Use</strong>: Initial dosage is based on 10 mg/kg of body weight daily in two to four doses. The daily dosage then is increased or decreased until an adequate response is achieved. The maximum dosage is 65 mg/kg or 3 gm daily, whichever is less.</p>', '<p>When Methyldopa is used with other antihypertensive drugs, potentiation of antihypertensive effect may occur. Patients may require reduced doses of anesthetics when on Methyldopa. When Methyldopa and lithium are given concomitantly the patient should be carefully monitored for symptoms of lithium toxicity. Coadministration of Methyldopa with ferrous sulfate or ferrous gluconate is not recommended.</p>', '<p>Methyldopa is contraindicated in patients:</p>\r\n\r\n<ul>\r\n	<li>with active hepatic disease, such as acute hepatitis and active cirrhosis</li>\r\n	<li>with liver disorders previously associated with Methyldopa therapy</li>\r\n	<li>with hypersensitivity to any component of these products</li>\r\n	<li>on therapy with monoamine oxidase (MAO) inhibitors.</li>\r\n</ul>', '<p>Sedation, usually transient, may occur during the initial period of therapy or whenever the dose is increased. Headache, asthenia, or weakness may be noted as early and transient symptoms. The following systemic side effects may rarely occur with the use of Methyldopa- angina pectoris, congestive heart failure, orthostatic hypotension, edema or weight gain, bradycardia, pancreatitis, colitis, vomiting, diarrhea, nausea, constipation, dryness of mouth, hyperprolactinemia, bone marrow depression, leukopenia, granulocytopenia, thrombocytopenia, hemolytic anemia; rheumatoid factor, hepatitis, jaundice, myocarditis, pericarditis, vasculitis, eosinophilia, parkinsonism, bell&#39;s palsy, nightmares and reversible mild psychoses or depression, dizziness, lightheadedness, paresthesias, arthralgia, myalgia, nasal stuffiness, rash, amenorrhea, gynecomastia, lactation, impotence. However, significant adverse effects due to Methyldopa have been infrequent and this agent usually is well tolerated.</p>', '<p>Pregnancy category B. Methyldopa appears in breast milk. Therefore, caution should be exercised when Methyldopa is given to a nursing woman.</p>', '<p>Methyldopa should be used with caution in patients with a history of previous liver disease or dysfunction. Some patients taking Methyldopa experience clinical edema or weight gain, which may be controlled by use of a diuretic. Methyldopa should not be continued if edema progresses or signs of heart failure appear. Hypertension has recurred occasionally after dialysis in patients given Methyldopa because the drug is removed by this procedure. Rarely involuntary choreoathetotic movements have been observed during therapy with Methyldopa in patients with severe bilateral cerebrovascular disease. If these movements occur, stop therapy.</p>', '<p>Acute overdosage may produce acute hypotension with other responses attributable to brain and gastrointestinal malfunction (excessive sedation, weakness, bradycardia, dizziness, lightheadedness, constipation, distention, flatus, diarrhea, nausea, vomiting). In the event of overdosage, symptomatic and supportive measures should be employed. When ingestion is recent, gastric lavage or emesis may reduce absorption. When ingestion has been earlier, infusions may be helpful to promote urinary excretion.</p>', '<p>Centrally acting antihypertensive drugs (central sympatholytic).</p>', '<p>Do not store above 30&deg;C. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: There are no well-controlled clinical trials in pediatric patients. Information on dosing in pediatric patients is supported by evidence from published literature regarding the treatment of hypertension in pediatric patients.</p>', '2022-03-09 07:02:56', '2022-03-09 07:02:56'),
(940, 940, '<p>Following delivery of the placenta, for routine management of uterine atony, hemorrhage and subinvolution of the uterus. For control of uterine hemorrhage in the second stage of labor following delivery of the anterior shoulder.</p>', '<p>Methylergonovine Maleate acts directly on the smooth muscle of the uterus and increases the tone, rate, and amplitude of rhythmic contractions. Thus, it induces a rapid and sustained tetanic uterotonic effect which shortens the third stage of labor and reduces blood loss. The onset of action after I.V. administration is immediate; after I.M. administration, 2-5 minutes, and after oral administration, 5&shy;-10 minutes.</p>', '<p><strong>Intramuscularly</strong>: 1 ml/0.2 mg, after delivery of the anterior shoulder, after delivery of the placenta, or during the puerperium. May be repeated as required, at intervals of 2-4 hours.<br />\r\n<br />\r\n<strong>Intravenously</strong>: 1 ml/0.2 mg, administered slowly over a period of no less than 60 seconds&nbsp;<br />\r\n<br />\r\n<strong>Orally</strong>: One tablet, 0.2 mg, 3 or 4 times daily in the puerperium for a maximum of 1 week.</p>', '<p>There have been rare reports of serious adverse events in connection with the coadministration of certain ergot alkaloid drugs (e.g., dihydroergotamine and ergotamine) and potent CYP 3A4 inhibitors, resulting in vasospasm leading to cerebral ischemia and/or ischemia of the extremities. Although there have been no reports of such interactions with methylergonovine alone, potent CYP 3A4 inhibitors should not be coadministered with methylergonovine. Examples of some of the more potent CYP 3A4 inhibitors include macrolide antibiotics (e.g., erythromycin, troleandomycin, clarithromycin), HIV protease or reverse transcriptase inhibitors (e.g., ritonavir, indinavir, nelfinavir, delavirdine) or azole antifungals (e.g., ketoconazole, itraconazole, voriconazole). Less potent CYP 3A4 inhibitors should be administered with caution. Less potent inhibitors include saquinavir, nefazodone, fluconazole, grapefruit juice, fluoxetine, fluvoxamine, zileuton, and clotrimazole. These lists are not exhaustive, and the prescriber should consider the effects on CYP 3A4 of other agents being considered for concomitant use with methylergonovine.</p>', '<p>Hypertension; toxemia; pregnancy; and hypersensitivity.</p>', '<p>The most common adverse reaction is hypertension associated in several cases with seizure and/or headache. Hypotension has also been reported. Abdominal pain (caused by uterine contractions), nausea and vomiting have occurred occasionally. Rarely observed reactions have included: acute myocardial infarction, transient chest pains, vasoconstriction, vasospasm, coronary arterial spasm, bradycardia, tachycardia, dyspnea, hematuria, thrombophlebitis, water intoxication, hallucinations, leg cramps, dizziness, tinnitus, nasal congestion, diarrhea, diaphoresis, palpitation, rash, and foul taste. There have been rare isolated reports of anaphylaxis, without a proven causal relationship to the drug product.</p>', '<p><strong>Pregnancy&nbsp;</strong>Category C. Animal reproductive studies have not been conducted with Methylergonovine. It is also not known whether methylergonovine maleate can cause fetal harm or can affect reproductive capacity. Use of Methylergonovine is contraindicated during pregnancy because of its uterotonic effects.<br />\r\n<br />\r\n<strong>Breast-feeding</strong>: Mothers should not breast-feed during treatment with Methylergonovine. Milk secreted during this period should be discarded. Methylergonovine may produce adverse effects in the breast-feeding infant. Methylergonovine may also reduce the yield of breast milk. Mothers should wait at least 12 hours after administration of the last dose of Methylergonovine before initiating or resuming breast feeding</p>', '<p>Caution should be exercised in the presence of sepsis, obliterative vascular disease. Also use with caution during the second stage of labor. The necessity for manual removal of a retained placenta should occur only rarely with proper technique and adequate allowance of time for its spontaneous separation.</p>', '<p>Symptoms of acute overdose may include: nausea, vomiting, oliquria, abdominal pain, numbness, tingling of the extremities, rise in blood pressure, in severe cases followed by hypotension, respiratory depression, hypothermia, convulsions, and coma.</p>', '<p>Drugs acting on the Uterus.</p>', '<p>Store below 25&deg;C; in tight, light-resistant container.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.</p>', '2022-03-09 07:05:04', '2022-03-09 07:05:04'),
(941, 941, '<p>Methylphenidate is used in the treatment of attention deficit hyper activity disorder (ADHD) and narcolepsy.</p>', '<p>methylphenidate (MPH) has been shown to act as a norepinephrine and dopamine reuptake inhibitor (NDRI), thereby increasing the presence of these neurotransmitters in the extraneuronal space and prolonging their action. There is a dose-related effect of psychostimulants on receptor stimulation, where higher doses are shown to increase norepinephrine (NE) and dopamine (DA) efflux throughout the brain which can result in impaired cognition and locomotor-activating effects. In contrast, low doses are found to selectively activate NE and DE neurotransmission within the prefrontal cortex which is an area of the brain thought to play a prominent role in ADHD pathophysiology, thereby improving clinical efficacy and preventing side effects. The lower doses used to treat ADHD are not associated with the locomotor-activating effects associated with higher doses and instead reduce movement, impulsivity, and increase cognitive function including sustained attention and working memory. Methylphenidate&#39;s beneficial effects in sustaining attention have also been shown to be mediated by alpha-1 adrenergic receptor activity.<br />\r\n<br />\r\nClinical findings have shown that children with ADHD have an abnormality in the dopamine transporter gene (DAT1), the D4 receptor gene (DRD-4), and/or the D2 receptor gene that may be at least partly overcome by the dopaminergic effects of methylphenidate, suggesting a possible mode of action.</p>', '<p><strong>Child</strong>: Over 6 years, initially 5 mg 1-2 times daily, increased if necessary at weekly intervals by 5-10 mg daily to max. 60 mg daily in divided doses; discontinue if no response after one month also suspend periodically to assess child&rsquo;s condition (usually finally discontinued during or after puberty); Child under 6 years not recommended.<br />\r\n<br />\r\n<strong>Adult</strong>: 10-15 mg daily in divided doses (2-3 times daily). Average dosage is 20-30 mg daily. Some patients may require 40-60 mg daily. Patients who are unable to sleep if medication is taken late in the day should take the last dose before 6 pm.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken on an empty stomach. Take 30-45 min before meals. May be taken with or without food.&nbsp;&nbsp;Swallow whole, do not divide/chew/crush.</p>', '<p>The elimination of phenytoin is slowed by methylphenidate. It may also increase the anticoagulant effect of Coumarin. It also increases the serum concentration of imipramine and desipramine.</p>', '<p>Methylphenidate is contraindicated in alcoholics, emotionally unstable patients, drug abusers, hypertension, cardiac arrhythmias, psychoses, epilepsy, thyro-toxicosis, glaucoma marked anxiety, severe depression and known sensitivity to methylphenidate.</p>', '<p>Sleep disturbances, restlessness, dizziness, headache, tremor, convulsion, rash, pruritis; urticaria, fever, arthralgia, alopecia, exfoliative, dermatitis, erythema multiforme, thrombocytopenic purpuria, thrombocytopenia, Leucopenia, urinary disorder and very rarely liver damage.</p>', '<p>The use of methylphenidate in pregnancy and lactation has not been established.</p>', '<p>In mild hypertension (contraindicated if moderate or severe)-monitor blood pressure; history of epilepsy; tics and Tourette syndrome. Occasional cystic ovarian swellings in premenopausal women, occasional hypercalcemia if bony metastases; increased risk of thromboembolic events when used with cytotoxics; breast feeding; endometrial changes; porphyria.</p>', NULL, '<p>CNS stimulant drugs.</p>', '<p>Store in a cool (below 25&deg;C) and dry place, away from light. Keep out of reach of the children.</p>', NULL, '2022-03-09 07:09:57', '2022-03-09 07:09:57'),
(942, 942, '<p><strong>Endocrine Disorders</strong>: Primary or Secondary Adrenocortical Insufficiency, Congenital Adrenal Hyperplasia, Nonsuppurative Thyroiditis, Hypercalcemia associated with Cancer.<br />\r\n<br />\r\n<strong>Rheumatic Disorders</strong>: Rheumatoid Arthritis. Juvenile Rheumatoid Arthritis, Ankylosing Spondylitis, Acute and Subacute Bursitis, Synovitis of Osteoarthritis, Acute nonspecific Tenosynovitis, Post-traumatic Osteoarthritis, Psoriatic Arthritis, Epicondylitis, Acute Gouty Arthritis.<br />\r\n<br />\r\n<strong>Collagen Diseases</strong>: Systemic lupus Erythematosus, Systemic Dermatomyositis and Acute Rheumatic Carditis.<br />\r\n<br />\r\n<strong>Dermatologic Diseases</strong>: Bullous Dermatitis Herpetiformis, Severe Erythema Multiforme (Stevens-Johnson syndrome), Severe Seborrheic Dermatitis, Exfoliative Dermatitis, Mycosis Fungoides, Pemphigus, Severe Psoriasis.<br />\r\n<br />\r\n<strong>Allergy</strong>: Seasonal or Perennial Allergic Rhinitis, Drug hypersensitivity reactions, Serum Sickness, Contact Dermatitis, Bronchial Asthma and Atopic Dermatitis;<br />\r\n<br />\r\n<strong>Ophthalmic Diseases</strong>: Allergic Corneal Ulcers, Herpes Zoster Ophthalmicus, Anterior segment inflammation, Sympathetic Ophthalmia, Keratitis, Optic Neuritis, Allergic Conjunctivitis, Chorioretinitis, iritis end iridocyclitis.<br />\r\n<br />\r\n<strong>Respiratory Diseases</strong>: Symptomatic sarcoidosis, Loeffler&#39;s syndrome not manageable by other means, berylliosis, Aspiration Pneumonitis.<br />\r\n<br />\r\n<strong>Hematological Disorders</strong>: Idiopathic Thrombocytopenic Purpura in adults, Secondary Thrombocytopenia in adults, Acquired (Autoimmune) Hemolytic Anemia, Erythroblastopenia, Congenital (Erythroid) Hypoplastic Anemia.<br />\r\n<br />\r\n<strong>Neoplastic Diseases</strong>: For palliative management of Leukemias and Lymphomas in adults, Acute leukemia of childhood.<br />\r\n<br />\r\n<strong>Edematous States</strong>: To induce a diuresis or remission of Proteinuria in the Nephrotic Syndrome, without Uremia, of the idiopathic type or that due to Lupus Erythematosus.<br />\r\n<br />\r\n<strong>Gastrointestinal Disease</strong>: To tide the patient over a critical period of the disease in Ulcerative Colitis &amp; Regional Enteritis.<br />\r\n<br />\r\n<strong>CNS Disease</strong>: Acute Exacerbations of Multiple Sclerosis.</p>', '<p><strong>Pharmacodynamic properties</strong>: Methylprednisolone Is a potent anti-inflammatory agent with the capacity to profoundly inhibit the immune system. Glucocorticoids primarily bind to and activate intracellular glucocorticoid receptors that being activated bind to promoter regions of DMA (which may activate or suppress transcription) and activate transcription factors that result in inactivation of genes through deacetylation of histones. Methylprednisolone influences the kidney and fluid &amp; electrolyte balance, lipid,<br />\r\nprotein, and carbohydrate metabolism, skeletal muscle, the cardiovascular system, the immune system, the nervous system, and the endocrine system.<br />\r\n<br />\r\n<strong>Pharmacokinetic properties</strong>: The absolute bioavailability of Methylprednisclone is generally high (82% to 89%) following oral administration and rapidly absorbed and the maximum plasma concentration is achieved around 1.5 to 2.3 hours across doses following oral administration in normal healthy adults. Methylprednisolone is widely distributed into the tissues and its volume of distribution is 41-61.5 liter. It crosses the Wood-brain barrier and the placental barrier and is secreted in breast milk. The plasma protein binding of Methylprednisolone in humans is approximately 77%. Methylprednisolone is metabolized in the liver to inactive metabolites. No dosing adjustments are necessary for renal failure. Methylprednisolone is haemodializable.</p>', '<p>The usual range is 2-48 mg daily in divided doses, depending on the specific disease being treated.&nbsp;<br />\r\n<br />\r\n<strong>As anti-inflammatory or immunosuppressive initial dosage</strong>: As anti-inflammatory or immunosuppressive, the initial dosage of Methylprednisolone tablets may vary from 4-48 mg per day depending on the specific disease entity being treated, in situations of less severity lower doses will generally suffice while in selected patients higher initial doses may be required. The initial dosage should be maintained or adjusted until a satisfactory response is noted. If after a reasonable period of time there is a lack of satisfactory dirtied response, Methylprednisolone should be discontinued and the patient transferred to other appropriate therapy. It should be emphasized that dosage requirements are variable and must be Individualized on the basis of the disease under treatment and the response of the patient.<br />\r\n<br />\r\n<strong>As anti-inflammatory or immunosuppressive&nbsp;maintenance dosage</strong>: After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage which will maintain an adequate clinical response is reached. It should be kept in mind that constant monitoring is needed in regard to drug dosage. If after long-term therapy the drug is to be stopped, it is recommended that it be withdrawn gradually rather than abruptly.<br />\r\n<br />\r\n<strong>Multiple Sclerosis</strong>: In the treatment of acute exacerbations of multiple sclerosis, daily doses of 160 mg of Methylprednisolone for a week followed by 64 mg every other day for 1 month have been shown to be effective.<br />\r\n<br />\r\nMethylprednisolone 4 mg tablet can be used to treat and to control severe allergy end dermatitis following the guideline listed below to minimize the steroid withdrawal syndromes:</p>\r\n\r\n<ul>\r\n	<li><strong>Day 1</strong>: 2 tablets before breakfast + 1 tablet after lunch + 1 tablet after dinner + 2 tablets at bedtime</li>\r\n	<li><strong>Day 2</strong>: 1 tablet before breakfast + 1 tablet after lunch + 1 tablet after dinner + 2 tablets at bedtime</li>\r\n	<li><strong>Day 3</strong>: 1 tablet before breakfast + 1 tablet after lunch + 1 tablet after dinner + 1 tablet at bedtime</li>\r\n	<li><strong>Day 4</strong>: 1 tablet before breakfast + 1 tablet after lunch + 1 tablet at bedtime</li>\r\n	<li><strong>Day 5</strong>: 1 tablet before breakfast + 1 tablet at bedtime</li>\r\n	<li><strong>Day 6</strong>: 1 tablet before breakfast</li>\r\n</ul>\r\n\r\n<p><strong>Alternate-day therapy (ADT)</strong>: Alternate-day therapy is a corticosteroid dosing regimen in which twice the usual daily dose of corticoid is administered every other morning. The purpose of this mode of therapy is to provide the patient requiring long-term pharmacologic dose treatment with the beneficial effects of corticoids, white minimizing certain undesirable effects, including pituitary-adrenal suppression, Cushingoid stats, Corficoid withdrawal symptoms, and growth suppression in children.<br />\r\n<br />\r\nThe following should be kept in mind when considering alternate-day therapy:</p>\r\n\r\n<ul>\r\n	<li>Basic principles and indications for corticosteroid therapy should be applied.</li>\r\n	<li>Alternate-day therapy is a therapeutic technique primarily designed for pefienis in whom long-term pharmacologic corticoid therapy is anticipated.</li>\r\n	<li>In less severe disease processes in which corticoid therapy is indicated, it may be possible to initiate treatment with alternate-day therapy. More severe disease state usually will require daily divided high dose therapy for initiai control of the disease process. The initial suppressive dose level should be continued until a satisfactory clinical response is obtained, usually four to ten days in the case of many allergic and collagen diseases.</li>\r\n</ul>', '<p>Erythromycin, Clarithromycin, Phenobarbital, Phenytoin, Rifampin and Ketoconazole inhibit the metabolism of Methylprednisolone. Estrogens, including With control pills, can increase the effect of corticosteroids by 50%. Cyclosporin reduces the metabolism of Methylprednisolone. while Methylprednisolone reduces the metabolism of Cyclosporin. Methylprednisolone may increase or decrease the effect of blood thinners (e.g. Warfarin). For all these Interactions, the dose of Methylprednisolone may need to be lowered.</p>', '<p>Systemic fungal infections arid known hypersensitivity to components.</p>', '<p>Short courses of Methylprednisolone are usually well-tolerated with few, mild side effects. Long term, high doses of Methyiprednisoione may produce predictable and potentially serious side effects. Whenever possible, the lowest effective doses of Methylprednisolone should be used for the shortest length of time to minimize side effects. Alternate day dosing also can help reduce side effects. Side effects of Methylprednisolone and other corticosteroids range from mild annoyances to serious irreversible bodily damage. Side effects include fluid retention, weight gain, high blood pressure, potassium loss, headache, muscle weakness, hair growth on the face, glaucoma, cataracts, peptic ulceration, growth retardation in children, convulsions, and psychic disturbances including depression, euphoria, insomnia etc. Prolonged use of Methylprednisolone can depress the ability of the body&#39;s adrenal glands to produce corticosteroids. Abruptly stopping Methylprednisolone in these individuals can cause symptoms of corticosteroid insufficiency, with accompanying nausea, vomiting, and even shock. Therefore, withdrawal of Methylprednisolone usually is accomplished by gradually lowering the dose. Gradually tapering Methylprednisolone not only minimizes the symptoms of corticosteroid insufficiency, it also reduces the risk of an abrupt flare of the disease being treated.</p>', '<p>Pregnancy category C. Dregs should be given only if the potential benefit justifies the potential risk te the foetus. Mefhyiprednisofone has not been adequately evaluated in nursing mothers.</p>', '<p>Adrenocortical insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently. There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis. Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation. Aspirin should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia. The growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.</p>', '<p>Report of acute toxicity and/or death following an overdose of glucocorticoid ere rare. No specific antidote is available; treatment is supportive and symptomatic. Serum electrolytes should be monitored.</p>', '<p>Glucocorticoids</p>', '<p>Store in a cool and dry place, away from light. Keep out of reach of children.</p>', NULL, '2022-03-09 07:12:16', '2022-03-09 07:12:16'),
(943, 943, '<p>Methyl Prednisolone Acetate is indicated in the treatment of asthma, atopic dermatitis, contact dermatitis, bullous dermatitis herpetiformis, mycosis fungoides, pemphigus, severe erythema multiforme, primary or secondary adrenocortical insufficiency, hypercalcemia associated with cancer, nonsuppurative thyroiditis, ulcerative colitis, hematologic disorders, palliative management of leukemias and lymphomas, sympathetic ophthalmia, keratitis, allergic conjunctivitis, Juvenile rheumatoid arthritis, ankylosing spondylitis, symptomatic sarcoidosis, aspiration pneumonitis.</p>', '<p>Methylprednisolone binds to and activates intracellular glucocorticoid receptors. Activated glucocorticoid receptors bind to promoter regions of DNA (which may activate or suppress transcription). Unbound glucocorticoids cross cell membranes and bind with high affinity to specific cytoplasmic receptors, modifying transcription and protein synthesis. By this mechanism, glucocorticoids can inhibit leukocyte infiltration at the site of inflammation, interfere with mediators of inflammatory response, and suppress humoral immune responses. The antiinflammatory actions of corticosteroids are thought to involve phospholipase A2 inhibitory proteins, lipocortins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes.</p>', '<p><strong>1. Administration For Local Effect</strong>:<br />\r\n<br />\r\n<strong>Rheumatoid and Osteoarthritis</strong>: The dose for intra-articular administration depends upon the size of the joint and varies with the severity of the condition in the individual patient. The doses in the following table are given as a general guide:</p>\r\n\r\n<ul>\r\n	<li>Large Size of joint (Knees, Ankles, Shoulders): 20 to 80 mg</li>\r\n	<li>Medium Size of joint (Elbows, Wrists): 10 to 40 mg</li>\r\n	<li>Small Size of joint (Metacarpophalangeal, Interphalangeal, Sternoclavicular, Acromioclavicular): 4 to 10 mg.</li>\r\n</ul>\r\n\r\n<p><strong>Miscellaneous (Ganglion, Tendinitis, Epicondylitis)</strong>: The dose in the treatment of the various conditions of the tendinous or bursal structures varies with the condition being treated and ranges from 4 to 30mg. In recurrent or chronic conditions, repeated injections may be necessary.<br />\r\n<br />\r\n<strong>Dermatological Conditions</strong>: 20 to 60mg of the suspension is injected into the lesion. It may be necessary to distribute doses ranging from 20 to 40mg by repeated local injections in the case of large lesions. One to four injections are usually employed, the intervals between injections varying with the type of lesion being treated and the duration of improvement produced by the initial injection.<br />\r\n<br />\r\n<strong>2. Administration For Systemic Effect</strong>: In patients with the adrenogenital syndrome, a single intramuscular injection of 40mg every two weeks may be adequate. For maintenance of patients with rheumatoid arthritis, the weekly intramuscular dose will vary from 40 to 120 mg. The usual dosage for patients with dermatologic lesions benefited by systemic corticoid therapy is 40 to 120 mg of methylprednisolone acetate administered intramuscularly at weekly intervals for one to four weeks. In acute severe dermatitis due to poison ivy, relief may result within 8 to 12 hours following intramuscular administration of a single dose of 80 to 120mg. In chronic contact dermatitis, repeated injections at 5 to 10 day intervals may be necessary. In seborrheic dermatitis, a weekly dose of 80mg may be adequate to control the condition. Following intramuscular administration of 80 to 120 mg to asthmatic patients, relief may result within 6 to 48 hours and persist for several days to two weeks. Similarly in patients with allergic rhinitis (hay fever), an intramuscular dose of 80 to 120mg may be followed by relief of coryzal symptoms within six hours persisting for several days to three weeks.<br />\r\n<br />\r\n<strong>3. Multiple Sclerosis</strong>: In treatment of acute exacerbations of multiple sclerosis, daily doses of 160 mg of methylprednisolone for a week followed by 64mg every other day for 1 month have been shown to be effective (4mg of methylprednisolone is equivalent to 5mg of prednisolone). Or, as directed by the registered physician.</p>', '<p>Convulsions have been reported with concurrent use of methylprednisolone and cyclosporine. Drug that induce hepatic enzymes such as phenobarbital, phenytoin and rifampicin may increase the clearance of methylprednisolone. Drug such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and decrease its clearance. Methylprednisolone may increase the clearance of chronic high dose aspirin. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids.</p>', '<p>Methylprednisolone acetate sterile aqueous suspension is contraindicated for intrathecal administration. It is also contraindicated in systemic fungal infections and patients with known hypersensitivity to the product and its constituents.</p>', '<p>Congestive heart failure in susceptible patients, hypertension, sodium retention, muscle weakness, osteoporosis, peptic ulcer with possible subsequent and hemorrhage, abdominal distention, increased sweating, convulsion, vertigo, headache, menstrual irregularities, secondary adrenocortical and pituitary unresponsiveness, increased intraocular pressure, glaucoma, allergic or hypersensitivity reactions, urticaria, hyperpigmentation or hypopigmentation.</p>', '<p>Pregnancy Category C. Since adequate human reproduction studies have not been done with corticosteroids, the use of these drug in pregnancy, nursing mothers, or women of childbearing potential requires that the possible benefits of the drug be weighed against the potential hazards to the mother and embryo or fetus.</p>', '<p>Corticosteroids should be used cautiously in patients with ocular herpes simplex, nonspecific ulcerative colitis, renal insufficiency, hypertension, osteoporosis and myasthenia gravis.</p>', NULL, '<p>Glucocorticoids</p>', '<p>Store between 20-25&deg; C.</p>', NULL, '2022-03-09 07:13:55', '2022-03-09 07:13:55'),
(944, 944, '<p>Methylprednisolone Sodium Succinate IM/IV is indicated in the following conditions:<br />\r\n<br />\r\n<strong>Endocrine disorder</strong>: Primary or secondary adrenocortical insufficiency, acute adrenocortical insufficiency, shock unresponsive to conventional, congenital adrenal hyperplasia, Nonsuppurative thyroiditis. Hypercalcemia associated with cancer.<br />\r\n<br />\r\n<strong>Rheumatic disorder</strong>: Rheumatoid arthritis, including juvenile rheumatoid arthritis, acute and subacute bursitis, epicondylitis, acute nonspecific tenosynovitis, acute gouty arthritis, psoriatic arthritis, ankylosing spondylitis.<br />\r\n<br />\r\n<strong>Collagen disease</strong>: During an exacerbation or as maintenance therapy in selected cases of systemic lupus erythematosus; acute rheumatic carditis, systemic dermatomyositis (polymyositis).<br />\r\n<br />\r\n<strong>Dermatological disease</strong>: Pemphigus, severe erythema multiforme (Stevens-Johnson syndrome), exfoliative dermatitis, bullous dermatitis herpetiformis, severe seborrheic dermatitis, severe psoriasis, mycosis fungoides.<br />\r\n<br />\r\n<strong>Allergic states</strong>: Controls bronchial asthma, contact dermatitis, atopic dermatitis, serum sickness, seasonal or perennial allergic rhinitis, drug hypersensitivity reaction, urticarial transfusion reactions, acute noninfectious laryngeal edema (epinephrine is the drug of first choice), anaphylactic reactions.<br />\r\n<br />\r\n<strong>Ophthalmic disease</strong>: Severe acute and chronic allergic and inflammatory processes involving the eye, such as: herpes zoster ophthalmicus, iritis, iridocyclitis, chorioretinitis, diffuse posterior uveitis and chroiditis, optic neuritis, sympathetic ophthalmia, anterior segment inflammation, allergic conjunctivitis, allergic corneal marginal ulcers, keratitis.<br />\r\n<br />\r\n<strong>Gastrointestinal disease</strong>: To tide the patient over a critical period of the disease in: ulcerative colitis (systemic therapy), regional enteritis (systemic therapy), Crohn&rsquo;s disease.<br />\r\n<br />\r\n<strong>Respiratory disease</strong>: Symptomatic sarcoidosis, berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculosis chemotherapy, Loafer syndrome not manageable by other means, aspiration pneumonitis.<br />\r\n<br />\r\n<strong>Hematologic disorder</strong>: Acquired (autoimmune) hemolytic anemia, idiopathic thrombocytopenic purpura in adults (IV only, IM administration is contraindicated), erythroblastopenia (RBC anemia), congenital (erythroid) hypoplastic anemia, secondary thrombocytopenia in adults.<br />\r\n<br />\r\n<strong>Neoplastic disease</strong>: For palliative management of: leukemias and lymphoma in adults, acute leukemia of childhood.<br />\r\n<br />\r\n<strong>Edematous state</strong>: To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia of the idiopathic type or that due to lupus erythematosus.<br />\r\n<br />\r\n<strong>Miscellaneous</strong>: Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculosis chemotherapy. Trichinosis with neurologic or myocardial involvement.</p>', '<p>Methylprednisolone, a naturally occurring glucocorticoid (hydrocortisone and cortisone), which has also salt-retaining properties, is used as replacement therapy in adrenocortical deficiency states. This synthetic analog is primarily used for its potent anti-inflammatory effects in disorders of many organ systems. The intravenous injection of Methylprednisolone Sodium Succinate, demonstrable effects are evident within one hour and persist for a variable period. Excretion of the administered dose is nearly complete within 12 hours. Thus, if constantly high blood levels are required, injections should be made every 4 to 6 hours. This preparation is also rapidly absorbed when administered intramuscularly and is excreted in a pattern similar to that observed after intravenous injection. Its anti-inflammatory potency is greater than prednisolone in the ratio of 5 to 4. It has only minimal mineralocorticoid properties and has less tendency than prednisolone to induce sodium and water retention. It influences carbohydrate, protein, fat and purine metabolism, electrolyte and water balance, and the functional capacities of the cardiovascular system, the kidney, the skeletal muscle, nervous system and other organs and tissues. It exerts a suppressive effect on the immune response.</p>', '<p>Methylprednisolone may be administered by IM or IV or by IV infusion. To administer by IM or IV injection, prepare solution as direction for reconstitution. The desired dose may be administered intravenously over a period of several minutes. When high dose therapy is desired, the recommended dose of Methylprednisolone Sodium Succinate for Injection, USP is 30 mg/kg administered intravenously over at least 30 minutes. This dose may be repeated every 4 to 6 hours for 48 hours. In general, high-dose corticosteroid therapy should be continued only until the patient&rsquo;s condition has stabilized usually not beyond 48 to 72 hours.<br />\r\n<br />\r\nAlthough adverse effects associated with high dose short-term corticoid therapy are uncommon, peptic ulceration may occur. Prophylactic antacid therapy may be indicated.<br />\r\n<br />\r\nIn other indications, the initial dosage will vary from 10 to 40 mg of Methylprednisolone depending on the clinical problem being treated. The larger doses may be required for short-term management of severe, acute conditions. The initial dose usually should be given intravenously over a period of several minutes. Subsequent doses may be given intravenously or intramuscularly at intervals dictated by the patient&rsquo;s response and clinical condition. Corticoid therapy is an adjunct to, and not a replacement for conventional therapy.<br />\r\n<br />\r\nDosage must be decreased or discontinued gradually when the drug has been administered for more than a few days. If a period of spontaneous remission occurs in a chronic condition, treatment should be discontinued. Routine laboratory studies, such as urinalysis, two-hour postprandial blood sugar, determination of blood pressure and body weight, and a chest X-ray should be made at regular intervals during prolonged therapy. Upper GI X-rays are desirable in patients with an ulcer history or significant dyspepsia.<br />\r\n<br />\r\nIn pediatric patients, the initial dose of Methylprednisolone may vary depending on the specific disease being treated. The initial dose is 0.11-1.6 mg/day in three or four divided doses. Dosage may be reduced for infants and children but should be governed more by the severity of the condition and response of the patient than by age or size but it should not be less than 0.5 mg per kg every 24 hours.<br />\r\n<br />\r\nIn the treatment of acute exacerbations of multiple sclerosis daily doses is 160 mg daily for 3 days. Methylprednisolone powder for injection/infusion should be given as an intravenous infusion over at least 30 minutes.</p>', '<ul>\r\n	<li><strong>Aminoglutethimide</strong>&nbsp;may lead to a loss of corticosteroid-induced adrenal suppression.</li>\r\n	<li><strong>Amphotericin B injection and potassium-depleting agents</strong>- When corticosteroids are administered concomitantly with potassium-depleting agents (i.e., amphotericin B, diuretics), patients should be observed closely for the development of hypokalemia.</li>\r\n	<li><strong>Macrolide antibiotics</strong>&nbsp;have been reported to cause a significant decrease in corticosteroid clearance.</li>\r\n	<li><strong>Anticholinesterases</strong>- Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. If possible, anticholinesterase agents should be withdrawn at least 24 hours before initiating corticosteroid therapy.</li>\r\n	<li><strong>Anticoagulants, oral</strong>- Coadministration of corticosteroids and warfarin usually results in inhibition of response to warfarin, although there have been some conflicting reports.</li>\r\n	<li><strong>Antidiabetics</strong>- Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required.</li>\r\n	<li><strong>Antitubercular drugs</strong>- Serum concentrations of isoniazid may be decreased.</li>\r\n	<li><strong>Cholestyramine</strong>&nbsp;may increase the clearance of corticosteroids.</li>\r\n	<li><strong>Cyclosporine</strong>&nbsp;Increased activity of both cyclosporine and corticosteroids may occur when the two are used concurrently. Convulsions have been reported with this concurrent use.</li>\r\n	<li><strong>Digitalis glycosides</strong>- Patients on digitalis glycosides may be at increased risk of arrhythmias due to hypokalemia.</li>\r\n	<li><strong>Estrogens, including oral contraceptive</strong>s- Estrogens may decrease the hepatic metabolism of certain corticosteroids, thereby increasing their effect.</li>\r\n	<li><strong>Hepatic Enzyme Inhibitors</strong>- Drugs which inhibit cytochrome P450 3A4 have the potential to result in increased plasma concentrations of corticosteroids.</li>\r\n	<li><strong>Ketoconazole</strong>&nbsp;has been reported to significantly decrease the metabolism of certain corticosteroids by up to 60%, leading to an increased risk of corticosteroid side effects.</li>\r\n	<li><strong>Nonsteroidal anti-inflammatory agents (NSAIDs)</strong>- Concomitant use of aspirin and corticosteroids increases the risk of gastrointestinal side effects.</li>\r\n	<li><strong>Skin tests</strong>- Corticosteroids may suppress reactions to skin tests.</li>\r\n	<li><strong>Vaccines</strong>- Patients on prolonged corticosteroid therapy may exhibit a diminished response to toxoids and live or inactivated vaccines due to inhibition of antibody response.</li>\r\n</ul>', '<p>Methylprednisolone Sterile Powder is contraindicated:</p>\r\n\r\n<ul>\r\n	<li>In systemic fungal infections and patients with known hypersensitivity to the product and its constituents.</li>\r\n	<li>For intrathecal administration. Reports of severe medical events have been associated with this route of administration.</li>\r\n	<li>Intramuscular corticosteroid preparations are contraindicated for idiopathic thrombocytopenic purpura.</li>\r\n</ul>', '<p>Fluid and Electrolyte Disturbances: Sodium retention, fluid retention, congestive heart failure in susceptible patients, potassium loss, hypokalemic alkalosis, hypertension.<br />\r\n<br />\r\n<strong>Musculoskeletal</strong>: Muscle weakness, steroid myopathy, loss of muscle mass, severe arthralgia, vertebral compression fractures, aseptic necrosis of femoral and humeral heads, pathologic fracture of long bones, osteoporosis.<br />\r\n<br />\r\n<strong>Gastrointestinal</strong>: Peptic ulcer with possible perforation and hemorrhage, pancreatitis, abdominal distention, and ulcerative esophagitis.<br />\r\n<br />\r\n<strong>Dermatologic</strong>: Impaired wound healing, thin fragile skin, petechiae and ecchymoses, facial erythema, increased sweating, may suppress reactions to skin tests.<br />\r\n<br />\r\n<strong>Neurological</strong>: Increased intracranial pressure with papilledema (pseudo-tumor cerebri) usually after treatment, convulsions, vertigo, headache.<br />\r\n<br />\r\n<strong>Endocrine</strong>: Development of Cushingoid state, suppression of growth in children, secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness, menstrual irregularities, decreased carbohydrate tolerance, manifestations of latent diabetes mellitus, increased requirements for insulin or oral hypoglycemic agents in diabetics.<br />\r\n<br />\r\n<strong>Ophthalmic</strong>: Posterior subcapsular cataracts, increased intraocular pressure, glaucoma, exophthalmos.<br />\r\n<br />\r\n<strong>Others</strong>: Negative nitrogen balance due to protein catabolism.<br />\r\n<br />\r\nThe following additional adverse reactions are related to parenteral corticosteroid therapy: hyperpigmentation or hypopigmentation, subcutaneous and cutaneous atrophy, sterile abscess, anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm, urticaria, nausea and vomiting, cardiac arrhythmias; hypotension or hypertension.</p>', '<p><strong>Pregnancy</strong>: Corticosteroids have been shown to be teratogenic in many species when given in doses equivalent to the human dose. There are no adequate and well-controlled studies in pregnant women. Corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Infants born to mothers who have received corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism.<br />\r\n<br />\r\n<strong>Lactation</strong>: Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects. Because of the potential for serious adverse reactions in nursing infants from corticosteroids, a decision should be made whether to continue nursing or discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>Methylprednisolone, like many other steroid formulations, is sensitive to heat. Therefore, it should not be autoclaved when it is desirable to sterilize the exterior of the vial. The lowest possible dose of corticosteroid should be used to control the condition under treatment. When reduction in dosage is possible, the reduction should be gradual. Since complications of treatment with glucocorticoids are dependent on the size of the dose and the duration of treatment a risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used. For chronic conditions, discontinuation of corticosteroids may result in clinical improvement.</p>', '<p>Treatment of acute over dosage is by supportive and symptomatic therapy. For chronic over dosage in the face of severe disease requiring continuous steroid therapy, the dosage of the corticosteroid may be reduced only temporarily or alternate day treatment may be introduced.</p>', '<p>Glucocorticoids</p>', '<p>Protect from light. Store at controlled room temperature 20&deg; to 25&deg;C. Store solution at controlled room temperature 20&deg; to 25&deg;C.Use solution within 48 hours after mixing.</p>', '<p><strong>Pediatric Use</strong>: The adverse effects of corticosteroids in pediatric patients are similar to those in adults. Like adults, pediatric patients should be carefully observed with frequent measurements of blood pressure, weight, height, intraocular pressure and clinical evaluation for the presence of infection, psychosocial disturbances, thromboembolism, peptic ulcers, cataracts and osteoporosis. Pediatric patients who are treated with corticosteroids by any route, including systemically administered corticosteroids, may experience a decrease in their growth velocity. In order to minimize the potential growth effects of corticosteroids, pediatric patients should be titrated to the lowest effective dose.</p>\r\n\r\n<p><br />\r\n<strong>Geriatric Use</strong>: Clinical studies 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, usually starting at the low end of the dosing range, refecting the greater frequency of decreased hepatic, renal or cardiac function and of concomitant disease or other drug therapy.</p>', '2022-03-09 07:16:28', '2022-03-09 07:16:28');
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
(945, 945, '<p>Intubation of the small intestine, Premedication for radiologic examination of the upper gastrointestinal tract,&nbsp;Prophylaxis of chemotherapy-induced nausea and vomiting,&nbsp;Nausea and vomiting associated with cancer chemotherapy or radiotherapy,&nbsp;Diabetic gastric stasis,&nbsp;Gastro-oesophageal reflux disease,&nbsp;Diabetic gastric stasis, Prophylaxis of postoperative nausea and vomiting.</p>', '<p>Metoclopramide blocks dopamine receptors and in higher doses, it also blocks serotonin receptors in chemoreceptor trigger zone of the CNS. It enhances the response to acetylcholine of tissue in upper GI tract causing enhanced motility and accelerated gastric emptying w/o stimulating gastric, biliary, or pancreatic secretions. It also increases lower esophageal sphincter tone.</p>', '<p>Oral-</p>\r\n\r\n<p><strong>Gastroesophageal Reflux</strong>: Administer Reglan continuously or intermittently:</p>\r\n\r\n<ul>\r\n	<li><strong>Continuous</strong>: Administer 10 to 15 mg, 30 minutes before each meal and at bedtime (maximum of 60 mg per day) for 4 to 12 weeks.</li>\r\n	<li><strong>Intermittent</strong>: Single doses up to 20 mg prior to provoking situation.</li>\r\n</ul>\r\n\r\n<p><strong>Acute and Recurrent Diabetic Gastroparesis</strong>: Administer 10 mg, 30 minutes before each meal and at bedtime (maximum of 40 mg per day) for 2 to 8 weeks.<br />\r\n<br />\r\n<strong>Dosage Adjustment in Specific Populations</strong>: For gastroesophageal reflux and acute and recurrent diabetic gastroparesis, in patients with moderate or severe hepatic or renal impairment, and cytochrome P450 2D6 (CYP2D6) poor metabolizers.</p>\r\n\r\n<p><br />\r\nInjection-</p>\r\n\r\n<p>For the Relief of Symptoms Associated with Diabetic Gastroparesis (Diabetic Gastric Stasis). If only the earliest manifestations of diabetic gastric stasis are present, oral administration of metoclopramide may be initiated. However, if severe symptoms are present, therapy should begin with metoclopramide injection (IM or IV). Doses of 10 mg may be administered slowly by the intravenous route over a 1 to 2 minute period.<br />\r\n<br />\r\nAdministration of Metoclopramide Injection, up to 10 days may be required before symptoms subside, at which time oral administration of metoclopramide may be instituted. The physician should make a thorough assessment of the risks and benefits prior to prescribing further metoclopramide treatment.<br />\r\n<br />\r\nFor the Prevention of Nausea and Vomiting Associated with Emetogenic Cancer Chemotherapy Intravenous infusions should be made slowly over a period of not less than 15 minutes, 30 minutes before beginning cancer chemotherapy and repeated every 2 hours for two doses, then every 3 hours for three doses.<br />\r\n<br />\r\nThe initial two doses should be 2 mg/kg if highly emetogenic drugs such as cisplatin or dacarbazine are used alone or in combination. For less emetogenic regimens, 1 mg/kg per dose may be adequate.<br />\r\n<br />\r\nFor doses in excess of 10 mg, Metoclopramide Injection, should be diluted in 50 mL of a parenteral solution. The preferred parenteral solution is Sodium Chloride Injection (normal saline), which when combined with Metoclopramide Injection, can be stored frozen for up to 4 weeks.<br />\r\n<br />\r\nMetoclopramide Injection, is degraded when admixed and frozen with Dextrose&shy;5% in Water. Metoclopramide Injection, diluted in Sodium Chloride Injection, Dextrose&shy;5% in Water, Dextrose &shy;5% in 0.45% Sodium Chloride, Ringer&#39;s Injection, or Lactated Ringer&#39;s Injection may be stored up to 48 hours (without freezing) after preparation if protected from light. All dilutions may be stored unprotected from light under normal light conditions up to 24 hours after preparation. If acute dystonic reactions should occur, inject 50 mg diphenhydramine hydrochloride intramuscularly, and the symptoms usually will subside.<br />\r\n<br />\r\nFor the Prevention of Postoperative Nausea and Vomiting Metoclopramide Injection, should be given intramuscularly near the end of surgery. The usual adult dose is 10 mg; however, doses of 20 mg may be used. To Facilitate Small Bowel Intubation. If the tube has not passed the pylorus with conventional maneuvers in 10 minutes, a single dose (undiluted) may be administered slowly by the intravenous route over a 1 to 2 minute period.<br />\r\n<br />\r\nThe recommended single use is:</p>\r\n\r\n<ul>\r\n	<li>Pediatric patients above 14 years of age and adults: 10 mg metoclopramide base.</li>\r\n	<li>Pediatric patients (6 to 14 years of age): 2.5 to 5 mg metoclopramide base;</li>\r\n	<li>Pediatric patients (under 6 years of age): 0.1 mg/kg metoclopramide base.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken on an empty stomach. Take &frac12; hr before meals.</p>', '<p>Antagonistic effect with anticholinergics and morphine derivatives. Potentiation of sedative effects with CNS depressants. Additive effect with other neuroleptics on the occurrence of extrapyramydal disorders. May increase the risk of serotonin syndrome with serotonergic drugs (e.g. SSRIs). May decrease digoxin bioavailability. May increase ciclosporin bioavailability. May prolong the neuromuscular blocking effect of mivacurium and suxamethonium. Increased exposure levels with strong CYP2D6 inhibitors (e.g. fluoxetine). May reduce plasma concentration of atovaquone.</p>', '<p>GI haemorrhage, mechanical obstruction or GI perforation; confirmed or suspected pheochromocytoma; history of neuroleptic or metoclopramide-induced tardive dyskinesia; epilepsy, Parkinson&#39;s disease; history of methaemoglobinaemia with metoclopramide or of NADH cytochrome-b5 deficiency. Concomitant use with levodopa or dopaminergic agonists.</p>', '<p>Extrapyramidal symptoms (usually acute dystonic reactions); parkinsonism; tardive dyskinesia; restlessness, drowsiness, dizziness, anxiety, confusion, tremor; hallucinations (rare); depression w/ suicidal ideation; hypotension, HTN, GI disturbances, dyspnoea, visual disturbances, urinary frequency and incontinence, headache; hypersensitivity reactions (rash, bronchospasm, angioedema); galactorrhoea or related disorders; blood disorders; transient increase in plasma-aldosterone concentration. IV: Cardiac conduction disorders, transient flushing of face and upper body (high dose).</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>Patients with underlying neurological conditions, cardiac conduction disturbances, uncorrected electrolyte imbalance, bradycardia. Renal and hepatic impairment. Elderly, childn. Pregnancy and lactation.</p>', '<p><strong>Symptoms:</strong>&nbsp;Extrapyramidal disorders, drowsiness, decreased level of consciousness, confusion, hallucination, cardiorespiratory arrest.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Symptomatic treatment with continuous monitoring of CV and resp functions. In case of extrapyramidal symptoms, treatment is symptomatic (benzodiazepines in childn and/or anticholinergic antiparkinsonian medicinal products in adults).</p>', '<p>Anti-emetic drugs, Prokinetic drugs.</p>', '<p>Store between 20-25&deg;C. Protect from light.</p>', NULL, '2022-03-09 07:18:47', '2022-03-09 07:18:47'),
(946, 946, '<p>Metolazone is indicated for the treatment of salt and water retention including:</p>\r\n\r\n<ul>\r\n	<li>Edema accompanying congestive heart failure</li>\r\n	<li>Edema accompanying renal diseases, including the nephrotic syndrome and states of diminished renal function.</li>\r\n</ul>\r\n\r\n<p>Metolazone is also indicated for the treatment of hypertension, alone or in combination with other antihypertensive drugs of a different class.</p>', '<p>Metolazone is a thiazide-like diuretic. It inhibits reabsorption of sodium in the distal tubules resulting in increased excretion of sodium and water, as well as potassium and hydrogen ions.</p>', '<p>Effective dosage of Metolazone tablets should be individualized according to indication and patient response. A single daily dose is recommended. Therapy with Metolazone tablets should be titrated to gain an initial therapeutic response and to determine the minimal dose possible to maintain the desired therapeutic response.<br />\r\n<br />\r\n<strong>Usual Single Daily Dosage Schedules</strong>: Suitable initial dosages will usually fall in the ranges given.<br />\r\n<br />\r\n<strong>Edema of Cardiac Failure</strong>: Metolazone tablets 5 to 20 mg once daily.<br />\r\n<br />\r\n<strong>Edema of Renal Disease</strong>: Metolazone tablets 5 to 20 mg once daily.<br />\r\n<br />\r\n<strong>Mild to Moderate Essential Hypertension</strong>: Metolazone tablets 2.5 to 5 mg once daily.<br />\r\n<br />\r\nNew patients- If considered desirable to switch patients currently on Zaroxolyn tablets and other formulations of Metolazone that share its slow and incomplete bioavailability to Mykrox , the dose should be determined by titration starting at one tablet (0.5 mg) once daily and increasing to two tablets (1 mg) once daily if needed.<br />\r\n<br />\r\n<strong>Treatment Of Edematous States</strong>: The time interval required for the initial dosage to produce an effect may vary.&nbsp;Diuresis&nbsp;and saluresis usually begin within one hour and persist for 24 hours or longer. When a desired therapeutic effect has been obtained, it may be advisable to reduce the dose if possible. The daily dose depends on the severity of the patient&#39;s condition, sodium intake, and responsiveness. A decision to change the daily dose should be based on the results of thorough clinical and laboratory evaluations. If antihypertensive drugs or diuretics are given concurrently with Metolazone tablets, more careful dosage adjustment may be necessary. For patients who tend to experience paroxysmal nocturnal&nbsp;dyspnea, it may be advisable to employ a larger dose to ensure prolongation of diuresis and saluresis for a full 24-hour period.<br />\r\n<br />\r\n<strong>Treatment Of Hypertension</strong>: The time interval required for the initial dosage regimen to show effect may vary from three or four days to three to six weeks in the treatment of elevated blood pressure. Doses should be adjusted at appropriate intervals to achieve maximum therapeutic effect.</p>', '<p>Hypotensive and nephrotoxic effects of ACE inhibitors may be enhanced. Absorption may be reduced with bile acid sequestrants. Hyperglycaemic effect may be enhanced with diazoxide. May increase serum concentration and QTc-prolonging effect of dofetilide. May reduce lithium excretion. Hypotensive effect may be increased with alcohol.</p>', '<p>Anuria; hepatic coma or pre-coma. Pregnancy.</p>', '<p>Chest pain, palpitation, necrotising angiitis, orthostatic hypotension, syncope, venous thrombosis, vertigo, volume depletion; depression, dizziness, chills, drowsiness, fatigue, restlessness, headache, lightheadedness; petechiae, photosensitivity, hypersensitivity reactions; gout attacks, electrolyte disturbances; abdominal bloating, diarrhoea, abdominal pain, anorexia, constipation, epigastric distress, nausea, xerostomia, pancreatitis, vomiting; impotence; aplastic anaemia, thrombocytopenia, haemoconcentration, leukopenia; cholestatic jaundice, hepatitis; joint pain, muscle cramps, weakness, neuropathy, paraesthesia; blurred vision; increased BUN, glucosuria.</p>', '<p>Pregnancy&nbsp;Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).<br />\r\n<br />\r\nIf used in gestational HTN: Pregnancy&nbsp;Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Pre-diabetes or DM; gout; SLE; hepatic and renal impairment; hypercholesterolaemia. Correct electrolyte disturbances prior to therapy. Risk of cross-sensitivity with sulfonamides, sulfonylureas, carbonic anhydrase inhibitors, thiazides and loop diuretics. Lactation.</p>', '<p><strong>Symptoms</strong>: Orthostatic hypotension, dizziness, drowsiness, syncope, haemoconcentration and haemodynamic changes due to plasma volume depletion.<br />\r\n<br />\r\n<strong>Management</strong>: Symptomatic and supportive.</p>', '<p>Thiazide diuretics &amp; related drugs.</p>', NULL, NULL, '2022-03-09 07:20:42', '2022-03-09 07:20:42'),
(947, 947, '<p>ln the management of hypertension and angina pectoris. Cardiac arrhythmias, especially supraventricular tachyarrhythmias. Adjunct to the treatment of hyperthyroidism. Early intervention with Metoprolol in acute myocardial infarction reduces infarct size and the incidence of ventricular fibrillation. Pain relief may also decrease the need for opiate analgesics. Metoprolol has been shown to reduce mortality when administered to patients with acute myocardial infarction.</p>', '<p>Metoprolol is a selective beta1-blocker. Metoprolol reduces or inhibits the agonistic effect on the heart of catecholamines (which are released during physical and mental stress). This means that the usual increase in heart rate, cardiac output, cardiac contractility and blood pressure, produced by the acute increase in catecholamines, is reduced by Metoprolol. Metoprolol interferes less with Insulin release and carbohydrate metabolism than do non-selective beta-blockers. Metoprolol interferes much less with the cardiovascular response to hypoglycaemia than do non-selective beta-blockers.</p>', '<p>Film-coated tablet<strong>-</strong></p>\r\n\r\n<ul>\r\n	<li><strong>Hypertension</strong>: Total daily dosage Metoprolol 100-400 mg to be given as a single or twice-daily dose. The starting dose is 100 mg (two Metoprolol-50 tablets) per day. This may be increased by 100 mg per day at weekly intervals. lf full control is not achieved using a single daily dose, a b.i.d. regimen should be initiated. Combination therapy with a diuretic or other antihypertensive agents may also be considered.</li>\r\n	<li><strong>Angina</strong>: Usually Metoprolol 50 mg (one Metoprolol-50 tablet) to 100 mg (two Metoprolol-50 tablets)&nbsp;twice or three times daily.</li>\r\n	<li><strong>Cardiac arrhythmia</strong>s: Metoprolol 50 mg (one Metoprolol-50 tablet) b.i.d or t.i.d should usually control the condition. It is necessary the dose can be increased up to 300 mg per day in divided doses. Following the treatment of an acute arrhythmia with Metoprolol injection, continuation therapy with Metoprolol tablets should be initiated 4-6 hours later. The initial oral dose should not exceed 50 mg t.i.d.</li>\r\n	<li><strong>Hyperthyroidism</strong>: Metoprolol 50 mg (one Metoprolol-50 tablet) four times a day. The dose should be reduced as the euthyroid state is achieved.</li>\r\n	<li><strong>Myocardial infarction</strong>: Orally, therapy should commence 15 minutes after the last injection with 50 mg every 6 hours for 48 hours. Patients who fail to tolerate the full intravenous dose should be given half the suggested oral dose. Maintenance- The usual maintenance dose is 200 mg daily given in divided doses. Elderly&rsquo; There are no special dosage requirements in otherwise healthy elderly patients. Significant hepatic dysfunction: A reduction in dosage may be necessary.</li>\r\n</ul>\r\n\r\n<p>Extended-release tablet-</p>\r\n\r\n<ul>\r\n	<li><strong>Hypertension</strong>: The usual initial dosage is 25 to 100 mg daily in a single dose, whether used alone or added to a diuretic.</li>\r\n	<li><strong>Angina Pectoris</strong>: The dosage of extended-release Metoprolol Succinate should be individualized. The usual initial dosage is 100 mg daily, in a single dose.</li>\r\n	<li><strong>Heart Failure</strong>: The recommended starting dose of sustained-release Metoprolol Succinate is 25 mg once daily for two weeks in patients with NYHA class II heart failure and 12.5 mg once daily in patients with more severe heart failure. The dosage may be increased at weekly (or longer) intervals until optimum blood pressure reduction is achieved. If treatment is to be discontinued, the dosage should be reduced gradually over a period of 1-2 weeks.</li>\r\n</ul>\r\n\r\n<p>IV Injection-</p>\r\n\r\n<ul>\r\n	<li><strong>Arrhythmias</strong>: By intravenous injection, up to 5 mg at a rate of 1-2 mg/minute, repeated after 5 minutes if necessary, total dose 10-15 mg.</li>\r\n	<li><strong>In surgery</strong>: By slow intravenous injection 2-4 mg at induction or to control arrhythmias developing during anaesthesia; 2 mg doses may be repeated to a maximum of 10 mg.</li>\r\n	<li><strong>Myocardial Infarction</strong>: Early intervention within 12 hours of infarction, by intravenous injection 5 mg every 2 minutes to a maximum of 15 mg, followed after 15 minutes by 50 mg by mouth every 6 hours for 48 hours; maintenance 200 mg daily in divided doses.</li>\r\n</ul>', '<p>Catecholamine‐depleting drugs (e.g. Reserpine, Monoamine Oxidase (MAO) inhibitors) may have an additive effect when given with beta‐blocking agents. Drugs that inhibit CYP2D6 such as quinidine, fluoxetine, paroxetine and propafenone are likely to increase Metoprolol concentration. These increases in plasma concentration would decrease the cardioselectivity of Metoprolol. Concomitant use of digitalis glycosides and beta‐blockers can increase the risk of bradycardia. Beta‐blockers may exacerbate the rebound hypertension which can follow the withdrawal of clonidine.</p>', '<p>AV block, Uncontrolled heart failure, severe bradycardia, sick-sinus syndrome, cardiogenic shock and severe peripheral arterial disease. Known hypersensitivity to Metoprolol or other B-blockers. Metoprolol is also contra-indicated when myocardial infarction is complicated by significant bradycardia, first-degree heart block, systolic hypotension (&lt;100mmHg) and/or severe heart failure.</p>', '<p>Tiredness, dizziness, depression, diarrhea, itching or rash, shortness of breath, slow heart rate, mental confusion, headache, somnolence, nightmares, insomnia, dyspnea, Nausea, dry mouth, gastric pain, constipation, flatulence, digestive tract disorders, heartburn, pruritus, musculoskeletal pain, blurred vision, decreased libido, and tinnitus have also&nbsp;been&nbsp;reported,&nbsp;intensification&nbsp;of&nbsp;AV&nbsp;block.</p>', '<p>Pregnancy Category C. There are no adequate and well‐controlled studies in pregnant women. This drug should be used during pregnancy only if clearly needed. Metoprolol is excreted in breast milk in very small quantities. Caution should be exercised when Metoprolol is administered to a nursing woman.</p>', '<p><strong>Bronchospastic Diseases</strong>: Because of its relative beta 1 ‐selectivity, however, Metoprolol may be used with caution in patients with bronchospastic disease who do not respond to, or cannot tolerate other antihypertensive treatment.<br />\r\n<br />\r\n<strong>Major Surgery</strong>: The necessity or desirability of withdrawing beta‐blocking therapy prior to major surgery is controversial; the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures.<br />\r\n<br />\r\n<strong>Diabetes and Hypoglycemia</strong>: Beta‐blockers may mask tachycardia occurring with hypoglycemia, but other manifestations such as dizziness and sweating may not be significantly affected. Peripheral Vascular Disease: Beta‐blockers can precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease. Calcium Channel Blockers: Because of significant inotropic and chronotropic effects in patients, caution should be exercised in patients treated with these agents concomitantly.</p>', '<p>Poisoning due to an overdose of metoprolol may lead to severe hypotension, sinus&nbsp;bradycardia, atrioventricular block, heart failure, cardiogenic shock, cardiac arrest,&nbsp;bronchospasm, impairment of consciousness, coma, nausea, vomiting, cyanosis, hypoglycaemia and, occasionally, hyperkalaemia. The first manifestations usually appear 20 minutes to 2 hours&nbsp;after drug ingestion. Treatment: Treatment should include close monitoring of cardiovascular,&nbsp;respiratory and renal function, and blood glucose and electrolytes. Further absorption may be&nbsp;prevented by induction of vomiting, gastric lavage or administration of activated-charcoal if&nbsp;ingestion is recent. Cardiovascular complications should be treated symptomatically, which may&nbsp;require the use of sympathomimetic agents (e.g. noradrenaline, metaramionl), atropine or&nbsp;inotropic agents (e.g. dopamine, dobutamine). Temporary pacing may be required for AV block.&nbsp;Glucagon can reverse the effects of excessive B-blockade, given in a dose of 1-10 mg&nbsp;intravenously. Intravenous B2-stimulants e.g. terbutaline may be required to relieve&nbsp;bronchospasm. Metoprolol cannot be effectively removed by haemodialysis.</p>', NULL, '<p>Store in a cool and dry place, protected from light.</p>', '<p><strong>Hepatic impaired patient</strong>: Metoprolol should be used with caution in patients with impaired hepatic function.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: No clinically relevant differences in the adverse event profile were observed for pediatric patients aged 6 to 16 years as compared with adult patients. Safety and effectiveness of Metoprolol have not been established in patients &lt;6 years of age.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: There were no notable differences in efficacy or the rate of adverse events between older and younger patients.</p>', '2022-03-09 07:23:05', '2022-03-09 07:23:05'),
(948, 948, '<p>Metronidazole is indicated in the treatment of following diseases:</p>\r\n\r\n<ul>\r\n	<li>The prevention of post-operative infections due to anaerobic bacteria (particularly species of bacteroides and anaerobic streptococci).</li>\r\n	<li>The treatment of septicaemia, bacteraemia, peritonitis, brain abscess, pelvic abscess, pelvic cellulitis and post-operative wound infections caused by anaerobes.</li>\r\n	<li>In the treatment of urogenital trichomoniasis.</li>\r\n	<li>Bacterial vaginosis (also known as non-specific vaginitis).</li>\r\n	<li>All forms of amoebiasis (intestinal, extra-intestinal disease and that of symptomless cyst passers).</li>\r\n	<li>Giardiasis.</li>\r\n	<li>Acute ulcerative gingivitis.</li>\r\n	<li>Anaerobically infected leg ulcers and pressure sores.</li>\r\n	<li>Acute dental infections due to anaerobic organisms.</li>\r\n	<li>Antibiotic associated pseudomembranus colitis.</li>\r\n</ul>', '<p>Metronidazole is a member of the imidazole class of antibacterial drug and is classified therapeutically as an antiprotozoal agent. The 5-nitro group of Metronidazole is reduced by anaerobes metabolically. Studies have demonstrated that the reduced form of this drug interacts with DNA and gives bactericidal action of Metronidazole.</p>', '<p>Tablet and Suspension:</p>\r\n\r\n<p>Trichomoniasis (Adults &amp; Children over 10 yrs)-</p>\r\n\r\n<ul>\r\n	<li>200 mg tid or 400 mg bid for 7 days</li>\r\n	<li>800 mg in the morning and 1-2 gm at night for 2 days</li>\r\n	<li>2 gm as a single dose for 1 days</li>\r\n</ul>\r\n\r\n<p>Trichomoniasis (Children)-</p>\r\n\r\n<ul>\r\n	<li>Children 7-10 yrs: 100 mg tid</li>\r\n	<li>Children 3-7 yrs: 100 mg bid</li>\r\n	<li>Children 1-3 yrs: 50 mg tid</li>\r\n</ul>\r\n\r\n<p>Intestinal amoebiasis (Adults &amp; Children over 10 yrs)-&nbsp;</p>\r\n\r\n<ul>\r\n	<li>800 mg tid for 5 days</li>\r\n</ul>\r\n\r\n<p>Intestinal amoebiasis (Children)-</p>\r\n\r\n<ul>\r\n	<li>Children 7-10 yrs: 400 mg tid</li>\r\n	<li>Children 3-7 yrs: 200 mg qid</li>\r\n	<li>Children 1-3 yrs: 200 mg tid</li>\r\n</ul>\r\n\r\n<p>Extra-intestinal &amp; Asymptomatic amoebiasis (Adults &amp; Children over 10 yrs)-</p>\r\n\r\n<ul>\r\n	<li>400-800 mg tid for 5-10 days</li>\r\n</ul>\r\n\r\n<p>Extra-intestinal &amp; Asymptomatic amoebiasis (Children)-</p>\r\n\r\n<ul>\r\n	<li>Children 7-10 yrs: 200-400 mg tid</li>\r\n	<li>Children 3-7 yrs: 100-200 mg qid</li>\r\n	<li>Children 1-3 yrs: 100-200 mg tid</li>\r\n</ul>\r\n\r\n<p>Giardiasis (Adults &amp; Children over 10 yrs)-</p>\r\n\r\n<ul>\r\n	<li>2 gm once daily for 3 days</li>\r\n</ul>\r\n\r\n<p>Giardiasis (Children)-</p>\r\n\r\n<ul>\r\n	<li>Children 7-10 yrs: 1 gm once daily</li>\r\n	<li>Children 3-7 yrs: 600-800 mg once daily</li>\r\n	<li>Children 1-3 yrs: 500 mg once daily</li>\r\n</ul>\r\n\r\n<p>Acute ulcerative&nbsp; gingivitis (Adults &amp; Children over 10 yrs)-</p>\r\n\r\n<ul>\r\n	<li>200 mg tid for 3 days</li>\r\n</ul>\r\n\r\n<p>Acute ulcerative&nbsp; gingivitis (Children)-</p>\r\n\r\n<ul>\r\n	<li>Children 7-10 yrs: 100 mg tid</li>\r\n	<li>Children 3-7 yrs: 100 mg bid</li>\r\n	<li>Children 1-3 yrs: 50 mg tid</li>\r\n</ul>\r\n\r\n<p>Acute dental infections (Adults &amp; Children over 10 yrs)-</p>\r\n\r\n<ul>\r\n	<li>200 mg tid for 3-7 days</li>\r\n</ul>\r\n\r\n<p>Bacterial Vaginosis (Adults &amp; Children over 10 yrs)-</p>\r\n\r\n<ul>\r\n	<li>400 mg bid for 7 days</li>\r\n	<li>2 gm as a single dose for 1 days</li>\r\n</ul>\r\n\r\n<p>Leg ulcers and pressure sores (Adults &amp; Children over 10 yrs)-</p>\r\n\r\n<ul>\r\n	<li>400 mg tid for 7 days</li>\r\n</ul>\r\n\r\n<p>Anaerobic infections (Adults &amp; Children over 10 yrs)-</p>\r\n\r\n<ul>\r\n	<li>800 mg initially and then 400 mg tid for 7 days</li>\r\n</ul>\r\n\r\n<p>Anaerobic infections (Children)-</p>\r\n\r\n<ul>\r\n	<li>Children 1-10 yrs: 7.5 mg/kg tid</li>\r\n</ul>\r\n\r\n<p>Surgical prophylaxis (Adults &amp; Children over 10 yrs)-</p>\r\n\r\n<ul>\r\n	<li>400 mg tid started 24&nbsp; hours before&nbsp; surgery for 1 days</li>\r\n</ul>\r\n\r\n<p>Surgical prophylaxis (Children)-</p>\r\n\r\n<ul>\r\n	<li>Children 1-10 yrs: 7.5 mg/kg tid</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Vaginal Gel:</p>\r\n\r\n<p>The recommended dose is one applicator full of Metronidazole gel (approximately 5 grams containing approximately 37.5 mg of Metronidazole) intravaginally once or twice a day for 5 days. For once a day dosing, Metronidazole gel should be administered at bedtime.</p>\r\n\r\n<p><br />\r\nSuppository:</p>\r\n\r\n<p>Anaerobic Infections-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 1 g every 8 hours for 3 days, then 1 g every 12 hours.</li>\r\n	<li><strong>Children</strong>: 5-10 years: 500 mg every 8 hours for 3 days, then every 12 hours, Over 10 years adult dose.</li>\r\n</ul>\r\n\r\n<p>Surgical Prophylaxis-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 1 g 2 hours before surgery; up to 3 further doses of 1 g may be given every 8 hours for high risk procedures.</li>\r\n	<li><strong>Children</strong>: 5-10 years: 500 mg 2 hours before surgery; up to 3 further doses of 500 mg may be given every 8 hours for high risk procedures.</li>\r\n</ul>\r\n\r\n<p><br />\r\nIV Infusion:</p>\r\n\r\n<p>Metronidazole intravenous infusion requires no dilution and should not be mixed with any other drugs prior to administration.</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children over 12 years</strong>: Infuse 500 mg 8 hourly at a rate of 5 ml/minute and a maximum of 4 g should not be exceeded during a 24-hour period. Treatment for 7 days is sufficient for most patients, but treatment can be extended, especially for cases where reinfection is likely. For surgical prophylaxis, administration shortly before surgery should be followed by 8-hourly doses for the next 24 hours.</li>\r\n	<li><strong>Children under 12 years</strong>: 7.5 mg/kg body weight/day every 8 hours at a rate of 5 ml/minute.</li>\r\n</ul>', '<ul>\r\n	<li><strong>Disulfiram</strong>: Psychotic reactions have been reported in patients who were using metronidazole and disulfiram concurrently.</li>\r\n	<li><strong>Alcohol</strong>: Alcoholic beverages and drugs containing alcohol should not be consumed during therapy and for at least one day afterwards because of the possibility of a disulfiram-like (antabuse effect) reaction (flushing, vomiting, tachycardia). Oral anticoagulant therapy (warfarin type): Potentiation of the anticoagulant effect and increased hemorrhagic risk caused by decreased hepatic catabolism. In case of co-administration, prothrombin time should be more frequently monitored and anticoagulant therapy adjusted during treatment with metronidazole.</li>\r\n	<li><strong>Lithium</strong>: Plasma levels of lithium may be increased by metronidazole.</li>\r\n	<li><strong>Cyclosporin</strong>: Serum cyclosporin and serum creatinine should be closely monitored when co-administration is necessary.</li>\r\n	<li><strong>Phenytoin or phenobarbital</strong>: increased elimination of metronidazole resulting in reduced plasma levels.</li>\r\n	<li><strong>5-Fluorouracil</strong>: Reduced clearance of 5-fluorouracil resulting in increased toxicity of 5-fluorouracil.</li>\r\n	<li><strong>Busulfan</strong>: Plasma levels of busulfan may be increased by metronidazole, which may lead to severe busulfan toxicity.</li>\r\n</ul>', '<p>Metronidazole is contraindicated in patients with a history of hypersensitivity to Metronidazole or other Nitroimidazole derivatives.</p>', '<p>Metallic taste, nausea, vomiting, diarrhoea, drowsiness, rashes may be observed during treatment.</p>', '<p>US FDA Pregnancy Category of Metronidazole 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. Metronidazole have been shown to be excreted in human milk. So, caution should be exercised when Metronidazole is administered to a nursing woman.</p>', '<ul>\r\n	<li>If for compelling reasons, metronidazole must be administered longer than the usually recommended duration, it is recommended that hematological tests, especially leucocyte count should be carried out regularly and that patients should be monitored for adverse reactions such as peripheral or central neuropathy (such as paresthesia, ataxia, dizziness, convulsive seizures).</li>\r\n	<li>Metronidazole should be administered with caution to patients with hepatic encephalopathy.</li>\r\n	<li>Patients should be warned that metronidazole may darken urine.</li>\r\n</ul>', '<p>Single oral doses of metronidazole, up to 12 g have been reported in suicide attempts and accidental overdoses. Symptoms were limited to vomiting, ataxia and slight disorientation. There is no specific antidote for metronidazole overdosages. In case of suspected massive overdosages, a symptomatic and supportive treatment should be instituted.</p>', '<p>Amoebicides, Anti-diarrhoeal Antiprotozoal.</p>', '<p>Store below 30&deg;C. Keep protected from light. Keep medicines out of the reach of children. Do not use later than the date of expiry.</p>', '<p><strong>Hepatic impairment</strong>: Metronidazole is mainly metabolised by hepatic oxidation. Substantial impairment of metronidazole clearance may occur in the presence of advanced hepatic insufficiency. Significant cumulation may occur in patients with hepatic encephalopathy and the resulting high plasma concentrations of metronidazole may contribute to the symptoms of the encephalopathy. Metronidazole should therefore, be administered with caution to patients with hepatic encephalopathy. The daily dosage should be reduced to one third and may be administered once daily. Patients should be warned that metronidazole may darken urine.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: The elimination half-life of metronidazole remains unchanged in the presence of renal failure. The dosage of metronidazole therefore needs no reduction. Such patients however retain the metabolites of metronidazole. The clinical significance of this is not known at present. In patients undergoing haemodialysis metronidazole and metabolites are efficiently removed during an eight hour period of dialysis. Metronidazole should therefore be re-administered immediately after haemodialysis. No routine adjustment in the dosage of Metronidazole need be made in patients with renal failure undergoing intermittent peritoneal dialysis (IDP) or continuous ambulatory peritoneal dialysis (CAPD).</p>', '2022-03-09 07:25:23', '2022-03-09 07:25:23'),
(949, 949, '<p>Vaginal treatment of female urogenital trichomonas infection, prevention &amp; local therapy of candidiasis.</p>', '<p>Metronidazole 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. It is active against most anaerobic protozoa, some gm+ve, gm-ve and facultative anaerobes.<br />\r\n<br />\r\nMiconazole inhibits ergosterol synthesis thus damaging fungal cell wall membrane and increases its permeability, allowing leakage of nutrients.</p>', '<p>In trichomoniasis, concurrently with oral metronidazole treatment and 1 vaginal tablet should be inserted high up into the vagina once a day (preferably before going to bed at night) for 10 days. Long-term recovery may be expected only is response to the simultaneous oral treatment of&nbsp;both partners.<br />\r\n<br />\r\nIn candidiasis or other fungal infections, 1 vaginal tablet has to be inserted high up into the vagina for 10 days. The vaginal tablet should be slightly moistened before application.</p>', '<p><strong>Metronidazole:</strong>&nbsp;Disulfiram-like reaction with alcohol. Increased oral anticoagulant effect, blood levels of phenytoin, lithium toxicity, plasma cone of astemizole &amp; terfenadine; blood cone of carbamazepine. Decreased blood levels with phenobarb. Risk of CNS-related effects (eg psychotic reactions) with disulfiram. Increased blood levels &amp; neurologic effects with cimetidine. May increase blood levels &amp; toxicity of fluorouracil; toxicity of cyclosporine. Increased cardiotoxicity with amiodarone. Interference with blood levels of liver enzymes, glucose (hexokinase method), theophylline &amp; procainamide. Decreased levels with phenytoin.<br />\r\n<br />\r\n<strong>Miconazole:</strong>&nbsp;Increased risk of bleeding with acenocoumarol, anisindione, dicumarol, phenindione, phenprocoumon, warfarin; plasma cone &amp; exposure to oxybutinin.<br />\r\n<br />\r\nMay increase risk of phenytoin, phosphenytoin, cyclosporine, trimetrexate toxicity &amp; cardiotoxicity with pimozide. May inhibit metabolism of astemizole, cisapride &amp; terfenadine. Reduced carbamazepine metabolism. Increased or prolonged effects of opioid (fentanyl). May cause hypoglycemia with glimepiride. Reduced clearance &amp; increased plasma cone of oxycodone. May increase bioavailability of tolterodine (in patients with deficient CYP2D6 activity).</p>', '<p>Hypersensitivity; hepatic impairment (oral gel). Porphyria.</p>', '<p>Nausea, vomiting, febrile reactions, rash, drowsiness, diarrhoea, anorexia and flushing, hepatitis. Local irritation and sensitisation, contact dermatitis.</p>', '<p>Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.<br />\r\n<br />\r\nAnimal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks</p>', '<p>For external use only; discontinue if sensitization or irritation occurs. Pregnancy and lactation.</p>', NULL, '<p>Drugs used in Vaginal and Vulval condition.</p>', NULL, NULL, '2022-03-09 07:27:21', '2022-03-09 07:27:21'),
(950, 950, '<p>This combination is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Vaginal trichomoniasis</li>\r\n	<li>Vaginal leucorrhoeas</li>\r\n	<li>Mixed vaginal infections (Fungal or Bacterial).</li>\r\n</ul>', '<p>Metronidazole, a nitroimidazole, is active against various anerobic bacteria and protozoa. Nystatin is a polyene antibiotic with antifungal activity. Neomycin is an aminoglycoside. It is bactericidal and active against some gram-positive and gram-negative organisms. Polymyxin is active against gram-negative organisms including Pseudomonas aeruginosa.</p>', '<p>One suppository in the vagina at bedtime for 12 days or as directed by the physician.</p>', NULL, '<p>Contraindicated to the patients who are hypersensitive to Metronidazole, Neomycin Sulphate, Polymyxin B Sulphate and Nystatin.</p>', '<p>Skin rash, urticaria may occur rarely.</p>', '<p>Caution should be practiced in pregnancy and lactation.</p>', '<p>Caution should be taken in case of renal impairment.</p>', NULL, '<p>Drugs used in Vaginal and Vulval condition</p>', '<p>Store in a cool and dry place, away from light &amp; children.</p>', NULL, '2022-03-09 07:29:25', '2022-03-09 07:29:25'),
(951, 951, '<p>Miconazole Nitrate oral gel is indicated-</p>\r\n\r\n<ul>\r\n	<li>For the treatment of oral and gastrointestinal candidiasis.</li>\r\n	<li>For eradication of fungal colonization in the mouth and gastrointestinal tract.</li>\r\n	<li>For the treatment of super infections due to gram-positive bacteria.</li>\r\n</ul>', '<p><strong>Pharmacodynamics</strong>: Miconazole possesses an antifungal activity against the common dermatophytes and yeasts as well as an antibacterial activity against certain gram-positive bacilli and cocci. Its activity is based on the inhibition of a demethylation step in the ergosterol biosynthesis. Ergosterol, the end-product of the biosynthetic pathway and the main sterol in yeast and fungi. The disruption in production of ergosterol disrupts the fungal cell membrane, causing holes to appear in it. These holes allow the essential constituents of the fungal cells to leak out and ultimately the fungal cells die.<br />\r\n<br />\r\n<strong>Pharmacokinetics</strong>: The oral bioavailability of Miconazole is low (25-30%) because there is little absorption of Miconazole from the intestinal tract. Miconazole is systemically absorbed after administration as the oral gel. Absorbed Miconazole is bound to plasma proteins (88.2%), primarily to serum albumin and red blood cells (10.6%). The absorbed portion of Miconazole oral gel is largely metabolized; less than 1% of the administered dose is excreted unchanged in the urine. The terminal plasma half-life is 20-25 hours in most patients. The elimination half-life of Miconazole is similar in any renal impaired patient.</p>', '<p><strong>Oropharyngeal candidosis</strong>-</p>\r\n\r\n<ul>\r\n	<li>Infants 4-24 months: 1.25 ml (1&frasl;4 measuring spoon) of gel, applied 4 times day after meals.</li>\r\n	<li>Adult and children 2 years of age and older: 2.5 ml (1&frasl;2 measuring spoon) of gel, applied 4 times a day after meals.</li>\r\n</ul>\r\n\r\n<p><strong>Gastrointestinal tract candidosis</strong>-</p>\r\n\r\n<ul>\r\n	<li>Infants (4 months of age or above): Children and adults who have difficulty swallowing tablets: 20 mg per kg body weight per day, in four divided doses. The daily dose should not exceed 250 mg (10 ml gel) four times daily.</li>\r\n</ul>\r\n\r\n<p><strong>Missed Dose</strong>: Apply the missed dose as soon as you remember. In case of next dosing time, omit the missed<br />\r\ndose and continue your usual course.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>In case of localized lesions of the mouth, a small amount of gel may be applied 2-4 times a day directly to the affected area with a clean finger. For best results, Miconazole oral gel should be kept in contact with the affected area as long as possible. The treatment should be continued for at least a week after symptoms have disappeared. For oral candidosis, dental prosthesis should be removed at night and brushed with the gel.</p>', '<ul>\r\n	<li>Concomitant treatment with Terfenadine, Astemizole and Cisapride should be avoided because in vitro studies suggest that Miconazole may inhibit their metabolism, so these products miqht precipitated.</li>\r\n	<li>Miconazole may delay Phenytoin and Cyclosporine metabolism and this might precipitate Phenytoin and Cyclosporine toxicity, respectively.</li>\r\n</ul>', '<p>Miconazole is contraindicated in patients with known hypersensitivity to the active ingredient.</p>', '<p>Occasionally nausea and vomiting, diarrhea with long term use and rarely allergic reactions.</p>', '<p>There is no information regarding the safety of Miconazole oral gel during pregnancy. So Miconazole oral gel should be avoided in pregnant women if possible or the potential hazards should be balanced against the possible benefits. As many drugs are excreted in human milk, caution should be exercised when Miconazole is administered to a nursing woman.</p>', '<p>If the concomitant use of Miconazole and anticoagulant is considered, the anti-coagulant effect should be monitored and titrated. Miconazole and phenytoin plasma level should also be monitored when used concomitantly. In infants and young children, caution must be taken to ensure that the gel does not obstruct the throat.</p>', '<p>Accidental overdosage may cause vomiting and diarrhea. Treatment is symptomatic and supportive. A specific antidote is not available.</p>', '<p>Aural Anti-fungal preparations.</p>', '<p>keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-09 07:31:37', '2022-03-09 07:31:37'),
(952, 952, '<p>Skin and nail infections due to dermatophytes, yeasts and other fungi such as: Tinea capitis, corporis, manuum, pedis, barbae, cruris, unguium or onychomycosis. Pityriasis versicolor, candidiasis of skin and nails, stomatitis angularis, otitis externa. Since Miconazole Topical Cream&nbsp;has an antibacterial effect on Gram-positive bacteria, it may be used in mycoses secondarily infected with such bacteria.</p>', '<p>Miconazole topical cream is a broad-spectrum antimycotic which offers a high antifungal activity against dermatophytes, yeasts and other phyco-Asco and Adelomycetes, with a potent antibacterial activity against Gram-positive bacilli and cocci. Miconazole topical cream proved to be markedly effective in secondary infected mycoses, which under other treatments were resistant or reappeared. Miconazole topical cream&nbsp;does not stain skin or clothes.</p>', '<p>The dosage is same for all the ages.<br />\r\n<br />\r\n<strong>For skin infections</strong>: Apply some cream to the lesions twice daily and rub it well with finger until it has fully penetrated the skin. All lesions usually disappear after 2 to 5 weeks. Prolong treatment for some 10 days to prevent relapse.<br />\r\n<br />\r\n<strong>For nail infections</strong>: Clip infected nail as shortly as possible. Apply some cream once daily to the infected nail and rub with your finger, cover nail with a non-perforated occlusive plastic bandage.<br />\r\n<br />\r\nAlso after loosening of the infected nail (from 2-3 weeks onwards) uniterrupted treatment should be continued until the growth of a new nail has set in and definite cure can be observed (usually after seven months or more).</p>', NULL, '<p>No contraindication is known.</p>', '<p>Topical application of Miconazole Nitrate has almost no side effect.</p>', '<p>Only small amounts of Miconazole nitrate are absorbed following local administration. However as with other imidazoles, Miconazole nitrate should be used with caution during pregnancy.</p>', '<p>Miconazole Nitrate is intended for topical use. If accidental ingestion of large quantities of the product occurs, an appropriate method of gastric emptying may be used if considered desirable.</p>', NULL, '<p>Topical Antifungal preparations.</p>', '<p>Store away from direct heat. Keep out of reach of children.</p>', NULL, '2022-03-10 16:31:16', '2022-03-10 16:31:16'),
(953, 953, '<p>For the topical treatment of inflamed dermatoses where&nbsp; infection by susceptible organisms and inflammation coexist e.g. intertrigo and infected eczema. For moist or dry eczema or dermatitis including atopic eczema, primary irritant or contact allergic eczema or seborrheic eczema including that associated with acne. Also for interiginous eczema including inflammatory interigo, perianal and genital dermatitis. Organisms which are&nbsp;susceptible to miconazole are dermatophytes and pathogenic yeasts (e.g. Candida spp.): also many Gram-positive bacteria including many strains of Streptococcus and Staphylococcus.</p>', '<p>Miconazole is a substituted imidazole, is one of the family of azoles useful in treating the superficial candidiasis and of the skin infections dermatophytosis and pityriasis versicolor, acanthameaba, seborrhoic dermatitis. Also active against Aspergillus spp., Cryptococcus neoformans, Pseudalescheria boydii and some gram-positive bacteria including Staphylococci and Streptococci.<br />\r\n<br />\r\nHydrocortisone is a naturally occurring glucocorticoid that&#39;s now prepared synthetically. Its important function is in the skin injury such as inflammation. Also it has antipruritic, antimycotic and vasoconstrictive activity.<br />\r\n<br />\r\nMiconazole is imidazole antifungal agents that interfere with ergosterol synthesis and therefore alters the permeability of the cell membrane of sensitive fungi. Thus causes the killing of fungi, when applied to the skin, Hydrocortisone is absorbed into the skin cells. It prevents the release of certain chemicals, which is responsible for inflammation. Thus hydrocortisone reduces inflammation.</p>', '<p>Apply to the affected area as a thin film two or four times daily for 1 to 2 weeks. Rub it well with your finger until this cream fully vanished on the skin. Treatment should be continued at least one week after the disappearance of all signs and symptoms. The same dosage applies to both adults and children.</p>', '<p>Amphotericin antagonizes the activity of Miconazole.</p>', '<p>It is contraindicated in individuals who are hypersensitive to it or any of its components. Should not be used in pregnant mother and lactating mother without physician&#39;s advice.</p>', '<p>Rarely local sensitivity may occur. Long term use may decrease in the production of natural hormones by the adrenal gland.</p>', '<p>Administration of corticosteroids to pregnant animal at high doses can cause abnormalities of fetal development. Topical steroids should not be extensively used in pregnancy.</p>', '<p>To be dispensed only on the prescription of a registered physician. Keep out of reach of children. Take care or consult with a physician in case of use in children and elderly people for long-term use.</p>', NULL, '<p>Hydrocortisone &amp; Combined preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-10 16:33:18', '2022-03-10 16:33:18');
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
(954, 954, '<p>It is indicated in the treatment of-</p>\r\n\r\n<ul>\r\n	<li>Acute hemorrhoidal attacks.</li>\r\n	<li>Chronic hemorrhoidal disease.</li>\r\n	<li>Organic and functional chronic venous insufficiency of the lower limbs with the following symptoms: heavy legs, pain, nocturnal cramps.</li>\r\n</ul>', '<p>Diosmin and Hesperidin is a phlebotonic drug and a vascular protecting agent. It reinforces venous tone by prolonging the activity of parietal noradrenaline. Thus Diosmin and Hesperidin decreases venous capacitance, venous distensibility, and venous emptying time.<br />\r\n<br />\r\nDiosmin and Hesperidin protects the microcirculation by fighting the microcirculation damaging process; It combats venous inflammation by decreasing leukocyte activation, and as a consequence, by inhibiting the release of inflammatory mediators, principally free radicals and prostaglandin. Thus Diosmin and Hesperidin normalizes capillary permeability and strengthens capillary resistance.<br />\r\n<br />\r\nDiosmin and Hesperidin acts on the lymphatic system, It improves lymphatic drainage by increasing lymph flow and lymph oncotic pressure.</p>', '<p>Diosmin 450 mg &amp; Hesperidin 50 mg-</p>\r\n\r\n<ul>\r\n	<li><strong>Acute hemorrhoidal attacks</strong>: 3 tablets twice daily for the first 4 days, then 2 tablets twice daily for three days and if required 1 tablet twice daily as a maintenance dosage.</li>\r\n	<li><strong>Chronic hemorrhoids</strong>: 1 tablet twice daily.</li>\r\n	<li><strong>Chronic venous insufficiency</strong>: 1 tablet twice daily initially for seven days. Duration may be increased depending on severity.</li>\r\n</ul>\r\n\r\n<p>Diosmin 900 mg &amp; Hesperidin 100 mg-</p>\r\n\r\n<ul>\r\n	<li><strong>Acute Hemorrhoid</strong>: 1 tablet thrice daily for first 4 days, followed by 1 tablet twice daily for 3 days &amp; then 1 tablet once daily as maintenance dose.</li>\r\n	<li><strong>Relapse of Internal Hemorrhoid &amp; Chronic Hemorrhoid</strong>: 1 tablet once daily for 3 months.</li>\r\n	<li><strong>Chronic venous insufficiency</strong>: 1 tablet once daily for 2-6 months.</li>\r\n	<li><strong>Leg Wounds</strong>: 1 tablet once daily for 2 months.</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>Tablet should be taken at meal times.</p>', '<p>No evidence of drug incompatibility (drug interaction) has been reported in clinical trials.</p>', '<p>Chronic venous insufficiency and its complications should be diagnosed and management monitored by a physician. It is contraindicated for anyone having a hypersensitivity to any ingredient in the product.</p>', '<p>Some cases of routine gastric disorders and neurovegetative disorders (feeling of discomfort) have been reported. In this cases discontinuation of treatment is not required.</p>', '<p>Experimental studies have not shown any teratogenic effect in animals. In human beings, no harmful effect has so far been reported. In the absence of data concerning excretion into breast milk, breast feeding is not recommended during treatment.</p>', '<p>If the hemorrhoidal symptoms do not disappear within 15 days, patient should ask doctor for advice. Diosmin (up to 900 mg/day) has been administered to a small number of breast cancer patients who were experiencing lymphedema following surgical and nodal irradiation treatment with resultant reduction of arm edema but no effect on the cancer. Animal studies and more than 20 years of clinical use in Europe have not found any evidence of carcinogenicity or mutagenicity when the components of Diosmin &amp; Hesperidin are used as recommended. As a precaution, Diosmin &amp; Hesperidin is not recommended for patients with a history of cancer since no specific studies have been performed in this population.</p>', NULL, '<p>Phlebotonic &amp; Vascular protecting preparation.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-10 16:35:36', '2022-03-10 16:35:36'),
(955, 955, '<p>Midazolam is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Short-term treatment of insomnia.</li>\r\n	<li>Sedation in premedication before surgical or diagnostic procedures.</li>\r\n</ul>', '<p>The actions of benzodiazepines such as midazolam are mediated through the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), which is one of the major inhibitory neurotransmitters in the central nervous system. Benzodiazepines increase the activity of GABA, thereby producing a sedating effect, relaxing skeletal muscles, and inducing sleep, anesthesia, and amnesia. Benzodiazepines bind to the benzodiazepine site on GABA-A receptors, which potentiates the effects of GABA by increasing the frequency of chloride channel opening. These receptors have been identified in different body tissues including the heart and skeletal muscle, although mainly appear to be present in the central nervous system.</p>', '<p>Oral dosage:</p>\r\n\r\n<ul>\r\n	<li><strong>For adults</strong>: 7.5-15 mg daily.</li>\r\n	<li><strong>In elderly and debilitated patients</strong>: The recommended dose is 7.5 mg.</li>\r\n	<li><strong>In premedication</strong>: 15 mg of Midazolam should be given 30-60 minutes before the procedure.</li>\r\n</ul>\r\n\r\n<p>Intravenous administration:</p>\r\n\r\n<ul>\r\n	<li><strong>Endoscopic or Cardiovascular Procedures</strong>: In healthy adults, the initial dose is approximately 2.5 mg. In cases of severe illness and in elderly patients, the initial dose must be reduced to 1 to 1.5 mg.</li>\r\n	<li><strong>Induction of Anesthesia</strong>: The dose is 10-15 mg.</li>\r\n</ul>\r\n\r\n<p>Intramuscular administration:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 0.07-0.1 mg/kg body weight. The usual dose is about 5 mg.</li>\r\n	<li><strong>Children</strong>: 0.15-0.20 mg/kg</li>\r\n	<li><strong>Elderly and debilitated patients</strong>: 0.025-0.05 mg/kg</li>\r\n</ul>\r\n\r\n<p>Rectal administration in children:</p>\r\n\r\n<ul>\r\n	<li><strong>For preoperative sedation</strong>: Rectal administration of the ampoule solution (0.35-0.45 mg/kg) 20-30 min. before induction of general anesthesia.</li>\r\n</ul>', '<p>Midazolam can enhance the central sedative effect of neuroleptics, tranquillizers, antidepressants, sleep-inducing drugs, analgesics, anaesthetics, antipsychotics, anxiolytics, antiepileptic drugs and sedative antihistamines.</p>', '<p>Midazolam must not be given to patients with severe respiratory insufficiency, severe hepatic insufficiency, myasthenia gravis, sleep apnea syndrome and with known hypersensitivity to benzodiazepines or to any component of the product</p>', '<p>At the start of therapy, drowsiness during daytime, confusion, fatigue, headache and muscle weakness may occur which usually disappear with repeated administration. Following parenteral (IV or IM) administration of Midazolam, fluctuations in vital signs have been noted including respiratory depression, apnea, variations in blood pressure and pulse rate.</p>', '<p>Midazolam should be avoided during pregnancy unless there is no safer alternative. Since Midazolam passes into breast milk, it should not be administered to breast-feeding mothers.</p>', '<p>Midazolam IV should be administered very slowly.</p>', '<p>Extreme overdosage may lead to coma, areflexia, cardiorespiratory depression and apnea. The effects of overdosage can be controlled with benzodiazepine antagonist flumazenil.</p>', '<p>Benzodiazepine hypnotics, Benzodiazepine sedatives.</p>', '<p>Protect from light and moisture, store in cool and dry place. Keep out of the reach of children.</p>', NULL, '2022-03-10 16:37:39', '2022-03-10 16:37:39'),
(956, 956, '<p>Mifepristone is indicated:</p>\r\n\r\n<ul>\r\n	<li>As a medical alternative to surgical termination of intra-uterine pregnancy</li>\r\n	<li>Softening and dilatation of the cervix uteri prior to surgical pregnancy termination</li>\r\n	<li>Preparation for the action of prostaglandin analogues in the termination of pregnancy for medical reasons</li>\r\n	<li>Labour induction for the expulsion of a dead fetus (fetal death in utero).</li>\r\n</ul>', '<p>Mifepristone is a synthetic steroid which blocks the effects of progesterone by competitively binding to the intracellular progesterone receptor. It sensitises the myometrium to the contraction-inducing action of prostaglandin. At higher doses, it blocks the effect of cortisol at the glucocorticoid receptor while increasing circulating cortisol concentrations.</p>', '<p><strong>As a medical alternative to surgical termination of intra-uterine pregnancy in early pregnancy</strong>: 600 mg Mifepristone in a single oral dose followed 36-48 hrs later, by the administration of a prostaglandin analogue Misoprostol 400 mcg orally (up to 49 days) or Gemeprost 1 mg vaginally (up to 63 days).&nbsp;<br />\r\n<br />\r\n<strong>Softening and dilatation of the cervix uteri prior to surgical pregnancy termination</strong>: 200 mg Mifepristone, followed 36-48 hrs later (but not beyond) by a surgical termination of pregnancy.&nbsp;<br />\r\n<br />\r\n<strong>Preparation for the action of prostaglandin analogues in the termination of pregnancy for medical reasons (to reduce the doses of prostaglandin)</strong>: 600 mg of Mifepristone taken in a single oral dose, 36-48 hrs prior to scheduled prostaglandin administration which will be repeated as often as indicated.&nbsp;<br />\r\n<br />\r\n<strong>Labour induction for expulsion of a dead fetus (fetal death in utero)</strong>: 600 mg of Mifepristone in a single oral daily dose for 2 consecutive days. Mifepristone alone leads to expulsion in about 60%. Labour should be induced by the usual methods if it has not started within 72 hrs following the first administration of Mifepristone.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>There are no precautions for timing in relation to food.</p>', '<p>ketoconazole, itraconazole, erythromycin and grapefruit juice may inhibit its metabolism (increasing serum levels of mifepristone). Furthermore, rifampicin, dexamethasone, St John&#39;s Wort and certain anticonvulsants (phenytoin, phenobarbital, carbamazepine) may induce mifepristone metabolism (lowering serum levels of Mifepristone).&nbsp;Based on invitro inhibition information, co-administration of mifepristone may lead to an increase in serum levels of drugs that are CYP3A4 substrates.<br />\r\n<br />\r\nLimited evidence suggests that co-administration of NSAIDs on the day of prostaglandin administration does not adversely influence the effects of Mifepristone or the prostaglandin on cervical ripening or uterine contractility and does not reduce the clinical efficacy of medical termination of pregnancy.</p>', '<p>Mifepristone must not be administered if there is doubt as to the existence or age of the pregnancy or if an extra-uterine pregnancy is suspected. An ultrasound scan and/or measurement of Beta-hCG must be performed before administration. For first trimester abortions, Mifepristone is contraindicated if the pregnancy is beyond 49 days of amenorrhoea when used with Misoprostol, or beyond 63 days of amenorrhoea when used with Gemeprost.&nbsp;Mifepristone should never be prescribed in patients with chronic adrenal failure, known allergy to Mifepristone or to any component of the product, severe asthma uncontrolled by corticosteroid therapy, porphyrias and renal failure, liver failure or malnutrition, or during breast feeding. Mifepristone is a lipophilic compound and may theoretically be excreted in the mother\\&#39;s breast milk, however no data is available.</p>', '<p>It is very common for women to experience uterine contractions or cramping (10-45%) in the hours following prostaglandin intake. Bleeding increases with gestational age. Heavy bleeding occurs in about 5% of cases and from 0-1.4% may require haemostatic curettage. Uterine rupture, hypotension, skin rashes, urticaria, hot flashes and dizziness have been uncommonly reported.</p>', '<p><strong>Pregnancy</strong>: Mifepristone is indicated for use in the termination of pregnancy (through 49 days&rsquo; pregnancy) and has no other approved indication for use during pregnancy.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether Mifepristone is excreted in human milk. Many hormones with a similar chemical structure, however, are excreted in breast milk. Since the effects of Mifepristone on infants are unknown, breast-feeding women should consult with their health care provider to decide if they should discard their breast milk for a few days following administration of the medications.</p>', '<p>Mifepristone is available only in single dose packaging. Administration must be under the supervision of a qualified physician. There are no data on the safety and efficacy of Mifepristone in women with chronic medical conditions such as cardiovascular, hypertensive, hepatic, respiratory or renal disease; insulin-dependent diabetes mellitus; severe anemia or heavy smoking. Women who are more than 35 years of age and who also smoke 10 or more cigarettes per day should be treated with caution because such patients were generally excluded from clinical trials of Mifepristone. Although there is no clinical evidence, the effectiveness of Mifepristone may be lower if Misoprostol is administered more than two days after Mifepristone administration.</p>', '<p>Single doses of Mifepristone up to 2 gm caused no unwanted reaction. In the event of massive ingestion, signs of adrenal failure might occur. Acute intoxication may require admission to hospital and if relevant treatment with dexamethasone.</p>', '<p>Drugs acting on the Uterus.</p>', '<p>Store at 25&deg; C.</p>', '<p><strong>Use in children</strong>: Safety and effectiveness in pediatric patients have not been established.</p>', '2022-03-10 16:40:19', '2022-03-10 16:40:19'),
(957, 957, '<p>This kit is indicated for early Menstrual Regulation (MR)/termination of pregnancy up to 9 weeks (63 days) of gestation.</p>', '<p>Mifepristone: Mifepristone is a synthetic steroid with anti-progestational activity results from competitive interaction with progesterone at progesterone-receptor sites. Based on studies with various oral doses in several animal species, the compound inhibits the activity of endogenous or exogenous progesterone and the Menstrual Regulation (MR) results. During pregnancy, the compound sensitizes the myometrium to the contraction-inducing activity of prostaglandins.<br />\r\n<br />\r\nMisoprostol: Misoprostol is a synthetic analogue of prostaglandin E1. It causes myometrial contraction by interacting with specific receptors on myometrial cells. This interaction results in a change in calcium concentration, thereby initiating muscle contraction. By interacting with prostaglandin receptors, Misoprostol causes the cervix to soften and the uterus to contract, resulting in the expulsion of the uterine contents.</p>', '<p>This can only be prescribed by qualified medical professionals who are able to assess the gestational age of an embryo and to diagnose ectopic pregnancies. The qualified medical professionals must also be able to provide surgical Intervention/MVA (Manual Vaccum Aspiration) in cases of incomplete abortion or severe bleeding or have made plans to provide such care through others and be able to assure patient access to medical facilities equipped to provide blood transfusions and resuscitation, if necessary.<br />\r\n<br />\r\n<strong>Day 1 (First visit)</strong>: Mifepristone administration: One tablet of Mifepristone (200 mg) is taken in a single oral dose under the supervision of a qualified medical professional in a clinic, medical office or hospital.<br />\r\n<br />\r\n<strong>Day 2 (Second visit)</strong>: Misoprostol administration: 24-48 hours after ingesting the Mifepristone tablet, the patient takes four 200 microgram tablets (800 micrograms) of Misoprostol buccally or sublingually. Misoprostol tablets can be administered by the patient herself (place two tablets on each side of cheeck &amp; gum or under the tongue). She should wait for 30 minutes. During the period immediately following the administration of Misoprostol, the patient may need medication for cramps or gastrointestinal symptoms. The patient should be given instructions on what to do if significant discomfort, excessive bleeding or other adverse reactions occur and should be given a phone number to call if she has questions following the administration of Misoprostol.<br />\r\n<br />\r\n<strong>Day 10 to 14 (Third visit)</strong>: Post-treatment examination: Patients must return to the clinic, medical office or hospital within 10 to 14 days after the administration of mifepristone. This visit is very important to confirm by clinical examination or ultrasonographic scan that a complete termination of pregnancy has occurred.<br />\r\n<br />\r\nPatients who have an ongoing pregnancy at this visit have a risk of fetal malformation resulting from the treatment. Surgical termination/MVA is recommended to manage Menstrual Regulation (MR)/termination of pregnancy failures.</p>', '<p>Mifepristone: Although specific drug or food interactions with Mifepristone have not been studied, on the basis of this drug&#39;s metabolism by CYP 3A4, it is possible that Ketoconazole, Itraconazole, Erythromycin and grapefruit juice may inhibit its metabolism (increasing serum levels of mifepristone).<br />\r\n<br />\r\nMisoprostol: Misoprostol has not been shown to interfere with the beneficial effects of aspirin on signs and symptoms of rheumatoid arthritis. Misoprostol does not exert clinically significant effects on the absorption,blood levels and antiplatelet effects of therapeutic doses of aspirin.</p>', '<p>Administration of Mifepristone is contraindicated in patients with any one of the following conditions: History of allergy or known hypersensitivity to Mifepristone, Misoprostol or other prostaglandin, confirmed or suspected ectopic pregnancy or undiagnosed adnexal mass (the treatment procedure will not be effective to terminate an ectopic pregnancy), IUD in place, chronic adrenal failure, haemorrhagic disorders or concurrent anticoagulant therapy, inherited porphyria, If a patient does not have adequate access to medical facilities equipped to provide emergency treatment of incomplete process, blood transfusions and emergency resuscitation during the period from the first visit until discharged by the administering physician.</p>', '<p>Mifepristone: The treatment procedure is designed to induce vaginal bleeding and uterine cramping necessary for Menstrual Regulation (MR). Commonly reported side effects were nausea, vomiting and diarrhoea. Pelvic pain, fainting, headache, dizziness, and asthenia occurred rarely.<br />\r\n<br />\r\nMisoprostol: Gastro-intestinal side-effects like diarrhoea, abdominal pain, nausea, flatulence, dyspepsia, headache, vomiting and constipation, shivering, hyperthermia, dizziness, pain due to uterine contractions, severe vaginal bleeding, shock, pelvic pain, uterine rupture (requiring surgical repair, hysterectomy and/or salpingo-oophorectomy).</p>', '<p>Pregnancy-&nbsp;<strong>Mifepristone</strong>: is indicated for Menstrual Regulation (MR) (through 63 days pregnancy) and has no other approved indication for use during pregnancy. Patients who have an ongoing pregnancy at the last visit have a risk of foetal malformation resulting from the treatment. Surgical termination is recommended to manage Menstrual Regulation (MR) treatment failures.<br />\r\n<br />\r\nLactation-</p>\r\n\r\n<ul>\r\n	<li><strong>Mifepristone</strong>: It is not known whether Mifepristone is excreted through human milk. Many hormones with a similar chemical structure, however, are excreted in breast milk. Since the effects of Mifepristone on infants are unknown, breast-feeding women should consult with their doctor to decide if they should discard their breast milk for a few days following administration of the medications.</li>\r\n	<li><strong>Misoprostol</strong>: Although it is not known whether Misoprostol or Misoprostol is excreted through human milk, Misoprostol should not be administered to nursing mothers because the potential excretion of misoprostol acid could cause diarrhoea in nursing infants.</li>\r\n</ul>', '<p>The patient should not give combination of Mifepristone &amp; Misoprostol to anyone else. The combination of Mifepristone &amp; Misoprostol has been prescribed for the patient&#39;s specific condition, it may not be the correct treatment for another person, and may be dangerous to the other person if she is or were to become pregnant. Any Intra Uterine Device [IUD] should be removed before treatment with Mifepristone begins. Menstrual Regulation (MR) by surgery is recommended in cases when combination of Mifepristone &amp; Misoprostol fails to cause Menstrual Regulation (MR). Patients who have an ongoing pregnancy at last visit have a risk of foetal malformation resulting from the treatment. Surgical termination/MVA is recommended to manage Menstrual Regulation (MR)/ termination of pregnancy failures.</p>', '<p>Mifepristone: No serious adverse reactions were reported in tolerance studies in healthy nonpregnant female and healthy male subjects where Mifepristone was administered in single doses greater than threefold of 600mg for Menstrual Regulation (MR). If a patient ingests a massive overdose, she should be observed closely for signs of adrenal failure.<br />\r\n<br />\r\nMisoprostol: Clinical signs that may indicate an overdose are a sedation, tremor, convulsions, dyspnea, abdominal pain, diarrhoea, fever, palpitations, hypotension or bradycardia. Symptoms should be treated with supportive therapy. However, because Misoprostol is metabolized like a fatty acid, it is unlikely that dialysis would be the appropriate treatment for overdosage.</p>', '<p>Drugs acting on the Uterus, Prostaglandin analogues.</p>', '<p>Store in a cool and dry place, protected from light.</p>', '<p>Use in Patients with Hepatic Impairment: Patients with hepatic disease should receive a decreased dose of Misoprostol.<br />\r\n<br />\r\nUse in Patients with Renal Impairment: No routine dosage adjustment is recommended of Misoprostol in older patients or patients with renal impairment but the dosage may need to be reduced if the usual dose is not tolerated.</p>', '2022-03-10 16:42:35', '2022-03-10 16:42:35'),
(958, 958, '<p>Miglitol is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2&nbsp;diabetes mellitus.</p>', '<p>Miglitol reversibly inhibits membrane-bound intestinal &alpha;-glucosidase enzymes which hydrolyse oligosaccharides and disaccharides to glucose and other monosaccharides in the small intestinal brush border. It delays carbohydrate breakdown, glucose absorption and reduces postprandial hyperglycaemia.</p>', '<p>There is no fixed dosage regimen for the management of&nbsp;diabetes&nbsp;mellitus with Miglitol Tablets or any other pharmacologic agent. Dosage of Miglitol must be individualized on the basis of both effectiveness and tolerance while not exceeding the maximum recommended dosage of 100 mg 3 times daily. Miglitol should be taken three times daily at the start of each main meal. Miglitol should be started at 25 mg, and the dosage gradually increased both to reduce&nbsp;gastrointestinaladverse effects and to permit identification of the minimum dose required for adequate glycemic control of the patient. During treatment initiation and dose titration one-hour&nbsp;postprandial&nbsp;plasma glucose may be used to determine the therapeutic response to Miglitol and identify the minimum&nbsp;effective dose&nbsp;for the patient.<br />\r\n<br />\r\nThereafter,&nbsp;glycosylated hemoglobin&nbsp;should be measured at intervals of approximately 3 months. The therapeutic goal should be to decrease both postprandial plasma glucose and glycosylated&nbsp;hemoglobin&nbsp;levels to normal or near normal by using the lowest effective dose of Miglitol, either as monotherapy or in combination with a&nbsp;sulfonylurea.<br />\r\n<br />\r\n<strong>Initial Dosage</strong>: The recommended starting dosage of Miglitol is 25 mg, given orally three times daily at the start of each main meal. However, some patients may benefit by starting at 25 mg once daily to minimize gastrointestinal adverse effects, and gradually increasing the frequency of administration to 3 times daily.<br />\r\n<br />\r\n<strong>Maintenance Dosage</strong>: The usual maintenance dose of Miglitol is 50 mg taken 3 times daily, although some patients may benefit from increasing the dose to 100 mg 3 times daily. To allow adaptation to potential gastrointestinal adverse effects, it is recommended that Miglitol therapy be initiated at a dosage of 25 mg 3 times daily, then gradually titrated upward to allow adaptation. After 4 to 8 weeks of the 25 mg 3 times daily regimen, the dosage should be increased to 50 mg 3 times daily for approximately three months, following which a glycosylated hemoglobin level should be measured to assess therapeutic response. If at that time, the glycosylated hemoglobin level is not satisfactory, the dosage may be further increased to 100 mg 3 times daily, the maximum recommended dosage.<br />\r\n<br />\r\n<strong>Maximum Dosage</strong>: The maximum recommended dosage of Miglitol is 100 mg 3 times daily. In one clinical trial, 200 mg 3 times daily gave additional improved glycemic control but increased the incidence of the gastrointestinal symptoms described above.<br />\r\n<br />\r\n<strong>Patients Receiving Sulfonylureas</strong>: Sulfonylurea agents may cause&nbsp;hypoglycemia. There was no increased incidence of hypoglycemia in patients who took Miglitol in combination with sulfonylurea agents compared to the incidence of hypoglycemia in patients receiving sulfonylureas alone in any clinical trial. However, Miglitol given in combination with a sulfonylurea will cause a further lowering of&nbsp;blood glucose&nbsp;and may increase the risk of hypoglycemia due to the additive effects of the two agents. If hypoglycemia occurs, appropriate adjustments in the dosage of these agents should be made</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken with food. Take with 1st bite of each main meal.</p>', '<p>Concomitant use with insulin increases the risk of hypoglycaemia. Intestinal adsorbents (e.g. charcoal) and carbohydrate-splitting digestive enzyme supplements (e.g. amylase, pancreatin) may reduce glycaemic effects. May significantly reduce the bioavailability of ranitidine and propranolol.</p>', '<p>Patient with diabetic ketoacidosis, inflammatory bowel disease, colonic ulceration, partial intestinal obstruction or predisposition to this condition, chronic intestinal diseases associated with marked disorders of digestion or absorption and co-existing conditions that may deteriorate as a result of increased intestinal gas formation.</p>', '<p>Abdominal pain or discomfort, diarrhoea, flatulence, skin rash.</p>', '<p><strong>Category B</strong>: Either animal-reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (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>Patient exposed to stress (e.g. fever, trauma, infection, surgery). Renal impairment. Pregnancy and lactation.</p>', NULL, '<p>Alpha-Glucosidase inhibitor.</p>', '<p>Store at 25&deg; C.</p>', NULL, '2022-03-10 16:45:13', '2022-03-10 16:45:13'),
(959, 959, '<p>Milnacipran is indicated for the management of&nbsp;fibromyalgia. Milnacipran is not approved for use in pediatric patients.</p>', '<p>Milnacipran is a potent inhibitor of neuronal norepinephrine and serotonin reuptake. It inhibits norepinephrine uptake with approx 3-fold higher potency in vitro than serotonin with directly affecting the uptake of dopamine or other neurotransmitters.</p>', '<p>The recommended dose of Milnacipran&nbsp;is 100 mg/day (50 mg twice daily). Based on efficacy and tolerability dosing may be titrated according to the following schedule:<br />\r\n<br />\r\n<strong>Day 1</strong>:&nbsp;12.5 mg once<br />\r\n<strong>Days 2-3</strong>:&nbsp;25 mg/day (12.5 mg twice daily)<br />\r\n<strong>Days 4-7</strong>:&nbsp;50 mg/day (25 mg twice daily)<br />\r\n<strong>After Day 7</strong>:&nbsp;100 mg/day (50 mg twice daily)<br />\r\n<br />\r\nBased on individual patient response, the dose may be increased to 200 mg/day (100 mg twice daily). Doses above 200 mg/day have not been studied.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken with food. Preferably taken during meals.</p>', '<p>Increased risk of bleeding with aspirin, NSAIDs, warfarin and other drugs that affect coagulation. Increased CNS effects with centrally-acting drugs (e.g. clomipramine). Increased risk of serotonin syndrome and NMS-like reactions with serotonergic drugs (e.g. tramadol), SSRIs, other selective serotonin-norepinephrine reuptake inhibitors, 5-HT1 receptor agonists (e.g. sumatriptan), antipsychotic agents and other dopamine antagonists. May inhibit antihypertensive effect of clonidine. May potentiate adverse haemodynamic effects with digoxin. Paroxysmal HTN and cardiac arrhythmia may occur when taken concurrently with epinephrine or norepinephrine.</p>', '<p>Uncontrolled narrow-angle glaucoma. Concomitant use with MAOI or within 2 wk after withdrawal of MAOI.</p>', '<p>Increased heart rate, HTN, increased liver enzymes, severe liver injury, hyponatraemia, abnormal bleeding, dysuria, mydriasis, nausea, vomiting, constipation, headache, insomnia, dizziness, hot flushes, hyperhidrosis, palpitations, dry mouth, migraine.</p>', '<p><strong>Pregnancy</strong>: Patients should be advised to notify their physician if they become pregnant or intend to become pregnant during Milnacipran&nbsp;therapy. Patients should be encouraged to enroll in the Milnacipran&nbsp;Pregnancy Registry if they become pregnant, preferably before any&nbsp;prenatal&nbsp;testing is done. This registry is collecting information about the safety of milnacipran during pregnancy.&nbsp;<br />\r\n<br />\r\n<strong>Nursing</strong>: Advise patients to notify their physician if they are&nbsp;breast feeding.</p>', '<p>Patient with major depressive disorder or other psychiatric disorders, history of dysuria, controlled narrow-angle glaucoma, pre-existing HTN, tachyarrhythmias or other CV disease, history of seizure disorder or condition predisposing to seizures (e.g. brain damage, alcoholism). Avoid abrupt withdrawal. Severe hepatic and moderate to severe renal impairment including ESRD. Pregnancy and lactation.</p>', '<p><strong>Symptoms</strong>: Increased BP, cardio-resp arrest, changes in the level of consciousness (ranging from somnolence to coma), confusional state, dizziness, and increased hepatic enzymes.<br />\r\n<br />\r\n<strong>Management</strong>: Symptomatic treatment with gastric lavage and activated charcoal. Maintain adequate airway, oxygenation and ventilation and monitor cardiac rhythm and vital signs. May give cyproheptadine with adequate temp control to treat serotonin syndrome.</p>', '<p>Serotonin-norepinephrine reuptake inhibitor (SNRI)</p>', '<p>Store at 25&deg; C.</p>', '<p><strong>Renal Impairment</strong>: Severe (CrCl 5-29 mL/min): 25 mg bid, may increase to 50 mg bid according to response.<br />\r\n<br />\r\n<strong>End stage renal disease (ESRD)</strong>: Not recommended.<br />\r\n<br />\r\n<strong>Pediatric use</strong>: Safety and effectiveness of Milnacipran in a fibromyalgia pediatric population below the age of 18 have not been established.&nbsp;The use of Milnacipran is not recommended in pediatric patients.</p>\r\n\r\n<p>&nbsp;</p>', '2022-03-10 16:47:50', '2022-03-10 16:47:50'),
(960, 960, '<p>Miltefosine is an antileishmanial drug indicated in adults and adolescents &ge;12 years of age weighing &ge;30 kg (66 lbs) for treatment of:</p>\r\n\r\n<ul>\r\n	<li>Visceral leishmaniasis due to Leishmania donovani.</li>\r\n	<li>Cutaneous leishmaniasis due to Leishmania braziliensis, Leishmania guyanensis, and Leishmania panamensis.</li>\r\n	<li>Mucosal leishmaniasis due to Leishmania braziliensis.</li>\r\n</ul>', '<p>Miltefosine has demonstrated activity against Leishmania parasites and neoplastic cells primarily due to its effects on apoptosis and disturbance of lipid-dependent cell signalling pathways. Several potential antileishmanial mechanisms of action have been proposed, however no mechanism has been identified definitely. Within the mitochondria, miltefosine inhibits cytochrome-c oxidase leading to mitochondrial dysfunction and apoptosis-like cell death. Antineoplastic mechanisms of action are related to antileishmanial targets and include inhibition of phosphatidylcholine biosynthesis and inhibition of Akt (also known as protein kinase B), which is a crucial protein within the PI3K/Akt/mTOR intracellular signalling pathway involved in regulating the cell cycle. Animal studies also suggest it may be effective against Trypanosome cruzi (the organism responsible for Chagas&#39; disease), metronidazole-resistant strains of Trichonomas vaginalis, and it may have broad-spectrum anti-fungal activity.</p>', '<p>Administer with food to ameliorate gastrointestinal adverse reactions.</p>\r\n\r\n<ul>\r\n	<li><strong>30 to 44 kg</strong>: one 50 mg capsule twice daily for 28 consecutive days.</li>\r\n	<li><strong>45 kg or greater</strong>: one 50 mg capsule three times daily for 28 consecutive days.</li>\r\n</ul>', '<ul>\r\n	<li>Miltefosine did not inhibit human cytochrome P450 enzymes in vitro.</li>\r\n	<li>Miltefosine did not induce cytochrome 3A activity in rats.</li>\r\n</ul>', NULL, '<p>Adverse reactions occurring in &ge;2% of patients include nausea, vomiting, diarrhea, headache, decreased appetite, dizziness, abdominal pain, pruritus, somnolence, elevated transaminases, and elevated creatinine.</p>', '<p><strong>Pregnancy</strong>: Miltefosine should not be used during pregnancy. Obtain a urine or serum pregnancy test in females of reproductive potential prior to prescribing.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: Discontinue drug or nursing depending on the importance of drug to the mother. Avoid breastfeeding for 5 months after Miltefosine therapy.<br />\r\n<br />\r\n<strong>Females and Males of Reproductive Potential</strong>: Advise females to use effective contraception during therapy and for 5 months after therapy. Advise patients of reproductive toxicities in animals, and that the potential for impaired fertility in humans has not been adequately evaluated</p>', '<ul>\r\n	<li>Embryo-Fetal Toxicity. Do not use in pregnant women. Obtain a urine or serum pregnancy test prior to initiation of therapy. Advise use of effective contraception in females of reproductive potential.</li>\r\n	<li>Reproductive effects. Miltefosine caused testicular atrophy and impaired fertility in male rats and impaired fertility in female rats. Advise patients of reproductive toxicities in animal studies and that the potential effects on human fertility have not been adequately evaluated.</li>\r\n	<li>Renal Effects. Monitor serum creatinine during therapy and for 4 weeks after end of therapy.</li>\r\n	<li>Hepatic Effects. Monitor transaminases and bilirubin during therapy.</li>\r\n	<li>Gastrointestinal Effects. Encourage fluid intake.</li>\r\n	<li>Thrombocytopenia. Monitor platelet count during therapy for visceral leishmaniasis.</li>\r\n	<li>Absorption of Oral Contraceptives. Advise use of alternative method of contraception if vomiting and/or diarrhea occur.</li>\r\n	<li>Stevens-Johnson syndrome. Discontinue miltefosine.</li>\r\n</ul>', NULL, '<p>Leishmaniacides.</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 16:49:45', '2022-03-10 16:49:45'),
(961, 961, '<p>Minocycline is indicated for oral administration, for the treatment of infections caused by tetracycline sensitive organisms and some tetracycline resistant strains of staphylococci. Indications include: Acne, skin and soft tissue infections, ophthamological infections, acute and chronic bronchitis, bronchiectasis, lung abscess, ear, nose and throat infections, pelvic inflammatory disease, nocardiosis, urinary tract infections, gonorrhoea, non-gonococcal urethritis and prostatitis. Minocycline may also be used in prophylactic treatment of asymptomatic meningococcal carriers. Also indicated in pre- and post-operative prophylaxis of infection.</p>', NULL, '<ul>\r\n	<li><strong>Routine antibiotic use</strong>: 200 mg daily in divided doses</li>\r\n	<li><strong>Acne</strong>: 50 mg twice daily for at least 6 weeks.</li>\r\n	<li><strong>Gonorrhoea</strong>: Males: 200 mg initially followed by 100 mg every 12 hours for a minimum of 4 days. Post therapy cultures within 2-3 days. Females: May require a more prolonged therapy.</li>\r\n	<li><strong>Prophylaxis of asymptomatic meningococcal carriers</strong>: 100 mg twice daily for 5 days, followed by treatment with rifampicin.</li>\r\n</ul>\r\n\r\n<p>If, after six months, there is no satisfactory response minocycline should be discontinued and other therapies considered. If minocycline is to be continued for longer than six months, patients should be monitored at least three monthly intervals thereafter for signs and symptoms of hepatitis or SLE.</p>', '<p><strong>Anticoagulants</strong>: Plasma prothrombin activity is depressed by tetracyclines. Reduced doses of any concomitant anticoagulants may be necessary.<br />\r\n<strong>ACE inhibitors, antacids and adsorbants</strong>: Tetracyclines bind to di-/tri-valent cations. Absorption from the gastrointestinal tract is impaired by the concomitant administration of iron, calcium, aluminium, magnesium, bismuth and zinc salt (interactions with specified salts, antacids, kaolin, bismuth containing ulcer-healing drugs, quinapril which contains a magnesium carbonate excipient). Dosages should be maximally separated. Absorption of tetracyclines is not significantly impaired by food, milk and milk products.<br />\r\n<strong>Diuretics</strong>: Diuretics may aggravate nephrotoxicity by volume depletion.<br />\r\n<strong>Antibacterials</strong>: Minocycline should not be used with penicillins.<br />\r\n<strong>Ergotamine and ergometrine</strong>: There is an increased risk of ergotism.<br />\r\nOral contraceptives: Both can induce hyperpigmentation.<br />\r\n<strong>Retinoids</strong>: Administration of isotretinoin should be avoided shortly before, during and shortly after minocycline therapy.</p>', '<p>Minocycline is contraindicated in patients with hypersensitivity to tetracyclines, systemic lupus erythematosus, pregnancy, lactation, complete renal failure and children under 12 years.</p>', '<p>Reported side effects are oral and anogenital candidiasis, vulvovaginitis, eosinophilia, leucopenia, neutropenia, thrombocytopenia, haemolytic anaemia, pancytopenia, agranulocytosis, anaphylaxis, anaphylactoid reaction, hypersensitivity, pulmonary infiltrates, anaphylactoid purpura, polyarthritisnodosa, abnormal thyroid function, brown-black discolouration of the thyroid, anorexia, dizziness, headache, hypaesthesia, paraesthesia, intracranial hypertension, vertigo, Bulging fontanelle, convulsions, sedation, impaired hearing, tinnitus, myocarditis, pericarditis, cough, dyspnoea, bronchospasm, exacerbation of asthma, pulmonary eosinophilia, pneumonitis, diarrhoea, nausea, stomatitis, discolouration of teeth, vomiting, dyspepsia, dysphagia, enamel hypoplasia, enterocolitis, oesophagitis, oesophageal ulceration, glossitis, pancreatitis, pseudomembranous colitis, increased liver enzymes, hepatitis, autoimmune hepatotoxicity, hepatic cholestatis, hepatic failure, hyperbilirubinemia, jaundice, autoimmune hepatitis, alopecia, erythema multiforme, erythema nodosum, fixed drug eruption, hyperpigmentation of the skin, photosensitivity, pruritis, rash, urticaria, vasculitis, angioedema, exfoliative dermatitis, hyperpigmentation of nails, Stevens-Johnson syndrome, toxic epidermal necrolysis, Drug reaction with eosinophilia and systemic symptoms (DRESS), arthralgia, lupus-like syndrome, myalgia, arthritis, bone discolouration, cases of systemic lupus erythematous (SLE), joint stiffness, joint swelling, increased serum urea, acute renal failure, interstitial nephritis, balanitis, fever, etc. In some cases involving these syndromes, death has been reported.<br />\r\n<br />\r\nHyperpigmentation of various body sites including the skin, nails, teeth, oral mucosa, bones, thyroid, eyes (including sclera and conjunctiva), breast milk, lacrimal secretions and perspiration has been reported. This blue/black/grey or muddy-brown discolouration may be localised or diffuse. The most frequently reported site is in the skin. Pigmentation is often reversible on discontinuation of the drug, although it may take several months or may persist in some cases. The generalised muddy-brown skin pigmentation may persist, particularly in areas exposed to the sun.</p>', '<p>Minocycline use during pregnancy and lactation is contraindicated. Animal studies have indicated that tetracyclines cross the placenta. Tetracyclines have been found in foetal tissues and can have toxic effects on the developing foetus (related to retardation of skeletal development). Studies on animals treated during early pregnancy also indicate embryotoxicity. The use of tetracyclines during the last half of pregnancy, when the teeth are developing, may cause permanent discolouration of teeth (more common with long term or repeated short term use). Enamel hypoplasia has also been reported. Tetracyclines have been detected in the milk of lactating women. Permanent tooth discolouration may occur in the developing infant and enamel hypoplasia has been reported.</p>', '<p><strong>Breathing difficulties</strong>: Cases of breathing difficulties including dyspnoea, bronchospasm, exacerbation of asthma, pulmonary eosinophilia and pneumonitis have been reported with minocycline use. If patients develop breathing difficulties they should seek urgent medical advice and minocycline should be discontinued.<br />\r\n<br />\r\n<strong>Paediatric population</strong>: All tetracyclines form a stable calcium complex in any bone forming tissue. An increase in the fibula growth rate has been observed in premature babies administered oral tetracyclines. Tetracyclines are known to cause a yellow to brown discoloration of the teeth and enamel hypoplasia in the developing child or foetus.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Minocycline should be used with caution in patients with hepatic dysfunction or in conjunction with potentially hepatotoxic drugs, including alcohol.<br />\r\n<br />\r\n<strong>Auto-immune disorders</strong>: Rare cases of auto-immune hepatotoxicity and isolated cases of systemic lupus erythematosus (SLE) have been reported. If patients develop signs or symptoms of SLE or hepatotoxicity, minocycline should be discontinued.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: Studies indicate there is no significant drug accumulation in patients with mild to moderate renal impairment when treated with the recommended dosages of minocycline. In cases of severe renal impairment a reduction of dosage and monitoring of renal function may be required.<br />\r\n<br />\r\n<strong>Cross-sensitivities</strong>: Micro-organisms can develop cross resistance to tetracyclines and patients can develop cross sensitivity. Minocycline should be discontinued there are signs/symptoms of overgrowth of resistant organisms.<br />\r\n<br />\r\n<strong>Intracranial hypertension</strong>: As with other tetracyclines, bulging fontanelles in infants and benign intracranial hypertension in juveniles and adults have been reported. Presenting features were headache and visual disturbances including blurring of vision, scotoma and diplopia. Permanent vision loss has been reported. Treatment should cease if evidence of raised intracranial pressure develops.<br />\r\n<br />\r\n<strong>Hyperpigmentation</strong>: As with other tetracyclines, minocycline may cause hyperpigmentation at various body sites. Hyperpigmentation may present regardless of dose or duration of therapy but develops more commonly during long term treatment. Patients should be advised to report any unusual pigmentation without delay and minocycline should be discontinued.<br />\r\n<br />\r\n<strong>Photosensitivity</strong>: Tetracyclines are known to cause photosensitivity reactions. Such patients should be warned to avoid direct exposure to natural or artificial sunlight and to discontinue therapy at the first sign of skin discomfort.</p>', '<p>Dizziness, nausea and vomiting are the adverse effects most commonly seen in overdose. Gastric lavage plus appropriate supportive treatment. Antacids and calcium salts will reduce absorption of minocycline but there is no specific antidote. Minocycline is not removed in significant quantities by haemodialysis or peritoneal dialysis.</p>', '<p>Tetracycline group of drugs.</p>', '<p>Store in a cool and dry place, protected from light, store below 25&deg;C.</p>', '<p><strong>Renal impairment</strong>: As adults even in cases of mild to moderate renal impairment. However, caution is advised in patients with severe renal impairment.<br />\r\n<strong>Paediatric population</strong>: Minocycline is not recommended in children under 12 years. Children over 12 years: 50mg every 12 hours.</p>', '2022-03-10 16:56:15', '2022-03-10 16:56:15');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(962, 962, '<p>Minoxidil is indicated in the treatment of androgenic alopecia in males and females and stabilisation of hair loss in patients with androgenic alopecia, and also of alopecia areata.</p>', '<p>Minoxidil stimulates hair growth by increasing oxygen, blood and nutrients supply to the hair follicle by widening blood vessels and inhibiting androgen hormone to affect hair follicles.<br />\r\n<br />\r\nFollowing topical application, an average of about 1.4% of the total applied dose is absorbed from the normal intact scalp. Topical Minoxidil absorption is increased by increasing the&nbsp; dose applied, increasing the frequency of dosing and decreasing the barrier function of the stratum corneum. Serum Minoxidil levels and systemic effects resulting from the administration of topical Minoxidil are governed by the drug&rsquo;s absorption rate through the skin. Following cessation of topical dosing, approximately 95% of the systemically absorbed drug is eliminated within 4 days. Minoxidil and its metabolites are excreted principally in the urine.</p>', '<p>Minoxidil topical solution is for external use only and should be applied when the hair and scalp are clean and dry. Apply 1 ml (7 sprays) of Minoxidil topical solution twice daily at 12-hour intervals to the scalp, beginning at the centre of the affected area and spreading the solution out to cover the entire affected area. The total daily application dose should not exceed 2 ml.<br />\r\n<br />\r\nFor the best results, Minoxidil topical solution should be allowed to remain on the scalp for about 4 hours before washing. The night-time application should be done 2-4 hours before going to bed to allow the solution to dry out. Minoxidil topical solution should not be massaged into the scalp, but applied lightly. A hair dryer should not be used to speed up the drying of the solution as it may decrease the effectiveness. Minoxidil topical solution should not be mixed with any hair oil. The drug should not be used more than two times a day, or be taken orally or applied to any other part of the body to avoid the risk of adverse effects and unwanted hair growth. More frequent use or longer application time have no effect on hair growth. In case of missing any daily applications of Minoxidil topical solution, the patient should continue with the next application.<br />\r\n<br />\r\nHands should be washed immediately if Minoxidil topical solution is applied with the fingertips. Clinical experience with Minoxidil indicates that twice-daily applications for 4 months or more may be required before there is evidence of hair growth. To arrest&nbsp;hair fall, Minoxidil topical solution should be used for not less than 45 days. Depending upon the severity of hair loss or type and extent of baldness, particular strength of Minoxidil topical solution may be selected.</p>', '<p>Minoxidil topical solution should not be used along with other topical agents known to alter the stratum corneum barrier such as tretinoin or dithranol, due to the enhanced absorption of Minoxidil. Although there is no clinical evidence, there exists the theoretical possibility of absorbed Minoxidil potentiating orthostatic hypotension caused by peripheral vasodilators.</p>', '<ul>\r\n	<li>Patients with cardiac abnormalities</li>\r\n	<li>Children below 18 years of age</li>\r\n	<li>Patients using occlusive dressings or other medicines on the scalp</li>\r\n	<li>Patients with red, inflamed infection, or irritated or painful scalp (including psoriasis &amp; sunburn)</li>\r\n</ul>', '<p>Commonly encountered side effects in clinical trials with Minoxidil topical solution were minor dermatological reactions. Dermatitis or hypertrichosis may occur. These incidences may occur in 0.1&ndash;5% of patients.</p>', '<p>Minoxidil topical solution should not be used during pregnancy and lactation.</p>', '<p>Minoxidil topical solution is more likely to cause scalp irritation. If scalp irritation continues or worsen, use of Minoxidil topical solution should be stopped.</p>', '<p>Increased systemic absorption of Minoxidil may potentially occur if higher-than-recommended doses of Minoxidil are applied to larger surface areas of the body or areas other than the scalp. There are no known cases of Minoxidil overdosage resulting from topical administration of Minoxidil.<br />\r\n<br />\r\nSigns and symptoms of Minoxidil overdosage would primarily be cardiovascular effects associated with sodium and water retention, and tachycardia. Fluid retention can be managed with appropriate diuretic therapy. Clinically significant tachycardia can be controlled by administration of a beta-adrenergic blocking agent.</p>', '<p>Other scalp preparations.</p>', '<p>Store at a cool and dry place, protected from light. Keep out of the reach of the children.</p>', NULL, '2022-03-10 16:58:41', '2022-03-10 16:58:41'),
(963, 963, '<p>Mirabegron is indicated for the symptomatic treatment of urgency, increased micturition frequency and urgency incontinence as may occur in adult patients with overactive bladder (OAB) syndrome.</p>', '<p>Mirabegron is the first beta-3 adrenoceptor agonist. Mirabegron exerts its effect via a dual mechanism, both directly acts on the bladder smooth muscle and also via the sensory nervous system, it increases the levels of cyclic adenosine monophosphate (cyclic AMP) and leads to relaxation of the detrusor smooth muscle during storage phase of urinary bladder fill-void cycle by activation of beta-3 adrenoceptor which increase bladder capacity.</p>', '<p><strong>Adults including elderly</strong>: The recommended starting dose is Mirabegron 25 mg tablet once daily with or without food. Based on individual patient efficacy and tolerability the dose may be increased to Mirabegron 50 mg tablet once daily.<br />\r\n<br />\r\n<strong>Renal or hepatic impairment</strong>:</p>\r\n\r\n<ul>\r\n	<li>Patients with severe renal impairment (ClCr 15 to 29 mL/min or eGFR 15 to 29 mL/min/1.73 m2) or moderate hepatic impairment (Child-Pugh Class B), the daily dose of Mirabegron should not exceed 25 mg tablet once daily.</li>\r\n	<li>Mirabegron has not been studied in patients with end stage renal disease (GFR &lt;15 mL/min/1.73 m2 or patients requiring haemodialysis) or severe hepatic impairment (Child Pugh Class C) and it is therefore not recommended for use in these patient populations.</li>\r\n</ul>\r\n\r\n<p><strong>Gender</strong>: No dose adjustment is necessary according to gender.<br />\r\n<br />\r\n<strong>Paediatric population</strong>: The safety and efficacy of Mirabegron in children below 18 years of age have not yet been established.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Mirabegron tablet is to be taken once daily, with liquids, swallowed whole and is not to be chewed, divided, or crushed.</p>', '<p><strong>Effect of enzyme inhibitors</strong>: Mirabegron exposure (AUC) was increased 1.8-fold in the presence of the strong inhibitor of CYP3A/P-gp ketoconazole in healthy volunteers. No dose adjustment is needed when Mirabegron is combined with inhibitors of CYP3A and/or P-gp. However, in patients with mild to moderate renal impairment or mild hepatic impairment concomitantly receiving strong CYP3A inhibitors, such as itraconazole, ketoconazole, ritonavir and clarithromycin, the recommended dose is 25 mg once daily with or without food. Mirabegron is not recommended in patients with severe renal impairment or patients with moderate hepatic impairment concomitantly receiving strong CYP3A inhibitors.<br />\r\n<br />\r\n<strong>Effect of enzyme inducers</strong>: Substances that are inducers of CYP3A or P-gp decrease the plasma concentrations of Mirabegron. No dose adjustment is needed for Mirabegron when administered with therapeutic doses of rifampicin or other CYP3A or P-gp inducers.<br />\r\n<br />\r\n<strong>Effect of Mirabegron on CYP2D6 substrates</strong>: In healthy volunteers, the inhibitory potency of Mirabegron towards CYP2D6 is moderate and the CYP2D6 activity recovers within 15 days after discontinuation of Mirabegron. Multiple once daily dosing of Mirabegron IR resulted in a 90% increase in Cmax and a 229% increase in AUC of a single dose of metoprolol. Multiple once daily dosing of Mirabegron resulted in a 79% increase in Cmax and a 241% increase in AUC of a single dose of desipramine. Caution is advised if Mirabegron is co-administered with medicinal products with a narrow therapeutic index and significantly metabolised by CYP2D6, such as thioridazine, Type 1 C antiarrhythmics (e.g., flecainide, propafenone) and tricyclic antidepressants (e.g., imipramine, desipramine). Caution is also advised if Mirabegron is co-administered with CYP2D6 substrates that are individually dose titrated.<br />\r\n<br />\r\n<strong>Effect of Mirabegron on transporters</strong>: Mirabegron is a weak inhibitor of P-gp. Mirabegron increased Cmax and AUC by 29% and 27%, respectively, of the P-gp substrate digoxin in healthy volunteers. For patients who are initiating a combination of Mirabegron and digoxin, the lowest dose for digoxin should be prescribed initially. Serum digoxin concentrations should be monitored and used for titration of the digoxin dose to obtain the desired clinical effect.<br />\r\n<br />\r\n<strong>Other interactions</strong>: No clinically relevant interactions have been observed when Mirabegron was co-administered with therapeutic doses of solifenacin, tamsulosin, warfarin, metformin or a combined oral contraceptive medicinal product containing ethinylestradiol and levonorgestrel. Dose-adjustment is not recommended.</p>', '<p>Mirabegron is contraindicated in patients with hypersensitivity to the active substance or to any of the excipients and severe uncontrolled hypertension defined as systolic blood pressure 180 mm Hg and/or diastolic blood pressure 110 mm Hg.</p>', '<p>The most common side effects reported for patients treated with Mirabegron 50 mg during the three 12-week phase 3 double blind, placebo controlled studies are tachycardia and urinary tract infections. The frequency of tachycardia was 1.2% in patients receiving Mirabegron 50 mg. Tachycardia led to discontinuation in 0.1% patients receiving Mirabegron 50 mg. The frequency of urinary tract infections was 2.9% in patients receiving Mirabegron 50 mg. Urinary tract infections led to discontinuation in none of the patients receiving Mirabegron 50 mg. Serious adverse reactions included atrial fibrillation (0.2%).</p>', '<p>There are limited amount of data from the use of Mirabegron in pregnant women. Studies in animals have shown reproductive toxicity. Mirabegron is not recommended during pregnancy and in women is planning to be pregnant. Mirabegron is excreted in the milk of rodents and therefore is predicted to be present in human milk. No studies have been conducted to assess the impact of Mirabegron on milk production in humans, its presence in human breast milk, or its effects on the breast-fed child. Mirabegron should not be administered during breast-feeding. There were no treatment-related effects of Mirabegron on fertility in animals. The effect of Mirabegron on human fertility has not been established.</p>', '<p><strong>Renal impairment</strong>: Mirabegron has not been studied in patients with end stage renal disease (GFR &lt;15 mL/min/1.73 m2 or patients requiring haemodialysis) and therefore, it is not recommended for use in this patient population. Data are limited in patients with severe renal impairment (GFR 15 to 29 mL/min/1.73 m2); based on a pharmacokinetic study a dose reduction to 25 mg is recommended in this population. Mirabegron is not recommended for use in patients with severe renal impairment (GFR 15 to 29 mL/min/1.73 m2) concomitantly receiving strong CYP3A inhibitors.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Mirabegron has not been studied in patients with severe hepatic impairment (Child-Pugh Class C) and, therefore, it is not recommended for use in this patient population. Mirabegron is not recommended for use in patients with moderate hepatic impairment (Child-Pugh Class B) concomitantly receiving strong CYP3A inhibitors.<br />\r\n<br />\r\n<strong>Hypertension</strong>: Mirabegron can increase blood pressure. Blood pressure should be measured at baseline and periodically during treatment with Mirabegron, especially in hypertensive patients. Data are limited in patients with stage 2 hypertension (systolic blood pressure 160 mm Hg or diastolic blood pressure 100 mm Hg).<br />\r\n<br />\r\n<strong>Patients with congenital or acquired QT prolongation</strong>: Caution should be exercised when administering Mirabegron in patients with congenital or acquired QT prolongation.<br />\r\n<br />\r\n<strong>Patients with bladder outlet obstruction and patients taking antimuscarinics medications for OAB</strong>: A controlled clinical safety study in patients with bladder outlet obstruction (BOO) did not demonstrate increased urinary retention in patients treated with Mirabegron; however, Mirabegron should be administered with caution to patients with clinically significant bladder outlet obstruction. Mirabegron should also be administered with caution to patients taking antimuscarinic medications for the treatment of OAB.</p>', '<p>Mirabegron has been administered to healthy volunteers at single doses up to 400 mg. At this dose, adverse events reported included palpitations and increased pulse rate exceeding 100 beats per minute (bpm). Multiple doses of Mirabegron up to 300 mg daily for 10 days showed increases in pulse rate and systolic blood pressure when administered to healthy volunteers. Treatment for overdose should be symptomatic and supportive. In the event of overdose, pulse rate, blood pressure, and ECG monitoring is recommended.</p>', '<p>BPH/ Urinary retention/ Urinary incontinence.</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-10 17:01:04', '2022-03-10 17:01:04'),
(964, 964, '<p>Mirtazapine Tablets are indicated for the treatment of major depressive disorder (MDD).</p>', '<p><strong>Pharmacodynamics</strong>: The mechanism of action of Mirtazapine as with other drugs effective in the treatment of major depressive disorder is unknown. Evidence gathered in preclinical studies suggests that Mirtazapine enhances central noradrenergic and serotonergic activity. These studies have shown that Mirtazapine acts as an antagonist at central presynaptic &alpha;2-adrenergic inhibitory autoreceptors and heteroreceptors, an action that is postulated to result in an increase in central noradrenergic and serotonergic activity. Mirtazapine is a potent antagonist of 5- HT2&nbsp;and 5-HT3&nbsp;receptors. Mirtazapine has no significant affinity for the 5-HT1A&nbsp;and 5-HT1B&nbsp;receptors. Mirtazapine is a potent antagonist of histamine (H1) receptors, a property that may explain its prominent sedative effects. Mirtazapine is a moderate peripheral &alpha;1-adrenergic antagonist, a property that may explain the occasional orthostatic hypotension reported in association with its use. Mirtazapine is a moderate antagonist at muscarinic receptors, a property that may explain the relatively low incidence of anticholinergic side effects associated with its use.<br />\r\n<br />\r\n<strong>Pharmacokinetics</strong>: After oral administration of Mirtazapine tablets, the active constituent mirtazapine is rapidly and well-absorbed, reaching peak plasma levels after about 2 hours. Binding of mirtazapine to plasma proteins is approximately 85%. The mean half-life of elimination is 20-40 hours; (26 hours in males, 37 hours in females). The half-life of elimination is sufficient to justify once-a-day dosing. Mirtazapine displays linear pharmacokinetics within the recommended dose range. Mirtazapine is extensively metabolized and eliminated via the urine and faeces four days. Major pathways of biotransformation are demethylation and oxidation followed by conjugation.</p>', '<p><strong>Adult dose</strong>: The recommended starting dose for Mirtazapine&nbsp;tablets is 15 mg/day, administered in a single dose, preferably in the evening or prior to sleep. The effective dose range was generally 15 to 45 mg/day and the patients not responding to the initial 15 mg dose may benefit from dose increases up to a 30 mg to maximum of 45 mg/day. Mirtazapine has an elimination half-life of approximately 20 to 40 hours; therefore, dose changes should be made at intervals of less than 1 to 2 weeks in order to allow sufficient time for the therapeutic response to a given dose.<br />\r\n<br />\r\n<strong>Use in children</strong>: Use in children are not recommended to Mirtazapine.<br />\r\n<br />\r\n<strong>Missed Dose</strong>: If anyone misses a dose of mirtazapine, take it as soon as remember unless it is close to when the next dose is due. If anyone missed a dose of medication and it is close to the time of next dose, skip the missed dose and should take next dose at the regularly scheduled time. One should not take double or more than prescribed dose.</p>', '<p>Mirtazapine has clinically significant drug-drug interactions with Monoamine Oxidase Inhibitors (MAOI) &amp; other serotonergic drugs such as tryptophan, triptans, linezolid, serotonin reuptake inhibitors, venlafaxine, lithium, tramadol, or St. John&#39;s wort. Mirtazapine may interrupt the metabolism or activity of Carbamazepine, Phenytoin or Cimetidine. Patient should avoid Alcohol &amp; Diazepam while taking Mirtazapine.</p>', '<p><strong>Hypersensitivity</strong>: Mirtazapine is contraindicated in patients with a known hypersensitivity to Mirtazapine or to any of the excipients.<br />\r\n<br />\r\n<strong>Monoamine Oxidase Inhibitors</strong>: The concomitant use of Mirtazapine and a monoamine oxidase (MAO) inhibitor is contraindicated. Mirtazapine should not be used within 14 days of initiating or discontinuing therapy with a monoamine oxidase inhibitor (MAOI).</p>', '<p>The most common side effects of Mirtazapine are dizziness, drowsiness, dry mouth, increased appetite, weight gain etc.</p>', '<p>Pregnancy Category-C. Patients should be advised to notify their physician if they become pregnant or intend to become pregnant during Mirtazapine therapy. Patients should be advised to notify their physician if they are breastfeeding an infant.</p>', '<p>Patients, their families, and their caregivers should be encouraged to be alert to the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment and when the dose is adjusted up or down. Patients who are to receive Mirtazapine should be warned about the risk of developing agranulocytosis. Mirtazapine may impair judgment, thinking, and particularly, motor skills, because of its prominent sedative effect. Clinically significant ALT (SGPT) elevations (&ge;3 times the upper limit of the normal range) may occur.</p>', NULL, '<p>Atypical anti-depressant drugs.</p>', '<p>Keep away from light and moisture. Store below 30&ordm; C. Keep all medicine out of the reach of children.</p>', NULL, '2022-03-10 17:04:09', '2022-03-10 17:04:09'),
(965, 965, '<p>Misoprostol is indicated for-</p>\r\n\r\n<ul>\r\n	<li>Prophylaxis of gastric and duodenal ulceration in NSAID users at high risk of complications from gastric ulcer e.g. the elderly, patients with concomitant debilitating disease and patients with a history of ulcer.</li>\r\n	<li>Healing of established NSAID- induced gastric and duodenal damage.</li>\r\n	<li>Healing of gastric and duodenal ulcers in the absence of NSAID therapy.</li>\r\n	<li>Induction of labor.</li>\r\n	<li>Prevention and treatment of postpartum hemorrhage.</li>\r\n</ul>', '<p>Misoprostol is extensively absorbed, and undergoes rapid de-esterification to its free acid, which is responsible for its clinical activity and, unlike the parent compound, is detectable in plasma. Maximum plasma concentrations of Misoprostol acid are diminished when the dose is taken with food and total availability of Misoprostol acid is reduced by use of concomitant antacid. Misoprostol has both antisecretory (inhibiting gastric acid secretion) and (in animals) mucosal protective properties. NSAIDs inhibit prostaglandin synthesis, and a deficiency of prostaglandins within the gastric mucosa may lead to diminishing bicarbonate and mucus secretion and may contribute to the mucosal damage caused by these agents. Misoprostol can increase bicarbonate and mucus production, but in man this has been shown at doses 200 meg and above that are also antisecretory. It is therefore not possible to tell whether the ability of Misoprostol to reduce the risk of gastric ulcer is the result of its antisecretory effect, its mucosal protective effect, or both.</p>', '<p><strong>Benign gastric and duodenal ulceration and NSAID associated ulceration</strong>: 800 mcg daily (in 2-4 divided doses) with breakfast or main meals and at bedtime; treatment should be continued for at least 4 weeks and may be continued for up to 8 weeks if required.<br />\r\n<br />\r\n<strong>Prophylaxis of NSAID-induced gastric and duodenal ulcer</strong>: 200 mcg 2-4 times daily taken with NSAID. If this dose cannot be tolerated, a dose of 100 mcg can be used. Misoprostol should be taken for the duration of NSAID therapy as prescribed by the physician.<br />\r\n<br />\r\n<strong>Induction of labor</strong>: Place 25 mcg in the posterior fornix of the vagina. Repeat after every 6 hours if necessary until the maximum dosage of 200 mcg total misoprostol is reached. Fetal heart rate and uterus contractions should be monitored. Alternatively, 100 mcg taken orally. If cervical ripening or active labor does not occur, repeated dose of 100-200 mcg of oral misoprostol is given every 4 hourly until labor is established (as evidenced by a Bishop score of 7 or more). Maximum number of dose is 6. Maternal vital signs, fetal heart rate and contractions should be monitored. Oxytocin can be started 4 hours after last dose of misoprostol. Physician should be notified for signs of fetal distress or tetanic uterine contractions. Oral misoprostol therapy should be monitored by Physician.<br />\r\n<br />\r\n<strong>Prevention of postpartum hemorrhage</strong>: 600 mcg orally immediately following delivery.<br />\r\n<br />\r\n<strong>Treatment of postpartum hemorrhage</strong>: 600 mcg orally or 1000 mcg per rectally.</p>', '<p>There is no evidence of clinically significant interaction between Misoprostol and cardiac, pulmonary, CNS drugs and NSAID&#39;s. The bioavailability&nbsp;of Misoprostol is decreased with high doses of antacid.</p>', '<p>Misoprostol is contraindicated to anyone with a history of allergy to prostaglandins and it is also contraindicated in pregnancy.</p>', '<p>Generally, Misoprostol is well tolerated. The most frequent adverse effects associated with Misoprostol therapy involve the GI tract such as diarrhea, abdominal pain, dyspepsia, flatulence, nausea, vomiting, rashes and dizziness. The incidence of diarrhea may be minimized by administering the drug after meal and at bedtime and by avoiding concomitant administration with a magnesium-containing or other laxative antacid.</p>', '<p>Because of the abortifacient property of the Misoprostol component, it is contraindicated in women who are pregnant. It should not be used in women of childbearing potential unless the patient requires nonsteroidal anti-inflammatory drug (NSAID) therapy and is at high risk of developing gastric or duodenal ulceration or for developing complications from gastric or duodenal ulcers associated with the use of the NSAID. In such patients, it may be prescribed if the patient:</p>\r\n\r\n<ul>\r\n	<li>has had a negative serum pregnancy test within 2 weeks prior to beginning therapy.</li>\r\n	<li>is capable of complying with effective contraceptive measures.</li>\r\n	<li>has received both oral and written warnings of the hazards of Misoprostol, the risk of possible contraception failure, and the danger to other women of childbearing potential should the drug be taken by mistake.</li>\r\n	<li>will begin it only on the second or third day of the next normal menstrual period.</li>\r\n</ul>\r\n\r\n<p>Excretion of the active metabolite (Misoprostol acid) into milk is possible but has not been studied. Because of the potential for serious adverse reactions in nursing infants, it is not recommended for use by nursing mothers.</p>', '<p><strong>In case of prevention and treatment of NSAID induced gastric and duodenal ulcer</strong>: Misoprostol is contraindicated in women who are pregnant, and should not be used in women of child bearing potential unless the patient requires NSAID therapy. Women of child bearing potential should be told that they must not be pregnant when Misoprostol therapy is initiated and they must use an effective contraception method while taking misoprostol.<br />\r\n<br />\r\n<strong>In case of induction of labor</strong>: The pregnancy should have completed 38 weeks gestation by reliable dating, or lung maturity as evidenced by a L/S &gt;2.0 or a positive phosphotidyl glycerol test, or completed 36 weeks gestation with a maternal or fetal medical indication for induction of labor. Induction of labor is contraindicated in acute fetal distress, abruptio placenta, placenta previa or unexplained vaginal bleeding. The fetus should be in vertex presentation.</p>', '<p>The toxic dose of Misoprostol in human has not been determined. Clinical signs that may indicate an overdose are a sedation, tremor, convulsions, dyspnea, abdominal pain, diarrhea and fever. Symptoms should be treated with supportive therapy.</p>', '<p>Drugs acting on the Uterus, Prostaglandin analogues.</p>', '<p>Store in a cool and dry place, protected from light and moisture. Keep out of the reach of the children.</p>', '<p>Use in children: Safety and effectiveness of Misoprostol in children below the age of 18 years have not been established.</p>', '2022-03-10 17:06:30', '2022-03-10 17:06:30'),
(966, 966, '<p>This&nbsp;is indicated in Diabetic foot infections; Chronic lymphatic leukaemia; Chronic myelogenous leukaemia; Gastric, Colorectal, Lung, Pancreatic, Cervix, Endometrium, Breast, Bladder, Head &amp; neck carcinoma.</p>', '<p>Mitomycin is an antineoplastic antibiotic which is enzymatically reduced to its active metabolite within susceptible cells. The active metabolite appears to cause cross-linking of DNA (primarily with guanine and cytosine pairs). It is also active against gm+ve bacteria and some viruses.</p>', '<p><strong>Solid tumours Suggested regimen</strong>: Initial: 10-20 mg/m2; may repeat 6-8 wkly depending on blood count. Do not repeat if leucocyte and platelet counts are below acceptable levels. Do not re-administer if the nadir of the leucocyte count is &lt;2,000 cells/mm3<br />\r\n<br />\r\n<strong>Intravesical Superficial bladder tumours</strong>: Instill 10-40 mg 1 -3 times/wk for a total of 20 doses<br />\r\n<br />\r\n<strong>Prevention of recurrent bladder tumours</strong>: Instill 20 mg 2 wkly or 40 mg 1-3-mthly.</p>', '<p>Increased incidence of cardiotoxicity with doxorubicin.</p>', '<p>Hypersensitivity. Patient with platelet counts &lt;100,000/mm3, leukocyte counts &lt;4,000/mm3 or serum creatinine concentration &gt;1.7 mg/dL. Patient with substantial prolongation of prothrombin time or bleeding time, coagulation disorders, increased bleeding tendency. Pregnancy and lactation.</p>', '<p>Hemolytic uremic syndrome (&lt;15%), Myelosuppression (64%), Nausea/ vomiting (14%), Fever (14%), Stomatitis (4%), Increased serum creatinine (2%), Mucous membrane toxicity (4%) , Fatigue, Pulmonary toxicity, Dyspnea, Cystitis, Interstitial fibrosis, Nephrotoxicity, Amenorrhea, Alopecia,&nbsp;Myelosuppression, haemolytic-uraemic syndrome.</p>', '<p>Pregnancy category- D.</p>', '<p>Repeated haematologic studies are necessary during treatment and for at least 7 wk after discontinuation of the drug. Discontinue use when the leucocyte count decreases to &lt;4000/mm3&nbsp;or the platelet count decreases to &lt;150,000/mm3&nbsp;or if a progressive decline in either occurs. Monitor patient for signs of renal or pulmonary toxicity.</p>', NULL, '<p>Cytotoxic Chemotherapy.</p>', '<p><strong>Powder for injection</strong>: Store between 15-30&deg;C. Protect from light.<br />\r\n<br />\r\n<strong>Reconstituted solution</strong>: Stable for 1 wk when stored between 15-25&deg;C and 2 wk when stored between 2-8&deg;C.</p>', NULL, '2022-03-10 17:08:19', '2022-03-10 17:08:19'),
(967, 967, '<p>Mizolastine is indicated for the symptomatic relief of the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Seasonal allergic rhinoconjunctivitis (hay fever)</li>\r\n	<li>Perennial allergic rhinoconjunctivitis</li>\r\n	<li>Urticaria</li>\r\n</ul>', '<p>Mizolastine, a non-sedating antihistamine, blocks histamine H1-receptors on effector cells of the GI tract, blood vessels and respiratory tract. It also has mast-cell stabilising properties.</p>', '<p><strong>Adult and children above 12 years</strong>: The usual recommended dose is one 10 mg tablet daily.<br />\r\n<strong>Children below 12 years</strong>: Not recommended.</p>', '<p>Systemically administered Ketoconazole and Erythromycin, antiarrythmics e.g. Amiodarone moderately increase the plasma concentration of Mizolastine. This could increase the risk of arrythmias. Concurrent use of other potent inhibitor of the cytochrome P 450 3A4 enzyme e.g. Ciclosporin should be approached with caution. No potentiation of the sedation and the alteration in performance caused by alcohol with Mizolastine has been observed.</p>', '<p>Mizolastine is contra-indicated in patients with clinically significant cardiac disease or a history of symptomatic arrhythmias and in patients with known or suspected QT prolongation, patients with electrolyte imbalance (particularly hypokalaemia), and in those with clinically significant bradycardia. It is also contra-indicated in patients taking other drugs that decrease its metabolism, patients with significantly impaired liver function, and in patients who are hypersensitive to the drug.</p>', '<p>Mizolastine is well tolerated in the recommended doses. The usual side effects are dry mouth, diarrhoea, abdominal pain, nausea, drowsiness, headache, dizziness, raised liver enzymes, hypotension, tachycardia and palpitations. Bronchospasm and aggravation of asthma were reported, but in view of the high frequency of asthma in the treated patient population, a causality relationship remains uncertain.</p>', '<p>The safety of Mizolastine for use in human pregnancy has not been established. The evaluation of experimental animal studies does not indicate direct or indirect harmful effects with respect to the development of the embryo or foetus, the course of gestation and peri and post-natal development. Mizolastine should be avoided in pregnancy (particularly the 1 st trimester). Mizolastine is excreted into breast milk, therefore it is not recommended during lactation.</p>', '<p>Patients should be warned that a small number of individuals may experience sedation. It is therefore advisable to determine individual response before driving or performing complicated task.</p>', '<p>In cases of overdosage, general symptomatic surveillance with cardiac monitoring including QT interval and cardiac rhythm for at least 24 hours is recommended, along with standard measures to remove any unabsorbed drug. Studies in patients with renal insufficiency suggest that haemodialysis does not increase clearance of the drug.</p>', '<p>Non-sedating antihistamines.</p>', '<p>Store in a cool &amp; dry place. Protect from light. It should be kept out of the reach of children.</p>', NULL, '2022-03-10 17:10:16', '2022-03-10 17:10:16'),
(968, 968, '<p>Molnupiravir is an antiviral medicine used to treat mild to moderate C0VID-19 (caused by SARS-CoV-2) in adults who are at risk for developing severe illness. Molnupiravir may help people with C0VID-19 stay out of the hospital and feel better. Emergency use authorized oral therapeutic for the treatment of C0VID-19 in Non-hospitalized patients with mild or moderate disease.<br />\r\n<br />\r\n<strong>Asymptomatic or pre-symptomatic Infection</strong>: Individuals who test positive for SARS-CoV-2 by virologic testing using a molecular diagnostic (e.g., polymerase chain reaction) or antigen test, but have no symptoms.<br />\r\n<br />\r\n<strong>Mild illness</strong>: individuals who have any of the various signs and symptoms of COVID-19 (e.g., fever, cough, sore throat, malaise, headache, muscle pain) without shortness of breath, dyspnoea, or abnormal chest imaging.<br />\r\n<br />\r\n<strong>Moderate illness</strong>: Individuals who have evidence of lower respiratory disease by clinical assessment or imaging and saturation of oxygen (Sp02) &gt;94% on room air at sea level.<br />\r\n<br />\r\n<strong>Severe illness</strong>: Individuals who have respiratory frequency &gt;30 breaths per minute, Sp02 &lt;94% on room air at sea level, ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (Pa02/Fi02) &lt;300 mmHg, or lung infiltrates &gt;50%.<br />\r\n<br />\r\n<strong>Critical illness</strong>: individuals who have respiratory failure, septic shock, and/or multiple organ dysfunction.</p>', '<p>Molnupiravir inhibits viral reproduction by promoting widespread mutations in the replication of viral RNA by RNA-directed RNA polymerase. It is metabolized into a ribonucleoside analog that resembles cytidine, &beta;-D-N 4-Hydroxycytidine 5&prime;-triphosphate (also called EIDD-1931 5&prime;-triphosphate or NHC-TP). During replication, the virus&#39;s enzyme incorporates NHC-TP into newly-made RNA instead of using real cytidine.<br />\r\n<br />\r\nMolnupiravir can swap between two forms (tautomers), one of which mimics cytidine (C) and the other of which mimics uridine (U). NHC-TP is not recognized as an error by the virus&#39; proofreading exonuclease enzymes, which can replace mutated nucleotides with corrected versions. When the viral RNA polymerase attempts to copy RNA containing molnupiravir, it sometimes interprets it as C and sometimes as U. This causes more mutations in all downstream copies than the virus can survive, an effect called viral error catastrophe or lethal mutagenesis.</p>', '<p>The recommended dose of Molnupiravir is four 200 mg capsules (4+0+4), every 12 hours for 5 days. Do not give this medicine to children and adolescents aged less than 18 years. The use of Molnupiravir in persons aged less than 18 years has not yet been studied.</p>', '<p>No drug interactions have been identified based on the limited available data. No clinical interaction studies have been performed with Molnupiravir. Molnupiravir is hydrolysed to n-hydroxycytidine (NHC) prior to reaching systemic circulation. Uptake of NHC and metabolism to NHC-TP are mediated by the same pathways involved in endogenous pyrimidine metabolism. NHC is not a substrate of major drug metabolising enzymes or transporters. Based on in vitro studies, neither molnupiravir nor NHC are inhibitors or inducers of major drug metabolising enzymes or inhibitors of major drug transporters. Therefore, the potential for molnupiravir or NHC to interact with concomitant medications is considered unlikely.</p>', '<p>Molnupiravir is contraindicated in patients with known hypersensitivity to Molnupiravir.</p>', '<p>Common side effects include diarrhoea, nausea, feeling dizzy, headache.</p>', '<p>Animal studies with molnupiravir have shown harmful effects to the unborn animal. Molnupiravir is not recommended in pregnancy. Molnupiravir has not been studied in pregnancy and it is not known if Molnupiravir will harm your baby while you are pregnant. If you are pregnant, think you may be pregnant, or are planning to have a baby, ask your doctor for advice. If you can become pregnant, you should use effective birth control while you are taking Molnupiravir and for 4 days after the last dose of Molnupiravir. If you are breast-feeding or are planning to breastfeed, tell your doctor before taking this medicine. Breast-feeding is not recommended during treatment and for 4 days after the last dose of Molnupiravir. This is because it is not known if Molnupiravir gets into breast milk and will be passed to the baby.</p>', '<p>There are limited clinical data available for Molnupiravir. Serious and unexpected adverse events may occur that have not been previously reported with Molnupiravir use.</p>', NULL, NULL, '<p>Store at or below 25&deg;C temperature. Keep away from light and wet places. Keep out of reach of children.</p>', NULL, '2022-03-10 17:12:14', '2022-03-10 17:12:14'),
(969, 969, '<p>Mometasone Furoate is indicated for the maintenance treatment of asthma as prophylactic therapy in patients 4 years of age and older. It is not indicated for the relief of acute bronchospasm. It is not indicated in children less than 4 years of age.</p>', '<p>Mometasone is a corticosteroid demonstrating anti-inflammatory properties. The precise mechanism of corticosteroids action on allergic rhinitis is not known. Corticosteroids have been shown to have a wide range of effects on multiple cell types (e.g., mast cells, eosinophils, neutrophils, macrophages, and lymphocytes) and mediators (e.g., histamine, eicosanoids, leukotrienes, and cytokines) involved in inflammation.</p>', '<p>Recommended Dosages in Patients 4 Years of Age and Older.<br />\r\n<br />\r\n<strong>Previous Therapy</strong>: Patients &ge; 12 years who received bronchodilators alone&nbsp;</p>\r\n\r\n<ul>\r\n	<li><strong>Recommended Starting Dose:&nbsp;</strong>220 &micro;g once daily in the evening</li>\r\n	<li><strong>Highest Recommended Daily:</strong>&nbsp;220 &micro;g twice daily or as 440 &micro;g once daily</li>\r\n</ul>\r\n\r\n<p><strong>Previous Therapy</strong>: Patients &ge; 12 years who received inhaled corticosteroids</p>\r\n\r\n<ul>\r\n	<li><strong>Recommended Starting Dose:&nbsp;</strong>220 &micro;g once daily</li>\r\n	<li><strong>Highest Recommended Daily:&nbsp;</strong>440 &micro;g once daily or 440 &micro;g twice daily.</li>\r\n</ul>\r\n\r\n<p><strong>Previous Therapy</strong>: Patients &ge; 12 years who received oral corticosteroids</p>\r\n\r\n<ul>\r\n	<li><strong>Recommended Starting Dose:&nbsp;</strong>4400 &micro;g once daily</li>\r\n	<li><strong>Highest Recommended Daily:</strong>&nbsp;440 &micro;g once daily or 440 &micro;g twice daily.</li>\r\n</ul>', '<p>Ketoconazole, a strong inhibitor of cytochrome P4503A4 may increase plasma levels of Mometasone Furoate during concomitant dosing.</p>', '<p>Hypersensitivity to any of the ingredients of this preparation contraindicates its use. Mometasone Furoate therapy is contraindicated in the primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required.</p>', '<p>Generally side effects are mild like headache, viral infection, sore throat, nosebleeds and coughing. Systemic and local corticosteroid use may result few side effects like candida infection, immunosuppression, hypercorticism, adrenal suppression, growth effects, glaucoma and cataracts.</p>', '<p><strong>Pregnancy</strong>: There are no adequate and well-controlled studies in pregnant women. Mometasone Furoate, like other corticosteroids should be used during pregnancy only if the potential benefits justify the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known if Mometasone Furoate is excreted in human milk. Since other corticosteroids are excreted in human milk, caution should be used when Mometasone Furoate is administered to nursing women.</p>', '<p>Use with caution in active or inactive tuberculosis infection, herpes simplex virus infection of the eye, untreated infections affecting the body as a whole etc.</p>', '<p>There are no data available on the effects of acute or chronic over dosage with Mometasone Furoate. Because of low systemic bioavailability and an absence of acute drug-related systemic findings in clinical studies, overdose is unlikely to require any therapy other than observation.</p>', '<p>Corticosteroid, Respiratory corticosteroids.</p>', '<p>Protect from light, store in cool &amp; dry place. Do not store above 30&deg; C. Keep out of the reach of children. Protect from freezing. Insert the Inhalation Capsule or ConviCap in the ConviHaler just prior to use to protect from deterioration by moisture.</p>', NULL, '2022-03-10 17:14:11', '2022-03-10 17:14:11'),
(970, 970, '<p>Mometasone Furoate Nasal Spray is indicated for the treatment of the nasal symptoms of seasonal and perennial allergic rhinitis, in adults and pediatric patients 2 years of age and older. It is indicated for the prophylaxis of the nasal symptoms of seasonal allergic rhinitis in adult and adolescent patients 12 years and older. It is also indicated for the treatment of nasal polyps in patients 18 years and older.</p>', '<p>Mometasone Furoate monohydrate is a corticosteroid demonstrating antiinflammatory properties. The precise mechanism of corticosteroid action on allergic rhinitis is not known. Corticosteroids have been shown to have a wide range of effects on multiple cell types (eg, mast cells, eosinophils, neutrophils, macrophages, and lymphocytes) and mediators (eg, histamines, eicosanoids, leukotrienes, and cytokines) involved in inflammation. Protein binding for Mometasone Furoate was reported to be 98% to 99% in concentration range of 5 to 500 ng/mL.The effective plasma elimination half life of Mometasone Furoate is 5.8 hours.</p>', '<p>Allergic Rhinitis-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and Children 12 Years of Age and Older</strong>: The recommended dose for prophylaxis and treatment of the nasal symptoms of seasonal allergic rhinitis and treatment of the nasal symptoms of perennial allergic rhinitis is two sprays (50 mcg of Mometasone Furoate in each spray) in each nostril once daily (total daily dose of 100 mcg). In patients with a known seasonal allergen that precipitates nasal symptoms of seasonal allergic rhinitis, prophylaxis with Mometasone Nasal Spray, 50 mcg (200 mcg/day) isrecommended 2 to 4 weeks prior to the anticipated start of the pollen season.</li>\r\n	<li><strong>Children 2 to 11 Years of Age</strong>: The recommended dose fortreatment ofthe nasalsymptoms of seasonal and perennial allergic rhinitis is one spray (50 mcg of Mometasone Furoate in each spray) in each nostril once daily (total daily dose of 100 mcg).</li>\r\n</ul>\r\n\r\n<p>Nasal Polyps Adults-</p>\r\n\r\n<ul>\r\n	<li><strong>18 years of Age and Older</strong>: The recommended dose for nasal polyps is two sprays (50 mcg of Mometasone Furoate in each spray) in each nostril twice daily (total daily dose of 400 mcg). A dose of two sprays (50 mcg of mometasone furoate in each spray) in each nostril once daily (total daily dose of 200 mcg) is also effective in some patients.</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>There are no drug interactions of note with Mometasone Furoate.</p>', '<p>Hypersensitivity to any of the ingredients of this preparation contraindicates its use.</p>', '<p>Side effects are generally mild and included headache, viral infection, sore throat, nosebleeds, and coughing.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. Mometasone Furoate, like other corticosteroids, should be used during pregnancy only if the potential benefits justify the potential risk to the fetus. It is not known if Mometasone Furoate is excreted in human milk. Because other corticosteroids are excreted in human milk, caution should be used when Mometasone is administered to nursing women.</p>', '<p>While using nasal corticosteroids, caution is required in patients with active or dormant tuberculous infection, or in untreated fungal, bacterial, systemic viral infections, or ocular herpes simplex.</p>', '<p>There are no data available on the effects of acute or chronic overdosage with Mometasone. Because of low systemic bioavailability, and an absence of acute drugrelated systemic findings in clinical studies, overdose is unlikely to require any therapy other than observation.</p>', '<p>Nasal Steroid Preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-10 17:16:39', '2022-03-10 17:16:39'),
(971, 971, '<p>Mometasone cream is indicated for the relief of inflammatory and pruritic manifestations of corticosteroid- responsive dermatoses, such as psoriasis and atopic dermatitis.</p>', '<p>Mometasone is a corticosteroid demonstrating anti-inflammatory properties. The precise mechanism of corticosteroids action on allergic rhinitis is not known. Corticosteroids have been shown to have a wide range of effects on multiple cell types (e.g., mast cells, eosinophils, neutrophils, macrophages, and lymphocytes) and mediators (e.g., histamine, eicosanoids, leukotrienes, and cytokines) involved in inflammation.</p>', '<p>A thin film of Mometasone Furoate cream should be applied to the affected skin areas once daily.&nbsp;Safety and effectiveness in paediatric patients below 2 years of age have not been established.</p>', NULL, '<p>The drug is contraindicated in individuals with a history of sensitivity reactions to Mometasone or any of the components of the preparation.</p>', '<p>Mometasone Furoate cream is generally well tolerated. Burning, Pruritus and skin atrophy may occur.</p>', '<p><strong>Pregnancy</strong>: There is no adequate and well-controlled studies in pregnant women.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether this drug passes into breast milk.</p>', '<p>If irritation develops with the use of Mometasone Furoate cream, treatment should be discontinued.</p>', NULL, '<p>Other Topical corticosteroids.</p>', NULL, NULL, '2022-03-10 17:18:31', '2022-03-10 17:18:31');
