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
(804, 804, '<p>Ketotifen&nbsp;eye drop is indicated for the treatment of signs &amp; symptoms (itchy, watery, red &amp; swollen eyes and eyelids) of allergic conjunctivitis including vernal kerato-conjunctivitis, vernal-keratitis, blepharitis, blepharo-conjunctivitis, and giant papillary conjunctivitis.</p>', '<p>Ketotifen is a potent anti-allergic substance possessing a powerful and sustained non-competitive histamine (H1) receptor blocking property. Ketotifen inhibits the release of mediators (e.g histamine, leukotrienes and prostaglandins) from cells responsible for type-(I) allergic reactions. Ketotifen also stabilizes mast cells, decreases chemotaxis, activation of degranulation of eosinophils.</p>', '<p><strong>Adults and children 3 years and older</strong>: 1 drop in the affected eye(s) twice daily, every 8-12 hours, not more than twice per day.<br />\r\n<br />\r\n<strong>Children under 3 years of age</strong>: Consult with a doctor.</p>', '<p>If Ketotifen eye drops is used concomitantly with other eye medications there must be an interval of at least 5 minutes between the two medications.</p>', '<p>Hypersensitivity to Ketotifen or any of the components</p>', '<p>Common side effects are burning, stinging, punctate corneal epithelial erosion, Blurring of vision upon drug instillation, dry eyes, eyelid disorder, conjunctivitis, eye pain, photophobia, subconjunctival haemorrhage.</p>', '<p>There are no adequate data from the use of ketotifen eye drops in pregnant women. Systemic levels after ocular administration are much lower than after oral use. Caution should be exercised when prescribing to pregnant women. Although animal data following oral administration show excretion into breast milk, topical administration to humans is unlikely to produce detectable quantities in breast milk. ketotifen 0.25% eye drops can be used during lactation.</p>', '<p>The formulation of Ketotifen 0.025% eye drops contains benzalkonium chloride as a preservative, which may be deposited in soft contact lenses; therefore this eye drops should not be instilled while the patient is wearing lenses. The lenses should be removed before application of the drops and not reinserted earlier than 15 minutes after use.</p>', '<p>No case of overdose has been reported. Oral ingestion of the contents of a 5 ml bottle would be equivalent to 1.25 mg of Ketotifen which is 60% of a recommended oral daily dose for a 3 years old child. Clinical results have shown no serious signs or symptoms after oral ingestion of up to 20 mg of Ketotifen.</p>', '<p>Ophthalmic Non-Steroid drugs.</p>', '<p>Store in a cool and dry place protected from light and moisture. Keep out of reach of children. Do not touch the dropper tip to any surface since this may contaminate the solution. Do not use after 30 days of first opening.</p>', NULL, '2022-03-07 21:43:50', '2022-03-07 21:43:50'),
(805, 805, '<p>Ketotifen is indicated in the following conditions-</p>\r\n\r\n<ul>\r\n	<li>For the prophylactic treatment of bronchial asthma.</li>\r\n	<li>Symptomatic treatment of allergic conditions including rhinitis and conjunctivitis.</li>\r\n	<li>For alleviating the complications of itching, pain and tenderness associated with neurofibroma.</li>\r\n	<li>Symptomatic treatment of allergy such as hayfever, urticaria.</li>\r\n</ul>', '<p>Ketotifen has anti-allergic properties and has been used similarly, to sodium chromoglycate in the prophylactic treatment of asthma. It also has the properties of an antihistamine. Ketotifen possesses marked anti-anaphylactic properties and is effective in preventing an asthmatic attacks. Ketotifen exerts as sustained inhibitory effect on histamine reactions, which can be clearly dissociated from its anti-anaphylactic properties. Experimental investigations in asthmatic subjects have shown that Ketotifen is as effective orally as a selective mast cell stabilizer administered by inhalation. Antihistamines were ineffective in those tests. The effectiveness of Ketotifen has been studied in long-term clinical trials. Asthma attacks were reduced in number, severity and duration and in some cases, the patients were completely freed from attacks. Progressive reduction of corticosteroids and/or bronchodilators was also possible. The prophylactic activity of Ketotifen may take several weeks to become fully established. Ketotifen will not abort established attacks of asthma.</p>', '<p><strong>Adults</strong>: 1 mg twice daily with food. If necessary the dose may be increased to 2 mg twice daily in severe cases.<br />\r\n<br />\r\n<strong>Children above 3 years</strong>: 1 mg twice daily with food. Patients known to be easily sedated should begin treatment with 0.5 to 1 mg at night for the first few days or as directed by the physician.<br />\r\n<br />\r\n<strong>Use in elderly</strong>: Same as adult dose or as advised by the physician.</p>', '<p>Ketotifen may potentiate the effects of sedatives, hypnotics, antihistamines and alcohols. A reversible fall in the platelet count has been observed in a few patients receiving Tifen concomitantly with oral antidiabetic agents and it has been suggested that this combination should therefore be avoided.</p>', '<p>A reversible fall in the platelet count has been observed in a few patients receiving Ketotifen concomitantly with oral antidiabetic agent and it has been suggested that this combination should therefore be avoided. Although there is no evidence of any teratogenic effect, recommendations for Ketotifen in pregnancy or when breast feeding can not be given.</p>', '<p>Drowsiness and in isolated cases, dry mouth and slight dizziness may occur at the beginning of treatment but usually disappear spontaneously after a few days.</p>', '<p>Although there is no evidence of any teratogenic effect, Ketotifen in pregnancy and lactation is not recommended.</p>', '<p>It is important to continue the previous treatment for a minimum of two weeks after starting Ketotifen to avoid the possibility of exacerbation of asthma. This applies specially to systemic corticosteroids and ACTH because of the possible existence of adrenocortical insufficiency in steroid dependent patient. If inter current infection occurs, Ketotifen treatment must be supplemented by specific antimicrobial therapy. During the first day of treatment with Ketotifen, reactions may be impaired and patients should be warned not to take charge of vehicle or machinery until the effect of Ketotifen treatment on the individual is known. Patients should be advised to avoid alcoholic drinks. Ketotifen may potentiate the effects of sedatives, hypnotics, antihistamines and alcohol.</p>', '<p>The reported features of overdosage include confusion, drowsiness, headache, bradycardia, respiratory depression etc. should be watched for. Elimination of the drug with gastric lavage or emessis is recommended. Otherwise, general supportive treatment is all that is required shall be instituted.</p>', '<p>Cromoglycate &amp; related drugs.</p>', '<p>Store in a cool and dry place, protect from light. Keep out of the reach of children.</p>', NULL, '2022-03-07 21:45:55', '2022-03-07 21:45:55'),
(806, 806, NULL, '<p>Pregnancy can be a delicate time for a mother. It can have several complications such as Pre-Eclampsia and IUGR (Intrauterine growth retardation). Previously the doctors advise to expectant mothers who suffer from this is to take rest as there is almost no treatment for this, UNTIL NOW. Presenting Pregcare. Pregcare contains L-arginie, Proanthocyanidin, Folic Acid, Zinc. L-Arginie helps to overcome pre-eclampsia by improving the blood flow and is very essential for the synthesis of Nitric&nbsp; Oxide which is a vasodilator. Proanthocyanidin helps to reduce the UTI infection in pregnancy which may lead to pre-eclampsia. Folic Acid protects against fetal structural anomalies, including Neural Tube defects, preterm birth and congenital heart defects. Zinc is an essential component for embryogenesis, fetal growth and development and mammary gland function for milk synthesis and secretion. Pregcare significantly decreases blood pressure in pregnancy induced hypertension (PIH) &amp; pre-eclampsia, helps to improve amniotic fluid within 1-4 weeks, improves fetal growth &amp; increases birth weight in IUGR. Pregcare is sugar free (Suitable for diabetic patients).</p>', '<p>As directed by healthcare professionals.</p>', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '<p>Store below 30 degree centigrade temperature. Protect from light and moisture. Keep out of the reach of children.</p>', NULL, '2022-03-07 22:03:10', '2022-03-07 22:03:10'),
(807, 807, '<p>For the treatment and prevention of infection in cuts, wounds abrasion, surgical incisions and burns. For the treatment of decubitus or stasis ulcers, advance chronic wounds, infected traumatic lesions etc.</p>', '<p>The active ingredient, Lysine hydrochloride is an essential amino acid, soluble in water; has been observed to promote in-situ cellular expansion in acute and chronic wound beds, in presence of blood plasma derived growth factor(s). The essential amino acid promotes healing of wounds by active and controlled regeneration of in-situ cells. It also protects the wounds against common organisms.</p>', '<p>Gel or Ointment may be used as often as required, preferably at an interval of 24, 48, 72 hrs. The affected areas should be cleaned with normal saline and/or surgically if necessary till the wound bed looks red/few bleeding points appear in the cleaned wound bed. Then gel should be applied liberally. The areas may be covered with a moist dressing and/or a bandage.</p>', NULL, '<p>Not to be used in known cases of hypersensitivity to the amino acid. No other known contraindication is known for this essential amino acid.</p>', '<p>Slight itching sensation might be there on application.</p>', '<p>No information provided.</p>', '<p>In cases of discomfort on application, please consult with the physician.</p>', '<p>No known adverse reactions/side effects are known for the essential amino acid.</p>', '<p>Dressing products for wounds/burns/ulcers.</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-07 22:05:15', '2022-03-07 22:05:15'),
(808, 808, '<p>This is indicated for the treatment of Hepatic Encephalopathy, Acute Liver Failure, Hyperammonemia due to Acute and Chronic Hepatitis, Fatty Liver, Alcoholic Liver damage, Adjunct to hepatotoxic drugs, Liver Cirrhosis, Post hepatitis convalescence etc.</p>', '<p>L-Ornithine L-Aspartate is a stable combination of two important endogenous Amino Acids, L-Ornithine and L-Aspartate. After administration, it quickly breaks down into L-Ornithine and L-Aspartate. L-Ornithine being a substrate of urea cycle, converts toxic ammonia into non-toxic urea which is eliminated via kidneys, helping the diseased liver to carry out its normal function smoothly (detoxification). The process lowers the elevated level of ammonia in blood (hyperammonemia) which is a common problem in most of the liver diseases. L-Aspartate is an essential component of citric acid cycle which liberates energy (ATP), and thus helps in regeneration of damaged liver cells.</p>', '<p><strong>Sachet</strong>: 1-2 sachets granules is dissolved in a large amount of fluid (e.g. in a glass of water or juice) and is taken orally 3 times a day during or after meals.<br />\r\n<br />\r\n<strong>Injection (Infusion Concentrate)</strong>: The recommended dose is up to 20 gm (4 ampoules daily). In case of loss of consciousness (pre-coma) and clouding of consciousness (coma) up to 8 ampoules within 24 hours, depending on the severity of the condition.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>L-Ornithine L-Aspartate infusion concentrate can be added to any of the conventional intravenous fluids (0.9% Sodium Chloride, 5% Dextrose and Ringer&#39;s lactate etc.)</li>\r\n	<li>The normal dilution rate is 1 ampoule per 100 ml of I.V. fluid. However, the dose should not exceed 6 ampoules per 500 ml infusion. The solution mixtures were stable up to 24 hours.</li>\r\n	<li>Infusion Rate: 5 gm/h at maximum.</li>\r\n</ul>', '<p>No data regarding the interactions of L-Ornithine L-Aspartate was found.</p>', NULL, '<p>Very rarely side effects like nausea and vomiting occur. These side effects are usually transient and do not necessitate the withdrawal of the drug.</p>', '<p>The administration in pregnancy and lactation should be avoided.</p>', '<p>Monitoring of serum and urinary urea levels at regular intervals should be done.</p>', NULL, '<p>Digestive Enzyme.</p>', '<p>Store in a cool and dry place, keep away from light.</p>', NULL, '2022-03-07 22:07:08', '2022-03-07 22:07:08'),
(809, 809, '<p>L-Ornithine-L-Aspartate / Pancreatin is used for the treatment, control, prevention, &amp; improvement of the following diseases, conditions and symptoms:</p>\r\n\r\n<ul>\r\n	<li>Hepatic encephalopathy</li>\r\n	<li>Digestion of food</li>\r\n	<li>Inflammatory disease of the pancreas</li>\r\n</ul>', '<p>Pancreatin is a preparation of Pancreatin having protease, lipase and amylase enzyme activity. Pancreatin hydrolyses fats to glycerol and fatty acids, changes protein into proteoses and derived substances and converts starch into dextrins and sugars. Pancreatin is employed in the conditions where the secretion of pancreatic juice is defcient.<br />\r\n<br />\r\nHepatic encephalopathy continues to be a major clinical problem and the current decade has not witnessed major therapeutic breakthroughs in this area. L-ornithine-L-aspartate (LOLA) is not frequently used as there are still some reservations about its benefits. The present study aimed to assess the effectiveness and safety of LOLA in the management of hepatic encephalopathy.</p>', '<p>1-2 tablets daily</p>', '<p>If you use other drugs or over the counter products at the same time, the effects of L-Ornithine-L-Aspartate / Pancreatin may change. This may increase your risk for side-effects or cause your drug not to work properly. Tell your doctor about all the drugs, vitamins, and herbal supplements you are using, so that you doctor can help you prevent or manage drug interactions. L-Ornithine-L-Aspartate / Pancreatin may interact with the following drugs and products:</p>\r\n\r\n<ul>\r\n	<li>Herbal products</li>\r\n	<li>Over-the-counter medicines</li>\r\n	<li>Prandase</li>\r\n	<li>Precose</li>\r\n	<li>Vitamins</li>\r\n</ul>', '<p>Hypersensitivity to L-Ornithine-L-Aspartate / Pancreatin is a contraindication. In addition, L-Ornithine-L-Aspartate / Pancreatin should not be used if you have the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Gastrectomy</li>\r\n	<li>Hypersensitivity</li>\r\n	<li>Pancreatectomy</li>\r\n	<li>Pregnant</li>\r\n</ul>', '<p>The following is a list of possible side-effects that may occur in medicines that contain L-Ornithine-L-Aspartate / Pancreatin. This is not a comprehensive list. These side-effects are possible, but do not always occur. Some of the side-effects may be rare but serious. Consult your doctor if you observe any of the following side-effects, especially if they do not go away.</p>\r\n\r\n<ul>\r\n	<li>Nausea</li>\r\n	<li>Vomiting</li>\r\n	<li>Abdominal</li>\r\n	<li>Stomach pain</li>\r\n	<li>Bloating</li>\r\n	<li>Diarrhea</li>\r\n</ul>', '<p>No data had found</p>', '<p>Before using L-Ornithine-L-Aspartate / Pancreatin, inform your doctor about your current list of medications, over the counter products (e.g. vitamins, herbal supplements, etc.), allergies, pre-existing diseases, and current health conditions (e.g. pregnancy, upcoming surgery, etc.). Some health conditions may make you more susceptible to the side-effects of the drug. Take as directed by your doctor or follow the direction printed on the product insert. Dosage is based on your condition. Tell your doctor if your condition persists or worsens. Important counseling points are listed below.</p>\r\n\r\n<ul>\r\n	<li>Avoid taking higher quantity than recommended dose</li>\r\n	<li>Avoid use of this drug if allergic to it</li>\r\n	<li>Consult your doctor before taking the drug in case of pregnancy or lactation</li>\r\n	<li>Drink plenty of water when taking pancreatin</li>\r\n	<li>Need doctor&#39;s consultation in abdominal cramps, blood in stools and loose motions</li>\r\n	<li>Planning to get pregnant or breastfeeding</li>\r\n</ul>', NULL, '<p>Digestive Enzyme.</p>', NULL, NULL, '2022-03-07 22:09:12', '2022-03-07 22:09:12'),
(810, 810, '<p>Labetalol Injection is indicated in Hypertension (including hypertension in pregnancy, hypertension after stroke, hypertension with angina, and hypertension following acute myocardial infarction); hypertensive crisis; Anaesthesia when a hypotensive technique is indicated.</p>', '<p>Labetalol is a competitive antagonist at b1&nbsp;and b2&nbsp;adrenoreceptors and has some intrinsic activity at b2&nbsp;adrenoreceptors. Labetalol has, in addition to its b-blocking action, a competitive antagonist action at postsynaptic a-adrenoreceptors. In isolated tissues Labetalol is four to eight times more potent at b than a-adrenoreceptors.</p>', '<p><strong>Bolus Injection</strong>: If it is essential to reduce the blood pressure quickly a dose of 50 mg should be given by intravenous injection (over a period of at least one minute) and, if necessary, repeated at five minute intervals until a satisfactory response occurs. The total dose should not exceed 200 mg.<br />\r\n<br />\r\n<strong>Intravenous Infusion</strong>: For intravenous infusion the injcetion should be diluted with a suitable intravenous infusion fluid to a concentation of 1 mg/1 ml. Compatible fluids include solution of 5% Dextrose, 0.9% Sodium Chloride and mixture of Sodium Chloride and Dextrose Injection.<br />\r\n<br />\r\n<strong>Hypertension in pregnancy</strong>: Initially 20 mg/hour, then doubled every 30 minutes until a satisfactory response is obtained or a dosage of 160 mg/hour is reached.<br />\r\n<br />\r\n<strong>Hypertension following acute myocardial infarction</strong>: Initially 15 mg/hour and gradually increased to a maximum of 120 mg/hour depending on the control of blood pressure.<br />\r\n<br />\r\n<strong>Hypertension after stroke</strong>: 10-20 mg by intravenous injection over 1 to 2 minutes may repeat or doubled every 10 minutes. (max. dose 300 mg).<br />\r\n<br />\r\n<strong>Hypertension due to other causes</strong>: Infuse at a rate of about 2 mg/min until a satisfactory response is obtained, then stop infusion. The effective dose is usually 50-200 mg but larger doses may be needed, especially in patients with phaeochromocytoma.<br />\r\n<br />\r\n<strong>Hypotensive anaesthesia</strong>: The recommended starting dose of Labetalol Injection is 10-20 mg intravenously depending on the age and condition of the patient. Patients for whom halothane is contraindicated usually require a higher initial dose of 25-30 mg. If satisfactory hypotension is not achieved after 5 minutes, increments of 5-10 mg should be given until the desired level of blood pressure is attained.</p>', '<p>Labetalol may enhance the hypotensive effects of halothane. Care should be taken if labetalol is used concomitantly with either Class I antiarrhythmic agents or calcium antagonists of the verapamil type. The hypotensive effect of Labetalol may be reduced when used in combination with prostaglandin synthetase inhibitors (NSAIDs). Dosage adjustments may therefore be necessary. Concomitant use of tricyclic antidepressants may increase the incidence of tremor. Cimetidine may increase the bioavailability of Labetalol and care is required in oral dosing of the latter.</p>', '<p>Labetalol is contraindicated for patients known to have hypersensitivity to the medicine. Labetalol is contraindicated in second or third degree heart block, infranodal A-V block, uncontrolled heart failure, sick-sinus syndrome, cardiogenic shock and other conditions associated with severe and prolonged hypotension or severe bradycardia, and bronchial asthma or other obstructive lung disorders.</p>', '<p>Adverse effects reported are postural hypotension (avoid upright position during and for 3 hours after intravenous administration), tiredness, weakness, headache, rashes, scalp tingling, difficulty in micturition, epigastric pain, nausea, vomiting; liver damage.</p>', '<p>Labetalol&nbsp;should only be used during the first trimester of pregnancy if the potential benefit outweighs the potential risk. Labetalol is excreted in breast milk in small amounts. Caution should be exercised when labetalol is administered to breast feeding women.</p>', '<p>There have been rare reports of severe hepatocellular injury with Labetalol therapy. The hepatic injury is usually reversible and has occurred after both short and long term treatment. If there is laboratory evidence of liver injury or the patient is jaundiced, Labetalol therapy should be stopped and not re-started. Particular care should be taken when Labetalol is to be used in patients with hepatic impairment. Labetalol&nbsp;should be used with caution in patients with peripheral vascular disease as their symptoms may be exacerbated.</p>', '<p>Profound cardiovascular effects are to be expected, e.g. excessive, posture-sensitive hypotension and sometimes bradycardia. Patients should be laid supine with the legs raised. Use a cardiac glycoside and a diuretic in cardiac failure; for bronchospasm, administer a b 2 -agonist per aerosol. Intravenous atropine 0.25 to 3 mg should be given to relieve bradycardia. Intravenous noradrenaline 5 to 10 mg initially, repeated according to response may be preferable to isoprenaline to improve circulation. Alternatively, noradrenaline may be infused at a rate of 5 mg per minute until the response is satisfactory. In severe overdose, intravenous glucagon may be preferred: an initial bolus dose of 5 to 10 mg in dextrose or saline should be followed by an intravenous infusion of 5 mg/hour or as sufficient to maintain cardiac output.</p>', '<p>Alpha adrenoceptor blocking drugs, Beta-adrenoceptor blocking drugs.</p>', '<p>Store in a cool &amp; dry place protected from light. Keep out of reach of children.</p>', NULL, '2022-03-07 22:13:37', '2022-03-07 22:13:37'),
(811, 811, '<p>Labetalol Hydrochloride indicated in the management of hypertension. Labetalol tablets may be used alone or in combination with other antihypertensive agents, especially thiazide and loop diuretics.</p>', '<p>Labetalol non-selectively antagonizes beta-adrenergic receptors, and selectively antagonizes alpha-1-adrenergic receptors. Following oral administration, labetalol has 3 times the beta-blocking ability than alpha-blocking ability. This increases to 6.9 times following intravenous administration. Antagonism of alpha-1-adrenergic receptors leads to vasodilation and decreased vascular resistance. This leads to a decrease in blood pressure that is most pronounced while standing. Antagonism of beta-1-adrenergic receptors leads to a slight decrease in heart rate. Antagonism of beta-2-adrenergic receptors leads to some of the side effects of labetalol such as bronchospasms, however this may be slightly attenuated by alpha-1-adrenergic antagonism. Labetalol leads to sustained vasodilation over the long term without a significant decrease in cardiac output or stroke volume, and a minimal decrease in heart rate.</p>', '<p><strong>Adult</strong>: The recommended initial dosage is 100 mg twice daily whether used alone or added to a diuretic regimen. The usual maintenance dosage of Labetalol Hydrochloride is between 200 and 400 mg twice daily.<br />\r\n<br />\r\n<strong>Patients with severe hypertension</strong>: May require from 1,200 to 2,400 mg per day, with or without thiazide diuretics. Titration increments should not exceed 200 mg twice daily.<br />\r\n<br />\r\n<strong>Elderly Patients</strong>: The majority of elderly patients will require between 100 and 200 mg twice daily.</p>', '<p>Labetalol in combination with tricyclic antidepressants may cause tremor; Cimetidine has been shown to increase the bioavailability of Labetalol. If Labetalol is used with nitroglycerin in patients with angina pectoris, additional antihypertensive effects may occur; Care should be taken if Labetalol is used concomitantly with calcium antagonists of the verapamil type; Both digitalis glycosides and beta-blockers slow atrioventricular conduction and decrease heart rate. Concomitant use can increase the risk of bradycardia.</p>', NULL, '<p>Most side effects are mild and transient and occur early in the course of treatment. The incidences of adverse reactions include Fatigue, Asthenia, Headache, Nausea, Vomiting, Dyspepsia, Abdominal pain, Diarrhea, Taste distortion, Dizziness, Paresthesia, Nasal stuffiness, Increased sweating, Edema, Postural hypotension, Bradycardia, Dyspnea, Rash, Vision abnormality and Vertigo.</p>', '<p>Pregnancy Category C. Teratogenic studies were performed with Labetalol in rats and rabbits at oral doses up to approximately six and four times the maximum recommended human dose (MRHD), respectively. No reproducible evidence of fetal malformations was observed. Labetalol Hydrochloride given to pregnant women with hypertension did not appear to affect the usual course of labor and delivery. Small amounts of Labetalol (approximately 0.004% of the maternal dose) are excreted in human milk. Caution should be exercised when Labetalol tablets are administered to a nursing woman.</p>', '<p>Labetalol Hydrochloride should be used with caution in patients with Impaired Hepatic Function, Congestive Heart Failure, Exacerbation of Ischemic Heart Disease, Nonallergic Bronchospasm, Pheochromocytoma, Diabetes Mellitus and Hypoglycemia.</p>', '<p>Overdosage with Labetalol causes excessive hypotension and sometimes, excessive bradycardia. If overdosage with Labetalol follows oral ingestion, gastric lavage or pharmacologically induced emesis (using syrup) may be useful for removal of the drug shortly after ingestion. The following additional measures should be employed if necessary: Excessive bradycardia-administer atropine or epinephrine; Cardiac failure-administer a digitalis glycoside and a diuretic; Hypotension-administer vasopressors, e.g., norepinephrine; Bronchospasm administer epinephrine and/or an aerosolized beta2-agonist; Seizures-administer diazepam. In severe beta blocker overdose resulting in hypotension and/or bradycardia, glucagon has been shown to be effective when administered in large doses (5 to 10 mg rapidly over 30 seconds, followed by continuous infusion of 5 mg per hour that can be reduced as the patient improves).</p>', '<p>Alpha adrenoceptor blocking drugs, Beta-adrenoceptor blocking drugs.</p>', '<p>Labetalol tablets should be stored below 30&deg;C. Keep out of the reach of children. Store in a cool and dry place protected from light.</p>', NULL, '2022-03-07 22:16:31', '2022-03-07 22:16:31'),
(812, 812, '<p>Lacidipine is indicated for the treatment of hypertension either alone or in combination with other antihypertensive agents, including &szlig;-blockers, diuretics, ACE-inhibitors etc.</p>', '<p>Lacidipine inhibits the influx of calcium into smooth muscle cells by the competitive inhibition of voltage-dependent calcium &#39;L&#39; channels. This action results in the inhibition of the effects triggered by the influx of calcium into the cells, such as the activation of the contractile proteins in smooth muscle.</p>', '<p>The recommended initial dose of Lacidipine is 2 mg once daily. The dose may be increased to 4 mg and then, if necessary, to 6 mg after 3 to 4 weeks. Lacidipine should be taken preferably in the morning.</p>', '<p>The plasma concentration of Lacidipine may be increased by simultaneous administration of cimetidine. No specific pharmacodynamic interaction problems have been identified in studies with common antihypertensive agents or with digoxin, tolbutamide or warfarin.</p>\r\n\r\n<p>&nbsp;</p>', '<p>Hypersensitivity to any ingredient of this product, cardiogenic shock, unstable angina, aortic stenosis, avoid within 1 month of myocardial infarction, impaired left ventricular function.</p>', '<p>Lacidipine is generally well tolerated. Some individuals may experience minor side effects like flushing, palpitation, edema, headache, dizziness, rarely gastro-intestinal disturbances, gum hyperplasia, mood disturbances, asthenia, polyuria, muscle cramps, skin rash etc.</p>', '<p><strong>Pregnancy</strong>: There are no data on the safety of Lacidipine in human pregnancy. Lacidipine provides no evidence of a teratogenic effect in animal study.<br />\r\n<br />\r\n<strong>Lactation</strong>: Milk transfer studies in animals have shown that Lacidipine (or its metabolites) are likely to be excreted into breast milk. There is, however, no clinical experience of Lacidipine in pregnancy and lactation. Accordingly, Lacidipine should not be used during pregnancy or lactation.</p>', '<p>Cardiac conduction abnormalities, poor cardiac reserves, hepatic impairment, withdraw if ischemic pain occurs shortly after initiating treatment or if cardiogenic shock develops, avoid grape fruit juice.</p>', '<p><strong>Symptoms</strong>: Prolonged peripheral vasodilation associated with hypotension and tachycardia, bradycardia or prolonged AV conduction.<br />\r\n<br />\r\n<strong>Management</strong>: Symptomatic and supportive treatment.</p>', '<p>Calcium-channel blockers.</p>', '<p>Store in a cool and dry place, protect from light and moisture. Keep out of the reach of children.</p>', '<p><strong>Use in Neonates</strong>: There are no data on safety or efficacy of Lacidipine in neonates.<br />\r\n<strong>Use in children</strong>: Treatment with Lacidipine have not been evaluated in Children.<br />\r\n<strong>Hepatic Impairment</strong>: Severe: Reduce dose.</p>', '2022-03-07 22:20:24', '2022-03-07 22:20:24'),
(813, 813, '<p>Lacosamide is indicated for the treatment of partial-onset seizures in patients 4 years of age and older.<br />\r\n<br />\r\nAs the safety of Lacosamide injection has not been established in pediatric patients, Lacosamide injection is indicated for the treatment of partial-onset seizures only in adult patients (17 years of age and older).</p>', '<p>It is proposed that lacosamide&#39;s inhibition of sodium channels is responsible for analgesia. Lacosamide may be selective for inhibiting depolarized neurons rather than neurons with normal resting potentials. Pain and nociceptor hyperexcitability are associated with neural membrane depolarization. Lacosamide binds to collapsin response mediator protein-2 (CRMP-2), a phosphoprotein which is expressed primarily in the nervous system and is involved in neuronal differentiation and control of axonal outgrowth. The role CRMP-2 of binding in seizure control is hasn&#39;t been elucidated.</p>', '<p><strong>Adults (17 years and older)</strong>: Initial dosage for monotherapy is 100 mg twice daily; initial dosage for adjunctive therapy is 50 mg twice daily; maximum recommended dosage for monotherapy and adjunctive therapy is 200 mg twice daily&nbsp;<br />\r\n<br />\r\n<strong>Pediatric Patients 4 Years to less than 17 years</strong>: The recommended dosage is based on body weight and is administered orally twice daily. Increase dosage based on clinical response and tolerability, no more frequently than once per week<br />\r\n<br />\r\n<strong>Injection</strong>: for intravenous and adult use only when oral administration is temporarily not feasible; dosing regimen is the same as oral regimen; administer over 15 to 60 minutes; obtaining ECG before initiation is recommended in certain patients</p>', '<p><strong>Strong CYP3A4 or CYP2C9 Inhibitors</strong>: Patients with renal or hepatic impairment who are taking strong inhibitors of CYP3A4 and CYP2C9 may have a significant increase in exposure to Lacosamide. Dose reduction may be necessary in these patients.<br />\r\n<br />\r\n<strong>Concomitant Medications that Prolong PR Interval</strong>: Lacosamide should be used with caution in patients on concomitant medications that prolong PR interval, because of a risk of AV block or bradycardia, e.g., beta-blockers and calcium channel blockers. In such patients, obtaining an ECG before beginning Lacosamide, and after Lacosamide is titrated to steady-state, is recommended. In addition, these patients should be closely monitored if they are administered Lacosamide through the intravenous route.</p>', '<p>None</p>', '<p><strong>Adjunctive therapy</strong>: Most common adverse reactions in adults (&ge;10% and greater than placebo) are diplopia, headache, dizziness, nausea<br />\r\n<br />\r\n<strong>Monotherapy</strong>: Most common adverse reactions are similar to those seen in adjunctive therapy studies<br />\r\n<br />\r\n<strong>Pediatric patients</strong>: Adverse reactions are similar to those seen in adult patients.</p>', '<p><strong>Pregnancy</strong>: Based on animal data, may cause fetal harm</p>', '<p>Monitor patients for suicidal behavior and ideation<br />\r\n<br />\r\nLacosamide may cause dizziness and ataxia<br />\r\n<br />\r\nCardiac Rhythm and Conduction Abnormalities: Obtaining ECG before beginning and after titration to steady-state maintenance is recommended in patients with known cardiac conduction problems, taking drugs known to induce PR interval prolongation, or with severe cardiac disease; closely monitor these patients<br />\r\n<br />\r\nLacosamide may cause syncope<br />\r\n<br />\r\nLacosamide should be gradually withdrawn to minimize the potential of increased seizure frequency<br />\r\n<br />\r\nDrug Reaction with Eosinophilia and Systemic Symptoms (DRESS)/Multi-Organ Hypersensitivity: Discontinue if no alternate etiology.</p>', NULL, '<p>Atypical anti-depressant drugs.</p>', '<p>Store at 20&deg;C to 25&deg;C</p>', '<p>Dose adjustment is recommended for severe renal impairment. Dose adjustment is recommended for mild or moderate hepatic impairment; use in patients with severe hepatic impairment is not recommended.</p>', '2022-03-07 22:23:12', '2022-03-07 22:23:12'),
(814, 814, '<p>Prevention of symptoms of lactose intolerance-</p>\r\n\r\n<ul>\r\n	<li>Infantile colic</li>\r\n	<li>Abdominal pain</li>\r\n	<li>Bloating</li>\r\n	<li>Flatulence</li>\r\n	<li>Diarrhea</li>\r\n	<li>Borborygmi</li>\r\n</ul>', '<p>Lactase is an enzyme that helps to prevent symptoms of lactose intolerance by breaking down milk sugar (lactose) to produce glucose and galactose via hydrolysis and making dairy foods easier to digest.</p>', '<p><strong>Adult:</strong>&nbsp;1 tablet (300 mg) with dairy food. If needed dose can be adjusted up to 2 tablets (600 mg) at a time.<br />\r\n<br />\r\n<strong>Infants</strong>: Add lactase enzyme to breast milk or formula in the following directions-<br />\r\n<br />\r\nBreast Milk:</p>\r\n\r\n<ul>\r\n	<li>Express a few tablespoons (2-3 tablespoons) of breast milk into sterilized container</li>\r\n	<li>Add 4 drops of lactase paediatric drops</li>\r\n	<li>Give mixture to infant on a spoon or oral syringe before initiating breastfeeding</li>\r\n	<li>Breast feed as normal</li>\r\n</ul>\r\n\r\n<p>Formula:</p>\r\n\r\n<ul>\r\n	<li>Add 4 drops of lactase paediatric drops to warm (not hot) formula</li>\r\n	<li>Wait 30 minutes, shaking formula occasionally</li>\r\n</ul>\r\n\r\n<p>Making formula in advance:</p>\r\n\r\n<ul>\r\n	<li>Add 2 drops of lactase paediatric drops to warm formula</li>\r\n	<li>Store in refrigerator for minimum 4 hours</li>\r\n	<li>Feed Infant as normal</li>\r\n	<li>Use within 12 hour</li>\r\n	<li>Discard any unused formula</li>\r\n</ul>\r\n\r\n<p><strong>Children</strong>: Effective &amp; safe in children above 4 years of age.</p>', '<p>No information for lactase interactions has been found yet.</p>', '<p>This drug is contraindicated in patients with known hypersensitivity to lactase or any other components of the product.</p>', '<p>There are no major side effects reported. The very few side effects may include rash, difficulty in breathing, tightness in chest etc.</p>', '<p>It is unknown if lactase may cause harm to the fetus. Therefore, lactase should be given during pregnancy only when clearly needed.&nbsp;It is unknown if lactase is excreted in breast milk. Thus, lactase should be given during lactation only when clearly needed.</p>', NULL, NULL, NULL, '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-07 22:27:39', '2022-03-07 22:27:39'),
(815, 815, '<p>This is a combination of lactic acid, citric acid, and potassium bitartrate indicated for the prevention of pregnancy in females of reproductive potential for use as an on-demand method of contraception.</p>', NULL, '<p>The combination of lactic acid, citric acid, and potassium bitartrate comes as a gel in a pre-filled applicator to be applied into the vagina. It is usually applied into the vagina immediately before (up to one hour) before each act of vaginal intercourse. If more than one act of vaginal intercourse occurs within one hour, apply another dose into the vagina. Do not apply more or less of it or apply it more often than prescribed by your doctor.<br />\r\n<br />\r\nLactic acid, citric acid, and potassium bitartrate vaginal gel may be used at any time during the menstrual cycle. It may be used with hormonal contraceptives (birth control pills, patches, or implants); latex, polyurethane and polyisoprene condoms; or a vaginal diaphragm. Do not use this medication along with a contraceptive vaginal ring. Lactic acid, citric acid, and potassium bitartrate vaginal gel may be applied after your doctor has told you that it is safe to resume vaginal intercourse after childbirth, abortion, or miscarriage.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>To use the lactic acid, citric acid, and potassium bitartrate vaginal gel, follow these steps:</p>\r\n\r\n<ul>\r\n	<li>Wash your hands with soap and water before opening the foil pouch.</li>\r\n	<li>Remove the pre-filled applicator and plunger rod from the foil pouch.</li>\r\n	<li>Slowly insert the plunger rod into the pre-filled applicator. Push until you feel the tip of the plunger rod connect to the inside of the pre-filled applicator.</li>\r\n	<li>Do not push hard or continue to push after the tip of the plunger rod connects to the inside of the pre-filled applicator as it could cause the gel to go into the pink cap. Use a new pre-filled applicator if the gel enters the pink cap.</li>\r\n	<li>After the plunger rod is connected to the pre-filled applicator, remove the pink cap from the pre-filled applicator. The extra space between the gel and the end of the pre-filled applicator is normal.</li>\r\n	<li>Hold the pre-filled applicator at the grooved area closest to the plunger rod. Gently insert the pre-filled applicator into the vagina as far as it will comfortably go while you continue to hold the plunger rod. You can do this while sitting with your knees apart, lying on your back with your knees bent, or while standing with your feet apart or knees bent.</li>\r\n	<li>While the pre-filled applicator is inserted in your vagina, use your index finger to push the plunger rod down until it stops to ensure that you receive the entire dose. It is normal for a small amount of gel to be left in the applicator.</li>\r\n	<li>Gently remove the plunger rod and pre-filled applicator from the vagina. Discard the used pre-filled applicator and cap in the trash.</li>\r\n</ul>', NULL, NULL, '<p>Most common adverse reactions (&ge;2%) were vulvovaginal burning sensation, vulvovaginal pruritus, vulvovaginal mycotic infection, urinary tract infection, vulvovaginal discomfort, bacterial vaginosis, vaginal discharge, genital discomfort, dysuria, and vulvovaginal pain.</p>', '<p>There is no use in pregnancy; therefore, discontinue this during pregnancy. There are no data on the presence of lactic acid, citric acid, and potassium bitartrate or their metabolites in human milk, the effects on the breastfed infant, or the effects on milk production.</p>', '<p>Before using lactic acid, citric acid, and potassium bitartrate vaginal,</p>\r\n\r\n<ul>\r\n	<li>tell your doctor and pharmacist if you or your sexual partner are allergic to lactic acid, citric acid, and potassium bitartrate, any other medications, or any of the ingredients in lactic acid, citric acid, and potassium bitartrate vaginal gel. Ask your pharmacist for a list of the ingredients.</li>\r\n	<li>tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take or use. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.</li>\r\n	<li>tell your doctor if you have or had urinary tract infections or problems with urination.</li>\r\n	<li>tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using lactic acid, citric acid, and potassium bitartrate vaginal, call your doctor.</li>\r\n</ul>', NULL, '<p>Miscellaneous topical agents.</p>', '<p>Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture.</p>', '<p>Pediatric Use: The safety and effectiveness of this gel have been established in females of reproductive potential. Efficacy is expected to be the same for post-menarchal females under the age of 17 as for users 17 years and older. The use of this gel before menarche is not indicated.</p>', '2022-03-07 22:29:43', '2022-03-07 22:29:43'),
(816, 816, '<p>This&nbsp;medication&nbsp;is used as a moisturizer to treat or prevent dry, rough, scaly,&nbsp;itchy skin&nbsp;and minor&nbsp;skin&nbsp;irritations (e.g.,&nbsp;diaper rash,&nbsp;skin&nbsp;burns from&nbsp;radiation therapy). Emollients are substances that soften and moisturize the&nbsp;skin&nbsp;and decrease&nbsp;itching&nbsp;and flaking. Some products (e.g., zinc oxide, white petrolatum) are used mostly to protect the&nbsp;skin&nbsp;against irritation (e.g., from wetness).</p>', '<p>Lactic acid: It is commonly used for lubricating and moisturising skin, thus relieving dryness and itch.<br />\r\n<br />\r\nSodium PCA: It is a keratolytic agent. It encourages exfoliation of the skin and opening up of the plugged follicles, which helps re-establish the normal skin- cell replacement cycle. For milder acne, salicylic acid helps unclog pores to resolve and prevent lesions.</p>', '<p>Use as required on affected areas.</p>', NULL, '<p>Hypersensitivity</p>', '<p>Most emollients can be used safely and effectively with no side effects. However, burning, stinging, redness, or irritation may occur. If any of these effects persist or worsen, tell your doctor or&nbsp;pharmacist&nbsp;promptly.</p>', '<p>Pregnancy category is not classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Before using this product, tell your doctor or&nbsp;pharmacist&nbsp;if you are allergic to any of the ingredients in the product; or if you have any other&nbsp;allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.</p>', NULL, '<p>Emollients &amp; combined preparations.</p>', NULL, NULL, '2022-03-07 22:32:01', '2022-03-07 22:32:01'),
(817, 817, '<p>Lactitol Monohydrate is indicated in chronic idiopathic constipation (CIC), acute and chronic portal systemic encephalopathy.</p>', '<p>Lactitol Monohydrate is a disaccharide derivatives consisting of galactose and sorbitol, which is only minimally absorbed and is not hydrolysed by the disaccharidases of the GIT and thus reaches the colon unchanged. In the colon it is broken down to short chain low molecular weight organic acids by the intestinal flora, resulting in an increase in osmotic pressure in the colon, thereby causing an increase in the stool water content and stool volume, which explains the laxative effect. Lactitol Monohydrate produces its effect in the lumen of the colon, where it is virtually 100% bioavailable. It is absorbed only in minimal amounts. Up to 2% can be found unchanged in the urine.</p>', '<p>Lactitol can be mixed with hot or cold beverages, puddings etc. Dosage will require adjustment to obtaine one daily bowel movement in constipated patients and two daily bowel movements in patients with portal systemic encephalopathy.<br />\r\n<br />\r\n<strong>In constipation</strong>: In adult: The initial daily dosage should be 20 g taken in a single dose with the morning or evening meal. After a few days, a daily dose of 10 g may be sufficient.<br />\r\n<br />\r\nChildren: The mean dosage is 0.25 g/kg body weight daily.</p>\r\n\r\n<ul>\r\n	<li>1 to 6 years: 2.5 to 5 gm</li>\r\n	<li>6 to 12 years: 5 to 10 gm</li>\r\n	<li>12 to 16 years: 10 to 20 gm</li>\r\n</ul>\r\n\r\n<p>The effect of lactitol has been found mostly to occur within a few hours after intake. But in some cases the first laxative response may be delayed until the second or third day of administration. Therefore patients should be advised to maintain an adequate daily fluid intake.<br />\r\n<br />\r\n<strong>In portal systemic encephalopathy</strong>: The dose should be adjusted according to the severity of the patient&rsquo;s disease and their individual response. The initial recommended dose is 0.5 to 0.7 gm/kg body weight daily, divided into three daily doses with meals.</p>', '<p>Antacids and neomycin should not be given simultaneously with Lactitol to cirrhotic patients with portal systemic encephalopathy. Lactitol may increase potassium loss caused by other drugs e.g. thiazide diuretics, corticosteroids, carbenoxolone, amphotericin B and it may enhance the risk of toxic effects of glycosides in patients receiving concomitant therapy.</p>', '<p>Patients with known hypersensitivity to any of the ingredients of this preparation.</p>', '<p>At the start of the treatment with lactitol may produce abdominal discomforts such as flatulence, pain, cramps or sensation of fullness. Such effects tend to diminish or disappear after a few days of regular intake of Lactitol. Occasionally, nausea or anal pruritus has been reported in some cases.</p>', '<p>Lactitol is minimally absorbed systemically following oral administration, and it is unknown whether maternal use will result in fetal exposure to the drug. There are no data on the presence of lactitol in human or animal milk, the effects on the breastfed infant, or the effects on milk production.</p>', '<ul>\r\n	<li>Elderly or debilitated patients receiving long-term treatment with lactitol should have their serum electrolytes monitored regularly.</li>\r\n	<li>As for all laxatives, pre-existing fluid or electrolyte imbalance should be corrected before starting treatment with lactitol.</li>\r\n	<li>Following treatment of Lactitol, hydrogen may accumulate in the bowel. Patients who need to undergo electrocauterisation procedure should therefore have a thorough bowel cleansing with a non-fermentable solution.</li>\r\n	<li>Lactitol is not recommended in case s of ileostomy or colostomy.</li>\r\n	<li>Prolonged use of laxatives without interruption should be avoided.</li>\r\n</ul>', NULL, '<p>Osmotic purgatives.</p>', '<p>Store in a cool, dry place and away from light. Keep out of reach of children.</p>', NULL, '2022-03-07 22:34:01', '2022-03-07 22:34:01');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(818, 818, '<p>Probiotics&nbsp;contain different types of micro-organisms such as yeast (saccharomyces boulardii) and bacteria (such as lactobacillus, bifidobacterium). Micro-organisms (flora) are naturally found in the&nbsp;stomach/intestines/vagina. Some conditions (such as antibiotic use, travel) can change the normal balance of bacteria/yeast.&nbsp;Probiotics&nbsp;are used to improve digestion and restore normal flora.Probiotics&nbsp;have been used to treat bowel problems (such as&nbsp;diarrhea, irritable bowel),&nbsp;eczema,&nbsp;vaginal yeast infections,&nbsp;lactose intolerance, and&nbsp;urinary tract infections.Probiotics&nbsp;are available in foods (such as yogurt, milk, juices, soy beverages) and as&nbsp;dietary supplements&nbsp;(capsules, tablets, powders). Different products have different uses. Check the label for information on uses for your particular product.Some diet supplement products have been found to contain possibly harmful impurities/additives. Check with your&nbsp;pharmacist&nbsp;for more details regarding the particular brand you use.The FDA has not reviewed this product for safety or effectiveness. Consult your doctor or pharmacist for more details.</p>', NULL, '<p><strong>For general use as a dietary supplement</strong>: Dose: 1 capsule per day<br />\r\n<br />\r\n<strong>Concurrently with antibiotics</strong>: Dose: 1 capsule twice a day throughout antibiotic therapy and for one week after antibiotic therapy<br />\r\n<br />\r\n<strong>Traveling</strong>: Dose: 1 capsule twice daily throughout the trip. It is best to start 2 to 3 days prior to travel.</p>', '<p>Drug interactions&nbsp;may change how your&nbsp;medications&nbsp;work or increase your risk for serious side effects. This document does not contain all possible&nbsp;drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and&nbsp;pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor&#39;s approval.</p>', NULL, '<p>An increase in stomach gas or bloating may occur. If this effect persists or worsens, notify your doctor or pharmacist promptly. A very serious allergic reaction to this product is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.</p>', '<p>During pregnancy, this product should be used only when clearly needed. Discuss the risks and benefits with your doctor. It is unknown whether this product passes into breast milk. Consult your doctor before breastfeeding.</p>', '<p>Before using this product, tell your doctor or&nbsp;pharmacist&nbsp;if you are allergic to it; or if you have any other&nbsp;allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.<br />\r\n<br />\r\nIf you have any of the following health problems, consult your doctor or pharmacist before using this product:&nbsp;diarrhea&nbsp;lasting more than 2 days (especially if you also have a&nbsp;high fever), weakened&nbsp;immune system&nbsp;(such as due to&nbsp;chemotherapy,&nbsp;HIV&nbsp;infection), recurring&nbsp;vaginal infections, recurring&nbsp;urinary tract infections.<br />\r\n<br />\r\nLiquid products, foods, powders, or chewable tablets may contain sugar and/or aspartame. Caution is advised if you have&nbsp;diabetes, phenylketonuria (PKU), or any other condition that requires you to limit/avoid these substances in your diet. Ask your doctor or pharmacist about using this product safely.<br />\r\n<br />\r\nBefore having surgery, tell your doctor or&nbsp;dentist&nbsp;about all the products you use (including&nbsp;prescription drugs, nonprescription drugs, and herbal products).</p>', NULL, NULL, '<p>Different types of&nbsp;probiotics&nbsp;may have different storage needs. Some may require refrigeration while others should not be refrigerated. Check the product package for instructions on how to store your product.</p>', NULL, '2022-03-07 22:35:56', '2022-03-07 22:35:56'),
(819, 819, '<p>Constipation (Chronic Constipation): In every case of chronic constipation, initial treatment should consist of a diet rich in fiber (vegetables, salads, fruits etc.) a generous amount of liquids and much physical exercise. Lactulose is only to be taken when these measures prove insufficient.<br />\r\n<br />\r\nIntestinal flora disturbances:</p>\r\n\r\n<ul>\r\n	<li>In damaged to intestinal flora (e.g. following long-term antibiotic treatment)</li>\r\n	<li>gall bladder diseases</li>\r\n	<li>intestinal diseases ( Colitis, Diverticulosis, Megacolon)</li>\r\n</ul>\r\n\r\n<p>Increased blood ammonia levels (hyper ammoniemia in hepatopathy, portal-systemic encephalopathy).</p>', '<p>Lactulose is a synthetic disaccharide. Lactulose is metabolized in the colon by the saccharolytic bacteria, producing low molecular weight organic acids (mainly lactic acid), which lowers the pH of the colon contents, promote the retention of water by an osmotic effect; thus increasing peristaltic activity. Lactulose is minimally absorbed; therefore, the pharmacokinetics of the absorbed material are not relevant to the principal therapeutic action.</p>', '<p>In constipation ( chronic constipation):</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: Initially 3-6 tea-spoons daily, In long-term therapy 1&frac12;-6 tea-spoons daily</li>\r\n	<li><strong>Children up to 14 years</strong>: Initially 3 tea-spoons daily, In long-term therapy 1-2 tea-spoons daily</li>\r\n	<li><strong>Infants and toddlers</strong>: Initially 1-2 tea-spoons daily, In long-term therapy 1 tea-spoon daily</li>\r\n</ul>\r\n\r\n<p>In damaged intestinal flora:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 1-2 tea-spoons daily</li>\r\n	<li><strong>Children</strong>: 1 tea-spoon daily</li>\r\n</ul>\r\n\r\n<p>For reduction of blood ammonia level:</p>\r\n\r\n<ul>\r\n	<li><strong>Hyper-ammoniemia in hepatopathy</strong>: a maximum of 18-30 tea-spoons daily.</li>\r\n	<li><strong>In portal systemic encephalopathy</strong>: hourly doses of 6-9 tea-spoons of Lactulose solution may be used to induce the rapid laxation. When the laxative effect has been achieved, the dose may then be reduced.</li>\r\n</ul>', '<p>There is no significant drug interactions with lactulose. The glycosidic effect of cardiac glycosides can be intensified by potassium deficiency in abuse.</p>', '<p>Hypersensitivity to either galactose and or lactose; galactose-free diet, gastro-cardial symptom complex, suspected intestinal obstruction.</p>', '<p>Occasionally flatulence, cramp and abdominal discomfort can occur at the beginning of treatment; this is rapidly eliminated by reducing the dose. Overdose can result in diarrhoea. In abuse, loss of electrolytes (primarily potassium).</p>', '<p>US FDA Pregnancy Category of Lactulose is B. Studies show that Lactulose has no adverse effects. Decisions regarding use during pregnancy and lactation must be made by registered physician.</p>', '<p>Lactulose should be administered with care to patients who are intolerant to lactulose. The dose used in the treatment of (pre) coma hepaticum is usually much higher and may need to be taken into consideration for diabetics.</p>', '<p>There have been no reports of accidental overdosage. In the event of acute overdosage it is expected that diarrhoea and abdominal cramps would be the major symptoms.</p>', '<p>Osmotic purgatives.</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-07 22:38:22', '2022-03-07 22:38:22'),
(820, 820, '<p>Lamivudine is indicated for the treatment of chronic hepatitis B associated with evidence of hepatitis B viral replication and active liver inflammation.</p>', '<p>Lamivudine is a synthetic nucleoside analogue. Lamivudine is phosphorylated intracellularly to lamivudine triphosphate. Incorporation of the monophosphate form into viral DNA occurs by hepatitis B virus (HBV) polymerase. As a result DNA chain is terminated. Lamivudine triphosphate also inhibits the RNA and DNA-dependent DNA polymerase activities of HIV-1 reverse transcriptase (RT). Lamivudine triphosphate is a very weak inhibitor of mammalian alpha, beta, and gamma-DNA polymerases.</p>', '<p>The recommended oral dose of Lamivudine for the treatment of chronic hepatitis B in adults is 100 mg once daily.</p>', '<p>Trimethoprim 160 mg / Sulfamethoxazole 800 mg once daily has been shown to increase lamivudine exposure (AUC). The effect of higher doses of trimethoprim /sulfamethoxazole on lamivudine pharmacokinetics has not been investigated.</p>', '<p>Lamivudine is contraindicated in patients hypersensitive to any of the components of the product.</p>', '<p>Several serious adverse events reported with lamivudine (lactic acidosis and severe hepatomegaly with steatosis, post treatment exacerbations of hepatitis B, pancreatitis, and emergence of viral mutants associated with reduced drug susceptibility and diminished treatment response). Malaise, fatigue, fever, ENT infections, sore throat, nausea, vomiting, abdominal discomfort, pain, diarrhea, myalgia, arthralgia, headache, skin rashes may occur. Lactic acidosis and severe hepatomegaly with steatosis, have been reported.</p>', '<p>There is no adequate and well-controlled study in pregnant women. Lamivudine should be used during pregnancy only if the potential benefits outweigh the risks. Although it is not known if lamivudine is excreted in human milk, there is the potential for adverse effects from lamivudine in nursing infants. Mothers should be instructed not to breast feed if they are receiving lamivudine.</p>', '<p>Patients should be assessed before beginning treatment and during treatment with lamivudine by a physician experienced in the management of chronic hepatitis B.</p>', NULL, '<p>Hepatic viral infections (Hepatitis B)</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>It is recommended that doses of Lamivudine should be adjusted in accordance with renal function. Dosage adjustment of Lamivudine in accordance with creatinine clearance is as follows:</p>\r\n\r\n<ul>\r\n	<li><strong>CrCl 50 ml/min</strong>: 100 mg once daily</li>\r\n	<li><strong>CrCl 30-49 ml/min</strong>: 100 mg first dose, then 50 mg once daily</li>\r\n	<li><strong>CrCl 15-29 ml/min</strong>: 100 mg first dose, then 25 mg once daily</li>\r\n	<li><strong>CrCl 5-14 ml/min</strong>: 35 mg first dose, then 15 mg once daily</li>\r\n	<li><strong>CrCl &lt;5 ml/min</strong>: 35 mg first dose, then 10 mg once daily</li>\r\n</ul>\r\n\r\n<p><strong>Use in children</strong>: Safety and efficacy of lamivudine for the treatment of chronic hepatitis B in children have not been established.</p>', '2022-03-07 22:40:44', '2022-03-07 22:40:44'),
(821, 821, '<p>Lamivudine in combination with other antiretroviral agents is indicated for the treatment of HIV infection.</p>', '<p>Lamivudine is a synthetic nucleoside analogue. Lamivudine is phosphorylated intracellularly to lamivudine triphosphate. Incorporation of the monophosphate form into viral DNA occurs by hepatitis B virus (HBV) polymerase. As a result DNA chain is terminated. Lamivudine triphosphate also inhibits the RNA and DNA dependent DNA polymerase activities of HIV-1 reverse transcriptase (RT). Lamivudine triphosphate is a very weak inhibitor of mammalian alpha, beta, and gamma-DNA polymerases.</p>\r\n\r\n<p>&nbsp;</p>', '<p><strong>Adults and adolescents over 12 years of age</strong>: The recommended dose for HIV infection is 300 mg daily. This is administered as 150 mg twice daily.<br />\r\n<br />\r\nChildren:</p>\r\n\r\n<ul>\r\n	<li><strong>Three months to 12 years of age</strong>: The recommended dose&nbsp;for HIV infection is 4 mg/kg twice daily up to a maximum of 300 mg daily.</li>\r\n	<li><strong>Less than three months of age</strong>: The limited data available are insufficient to propose specific dosage recommendations.</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>Lamivudine may be administered with or without food.</p>', '<p>The possibility of interactions with other medicinal products administered concurrently should be considered, particularly when the main route of elimination is active renal secretion. Administration of trimethoprim/sulfamethoxazole 160 mg/800 mg results in a 40% increase in Lamivudine exposure. Lamivudine and zalcitabine may inhibit the intracellular phosphorylation of one another. Therefore, use of Lamivudine in combination with zalcitabine is not recommended.</p>', '<p>Hypersensitivity to Lamivudine or to any of the excipients.</p>', '<p>The following adverse events have been reported during therapy for HIV disease with Lamivudine.<br />\r\n<br />\r\nBlood and lymphatic systems disorders-</p>\r\n\r\n<ul>\r\n	<li><strong>Uncommon</strong>: Neutropenia, anaemia and thrombocytopenia</li>\r\n	<li><strong>Very rare</strong>: Pure red cell aplasia</li>\r\n</ul>\r\n\r\n<p>Nervous system disorders-</p>\r\n\r\n<ul>\r\n	<li><strong>Common</strong>: Headache, insomnia</li>\r\n	<li><strong>Very rare</strong>: Cases of peripheral neuropathy (or paraesthesia).</li>\r\n</ul>\r\n\r\n<p>Respiratory, thoracic and mediastinal disorders</p>\r\n\r\n<ul>\r\n	<li><strong>Common</strong>: Cough, nasal symptoms-</li>\r\n</ul>\r\n\r\n<p>Gastrointestinal disorders-</p>\r\n\r\n<ul>\r\n	<li><strong>Common</strong>: Nausea, vomiting, abdominal pain or cramps, diarrhea</li>\r\n	<li><strong>Rare</strong>: Rises in serum amylase. Cases of pancreatitis have been reported.</li>\r\n</ul>\r\n\r\n<p>Hepatobiliary disorders-</p>\r\n\r\n<ul>\r\n	<li><strong>Uncommon</strong>: Transient rises in liver enzymes (AST, ALT).</li>\r\n	<li><strong>Rare</strong>: Hepatitis</li>\r\n</ul>\r\n\r\n<p>Skin and subcutaneous tissue disorders-</p>\r\n\r\n<ul>\r\n	<li><strong>Common</strong>: Rash, alopecia</li>\r\n</ul>\r\n\r\n<p>Musculoskeletal and connective tissue disorders-</p>\r\n\r\n<ul>\r\n	<li><strong>Common</strong>: Arthralgia, muscle disorders</li>\r\n	<li><strong>Rare</strong>: Rhabdomyolysis, Lipodystrophy</li>\r\n</ul>\r\n\r\n<p>General disorders and administration site conditions-</p>\r\n\r\n<ul>\r\n	<li><strong>Common</strong>: Fatigue, malaise, fever.</li>\r\n</ul>\r\n\r\n<p>Cases of lactic acidosis, usually associated with severe hepatomegaly and hepatic steatosis, have been reported with the use of nucleoside analogues.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C. The safety of Lamivudine in human pregnancy has not been established.<br />\r\n<br />\r\n<strong>Lactation</strong>: Following oral administration Lamivudine excreted in breast milk at similar concentrations to those found in serum. That&rsquo;s why it is recommended that mothers taking Lamivudine do not breast-feed their infants.</p>', '<p>Lamivudin is not recommended for use as monotherapy.&nbsp;In pediatric patients with a history of prior antiretroviral nucleoside exposure, a history of pancreatitis, or other significant risk factors for the development of pancreatitis, Lamivudine should be used with caution. Treatment with Lamivudine should be stopped immediately if clinical signs, symptoms, or laboratory abnormalities suggestive of pancreatitis occur<br />\r\n<br />\r\nLactic Acidosis/Severe Hepatomegaly with Steatosis: Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues alone or in combination, including Lamivudine and other antiretrovirals. A majority of these cases have been in women. Obesity and prolonged nucleoside exposure may be risk factors. Particular caution should be exercised when administering Lamivudine to any patient with known risk factors for liver disease.<br />\r\n<br />\r\nIn patients with moderate to severe renal impairment, the dose should be adjusted. Patients receiving Lamivudin or any other antiretroviral therapy may continue to develop opportunistic infections and other complications of HIV infection, and therefore should remain under close clinical observation by physicians experienced in the treatment of patients with associated HIV diseases.</p>', NULL, '<p>Drugs for HIV / Anti-retroviral drugs.</p>', '<p><strong>Tablet</strong>: Store in a cool and dry place, protect from light and moisture.<br />\r\n<strong>Oral Solution</strong>: Store in a cool and dry place, protect from light.</p>', '<p><strong>Renal impairment</strong>: Lamivudine concentrations are increased in patients with moderate to severe renal impairment due to decreased clearance. The dose should therefore be adjusted.<br />\r\n<br />\r\n<strong>Adults and adolescents over 12 years</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>CrCl 50 ml/min</strong>: first dose 150 mg &amp;&nbsp;maintenance dose 150 mg twice daily</li>\r\n	<li><strong>CrCl 30 to &lt;50&nbsp;ml/min</strong>:&nbsp;first dose 150 mg&nbsp;&amp;&nbsp;maintenance dose 150 mg once daily</li>\r\n	<li><strong>CrCl 15 to 29&nbsp;ml/min</strong>: first dose 150 mg&nbsp;&amp;&nbsp;maintenance dose 100 mg once daily</li>\r\n	<li><strong>CrCl 5 to 14&nbsp;ml/min</strong>:&nbsp;first dose 150 mg&nbsp;&amp;&nbsp;maintenance dose 50 mg once daily</li>\r\n	<li><strong>CrCl &lt;5&nbsp;ml/min</strong>: first dose 50 mg&nbsp;&amp;&nbsp;maintenance dose 25 mg once daily</li>\r\n</ul>\r\n\r\n<p><strong>Hepatic Impairment</strong>: Data obtained in patients with moderate to severe hepatic impairment shows that Lamivudine pharmacokinetics are not significantly affected by&nbsp;hepatic dysfunction. Based on these data, no dose adjustment is necessary in patients with moderate or severe hepatic impairment unless accompanied by renal impairment.</p>', '2022-03-07 22:43:30', '2022-03-07 22:43:30'),
(822, 822, '<p>Lamivudine and zidovudine tablets, a combination of 2 nucleoside analogue reverse transcriptase inhibitors, are indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection.</p>', '<p>Lamivudine and Zidovudine are synthetic nucleoside analogues with activity against human immunodeficiency virus (HIV).<br />\r\n<br />\r\n<strong>Lamivudine:</strong>&nbsp;Intracellularly, Lamivudine is phosphorylated to its active 5&rsquo;-triphosphate metabolite, Lamivudine triphosphate (L-TP). The principal mode of action of L-TP is inhibition of reverse transcription (RT) via DNA chain termination after incorporation of the nucleoside analogue. Following oral administration, Lamivudine is rapidly absorbed and extensively distributed. Binding to plasma protein is low.<br />\r\n<br />\r\n<strong>Zidovudine:</strong>&nbsp;Intracellularly, Zidovudine is phosphorylated to its active 5&rsquo;-triphosphate metabolite, Zidovudine triphosphate (ZDV-TP). The principal mode of action of ZDV-TP is inhibition of RT via DNA chain termination after incorporation of the nucleoside analogue. Following oral administration, Zidovudine is rapidly absorbed and extensively distributed. Binding to plasma protein is low. Zidovudine is eliminated primarily by hepatic metabolism.</p>', '<p><strong>Recommended Dosage for Adults and Adolescents</strong>: The recommended dosage of lamivudine and zidovudine tablets in HIV-1-infected adults and adolescents weighing greater than or equal to 30 kg is 1 tablet (containing 150 mg of lamivudine and 300 mg of zidovudine) taken orally twice daily.<br />\r\n<br />\r\n<strong>Recommended Dosage for Pediatric Patients</strong>: The recommended dosage of lamivudine and zidovudine tablets for pediatric patients who weigh greater than or equal to 30 kg and for whom a solid oral dosage form is appropriate is 1 tablet administered orally twice daily on an empty stomach. Before prescribing lamivudine and zidovudine tablets, children should be assessed for the ability to swallow tablets. If a child is unable to reliably swallow a lamivudine and zidovudine tablet, the liquid oral formulations should be prescribed.<br />\r\n<br />\r\nNot Recommended Due to Lack of Dosage Adjustment Because lamivudine and zidovudine tablets are a fixed-dose formulation and cannot be dose adjusted, lamivudine and zidovudine tablets are not recommended for:</p>\r\n\r\n<ul>\r\n	<li>Pediatric patients weighing less than 30 kg&nbsp;</li>\r\n	<li>Patients with creatinine clearance less than 50 mL per minute</li>\r\n	<li>Patients with hepatic impairment</li>\r\n	<li>Patients experiencing dose-limiting adverse reactions. Liquid and solid oral formulations of the individual components of lamivudine and zidovudine tablets are available for these populations.</li>\r\n</ul>', '<p>Cross-resistance may develop when given with emtricitabine. Exacerbation of anaemia with concomitant use of zidovudine with ribavirin. Increased adverse effects to zidovudine with nephrotoxic or myelosuppressive drugs (e.g. systemic pentamide, dapsone, pyrimethamine, co-trimoxazole, amphotericin, flucytosine, ganciclovir, interferon, vincristine, vinblastine, doxorubicin). Lamivudine and zalcitabine may inhibit the intracellular phosphorylation of one another. Antagonistic effect when zidovudine is used concomitantly with stavudine or doxorubicin.</p>', '<p>This is contraindicated in patients with previously demonstrated clinically significant hypersensitivity to any of the components of the product. Reduction of doses of Lamivudine is recommended for patients with low body weight (less than 50 kg or 110 lb); therefore, patients with low body weight should not receive Lamivudine &amp; Zidovudine.</p>', '<p>Side effects of this medicine-</p>\r\n\r\n<ul>\r\n	<li><strong>More common</strong>: Chills, fever, pale skin; sore throat; unusual tiredness or weakness, headache</li>\r\n	<li><strong>Less common</strong>: Abdominal pain, burning, tingling, numbness, or pain in the hands, arms, feet, or legs, muscle tenderness and weakness, nausea, skin rash, vomiting, yellow eyes or skin. Coughing, decreased appetite, diarrhea, dizziness and trouble in sleeping may occurs</li>\r\n</ul>', '<p>Pregnancy Category C. There arc no adequate and well controlled studies of this drug in pregnant women. This drug should be used during pregnancy only if the potential benefits outweigh the risks. The Centers for Disease Control and Prevention recommend that HIV-infected mothers should not breast-feed their infants to avoid risking postnatal transmission of HIV. Because of the potential for HIV transmission and the potential for serious adverse effects in nursing infants, mothers should be instructed not to breast feed if they are receiving efavirenz.</p>', '<p><strong>Patients with HIV and Hepatitis B virus Coinfection</strong>: Safety and efficacy of Lamivudine have not been established for treatment of chronic hepatitis B in patients dually infected with HIV and HBV. Emergence of hepatitis B virus variants associated with resistance to Lamivudine has also been reported in HIV-infected patients who have received Lamivuuine-containing antiretroviral regimens in the presence of concurrent infection with Hepatitis B virus. Post-treatment exacerbations of hepatitis have also been reported.<br />\r\n<br />\r\n<strong>Patients with Impaired Renal Function</strong>: Reduction of the dosages of Lamivudine and Zidovudine is recommended for patients with impaired renal function. Patients with creatinine clearance &lt;50 ml/min should not receive this combination tablet.<br />\r\n<br />\r\n<strong>Fat Redistribution</strong>: Redistribution/accumulation of body fat including central obesity, dorsocervical fat enlargement (buffalo hump), peripheral wasting, facial wasting, breast<br />\r\nenlargement, and cushingoid appearance have been observed in patients receiving antiretroviral therapy.</p>', NULL, '<p>Drugs for HIV / Anti-retroviral drugs</p>', '<p>Stored at a cool and dry place, protected from light and moisture. Keep the medicine out of the reach of children.</p>', NULL, '2022-03-07 22:45:46', '2022-03-07 22:45:46'),
(823, 823, '<p>A fixed dose combination of Lamivudine, Zidovudine and Nevirapine is recommended for HIV-1 infected patients who are able to tolerate maintenance therapy with Nevirapine 200 mg twice daily. All three drugs are to be administered twice daily and each tablet contains half of the daily dose for each component. Twice daily formulation in single tablet for three drugs is convenient for patients to take, ensuring higher rate of compliance.</p>', '<p>Lamivudine, Zidovudine &amp; Nevirapine synergistically reduce the viral resistance and inhibit reverse transcriptase via DNA chain termination.<br />\r\n<br />\r\n<strong>Lamivudine</strong>:&nbsp;Intracellularly, Lamivudine is phosphorylated to its active 5&rsquo;-triphosphate metabolite, Lamivudine triphosphate (L-TP). The principal mode of action of L-TP is inhibition of reverse transcription (RT) via DNA chain termination after incorporation of the nucleoside analogue. Following oral administration, Lamivudine is rapidly absorbed and extensively distributed. Binding to plasma protein is low.<br />\r\n<br />\r\n<strong>Zidovudine</strong>:&nbsp;Intracellularly, Zidovudine is phosphorylated to its active 5&rsquo;-triphosphate metabolite, Zidovudine triphosphate (ZDV-TP). The principal mode of action of ZDV-TP is inhibition of RT via DNA chain termination after incorporation of the nucleoside analogue. Following oral administration, Zidovudine is rapidly absorbed and extensively distributed. Binding to plasma protein is low. Zidovudine is eliminated primarily by hepatic metabolism.<br />\r\n<br />\r\n<strong>Nevirapine</strong>: Nevirapine binds directly to reverse transcriptase (RT) and blocks the RNA-dependent and DNA-dependent DNA polymerase activities by causing a disruption of the enzyme&#39;s catalytic site. The activity of nevirapine does not compete with template or nucleoside triphosphates.</p>', '<p><strong>Adult dose</strong>: One tablet twice daily. This fixed dose combination is not recommended for patients who have not been on initial lower dose of Nevirapine 200 mg once daily for 2 weeks and /or have not tolerated this dose. After successful therapy with low dose Nevirapine for two weeks, patients can be switched over to 200 mg bid dose provided they have not demonstrated any hypersensitivity reaction (rash, abnormal liver function tests) during their initial exposure to Nevirapine. Monitoring of patients for their liver function tests etc. is desirable prior to initiating therapy with Nevirapine and monitoring at frequent intervals once therapy with fixed dose combination is continued.<br />\r\n<br />\r\nDosage adjustment:</p>\r\n\r\n<ul>\r\n	<li><strong>Lamivudine</strong>: For patients with low body weight (&lt;50 kg) where dosage adjustment may be required, it is preferable not to use this fixed dose combination.</li>\r\n	<li><strong>Zidovudine</strong>: Because it is a fixed dose combination, this should not be prescribed for patients requiring dosage adjustment such as those with reduced renal function (creatinine clearance 50 ml/min) or those experiencing dose imiting adverse events.</li>\r\n	<li><strong>Nevirapine</strong>: For patients who experience severe rash or rash with constitutional complaints during the initial low dose Nevirapine phase of 14 days with once daily dose of 200 mg; neither, dose should be increased to twice daily nor they should receive triple fixed dose combination until the rash is resolved. Similarly for patients with abnormal liver function tests, Nevirapine therapy should be stopped till liver function return to normal and careful restart is advisable after extended observation. In event of recurrence, Nevirapine therapy can not be restarted.</li>\r\n	<li>For patients where Nevirapine therapy has to be restarted after an interruption, daily dose of Nevirapine 200 mg for 14 days should be followed with twice daily dose in absence of any hypersensitivity reaction. Studies have not been documented to suggest dosage of Nevirapine in patients with hepatic dysfunction, renal insufficiency or undergoing dialysis.</li>\r\n</ul>', '<p><strong>Zidovudine:</strong>&nbsp;acyclovir and valacyclovir may increase CNS depression. Increased risk of haematologic toxicity with ganciclovir, valganciclovir, dapsone, doxorubicin, vincristine and vinblastine. Doxorubicin may reduce phophorylation; fluconazole may increase levels/effects; increased risk of hepatic decompensation or haematologic toxicities with interferon and ribavirin (also increases risk of pancreatitis and lactic acidosis). Methadone may increase effects/levels. Increased risk of myalgia, malaise and/or fever, maculopapular rash and effects/levels with probenecid. Stavudine may decrease antiviral activity; valproic acid may increase plasma levels (AUC increased by 80%).<br />\r\n<br />\r\n<strong>Lamivudine</strong>: Increased risk of hepatic decompensation or haematologic toxicities with interferon and ribavirin (also increases risk of mitochondrial toxicity, pancreatitis and lactic acidosis). Ganciclovir and valganciclovir may increase effects and toxicity; sulfamethoxazole/ trimethoprim may increase AUC and decrease clearance (increasing levels and effects).</p>', '<p>History of hypersensitivity to Lamivudine, Zidovudine, Nevirapine and to any of the excipients available in formulation. Not to be used as initial therapy because initial therapy requires 200 mg once daily of Nevirapine whereas fixed dose combination allows for 200 mg twice daily of Nevirapine.</p>', '<p><strong>Lamivudine</strong>: Pancreatitis, paresthesia, peripheral neuropathy, cough, dizziness, fatigue, gastrointestinal problems, headache, insomnia, anaemia, neutropenia, drug induced skin rash, hair loss.<br />\r\n<br />\r\n<strong>Zidovudine</strong>: Headache (which may be severe, has been reported in up to 63% of patients receiving Zidovudine and asthenia has been reported in 9-69%), malaise and fatigue, fever or chills, nausea (61% cases), diaphoresis, dyspnoea, rash and taste perversion have been reported. Skin rashes and myalgia has been reported in patients receiving Zidovudine. Myopathy and myositis with pathologic changes similar to that produced by HIV infection, have been associated with prolonged use of Zidovudine. The major adverse effect is bone marrow toxicity resulting in severe anaemia and/or neutropenia. Patients with low serum folate or vitamin B12 concentrations may be at increased risk for developing bone marrow toxicity during Zidovudine therapy. There also are limited data suggesting that bone marrow of patients with fulminant acquired immunodeficiency syndrome (AIDS) may be more sensitive to Zidovudine induced toxicity than that of patients with less advanced disease (eg, AIDS related complex). Anaemia and granulocytopenia usually resolve when Zidovudine is discontinued or when dosage is decreased. Lactic acidosis (in the absence of hypoxaemia) and severe hepatomegaly with steatosis, including some fatalities, have been reported in patients receiving Zidovudine.<br />\r\n<br />\r\n<strong>Nevirapine</strong>: More frequent incidences are skin rash, diarrhoea, gastrointestinal problems, headache, nausea and stomach pain. Incidence of less frequents are aphthous stomatitis, fever, hepatitis and Stevens Johnson syndrome.</p>', '<p>Pregnancy Category C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks</p>', '<p>For the following conditions, assess risk to patient and take action as needed, chronic hepatitis B, hepatomegaly with steatosis, lactic acidosis, liver function impairment, severe renal function impairment, peripheral neuropathy.</p>', NULL, '<p>Drugs for HIV / Anti-retroviral drugs.</p>', '<p>Should be stored in cool and dry place.</p>', NULL, '2022-03-07 22:47:56', '2022-03-07 22:47:56'),
(824, 824, '<p>Lamotrigine is indicated for:<br />\r\n<br />\r\nEpilepsy-combination therapy in patients aged 2 years and older:</p>\r\n\r\n<ul>\r\n	<li>partial-onset seizures</li>\r\n	<li>primary generalized tonic-clonic seizures</li>\r\n	<li>generalized seizures of Lennox-Gastaut syndrome</li>\r\n</ul>\r\n\r\n<p>Epilepsy-monotherapy in patients aged 16 years and older.<br />\r\n<br />\r\nAdults with Bipolar Disorder.</p>', '<p>The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.<br />\r\n<br />\r\nLamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.<br />\r\n<br />\r\nLamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, &alpha;1/&alpha;2/&beta; adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, &kappa;-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50&gt;100 &micro;M. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.</p>', '<p><strong>Epilepsy</strong>-<br />\r\n<strong>Table-1:</strong>&nbsp;<strong>Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy</strong></p>\r\n\r\n<p>Weeks 1 &amp; 2:</p>\r\n\r\n<ul>\r\n	<li>In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day</li>\r\n	<li>In patients taking Valproate: 25 mg every other day</li>\r\n	<li>In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day</li>\r\n</ul>\r\n\r\n<p>Weeks 3 &amp; 4:</p>\r\n\r\n<ul>\r\n	<li>In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day</li>\r\n	<li>In patients taking Valproate: 25 mg every day</li>\r\n	<li>In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)</li>\r\n</ul>\r\n\r\n<p>Week 5 onward to maintenance:</p>\r\n\r\n<ul>\r\n	<li>In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks</li>\r\n	<li>In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks</li>\r\n	<li>In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks</li>\r\n</ul>\r\n\r\n<p>Usual maintenance dose:</p>\r\n\r\n<ul>\r\n	<li>In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)</li>\r\n	<li>In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)</li>\r\n	<li>In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)</li>\r\n</ul>\r\n\r\n<p><strong>Table-2: Escalation Regimen for Lamotrigine in Patients Aged 2 to 12 Years with Epilepsy</strong><br />\r\n<br />\r\nWeeks 1 &amp; 2:</p>\r\n\r\n<ul>\r\n	<li>In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses</li>\r\n	<li>In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses</li>\r\n	<li>In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)</li>\r\n</ul>\r\n\r\n<p>Weeks 3 &amp; 4:<br />\r\nIn patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)</p>\r\n\r\n<ul>\r\n	<li>In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses</li>\r\n	<li>In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)</li>\r\n</ul>\r\n\r\n<p>Week 5 onward to maintenance:</p>\r\n\r\n<ul>\r\n	<li>In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day</li>\r\n	<li>In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day</li>\r\n	<li>In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day</li>\r\n</ul>\r\n\r\n<p>Usual maintenance dose:</p>\r\n\r\n<ul>\r\n	<li>In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)</li>\r\n	<li>In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)</li>\r\n	<li>In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)</li>\r\n</ul>\r\n\r\n<p><strong>Table-3:</strong>&nbsp;<strong>The Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4) with Epilepsy</strong><br />\r\n<br />\r\nWeeks 1 &amp; 2:</p>\r\n\r\n<ul>\r\n	<li>If the patients weight is 6.7 kg to 14 kg: 2 mg every other day</li>\r\n	<li>If the patients weight is 14.1 kg to 27 kg: 2 mg every day</li>\r\n	<li>If the patients weight is 27.1 kg to 34 kg: 4 mg every day</li>\r\n	<li>If the patients weight is 34.1 kg to 40 kg: 5 mg every day</li>\r\n</ul>\r\n\r\n<p>Weeks 3 &amp; 4:</p>\r\n\r\n<ul>\r\n	<li>If the patients weight is 6.7 kg to 14 kg: 2 mg every day</li>\r\n	<li>If the patients weight is 14.1 kg to 27 kg: 4 mg every day</li>\r\n	<li>If the patients weight is 27.1 kg to 34 kg: 8 mg every day</li>\r\n	<li>If the patients weight is 34.1 kg to 40 kg: 10 mg every day</li>\r\n</ul>\r\n\r\n<p><strong>Bipolar disorder</strong>-<br />\r\n<br />\r\n<strong>Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder</strong><br />\r\nWeeks 1 &amp; 2:</p>\r\n\r\n<ul>\r\n	<li>In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily</li>\r\n	<li>In patients taking Valproate: 25 mg every other day</li>\r\n	<li>In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily</li>\r\n</ul>\r\n\r\n<p>Weeks 3 &amp; 4:</p>\r\n\r\n<ul>\r\n	<li>In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily</li>\r\n	<li>In patients taking Valproate: 25 mg daily</li>\r\n	<li>In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)</li>\r\n</ul>\r\n\r\n<p>Week 5:</p>\r\n\r\n<ul>\r\n	<li>In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily</li>\r\n	<li>In patients taking Valproate: 50 mg daily</li>\r\n	<li>In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)</li>\r\n</ul>\r\n\r\n<p>Week 6:</p>\r\n\r\n<ul>\r\n	<li>In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily</li>\r\n	<li>In patients taking Valproate: 100 mg daily</li>\r\n	<li>In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)</li>\r\n</ul>\r\n\r\n<p>Week 7:</p>\r\n\r\n<ul>\r\n	<li>In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily</li>\r\n	<li>In patients taking Valproate: 100 mg daily</li>\r\n	<li>In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)</li>\r\n</ul>', '<p>Lamotrigine interacts with Oral contraceptives, Atazanavir/ritonavir, Carbamazepine, Levetiracetam, Lithium, Lopinavir/ritonavir , Olanzapine, Phenobarbital/primidone , Phenytoin, Pregabalin etc.</p>', NULL, '<p>Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.</p>', '<p>Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.</p>', '<p>Overdose has resulted in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased level of consciousness, coma, and intraventricular conduction delay.</p>', '<p>Primary anti-epileptic drugs</p>', '<p>Store below 30&deg;C. Protect from light and moisture. Keep out of the reach of children.</p>', '<p>Pediatric Use:</p>\r\n\r\n<ul>\r\n	<li><strong>Epilepsy</strong>: Safety and effectiveness of Lamotrigine used as adjunctive treatment for partial onset seizures were not demonstrated in very young pediatric patient&#39;s aged 1 to 24 months.</li>\r\n	<li><strong>Bipolar Disorder</strong>: Safety and effectiveness of Lamotrigine for the maintenance treatment of bipolar disorder were not established in pediatric patient&#39;s aged 10 to 17 years.</li>\r\n</ul>', '2022-03-07 22:50:43', '2022-03-07 22:50:43'),
(825, 825, '<p>Lansoprazole is indicated for:</p>\r\n\r\n<ul>\r\n	<li>Short term treatment of active duodenal ulcer</li>\r\n	<li>Maintenance of healed duodenal ulcers</li>\r\n	<li>Short term treatment of active benign gastric ulcers</li>\r\n	<li>Short term treatment of active erosive esophagitis</li>\r\n	<li>Maintenance of healing of erosive esophagitis</li>\r\n	<li>Pathological hypersecretory conditions including Zollinger- Ellison Syndrome</li>\r\n	<li>H. pylori eradication to reduce the risk of duodenal ulcer recurrence.</li>\r\n</ul>', '<p>Lansoprazole is a substituted benzimidazole, and is also known as PPI due to its property to block the final step of acid secretion by inhibiting H+/K+&nbsp;ATPase enzyme system in gastric parietal cell. Both basal and stimulated acid are inhibited.</p>', '<p><strong>Benign gastric ulcer</strong>: 30 mg daily in the morning for 8 weeks.<br />\r\n<br />\r\n<strong>Duodenal ulcer</strong>: 30 mg daily in the morning for 4 weeks; maintenance 15 mg.<br />\r\n<br />\r\n<strong>NSAID-associated duodenal or gastric ulcer</strong>: 15-30 mg daily for 4 weeks, followed by a further 4 weeks if not fully healed.<br />\r\n<br />\r\n<strong>Zollinger-Ellison syndrome (and other hypersecretory conditions)</strong>: Initially 60 mg once daily adjusted according to response; daily doses of 120 mg or more is given in two divided doses.<br />\r\n<br />\r\n<strong>Gastroesophageal reflux disease</strong>: 30 mg daily in the morning for 4 weeks, followed by a further 4 weeks if not fully healed; maintenance 15-30 mg daily.<br />\r\n<br />\r\n<strong>Acid-related dyspepsia</strong>: 15-30 mg daily in the morning for 2-4 weeks.</p>', '<p>Lansoprazole appears to be a selective inhibitor of the cytochrome P-450 monooxygenase system; there may be an effect on hepatic clearance, but there have been no reports to date of clinically relevant interactions. There is some uncertainty over the effect of Lansoprazole on the oral combined contraceptive pill. Further assessment is currently underway. Physiological changes similar to those found with Omeprazole are likely to take place because of the reduction in gastric acid, which is likely to influence the bacterial colonization of the stomach and duodenum and also vitamin B12 absorption.</p>', '<p>Lansoprazole is contraindicated in patients with known hypersensitivity to any component of the formulation.</p>', '<p><strong>Severe or irreversible adverse effects</strong>: The possible induction of carcinoid tumors by profound acid suppression, and a rise in serum gastrin may occur. There is a rise in serum gastrin levels in the first 3 months of treatment, which are then maintained though at a lower level than those found in pernicious anaemia. Long term treatment with a proton pump inhibitor in patients with Helicobacter pylori infection may accelerate the development of atrophic gastritis.<br />\r\n<br />\r\n<strong>Symptomatic adverse effect</strong>: Dose dependent diarrhoea occurs with an incidence of about 4% at 30 mg per day, rising to 8% at 60 mg per day. Headache occurs in 2-3% of treated patients.</p>', '<p>Lansoprazole should be avoided in pregnancy unless there are compelling reasons.</p>', '<p>Gastric malignancy should be ruled out. Hepatic impairment. Pregnancy and lactation.</p>', NULL, '<p>Proton Pump Inhibitor.</p>', '<p>Store at 25&deg; C.</p>', '<p><strong>Neonates</strong>:There is no relevant human data. The drug is not recommended for use with neonates.<br />\r\n<br />\r\n<strong>Children:</strong>&nbsp;The youngest person to have received Lansoprazole in clinical trials was 13 years old.<br />\r\n<br />\r\n<strong>The Elderly</strong>: No problems have been encoun- tered in clinical use and there has been no increase in adverse drug reaction in the elderly.</p>', '2022-03-07 22:52:34', '2022-03-07 22:52:34');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(826, 826, '<p>This is indicated for the eradication of H. pylori in active chronic gastric, duodenal and gastric ulcers.</p>', '<p>Lansoprazole is a proton-pump inhibitor which inhibits the stomach&#39;s production of gastric acids.<br />\r\n<br />\r\nAmoxicillin is a penicillin antibiotic. It acts by inhibiting the synthesis of bacterial cell walls.lt inhibits cross-linkage between the linear peptidoglycan polymer chains that make up a major component of the cell walls of both Gram-positive and Gram-negative bacteria.<br />\r\n<br />\r\nClarithromycin is a macrolide antibiotic.It prevents bacteria from growing by interfering with their protein synthesis. It binds to the subunit 50S of the bacterial ribosome and thus inhibits the translation of peptides.</p>', '<p>One strip twice daily for 7-14 days or as per the physician&#39;s advice.</p>', '<p>Lansoprazole is metabolized through the cytochrome P450 system,specially through the CYP3A and CYP2C19 isozymes.Studies in healthy subjects have shown that Lansoprazole does not have clinically significant interactions with other drugs metabolized by the cytochrome P450 system, such as warfarin, antipyrine, indomethacin, ibuprofen, phenytoin, propranolol, prednisolone, diazepam, clarithromycin or terfenadine.<br />\r\n<br />\r\nClarithromycin use in patients who are receiving theophylline may be associated with increase of serum theophylline concentrations.<br />\r\n<br />\r\nThere have been reports of interactions of erythromycin and/or clarithromycin with carbamazepine, cyclosporine, tacrolimus, hexobarbital, phenytoin, alfetanil, disopyramide, lovastatin, bromocriptine, valproate, terfenadine, cisapride, pimozide &amp; astemizole.</p>', '<p>This is contraindicated in patients with known hypersensitivity to any of its component.</p>', '<p>Adverse reactions which were reported as possibly or probably related to treatment (&gt;3%) in clinical trials when all three components of this therapy were given concomitantly are listed below and devided by body systems.<br />\r\n<br />\r\n<strong>Digestive system</strong>: Nausea, vomitng, diarrhoea, dark stools, dry mouth, glossitis, oral moniliasis, stomatitis, tongue discoloration<br />\r\n<strong>Musculoskeletal System</strong>: myalgia<br />\r\n<strong>Nervous System</strong>: confusion,headache,dizziness;<br />\r\n<strong>Skin</strong>: skin reactions<br />\r\n<strong>Urogenital System</strong>: vaginitis,vaginal moniliasis.</p>', '<p>There were no adequate and well-controlled studies&nbsp; in pregnant women. This should be used during pregnancy only if the potential benefit justifies the potential risk of the mother. Amoxicillin is excreted in human milk in very small amounts. Because of the potential for serious adverse reactions in nursing infants. A decision should be made whether to discontinue nursing or to discontinue the drug therapy, taking into account the importance of the therapy to the mother.</p>', '<p>Serious and occasionally fatal hypersensitivity (anaphylactoid) reactions have been reported in patients on Amoxicillin therapy. These reactions are more appropriate to occur in individuals with a history of penicillin hypersensitivity. Clarithromycin should not be used in pregnant women except in clinical circumstances where no alternative therapy is appropriate.</p>', NULL, '<p>Anti H. pylori drugs</p>', '<p>Store in a cool and dry place, protected from light.</p>', '<p><strong>Pediatric Use</strong>: Because of incompletely developed renal function in neonates and young infants, the elimination of amoxicillin may be delayed. Dosing of amoxicillin should be modified in pediatric patients 12 weeks or younger (&le; 3 months)<br />\r\n<br />\r\n<strong>Geriatric use</strong>: Elderly patients may suffer from asymptomatic renal and hepatic dysfunction. Care should be taken when administering to these patients.</p>', '2022-03-08 05:44:18', '2022-03-08 05:44:18'),
(827, 827, '<p>Lanthanum Carbonate is a phosphate binder indicated to reduce serum phosphate in patients with end-stage renal disease (ESRD).</p>', '<p>Lanthanum Carbonate is a phosphate binder that reduces absorption of phosphate by forming insoluble Lanthanum phosphate complexes that pass through the Gl tract unabsorbed. Both serum phosphate and calcium phosphate product are reduced as a consequence of the reduced dietary phosphate absorption.<br />\r\n<br />\r\nIn vitro studies have shown that Lanthanum binds phosphate in the physiologically relevant pH range of 3 to 7. In simulated gastric fluid, Lanthanum binds approximately 97% of the available phosphate at pH 3-5 and 67% at pH 7, when Lanthanum is present in a two-fold molar excess to phosphate. Bile acids have not been shown to affect the phosphate binding affinity of Lanthanum. In order to bind dietary phosphate, Lanthanum Carbonate must be administered with or immediately after meals.</p>', '<p>The recommended initial total daily dose of Lanthanum Carbonate is 1,500 mg in divided doses. Titrate every 2 to 3 weeks based on serum phosphate level. Take Lanthanum Carbonate with or immediately after meals.<br />\r\n<br />\r\nLanthanum Carbonate Chewable Tablets: Do not swallow tablets whole. Chew or crush tablet completely before swallowing.</p>', '<p><strong>Drugs Binding to Antacids</strong>: There is a potential for Lanthanum Carbonate to interact with compounds which bind to cationic antacids (i.e., aluminum-,magnesium-, or calcium-based); therefore, do not administer such compounds within 2 hours of dosing with Lanthanum Carbonate.<br />\r\n<br />\r\n<strong>Quinolone Antibiotic</strong>s: Co-administration of Lanthanum Carbonate with quinolone antibiotics may reduce the extent of their absorption. The bioavailability of oral ciprofloxacin was decreased by approximately 50% when taken with Lanthanum Carbonate in a single-dose study in healthy volunteers. Administer oral quinolone antibiotics at least 1 hour before or 4 hours after Lanthanum Carbonate. When oral quinolones are given for short courses, consider eliminating the doses of Lanthanum Carbonate that would normally be scheduled near the time of quinolone intake to improve quinolone absorption.<br />\r\n<br />\r\n<strong>Levothyroxine</strong>: the bioavailability of levothyroxine was decreased by approximately 40% when taken together with Lanthanum Carbonate. Administer thyroid hormone replacement therapy at least 2 hours before or 2 hours after dosing with Lanthanum Carbonate and monitor thyroid stimulating hormone (TSH).</p>', '<p>Contraindicated in bowel obstruction, including ileus and fecal impaction.</p>', '<p>The most common adverse reactions for Lanthanum Carbonate were gastrointestinal events, such as nausea, vomiting, and abdominal pain and they generally abated over time with continued dosing. The following adverse reactions have been identified during post-approval use of Lanthanum Carbonate constipation, dyspepsia, allergic skin reactions, and tooth injury while chewing the tablet.</p>', '<p><strong>Pregnancy</strong>: Available data from case reports with use of Lanthanum Carbonate in pregnant women are insufficient to identify a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Use a non-Lanthanum containing phosphate binder in a pregnant woman.<br />\r\n<br />\r\n<strong>Lactation</strong>: There are no data on the presence of Lanthanum Carbonate from Lanthanum Carbonate in human milk, the effects on the breastfed infant, or the effects on milk production. Use a non-Lanthanum containing phosphate binder in a lactating woman.</p>', '<p>Gastrointestinal Adverse Effects: Serious cases of gastrointestinal obstruction, ileus, subileus, gastrointestinal perforation, and fecal impaction have been reported in patients taking Lanthanum, some requiring surgery or hospitalization. During treatment with Lanthanum Carbonate, physicians and patients should remain vigilant for signs and symptoms of gastrointestinal disorders, especially constipation and abdominal pain/distention, which may indicate bowel obstruction, ileus, or subileus. Treatment with Lanthanum Carbonate should be re-evaluated in patients who develop severe constipation or other severe gastrointestinal signs and symptoms. Advise patients who are prescribed Lanthanum Carbonate Chewable Tablets to chew the tablet completely and not to swallow them whole. Serious gastrointestinal complications have been reported in association with unchewed or incompletely chewed tablets.</p>', '<p>The symptoms associated with overdose are adverse reactions such as headache, nausea and vomiting. In clinical trials in healthy adults, gastrointestinal (Gl) symptoms were reported with daily doses up to 6,000 mg/day of Lanthanum Carbonate administered with food.</p>', '<p>Drugs used in chronic kidney dialysis.</p>', '<p>Store in a cool (below 30&deg; C) and dry place, away from light. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: The safety and efficacy of Lanthanum Carbonate in pediatric patients have not been established. The use of Lanthanum Carbonate in this population is not recommended.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Of the total number of patients in clinical studies of Lanthanum Carbonate, 32% (538) were &gt;65 years of age, while 9.3% (159) were &gt;75 years of age. No overall differences in safety or effectiveness were observed between patients &gt;65 years of age and younger patients.</p>', '2022-03-08 05:47:50', '2022-03-08 05:47:50'),
(828, 828, '<p>Lapatinib, a kinase inhibitor, is indicated in combination with:</p>\r\n\r\n<ul>\r\n	<li>Capecitabine, for the treatment of patients with advanced or metastatic breast cancer whose tumors overexpress HER2 and who have received prior therapy including an anthracycline, a taxane, and trastuzumab.</li>\r\n	<li>Letrozole for the treatment of postmenopausal women with hormone receptor positive metastatic breast cancer that overexpresses the HER2 receptor for whom hormonal therapy is indicated.</li>\r\n</ul>\r\n\r\n<p>Lapatinib in combination with an aromatase inhibitor has not been compared to a trastuzumab-containing chemotherapy regimen for the treatment of metastatic breast cancer.</p>', '<p>Lapatinib is a 4-anilinoquinazoline tyrosine kinase inhibitor of both Epidermal Growth Factor Receptor (EGFR [ErbB1]) and Human Epidermal Receptor Type 2 (HER2 [ErbB2]) receptors. It blocks the phosphorylation and activation of downstream 2nd messengers (Erk1/2 and Akt) which regulate cellular proliferation and survival of ErbB- and ErbB2-expressing tumours.</p>', '<p>The recommended dosage of Lapatinib for advanced or metastatic breast cancer is 1,250 mg (5 tablets) given orally once daily on Days 1-21 continuously in combination with capecitabine 2,000 mg/m2/day (administered orally in 2 doses approximately 12 hours apart) on Days 1-14 in a repeating 21 day cycle.<br />\r\n<br />\r\nThe recommended dose of Lapatinib for hormone receptor positive, HER2 positive metastatic breast cancer is 1500 mg (6 tablets) given orally once daily continuously in combination with letrozole. When Lapatinib is coadministered with letrozole, the recommended dose of letrozole is 2.5 mg once daily.</p>\r\n\r\n<ul>\r\n	<li>Lapatinib should be taken at least one hour before or one hour after a meal. However, capecitabine should be taken with food or within 30 minutes after food.</li>\r\n	<li>Lapatinib should be taken once daily. Do not divide daily doses of Lapatinib.</li>\r\n	<li>Modify dose for cardiac and other toxicities, severe hepatic impairment, and CYP3A4 drug interactions.</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 at least 1 hr before or 1 hr after a meal. Do not eat/drink grapefruit products.</p>', '<p>May increase the serum levels of CYP3A4, CYP2C8 and P-glycoprotein substrates. Increased exposure with CYP3A4 inhibitors (e.g. ketoconazole, clarithromycin, atazanavir, ritonavir). CYP3A4 inducers (e.g. carbamazepine, rifampicin) may reduce exposure to lapatinib. Increased risk of QT prolongation with drugs known to prolong QT intervals (e.g. antiarrythmic agents, cumulative high-dose anthracycline therapy). May increase serum levels of digoxin.</p>', '<p>Contraindicated to hypersensitivity to any other ingredient of this product.</p>', '<p>GI disturbances, dermatological reactions (e.g. palmar-plantar erythrodysesthesia, rash), fatigue, decreases in LVEF, QT interval prolongation, stomatitis, mucosal inflammation, pain in extremities, back pain, dyspnoea, insomnia, epistaxis, alopecia, nail disorders (e.g. paronychia), interstitial lung disease, pneumonitis and hypersensitivity reactions including anaphylaxis.</p>', '<p>Pregnancy category D. There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Patient with hypokalaemia or hypomagnesaemia, congenital QT prolongation. Severe hepatic impairment. Pregnancy and lactation.</p>', NULL, '<p>Cytotoxic Chemotherapy</p>', '<p>Store between 15-30&deg; C.</p>', '<p><strong>Patient on potent CYP3A4 inhibitor-</strong></p>\r\n\r\n<ul>\r\n	<li>HER2 overexpressing advanced or metastatic breast cancer: Increase gradually from 1.25 g daily up to 4.5 g daily.</li>\r\n	<li>HER2 overexpressing hormone receptor positive metastatic breast cancer: Increase gradually from 1.5 g daily up to 5.5 g daily.</li>\r\n</ul>\r\n\r\n<p><strong>Hepatic Impairment (Severe)-</strong></p>\r\n\r\n<ul>\r\n	<li>HER2 overexpressing advanced or metastatic breast cancer: 750 mg once daily.</li>\r\n	<li>HER2 overexpressing hormone receptor positive metastatic breast cancer: 1 g once daily.</li>\r\n</ul>', '2022-03-08 05:50:41', '2022-03-08 05:50:41'),
(829, 829, '<p>Larotrectinib is indicated for the treatment of adult and pediatric patients with solid tumors that:</p>\r\n\r\n<ul>\r\n	<li>have a neurotrophic receptor tyrosine kinase (NTRK) gene fusion without a known acquired resistance mutation,</li>\r\n	<li>are metastatic or where surgical resection is likely to result in severe morbidity, and</li>\r\n	<li>have no satisfactory alternative treatments or that have progressed following treatment.</li>\r\n</ul>', '<p>Larotrectinib is an inhibitor of the tropomyosin receptor kinases (TRK), TRKA, TRKB, and TRKC. In a broad panel of purified enzyme assays, larotrectinib inhibited TRKA, TRKB, and TRKC with IC50 values between 5-11 nM. One other kinase TNK2 was inhibited at approximately 100-fold higher concentrations. TRKA, B, and C are encoded by the genes NTRK1, NTRK2, and NTRK3. Chromosomal rearrangements involving in-frame fusions of these genes with various partner scan result in constitutively activated chimeric TRK fusion proteins that can act as an oncogenic driver, promoting cell proliferation and survival in tumor cell lines.<br />\r\n<br />\r\n<strong>Absorption</strong>: The mean absolute bioavailability of Larotrectinib capsules was 34% (range: 32% to 37%).<br />\r\n<br />\r\n<strong>Distribution</strong>: The mean (CV%) volume of distribution (Vss) of Larotrectinib is 48 (38%) L following intravenous administration of Larotrectinib in healthy subjects. Larotrectinib is 70% bound to human plasma proteins in vitro and binding is independent of drug concentrations. The blood-to-plasma concentration ratio is 0.9.<br />\r\n<br />\r\n<strong>Elimination</strong>: The mean (CV%) clearance (CL/F) of Larotrectinib is 98 (44%) L/h and the half-life is 2.9 hours following oral administration of Larotrectinib in healthy subjects.<br />\r\n<br />\r\n<strong>Metabolism</strong>: Larotrectinib is metabolized predominantly by CYP3A4. Following oral administration of a single [14C] radiolabeled 100 mg dose of Larotrectinib to healthy subjects, unchanged Larotrectinib constituted 19% and an O-linked glucuronide constituted 26% of the major circulating radioactive drug components in plasma.<br />\r\n<br />\r\n<strong>Excretion</strong>: Following oral administration of a single [ 14 C] radiolabeled 100 mg dose of Larotrectinib to healthy subjects, 58% (5% unchanged) of the administered radioactivity was recovered in feces and 39% (20% unchanged) was recovered in urine.</p>', '<p><strong>Recommended Dosage in Adult and Pediatric Patients with Body Surface Area of at Least 1 m2</strong>: The recommended dosage of Larotrectinib is 100 mg orally twice daily, with or without food, until disease progression or until unacceptable toxicity.<br />\r\n<br />\r\n<strong>Recommended Dosage in Pediatric Patients with Body Surface Area Less Than 1 m2</strong>: The recommended dosage of Larotrectinib is 100 mg/m2&nbsp;orally twice daily, with or without food, until disease progression or until unacceptable toxicity. Whole capsules should be swallowed with water and the capsules should not be chewed or crushed. A missed dose should not be made up within 6 hours of the next scheduled dose. If vomiting occurs after taking a dose of Larotrectinib, the next dose should be taken at the scheduled time. Or, as directed by the registered physicians.</p>', '<p><strong>Effects of Other Drugs on Larotrectinib</strong>: Strong CYP3A4 Inhibitors: Coadministration of Larotrectinib with a strong CYP3A4 inhibitor may increase Larotrectinib plasma concentrations, which may result in a higher incidence of adverse reactions. Coadministration of Larotrectinib should be avoided with strong CYP3A4 inhibitors, including grapefruit or grapefruit juice. If coadministration of strong CYP3A4 inhibitors cannot be avoided, Larotrectinib dose as recommended should be modified.<br />\r\n<br />\r\n<strong>Strong CYP3A4 Inducers</strong>: Coadministration of Larotrectinib with a strong CYP3A4 inducer may decrease Larotrectinib plasma concentrations, which may decrease the efficacy of Larotrectinib. Coadministration of Larotrectinib should be avoided with strong CYP3A4 inducers, including St. John&rsquo;s wort. If coadministration of strong CYP3A4 inducers cannot be avoided, Larotrectinib dose as recommended should be modified.<br />\r\n<br />\r\n<strong>Effects of Larotrectinib on Other Drugs</strong>: Sensitive CYP3A4 Substrates: Coadministration of Larotrectinib with sensitive CYP3A4 substrates may increase their plasma concentrations, which may increase the incidence or severity of adverse reactions. Coadministration of Larotrectinib should be avoided with sensitive CYP3A4 substrates. If coadministration of these sensitive CYP3A4 substrates cannot be avoided, patients for increased adverse reactions of these drugs should be monitored.</p>', '<p>It is contraindicated in patients with known hypersensitivity to Larotrectinib or any other components of this product.</p>', '<p>Common side effects are Neurotoxicity, Hepatotoxicity.</p>', '<p>Larotrectinib can cause embryo-fetal harm when administered to a pregnant woman. There are no available data on Larotrectinib&nbsp;use in pregnant women. Pregnant women should be advised of the potential risk to a fetus. There are no data on the presence of Larotrectinib or its metabolites in human milk and no data on its effects on the breastfed child or on milk production. Because of the potential for serious adverse reactions in breastfed children, women should be advised not to breastfeed during treatment with Larotrectinib and for 1 week after the final dose.</p>', '<p><strong>Neurotoxicity</strong>: Among the 176 patients who received Larotrectinib, neurologic adverse reactions of any grade occurred in 53% of patients, including Grade 3 and Grade 4 neurologic adverse reactions in 6% and 0.6% of patients, respectively. The majority (65%) of neurologic adverse reactions occurred within the first three months of treatment (range: 1 day to 2.2 years). Grade 3 neurologic adverse reactions included delirium (2%), dysarthria (1%), dizziness (1%), gait disturbance (1%), and paresthesia (1%). Grade 4 encephalopathy (0.6%) occurred in a single patient. Neurologic adverse reactions leading to dose modification included dizziness (3%), gait disturbance (1%), delirium (1%), memory impairment (1%), and tremor (1%). Patients and caretakers should be advised of these risks with Larotrectinib. Patients should be advised not to drive or operate hazardous machinery if they are experiencing neurologic adverse reactions. Larotrectinib should be withheld or permanently discontinued based on the severity. If withheld, Larotrectinib dosage should be modified when resumed.<br />\r\n<br />\r\n<strong>Hepatotoxicity</strong>: Among the 176 patients who received Larotrectinib, increased transaminases of any grade occurred in 45%, including Grade 3 increased AST or ALT in 6% of patients. One patient (0.6%) experienced Grade 4 increased ALT. The median time to onset of increased AST was 2 months (range: 1 month to 2.6 years). The median time to onset of increased ALT was 2 months (range: 1 month to 1.1 years). Increased AST and ALT leading to dose modifications occurred in 4% and 6% of patients, respectively. Increased AST or ALT led to permanent discontinuation in 2% of patients. Liver tests should be monitored, including ALT and AST, every 2 weeks during the first month of treatment, then monthly thereafter, and as clinically indicated. Larotrectinib should be withheld or permanently discontinued based on the severity. If withheld, Larotrectinib dosage should be modified when resumed.<br />\r\n<br />\r\n<strong>Embryo-Fetal Toxicity</strong>: Based on literature reports in human subjects with congenital mutations leading to changes in TRK signaling, findings from animal studies, and its mechanism of action, Larotrectinib can cause fetal harm when administered to a pregnant woman. Women should be advised of the potential risk to a fetus. Females of reproductive potential should be advised to use an effective method of contraception during treatment and for 1 week after the final dose of Larotrectinib.</p>', NULL, NULL, '<p>Store below 30&deg;C in a cool and dry place, away from sunlight. Keep out of reach of children.</p>', '<p><strong>Females</strong>: Female patients of reproductive potential should be advised to use effective contraception during treatment with Larotrectinib and for at least 1 week after the final dose.<br />\r\n<br />\r\n<strong>Males</strong>: Males with female partners of reproductive potential should be advised to use effective contraception during treatment with Larotrectinib and for 1 week after the final dose.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: The safety and effectiveness of Larotrectinib in pediatric patients was established based upon data from three multicenter, open-label, single-arm clinical trials in adult or pediatric patients 28 days and older.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of Larotrectinib did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.</p>', '2022-03-08 05:53:29', '2022-03-08 05:53:29'),
(830, 830, '<p>Latanoprost Sterile Ophthalmic Solution is indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension.</p>', '<p>Latanoprost is an analogue of prostaglandin F2&alpha;. Latanoprost is a prostanoid selective FP receptor agonist that is believed to reduce the intraocular pressure (IOP) by increasing the outflow of aqueous humor. Studies in animals and man suggest that the main mechanism of action is increased uveoscleral outflow. Elevated IOP represents a major risk factor for glaucomatous field loss. The higher the level of IOP, the greater the likelihood of optic nerve damage and visual field loss.</p>', '<p>The recommended dosage is 1 drop (1.5 mcg) in the affected eye(s) once daily in the evening. This is for topical ophthalmic use only. Not for injection or oral use.</p>', '<p>In vitro studies have shown that precipitation occurs when eye drops containing thimerosal are mixed with latanoprost. If such drugs are used they should be administered with an interval of at least 5 minutes between applications.</p>', '<p>Known hypersensitivity to latanoprost, benzalkonium chloride or any other ingredients in this product.</p>', '<p>Eyelash changes (increased length, thickness, pigmentation, and number of lashes); eyelid skin darkening; intraocular inflammation (iritis/uveitis); iris pigmentation changes; and macular edema, including cystoid macular edema. The ocular adverse events and ocular signs and symptoms reported in 5- 15% of the patients on latanoprost in the 6 month, multicenter, double-masked, active-controlled trials were blurred vision, burning and stinging, conjunctival hyperemia, foreign body sensation, itching, increased pigmentation of the iris, and punctate epithelial keratopathy. Local conjunctiva hyperemia was observed; however, less than 1% of the latanoprost treated patients required discontinuation of therapy because of intolerance to conjunctival hyperemia.</p>', '<p>Pregnancy Category C. There are no adequate and well controlled studies in pregnant women. The drug should be used&nbsp;during pregnancy only if the potential benefit justifies the potential risk to the fetus.</p>', '<p>Ophthalmic Solution may gradually increase the pigmentation of the iris. The eye color change is due to increased melanin content in the stromal melanocytes of the iris rather than to an increase in the number of melanocytes. During clinical trials, the increase in brown iris pigment has not been shown to progress further upon discontinuation of treatment, but the resultant color change may be permanent. Eyelid skin darkening, which may be reversible. There may be increased length, thickness, pigmentation, the number of lashes or hairs, and misdirected growth of eyelashes. Eyelash changes are usually reversible upon discontinuation of treatment. It should be used with caution in patients with a history of intraocular inflammation (iritis/uveitis) and should generally not be used in patients with active intraocular inflammation. This drug should be used with caution in patients who do not have an intact posterior capsule or who have known risk factors for macular edema.</p>', NULL, '<p>Drugs for miotics and glaucoma.</p>', '<p>Before opening the cap, keep the bottle in its box in a refrigerator (2&deg;-8&deg;&nbsp;C) protected from light. After opening, keep the bottle in its box in a cool place below 25&deg;&nbsp;C. The contents should be used within one month after the dropper is opened. Keep out of reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No overall differences in safety or effectiveness have been observed between elderly and younger patients.</p>', '2022-03-08 05:55:51', '2022-03-08 05:55:51'),
(831, 831, '<p>This preparation is indicated for the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension who are insufftciently responsive to &beta;-blockers, prostaglandins or other IOP lowering agents.</p>', '<p>Latanoprost is an analogue of prostaglandin F2&alpha;, it reduces intraocular pressure (IOP) by increasing outflow of aqueous humour.<br />\r\n<br />\r\nTimolol is a non-selective adrenergic blocker. It lowers IOP by decreasing the formation of aqueous by the ciliary epithelium.</p>', '<p><strong>Adult or elderly</strong>: The recommended adult (including the elderly) dosage of is one drop in the affected eye(s) once daily. If one dose is missed, treatment should continue with the next dose as normal.<br />\r\n<br />\r\n<strong>Children</strong>: Safety and effectiveness in children has not been established. This is therefore is not recommended for use in children.</p>', '<p>No specific interaction studies have been performed with this preparation. Patients who are receiving treatment with this preparation and an oral &beta;-adrenergic blocking agent should be observed for potential additive effects of &beta;-blockade, both systemic and on lntraocular pressure The concomitant use of two topical &beta;-adrenergic blocking agents is not recommended. Although this preparation alone has little or no effect on pupil size, mydriasis has occasionally been reported when Timolol is given with epinephrine. &beta;-blockers may increase the hypoglycemic effect of antidiabetic agents. In vitro studies have shown that precipitation occurs when eye drops containing thimerosal are mixed with Benzalkonium chloride, the preservative used in this preparatlon. If such drugs are used they should be administered with an interval of at least 5 minutes between applications. Similarly, several contact lens soakinq solutions contain thimerosal.</p>', '<p>This combination is contraindicated in patients with Known hypersensitivity to Latanoprost, Timolol and benzalkonium chloride or any other ingredient in the product. This combination is also contraindicated for the following conditions such as reactive airway disease including bronchial asthma, history of bronchial asthma or severe chronic obstructive pulmonary disease, sinus bradycardia, second or third degree atrioventricular block, overt cardiac failure, or cardiogenic shock.</p>', '<p>This combination is generally well tolerated. The most frequent findings of increased iris pigmentation were in patients with green-brown, yellow-brown and blue/grey/brown irides. In patients with homogeneously blue, grey, green or brown eyes, the change was only rarely seen. Darkening, thickening and lengthening of the eye lashes have been reported. The most frequently reported undesirable effects in clinical trials were irritation of the eye, including stinging, burning and ,itching, eye hyperaemia, corneal disorders, coniunctivitis blepharitis, eye pain, headache and skin rash.</p>', '<p>No reproduction toxicity studies have been conducted with this combination.This combination should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Latanoprost and its metabolites may pass into breast milk. Timolol maleate has been detected in human milk following ocular administration. Because of the potential serious adverse reactions in nursing infants, this preparation should be used with caution in nursing women.</p>', '<p>This preparation should be used with caution in patients with macular edema, aphakic patients, pseudophakic parients with a torn posterior lens capsule or in patients with known risk factors for macular edema.It should be administered with caution in patients subjected to spontaneous hypoglycaemia or to diabetic patients who are receiving insulin or oral hypoglycaemic agents.Caution should also be exercised to patients wearing contact lenses or drive and use machines.</p>', '<p>There is no human data available on over dosage with this preparation.Symptoms of systemic Timolol over dosage are bradycardia, hypotenslon, bronchospasm, and cardiac arrest. If such symptoms occur,treatment should be symptomatic and supportive. The ocular effects of Latanoprost administered at high doses are not known. If overdose with this preparation occurs, treatment should be symptomatic.</p>', '<p>Drugs for miotics and glaucoma.</p>', '<p>Store at 2-8&deg; C. For opened bottles, may store below 25&deg; C.</p>', NULL, '2022-03-08 05:57:59', '2022-03-08 05:57:59'),
(832, 832, '<p>Ledipasvir and Sofosbuvir combination is indicated for the treatment of chronic hepatitis C (CHC) genotype 1, 4 &amp; 6 infection in adults.</p>', '<p>It is a fixed-dose combination tablet containing Ledipasvir and Sofosbuvir for oral administration. Ledipasvir is an HCV NS5A inhibitor and Sofosbuvir is a nucleotide analog inhibitor of HCV NS5B polymerase.</p>', '<p><strong>Recommended dosage</strong>: One tablet (90 mg of Ledipasvir and 400 mg of Sofosbuvir) taken orally once daily with or without food<br />\r\n<br />\r\n<strong>Recommended treatment duration</strong>:</p>\r\n\r\n<ul>\r\n	<li>Treatment-naive with or without cirrhosis: 12 weeks</li>\r\n	<li>Treatment-experienced without cirrhosis: 12 weeks</li>\r\n	<li>Treatment-experienced with cirrhosis: 24 weeks</li>\r\n</ul>\r\n\r\n<p>A dose recommendation cannot be made for patients with severe renal impairment or end stage renal disease.</p>', '<ul>\r\n	<li>Coadministration with amiodarone may result in serious symptomatic bradycardia. Use of Ledipasvir and Sofosbuvir combination with Amiodarone is not recommended</li>\r\n	<li>P-gp inducers (e.g., Rifampin, St. John&rsquo;s wort): May alter concentrations of Ledipasvir and Sofosbuvir. Use of Ledipasvir and Sofosbuvir combination with P-gp inducers is not recommended</li>\r\n</ul>', '<p>This combination is contraindicated in patients with Known hypersensitivity to Ledipasvir, Sofosbuvir or any other ingredient in the product.</p>', '<p>The most common adverse reactions with treatment with Ledipasvir and Sofosbuvir combination for 8, 12, or 24 weeks are fatigue and headache.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category B. There are no adequate and well-controlled studies with Ledipasvir and Sofosbuvir&nbsp;in pregnant women. Because animal reproduction&nbsp;studies are not always predictive of human response, this should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether Ledipasvir and Sofosbuvir&nbsp;and its metabolites are present in human breast milk.</p>', '<p>Bradycardia with Amiodarone coadministration: Serious symptomatic bradycardia may occur in patients taking Amiodarone, particularly in patients also receiving beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease. Coadministration of Amiodarone with Ledipasvir and Sofosbuvir combination is not recommended. In patients without viable treatment options, cardiac monitoring is recommended.<br />\r\n<br />\r\nUse with other drugs containing sofosbuvir, is not recommended.</p>', '<p>No specific antidote is available for overdose.</p>', '<p>Hepatic viral infections (Hepatitis C).</p>', '<p>Keep out of the reach of children. Keep in a cool &amp; dry place. Protect from light.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of Ledipasvir and Sofosbuvir have not been established in pediatric patients.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients. No dosage adjustment of Ledipasvir and Sofosbuvir is warranted in geriatric patients.</p>', '2022-03-08 06:00:31', '2022-03-08 06:00:31'),
(833, 833, '<p>Leflunomide is indicated in adults for the treatment of active rheumatoid arthritis (RA) to reduce signs and symptoms and to retard structural damage as manifested by x-ray erosions and joint space narrowing.</p>', '<p>Leflunomide is an isoxazole immunomodulatory agent which inhibits de novo pyrimidine synthesis and has anti-proliferative activity. Following oral administration, it is rapidly metabolized to A771726, which is active in vitro and is presumed to be the active drug in vivo. Leflunomide has demonstrated prophylactic and therapeutic effects in animal models of autoimmune disease. In addition, leflunomide has exhibited anti-inflammatory and weak analgesic and antipyretic activity. In a model of experimental septicemia, leflunomide did not alter the resistance of mice to bacterial pathogens.</p>', '<p>Leflunomide once-daily oral dosing for rheumatoid arthritis patients. After a loading dose of 100 mg once daily for 3 days, the maintenance dose is 20 mg once daily. Leflunomide does not require step wise dose increment over time. The dose may be decreased to 10 mg daily if tolerability issues arise.</p>', '<p>Cholestyramine and activated charcoal may decrease plasma concentration of active metabolite. Concurrent use of methotrexate and other hepatotoxic drugs may increase the risk of hepatotoxicity. Rifampicin increases serum levels of the active metabolite.</p>', '<p>Leflunomide is contraindicated in patients with known hypersensitivity to leflunomide or any of the other components of leflunomide, hepatic impairment, severe uncontrolled infections and bone marrow dysplasia.</p>', '<p>Adverse reactions associated with the use of leflunomide include diarrhea, nausea, vomiting, abdominal pain, headache, respiratory infection, bronchitis, elevated liver enzymes, aggravation of pre-existing hypertension, alopecia, and rash.</p>', '<p>Leflunomide is not recommended for pregnant women. Pregnancy must be avoided during leflunomide treatment or prior to the completion of the drug elimination procedure after leflunomide treatment. Leflunomide should not be used by nursing mothers. It is not known whether leflunomide is excreted in human milk. Many drugs are excreted in human milk and there is a potential for serious adverse reactions in nursing infants from leflunomide. Therefore, a decision should be made whether to proceed with nursing or initiate treatment with leflunomide, taking into account the importance of the drug to the mother.</p>', '<p>Caution should be taken for those female with child bearing potential who are not using reliable contraception and for the subject of renal insufficiency. Leflunomide should be stopped before becoming pregnant. Liver function should be monitored before starting treatment.</p>', '<p>There is no human experience regarding leflunomide over dosage. In the event of a significant overdose or toxicity, cholestyramine or charcoal administration is recommended to accelerate elimination.</p>', '<p>Drugs used for Rheumatoid Arthritis.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-08 06:02:36', '2022-03-08 06:02:36');
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
(834, 834, '<p><strong>Multiple Myeloma</strong>: Lenalidomide in combination with Dexamethasone is indicated for the treatment of adult patients with multiple myeloma (MM). Lenalidomide is indicated as maintenance therapy in adult patients with MM following autologous hematopoietic stem cell transplantation (auto-HSCT).<br />\r\n<br />\r\n<strong>Myelodysplastic Syndromes</strong>: Lenalidomide is indicated for the treatment of adult patients with transfusion-dependent anemia due to low- or intermediate-1-risk myelodysplastic syndromes (MDS) associated with a deletion 5q cytogenetic abnormality with or without additional cytogenetic abnormalities.<br />\r\n<br />\r\n<strong>Mantle Cell Lymphoma</strong>: Lenalidomide is indicated for the treatment of adult patients with mantle cell lymphoma (MCL) whose disease has relapsed or progressed after two prior therapies, one of which included Bortezomib.<br />\r\n<br />\r\n<strong>Follicular Lymphoma</strong>: Lenalidomide in combination with a Rituximab product, is indicated for the treatment of adult patients with previously treated follicular lymphoma (FL).<br />\r\n<br />\r\n<strong>Marginal Zone Lymphoma</strong>: Lenalidomide in combination with a Rituximab product, is indicated for the treatment of adult patients with previously treated marginal zone lymphoma (MZL).<br />\r\n<br />\r\n<strong>Limitations of Use</strong>: Lenalidomide is not indicated and is not recommended for the treatment of patients with CLL outside of controlled clinical trials.</p>', '<p>Lenalidomide is an analogue of thalidomide with immunomodulatory, antiangiogenic, and antineoplastic properties. Cellular activities of Lenalidomide are mediated through its target cereblon, a component of a cullin ring E3 ubiquitin ligase enzyme complex. In vitro, in the presence of drug, substrate proteins (including Aiolos, Ikaros, and CK1&alpha;) are targeted for ubiquitination and subsequent degradation leading to direct cytotoxic and immunomodulatory effects. Lenalidomide inhibits proliferation and induces apoptosis of certain hematopoietic tumor cells including MM, mantle cell lymphoma, and del (5q) myelodysplastic syndromes in vitro. Lenalidomide causes a delay in tumor growth in some in vivo nonclinical hematopoietic tumor models including MM. Immunomodulatory properties of Lenalidomide include increased number and activation of T cells and natural killer (NK) cells leading to direct and enhanced antibody-dependent cell-mediated cytotoxicity (ADCC) via increased secretion of interleukin-2 and interferon-gamma, increased numbers of NKT cells, and inhibition of pro-inflammatory cytokines (e.g., TNF-&alpha; and IL-6) by monocytes. In MM cells, the combination of Lenalidomide and Dxamethasone synergizes the inhibition of cell proliferation and the induction of apoptosis.<br />\r\n<br />\r\n<strong>Absorption</strong>: Lenalidomide is rapidly absorbed following oral administration. Following single and multiple doses of Lenalidomide in patients with MM or MDS, the maximum plasma concentrations occurred between 0.5 and 6 hours post-dose. The single and multiple dose pharmacokinetic disposition of Lenalidomide is linear with AUC and Cmax values increasing proportionally with dose. Multiple doses of Lenalidomide at the recommended dosage does not result in drug accumulation. Administration of a single 25 mg dose of Lenalidomide with a high-fat meal in healthy subjects reduces the extent of absorption, with an approximate 20% decrease in AUC and 50% decrease in Cmax. In the trials where the efficacy and safety were established for Lenalidomide, the drug was administered without regard to food intake. Lenalidomide can be administered with or without food. The oral absorption rate of Lenalidomide in patients with MCL is similar to that observed in patients with MM or MDS.<br />\r\n<br />\r\n<strong>Distribution</strong>: In vitro [14 C]-Lenalidomide binding to plasma proteins is approximately 30%. Lenalidomide is present in semen at 2 hours (1379 ng/ejaculate) and 24 hours (35 ng/ejaculate) after the administration of Lenalidomide 25 mg daily.<br />\r\n<br />\r\n<strong>Elimination</strong>: The mean half-life of Lenalidomide is 3 hours in healthy subjects and 3 to 5 hours in patients with MM, MDS or MCL.<br />\r\n<br />\r\n<strong>Metabolism</strong>: Lenalidomide undergoes limited metabolism. Unchanged Lenalidomide is the predominant circulating component in humans. Two identified metabolites are 5&not; Hydroxy-Lenalidomide and N-Acetyl Lenalidomide; each constitutes less than 5% of parent levels in circulation.<br />\r\n<br />\r\n<strong>Excretion</strong>: Elimination is primarily renal. Following a single oral administration of [14 C]-Lenalidomide 25 mg to healthy subjects, approximately 90% and 4% of the radioactive dose was eliminated within ten days in urine and feces, respectively. Approximately 82% of the radioactive dose was excreted as Lenalidomide in the urine within 24 hours. Hydroxy-Lenalidomide and N-Acetyl-Lenalidomide represented 4.6% and 1.8% of the excreted dose, respectively. The renal clearance of Lenalidomide exceeds the glomerular filtration rate.</p>', '<p><strong>Lenalidomide Combination Therapy</strong>: The recommended starting dose of Lenalidomide is 25 mg orally once daily on Days 1-21 of repeated 28-day cycles in combination with Dexamethasone. For patients greater than 75 years old, the starting dose of Dexamethasone may be reduced. Treatment should be continued until disease progression or unacceptable toxicity. In patients who are not eligible for auto-HSCT, treatment should continue until disease progression or unacceptable toxicity. For patients who are auto-HSCT-eligible, hematopoietic stem cell mobilization should occur within 4 cycles of a Lenalidomide-containing therapy.<br />\r\n<br />\r\n<strong>Lenalidomide Maintenance Therapy Following Auto-HSCT</strong>: Following auto-HSCT, initiate Lenalidomide maintenance therapy after adequate hematologic recovery (ANC at least 1000/mcL and/or platelet counts at least 75,000/mcL). The recommended starting dose of Lenalidomide is 10 mg once daily continuously (Days 1-28 of repeated 28-day cycles) until disease progression or unacceptable toxicity. After 3 cycles of maintenance therapy, the dose can be increased to 15 mg once daily if tolerated.<br />\r\n<br />\r\n<strong>Recommended Dosage for Myelodysplastic Syndromes</strong>: The recommended starting dose of Lenalidomide is 10 mg daily. Treatment is continued or modified based upon clinical and laboratory findings. Continue treatment until disease progression or unacceptable toxicity.<br />\r\n<br />\r\n<strong>Recommended Dosage for Mantle Cell Lymphoma</strong>: The recommended starting dose of Lenalidomide is 25 mg/day orally on Days 1-21 of repeated 28-day cycles for relapsed or refractory mantle cell lymphoma. Treatment should be continued until disease progression or unacceptable toxicity. Treatment is continued, modified or discontinued based upon clinical and laboratory findings.<br />\r\n<br />\r\n<strong>Recommended Dosage for Follicular Lymphoma or Marginal Zone Lymphoma</strong>: The recommended starting dose of Lenalidomide is 20 mg orally once daily on Days 1-21 of repeated 28-day cycles for up to 12 cycles of treatment in combination with a Rituximab-product.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Patients should be advised to take Lenalidomide orally at about the same time each day, either with or without food. Patients should be advised to swallow Lenalidomide capsules whole with water and not to open, break, or chew them.</p>', '<p><strong>Digoxin</strong>: When Digoxin was co-administered with multiple doses of Lenalidomide (10 mg/day) the Digoxin Cmax and AUCinf were increased by 14%. Periodic monitoring of Digoxin plasma levels, in accordance with clinical judgment and based on standard clinical practice in patients receiving this medication, is recommended during administration of Lenalidomide.<br />\r\n<br />\r\n<strong>Concomitant Therapies That May Increase the Risk of Thrombosis</strong>: Erythropoietic agents, or other agents that may increase the risk of thrombosis, such as estrogen-containing therapies, should be used with caution after making a benefit-risk assessment in patients receiving Lenalidomide.<br />\r\n<br />\r\n<strong>Warfarin</strong>: Co-administration of multiple doses of Lenalidomide (10 mg/day) with a single dose of Warfarin (25 mg) had no effect on the pharmacokinetics of Lenalidomide or R- and S-Warfarin. It is not known whether there is an interaction between Dexamethasone and Warfarin. Close monitoring of PT and INR is recommended in patients with MM taking concomitant Warfarin.</p>', '<p><strong>Pregnancy</strong>: Lenalidomide can cause fetal harm when administered to a pregnant female. Limb abnormalities were seen in the offspring of monkeys that were dosed with lenalidomide during organogenesis. This effect was seen at all doses tested. Due to the results of this developmental monkey study, and lenalidomide&rsquo;s structural similarities to&nbsp;thalidomide, a known human&nbsp;teratogen, lenalidomide is contraindicated in females who are pregnant. If this drug is used during pregnancy or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential risk to a fetus&nbsp;<br />\r\n<br />\r\n<strong>Severe Hypersensitivity Reactions</strong>: Lenalidomide is contraindicated in patients who have demonstrated severe hypersensitivity</p>', '<p>Embryo-fetal toxicity, hematologic toxicity, venous and arterial thromboembolism, increased mortality in patients with CLL, second primary malignancies, hepatotoxicity, severe cutaneous reaction tumor lysis syndrome, tumor flare reactions, impaired stem cell mobilization, thyroid disorders. early mortality in patients with MCL, hypersensitivity. Severe Hypersensitivity Reactions: Lenalidomide is contraindicated in patients who have demonstrated hypersensitivity (e.g., angioedema, Stevens-Johnson syndrome, toxic epidermal necrolysis) to Lenalidomide.</p>', '<p>Based on the mechanism of action, Lenalidomide can cause embryo-fetal harm when administered to a pregnant female and is contraindicated during pregnancy. There is no information regarding the presence of Lenalidomide in human milk, the effects of Lenalidomide on the breastfed infant, or the effects of Lenalidomide on milk production. Because many drugs are excreted in human milk and because of the potential for adverse reactions in breastfed infants from Lenalidomide, advise women not to breastfeed during treatment with Lenalidomide.</p>', '<p><strong>Lenalidomide REMS Program</strong>: Because of the embryo-fetal risk, Lenalidomide is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS), the Lenalidomide REMS<br />\r\nprogram. Required components of the Lenalidomide REMS program include the following:</p>\r\n\r\n<ul>\r\n	<li>Prescribers must be certified with the Lenalidomide REMS program by enrolling and complying with the REMS requirements.</li>\r\n	<li>Patients must sign a Patient-Physician agreement form and comply with the REMS requirements. In particular, female patients of reproductive potential who are not pregnant must comply with the pregnancy testing and contraception requirements and males must comply with contraception requirements.</li>\r\n	<li>Pharmacies must be certified with the Lenalidomide REMS program, must only dispense to patients who are authorized to receive Lenalidomide and comply with REMS requirements.</li>\r\n</ul>\r\n\r\n<p><strong>Hematologic Toxicity</strong>: Lenalidomide can cause significant neutropenia and thrombocytopenia. Monitor patients with neutropenia for signs of infection. Advise patients to observe for bleeding or bruising, especially with use of concomitant medication that may increase risk of bleeding. Patients taking Lenalidomide should have their complete blood counts assessed periodically as described below. Monitor complete blood counts (CBC) in patients taking Lenalidomide in combination with Dexamethasone or as Lenalidomide maintenance therapy for MM every 7 days (weekly) for the first 2 cycles, on Days 1 and 15 of Cycle 3, and every 28 days (4 weeks) thereafter. A dose interruption and/or dose reduction may be required. Monitor complete blood counts (CBC) in patients taking Lenalidomide for MDS weekly for the first 8 weeks and at least monthly thereafter. Monitor complete blood counts (CBC) in patients taking Lenalidomide for MCL weekly for the first cycle (28 days), every 2 weeks during cycles 2-4, and then monthly thereafter. Patients may require dose interruption and/or dose reduction. Monitor complete blood counts (CBC) in patients taking Lenalidomide for FL or MZL weekly for the first 3 weeks of Cycle 1 (28 days), every 2 weeks during Cycles 24, and then monthly thereafter. Patients may require dose interruption and/or dose reduction.<br />\r\n<br />\r\n<strong>Venous and Arterial Thromboembolism</strong>: Venous thromboembolic events (VTE [DVT and PE]) and arterial thromboembolic events (ATE, myocardial infarction and stroke) are increased in patients treated with Lenalidomide. Patients with known risk factors, including prior thrombosis, may be at greater risk and actions should be taken to try to minimize all modifiable factors (e.g. hyperlipidemia, hypertension, smoking). Thromboprophylaxis is recommended. The regimen of thromboprophylaxis should be based on an assessment of the patient&rsquo;s underlying risks. Instruct patients to report immediately any signs and symptoms suggestive of thrombotic events. ESAs and estrogens may further increase the risk of thrombosis and their use should be based on a benefit-risk decision in patients receiving Lenalidomide.<br />\r\n<br />\r\n<strong>Increased Mortality in Patients with CLL</strong>: Lenalidomide is not indicated and not recommended for use in CLL outside of controlled clinical trials.<br />\r\n<br />\r\n<strong>Second Primary Malignancies</strong>: Monitor patients for the development of second primary malignancies. Take into account both the potential benefit of Lenalidomide and the risk of second primary malignancies when considering treatment with Lenalidomide.<br />\r\n<br />\r\n<strong>Increased Mortality in Patients with MM When Pembrolizumab Is Added to a Thalidomide Analogue and Dexamethasone</strong>: Treatment of patients with MM with a PD-1 or PD-L1 blocking antibody in combination with a thalidomide analogue plus Dexamethasone is not recommended outside of controlled clinical trials.<br />\r\n<br />\r\n<strong>Hepatotoxicity</strong>: Hepatic failure, including fatal cases, has occurred in patients treated with Lenalidomide in combination with Dexamethasone. The mechanism of drug-induced hepatotoxicity is unknown. Pre-existing viral liver disease, elevated baseline liver enzymes, and concomitant medications may be risk factors. Monitor liver enzymes periodically. Stop Lenalidomide upon elevation of liver enzymes. After return to baseline values, treatment at a lower dose may be considered.<br />\r\n<br />\r\n<strong>Severe Cutaneous Reactions Including Hypersensitivity Reactions</strong>: Angioedema and severe cutaneous reactions including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) have been reported. DRESS may present with a cutaneous reaction (such as rash or exfoliative dermatitis), eosinophilia, fever, and/or lymphadenopathy with systemic complications such as hepatitis, nephritis, pneumonitis, myocarditis, and/or pericarditis. These events can be fatal. Patients with a prior history of Grade 4 rash associated with thalidomide treatment should not receive Lenalidomide. Lenalidomide interruption or discontinuation should be considered for Grade 2-3 skin rash. Lenalidomide must be discontinued for angioedema, Grade 4 rash, exfoliative or bullous rash, or if SJS, TEN or DRESS is suspected and should not be resumed following discontinuation for these reactions.<br />\r\n<br />\r\n<strong>Tumor Lysis Syndrome</strong>: Monitor patients at risk closely and take appropriate preventive approaches. Tumor Flare Reaction: Monitoring and evaluation for TFR is recommended in patients with MCL, FL, or MZL. Tumor flare reaction may mimic the progression of disease (PD).<br />\r\n<br />\r\n<strong>Impaired Stem Cell Mobilization</strong>: A decrease in the number of CD34+ cells collected after treatment (&gt;4 cycles) with Lenalidomide has been reported. In patients who are auto-HSCT candidates, referral to a transplant center should occur early in treatment to optimize the timing of the stem cell collection. In patients who received more than 4 cycles of a Lenalidomide-containing treatment or for whom inadequate numbers of CD 34+ cells have been collected with G-CSF alone, G-CSF with cyclophosphamide or the combination of GCSF with a CXCR4 inhibitor may be considered.<br />\r\n<br />\r\n<strong>Thyroid Disorders</strong>: Both hypothyroidism and hyperthyroidism have been reported. Measure thyroid function before the start of Lenalidomide treatment and during therapy.</p>', '<p>There is no specific experience in the management of Lenalidomide overdose in patients with MM, MDS, or MCL.</p>', NULL, '<p>Store below 30&deg;C in a dry place. Protect from light. Keep out of the reach of children.</p>', '<p>Pediatric Use: The safety and effectiveness in pediatric patients have not been established.</p>', '2022-03-08 06:05:55', '2022-03-08 06:05:55'),
(835, 835, '<p>The drug is used to reduce the risk of life-threatening infection in patients with neutropenia, particularly after cytotoxic chemotherapy. Lenograstim is indicated as a treatment to reduce the duration of neutropenia and the severity of infections in patients with non-myeloid malignancy who have undergone autologous or allogeneic bone marrow transplantation, or treatment with established cytotoxic chemotherapy and in addition to reduce the incidence of infection associated with established cytotoxic chemotherapy. Lenograstim is also indicated to mobilise peripheral blood progenitor cells (PBPCs) with Lenograstim alone, or after myelosuppressive chemotherapy, in order to accelerate haematopoietic recovery by infusion of such cells, after myelosuppressive or myeloablative therapy. Lenograstim is also indicated to accelerate the engraftment of these cells after their reinfusion.</p>', '<p>Lenograstim is the glycosylated recombinant form of human granulocyte colony stimulating factor. Lenograstim accelerates neutrophil recovery significantly after chemotherapy, with beneficial effects on clinical end-points such as incidence of laboratory-confirmed infection and length of hospital stay. Chemotherapy dose intensity has also been increased in patients receiving lenograstim, notably those with breast or small cell lung cancer, although improvements in tumour response and survival have not been demonstrated. Lenograstim also assists neutrophil recovery in patients undergoing bone marrow transplantation, and stimulates the production of peripheral blood stem cells (PBSCs) for autologous transfusion after aggressive chemotherapy.</p>', '<p><strong>Intravenous-</strong><br />\r\nNeutropenia following bone marrow transplantation:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;19.2 million IU/m2&nbsp;or 150 mcg/m2&nbsp;daily by IV infusion started the day after transplantation for a maximum of 28 consecutive days.</li>\r\n	<li><strong>Child:</strong>&nbsp;&gt;2 yr: 19.2 million IU/m2&nbsp;or 150 mcg/m2&nbsp;daily by IV infusion started the day after transplantation for a maximum of 28 consecutive days.</li>\r\n</ul>\r\n\r\n<p><strong>Subcutaneous-</strong><br />\r\nMobilisation of peripheral blood progenitor cells for autologous peripheral blood stem cell transplantation:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;As monotherapy: 1.28 million IU/kg or 10 mcg/kg daily for 4-6 days (5-6 days in healthy donors). Following adjunctive myelosuppressive chemotherapy: 19.2 million IU/m2&nbsp;or 150 mcg/m2&nbsp;daily, started the day after completion of chemotherapy for a maximum of 28 consecutive days.</li>\r\n</ul>\r\n\r\n<p><strong>Subcutaneous-</strong><br />\r\nChemotherapy-induced neutropenia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;19.2 million IU/m2&nbsp;or 150 mcg/m2&nbsp;daily, start the day after completion of chemotherapy for a maximum of 28 consecutive days.</li>\r\n</ul>', '<p>Increased risk of myelosuppression with myelosuppressive antineoplastic agents; increased pulmonary toxicity with bleomycin and cyclophosphamide.</p>', '<p>Myeloid malignancies. Not to be used for 24 hr before or after cytotoxic chemotherapy.</p>', '<p>Musculoskeletal pain, bone pain, splenic enlargement, nausea, fever, thrombocytopenia, anaemia, epistaxis, headache, diarrhoea, dysuria, osteoporosis, cutaneous vasculitis, anorexia, Sweet&#39;s syndrome, toxic epidermal necrolysis.</p>', '<p>Pregnancy category is not classified.</p>', '<p>Premalignant or malignant myeloid condition; sickle-cell disease; osteoporotic bone disease; signs of pulmonary infiltrates (withdraw treatment). Monitor CBC during therapy. Pregnancy and lactation.</p>', NULL, '<p>Haematopoietic Agents.</p>', '<p>Should be stored in cool and dry place.</p>', NULL, '2022-03-08 06:08:01', '2022-03-08 06:08:01'),
(836, 836, '<p>Lenvatinib is a kinase inhibitor that is indicated:</p>\r\n\r\n<ul>\r\n	<li><strong>Differentiated Thyroid Cancer</strong>: Lenvatinib is indicated for the treatment of patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer (DTC).</li>\r\n	<li><strong>Renal Cell Carcinoma</strong>: Lenvatinib is indicated in combination with Everolimus for the treatment of patients with advanced renal cell carcinoma (RCC) following one prior anti-angiogenic therapy.</li>\r\n	<li><strong>Hepatocellular Carcinoma</strong>: Lenvatinib is indicated for the first-line treatment of patients with unresectable hepatocellular carcinoma (HCC).</li>\r\n	<li><strong>Endometrial Carcinoma</strong>: Lenvatinib, in combination with Pembrolizumab, is indicated for the treatment of patients with advanced endometrial carcinoma that is not microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR), who have disease progression following prior systemic therapy and are not candidates for curative surgery or radiation.</li>\r\n</ul>', '<p>Lenvatinib is a kinase inhibitor that inhibits the kinase activities of vascular endothelial growth factor (VEGF) receptors VEGFR1 (FLT1), VEGFR2 (KDR), and VEGFR3 (FLT4). Lenvatinib inhibits other kinases that have been implicated in pathogenic angiogenesis, tumor growth, and cancer progression in addition to their normal cellular functions, including fibroblast growth factor (FGF) receptors FGFR1, 2, 3, and 4; platelet-derived growth factor receptor alpha (PDGFR ), KIT, and RET. Lenvatinib also exhibited antiproliferative activity in hepatocellular carcinoma cell lines dependent on activated FGFR signaling with concurrent inhibition of FGF-receptor substrate 2 (FRS2 ) phosphorylation.<br />\r\n<br />\r\n<strong>Absorption</strong>: The time to peak plasma concentration (Tmax) typically occurred from 1 to 4 hours post-dose. Administration with a high-fat meal (approximately 900 calories of which approximately 55% were from fat, 15% from protein, and 30% from carbohydrates) did not affect the extent of absorption, but decreased the rate of absorption and delayed the median Tmax from 2 hours to 4 hours.<br />\r\n<br />\r\n<strong>Distribution</strong>: In vitro binding of Lenvatinib to human plasma proteins ranged from 98% to 99% at concentrations of 0.3 to 30 &mu;g/mL. The blood-to-plasma concentration ratio ranged from 0.59 to 0.61 at concentrations of 0.1 to 10 &mu;g/mL in vitro.<br />\r\n<br />\r\n<strong>Metabolism</strong>: The main metabolic pathways for Lenvatinib in humans were identified as enzymatic (CYP3A and aldehyde oxidase) and non-enzymatic processes. Excretion: Ten days after a single administration of radiolabeled Lenvatinib, approximately 64% and 25% of the radiolabel were eliminated in the feces and urine, respectively.<br />\r\n<br />\r\n<strong>Elimination</strong>: The terminal elimination half-life of Lenvatinib was approximately 28 hours.</p>', '<p><strong>Important Dosage Information</strong>: The dose reduction is needed for certain patients with renal or hepatic impairment. Lenvatinib should be taken once daily, with or without food, at the same time each day. If a dose is missed and cannot be taken within 12 hours, skip that dose and take the next dose at the usual time of administration.<br />\r\n<br />\r\n<strong>Recommended Dosage for Differentiated Thyroid Cancer (DTC)</strong>: The recommended dosage of Lenvatinib is 24 mg orally once daily until disease progression or until unacceptable toxicity.<br />\r\n<br />\r\n<strong>Recommended Dosage for Renal Cell Carcinoma (RCC)</strong>: The recommended dosage of Lenvatinib is 18 mg in combination with 5 mg Everolimus orally once daily until disease progression or until unacceptable toxicity.<br />\r\n<br />\r\n<strong>Recommended Dosage for Hepatocellular Carcinoma (HCC)</strong>: The recommended dosage of Lenvatinib is based on actual body weight: 12 mg for patients greater than or equal to 60 kg or 8 mg for patients less than 60 kg. Lenvatinib should be taken orally once daily until disease progression or until unacceptable toxicity.<br />\r\n<br />\r\n<strong>Recommended Dosage for Endometrial Carcinoma</strong>: The recommended dosage of Lenvatinib is 20 mg orally once daily, in combination with Pembrolizumab 200 mg administered as an intravenous infusion over 30 minutes every 3 weeks, until unacceptable toxicity or disease progression.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Lenvatinib capsules can be swallowed whole or dissolved in a small glass of liquid. To dissolve in liquid, put capsules into 1 tablespoon of water or apple juice without breaking or crushing the capsules. Leave the capsules in the water or apple juice for at least 10 minutes. Stir for at least 3 minutes. After drinking the mixture, add 1 tablespoon of water or apple juice to the glass, swirl the contents a few times and swallow the water or apple juice.</p>', '<p><strong>Drugs That Prolong the QT Interval</strong>: Lenvatinib has been reported to prolong the QT/QTc interval. Avoid coadministration of Lenvatinib with medicinal products with a known potential to prolong the QT/QTc interval.</p>', '<p>It is contraindicated in patients with known hypersensitivity to Lenvatinib or to any component of the formulation.</p>', '<p>Hypertension, cardiac dysfunction, arterial thromboembolic events, hepatotoxicity, renal failure and impairment, proteinuria, diarrhea, fistula formation and gastrointestinal perforation, QT Interval Prolongation, hypocalcemia, reversible posterior leukoencephalopathy syndrome, hemorrhagic events, impairment of thyroid stimulating hormone suppression/thyroid dysfunction, wound healing complications.</p>', '<p><strong>Use in Pregnancy</strong>: Based on the mechanism of action, Lenvatinib can cause embryo-fetal harm when administered to a pregnant female. Pregnant women should be advised of the potential risk to a fetus. Females of reproductive potential should be advised to use effective contraception during treatment with Lenvatinib and for at least 30 days after the last dose.<br />\r\n<br />\r\n<strong>Use in Lactation</strong>: It is not known whether Lenvatinib is present in human milk. Because of the potential for serious adverse reactions in breastfed infants, women should be advised to discontinue breastfeeding during treatment with Lenvatinib and for at least 1 week after the last dose.</p>', '<p><strong>Hypertension</strong>: Control blood pressure prior to initiating Lenvatinib. Monitor blood pressure after 1 week, then every 2 weeks for the first 2 months, and then at least monthly thereafter during treatment. Withhold and resume at a reduced dose when hypertension is controlled or permanently discontinue Lenvatinib is based on severity.<br />\r\n<br />\r\n<strong>Cardiac Dysfunction</strong>: Serious and fatal cardiac dysfunction can occur with Lenvatinib. Monitor patients for clinical symptoms or signs of cardiac dysfunction. Withhold and resume at a reduced dose upon recovery or permanently discontinue Lenvatinib based on severity.<br />\r\n<br />\r\n<strong>Arterial Thromboembolic Events</strong>: Permanently discontinue Lenvatinib following an arterial thrombotic event. The safety of resuming Lenvatinib after an arterial thromboembolic event has not been established and Lenvatinib has not been studied in patients who have had an arterial thromboembolic event within the previous 6 months.<br />\r\n<br />\r\n<strong>Hepatotoxicity</strong>: Monitor liver function prior to initiating Lenvatinib, then every 2 weeks for the first 2 months, and at least monthly thereafter during treatment. Monitor patients with HCC closely for signs of hepatic failure, including hepatic encephalopathy. Withhold and resume at a reduced dose upon recovery or permanently discontinue Lenvatinib based on severity.<br />\r\n<br />\r\n<strong>Renal Failure or Impairment</strong>: Withhold and resume at a reduced dose upon recovery or permanently discontinue Lenvatinib for renal failure or impairment based on severity.<br />\r\n<br />\r\n<strong>Proteinuria</strong>: Monitor for proteinuria prior to initiating Lenvatinib and periodically during treatment. If urine dipstick proteinuria greater than or equal to 2+ is detected, obtain a 24-hour urine protein. Withhold and resume at a reduced dose upon recovery or permanently discontinue Lenvatinib based on severity.<br />\r\n<br />\r\n<strong>Diarrhea</strong>: Diarrhea was the most frequent cause of dose interruption/reduction and diarrhea recurred despite dose reduction. Promptly initiate management of diarrhea. Withhold and resume at a reduced dose upon recovery or permanently discontinue Lenvatinib based on severity.<br />\r\n<br />\r\n<strong>Fistula Formation and Gastrointestinal Perforation</strong>: Permanently discontinue Lenvatinib in patients who develop gastrointestinal perforation of any severity or Grade 3 or 4 fistula.<br />\r\n<br />\r\n<strong>QT Interval Prolongation</strong>: Monitor and correct electrolyte abnormalities at baseline and periodically during treatment. Monitor electrocardiograms in patients with congenital long QT syndrome, congestive heart failure, bradyarrhythmias, or those who are taking drugs known to prolong the QT interval, including Class Ia and III antiarrhythmics. Withhold and resume at a reduced dose of Lenvatinib upon recovery based on severity.<br />\r\n<br />\r\n<strong>Hypocalcemia</strong>: Hypocalcemia improved or resolved following calcium supplementation, with or without dose interruption or dose reduction.<br />\r\n<br />\r\n<strong>Reversible Posterior Leukoencephalopathy Syndrome</strong>: Withhold and resume at a reduced dose upon recovery or permanently discontinue Lenvatinib depending on severity and persistence of neurologic symptoms.<br />\r\n<br />\r\n<strong>Hemorrhagic Events</strong>: Consider the risk of severe or fatal hemorrhage associated with tumor invasion or infiltration of major blood vessels (e.g. carotid artery). Withhold and resume at reduced dose upon recovery or permanently discontinue Lenvatinib based on the severity.<br />\r\n<br />\r\n<strong>Impairment of Thyroid Stimulating Hormone Suppression/Thyroid Dysfunction</strong>: Monitor thyroid function prior to initiating Lenvatinib and at least monthly during treatment. Treat hypothyroidism according to standard medical practice.<br />\r\n<br />\r\n<strong>Wound Healing Complications</strong>: Wound healing complications, including fistula formation and wound dehiscence, can occur with Lenvatinib. Withhold Lenvatinib for at least 6 days prior to scheduled surgery. Resume Lenvatinib after surgery based on clinical judgment of adequate wound healing. Permanently discontinue Lenvatinib in patients with wound healing complications.</p>', '<p>Due to the high plasma protein binding, Lenvatinib is not expected to be dialyzable. Death due to multiorgan dysfunction occurred in a patient who received a single dose of Lenvatinib 120 mg orally.</p>', NULL, '<p>Store below 30&deg;C in a dry place. Protect from light. Keep out of the reach of children.</p>', '<p><strong>Dosage Modifications for Severe Renal Impairment</strong>: The recommended dosage of Lenvatinib for patients with DTC, RCC, or endometrial carcinoma and severe renal impairment (creatinine clearance less than 30 mL/min calculated by Cockcroft-Gault equation using actual body weight) is:</p>\r\n\r\n<ul>\r\n	<li>Differentiated thyroid cancer: 14 mg orally once daily</li>\r\n	<li>Renal cell carcinoma: 10 mg orally once daily</li>\r\n	<li>Endometrial carcinoma: 10 mg orally once daily</li>\r\n</ul>\r\n\r\n<p><strong>Dosage Modifications for Severe Hepatic Impairment</strong>: The recommended dosage of Lenvatinib for patients with DTC, RCC, or endometrial carcinoma and severe hepatic impairment (Child-Pugh C) is:</p>\r\n\r\n<ul>\r\n	<li>Differentiated thyroid cancer: 14 mg taken orally once daily</li>\r\n	<li>Renal cell carcinoma: 10 mg taken orally once daily</li>\r\n	<li>Endometrial carcinoma: 10 mg orally once daily Or as directed by the registered physician.</li>\r\n</ul>\r\n\r\n<p><strong>Pediatric Use</strong>: The safety and effectiveness in pediatric patients have not been established.</p>', '2022-03-08 06:10:56', '2022-03-08 06:10:56'),
(837, 837, '<p>Lercanidipine is indicated for the treatment of mild to moderate essential hypertension.</p>', '<p>Lercanidipine is a selective calcium channel blocker of the dihydropyridine group and it inhibits the transmembrane influx of calcium into smooth muscle. The mechanism of its antihypertensive action is due to a direct relaxant effect on vascular smooth muscle, thus lowering total peripheral resistance. Lercanidipine is endowed with a prolonged antihypertensive activity because of its high membrane partition coefficient and is devoid of negative inotropic effects due to its high vascular selectivity.</p>', '<p><strong>Use in the elderly</strong>: The recommended dosage is 10 mg orally once a day at least 15 minutes before meals; the dose may be increased to 20 mg depending on the individual patient&#39;s response. It may take about 2 weeks before the maximal antihypertensive effect is apparent.<br />\r\n<br />\r\nSome individuals, not adequately controlled on a single antihypertensive agent, may benefit from the addition of Lercanidipine to therapy with a beta-adrenoceptor blocking drug (atenolol), a diuretic (hydrochlorothiazide) or an ACE inhibitor (ramiprii).<br />\r\n<br />\r\n<strong>Use in children</strong>: Since there is no clinical data in patients under the age of 18 years, use in children is not currently recommended.<br />\r\n<br />\r\n<strong>Use in renal or hepatic dysfunction</strong>: Special care should be exercised in patients with mild to moderate renal or hepatic dysfunction. Dosage above 20 mg daily must be approached with caution. Lercanidipine is not recommended for use in patients with severe hepatic or renal dysfunction.</p>', '<p>Concomitant treatment of Lercanidipine with cyclosporin, phenytoin, carbamazepine, rifampicin, ketoconazole, itraconazole, ritonavir, erythromycin, troleandomycin, and midazolam should be avoided. Caution should be exercised when Lercanidipine is co-prescribed with astemizole, amiodarone, quinidine, cimetidine, metoprolol and simvastatin.</p>', '<p>Lercanidipine is contraindicated in patients with left ventricular outflow tract obstruction, untreated congestive cardiac failure, unstable angina pectoris, within 1 month of a myocardial infarction and known hypersensitivity to any dihydropyridine. Lercanidipine should not be taken with grapefruit juice.</p>', '<p>Treatment with Lercanidipine is generally well tolerated. The most common side effects are related to the vasodilatory properties of Lercanidipine such as flushing, peripheral edema, headache, dizziness and asthenia. Other side effects, which occurred in less than 1% of patients include fatigue; Gl disturbances such as dyspepsia, nausea, vomiting, epigastric pain and diarrhea, polyurea, rash, somnolence and myalgia.</p>', '<p>Since there is no clinical data with Lercanidipine in pregnancy, it should not be administered during pregnancy or to woman with child bearing potential unless effective contraception is used. Lercanidipine is highly lipophilic and distribution in milk may be expected. Therefore, it should not be administered to nursing mother.</p>', '<p>Special care should be exercised when Lercanidipine is used in patients with sick sinus syndrome, left ventricular dysfunction and ischaemic heart disease.</p>', '<p>There is no data with Lercanidipine overdosage. As with other dihydropyridines, overdosage might be expected to cause excessive peripheral vasodilation with marked hypotension and reflex tachycardia. Since the drug is highly lipophilic, it is most probable that plasma levels are no guide to the duration of the period of risk and dialysis may not be effective.</p>', '<p>Calcium-channel blockers.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-08 06:12:55', '2022-03-08 06:12:55'),
(838, 838, '<p>Letrozole is indicated for the first-line treatment of advanced/metastatic breast cancer (hormone receptor positive or receptor status unknown) in post-menopausal women.</p>', '<p><strong>Mechanism of Action</strong>: Letrozole is a potent and highly specific nonsteroidal aromatase inhibitor. It inhibits the aromatase enzyme by competitively binding to the haem of the cytochrome P450 subunit of the enzyme, resulting in a reduction of estrogen biosynthesis in all tissues. Letrozole exerts its antitumor effect by depriving estrogen-dependent breast cancer cells of their growth stimulus. In postmenopausal women, estrogens are derived mainly from the action of the aromatase enzyme, which coverts adrenal androgens primarily androstenedione and testosterone-to oestrone (E1) and oestradiol (E2). The suppression of estrogen biosynthesis in the peripheral tissues and the malignant tissues can be achieved by specifically inhibiting the aromatase enzyme.<br />\r\n<br />\r\nIn healthy postmenopausal women, single doses of 0.1, 0.5 and 2.5mg letrozole suppress serum oestrone and oestradiol by 75-78% and 78% from baseline respectively. Maximum suppression is achieved in 48-78 hours. In post-menopausal patients, with advanced breast cancer, daily doses of 0.1 to 5mg suppress plasma concentration of oestradiol, oestrone, and oestrone sulphate by 78-95% from baseline in all patients treated. Letrozole had no effect on plasma androgen concentrations (androstenedione and testosterone) among healthy postmenopausal women after single doses of 0.1, 0.5 and 2.5mg indicating that the blockade of estrogen biosynthesis does not lead to accumulation of androgenic precursors. Impairment of adrenal steroidogenesis has not been observed.<br />\r\n<br />\r\n<strong>Pharmacokinetics</strong>: Letrozole is rapidly and completely absorbed from the gastrointestinal tract (absolute bioavailability 99.9%). Food slightly decreases the rate of absorption, but the extent of absorption remains unchanged. The minor effect of the absorption rate is not considered to be of clinical relevance and therefore letrozole may be taken after, with or before food. Plasma protein binding of letrozole is approximately 60%, mainly to albumin (55%). The concentration of letrozole in erythrocytes is about 80% of that in plasma. Metabolic clearance to a pharmacologically inactive carbinol metabolite is the major elimination pathway of letrozole but is relatively slow when compared to hepatic blood flow. The cytochrome P450 isoenzymes 3A4 and 2A6 were found to be capable of converting letrozole to this metabolite in vitro but their individual contributions to letrozole metabolism in vivo have not been established. The apparent terminal elimination half-life in plasma is about 2 days. After daily administration of 2.5mg of letrozole, steady-state levels are reached within 2 to 6 weeks.</p>', '<p>The recommended dose of Letrozole is 2.5 mg once daily. Treatment with Letrozole should continue as long as tumor response is seen. The drug should be discontinued if tumor stops responding as judged by tumor progression. For elderly patients, no modification of the normal adult dosage regimen is necessary. No dosage adjustment is required for patients with mild to moderate hepatic impairment or renal impairment.</p>', '<p>Clinical interaction studies with cimetidine and warfarin indicated that the co-administration of letrozole with these drugs does not result in clinically significant drug reactions, even through cimetidine is a known inhibitor of one of the cytochrome P450 isoenzymes capable of metabolising letrozole in vitro.</p>', '<p>Letrozole is contraindicated in known or suspected hypersensitivity to letrozole, other aromatase inhibitors, or to any of their ingredients. It is contraindicated during pregnancy, lactation and in pre-menopausal women. It is also contraindicated in severe hepatic dysfunction.</p>', '<p>Adverse events associated with letrozole are generally mild to moderate and rarely severe enough to require discontinuation. Many can be attributed to either the underlying disease or the normal pharmacological consequence of oestrogen deprivation (hot flushes, hair thinning). The most frequently reported adverse events are musculoskeletal pain, arthralgia, headache, fatigue, nausea, dyspnoea, peripheral oedema, coughing, constipation, vomiting, chest pain, viral infection, diarrhoea, rash, abdominal pain, dyspepsia and anorexia. Dizziness, weight increase and pruritus are less commonly seen.</p>', '<p>Oral administration of letrozole in pregnant rats resulted in teratogenicity and maternal toxicity at 0.03 mg/kg. Embryotoxicity and foetotoxicity were seen at doses &gt;0.003 mg/kg and there was an increase in the incidence of foetal malformation among the animals treated. However, there are no adequate and well-controlled studies of letrozole in pregnant women and its use in these patients is not recommended. It is not known whether letrozole is excreted in human milk. Because many drugs are excreted in human milk, letrozole should not be administered to a nursing woman.</p>', '<p>In breast cancer patients with moderate hepatic dysfunction, no dosage adjustment is necessary, but caution is recommended since letrozole elimination depends mainly on intrinsic metabolic clearance. Renal impairment (calculated creatinine clearance: 20 to 50 ml/min) did not affect steady-state plasma letrozole concentration at a dose of 2.5 mg or 5 mg. Hence, no dose adjustment is necessary for such renal function impairment. It is anticipated that letrozole could be removed from blood by dialysis since it is weakly bound to plasma proteins. The potential risks and benefits to such patients should be considered carefully before prescribing letrozole. In some cases, fatigue and dizziness have been observed with the use of letrozole. Patients should therefore, be advised that their physical and/or mental abilities required for operating machinery or driving a car may be impaired.</p>', '<p>There is no clinical experience of overdosage. There is no specific antidote to letrozole. Since letrozole is not highly protein-bound, dialysis may be helpful. Emesis may be induced if the patient is alert. In general, supportive care and frequent monitoring of vital signs is appropriate.</p>', '<p>Hormonal Chemotherapy.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-08 06:15:21', '2022-03-08 06:15:21');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(839, 839, '<p>For treatment of prostate cancer, endometriosis, uterine fibroids and premature puberty</p>\r\n\r\n<p>&nbsp;</p>', '<p>Leuprorelin is a gonadotropin-releasing hormone (GnRH) analogue. Following an initial stimulation of gonadotrophins, continuous admin of Leuprorelin leads to down regulation of GnRH receptors and subsequently reduces pituitary gonadotrophin secretion. Reduced gonadotrophin levels lead to inhibition of sex hormone (testosterone and oestrogen) production. Within 2-4 wk after treatment initiation, testosterone levels in male may be reduced to below castrate threshold.</p>', '<p><strong>Adult:&nbsp;</strong>Palliative treatment of advanced prostate cancer:&nbsp;1 mg as single daily dose by SC inj. Depot preparations may be given by IM or SC route, dosage and route may differ between different brands and countries. In the UK: As depot preparations: 3.75 mg every mth as single IM/SC inj; or 11.25 mg every 3 mth via SC inj. In the US: As depot preparations: 7.5 mg every mth, or 22.5 mg every 3 mth, or 30 mg every 4 mth via IM/SC inj depending on the preparations; or 45 mg every 6 mth via SC inj.<br />\r\n<br />\r\nEndometriosis:&nbsp;As depot preparations: 3.75 mg every mth given as a single IM/SC inj or 11.25 mg every 3 mth as IM depot Inj. Initiate treatment during the 1st 5 days of menstrual cycle up to 6 mth. May be used with norethindrone acetate 5 mg daily for initial management of endometriosis and for management of recurrence symptoms. Duration of retreatment: Should not exceed one additional 6 mth course.<br />\r\n<br />\r\nUterine fibroids:&nbsp;As depot preparations: In combination with iron therapy for women with anaemia due to uterine fibroids, 3.75 mg every mth given as a single IM/SC inj or 11.25 mg every 3 mth as IM Inj. Treatment duration: Usually up to 3 mth.<br />\r\n<br />\r\nPreparation for intrauterine surgery:&nbsp;Endometrial preparation prior to intrauterine surgery: As depot preparations: 3.75 mg as a single inj via IM/SC given 5-6 wk before the procedure; therapy should be initiated during days 3-5 of the menstrual cycle.<br />\r\n<br />\r\n<strong>Child:&nbsp;</strong>Precocious puberty:&nbsp;As aqueous soln inj: Initial: 50 mcg/kg daily by SC inj, may be titrated upwards by 10 mcg/kg/day if total down-regulation is not achieved. As depot preparations: Initial: 0.3 mg/kg/dose (minimum dose: 7.5 mg) given every 4 wk via IM inj; which equates to children &le;25 kg: 7.5 mg; &gt;25-37.5 kg: 11.25 mg and &gt;37.5 kg: 15 mg given every 4 wk. Maintenance: May titrate dose upwards in steps of 3.75 mg every 4 wk if down-regulation is not achieved. Consider discontinuing therapy before age 11 (females) and age 12 (males).</p>', NULL, '<p>Pregnancy, lactation; hypersensitivity to GnRH, GnRH agonist analogs or product excipients; undiagnosed abnormal vaginal bleeding.</p>', '<p><strong>Treatment of precocious puberty</strong>: General pain, headache, acne, rash, seborrhoea, emotional lability, vaginitis, vaginal bleeding vaginal discharge<br />\r\n<br />\r\n<strong>Treatment of prostate cancer</strong>: Transient worsening of signs and symptoms (usually increase in bone pain), ECG changes, high blood pressure, peripheral oedema, anorexia, constipation, nausea, vomiting, anaemia, myalgia, dizziness, general pain, headache, insomnia or sleep disorder, sinus congestion, urinary frequency/urgency, haematuria, UTI, asthaenia, physiological effects of decreased testosterone (e.g. gynaecomastia, breast tenderness, decreased testicular size, hot flashes, impotence).<br />\r\n<br />\r\n<strong>Treatment of endometriosis and uterine fibroids treatment</strong>: General pain, headache, asthaenia, nausea, vomiting, oedema, weight changes, acne, hirsutism, dizziness, insomnia, sleep disturbance, paraesthesias, skin reactions, effects of hypoestrogenism such as hot flashes, joint disorder, myalgia, decreased libido, depression, emotional lability, nervousness, breast tenderness, vaginitis.</p>', '<p><strong>Category X</strong>: Studies in animals or human beings have demonstrated foetal abnormalities or there is evidence of foetal risk based on human experience or both, and the risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant.</p>', '<p>Vary inj site periodically. May cause transient elevation of testosterone levels during the first 1-2 wk, which may lead to worsening or onset of new symptoms (e.g. bone pain, neuropathy, haematuria) in prostate cancer patients. Ureteral obstruction and spinal cord compression have been reported; closely monitor patients with urinary obstruction and/or metastatic vertebral lesion. Leuprorelin is associated with increased risk of diabetes and certain CV diseases (heart attack, sudden cardiac death, stroke) when used in men for treatment of prostate cancer. For prostate cancer, monitor response by testosterone and prostate-specific antigen (PSA) levels. For precocious puberty in children, monitor response by GnRH stimulation test sex steroid levels 1-2 month after treatment initiation. Leuprorelin usually inhibits ovulation and stops menstruation in women, but does not incur contraception, non-hormonal contraception should be used as pregnancy is contraindicated. May cause adverse reactions associated with hypoestrogenism and loss in bone density.</p>', NULL, '<p>Drugs acting on the Uterus, Drugs affecting (inhibiting) gonadotrophin</p>', NULL, NULL, '2022-03-08 06:17:31', '2022-03-08 06:17:31'),
(840, 840, '<p>Levamisole is a fast acting drug which acts on nematode nerve ganglia paralysing the worm&rsquo;s musculature within seconds of contact. Unable to maintain their position, the worms are then ejected by normal peristaltic movement, usually within 24 hours of levamisole administration. Although it is certain that levamisole primarily influences the neuromuscular system of nematodes, it is possible that in some helminthes the inhibition of the fumarate reductase system contributes to the anthelmintic efficacy of levamisole. Levamisole&nbsp;is indicated for the treatment of infections by the following gastrointestinal worm<br />\r\nspecies:</p>\r\n\r\n<ul>\r\n	<li>Ascaris lumbricoides: Roundworm</li>\r\n	<li>Necator americanus: Hookworm</li>\r\n	<li>Ancylostoma duodenal: Hookworm</li>\r\n	<li>E nterobius vermicularis: Pinworm</li>\r\n	<li>Trichuris trichuria: Whipworm</li>\r\n	<li>Strongyloides stercoralis: Threadworm</li>\r\n	<li>Trichostrongylus colubriformis</li>\r\n</ul>', '<p>Levamisole is the active laevo-isomer of tetramisole. It works by paralysing susceptible intestinal worms which are then excreted from the intestines. Levamisole also enhances cellular immune responses in humans.</p>', '<p>The following doses of Levamisole are given as a single administration, preferably after a light meal.</p>\r\n\r\n<ul>\r\n	<li><strong>Age 1-4 year</strong>: 1 Tablets or&nbsp;5 ml&nbsp;Syrup</li>\r\n	<li><strong>Age 5-15 year</strong>: 2 Tablets or&nbsp;10 ml&nbsp;Syrup</li>\r\n	<li><strong>Age 16&nbsp;year and over</strong>: 3 Tablets or 15 ml&nbsp;Syrup</li>\r\n</ul>\r\n\r\n<p>In cases of severe hookworm infection it is suggested that a second standard dose be given one or seven days after the first, whichever timing is feasible.</p>', '<p>May increase toxicity of phenytoin. Increases bioavailability of ivermectin; decreases bioavailability of albendazole. Alcohol causes disulfiram-like reaction.</p>', '<p>There is no absolute contra-indication to the use of Levamisole.</p>', '<p>Side-effects are infrequent. They are usually mild and transient and include nausea, vomiting, abdominal pain, giddiness(dizziness) and headache. An encephalopathylike syndrome has been reported to have occurred in a few patients two or three weeks after treatment.</p>', '<p>Although studies in animals have shown that Levamisole produces no teratogenic effects, current medical practice requires that the benefits of any drug used during pregnancy should be weighed against the possible dangers.</p>', '<p><strong>Effect on ability to drive or operate machinery</strong>: There is no evidence to suggest that Levamisole&nbsp;, used for anthelmintic purpose, will produce sedation. Mild and transient giddiness is an infrequent side-effect of treatment. No precautions are suggested concerning the ability to drive or operate machinery.<br />\r\n<br />\r\nIn case of concurrent microfilaraemia transient fever may occur.</p>', '<p>Counter possible anticholinesterase activity with e.g. atropine. Control blood pressure and respiration . Do not use sedatives.</p>', '<p>Anthelmintic</p>', '<p><strong>Tablet</strong>: Store in room temperature and protect from moisture.<br />\r\n<strong>Syrup</strong>: Store in room temperature and protect from light.</p>', NULL, '2022-03-08 06:20:53', '2022-03-08 06:20:53'),
(841, 841, '<p>Levetiracetam is indicated as monotherapy in the treatment of partial-onset seizures with or without secondary generalisation in adults and adolescents from 16 years of age with newly diagnosed epilepsy. Levetiracetam is indicated as adjunctive therapy-</p>\r\n\r\n<ul>\r\n	<li>in the treatment of partial-onset seizures with or without secondary generalization in adults, adolescents, children and infants from 1 month of age with epilepsy.</li>\r\n	<li>in the treatment of myoclonic seizures in adults and adolescents from 12 years of age with Juvenile Myoclonic Epilepsy.</li>\r\n	<li>in the treatment of primary generalized tonic-clonic seizures in adults and adolescents from 12 years of age with Idiopathic Generalised Epilepsy.</li>\r\n</ul>', NULL, '<p><strong>Adults and adolescents from 16 years of age</strong>: The recommended starting dose is 250 mg twice daily which should be increased to an initial therapeutic dose of 500 mg twice daily after two weeks. The dose can be further increased by 250 mg twice daily every two weeks depending upon the clinical response. The maximum dose is 1500 mg twice daily.<br />\r\n<br />\r\n<strong>Adults (&ge;18 years) and adolescents (12 to 17 years) weighing 50 kg or more</strong>: The initial therapeutic dose is 500 mg twice daily. This dose can be started on the first day of treatment. Depending upon the clinical response and tolerability, the daily dose can be increased up to 1,500 mg twice daily. Dose changes can be made in 500 mg twice daily increases or decrease every two to four weeks.<br />\r\n<br />\r\n<strong>Pediatric population</strong>: The tablet formulation is not adapted for use in infants and children under the age of 6 years. Oral solution is the preferred formulation for use in this population. In addition, the available dose strengths of the tablets are not appropriate for initial treatment in children weighing less than 25 kg, for patients unable to swallow tablets or for the administration of doses below 250 mg. In all of the above cases, oral solution should be used.<br />\r\n&nbsp;</p>\r\n\r\n<ul>\r\n	<li><strong>Monotherapy</strong>: The safety and efficacy of levetiracetam in children and adolescents below 16 years as monotherapy treatment have not been established.</li>\r\n	<li><strong>Add-on therapy</strong>: Oral solution is the preferred formulation for use in infants and children under the age of 6 years. For children 6 years and above, oral solution should be used for doses under 250 mg, for doses not in multiples of 250 mg when dosing recommendation is not achievable by taking multiple tablets and for patients unable to swallow tablets. The lowest effective dose should be used. The starting dose for a child or adolescent of 25 kg should be 250 mg twice daily with a maximum dose of 750 mg twice daily. Dosing for children 50 kg or greater is the same as in adults.</li>\r\n	<li><strong>Add-on therapy</strong>: For&nbsp;infants aged from 1 month to less than 6 months: The oral solution is the formulation to use in infants.</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 flm-coated tablets must be taken orally, swallowed with a sufcient quantity of liquid and may be taken with or without food. The daily dose is administered in two equally divided doses.</p>', '<p><strong>Antiepileptic medicinal products</strong>: Pre-marketing data from clinical studies conducted in adults indicate that levetiracetam did not influence the serum concentrations of existing antiepileptic medicinal products (phenytoin, carbamazepine, valproic acid, phenobarbital, lamotrigine, gabapentin and primidone) and that these antiepileptic medicinal products did not influence the pharmacokinetics of levetiracetam.<br />\r\n<br />\r\n<strong>Probenecid</strong>: Probenecid (500 mg four times daily), a renal tubular secretion blocking agent, has been shown to inhibit the renal clearance of the primary metabolite but not of levetiracetam. Nevertheless, the concentration of this metabolite remains low.<br />\r\n<br />\r\n<strong>Methotrexate</strong>: Concomitant administration of levetiracetam and methotrexate has been reported to decrease methotrexate clearance, resulting in increased/prolonged blood methotrexate concentration to potentially toxic levels. Blood methotrexate and levetiracetam levels should be carefully monitored in patients treated concomitantly with the two drugs.<br />\r\n<br />\r\n<strong>Laxatives</strong>: There have been isolated reports of decreased levetiracetam efficacy when the osmotic laxative macrogol has been concomitantly administered with oral levetiracetam. Therefore, macrogol should not be taken orally for one hour before and for one hour after taking levetiracetam.<br />\r\n<br />\r\n<strong>Food and alcohol</strong>: The extent of absorption of levetiracetam was not altered by food, but the rate of absorption was slightly reduced. No data on the interaction of levetiracetam with alcohol are available.</p>', '<p>Hypersensitivity to the active substance or other pyrrolidone derivatives or to any of the excipients.</p>', '<p>Most common adverse reactions (incidence &ge; 5% more than placebo) include:</p>\r\n\r\n<ul>\r\n	<li>Adult patients: somnolence, asthenia, infection and dizziness</li>\r\n	<li>Pediatric patients: fatigue, aggression, nasal congestion, decreased appetite, and irritability.</li>\r\n</ul>', '<p>Levetiracetam is not recommended during pregnancy and in women of childbearing potential not using contraception unless clinically necessary. Levetiracetam is excreted in human breast milk. Therefore, breastfeeding is not recommended. However, if levetiracetam treatment is needed during breastfeeding, the benefit/risk of the treatment should be weighed considering the importance of breastfeeding. No impact on fertility was detected in animal studies. No clinical data are available, the potential risk for humans is unknown.</p>', '<p><strong>Renal impairment</strong>: The administration of levetiracetam to patients with renal impairment may require dose adjustment. In patients with severely impaired hepatic function, assessment of renal function is recommended before dose selection.<br />\r\n<br />\r\n<strong>Acute kidney injury</strong>: The use of levetiracetam has been very rarely associated with acute kidney injury with a time to onset ranging from a few days to several months.<br />\r\n<br />\r\n<strong>Blood cell counts</strong>: Rare cases of decreased blood cell counts (neutropenia, agranulocytosis, leucopenia, thrombocytopenia and pancytopenia) have been described in association with levetiracetam administration, generally at the beginning of the treatment. Complete blood cell counts are advised in patients experiencing important weakness, pyrexia, recurrent infections or coagulation disorders.<br />\r\n<br />\r\n<strong>Suicide</strong>: Suicide, suicide attempt, suicidal ideation and behaviour have been reported in patients treated with anti-epileptic agents (including levetiracetam). A meta-analysis of randomized placebo-controlled trials of anti-epileptic medicinal products has shown a small increased risk of suicidal thoughts and behaviour. The mechanism of this risk is not known. Therefore patients should be monitored for signs of depression and/or suicidal ideation and behaviours and appropriate treatment should be considered. Patients (and caregivers of patients) should be advised to seek medical advice should signs of depression and/or suicidal ideation or behaviour emerge.<br />\r\n<br />\r\n<strong>Paediatric population</strong>: The tablet formulation is not adapted for use in infants and children under the age of 6 years. Available data in children did not suggest an impact on growth and puberty. However, long term effects on learning, intelligence, growth, endocrine function, puberty and childbearing potential in children remain unknown.</p>', '<p>Somnolence, agitation, aggression, depressed level of consciousness, respiratory depression and coma were observed with levetiracetam overdoses. After an acute overdose, the stomach may be emptied by gastric lavage or by induction of emesis. There is no specifc antidote for levetiracetam. Treatment of an overdose will be symptomatic and may include haemodialysis. The dialyser extraction efficiency is 60 % for levetiracetam and 74% for the primary metabolite.</p>', '<p>Adjunct anti-epileptic drugs.</p>', '<p>Store at a cool temperature (not exceeding 25&deg;C) and dry place, protected from light.</p>', '<p><strong>Elderly (65 years and older)</strong>: Adjustment of the dose is recommended in elderly patients with compromised renal function.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: The daily dose must be individualized according to renal function.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: No dose adjustment is needed in patients with mild to moderate hepatic impairment. In patients with severe hepatic impairment, the creatinine clearance may underestimate renal insufficiency. Therefore a 50 % reduction of the daily maintenance dose is recommended when the creatinine clearance is &lt; 60 ml/min.</p>', '2022-03-08 06:25:03', '2022-03-08 06:25:03'),
(842, 842, '<p>Levobunolol ophthalmic&nbsp;solution has been shown to be effective in lowering&nbsp;intraocular pressure&nbsp;and may be used in patients with chronic&nbsp;open-angle glaucoma&nbsp;or&nbsp;ocular&nbsp;hypertension.</p>', '<p>Levobunolol is a nonselective &beta;-adrenergic blocking agent. It causes the reduction of intraocular pressure by decreasing the production of aqueous humour.</p>', '<p>The recommended starting dose is one to two drops of Levobunolo ophthalmic solution 0.5% in the affected eye(s) once a day. Typical dosing with Levobunolol 0.25% is one to two drops twice daily. In patients with more severe or uncontrolled&nbsp;glaucoma, Levobunolo 0.5% can be administered&nbsp;b.i.d.&nbsp;As with any new medication, careful monitoring of patients is advised. Dosages above one drop of Levobunolol 0.5% b.i.d. are not generally more effective. If the patient&#39;s&nbsp;IOP&nbsp;is not at a satisfactory level on this regimen, concomitant therapy with dipivefrin and/or&nbsp;epinephrine, and/or pilocarpine and other miotics, and/or systemically administered carbonic anhydrase inhibitors, such as acetazolamide, can be instituted. Patients should not typically use two or more topical ophthalmic beta-adrenergic blocking agents simultaneously.</p>', '<p>Additive hypotensive effect with catecholamine-depleting drug (e.g. reserpine), Ca channel blockers, &beta;-adrenergic blockers, digitalis glycosides, antiarrhythmics, guanethidine, parasympathomimetics. Mydriasis may occur when used with epinephrine.</p>', '<p>Levobunolol ophthalmic&nbsp;solution is contraindicated in those individuals with bronchial asthma, or with a history of bronchial asthma, or severe&nbsp;chronic obstructive pulmonary disease;&nbsp;sinus&nbsp;bradycardia; second and third degree&nbsp;atrioventricular&nbsp;block; overt cardiac failure; cardiogenic&nbsp;shock; or hypersensitivity to any component of these products.</p>', '<p>Common side effects are ocular stinging, burning, blepharoconjunctivitis, blepharitis, decreased visual acuity, band keratopathy, erythema, iridocyclitis, conjunctivitis and itching sensation; bradycardia, CVA, syncope, arrhythmia, heart block, hypotension, cerebral ischaemia, bronchospasm. Rarely, reduced corneal sensitivity and tearing.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. Levobunolol ophthalmic solution should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\nIt is not known whether this drug is excreted in human milk. Systemic beta-blockers and topical&nbsp;timolol&nbsp;maleate are known to be excreted in human milk. Caution should be exercised when Levobunolol is administered to a nursing woman.</p>', '<p>Patients with diminished pulmonary function, nonallergic bronchospasm, inadequate cardiac function, DM, myasthenia gravis. May mask signs and symptoms of hypoglycaemia and hyperthyroidism. Avoid abrupt withdrawal as it may precipitate thyroid storm. Pregnancy and lactation.</p>', '<p>No data are available regarding overdosage in humans. Should accidental ocular overdosage occur,&nbsp;flush&nbsp;eye(s) with water or normal&nbsp;saline. If accidentally ingested, efforts to decrease further absorption may be appropriate (gastric&nbsp;lavage). The most common signs and symptoms to be expected with overdosage with administration of a systemic beta-adrenergic blocking agent are symptomatic&nbsp;bradycardia,&nbsp;hypotension, bronchospasm, and acute cardiac failure. Should these symptoms occur, discontinue Levobunolol therapy and initiate appropriate supportive therapy. The following supportive measures should be considered:<br />\r\n<br />\r\n<strong>Symptomatic bradycardia</strong>: Use&nbsp;atropine&nbsp;sulfate intravenously in a dosage of 0.25 mg to 2 mg to induce vagal blockade. If bradycardia persists, intravenous isoproterenol hydrochloride should be administered cautiously. In&nbsp;refractory&nbsp;cases the use of a transvenous cardiac&nbsp;pacemaker&nbsp;should be considered.<br />\r\n<br />\r\n<strong>Hypotension</strong>: Use sympathomimetic&nbsp;pressor&nbsp;drug therapy, such as&nbsp;dopamine, dobutamine or levarterenol. In refractory cases the use of&nbsp;glucagon&nbsp;hydrochloride may be useful.<br />\r\n<br />\r\n<strong>Bronchospasm</strong>: Use isoproterenol hydrochloride. Additional therapy with aminophylline may be considered.<br />\r\n<br />\r\n<strong>Acute cardiac failure</strong>: Conventional therapy with digitalis, diuretics and oxygen should be instituted immediately. In refractory cases the use of intravenous aminophylline is suggested. This may be followed, if necessary, by glucagon hydrochloride which may be useful.<br />\r\n<br />\r\n<strong>Heart block&nbsp;(second or third degree)</strong>: Use isoproterenol hydrochloride or a transvenous cardiac pacemaker.</p>', '<p>Drugs for miotics and glaucoma.</p>', NULL, '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No overall differences in safety or effectiveness have been observed between elderly and younger patients.</p>', '2022-03-08 06:27:20', '2022-03-08 06:27:20'),
(843, 843, '<p>For the production of local or regional anesthesia for surgery and obstetrics, and for post-operative pain management.</p>', '<p>Levobupivacaine is a long acting local anaesthetic of the amide type. It is the S-enantiomer of bupivacaine. It blocks nerve conduction in sensory and motor nerves mainly by interacting with voltage sensitive sodium channels on the cell membrane. It also interferes with impulse transmission and conduction in other tissues. Levobupivacaine is given as the hydrochloride for infiltration anaesthesia and regional nerve blocks including epidural block. It is contraindicated in obstetric paracervical block and IV regional anaesthesia (Bier&#39;s block). The 0.75% solution is also contraindicated for epidural blocks in obstetrics.</p>', '<p><strong>Acute pain</strong>: Pain relief during labour: 15-50 mg (6-20 ml) of a 0.25% solution, to be given as a bolus dose; alternatively, dose may be given via continuous infusion at 5-12.5 mg (4-10 ml) per hr using 0.125% solution or 5-12.5 mg (8-20 ml) per hr using 0.0625% solution.<br />\r\n<br />\r\n<strong>Postoperative pain</strong>: 10-25 mg (4-10 ml) per hr of a 0.25% solution, 12.5-18.75 mg (10-15 ml) per hr of a 0.125% solution or 12.5-18.75 mg (20-30 ml) per hr of a 0.0625% solution; dose may be given as an epidural infusion. Max: 150 mg/dose; 400 mg/day.<br />\r\n<br />\r\n<strong>Peripheral nerve block</strong>: 2.5-150 mg or 1-2 mg/kg (0.4 ml/kg) of a 0.25 or 0.5% solution. Not to exceed 40 ml. Max: 150 mg/dose; 400 mg/day.<br />\r\n<br />\r\n<strong>Surgical anaesthesia</strong>: Epidural block: 50-100 mg (10-20 ml) of a 0.5% solution or 75-150 mg (10-20 ml) of a 0.75% solution. Caesarean section: 75-150 mg (15-30 ml) of a 0.5% solution. Spinal block: 15 mg (3 ml) of a 0.5% solution. Max: 150 mg/dose; 400 mg/day.<br />\r\n<br />\r\nInfiltration anaesthesia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Up to 150 mg (60 ml) of a 0.25% solution. For peribulbar block in ophth procedures: 37.5-112.5 mg (5-15 ml) of a 0.75% solution. Max: 150 mg/dose; 400 mg/day.</li>\r\n	<li><strong>Child</strong>: For ilioinguinal or iliohypogastric blocks in children &lt;12 yr: 0.625-2.5 mg/kg (0.25-0.5 ml/kg) of a 0.25 or 0.5% solution.</li>\r\n</ul>', '<p>Plasma levels may be reduced when used with enzyme-inducing drugs such as rifampicin. Substrates for or inhibitors of CYP3A4 and CYP1A2 may affect the plasma levels of levobupivacaine.</p>', '<p>Not to be used in IV regional anesth (Bier&#39;s block) and paracervical block in obstetrics. Do not use 0.75% solution for epidural block in obstetrics. Hypovolaemia, complete heart block.</p>', '<p>CNS effects such as restlessness, anxiety, dizziness, confusion, respiratory depression and convulsions. Neuromuscular and skeletal weakness, blurred vision, pupillary constriction, tinnitus. Hypotension, bradycardia and CV collapse which may lead to cardiac arrest. Rarely, hypersensitivity reactions.</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>Epilepsy, respiratory impairment, impaired cardiac conduction, bradycardia, severe shock, acute porphyria, myasthenia gravis, renal or hepatic impairment. Pregnancy, lactation. Reduce dose in elderly or debilitated patients. Resuscitative equipment should be available. Do not use solutions containing adrenaline for anesth in appendages. Do not use solutions containing preservatives for caudal or epidural block.</p>', NULL, '<p>Regional anesthesia.</p>', '<p>To be used immediately after opening. After dilution in normal saline: Chemical and physical in-use stability at 20-22&deg;C for 7 days.</p>', NULL, '2022-03-08 06:29:37', '2022-03-08 06:29:37'),
(844, 844, NULL, '<p>Levocarnitine is a naturally occurring substance required in mammalian energy metabolism. It has been shown to facilitate long-chain fatty acid entry into cellular mitochondria, thereby delivering substrate for oxidation and subsequent energy production. Fatty acids are utilized as an energy substrate in all tissues except the brain. In skeletal and cardiac muscle, fatty acids are the main substrate for energy production.</p>', '<p>Levocarnitine tablet-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 330 mg two or three times daily. Depending on clinical response.</li>\r\n	<li><strong>Infants and children</strong>: 50 to 100 mg/kg/day in divided doses, with a maximum of 3 g/day. Dosage should begin at 50 mg/kg/day. The exact dosage will depend on clinical response.</li>\r\n</ul>\r\n\r\n<p>Levocarnitine solution (For oral use only. Not for parenteral use)-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: The recommended dosage of Levocarnitine 100 ml solution is 10 to 30 ml/day. Higher doses should be administered with caution. Dosage should be started at 10 ml/day and be increased slowly while assessing tolerance and therapeutic response.</li>\r\n	<li><strong>Infants and children</strong>: The recommended dosage of Levocarnitine 100 ml solution is 50 to 100 mg/kg/day. Dosage should be started at 50 mg/kg/day and be increased slowly to a maximum of 30 ml. /day. Levocarnitine oral solution can be given from 2-spoonful to 6-spoonful in divided dose as directed by physicians. Higher doses should be administered with caution.</li>\r\n</ul>\r\n\r\n<p>Note: Levocarnitine 100 ml solution may be consumed alone or dissolved in drink or other liquid food. Doses should be spaced evenly throughout the day preferably during or following meals and should be consumed slowly in order to maximize tolerance.</p>', NULL, NULL, '<p>Generally, Levocarnitine is well tolerated. However, few side effects including transient nausea and vomiting, abdominal cramps, and diarrhoea may occur.</p>', '<p>There is no adequate and well-controlled studies in pregnant women. This drug should be used during pregnancy only if clearly needed. Levocarnitine supplementation in nursing mothers has not been specifically studied. In nursing mothers receiving levocarnitine, any risks to the child of excess carnitine intake need to be weighed against the benefits of levocarnitine supplementation to the mother. Consideration may be given to discontinuation of nursing or of levocarnitine treatment.</p>', '<p>Gastrointestinal reactions may result from a too rapid consumption of Levocarnitine. The safety and efficacy of oral levocarnitine has not been evaluated in patients with renal insufficiency. Chronic administration of high doses of oral levocarnitine in patients with severely compromised renal function or in ESRD patients on dialysis may result in accumulation of the potentially toxic metabolites, trimethylamine (TMA) and trimethylamine-N oxide (TMAO), since these metabolites are normally excreted in the urine.</p>', '<p>There have been no reports of toxicity from levocarnitine overdosage.</p>', '<p>Drugs for muscular energy metabolism.</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-08 06:32:35', '2022-03-08 06:32:35'),
(845, 845, '<p>Levocetirizine is indicated in the treatment of symptoms associated with allergic conditions such as perennial allergic rhinitis, seasonal allergic rhinitis and chronic idiopathic urticaria.</p>', '<p>This preparation contains Levocetirizine Dihydrochloride. Levocetirizine is the active (Levo) isomer of cetirizine. It is a new highly effective and well-tolerated nonsedating antihistamine with potent antiallergic properties. It has a two-fold higher affinity for H1 receptors than cetirizine. Levocetirizine has a rapid and long-acting action, allowing once-a-day administration.</p>', '<p><strong>Adult and children 12 years of age and older</strong>: The recommended&nbsp;dose is 5 mg once daily.<br />\r\n<br />\r\n<strong>Children 6 to 11 years of age</strong>: The recommended dose is 2.5 mg (1/2 tablet or 1 teaspoon oral solution) once daily.<br />\r\n<br />\r\n<strong>Children 6 months to 5 years of age</strong>: The recommended dose is 1.25 mg (1/2 teaspoon oral solution) once daily.</p>', '<p>Levocetirizine is not known to have any interactions with other drugs.</p>', '<p>Hypersensitivity to levocetirizine, cetirizine or its parent compound hydroxyzine. Patients with severe renal impairment (creatinine clearance: &lt;10 ml/min) should not be administered levocetirizine.</p>', '<p>Generally, levocetirizine is well tolerated. However, a few side effects like headache, dry mouth, fatigue and skin rash have been reported rarely.</p>', '<p>Pregnancy Catagory B. There are no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, levocetirizine should be used during pregnancy only if clearly needed. Since levocetirizine is excreted in breast milk it is not recommended for use by nursing mothers.</p>', '<p>Epileptic patients and patients at risk of convulsions. Renal impairment. Pregnancy and lactation.</p>', '<p>No clinically relevant adverse events have been reported in case of overdose. However in the event of overdosage, symptomatic and supportive treatment is recommended.</p>', '<p>Non-sedating antihistamines.</p>', '<p>Store at a temperature not exceeding 30&deg;C in a dry place. Protect from light.</p>', '<p><strong>Pediatric use</strong>: The recommended dose for the treatment of the uncomplicated skin manifestations of chronic idiopathic urticaria in patients 6 months to 17 years of age is based on extrapolation of efficacy from adults 18 years of age and older.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: In clinical studies, each approved indication did not include sufficient numbers of patients aged 65 years and older to determine whether they respond differently than younger patients.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: No dosage adjustment is required in patients with solely hepatic impairment.<br />\r\n<br />\r\n<strong>Renal impairment</strong>:</p>\r\n\r\n<ul>\r\n	<li>Mild renal impairment (creatinine clearance: 50-80 ml/min): a dose of 2.5 mg once daily is recommended.</li>\r\n	<li>Moderate renal impairment (creatinine clearance: 30-50 ml/min): a dose of 2.5 mg once every other day is recommended.</li>\r\n	<li>Severe renal impairment (creatinine clearance: 10-30 ml/min): a dose of 2.5 mg twice weekly (administered once every 3-4 days) is recommended.</li>\r\n	<li>End-stage renal disease patients (creatinine clearance: &lt;10 ml/min) and patients undergoing hemodialysis: should not receive Levocetirizine.</li>\r\n</ul>', '2022-03-08 06:34:31', '2022-03-08 06:34:31'),
(846, 846, '<p>Levodopa &amp; benserazide is indicated for the treatment of all forms of Parkinson&#39;s syndrome with the exception of medicine-induced parkinsonism. Levodopa &amp; benserazide dispersible is a formulation which is suitable for patients with dysphagia (difficulties in swallowing) or who require a formulation with a more rapid onset of action, e.g. patients suffering from early morning and afternoon akinesia, or who exhibit &quot;delayed on&quot; or &quot;wearing off&quot; phenomena. Levodopa &amp; benserazide HBS is indicated for patients presenting with all types of fluctuations in response, especially those related to fluctuations in plasma levels (i.e. &quot;peak dose dyskinesia&quot; and &quot;end of dose deterioration&quot;) and for better control of nocturnal symptoms. Further experience is required to determine whether it is also advantageous to use Levodopa &amp; benserazide HBS in new Parkinson patients.</p>', '<p>Dopamine, which acts as a neurotransmitter in the brain, is not present in sufficient quantities in the basal ganglia of parkinsonian patients. Levodopa or L-DOPA (3,4-dihydroxy phenylalanine) is an intermediate in dopamine biosynthesis. Levodopa (dopamine precursor) is used as a prodrug to increase dopamine levels since it is able to cross the blood-brain barrier whereas dopamine itself cannot. Once levodopa has entered the central nervous system, it is metabolised to dopamine by aromatic L-amino acid decarboxylase After administration, levodopa is rapidly decarboxylated to dopamine in extracerebral as well as cerebral tissues. As a result, most of the levodopa administered is not available to the basal ganglia, and the dopamine produced peripherally frequently causes unwanted effects. It is therefore particularly desirable to inhibit extracerebral decarboxylation of levodopa. This can be achieved by simultaneous administration of levodopa and benserazide, a peripheral decarboxylase inhibitor. This preparation is a combination of these two substances in a ratio of 4:1- this ratio having proved optimal in clinical trials and therapeutic use- and is just as effective as large doses of levodopa given alone.</p>', '<p><strong>Standard dosage</strong>: Treatment with this combination should be introduced gradually; dosage should be assessed individually and titrated for optimal effect. The following dosage instructions should therefore be regarded as guidelines.<br />\r\n<br />\r\n<strong>Initial therapy</strong>: In the early stages of Parkinson&rsquo;s disease, it is advisable to start treatment with one capsule of this combination 62.5 three to four times daily. As soon as tolerability of the initial dosing schedule is confirmed, the dosage should be increased slowly in accordance with the patient&rsquo;s&nbsp; response. An optimal effect is generally achieved with a daily dosage of this combination corresponding to 300-800 mg of levodopa 75-200 mg benserazide, to be divided into 3 or more doses. Between 4 and 6 weeks may be needed to achieve the optimal effect. If it proves necessary to further, increase the daily dosage, this should be done on a monthly basis.<br />\r\n<br />\r\n<strong>Maintenance therapy</strong>: The average maintenance dosage is 1 capsule of this combination 125 three to six times daily. The number of individual doses (not less than 3) and their distribution throughout the day must be titrated for optimal effect. this combination HBS and this combination dispersible may substitute standard this combination to achieve an optimal effect.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>When taking standard this combination capsules or this combination HBS, patients must always ensure that they swallow the whole capsule without chewing it. this combination dispersible tablets are to be dispersed in a quarter of a glass of water (approx. 25-50 ml). The tablets disintegrate completely, producing a milky-white dispersion within a few minutes. Because of rapid sedimentation, it is advisable to stir the dispersion before drinking. this combination dispersible tablets should be taken within half an hour of preparing the dispersion.<br />\r\n<br />\r\nWhere possible, this combination should be taken at least 30 minutes before or 1 hour after meals, so that the competitive effect of dietary protein on levodopa uptake can be avoided and to facilitate a more rapid onset of action. Undesirable gastrointestinal effects, which may occur mainly in the early stages of the treatment, can largely be controlled by taking this combination with a low protein snack (e.g. biscuits) or liquid or by increasing the dose slowly.</p>', '<p>&nbsp;</p>\r\n\r\n<ul>\r\n</ul>', '<p>This combination is contraindicated in:</p>\r\n\r\n<ul>\r\n	<li>Patients with known hypersensitivity to levodopa or benserazide or any of the excipients.</li>\r\n	<li>Patients receiving non-selective monoamine oxidase (MAO) inhibitors due to the risk of hypertensive crisis. However, selective MAO-B inhibitors, such as selegiline and rasagiline, or selective MAO-A inhibitors, such as moclobemide, are not contraindicated. Combination of MAO-A and MAO-B inhibitors is equivalent to non-selective MAO inhibition, and hence this combination should not be given concomitantly with this combination.</li>\r\n	<li>Patients with decompensated endocrine, renal or hepatic function, cardiac disorders, psychiatric diseases with a psychotic component or closed angle glaucoma. Because levodopa may activate a malignant melanoma, this combination should not be used in patients with suspicious, undiagnosed lesions or a history of melanoma.</li>\r\n	<li>The management of patients with intention tremor and Huntington&rsquo;s chorea.</li>\r\n	<li>Patients less than 30 years old (skeletal development must be complete).</li>\r\n</ul>', NULL, '<p>Pregnancy Category B3. This combination is contraindicated during pregnancy and in women of childbearing potential in the absence of adequate contraception. If pregnancy occurs in a woman taking this combination, the medicine must be discontinued (as advised by the prescribing physician). The safe use of this combination during lactation has not been established. Since it is not known whether benserazide passes into breast milk, mothers requiring this combination treatment should not nurse their infants, since the occurrence of skeletal malformations in the infants cannot be excluded.</p>', NULL, NULL, '<p>Antiparkinson drugs.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Renal impairment</strong>: Levodopa and benserazide are both extensively metabolised and less than 10% of levodopa is excreted unchanged through the kidneys. No dose reduction is therefore necessary in case of mild or moderate renal insufficiency. Pharmacokinetic data with levodopa in renal impaired patients are not available. This combination is well tolerated by uraemic patients undergoing haemodialysis.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Levodopa is mainly metabolised by the aromatic amino acid decarboxylase that is abundantly present in the intestinal tract, in the kidney and heart in addition to the liver. Pharmacokinetic data with levodopa in hepatic impaired patients are not available.<br />\r\n<br />\r\n<strong>Paediatric use</strong>: This combination is contraindicated in patients less than 30 years old.</p>', '2022-03-08 06:53:02', '2022-03-08 06:53:02');
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
(847, 847, '<p>Idiopathic Parkinson&#39;s disease, in particular to reduce off-period in patients who previously have been treated with levodopa/decarboxylase inhibitors, or with levodopa alone and who have experienced motor fluctuations.</p>', NULL, '<p>Patients currently treated with conventional levodopa/decarboxylase inhibitor combinations: Dosage with Levodopa-Carbidopa prolonged-release tablet should be substituted initially at an amount that provides no more than approximately 10% more levodopa per day when higher dosages are given (more than 900 mg per day). The dosing interval between doses should be prolonged by 30 to 50% at intervals ranging from 4 to 12 hours. It is recommended to give the smaller dose, if divided doses are not equal, at the end of the day. The dose needs to be titrated further depending on clinical response, as indicated below under &#39;Titration&#39;. Dosages that provide up to 30% more levodopa per day may be necessary. A guide for substitution of Levodopa Carbidopa prolonged-release tablet treatment for conventional levodopa/decarboxylase inhibitor combinations is shown in the table below:<br />\r\n<br />\r\n<strong>Guideline for conversion from conventional Levodopa/Carbidopa tablet to Levodopa-Carbidopa prolonged-release tablet:</strong><br />\r\n<br />\r\nConventional tablet: Daily Dosage of Levodopa 300-400 mg</p>\r\n\r\n<ul>\r\n	<li>Controlled Release tablet: Daily Dosage of Levodopa 400 mg. Dosage Regimen: 1 tablet 2x daily.</li>\r\n</ul>\r\n\r\n<p>Conventional tablet: Daily Dosage of Levodopa 500-600 mg</p>\r\n\r\n<ul>\r\n	<li>Controlled Release tablet: Daily Dosage of Levodopa 600 mg. Dosage Regimen: 1 tablet 3x daily.</li>\r\n</ul>\r\n\r\n<p>Conventional tablet: Daily Dosage of Levodopa 700-800 mg</p>\r\n\r\n<ul>\r\n	<li>Controlled Release tablet: Daily Dosage of Levodopa 800 mg. Dosage Regimen: 4 tablets in 3 or 4 divided doses.</li>\r\n</ul>\r\n\r\n<p>Conventional tablet: Daily Dosage of Levodopa 900-1000 mg</p>\r\n\r\n<ul>\r\n	<li>Controlled Release tablet: Daily Dosage of Levodopa 1000 mg. Dosage Regimen: 5 tablets in 3 or more divided doses.</li>\r\n</ul>\r\n\r\n<p>Conventional tablet: Daily Dosage of Levodopa 1100-1200 mg</p>\r\n\r\n<ul>\r\n	<li>Controlled Release tablet: Daily Dosage of Levodopa 1200 mg. Dosage Regimen: 6 tablets in 3 or more divided doses.</li>\r\n</ul>\r\n\r\n<p>Conventional tablet: Daily Dosage of Levodopa 1300-1400 mg</p>\r\n\r\n<ul>\r\n	<li>Controlled Release tablet: Daily Dosage of Levodopa 1400 mg. Dosage Regimen: 7 tablets in 3 or more divided doses.</li>\r\n</ul>\r\n\r\n<p>Conventional tablet: Daily Dosage of Levodopa 1500-1600 mg</p>\r\n\r\n<ul>\r\n	<li>Controlled Release tablet: Daily Dosage of Levodopa 1600 mg. Dosage Regimen: 8 tablets in 3 or more divided doses.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p><strong>Patients currently treated with levodopa alone</strong>: Levodopa must be discontinued at least eight hours before therapy with this CR tablet is started. In patients with mild to moderate disease, the initial recommended dose is one tablet of this CR tablet twice daily.<br />\r\n<br />\r\n<strong>Patients not receiving levodopa</strong>: In patients with mild to moderate disease, the initial recommended dose is one tablet of this CR tablet twice daily. Initial dosages should not exceed 600 mg per day of levodopa, nor be given at intervals of less than six hours.<br />\r\n<br />\r\n<strong>Titration</strong>: Following initiation of therapy, doses and dosing intervals may be increased or decreased, depending upon therapeutic response. Most patients have been adequately treated with two to eight tablets per day of this CR tablet administered as divided doses at intervals ranging from four to twelve hours during the waking day. Higher doses (up to 12 tablets) and shorter intervals (less than four hours) have been used, but are not usually recommended. When doses of this CR tablet are given at intervals of less than four hours, or if the divided doses are not equal, it is recommended that the smaller doses be given at the end of the day. In some patients the onset of effect of the first morning dose may be delayed for up to one hour compared with the response usually obtained from the first morning dose of conventional levodopa-carbidopa tablet. An interval of at least three days between dosage adjustments is recommended.<br />\r\n<br />\r\n<strong>Maintenance</strong>: Because Parkinson&rsquo;s disease is progressive, periodic clinical evaluations are recommended and adjustment of the dosage regimen of this CR tablet may be required.<br />\r\n<br />\r\n<strong>Addition of other antiparkinson medication</strong>: Anticholinergic agents, dopamine agonists and amantadine can be given with this CR tablet. Dosage adjustment of this CR tablet may be necessary when these agents are added to an existing treatment regimen for this CR tablet.<br />\r\n<br />\r\n<strong>Interruption of therapy</strong>: Patients should be observed carefully if abrupt reduction or discontinuation of this CR tablet is required, especially if the patient is receiving antipsychotics.</p>', '<p>Caution should be exercised when the following drugs are administered concomitantly with Levodopa-Carbidopa prolonged-release tablet.<br />\r\n<br />\r\n<strong>Antihypertensive agents</strong>: Symptomatic postural hypotension has occurred when levodopa/decarboxylase inhibitor combinations were added to the treatment of patients receiving some antihypertensive drugs. Therefore when therapy with Levodopa-Carbidopa prolonged-release tablet is started, dosage adjustment of the antihypertensive drug may be required.<br />\r\n<br />\r\n<strong>Antidepressants</strong>: There have been rare reports of adverse reactions, including hypertension and dyskinesia, resulting from the concomitant use of tricyclic antidepressants and carbidopa-levodopa preparations.<br />\r\n<br />\r\n<strong>Anticholinergics</strong>: Anticholinergics may affect the absorption and thus the patient&rsquo;s response.<br />\r\n<br />\r\n<strong>Iron</strong>: Studies demonstrate a decrease in the bioavailability of carbidopa and/or levodopa when it is ingested with ferrous sulphate or ferrous gluconate.<br />\r\n<br />\r\n<strong>Other drugs</strong>: Dopamine D2 receptor antagonists (e.g. phenothiazines, butyrophenones and risperidone) and isoniazid may reduce the therapeutic effects of levodopa. The beneficial effects of levodopa in Parkinson&rsquo;s disease have been reported to be reversed by phenytoin and papaverine. Patients taking these drugs with Levodopa-Carbidopa prolonged-release tablet should be observed carefully for loss of therapeutic response. Concomitant therapy with selegiline and carbidopa-levodopa may be associated with severe orthostatic hypotension not attributable to carbidopa-levodopa alone. Since levodopa competes with certain amino acids, the absorption of levodopa may be impaired in some patients on a high protein diet. The effect of simultaneous administration of antacids with Levodopa-Carbidopa prolonged-release tablet on the bioavailability of levodopa has not been studied.</p>', '<p>Levodopa-Carbidopa prolonged-release tablet should not be given when administration of a sympathomimetic amine is contraindicated. Non-selective monoamine oxidase (MAO) inhibitors are contraindicated for use with Levodopa-Carbidopa prolonged release tablet. These inhibitors must be discontinued at least two weeks prior to initiating therapy with Levodopa-Carbidopa prolonged release tablet. Levodopa-Carbidopa prolonged release tablet may be administered concomitantly with the manufacturer&#39;s recommended dose of an MAO inhibitor with selectivity for MAO type B (e.g. selegiline hydrochloride). Levodopa-Carbidopa prolonged release tablet is contraindicated in patients with known hypersensitivity to any component of this medication, and in patients with narrow-angle glaucoma. Because levodopa may activate a malignant melanoma, Levodopa-Carbidopa prolonged release tablet should not be used in patients with suspicious undiagnosed skin lesions or a history of melanoma.</p>', '<p>The side-effect reported most frequently was dyskinesia (a form of abnormal involuntary movements). A greater incidence of dyskinesias was seen with Levodopa-Carbidopa prolonged-release tablet than with Levodopa-Carbidopa tablet. Other side-effects: nausea, hallucinations, confusion, dizziness, chorea, dry mouth, dream abnormalities, dystonia, insomnia, depression, asthenia, vomiting, anorexia, chest pain, palpitation, constipation, diarrhoea, dyspepsia, gastro-intestinal pain, dark saliva, angioedema, urticaria, pruritus, weight loss, neuroleptic malignant syndrome, agitation, anxiety, decreased mental acuity, paraesthesia, disorientation, fatigue, headache, extrapyramidal and movement disorders, falling, gait abnormalities, muscle cramps, on-off phenomenon, increased libido, psychotic episodes, dyspnoea, flushing, alopecia, rash, dark sweat, blurred vision, dark urine, cardiac irregularities, hypertension, phlebitis, bitter taste, sialorrhoea, dysphagia, bruxism, hiccups, gastro-intestinal bleeding, flatulence, burning sensation of tongue, development of duodenal ulcer, leucopenia, haemolytic and non-haemolytic anaemia, thrombocytopenia, agranulocytosis.</p>', '<p>There are insufficient data to evaluate the possible harmfulness of this substance when used in human pregnancy. It is not known whether carbidopa is excreted in human milk. In a study of one nursing mother with Parkinson&#39;s disease, excretion of levodopa in breast milk was reported. Levodopa-Carbidopa prolonged-release tablet should not be given during pregnancy and to nursing mothers.</p>', '<p>When patients are receiving levodopa monotherapy, levodopa must be discontinued at least eight hours before therapy with Levodopa-Carbidopa prolonged-release tablet is started (at least 12 hours if slow-release levodopa has been administered). Dyskinesias may occur in patients previously treated with levodopa alone because carbidopa permits more levodopa to reach the brain and, thus, more dopamine to be formed. The occurrence of dyskinesias may require dosage reduction. Levodopa-Carbidopa prolonged-release tablet is not recommended for the treatment of drug-induced extrapyramidal reactions or for the treatment of Huntingdon&rsquo;s chorea. Based on the pharmacokinetic profile of Levodopa-Carbidopa prolonged-release tablet the onset of effect in patients with early morning dyskinesias may be slower than with conventional&nbsp;Levodopa-Carbidopa tablet. The incidence of dyskinesias is slightly higher during treatment with Levodopa-Carbidopa prolonged-release tablet than with conventional Levodopa-Carbidopa tablet (16.5% vs 12.2%) in advanced patients with motor fluctuations. Levodopa-Carbidopa prolonged-release tablet should be administered cautiously to patients with severe cardiovascular or pulmonary disease, bronchial asthma, renal, hepatic or endocrine disease, or with a history of peptic ulcer disease or of convulsions. Care should be exercised in administering Levodopa-Carbidopa prolonged-release tablet to patients with a history of recent myocardial infarction who have residual atrial, nodal, or ventricular arrhythmia. In such patients, cardiac function should be monitored with particular care during the period of initial dosage administration and titration. Levodopa has been associated with somnolence and episodes of sudden sleep onset. Sudden onset of sleep during daily activities, in some cases without awareness or warning signs, has been reported very rarely. Patients must be informed of this and advised to exercise caution while driving or operating machines during treatment with levodopa. Patients who have experienced somnolence and/or an episode of sudden sleep onset must refrain from driving or operating machines. Furthermore a reduction of dosage or termination of therapy may be considered.&nbsp;<br />\r\n<br />\r\nAs with levodopa, Levodopa-Carbidopa prolonged-release tablet may cause involuntary movements and mental disturbances. Patients with a history of severe involuntary movements or psychotic episodes when treated with levodopa alone or levodopa/decarboxylase inhibitor combination should be observed carefully when Levodopa-Carbidopa prolonged-release tablet is substituted. These reactions are thought to be due to increased brain dopamine following administration of levodopa and use of Levodopa-Carbidopa prolonged-release tablet may cause recurrence. Dosage reduction may be required. All patients should be observed carefully for the development of depression with concomitant suicidal tendencies. Patients with past or current psychoses should be treated with caution. Impulse control disorders: Patients should be regularly monitored for the development of impulse control disorders. Patients and carers should be made aware that behavioural symptoms of impulse control disorders including pathological gambling, increased libido, hypersexuality, compulsive spending or buying, binge eating and compulsive eating can occur in patients treated with dopamine agonists and/or other dopaminergic treatments containing levodopa including Levodopa-Carbidopa tablet. Review of treatment is recommended if such symptoms develop.</p>', NULL, '<p>Antiparkinson drugs.</p>', '<p>Store in a cool and dry place, protected from light.</p>', '<p><strong>Use in Children</strong>: Safety and effectiveness of Levodopa-Carbidopa prolonged-release tablet in infants and children have not been established, and its use in patients below the age of 18 is not recommended.</p>', '2022-03-08 06:56:10', '2022-03-08 06:56:10'),
(848, 848, '<p>This tablet is indicated for the treatment of Parkinson&#39;s disease and syndrome. It is useful in relieving many of the symptoms of parkinsonism, particularly rigidity and bradykinesia. This tablet is frequently helpful in the management of tremor, dysphagia, sialorrhea and postural instability associated with Parkinson&#39;s disease and syndrome. Levodopa plus carbidopa before physiotherapy increases motor recovery after stroke.</p>', NULL, '<p><strong>If 100/10 mg tablet is used</strong>: Dosage may be initiated with one tablet three or four times a day. Titration upward may be required in some patients to achieve optimum dosage of carbidopa. The dosage may be increased by one tablet every day or every other day until a total of eight tablets (two tablets q.d.s.) is reached.<br />\r\n<br />\r\n<strong>For patients starting with 250/25 mg tablet</strong>: The initial dose is one half taken once or twice daily. However, this may not provide the optimal amount of Carbidopa needed by many patients. If necessary, add one-half every day or every other day until optimal response is reached. The suggested starting dosage for most patients taking more than 1500 mg of Levodopa a day is one tablet of 250/25 mg three or four times a day.<br />\r\n<br />\r\n<strong>Maintenance dose</strong>: Therapy should be individualized and adjusted according to the desired therapeutic response. When more levodopa is requried, 250/25 mg tablet should be substituted at a dosage of one tablet three or four times a day. If necessary, the dosage of 250/25 mg tablet may be increased by half to one tablet every other day to a maximum of eight tablets a day. Experience with a total daily dosage greater than 200 mg Carbidopa is limited.</p>', '<p>Symptomatic postural hypotension has occurred when Carbidopa-Levodopa is added to the treatment of a patient receiving antihypertensive medicines. Therefore, when therapy with CarbidopaLevodopa is started, dosage adjustment of the antihypertensive medicine may be required. There have been rare reports of adverse reactions, including hypertension and dyskinesia, resulting from the concomitant use of tricyclic antidepressants and Carbidopa-Levodopa. Studies demonstrate a decrease in the bioavailability of Carbidopa and/or Levodopa when it is ingested with ferrous sulphate or ferrous gluconate. Dopamine-2 receptor antagonists (e.g., phenothiazines, butyrophenones and risperidone) and isoniazid may reduce the therapeutic effects of Levodopa. In addition, the beneficial effects of Levodopa in Parkinson&#39;s disease have been reported to be reversed by phenytoin and papaverine. Patients taking these medicines with Carbidopa-Levodopa should be carefully observed for loss of therapeutic response. Concomitant therapy with selegiline and Carbidopa-Levodopa may be associated with severe orthostatic hypotension not attributable to Carbidopa-Levodopa alone.</p>', '<p>Carbidopa-Levodopa tablet is contraindicated in patients with hypersensitivity to Carbidopa and Levodopa, and in patients with narrow-angle glaucoma. Since Levodopa may activate a malignant melanoma, Carbidopa-Levodopa should not be used in patients with suspicious undiagnosed skin lesions or a history of melanoma.</p>', '<p>Adverse effects that occur frequently in patients receiving Carbidopa-Levodopa are those due to the central neuropharmacologic activity of dopamine. These reactions usually can be diminished by dosage reduction. The most common adverse effects are dyskinesias including choreiform, dystonic, and other involuntary movements and nausea.</p>\r\n\r\n<ul>\r\n	<li><strong>Body as a whole</strong>: syncope, chest pain, anorexia.</li>\r\n	<li><strong>Cardiovascular</strong>: palpitation, orthostatic effects including hypotensive episodes, hypertension, phlebitis.</li>\r\n	<li><strong>Gastrointestinal</strong>: vomiting, gastrointestinal bleeding, development of duodenal ulcer, diarrhoea, dark saliva.</li>\r\n	<li><strong>Haemotologic</strong>: leukopenia, haemolytic and non-haemolytic anaemia, thrombocytopenia, agranulocytosis.</li>\r\n	<li><strong>Hypersensitivity</strong>: angioedema, urticaria, pruritus, Henoch-Schonlein purpura.</li>\r\n	<li><strong>Nervous System</strong>: dizziness, somnolence, paresthesia, delusions, hallucinations and paranoid ideation, depression with or without development of suicidal tendencies, dementia, dream abnormalities, agitation, confusion, increased libido.</li>\r\n	<li><strong>Respiratory</strong>: dyspnea.</li>\r\n	<li><strong>Skin</strong>: alopecia, rash, dark sweat.</li>\r\n	<li><strong>Urogenital</strong>: dark urine.</li>\r\n</ul>', '<p>Although the effects of CarbidopaLevodopa on human pregnancy are unknown both Levodopa and combinations of Carbidopa and Levodopa have caused visceral and skeletal malformations in rabbits. Therefore, use of CarbidopaLevodopa in women of childbearing potential requires that the anticipated benefits of the medicine be weighed against possible hazards should pregnancy occur. It is not known whether Carbidopa is excreted in human milk. Because many medicines are excreted in human milk and because of the potential for serious adverse reactions in infants, a decision should be made whether to discontinue nursing or to discontinue the use of Carbidopa-Levodopa, taking into account the importance of the medicine to the mother.</p>', '<p>Carbidopa-Levodopa is not recommended for the treatment of medicine-induced extrapyramidal reactions. Carbidopa Levodopa may be given to patients already taking Levodopa alone; however, the Levodopa must be discontinued at least 12 hours before Carbidopa-Levodopa started. Dyskinesias may occur in patients previously treated with Levodopa alone because Carbidopa permits more Levodopa to reach the brain and, thus, more dopamine to be formed. The occurrence of dyskinesias may require dosage reduction. All patients should be observed carefully for the development of depression with concomitant suicidal tendencies. Patients with past or current psychoses should be treated with caution. Carbidopa-Levodopa should be administered cautiously to patients with severe cardiovascular or pulmonary disease, bronchial asthma, renal, hepatic or endocrine disease, or a history of peptic ulcer disease or of convulsions.<br />\r\n<br />\r\nCare should be exercised to patients with a history of myocardial infarction who have atriai, nodal, or ventricular arrhythmia. In such patients, cardiac function should be monitored with particular care during the period of initial dosage administration and titration. Patients with chronic wide-angle glaucoma may be treated cautiously with Carbidopa-Levodopa, provided the intraocular pressure is weli controlled and the patient monitored carefully for changes in intraocular pressure during therapy.</p>', NULL, '<p>Antiparkinson drugs.</p>', '<p>Store in a cool and dry place, protected from light.</p>', '<p><strong>Use in children</strong>: Safety and effectiveness of Carbidopa-Levodopa in infants and children have not been established, and its use in patients below the age of 18 years is not recommended.</p>', '2022-03-08 06:58:22', '2022-03-08 06:58:22'),
(849, 849, '<p>This medicine&nbsp;is indicated for the treatment of adult patients with Parkinson&#39;s disease and end-of-dose motor fluctuations not stabilized on levodopa/dopa decarboxylase (DDC) inhibitor treatment.</p>', '<p>Levodopa is the metabolic precursor of dopamine. It crosses the blood-brain barrier and is converted to dopamine in the brain. Carbidopa increases the amount of levodopa that is transported into the CNS by inhibiting the decarboxylation of peripheral levodopa. Entacapone is a selective inhibitor of COMT which alters the pharmacokinetics of levodopa, resulting to increased and more sustained levodopa serum levels.</p>', '<p><strong>Adults</strong>: The optimum daily dose must be determined by careful titration of levodopa in each patient. Patients should be instructed to take only 1 (one) tablet per dose administration. The maximum recommended daily dose of entacapone is 2,000 mg. Usually this combination is to be used in patients who are currently treated with corresponding doses of standard release Levodopa or Dopa Decarboxylase (DDC)&nbsp;inhibitor and entacapone.</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. Keep a consistent diet. A change in diet to foods high in protein may delay levodopa absorption &amp; reduce amount taken up in circulation. Excessive acidity also delays stomach emptying &amp; thus delays levodopa absorption. Iron salts may also reduce amount of levodopa available to the body. Swallow whole.</p>', '<p>Symptomatic postural hypotension may occur when levodopa is added to the treatment of patients already receiving antihypertensive. Dose adjustment of the antihypertensive agent may be required. Dopamine receptor antagonists (e.g. some antipsychotics and antiemetics), phenytoin and papaverine may reduce the therapeutic effect of levodopa. Patients taking these medicinal products with levodopa/ carbidopa/ entacapone combination should be carefully observed for loss of therapeutic response. Since levodopa competes with certain amino acids, the absorption of Levodopa, Carbidopa &amp; Entacapone&nbsp;may be impaired in some patients on high protein diet.</p>', '<p>Narrow-angle glaucoma, phaeochromocytoma, history of neuroleptic malignant syndrome (NMS) and/ or non-traumatic rhabdomyolysis. Severe hepatic impairment. Concurrent use of or within 14 days of discontinuing non-selective MAOIs.</p>', '<p>Common side effects include dyskinesia, nausea, hyperkinesia, change in urine color, diarrhea and stomach pain. Other side effects may include diarrhea, sometimes severe; colitis; hallucinations; other mental disturbances; orthostatic hypotension; rhabdomyolysis; and symptoms resembling neuroleptic malignant syndrome (a condition characterized by high fever, muscle stiffness, and confusion); fibrosis; skin cancer, etc.</p>', '<p>Pregnancy category C. The combination of levodopa/ carbidopa/ entacapone should not be used during pregnancy unless the potential benefit justifies the potential risk to the fetus. The safety of this combination in the infant is not known. Women should not breast-feed during treatment with this combination.</p>', '<p>Levodopa, carbidopa and entacapone together may cause dizziness and symptomatic orthostatism. Therefore, caution should be exercised when driving or using machines. As with levodopa, periodic evaluations of hepatic, hematopoietic, cardiovascular and renal function are recommended during extended therapy.</p>', '<p>The acute symptoms and signs of overdose include agitation, confusional state, coma, bradycardia, ventricular tachycardia, Cheyne Stokes respiration, discolorations of skin, tongue and conjunctiva, and chromaturia. Management of acute overdose with levodopa/ carbidopa/ entacapone combination is similar to acute overdose with levodopa. Pyridoxine, however, is not effective in reversing the actions of levodopa/ carbidopa/ entacapone combination. Hospitalization is advised and general supportive measures should be employed with immediate gastric lavage and repeated doses of charcoal over time.</p>', '<p>Antiparkinson drugs</p>', '<p>Store in a cool and dry place. Protect from light.</p>', '<p><strong>Children</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Elderly</strong>: No dose adjustment is required for elderly patients.<br />\r\n<br />\r\n<strong>Hepatic impaired patients</strong>: Should be administered cautiously to patients with mild to moderate hepatic impairment. Dose reduction may be needed.<br />\r\n<br />\r\n<strong>Renally impaired patients</strong>: Should be administered cautiously to patients in severe renal impairment including those receiving dialysis therapy</p>', '2022-03-08 07:01:03', '2022-03-08 07:01:03'),
(850, 850, '<p>Levofloxacin eye drops is indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of the following bacteria:<br />\r\n<br />\r\n<strong>Aerobic Gram-Positive bacteria</strong>-</p>\r\n\r\n<ul>\r\n	<li>Corynebacterium species</li>\r\n	<li>Staphylococcus oureus&nbsp;</li>\r\n	<li>Staphylococcus epidermidis&nbsp;</li>\r\n	<li>Streptococcus pneumoniae</li>\r\n	<li>Streptococcus (Groups C/F)</li>\r\n	<li>Streptococcus (Group G)</li>\r\n	<li>Streptococcus viridons group</li>\r\n</ul>\r\n\r\n<p><strong>Aerobic Gram-Negative bacteria</strong>-</p>\r\n\r\n<ul>\r\n	<li>Acinetobocter Iwoffii</li>\r\n	<li>Haemophilus influenzae</li>\r\n	<li>Serrotia morcescens</li>\r\n</ul>\r\n\r\n<p>Levofloxacin also provides a promising treatment for other ocular infections including- Bacterial corneal ulcer, Blepharitis, Hordeolum &amp; Perioperative condition.</p>', '<p>Levofloxacin eye drops is a sterile topical ophthalmic solution. It is a synthetic, broad spectrum, third generation fluoroquinolone bactericidal antibiotic, which active against a broad spectrum of Gram-positive &amp; Gram-negative ocular pathogens. It functions by inhibiting bacterial topoisomerase IV and DNA gyrase enzymes required for DNA replication, transcription, repair and recombination.</p>', '<p><strong>0.5% eye drop</strong>: Adults and children 1 year of age and older:</p>\r\n\r\n<ul>\r\n	<li><strong>Days 1 and 2</strong>: Instill 1-2 drops in the affected eye(s) every 2 hours while awake, up to 8 times per day.</li>\r\n	<li><strong>Days 3 through 7</strong>: Instill 1-2 drops in the affected eye(s) every 4 hours while awake, up to 4 times per day.</li>\r\n</ul>\r\n\r\n<p><strong>1.5% eye drop</strong>: Adults and children 6 years of age and older:</p>\r\n\r\n<ul>\r\n	<li><strong>Days 1 through 3</strong>: Instill one to two drops in the affected eye(s) every 30 minutes to 2 hours while awake and approximately 4 and 6 hours after retiring.</li>\r\n	<li><strong>Day 4 through treatment completion</strong>: Instill one to two drops in the affected eye(s) every 1 to 4 hours while awake.</li>\r\n</ul>\r\n\r\n<p><strong>Children &lt;1 year</strong>: Safety and effectiveness of Levofloxacin below 1 year of age have not been established.</p>', '<p>Specific drug interaction studies have not been conducted with levofloxacin eye drops. But the systemic administration of some quinolones has been shown to elevate plasma concentrations of theophylline, interfere with the metabolism of caffeine and enhance the effects of the oral anticoagulant warfarin and its derivatives.</p>', '<p>It is contraindicated in patients with a history of hypersensitivity to Levofloxacin, to other quinolones or to any of the components of this medication.</p>', '<p>Side effects occurred only approximately 1-3% of patients that may include transient blurred vision, fever, foreign body sensation, headache, transient ocular burning, ocular pain or discomfort, pharyngitis and photophobia. In less than 1% of patients included allergic reactions, lid edema, ocular dryness and ocular itching.</p>', '<p>Pregnancy Category C. Levofloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Levofloxacin has not been measured in human milk. Caution should be exercised when Levofloxacin eye drops is administered to a nursing mother.</p>', '<p>Prolonged use may result in the overgrowth of non-susceptible organisms, including fungi. If superinfection occurs, discontinue use and institute alternative therapy.</p>', NULL, '<p>4-Quinolone preparations</p>', '<p>Eye drops should be protected from light, store in a cool (15&deg;-25&deg; C) and dry place &amp; keep out of reach of children.</p>', NULL, '2022-03-08 07:02:58', '2022-03-08 07:02:58'),
(851, 851, '<p>Levofloxacin is indicated for the treatment of mild, moderate and severe infections caused by susceptible strains of the designated micro-organisms in the condition listed below:</p>\r\n\r\n<ul>\r\n	<li>Acute maxillary sinusitis due to Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis.</li>\r\n	<li>Acute bacterial exacerbation of chronic bronchitis due to Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis.</li>\r\n	<li>Community-acquired pneumonia due to Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae, Moraxella catarrhalis, Chlamydia pneumoniae, Legionella pneumophila, or Mycoplasma pneumoniae.</li>\r\n	<li>Uncomplicated &amp; complicated urinary tract infections due to Escherichia coli, Klebsiella pneumoniae, or Staphylococcus saprophyticus.</li>\r\n	<li>Acute pyelonephritis caused by Escherichia coli.</li>\r\n	<li>Uncomplicated &amp; complicated skin and soft tissue infections including abscesses, cellulitis, furuncles, impetigo, pyoderma, wound infections, due to Staphylococcus aureus, Streptococcus pyogenes, Proteus mirabilis or Enterococcus faecalis.</li>\r\n	<li>Enteric infections caused by Enterobacter sp., Escherichia coli, Campylobacter sp., Vibrio cholerae, Shigella sp., Salmonella sp.</li>\r\n</ul>', '<p>Levofloxacin is a synthetic, broad-spectrum, third generation fluoroquinolone antibiotic. Chemically, Levofloxacin is a chiral fluorinated carboxyquinolone. Levofloxacin exerts antibacterial action by inhibiting bacterial topoisomerase IV and DNA gyrase, the enzymes required for DNA replication, transcription repair and recombination. It has in vitro activity against a wide range of gm-ve and gm+ve microorganisms.</p>', '<p>The usual dose of Levofloxacin Tablets is 250 mg or 500 mg or 750 mg administered orally every 24 hours. Levofloxacin tablets can be administered without regard to food. Levofloxacin oral solution should be taken 1 hour before, or&nbsp; 2 hours after eating.<br />\r\n<br />\r\nLevofloxacin injection should only be administered by intravenous infusion. It is not for intramuscular, intrathecal, intraperitoneal, or subcutaneous administration. The usual dose of Levofloxacin injection is 250 mg or 500 mg administered by slow infusion over 60 minutes every 24 hours or 750 mg administered by slow infusion over 90 minutes every 24 hours. Since the Levofloxacin injections are for single-use only, any unused portion should be discarded. Additives or other medications should not be added to Levofloxacin Injection or infused simultaneously through the same intravenous line.<br />\r\n<br />\r\nAdults:</p>\r\n\r\n<ul>\r\n	<li><strong>Acute sinusitis</strong>: 500 mg once daily for 10-14 days, or 750 mg once daily for 5 days</li>\r\n	<li><strong>Exacerbation of chronic bronchitis</strong>: 500 mg once daily for 7 days, or 750 mg once daily for 3 days (Uncomplicated), 750 mg once daily for 5 days (Complicated)</li>\r\n	<li><strong>Community-acquired pneumonia</strong>: 500 mg once daily for 7-14 days, or 750 mg once daily for 5 days</li>\r\n	<li><strong>Uncomplicated urinary-tract infections</strong>: 250 mg once daily for 3 days</li>\r\n	<li><strong>Complicated urinary-tract infections and acute pyelonephritis</strong>: 250 mg once daily for 7-10 days</li>\r\n	<li><strong>Uncomplicated skin and soft-tissue infections</strong>: 500 mg once daily for 7-10 days.</li>\r\n	<li><strong>Complicated skin and soft-tissue infections</strong>: 750 mg once daily for 7-14 days.</li>\r\n	<li><strong>Enteric fever</strong>: 500 mg once daily for 7-14 days.</li>\r\n	<li><strong>Diarrhea, cholera, shigellosis &amp; enteritis</strong>: Mild to moderate case: 500 mg (single dose). Moderate to sever case: 500 mg once daily for 3 days</li>\r\n</ul>\r\n\r\n<p>Children:</p>\r\n\r\n<ul>\r\n	<li><strong>Children 6 months to &lt;5 years</strong>: 10 mg/kg every 12 hours.</li>\r\n	<li><strong>Children &gt;5 years</strong>: 10 mg/kg every 24 hours</li>\r\n</ul>\r\n\r\n<p>In each case, sequential therapy (intravenous to oral) may be instituted at the discretion of the physician.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Instructions for the Use of Levofloxacin Infusion-</p>\r\n\r\n<ul>\r\n	<li>Check the container for minute leaks by squeezing the inner bag firmly. If leaks are found, or if the seal is not intact, discard the solution.</li>\r\n	<li>Do not use if the solution is cloudy or a precipitate is present.</li>\r\n	<li>Do not use flexible containers in series connections.</li>\r\n	<li>Close flow control clamp of administration set.</li>\r\n	<li>Remove cover from port at bottom of container.</li>\r\n	<li>Insert piercing pin of administration set into port with a twisting motion until the pin is firmly seated.</li>\r\n	<li>Suspend container from hanger.</li>\r\n	<li>Squeeze and release drip chamber to establish proper fluid level in chamber during infusion of Levoxin Injection.</li>\r\n	<li>Open flow control clamp to expel air from set. Close clamp.</li>\r\n	<li>Regulate rate of administration with flow control clamp.</li>\r\n</ul>', '<p>No quinolone should be co-administered with any solution containing multivalent cations, e.g., magnesium, through the same intravenous line. Antacids, Iron and Adsorbents reduce absorption of Levofloxacin. NSAID may increase the risk of CNS stimulation. Warfarin may increase the risk of bleeding.</p>', '<p>Levofloxacin is contraindicated in patients with a history of hypersensitivity to levofloxacin, quinolone antimicrobial agents, or any other components of this product.</p>', '<p>Levofloxacin is generally well tolerated. However, a few side-effects can usually be seen. There is a risk of retinal detachment. Other side-effects include: nausea, vomiting, diarrhea, abdominal pain, flatulence and rare occurrence of phototoxicity (0.1%). Side-effects that may be seen very rarely include tremors, depression, anxiety, confusion etc.</p>', '<p>Levofloxacin is not recommended for use during pregnancy or nursing, as the effects on the unborn child or nursing infant are unknown.</p>', '<p>The following measures should be taken during administration of Levofloxacin:</p>\r\n\r\n<ul>\r\n	<li>Levofloxacin Injection should only be administered by slow intravenous infusion over a period of 60 or 90 minutes depending on the dosage.</li>\r\n	<li>While administrating Levofloxacin, adequate amount of water should be taken to avoid concentrated form of urine.</li>\r\n	<li>Dose adjustment should be exercised during Levofloxacin administration in presence of renal insufficiency.</li>\r\n</ul>', '<p>Levofloxacin exhibits a low potential for acute toxicity. However, in the events of an acute overdosage, the stomach should be emptied. The patients should be kept under observation and appropriate hydration should be maintained.</p>', '<p>4-Quinolone preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-08 07:05:44', '2022-03-08 07:05:44'),
(852, 852, '<p>A head cold can hamper sleep, making for restless nights. Espirar&rsquo;s combination of natural vapors from Levomenthol, Thymol, Chlorobutanol &amp; Terpineol work gently to help you or your child breathe more easily.</p>', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-03-08 07:06:17', '2022-03-08 07:06:17'),
(853, 853, '<p>Levomilnacipran is a serotonin and norepinephrine reuptake inhibitor (SNRI) indicated for the treatment of Major Depressive Disorder (MDD) in adults.<br />\r\n<br />\r\nLimitation of Use: Levomilnacipran is not approved for the management of fibromyalgia. The efficacy and safety of Levomilnacipran for the management of fibromyalgia have not been established.</p>', '<p>The exact mechanism of the antidepressant action of levomilnacipran is unknown, but is thought to be related to the potentiation of serotonin and norepinephrine in the central nervous system, through inhibition of reuptake at serotonin and norepinephrine transporters. Non-clinical studies have shown that levomilnacipran is a potent and selective serotonin and norepinephrine reuptake inhibitor (SNRI).<br />\r\n<br />\r\nLevomilnacipran binds with high affinity to the human serotonin (5-HT) and norepinephrine (NE) transporters (Ki = 11 and 91 nM, respectively) and potently inhibits 5-HT and NE reuptake (IC50 = 16-19 and 11 nM, respectively). Levomilnacipran lacks significant affinity for any other receptors, ion channels or transporters tested in vitro, including serotonergic (5HT1-7), &alpha;- and &beta;-adrenergic, muscarinic, or histaminergic receptors and Ca2+, Na+, K+&nbsp;or Cl-&nbsp;channels. Levomilnacipran did not inhibit monoamine oxidase (MAO).</p>', '<p><strong>Recommended dose</strong>: 40 mg to 120 mg once daily with or without food. Initiate dose at 20 mg once daily for 2 days and then increase to 40 mg once daily. Based on efficacy and tolerability, increase dose in increments of 40 mg at intervals of 2 or more days. The maximum recommended dose is 120 mg once daily. Take capsules whole; do not open, chew or crush.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: Do not exceed 80 mg once daily for moderate impairment. Do not exceed 40 mg once daily for severe renal impairment.<br />\r\n<br />\r\n<strong>Discontinuation</strong>: Reduce dose gradually whenever possible.</p>', '<p>Strong CYP3A4 inhibitors such as ketoconazole: Do not exceed 80 mg once daily.</p>', '<p>Hypersensitivity to levomilnacipran, milnacipran HCl or to any excipient in the formulation.<br />\r\n<br />\r\nThe use of MAOIs intended to treat psychiatric disorders with Levomilnacipran or within 7 days of stopping treatment with Levomilnacipran is contraindicated because of an increased risk of serotonin syndrome. The use of Levomilnacipran within 14 days of stopping an MAOI intended to treat psychiatric disorders is also contraindicated.<br />\r\n<br />\r\nStarting Levomilnacipran in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome.</p>', '<ul>\r\n	<li>Hypersensitivity</li>\r\n	<li>Suicidal Thoughts and Behaviors in Adolescents and Young Adults&nbsp;</li>\r\n	<li>Serotonin Syndrome</li>\r\n	<li>Elevated Blood Pressure</li>\r\n	<li>Elevated Heart Rate</li>\r\n	<li>Increased Risk of Bleeding</li>\r\n	<li>Angle Closure Glaucoma</li>\r\n	<li>Urinary Hesitation or Retention</li>\r\n	<li>Activation of Mania/Hypomania</li>\r\n	<li>Seizure</li>\r\n	<li>Discontinuation Syndrome</li>\r\n	<li>Hyponatremia</li>\r\n</ul>', '<p>Pregnancy: Third trimester use may increase risk for symptoms of poor adaptation (respiratory distress, temperature instability, feeding difficulty, hypotonia, tremor, irritability) in the neonate.</p>', NULL, NULL, '<p>Serotonin-norepinephrine reuptake inhibitor (SNRI).</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>: Clinical studies on the use of Levomilnacipran in pediatric patients have not been conducted; therefore, the safety and effectiveness of Levomilnacipran in the pediatric population have not been established. Levomilnacipran is not approved for use in pediatric patients.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No dose adjustment is recommended on the basis of age. In a multiple-dose clinical pharmacokinetic study, elderly subjects (&gt; 65 years) had a slightly higher exposure (C max by 24% and AUC by 26%) of levomilnacipran than younger subjects (18-45 years). Of the total number of subjects in the 8-week clinical studies of Levomilnacipran, 2.8% of patients were age 65 or older. Because levomilnacipran is predominately excreted by the kidney, renal clearance of levomilnacipran should be considered when determining the dose. SSRIs and SNRIs, including Levomilnacipran, have been associated with cases of clinically significant hyponatremia in elderly patients, who may be at greater risk for this adverse event.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Hepatic elimination of levomilnacipran is low. Dose adjustment is not recommended in subjects with mild (Child-Pugh score of 1-6), moderate (Child-Pugh score of 7-9), or severe (Child-Pugh score of 10-13) hepatic impairment.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: Renal excretion plays a predominant role in the elimination of levomilnacipran. Dose adjustment is not recommended for patients with mild (creatinine clearance of 60-89 ml/min) renal impairment. Dosing adjustment is recommended for patients with moderate (creatinine clearance of 30-59 ml/min) or severe (creatinine clearance of 15-29 ml/min) renal impairment. Levomilnacipran is not recommended for patients with end stage renal disease.</p>', '2022-03-08 07:08:37', '2022-03-08 07:08:37'),
(854, 854, '<p>Emergency contraception is a rescue method that is aimed to prevent fertilization in case of unprotected intercourse.<br />\r\n<br />\r\nThis contraception must be used as soon as possible, preferably within 12 hours and no later than 72 hours (3 days) after the unprotected sexual intercourse, particularly;</p>\r\n\r\n<ul>\r\n	<li>if you have had sexual intercourse whereas either yourself or your partner did not use a contraceptive method;</li>\r\n	<li>if you have forgotten to take consecutive 3 contraceptive pills;</li>\r\n	<li>if your partner&#39;s condom has broken, slipped, or been improperly removed, or if he has forgotten to use it;</li>\r\n	<li>if you fear that your intrauterine device has been expelled;</li>\r\n	<li>if your vaginal diaphragm or your contraceptive cap has moved or if you have removed it too early;</li>\r\n	<li>if you are afraid that the method of coitus interruptus has failed or if you have had sexual intercourse during the period when you are supposed to be fertile while using the rhythm method;</li>\r\n	<li>in the event of rape.</li>\r\n</ul>', '<p>Oral contraceptives containing levonorgestrel suppress gonadotropins, inhibiting ovulation. Specifically, levonorgestrel binds to progesterone and androgen receptors and slows the release of gonadotropin-releasing hormone (GnRH) from the hypothalamus. This process results in the suppression of the normal physiological luteinizing hormone (LH) surge that precedes ovulation. It inhibits the rupture of follicles and viable egg release from the ovaries. Levonorgestrel has been proven to be more effective when administered before ovulation.</p>', '<p><strong>1.5 mg Tablet</strong>: The treatment necessitates the intake of one tablet. The Levonorgestrel tablet must be taken as soon as possible, preferably within 12 hours, after the unprotected intercourse, and no longer than within 72 hours (3 days) after the intercourse. Levonorgestrel can be taken at any moment during the menstrual cycle.<br />\r\n<br />\r\n<strong>0.75 mg Tablet</strong>: The first Levonorgestrel tablet must be taken within 72 hours of the intercourse and the second tablet should be taken after 12 hours of the intake of the first tablet. Levonorgestrel must be taken within 48 hours of unprotected intercourse and in no way after 72 hours because the effectiveness of the medicine starts reducing after 48 hours of intercourse. Levonorgestrel can be taken at any moment during the menstrual cycle.<br />\r\n<br />\r\nAfter using emergency contraception, it is recommended to use a local contraceptive mean (condom, spermicide, and cervical cap) until the next menstrual period resumes. The use of Levonorgestrel does not contraindicate the continuation of regular hormonal contraception. If you have used this medicine while you were using oral contraception (contraceptive pill), you should carry on taking the usual tablets until the end of the treatment. In case no menstrual period occurs in the next pill-free period following the use of Levonorgestrel a pregnancy test should be performed to rule out a pregnancy.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Oral use. The tablet should be taken with a glass of water.</p>', '<p>Interactions with other medicines and other forms of interaction: Simultaneous administration of certain anticonvulsant agents (phenobarbitone, phenytoin, primidone, carbamazepine), also other medications such as rifampicin, and griseofulvin can reduce or suppress the effectiveness of this emergency contraception.</p>', '<p>If you have hypersensitivity to levonorgestrel or any of the excipients of Levonorgestrel.</p>', '<p>Undesirable effects which have been observed are:</p>\r\n\r\n<ul>\r\n	<li>Nausea and vomiting</li>\r\n	<li>Dizziness, fatigue, headache</li>\r\n	<li>Abdominal pain</li>\r\n	<li>A feeling of breast tenderness</li>\r\n	<li>Bleeding can occur after taking this medicine</li>\r\n</ul>\r\n\r\n<p>Inform the doctor of any unwanted effect which is not mentioned here.</p>', '<p>This medicine is not indicated in case of pre-existing pregnancy and cannot interrupt it. In case of failure of this contraceptive mean persisting pregnancy, epidemiological studies indicate no adverse effects of progestogen on the malformation of a fetus. Lactation is possible. However, since levonorgestrel is secreted into breast milk, it is suggested that you breastfeed immediately before taking each Levonorgestrel tablet and that you skip the nursing following each Levonorgestrel administration.</p>', '<p>Emergency contraception must be used exceptionally, since:</p>\r\n\r\n<ul>\r\n	<li>It does not allow to prevent a pregnancy in every instance:</li>\r\n	<li>The associated hormonal overdosing is not advisable in the case of regular intake.</li>\r\n	<li>It cannot replace regular contraception.</li>\r\n</ul>\r\n\r\n<p>After taking Levonorgestrel, the menstrual period usually occurs at the expected date nevertheless, it can occur earlier or later by a few days. After taking this medicine, it is therefore mandatory to check the absence of pregnancy by performing a pregnancy test in case of abnormal bleeding at the date of excepted menses or in case of menstrual delay of more than 5 days.<br />\r\n<br />\r\nThe use of emergency contraception does not replace the necessary precautions against sexually transmitted diseases and the measures to be taken in case of risk of transmission.<br />\r\n<br />\r\nTaking this medicine is not recommended if you have had an ectopic pregnancy or if you have had salpingitis or if you have a severe digestive disease that impairs the absorption of medications.<br />\r\n<br />\r\nIf vomiting would occur within three hours after taking this medicine, it is recommended to take immediately another Levonorgestrel tablet.</p>', '<p>No acute toxicity has been demonstrated with this medicine in the case of intake of several doses. The efficacy of this medicine is not guaranteed if the dose has been omitted.</p>', '<p>Emergency Contraceptive Pill, Oral Contraceptive preparations.</p>', '<p>Do not exceed the expiry date printed on the outer packaging. Keep the tablet in the outer carton. Keep the medicine away from children. Store in cool dry conditions (below 30&deg; C).</p>', NULL, '2022-03-08 07:11:15', '2022-03-08 07:11:15');
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
(855, 855, '<p>Levosalbutamol&nbsp;Nebuliser Solution or Inhaler &nbsp;is indicated for the treatment or prevention of bronchospasm in adults, adolescents, and children with reversible obstructive airway disease.</p>', '<p>Levosalbutamol Nebuliser Solution is a sterile, clear, colorless, preservative-free solution of the hydrochloride salt of Levosalbutamol, the (R)-enantiomer of the drug substance racemic salbutamol. Levosalbutamol Hydrochloride is a relatively selective &beta;2&nbsp;adrenergic receptor agonist.<br />\r\n<br />\r\nActivation of &beta;2 adrenergic receptors on airway smooth muscle leads to the activation of adenylcyclase and to an increase in the intracellular concentration of cyclic AMP. This increase in cAMP leads to the activation of protein kinase A, which inhibits the phosphorylation of myosin and lowers intracellular ionic calcium concentrations, resulting in relaxation. Levosalbutamol relaxes the smooth muscles of all airways, from the trachea to the terminal bronchioles. Levosalbutamol acts as a functional antagonist to relax the airway irrespective of the spasmogen involved, thus protecting against all bronchoconstrictor.</p>', '<p><strong>Nebuliser Solution</strong>: This Nebuliser Solutions supplied in unit-dose ampoules and requires no dilution before administration by nebulization.</p>\r\n\r\n<ul>\r\n	<li><strong>Children (6 months-11 years)</strong>: The recommended dosage is 0.31 mg administered three times a day, by nebulization. Routine dosing should not exceed 0.63 mg three times a day.&nbsp;</li>\r\n	<li><strong>Adults and Adolescents above 12 years old</strong>: The recommended starting dosage is 0.63 mg administered three to four times a day, every 6 to 8 hours, by nebulization.&nbsp;</li>\r\n	<li><strong>Patients 12 years of age and older</strong>: With more severe asthma or patients who do not respond adequately: 0.63 mg of Levosalbutamol Nebuliser Solution may benefit from a dosage of 1.25 mg three times a day.</li>\r\n</ul>\r\n\r\n<p><strong>Inhaler</strong>: You should take your Levosalbutamol Inhaler as needed for an asthma attack at any time of day, with or without food, by taking 1-2 puffs up to 4 times daily and no more than 8 puffs in 24 hours. If you are using your Levosalbutamol Inhaler more than 3-4 times a week this may indicate that your asthma is not well controlled and you may need to review your medication. You can also use your Levosalbutamol Inhaler to prevent allergy or exercise induced asthma by taking 2 puffs 15 minutes before exercise or exposure to a known allergen.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Using an Inhaler seems simple, but most patients do not know how to use it in the right way. If the Inhaler is used in the wrong way, less medicine can reach the lungs. Correct and regular use of the Inhaler will prevent or lessen the severity of asthma attacks.<br />\r\n<br />\r\nFollowing simple steps can help to use Inhaler effectively (According to &quot;<strong>National Asthma Guidelines for Medical Practitioners</strong>&quot; published by Asthma Association):</p>\r\n\r\n<ol>\r\n	<li>Take off the cap.</li>\r\n	<li>Shake the inhaler (at least six times) vigorously before each use.</li>\r\n	<li>If the inhaler is new or if it has not been used for a week or more, shake it well and release one puff into the air to make sure that it works.</li>\r\n	<li>Breathe out as full as comfortably possible &amp; hold the inhaler upright.</li>\r\n	<li>Place the actuator into mouth between the teeth and close lips around the mouthpiece.</li>\r\n	<li>While breathing deeply and slowly through the mouth, press down firmly add fully on the canister to release medicine.</li>\r\n	<li>Remove the inhaler from mouth. Continue holding breath for at least for 10 seconds or as long as it is comfortable.</li>\r\n	<li>If doctor has prescribed more than one inhalation per treatment, wait 1 minute between puffs (inhalations). Shake the inhaler well and repeat steps 4 to 7.</li>\r\n	<li>After use, replace the cap on the mouthpiece. After each treatment, rinse mouth with water.</li>\r\n	<li>Check your technique in front of a mirror from time to time, if you see a white mist during the inhalation, you may not have closed your lips properly around mouthpiece, or you may not be breathing in as you press the can. This indicates failure of technique. If this happens, repeat the procedure from step 4 carefully.</li>\r\n</ol>\r\n\r\n<p><strong>Instructions for Cleaning Inhaler</strong>: Clean your Inhaler at least once a week. Remove canister and rinse the plastic actuator and cap in warm water but do not put the metal canister into water. Dry the actuator and cap thoroughly and gently replace the metal canister into the actuator with a twisting motion. Put the cap on the mouthpiece.</p>', '<p>Other short-acting sympathomimetic aerosol bronchodilators or epinephrine should be used with caution with Levosalbutamol. If additional adrenergic drugs are to be administered by any route, they should be used with caution to avoid deleterious cardiovascular effects.<br />\r\n<br />\r\n<strong>Beta-blockers</strong>: Beta-adrenergic receptor blocking agents not only block the pulmonary effect of beta-agonists such as Levosalbutamol Nebuliser Solution or Inhaler, but may also produce severe bronchospasm in asthmatic patients. However, under certain circumstances, e.g. prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-adrenergic blocking agents in patients with asthma. In this setting, cardio selective beta-blockers could be considered with caution.<br />\r\n<br />\r\n<strong>Diuretics</strong>: The ECG changes and/or hypokalemia that may result from the administration of non-potassium sparing diuretics can be acutely worsened by beta-agonists when the recommended dose of the beta-agonist is exceeded.<br />\r\n<br />\r\n<strong>Digoxin</strong>: It is necessary to carefully evaluate the serum digoxin levels in patients who are currently receiving digoxin and Levosalbutamol Nebuliser Solution or Inhaler.&nbsp;<br />\r\n<br />\r\n<strong>Monoamine Oxidase Inhibitors or Tricyclic Antidepressants</strong>: Levosalbutamol Nebuliser Solution or Inhaler should be administered with extreme caution to patients being treated with monoamine oxidase inhibitors or tricyclic antidepressants, or within 2 weeks of discontinuation of such agents.</p>', NULL, '<p>Side Effects</p>\r\n\r\n<p>Potentially serious hypokalaemia may result from beta 2 - agonist therapy. This effect may be potentiated by hypoxia. Other side effects such as palpitation, fine tremors of the skeletal muscle (particularly the hand) and muscle cramps may occur. In few cases nervousness, headache, dizziness, fatigue and sleeplessness have also been reported.</p>', '<p><strong>Pregnancy</strong>: There are no adequate and well-controlled studies of Levosalbutamol Nebuliser Solution in pregnant women. Levosalbutamol Solution should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether Levosalbutamol is excreted in human milk. Caution should be exercised when Levosalbutamol Nebuliser Solution is administered to a nursing woman.</p>', '<p>Levosalbutamol Hydrochloride, like all sympathomimetic amines, should be used with caution in patients with cardiovascular disorders, especially coronary insufficiency, hypertension, and cardiac arrhythmias; in patients with convulsive disorders, hyperthyroidism, or diabetes mellitus; and in patients who are unusually responsive to sympathomimetic amines. Levosalbutamol Nebuliser Solution or Inhaler&nbsp;must not be injected.</p>', '<p>The expected symptoms with over dosage are those of excessive beta-adrenergic receptor stimulation and/or occurrence or exaggeration of any of the symptoms listed under side effects. Treatment consists of discontinuation of Levosalbutamol Nebuliser Solution&nbsp;or Inhaler together with appropriate symptomatic therapy. The judicious use of a cardioselective beta-receptor blocker may be considered.</p>', '<p>Short-acting selective &amp; &beta;2-adrenoceptor stimulants</p>', '<p>Store below 25&deg;C. Protect from light. Do not refrigerate.</p>', NULL, '2022-03-08 07:13:38', '2022-03-08 07:13:38'),
(856, 856, '<p>Levosalbutamol is indicated for the treatment or prevention of bronchospasm in adults, adolescents and children 6 years of age and older with reversible obstructive airway disease.</p>', '<p>Levosalbutamol is a single isomer beta 2-agonist that differs from racemic salbutamol by elimination of (S)-salbutamol. Levosalbutamol is an effective bronchodilator whose primary mechanism of action is unimpeded by (S)-salbutamol. Thus, when compared with racemic salbutamol, clinically comparable bronchodilation can be achieved with doses that substantially lessen beta-mediated side effects.</p>', '<p>Dosage &amp; Administration</p>\r\n\r\n<p>Tablet-</p>\r\n\r\n<ul>\r\n	<li>Adults and adolescents above 12 years: 1-2 mg three times daily.</li>\r\n	<li>Children (6 -11 years): 1 mg three times daily.</li>\r\n</ul>\r\n\r\n<p>Syrup-</p>\r\n\r\n<ul>\r\n	<li>Adults : 5-10 ml three times daily.</li>\r\n	<li>Childrn (6-11 years): 5 ml three times daily.</li>\r\n</ul>', '<p>Other short acting sympathomimetic bronchodilators or epinephrine should be used with caution with Levosalbutamol. If additional adrenergic drugs are to be administered by any route, they will be used with caution to avoid deleterious cardiovascular effects.</p>', '<p>Levosalbutamol is contraindicated in patients with a history of hypersensitivity to levosalbutamol or any of its components.</p>', '<p>Hypocalcaemia, palpitation, fine tremors of the skeletal muscle and muscle cramps may occur. The other likely side effects are nausea, vomiting, burning substernal or epigastric pain and diarrhoea.</p>', '<p>The drug should be used during pregnancy only if the potential benefit justifies the potential risk of the fetus. It is not known whether Levosalbutamol is excreted in human milk. Caution should be exercised when oral Levosalbutamol is administered to a nursing woman.</p>', '<p>Particular caution is advised in acute severe asthma as this effect may be potentiated by hypoxia and by concomitant treatment with xanthine derivatives, steroids and diuretics. Serum potassium levels should be monitored in such situations.</p>', '<p>The expected symptoms with over dosage are those of excessive beta-adrenergic stimulation and the symptoms listed under side effects. In the event of serious poisoning, the stomach should be emptied and, if necessary, a beta-blocker administered with caution in patients with a history of bronchospasm.</p>', '<p>Short-acting selective &amp; &beta;2-adrenoceptor stimulants.</p>', '<p>Keep all medicines out of reach of children. Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-09 01:02:42', '2022-03-09 01:02:42'),
(857, 857, '<ul>\r\n	<li>As replacement therapy in hypothyroidism of any aetiology. Replacement therapy should not be instituted in transient hypothyroidism during the recovery phase of subacute Thyroiditis.</li>\r\n	<li>For the suppression of Thyroid Stimulating Hormone (TSH) levels in the presence of goitres, nodules and after radiological and/or surgical treatment of Thyroid cancer.</li>\r\n	<li>For the suppression of the goitrogenic effects of other drugs such as Lithium.</li>\r\n	<li>As a diagnostic aid in suppression tests.</li>\r\n</ul>', '<p>This tablet contains synthetic Levothyroxine (also called Thyroxine or T4) which is identical to the natural hormone T4, produced in the Thyroid gland. About 30% of T4 is converted to the much more active Triiodothyronine (T3) in peripheral tissues. TBG (Thyroxine Binding Globulin) is the major carrier of T4. This binding protects T4 from metabolism and excretion resulting in its long half-life in the circulation. Only about 0.03% of total T4 in plasma is unbound. The half-life of elimination of T4 is 6 to 7 days. In hyperthyroidism, the half-life is shortened to 3 or 4 days, whereas in hypothyroidism it may be 9 to 10 days. In conditions associated with reduced protein in plasma as in nephrosis or hepatic cirrhosis or when binding to protein is inhibited by certain drugs the half-life of T4 may be shortened. The liver is the major site of degradation of Thyroid hormones. T4 is conjugated with Glucuronic and Sulphate conjugates through the Phenolic hydroxyl group and excreted in the urine.There is an enterohepatic circulation of the Thyroid hormones, since they are liberated by hydrolysis in the intestine and reabsorbed. Because of the long half-life of T4, a steady blood level of the biologically more active T3 can be obtained from one single daily dose of Levothyroxine. Therefore, variations in the therapeutic effect are unlikely once the correct dosage has been established.</p>', '<p><strong>Adult dose</strong>:</p>\r\n\r\n<ul>\r\n	<li>Initial starting dose: 25-50 meg/day, with gradual increments in dose at 6-8 week intervals, as needed. The Levothyroxine Sodium dose is generally adjusted in 12.5-25 meg increments until the patient with primary hypothyroidism is clinically euthyroid and the serum TSH has normalized.</li>\r\n	<li>In patients with severe hypothyroidism: Initial dose is 12.5-25 meg/day with increases of 25 meg/day every 2-4 weeks, accompanied by clinical and laboratory assessment,until the TSH level is normalized.</li>\r\n	<li>In patients with secondary (pituitary) or tertiary (hypothalamic) hypothyroidism: Levothyroxine Sodium dose should be titrated until the patient is clinically euthyroid and the serum free - T4 level is restored to the upper half of the normal range.</li>\r\n	<li>For patients older than 50 years or for patients under 50 years of age with underlying cardiac disease: 1.7 meg/kg/day.</li>\r\n</ul>\r\n\r\n<p><strong>Pediatric Dosage (Newborns)</strong>: The recommended starting dose is 10-15 meg/kg/day. A lower starting dose should be considered in infants at risk for cardiac failure and the dose should be increased in 4-6 weeks as needed based on clinical and laboratory response to treatment. In infants with very low (&lt;5 mcg/dL) or undetectable serum T4 concentrations, the recommended initial starting dose is 50 meg/day of Levothyroxine Sodium.<br />\r\n<br />\r\n<strong>Pediatric Dosage (Infants and Children)</strong>: In children with chronic or severe hypothyroidism, initial dose of 25 meg/day with increments of 25 meg every 2-4 weeks until the desired effect is achieved. Hyperactivity in an older child can be minimized if the starting dose is one-fourth of the recommended full replacement dose and the dose is then increased on a weekly basis by an amount equal to one-fourth the full recommended replacement dose until the full recommended replacement dose is reached.</p>\r\n\r\n<ul>\r\n	<li>0-3 months: 10-15 meg/kg/day</li>\r\n	<li>3-6 months: 8-10 meg/kg/day</li>\r\n	<li>6-12 months: 6-8 meg/kg/day</li>\r\n	<li>1-5 years: 5-6 meg/kg/day</li>\r\n	<li>6-12 years: 4-5 meg/kg/day</li>\r\n	<li>&gt;12 years but growth and puberty incomplete: 2-3 meg/kg/day</li>\r\n	<li>Growth and puberty complete: 1.7 meg/kg/day.</li>\r\n</ul>\r\n\r\n<p>The dose should be adjusted based on clinical response and laboratory parameters.</p>', '<p>Concurrent use of tri/tetracyclic antidepressants and Levothyroxine may increase the therapeutic and toxic effects of both drugs, possibly due to increased receptor sensitivity to catecholamines.Toxic effects may include increased risk of cardiac arrhythmias and CNS stimulation; onset of action of tricyclics may be accelerated. Administration of sertraline in patients stabilized on Levothyroxine may result in increased Levothyroxine requirements. Addition of Levothyroxine to antidiabetic or insulin therapy may result in increased antidiabetic agent or insulin requirements. Careful monitoring of diabetic control is recommended, especially when thyroid therapy is started, changed, or discontinued. Serum digitalis glycoside levels may be reduced in hyperthyroidism or when the hypothyroid patient is converted to the euthyroid state. Therapeutic effect of digitalis glycosides may be reduced.</p>', '<ul>\r\n	<li>Untreated subclinical or overt Thyrotoxicosis of any etiology</li>\r\n	<li>Acute Myocardial Infarction</li>\r\n	<li>Uncorrected Adrenal failure.</li>\r\n</ul>', '<p>Adverse reactions associated with Levothyroxine therapy are primarily those of hyperthyroidism due to therapeutic overdose. They include the following:</p>\r\n\r\n<ul>\r\n	<li>General: Fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating;</li>\r\n	<li>Central nervous system: Headache, hyperactivity, nervousness, anxiety, irritability, emotional lability, insomnia.</li>\r\n	<li>Musculoskeletal: Tremors, muscle weakness.</li>\r\n	<li>Cardiovascular: Palpitations, tachycardia, arrhythmias, increased pulse and blood pressure</li>\r\n	<li>Respiratory: Dyspnea.</li>\r\n	<li>Gastrointestinal: Diarrhea, vomiting, abdominal cramps.</li>\r\n	<li>Dermatologic: Hair loss, flushing.</li>\r\n</ul>', '<p>Pregnancy Category A. Pregnancy may increase Levothyroxine requirements. Although Thyroid hormones are excreted only minimally in human milk,caution should be exercised when it is administered to a nursing woman.However, adequate replacement doses of Levothyroxine are generally needed to maintain normal lactation.</p>', '<ul>\r\n	<li>In patients whose hypothyroidism is due to a decrease in pituitary gland function, there may also be adrenocortical insufficiency;before starting Levothyroxine therapy, this should be treated by adequate replacement with Corticosteroids to prevent acute adrenal insufficiency.</li>\r\n	<li>The choice of the starting dose and of any increases in dosing should be made with great care in patients with cardiovascular disease and/or severe and long-existing hypothyroidism.Too high an initial dose or too rapid an increase in dosing may lead to development or worsening of angina complaints, arrhythmias, myocardial infarction, cardiac failure or to sudden increase in blood pressure, especially in older patients.</li>\r\n	<li>Any marked change of body weight during treatment with T4 requires adjustment of the dosage.</li>\r\n	<li>When monitoring blood levels of T3 and T4, it should be borne in mind that a &quot;high&quot; normal to slightly increased T4 level will be necessary in order to obtain a normal level of T3. The correct dosage of Levothyroxine in primary hypothyroidism should generally be established by monitoring the serum level of TSH to see whether it has normalized. Because intoxication with Thyroid preparations may have serious consequences.</li>\r\n</ul>', '<p>The signs and symptoms of overdose are those of hyperthyroidism - agitation, confusion, irritability, hyperactivity, headache, sweating, mydriasis, tachycardia, arrhythmias, tachypnoea, pyrexia, increased bowel movements and convulsions. Cerebral embolism, shock, coma, and death have been reported. Symptoms may not necessarily be evident or may not appear until several days after ingestion of Levothyroxine Sodium. Dose of Levothyroxine Sodium should be reduced or temporarily discontinued if signs or symptoms of overdosage occur. Treatment is symptomatic.</p>', '<p>Thyroid drugs &amp; hormone.</p>', '<p>Store below 30&deg;C and dry place, protect from light. Keep out of the reach of children.</p>', NULL, '2022-03-09 01:06:08', '2022-03-09 01:06:08'),
(858, 858, '<p>This drug&nbsp;is indicated for production of local or regional anesthesia by infiltration techniques such as percutaneous injection, by peripheral nerve block techniques such as brachial plexus and intercostal and by central neural techniques such as lumbar and caudal epidural blocks, when the accepted procedures for these techniques as described in standard textbooks are observed.</p>', '<p>Lidocaine is a local anaesthetic which decreases permeability of sodium ions, blocking induction and conduction of nerve impulses. Combination with epinephrine restricts systemic spread of lidocaine, vascular absorption and its duration of local anaesthetic effect.</p>', '<p>Dosage depends on several factors such as route, type and extent of surgical procedure, duration of anaesthesia and patient&#39;s condition and age.<br />\r\n<br />\r\n<strong>Adult</strong>: Max dose of lidocaine given with epinephrine: 7 mg/kg and not &gt;500 mg.<br />\r\n<strong>Child</strong>: 3 mth-12 yr: Max dose 3 mg/kg. Ideal body weight should be used in children with high body weight.</p>', '<p>Halogenated inhalation anaesthetics; alpha or beta blocking agents; methyldopa, guanethidine; drugs with vasoconstrictor and pressor effects; antihypertensives; adrenergic neuron blockers; potassium-depleting drugs; cardiac glycosides; ephedra, yohimbe. TCAs may induce hypertension and arrhythmia.</p>', '<p>Tachycardia, hypertension, cerebral arteriosclerosis, ischaemic heart disease, IV admin, anaesthetise digits or appendages, myasthenia gravis.Tachycardia, hypertension, cerebral arteriosclerosis, ischaemic heart disease, IV admin, anaesthetise digits or appendages, myasthenia gravis.</p>', '<p><strong>More common side effects</strong>:&nbsp;Minor redness, burning, irritation, or numbness at the application site; lightheadedness; nausea.<br />\r\n<br />\r\n<strong>Severe side effects</strong>:&nbsp;Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; dizziness; fainting; fast, slow, or irregular heartbeat; loss of consciousness; mental or mood changes; nervousness; paleness; redness or warmth of skin; ringing in the ears or hearing changes; seizures; sensation of heat or cold; shortness of breath; swelling or blistering of skin; tremors or twitching; vision changes or double vision; vomiting.</p>', '<p>Pregnancy Category C+B. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using epinephrine/lidocaine iontophoretic patch while you are pregnant. Epinephrine/lidocaine iontophoretic patch is found in breast milk. If you are or will be breast-feeding while you use epinephrine/lidocaine iontophoretic patch, check with your doctor. Discuss any possible risks to your baby.</p>', '<p>Epilepsy, impaired cardiac conduction, CHE DM, closed angle glaucoma, impaired liver function (if site of admin is likely to result in high blood levels), severe renal dysfunction. Local anaesthetic effect may be reduced if injected into an inflamed or infected area. Cerebrovascular insufficiency, hyperthyroidism. Neonates, elderly, patients in poor general condition (optimise patient&#39;s condition before major block), pregnancy.</p>', NULL, '<p>Local &amp; Surface anesthesia.</p>', '<p>Store at room temperature, between 20℃ to 25℃. Store away from heat and light. Keep the child-resistant envelope sealed at all times when not in use. Keep out of the reach of children and away from pets.</p>', NULL, '2022-03-09 01:08:52', '2022-03-09 01:08:52'),
(859, 859, '<p>This is indicated for the production of local&nbsp;anesthesia&nbsp;for dental procedures by&nbsp;nerve block&nbsp;or infiltration techniques. Only accepted procedures for these techniques as described in standard textbooks are recommended.</p>', '<p><strong>Lidocaine</strong>&nbsp;stabilizes the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of nerve impulses, thereby effecting local&nbsp;anesthetic&nbsp;action.<br />\r\n<br />\r\n<strong>Epinephrine</strong>&nbsp;works via the stimulation of alpha and beta-1 adrenergic receptors, and a moderate activity at beta-2 adrenergic receptors.</p>', '<p><strong>Adult</strong>: For normal healthy adults, the amount of lidocaine HCl administered should be kept below 500 mg, and in any case, should not exceed 7 mg/kg (3.2 mg/lb) of body weight.<br />\r\n<br />\r\n<strong>Pediatric</strong>: Dosages in pediatric population should be reduced, commensurate with age, body weight and physical condition. It is difficult to recommend a maximum dose of any drug for pediatric patients since this varies as a function of age and weight. For pediatric patients of less than ten years who have a normal&nbsp;lean body mass&nbsp;and normal body development, the maximum dose may be determined by the application of one of the standard pediatric drug formulas (e.g., Clark&#39;s rule). For example, in pediatric patients of five years weighing 50 Ibs, the dose of lidocaine hydrochloride should not exceed 75-100mg when calculated according to Clark&#39;s rule. In any case, the maximum dose of lidocaine hydrochloride should not exceed 7 mg/kg (3.2 mg/lb) of body weight.</p>', NULL, '<p>This contraindicated in patients with a known history of hypersensitivity to local anesthetics of the amide type or to any components of the injectable formulations.</p>', NULL, '<p><strong>Pregnancy</strong>&nbsp;Category B. Reproduction studies have been performed in rats at doses up to 6.6 times the human dose and have revealed no evidence of harm to the fetus caused by lidocaine. There are, however, no adequate and well-controlled studies in pregnant women. Animal reproduction studies are not always predictive of human response. General consideration should be given to this fact before administering lidocaine to women of childbearing potential, especially during early pregnancy when maximum organogenesis takes place.<br />\r\n<br />\r\n<strong>Nursing Mother</strong>: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when lidocaine is administered to a nursing woman.</p>', NULL, NULL, '<p>Local &amp; Surface anesthesia.</p>', '<p>Store at controlled room temperature, below 25&deg;C</p>', NULL, '2022-03-09 01:12:07', '2022-03-09 01:12:07'),
(860, 860, '<p>Indicated as a topical anesthetic for use on normal intact skin for local analgesia, genital mucous&nbsp;membranes for superficial minor surgery and as pretreatment for infiltration anesthesia.</p>', '<p>Lidocaine and prilocaine are local anaesthetic agents of the amide type. Both work by stabilising the neuronal membranes and inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby giving rise to the anaesthetic action.</p>', '<p>A thick layer of Lidocaine &amp; Prilocaine cream is applied to intact skin and covered with an occlusive dressing.<br />\r\n<br />\r\n<strong>Minor Dermal Procedures</strong>: For intravenous cannulation and venipuncture, apply 2.5 grams of&nbsp;Lidocaine &amp; Prilocaine cream over 20 &ndash; 25cm2 of skin surface for at least 1 hour.<br />\r\n<br />\r\n<strong>Major Dermal Procedures</strong>: For more painful dermatological procedures involving a larger skin&nbsp;area, apply 2grams of Lidocaine &amp; Prilocaine cream per 10cm2 of skin and allow to remain in contact with the&nbsp;skin for at least 2 hours.<br />\r\n<br />\r\n<strong>Adult Male Genital Skin</strong>: As an adjunct prior to local anesthetic infiltration, apply a thick layer of&nbsp;Lidocaine &amp; Prilocaine cream to the skin surface for 15 minutes. Local anesthetic infiltration should be&nbsp;performed immediately after removal of Lidocaine &amp; Prilocaine cream.&nbsp;<br />\r\n<br />\r\n<strong>Adult Female Genital&nbsp;Mucous Membranes</strong>: For minor procedures on the female&nbsp;external genitalia, such as removal of condylomata acuminata, as well as for use as pretreatment&nbsp;for anesthetic infiltration, apply a thick layer (5-10 grams) of Lidocaine &amp; Prilocaine cream for 5 to 10 minutes.&nbsp;Occlusion is not necessary for absorption, but may be helpful to keep the cream in place.&nbsp;Patients should be lying down during the Lidocaine &amp; Prilocaine cream application, especially if no occlusion is&nbsp;used. The procedure or the local anesthetic infiltration should be performed immediately after&nbsp;the removal of Lidocaine &amp; Prilocaine cream.<br />\r\n<br />\r\n<strong>Pediatric Patients</strong>: The following are the maximum recommended doses, application areas and&nbsp;application times for Lidocaine &amp; Prilocaine cream based on a child&rsquo;s age and weight:</p>\r\n\r\n<ul>\r\n	<li><strong>0 to 3 months or &lt;5 kg</strong>: Maximum Total Dose&nbsp;1 gm,&nbsp;Maximum Application Time: 1 hour</li>\r\n	<li><strong>3 to 12 months and &gt;5 kg</strong>:&nbsp;Maximum Total Dose 2 gm, Maximum Application Time 4 hour</li>\r\n	<li><strong>1 to 6 years and &gt;10 kg</strong>:&nbsp;Maximum Total Dose 10 gm, Maximum Application Time 4 hour</li>\r\n	<li><strong>7 to 12 years and &gt;20 kg</strong>:&nbsp;Maximum Total Dose 20 gm, Maximum Application Time 4 hour</li>\r\n</ul>', '<p>Cream should be used with caution in patients receiving antiarrhythmic drugs,&nbsp;such as tocainide, since the toxic effects are additive.</p>', '<p>Hypersensitivity to local anaesthetics of the amide type or to any other component of the product.</p>', '<p>Nervousness, dizziness, blurred vision, tremors, drowsiness, convulsions,&nbsp;unconsciousness, respiratory arrest, hypotension, myocardial depression, bradycardia, cardiac&nbsp;arrest and anaphylactoid reactions (cutaneous lesion, urticaria, oedema).</p>', '<p>There is no, or inadequate, evidence of safety of the drug in&nbsp;human pregnancy but it has been in wide use for many years without apparent ill consequence.&nbsp;If drug therapy is needed in pregnancy, this drug can be used if there is no safer alternative.&nbsp;Cream enters the mothers milk, but in such small quantities that there is generally no risk of&nbsp;affecting the child at therapeutic dose levels.</p>', '<p>Absorption from wound surfaces and mucous membranes is&nbsp;relatively high, especially in the bronchial tree. This cream should be used with caution in&nbsp;patients with traumatised mucosa and/or sepsis in the region of the proposed application. If the&nbsp;dose or site of administration is likely to result in high blood levels, cream should be used&nbsp;cautiously in patients with epilepsy, impaired cardiac condition, bradycardia, impaired hepatic&nbsp;function and in severe shock. The use of oropharyngeal topical anesthetic agents may interfere&nbsp;with swallowing and thus enhance the danger of aspiration. This is particularly important in&nbsp;children because of their frequency of eating. Numbness of the tongue or buccal mucosa may&nbsp;increase the danger of biting trauma.</p>', '<p>Toxic levels of lidocaine (&gt;5 &micro;g/ml) and/or prilocaine (&gt;6 &micro;g/ml) may decrease cardiac output, total peripheral resistance and mean arterial pressure. These changes are due to direct depressant effects of these local anaesthetic agents on the CVS.</p>', '<p>Local &amp; Surface anesthesia, Topical Local Anesthetics.</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-09 01:15:09', '2022-03-09 01:15:09'),
(861, 861, '<p>Lidocaine Injection is indicated-</p>\r\n\r\n<ul>\r\n	<li>As a local anaesthetic for use in infiltration blockade and intravenous regional analgesia.</li>\r\n	<li>For the prevention and treatment of ventricular tachyarrhythmias.</li>\r\n</ul>', '<p>Lidocaine acts mainly by inhibiting sodium influx through sodium specific ion channels in the neuronal cell membrane, in particular the so called voltage-gated sodium channels. When the influx of sodium is interrupted, an action potential cannot arise and signal conduction is inhibited. The receptor site is thought to be located at the cytoplasmic (inner) portion of the sodium channel. Lidocaine binds more readily to sodium channels in activated state, thus onset of neuronal blockade is faster in neurons that are rapidly firing. This is referred to as state dependent blockade.</p>', '<p>The dosage is adjusted according to the response of the patient and site of administration.<br />\r\n<br />\r\n<strong>Adult</strong>: For healthy adults, the maximum individual dose should not exceed 4.5mg/kg of body weight and in general it is recommended that the maximum total dose does not exceed 300 mg. Recommended doses given in the below serve only as a guide to the amount of anaesthetic required for most routine procedures.<br />\r\n<br />\r\nInfiltration-</p>\r\n\r\n<ul>\r\n	<li>Percutaneous: Total dose 5-300 mg</li>\r\n	<li>Intravenous regional: Total dose 50-300 mg</li>\r\n</ul>\r\n\r\n<p>Peripheral Nerve Blocks-</p>\r\n\r\n<ul>\r\n	<li>Brachial: Total dose 225-300 mg</li>\r\n	<li>Dental: Total dose 20-100 mg</li>\r\n	<li>Intercostal: Total dose 30 mg</li>\r\n	<li>Paravertebral: Total dose 30-50 mg</li>\r\n</ul>\r\n\r\n<p>Pudenal (each side):&nbsp;</p>\r\n\r\n<ul>\r\n	<li>Paracervical Obstetrical analgesia: Total dose 100 mg</li>\r\n</ul>\r\n\r\n<p>Sympathetic Nerve Blocks</p>\r\n\r\n<ul>\r\n	<li>Cervical: Total dose 50 mg</li>\r\n	<li>Lumbar: Total dose 50-100 mg</li>\r\n</ul>\r\n\r\n<p>Central Neural Blocks</p>\r\n\r\n<ul>\r\n	<li>Epidural: Total dose 200-300 mg [Dose determined by number of dermatomes to be anesthetized (2-3 mL/dermatome) periodically.]</li>\r\n	<li>Thoracic: Total dose 200-300 mg</li>\r\n</ul>\r\n\r\n<p>Lumbar</p>\r\n\r\n<ul>\r\n	<li>Analgesia: Total dose 250-300 mg</li>\r\n	<li>Anesthesia: Total dose 200-300 mg</li>\r\n</ul>\r\n\r\n<p>Caudal</p>\r\n\r\n<ul>\r\n	<li>Obstetrical analgesia: Total dose 200-300 mg</li>\r\n	<li>Surgical anesthesia: Total dose 225-300 mg<strong>.</strong></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>Antiarrhythmic treatment: An intravenous dose of 1 mg.kg-1&nbsp;may be given over 2 min and repeated after 5 min, but giving an infusion of 2-4 mg.min-1&nbsp;to produce a plasma level of 2-4 mg. l-1&nbsp;is a more satisfactory technique. To avoid a long delay in achieving a steady state, a loading dose of approximately 1 mg.kg-1&nbsp;is usually given intravenously over 2 min at the outset.</p>', '<p>Cimetidine can impair the metabolism of lidocaine absorbed into the circulation. Elimination will be delayed and the risk of adverse reactions increased. Significant increases in plasma lidocaine concentrations have occurred during concomitant therapy with beta blockers such as propranolol, metoprolol or nadolol. It prolongs the duration of action of suxamethonium.</p>', '<p>Known hypersensitivity to anaesthetics of the amide type.</p>', '<p>In common with other local anaesthetics, adverse reactions to lidocaine are rare and are usually the result of excessively high blood concentrations due to inadvertent intravascular injection, excessive dosage, rapid absorption or occasionally to hypersensitivity, idiosyncracy or diminished tolerance on the part of the patient. In such circumstances systemic effects occur involving the central nervous system and/or the cardiovascular system. CNS reactions are excitatory and/or depressant and may be characterized by nervousness, dizziness, blurred vision and tremors, followed by drowsiness, convulsions, unconsciousness and possibly respiratory arrest. Cardiovascular reactions are hypotension, myocardial depression, bradycardia and possibly cardiac arrest. Allergic reactions are extremely rare. They may be characterized by cutaneous lesions, urticaria, oedema or anaphylactoid reactions.</p>', '<p>Although there is no evidence from animal studies of harm to the foetus, as with all drugs, it should not be given during early pregnancy unless the benefits are considered to outweigh the risks. Caution should be exercised when it is administered to a nursing woman.</p>', '<p>Lidocaine for infiltration and nerve block should be employed only by clinicians who are well versed in diagnosis and management of dose-related toxicity. The safety and effectiveness of lidocaine depend on proper dosage, correct technique, adequate precautions, and readiness for emergencies. Standard text books should be consulted for specific techniques and precautions for various regional anaesthetic procedures. Resuscitative equipment, oxygen and other resuscitative drugs should be available for immediate use.<br />\r\n<br />\r\nIt should be used cautiously in patients with epilepsy, impaired cardiac conduction, bradycardia, impaired respiratory function and in patients with impaired hepatic function, if the dose or site of administration is likely to result in high blood levels. The effect of local anaesthetics may be reduced if an injection is made into an inflamed or infected area. Repeated doses of lidocaine may cause significant increases in blood levels with each repeated dose because of slow accumulation of the drug or its metabolites. Tolerance to elevated blood levels varies with the status of the patient. Careful and constant monitoring of cardiovascular and respiratory vital signs and the patient&#39;s state of consciousness should be accomplished after each local anaesthetic injection.</p>', NULL, '<p>Local &amp; Surface anesthesia.</p>', '<p>Keep below 25&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Dosages in children should be reduced, commensurate with age, body-weight and physical condition. Elderly patients may be more sensitive to systemic effects and may require dose reductions.</p>', '2022-03-09 01:19:31', '2022-03-09 01:19:31'),
(862, 862, '<p>Lidocaine Jelly is indicated for-</p>\r\n\r\n<ul>\r\n	<li>Surface anaesthesia of the male and female urethra</li>\r\n	<li>Topical treatment of painful urethritis</li>\r\n	<li>Anaesthetic lubrication for endotracheal intubation</li>\r\n	<li>Adequate analgesia in endoscopy.</li>\r\n</ul>', '<p>Lidocaine acts mainly by inhibiting sodium influx through sodium specific ion channels in the neuronal cell membrane, in particular the so called voltage-gated sodium channels. When the influx of sodium is interrupted, an action potential cannot arise and signal conduction is inhibited. The receptor site is thought to be located at the cytoplasmic (inner) portion of the sodium channel. Lidocaine binds more readily to sodium channels in activated state, thus onset of neuronal blockade is faster in neurons that are rapidly firing. This is referred to as state dependent blockade.</p>', '<p><strong>Urethral anaesthesia</strong>:</p>\r\n\r\n<ul>\r\n	<li>Surface anaesthesia of the male adult urethra: For adequate analgesia in males 400 mg is required.</li>\r\n	<li>Surface anaesthesia of the female adult urethra: Instil 100-200 mg in small portions to fill the whole urethra. In order to obtain adequate anaesthesia, several minutes should be allowed prior to perform in the urological procedure.</li>\r\n</ul>\r\n\r\n<p><strong>Lubrication for endotracheal intubation</strong>: 100 mg applied on the surface of the tube just prior to insertion. Care should be taken to avoid introducing the product into the lumen of the tube.<br />\r\n<br />\r\n<strong>Endoscopy</strong>: Instillation of 200-400 mg is recommended for adequate analgesia and a small amount should be applied on the instrument for lubrication. Debilitated, elderly patients and children should be given doses commensurate with their age and physical condition.<br />\r\n<br />\r\n<strong>Note</strong>: The applicator is sterilized for 5 minutes in boiling water, cooled and attached to the tube. The jelly is instilled slowly as required. The applicator should be detached after each use and keep the tube tightly closed.</p>', '<p>Lidocaine should be used with caution in patients receiving antiarrhythmic drugs, such as tocainide since the toxic effects are additive.</p>', '<p>It is contraindicated in patients with a known history of hypersensitivity of local anaesthetics of the amide type.</p>', '<p>Nervousness, dizziness, blurred vision, tremors, drowsiness, convulsions, unconsciousness, respiratory arrest, hypotension, myocardial depression, bradycardia, cardiac arrest and anaphylactic reactions (cutaneous lesion, urticaria, oedema).</p>', '<p>There is no, or inadequate, evidence of safety of the drug in human pregnancy but it has been in wide use for many years without apparent ill consequence. If drug therapy is needed in pregnancy, this drug can be used if there is no safer alternative. Lidocaine enters the mother&#39;s milk, but in such small quantities that there is generally no risk of affecting the child at therapeutic dose levels.</p>', '<p>Absorption from wound surfaces and mucous membranes is relatively high, especially in the bronchial tree. Lidocaine Jelly should be used with caution in patients with traumatised mucosa and/or sepsis in the region of the proposed application.<br />\r\n<br />\r\nIf the dose or site of administration is likely to result in high blood levels, Lidocaine, in common with other local anaesthetics, should be used cautiously in patients with epilepsy, impaired cardiac condition, bradycardia, impaired hepatic function and in severe shock.<br />\r\n<br />\r\nThe use of oropharyngeal topical anaesthetic agents may interfere with swallowing and thus enhance the danger of aspiration. This is particularly important in children because of their frequency of eating. Numbness of the tongue or buccal mucosa may increase the danger of biting trauma.</p>', NULL, '<p>Local &amp; Surface anesthesia</p>', '<p>Store below 25&deg;C in a dry place, away from light.</p>', NULL, '2022-03-09 01:22:15', '2022-03-09 01:22:15'),
(863, 863, '<p>Lidocaine is a topical anesthetic used for the following purposes-</p>\r\n\r\n<ul>\r\n	<li>To help prevent pain associated with minor surgical procedures in the ear, nose and throat</li>\r\n	<li>To help prevent pain and or discomfort during dental procedures (e.g., prior to an injection)</li>\r\n	<li>During general anesthesia to prevent coughing</li>\r\n	<li>To help prevent pain during the final stages of childbirth, before the cutting or stitching of the perineum (skin between the vagina and anus)</li>\r\n</ul>', '<p>Lidocaine acts mainly by inhibiting sodium influx through sodium specific ion channels in the neuronal cell membrane, in particular the so called voltage-gated sodium channels. When the influx of sodium is interrupted, an action potential cannot arise and signal conduction is inhibited. The receptor site is thought to be located at the cytoplasmic (inner) portion of the sodium channel. Lidocaine binds more readily to sodium channels in activated state, thus onset of neuronal blockade is faster in neurons that are rapidly firing. This is referred to as state dependent blockade.</p>', '<ul>\r\n	<li>Each spray delivers 10 mg of Lidocaine. The maximum dose is 20 sprays (200 mg).</li>\r\n	<li>In dentistry, the normal dose is 1-5 sprays. Two sprays per quarter of the mouth is recommended, with a maximum of 3 sprays per quarter of the mouth over 30 minutes.</li>\r\n	<li>In sinus procedures 3 sprays are used.</li>\r\n	<li>In procedures of the throat and windpipe, up to 20 sprays may be necessary.</li>\r\n	<li>Up to 20 sprays may be necessary in child birth (cesarian procedure).</li>\r\n	<li>Lower doses are used for children aged 3-12 years. Lidocaine 10% Spray is not recommended for children under 3 years.</li>\r\n</ul>', NULL, '<p>Should not be given to patients with myasthenia gravis, epilepsy, impaired cardiac condition or liver damage.</p>', '<p>Skin rash or irritation, drowsiness, wheezing or difficulty breathing, chest pain, severe rash or itching, increased sweating, numbness.</p>', '<p>No study available. Can be given to a pregnant woman as per doctor&#39;s judgment. Small amount of Lidocaine may pass to a lactating baby, but the amount is insignificant to cause any harm.</p>', '<p>Patient should be careful driving or operating machinery after use of Lidocaine 10% Spray. Patient may be drowsy and reflexes may be slow. Patient should not eat or drink anything for at least 1 hour after using Lidocaine 10% Spray in the mouth or throat area. Should be careful not to spray Lidocaine 10% Spray near the eyes. If any of the spray does go in the eye, should rinse immediately with lots of water for at least 15 minutes and doctor should be called.</p>', '<p>The first signs that too much Lidocaine 10% Spray has been used usually take the form of light-headedness, drowsiness, dizziness and sometimes blurred vision. In the event of serious over dosage trembling, seizures or unconsciousness may occur.</p>', '<p>Local &amp; Surface anesthesia.</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 01:25:37', '2022-03-09 01:25:37'),
(864, 864, '<p>Lifitegrast 5% ophthalmic solution is indicated for the treatment of the signs and symptoms of dry eye disease (DED).</p>', '<p>Lifitegrast binds to the integrin LFA-1, a cell surface protein found on leukocytes and blocks the interaction of LFA-1 with its cognate ligand intercellular adhesion molecule-1 (ICAM-1). ICAM-1 may be overexpressed in corneal and conjunctival tissues in DED. LFA-1/ICAM-1 interaction can contribute to the formation of an immunological synapse resulting in T-cell activation and migration to target tissues. In vitro studies demonstrated that lifitegrast may inhibit Tcell adhesion to ICAM-1 in a human T-cell line and may inhibit secretion of inflammatory cytokines in human peripheral blood mononuclear cells. The exact mechanism of action of lifitegrast in DED is not known.</p>', '<p>Instill one drop of Lifitegrast twice daily (approximately 12 hours apart) into each eye. Contact lenses should be removed prior to the administration of Lifitegrast and may be reinserted 15 minutes following administration.</p>', NULL, '<p>Patients who are hypersensitive to this drug or to any ingredient in the formulation or component of the container.</p>', '<p>The common adverse effects are instillation site irritation, dysgeusia and reduced visual acuity. Less common are blurred vision, conjunctival hyperemia, headache, increased lacrimation, eye discharge, eye discomfort, eye pruritus and sinusitis.</p>', '<p>There are no available data on Lifitegrast use in pregnant women to inform any drug associated risks. There are no data on the presence of Lifitegrast in human milk, the effects on the breastfed infant or the effects on milk production.</p>', '<p>Do not touch the dropper tip to surfaces since this may contaminate the solution. After one month of the opening do not use the medicine of dropper.</p>', '<p>There is no information regarding overdose in patients taking Lifitegrast. For management of a suspected drug overdose, contact your ophthalmologist.</p>', '<p>Other ophthalmic preparations.</p>', '<p>Store in a cool (below 30&deg;C) and dry place, away from light. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and efficacy in pediatric patients below the age of 17 years have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No overall differences in safety or effectiveness have been observed between elderly and younger adult patients.</p>', '2022-03-09 01:29:15', '2022-03-09 01:29:15'),
(865, 865, '<p>This cream is a highly concentrated moisturizing cream that is indicated to-</p>\r\n\r\n<ul>\r\n	<li>Prevent and relieve dry skin</li>\r\n	<li>Manage dry skin problems associated with eczema, dermatitis and psoriasis.</li>\r\n</ul>', '<p>Glycerine is an exceptionally good moisturizing, emollient and protective agent. Its ability to capture and retain water slows down the evaporation of water from the surface of the skin. It is also a humectant (wetting agent), which promotes hydration of the skin. Light Liquid Paraffin and White Soft Paraffin exert an emollient effect by forming an occlusive film that reduces trans-epidermal water loss, thus helping to maintain normal skin humidity levels.</p>', '<p>A combination of Light Liquid Paraffin, White Soft Paraffin &amp; Glycerine Cream is to be used as &#39;on-demand&#39; basis when required. Apply to the affected area and rub in well. It is especially effective after bathing, showering, and exposure to harsh climatic conditions and at night.</p>', NULL, '<p>Hypersensitivity to any of the ingredients.</p>', '<p>No remarkable adverse effects have been reported.</p>', '<p>There are no restrictions on the use during pregnancy or lactation.</p>', '<p>No remarkable adverse effects have been reported.</p>', NULL, '<p>Emollients &amp; combined preparations.</p>', '<p>Store below 30&deg;C, protected from light.</p>', '<p>Use in pediatric patients: Suitable for infants and children.<br />\r\nUse in geriatric patients: Suitable for the elderly.</p>', '2022-03-09 01:46:24', '2022-03-09 01:46:24');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(866, 866, '<p>Linagliptin is indicated in the treatment of type 2 diabetes mellitus to improve glycaemic control in adults.</p>\r\n\r\n<ul>\r\n	<li><strong>As monotherapy</strong>: in patients inadequately controlled by diet and exercise alone and for whom metformin is inappropriate due to intolerance or contraindicated due to renal impairment.</li>\r\n	<li><strong>As combination therapy</strong>: in combination with metformin when diet and exercise plus metformin alone do not provide adequate glycaemic control in combination with a sulphonylurea and metformin when diet and exercise plus dual therapy with these medicinal products do not provide adequate glycaemic control.</li>\r\n</ul>', '<p>Linagliptin is indicated to improve glycemic control in patients with type 2 diabetes mellitus. Linagliptin is an inhibitor of DPP-4 (dipeptidyl peptidase-4), an enzyme that degrades the incretin hormones GLP-1 (glucagon like peptide-1) and GIP (glucose dependent insulinotropic polypeptide). Thus, Linagliptin increases the concentrations of active incretin hormones, stimulating the release of insulin from pancreatic beta (&beta;) cells in a glucose-dependent manner and decreasing the secretion of glucagon from pancreatic alpha (&alpha;) cells in the circulation.</p>', '<p>Linagliptin 5 mg once daily. If added to metformin, the dose of metformin should be maintained and linagliptin administered concomitantly. When used in combination with a sulfonylurea, a lower dose of the sulphonylurea may be considered to reduce the risk of hypoglycaemia.<br />\r\n<br />\r\nPatients with renal impairment: No dose adjustment required. Linagliptin can be taken with or without a meal at any time of the day.</p>', '<p>Linagliptin is a weak competitive and a weak to moderate mechanism-based inhibitor of CYP isozyme CYP3A4, but does not inhibit other CYP isozymes. The risk for clinically meaningful interactions by other medicinal products on linagliptin is low and in clinical studies linagliptin had no clinically relevant effect on the pharmacokinetics of metformin, glyburide, simvastatin, warfarin, digoxin or oral contraceptives.</p>', '<p>Hypersensitivity to the active substance or to any of the excipients.</p>', '<p>There may be hypoglycaemia, nasopharyngitis, cough and pancreatitis in combination with metformin and sulfonylurea.</p>', '<p>Pregnancy category B. There are no adequate and well controlled studies in pregnant women. So, Linagliptin tablets should be used during pregnancy only if clearly needed. It is not known whether Linagliptin passes into breast milk or not.</p>', '<p>Hypersensitivity to the active substance or to any of the excipients.</p>', NULL, '<p>Dipeptidyl Peptidase-4 (DPP-4) inhibitor</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-09 01:49:55', '2022-03-09 01:49:55'),
(867, 867, '<p>This is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus when treatment with both Linagliptin and Metformin Hydrochloride is appropriate.</p>', '<p>Linagliptin is indicated to improve glycemic control in patients with type 2 diabetes mellitus. Linagliptin is an inhibitor of DPP-4 (dipeptidyl peptidase-4), an enzyme that degrades the incretin hormones GLP-1 (glucagon like peptide-1) and GIP (glucose dependent insulinotropic polypeptide). Thus, Linagliptin increases the concentrations of active incretin hormones, stimulating the release of insulin from pancreatic beta (&beta;) cells in a glucose-dependent manner and decreasing the secretion of glucagon from pancreatic alpha (&alpha;) cells in the circulation.<br />\r\n<br />\r\nMetformin Hydrochloride 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 Hydrochloride 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>Linagliptin &amp; Metformin immediate release tablet</strong>: The dosage of Linagliptin &amp; Metformin should be individualized on the basis of both effectiveness and tolerability. Maximum recommended dose of 2.5 mg Linagliptin and 1000 mg Metformin Hydrochloride twice daily with meals. Dose escalation should be gradual to reduce the gastrointestinal (GI) side effects associated with Metformin Hydrochloride use.<br />\r\n<br />\r\nRecommended starting dose: In patients currently not treated with Metformin Hydrochloride, initiate treatment with 2.5 mg Linagliptin and 500 mg Metformin Hydrochloride twice daily.<br />\r\n<br />\r\nIn patients already treated with Metformin Hydrochloride, start with 2.5 mg Linagliptin and the current dose of Metformin Hydrochloride twice daily.<br />\r\n<br />\r\nPatients already treated with Linagliptin and Metformin Hydrochloride, individual components may be switched to this combination containing the same doses of each component.<br />\r\n<br />\r\n<br />\r\n<strong>Linagliptin &amp; Metformin extend release tablet</strong>: The dosage of this combination should be individualized on the basis of both effectiveness and tolerability, while not exceeding the maximum recommended total daily dose of Linagliptin 5 mg and Metformin Hydrochloride 2000 mg. this combination should be given once daily with a meal.<br />\r\n<br />\r\nRecommended starting dose: In patients currently not treated with metformin, initiate this combination treatment with 5 mg Linagliptin/1000 mg Metformin Hydrochloride extended-release once daily with a meal.<br />\r\n<br />\r\nIn patients already treated with Metformin, start this combination with 5 mg of Linagliptin total daily dose and a similar total daily dose of Metformin once daily with a meal.<br />\r\n<br />\r\nIn patients already treated with Linagliptin &amp; Metformin immediate release tablet, switch to extend release tablet containing 5 mg of Linagliptin total daily dose and a similar total daily dose of Metformin once daily with a meal.<br />\r\n<br />\r\n5 mg Linagliptin &amp; 1000 mg Metformin Hydrochloride extended-release tablet should be taken as a single tablet once daily. Patients using 2.5 mg Linagliptin &amp; 1000 mg Metformin extended release tablets should take two tablets together once daily.</p>', '<p><strong>Cationic drugs (amiloride, digoxin, morphine, ranitidine, trimethoprim etc.)</strong>: May reduce metformin elimination.<br />\r\n<br />\r\n<strong>P-glycoprotien/CYP3A4 inducer (i.e. rifampin)</strong>: The efficacy of this medicine may be reduced when administered in combination.</p>', '<p>Although Linagliptin undergoes minimal renal excretion, Metformin Hydrochloride is known to be substantially excreted by the kidney. The risk of Metformin Hydrochloride accumulation and lactic acidosis increases with the degree of renal impairment. Therefore, this combination is contraindicated in patients with renal impairment. It is also contraindicated in acute or chronic metabolic acidosis (diabetic ketoacidosis) and in hypersensitivity to Linagliptin or Metformin Hydrochloride.</p>', '<p>Most common side effects are nasopharyngitis and diarrhea. Hypoglycemia is more common in patients treated with this combination and sulfonylureas.</p>', '<p>There are no adequate and well-controlled studies in pregnant women with this combination or its individual component; so it should be used during pregnancy only if clearly needed. Caution should also be excercised when it is administered to a lactating mother.</p>', '<p>In a patient with lactic acidosis who is taking Metformin, the drug should be discontinued immediately and supportive therapy promptly instituted. There have been postmarketing reports of acute pancreatitis. If pancreatitis is suspected, promptly discontinue Linagliptin &amp; Metformin. Temporarily discontinue Linagliptin &amp; Metformin&nbsp;in patients undergoing radiologic studies with intravascular administration of iodinated contrast materials or any surgical procedures necessitating restricted intake of food and fluids. Metformin may lower Vitamin B12 levels; so hematologic parameters shoud be monitored annually.</p>', '<p>In the event of an overdose with this combination the usual supportive measures (i.e. remove unabsorbed material from the gastrointestinal tract, perform clinical monitoring, and institute supportive treatment) should be employed. Removal of Linagliptin by hemodialysis or peritoneal dialysis is unlikely but Metformin Hydrochloride is dialyzable.<br />\r\n<br />\r\nDuring controlled clinical trials in healthy subjects, with single doses of up to 600 mg of Linagliptin (equivalent to 120 times the recommended daily dose), there were no dose-related clinical adverse drug reactions.<br />\r\n<br />\r\nOverdose of Metformin Hydrochloride has occurred in case of ingestion of amounts greater than 50 grams. Hypoglycemia was reported in approximately 10% of cases, but no causal association with Metformin Hydrochloride has been established. Lactic acidosis has been reported in approximately 32% of Metformin Hydrochloride overdose cases.</p>', '<p>Combination Oral hypoglycemic preparations.</p>', '<p>Keep in a cool &amp; dry place (below 30&deg;C), protected from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-09 01:53:14', '2022-03-09 01:53:14'),
(868, 868, '<p>Vancomycin-Resistant Enterococcus faecium infections including cases with concurrent bacteremia.<br />\r\n<br />\r\nNosocomial pneumonia caused by Staphylococcus aureus (methicillin-susceptible and -resistant strains) or Streptococcus pneumoniae (including multi-drug resistant strains). Combination therapy may be clinically indicated if the documented or presumptive pathogens include Gram-negative organism.<br />\r\n<br />\r\nComplicated skin and skin structure infections, including diabetic foot infections (without concomitant osteomyelitis) caused by Staphylococcus aureus (methicillin-susceptible and methicillin-resistant strains), Streptococcus pyogenes or Streptococcus agalactiae.<br />\r\n<br />\r\nUncomplicated skin and skin structure infections caused by Staphylococcus aureus (methicillin-susceptible only) or Streptococcus pyogenes.<br />\r\n<br />\r\nCommunity-acquired pneumonia caused by Streptococcus pneumoniae (including multi-drug resistant strains) including cases with concurrent bacteremia or Staphylococcus aureus (methicillin-susceptible strains only).</p>', '<p>Linezolid is a synthetic, antibacterial agent belonging to a new class of antibiotics, the oxazolidinones, with in vitro activity against Gram positive aerobic bacteria, some Gram positive anaerobic bacteria and certain Gram negative bacteria. It selectively inhibits bacterial protein synthesis via a mechanism of action different from that of other antibacterial agents. Linezolid binds to the 23S ribosomal RNA of the 50S subunit of the bacterial ribosome and prevents the formation of a functional 70S initiation complex which is an essential component of the bacterial translation process. The results of time-kill studies have shown Linezolid to be bacteriostatic against enterococci and staphylococci. For streptococci, Linezolid was found to be bactericidal for the majority of strains.</p>', '<p>Patients who commence treatment on the parenteral formulation may be switched to oral presentation when clinically indicated. In such circumstances, no dose adjustment is required as Linezolid has an oral bioavailability of approximately 100%. The injection should be administered over a period of 30 to 120 minutes. The film-coated tablets or oral suspension may be taken with or without food.<br />\r\n<br />\r\nComplicated skin and skin structure infections, Community-acquired pneumonia, including concurrent bacteremia-</p>\r\n\r\n<ul>\r\n	<li><strong>Pediatric Patients (Birth through 11 Years of Age)</strong>: 10 mg/kg IV or oral t.i.d.</li>\r\n	<li><strong>Adults and Adolescents (12 Years and Older)</strong>: 600 mg IV or oral b.i.d.</li>\r\n	<li><strong>Recommended Duration of Treatment (consecutive days)</strong>: 10 to 14</li>\r\n</ul>\r\n\r\n<p>Nosocomial pneumonia, Vancomycin-resistant Enterococcus faecium infections including concurrent bacteremia-</p>\r\n\r\n<ul>\r\n	<li><strong>Pediatric Patients (Birth through 11 Years of Age)</strong>: 10 mg/kg IV or oral t.i.d.</li>\r\n	<li><strong>Adults and Adolescents (12 Years and Older)</strong>: 600 mg IV or oral b.i.d.</li>\r\n	<li><strong>Recommended Duration of Treatment (consecutive days)</strong>: 14 to 28</li>\r\n</ul>\r\n\r\n<p>Uncomplicated skin and skin structure infections-</p>\r\n\r\n<ul>\r\n	<li><strong>Pediatric Patients (Birth through 11 Years of Age)</strong>: &lt;5 yrs: 10 mg/kg oral t.i.d. 5-11 yrs: 10 mg/kg oral b.i.d</li>\r\n	<li><strong>Adults and Adolescents (12 Years and Older)</strong>: Adults: 400 mg oral b.i.d. Adolescents: 600 mg oral b.i.d</li>\r\n	<li><strong>Recommended Duration of Treatment (consecutive days)</strong>: 10 to 14</li>\r\n</ul>\r\n\r\n<p><strong>Neonates &lt;7 days</strong>: Most pre-term neonates &lt;7 days of age (gestational age &lt;34 weeks) have lower systemic Linezolid clearance values and larger AUC values than many full-term neonates and older infants. These neonates should be initiated with a dosing regimen of 10 mg/kg every 12 hours. Consideration may be given to the use of 10 mg/kg in every eight hours regimen in neonates with a sub-optimal clinical response. All neonatal patients should receive 10 mg/kg t.i.d. by 7 days of life.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p><strong>Reconstitution of Oral Suspension</strong>: Shake the bottle to loosen powder. Add 75 ml (with the help of given cup) of boiled and cooled water to the dry mixture in the bottle. For the ease of preparation, add water to the bottle in two portions. Shake well after each addition until all the powder is in suspension.<br />\r\n<br />\r\nNote: Shake the suspension well before each use. Keep the bottle tightly closed. The reconstituted suspension should be stored in a cool and dry place. Use within 21 days after constitution.<br />\r\n<br />\r\n<strong>Intravenous Administration</strong>: Linezolid IV Injection is supplied in single-use, ready-to-use infusion bottles. Linezolid IV Injection should be administered by intravenous infusion over a period of 30 to 120 minutes. The intravenous infusion bottles should not be used in series connections. Additives should not be introduced into this solution. The infusion bottles should be stored at room temperature and protected from freezing. Linezolid IV Injection may exhibit a yellow color that can intensify over time without adversely affecting potency.</p>', '<p><strong>Monoamine Oxidase Inhibition</strong>: Linezolid is a reversible and nonselective inhibitor of monoamine oxidase. Therefore, Linezolid has the potential for interaction with adrenergic and serotonergic agents.<br />\r\n<br />\r\n<strong>Adrenergic Agents</strong>: Some individuals receiving Linezolid may experience a reversible enhancement of the pressor response to indirect-acting sympathomimetic agents, vasopressor or dopaminergic agents. Initial doses of adrenergic agents such as dopamine or epinephrine should be reduced and titrated to achieve the desired response.<br />\r\n<br />\r\n<strong>Serotonergic Agents</strong>: Physicians should be alert to the possible signs and symptoms of serotonergic syndrome in patients receiving concomitant Linezolid and serotonergic agents.</p>', '<p>Linezolid formulations are contraindicated for using in patients who have known hypersensitivity to Linezolid or any of the other product components. Linezolid should not be used in patients taking any medicinal product which inhibits monoamine oxidases A or B (e.g. Phenelzine, Isocarboxazid) or within two weeks of taking any such medicinal product. Linezolid should not be administered to patients with uncontrolled hypertension, pheochromocytoma, thyrotoxicosis, carcinoid syndrome and/or patients taking directly and indirectly acting sympathomimetic agents (e.g. Pseudoephedrine), vasopressive agents (e.g. Epinephrine, Norepinephrine), dopaminergic agents (e.g. Dopamine, Dobutamine), serotonin re-uptake inhibitors, tricyclic antidepressants, serotonin 5-HT1 receptor agonists (triptans), meperidine or buspirone.</p>', '<p>Most of the adverse events reported with Linezolid were mild to moderate in intensity. The most common adverse events in patients treated with Linezolid were diarrhea, headache and nausea. Other adverse events includes oral moniliasis, vaginal moniliasis, hypertension, dyspepsia, localized abdominal pain, pruritus, and tongue discoloration.</p>', '<p>Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Linezolid should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Linezolid is excreted in human milk. Because many drugs are excreted in human milk. Caution should be exercised when Linezolid is administered to a nursing woman.</p>', '<p>Patients who develop recurrent nausea or vomiting, unexplained acidosis or low bicarbonate level while receiving Linezolid should receive immediate medical evaluation. Where administration of Linezolid and concomitant serotonergic agents are clinically appropriate, patients should be closely observed for signs and symptoms of serotonin syndrome such as cognitive dysfunction, hyperpyrexia, hyperreflexia and incoordination. If signs or symptoms occur, physicians should consider discontinuation of either one or both agents. If the concomitant serotonergic agent is withdrawn, discontinuation symptoms can be observed. If patients experience symptoms of visual impairment, such as changes in visual acuity, changes in color vision, blurred vision or visual field defect, prompt ophthalmic evaluation is recommended. Convulsions have been reported in patients when treated with Linezolid. In some of these cases, a history of seizures or risk factors for seizures was reported.</p>', '<p>No cases of overdose have been reported. Symptomatic and supportive care is advised together with maintenance of glomerular filtration. Approximately 30% of a Linezolid dose is removed during 3 hours of haemodialysis. No data are available for the removal of Linezolid by peritoneal dialysis or haemoperfusion.</p>', '<p>Macrolides.</p>', '<p>Linezolid formulations should be stored at room temperature (15&deg;C-30&deg;C), away from light and moisture. All medicines should be kept away from children.</p>', NULL, '2022-03-09 01:56:21', '2022-03-09 01:56:21'),
(869, 869, '<p>The combined action of liposomes and sodium hyaluronate helps to restore and improve the tear film stability, keeping the ocular surface more hydrated and lubricated. Perilla helps to relieve symptoms of ocular irritation thanks to its anti-inflammatory and antiallergic properties.</p>', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '<p>Other ophthalmic preparations.</p>', NULL, NULL, '2022-03-09 01:57:58', '2022-03-09 01:57:58'),
(870, 870, '<p>Liraglutide is indicated as an adjunct to diet and exercise to improve glycemic control in adults with&nbsp;type 2 diabetes mellitus, to reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal&nbsp;myocardial infarction, or non-fatal&nbsp;stroke) in adults with type 2&nbsp;diabetes mellitus&nbsp;and established&nbsp;cardiovascular disease.</p>', '<p>Liraglutide is an acylated analog of human glucagon-like peptide 1 (GLP-1), an endogenous incretin hormone and acts as a GLP-1 receptor agonist. Activation of GLP-1 receptor stimulates insulin secretion and suppression of glucagon secretion in a glucose-dependent manner. It also delays gastric emptying thus reduces the rate of postprandial glucose present in the circulation. It has lowering effects of fasting, premeal and postprandial glucose; with a decrease in HbA1c by approx 1%.</p>', '<p>Inject Liraglutide subcutaneously once-daily at any time of day, independently of meals. Initiate Liraglutide with a dose of 0.6 mg per day for one week. The 0.6 mg dose is a starting dose intended to reduce gastrointestinal&nbsp;symptoms during initial titration, and is not effective for glycemic control. After one week at 0.6 mg per day, the dose should be increased to 1.2 mg. If the 1.2 mg dose does not result in acceptable glycemic control, the dose can be increased to 1.8 mg. If a dose is missed, resume the once-daily regimen as prescribed with the next scheduled dose. Do not administer an extra dose or increase in dose to make up for the missed dose.<br />\r\n<br />\r\nIf more than 3 days have elapsed since the last Liraglutide dose, reinitiate Liraglutide at 0.6 mg to mitigate any gastrointestinal symptoms associated with reinitiation of treatment. Upon reinitiation, Liraglutide should be titrated at the discretion of the prescriber.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Inspect visually prior to each injection. Only use if solution is clear, colorless, and contains no particles.</li>\r\n	<li>Inject Liraglutide subcutaneously in the abdomen, thigh or upper arm. No dose adjustment is needed if changing the injection site and/or timing.</li>\r\n	<li>When using Liraglutide with insulin, administer as separate injections. Never mix.</li>\r\n	<li>It is acceptable to inject Liraglutide and insulin in the same body region but the injections should not be&nbsp;adjacent&nbsp;to each other.</li>\r\n</ul>', '<p>Increased risk of hypoglycaemia when used w/ insulin secretagogues (e.g. sulfonylurea, meglitinide). May affect absorption of concomitantly administered oral drugs due to slow gastric emptying.</p>', '<p>Personal or family history of medullary thyroid carcinoma (MTC). Patients with multiple endocrine neoplasia syndrome type 2; type 1 DM or diabetic ketoacidosis. Liraglutide is not a substitute for insulin.</p>', '<p>Nausea, diarrhoea, vomiting, constipation, headache, dizziness, upper resp tract infection, influenza, sinusitis, nasopharyngitis, UTI, back pain, dehydration. Increased blood calcitonin, goitre, and thyroid neoplasms.</p>', '<p><strong>Pregnancy c</strong>ategory C.&nbsp;Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Patients with history of pancreatitis or alcoholism, inflammatory bowel disease, diabetic gastroparesis, pre-existing thyroid disease. Renal impairment. Pregnancy and lactation</p>', '<p>Overdoses have been reported in clinical trials and post-marketing use of Liraglutide. Effects have included severe nausea and severe vomiting. In the event of overdosage, appropriate supportive treatment should be initiated according to the patient&rsquo;s clinical signs and symptoms.</p>', '<p>GLP-1 receptor agonists.</p>', '<p>Store between 2-8&deg; C. Do not freeze. After initial use, it can be stored between 15-30&deg; C for 30 days. Protect from heat and light.</p>', NULL, '2022-03-09 02:00:48', '2022-03-09 02:00:48'),
(871, 871, '<p><strong>Hypertension</strong>: Lisinopril is indicated for the treatment of&nbsp;hypertension&nbsp;in adult patients and pediatric patients 6 years of age and older to lower blood pressure. Lowering blood pressure lowers the risk of fatal and non-fatal&nbsp;cardiovascular&nbsp;events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of&nbsp;antihypertensive&nbsp;drugs from a wide variety of pharmacologic classes.<br />\r\n<br />\r\nControl of&nbsp;high blood pressure&nbsp;should be part of comprehensive cardiovascular risk management, including, as appropriate,&nbsp;lipid control, diabetes&nbsp;management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. Many patients will require more than 1 drug to achieve blood pressure goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Program&rsquo;s Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC).<br />\r\n<br />\r\nNumerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of&nbsp;stroke, but reductions in&nbsp;myocardial infarction&nbsp;and cardiovascular mortality also have been seen regularly.<br />\r\n<br />\r\nElevated&nbsp;systolic&nbsp;or&nbsp;diastolic&nbsp;pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension (for example, patients with diabetes or&nbsp;hyperlipidemia), and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal.<br />\r\n<br />\r\nSome antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (e.g., on&nbsp;angina,&nbsp;heart failure, or diabetic kidney disease). These considerations may guide selection of therapy.<br />\r\n<br />\r\nLisinopril may be administered alone or with other antihypertensive agents.<br />\r\n<br />\r\n<strong>Heart Failure</strong>: Lisinopril is indicated to reduce signs and symptoms of heart failure in patients who are not responding adequately to&nbsp;diuretics&nbsp;and digitalis.<br />\r\n<br />\r\n<strong>Acute Myocardial Infarction</strong>: Lisinopril is indicated for the reduction of mortality in treatment of hemodynamically stable patients within 24 hours of&nbsp;acute myocardial infarction. Patients should receive, as appropriate, the standard recommended treatments such as thrombolytics, aspirin and beta-blockers</p>', '<p>Lisinopril competitively inhibits ACE from converting angiotensin I to angiotensin II (a potent vasoconstrictor) resulting in increased plasma renin activity and reduced aldosterone (a hormone that causes water and Na retention) secretion. This promotes vasodilation and BP reduction.</p>', '<p>Oral (Adult)-</p>\r\n\r\n<p><strong>Hypertension:</strong>&nbsp;Initially, 10 mg/day, 1st dose given preferably at bedtime to avoid precipitous fall in BP. Patient with renovascular HTN, volume depletion, severe HTN: Initially, 2.5-5 mg once daily. Patient on diuretic: Initially, 5 mg once daily. Maintenance: 20 mg once daily, up to 80 mg/day may be given if needed.<br />\r\n<br />\r\n<strong>Diabetic nephropathy:</strong>&nbsp;Hypertensive type 2 diabetics with microalbuminuria: 10 mg once daily, may increase to 20 mg once daily to achieve a sitting diastolic BP<br />\r\n<br />\r\n<strong>Heart failure</strong>: As adjunct: Initially, 2.5 or 5 mg/day, increased by increments of &le;10 mg at intervals of at least 2 wk to max maintenance dose of 40 mg/day.<br />\r\n<br />\r\n<strong>Post-myocardial infarction</strong>: Initially, 5 mg once daily for 2 days started within 24 hr of the onset of symptoms. Increase to 10 mg once daily. Patients with low systolic BP: Initially, 2.5 mg once daily.</p>\r\n\r\n<p><br />\r\nOral (Child)-</p>\r\n\r\n<p><strong>Hypertension</strong>: &ge;6 yr Initially, 0.07 mg/kg, up to 5 mg once daily.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>May be taken with or without food.</p>', '<p>May enhance hypotensive effect with diuretics. May increase risk of renal function deterioration and decrease antihypertensive effect with NSAIDs. May increase serum levels and toxicity of lithium. Increased risk of hyperkalaemia with K-sparing diuretics and K supplements. May increase nitritoid reactions of gold Na thiomalate.</p>', '<p>History of angioedema related to previous ACE inhibitor treatment, hereditary or idiopathic angioedema. Concomitant use with aliskiren in patients with diabetes or renal impairment. Pregnancy. Children with GFR &lt;30 mL/min/1.73 m2.</p>', '<p>Headache, fatigue, persistent and non-productive cough, chest and abdominal pain, dizziness, nausea, vomiting, diarrhoea, upper resp tract infection, asthenia, rash, orthostatic effects, hypotension, renal dysfunction, hyperkalaemia, intestinal angioedema; increased BUN and serum creatinine levels.</p>', '<p>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>Bilateral renal artery stenosis or a single kidney with unilateral renal artery stenosis. Patients with collagen vascular disease, acute MI at risk of further haemodynamic deterioration, angioedema unrelated to ACE inhibitor therapy, aortic stenosis and hypertrophic cardiomyopathy. Increased risk of angioedema in black patients. Renal impairment. Lactation. Childn &lt;6 yr.</p>', '<p><strong>Symptoms:</strong>&nbsp;Hypotension, tachycardia, circulatory shock, palpitations, bradycardia, hyperventilation, renal failure, electrolyte disturbances, anxiety, dizziness and cough.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Normal saline IV infusion may be used. Perform haemodialysis, emesis, gastric lavage, admin of absorbents and Na sulfate if recently taken. Consider admin of angiotensin II infusion and/or IV catecholamines if available.</p>', '<p>Angiotensin-converting enzyme (ACE) inhibitors.</p>', '<p>Store at below 25&deg; C.</p>', '<p><strong>Adult</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>CrCl 10-30 ml/min</strong>: Initially, 2.5-5 mg once daily.</li>\r\n	<li><strong>CrCl 31-80 ml/min</strong>: Initially 5-10 mg once daily. Dose can be adjusted up to max 40 mg once daily based on patient&#39;s response.</li>\r\n</ul>\r\n\r\n<p><strong>Child</strong>: Do not give if GFR &lt;30 mL/min/1.73 m2.</p>', '2022-03-09 02:04:00', '2022-03-09 02:04:00'),
(872, 872, '<p>Treatment and prophylaxis of mania, bipolar disorder and recurrent depression.</p>', '<p>Although lithium has been used for over 50 years in treatment of bipolar disorder, the mechanism of action is still unknown.&nbsp; Lithium&#39;s therapeutic action may be due to a number of effects, ranging from inhibition of enzymes such as glycogen synthase kinase 3, inositol phosphatases, or modulation of glutamate receptors. Lithium Carbonate alters intraneuronal metabolism of catecholamines and sodium transport in neurons and muscle cells.</p>', '<p><strong>Adult and child over 12 years:</strong>&nbsp;initially 1 gm to 1.5 gm daily; prophylaxis, initially 300-400 mg daily. Should be taken with food.</p>', '<p>Reduced serum levels with carbonic anhydrase inhibitors, chlorpromazine, sodium-containing preparations, theophylline, urea. Enhanced hypothyroid effects with iodine salts. Enhanced effects of neuromuscular-blocking agents. Reduced pressor response to sympathomimetics.</p>', '<p>Renal insufficiency, cardiovascular insufficiency, Addison&#39;s disease and untreated hypothyroidism are all contraindications to lithium therapy.</p>', '<p>Tiredness, loss of appetite, nausea, vomiting, diarrhoea, hands shaking, memory problems, increased thirst and consequently passing urine more often by day, and perhaps also by night.</p>', '<p>Pregnancy Category D. An increased incidence of cardiovascular abnormality has been noted in infants of women given lithium during the first 3 months of pregnancy, such use should be avoided unless essential. Breast feeding is not advised unless the benefits of lithium use outweigh the advantages.</p>', '<p>Decreased tolerance to lithium has been reported to ensue from protracted sweating or diarrhoea and, if such occur, supplemental fluid and salt should be administered under careful medical supervision and lithium intake reduced or suspended until the condition is resolved.</p>', '<p>In the event of accumulation, lithium should be stopped and serum estimations should be carried out every six hours.Under no circumstances should a diuretic be used. Osmotic diuresis (mannitol or urea infusion) or alkalinisation of the urine (sodium lactate or sodium bicarbonate infusion) should be initiated. If the serum lithium level is over 4.0 mmol/L, or if there is a deterioration in the patient&#39;s condition, or if the serum lithium concentration is not falling at a rate corresponding to a half-life of under 30 hours, peritoneal or haemodialysis should be instituted promptly. This should be continued until there is no lithium in the serum or dialysis fluid. Serum lithium levels should be monitored for at least a further week to take account of any possible rebound in serum lithium levels as a result of delayed diffusion from body tissues.</p>', '<p>Anti-manic drugs.</p>', '<p>Store at 25&deg; C.</p>', '<p><strong>Renal Impairment:</strong>&nbsp;CrCl 10-50: 50-75% of normal dose.</p>', '2022-03-09 02:06:33', '2022-03-09 02:06:33'),
(873, 873, '<p>Lomefloxacin ophthalmic preparation is indicated in the bacterial infections, including conjunctivitis, blepharitis, blepharoconjunctivitis which are due to Lomefloxacin susceptible germs and Staphylococcus aureus- induced corneal ulcers.</p>', '<p>Lomefloxacin, a difluorinated quinolone derivative, is a bacterial gyrase inhibitor, effective against gram positive and gram negative bacteria. The acute toxicity of Lomefloxacin following systemic and topical ophthalmic application is low. Lomefloxacin interferes with bacterial DNA related processes like initiation, elongation, and termination phases of replication, transcription, DNA repairing, recombination, transposition, supercoiling and relaxation of DNA. The target molecule for quinolones is the A-subunit of bacterial enzyme gyrase (topoisomerase II). The forming of a stable complex between the quinolone and the whole gyrase teramer A2B2 leads to impaired enzyme functions, resulting in a rapid killing of sensitive bacteria.<br />\r\n<br />\r\nCross-resistance has only been reported with other quinolones, but not with any other group of antibiotics. No clinical studies are available about the efficacy in cases of infections with chlamydia.</p>', '<p><strong>Adults and children (above 1 year of age)</strong>: Instill 2-3 times daily 1 drop into the lower conjunctival sac. At the beginning of the treatment application should be more frequent, apply 5 drops within 20 minutes or 1 drop every hour during 6-10 hours. Duration of the treatment: 7 to 9 days.</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>In order to avoid reduction of efficacy, no ophthalmic preparations containing heavy metals, such as zinc, should be used during 15 minutes preceding and following application of Lomefloxacin. Bacteriostatic ophthalmic antibiotics should not be used concomitantly with Lomefloxacin eye drops.</p>', '<p>Hypersensitivity to the active ingredient, to excipients, or to quinolones. Long term treatment with antibiotics may enhance development of secondary fungal infections or may support growth of non susceptible bacteria.</p>', '<p>Slight and transient burning immediately after instillation of the eye drops has been reported in 4.7% of users. Although phototoxicity has not been reported after ophthalmic use, photosensitization is possible. Since the following allergic reactions have been reported after systemic use of Lomefloxacin, they can not be excluded after topical ophthalmic use: allergic reactions, asthma, dyspnoea, urticaria, erythema, pruritus, and hypersensitization.</p>', '<p>Animal studies revealed that after systemic use of 20 mg/kg, Lomefloxacin passes the placenta barrier and is excreted into the maternal milk. Clinical studies on the use of Lomefloxacin eye drops during human pregnancy or lactation are not available. Therefore, the drug should only be used when the benefit outweighs the potential risk for the foetus or the infant.</p>', '<p>Some isolated cases of phototoxicity have been reported after systemic but not after topical ophthalmic use of Lomefloxacin. Nevertheless, during treatment with Lomefloxacin intensive exposure to sunlight or UV-radiation should be avoided.</p>', '<p>Practically there is no risk of adverse effects due to accidental oral ingestion, since a bottle of 5 ml eye drop solution contains only 15 mg Lomefloxacin. This corresponds to 3.75% of the recommended oral daily dose for adults of 400 mg Lomefloxacin.</p>', '<p>4-Quinolone preparations, Ophthalmic antibacterial drugs.</p>', '<p>Store at 15-25&deg; C.</p>', NULL, '2022-03-09 02:09:03', '2022-03-09 02:09:03'),
(874, 874, '<p>Lomefloxacin oral preparation is indicated for the treatment of:</p>\r\n\r\n<ul>\r\n	<li>Uncomplicated urinary tract infections.</li>\r\n	<li>Complicated including recurrent and pyelonephritis, urinary tract infections.</li>\r\n	<li>Acute exacerbation of chronic bronchitis.</li>\r\n	<li>Skin and skin structure infections.</li>\r\n</ul>\r\n\r\n<p>Prevention/Prophylaxis:&nbsp;Lomefloxacin is indicated preperatively to prevent postoperative urinary tract infections in patients undergoing transurethral surgical procedures.</p>', '<p>Lomefloxacin, a difluorinated quinolone derivative, is a bacterial gyrase inhibitor, effective against gram positive and gram negative bacteria. The acute toxicity of Lomefloxacin following systemic and topical ophthalmic application is low. Lomefloxacin interferes with bacterial DNA related processes like initiation, elongation, and termination phases of replication, transcription, DNA repairing, recombination, transposition, supercoiling and relaxation of DNA. The target molecule for quinolones is the A-subunit of bacterial enzyme gyrase (topoisomerase II). The forming of a stable complex between the quinolone and the whole gyrase teramer A2B2 leads to impaired enzyme functions, resulting in a rapid killing of sensitive bacteria.<br />\r\n<br />\r\nCross-resistance has only been reported with other quinolones, but not with any other group of antibiotics. No clinical studies are available about the efficacy in cases of infections with chlamydia.</p>', '<p>Typhoid fever: 400 mg once daily or 200 mg b.i.d 10-14 days.<br />\r\nUTI infections:</p>\r\n\r\n<ul>\r\n	<li>Uncomplicated:&nbsp;400 mg once daily or 200 mg b.i.d 3 days.</li>\r\n	<li>Complicated:&nbsp;400 mg once daily or 200 mg b.i.d 10-14 days.</li>\r\n</ul>\r\n\r\n<p>Bacterial Diarrhea: 400 mg once daily or 200 mg b.i.d 5-7 days.<br />\r\nAcute exacerbation of chronic bronchitis: 400 mg once daily 7-10 days.<br />\r\nSkin and skin structure infections: 400 mg once daily 10-14 days.<br />\r\nProphylaxis of UTI following surgery: 400 mg Single dose 2-6 hours prior to transurethral surgery.</p>', '<p>Lomefloxacin does not alter theophylline clearance and concentration. No change of caffeine is reported. Sucralfate and antacid containing magnesium and aluminium interfere with its bioavailability. Enhances effects of warfarin. Probenecid slows renal elimination of Lomefloxacin.</p>', '<p>Lomefloxacin is contraindicated in patients with a history of hypersensitivity to Lomefloxacin or to other quinolones. Lomefloxacin like other drugs in its class, cause arthropathy in juvenile animals. Therefore, its use in children, growing adolescents, and pregnant women is not recommended.</p>', '<p>Common side effects are&nbsp;Nausea, headache, photosensitivity, dizziness, diarrhea, dry mouth, fatigue, convulsions, CNS stimulation which may lead to tremors, restlessness, light headedness, confusion &amp; hallucinations and pseudomembranous colitis.</p>', '<p>Pregnancy Category C. Reproductive function studies have been performed in rats at doses up to 8 times the recommended human dose based on mg/m&sup2; (34 times the recommended human dose based on mg/kg), and no impaired fertility or harm to the fetus was reported due to lomefloxacin. Increased incidence of fetal loss in monkeys has been observed at approximately 3 to 6 times the recommended human dose based on mg/m&sup2; (6 to 12 times the recommended human dose based on mg/kg). No teratogenicity has been observed in rats and monkeys at up to 16 times the recommended human dose exposure. In the rabbit, maternal toxicity and associated fetotoxicity, decreased placental weight, and variations of the&nbsp;coccygeal vertebrae occurred at doses 2 times the recommended human exposure based on mg/m&sup2;. There are, however, no adequate and well-controlled studies in pregnant women. Lomefloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\nNursing mothers: It is not known whether lomefloxacin is excreted in human milk. However, it is known that other drugs of this class are excreted in human milk and that lomefloxacin is excreted in the milk of lactating rats. Because of the potential for serious adverse reactions from lomefloxacin in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>Alterations of the dosage regimen is recommended for patients with impairment of renal function (CrCl &lt;40 ml/min/1.73 m2). Avoid exposure to excessive sunlight or artificial UV light. Phototoxicity reaction may occur if undue exposure occurs. Safety and efficacy of Lomefloxacin has not been established in children, pregnant and lactating women.</p>', NULL, '<p>4-Quinolone preparations, Aural Anti-bacterial preparations.</p>', '<p>Should be stored in cool and dry place.</p>', '<p><strong>Pediatric use</strong>: The safety and effectiveness of lomefloxacin in pediatric patients and adolescents less than 18 years of age have not been established. Lomefloxacin causes arthropathy in juvenile animals of several species.&nbsp;<br />\r\n<br />\r\n<strong>Geriatric use</strong>: Of the total number of subjects in clinical studies of lomefloxacin, 25% were &ge;65 years and 9% were &ge; 75 years. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.</p>', '2022-03-09 02:11:21', '2022-03-09 02:11:21'),
(875, 875, '<p>Loperamide Hydrochloride is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Acute diarrhea</li>\r\n	<li>Chronic diarrhea</li>\r\n	<li>Abdominal cramps associated with diarrhea</li>\r\n	<li>Crohn&#39;s disease</li>\r\n	<li>Postgastric surgery</li>\r\n	<li>Ulcerative colitis.</li>\r\n</ul>', '<p>Loperamide Hydrochloride inhibits the peristaltic activity of the longitudinal and circular smooth muscle in the intestine by interacting with cholinergic and noncholinergic neuronal mechanisms responsible for producing the peristaltic reflex. Loperamide Hydrochloride binds to the opiate receptor in the gut wall, reducing propulsive peristalsis and increasing intestinal transit time. Loperamide Hydrochloride increases the tone of the anal sphincter. This also inhibits electrolyte and fluid secretion in the intestine.<br />\r\n<br />\r\nLoperamide Hydrochloride is an orally administered capsule. After administration absorption is more than 65% which occurs at a modest rate, with peak serum levels of 2-3 &micro;gm/litre occurring at about 4 hours later after oral administration. The rest 35% is excreted unchanged in the faeces. Loperamide Hydrochloride undergoes an extensive presystemic first-pass metabolism in the gut wall and in the liver. Loperamide does not act centrally due to its high affinity for the gut wall and its presystemic metabolism. This is why it reaches the systemic circulation in a very minute amount. The route of elimination is 0.63-1.4% in urine as an unchanged drug, 58% is excreted in the bile and 15-23% appears in the faeces.</p>', '<p>Acute diarrhea-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 2 capsules initially followed by 1 capsule after every loose stool.</li>\r\n	<li>Usual dosage: 3-4 capsules/day. The maximum daily dose should not exceed 8 capsules.</li>\r\n	<li><strong>Children (9-12 years)</strong>: 1 capsule after each loose stool until diarrhea is controlled. But not more than 6 capsules daily.</li>\r\n	<li><strong>Children (5-9 years)</strong>: 1 capsule 4 times daily until diarrhea is controlled. But not more than 4 capsules daily.</li>\r\n</ul>\r\n\r\n<p>Chronic diarrhea-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 2-4 capsules daily in divided doses, depending on severity.</li>\r\n	<li><strong>Children</strong>: 1-2 capsules daily, depending on severity. Or directed by physician.</li>\r\n</ul>', '<p>There are no data available.</p>', '<p>Hypersensitivity to the drug and in patients who must avoid constipation. Loperamide Hydrochloride should not be used alone in acute dysentery, which is characterized by blood in the stool and elevated body temperature.</p>', '<p>Abdominal pain and other gastrointestinal disturbances including dry mouth, dizziness, fatigue and skin rashes etc. have been reported.</p>', '<p>Safety in human pregnancy has not been established. As with other drugs, it is not advisable to administer Loperamide in pregnancy. Although the fraction of Loperamide Hydrochloride secreted in human breast milk is extremely low, caution is advised if Loperamide Hydrochloride is to be administered to a nursing mother.</p>', '<p>Loperamide Hydrochloride must be used with caution in cases of severe hepatic disturbance.</p>', '<p>Overdosage of Loperamide may result in constipation, CNS depression, and nausea.</p>', '<p>Anti-diarrhoeal, Anti-motility drugs.</p>', '<p>Keep all medicines out of reach of children. Store in a cool and dry place protected from light.</p>', NULL, '2022-03-09 02:13:50', '2022-03-09 02:13:50');
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
(876, 876, '<p>Lopinavir and Ritonavir is an HIV-1 protease inhibitor indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection in adults and pediatric patients (14 days and older).</p>', NULL, '<p>Lopinavir and Ritonavir tablets may be taken with or without food, swallowed whole and not chewed, broken, or crushed.<br />\r\n<br />\r\nAdult Patients:</p>\r\n\r\n<ul>\r\n	<li>400/100 mg (two 200/50 mg tablets) twice daily, or</li>\r\n	<li>800/200 mg (four 200/50 mg tablets) once daily in patients with less than three lopinavir resistance-associated substitutions.</li>\r\n</ul>\r\n\r\n<p><strong>Concomitant Therapy in Adults Patients</strong>: Dose adjustments of Lopinavir and Ritonavir may be needed when co-administering with efavirenz, nevirapine, or nelfinavir.<br />\r\n<strong>Do not use once daily administration of Lopinavir and Ritonavir in</strong>: HIV-1 infected patients with three or more of the following lopinavir resistance-associated substitutions: L10F/I/R/V, K20M/N/R, L24I, L33F, M36I, I47V, G48V, I54L/T/V, V82A/C/F/S/T, and I84V. Combination with efavirenz, nevirapine, nelfinavir, carbamazepine, phenobarbital, or phenytoin.</p>', '<p>Co-administration of Lopinavir and Ritonavir is contraindicated with potent CYP3A inducers where significantly reduced lopinavir plasma concentrations may be associated with the potential for loss of virologic response and possible resistance and cross resistance. It is also contraindicated with Alpha 1 Adrenoreceptor Antagonist (Alfuzosin), Antimycobacterial (Rifampin), Ergot Derivatives ( Dihydroergotamine, ergotamine, methylergonovine), Gl Motility Agent (Cisapride), HMG-CoA Reductase Inhibitors (Lovastatin, simvastatin), PDE5 Enzyme Inhibitor (Sildenafil, when used for the treatment of pulmonary arterial hypertension), Neuroleptic (Pimozide) Sedative/Hypnotics (Triazolam; orally administered midazolam).</p>', '<p>Lopinavir and Ritonavir is contraindicated in patients with previously demonstrated clinically significant hypersensitivity (e.g., toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, urticaria, angioedema) to any of its ingredients, including lopinavir and ritonavir.<br />\r\n<br />\r\nCo-administration of Lopinavir and Ritonavir is contraindicated with drugs that are highly dependent on CYP3A for clearance and for which elevated plasma concentrations are associated with serious and/or life-threatening reactions.</p>', '<p>Commonly reported side effects included diarrhea, nausea, vomiting, hypertriglyceridemia and hypercholesterolemia.</p>', '<p><strong>Nursing Mothers</strong>: The Centers for Disease Control and Prevention recommend that HIV-1 infected mothers not breastfeed their infants to avoid risking postnatal transmission of HIV-1. Studies in rats have demonstrated that lopinavir is secreted in milk. It is not known whether lopinavir is secreted in human milk. Because of both the potential for HIV-1 transmission and the potential for serious adverse reactions in nursing infants, mothers should be instructed not to breastfeed if they are receiving this combination.</p>', '<p>The following have been observed in patients receiving Lopinavir and Ritonavir:<br />\r\n<br />\r\n<strong>Hepatotoxicity</strong>: Patients with underlying hepatitis B or C or marked elevations in transaminase prior to treatment may be at increased risk for developing or worsening of transaminase elevations or hepatic decompensation with use of this combination.<br />\r\n<br />\r\n<strong>QT Interval Prolongation</strong>: In cases of QT interval prolongation and torsade de pointes have been reported although causality of this combination could not be established. Avoid use in patients with congenital long QT syndrome, those with hypokalemia, and with other drugs that prolong the QT interval.<br />\r\n<br />\r\n<strong>PR Interval Prolongation</strong>: Lopinavir/ritonavir prolongs the PR interval in some patients. Cases of second or third degree atrioventricular block have been reported. This combination should be used with caution in patients with underlying structural heart disease, pre-existing conduction system abnormalities, ischemic heart disease or cardiomyopathies, as these patients may be at increased risk for developing cardiac conduction abnormalities.<br />\r\n<br />\r\n<strong>Diabetes Mellitus/Hyperglycemia</strong>: New onset diabetes mellitus, exacerbation of pre-existing diabetes mellitus, and hyperglycemia have been reported in HIV-1 infected patients receiving protease inhibitor therapy. Some patients required either initiation or dose adjustments of insulin or oral hypoglycemic agents for treatment of these events. In some cases, diabetic ketoacidosis has occurred. In those patients who discontinued protease inhibitor therapy, hyperglycemia persisted in some cases.<br />\r\n<br />\r\n<strong>Lipid Elevations</strong>: Treatment with Lopinavir and Ritonavir has resulted in large increases in the concentration of total cholesterol and triglycerides.</p>', '<p>Human experience of acute overdosage with this combination is limited. Treatment of overdose should consist of general supportive measures including monitoring of vital signs and observation of the clinical status of the patient. There is no specific antidote for overdose with this combination. If indicated, elimination of unabsorbed drug should be achieved by gastric lavage. Administration of activated charcoal may also be used to aid in removal of unabsorbed drug. Since lopinavir is highly protein bound, dialysis is unlikely to be beneficial in significant removal of the drug. However, dialysis can remove both alcohol and propylene glycol in the case of overdose with this combination.</p>', '<p>Drugs for HIV / Anti-retroviral drugs.</p>', '<p>Keep in a dry place &amp; store below 30&deg; C. Protect from light &amp; keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: The safety, efficacy, and pharmacokinetic profiles of this combination in pediatric patients below the age of 14 days have not been established.</p>', '2022-03-09 02:33:33', '2022-03-09 02:33:33'),
(877, 877, '<p>Loratadine tablet provides fast, effective relief from the symptoms of seasonal allergic rhinitis, perennial allergic rhinitis and skin allergies including chronic urticaria. It is also effective in alleviating symptoms of allergic rhinitis such as sneezing, nasal discharge, itching, ocular itching and burning. Nasal and ocular sign and symptoms are relieved rapidly after oral administration. Loratadine tablet is also indicated in idiopathic urticaria. In children over 2 years Loratadine tablet is indicated for the symptomatic relief of seasonal allergic rhinitis and allergic skin conditions such as urticaria, nettlerash.</p>', '<p>This tablet is a preparation of Loratadine. Loratadine is a non-sedative histamine Hr receptor antagonist with antiallergic properties. Loratadine is a long-acting tricyclic antihistamine with selective peripheral Hi-receptor antagonistic activity and no central sedative or anticholinergic effect. It is rapidly effective and long-lasting, allowing once-a-day administration.</p>', '<p><strong>Adults and children over 12 years of age</strong>: One Loratadine tablet once daily. It is usually administered in the morning or when symptoms require treatment.<br />\r\n<br />\r\n<strong>Children 2-12 years</strong>: Body weight over 30 kg: one Loratadine tablet once daily, below 30 kg: half Loratadine tablet once daily.<br />\r\n<br />\r\n<strong>Below 2 years of age</strong>: Loratadine tablet is not recommended for use below 2 years of age since safety and efficacy has not been established.</p>', '<p>There are no reports of potentially hazardous interactions with other drugs. In contrast to many other histamine H1 receptor antagonists, Loratadine has no potentiating effects when administered concurrently with alcohol, as measured by psychomotor performance studies. Concomitant therapy with drugs that inhibit or are metabolized by hepatic cytochromes P450 3A4 and 2D6 may elevate plasma concentrations of either drug and this mayifesult in adverse effects. Cimetidine inhibits both enzymes while erythromycin or ketoconazole inhibits P450 3A4. These drugs increase loratadine serum concentrations but no adverse effects are reported.</p>', '<p>Loratadine is contraindicated in patients who have shown hypersensitivity or idiosyncrasy to their components.</p>', '<p>During controlled clinical studies the incidence of adverse events, including sedation and anticholinergic effects observed with 10 mg Loratadine was comparable to that observed with placebo. Studies on the effect of Loratadine on actual driving performance, and on tests of cognitive and psychomotor functioning have shown it to be comparable to placebo.</p>', '<p>There is no experience of the use of Loratadine in human pregnancy. Therefore its use during pregnancy is not advisable. Loratadine is excreted in breast milk in a very small amount. So nursing mothers are advised not to take the drug.</p>', '<p>Caution should be taken in patients with liver impairment or renal insufficiency (eGFR &lt;30 ml/min).</p>', '<p>In adults somnolence, tachycardia and headache have been reported with overdose greater than 10 mg. Extrapyramidal signs and palpitations have been reported in children with overdoses of greater than 10 mg. In the event of overdosage, general symptomatic and supportive measures should be instituted promptly and maintained for as long as necessary. It would seem reasonable to treat patients presenting early after large overdoses with oral activated charcoal. The conscious patients may be induced to vomit or gastric lavage may be performed.</p>', '<p>Non-sedating antihistamines.</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-09 02:36:03', '2022-03-09 02:36:03'),
(878, 878, '<p>Loratadine &amp; Pseudoephedrine tablet is indicated for the relief of symptoms of seasonal and perennial allergic rhinitis, temporarily relieves runny nose, sneezing, itching, watery eyes, nasal congestion, itching of the nose or throat due to allergic rhinitis or other upper respiratory allergies, symptoms of common cold, nasal congestion &amp; sinus pressure associated with sinusitis.</p>', '<p>Loratadine is a non-sedative histamine H1-receptor antagonist with anti-allergic properties. Loratadine is a long acting tricyclic anti-histamine with selective peripheral H1-receptor antagonistic activity and no central sedative or anti-cholinergic effect.<br />\r\n<br />\r\nPseudoephedrine is an orally active sympathomimetic amine and exerts a decongestant action on the nasal mucosa. This is recognized as an effective agent for the relief of nasal congestion due to allergic rhinitis.&nbsp;It has nasal and bronchial decongestant activity.<br />\r\n<br />\r\nPseudoephedrine is both an &alpha;-and &beta;-adrenergic receptor agonist. It causes vasoconstriction via direct stimulation of &alpha;-adrenergic receptors of the respiratory mucosa. It also directly stimulates &beta;-adrenergic receptors causing bronchial relaxation, increased heart rate and contractility.</p>', '<p>Adults and Children 12 years of age and over:</p>\r\n\r\n<ul>\r\n	<li><strong>Loratadine 5 mg and Pseudoephedrine 120 mg</strong>: One tablet twice a day (every 12 hours).</li>\r\n	<li><strong>Loratadine 10 mg and Pseudoephedrine 240 mg</strong>: One tablet once daily.</li>\r\n</ul>\r\n\r\n<p>Safety and effectiveness of this drug in children below the age of 12 years have not been established.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Loratadine &amp; Pseudoephedrine tablet should be administered when both the antihistaminic properties of Loratadine and the nasal decongestant activity of Pseudoephedrine Sulfate are desired in patients 12 years of age and older.</p>', '<p>No specific interaction studies have been conducted with loratadine and pseudoephedrine sulfate extended release tablets. However, loratadine (10 mg once daily) has been safely coadministered with therapeutic doses of erythromycin, cimetidine, and Ketoconazole in controlled clinical pharmacology studies.<br />\r\n<br />\r\nLoratadine and pseudoephedrine sulfate combination tablet is contraindicated in patients taking monoamine oxidase inhibitors and for 2 weeks after stopping use of an MAO inhibitor. The antihypertensive effects of beta- adrenergic blocking agents, methyldopa, reserpine and veratrum alkaloids may be reduced by sympathomimetics. Increased ectopic pacemaker activity can occur when Pseudoephedrine is used concomitantly with digitalis.</p>', '<p>Loratadine &amp; Pseudoephedrine tablet is contraindicated in patients who are hypersensitive to this medication or any of its ingredients. It is also contraindicated in patients with narrow-angle glaucoma or urinary retention, and in patients receiving monoamine oxidase (MAO) inhibitor therapy or within fourteen (14) days of stopping such treatment. It is also contraindicated in patients with severe hypertension, severe coronary artery disease, and in those who have shown hypersensitivity to its components, to adrenergic agents, or to other drugs of similar chemical structures.</p>', '<p>In general loratadine and pseudoephedrine sulfate combination tablet is well tolerated. Clinical trial suggests a very low rate of adverse effects associated with its administration. Among the very few adverse effects, commonly reported are difficulty in sleeping, dry mouth, mild stomach upset, headache, nervousness, dizziness and loss of appetite or thirst. These effects subside as the body adjusts to this medication.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category B. There was no evidence of animal teratogenicity in reproduction studies. Loratadine and pseudoephedrine sulfate combination tablet should be used during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known if this combination product is excreted in human milk. However, both loratadine and pseudoephedrine sulfate when administered alone passes into breast milk, therefore, a decision should be made whether to discontinue lactation or to discontinue loratadine and pseudoephedrine sulfate combination tablet, taking into account the importance of the drug to the mother.</p>', '<p>Loratadine and pseudoephedrine sulfate combination tablet should be used with caution in patients with hypertension, diabetes mellitus, ischemic heart disease, increased intraocular pressure, hyperthyroidism, renal impairment or prostatic hypertrophy. Central nervous system stimulation with convulsions or cardiovascular collapse with accompanying hypotension may be produced by sympathomimetic amines.</p>', '<p>In the event of overdosage, general symptomatic and supportive, measures should be instituted promptly and maintained for as long as necessary. Treatment of overdosage would reasonably consist of emesis (ipecac syrup), except in patients with impaired consciousness, followed by the administration of activated charcoal to absorb any remaining drug. If vomiting is unsuccessful, or contraindicated, gastric lavage should be performed with normal saline. Saline cathartics may also be of value for rapid dilution of bowel contents.</p>', '<p>Anti-histamine &amp; decongestant.</p>', '<p>Store at a cool and dry place, away from light. Keep out of the reach of children.</p>', '<p>Use in patients Approximately 60 years age and older: The safety and efficacy in patients greater than 60 years old have not been investigated in placebo-controlled clinical trials. The elderly are more likely to have adverse reactions to sympathomimetic amines.<br />\r\n<br />\r\nUse in children: Safety and effectiveness in children below the age of 12 years have not been established.</p>', '2022-03-09 02:38:35', '2022-03-09 02:38:35'),
(879, 879, '<p>Lorazepam is used for the treatment of anxiety states; including anxiety associated with phobic &amp; obsessional states, psychosomatic, organic or psychotic illness, insomnia associated with anxiety, nervousness, restlessness, nausea and vomiting related to chemotherapy and anticonvulsants, and as a premedicant before dental or general surgery or prior to investigative procedures where there may be discomfort. Lorazepam is not recommended in anxiety states in children but may be used as premedicant before surgery at a dose of 0.05 mg/Kg in children aged 5 to 13 years. The dosage of Lorazepam tablet should be increased gradually when needed to avoid adverse effects. When higher dosage is indicated, the evening dose should be increased before the daytime.</p>', '<p>Lorazepam is a short-acting tranquilizer of the benzodiazepine group. It is an agonist at benzodiazepine receptors in the CNS. It exerts a depressant action on the CNS, which may be mediated by potentiating the inhibitory actions of GABA (gamma amino butyric acid) in the CNS. This will result in diminution of the ascending activating systems, particularly the serotonergic and noradrenergic pathway from brain stem or the mid-brain to the cerebral cortex.</p>', '<p>Lorazepam is administered orally. For optimal results; dose, frequency of administration and duration of therapy should be individualized according to patient&#39;s response.</p>\r\n\r\n<ul>\r\n	<li>The usual range is 2 to 6 mg/day given in divided doses, the largest dose being taken before bedtime, but the largest dosage may vary from 1 to 10 mg/day.</li>\r\n	<li>For anxiety, most patients require an initial dose of 2 to 3 mg/day given b.i.d. or t.i.d.</li>\r\n	<li>For elderly or debilitated patients, an initial dosage of 1 to 2 mg/day in divided doses is recommended, to be adjusted as needed and tolerated.</li>\r\n	<li>For insomnia 1 to 2 mg before bedtime and as premedicant 1 to 2 mg the night before surgery and 1 to 2 hour before surgery.</li>\r\n</ul>', '<p>Lorazepam may potentiate the central depressant effect when combined with other drugs with central depressant action. Such drugs include alcohol, general anesthetics, tricyclic antidepressants and monoamine oxidase inhibitors.</p>', '<p>Lorazepam should not be given to patients with a previous sensitivity to benzodiazepines or with acute narrow-angle glaucoma and myasthenia gravis.</p>', '<p>Adverse reactions are usually observed at the beginning of therapy and generally disappeared on continued medication or upon decreasing the dose. The most frequent adverse reactions of Lorazepam&nbsp;are sedation followed by dizziness, weakness and unsteadiness. Less frequent adverse reactions are disorientation, depression, nausea, change in appetite, headache, sleep disturbance, agitation, dermatological symptoms, eye-function disturbance, together with various gastrointestinal symptoms and autonomic manifestations.</p>', '<p>Safety of Lorazepam in pregnancy has not been established. Because the use of this drug is rarely a matter of urgency, the use of Lorazepam during this period should almost always be avoided.<br />\r\n<br />\r\nIt is not known whether oral Lorazepam is excreted in human milk like other benzodiazepine tranquilizers. As a general rule, nursing should not be undertaken while a patient is on a drug since many drugs are excreted in human milk.</p>', '<p>In patients with depression accompanying anxiety, a possibility for suicide should be borne in mind. For elderly or debilitated patients, the initial daily dosage should not exceed 2 mg in order to avoid over sedation. The usual precautions for treating patients with impaired renal or hepatic function and with acute and chronic pulmonary insufficiency should be observed. Use of Lorazepam for prolonged period and gastric patients requires caution and there should be frequent monitoring for symptoms of upper gastrointestinal disease. Machineries should be avoided during taking Lorazepam.</p>', '<p>Overdosage of Lorazepam is usually manifested by varying degrees of central nervous system depression ranging from drowsiness to coma. In mild cases, symptoms include drowsiness, mental confusion and lethargy. In more serious cases and especially when other drugs or alcohol were ingested, symptoms may include ataxia, hypotonia, hypotension, hypnotic states (stages I to III), coma.</p>', '<p>Benzodiazepine hypnotics, Benzodiazepine sedatives.</p>', '<p>Store between 20-25&deg;C</p>', NULL, '2022-03-09 02:40:43', '2022-03-09 02:40:43'),
(880, 880, '<p><strong>Hypertension</strong>: Losartan Potassium is indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive agents (eg. thiazide diuretics).<br />\r\n<br />\r\n<strong>Renal Protection in Type-2 Diabetic Patients with Proteinuria</strong>: Losartan Potassium is indicated to delay the progression of renal disease in hypertensive type-2 diabetics with proteinuria, defined as urinary albumin to creatinine ratio &gt;300 mg/g.</p>', '<p>Losartan Potassium is the first non-peptide orally active angiotensin II receptor blocker. It binds to the AT1 receptor found in many tissues (e.g. vascular smooth muscle, adrenal gland, kidneys and the heart) and reduces several important biological actions including vasoconstriction and the release of aldosterone responsible for hypertension.</p>', '<p>The usual starting and maintenance dose is 50 mg once daily for most patients. If the antihypertensive effect using 50 mg once daily is inadequate, 25 mg twice daily is recommended prior to increasing the dose. For patients with intravascular volume-depletion (e.g., those treated with high-dose diuretics), a starting dose of 25 mg once daily should be considered. Losartan Potassium can be administered once or twice daily. The total daily dose ranges from 25 mg to 100 mg.</p>', '<p>Rifampicin and fluconazole reduce levels of active metabolite of Losartan Potassium. Concomitant use of Losartan Potassium and hydrochlorothiazide may lead to potentiation of the antihypertensive effects. Concomitant use of potassium-sparing diuretics (eg, spironolactone, triamterene, amiloride), potassium supplements or salt substitutes containing potassium may lead to increases in serum potassium. The antihypertensive effect of losartan may be attenuated by the non-steroidal anti-inflammatory drug indomethacin. The use of ACE-inhibitor, angiotensin receptor antagonist, an anti-inflammatory drug and a thiazide diuretic at the same time increases the risk of renal impairment.</p>', '<p>Losartan Potassium is contraindicated in pregnant women and in patients who are hypersensitive to any component of this product. Losartan Potassium should not be administered with Aliskiren in patients with diabetes.</p>', '<p>The side effects with the use of Losartan Potassium are mild and transient in nature. The most common side effects are dizziness, diarrhea, nasal congestion, cough, upper respiratory infection. Other side effects are fatigue, oedema, abdominal pain, chest pain, nausea, headache &amp; pharyngitis.</p>', '<p>Pregnancy Category D. The risk to the fetus increases if Losartan Potassium is administered during the second or third trimesters of pregnancy. It is not known whether Losartan Potassium is excreted in human milk, as many drugs are excreted in human milk and because of the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>Use of Losartan Potassium during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. In patients who are intravascularly volume-depleted (e.g., those treated with high-dose diuretics), symptomatic hypotension may occur. Plasma concentration of Losartan Potassium is significantly increased in cirrhotic patients. Changes in renal function including renal failure have been reported in renal impaired patient.</p>', NULL, '<p>Angiotensin-ll receptor blocker.</p>', '<p>keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-09 02:43:10', '2022-03-09 02:43:10'),
(881, 881, '<p>This is indicated for the treatment of hypertension. It is also indicated to reduce the risk of stroke in patients with hypertension and left ventricular hypertrophy.</p>', '<p>Angiotensin II formed from angiotensin I in a reaction catalyzed by angiotensin converting enzyme (ACE), is a potent vasoconstrictor, the primary vasoactive hormone of the renin-angiotensin system and an important component in the pathophysiology of hypertension. It also stimulates aldosterone secretion by the adrenal cortex. Losartan and its principal active metabolite block the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1&nbsp;receptor found in many tissues, (e.g. vascular smooth muscle, adrenal gland). In vitro binding studies indicate that losartan is a reversible, competitive inhibitor of the AT1&nbsp;receptor. Neither Losartan nor its active metabolite inhibits ACE (kinase II, the enzyme that converts angiotensin I to angiotensin II and degrades bradykinin); nor do they bind to or block other hormone receptors or ion channels known to be important in cardiovascular regulation.<br />\r\n<br />\r\nHydrochlorothiazide is a thiazide diuretic. Thiazides affect the renal tubular mechanisms of electrolyte reabsorption, directly increasing excretion of Sodium and Chloride in approximately equivalent amounts. Indirectly, the diuretic action of Hydrochlorothiazide reduces plasma volume, with consequent increases in plasma renin activity, increases in Aldosterone secretion, increases in urinary Potassium loss, and decreases in serum Potassium. The renin-aldosterone link is mediated by angiotensin II, so co-administration of an angiotensin II receptor antagonist tends to reverse the Potassium loss associated with these diuretics.</p>', '<p><strong>Hypertension</strong>-</p>\r\n\r\n<ul>\r\n	<li>The usual starting dose of 50/12.5 is one tablet once daily.</li>\r\n	<li>For patients who do not respond adequately to one tablet the dosage may be increased to 100/25 once daily.</li>\r\n	<li>A patient whose blood pressure is not adequately controlled with Losartan 100 mg monotherapy may be switched to this combination 100/12.5 once daily.</li>\r\n	<li>In hypertensive patients with left ventricular hypertrophy initial dose is 50/12.5, if additional blood pressure reduction is needed, 100/12.5 may be given, followed by 100/25 if required. The maximum dose is 100/25 once daily.</li>\r\n	<li>In general, the antihypertensive effect is attained within three weeks after initiation of therapy.</li>\r\n	<li>No initial dosage adjustment of 50/12.5 is necessary for elderly patients. But maximum dose of 100/25 once daily dose should not be used as initial therapy in elderly patients.</li>\r\n</ul>\r\n\r\n<p><strong>Severe Hypertension</strong>:</p>\r\n\r\n<ul>\r\n	<li>The starting dose for initial treatment of severe hypertension is one tablet of 50/12.5 once daily.</li>\r\n	<li>For patients who do not respond adequately to this dose after 2 to 4 weeks of therapy, the dosage may be increased to 100/25 once daily. The maximum dose is one tablet of 100/25 once daily.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>This preparation may be administered with other antihypertensive agents. This may be administered with or without food.</p>', '<p><strong>Losartan Potassium</strong>: No significant drug-drug pharmacokinetic interactions have been found in interaction studies with Hydrochlorothiazide, Digoxin, Warfarin, Cimetidine and Phenobarbital. As with other drugs that block angiotensin II or its effects, concomitant use of potassium-sparing diuretics (e.g. Spironolactone, Triamterene, Amiloride), potassium supplements, or salt substitutes containing potassium may lead to increase in serum potassium. As with other antihypertensive agents, the antihypertensive effect of Losartan may be blunted by the non-steroidal anti-inflammatory drug Indomethacin.<br />\r\n<br />\r\n<strong>Hydrochlorothiazide</strong>: When administered concurrently, the following drugs may interact with Thiazide diuretics: alcohol, barbiturates, or narcotics-potentiation of orthostatic hypotension may occur.<br />\r\n<br />\r\n<strong>Antidiabetic drugs (oral agents and Insulin)</strong>: dosage adjustment of the antidiabetic drug may be required.<br />\r\n<br />\r\n<strong>Other antihypertensive drugs</strong>: additive effect or potentiation.<br />\r\n<br />\r\n<strong>Cholestyramine and colestipol resins</strong>: absorption of Hydrochlorothiazide is impaired in the presence of anionic exchange resins</p>', '<p>The combination of Losartan and Hydrochlorothiazide is contraindicated in patients who are hypersensitive to any component of this product. Because of the Hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs.</p>', '<p>Side-effects are usually mild. Symptomatic hypotension including dizziness may occur, particularly in patients with intravascular volume depletion (e.g. those taking high-dose diuretics). Hyperkalaemia occurs occasionally; angioedema has also been reported with some angiotensin-II receptor antagonists. Vertigo; less commonly gastro-intestinal disturbances, angina, palpitation, oedema, dyspnoea, headache, sleep disorders, malaise, urticaria, pruritus, rash; rarely hepatitis, atrial fibrillation, cerebrovascular accident, syncope, paraesthesia; also reported pancreatitis, anaphylaxis, cough, depression, erectile dysfunction, anaemia, thrombocytopenia, hyponatraemia, arthralgia, myalgia, renal impairment, rhabdomyolysis, tinnitus, photosensitivity, and vasculitis (including Henoch-Schonlein purpura).</p>', '<p>Angiotensin-II receptor antagonists should be avoided in pregnancy unless essential. They may adversely affect fetal and neonatal blood pressure control and renal function; skull defects and oligohy dramnios have also been reported. Information on the use of angiotensin-II receptor antagonists in breastfeeding is limited. They are not recommended in breastfeeding and alternative treatment options, with better-established&nbsp;safety information during breastfeeding, are available.</p>', '<ul>\r\n	<li>Hypersensitivity: Angiooedema</li>\r\n	<li>Periodic determination of serum electrolytes to detect possible electrolyte imbalance should be performed at appropriate intervals</li>\r\n	<li>Hypokalemia may rarely develop, especially with brisk diuresis, when severe cirrhosis is present, or after prolonged therapy</li>\r\n	<li>Impaired renal function and</li>\r\n	<li>Symptomatic hypotension</li>\r\n</ul>', '<p><strong>Losartan Potassium</strong>: Limited data are available in regard to overdosage in humans. The most likely manifestation of overdosage would be hypotension and tachycardia; bradycardia could occur from parasympathetic (vagal) stimulation. If symptomatic hypotension should occur, supportive treatment should be instituted. Neither losartan nor its metabolite can be removed by hemodialysis.<br />\r\n<br />\r\n<strong>Hydrochlorothiazide</strong>: The most common signs and symptoms observed are those caused by electrolyte depletion (hypokalemia, hypochloremia, and dehydration resulting from excessive diuresis. If digitalis has also been administered, hypokalemia, may accentuate cardiac arrhythmias. The degree to which Hydrochlorothiazide is removed by hemodialysis has not been established.</p>', '<p>Combined antihypertensive preparations.</p>', '<p>Do not store above 30&deg;C. Keep out of the reach of children.</p>', '<p><strong>Use in Patients with Renal Impairment</strong>: The usual regimens of therapy with 50/12.5 may be followed as long as the patient&#39;s creatinine clearance is &gt;30 ml/min. In patients with more severe renal impairment, loop diuretics are preferred to thiazides. In that case, hydrochlorothiazide is not recommended.<br />\r\n<br />\r\n<strong>Use in Patients with Hepatic Impairment</strong>: The combination of Losartan and Hydrochlorothiazide is not recommended for titration in patients with hepatic impairment because the appropriate 25 mg starting dose of Losartan cannot be given.<br />\r\n<br />\r\n<strong>Use in pediatric patients</strong>: The safety and effectiveness in pediatric patients have not been established.</p>', '2022-03-09 02:46:09', '2022-03-09 02:46:09'),
(882, 882, '<p>Loteprednol Gel is indicated for the treatment of post-operative inflammation and pain following ocular surgery. It is also effective in steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea and anterior segment of eyeball such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis &amp; cyclitis.</p>', '<p>Loteprednol is a corticosteroid which is thought to act by the induction of phospholipase A2 inhibitory proteins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid.</p>', NULL, NULL, '<p>It is contraindicated in most viral diseases of the cornea and conjunctiva. It is also contraindicated in individuals with known or suspected hypersensitivity to any of the ingredients of this preparation and to other corticosteroids.</p>', '<p>Glaucoma with optic nerve damage, visual acuity and field defects; cataract formation; secondary ocular infection following suppression of host response.</p>', '<p>No clinical data available for use in pregnancy. It is not known whether Loteprednol Etabonate passes into breast milk.</p>', '<ul>\r\n	<li>For ophthalmic use only.</li>\r\n	<li>If this product is used for 10 days or longer, intraocular pressure should be monitored.</li>\r\n	<li>Fungal infections of the cornea are particularly prone to develop coincidentally with long-term use of steroid topically.</li>\r\n	<li>Prolonged use of corticosteroids may result in glaucoma with damage to the optic nerve, defects in visual acuity and visual field, and in posterior subcapsular cataract formation.</li>\r\n	<li>Use of a corticosteroid medication in the treatment of patients with a history of herpes simplex requires great caution.</li>\r\n</ul>', NULL, '<p>Ophthalmic Steroid preparations.</p>', '<p>Protect from light. Store in cool &amp; dry place. Keep out of the reach of children.</p>', '<p>Safety and effectiveness in pediatric patients have not been established.</p>', '2022-03-09 02:48:16', '2022-03-09 02:48:16'),
(883, 883, '<p>Loteprednol etabonate is indicated for the treatment of steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe such as:</p>\r\n\r\n<ul>\r\n	<li>Allergic conjunctivitis</li>\r\n	<li>Acne rosacea</li>\r\n	<li>Superficial punctate keratitis</li>\r\n	<li>Herpes zoster keratitis</li>\r\n	<li>Iritis</li>\r\n	<li>Cyclitis</li>\r\n</ul>\r\n\r\n<p>It is also indicated for the treatment of post-operative inflammation following ocular surgery.</p>', '<p>Corticosteroids inhibit the inflammatory response to a variety of inciting agents and probably delay or slow healing. They inhibit the edema, fibrin deposition, capillary dilation, leukocyte migration, capillary proliferation, fibroblast proliferation, deposition of collagen and scar formation associated with inflammation. There is no generally accepted explanation for the mechanism of action of ocular corticosteroids.<br />\r\n<br />\r\nHowever, corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.</p>', '<p>Shake the bottle vigorously before using<br />\r\n<br />\r\n<strong>Steroid responsive disease treatment:</strong>&nbsp;Apply 1 to 2 drops of Loteprednol into the conjunctival sac of the affected eye(s) four times daily. During the initial treatment within the first week, the dosing may be increased, up to 1 drop every hour, if necessary. Care should be taken not to discontinue therapy prematurely.<br />\r\n<br />\r\n<strong>Post-Operative Inflammation:</strong>&nbsp;Apply 1 to 2 drops of Loteprednol into the conjunctival sac of the operated eye(s) four times daily beginning 24 hours after surgery and continuing throughout the first 2 weeks of the post-operative period.</p>', '<p>Since Loteprednol Etabonate is not detected in plasma following the topical administration, it is not expected to affect the pharmacokinetics of systemically administered medicinal products.</p>', '<p>Loteprednol, as with other ophthalmic corticosteroids, is contraindicated in most viral diseases of the cornea and conjunctiva including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella, and also in mycobacterial infection of the eye and fungal diseases of ocular structures.<br />\r\n<br />\r\nLoteprednol is also contraindicated in individuals with known or suspected hypersensitivity to any of the ingredients of this preparation and to other corticosteroids.</p>', '<p>Local reactions (e.g. blurred vision, burning, itching, dry eye), photophobia, headache, rhinitis, pharyngitis. Prolonged use may increase IOP, which may be associated with possible development of glaucoma and infrequent optic nerve damage; posterior sub-capsular cataract formation and perforation of the globe where there is thinning of the cornea or sclera.</p>', '<p>It is Pregnancy Category C.&nbsp;It is not known whether topical ophthalmic administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human milk.</p>', '<ul>\r\n	<li>Shake the bottle well before use</li>\r\n	<li>Patients should be advised not to allow the dropper tip to touch the eye, eyelid, fingers, or any other surface to prevent contamination</li>\r\n	<li>Patients should be advised not to wear soft contact lenses when using this drug</li>\r\n	<li>If this product is used for 10 days or longer, intraocular pressure should be monitored.</li>\r\n	<li>The possibility of fungal infections of the cornea should be considered after long-term steroid dosing</li>\r\n	<li>The use of steroids may delay wound healing.</li>\r\n</ul>', NULL, '<p>Ophthalmic Steroid preparations.</p>', '<p>Protect from light. Store in cool &amp; dry place. Keep out of the reach of children. Do not use more than 4 weeks after opening. Shake well before using.</p>', NULL, '2022-03-09 02:50:30', '2022-03-09 02:50:30'),
(884, 884, '<p>This ophthalmic suspension is indicated for steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where superficial bacterial ocular infection or a risk of bacterial ocular infection exists. Ocular steroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, and cyclitis. It is also indicated for the treatment of post-operative inflammation following ocular surgery.</p>', '<p>This is a sterile ophthalmic suspension containing Loteprednol Etabonate (corticosteroid) and Gatifloxacin (antibiotic) for topical administration to the eyes.<br />\r\n<br />\r\n<strong>Loteprednol&nbsp;</strong>are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.<br />\r\n<br />\r\n<strong>Gatifloxacin:&nbsp;</strong>The antibacterial action of gatifloxacin results from inhibition of DNA gyrase and topoisomerase IV. DNA gyrase is an essential enzyme that is involved in the replication, transcription, and repair of bacterial DNA. Topoisomerase IV is an enzyme known to play a key role in the partitioning of the chromosomal DNA during bacterial cell division. The mechanism of action of fluoroquinolones including gatifloxacin is different from that of aminoglycoside, macrolide, and tetracycline antibiotics. Therefore, gatifloxacin may be active against pathogens that are resistant to these antibiotics and these antibiotics may be active against pathogens that are resistant to gatifloxacin. Gatifloxacin has been shown to be active against most isolates of the following organisms both microbiologically and clinically. Aerobic Gram-Positive Bacteria: Staphylococcus aureus Staphylococcus epidermidis Streptococcus mitis group Streptococcus oralis Streptococcus pneumoniae Aerobic Gram-Negative Bacteria: Haemophilus influenza.</p>', '<p>Apply one or two drops of sterile ophthalmic suspension into the conjunctival sac of the affected eye(s) every four to six hours. During the initial 24 to 48 hours, the dosing maybe increased, to every one to two hours. Frequency should be decreased gradually as warranted by improvement in clinical signs. Care should be taken not to discontinue therapy prematurely.</p>', '<p>No drug interaction is reported yet. If several medicines are to be administered to the eye, there should be an interval of at least 5 minutes between each application.</p>', '<p>This sterile ophthalmic suspension is contraindicated in most viral diseases of the cornea and conjunctiva including epithelial herpes simplex and also in mycobacterial infection of the eye and fungal diseases of ocular structures. It is also contraindicated in known hypersensitivity to any of the ingredients of this preparation. It is also contraindicated in patients with a history of hypersensitivity to other quinolones, acetylsalicylic acid and other no steroidal inflammatory medicines.</p>', '<p>Adverse reactions have occurred with steroid/anti-infective combination drugs which can be attributed to the steroid component or the anti-infective component, or the combination. Reactions associated with ophthalmic steroids include elevated IOP, which may be associated with infrequent optic nerve damage, visual acuity and field detects, posterior sub capsular cataract formation, delayed wound healing, and secondary ocular infections from pathogens including herpes simplex, and perforation of the globe where there is thinning of cornea or sclera. The most frequently reported adverse effects for gatifloxacin in the overall study population were conjunctival irritation, increased lacrimation, keratitis and papillary conjunctivitis. These events occurred in approximately 5-10% of patients. Other reported reactions occurring in 1-4% of patients were chemosis, conjunctival hemorrhage, dry eye, eye discharge, eye irritation, eye pain, eyelid edema, headache, red eye, reduced visual acuity and taste disturbance. Redness was the most commonly observed adverse event occurring in 6%. Itching, discharge photophobia and blurred vision were seen in less than 2% cases.</p>', '<p>No data found.</p>', '<p>The preparation should not be injected sub conjunctively, nor should it be introduced directly into the anterior chamber of the eye. If this product is used for 10 days or longer, intraocular pressure should be monitored. Fungus invasion must be considered in any persistent corneal ulceration where a steroid has been used or is in use. If redness or itching becomes aggravated, the patient should be advised to consult a physician. Patients who wear soft contact lenses and whose eyes are not red, should be instructed to wait at least ten minutes after instilling it before they insert their contact lenses.</p>', NULL, '<p>Ophthalmic steroid - antibiotic combined preparations.</p>', '<p>Store at room temperature &amp; protect from light. Do not touch dropper tip to any surface. It is desirable that the contents should not be used one month after first opening of the bottle. Protect from freezing.</p>', NULL, '2022-03-09 02:53:20', '2022-03-09 02:53:20'),
(885, 885, '<p>This is indicated for steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where superficial bacterial ocular infection or a risk of bacterial ocular infection exists. Ocular steroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis. It is also indicated in chronic anterior uveitis and corneal injury from chemical, radiation or thermal burns, or penetration of foreign bodies. This&nbsp;is also indicated for the treatment of post-operative inflammation following ocular surgery.</p>', '<p><strong>Loteprednol</strong>&nbsp;is a corticosteroid which is thought to act by the induction of phospholipase A2 inhibitory proteins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid.<br />\r\n<br />\r\n<strong>Tobramycin</strong>&nbsp;is a member of aminoglycoside which shows bactericidal activity by inhibiting protein synthesis of bacteria.</p>', '<p>Shake well before use. Apply one drop into the conjunctival sac of the affected eye(s) every four to six hours. During the initial 24 to 48 hours, the dosing may be increased, to every one to two hours.</p>', '<p>Since Loteprednol Etabonate is not detected in plasma following the topical administration, it is not expected to affect the pharmacokinetics of systemically administered medicinal products.</p>', '<p>Contraindicated in most viral diseases of the cornea and conjunctiva. Also contraindicated in individuals with known or suspected hypersensitivity to any of the ingredients of this preparation and to other corticosteroids.</p>', '<p>Increased intraocular pressure, burning and stinging upon instillation, vision disorders, discharge, itching, lacrimation disorder, photophobia, corneal deposits, ocular discomfort, eyelid disorder, and other unspecified eye disorders may occur. The incidence of non-ocular adverse events (headache) also reported.</p>', '<p><strong>Use in pregnancy:</strong>&nbsp;There are no adequate and well-controlled studies in pregnant women. Loteprednol Etabonate &amp; Tobramycin&nbsp;should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Use in lactation:</strong>&nbsp;Caution should be exercised when Loteprednol Etabonate &amp; Tobramycin is administered to a nursing mother.</p>', '<ul>\r\n	<li>For ophthalmic use only.</li>\r\n	<li>If this product is used for 10 days or longer, intraocular pressure should be monitored.</li>\r\n	<li>Fungal infections of the cornea are particularly prone to develop coincidentally with long-term use of steroid topically.</li>\r\n	<li>Prolonged use may result in overgrowth of nonsusceptible organisms including fungi. If superinfection occurs, appropriate therapy should be initiated.</li>\r\n	<li>Cross-sensitivity to other aminoglycoside antibiotics may occur.</li>\r\n</ul>', NULL, '<p>Ophthalmic steroid - antibiotic combined preparations.</p>', '<p>Store at room temperature &amp; protect from light. Do not touch dropper tip to any surface. It is desirable that the contents should not be used four weeks after first opening of the bottle. Protect from freezing.</p>', '<p><strong>Use in children:</strong>&nbsp;Safety and effectiveness in pediatric patients have not been established.</p>', '2022-03-09 02:55:47', '2022-03-09 02:55:47');
