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
(1353, 1353, '<p><strong>6% Salicylic Acid</strong>: This topical preparations treat the following common scaly conditions:</p>\r\n\r\n<ul>\r\n	<li>Chronic atopic dermatitis</li>\r\n	<li>Lichen simplex</li>\r\n	<li>Psoriasis&nbsp;</li>\r\n	<li>Seborrhoeic dermatitis</li>\r\n	<li>Ichthiosis</li>\r\n</ul>\r\n\r\n<p><strong>12% Salicylic Acid</strong>: This topical preparations treat the following common scaly conditions:</p>\r\n\r\n<ul>\r\n	<li>Warts (small excessive growths of skin caused by a type of virus. Warts often occur on the fingers or on the back of the hands).</li>\r\n	<li>Verruca (occurs only on the sole of the feet and can be painful. It often looks like a small white ring of skin with a black dot in the centre).</li>\r\n	<li>Corns and Calluses (are hard, thick pads of skin caused by pressure and friction. They usually occur on the feet due to poorly fitting shoes and can occur on the hands).</li>\r\n</ul>', '<p>Salicylic Acid has a potent keratolytic &amp; a slight antiseptic action when applied topically to the skin. In low concentrations, the drug has keratoplastic activity (correction of abnormal keratinization) &amp; in higher concentrations, the drug has keratolytic activity (causes peeling of skin). Salicylic Acid softens &amp; destroys the stratum corneum by increasing endogenous hydration (water concentration), probably because of decreased pH, which causes the cornified epithelium (horny layer of the skin) to swell, soften, &amp; then desquamate. Necrosis of normal skin has been associated with overuse of the drug. At high concentrations, Salicylic Acid has a caustic effect. Moisture is essential for Salicylic Acid to exert its action on the skin and for maceration and desquamation of epidermal tissue to occur. The drug has weak antifungal &amp; antibacterial activity.</p>', '<p>Apply to affected area once daily. Hydrate area for 5 minutes prior to application if possible. Occlude the area at night. Wash off in morning. Salicylic Acid is used in children over 2 years.</p>', '<p>Do not use other topical preparations on the treated area unless otherwise directed by your healthcare provider. They may interfere with treatment or increase skin irritation.</p>', '<p>It should not be used in any patient known to be sensitive to Salicylic Acid or any other listed ingredients.</p>', '<p>An allergic reaction (shortness of breath, closing of the throat, swelling of the lips, face or tongue or hives) or severe skin irritation.</p>', '<p>Pregnancy Category C. If used by nursing mothers, it should not be used on the chest area to avoid accidental contamination of the child.</p>', '<p>For external use only. Avoid contact with eyes and other mucous membranes.</p>', '<p>An overdose of Salicylic Acid topical is unlikely to occur. If the medication has been ingested or an overdose is suspected, the patient needs to be hospitalized immediately.</p>', '<p>Topical salicylic preparation.</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-19 01:54:03', '2022-03-19 01:54:03'),
(1354, 1354, '<p>This is a topical solution indicated in the treatment of warts, corns and calluses.<br />\r\n<br />\r\nInformation For Patients</p>\r\n\r\n<ul>\r\n	<li><strong>Warts</strong>: A wart is a viral infection of the surface layers of the skin. The incubation period varies from a few weeks to several months. Warts can spread by direct contact with a wart to damaged skin.</li>\r\n	<li><strong>Corns</strong>: A corn is a small, hardened area of skin which often looks yellow compared to the surrounding skin. It is typically round or cone-shaped, pointing down into the skin. Corns most often form on the feet and sometimes on the hands and are caused by constant or repeated friction or pressure.</li>\r\n	<li><strong>Calluses</strong>: A callus is rough, thickened skin spread over a wide area. Like a corn, it is caused by constant or repeated friction or pressure, but unlike corns, calluses are flat and have normal skin markings.</li>\r\n</ul>', '<p>Salicylic acid is a widely used and effective keratolytic, it produces desquamation and destruction of the epithelium by solubilising the intercellular cement of the Stratum Corneum. Lactic acid affects the keratinisation process, reducing hyperkeratosis and is also caustic, leading to the destruction of hyperkeratotic tissue. Collodion is derived from cellulose in a base containing ethanol and ether. It allows easy and accurate application of the product and dries to leave a film which hydrates the tissue and facilitates penetration of the active ingredients.</p>', '<p>Unscrew bottle cap and with the help of brush applicator, apply to the affected areas. &lsquo;Before starting to use this topical solution, unscrew the fitted cap, discard it. Carefully remove the plug away from your body to avoid splashing into eyes/ face and discard it, replace with the brush applicator cap provided in<br />\r\nthe sealed polybag given in the carton. This topical solution should be applied to the affected areas once daily, according to the following instructions:</p>\r\n\r\n<ol>\r\n	<li>Soak affected site in hot water for five minutes.</li>\r\n	<li>Rub surface carefully with pumice stone or emeryboard to remove any hard skin. Dry with your own towel.</li>\r\n	<li>Apply this topical solution using the brush applicator supplied, taking care to avoid contact with normal skin.</li>\r\n	<li>Allow to dry thoroughly and cover with plaster if lesion is large or on the foot to help penetration of active ingredients.</li>\r\n	<li>Continue treatment once daily until the lesion is completely cleared and the ridge lines of the skin have been restored or when the corn can be removed.</li>\r\n	<li>The usual treatment period is 6 to 12 weeks.</li>\r\n</ol>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Not for prolonged use in high concentrations and on large areas of the body. Impaired peripheral circulation or diabetes. Avoid broken skin, mouth, eyes, mucous membranes and anogenital region.</p>', '<p>Stinging, burning, or irritation of the skin,Itching, prolonged use over a large skin area may cause salicylate toxicity, ringing sound in the ears (tinnitus), Diarrhoea, Vomiting.</p>', '<p>Pregnancy Category- Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>This preparation is formulated for the controlled corrosion of keratin and thus care should be taken to apply the product to the affected area only. Do not use on the face or anogenital regions or if you are diabetic or have impaired circulation. Do not use on moles, birthmarks or unusual skin growths. Do not treat warts over large areas at one time, or use on infants and very young children unless on medical advice. For External Use Only.</p>', '<p>Excessive topical use may result in burning, particularly of normal skin. Following excessive topical use, apply emollients as required. Following ingestion, administer copious quantities of water and antacids as required. Ingestion may cause nausea, vomiting and abdominal pain.</p>', '<p>Combined preparations.</p>', '<p>In view of its high inflammability, it is recommended that Salicylic Acid &amp; Lactic Acid be stored in a cool place not exceeding 25&deg;C. Keep away from naked flame. Keep out of reach of children. Since this topical solution is volatile, close the bottle tightly after each use.</p>', NULL, '2022-03-19 02:02:39', '2022-03-19 02:02:39'),
(1355, 1355, '<p>This is indicated in the regular treatment of asthma where use of a combination product (long-acting &beta;2-agonist and inhaled corticosteroid) is appropriate:</p>\r\n\r\n<ul>\r\n	<li>patients not adequately controlled with inhaled corticosteroids and &#39;as needed&#39; inhaled short acting &beta;2-agonist or</li>\r\n	<li>patients already adequately controlled on both inhaled corticosteroid and long-acting &beta;2-agonist.</li>\r\n</ul>', '<p>Salmeterol Xinafoate is a selective, long acting beta-2 agonist used in the treatment of asthma and other forms of diffuse airways obstruction. Fluticasone Propionate is a corticosteroid with mainly glucocorticoid activity. Fluticasone Propionate is stated to exert a topical effect on the lungs without systematic effects at usual dose.<br />\r\n<br />\r\nSalmeterol protects against symptoms, Fluticasone Propionate improves lung function and prevents exacerbations of the condition. This preparation can offer a more convenient regime for patients on concurrent &beta;-agonist and inhaled corticosteroid therapy. The respective mechanisms of action of both drugs are discussed below:<br />\r\n<br />\r\nSalmeterol: Salmeterol is a selective long-acting (12 hour) beta-2-adrenoceptor agonist with a long side chain which binds to the exo-site of the receptor.<br />\r\n<br />\r\nFluticasone Propionate: Fluticasone Propionate given by inhalation at recommended doses has a potent glucocorticoid anti-inflammatory action within the lungs, resulting in reduced symptoms and exacerbaions of asthma, without the adverse effects observed when corticosteroids are administered systemically.</p>', '<p><strong>Inhalation Aerosol</strong>:</p>\r\n\r\n<ul>\r\n	<li>Adults and adolescents 12 years and older: 2 puffs of 25 &micro;g Salmeterol and 50 &micro;g Fluticasone Propionate twice daily or 2 puffs of 25 &micro;g Salmeterol and 125 &micro;g Fluticasone Propionate twice daily or 2 puffs of 25 &micro;g Salmeterol and 250 &micro;g Fluticasone Propionate twice daily.</li>\r\n	<li>Children (4-12 years): 2 puffs of 25 &micro;g salmeterol and 50 &micro;g Fluticasone Propionate twice daily.</li>\r\n</ul>\r\n\r\n<p><strong>Inhalation Powder in Capsule (For Asthma)</strong>:</p>\r\n\r\n<ul>\r\n	<li>Adult and Adolescent (12 Years and Older): Salmeterol 50 &micro;g &amp; Fluticasone 100 &micro;g or&nbsp;Salmeterol&nbsp;50 &micro;g &amp; Fluticasone 250 &micro;g twice daily (morning and evening, approximately 12 hours apart).&nbsp;</li>\r\n	<li>The recommended starting dosages for&nbsp;Salmeterol&nbsp;50 &micro;g &amp; Fluticasone&nbsp;100 &micro;g &amp;&nbsp;Salmeterol&nbsp;50 &micro;g &amp; Fluticasone 250 &micro;g for patients aged 12 years and older are based upon patients asthma severity.&nbsp;</li>\r\n	<li>The maximum recommended dosage is&nbsp;Salmeterol&nbsp;50 &micro;g &amp; Fluticasone 500 &micro;g twice daily.</li>\r\n	<li>Pediatric Patients (4 to 11 Years): For patients with asthma who are not controlled on an inhaled corticosteroid, the dosage is Salmeterol&nbsp;50 &micro;g &amp; Fluticasone&nbsp;100 &micro;g twice daily (morning and evening, approximately 12 hours apart).</li>\r\n</ul>\r\n\r\n<p><strong>Inhalation Powder in Capsule (For COPD)</strong>: Salmeterol 50 &micro;g &amp; Fluticasone 250 &micro;g twice daily (morning and evening, approximately 12 hours apart). Rinsing the mouth after each inhalation is advised.<br />\r\n<br />\r\n<strong>Inhalation Powder in Maxhaler (For Asthma)</strong>: This is a moulded plastic device containing a foil strip with 60 regularly placed blisters containing pre-dispensed inhalation powder. Patients should be made aware that Maxhaler must be used daily for optimum benefit, even when asymptomatic.<br />\r\n<br />\r\nAdults and Adolescents (12 years and older)-</p>\r\n\r\n<ul>\r\n	<li>50/100 Maxhaler: One Inhalation twice daily</li>\r\n	<li>50/250 Maxhaler: One Inhalation twice daily</li>\r\n	<li>50/500 Maxhaler: One Inhalation twice daily</li>\r\n</ul>\r\n\r\n<p>Children (4 years and older)-</p>\r\n\r\n<ul>\r\n	<li>50/100 Maxhaler: One Inhalation twice daily. The maximum licensed dose of fluticasone propionate delivered by this Maxhaler in children is 100 ug twice daily. There are no data available for use of this Maxhaler in children aged under 4 years.</li>\r\n</ul>\r\n\r\n<p><strong>Inhalation Powder in Maxhaler (For COPD)</strong>:</p>\r\n\r\n<ul>\r\n	<li>Maxhaler: One Inhalation twice daily</li>\r\n	<li>Special patient groups: There is no need to adjust the dose in elderly patients or in those with renal impairment. There are no data available for use of this in patients with hepatic impairment.</li>\r\n	<li>Using the Maxhaler: This is a patient friendly, ready to use and easy to grip device. Use as per instructions for use.</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>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>Both non-selective and selective &beta;-blockers should be avoided in patients with asthma, unless there are compelling reasons for their use. Due to the very low plasma concentrations achieved after inhaled dosing clinically significant drug interactions are unlikely. Care should be taken when co-administering known strong CYP3A4 inhibitors (e.g. ketoconazole, ritonavir), as there is potential for increased systemic exposure to Fluticasone Propionate.</p>', '<p>This is contraindicated in patients with a history of hypersensitivity to any of the ingredients.</p>\r\n\r\n<p>&nbsp;</p>', '<p>As this preparation contains Salmeterol and Fluticasone Propionate, the type and severity of adverse reactions associated with each of the compounds may be expected. There is no incidence of additional adverse events following concurrent administration of the two compounds. Adverse events, which have been associated with Salmeterol or Fluticasone Propionate, are given below.<br />\r\n<br />\r\nSalmeterol: The pharmacological side effects of beta-2-agonist treatment, such as tremor, subjective palpitations and headache, have been reported, but tend to be transient and reduce with regular therapy. Cardiac arrhythmia (including atrial fibrillation, supraventricular tachycardia and extra systoles) may occur, usually in susceptible patients. There have been reports of arthralgia and hypersensitivity reactions, including rash, oedema and angioedema. There have been reports of oropharyngeal irritation. There have been rare reports of muscle cramps.<br />\r\n<br />\r\nFluticasone propionate: Hoarseness and candidiasis (thrush) of the mouth and throat can occur in some patients. Cutaneous hypersensitivity reactions have been reported. Rare cases of facial and oropharyngeal oedema have been reported. Both hoarseness and incidence of candidiasis may be relieved by gargling with water after use of Salmeterol/ Fluticasone Propionate Inhaler.</p>', '<p>Administration of drugs during pregnancy and lactation should only be considered if the expected benefit to the mother is greater than any possible risk to the foetus or child. There is insufficient experience of the use of Salmeterol Xinafoate and Fluticasone Propionate in human pregnancy and lactation. There are no data available for human breast milk.</p>', '<p>Consideration should be given to additional corticosteroid therapies, and to including administration of antibiotics if an infection is present. As with all inhaled medication containing corticosteroids, this preparation should be administered with caution in patients with active or quiescent pulmonary tuberculosis. This preparation should be administered with caution in patients with thyrotoxicosis.</p>', NULL, '<p>Long-acting selective &beta;-adrenoceptor stimulants, Respiratory corticosteroids.</p>', '<p>Pressurised canister, do not puncture, break or incinerate even when apparently empty. Avoid storage in direct sunlight or heat. Store below 30&deg;C. Keep away from eyes. Keep away from children.</p>', '<p>Orally inhaled corticosteroids may cause a reduction in growth velocity when administered to paediatric patients. The long-term effects of this reduction including the impact of final adult height are unknown.</p>', '2022-03-19 02:04:41', '2022-03-19 02:04:41'),
(1356, 1356, '<p>Salmon Calcitonin is indicated in Active Paget&#39;s disease in patients who do not respond to alternative treatments or for whom such treatments are not suitable; Hypercalcaemia.</p>', '<p>Calcitonin is a polypeptide hormone produced by the ultimobranchial gland in non-mammalian vertebrates or by the mammalian thyroid parafollicular cells. It inhibits osteoclastic bone resorption and reduces bone turnover. It decreases tubular reabsorption and promotes renal excretion of Ca, Cl, Na, Mg, K and phosphate.</p>', '<p>Intravenous (Adult)-</p>\r\n\r\n<ul>\r\n	<li><strong>Emergency treatment of hypercalcaemia</strong>: Up to 10 u/kg in 500 mL of sodium chloride 0.9% by slow IV infusion over at least 6 hr.</li>\r\n</ul>\r\n\r\n<p>Parenteral (Adult)-</p>\r\n\r\n<ul>\r\n	<li><strong>Adjunct in hypercalcaemia:</strong>&nbsp;SC/IM: 4 u/kg 12 hrly, may increase after 1-2 days to 8 u/kg 12 hrly to max 8 u/kg 6 hrly after 2 days. Alternatively, 100 u every 6-8 hr, increased after 1-2 days to max 400 u every 6-8 hr.</li>\r\n	<li><strong>Paget&#39;s disease of bone:</strong>&nbsp;SC/IM: 50 u 3 times wkly to 100 u/day.</li>\r\n</ul>\r\n\r\n<p>Nasal (Adult)-</p>\r\n\r\n<ul>\r\n	<li><strong>Nasal postmenopausal osteoporosis:</strong>&nbsp;200 u/day, alternation nostrils everyday.</li>\r\n</ul>', '<p>Concurrent use wth cardiac glycosides (e.g. digitalis) or Ca-channel blockers requires dosage adjustments of these drugs. May decrease serum concentration of lithium.</p>', '<p>Hypersensitivity. Patients with hypocalcaemia.</p>', '<p>GI disturbances, dizziness, flushing, tingling of the hands, unpleasant taste, skin rash, abdominal pain, urinary frequency, tremor, inj site inflammation. Rarely, diabetogenic effect.</p>', '<p>Pregnancy&nbsp;Category C.&nbsp;Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Skin test should be done before initiating therapy. Heart failure; renal impairment. Pregnancy, lactation, childn.</p>', '<p><strong>Symptoms</strong>: Flushing, nausea, vomiting and dizziness.<br />\r\n<strong>Management</strong>: Symptomatic and supportive treatment.</p>', '<p>Hormone in bone formation by Inhibiting bone resorption</p>', '<p>Store between 2-8&deg; C.</p>', '<p><strong>Renal Impairment:</strong>&nbsp;Dosage adjustment needed.</p>', '2022-03-19 05:00:42', '2022-03-19 05:05:37'),
(1357, 1357, '<p>Salsalate is indicated for relief of the signs and symptoms of rheumatoid arthritis, osteoarthritis&nbsp;and related rheumatic disorders, pain, fever and inflammation.</p>', '<p>The mode of anti-inflammatory action of salsalate and other nonsteroidal anti-inflammatory drugs is not fully defined, but appears to be primarily associated with inhibition of prostaglandin synthesis. This inhibition of prostaglandin synthesis is done through the inactivation of cyclooxygenase-1 (COX-1) and COX-2, which are reponsible for catalyzing the formation of prostaglandins in the arachidonic acid pathway. Although salicylic acid (the primary metabolite of salsalate) is a weak inhibitor of prostaglandin synthesis in vitro, salsalate appears to selectively inhibit prostaglandin synthesis in vivo, providing anti-inflammatory activity equivalent to aspirin and indomethacin. Unlike aspirin, salsalate does not inhibit platelet aggregation.</p>', '<p><strong>Adults</strong>: The usual dosage is 3000 mg daily, given in divided doses as follows:</p>\r\n\r\n<ul>\r\n	<li>Two doses of two 750 mg tablets</li>\r\n	<li>Two doses of three 500 mg tablets/capsules&nbsp;</li>\r\n	<li>Three doses of two 500 mg tablets/capsules</li>\r\n</ul>\r\n\r\n<p>Some patients, e.g., the elderly, may require a lower dosage to achieve therapeutic blood concentrations and to avoid the more common side effects such as auditory.<br />\r\n<br />\r\nAlleviation of symptoms is gradual, and full benefit may not be evident for 3 to 4 days, when&nbsp;plasma&nbsp;salicylate levels have achieved steady state. There is no evidence for development of tissue tolerance (tachyphylaxis) but salicylate therapy may induce increased activity of metabolizing liver enzymes, causing a greater rate of salicyluric acid production and excretion, with a resultant increase in dosage requirement for maintenance of therapeutic&nbsp;serum&nbsp;salicylate levels.<br />\r\n<br />\r\n<strong>Children</strong>: Dosage recommendations and indications for Salsalate use in children 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>Should be taken with food. Take with food or milk.</p>', '<p>May increase risk of liver damage when used with gold compounds. GI effects may be enhanced with alcohol or concurrent use with corticosteroids. May increase activity of coumarin anticoagulants, sulfonylureas, zafirlukast, methotrexate, phenytoin and valproate. May decrease the activity of probenecid and sulfinpyrazone.</p>', '<p>Haemophilia, haemorrhagic disorders, gout, hypersensitivity to aspirin or NSAIDs. Children &lt;12 yr. Pregnancy (3rd trimester) and lactation. Severe renal or hepatic impairment.</p>', '<p>GI symptoms, hypersensitivity reactions, skin eruptions, angioedema, weakness, rhinitis and dyspnoea, hypoprothrombinaemia. Hepatotoxicity, renal impairment, iron-deficiency anaemia, occult bleeding. Local irritation (rectally); Reye&#39;s syndrome.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C. Salsalate and salicylic acid have been shown to be&nbsp;teratogenic&nbsp;and embryocidal in rats when given in doses 4 to 5 times the usual human dose. The effects were not observed at doses twice as great as the usual human dose. There are no adequate and well-controlled studies in&nbsp;pregnantwomen. Salsalate should be used during pregnancy only if the potential benefit justifies the potential risk to the&nbsp;fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether salsalate per se is excreted in human milk; salicylic acid, the primary metabolite of Salsalate , has been shown to appear in human milk in concentrations approximating the maternal&nbsp;blood&nbsp;level. Thus, the infant of a mother on Salsalate&nbsp;therapy&nbsp;might ingest in mother&dagger;s milk 30 to 80% as much salicylate per kg body weight as the mother is taking. Accordingly, caution should be exercised when Salsalate is administered to a nursing woman.</p>', '<p>Peptic ulcers; asthma, allergic disorders. Impaired hepatic or renal function. Dehydrated patients; uncontrolled hypertension. May cause acute haemolytic anaemia in patients with G6PD deficiency.</p>', '<p><strong>Symptoms</strong>: Tinnitus,&nbsp;vertigo, headache, confusion, drowsiness, sweating, hyperventilation, vomiting and&nbsp;diarrhea will occur. More severe intoxication will lead to disruption of&nbsp;electrolyte&nbsp;balance and&nbsp;blood pH, and hyperthermia and dehydration.<br />\r\n<br />\r\n<strong>Treatment</strong>: Further&nbsp;absorption&nbsp;of Salsalate from the G.I. tract should be prevented by emesis (syrup of&nbsp;ipecac) and if necessary, by gastric lavage. Fluid and electrolyte imbalance should be corrected by the administration of appropriate I.V. therapy. Adequate renal function should be maintained. Hemodialysis or&nbsp;peritoneal dialysis&nbsp;may be required in extreme cases.</p>', '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)</p>', NULL, NULL, '2022-03-20 03:22:03', '2022-03-20 03:22:03'),
(1358, 1358, '<p>Preventive action in providing daily intimate hygiene, specific for the young and middle aged woman. Intimate care wash with Salvia officinalis. This is indicated for daily intimate hygiene.</p>', '<p>Because it has a specific pH of 3.5 intimate wash with Salvia officinalis, it helps prevent alterations of the vaginal ecosystem, with deodorant actions.</p>', NULL, NULL, '<p>Hypersensitivity to the active substance or to any of the excipients.</p>', NULL, NULL, NULL, NULL, '<p>Miscellaneous topical agents</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-20 03:23:12', '2022-03-20 03:23:12'),
(1359, 1359, '<p>Saquinavir is an HIV-1 protease inhibitor indicated for the treatment of HIV1 infection in combination with ritonavir and other antiretroviral agents in adults (over the age of 16 years).</p>', '<p>Saquinavir is a protease inhibitor with activity against Human Immunodeficiency Virus Type 1 (HIV-1). Protease inhibitors block the part of HIV called protease. HIV-1 protease is an enzyme required for the proteolytic cleavage of the viral polyprotein precursors into the individual functional proteins found in infectious HIV-1. Saquinavir binds to the protease active site and inhibits the activity of the enzyme. This inhibition prevents cleavage of the viral polyproteins resulting in the formation of immature non-infectious viral particles. Protease inhibitors are almost always used in combination with at least two other anti-HIV drugs.&nbsp;<br />\r\n<br />\r\nSaquinavir inhibits the HIV viral proteinase enzyme which prevents cleavage of the gag-pol polyprotein, resulting in noninfectious, immature viral particles.</p>', '<p>Saquinavir must be administered in combination with ritonavir.<br />\r\n<br />\r\n<strong>Adults (over the age of 16 years)</strong>: Saquinavir 1000 mg twice daily (5x200 mg capsules or 2x500 mg tablets) in combination with ritonavir 100 mg twice daily.<br />\r\n<br />\r\nSaquinavir and ritonavir should be taken within 2 hours after a meal.</p>', '<p>Saquinavir/ritonavir is a potent inhibitor of CYP3A, significantly increasing the exposure of drugs primarily metabolized by CYP3A.<br />\r\n<br />\r\nCoadministration of Saquinavir/ritonavir with drugs that induce CYP3A may result in decreased plasma concentrations of saquinavir and reduced efficacy.<br />\r\n<br />\r\nCertain drugs or drug classes should not be coadministered with Saquinavir/ritonavir based on drug interaction studies or predicted drug interactions.</p>', '<p>Patients with congenital or documented acquired QT prolongation, patients with refractory hypokalemia or hypomagnesemia, or those on concomitant therapy with other drugs that prolong the QT interval.<br />\r\n<br />\r\nSaquinavir is contraindicated in patients with complete atrioventricular (AV) block without implanted pacemakers, or patients who are at high risk of complete AV block.<br />\r\n<br />\r\nSaquinavir is contraindicated in patients with clinically significant hypersensitivity (e.g., anaphylactic reaction, Stevens-Johnson syndrome) to saquinavir, saquinavir mesylate, or any of its ingredients<br />\r\n<br />\r\nSaquinavir when administered with ritonavir is contraindicated in patients with severe hepatic impairment.<br />\r\n<br />\r\nCoadministration of Saquinavir/ritonavir with CYP3A substrates for which increased plasma levels may result in serious or life-threatening reactions.<br />\r\n<br />\r\nCoadministration of Saquinavir/ritonavir with rifampin due to the risk of severe hepatotoxicity.</p>', '<p>The most common adverse reactions are nausea, vomiting, diarrhea, fatigue, pneumonia, lipodystrophy and abdominal pain.</p>', '<p><strong>Pregnancy</strong>: Use during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: Do not breastfeed if HIV-1-infected mothers are receiving Saquinavir therapy.</p>', NULL, NULL, '<p>Anti-viral drugs</p>', '<p>The capsules and tablets should be stored at 25 degree C.</p>', '<p><strong>Pediatric Use</strong>: Pediatric dose recommendations that are both reliably effective and below thresholds of concern with respect to QT and PR prolongation could not be determined<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Caution should be exercised due to greater frequency of decreased hepatic, renal or cardiac function in elderly population.<br />\r\n<br />\r\n<strong>Impaired Renal Function</strong>: No initial dose adjustment is necessary for patients with renal impairment.<br />\r\n<br />\r\n<strong>Impaired Hepatic Function</strong>: No dose adjustment is necessary for patients with mild or moderate hepatic impairment.</p>', '2022-03-20 03:38:04', '2022-03-20 03:38:04'),
(1360, 1360, '<p><strong>Monotherapy And Combination Therapy:&nbsp;</strong>Saxagliptin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus<br />\r\n<br />\r\n<strong>Limitation Of Use</strong>: Saxagliptin is not indicated for the treatment of&nbsp;type 1 diabetes&nbsp;mellitus or&nbsp;diabetic ketoacidosis, as it would not be effective in these settings.</p>', '<p>Saxagliptin inhibits dipeptidyl peptidase IV (DPP-IV) enzyme resulting in prolonged active incretin levels. It elevates the circulating levels of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) which stimulates insulin secretion in pancreatic &beta;-cells in a glucose dependent manner. It improves glycaemic control by reducing fasting and postprandial plasma glucose concentration in patients w/ type 2 DM.</p>', '<p><strong>Recommended Dosage</strong>: The recommended dosage of Saxagliptin is 2.5 mg or 5 mg once daily taken regardless of meals. Saxagliptin tablets must not be split or cut.<br />\r\n<br />\r\n<strong>Dosage In Patients With Renal Impairment</strong>: No dosage adjustment for Saxagliptin is recommended for patients with mild renal impairment (CrCl &gt;50 mL/min).<br />\r\n<br />\r\nThe dosage of Saxagliptin is 2.5 mg once daily (regardless of meals) for patients with moderate or severe renal impairment, or with end-stage renal disease (ESRD) requiring hemodialysis (CrCl &le; 50 mL/min). Saxagliptin should be administered following hemodialysis. Saxagliptin has not been studied in patients undergoing&nbsp;peritoneal dialysis.<br />\r\n<br />\r\nBecause the dosage of Saxagliptin should be limited to 2.5 mg based upon renal function, assessment of renal function is recommended prior to initiation of Saxagliptin and periodically thereafter. Renal function can be estimated from serum creatinine using the Cockcroft-Gault formula or Modification of Diet in Renal Disease formula.<br />\r\n<br />\r\n<strong>Dosage Adjustment With Concomitant Use Of Strong CYP3A4/5 Inhibitors</strong>: The dosage of Saxagliptin is 2.5 mg once daily when coadministered with strong cytochrome P450 3A4/5 (CYP3A4/5) inhibitors (e.g., ketoconazole, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, ritonavir, saquinavir, and telithromycin)&nbsp;<br />\r\n<br />\r\nConcomitant Use With An Insulin Secretagogue (e.g., Sulfonylurea) Or With Insulin When Saxagliptin is used in combination with an&nbsp;insulin&nbsp;secretagogue (e.g.,&nbsp;sulfonylurea) or with insulin, a lower dose of the insulin secretagogue or insulin may be required to minimize the risk of&nbsp;hypoglycemia</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>Increased risk of hypoglycaemia with concomitant sulfonylureas, dose reduction may be necessary. Increased serum levels with CYP3A4/5 inhibitors (e.g. atazanavir, ketoconazole, nefazodone, ritonavir). Concomitant CYP3A4 inducers (e.g. carbamazepine, phenobarbital) may reduce the glycaemic lowering effect of saxagliptin.</p>', '<p>Type 1 diabetes, diabetic ketoacidosis.</p>', '<p>The following serious adverse reactions are described below or elsewhere in the prescribing information: Pancreatitis, Heart Failure, Hypoglycemia&nbsp;with Concomitant Use of&nbsp;Sulfonylurea&nbsp;or&nbsp;Insulin, Hypersensitivity Reactions, Severe and disabling&nbsp;arthralgia, Bullous pemphigoid.</p>', '<p><strong>Category B</strong>: 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>Moderate and severe renal impairment. Pregnancy and lactation.</p>', NULL, '<p>Dipeptidyl Peptidase-4 (DPP-4) inhibitor.</p>', '<p>Store between 20-25&deg; C.</p>', '<p><strong>Mild Renal Impairment:</strong>&nbsp;No dosage adjustment needed.<br />\r\n<br />\r\n<strong>Moderate to Severe including with ESRD requiring hemodialysis</strong>: 2.5 mg once daily.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>&nbsp;No dosage adjustment.</p>', '2022-03-20 03:40:10', '2022-03-20 03:40:10'),
(1361, 1361, '<p>Secnidazole is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Intestinal Amoebiasis</li>\r\n	<li>Hepatic Amoebiasis</li>\r\n	<li>Urethritis and vaginitis due to Trichomonas vaginalis</li>\r\n	<li>Giardiasis</li>\r\n</ul>', '<p>Secnidazole is rapidly absorbed following oral administration. The maximum serum level is obtained after 3 hours following oral administration of 2 gm Secnidazole. The plasma elimination half-life is about 20 hours. The majority of Secnidazole is eliminated via urine (50% of the ingested dose is excreted within 120 hours). The pharmacokinetic profile of Secnidazole gives it the longest half-life of second-generation nitroimidazoles, ensuring 72-hour therapeutic blood levels from a 2 gm single dose.</p>', '<p>Secnidazole tablet should be administered orally. The dosage schedule of is mentioned below:<br />\r\n<br />\r\nAcute Intestinal Amoebiasis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 2 gm single dose, taken preferably just before meal.</li>\r\n	<li><strong>Children</strong>: 30 mg/kg single dose, taken preferably just before meal.</li>\r\n</ul>\r\n\r\n<p>Asymptomatic Amoebiasis (minute&amp; cystic form):</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 2 gm once daily for only 3 days, taken preferably just before meal.</li>\r\n	<li><strong>Children</strong>: 30 mg/kg once daily for only 3 days, taken preferably just before meal.</li>\r\n</ul>\r\n\r\n<p>Hepatic Amoebiasis: Evacuation of pus must be performed simultaneously with Secnidazole treatment at the suppurative stage of hepatic amoebiasis.</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 1.50 gm/day in a single or divided doses, just before meal, for 5 days.</li>\r\n	<li><strong>Children</strong>: 30 mg/kg/day, in a single or divided dose, just before meal, for 5 days.</li>\r\n</ul>\r\n\r\n<p>Giardiasis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 2 gm single dose, taken preferably just before meal.</li>\r\n	<li><strong>Children</strong>: 35-50 mg/kg single dose, taken preferably just before meal.</li>\r\n</ul>\r\n\r\n<p>Trichomoniasis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 2 gm single dose, taken preferably just before meal. The partner should also receive the same treatment concomitantly.</li>\r\n</ul>', '<p>Administration of Secnidazole with disulfiram is not recommended: confusional state &amp; paranoid reaction may occur.<br />\r\n<br />\r\nUse of Secnidazole simultaneously with warfarin requires close monitoring: increased effect or oral anticoagulants and of the hemormagic risk is likely.</p>', '<p>Secnidazole is contra-indicated for those patients who are hypersensitive to imidazole derivatives.</p>', '<p>The clinical studies have shown that Secnidazole is characterized by very good tolerance and no serious adverse reactions have been reported to date. The following side-effects may be observed with Secnidazole as with all nitroimidazole derivatives &amp; are rarely serious:</p>\r\n\r\n<ul>\r\n	<li><strong>Most frequent side-effects</strong>: Gastrointestinal disturbances, nausea, epigastric pain, metallic taste, glossitis, stomatitis.</li>\r\n	<li><strong>Occasional side effects</strong>: Urticaria, moderate leukopenia which is reversible on treatment discontinuation.</li>\r\n	<li><strong>Rare side-effects</strong>: Vertigo, ataxia and motor incoordination, paresthesia, peripheral neuropathy. With Secnidazole, gastrointestinal disorders e.g. nausea, vomiting, eoigastric pain, etc., have been reported in very rare cases.</li>\r\n</ul>', '<p>Secnidazole may be prescribed in pregnancy after the first trimester. As with other similar drugs, Secnidazole should not be administered during the first trimester of pregnancy or during lactation because Secnidazoleis found in the placenta and breast milk.</p>', '<p>Patients should be advised not to take alcohol during treatment with Secnidazole (because of the possibility of antabuse effect). Administration of Secnidazoleshould be avoided to patients with a history of blood dyscrasia.</p>', NULL, '<p>Amoebicides, Anti-diarrhoeal Antiprotozoal.</p>', '<p>Store in a cool, dry place,protected from heat.</p>', NULL, '2022-03-20 03:41:42', '2022-03-20 03:41:42'),
(1362, 1362, '<p>Secukinumab is a human interleukin-17A antagonist indicated for the treatment of:</p>\r\n\r\n<ul>\r\n	<li>Moderate to severe plaque psoriasis in adult patients who are candidates for systemic therapy or phototherapy</li>\r\n	<li>Adults with active psoriatic arthritis (PsA)</li>\r\n	<li>Adults with active ankylosing spondylitis (AS)</li>\r\n</ul>', '<p>Secukinumab is a human monoclonal antibody that targets IL-17A cytokine to downregulate inflammation in psoriasis, an autoimmune dermatological disease. The pathophysiology of psoriasis has not been fully established, however it is known that dysregulation of innate and adaptive immune responses plays part in the chronic inflammation associated with the disease. IL-17 represents is a six-membered family (IL-17A to F) of pleiotropic pro-inflammatory cytokines, expression of which is found to be elevated in psoriatic skin. These cytokines act on many different cell types and provide defense against different extracellular pathogens causing fungal or bacterial infections. IL-17 cytokines are produced by many cells involved in immune system defense, such as Th17, mast cells, neutrophils, and dendritic cells - all implicated in promoting inflammation. There is evidence linking IL-17 to pathogenesis of multiple autoimmune diseases including rheumatoid arthritis, spondyloarthritis, psoriasis, Crohn&#39;s disease, multiple sclerosis, and even atherosclerosis.</p>', '<p><strong>Plaque Psoriasis-</strong><br />\r\n<br />\r\n1. Recommended dosage is 300 mg by subcutaneous injection at Weeks 0, 1, 2, 3, and 4 followed by 300 mg every 4 weeks. For some patients, a dose of 150 mg may be acceptable.<br />\r\n<br />\r\n<strong>Psoriatic Arthritis-</strong><br />\r\n<br />\r\n1. For psoriatic arthritis patients with coexistent moderate to severe plaque psoriasis, use the dosage and administration for plaque psoriasis.<br />\r\n<br />\r\n2. For other psoriatic arthritis patients administer with or without a loading dosage. The recommended dosage:</p>\r\n\r\n<ul>\r\n	<li>With a loading dosage is 150 mg at weeks 0, 1, 2, 3, and 4 and every 4 weeks thereafter</li>\r\n	<li>Without a loading dosage is 150 mg every 4 weeks</li>\r\n	<li>If a patient continues to have active psoriatic arthritis, consider a dosage of 300 mg.</li>\r\n</ul>\r\n\r\n<p><br />\r\n<strong>Ankylosing Spondylitis-</strong><br />\r\n<br />\r\n1. Administer with or without a loading dosage. The recommended dosage:</p>\r\n\r\n<ul>\r\n	<li>With a loading dosage is 150 mg at weeks 0, 1, 2, 3, and 4 and every 4 weeks thereafter</li>\r\n	<li>Without a loading dosage is 150 mg every 4 weeks</li>\r\n</ul>', '<p>Live vaccines should not be given with Secukinumab.</p>', '<p>Serious hypersensitivity reaction to secukinumab or to any of the excipients.</p>', '<p>Most common adverse reactions (greater than 1%) are nasopharyngitis, diarrhea, and upper respiratory tract infection.</p>', '<p><strong>Pregnancy</strong>: Limited available human data with secukinumab use in pregnant women are insufficient to inform a drug associated risk of adverse developmental outcomes. In an embryo-fetal development study, no adverse developmental effects were observed in infants born to pregnant monkeys after subcutaneous administration of secukinumab during organogenesis at doses up to 30 times the maximum recommended human dose<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether secukinumab is excreted in human milk or absorbed systemically after ingestion. There are no data on the effects of secukinumab on the breastfed child or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for secukinumab and any potential adverse effects on the breastfed child from secukinumab or from the underlying maternal condition.</p>', '<p><strong>Infections</strong>: Serious infections have occurred. Caution should be exercised when considering the use of secukinumab in patients with a chronic infection or a history of recurrent infection. If a serious infection develops, discontinue secukinumab until the infection resolves.<br />\r\n<br />\r\n<strong>Tuberculosis (TB)</strong>: Prior to initiating treatment with secukinumab, evaluate for TB.<br />\r\n<br />\r\n<strong>Inflammatory Bowel Disease</strong>: Cases of inflammatory bowel disease were observed in clinical trials. Caution should be exercised when prescribing secukinumab to patients with inflammatory bowel disease.<br />\r\n<br />\r\n<strong>Hypersensitivity Reactions</strong>: If an anaphylactic reaction or other serious allergic reaction occurs, discontinue secukinumab immediately and initiate appropriate therapy.</p>', '<p>Doses up to 30 mg/kg intravenously have been administered in clinical trials without dose-limiting toxicity. In the event of overdosage, it is recommended that the patient be monitored for any signs or symptoms of adverse reactions and appropriate symptomatic treatment be instituted immediately.</p>', '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis.</p>', '<p>Secukinumab Sensoready pens, prefilled syringes and vials must be refrigerated at 2&ordm;C to 8&ordm;C. Keep the product in the original carton to protect from light until the time of use. Do not freeze. To avoid foaming do not shake. Secukinumab does not contain a preservative; discard any unused portion.</p>', NULL, '2022-03-20 03:43:26', '2022-03-20 03:43:26'),
(1363, 1363, '<p>Selegiline is indicated as an adjunct in the management of Parkinsonian patients being treated with levodopa/carbidopa who exhibit deterioration in the quality of their response to this therapy. There is no evidence from controlled studies that selegiline has any beneficial effect in the absence of concurrent levodopa therapy.<br />\r\n<br />\r\nEvidence supporting this claim was obtained in randomized controlled clinical investigations that compared the effects of added selegiline or placebo in patients receiving levodopa/carbidopa. Selegiline was significantly superior to placebo on all three principal outcome measures employed: change from baseline in daily levodopa/carbidopa dose, the amount of &#39;off&#39; time, and patient selfrating of treatment success. Beneficial effects were also observed on other measures of treatment success (e.g., measures of reduced end of dose akinesia, decreased tremor and sialorrhea, improved speech and dressing ability and improved overall disability as assessed by walking and comparison to previous state).</p>', '<p>Although the mechanisms for selegiline&#39;s beneficial action in the treatment of Parkinson&#39;s disease are not fully understood, the selective, irreversible inhibition of monoamine oxidase type B (MAO-B) is thought to be of primary importance. MAO-B is involved in the oxidative deamination of dopamine in the brain. Selegiline binds to MAO-B within the nigrostriatal pathways in the central nervous system, thus blocking microsomal metabolism of dopamine and enhancing the dopaminergic activity in the substantial nigra. Selegiline may also increase dopaminergic activity through mechanisms other than inhibition of MAO-B. At higher doses, selegiline can also inhibit monozmine oxidase type A (MAO-A), allowing it to be used for the treatment of depression.</p>', '<p>Selegiline Hydrochloride is intended for administration to Parkinsonian patients receiving levodopa/carbidopa therapy who demonstrate a deteriorating response to this treatment. The recommended regimen for the administration of Selegiline Hydrochloride is 10 mg per day administered as divided doses of 5 mg each taken at breakfast and lunch. There is no evidence that additional benefit will be obtained from the administration of higher doses. Moreover, higher doses should ordinarily be avoided because of the increased risk of side effects.<br />\r\n<br />\r\nAfter two to three days of selegiline treatment, an attempt may be made to reduce the dose of levodopa/carbidopa. A reduction of 10 to 30% was achieved with the typical participant in the domestic placebo controlled trials who was assigned to selegiline treatment. Further reductions of levodopa/carbidopa may be possible during continued selegiline therapy.</p>', NULL, '<p>Selegiline is contraindicated in patients with a known hypersensitivity to this drug. Selegiline is contraindicated for use with meperidine. This contraindication is often extended to other opioids.</p>', NULL, '<p><strong>Pregnancy</strong>&nbsp;Category C. No teratogenic effects were observed in a study of embryo-fetal development in Sprague-Dawley rats at oral doses of 4, 12, and 36 mg/kg or 4, 12 and 35 times the human therapeutic dose on a mg/m2 basis.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether selegiline hydrochloride is excreted in human milk. Because many drugs are excreted in human milk, consideration should be given to discontinuing the use of all but absolutely essential drug treatments in nursing women.</p>', '<p>Some patients given selegiline may experience an exacerbation of levodopa associated side effects, presumably due to the increased amounts of dopamine reaction with super sensitive, post-synaptic receptors. These effects may often be mitigated by reducing the dose of levodopa/carbidopa by approximately 10 to 30%.<br />\r\n<br />\r\nThe decision to prescribe selegiline should take into consideration that the MAO system of enzymes is complex and incompletely understood and there is only a limited amount of carefully documented clinical experience with selegiline. Consequently, the full spectrum of possible responses to selegiline may not have been observed in pre-marketing evaluation of the drug. It is advisable, therefore, to observe patients closely for atypical responses.</p>', NULL, '<p>Antiparkinson drugs.</p>', NULL, '<p><strong>Renal Impairment</strong>: No pharmacokinetic information is available on selegiline or its metabolites in renally impaired subjects.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No pharmacokinetic information is available on selegiline or its metabolites in hepatically impaired subjects.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: The effects of selegiline hydrochloride in children have not been evaluated.</p>', '2022-03-20 03:44:59', '2022-03-20 03:44:59');

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
(1374, 1374, '<p>Sibutramine is used in the management of obesity, including weight loss and management of weight loss. It should be used in conjunction with a reduced caloric diet. Sibutramine is recommended for obese patients with&nbsp;an initial body mass index (BMI) &ge;30 kg/m2&nbsp;or &ge;27 kg/m2&nbsp;in the presence of other risk factors (e.g., hypertension, diabetes, dyslipidemia).</p>', '<p>Sibutramine produces its therapeutic effect by norepinephrine, serotonin and dopamine reuptake inhibition. Sibutramine exerts its pharmacological actions predominantly via its secondary (M1) and primary (M2) amine metabolites. The parent compound Sibutramine is a potent inhibitor of serotonin and norepinephrine reuptake in vivo. However metabolites M1 and M2 inhibit the reuptake of these neurotransmitters both in vivo and in vitro.</p>', '<p>The recommended starting dose is 10 mg administered once daily with or without food. If there is inadequate weight loss, the dose may be titrated after 4 weeks to a total of 15 mg once daily. The 5 mg dose should be reserved for patients who do not tolerate the 10 mg dose. Blood pressure and heart rate changes should be taken into account when making decisions regarding dose titration. Analysis of numerous variables has indicated that &asymp; 60% of patients who lose at least 4 lbs in the first 4 weeks of treatment with a given dose of Sibutramine in combination with a reduced-calorie diet lose at least 5% (placebo-subtracted) of their initial body weight by the end of 6 months to 1 year of treatment on that dose. Conversely, &asymp; 80% of patients who do not lose at least 4 lbs in the first 4 weeks of treatment with a given dose do not lose at least 5% (placebo-subtracted) of their initial body weight by the end of 6 months to 1 year of treatment on that dose. If a patient has not lost at least 4 lbs in the first 4 weeks of treatment, consider reevaluation of therapy which may include increasing the dose or discontinuing Sibutramine. The safety and efficacy of Sibutramine have not been determined beyond 1 year at this time.</p>', '<p>Sibutramine should not be given concurrently with, or within at least two weeks of stopping an MAOI; at least two weeks should elapse between discontinuation of Sibutramine and starting therapy with an MAOI. There is a risk of the serotonin syndrome developing if Sibutramine is administered together with other serotonergic drug such as selective serotonin reuptake inhibitors (SSRIs), sumatriptan, lithium, pethidine, fentanyl, dextromethorphan and pentazocine. Sibutramine should not be used with other drugs that may increase heart rate or blood pressure such as ephedrine, phenylpropanolamine, and pseudoephedrine (which may be ingredients of some cough and cold remedies). Alcohol should be avoided. Inhibitors of the cytochrome P450 isoenzyme CYP3A4, such as ketoconazole and erythromycin, may increase plasma concentrations of Sibutramine.</p>', '<p>Patients receiving monoamine oxidase inhibitors (MAOIs), hypersensitivity to Sibutramine or any of the active ingredients of Sibutramine; patients with anorexia nervosa, patients taking other centrally acting appetite-suppressant drugs. Give with caution to those patients with a history of hypertension and do not give to patients with uncontrolled or&nbsp; poorly controlled hypertension.</p>', '<p>Commonly reported side-effects of Sibutramine are dry mouth, headache, insomnia and constipation; diarrhoea, dizziness, drowsiness and rhinitis&nbsp;have also occurred. Less frequently reported side-effects include dysmenorrhoea, oedema, influenza-like symptoms, and depression. Abnormal bleeding, acute interstitial nephritis, emotional lability, migraine, seizures and skin rashes have been reported rarely. Clinically significant increases in heart rate and blood pressure may occur. Sibutramine may decrease salivary flow and therefore increase the risk of dental caries, periodontal disease, or other oral disorders. It may also produce mydriasis. Increases in liver enzyme have been reported.</p>', '<p>The use of Sibutramine is not recommended during pregnancy. Women of child-bearing potential should use adequate contraception while taking this drug. Patients should be advised to notify their physician if they become pregnant or intend to become pregnant during therapy. It is not known whether Sibutramine or its active metabolites are excreted in breast milk. It is not recommended for use in nursing mothers. Patients should be advised to notify their physician if they are breast-feeding.</p>', '<p>Use caution when prescribing Sibutramine with other agents that may raise blood pressure or heart rate including certain decongestant, cough, cold and allergy medications that contain agents such as phenylpropanolamine, ephedrine or pseudoephedrine.</p>', NULL, '<p>Appetite suppressant drugs/Anti-obesity drugs</p>', '<p>Should be protected from light. Store in a dry place and between 15˚ to 30˚C temperature.</p>', NULL, '2022-03-20 04:35:23', '2022-03-20 04:35:23'),
(1375, 1375, '<p>Sildenafil is indicated for the treatment of erectile dysfunction.</p>', '<p>Sildenafil is a selective inhibitor of cyclic Guanosine Monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5) used for treatment of erectile dysfunction. Danafil (Sildenafil) enhances the effect of nitric oxide (NO) by inhibiting phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum that results in smooth muscle relaxation and inflow of blood to the corpus cavernosum.</p>', '<p>The recommended dose of Sildenafil is 50 mg taken approximately 1 hour before sexual activity. However, Sildenafil may be taken anywhere from half an hour to 4 hours before sexual activity. Based on effectiveness and toleration, the dose may be increased to a maximum 100 mg or decreased to 25 mg. The maximum recommended dosing frequency is once per day.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Administration</p>\r\n\r\n<p>Sildenafil&nbsp;may takes longer time to work if you take it with a heavy meal.</p>', '<p>Concomitant use of Sildenafil with organic nitrates for angina may cause hypotension. Cimetidine, a medicine used to treat gastric ulcers, some antibiotics including Erythromycin and Rifampicin, some protease inhibitors such as Ritonavir and Saquinavir for the treatment of HIV infection may increase the plasma concentration of Sildenafil. Some medicines used to treat fungal infections including Ketoconazole and Itraconazole may reduce the clearance of Sildenafil.</p>', '<p>Sildenafil is contraindicated in patient with hypersensitivity to any component of this medication. Sildenafil potentiates the hypotensive effects of nitrates, so it is contraindicated in patients who are using organic nitrates, either regularly or intermittently.</p>', '<p>The adverse effects treated with Sildenafil are headache, flushing, dyspepsia, nasal congestion, urinary tract infection, abnormal vision, diarrhea, dizziness and rash.</p>', '<p>Pregnancy category B. There are no adequate and well-controlled studies of Sildenafil in pregnant women. Sildenafil is not indicated for use by women. In animal study shows that Sildenafil has no evidence of teratogenicity or embryotoxicity.</p>', '<p>Caution should be exercised if patients have any allergies to any other medicines or any other substances such as foods, preservatives or dyes, heart or blood vessel problems, sudden loss of eyesight in one or both eyes. Caution should be taken if patients have any of the following medical conditions such as diabetes, kidney or liver problems, leukaemia, multiple myeloma, any disease or deformity of penis, any bleeding disorder such as haemophilia, stomach ulcer, sickle cell anaemia, color vision problems, sudden decrease or loss of hearing or receiving any other treatment for impotence.</p>', NULL, '<p>Drugs for Erectile Dysfunction.</p>', '<p>Keep in a dry place, away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-20 04:36:51', '2022-03-20 04:36:51'),
(1376, 1376, '<p>Silodosin, a selective alpha-1 adrenergic receptor antagonist, is indicated for the treatment of the signs and symptoms of benign prostatic hyperplasia (BPH). Silodosin is not indicated for the treatment of hypertension.</p>\r\n\r\n<ul>\r\n	<li>Highly effective for the treatment of Benign Prostatic Hyperplasia.</li>\r\n	<li>Highest uroselectivity to alpha-1 adrenergic receptor.</li>\r\n	<li>Effective treatment option for BPH who are not responding to Tamsulosin.</li>\r\n	<li>Dose not cause Orthostatic hypotension.</li>\r\n	<li>Convenient once-daily dosing.</li>\r\n</ul>', '<p>Silodosin is a selective antagonist of post-synaptic alpha-1 adrenoreceptors, which are located in the human prostate, bladder base, bladder neck, prostatic capsule and prostatic urethra. Blockade of these alpha-1 adrenoreceptors can cause smooth muscle in these tissues to relax, resulting in an improvement in urine flow and a reduction in BPH symptoms.</p>', '<p>The recommended dose is Silodosin 8 mg orally once daily with a meal.&nbsp;4 mg capsules taken orally once daily with a meal for those with moderate renal impairment (CrCl 30-50 mL/min).</p>', '<p>Strong P-glycoprotein inhibitors (e.g., cyclosporine): Co-administration may increase plasma Silodosin concentration. Concomitant use of PDE5 inhibitors with alpha-blockers including Silodosin can potentially cause symptomatic hypotension.</p>', '<p>Patients with severe renal &amp; hepatic impairment, concomitant administration with strong Cytochrome P450 3A4 (CYP3A4) inhibitors (e.g., ketoconazole, clarithromycin, itraconazole, ritonavir) and patients with a history of hypersensitivity to Silodosin.</p>', '<p>Most common adverse reactions are retrograde ejaculation, dizziness, diarrhea, orthostatic hypotension, headache, nasopharyngitis and nasal congestion.</p>', '<p>Pregnancy Category B. Silodosin is not indicated for use in women. An embryo/fetal study in rabbits showed decreased maternal body weight at 200 mg/kg/day (approximately 13-25 times the maximum recommended human exposure or MRHE of Silodosin via AUC). No statistically significant teratogenicity was observed at this dose. Silodosin was not teratogenic when administered to pregnant rats during organogenesis at 1000 mg/kg/day (estimated to be approximately 20 times the MRHE). No maternal or fetal effects were observed at this dose. Rats and rabbits do not produce glucuronidated Silodosin, which is present in human serum at approximately 4 times the level of circulating Silodosin and which has similar pharmacological activity to Silodosin. No effects on physical or behavioral development of offspring were observed when rats were treated during pregnancy and lactation at up to 300 mg/kg/day.</p>', '<p>Postural hypotension with or without symptoms (e.g. dizziness) may develop when beginning Silodosin treatment. Silodosin should not be used in combination with other alpha-blocker. Inform patients planning cataract surgery to notify their ophthalmologist that they are taking Silodosin because of the possibility of Intraoperative Floppy Iris Syndrome (IFIS).</p>', '<p>Silodosin was evaluated at doses of up to 48 mg/day in healthy male subjects. The dose-limiting adverse event was postural hypotension. Should overdose of Silodosin lead to hypotension, support of the cardiovascular system is of first importance. Restoration of blood pressure and normalization of heart rate may be accomplished by maintaining the patient in the supine position. If this measure is inadequate, administration of intravenous fluid should be considered. If necessary, vasopressors could be used, and renal function should be monitored and supported as needed. Dialysis is unlikely to be of significant benefit since Silodosin is highly (97%) protein bound.</p>', '<p>BPH/ Urinary retention/ Urinary incontinence.</p>', '<p>Store at below 30&deg;C in a dry place protected from light. Keep out of reach of Children.</p>', '<p><strong>Pediatric patients</strong>: Silodosin is not indicated for use in pediatric patients.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: In double-blind, placebo-controlled, 12-week clinical studies of Silodosin, 259 (55.6%) were under 65 years of age, 207 (44.4%) patients were 65 years of age and over, while 60 (12.9%) patients were 75 years of age and over. Orthostatic hypotension was reported in 2.3% of Silodosin patients &lt; 65 years of age (1.2% for placebo), 2.9% of Silodosin patients &gt; 65 years of age (1.9% for placebo), and 5.0% of patients &gt; 75 years of age (0% for placebo). There were otherwise no significant differences in safety or effectiveness between older and younger patients.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: Silodosin is contra-indicated in patients with severe renal impairment (CCr &lt;30 mL/min). In patients with moderate renal impairment (CCr 30-50 mL/min), the dose should be reduced to Silodosin 4 mg once daily taken with a meal. No dosage adjustment is needed in patients with mild renal impairment (CCr 50-80 mL/min).<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Silodosin has not been studied in patients with severe hepatic impairment (Child-Pugh score &gt;10) and is therefore contra-indicated in these patients. No dosage adjustment is needed in patients with mild or moderate hepatic impairment.</p>', '2022-03-20 04:38:38', '2022-03-20 04:38:38'),
(1377, 1377, '<p>Silver Sulfadiazine cream is indicated in-</p>\r\n\r\n<ul>\r\n	<li>The topical prophylaxis against bacterial colonization and infection in burn wounds.</li>\r\n	<li>The topical antibacterial management of certain contaminated or infection-prone wounds, other than burns.</li>\r\n</ul>', '<p>The mechanism of Silver Sulfadiazine&#39;s antibacterial action has not been fully elucidated. After exposure to the drug, structural changes in the bacterial cell membrane occur, including distortion and enlargement of the cell and a weakening of the cell wall membrane. This is accompanied by reduced viability in sensitive strains. The silver sulfadiazine molecule dissociates and the silver moiety is bound to the bacterial cells. It is believed that, after penetrating the cell wall, the silver moiety is attached to deoxyribonucleic acid (DNA) and prevents bacterial cell proliferation. There is approximately 100 times more DNA in mammalian cells than in bacterial cells. It is thought that the ratio of silver sulfadiazine to bacterial DNA is sufficiently high to prevent bacterial division but the corresponding ratio to epithelial DNA is low enough not to block epithelial cell regeneration. The sulfadiazine moiety also provides a bacteriostatic action against sensitive organisms. In adults, up to 10% of the sulfadiazine may be absorbed and 60 to 85% of the absorbed amount is excreted in the urine. In children with 13% body surface area burns, the urinary sulfadiazine concentration was 31.8 mg/L.</p>', '<p>The burn wounds are cleansed, and Silver Sulfadiazine is applied over the burn wound. The burn areas should be covered with Silver Sulfadiazine at all times. The cream should be applied once to twice daily to a thickness of approximately 1/16 inches or 1.5 mm. Whenever necessary; the cream should be reapplied to any areas from which it has been removed by patient activity. If individual patient requirements make dressings necessary, they may be used. Reapplication should be ensured immediately after hydrotherapy. Treatment with Silver Sulfadiazine should be continued until satisfactory healing is occurred, or until the burn site is ready for grafting. The drug should not be withdrawn from the therapeutic regimen while there remains the possibility of infection except if a significant adverse reaction occurs.</p>', '<p><strong>Enzymatic debriding agents</strong>: Silver sulfadiazine may inactivate enzymatic debriding agents, thus the concomitant use of these compounds may be inappropriate.<br />\r\n<br />\r\n<strong>Oral hypoglycemic agents and phenytoin</strong>: In patients with large area burns where serum sulfadiazine levels may approach therapeutic levels, the action of oral hypoglycemic agents and phenytoin may be potentiated and it is recommended that blood levels be monitored.<br />\r\n<br />\r\n<strong>Cimetidine</strong>: In-patients with large area burns, it has been reported that co-administration of Cimetidine may increase the incidence of leukopenia.</p>', '<p>It is contraindicated in-patients who are hypersensitive to it or any of the other ingredients in the preparation. It should not be used on pregnant women approaching or at term, on premature infants, or on newborn infants during the first 2 months of life.</p>', '<p>Several cases of transient leukopenia have been reported in-patients receiving Silver Sulfadiazine therapy. Other infrequently occurring events include skin necrosis, erythema multiform, skin discoloration, burning sensation, rashes, and interstitial nephritis.</p>', '<p>Pregnancy Category B. This drug should be used during pregnancy only if clearly justified, especially in pregnant women approaching or at term. It is not known whether Silver Sulfadiazine is excreted in human milk. 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. Pediatric Use Safety and effectiveness in pediatric patients have not been established.</p>', '<p><strong>General</strong>: If hepatic and renal functions become impaired and elimination of drug decreases, accumulation may occur and discontinuation of this should be weighed against the therapeutic benefit being achieved. In considering the use of topical proteolytic enzymes in conjunction with it, the possibility should be noted that silver might inactivate such enzymes.<br />\r\n<br />\r\n<strong>Laboratory Tests</strong>: In the treatment of burn wounds involving extensive areas of the body, the serum sulfa concentrations may approach adult therapeutic levels (8 mg% to 12 mg%). Therefore, in these patients it would be advisable to monitor serum sulfa concentrations. Renal function should be carefully monitored and the urine should be checked for sulfa crystals.</p>', NULL, '<p>Topical Antibiotic preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-20 04:40:10', '2022-03-20 04:40:10'),
(1378, 1378, '<p><strong>Flatulence, abdominal distention, fullness, gas and windy colic</strong>: Simethicone is an excellent and effective antiflatulent. It is used for relief of the painful symptoms of excess gas in the digestive tract. Such gas is frequently caused by excessive swallowing of air or by eating foods that disagree. Simethicone drop is especially used in infants, acts in the stomach and intestines. Thus Simethicone enables freeing and eliminating the gas more easily by belching or passing flatus.<br />\r\n<br />\r\n<strong>Large bowel preparation</strong>: Addition of Simethicone to a polyethylene glycol bowel preparation produces symptomatic improvement prior to investigation in the management of accidental ingestion of foaming detergents.<br />\r\n<br />\r\n<strong>Treatment of poisoning</strong>: Simethicone has an anecdotal use as an antifoaming agent in the management of accidental ingestion of foaming detergents.</p>', '<p>Simethicone is used as an antiflatulent to relieve symptoms commonly referred to gas including upper GI bloating, pressure, fullness or stuffed feeling. The clinical use of Simeticone is based on its antifoaming properties. Its antifoaming action relieves flatulence by dispersing and preventing the formation of mucous surrounded&nbsp;gas pockets in the GI tract.<br />\r\n<br />\r\nSimeticone acts in the stomach and intestines to change the surface tension of gas bubbles, enabling them to coalesce; thus gas is freed and eliminated more easily by belching or passing flatus. Simeticone aids in the elimination of gas from the GI tract and can be used to reduce postoperative gas pains. Simeticone can also be used prior to gastroscopy to enhance visualization and prior to radiography of the intestine to reduce gas shadows.</p>', '<p>Take after meals and at bedtime. Can be given with infant&#39;s feeds. Shake the bottle well before each use.<br />\r\n<br />\r\n<strong>Children less than 2 years of age</strong>: 20 mg (0.3 ml Simethicone Paediatric Drops) 4 times daily up to 240 mg/day (3.6 ml Simethicone Paediatric Drops).<br />\r\n<br />\r\n<strong>Children 2-12 years of age</strong>: 40 mg (0.6 ml Simethicone Paediatric Drops) 4 times daily.<br />\r\n<br />\r\n<strong>Adults</strong>:</p>\r\n\r\n<ul>\r\n	<li>40-125 mg (0.6 ml-1.9 ml Simethicone Paediatric Drops) 4 times daily, up to 500 mg/day (7.5 ml Simethicone Paediatric Drops) or</li>\r\n	<li>1-3 Simethicone chewable tablets; 4 times daily, up to 500 mg/day (12 Simethicone chewable</li>\r\n</ul>', '<p>There is no evidence that Simethicone modifies the effect of other drugs. The defoaming effect of Simethicone is reduced by antacids such as Aluminium Hydroxide and Magnesium Carbonate, which absorb the Silicone.</p>', NULL, '<p>Simethicone is physiologically inert and no adverse effect has been noted after oral ingestion.</p>', '<p><strong>Pregnant women</strong>: No data are available to suggest any harmful effects.<br />\r\n<br />\r\n<strong>Lactating mother</strong>: Excretion of simethicone in breast milk has not been established, and would be most unlikely.</p>', '<p>Do not exceed 12 doses per day except under the advice and supervision of a physician.</p>', NULL, '<p>Anti-dyspeptic/Carminatives.</p>', '<p>Should be stored in cool and dry place, protected from light.&nbsp;Keep the medicine out of the reach of children.</p>', NULL, '2022-03-20 04:41:36', '2022-03-20 04:41:36'),
(1379, 1379, '<p>Primary hypercholesterolemia (type IIa and IIb) in patients who have not responded adequately to diet and other appropriate measures. Coronary heart disease and elevated plasma cholesterol level.</p>', '<p>Simvastatin&nbsp;is a preparation of Simvastatin which acts as a Cholesterol lowering agent. The main mechanism of reduction of low density lipoprotein (LDL) cholesterol is that following inhibition of HMG-CoA reductase activity, the LDL receptor density on the liver cells is increased and this leads to an increased removal of LDL cholesterol from the plasma and increased catabolism of LDL cholesterol. In addition, there is a reduction in the very low- density lipoprotein (VLDL) cholesterol and reduced formation of LDL from VLDL. Simvastatin is extensively metabolised in the liver; which is also the main site of action of the drug.</p>', '<p>The patient should be placed on a standard cholesterol lowering diet before receiving Simvastatin and should continue on this during treatment with Simvastatin. The usual starting dose is 10 mg/day given as a single dose in the evening. Adjustment of dosage, if required, should be made at intervals of not less than four weeks, to a maximum of 40 mg daily given as a single dose in the evening. If LDL-cholesterol levels fall below 2 mmol/L or total plasma cholesterol levels fall below 3.5 mmol/L consideration should be given to reducing the dose of Simvastatin. In hypercholesterolemia, the recommended starting dose is 5-10 mg once a day in the evening and the recommended dosing range is 5-40 mg per day as a single dose in the evening. In patients with coronary heart disease and hypercholesterolemia, the starting dose should be 20 mg once a day in the evening. Because Simvastatin does not undergo significant renal excretion, modification of dosage should not be necessary in patients with renal insufficiency. Safety and effectiveness in children and adolescents have not been established.</p>', '<p><strong>Digoxin</strong>: Concomitant administration of Simvastatin and Digoxin in normal volunteers resulted in a slight elevation (less than 0.3 &micro;gm/ml) in drug concentrations in plasma compared to concomitant administration of placebo and Digoxin.<br />\r\n<br />\r\n<strong>Coumarin derivatives</strong>: Slightly enhance the anticoagulant effect of Warfarin (mean changes in p rothrombin time less than two seconds) in normal volunteers maintained in a state of low therapeutic anticoagulation.<br />\r\n<br />\r\n<strong>Others</strong>: In clinical studies, Simvastatin was used concomitantly with ACE inhibitors, beta-blockers, calcium channel blockers, diuretics and NSAIDs without evidence of clinically significant adverse interactions.</p>', '<p>Simvastatin should not be used in-</p>\r\n\r\n<ul>\r\n	<li>Active liver disease</li>\r\n	<li>Pregnant and breast feeding mother</li>\r\n	<li>Women of child bearing age unless they have been adequately protected by contraception</li>\r\n	<li>Hypersensitivity to any component of the preparation</li>\r\n	<li>Patients with the homozygous familial hypercholesterolemia who have a complete absence of LDL receptors</li>\r\n</ul>', '<p>Simvastatin is generally well tolerated. Headache, fatigue, insomnia, gastrointestinal effects like nausea, constipation or diarrhoea, flatulence, dyspepsia, abdominal cramps and muscular effects like myalgia, myositis and myopathy have been reported. Rare cases of rhabdomyolysis with acute renal failure secondary to myoglobinuria have been associated with Simvastatin therapy. Hepatitis, pancreatitis, rash, Angio-oedema have also been reported. No potentially life threatening effects have been reported.</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>', '<ul>\r\n	<li>If there is a history of liver disease</li>\r\n	<li>Who take high alcohol</li>\r\n	<li>Liver function test should be done before and during treatment</li>\r\n	<li>If serum transaminase rises three times the upper limit of normal, treatment should be discontinued</li>\r\n	<li>Avoid pregnancy during and for one month after treatment</li>\r\n</ul>', '<p>There are no data available on overdose. No antidote is available. General measures should be adopted and liver function should be monitored.</p>', '<p>Other Anti-anginal &amp; Anti-ischaemic drugs, Statins.</p>', '<p>Store in a cool, dry place, Away from light keep out of reach of children.</p>', NULL, '2022-03-20 04:43:11', '2022-03-20 04:43:11'),
(1380, 1380, '<p><strong>Monotherapy and Combination Therapy</strong>: Sitagliptin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.<br />\r\n<br />\r\n<strong>Important Limitations of Use</strong>: Sitagliptin should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis, as it would not be effective in these settings. Sitagliptin has not been studied in patients with a history of pancreatitis. It is unknown whether patients with a history of pancreatitis are at increased risk for the development of pancreatitis while using Sitagliptin.</p>', '<p>Sitagliptin is a DPP-4 inhibitor, which is believed to exert its actions in patients with type 2 diabetes by slowing the inactivation of incretin hormones. Concentrations of the active intact hormones are increased by Sitagliptin, thereby increasing and prolonging the action of these hormones. Incretin hormones, including glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are released by the intestine throughout the day, and levels are increased in response to a meal. These hormones are rapidly inactivated by the enzyme, DPP-4. The incretins are part of an endogenous system involved in the physiologic regulation of glucose homeostasis. When blood glucose concentrations are normal or elevated, GLP-1 and GIP increase insulin synthesis and release from pancreatic beta cells by intracellular signaling pathways involving cyclic AMP. GLP-1 also lowers glucagon secretion from pancreatic alpha cells, leading to reduced hepatic glucose production. By increasing and prolonging active incretin levels, Sitagliptin increases insulin release and decreases glucagon levels in the circulation in a glucose-dependent manner. Sitagliptin demonstrates selectivity for DPP-4 and does not inhibit DPP-8 or DPP-9 activity in vitro at concentrations approximating those from therapeutic doses.</p>', '<p>The recommended dose of sitagliptin is 50 mg twice a day and 100 mg once daily. Sitagliptin can be taken with or without food.</p>', '<p><strong>Effects of sitagliptin on other Drugs</strong>: Sitagliptin did not meaningfully alter the pharmacokinetics of metformin, glyburide, simvastatin, rosiglitazone, warfarin, or oral contraceptive.<br />\r\n<br />\r\n<strong>Digoxin</strong>: Sitagliptin slightly increases the mean of Digoxin concentration. However, no dose adjustment of either drug is required.</p>', '<p>History of a serious hypersensitivity reaction to sitagliptin, such as anaphylaxis or angioedema.</p>', '<p>The most common adverse reactions include headache, upper respiratory tract infection and nasopharyngitis. Hypoglycemia may occur in patients treated with the combination to Sitagliptin and sulfonylurea and add on to insulin.</p>', '<p>Pregnancy Category B. Reproduction studies have been performed in rats and rabbits. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Sitagliptin is secreted in the milk of lactating rats at milk to plasma ratio of 4:1. It is not known whether sitagliptin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when sitagliptin is administered to a nursing woman.</p>', '<p>If pancreatitis is suspected, sitagliptin should promptly be discontinued and appropriate management should be initiated.<br />\r\n<br />\r\n<strong>Use in Patients with Renal Insufficiency</strong>: Dosage adjustment is recommended in patients with moderate or severe renal insufficiency and in patients with ESRD requiring hemodialysis or peritoneal dialysis.<br />\r\n<br />\r\n<strong>Use with medications known to cause Hypoglycemia</strong>: When sitagliptin is used in combination therapy dosage adjustment of sulfonylurea or insulin may be required to reduce the risk of hypoglycemia.<br />\r\n<br />\r\n<strong>Hypersensitivity Reactions</strong>: There have been post-marketing reports of serious hypersensitivity reactions in patients treated with sitagliptin. These reactions include anaphylaxis, angioedema, and exfoliative skin conditions including Stevens-Johnson syndrome. If a hypersensitivity reaction is suspected, discontinue sitagliptin, assess for other potential causes for the event, and institute alternative treatment for diabetes.</p>', '<p>During controlled clinical trials in healthy subjects, single doses of up to 800 mg Sitagliptin were administered. Maximal mean increases in QTc of 8.0 msec were observed in one study at a dose of 800 mg Sitagliptin, a mean effect that is not considered clinically important. There is no experience with doses above 800 mg in clinical studies. In Phase I multiple-dose studies, there were no dose-related clinical adverse reactions observed with Sitagliptin with doses of up to 600 mg per day for periods of up to 10 days and 400 mg per day for up to 28 days.<br />\r\n<br />\r\nIn the event of an overdose, it is reasonable to employ the usual supportive measures, e.g., remove unabsorbed material from the gastrointestinal tract, employ clinical monitoring (including obtaining an electrocardiogram), and institute supportive therapy as dictated by the patient&#39;s clinical status. Sitagliptin is modestly dialyzable. In clinical studies, approximately 13.5% of the dose was removed over a 3- to 4-hour hemodialysis session. Prolonged hemodialysis may be considered if clinically appropriate. It is not known if sitagliptin is dialyzable by peritoneal dialysis.</p>', '<p>Dipeptidyl Peptidase-4 (DPP-4) inhibitor.</p>', '<p>Store below 25&deg;C in a dry place away from light. Keep the medicines in a safe place, out of the reach of children. Do not use later than the date of expiry. To be dispensed only on the prescription of a registered physician.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of sitagliptin in pediatric patients under 18 years of age have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: This drug is known to be substantially excreted by the kidney. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection in the elderly, and it may be useful to assess renal function in these patients prior to initiating dosing and periodically thereafter.<br />\r\n<br />\r\n<strong>For patients with mild renal insufciency</strong>: (CrCl &lt;50 ml/min or serum creatinine levels of &lt;1.7 mg/DL in men and &lt;1.5 mg/DL in women), no dosage adjustment for sitagliptin is required.<br />\r\n<br />\r\n<strong>For patients with moderate renal insufciency</strong>: (CrCl &lt;30 to &lt;50 mL/min, or serum creatinine levels of &gt;1.7 to &lt;3.0 mg/dL in men and &gt;1.5 to &lt;2.5 mg/dL in women), the dose of sitagliptin is 50 mg once daily.<br />\r\n<br />\r\n<strong>For patients with severe renal insufficiency</strong>: (CrCl &lt;30 mL/min or serum creatinine levels of &gt;3.0 mg/dL in men and 2.5 mg/dL in women) or with end-stage renal disease (ESRD) requiring hemodialysis or peritoneal dialysis, the dose of sitagliptin is 25 mg once daily. Sitagliptin may be administered without regard to the limiting of hemodialysis.</p>', '2022-03-20 04:45:02', '2022-03-20 04:45:02'),
(1381, 1381, '<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 sitagliptin and metformin is appropriate. Important limitations of use:</p>\r\n\r\n<ul>\r\n	<li>This should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis, as it would not be efective in these settings.</li>\r\n	<li>This has not been studied in patients with a history of pancreatitis. It is unknown whether patients with a history of pancreatitis are at increased risk for the development of pancreatitis while using This.</li>\r\n</ul>', '<p>This tablet combines two antihyperglycemic agents with complementary mechanisms of action to improve glycemic control in patients with type 2 diabetes. Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, and Metformin HCl, a member of the biguanide class. Sitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor, which is believed to exert its actions in patients with type 2 diabetes by slowing the inactivation of incretin hormones. Incretin hormones, including glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are released by the intestine throughout the day, and levels are increased in response to a meal. These hormones are rapidly inactivated by the enzyme, DPP-4. The incretins are part of an endogenous system involved in the physiologic regulation of glucose homeostasis. When blood glucose concentrations are normal or elevated then GLP-1 and GIP increase insulin synthesis and release from pancreatic beta cells by intracellular signaling pathways involving cyclic AMP. GLP-1 also lowers glucagon secretion from pancreatic alpha cells, leading to reduced hepatic glucose production. By increasing and prolonging active incretin levels, Sitagliptin increases insulin release and decreases glucagon levels in the circulation in a glucose-dependent manner. The pharmacologic mechanism of action of Metformin HCl is different from other classes of oral antihyperglycemic agents. Metformin HCl decreases hepatic glucose production, decreases intestinal absorption of glucose and increases peripheral glucose uptake and utilization.</p>', '<p><strong>Dose of film-coated tablet</strong>: The dosage of this tablet should be individualized on the basis of the patient&#39;s current regimen, efectiveness, and tolerability while not exceeding the maximum recommended daily dose of 100 mg sitagliptin and 2000 mg metformin. Initial combination therapy or maintenance of combination therapy should be individualized and left to the discretion of the health care provider.<br />\r\n<br />\r\nThis tablet should generally be given twice daily with meals, with gradual dose escalation, to reduce the gastrointestinal (GI) side efects due to metformin.<br />\r\n<br />\r\nThe starting dose of this tablet should be based on the patient&rsquo;s current regimen. This tablet should be given twice daily with meals.<br />\r\n<br />\r\nThe recommended starting dose in patients not currently treated with metformin is 50 mg sitagliptin/500 mg metformin hydrochloride twice daily, with gradual dose escalation recommended to reduce gastrointestinal side efects associated with metformin.<br />\r\n<br />\r\nThe starting dose in patients already treated with metformin should provide sitagliptin dosed as 50 mg twice daily (100 mg total daily dose) and the dose of metformin already being taken. For patients taking metformin 850 mg twice daily, the recommended starting dose of this tablet is 50 mg sitagliptin/1000 mg metformin hydrochloride twice daily.<br />\r\n<br />\r\nNo studies have been performed specifcally examining the safety and efcacy of Sitagliptin Phosphate Monohydrate INN/Metformin Hydrochloride BP in patients previously treated with other oral antihyperglycemic agents and switched to Sitagliptin Phosphate Monohydrate INN/Metformin Hydrochloride BP. Any change in therapy of type 2 diabetes should be undertaken with care and appropriate monitoring as changes in glycemic control can occur.<br />\r\n<br />\r\n<strong>Dose of extended-release tablet</strong>: Administer once daily with a meal preferably in the evening. Gradually escalate the dose to reduce the gastrointestinal side effects due to Metformin. May adjust the dosing based on effectiveness and tolerability while not exceeding the maximum recommended daily dose of 100 mg Sitagliptin and 2000 mg Metformin extended-release. Maintain the same total daily dose of Sitagliptin and Metformin when changing between film-coated tablet and extended-release tablet, without exceeding the maximum recommended daily dose of 2000 mg Metformin extended-release.<br />\r\n<br />\r\nPatients using two extended-release tablets (such as two 50/500 or two 50/1000 tablets) should take the two tablets together once daily. The 100 mg Sitagliptin/1000 mg Metformin HCI extended-release tablet should be taken as a single tablet once daily.<br />\r\n<br />\r\nPatients treated with an insulin secretagogue or insulin: Co-administration of the combination with an insulin secretagogue (e.g., sulfonylurea) or insulin may require lower doses of the insulin secretagogue or insulin to reduce the risk of hypoglycemia.</p>', '<p><strong>Cationic Drugs</strong>: Cationic drugs eliminated by renal tubular secretion: Use with caution.<br />\r\n<br />\r\n<strong>Phenprocoumon</strong>: Metformin may decrease the anticoagulant effect of phenprocoumon. Therefore, close monitoring of the INR is recommended.<br />\r\n<br />\r\n<strong>Levothyroxine</strong>: Levothyroxine can reduce the hypoglycemic effect of metformin. Monitoring of blood glucose levels is recommended, especially when thyroid hormone therapy is initiated or stopped, and the dosage of metformin must be adjusted if necessary.</p>', '<p>This tablet is contraindicated in patients with:</p>\r\n\r\n<ul>\r\n	<li>Renal disease or renal dysfunction, e.g., as suggested by serum creatinine levels &ge;1.5 mg/dL [males], &ge;1.4 mg/dL [females] or abnormal creatinine clearance which may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction, and septicemia</li>\r\n	<li>Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma.</li>\r\n	<li>History of a serious hypersensitivity reaction to this tablet or sitagliptin, such as anaphylaxis or angioedema.</li>\r\n</ul>\r\n\r\n<p>This tablet should be temporarily discontinued in patients undergoing radiologic studies involving intravascular administration of iodinated contrast materials, because use of such products may result in acute alteration of renal function.</p>', '<p>The most common adverse reactions reported in &ge;5% of patients simultaneously started on sitagliptin and metformin and more commonly than in patients treated with placebo were diarrhea, upper respiratory tract infection, and headache.<br />\r\n<br />\r\nAdverse reactions reported in &ge;5% of patients treated with sitagliptin in combination with sulfonylurea and metformin and more commonly than in patients treated with placebo in combination with sulfonylurea and metformin were hypoglycemia and headache.<br />\r\n<br />\r\nHypoglycemia was the only adverse reaction reported in &ge;5% of patients treated with sitagliptin in combination with insulin and metformin and more commonly than in patients treated with placebo in combination with insulin and metformin.<br />\r\n<br />\r\nNasopharyngitis was the only adverse reaction reported in &ge;5% of patients treated with sitagliptin monotherapy and more commonly than in patients given placebo.<br />\r\n<br />\r\nThe most common (&gt;5%) adverse reactions due to initiation of metformin therapy are diarrhea, nausea/vomiting, fatulence, abdominal discomfort, indigestion, asthenia, and headache.</p>', '<p>Pregnancy Category B. There are no adequate and well-controlled studies in pregnant women with Sitagliptin Phosphate Monohydrate INN/Metformin Hydrochloride BP or its individual components; therefore, the safety of Sitagliptin Phosphate Monohydrate INN/Metformin Hydrochloride BP in pregnant women is not known. This tablet should be used during pregnancy only if clearly needed.<br />\r\n<br />\r\nIt is not known whether sitagliptin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when this tablet is administered to a nursing woman.</p>', '<p>Lactic Acidosis-</p>\r\n\r\n<ul>\r\n	<li>Lactic acidosis can occur due to metformin accumulation. The risk increases with conditions such as sepsis, dehydration, excess alcohol intake, hepatic insufciency, renal impairment, and acute congestive heart failure.</li>\r\n	<li>Symptoms include malaise, myalgias, respiratory distress, increasing somnolence, and nonspecifc abdominal distress. Laboratory abnormalities include low pH, increased anion gap and elevated blood lactate.</li>\r\n	<li>If acidosis is suspected, discontinue this tablet and hospitalize the patient immediately.</li>\r\n	<li>Regular monitoring of thyroid-stimulating hormone (TSH) levels is recommended in patients with hypothyroidism.</li>\r\n	<li>Long-term treatment with metformin has been associated with a decrease in vitamin B12 serum levels which may cause peripheral neuropathy. Monitoring of the vitamin B12 level is recommended.</li>\r\n</ul>\r\n\r\n<p>Others-</p>\r\n\r\n<ul>\r\n	<li>Do not use this tablet in patients with hepatic disease.</li>\r\n	<li>There have been postmarketing reports of acute renal failure, sometimes requiring dialysis. Before initiating this tablet and at least annually thereafter, assess renal function and verify as normal.</li>\r\n	<li>There have been postmarketing reports of acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis. If pancreatitis is suspected, promptly discontinue this tablet.</li>\r\n	<li>Measure hematologic parameters annually.</li>\r\n	<li>Warn patients against excessive alcohol intake.</li>\r\n	<li>May need to discontinue this tablet and temporarily use insulin during periods of stress and decreased intake of fluids and food as may occur with fever, trauma, infection or surgery.</li>\r\n	<li>Promptly evaluate patients previously controlled on this tablet who develop laboratory abnormalities or clinical illness for evidence of ketoacidosis or lactic acidosis.</li>\r\n	<li>When used with an insulin secretagogue (e.g., sulfonylurea) or with insulin, a lower dose of the insulin secretagogue or insulin may be required to reduce the risk of hypoglycemia.</li>\r\n	<li>There have been postmarketing reports of serious allergic and hypersensitivity reactions in patients treated with sitagliptin (one of the components of this tablet ), such as anaphylaxis, angioedema, and exfoliative skin conditions including Stevens-Johnson syndrome. In such cases, promptly stop this tablet, assess for other potential causes, and institute appropriate monitoring and treatment, and initiate alternative treatment for diabetes.</li>\r\n	<li>There have been no clinical studies establishing conclusive evidence of macrovascular risk reduction with Sitagliptin Phosphate Monohydrate INN/Metformin Hydrochloride BP or any other anti-diabetic drug.</li>\r\n</ul>', '<p><strong>Sitagliptin</strong>: In the event of an overdose, it is reasonable to employ the usual supportive measures, e.g., remove unabsorbed material from the gastrointestinal tract, employ clinical monitoring (including obtaining an electrocardiogram), and institute supportive therapy as indicated by the patient&#39;s clinical status. Sitagliptin is modestly dialyzable. Prolonged hemodialysis may be considered if clinically appropriate. It is not known if sitagliptin is dialyzable by peritoneal dialysis.<br />\r\n<br />\r\n<strong>Metformin hydrochloride</strong>: Overdose of metformin hydrochloride has occurred, including ingestion of amounts greater than 50 grams. Metformin is dialyzable with a clearance of up to 170 mL/min under good hemodynamic conditions. Therefore, hemodialysis may be useful for removal of accumulated drug from patients in whom metformin overdosage is suspected. Pancreatitis may occur in the context of a metformin overdose.</p>', '<p>Combination Oral hypoglycemic preparations.</p>', '<p>Store below 25&deg;C in a dry place away from light. Keep the medicines in a safe place, out of the reach of children. Do not use later than the date of expiry. To be dispensed only on the prescription of a registered physician.</p>', NULL, '2022-03-20 04:46:52', '2022-03-20 04:46:52');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1382, 1382, '<p>Snake Venom Antiserum is indicated for bites caused by Cobra, Common Krait, Russell&#39;s Viper and Saw-Scaled Viper, where the patient presents with one or more of fallowing visible clinical signs and symptoms of envenomation &ndash;<br />\r\n<br />\r\nLocal envenomation-</p>\r\n\r\n<ul>\r\n	<li>Presence of bite marks with or without oozing of blood, blistering and change in color of skin.</li>\r\n	<li>Rapidly progressive or massive swelling involving more than half of the bitten limb within few hours of bite (without tourniquet)</li>\r\n	<li>Development of enlarged tender lymph nodes draining the bitten part within couple of hours after bite</li>\r\n</ul>\r\n\r\n<p>Systemic envenomation-</p>\r\n\r\n<ul>\r\n	<li>Neurotoxic syndrome- signs of neuro-paralysis like blurring of vision, double vision, and difficulty in swallowing, sleepy feeling, drooping of head, slurring of speech and the voice may become indistinct with shallow breathing, ptosis, ataxia, respiratory paralysis and generalized flaccid paralysis.</li>\r\n	<li>Hemotoxic syndrome- spontaneous systemic bleeding, nausea, vomiting, abdominal pain and abdominal tenderness suggestive of gastro-intestinal or retro-peritoneal bleed and/or renal damage, coagulopathy detected by 20 min WBCT with or without external bleeding and shock.</li>\r\n</ul>\r\n\r\n<p><strong>Immediate actions and first aid:</strong>&nbsp;Quick and positive measures should be taken to meet the emergency. Do not try to catch or kill the snake without proper tools and avoid unnecessary exposure to snack. Patient should be removed to a well-ventilated and quiet place and restrict his/her movement. Patient should be reassured to overcome fear. Immobilize the bitten part by applying immobilization bandage as done for a fracture and bitten part is kept below heart level. Ligation by applying tourniquets should be avoided, however, if applied it should be tied at moderate distance above the bitten part to prevent the entry of venom into the circulation. Patient should be immediately taken to nearby medical centre for treatment without loss of time.</p>', '<p>Snake venom antiserum is a sterile preparation containing antitoxin globulins and their derivatives. It is the only specific treatment for venomous snake bites.</p>', '<p>As of now Snake venom antiserum is the only specific antidote for snake envenomation and prompt administration of adequate dose of Antiserum is of paramount importance for neutralization of unbound circulating snake venom components for early response to treatment. Any delay in administration may result in increased dose requirement and decreased effectiveness. As the clinical signs can vary due to many factors such as type of snake, time of reporting after bite, size of snake, amount of venom injected during bite, seasonal &amp; regional variation in venom composition etc., no accurate dosage can be recommended.<br />\r\n<br />\r\nHowever, considering the average quantity of venom injected by snake at the time of bite and degree of envenomation, it is recommended to administer initial dose of 5-10 vials of Snake venom antiserum by slow intravenous infusion either undiluted at a speed of not more than 2 ml per minute or after dilution with Normal /glucose saline at a rate of 5-10 ml/kg body weight over one hour. Children should receive the same dose as adults. Constant monitoring of the vital signs at frequent intervals during initial 1 hour is recommended. Requirement of further dosing depends on extent of&nbsp;reversal of coagulopathy confirmed after 6 hours of Antiserum administration by WBCT in haemotoxic bite or if symptoms persist or worsen or in respiratory failure in neurotoxic bite after 1 hour of Antiserum administration.<br />\r\n<br />\r\nIf the blood is still in coagulable or no signs of reversal of paralysis are seen, a further dose of 5 to 10 vials of Antiserum should be administered by slow IV route only. Administration by IM or locally around the bite wound is not recommended. In the majority of cases of both neurotoxic and haemotoxic bites, total dose of 15-20 vials is adequate unless a proven recurrence of envenomation is established. In such a scenario, further doses can be given as per clinical condition of the patient. Hypersensitivity skin test has no predictability value and hence should not be used.</p>', '<p>Risk of increased severity of acute anaphylaxis when used with &beta;-adrenergic blockers.</p>', '<p>There are no known contraindications for the administration of Snake venom antiserum. Proper precautions are necessary while dealing with persons with a known hypersensitivity to constituents of product. Few doctors prefer to premedicate patients with Inj. Adrenaline 0.25 ml s/c to prevent possibility of adverse reactions. In haemotoxic bites, IM injections should be avoided till correction of coagulopathy to avoid formation of haematoma and oozing of blood. In patients having tourniquet, it should be released slowly only after start of Snake venom antiserum administration.</p>', '<p>Snake venom antiserum being derived from equines is heterologous to human can give either early or late reaction. Adrenaline should be always kept handy, before starting the dose of Snake venom antiserum.&nbsp;Reduction in adverse reactions has been reported by use of adequate dilution of Snake venom antiserum with saline and controlling rate of infusion.</p>', '<p>Considering the risk associated with snake bite envenomation, pregnancy is not a contraindication for the administration of Snake Venom Antiserum subsequent to bite.</p>', '<p>Proper skin test should be done prior to parenteral admin of the antivenom to identify risk of anaphylaxis.</p>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', '<p>Lyophilized Snake venom antiserum&nbsp;is stable at room temperature and does not require special storage facilities. Ideally, it should be stored in a cool &amp; dark place and do not expose to excessive heat.</p>', NULL, '2022-03-20 04:48:37', '2022-03-20 04:48:37'),
(1383, 1383, '<p>This preparation is indicated in the treatment of symptoms of gastro-oesophageal reflux, such as acid regurgitation, heartburn and indigestion (related to reflux), for example, following meals or during pregnancy or in patients with symptoms related to reflux esophagitis.</p>', '<p>This preparation works by forming a raft (thick layer) on top of the stomach contents soon after it has made contact with the stomach acid. The raft acts as a strong physical barrier and helps keep all the components of the stomach contents in the stomach where they work, not letting them seep back up into the esophagus where they hurt.</p>', '<p>Daily 4 times, after meals &amp; before bedtime.<br />\r\nTablet-</p>\r\n\r\n<ul>\r\n	<li>Adult and child over 12 years: 1-2 tablets.</li>\r\n	<li>Child 6-12 years: 1 tablet.</li>\r\n</ul>\r\n\r\n<p>Suspension-</p>\r\n\r\n<ul>\r\n	<li>Adult and child over 12 years: 5-10 ml.</li>\r\n	<li>Child 2-12 years: 2.5-5 ml.</li>\r\n</ul>\r\n\r\n<p>This preparation is not recommended for children under 2 years of age.</p>', '<p>If you are taking other medicines concomitantly, or have just completed another drug treatment, inform your physician in order to prevent hazards or inefficacy arising from drug interactions.</p>', '<p>Sodium alginate and potassium bicarbonate is contraindicated in patients with known hypersensitivity to these.</p>', '<p>In addition to the desired effect of the drug, some side effects may appear such as: nausea, constipation, diarrhea or headache. In these cases consult a physician In case too big dosage has been taken, there might appear a sensation of swelling. In this case it is advisable to consult a physician.</p>', '<p>This preparation can be given in pregnant and lactating women.</p>', '<p>This preparation should be prescribed with caution in patients with renal impairment and congestive cardiac failure.</p>', '<p>Overdosage with this formulation is a rare case. In case of overdose please consult with a registered physician.</p>', '<p>Antacids</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-20 04:50:08', '2022-03-20 04:50:08'),
(1384, 1384, '<p>This is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Gastric reflux</li>\r\n	<li>Heartburn</li>\r\n	<li>Flatulence associated with gastric reflux</li>\r\n	<li>Heartburn of pregnancy</li>\r\n	<li>All cases of epigastric and retrosternal distress where the underlying cause is gastric reflux.</li>\r\n</ul>', '<p>The mode of action of the product is physical and does not depend on absorption into the systemic circulation. On ingestion, the product reacts rapidly with gastric acid to form a raft of Alginic acid gel having a near-neutral pH and which floats on the stomach contents quickly and effectively impeding gastro-esophageal reflux, for up to 4 hours. In severe cases, the raft itself may be refluxed into the esophagus in preference to the stomach contents and exert a demulcent effect.</p>', '<p>For oral administration:<br />\r\n<br />\r\n<strong>Adult and children over 12 years</strong>:10-20 mL after meals and at bedtime, up to four times a day.<br />\r\n<br />\r\n<strong>Children 6 to 12 years</strong>: 5-10 mL after meals and at bedtime, up to four times a day.<br />\r\n<br />\r\n<strong>Children under 6 years</strong>: Not recommended.<br />\r\n<br />\r\n<strong>Elderly</strong>: No dosage modification is required for this age group.</p>', '<p>A time-interval of 2 hours should be considered between this drug intake and the administration of other medicinal products, especially Tetracyclines, Digoxine, Fluoroquinolone, Iron salt, Ketoconazole, Neuroleptics, Thyroid Hormones, Penicillamine, beta-blockers (Atenolol, Metoprolol, Propranolol), Glucocorticoid, Chloroquine and Biphosphonates (diphosphonates) and Estramustine.</p>', '<p>This product is contraindicated in patients with known or suspected hypersensitivity to the active ingredients or to any of the excipients.</p>', '<p>In addition to the desired effect of the drug, some side effects may appear such as: constipation, flatulence, stomach cramp or belching. In these cases consult a physician. If too big dose has been taken, there might appear a sensation of swelling. In this case, it is advisable to consult a physician.</p>', '<p><strong>Pregnancy</strong>: Clinical studies in more than 500 pregnant women, as well as a large amount of data from post-marketing experience,&nbsp;indicate no malformative nor feto/neonatal toxicity of the active ingredients. This drug can be used during pregnancy, if clinically needed.<br />\r\n<br />\r\n<strong>Breastfeeding</strong>: No effects of the active substances have been shown in breastfed newborns/infants of treated mothers. This drug can be used during breastfeeding.<br />\r\n<br />\r\n<strong>Fertility</strong>: Pre-clinical investigations have revealed Alginate has no negative effect on parental or offspring fertility or reproduction. Clinical data do not suggest that this drug has an effect on human fertility.</p>', '<p>If symptoms do not improve after 7 days, the clinical situation should be reviewed. Each 10 mL dose has a Sodium content of 141 mg (6.2 mmoL). This should be taken into account when a highly restricted salt diet is recommended, e.g. in some cases of congestive cardiac failure and renal impairment. Each 10 mL dose contains 160 mg (1.6 mmoL) of Calcium Carbonate. Care needs to be taken in treating patients with hypercalcaemia, nephrocalcinosis and recurrent calcium containing renal calculi.</p>', '<p>In the event of over dosage symptomatic treatment should be given. The patient may notice abdominal distension.</p>', '<p>Antacids</p>', '<p>Store in a cool (below 30&deg;C) and dry place, away from light. Keep out of the reach of children. Do not refrigerate or freeze.</p>', NULL, '2022-03-20 04:51:52', '2022-03-20 04:51:52'),
(1385, 1385, '<p>Management of acidosis in cardiac arrest.&nbsp;<br />\r\nManagement of metabolic acidosis in:</p>\r\n\r\n<ul>\r\n	<li>Severe renal disease</li>\r\n	<li>Uncontrolled diabetes</li>\r\n	<li>Circulatory insufficiency from shock or dehydration</li>\r\n	<li>Severe primary lactic acidosis</li>\r\n</ul>\r\n\r\n<p>Alkalinization of urine.</p>', '<p>Sodium bicarbonate is a systemic alkalinizing agent. It increases plasma bicarbonate, buffers excess hydrogen ion concentration, and raises blood pH, thereby reversing the clinical manifestations of acidosis. It can also be used to replenish electrolyte imbalance as a treatment adjunct for severe diarrhea where the loss of bicarbonate can be significant.</p>', '<p><strong>Oral</strong>: The usual dose is 300 mg to 2 grams, 1 to 4 times daily.<br />\r\n<br />\r\n<strong>Intravenous&nbsp;</strong>(Severe metabolic acidosis):</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;By slow inj of a hypertonic solution of up to 8.4% (1000 mmol/L), or by continuous infusion of a weaker solution, usually 1.26% (150 mmol/L). For correction of acidosis during advanced cardiac life support procedures, 50 ml of an 8.4% solution may be given.</li>\r\n	<li><strong>Elderly:</strong>&nbsp;Dosage adjustments may be required.</li>\r\n</ul>', '<p>This medication has the potential to interact with many medications. Should not take any other medication within 1 to 2 hours of taking an antacid. Potentially hazardous interactions with Corticosteroids and Corticotropin, Alkalis, Calcium, Diuretics and Potassium.</p>', '<p>This drug is contraindicated in hypoventilatory states, chloride depletion owing to continuous gastric fluid loss, metabolic and/or respiratory alkalosis, hypocalcemia and diuretics known to produce hypochloremic alkalosis.</p>', '<p>This medication is generally well tolerated. However, high doses may cause headache, nausea or irritability. If any of these effects continue or become bothersome, inform your doctor. Notify your doctor if you develop: muscle weakness, slow reflexes, confusion, swelling of the feet or ankles, black tar-like stools, coffee-ground vomit. If you notice other effects not listed above, contact your doctor or pharmacist.</p>', '<p><strong>Category C:</strong>&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>Pre-existing heart disease, kidney disease, liver disease, high blood pressure, any allergies.</p>', '<p>If alkalosis results, the bicarbonate should be stopped and the patient managed according to the degree of alkalosis present. 0.9% sodium chloride injection intravenous may be given; potassium chloride also may be indicated if there is hypokalemia. Severe alkalosis may be accompanied by hyperirritability or tetany and these symptoms may be controlled by calcium gluconate. An acidifying agent such as ammonium chloride may also be indication in severe alkalosis.</p>', '<p>Intravenous fluid preparations, Urinary Alkalinizing Agent.</p>', '<p>Store in a cool &amp; dry place protected from light. Keep out of reach of children.</p>', '<p>Renal Impairment: Dosage adjustments may be required.<br />\r\nHepatic Impairment: Dosage adjustments may be required.</p>', '2022-03-20 04:54:06', '2022-03-20 04:54:06'),
(1386, 1386, '<p>Sodium Chloride is a sterile solution of Sodium Chloride in water for injection. Each 100 ml solution contains Sodium Chloride B.P. 0.9 gm. Isotonic (0.9% w/v) Sodium Chloride infusion is used in sodium and water depletion.<br />\r\n<br />\r\nFor instance, in the management of metabolic alkalosis, in case of gastro-enteritis, during and after surgery. It may also be used as a priming fluid for haemodialysis procedures. Sodium Chloride 0.9% infusion is often used as diluents for infusion of drug additives etc. It is widely used for sterile irrigation and dilution process.</p>', NULL, '<p>The concentration and dosage of Sodium Chloride solution for intravenous use is determined by several factors including age, weight and clinical condition of the patient. Usually, the adult dose is about 1000 ml of 0.9% injection.</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>Check infusion set and infusion solution prior to use.</li>\r\n	<li>Pull moderately to tear off the protective cover of the Eurocap.</li>\r\n	<li>Hold lightly the Eurocap but not the bottle body.</li>\r\n	<li>Open the flow regulator fully and hold the giving set on the top white area, but not the memorane venting region.</li>\r\n	<li>Insert the spike of the administration set to the Eurocap and fit the connector of the administration set firmly to the needle.</li>\r\n	<li>Gradually allow the fluid to flow down to the needletip and close.</li>\r\n	<li>Remove the protective cover of the needle.</li>\r\n	<li>Locate the venpuncture site and clean the site with an antiseptic solution, and then insert the needle.</li>\r\n	<li>Securely tape the puncture site.</li>\r\n	<li>Securely tape the wings and tubing</li>\r\n	<li>Start infusion while adjusting drip speed.</li>\r\n</ul>', NULL, NULL, '<p>Reactions which may occur because of the solution or the technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation, and hypervolemia. If an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute appropriate therapeutic countermeasures and save the remainder of the fluid for examination if deemed necessary.</p>', '<p>Pregnancy Category C. Animal reproductive studies have not been conducted with Sodium Chloride Injection USP 0.9%. It is also not known whether Sodium Chloride Injection USP 0.9% can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Sodium Chloride Injection USP 0.9% should be given to a pregnant woman only if clearly needed.</p>', '<p>Serum electrolyte concentration should be carefully monitored. Sodium Chloride should be administered with caution to patients with congestive heart failure, peripheral or pulmonary oedema, impaired renal function or pre-eclampsia. Care should also be taken when administering Sodium Chloride intravenously to very young or elderly patients. Excessive administration should be avoided as this may result in hypokalaemia. Infusion of fluid should be immediately discontinued if rigor arises for any reason during its application. Do not use if the solution is cloudy, contains particles, or after expiry date.</p>', NULL, '<p>Intravenous fluid preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-20 04:55:18', '2022-03-20 04:55:18'),
(1387, 1387, '<p>Sodium Chloride nasal wash is indicated for dry nasal membranes including dry nose resulting from cold and allergy medications. It moistens dry nasal passages from dry climates or from airplane travel, may help dissolve mucus from study noses and clears the nose after surgery. This sterile saline solution is also used to cleanse various parts of the body (wounds, body cavities) and medical equipment (e.g. bandages, catheters, drainage tubes). It is also used as a mixing solution (diluent) for other medications used to irrigate the body (e.g. bacitracin, polymyxin).</p>', '<p>Sodium Chloride nasal wash is a non-drug, isotonic saline solution that is used to moisturize nasal membranes. This formulation provides comfort for extensive and continuous use.<br />\r\n<br />\r\nSodium Chloride 0.9% nasal wash moistures inside the nose by dissolving and softening thick or crusty mucus thus helps to remove the mucus from the nose and makes breathing easier. Excess sodium is predominantly excreted by the kidneys with small amounts lost in faeces and sweat.</p>', '<p><strong>Nasal Congestion</strong>: In infants, 1-2 drops of Sodium Chloride nasal wash in each nostril before feeds will help relieve congestion and allow more effective suckling.<br />\r\n<br />\r\n<strong>Ear Wax Removal</strong>: Allow the Sodium Chloride nasal wash to warm to room temperature before use. It is important to put the drops into the ear carefully. Lie down on one side and fill the ear canal with the drops and wait for a few minutes before standing up. Age: from 6 months onwards. Put 3 to 4 drops into the affected ear(s) 3 to 4 times a day for 3 to 5 days.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>How to use the Nasal Spray-</p>\r\n\r\n<ul>\r\n	<li>Shake the bottle gently and remove the dust cover.</li>\r\n	<li>Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.</li>\r\n	<li>Gently blow the nose to clear the nostrils.</li>\r\n	<li>Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.</li>\r\n	<li>Breathe out through your mouth.</li>\r\n	<li>Repeat the above steps in the same/ other nostril for consecutive doses.</li>\r\n</ul>\r\n\r\n<p>Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-</p>\r\n\r\n<ul>\r\n	<li>Remove the dust cover.</li>\r\n	<li>Gently pull off the nasal applicator.</li>\r\n	<li>Wash the applicator and dust cover in warm water.</li>\r\n	<li>Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.</li>\r\n	<li>Gently push the applicator back on the top of the bottle and re-fix the dust cover.</li>\r\n</ul>', NULL, '<p>Do not share this medication with others. Doing so may increase the risk of infection.</p>', '<p>No side effects are expected to occur. However stinging, sneezing, increased nasal discharge, or salty taste may occur in some cases.</p>', '<p>Tell your doctor if you are pregnant before using this medication. It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.</p>', '<p>Tell your doctor about your medical history, especially of heart problems (e.g., congestive heart failure), lung problems (pulmonary edema), kidney problems, low levels of potassium (hypokalemia), high levels of sodium (hypernatremia), and any allergies.</p>', '<p>There have been no adverse reports of overdose with Sodium Chloride 0.9% nasal wash.</p>', '<p>Nasal Decongestants &amp; Other Nasal Preparations.</p>', '<p>Keep out of the reach of children. Store at room temperature (between 15&deg;C to 30&deg;C), away from light and moisture.</p>', NULL, '2022-03-20 04:56:58', '2022-03-20 04:56:58'),
(1388, 1388, '<p>This medication is used to reduce swelling of the cornea in certain eye conditions.</p>', '<p>5% Sodium chloride ophthalmic solution is a hypertonic preparation. It is used to reduce the edema or swelling of the cornea. This solution exerts its effect through using the tonicity difference.</p>', '<p>Instill 1 or 2 drops in the affected eye(s) every 3 or 4 hours, or as directed by a physician.</p>', NULL, '<p>It is contraindicated in individuals with known hypersensitivity to any of the ingredients of this preparation.</p>', '<p>Vision may be temporarily blurred or unstable for a period after applying the drops. Use caution if driving or performing duties requiring clear vision. Burning or irritation of the eye may occur when first applied. If these symptoms continue or become worse, inform your doctor. Notify your doctor immediately if you develop: redness, pain, swelling in or around the eyes, vision problems, sensitivity to light, headache. If you notice other effects not listed above, contact your doctor or pharmacist.</p>', NULL, '<p>Tell your doctor if you have history of eye problems, any allergies. As with any medication, this should be used cautiously during pregnancy or while breast-feeding. Discuss the risks and benefits with your doctor. If the condition for which this was prescribed does not improve or becomes worse after a few days, Stop using and consult your doctor.<br />\r\n<br />\r\nIf you miss a dose, use it as soon as remembered; do not use it if it is near the time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not &quot;double-up&quot; the dose to catch up.</p>', NULL, '<p>Other ophthalmic preparations.</p>', '<p>Store in a cool and dry place, away from light. Keep out of reach of children.</p>', NULL, '2022-03-20 04:58:32', '2022-03-20 04:58:32'),
(1389, 1389, '<p>For the treatment and prophylaxis of Sodium Chloride deficiency.</p>', '<p>Sodium chloride is the principle salt involved in maintaining the osmotic tension of blood and tissues, changes in osmotic tension influence the movement of fluids and diffusion of salts in cellular tissue. Sodium Chloride tablet provides a source of sodium where a deficiency exists. Sodium chloride is readily absorbed from the gastro-intestinal tract. It is present in all body fluids but specially in the extracellular fluid. The amount of sodium lost (as sweat) is normally small. Osmotic balance is maintained by excretion of surplus amounts in the urine.</p>', '<p>It is important that the tablet should be swallowed whole with water (approx. 70 ml per tablet where kidney function is normal to avoid hypernatremia), and not chewed.<br />\r\n<br />\r\n<strong>Adults</strong>: For prophylaxis 8-16 tablets per day. For treatment dosage to be adjusted to individual needs up to a maximum of 40 tablets per day in case of severe salt depletion. For control of muscle cramps during routine maintenance haemodialysis usually 20-32 tablets per dialysis. In some cases of chronic renal salt-wasting, up to 40 tablets per day may be required with appropriate fluid intake.<br />\r\n<br />\r\n<strong>Children</strong>: Dosage should be adjusted to individual needs.<br />\r\n<br />\r\n<strong>Elderly</strong>: No special dosage adjustment.</p>', '<p>In hypertensive patients with chronic renal failure Sodium Chloride, 300 mg tablet may tend to impair the efficacy of antihypertensive drugs.</p>', '<p>Sodium Chloride is contra-indicated in any situation where salt retention is undesirable, such as edema, heart disease, cardiac decompensation and primary or secondary aldosteronism; or where therapy is being given to produce salt and water loss.</p>', '<p>No side effects have been reported with Sodium Chloride 300 mg tablet at the recommended dosage.</p>', '<p>Use in Pregnancy: No additional precautions required during pregnancy.</p>', '<p>No special warnings and precautions are required to maintain.</p>', '<p><strong>Signs and symptoms</strong>: Excessive intake of sodium chloride can result in hypernatraemia. Symptoms of hypernatraemia include restlessness, weakness, thirst, reduced salivation and lachrymation, swollen tongue, flushing of the skin, pyrexia, dizziness, headache, oliguria, hypertension, tachycardia, delirium, hyperpnoea and respiratory arrest.<br />\r\n<br />\r\n<strong>Treatment</strong>: Treatment requires the use of sodium-free liquids and the cessation of excessive sodium intake. In the event of a significant overdose serum sodium levels should be evaluated as soon as possible and appropriate steps taken to correct any abnormalities. The use of a loop diuretic e.g. frusemide (with potassium supplementation as required) may be appropriate in severe cases of hypernatraemia. Levels should be monitored until they return to normal.</p>', '<p>Oral electrolytes preparations.</p>', '<p>Store below 30&deg;C in a dry place protected from light. Keep out of reach of Children.</p>', NULL, '2022-03-20 05:00:39', '2022-03-20 05:00:39'),
(1390, 1390, '<p>This solution is indicated when there is combined water and sodium depletion. It provides Dextrose as a nutrient in a suitable medium of Sodium Chloride which is isotonic to body fluid, or it may also be employed as a source of isotonic Sodium Chloride or both. It is usually used in the maintenance and replacement of fluid, electrolyte and carbohydrate in patients who are unable to take fluid and nutrients by mouth e.g. in case of persistent vomiting, during and after surgery, shock or accidents.</p>', NULL, '<p>Dose is variable. It depends on the clinical condition, age and body surface area of the patients.</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>Check infusion set and infusion solution prior to use.</li>\r\n	<li>Pull moderately to tear off the protective cover of the Eurocap.</li>\r\n	<li>Hold lightly the Eurocap but not the bottle body.</li>\r\n	<li>Open the flow regulator fully and hold the giving set on the top white area, but not the memorane venting region.</li>\r\n	<li>Insert the spike of the administration set to the Eurocap and fit the connector of the administration set firmly to the needle.</li>\r\n	<li>Gradually allow the fluid to flow down to the needletip and close.</li>\r\n	<li>Remove the protective cover of the needle.</li>\r\n	<li>Locate the venpuncture site and clean the site with an antiseptic solution, and then insert the needle.</li>\r\n	<li>Securely tape the puncture site.</li>\r\n	<li>Securely tape the wings and tubing</li>\r\n	<li>Start infusion while adjusting drip speed.</li>\r\n</ul>', NULL, '<p>Do not take this medicine and tell your doctor if: Solutions containing dextrose may be contraindicated in patients with known allergy to corn or corn products.</p>', '<p>Reactions which may occur because of the solution or the technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation and hypervolemia. If an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute appropriate therapeutic countermeasures and save the remainder of the fluid for examination if deemed necessary.</p>', '<p>FDA pregnancy category C. It is not known whether dextrose 5% in water will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether dextrose 5% in water passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.</p>', '<p>As the preparation contains Sodium Chloride, it should be administered with caution to patients with congestive heart failure, peripheral or pulmonary oedema, impaired renal function or pre-eclampsia. Serum glucose concentration should also be carefully monitored and concurrent use of insulin may be needed in case of diabetic patients. Infusion of fluid should be immediately discontinued if rigor arises for any reason during the process. Do not use if the solution is cloudy, contains particles, or after expiry date.</p>', NULL, '<p>Intravenous fluid preparations, Parenteral nutritional preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-20 05:02:04', '2022-03-20 05:02:04'),
(1391, 1391, '<p>Cholera, Diarrhea, Severe vomiting and fluid loss due to excessive sweating</p>', NULL, '<p>The volume and rate of infusion of Cholera Saline depends upon the requirements of the patient and the judgment of the physician. It usually varies with age, weight and clinical condition of the patient.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Electrolytes preparations.</p>', NULL, NULL, '2022-03-20 05:02:52', '2022-03-20 05:02:52'),
(1392, 1392, '<p>Sodium Cromoglycate 2% Eye Drops is used for the prophylaxis and symptomatic treatment of certain allergic ocular disorders including vernal kerato conjunctivitis, vernal conjunctivitis, giant papillary conjunctivitis, vernal keratitis and allergic keratoconjunctivitis. Ophthalmic administration of Sodium Cromoglycate 2% Eye Drops generally provides symptomatic relief of itching, tearing, redness and discharge within a few days following initiation of therapy; however, up to 6 weeks of therapy may be required for optimum symptomatic relief in some patients. Once symptomatic improvement has been established therapy should be continued for as long as needed to sustain improvement.</p>', '<p>Sodium Cromoglycate 2% sterile Eye Drops inhibits the release of chemical mediators from sensitised mast cells and is capable of rapid phosphorylation of mast cell protein. The exact mechanism of action of the drug remains to be elucidated but Sodium Cromoglycate appears to modulate the allergic response to antigen antibody interactions in a way which prevents the subsequent formation or release of toxic or inflammatory mediators. Sodium Cromoglycate 2% Eye Drops appears to act mainly through a local effect on the mucous of the eye. Approximately 0.03% of an ophthalmic dose of Sodium Cromoglycate 2% Eye Drops is absorbed systemically. Sodium Cromoglycate 2% Eye Drops prevent, release of mediators of type-I allergic reactions, including histamine and slow reacting substance of anaphylaxis (SRS-A) from sensitised mast cells after the antigen antibody union has taken place. The drug does not inhibit the binding of IgE to mast cells nor the interaction between cell bound IgE and the specific antigen; instead Sodium Cromoglycate suppresses the release of substances (e.g. histamine, SRS-A) in response to this reaction. The drug also inhibits Type-III (late allergic, Arthus) reactions.</p>', '<p>The usual dosage of Sodium Cromoglycate 2% Eye Drops in adults and children over 4 years of age or older is 1 or 2 drops in each eye 4-6 times daily at regular intervals. The recommended frequency of administration should not be exceeded. Patients should be advised that the therapeutic effects of Sodium Cromoglycate 2% Eye Drops depend on administration of the drug at regular intervals.</p>', '<p>Sodium Cromoglycate has no known drug interactions.</p>', '<p>Sodium Cromoglycate 2% Eye Drops is contraindicated in individuals who have shown hypersensitivity to the drug or any of the ingredients.</p>', '<p>The most frequent adverse effect reported with use of Sodium Cromoglycate 2% Eye Drops is transient ocular stinging or burning upon instillation of the drug.</p>', '<p>In animal studies, Sodium Cromoglycate has produced adverse effects on the foetus only in high parenteral doses. There was no evidence of impaired fertility in reproduction studies in animals. Healthy infants have been born to women who received Sodium Cromoglycate throughout pregnancy; nevertheless, there is insufficient evidence to establish the safety in pregnancy. It should be used during pregnancy only when clearly needed. Since it is not known if Sodium Cromoglycate is distributed into milk in humans, the drug should be used with caution in nursing women.</p>', '<p>Sodium Cromoglycate 2% Eye Drops contains benzalkonium chloride and patients should be advised not to wear soft contact lenses during treatment with Sodium Cromoglycate 2% Eye Drops.</p>', '<p>Overdose is unlikely. In the event of accidental ingestion, symptomatic treatment is recommended.</p>', '<p>Mast Cell Stabiliser, Ophthalmic Non-Steroid drugs.</p>', '<p>Sodium Cromoglycate 2% Eye Drops should be protected from direct sunlight and stored at a temperature less than 30˚C; any unused ophthalmic solution should be discarded 4 weeks after opening the cap of the bottle.</p>', NULL, '2022-03-20 05:04:29', '2022-03-20 05:04:29'),
(1393, 1393, '<p><strong>Ophthalmic use:</strong>&nbsp;Prevention of acute allergic conjunctivitis, seasonal conjunctivitis, vernal kerato conjunctivitis<br />\r\n<br />\r\n<strong>Nasal use:</strong>&nbsp;It is also used for the symptomatic prevention &amp; treatment of seasonal or perennial allergic rhinitis. Prophylactic treatment for seasonal allergic rhinitis should begin 2 to 3 weeks before exposure to the allergen and should continue throughout the season.</p>', '<p>Sodium Cromoglicate inhibits the degranulation of sensitized mast cells which occurs after exposure to specific antigens. Sodium Cromoglicate acts by inhibiting the release of histamine and various membrane derived mediators of inflammation from mast cells. Sodium Cromoglicate has no vasoconstrictor or antihistaminic activity.</p>', '<p><strong>For eyes</strong>: For Child and Adult: 1 to 2 drops into each eye 2 to 3 times daily.<br />\r\n<strong>For nose</strong>: For Child and Adult: 1 drop to each nostril 2 to 3 times daily.</p>', '<p>No evidence of interaction with other drugs has been observed.</p>', '<p>This drop is contraindicated in patient with hypersensitivity to Sodium Cromoglicate .</p>', '<p>Transient stinging and burning may occur after instillation of this drops. Other symptoms of local irritation have been reported rarely.</p>', '<p>Sodium Cromoglicate should be used with caution during pregnancy and only if the expected benefit to the mother is greater than any possible risk to the fetus. There are no known harmful effects when this medicine is used by breastfeeding mothers.</p>', '<p>As this drop contains benzalkonium chloride, patients should not wear contact lenses during treatment with this drop.</p>', '<p>Overdose is unlikely. In the event of accidental ingestion, symptomatic treatment is recommended.</p>', '<p>Mast Cell Stabiliser, Ophthalmic Non-Steroid drugs</p>', '<p>Store at room temperature and protect from light. Any remaining contents should be discarded 4 weeks after opening. Do not touch dropper tip to any surface since this may contaminate the solution.</p>', NULL, '2022-03-20 05:06:12', '2022-03-20 05:06:12'),
(1394, 1394, '<p>This Nasal Spray is indicated for the prophylaxis and treatment of allergic rhinitis (such as hay fever and perennial rhinitis) where this is accompanied by nasal congestion.</p>', '<p><strong>Xylometazoline Hydrochloride</strong>&nbsp;is a sympathomimetic agent with alpha-adrenergic activity. It produces vasoconstriction thus reducing nasal congestion. This enables patients suffering from colds to breathe more easily through the nose.<br />\r\n<br />\r\n<strong>Sodium Cromoglicate</strong>&nbsp;usually acts through a local effect on the nasal mucosa. It prevents release of the mediators of type-l allergic reactions, including histamine and slow reacting substance of anaphylaxis (SRS-A) from sensitized mast cells after the antigen-antibody union has taken place. The drug does not inhibit the binding of IgE and the specific antigen; instead it suppresses the release of substances (e.g., histamine, SRS-A) in response to this reaction. The drug also inhibits Type-III (late allergic, Arthers) reactions to a lesser extent.</p>', '<p><strong>Adults (including the elderly) and children</strong>: One spray each nostril four times daily.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>How to use the Nasal Spray-</p>\r\n\r\n<ul>\r\n	<li>Shake the bottle gently and remove the dust cover.</li>\r\n	<li>Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.</li>\r\n	<li>Gently blow the nose to clear the nostrils.</li>\r\n	<li>Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.</li>\r\n	<li>Breathe out through your mouth.</li>\r\n	<li>Repeat the above steps in the same/ other nostril for consecutive doses.</li>\r\n</ul>\r\n\r\n<p>Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-</p>\r\n\r\n<ul>\r\n	<li>Remove the dust cover.</li>\r\n	<li>Gently pull off the nasal applicator.</li>\r\n	<li>Wash the applicator and dust cover in warm water.</li>\r\n	<li>Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.</li>\r\n	<li>Gently push the applicator back on the top of the bottle and re-fix the dust cover.</li>\r\n</ul>', NULL, '<p>Contraindicated in patients with a known hypersensitivity to any ingredients of the preparation.</p>', '<p>No serious side effects have been reported. Occasional irritation of the nasal mucosa may occur during the first day of use. In rare cases with Sodium Cromoglicate solutions alone wheezing and tightness of the chest has been reported. Because a lower dose of Xylometazoline is employed in this preparation it causes mild side effects such as nasal irritation, dryness of the nose, sneezing, headache, insomnia, drowsiness and palpitations.</p>', '<p>As with all medicines, caution should be exercised during pregnancy especially during the first trimester.</p>', '<p>The prolonged use or abuse of decongestants in general may lead to rebound congestion or drug induced rhinitis.</p>', NULL, '<p>Mast Cell Stabiliser.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-20 05:07:51', '2022-03-20 05:07:51'),
(1395, 1395, '<p>Effervescent water purification tablets make water safer by destroying harmful micro- organisms. It can also be used for washing fruits and vegetables and for cleaning teeth.</p>', '<p>Sodium Dichloroisocyanurate is a disinfectant with the general properties of Chlorine and Sodium hypochlorite. It contains about 65% of available chlorine. It rapidly dissolves into water to kill micro-organisms.</p>', '<p>Sodium Dichloroisocyanurate 17 mg:</p>\r\n\r\n<ul>\r\n	<li><strong>For drinking water:</strong>&nbsp;1 (one) tablet to 1 (one) liter of water.</li>\r\n	<li><strong>For fruits, vegetables washing water:</strong>&nbsp;3 (three) tablets to 1 (one) liter of water.</li>\r\n	<li>Double the amount of tablets if the water is heavily contaminated. Leave for 15 (fifteen) minutes before use.</li>\r\n</ul>\r\n\r\n<p>Sodium Dichloroisocyanurate 51 mg:</p>\r\n\r\n<ul>\r\n	<li><strong>For drinking water:</strong>&nbsp;1 (one) tablet to 3 (three) liters of water.</li>\r\n	<li><strong>For fruits, vegetables washing water:</strong>&nbsp;3 (three) tablets to 3 (three) liters of water.</li>\r\n	<li>Double the amount of tablets if the water is heavily contaminated. Leave for 15 (fifteen) minutes before use.</li>\r\n</ul>', '<p>Store away from Calcium or Sodium hypochlorite. Store away from acids and compounds containing ammonia.</p>', '<p>Do not use with other products. It may release dangerous gases (chlorine). It may react violently with many substances, causing fire and explosion hazard.</p>', '<p><strong>Skin contact</strong>: There may be irritation and redness at the site of contact. Repeated or prolonged contact may cause dermatitis.<br />\r\n<br />\r\n<strong>Eye contact:</strong>&nbsp;There may be severe pain, redness and irritation.<br />\r\n<br />\r\n<strong>Ingestion</strong>: There may be nausea and vomiting, occasionally with abdominal pain.<br />\r\n<br />\r\n<strong>Inhalation</strong>: Mild poisoning causes cough, irritation of the throat and shortness of breath. Very toxic to aquatic organisms, may cause long term adverse effects in the aquatic environment.</p>', '<p>No data found</p>', '<p>Harmful if swallowed. If tablet is swallowed seek medical advice immediately. Keep away from other materials, especially from flammable materials. Slit off the tablets only before use.</p>', NULL, '<p>Water purifying agent.</p>', '<p>Store in a cool &amp; dry place, protected from light and moisture.</p>', NULL, '2022-03-20 05:10:17', '2022-03-20 05:10:17');
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
(1396, 1396, '<p>This&nbsp;is an stable clear, colorless, buffered, ginger-lemon flavored, aqueous oral solution, that is used to treat relief of occasional constipation, bowel cleansing regimen in preparing the patient for surgery or for preparing the colon for X-Ray or endoscopic examination.</p>', '<p>Sodium phosphate can be used in the management of hypophosphataemia. It also acts as a mild osmotic laxative when given orally as dilute solutions or by the rectal route. Phosphate enemas or concentrated oral solutions are used for bowel cleansing before surgery or endoscopy procedures.</p>', '<p>Dose for bowel preparation-</p>\r\n\r\n<p><strong>Adults and children 5 years of age &amp; over</strong>: The recommended dosage for adults and&nbsp;children 5 years of age &amp; over is 45 ml and&nbsp;repeated 10 to 12 hours later. The intake of&nbsp;clear liquids is an essential part of this&nbsp;regimen. On the day before the procedure,&nbsp;the patient should only take clear liquids&nbsp;for breakfast, lunch and dinner and&nbsp;between doses. No solid food, milk or milk&nbsp;products should be taken on the day&nbsp;before the procedure. The patient should&nbsp;not drink anything colored red or purple.&nbsp;Medical procedure is intended to be&nbsp;performed at early morning, mid-morning&nbsp;or later, by two alternative dosage&nbsp;regimens.<br />\r\n<br />\r\n<strong>Early morning procedure</strong>: The first dose is taken at 7 a.m. on the&nbsp;morning before the procedure. The second&nbsp;dose is taken at 7 p.m. on the evening&nbsp;before the procedure.<br />\r\n<br />\r\n<strong>Mid-morning (or later) procedure</strong>: The first dose is taken at 7 p.m. on the evening before the procedure. The second dose is taken at 7 a.m. (or at least 3 hours before leaving for the appointment) on the morning before the procedure.</p>\r\n\r\n<ul>\r\n	<li><strong>First dose</strong>: Mix 15 ml (one third of the bottle) of This into a full glass (approximately 250 ml) of clear liquids and drink. Repeat two more times within the next 20 minutes.</li>\r\n	<li><strong>Between Doses</strong>: Between the first and&nbsp;second doses, the patient should drink at&nbsp;least three more glasses (approximately&nbsp;250 ml each) of clear liquids or more if&nbsp;desired to prevent dehydration and to&nbsp;ensure that their bowel remains easily&nbsp;examinable for the procedure.</li>\r\n	<li><strong>Second Dose</strong>: Mix 15 ml of This&nbsp;into a full glass of clear liquid and drink.&nbsp;Repeat two more times within the next 20&nbsp;minutes. Please refer to clear liquids list&nbsp;below. Beverages, water, tea or coffee (no&nbsp;milk or non dairy creamer), sweeteners are&nbsp;acceptable, carbonated or non carbonated&nbsp;soft drinks (not colored red or purple) fruit&nbsp;flavored cordials (not colored red or purple)&nbsp;and strained fruit juices without pulp. Do&nbsp;not drink any alcoholic beverage.</li>\r\n</ul>\r\n\r\n<p><br />\r\nDose for occasional constipation-</p>\r\n\r\n<p>Adult/child over:</p>\r\n\r\n<ul>\r\n	<li>12 years old: 20-45 ml</li>\r\n	<li>10-11 years old child: 10-20 ml</li>\r\n	<li>5-9 years old child: 5-10 ml</li>\r\n</ul>', '<p>Use with caution in patients taking calcium channel blockers, diuretics, angiotensin converting enzyme inhibitors (ACE-Is), angiotensin receptor blockers (ARBs), non-steroidal anti-inflammatory drugs (NSAIDs), and lithium preparations or other medication that might affect electrolyte levels, as hyperphosphataemia, hypocalcaemia, hypernatraemic dehydration and acidosis may occur. Concurrent administration of polyethylene glycol bowel cleansing preparations and this solution may be dangerous and is not recommended.</p>', '<p>CHF, renal failure or clinically significant impaired renal function, congenital or acquired megacolon, bowel/GI obstructions, ascites, perforation of ileus, active inflammatory bowel disease.</p>', '<p>Gastrointestinal side effects of sodium biphosphate and sodium phosphate have included bloating (31% to 41%), nausea (26% to 30%), abdominal pain (23% to 25%), and vomiting (4% to 9%). Nervous system side effects have included dizziness, headache, and seizures. Renal side effects have included renal impairment, increased blood urea nitrogen (BUN), increased creatinine, acute renal failure, acute phosphate nephropathy, nephrocalcinosis, and renal tubular necrosis. Hypersensitivity reactions reported have included anaphylaxis, rash, pruritus, urticaria, throat tightness, bronchospasm, dyspnea .</p>', '<p><strong>Use in pregnancy</strong>: Because of potential harm to the fetus from phosphate absorbed across the placenta, the use of this product is not recommended in pregnant women unless the probable clinical benefit outweighs the possible risk.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: Because of potential harm to the infant from phosphate excreted in breast milk, the use of this product is not recommended in&nbsp;nursing mothers unless the probable clinical benefit outweighs the possible risk.</p>', '<p>This solution should be used with extreme caution, in the elderly, the frail or debilitated, patients with colostomy and this solution patients on a low salt diet, as they are particularly at risk. These patients should receive additional fluids by mouth, both prior to, and after administration of this solution, to ensure that dehydration does not occur. Patients undergoing major bowel procedures, who are on nil by mouth for significant periods of time, should have their electrolytes monitored and receive intravenous fluids containing potassium and calcium, prior to surgery. Use with caution in patients taking diuretics and in patients using medicines known to prolong the QT interval. Concurrent administration of polyethylene glycol bowel cleansing preparations and this solution may be dangerous and is not recommended. Patients should be advised not to use this solution when nausea, vomiting or abdominal pain are present, unless directed by a physician.</p>', NULL, '<p>Enema &amp; bowel cleansing solution.</p>', '<p>Store in a cool and dry place, procted from light. Keep out of children&rsquo;s reach.</p>', '<p><strong>Use in children</strong>: This is not to be taken by children&nbsp;under 5 years of age.<br />\r\n<br />\r\n<strong>Use in diabetics</strong>:As the liquid diet during the period of administration and prior to bowel surgery, X-Ray of the colon or colonoscopy may affect the diabetic patients&rsquo; glucose blood levels, adjustment of their insulin or oral anti-diabetic medication may be necessary.</p>', '2022-03-20 05:11:51', '2022-03-20 05:11:51'),
(1397, 1397, '<p>Sodium fluoride is an antiseptic &amp; anticavity mouthwash which-&nbsp;</p>\r\n\r\n<ul>\r\n	<li>Restores enamel to strengthen teeth</li>\r\n	<li>Protects teeth from cavity</li>\r\n	<li>Helps to prevent tooth decay</li>\r\n	<li>Controls tartar that can discolor teeth</li>\r\n	<li>whitens teeth safety</li>\r\n</ul>', '<p>Sodium fluoride is a cariostatic agent that is used to prevent dental caries. It can also be used as a source of fluoride in total parenteral nutrition.</p>', '<p>Rinse (gargle) with fall strength Sodium fluoride for 30 seconds with 20 ml (with the help of supplied cup) two times daily (morning and evening). Do not swallow. Don&rsquo;t eat or drink within 30 minutes after rinsing with Sodium fluoride restoring.</p>', '<p>Absorption of fluoride may be reduced by aluminium, calcium and magnesium salts.</p>', '<p>Not to use 1 mg tablets in children less then 3 yr of age or when drinking water fluoride content is &gt;= 0.3 ppm.</p>', '<p>Hypersensitivity reactions, rash, nausea, vomiting. Products containing stannous fluoride may cause teeth staining.</p>', '<p>No data found</p>', '<p>Prolonged treatment with large amounts of fluoride may result in dental fluorosis and osseous changes; do not exceed recommended dosage. Renal impairment. Pregnancy.</p>', '<p>In acute poisoning, symptoms include a salty or soapy taste, increased salivation, GI disturbances, abdominal pain, weakness, drowsiness, faintness and shallow breathing; more serious effects include hypocalcaemia, hypomagnesaemia, hyperkalaemia, tremors, convulsions, cardiac arrhythmias, shock, respiratory arrest and cardiac failure. Death may occur within 2-4 hr. Treatment includes gastric lavage with lime water or a weak solution of another calcium salt to precipitate fluoride. Maintain high urine output, slow IV inj of calcium gluconate 10% may be used for hypocalcaemia and tetany. Magnesium sulfate may be given to treat hypomagnesaemia, and aluminium hydroxide may help to reduce fluoride absorption. Haemodialysis may be considered. Chronic fluoride poisoning may cause skeletal fluorosis resulting in bone pain, stiffness, limited movment and in severe cases, crippling deformities. In children, prolonged excessive intake during tooth development before eruption may cause dental fluorosis characterised by mottled enamel.</p>', '<p>Anticavity Mouthwash</p>', '<p>Store in tight plastic containers.</p>', NULL, '2022-03-20 05:13:21', '2022-03-20 05:13:21'),
(1398, 1398, '<p>Treatment of infections caused by susceptible organisms especially Staph eg, osteomyelitis, septicaemia, endocarditis, superinfected cystic fibrosis, pneumonia, skin &amp; soft tissue infections, surgical &amp; traumatic wound infections.</p>', '<p>Fusidic acid inhibits bacterial protein synthesis by interfering with amino acid transfer from aminoacyl-tRNA to protein on the ribosomes.</p>', '<p><strong>Adult:</strong>&nbsp;250-500 mg every 8 hourly<br />\r\n<strong>Skin &amp; soft tissue infection:</strong>&nbsp;250 mg twice daily.</p>', '<p>Drugs metabolized by CYP450 isoenzymes.</p>', '<p>Hypersensitivity</p>', '<p>GI disturbances eg, dyspepsia, nausea, vomiting, epigastric pain, anorexia; jaundice &amp; change of liver function.</p>', '<p>No data found</p>', '<p>Hepatic impairment, biliary obstruction or disease. Monitor hepatic function periodically in patients on high or prolonged oral doses. Avoid during 3rd trimester of pregnancy. Lactation. Premature, jaundiced, acidotic or seriously ill neonates.</p>', NULL, '<p>Other antibiotic.</p>', NULL, NULL, '2022-03-20 05:14:43', '2022-03-20 05:14:43'),
(1399, 1399, '<p>Sodium Fusidate Ointment is indicated for treatment of skin infections caused by Staphylococci, Streptococci, Corynebacterium minutissimum and other Fusidate sensitive organisms. The most important indications being: impetigo, boils, abscess, varicose ulcers, skin grafts, hidradenitis, infected wounds, sycosis barbae, paronychia, folliculitis, carbuncles and erythrasma.</p>', '<p>Sodium&nbsp;Fusidate, an antibiotic derived from Fusidium coccineum, exerts powerful activity against a number of gram-positive organisms. Staphylococci, including the strains resistant to penicillin or other antibiotics, are particularly susceptible to Sodium Fusidate. The therapeutic efficacy of topically applied Sodium Fusidate is due partly to the pronounced antibacterial activity of Sodium Fusidate against the organisms responsible for skin infection and partly to the unique ability of this antibiotic to penetrate intact skin.<br />\r\n<br />\r\nFusidic Acid is an anti-microbial agent that acts as an inhibitor of protein synthesis in the microorganism. It interferes with the translocation step by stabilizing the ribosome-guanosine dephosphate elongation factor G-complex. This prevents binding of aminoacyl t-RNA to the ribosome and thereafter stops transfer of additional amino acids to the growing polypeptide.</p>', '<p>Sodium Fusidate Ointment or cream is applied to the affected areas 2 to 3 times daily, generally for a period of 7 days. It can be used with or without a covering dressing. Caution should be observed when applying Sodium Fusidate Ointment near the eye region as this preparation may cause irritation if it gets into the eye. No special dosage modifications or special precautions are required for children.</p>', NULL, '<p>Known hypersensitivity to Sodium Fusidate, severe hepatic failure.</p>', '<p>Sodium Fusidate Ointment is remarkably well tolerated, and there is an extremely low frequency of hypersensitivity reactions.</p>', '<p>Data no found</p>', '<p>Caution should be observed when applying Sodium Fusidate ointment in the eye region as this preparation may cause irritation upon contact with the eye.</p>', NULL, '<p>Topical Antibiotic preparations.</p>', NULL, NULL, '2022-03-20 05:16:02', '2022-03-20 05:16:02'),
(1400, 1400, '<p>Sodium Hyaluronate is indicated for the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative nonpharmacologic therapy, and to simple analgesics, e.g., acetaminophen.</p>', '<p>Sodium hyaluronate is a polysaccharide which functions as a tissue lubricant. It is widely used in ophthalmic surgery because it forms a viscoelastic solution in water which makes it a suitable substitute for aqueous and vitreous humour.</p>', '<p>Sodium Hyaluronate is administered by intra-articular injection. A treatment cycle consists of five injections given at weekly intervals. Some patients may experience benefit with three injections given at weekly intervals. Inject the full 2 ml in one knee only. If treatment is bilateral, a separate injection should be used for each knee.</p>', NULL, '<p>The drug is contraindicated in patients with known hypersensitivity to hyaluronate preparations. Intra-articular injections are contraindicated in cases of past and present infections or skin diseases in the area of the injection site.</p>', '<p>The common side-effects include gastrointestinal complaints, injection site pain, knee swelling/effusion, local skin reactions (rash, ecchymosis), pruritus, and headache.</p>', '<p>The safety and effectiveness of Sodium Hyaluronate have not been established in pregnant women. It is not known if Sodium Hyaluronate is excreted in human milk. The safety and effectiveness of Sodium Hyaluronate have not been established in lactating mother. The safety and effectiveness of Sodium Hyaluronate have not been demonstrated in children.</p>', '<p>Use caution when injecting Sodium Hyaluronate into patients who are allergic to avian proteins, feathers, and egg products. Strict aseptic administration technique must be followed. Remove joint effusion, if present, before injecting Sodium Hyaluronate. Do not use the same syringe for removing joint effusion and for injecting Sodium Hyaluronate. It is recommended that the patient avoid any strenuous activities or prolonged (i.e., more than 1 hour) weight-bearing activities such as jogging or tennis within 48 hours following the intra-articular injection.</p>', '<p>No case of over dosage has been reported to date.</p>', '<p>Drugs for Osteoarthritis</p>', '<p>Hyronate injection should be stored in a cool (below 25&deg; C) and dry place and protected from light. Protect from freezing.</p>', NULL, '2022-03-20 05:17:24', '2022-03-20 05:17:24'),
(1401, 1401, '<p>Sodium Hyaluronate 0.1% sterile ophthalmic preparation is indicated for all forms of dry eye and for post-surgical lubrication. Sodium Hyaluronate 0.2% sterile ophthalmic preparation is indicated for severe &amp; chronic dry eye including after surgery. Both strengths are also indicated for dry eye associated with contact lens user.<br />\r\n<br />\r\nSodium Hyaluronate eye drops provide intensive and long-lasting lubrication for severe cases of dry eyes. The drops have a highly viscous consistency and are therefore ideal for the special needs of severe and chronic eye symptoms. In addition, they are outstandingly well-suited to supporting the healing of eyes following an operation. Sodium Hyaluronate lubricating eye drops can be prescribed for some diseases because of their therapeutic properties. In these cases, they can be prescribed by the doctor and the costs can be paid by health insurance funds. Sodium Hyaluronate eye drops contain the ingredient hyaluronan and are free from preservatives and phosphates. That is why Sodium Hyaluronate lubricating eye drops have very good tolerability.</p>', '<p>Sodium hyaluronate is a polysaccharide which functions as a tissue lubricant. It is widely used in ophthalmic surgery because it forms a viscoelastic solution in water which makes it a suitable substitute for aqueous and vitreous humour.</p>', '<p><strong>Adult</strong>: Instill 1 drop 3 times daily. If necessary this can be increased or as directed by a physician.<br />\r\n<br />\r\n<strong>Use in children:</strong>&nbsp;There is no known experience with patients under 18 years old.</p>', NULL, '<p>Known hypersensitivity to any of the components.</p>', '<p>Transient burning sensation, temporarily blurred vision and transient rise in intraocular pressure. Precautions: To avoid contamination, the tip of the container should not touch any surface and should be fully closed between applications.</p>', '<p>Pregnancy category B. Reproductive studies have not demonstrated any risk, but no controlled studies in pregnant women are available. Sodium Hyaluronate has a purely physical effect on the eyes without being absorbed and hence can be used during pregnancy and lactation.</p>', NULL, NULL, '<p>Drugs for Dry eyes.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-20 05:18:32', '2022-03-20 05:18:32'),
(1402, 1402, '<p>This eye drops is useful for the instant relief of dry, irritated and gritty eyes which is compatible with contact lenses.</p>', '<p>This eye drops have a unique formula that blends several ocular lubricants (Sodium Hyaluronate and Carboxymethylcellulose) to lubricate, protect and restore eye surface integrity. Sodium Hyaluronate is a natural polymer with viscoelastic property that promotes healing and guards against dehydration on the eye surface. Carboxymethylcellulose is one of the strongest mucoadhesive polymers, which retains direct contact with corneal epithelial cells to provide long-lasting clinical benefits.</p>', '<p>Instill 1 or 2 drops in the affected eye(s) as needed.</p>', NULL, '<p>This eye drops is contraindicated in patients who are hypersensitive to any component of this preparation.</p>', '<p>The chance of side effect is highly unlikely. However, transient blurring of vision may occur.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. This eye drops should be used during pregnancy unless the potential benefit justifies the potential risk to the fetus.&nbsp;It is not clear if enough medication from the eye drops would pass into breast milk. Caution should be exercised while giving this ophthalmic solution to a nursing mother.</p>', '<ul>\r\n	<li>For ophthalmic use only.</li>\r\n	<li>To avoid possible contamination of the drops, do not touch the dropper tip or to any surface. Replace the cap after use.</li>\r\n	<li>Do not use if solution changes color or becomes cloudy.</li>\r\n	<li>If more than one topical ophthalmic drug is being used, the drugs should be administered at least five (5) minutes interval between applications.</li>\r\n</ul>', NULL, '<p>Drugs for Dry eyes</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Pediatric use: Safety and effectiveness have not been demonstrated with this eye drops in pediatric patients.</p>', '2022-03-20 05:19:54', '2022-03-20 05:19:54'),
(1403, 1403, '<p>Sodium Hypochlorite is indicated in diabetic foot ulcer, necrotic wound infections, post-surgical wounds, first, second and third degree burns, pressure ulcer, and grafted and donor sites. This solution is safe to use around the eyes, nose and mouth.</p>', '<p>Hypochlorous acid, is a powerful oxidizing agent (meaning it can accept electrons from other materials) that lends hypochlorite excellent bleaching and disinfecting abilities.</p>', '<p>Use as required. This may require a secondary cover dressing.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>No known contraindications</p>', NULL, '<p>Pregnancy Category: Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Wound healing rates and characteristics will vary significantly with patient age, nutritional status, metabolic status, immunologic status and compliance. In the presence of vascular compromise, care must be taken to avoid circumferential bandage compression pressures in excess of arterial perfusion pressures.</p>', NULL, '<p>Bleaching and Disinfectants</p>', NULL, NULL, '2022-03-20 05:21:09', '2022-03-20 05:21:09'),
(1404, 1404, '<p>Sodium nitroprusside is indicated for the immediate reduction of blood pressure of adult and pediatric patients in hypertensive crises. Concomitant longer-acting&nbsp;antihypertensive&nbsp;medication should be administered so that the duration of treatment with sodium nitroprusside can be minimized. Sodium nitroprusside is also indicated for producing controlled&nbsp;hypotension&nbsp;in order to reduce bleeding during surgery. This is also indicated for the treatment of acute&nbsp;congestive heart failure.</p>', '<p>Nitroprusside a powerful vasodilator relaxes the vascular smooth muscle and produce consequent dilatation of peripheral arteries and veins. Other smooth muscle (e.g., uterus, duodenum) is not affected. Sodium nitroprusside is more active on veins than on arteries.<br />\r\n<br />\r\nOne molecule of sodium nitroprusside is metabolized by combination with hemoglobin to produce one molecule of cyanmethemoglobin and four CN-&nbsp;ions; methemoglobin, obtained from hemoglobin, can sequester cyanide as cyanmethemoglobin; thiosulfate reacts with cyanide to produce thiocyanate; thiocyanate is eliminated in the urine; cyanide not otherwise removed binds to cytochromes. Cyanide ion is normally found in serum; it is derived from dietary substrates and from tobacco smoke. Cyanide binds avidly (but reversibly) to ferric ion (Fe+++), most body stores of which are found in erythrocyte methemoglobin (metHgb) and in mitochondrial cytochromes. When CN is infused or generated within the bloodstream, essentially all of it is bound to methemoglobin until intraerythrocytic methemoglobin has been saturated. Once activated to NO, it activates guanylate cyclase in vascular smooth muscle and increases intracellular production of cGMP. cGMP stimulates calcium movement from the cytoplasm to the endoplasmic reticulum and reduces calcium available to bind with calmodulin. This eventually leads to vascular smooth muscle relaxation and vessel dilatation.</p>', '<p>Intravenous Hypertensive crisis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: For patients not receiving any antihypertensives, initially 0.3-1.5 mcg/kg/ min, adjust gradually according to response. Usual range 0.5-6 mcg/kg/min. Lower doses should be used in patients receiving antihypertensives. Max rate: 8 mcg/kg/min, discontinue infusion if there is no response after 10 min. May continue for a few hr if there is response. Introduce oral antihypertensive as soon as possible.</li>\r\n	<li><strong>Child</strong>: Initially, 250-500 nanograms/kg/min, rate may be repeatedly doubled at intervals of 15-20 min until the desired effect is achieved or treatment is judged ineffective. Max rate: 6 mcg/kg/min.</li>\r\n	<li><strong>Elderly</strong>: Lower doses may be required.</li>\r\n</ul>\r\n\r\n<p>Induction of hypotension during anaesthesia :</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Recommended max dose: 1.5 mcg/kg/min.</li>\r\n</ul>\r\n\r\n<p>Heart failure:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Intially 10-15 mcg/min, may increase by 10-15 mcg/min every 5-10 min according to response; usual range 10-200 mcg/min. Max: 280 mcg/min.</li>\r\n</ul>', '<p>Additive effect when used with other antihypertensives. May prolong the fibrinolytic activity of alteplase. Risk of severe hypotension if used with phosphodiesterase inhibitors. May reduce serum digoxin levels.</p>', '<p>Sodium nitroprusside should not be used in the treatment of compensatory hypertension, where the primary hemodynamic lesion is&nbsp;aortic&nbsp;coarctationor arteriovenous shunting.<br />\r\n<br />\r\nSodium nitroprusside should not be used to produce hypotension during surgery in patients with known inadequate cerebral circulation, or in moribund patients (A.S.A. Class 5E) coming to emergency surgery.<br />\r\n<br />\r\nPatients with congenital (Leber&#39;s) optic atrophy or with tobacco amblyopia have unusually high cyanide/thiocyanate ratios. These rare conditions are probably associated with defective or absent rhodanase, and sodium nitroprusside should be avoided in these patients.<br />\r\n<br />\r\nSodium nitroprusside should not be used for the treatment of acute&nbsp;congestive heart failure&nbsp;associated with reduced peripheral vascular resistance such as high-output&nbsp;heart failure&nbsp;that may be seen in endotoxic sepsis.</p>', '<p>Bradyarrhythmia, hypotension, palpitations, tachyarrhythmia Apprehension, restlessness, confusion, dizziness, headache, somnolence Rash, sweating, Thyroid suppression, Injection site irritation, Muscle twitch, oliguria, renal azotemia, Cardiac dysrhythmia, hemorrhage, decreased platelet aggregation, excessive hypotensive response, Raised intracranial pressure, Metabolic acidosis, Bowel obstruction, Methemoglobinemia, Cyanide poisoning, Thiocyanate toxicity</p>', '<p>Pregnancy Category C. There are no adequate, well-controlled studies of Sodium Nitroprusside in either laboratory animals or pregnant women. It is not known whether Sodium Nitroprusside can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. Sodium Nitroprusside should be given to a pregnant woman only if clearly needed.<br />\r\n<br />\r\nNursing Mothers: It is not known whether sodium nitroprusside and its metabolites are excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from sodium nitroprusside, 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>Hypothyroidism, renal and hepatic impairment, ischaemic heart disease, impaired cerebral circulation, elderly. Monitor blood thiocyanate concentration if treatment is longer than 3 days and should not exceed 100 mcg/ml. Monitor acid-base balance, venous oxygen concentration and BP. Caution to avoid extravasation. To be diluted with sterile dextrose 5% solution before infusion. Avoid sudden withdrawal. Leber&#39;s optic atrophy, low plasma-cobalamin concentrations, impaired pulmonary function. Pregnancy and lactation.</p>', NULL, '<p>Vasodilator antihypertensive drugs.</p>', NULL, '<p>Renal impairment: Dosage adjustments may be necessary.</p>', '2022-03-20 05:22:36', '2022-03-20 05:22:36'),
(1405, 1405, '<p>Sodium Picosulfate is indicated in the following conditions-</p>\r\n\r\n<ul>\r\n	<li>Constipation of any etiology</li>\r\n	<li>Relief from prolonged &amp; recurrent constipation</li>\r\n	<li>Bowel clearance before surgery, childbirth or radiological investigations.</li>\r\n</ul>', '<p>Sodium Picosulfate is a triarylmethane group derivative stimulant laxative. After oral administration it is activated by the colonic bacteria and acts locally in the colon. The active form then stimulates the nerve endings of the intestinal wall and results in colonic peristalsis with promotion of accumulation of water and electrolytes in the colonic lumen. This results in stimulation of defecation, reduction of transit time and softening of the stool. Stimulation of the rectum causes increased motility and a feeling of rectal fullness. The rectal effect may help to restore the &quot;call to stool&quot;.</p>', '<p>For oral administration. The following dosages are recommended to be taken at night to produce evacuation the following morning. It is recommended to start with the lowest dose. The dose may be adjusted up to the maximum recommended dose to produce regular stools. The maximum recommended daily dose should not be exceeded:<br />\r\n<br />\r\nAdults and children over 10 years of age-</p>\r\n\r\n<ul>\r\n	<li>Tablet: 5-10 mg per day.</li>\r\n	<li>Oral Solution: 5-10 ml or one to two teaspoonful per day.</li>\r\n</ul>\r\n\r\n<p>Children are aged 4-10 years-</p>\r\n\r\n<ul>\r\n	<li>Tablet: 2.5-5 mg per day.</li>\r\n	<li>Oral Solution: 2.5-5 ml or Half to one teaspoonful per day.</li>\r\n</ul>\r\n\r\n<p>Children under 4 years of age-</p>\r\n\r\n<ul>\r\n	<li>Oral Solution: 0.25 ml/kg body weight per day.</li>\r\n</ul>', '<p>The concomitant use of diuretics or adreno-corticosteroids may increase the risk of electrolyte imbalance if excessive doses are taken. Concurrent administration of antibiotics may reduce the laxative action of this product.</p>', '<p>Ileus or intestinal obstruction, severe painful and/or feverish acute abdominal conditions (e.g. appendicitis) potentially associated with nausea and vomiting, acute inflammatory bowel diseases, severe dehydration, known hypersensitivity to Sodium Picosulfate or any other component of the product.</p>', '<p>Hypersensitivity, dizziness, syncope, vasovagal response, gastrointestinal disorders, diarrhea, abdominal pain and abdominal cramps, nausea, vomiting.</p>', '<p>There are no reports of undesirable or damaging effects during pregnancy or to the foetus attributable to the use of this product. Use of the drug should be avoided during the first trimester. Clinical data show that neither the active moiety of sodium Picosulfate (BHPM or bis-(p hydroxyphenyl)-pyridyl-2-methane) nor its glucuronides are excreted into the milk of healthy lactating females.</p>', '<p>Prolonged excessive use may lead to fluid and electrolyte imbalance and hypokalemia. Harmful for those suffering from alcoholism. To be taken into account in pregnant or breast-feeding women, children and high-risk groups such as patients with liver disease or epilepsy.</p>', '<p>Laxatives when taken in chronic overdosage may cause chronic diarrhea, abdominal pain, hypokalemia, secondary hyperaldosteronism, and renal calculi. Renal tubular damage, metabolic alkalosis, and muscle weakness secondary to hypokalemia have also been described in association with chronic laxative abuse.</p>', '<p>Osmotic purgatives.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-20 05:24:41', '2022-03-20 05:24:41'),
(1406, 1406, '<p>Sodium Picosulfate, Magnesium Oxide and Anhydrous Citric Acid oral solution/powder for oral solution is indicated for cleansing of the colon as a preparation for colonoscopy in adults and child 9 years &amp; above. Also used in barium enema x-ray exam or surgical procedures that require a clean colon.</p>', NULL, '<p>There are two dosing regimens, each requires two separate dosing times:<br />\r\n<br />\r\n<strong>Split-Dose Dosing Regimen (Preferred Method)</strong>: The Split-Dose regimen is the preferred dosing method. Instruct patients to take two separate doses in conjunction with fluids, as follows:</p>\r\n\r\n<ul>\r\n	<li>Take the first dose (1 bottle/1 sachet) during the evening before the colonoscopy (e.g., 5:00 to 9:00 PM) followed by 1200 ml liquid (5x 240 ml) drinks (using provided measuring cup) of clear liquids before bed. Consume clear liquids within 5 hours.</li>\r\n	<li>Take second dose (1 bottle/1 sachet) the next day approximately 5 hours before the colonoscopy followed by at least 720 ml (3x240 ml) drinks of clear liquids before the colonoscopy. Consume clear liquids within next 5 hours but atleast 2 hours before the time of the colonoscopy.</li>\r\n</ul>\r\n\r\n<p><strong>Day-Before Dosing Regimen (Alternative Method)</strong>: The Day-Before regimen is the alternative dosing method for patients for whom the Split-Dosing is inappropriate. Instruct patients to take two separate doses in conjunction with fluids, as follows:</p>\r\n\r\n<ul>\r\n	<li>Take the first dose (1 bottle/1 sachet) in the afternoon or early evening (e.g., 4:00 to 6:00 PM) before the colonoscopy followed 1200 ml (5x 240 ml) using provided measuring cup of clear liquids before the next dose. Consume clear liquids within 5 hours.</li>\r\n	<li>Take the second dose (1 bottle/1 sachet) approximately 6 hours later in the late evening (e.g., 10:00 PM to 12:00 AM), the night before the colonoscopy followed by at least 720 ml (3x240 ml) drinks of clear liquids before bed. Consume clear liquids within 5 hours.</li>\r\n	<li>Additional fluids must be consumed after every dose in both dosing regimens.</li>\r\n	<li>Instruct patients to consume only clear liquids (no solid food or milk) on the day before the colonoscopy up until 2 hours before the time of the colonoscopy. Instruct patients that if they experience severe bloating, distention, or abdominal pain following the first dose, delay the second dose until their symptoms resolve.</li>\r\n</ul>', '<ul>\r\n	<li>Drugs that may increase risks of fluid and electrolyte abnormalities: Use caution when prescribing this solution for patients with conditions or who are using medications that increase the risk for fluid and electrolyte disturbances or may increase the risk of seizure, arrhythmias and prolonged QT in the setting of fluid and electrolyte abnormalities. This includes patients receiving drugs which may be associated with hypokalemia (such as diuretics or corticosteroids, or drugs where hypokalemia is a particular risk, such as cardiac glycosides) or hyponatremia. Use caution when this solution is used in patients on nonsteroidal anti-inflammatory drugs (NSAID) or drugs known to induce Antidiuretic Hormone Secretion (SIADH), such as tricyclic antidepressants, selective serotonin re-uptake inhibitors, antipsychotic drugs and carbamazepine, as these drugs may increase the risk of water retention and/or electrolyte imbalance.</li>\r\n	<li>Tetracycline and fluoroquinolone antibiotics, iron, digoxin, chlorpromazine and penicillamine, should be taken at least 2 hours before and not less than 6 hours after administration of this solution to avoid chelation with magnesium.</li>\r\n	<li>Antibiotics: Prior or concomitant use of antibiotics with this solution may reduce the efficacy of this solution.</li>\r\n</ul>', '<p>This solution is contraindicated in the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Patients with severely reduced renal function (creatinine clearance less than 30 ml/minute) which may result in accumulation of magnesium.</li>\r\n	<li>Gastrointestinal obstruction or ileus.</li>\r\n	<li>Bowel perforation</li>\r\n	<li>Toxic colitis or toxic megacolon</li>\r\n	<li>Gastric retention</li>\r\n	<li>An allergy to any of the ingredients in this solution.</li>\r\n</ul>', '<p>Most common adverse reactions (&gt;1%) are nausea, headache and vomiting (abdominal bloating, distension, pain/cramping and watery diarrhea not requiring an intervention were not collected).</p>', '<p>Pregnancy Category B. There are no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this solution should be used during pregnancy only if clearly needed. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when this solution is administered to a nursing woman.</p>', '<p>Serious Fluid and Serum Chemistry Abnormalities, Advise patients to hydrate adequately before, during and after the use of this solution. Use caution in patients with congestive heart failure when replacing fluids. If a patient develops significant vomiting or signs of dehydration including signs of orthostatic hypotension after taking this solution, consider performing post-colonoscopy lab tests (electrolytes, creatinine and BUN) and treat accordingly. Fluid and electrolyte disturbances can lead to serious adverse events including cardiac arrhythmias or seizures and renal impairment. Fluid and electrolyte abnormalities should be corrected before treatment with this solution. There have been reports of generalized tonic-clonic seizures with the use of bowel preparation products in patients with no prior history of seizures. The seizure cases were associated with electrolyte abnormalities (e.g. hyponatremia, hypokalemia, hypocalcemia and hypomagnesemia) and low serum osmolality. The neurologic abnormalities resolved with correction of fluid and electrolyte abnormalities.</p>', NULL, '<p>Enema &amp; bowel cleansing solution,</p>', '<p>Store at temperature 15&deg;-30&deg;C.</p>', '<p><strong>Pediatric Use</strong>: The safety and effectiveness of this oral solution in pediatric patients has not been established.<br />\r\n<br />\r\n<strong>Renal Insufficiency</strong>: Patients with impaired renal function or patients taking concomitant medications that may affect renal function (such as diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers or patients of the importance of adequate hydration before, during and after the use of this oral solution. In patients with severely reduced renal function (creatinine clearance &lt;30 mL/min), accumulation of magnesium in plasma may occur.</p>', '2022-03-20 05:26:22', '2022-03-20 05:26:22'),
(1407, 1407, '<p>Indicated for the treatment of hyperkalemia. (Hyperkalemia is mainly caused by Acute or Chronic Kidney Disease. Other causes may include Liver failure, Adrenal insufficiency, Use of certain drugs like ARB, ACE inhibitors, Beta blockers or Excessive use of Potassium supplements.)</p>', '<p>Sodium Polystyrene Sulfonate is a non-absorbed, cation exchange polymer that contains a sodium counterion. Sodium Polystyrene Sulfonate increases fecal potassium excretion through binding of potassium in the lumen of the gastrointestinal tract. Binding of potassium reduces the concentration of free potassium in the gastrointestinal lumen, resulting in a reduction of serum potassium levels. The practical exchange ratio is 1 mEq K per 1 gram of resin.<br />\r\n<br />\r\nAs the resin passes along the intestine or is retained in the&nbsp;colon&nbsp;after administration by&nbsp;enema, the sodium ions are partially released and are replaced by potassium ions. This action occurs primarily in the&nbsp;large intestine, which excretes potassium ions to a greater degree than does the&nbsp;small intestine. The efficiency of this process is limited and unpredictably variable.</p>', '<p>Adults (including the elderly)-</p>\r\n\r\n<ul>\r\n	<li><strong>Oral Dose</strong>: The average daily oral dose for adult is 15 gm to 60 gm (1 Sachet 1-4 times daily).</li>\r\n	<li><strong>Rectal dose</strong>: In patients who are unable to intake this medicine orally, rectal administration is possible (as enema). 30 gm to 50 gm of resin is given once or twice daily (at intervals of 6 hours). Each dose is administered as a warm emulsion (at body temperature) in 150 ml to 200 ml of aqueous vehicle (such as plain water, 10% dextrose in water or equal parts of water and 2% Methylcellulose suspension). The emulsion should be agitated gently during administration. The enema should be retained for as long as possible and should be followed by a cleansing enema.</li>\r\n</ul>\r\n\r\n<p>Children-</p>\r\n\r\n<ul>\r\n	<li><strong>Oral dose</strong>: In smaller children and infants correspondingly lower doses should be employed. An appropriate initial dose is 1 gm/kg body weight daily in divided doses in acute hyperkalemia. For maintenance therapy, dosage may be reduced to 0.5 gm/kg body weight daily.</li>\r\n	<li><strong>Rectal dose</strong>: When refused by mouth, the resin may be given rectally using a dose at least as much as that which would have been given orally. The resin should be suspended in a proportional amount of 10% Dextrose in water. Following retention of the enema, the colon should be irrigated to ensure adequate removal of the resin.</li>\r\n</ul>\r\n\r\n<p>Neonates-</p>\r\n\r\n<ul>\r\n	<li><strong>Rectal dose</strong>: Since it is advised that the oral route should not be employed, only rectal administration should be considered. With rectal administration, the minimum effective dosage within the range of 0.5 to 1 gm/kg of resin should be employed. The resultant suspension should be diluted as for adults. Following administration of the resin, the colon should be adequately irrigated to ensure recovery of the resin.</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>Mixing procedure: Each dose should be given as a suspension in a small quantity of water or, for greater palatability, in sweetened liquid or syrup (but not with orange or other fruit juices which contain potassium). The amount of fluid usually ranges from 20 ml to 100 ml, depending on the dose. It may be simply determined by allowing 3 ml to 4 ml per gram of drug. The prepared suspension should be administered by placing and maintaining the patient in an upright position. The resin may be introduced into the stomach through a plastic tube. If desired, it may be mixed with a diet appropriate for a patient in renal failure.The intensity and duration of therapy depend upon the severity and resistance of hyperkalemia. Sodium Polystyrene Sulfonate should not be heated because it may alter the exchange properties of the resin.<br />\r\n<br />\r\nSuspension of this drug should be freshly prepared and not to be stored beyond 24 hours.</p>', '<p>Sodium Polystyrene Sulfonate may cause drug interactions with Antacids, Non absorbable cation-donating antacids and laxatives, Digitalis, Sorbitol, Lithium, Thyroxine.</p>', '<p>Sodium Polystyrene Sulfonate is contraindicated in the following conditions: patients with hypokalemia, patients with a history of hypersensitivity to polystyrene sulfonate resins, obstructive bowel disease, neonates with reduced gut motility (postoperatively or drug induced) and oral administration in neonates.</p>', '<p>The drug may cause some degree of gastric irritation. Anorexia, nausea, vomiting, and constipation may occur especially if high doses are given. Also, hypokalemia, hypocalcemia, and significant sodium retention, and their related clinical manifestations, may occur. Occasionally diarrhea develops. Large doses in elderly individuals may cause fecal impaction. Rare instances of colonic necrosis have been reported. Intestinal obstruction due to concretions of aluminum hydroxide, when used in combination with such resin has been reported.</p>', '<p>Pregnancy Category C. Animal reproduction studies have not been conducted with Sodium Polystyrene Sulfonate. It is also not known whether it can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. It should be given to a pregnant woman only if clearly needed.<br />\r\n<br />\r\nNursing Mothers: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when this product is administered to a nursing woman.</p>', '<p>Caution is advised when this product is administered to patients who cannot tolerate even a small increase in sodium loads (i.e., severe congestive heart failure, severe hypertension, or marked edema). In such instances compensatory restriction of sodium intake from other sources may be indicated. In the event of clinically signifcant constipation, treatment with this drug should be discontinued until normal bowel motion is resumed. Magnesium-containing laxatives or sorbitol should not be used.</p>', '<p>Overdosage may result in electrolyte disturbances including hypokalemia, hypocalcemia, and hypomagnesemia. Biochemical disturbances resulting from overdosage may give rise to clinical signs and symptoms of hypokalemia, including: irritability, confusion, delayed thought processes, muscle weakness, hyporeflexia, which may progress to frank paralysis and/or apnea.</p>', '<p>Calcium Regulator.</p>', '<p>Store below 30&deg;C. Keep out of the reach of children. Suspension of this drug should be freshly prepared and not to be stored beyond 24 hours.</p>', NULL, '2022-03-20 05:28:05', '2022-03-20 05:28:05'),
(1408, 1408, '<p>For the treatment of various types of a protozoal infection called leishmaniasis, which may result from sandfly bites in tropical and temperate parts of the world. Also investigated for use or treatment in cancer/tumors (unspecified) and solid tumors</p>', '<p>The mode of action of sodium stibogluconate is not clearly understood. In vitro exposure of amastigotes to 500 mg pentavalent antimony/ml results in a greater than 50% decrease in parasite DNA, RNA protein and purine nucleoside triphosphate levels. It has been postulated that the reduction in ATP (adenosine triphosphate) and GTP (guanosine triphosphate) synthesis contributes to decreased macromolecular synthesis.</p>', '<p><strong>Leishmaniasis</strong>:&nbsp;20 mg/kg/day (maximum 850 mg) intramuscularly or intravenously for 20 to 28 days.</p>', NULL, '<p>Hypersensitivity, significant renal impairment, breast feeding.</p>', '<p>Sodium stibogluconate is exceedingly toxic to&nbsp;veins. One of the practical problems is that after a few doses it can become exceedingly difficult to find a vein in which to inject the drug. The insertion of a&nbsp;PICC&nbsp;does not prevent the problem and can instead exacerbate it: the entire vein along the course of the PICC line can become inflamed and&nbsp;thrombose. Large doses of sodium stibogluconate are often administered as dilute solutions.<br />\r\n<br />\r\nPancreatitis&nbsp;is a common deleterious effect of the drug, and the&nbsp;serum&nbsp;amylase&nbsp;or&nbsp;lipase&nbsp;should be monitored twice weekly; there is no need to stop treatment if the amylase remains less than four times the upper limit of normal; if the amylase rises above the cut-off, then treatment should be interrupted until the amylase falls to less than twice the upper limit of normal, whereupon treatment can be resumed. Cardiac conduction disturbances are less common, but&nbsp;ECG&nbsp;monitoring while the medicine is injected is advisable and changes quickly reverse after the drug is stopped or the infusion rate is decreased.<br />\r\n<br />\r\nThe drug can be given intramuscularly but is exceedingly painful when given by this route. It can also be given intralesionally when treating&nbsp;cutaneous leishmaniasis&nbsp;(i.e., injected directly into the area of infected skin) and again, this is exceedingly painful and does not give results superior to intravenous administration.<br />\r\n<br />\r\nSodium stibogluconate can also cause a reduced appetite, metallic taste in mouth,&nbsp;nausea,&nbsp;vomiting,&nbsp;diarrhoea, headache, tiredness, joint pains, muscle aches, dizziness, and&nbsp;anaphylaxis.</p>', '<p>Pregnancy category is not classified.</p>', NULL, NULL, '<p>Leishmaniacides.</p>', NULL, NULL, '2022-03-20 05:29:28', '2022-03-20 05:29:28'),
(1409, 1409, '<p>This&nbsp;eye drops is used for the treatment of lens opacification.</p>', '<p><strong>Anhydrous Sodium Succinate</strong>&nbsp;(intermediate substance) promotes the production of ATP<br />\r\n<br />\r\n<strong>Cytochrome C</strong>&nbsp;is involved in the oxidative phosphorylation for synthesizing ATP from ADP.<br />\r\n<br />\r\n<strong>Adenosine</strong>&nbsp;plays essential role in producing energy required for the vital function of the life lens e.g. the biosynthesis of glutathione, intermembrane active transport of ions and amino acid, the synthesis of DNA, RNA and nucleic acids.<br />\r\n<br />\r\n<strong>Nicotinamide</strong>&nbsp;is said to be involved in the process of creating ATP. NADPH plays a major role in protecting cell against oxidizing agents and from free radicals by maintaining glutathione in its reduced form.</p>', '<p>One drop into the affected eye twice daily.</p>', '<p>To avoid interaction with other drugs, it is recommended to inform your doctor of any concomitant treatment particularly with other eye drops.</p>', '<p>This eye drops is contraindicated in patients with known hypersensitivity to any ingredient of the product.</p>', '<p>Like any active ingredient, this drug may cause more or less discomfort in some patients..</p>', '<p>It is recommended to take advice from doctor before using this medicine in pregnancy and lactation.</p>', '<p>Do not inject or swallow. In case of concomitant treatment with another ophthalmic solution, wait 15 minutes between each instillation.</p>', '<p>Accidental ingestion of the medicine is unlikely to cause any toxicity due to low content of ingredients. The medication should be kept out of reach of children.</p>', '<p>Drugs for lens opacification.</p>', '<p>Store at room temperature and protect from light. It is desirable that the content should not be used more than 4 weeks after first opening of the bottle.</p>', NULL, '2022-03-20 05:31:07', '2022-03-20 05:31:07');
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
(1410, 1410, '<p>Sodium Thiosulfate is indicated for sequential use with sodium nitrite for treatment of acute cyanide poisoning that is judged to be life threatening. Use with caution if the diagnosis of cyanide poisoning is uncertain.</p>', '<p>Sodium thiosulfate acts as an antidote in the treatment of cyanide poisoning. It acts as a sulphur-donating substrate for the enzyme rhodanese, thus speeding up the conversion of cyanide to thiocyanide, which is relatively non toxic. It is often used in combination with sodium nitrite but may be used alone in less severe poisoning.</p>', '<p><strong>Adult:</strong>&nbsp;To be given after 300 mg of sodium nitrite has been admin over 5-20 min: 12.5 g of sodium thiosulfate (50 ml of a 25% solution or 25 ml of a 50% solution) given over 10 min. Methaemoglobin concentration should not exceed 30-40%. If symptoms of cyanide toxicity recur, the doses of nitrite and thiosulfate may be repeated after 30 min at half the initial doses.<br />\r\n<br />\r\n<strong>Child:</strong>&nbsp;To be given after 4-10 mg/kg of sodium nitrite (max: 300 mg) has been admin: 400 mg/kg of sodium thiosulfate, as a 25 or 50% solution (max: 12.5 g). Methaemoglobin concentration should not exceed 30-40%. If symptoms of cyanide toxicity recur, the doses of nitrite and thiosulfate may be repeated after 30 min at half the initial doses.</p>', '<p>Formal drug interaction studies have not been conducted with Sodium Thiosulfate.</p>', NULL, '<p>Osmotic disturbances. Oral: catharsis (at high doses).</p>', '<p>Pregnancy Category C. There are no adequate and well controlled studies in pregnant women. Sodium Thiosulfate Injection should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether sodium thiosulfate is excreted in human milk. Because Sodium Thiosulfate Injection may be administered in life-threatening situations, breast-feeding is not a contraindication to its use. Because many drugs are excreted in human milk, caution should be exercised following Sodium Thiosulfate Injection administration to a nursing woman. There are no data to determine when breastfeeding may be safely restarted following administration of sodium thiosulfate.</p>', '<p>Sodium thiosulfate drug product may contain trace impurities of sodium sulfite. The presence of a trace amount of sulfites in this product should not deter administration of the drug for treatment of emergency situations, even if the patient is sulfite-sensitive.</p>', '<p>There is limited information about the effects of large doses of sodium thiosulfate in humans. Oral administration of 3 g sodium thiosulfate per day for 1-2 weeks in humans resulted in reductions in room air arterial oxygen saturation to as low as 75%, which was due to a rightward shift in the oxygen hemoglobin dissociation curve. The subjects returned to baseline oxygen saturations 1 week after discontinuation of sodium thiosulfate. A single intravenous administration of 20 mL of 10% sodium thiosulfate reportedly did not change oxygen saturations.</p>', '<p>Antidote preparations.</p>', '<p>Store at controlled room temperature between 20&deg;C and 25&deg;C. Protect from direct light. Do not freeze.</p>', '<p><strong>Pediatric Use</strong>: There are case reports in the medical literature of sodium nitrite in conjunction with sodium thiosulfate being administered to pediatric patients with cyanide poisoning; however, there have been no clinical studies to evaluate the safety or efficacy of sodium thiosulfate in the pediatric population.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Sodium thiosulfate is known to be substantially excreted by the kidney, and the risk of adverse reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.</p>', '2022-03-20 05:32:35', '2022-03-20 05:32:35'),
(1411, 1411, '<p>Sodium Vaiproate oral is indicated for the treatment of all types of epilepsy, e.g.</p>\r\n\r\n<ul>\r\n	<li>Partial seizures</li>\r\n	<li>Absence seizures (petit mal)</li>\r\n	<li>Generalized tonic-clonic seizures (grand mal)</li>\r\n	<li>Myoclonic seizures</li>\r\n	<li>Atonic seizures</li>\r\n	<li>Mixed seizures that include absence attack</li>\r\n	<li>Prophylaxis of febrile convulsion</li>\r\n	<li>Prophylaxis of post-traumatic epilepsy.</li>\r\n</ul>\r\n\r\n<p>It is also indicated in the treatment of bipolar disorder &amp; prophylaxis of migraine.</p>', '<p>Sodium Valproate, the active ingredient of this preparation is endowed with anti-epileptic activity against a variety of seizures. The mechanism by which Sodium Valproate exerts its anti-epileptic effects has not been established. However, it has been suggested that its activity is related to increase brain levels of gamma-aminobutyric acid (GABA).</p>', '<p>Sodium Valproate tablets may be given once or twice daily. Sodium Valproate syrup should be given in divided doses.<br />\r\n<br />\r\nEpilepsy-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: Initially 600 mg daily given in 2 divided doses, preferably after food, increasing by 200 mg/day at 3-day intervals to a maximum of 2.5 g daily in divided doses until control of seizure is achieved. Usual maintenance dose is 1-2 g daily (20-30 mg/kg daily)</li>\r\n	<li><strong>Children (up to 20 kg)</strong>: Initially 20 mg/kg daily in divided doses, may be increased provided plasma concentrations monitored (above 40 mg/kg daily also monitor clinical chemistry and hematological parameters).</li>\r\n	<li><strong>Children (over 20 kg)</strong>: Initially 400 mg daily in divided doses increased until control (usually in the range of 20-30 mg/kg daily) Maximum 35 mg/kg daily.</li>\r\n</ul>\r\n\r\n<p><strong>Febrile convulsion</strong>: 20-30 mg/kg/day in 3 divided doses.<br />\r\n<br />\r\n<strong>Bipolar disorder</strong>: Initially 20-30 mg/kg/day in 2-3 divided doses; adjust dosage in 3-5 days. Maintenance dosage is 1000-2000 mg/day.<br />\r\n<br />\r\n<strong>Prophylaxis of migraine</strong>: 300 mg twice daily, although some may require 1000 mg daily.</p>', '<p>Sodium Vaiproate appears to act as a non specific inhibitor of drug metabolism. Drugs to which it interacts most significantly are Phenobarbital, Phenytoin, Warfarin, Aspirin etc.</p>', '<p>Sodium Valproate is contraindicated to patients who have known hypersensitivity to the drug and liver dysfunction. Use of Sodium Valproate is restricted during pregnancy and in women of childbearing potential.</p>', '<p>The most common side effects are anorexia, nausea and vomiting. However, these side effects are minimized with the use of enteric coated tablets. Effects on the CNS include sedation, ataxia and tremor. These symptoms occur infrequently and usually respond to a decrease in doses. Rash, alopecia and stimulation of appetite have been observed occasionally. Sodium Vaiproate has several effects on hepatic function of which elevation of liver enzymes in plasma is observed in up to 40% of patients and often occurs asymptomatically during the first few months of therapy. Rarely a fulminate hepatitis that may be fatal may develop. Children below 2 years of age with other medical conditions and those being treated with multiple antiepileptic agents are specially prone to suffer from hepatic injury, acute pancreatitis and hyperammonemia have also been frequently associated with the use of Sodium Valproate.</p>', '<p>Sodium Vaiproate crosses the placenta and in humans, exposure to valproate in the first trimester has been associated with neural tube defects such as anencephaly and spina bifida in newborn. Pregnant women treated with Sodium Vaiproate should be offered to estimate serum a-fetoprotein. Sodium Valproate is excreted in breast miik. However, breast-feeding by a mother taking Sodium Valproate probably causes no risk to the child.</p>', '<p>Liver functions should be monitored before therapy and during first 6 months especially in patients most at risk, No undue potential for bleeding before starting and before major surgery must be ensured, Care should be taken in renal impairment, pregnancy, breast-feeding and systemic lupus erythematosus. Sodium Valproate is partially eliminated in the urine as a ketone metabolite, which may lead to a false interpretation of the urine ketone test. Sudden withdrawal of therapy should be avoided. Sodium Valproate should not be used during pregnancy and in women of childbearing potential.</p>', NULL, '<p>Primary anti-epileptic drugs.</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-20 05:34:07', '2022-03-20 05:34:07'),
(1412, 1412, '<p>Sofosbuvir is a hepatitis C virus (HCV) nucleotide analog NS5B polymerase inhibitor indicated for the treatment of chronic hepatitis C (CHC) infection as a component of a combination antiviral treatment regimen.<br />\r\n<br />\r\nSofosbuvir efficacy has been established in subjects with HCV genotype 1, 2, 3 or 4 infection, including those with hepatocellular carcinoma meeting Milan criteria (awaiting liver transplantation) and those with HCV/HIV-1 co-infection.<br />\r\n<br />\r\nThe following points should be considered when initiating treatment with Sofosbuvir:</p>\r\n\r\n<ul>\r\n	<li>Monotherapy of Sofosbuvir is not recommended for treatment of CHC.</li>\r\n	<li>Treatment regimen and duration are dependent on both viral genotype and patient population.</li>\r\n	<li>Treatment response varies based on baseline host and viral factor.</li>\r\n</ul>', '<p>Sofosbuvir is nucleotide analog inhibitor, which specifically inhibits HCV NS5B (non-structural protein 5B) RNA-dependent RNA polymerase. Following intracellular metabolism to form the pharmacologically active uridine analog triphosphate (GS-461203), sofosbuvir incorporates into HCV RNA by the NS5B polymerase and acts as a chain terminator. More specifically, Sofosbuvir prevents HCV viral replication by binding to the two Mg2+ ions present in HCV NS5B polymerase&#39;s GDD active site motif and preventing further replication of HCV genetic material</p>', '<p>One 400 mg tablet taken once daily with or without food. Should be used in combination with Ribavirin or in combination with Pegylated Interferon and Ribavirin for the treatment of CHC.<br />\r\n<br />\r\nRecommended combination therapy: (HCV Mono-infected and HCV/HIV-1 Co-infected)-</p>\r\n\r\n<ul>\r\n	<li><strong>Genotype 1 or 4</strong>: Sofosbuvir + Peginterferon alfa + Ribavirin for 12 weeks</li>\r\n	<li><strong>Genotype 2</strong>: Sofosbuvir + Ribavirin for 12 weeks</li>\r\n	<li><strong>Genotype 3</strong>: Sofosbuvir + Ribavirin for 24 weeks</li>\r\n</ul>\r\n\r\n<p>Sofosbuvir in combination with Ribavirin for 24 weeks can be considered for CHC patients with genotype 1 infection who are Interferon ineligible<br />\r\n<br />\r\nShould be used in combination with Ribavirin for treatment of CHC in patients with hepatocellular carcinoma awaiting liver transplantation for up to 48 weeks or until liver transplantation whichever occurs first<br />\r\n<br />\r\nA dose recommendation cannot be made for patients with severe renal impairment or end stage renal disease</p>', '<p>Reduced therapeutic effect with drugs that are potent P-gp inducers in the intestine (eg rifampicin, St. John&#39;s wort, carbamazepine &amp; phenytoin), modafinil, phenobarb/ oxcarbazepine, rifabutin/ rifapentine. P-gp &amp;/or BCRP inhibitors. May result in serious symptomatic bradycardia when co-administered with amiodarone in combination with another direct acting antiviral.</p>', '<p>When Sofosbivur is used in combination with Ribavirin or Peginterferon alfa/ Ribavirin, the contraindications applicable to those agents are applicable to combination therapies. Sofosbuvir combination treatment with Ribavirin or Peginterferon alfa/Ribavirin is contraindicated in women who are pregnant or may become pregnant and men whose female partners are pregnant, because of the risks for birth defects and fetal death associated with Ribavirin.</p>', '<p>The most common adverse events (incidence greater than or equal to 20%, all grades) observed with Sofosbuvir in combination with Ribavirin were fatigue and headache. The most common adverse events observed with Sofosbuvir in combination with Peginterferon alfa and Ribavirin were fatigue, headache, nausea, insomnia, anemia, pruritus, asthenia, rash, decreased appetite, chills, influenza like illness, pyrexia, diarrhea, neutropenia, myalgia, irritability.</p>', '<p>Pregnancy Category B: Sofosbuvir There are no adequate and well-controlled studies with Sofosbuvir in pregnant women.<br />\r\n<br />\r\nNursing Mothers: It is not known whether Sofosbuvir and its metabolites are present in human breast milk.</p>', '<p>Bradycardia with amiodarone co-administration: Serious symptomatic bradycardia may occur in patients taking amiodarone and Sofosbuvir in combination with another direct acting antiviral (DAA), particularly in patients also receiving beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease. Co-administration of amiodarone with Sofosbuvir in combination with another DAA is not recommended. In patients without alternative, viable treatment options, cardiac monitoring is recommended.</p>', '<p>The highest dose of Sofosbuvir is a single dose of Sofosbuvir 1200 mg. No specific antidote is available for overdose treatment. Treatment of overdose with Sofosbuvir consists of general supportive measures including monitoring of vital signs as well as observation of the clinical status of the patient.</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 Sofosbuvir in children less than 18 years of age have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Sofosbuvir was administered to 90 subjects aged 65 and over. The response rates observed for subjects over 65 years of age were similar to that of younger subjects across treatment groups. No dose adjustment of Sofosbuvir is warranted in geriatric patients.</p>', '2022-03-20 05:35:45', '2022-03-20 05:35:45'),
(1413, 1413, '<p>Sofosbuvir and Velpatasvir combination is indicated for the treatment of adult patients with chronic hepatitis C virus (HCV) genotype 1, 2, 3, 4, 5 or 6 infection-</p>\r\n\r\n<ul>\r\n	<li>Without cirrhosis or with compensated cirrhosis</li>\r\n	<li>With decompensated cirrhosis for use in combination with ribavirin</li>\r\n</ul>', '<p>It is a fixed-dose combination tablet containing sofosbuvir and velpatasvir for oral administration. Sofosbuvir is a nucleotide analog HCV NS5B polymerase inhibitor and velpatasvir is an NS5A inhibitor.</p>', '<p>The recommended dosage is one tablet (400 mg of Sofosbuvir and 100 mg of Velpatasvir) taken orally once daily. Recommended treatment regimen:</p>\r\n\r\n<ul>\r\n	<li><strong>Patients without cirrhosis and patients with compensated cirrhosis (Child-Pugh A)</strong>: one tablet once daily for 12 weeks</li>\r\n	<li><strong>Patients with decompensated cirrhosis (Child-Pugh B or C)</strong>: one tablet once daily and Ribavirin for 12 weeks. The recommended dosage of Ribavirin is based on bodyweight (1000 mg/day for patients &lt; 75 kg and 1200 mg/day for &ge; 75 kg, in two divided dose/day)</li>\r\n</ul>', '<p>Drugs may decrease the concentrations of sofosbuvir and/or velpatasvir: Antacids, H2-receptor antagonists, Proton-pump inhibitors etc.<br />\r\n<br />\r\nCoadministration is not recommended with: topotecan, Carbamazepine, Phenytoin, Phenobarbital, Oxcarbazepine, Rifabutin, Rifampin, Rifapentine, efavirenz, Tipranavir, Ritonavir, Hypericum perforatum.<br />\r\n<br />\r\nCoadministration of Sofosbuvir and Velpatasvir combination, with Rosuvastatin, Atorvastatin may significantly increase the concentration of Rosuvastatin, Atorvastatin.</p>', '<p>Sofosbuvir, Velpatasvir and Ribavirin combination regimen is contraindicated in patients for whom Ribavirin is contraindicated.</p>', '<p>The most common side effects of Sofosbuvir and Velpatasvir combination include headache and tiredness. Treatment may result in slowing of the heart rate along with other symptoms when taken with amiodarone (a medicine used to treat certain heart problems).</p>', '<p>No adequate human data are available to establish whether or not Sofosbuvir and Velpatasvir combination poses a risk to pregnancy outcomes. If Sofosbuvir and Velpatasvir combination administered with Ribavirin, the combination regimen is contraindicated in pregnant women and in men whose female partner is pregnant or going to be pregnant in next six months.</p>', '<p>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 Sofosbuvir and Velpatasvir combination is not recommended. In patients without alternative viable treatment options, cardiac monitoring is recommended.</p>', '<p>If overdose occurs the patient must be monitored for evidence of toxicity. Treatment of overdose includes monitoring of vital signs as well as observation of the clinical status of the patient.</p>', '<p>Hepatic viral infections (Hepatitis C)</p>', '<p>Store in a cool and dry place (preferably below 30&deg; C). Keep out of reach of children.</p>', '<p><strong>Renal impairment patient</strong>: No dosage recommendation can be given for patients with severe renal impairment (eGFR &le;30 mL/min/1.73 m2) or with ESRD, due to higher exposures of the predominant sofosbuvir metabolite.</p>', '2022-03-20 05:37:54', '2022-03-20 05:37:54'),
(1414, 1414, '<p>Symptomatic treatment of urge incontinence and/or increased urinary frequency and urgency as&nbsp;may occur in patients with overactive bladder syndrome.</p>', '<p>Solifenacin is a competitive muscarinic receptor antagonist. It has the highest affinity for M3, M1, and M2 muscarinic receptors. 80% of the muscarinic receptors in the bladder are M2, while 20% are M3. Solifenacin&#39;s antagonism of the M3 receptor prevents contraction of the detrusor muscle, while antagonism of the M2 receptor may prevent contraction of smooth muscle in the bladder.</p>', '<p><strong>The recommended dose for adults and the elderly</strong>: Solifenacin Succinate 5 mg once daily. If needed, the dose may be increased to Solifenacin Succinate 10 mg once daily.<br />\r\n<br />\r\n<strong>Use in children</strong>: Safety and effectiveness in children have not yet been established. Therefore, Solifenacin Succinate should not be used in children.</p>', '<p>Concomitant medication with other medicinal products with anticholinergic properties may result in more pronounced therapeutic effects and undesirable effects. An interval of approximately one week should be allowed after stopping treatment with Solifenacin Succinate before commencing other anticholinergic therapy. The therapeutic effect of Solifenacin may be reduced by concomitant administration of cholinergic receptor agonists. Solifenacin can reduce the effect of medicinal products that stimulate the motility of the gastrointestinal tract, such as Metoclopramide and Cisapride. In vitro studies have demonstrated that at therapeutic concentrations, Solifenacin does not inhibit CYP1A1/2, 2C9, 2C19, 2D6, or 3A4 derived from human liver microsomes. Therefore, Solifenacin is unlikely to alter the clearance of drugs metabolized by these CYP enzymes. Solifenacin is metabolized by CYP3A4. Simultaneous administration of Ketoconazole (200 mg/day), a potent CYP3A4 inhibitor, resulted in a two-fold increase of the AUC of Solifenacin, while Ketoconazole at a dose of 400 mg/day resulted in a three-fold increase of the AUC of Solifenacin. Therefore, the maximum dose of Solifenacin Succinate should be restricted to 5 mg when used simultaneously with Ketoconazole or therapeutic doses of other potent CYP3A4 inhibitors (e.g. Ritonavir, Nelfinavir, Itraconazole).<br />\r\n<br />\r\nSimultaneous treatment of Solifenacin and a potent CYP3A4 inhibitor is contra-indicated in patients with severe renal impairment or moderate hepatic impairment. The effects of enzyme induction on the pharmacokinetics of Solifenacin and its metabolites have not been studied as well as the effect of higher affinity CYP3A4 substrates on Solifenacin exposure. Since Solifenacin is metabolised by CYP3A4, pharmacokinetic interactions are possible with other CYP3A4 substrates with higher affinity (e.g. Verapamil, Diltiazem) and CYP3A4 inducers (e.g. Rifampicin, Phenytoin, Carbamazepine).<br />\r\n<br />\r\nEffect of Solifenacin on the pharmacokinetics of other medicinal products:</p>\r\n\r\n<ul>\r\n	<li><strong>Oral Contraceptives</strong>: Intake of Solifenacin showed no pharmacokinetic interaction on combined oral contraceptives (Ethinylestradiol/Levonorgestrel).</li>\r\n	<li><strong>Warfarin</strong>: Intake of Solifenacin did not alter the pharmacokinetics of R-warfarin or S-warfarin or their effect on prothrombin time.</li>\r\n	<li><strong>Digoxin</strong>: Intake of Solifenacin showed no effect on the pharmacokinetics of digoxin.</li>\r\n	<li><strong>Effects on ability to drive and use machines</strong>: Since Solifenacin, like other anticholinergics may cause blurred vision and, uncommonly, somnolence and fatigue, the ability to drive and use machines may be negatively affected.</li>\r\n</ul>', '<p>Solifenacin is contraindicated in patients with hypersensitivity to solifenacin or to any of the excipients. It is also contraindicated in myasthenia gravis, urinary retention, uncontrolled narrow angle glaucoma, severe gastro-intestinal condition (including toxic megacolon), patients undergoing haemodialysis, patients with severe hepatic impairment, patients with severe renal impairment or moderate hepatic impairment and on treatment with a strong CYP3A4 inhibitor, e.g. ketoconazole.</p>', '<p>Due to the pharmacological effect of Solifenacin, it may cause anticholinergic undesirable effects of (in general) mild or moderate severity. The frequency of anticholinergic undesirable effects is dose related. The most commonly reported adverse reactionwith Solifenacin is dry mouth. It occurred in 11% of patients treated with 5 mg once daily, in 22% of patients treated with 10 mg once daily and in 4% of placebo-treated patients. The severity of dry mouth was generally mild and only occasionally led to discontinuation of treatment. In general,medicinal product compliance was very high (approximately 99%) and approximately 90% of the patients treated with Solifenacin completed the full study period of 12 weeks treatment.</p>\r\n\r\n<ul>\r\n	<li>Gastrointestinal disorders: very common- dry mouth, common-constipation, nausea, dyspepsia, abdominal pain, uncommon- gastroesophageal reflux diseases, dry throat, rare- colonic obstruction, faecal impaction, very rare- vomiting.</li>\r\n	<li>Infections and infestations: uncommonurinary tract infection, cystitis.</li>\r\n	<li>nervous system disorders: uncommon- somnolence, dysgeusia, very rare-dizziness, headache.</li>\r\n	<li>psychiatric disorders: very rare- hallucinations.</li>\r\n	<li>eye disorders: common- blurred vision, uncommon- dry eyes.</li>\r\n	<li>General disorders and administration site conditions: uncommon- fatigue, peripheral oedema.</li>\r\n	<li>Respiratory, thoracic and mediastinal disorders: uncommon nasal dryness.</li>\r\n	<li>skin and subcutaneous tissue disorders: uncommon- dry skin, very rare- pruritus, rash, urticaria.</li>\r\n	<li>renal and urinary disorders: uncommon- difficulty in micturition, rare- urinary retention.</li>\r\n</ul>', '<p>No clinical data are available from women who became pregnant while taking Solifenacin. Animal studies do not indicate direct harmful effects on fertility, embryonal / foetal development or parturition. The potential risk for humans is unknown. Caution should be exercised when prescribing to pregnant women. No data on the excretion of Solifenacin in human milk are available. In mice, Solifenacin and/or its metabolites was excreted in milk, and caused a dose dependent failure to thrive in neonatal mice. The use of Solifenacin should therefore be avoided during breast-feeding.</p>', '<p>Other causes of frequent urination (heart failure or renal disease) should be assessed before treatment with Solifenacin Succinate. If urinary tract infection is present, an appropriate antibacterial therapy should be started. Solifenacin Succinate should be used with caution in patients with: clinically significant bladder outflow obstruction at risk of urinary retention, gastrointestinal obstructive disorders, risk of decreased gastrointestinal motility, severe renal impairment (creatinine clearance 30 ml/min), moderate hepatic impairment (Child-Pugh score of 7 to 9) and doses should not exceed 5 mg for these patients. Caution should be taken in concomitant use of a potent CYP3A4 inhibitor e.g. Ketoconazole, hiatus hernia/ gastroesophageal reflux and/or who are concurrently taking medicinal products (such as Bisphosphonates) that can cause or exacerbate oesophagitis, autonomic neuropathy. Safety and efficacy have not yet been established in patients with a neurogenic cause for detrusor overactivity. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicinal product. The maximum effect of Solifenacin Succinate can be determined after 4 weeks at the earliest.</p>', '<p>Over dosage with Solifenacin Succinate can potentially result in severe anticholinergic effects. The highest dose of Solifenacin Succinate accidentally given to a single patient was 280 mg in a 5 hour period, resulting in mental status changes not requiring hospitalization. In the event of overdose with Solifenacin Succinate, the patient should be treated with activated charcoal. Gastric lavage is useful if performed within 1 hour, but vomiting should not be induced. As for other anticholinergics, symptoms can be treated as follows:</p>\r\n\r\n<ul>\r\n	<li>Severe central anticholinergic effects such as hallucinations or pronounced excitation: treat with physostigmine or carbachol.</li>\r\n	<li>Convulsions or pronounced excitation: treat with benzodiazepines.</li>\r\n	<li>Respiratory insufficiency: treat with artificial respiration.</li>\r\n	<li>Tachycardia: treat with beta-blockers.</li>\r\n	<li>Urinary retention: treat with catheterisation.</li>\r\n	<li>Mydriasis: treat with pilocarpine eye drops and/or place patient in a dark room.</li>\r\n</ul>\r\n\r\n<p>As with other antimuscarinics, in case of overdosing, specific attention should be paid to patients with known risk for QT-prolongation (i.e. hypokalaemia, bradycardia and concurrent administration of medicinal products known to prolong QT interval) and relevant pre-existing cardiac diseases (i.e. myocardial ischaemia, arrhythmia, congestive heart failure).</p>', '<p>Anticholinergics (antimuscarinics)/ Anti-spasmodics, BPH/ Urinary retention/ Urinary incontinence.</p>', '<p>Store in a cool and dry place, protected from light.</p>', '<p><strong>Patients with renal impairment</strong>: No dose adjustment is necessary for patients with mild to moderate renal impairment (creatinine clearance &gt;30 ml/min). Patients with severe renal impairment (creatinine clearance &lt;30 ml/min) should be treated with caution and receive no more than 5 mg once daily.<br />\r\n<br />\r\n<strong>Patients with hepatic impairment</strong>: No dose adjustment is necessary for patients with mild hepatic impairment. Patients with moderate hepatic impairment (Child-Pugh score of 7 to 9) should be treated with caution and receive no more than 5 mg once daily.<br />\r\n<br />\r\n<strong>Potent inhibitors of cytochrome P450 3A4</strong>: The maximum dose of Solifenacin Succinate should be limited to 5 mg when treated simultaneously with Ketoconazole or therapeutic doses of other potent CYP3A4 inhibitors e.g. Ritonavir, Nelfinavir, Itraconazole. Solifenacin Succinate tablet should be taken orally and should be swallowed whole with liquids. It can be taken with or without food.</p>', '2022-03-20 05:39:50', '2022-03-20 05:39:50'),
(1415, 1415, '<p>Somatostatin is indicated for:</p>\r\n\r\n<ul>\r\n	<li>Severe acute haemorrhage from oesophageal varices.</li>\r\n	<li>Severe acute haemorrhage from gastric or duodenal ulcers, or accompanying acute erosive or haemorrhagic gastritis.</li>\r\n	<li>Adjuvant treatment of pancreatic, biliary and intestinal fistulae.</li>\r\n	<li>Prophylaxis and treatment of postoperative complications following pancreatic surgery.</li>\r\n</ul>', '<p>Somatostatin is a synthetic cyclic 14 amino-acid peptide, which is identical in structure and action to natural somatostatin. By intravenous infusion in humans, somatostatin causes inhibition of growth hormone, thyroid stimulating hormone, insulin and glucagon secretion as well as inhibition of gastric acid secretion. It also affects the absorption, motility, splanchnic blood flow and trophic functions of the gastro-intestinal tract. Physiologically, somatostatin is found mainly in the gastro-intestinal tract and in the hypothalamus.<br />\r\n<br />\r\nSomatostatin inhibits the release of gastrin, gastric acid, and pepsin which supports its indication in the treatment of upper gastro-intestinal haemorrhage. Furthermore, somatostatin is capable of reducing remarkably splanchnic blood flow without causing significant variations in the systemic arterial pressure, which proves to be valuable for the management of oesophageal variceal haemorrhage. Somatostatin reduces both pancreatic endocrine and exocrine secretion which makes it effective in the prophylaxis and treatment of postoperative complications of pancreatic surgery. The positive effect of somatostatin in the management of diabetic ketoacidosis can be ascribed to its suppression activity of glucagon secretion.</p>', '<p>Somatostatin is given intravenously, by slow bolus injection (3 to 5 minutes) of 250 &micro;g or by continuous infusion at a rate of 250 &micro;g/hour (equivalent of approximately 3.5 &micro;g/kg body weight/hour). The lyophilised powder should be reconstituted with the physiological sodium chloride solution immediately prior to use. For continuous infusion one 3 mg of Somatostatin ampoule should be used to prepare a 12 hours infusion. The solution may be either saline or 5 % dextrose and should be adjusted to guarantee an outflow of 250 &micro;g somatostatin/hour. The use of a perfusion syringe is recommended.<br />\r\n<br />\r\n<strong>Treatment of severe acute bleeding from the upper gastro-</strong><strong>intestinal tract, including from oesophageal varices</strong>: It is recommended to start by a slow intravenous injection of 250 &micro;g of Somatostatin as loading dose, then immediately followed by an intravenous infusion at a rate of 250 &micro;g/h. In case of interruption of more than 3 to 5 minutes between two infusions, an additional slow intravenous injection of 250 &micro;g is recommended to ensure a continuous treatment. Once the haemorrhage has stopped (usually in less than 12 to 24 hours), treatment should be continued for 48-72 hours in order to avoid rebleeding. Treatment up to 120 hours has been routinely performed in this indication.<br />\r\n<br />\r\n<strong>Adjuvant treatment in pancreatic, biliary and intestinal fistulae</strong>: A continuous infusion of Somatostatin at a rate of 250 &micro;g/h is recommended until closure of the fistulae (2-20 days). This infusion should be performed in addition to total parenteral nutrition. Once the fistula has been closed, treatment should be continued for 1 to 3 days and stopped progressively in order to avoid rebound effect. Prophylactic treatment of postoperative complications following pancreatic surgery: Somatostatin is administered at the beginning of the surgical intervention at a rate of 250 &micro;g/h and treatment is continued for 5 days.</p>', '<p>Since somatostatin lengthens the time of hexobarbital-induced sleep and potentiates the action of pentetrazol, Somatostatin should not be administered concomitantly with these drugs or with drugs exerting the same effects.</p>', '<p>Somatostatin is contra-indicated:</p>\r\n\r\n<ul>\r\n	<li>During pregnancy and the immediate post-partum period (puerperium) as well as during lactation. There is no evidence of the drug&rsquo;s safety in human pregnancy nor is there evidence from animal work that it is free from hazard.</li>\r\n	<li>In states of proven hypersensitivity to somatostatin.</li>\r\n</ul>', '<p>Nausea, vertigo, and flushing have been reported rarely. Nausea and vomiting have been reported when the infusion rate is greater than 50&nbsp;&micro;g/min.</p>', '<p>Avoid in pregnancy unless there is no safer alternative.</p>', '<p>Due to its inhibitory effect on the secretion of insulin and glucagon, the administration of Somatostatin can, at the onset of treatment, lead to a transient fall in blood glucose level. Caution is, therefore, called for in insulin-dependent diabetic patients in whom blood glucose should be measured every 3-4 hours. Simultaneous administration of insulin-requiring sugars should, if possible, be avoided. If necessary, insulin should be administered.</p>', NULL, '<p>Growth hormone antagonist</p>', '<p>Storage condition and expiry date are indicated on the box. Solutions of Somatostatin in physiological sodium chloride are stable for 24 hours.</p>', NULL, '2022-03-20 05:41:26', '2022-03-20 05:41:26'),
(1416, 1416, '<p>Treatment of growth failure in children due to pituitary growth hormone deficiency. Treatment of growth failure in girls due to gonadal dysgenesis (Turner Syndrome). Treatment of growth failure in children due to chronic renal insufficiency whose height is on or less than the twenty-fifth percentile and whose growth velocity is on or less than the twenty-fifth percentile for bone age.<br />\r\n<br />\r\nTreatment of adults with severe growth hormone deficiency as diagnosed in the insulin tolerance test for growth hormone deficiency and defined by peak growth hormone concentrations of less than 2.5 nanogram/mL.</p>', '<p>Somatropin is a synthetic human growth hormone of recombinant DNA origin. It stimulates skeletal and soft tissue growth by promoting cell division, amino acid uptake and protein synthesis. It also possesses both insulin-like and diabetogenic effects.</p>', '<p>Children with short stature homeobox-containing (SHOX) deficiency:</p>\r\n\r\n<ul>\r\n	<li><strong>Child:</strong>&nbsp;50 mcg/kg/day may be used.</li>\r\n</ul>\r\n\r\n<p>Growth retardation due to chronic renal insufficiency, Turner&#39;s syndrome:</p>\r\n\r\n<ul>\r\n	<li><strong>Child:</strong>&nbsp;45-50 mcg/kg or 1.4 mg/m2 daily.</li>\r\n</ul>\r\n\r\n<p>Growth retardation in children who were born small for gestational age, Prader-Will syndrome:</p>\r\n\r\n<ul>\r\n	<li><strong>Child:</strong>&nbsp;35 mcg/kg or 1 mg/m2 daily. Max: 2.7 mg daily.</li>\r\n</ul>\r\n\r\n<p>Growth hormone deficiency:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initially, 6 mcg/kg daily. May increase gradually according to patient response. Max: 12.5 mcg/kg/day. Reassess 9 mth after starting treatment.</li>\r\n	<li><strong>Child:</strong>&nbsp;25-35 mcg/kg daily. Reassess 9 mth after starting treatment.</li>\r\n	<li><strong>Elderly:</strong>&nbsp;Lower doses may be required.</li>\r\n</ul>\r\n\r\n<p>Short bowel syndrome:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;100 mcg/kg/day for 4 wk. Max: 8 mg/day.</li>\r\n</ul>\r\n\r\n<p>HIV-associated wasting or cachexia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;0.1 mg/kg daily at bedtime. May be taken on alternate days for patients at increased risk of adverse effects. Max: 6 mg/day.</li>\r\n</ul>', '<p>High doses of corticosteroid may inhibit growth-promoting effects of somatropin.</p>', '<p>Acute critical illness due to heart or abdominal surgery, multiple accidental trauma or respiratory failure; active neoplasms, proliferative or preproliferative diabetic retinopathy; lactation; patients with closed epiphyses. Intracranial lesions. Patients with Prader-Willi syndrome who are severely obese or have severe respiratory impairment.</p>', '<p>Hypothyroidism, peripheral oedema; headache; muscle and joint pain; benign intracranial hypertension. Loss of glycaemic control in diabetics.</p>', '<p>Pregnancy category B1. Animal reproduction studies have not been conducted with Norditropin. It is not known whether Norditropin can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. There have been no studies conducted with Norditropin in nursing mothers and it is not known whether Norditropin is excreted in breast milk.</p>', '<p>Monitor thyroid function; benign intracranial hypertension. DM; may require dose reduction in insulin. Pregnancy. Discontinue treatment if there is evidence of tumour growth. Monitoring in patients with scoliosis is recommended due to risk of progression of scoliosis.</p>', NULL, '<p>Drugs for Growth failure</p>', '<p>Store at 2-8&deg; C.</p>', NULL, '2022-03-20 05:42:49', '2022-03-20 05:42:49'),
(1417, 1417, '<p><strong>Hepatocellular Carcinoma</strong>: Sorafenib is indicated for the treatment of patients with unresectablehepatocellular carcinoma (HCC).<br />\r\n<br />\r\n<strong>Renal Cell Carcinoma</strong>: Sorafenib is indicated for the treatment of patients with advanced&nbsp;renal cell carcinoma&nbsp;(RCC).</p>', '<p>Sorafenib is a kinase inhibitor that decreases tumor cell proliferation in vitro. Sorafenib was shown to inhibit multiple intracellular (CRAF, BRAF and mutant BRAF) and cell surface kinases (KIT, FLT-3, RET, VEGFR-1, VEGFR-2, VEGFR-3, and PDGFR-&szlig;). Several of these kinases are thought to be involved in tumor cell signaling,&nbsp;angiogenesis, and&nbsp;apoptosis. Sorafenib inhibited tumor growth and angiogenesis of human&nbsp;hepatocellular carcinoma&nbsp;and&nbsp;renal cell carcinoma, and several other human tumor xenografts in&nbsp;immunocompromised&nbsp;mice.</p>', '<p><strong>Advanced renal cell carcinoma</strong>: 400 mg bid. May continue until patient is no longer responding or unacceptable toxicity occurs.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No safety data is available for use in patients with Child-Pugh C hepatic impairment.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken on an empty stomach. May be taken with a low or moderate fat meal. If the patient intends to have a high fat meal, sorafenib should be taken on an empty stomach at least 1 hr before or 2 hr after meals. Swallow whole, do not chew/crush.</p>', '<p>Inducers of isoenzyme CYP3A4 e.g. carbamazepine, dexamethasone, phenobarbital, phenytoin, rifampicin may decrease sorafenib plasma concentration. Coadmin with sorafenib may increase the plasma concentration of doxorubicin and irinotecan.</p>', '<p>Sorafenib is contraindicated in patients with known severe hypersensitivity to sorafenib or any other component of Sorafenib. Sorafenib in combination with carboplatin and paclitaxel is contraindicated in patients with squamous cell lung cancer.</p>', '<p>Rash and hand-foot skin reactions. Hypophosphataemia, hypertension, bleeding, tinnitus, depression and erectile dysfunction. Alopecia, pruritus, dry skin, erythema, acne, flushing, exfoliative dermatitis, hoarseness, GI disturbances, arthralgia, myalgia, asthenia, pain and peripheral neuropathy.</p>', '<p>Pregnancy category D&nbsp;There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Interrupt teatment if patient develops cardiac infarction, ischaemia and/or bleeding fatalities. Regular monitoring of BP, CBC and platelet is recommended. Monitor INR in patients who are on treatment with warfarin. Adequate contraception should be used during and for at least 2 wk after stopping treatment. May need to discontinue treatment if severe or persistent hypertension occurs.</p>', '<p>There is no specific treatment for Sorafenib overdose. The highest dose of Sorafenib studied clinically is 800 mg twice daily. The adverse reactions observed at this dose were primarily diarrhea and&nbsp;dermatologic. No information is available on symptoms of acute overdose in animals because of the saturation of&nbsp;absorption&nbsp;in oral acute toxicity studies conducted in animals. In cases of suspected overdose, Sorafenib should be withheld and&nbsp;supportive care&nbsp;instituted.</p>', '<p>Targeted Cancer Therapy.</p>', '<p>Store at 25&deg; C.</p>', NULL, '2022-03-20 05:44:25', '2022-03-20 05:44:25'),
(1418, 1418, '<p>Treatment of life-threatening arrhythmias including ventricular tachyarrhythmias, symptomatic non-sustained ventricular tachyarrhythmias. Prophylaxis of paroxysmal atrial tachycardia or fibrillation, paroxysmal AV re-entrant tachycardias (both nodal and involving accessory pathways), paroxysmal supraventricular tachycardia after cardiac surgery, maintenance of sinus rhythm following cardioversion of atrial fibrillation or flutter.</p>', '<p>Sotalol is a non-cardioselective beta-blocker. It increases sinus cycle length, slows heart rate, decreases AV nodal conduction and increases AV nodal refractoriness. It also prolongs AV monophasic action potentials. However, it lacks intrinsic sympathomimetic and membrane-stabilising properties.</p>', '<p>Initially 80 mg daily in 1-2 divided doses. After ECG monitoring and measurement of corrected QT interval, arrhythmias, dose is increased gradually at intervals of 2- 3 days to usual dose of 160-320 mg daily in 2 divided doses; higher doses of 480-640 mg daily for life-threatening ventricular arrhythmias under specialist supervision.<br />\r\n<br />\r\nThe dosage should be reduced in renal impairment. lf creatinine clearance is &gt;60 ml/min, recommended dose 160 mg twice daily while in those with creatinine clearance between 40 and 60 ml/ min, the dose is administered once daily. ln patients with creatnine clearance less than 40 ml/min, Sotalol is contraindicated.</p>', '<p>ln combined therapy, clonidine should not be discontinued unitil several days&nbsp;after withdrawal of Sotalol. Use with great caution with drugs that also prolong OT interval, e.g.&nbsp;disopyramide, amiodarone, Class I antiarrhythmic agents, calcium antagonists of the verapamil&nbsp;type or tricyclic antidepressants. Interactions also occur with phenothiazines, terfenadine,&nbsp;astemizole and diltiazem. Concomitant use of reserpine, guanethidine, or alpha methyldopa&nbsp;requires close monitoring for evidence of hypotension and/or marked bradycardia, syncope.&nbsp;Hypoglycemia may occur and the dosage of insulin or antidiabetic drugs may require adjustment.</p>', '<p>Sotalol should not be given to patients with sinus, bradycardia, sick sinus&nbsp;syndrome or second or third degree AV block (unless a functional pacemaker is present);&nbsp;congenital or acquired long QT syndromes, torsades de pointes, uncontrolled congestive heart&nbsp;failure, cardiogenic shock; anaesthesia that produces myocardial depression, hypotension&nbsp;(except due to arrhythmia), severe peripheral circulatory disturbances, chronic obstructive airway&nbsp;disease or bronchial asthma, renal failure (ceratinine clearance &lt;40mL/min) and previous&nbsp;evidence of hypersensitivity to Sotalol. Sotalol should not be given to patients suffering from&nbsp;diabetic keto-acidosis or metabolic acidosis, therapy with Sotalol can be recommenced or&nbsp;resumed when the metabolic condition has been corrected.</p>', '<p>The most significant adverse effects are those which are typical of its class I and class II (Cardiac action potential duration prolongation) effects.</p>', '<p>Its use throughout pregnancy should be avoided unless it is absolutely necessary as it crosses the placenta and may cause foetal bardycardia. Infants should not be fed with breast milk from mothers being treated with Sotalol.</p>', '<p>Sotalol is not for everyone with irregular heartbeats (atrial fibrillation).&nbsp;Sotalol is not indicated for those patients who have serious kidney problems or are on kidney&nbsp;dialysis, lung disease causing shortness of breath (such as asthma, chronic bronchitis or&nbsp;emphysema), symptoms of heart failure (such as shortness of breath when in exercise or&nbsp;physically active and swelling of the ankles or legs), very slow heart beat and do not have an&nbsp;implanted artificial pacemaker.</p>', '<p>Overdosage causes excessive bradycardia and hypotension; congestive heart&nbsp;failure, bronchospasm and hypoglycemia.</p>', '<p>Anti adrenergic agent (Beta blockers).</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-20 05:45:56', '2022-03-20 05:45:56'),
(1419, 1419, '<p>Sparfloxacin is indicated for the treatment of the following infections due to susceptible microorganisms:</p>\r\n\r\n<ul>\r\n	<li>Upper and lower respiratory tract infections including sinusitis, acute exacerbation of chronic bronchitis, community and hospital acquired pneumonia.</li>\r\n	<li>Urinary tract infections including gonococcal and non-gonococcal urethritis, chancroid and other sexually transmitted diseases.</li>\r\n	<li>Skin and soft tissue infections.</li>\r\n	<li>Prophylactic use in different urological and ophthalmic operations.</li>\r\n</ul>', '<p>Sparfloxacin is a synthetic, broad-spectrum antibacterial agent from the difluoroquinolone family. It has been reported to be more active in vitro than ciprofloxacin against some organisms, including staphylococci and Mycobacteria, and has a much longer plasma half-life (16 hours).<br />\r\n<br />\r\nSparfloxacin inhibits the supercoiling activity of DNA gyrase which is an enzyme essential for DNA replication thus promoting the breakage of DNA structures. It has activity against S. pneumoniae, S. aureus, H. influenzae, K. pneumoniae, M. catarrhalis and Mycobacterium spp.</p>', '<p>In patients with normal renal function the recommended daily dose is two tablets of Sparfloxacin 200 mg on first day as a loading dose, thereafter take one tablet of Sparfloxacin 200 mg every 24 hours for a total of 10 days of therapy.<br />\r\n<br />\r\nThe recommended daily dose of Sparfloxacin in patients with renal impairment (Creatinine clearance &lt; 30 ml/min) is two tablets of 200 mg taken on the first day as a loading dose. Thereafter, should be taken one tablet of 200 mg every 48 hours for total of 9 days of therapy.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Sparfloxacin can be taken with or without food.</p>', '<p>On concomitant use with Quinidine, Sotalol, Erythromycin, Astemizole, Terfenadine, vinca alkaloids there is increased risk of arrhythmia. Salts, oxides and hydroxides of Magnesium, Aluminium and Calcium decrease absorption of Sparfloxacin.</p>', '<p>Sparfloxacin is contraindicated for individuals with a history of hypersensifivity and in achilles tend in its following the use of fluoroquinolone and in pregnancy and lactation. Sparfloxacin is contraindicated in patients with known QTc prolongation or in patients being treated concomitantly with medications known to produce an increase in the QTc interval and/or torsade depointes.</p>', '<p>Most of the adverse events were mild to moderate in severity and transient in nature. The most frequently reported events among the Sparfloxacin treated patients with the recommended dosage are: diarrhea, nausea, headache, dyspepsia, dizziness, insomnia, abdominal pain and QTc interval prolongation.</p>', '<p>There are no adequate and well controlled studies in pregnant women. Sparfloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.</p>', '<p>It should be used with caution in renal diseases, gastric ulcers and with concomitant use of NSAIDs. In renal failure of third degree severity (creatinine clearance &lt; 30 ml/min) dosage modification is recommended 400 mg on 1st day, 200 mg on 2nd and 3rd day followed by 200 mg every 48 hours. Because fluoroquinolones have been associated with tendon rupture, Sparfloxacin should be discontinued at the first sign of tendon pain. Exposure to UV radiation during treatment should be avoided.</p>', NULL, '<p>4-Quinolone preparations.</p>', '<p>Store at temperature below 30&deg; C.</p>', '<p><strong>Use in children:</strong>&nbsp;Safety and effectiveness have not been established in patients below the age of 18 years.</p>', '2022-03-20 05:47:35', '2022-03-20 05:47:35');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1420, 1420, '<p>Spectinomycin Sterile Powder is indicated in the treatment of:</p>\r\n\r\n<ul>\r\n	<li>Acute gonorrheal urethritis and proctitis in the male</li>\r\n	<li>Acute gonorrheal cervicitis and proctitis in the female</li>\r\n	<li>Men and women with known recent exposure to gonorrhea should be treated as those known to have gonorrhea.</li>\r\n</ul>', '<p>Tinobac Sterile Powder contains Spectinomycin Hydrochloride which is an aminocyclitol antibiotic produced by a species of soil microorganism designated as Streptomyces spectabilis. Spectinomycin Hydrochloride is an inhibitor of protein synthesis in the bacterial cell; the site of action is the 30S ribosomal subunit. In vitro studies have shown Spectinomycin Hydrochloride to be active against most strains of Neisseria gonorrhoeae</p>', '<p><strong>Adults (Men and Women)</strong>: Inject 5 ml intramuscularly for a 2 gm dose.This is also the recommended dose for patients being treated after failure of previous antibiotic therapy.<br />\r\n<br />\r\nIntramuscular injections should be made deep into the upper outer quadrant of the gluteal muscle.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness in the pediatric population have not been established.</p>', NULL, NULL, '<p>The following reactions were observed during the single dose clinical trials: soreness at the injection site, urticaria, dizziness, nausea, chills, fever and insomnia</p>', '<p>Pregnancy Category B. Since there are no controlled studies of Spectinomycin in pregnant women, and because animal reproduction studies are not always predictive of human responses, Spectinomycin should be used during pregnancy only if clearly needed. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Spectinomycin is administered to a nursing woman.</p>', '<p>The usual precautions should be observed with atopic individuals. Prescribing Spectinomycin Sterile Powder in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.</p>', '<p>Information on overdosage in humans is not available. Hemodialysis has been reported to aid in the removal of intravenously administered Spectinomycin from the body.</p>', '<p>Macrolides</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-20 05:48:57', '2022-03-20 05:48:57'),
(1421, 1421, '<p>Spiramycin is indicated for the treatment of infections of the respiratory tract, buccal cavity, skin and soft tissues due to susceptible organisms. Neisseria gonorrhoeae: as an alternate choice of treatment for gonorrhea in patients allergic to the penicillins. Before treatment of gonorrhea, the possibility of concomitant infection due to T. pallidum should be excluded.</p>', '<p>The mechanism of action of macrolides has been a matter of controversy for some time. Spiramycin, a 16-membered macrolide, inhibits translocation by binding to bacterial 50S ribosomal subunits with an apparent 1 : 1 stoichiometry. This antibiotic is a potent inhibitor of the binding to the ribosome of both donor and acceptor substrates. The primary mechanism of action is done by stimulation of dissociation of peptidyl-tRNA from ribosomes during translocation.</p>', '<p><strong>Adult</strong>: 6 to 9 Million International Units per 24 hours, in 2 divided doses. In severe infections, the daily dosage may be increased to 12 to 15 Million International Units per day. Gonorrhea: 12 to 13.5&nbsp; Million International Units in a single dose.<br />\r\n<br />\r\n<strong>Children</strong>: The usual daily dosage is based on 150,000 l.U./kg body weight in 2 or 3 divided doses.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Spiramycin is stable in gastric juices and absorption is not affected by food. In severe infections, the daily dosage may be increased by one half. In the treatment of beta hemolytic streptococcal infections, adequate Spiramycin dosage should be administered for 10 days.</p>', '<p>Rovamycine has been reported to inhibit the absorption of carbidopa and decrease levodopa plasma levels. When necessary, patients should be closely monitored and the levodopa dosage levels adjusted.</p>', '<p>Spiramycin is contraindicated in patients with known hypersensitivity to the drug. The levels of spiramycin attained in the cerebrospinal fluid are much lower than those in the blood and are too low to be clinically useful. Therefore Spiramycin must not be used in patients with meningitis.</p>', '<p>Side effects of include: nausea, vomiting, diarrhea, inflamed bowels, pruritus (itchy skin), tingling or numbness in the skin.</p>', '<p>Safety of this product for use during pregnancy has not been established.</p>', '<p>Administer antibiotics, including Spiramycin cautiously to any patient who has demonstrated some form of allergy, particularly to drugs. The possibility of superinfection caused by overgrowth of nonsusceptible organisms should be kept in mind during prolonged or repeated therapy. If superinfection occurs, discontinue the drug and take appropriate measures.</p>', '<p>No case of accidental overdosage has been reported. In oral doses over 4 gm per day, abdominal discomfort, nausea or diarrhea may occur. No specific treatment has been proposed. Management should be symptomatic</p>', '<p>Macrolides</p>', '<p>Store in a dry place between 15&ordm;C and 30&ordm;C.</p>', NULL, '2022-03-20 05:50:35', '2022-03-20 05:50:35'),
(1422, 1422, '<p>Spironolactone is indicated in Congestive heart failure, Hepatic cirrhosis with ascites and oedema, Nephrotic syndrome, Primary hyperaldosteronism, Essential hypertension, For the treatment of patients with hypokalemia.</p>', '<p>Spironolactone is a specific pharmacologic antagonist of aldosterone, acting primarily through competitive binding of receptors at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted renal tubule. Spironolactone causes increased amounts of sodium and water to be excreted, while potassium is retained. Spironolactone acts both as a diuretic and as an antihypertensive drug by this mechanism. It may be given alone or with other diuretic agents which act more proximally in the renal tubule. Aldosterone interacts with a cytoplasmic mineralocorticoid receptor to enhance the expression of the Na+&nbsp;K+&nbsp;ATPase and the Na+&nbsp;channel involved in a Na+&nbsp;K+&nbsp;transport in the distal tubule . Spironolactone bind to this mineralcorticoid receptor, blocking the actions of aldosterone on gene expression. Aldosterone is a hormone; its primary function is to retain sodium and excrete potassium in the kidneys.</p>', '<p><strong>Edema in adults (congestive heart failure, hepatic cirrhosis, or nephrotic syndrome)</strong>: An initial daily dosage of 100 mg of Spironolactone administered in either single or divided doses is recommended, but may range from 25 to 200 mg daily. Combined therapy with other diuretics is indicated when more rapid diuresis is desired.<br />\r\n<br />\r\n<strong>Primary hyperaldosteronism</strong>: After the diagnosis of hyperaldosteronism has been established, Spironolactone may be administered in doses of 100 to 400 mg daily in preparation for surgery. For patients who are considered unsuitable for surgery, Spironolactone may be employed for long-term maintenance therapy at the lowest effective dosage determined for the individual patient.<br />\r\n<br />\r\n<strong>Essential hypertension</strong>: For adults, an initial daily dosage of 50 to 100 mg of Spironolactone administered in either single or divided doses is recommended.<br />\r\n<br />\r\n<strong>Hypokalemia</strong>: Spironolactone in a dosage ranging from 25 mg to 100 mg daily is useful in treating a diuretic-induced hypokalemia.</p>', '<p><strong>ACE inhibitors</strong>: Concomitant administration of ACE inhibitors with potassium-sparing diuretics has been associated with severe hyperkalemia.<br />\r\n<br />\r\n<strong>Alcohol, barbiturates, or narcotics</strong>: Potentiation of orthostatic hypotension may occur.<br />\r\n<br />\r\n<strong>Corticosteroids, ACTH</strong>: Intensified electrolyte depletion, particularly hypokalemia, may occur.<br />\r\n&nbsp;<br />\r\n<strong>Lithium</strong>: Lithium generally should not be given with diuretics. Diuretic agents reduce the renal clearance of lithium and add a high risk of lithium toxicity.<br />\r\n<br />\r\n<strong>Digoxin</strong>: Spironolactone has been shown to increase the half-life of digoxin.</p>', '<p>Spironolactone is contraindicated in patients with acute renal insufficiency, significant impairment of renal function, anuria, hyperkalaemia or sensitivity to Spironolactone.</p>', '<p>Gynaecomastia may develop in association with the use of Spironolactone. Other adverse reactions are: GI symptoms including cramping and diarrhoea, drowsiness, lethargy, headache, urticaria, mental confusion, impotence, irregular menses or amenorrhoea and post-menopausal bleeding.</p>', '<p><strong>Pregnancy</strong>: Spironolactone should not be used during pregnancy<br />\r\n<br />\r\n<strong>Lactation</strong>: Canrenone, an active metabolite of Spironolactone, appears in breast milk. If use of the drug is deemed essential an alternative method of infant feeding should be instituted.</p>', '<p>All patients receiving diuretic therapy should be observed for evidence of fluid or electrolyte imbalance. Hyperkalemia may occur in patients with impaired renal function or excessive potassium intake and can cause cardiac irregularities, which may be fatal.</p>', '<p>Symptoms of overdosage include drowsiness, mental confusion, dizziness, diarrhea and vomiting etc. Patients should induce vomiting or evacuate the stomach by lavage during Spironolactone overdoasge.</p>', '<p>Potassium-sparing diuretics, Potassium-sparing diuretics &amp; Aldosterone antagonists</p>', '<p>Store in a cool and dry place protected from light. Keep out of reach of children.</p>', NULL, '2022-03-20 05:52:16', '2022-03-20 05:52:16'),
(1423, 1423, '<p>Streptokinase is indicated for use in the management of acute myocardial infarction, for the lysis of intracoronary thrombi, for the improvement of ventricular function, and reduction of mortality when administered by either the intravenous or intracoronary route. Earlier administration of streptokinase is correlated with greater clinical benefit, the greatest benefit (in terms of mortality reduction) being seen when Streptase is administered within the first 4 hours after onset of symptoms. The treatment should always commence within 6 hours of the onset of pain.</p>', '<p>Streptokinase forms a complex with plasminogen which then converts plasminogen to plasmin. Plasmin breaks down clots as well as fibrinogen and other plasma proteins.</p>', '<p>Streptokinase can be reconstituted using 5 ml sodium chloride injection or 5% Dextrose Injection directing the diluent at the side of the vacuum packed vial rather than into drug powder</p>\r\n\r\n<p>Acute Myocardial Infarction:</p>\r\n\r\n<p>IV infusion:</p>\r\n\r\n<ul>\r\n	<li><strong>Vial size (IU)</strong>: 15,00,000</li>\r\n	<li><strong>Total solution volume</strong>: 45 ml</li>\r\n	<li><strong>Infusion rate</strong>: Infuse 45 ml within 60 mins</li>\r\n</ul>\r\n\r\n<p>Intracoronary infusion:</p>\r\n\r\n<ul>\r\n	<li><strong>Vial size (IU)</strong>: 2,50,000</li>\r\n	<li><strong>Total solution volume:</strong>&nbsp;125 ml</li>\r\n	<li><strong>20,000 IU bolus, Infusion rate</strong>: Loading dose of 10 ml</li>\r\n	<li><strong>2,000 IU/min. for 60 minutes, Infusion rate</strong>: 60 ml/hour</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Pulmonary Embolism, Deep Vein Thrombosis, Arterial Thrombosis or Embolism:</p>\r\n\r\n<ul>\r\n	<li><strong>2,50,000 IU loading dose over 30 min, Vial size (IU)</strong>: 15,00,000, Total solution volume 90 ml, Infusion rate: Infuse 30 ml/hour for 30 min</li>\r\n	<li><strong>1,00,000 IU/hour for maintenance dose, Infusion rate</strong>: Infuse 6 ml/hour</li>\r\n</ul>', '<p>There is an increased risk of haemorrhage in patients simultaneously or previously receiving anticoagulants (such as Heparin or Coumarin derivatives) or drugs which inhibit platelet formation or function (e.g., Platelet aggregation inhibitors, Dextrans, Phenylbutazone, Dipyridamole, Non-steroidal anti-inflammatory drugs). The effect of Heparin can be neutralized rapidly by administration of Protamine Sulphate. The Thrombin time (TT) should not be more than twice the normal control value before thrombolytic therapy is started. In the case of prior treatment with coumarin derivatives, the International Normalized Ratio (INR) must be less than 1.3 before starting Streptokinase infusion.<br />\r\n<br />\r\n<strong>Combination of Streptokinase with Aspirin for treatment of Myocardial infarction</strong>: Study showed a significant benefit to patients treated with these two agents after acute myocardial infarction. Mortality (both short and longer term) was reduced in these patients to a greater extent than in those treated with either agent alone.<br />\r\n<br />\r\nUnless contraindicated, the concomitant use of Acetylsalicylic acid (ASA, Aspirin), starting prior to Streptokinase infusion and continued for one month thereafter may be instituted at the discretion of the physician. The benefit of combination therapy should therefore be weighed against the risk of increased haemorrhage.<br />\r\n<br />\r\n<strong>Anticoagulation treatment following Streptokinase</strong>: Following high dose (1.5 million IU), short term treatment with Streptokinase, for acute myocardial infarction, the use of subsequent anticoagulant treatment has not yet been shown to be of unequivocal benefit. Therefore, in this situation, the use of anticoagulants should be decided by the physician.</p>', '<p>As thrombolytic therapy increases the risk of bleeding, Streptokinase, administered either systemically or locally, is contraindicated in the following situations:<br />\r\n<br />\r\nExisting or recent haemorrhage and haemorrhagic diathesis (with the exception of consumption coagulopathy) Potential for internal bleeding (e.g., peptic ulcer, ulcerative colitis, diverticulitis or visceral tumours) All forms of reduced blood coagulability, in particular spontaneous fibrinolysis and extensive clotting disorders.<br />\r\n<br />\r\nRecent (within 2 months) cerebrovascular accident, recent (within 10 days) facial or head trauma, intracranial or intraspinal surgery, known intracranial neoplasm and all known neoplasms with risk of haemorrhage&nbsp;<br />\r\n<br />\r\nInvasive operations, e.g., recent organ biopsy, invasive diagnostic procedure, recent implantation of a vessel prosthesis, long-term traumatic closed-chest massage or other recent surgery (until the 6th to 10th post operative day, depending on the severity of surgical intervention)<br />\r\n<br />\r\nArteriovenous malformation or aneurysm: Haemorrhagic diathesis including thrombocytopenia or pronounced hepatic or renal dysfunction&nbsp;<br />\r\n<br />\r\nSevere uncontrolled hypertension (systolic BP &gt; 200 mm Hg, diastolic BP &gt; 100 mm Hg), or hypertensive retinal changes grades III/IV), hypertonic fundus&nbsp;<br />\r\n<br />\r\nSevere liver or kidney damage: Simultaneous treatment with oral anticoagulants (International Normalized Ratio (INR) &gt;1.3)&nbsp;<br />\r\n<br />\r\nEndocarditis or pericarditis (Immediately after streptococcal infections which have produced a high antiStreptokinase titre (acute rheumatic fever, acute glomerulo-nephritis, etc.). More than 5 days and less than 12 months since previous Streptokinase therapy.</p>', '<p>The following adverse reactions are based on experience from clinical trials and on post marketing experience of Streptokinase.&nbsp;<br />\r\n<br />\r\nGeneral disorders:</p>\r\n\r\n<ul>\r\n	<li><strong>Common</strong>: Headache and back pain, muscle pain (including myalgia), chills and/or fever as well as asthenia/malaise.</li>\r\n</ul>\r\n\r\n<p>Haemorrhage and bleeding:</p>\r\n\r\n<ul>\r\n	<li><strong>Common</strong>: Haemorrhages at invaded or disturbed sites, including the injection site, and ecchymoses. Gastrointestinal or genitourinary bleedings (including aggravation of menstrual bleeding), epistaxis.&nbsp;</li>\r\n	<li><strong>Uncommon</strong>: Intracranial haemorrhages with their complications and possible fatal outcome, retinal haemorrhages, severe haemorrhages (also with fatal outcome) including liver haemorrhages, retroperitoneal bleedings, splenic rupture. Blood transfusions are rarely required.</li>\r\n</ul>\r\n\r\n<p>Immune system disorders:</p>\r\n\r\n<ul>\r\n	<li><strong>Very common</strong>: Development of antistreptokinase antibodies&nbsp;</li>\r\n	<li><strong>Common</strong>: Allergic-anaphylactic reactions such as rash, flushing, itching, urticaria, angioneurotic oedema, minor breathing difficulty, periorbital swelling, bronchospasm or hypotension.</li>\r\n</ul>\r\n\r\n<p>Nervous system disorders:</p>\r\n\r\n<ul>\r\n	<li><strong>Rare</strong>: Neurologic symptoms (e.g., dizziness, confusion, paralysis, hemiparesis, agitation or convulsion) in the context of cerebral haemorrhages or cardiovascular disorders with hypoperfusion of the brain.</li>\r\n</ul>\r\n\r\n<p>Cardiac complication and vascular disorders:</p>\r\n\r\n<ul>\r\n	<li><strong>Very common</strong>: Hypotension, heart rate and rhythm disorders, angina pectoris.&nbsp;</li>\r\n	<li><strong>Common</strong>: Recurrent ischaemia, heart failure, reinfarction, cardiogenic shock, pericarditis, pulmonary oedema.&nbsp;</li>\r\n	<li><strong>Uncommon</strong>: Cardiac arrest (leading to respiratory arrest), mitral insufficiency, pericardial effusion, cardiac tamponade, myocardial rupture, pulmonary or distal embolism.</li>\r\n</ul>\r\n\r\n<p>Respiratory disorders:</p>\r\n\r\n<ul>\r\n	<li><strong>Very rare</strong>: Non-cardiogenic pulmonary oedema after intracoronary thrombolytic therapy in patients with extensive myocardial infarction.</li>\r\n</ul>\r\n\r\n<p>Gastrointestinal disorders:</p>\r\n\r\n<ul>\r\n	<li><strong>Common</strong>: Nausea, diarrhoea, epigastric pain and vomiting.</li>\r\n</ul>', '<p>Pregnancy category C. It is not known whether Streptokinase is excreted in the breast milk, nor whether it has harmful effects on the newborn. In the absence of further information, it is recommended that breast-feeding be discontinued in women who are to receive Streptokinase.</p>', '<p>Because of the increased likelihood of resistance, due to antistreptokinase antibodies, retreatment with Streptokinase or Streptokinase-containing products may not be effective if administered between five days and twelve months of prior Streptokinase administration or Streptococcal infections, such as Streptococcal pharyngitis, acute rheumatic fever or acute glomerulonephritis secondary to a Streptococcal infection.<br />\r\n<br />\r\nIn principle, no thrombolytic treatment should be commenced before the 10th postoperative day. However, in cases of pulmonary embolism, the indication for earlier treatment may be very strong and after careful consideration of all the risks, Streptokinase may be given before the tenth postoperative day. The danger of bleeding from the operative area must, of course, be taken into account.<br />\r\nThe danger of haemorrhage is increased by simultaneous or previous treatment with anticoagulants (e.g., Heparin) or substances which inhibit platelet formation or function. If the patient is under active heparinisation, it should be neutralised by the administration of protamine sulphate before the start of thrombolytic therapy.&nbsp;<br />\r\n<br />\r\n<strong>Repeated Administration</strong>: After administration of Streptokinase, the titre of antistreptokinase antibodies begins to rise after approximately one week, reaching a peak at 2 to 3 weeks and remains elevated for 8 to 12 months. Because of the increased likelihood of resistance, Streptokinase may not be effective if given during this period.</p>', '<p>If uncontrollable bleeding occurs as a result of overdosage, Streptokinase infusion should be ceased immediately. Bleeding can be reversed and blood loss managed effectively with appropriate replacement therapy. Administration of aminocaproic acid or aprotinin may be useful.</p>', '<p>Fibrinolytics (Thrombolytics)</p>', '<p>Streptokinase vial should be stored at 2 to 25&deg; C. Once reconstituted with physiological saline, the physico-chemical stability has been demonstrated for 24 hours at 2 to 8&deg; C. From a microbiological point of view and as Streptokinase 1500000 contains no preservative, the reconstituted product should be used immediately. If it is not administered immediately, storage shall not exceed 24 hours at 2 to 8&deg; C. Keep out of the reach of children.</p>', '<p><strong>Pediatric use</strong>: Safety &amp; effectiveness in children have not been established.</p>', '2022-03-20 05:54:32', '2022-03-20 05:54:32'),
(1424, 1424, '<p>Streptomycin is indicated for the treatment of individuals with moderate to severe infections caused by susceptible strains of microorganisms in the specific conditions listed below:<br />\r\n<br />\r\nMycobacterium tuberculosis: The Advisory Council for the Elimination of Tuberculosis, the American Thoracic Society, and the Center for Disease Control recommend that either streptomycin or ethambutol be added as a fourth drug in a regimen containing isoniazid (INH), rifampin and pyrazinamide for initial treatment of tuberculosis unless the likelihood of INH or rifampin resistance is very low. The need for a fourth drug should be reassessed when the results of susceptibility testing are known. In the past when the national rate of primary drug resistance to isoniazid was known to be less than 4% and was either stable or declining, therapy with two and three drug regimens was considered adequate. If community rates of INH resistance are currently less than 4%, an initial treatment regimen with less than four drugs may be considered. Streptomycin is also indicated for therapy of tuberculosis when one or more of the above drugs is contraindicated because of toxicity or intolerance. The management of tuberculosis has become more complex as a consequence of increasing rates of drug resistance and concomitant HIV infection. Additional consultation from experts in the treatment of tuberculosis may be desirable in those settings.<br />\r\n<br />\r\nNon-tuberculosis infections: The use of streptomycin should be limited to the treatment of infections caused by bacteria which have been shown to be susceptible to the antibacterial effects of streptomycin and which are not amenable to therapy with less potentially toxic agents.</p>\r\n\r\n<ul>\r\n	<li>Pasteurella pestis (plague)</li>\r\n	<li>Francisella tularensis (tularemia)</li>\r\n	<li>Brucella</li>\r\n	<li>Calymmatobacterium granulomatis (donovanosis, granuloma inguinale)</li>\r\n	<li>H. ducreyi (chancroid)</li>\r\n	<li>H. influenzae (in respiratory, endocardial, and meningeal infections - concomitantly with another antibacterial agent)</li>\r\n	<li>K. pneumoniae pneumonia (concomitantly with another antibacterial agent)</li>\r\n	<li>E.coli, Proteus, A. aerogenes, K. pneumoniae, and Enterococcus faecalis in urinary tract infections</li>\r\n	<li>Streptococcus viridans, Enterococcus faecalis (in endocardial infections - concomitantly with penicillin)</li>\r\n	<li>Gram-negative bacillary bacteremia (concomitantly with another antibacterial agent)</li>\r\n</ul>\r\n\r\n<p>To reduce the development of drug-resistant bacteria and maintain the effectiveness of streptomycin and other antibacterial drugs, streptomycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy</p>', '<p>Aminoglycosides like Streptomycin &quot;irreversibly&quot; bind to specific 30S-subunit proteins and 16S rRNA. Specifically Streptomycin binds to four nucleotides of 16S rRNA and a single amino acid of protein S12. This interferes with decoding site in the vicinity of nucleotide 1400 in 16S rRNA of 30S subunit. This region interacts with the wobble base in the anticodon of tRNA. This leads to interference with the initiation complex, misreading of mRNA so incorrect amino acids are inserted into the polypeptide leading to nonfunctional or toxic peptides and the breakup of polysomes into nonfunctional monosomes.</p>', '<p>Tularaemia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;1-2 g daily in divided doses for 7-14 days until the patient is afebrile for 5-7 days.</li>\r\n	<li><strong>Child:</strong>&nbsp;15 mg/kg bid for at least 10-14 days. Max: 2 g daily</li>\r\n</ul>\r\n\r\n<p>Bacterial endocarditis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Streptococcal endocarditis: 1 g bid for 1 wk, then 500 mg bid for the 2nd wk. Enterococcal endocarditis: 1 g bid for 2 wk then 500 mg bid for an additional 4 wk. Doses are given in combination with penicillin.</li>\r\n	<li><strong>Child:</strong>&nbsp;Enterococcal endocarditis: 20-30 mg/kg daily in 2 divided doses, in combination w/ penicillin.</li>\r\n	<li><strong>Elderly:</strong>&nbsp;Streptococcal endocarditis: &gt;60 yr 500 mg bid for the entire 2 wk period.</li>\r\n</ul>\r\n\r\n<p>Tuberculosis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;15 mg/kg as a single dose daily. Max: 1 g daily. As part of intermittent regimen: 25-30 mg/kg 2-3 times wkly. Max: 1.5 g/dose.</li>\r\n	<li><strong>Child:</strong>&nbsp;20-40 mg/kg as a single dose daily. Max: 1 g daily. As part of intermittent regimen: 25-30 mg/kg 2-3 times wkly. Max: 1.5 g/dose.</li>\r\n	<li><strong>Elderly:</strong>&nbsp;&gt;40 yr Max: 500-750 mg daily.</li>\r\n</ul>\r\n\r\n<p>Plague:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;2 g daily in 2 divided doses for a minimum of 10 days.</li>\r\n	<li><strong>Child:</strong>&nbsp;30 mg/kg daily in 2-3 divided doses. Max: 2 g daily.</li>\r\n</ul>\r\n\r\n<p>Bacteraemia, Brucellosis, Meningitis, Pneumonia, Urinary tract infections:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;For concomitant use with other agents and as 2nd line agent: 1-2 g daily in divided doses 6-12 hrly. Max: 2 g daily.</li>\r\n	<li><strong>Child:</strong>&nbsp;20-40 mg/kg daily in divided doses 6-12 hrly.</li>\r\n</ul>', '<p>Additive neurotoxic and nephrotoxic effect with neomycin, kanamycin, gentamicin, cefaloridine, paronomycin, viomycin, polymyxin B, colistin, tobramycin, and ciclosporin. Enhanced ototoxic and nephrotoxic effect with ethacrynic acid, mannitol, furosemide and possibly other diuretics. May enhance the resp depressant effect of neuromuscular blockers. Increased risk of nephrotoxicity with cephalosporins. Reduced excretion with NSAIDs.</p>', '<p>Hypersensitivity to streptomycin and other aminoglycosides.</p>', '<p>Neurotoxic reactions (e.g. vestibular and cochlear function disturbance, optic nerve dysfunction, peripheral neuritis, arachnoiditis, encephalopathy); paraesthesia of face, rash, fever, angioneurotic oedema, eosinophilia; exfoliative dermatitis, azotemia, leucopenia, thrombocytopenia, pancytopenia, haemolytic anaemia, muscular weakness, amblyopia.</p>', '<p>Streptomycin can cause fetal harm when administered to a pregnant woman. Because streptomycin readily crosses the placental barrier, caution in use of the drug is important to prevent ototoxicity in the fetus. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus.</p>', '<p>Patient with neuromuscular disorders (e.g. myasthenia gravis), pre-existing vertigo, or hearing loss. Renal impairment. Elderly, childn. Pregnancy and lactation.</p>', NULL, '<p>Aminoglycosides, Anti-Tubercular Antibiotics.</p>', '<p>Store between 15-30&deg;C. Protect from light.</p>', '<p><strong>Renal Impairment:</strong>&nbsp;Dosage adjustment needed.</p>', '2022-03-20 05:56:16', '2022-03-20 05:56:16'),
(1425, 1425, '<p>Strontium Ranelate is a non-hormonal medicine used to treat osteoporosis in postmenopausal women. Strontium Ranelate reduces the risk of fracture at the spine and at the hip<br />\r\n<br />\r\n<strong>About osteoporosis</strong>: Your body is constantly breaking down old bone and making new bone tissue. If you have osteoporosis, your body breaks down more bone than it forms so that gradually bone loss occurs and your bones become thinner and fragile. This is especially common in women after the menopause (change of life). Many people with osteoporosis have no symptoms and you may not even know that you have it. However, osteoporosis makes you more likely to have fractures (break bones), especially in your spine, hips and wrists.</p>', '<p>Strontium Ranelate works by reducing bone breakdown and stimulating rebuilding of bone and therefore reduces the risk of fracture. The newly formed bone is of normal quality.</p>', '<p>The recommended dose is one 2 gm sachet a day. Strontium should always be taken as per the advice of the doctor. Please check with your doctor in case of any confusion. Strontium is for oral use.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>It is recommended that you take Strontium at bedtime. You may lie down immediately after taking Strontium if you wish. Take the granules contained in the sachets as a suspension in a glass of water (see instructions below). Strontium can interact with milk and milk products, so it is important that you mix Strontium only with water to be sure it works properly<br />\r\n<br />\r\nDrink straight away. If for some reason you do not drink the medicine straight away, make sure you stir it again before drinking. You should not leave it more than 24 hours before you drink it. Your doctor may advise you to take calcium and vitamin D supplements in addition to Strontium. Do not take calcium supplements at bedtime, at the same time as Strontium. Your doctor will tell you how long you should continue to take Strontium. Osteoporosis therapy is usually required for a long period. It is important that you continue taking Strontium<br />\r\n<br />\r\nIf you forget to take Strontium:&nbsp;Do not take a double dose to make up for forgotten individual doses. Just carry on with the next dose at the normal time.</p>', '<p><strong>Taking other medicines:&nbsp;</strong>Please tell your doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. If you are taking medicines containing calcium, you should leave at least 2 hours before you take Strontium Ranelate . If you take antacids (medicines to relieve heartburn) you should take them at least 2 hours after Strontium Ranelate . If this is not possible, it is acceptable to take the two medicines at the same time. You should stop taking Strontium Ranelate if you have to take oral tetracyclines or quinolones (two types of antibiotics). You can take Strontium Ranelate again when you have finished taking these antibiotics. If you are unsure about this ask your doctor.<br />\r\n<br />\r\n<strong>Taking Strontium Ranelate with food and drink:&nbsp;</strong>Food, milk and milk products reduce the absorption of strontium ranelate. It is recommended that you take Strontium Ranelate in-between meals, preferably at bedtime at least two hours after food, milk or milk products or calcium supplements.</p>', '<p>Strontium Ranelate is not intended for use in children and adolescents. During treatment, if you experience an allergic reaction (such as swelling of the face, tongue or throat, difficulty in breathing or swallowing, skin rash), you must stop taking Strontium Ranelate and seek medical advice immediately. If you have stopped treatment due to hypersensitivity reactions you should not re-start therapy with Strontium Ranelate.</p>', '<p>Like all medicines, Strontium&nbsp;can cause side effects, although not everybody gets them. The most common side effects are nausea, diarrhoea, headache and skin irritation. However,these effects were mild and short-lived and usually did not cause the patients to stop taking their treatment. Other events less commonly reported included blood clots, fainting fit, memory troubles and, in rare cases, seizures. If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor.</p>', '<p><strong>Pregnancy:&nbsp;</strong>Strontium Ranelate is meant for use only in postmenopausal women. Therefore, this&nbsp;should not be taken during pregnancy. If you take it by accident during pregnancy, stop taking it straight away and talk to your doctor.<br />\r\n<br />\r\n<strong>Breast-feeding:</strong>&nbsp;Strontium Ranelate is meant for use only in postmenopausal women. Therefore, breast-feeding women should not take this medicine. If you take it by accident during breast- feeding, stop taking it straight away and talk to your doctor.</p>', '<p>Before taking Strontium Ranelate talk to your doctor:</p>\r\n\r\n<ul>\r\n	<li>if you have severe kidney disease.</li>\r\n	<li>if you are being treated or have been treated for blood clots.</li>\r\n	<li>if you are confined to bed or if you are to undergo an operation. The risk of vein thrombosis (blood clots in the leg) may be increased in the event of lengthy immobilization.</li>\r\n	<li>if you are allergic (hypersensitive) to strontium ranelate.</li>\r\n</ul>\r\n\r\n<p>Strontium Ranelate is not intended for use in children and adolescents. During treatment, if you experience an allergic reaction (such as swelling of the face, tongue or throat, difficulty in breathing or swallowing, skin rash), you must stop taking Strontium Ranelate and seek medical advice immediately. If you have stopped treatment due to hypersensitivity reactions you should not re-start therapy with Strontium Ranelate.</p>', '<p>If you take too many sachets of Strontium Ranelate, tell your doctor. They may advise you to drink milk or take antacids to reduce the absorption of the active ingredient.</p>', '<p>Inhibiting bone resorption.</p>', '<p>Keep out of the reach and sight of children. Store at a cool and dry place, away from light.</p>', NULL, '2022-03-21 03:30:34', '2022-03-21 03:30:34'),
(1426, 1426, '<p>Sucralfate is indicated in adults and adolescents over 14 years old for treatment of-</p>\r\n\r\n<ul>\r\n	<li>Duodenal ulcer</li>\r\n	<li>Gastric ulcer</li>\r\n	<li>Chronic gastritis</li>\r\n	<li>The prophylaxis of gastrointestinal hemorrhage from stress ulceration in seriously ill patients.</li>\r\n</ul>', '<p>Sucralfate is non-systemic as the drug is only minimally absorbed from the gastrointestinal tract. The minute amount which absorbed primarily excretes in the urine. Sucralfate promotes the healing of gastric and duodenal ulcers by the formation of a chemical complex that binds to the ulcer site to establish a protective barrier. Besides, Sucralfate inhibits the action of pepsin and bile.</p>', '<p>Duodenal ulcer, gastric ulcer, chronic gastritis-</p>\r\n\r\n<ul>\r\n	<li>Adults: The usual dose is Sucralfate 2 gm twice daily to be taken on rising and at bedtime or Sucralfate 1 gm four times a day to be taken 1 hour before meals and at bedtime. Maximum daily dose is 8 gm but up to twelve weeks may be necessary in resistant cases.</li>\r\n	<li>Pediatric population: The safety and efficacy of Sucralfate in children under 14 years of age has not been established.</li>\r\n	<li>Elderly: There are no special dosage requirements for elderly patients but as with all medicines the lowest effective dose should be used.</li>\r\n</ul>\r\n\r\n<p>Prophylaxis of gastrointestinal hemorrhage from stress ulceration-</p>\r\n\r\n<ul>\r\n	<li>Adults: The usual dose is Sucralfate 1 gm orally or via a nasogastric tube 4 to 6 times a day. To prevent clogging of the nasogastric tube flush with 10 ml of water following each administration. The duration of treatment for prophylaxis of stress ulceration must be individually determined. Treatment should be continued for as long as one or more of the risk factors for stress ulceration is present but normally not for more than 14 days.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Sucralfate should be taken on an empty stomach. Antacid should not be administered within 30 minutes of Sucralfate.</p>', '<p>Concomitant administration of Sucralfate may reduce the bioavailability of certain drugs including Fluoroquinolones such as Ciprofloxacin and Norfloxacin, Tetracycline, Ketoconazole, Sulpiride, Digoxin, Warfarin, Phenytoin, Theophylline, Levothyroxine, Quinidine, and H2 antagonists. The bioavailability of these agents may be restored by separating the administration of these agents from Sucralfate by two hours. This interaction appears to be non-systemic in origin presumably resulting from these agents being bound by Sucralfate in the gastrointestinal tract. Because of the potential of Sucralfate to alter the absorption of some drugs from the gastrointestinal tract, the separate administration of Sucralfate from that of other agents should be considered when alterations in bioavailability are felt to be critical for concomitantly administered drugs. Sucralfate should not be co-administered with citrate preparations. Co-administration citrate preparations with sucralfate may increase the blood concentrations of aluminium. The mechanism may be due to the chelation of aluminium which is assumed to increase its absorption. The administration of Sucralfate&nbsp;&nbsp; 1 g and enteral feeds by nasogastric tube should be separated by one hour in patients receiving Sucralfate 1 g for the prophylaxis of stress ulceration. In rare cases, bezoar formation has been reported when Sucralfate and enteral feeds have been given too closely together.</p>', '<p>Sucralfate tablet and suspension are contraindicated in patients with hypersensitivity to sucralfate.</p>', '<p>The most common adverse event was headache (3.4%) followed by nausea (2.3%), abdominal pain (2.3%), constipation (1.1%), diarrhea (1.1%), and urticaria (1.1%). The majority of patients who reported bezoars, had underlying medical conditions that may predispose to bezoar formation (such as delayed gastric emptying) or were receiving concomitant enteral tube feedings. Episodes of hyperglycemia have been reported in diabetic patient.</p>', '<p>Safety in pregnant women has not been established and Sucralfate should be used during pregnancy only if clearly needed. It is not known whether this drug is excreted in human milk. Caution should be exercised when Sucralfate is administered to breast-feeding women.</p>', '<p>Sucralfate should only be used with caution in patients with renal dysfunction, due to the possibility of increased aluminium absorption. Sucralfate is not recommended for use in individuals on dialysis. In patients with severe or chronic renal impairment, Sucralfate should be used with extreme caution and only for short-term treatment. Small amounts of aluminium are absorbed through the gastrointestinal tract and aluminium may accumulate. Aluminium osteodystrophy, osteomalacia, encephalopathy and anaemia have been reported in patients with chronic renal impairment. For patients with impairment of renal function, laboratory testing such as aluminium, phosphate, calcium and alkaline phosphatase is recommended to be periodically performed due to excretion impairment. The concomitant use of other aluminium containing medications is not recommended in view of the enhanced potential for aluminium absorption and toxicity. Bezoars have been reported after administration of sucralfate mainly to severely ill patients in intensive care units. The majority of these patients (including neonates in whom sucralfate is not recommended) had underlying conditions that may predispose to bezoar formation (such as delayed gastric emptying due to surgery, drug therapy or diseases that reduce motility) or were receiving concomitant enteral tube feeding.</p>', '<p>In a clinical trial on healthy men of overdose with Sucralfate, most cases remained asymptomatic but symptoms of abdominal pain, nausea, and vomiting were reported in a few cases. Acute oral toxicity studies in animals using doses up to 12 gm/kg body weight could not find a lethal dose. Risks associated with overdose should therefore be minimal.</p>', '<p>Chelating complex.</p>', '<p>Store in a cool and dry place, protected from light.</p>', '<p>Pediatric Population: Sucralfate is not recommended for use in children under 14 years of age due to insufficient data on safety and efficacy.<br />\r\n<br />\r\nIn elderly patients: Dose adjustments are not necessary.<br />\r\n<br />\r\nRenal Impairment: Sucralfate should be used with caution in renal insufficiency patients.<br />\r\n<br />\r\nEffects on ability to drive and use machines: Patients should not be drive if feel dizzy or drowsy.</p>', '2022-03-21 03:32:30', '2022-03-21 03:32:30'),
(1427, 1427, '<p>Sucralose is a sugar substitute, can be used as sweetener in different foods like tea, coffee, pudding, milk products, jelly, fruit juices, desserts, hot and cold beverage etc. Due to zero calorie sweetener, it is a nice preparation for the health conscious people. Sucralose can be a unique choice for the diabetic patients who have excess amount of glucose in blood. FDA has confirmed that sucralose is suitable for use by everyone, including children, pregnant women and any person who wants to reduce calorie intake.</p>', '<p>Sucralose is a Zero Calorie artificial sweetener. Sucralose is about 600 times sweeter than sugar. Sucralose Obtained from sucrose where three hydroxyl groups are replaced by three chlorine atoms. Because it is made from sugar, sucralose tastes like sugar. Tightly bound Carbon-chlorine bonds are exceptionally stable and prevent Sucralose from being metabolized for energy, making Sucralose calorie free. The chlorine atoms also provide heat stability, enabling sucralose to withstand of cooking and baking without losing sweetness. Sucralose is not broken down for energy in the body. So it has no calorie. The sucralose molecule passes through the body unchanged, is not metabolized and is eliminated after consumption. Sucralose does not cause tooth decay, has no effect on carbohydrate metabolism, no effect on fetal or neonatal development because sucralose is not actively transported across the blood-brain barrier, the placental barrier or the mammary gland. Sucralose is non-interference in the utilization and absorption of glucose, metabolism of carbohydrates and secretion of insulin. Therefore, it is a safe substance able to be ingested by diabetes patients.</p>', '<p>The acceptable daily intake of sucralose is 5-15 mg/kg body weight. Normally 1 tablet (8 mg) in a cup of tea or coffee is enough to sweeten the drink.</p>\r\n\r\n<p><br />\r\nThe acceptable daily intake (ADI) of Sucralose Sweet Drops is 5-15 mg per kg of body weight. Each drops sweetness is like one teaspoon of sugar. Normally one drop in a cup of tea or coffee is enough to sweeten the drink or as directed by the physician.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>No known contraindication.</p>', '<p>No known side effects.</p>', '<p>FDA has not yet classified the drug into a specified pregnancy category.</p>', NULL, NULL, '<p>Oral nutritional preparations.</p>', '<p>Store at temperature not exceeding 30&deg;C. Keep in a cool and dry place, protected from light. Keep out of reach of children.</p>', NULL, '2022-03-21 03:33:58', '2022-03-21 03:33:58'),
(1428, 1428, '<p>Tea, Coffee, fruit juices, baked foods, baking mixes, non alcoholic beverages, confections and frostings, fats and oils, frozen dairy desserts and mixes, sugar substitutes, sweet sauces, toppings and syrups.</p>', '<p>Suito is non-caloric sweetener. The majority of ingested Suito is not broken down by the body and therefore it is non-caloric. Sucralose &amp; Acesulfame Potassium is 600 and 200 times as sweet as sucrose (table sugar) respectively. Sucralose is 3 times as sweet as Aspartame whereas Acesulfame Potassium is as sweet as Aspartame. Sucralose &amp; Acesulfame Potassium are blended to give a more sugar-like taste whereby each sweetener masks the others aftertaste and exhibits a synergistic effect by which the blend is sweeter than its components. Suito is stable under heat and over a broad range of pH conditions.</p>', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '<p>Oral nutritional preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-21 03:35:00', '2022-03-21 03:35:00'),
(1429, 1429, '<p>Sulconazole nitrate is a broad-spectrum antifungal agent indicated for the treatment of tinea cruris and tinea corporis caused by Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, and Microsporum canis; and for the treatment of tinea versicolor. Effectiveness has not been proven in tinea pedis (athlete&#39;s foot). Symptomatic relief usually occurs within a few days after starting Sulconazole nitrate and clinical improvement usually occurs within one week.</p>', '<p>Sulconazole nitrate is an imidazole derivative that inhibits the growth of the common pathogenic dermatophytes including Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, and Microsporum canis. It also inhibits the organism responsible for tinea versicolor, Malassezia furfur, and certain gram positive bacteria. A maximization test with sulconazole nitrate solution showed no evidence of irritation or contact sensitization.</p>', '<p>A small amount of the solution should be gently massaged into the affected and surrounding skin areas once or twice daily. Symptomatic relief usually occurs within a few days after starting Sulconazole nitrate, and clinical improvement usually occurs within one week. To reduce the possibility of recurrence, tinea cruris, tinea corporis, and tinea versicolor should be treated for 3 weeks. If significant clinical improvement is not seen after 4 weeks of treatment, an alternate diagnosis should be considered.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness in children have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of Sulconazole Nitrate, did not include sufficient numbers of patients aged 65 years and over to determine whether they respond differently than younger patients. Other reported clinical experience has not identified differences in responses between elderly and younger patients.</p>', NULL, '<p>Sulconazole nitrate is contraindicated in patients who have a history of hypersensitivity to any of the ingredients.</p>', '<p>There were no systemic effects and only infrequent cutaneous adverse reactions in 370 patients treated with sulconazole nitrate solution in controlled clinical trials. Approximately 1% of these patients reported itching and 1% burning or stinging. These complaints did not usually interfere with treatment.</p>', '<p>US FDA pregnancy category C. Animal studies have revealed evidence of embryotoxicity in rats at doses 125 times the human dose (in mg/kg); this dose given orally to rats led to prolonged gestation and dystocia, and several females died during the perinatal period (likely due to labor complications). Animal studies have failed to reveal evidence of teratogenicity in rats or rabbits at oral doses of 50 mg/kg/day. There are no controlled data in human pregnancy.<br />\r\n<br />\r\nExcreted into human milk: Unknown. Excreted into animal milk: Data not available</p>', '<p><strong>General</strong>: Sulconazole nitrate is for external use only. Avoid contact with the eyes. If irritation develops, the solution should be discontinued and appropriate therapy instituted.<br />\r\n<br />\r\n<strong>Information for Patients</strong>: Patients should be told to use Sulconazole nitrate as directed by the physician, to use it externally only, and to avoid contact with the eyes.<br />\r\n<br />\r\n<strong>Carcinogenesis, Mutagenesis, Impairment of Fertility</strong>: Long-term animal studies to determine carcinogenic potential have not been performed. In vitro studies have shown no mutagenic activity.</p>', NULL, NULL, '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-21 03:36:24', '2022-03-21 03:36:24');
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
(1430, 1430, '<p>Sulfacetamide sodium ophthalmic solution is indicated for the treatment of conjunctivitis and other superficial ocular infections due to susceptible microorganisms, and as an adjunctive in systemic sulfonamide therapy of trachoma: Escherichia coli, Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus (viridans group), Haemophilus influenzae, Klebsiella species, and Enterobacter species.<br />\r\n<br />\r\nTopically applied sulfonamides do not provide adequate coverage against Neisseria species, Serratia marcescens and Pseudomonas aeruginosa. A significant percentage of staphylococcal isolates are completely resistant to sulfa drugs.</p>', '<p>The sulfonamides are bacteriostatic agents and the spectrum of activity is similar for all. Sulfonamides inhibit bacterial synthesis of dihydrofolic acid by preventing the condensation of the pteridine with aminobenzoic acid through competitive inhibition of the enzyme dihydropteroate synthetase. Resistant strains have altered dihydropteroate synthetase with reduced affinity for sulfonamides or produce increased quantities of aminobenzoic acid.<br />\r\n<br />\r\nTopically applied sulfonamides are considered active against susceptible strains of the following common bacterial eye pathogens: Escherichia coli, Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus (viridans group), Haemophilus influenzae, Klebsiella species, and Enterobacter species.<br />\r\n<br />\r\nTopically applied sulfonamides do not provide adequate coverage against Neisseria species, Serratia marcescens and Pseudomonas aeruginosa. A significant percentage of staphylococcal isolates are completely resistant to sulfa drugs.</p>', '<p><strong>For conjunctivitis and other superficial ocular infections</strong>: Instill one or two drops into the conjunctival sac(s) of the affected eye(s) every two to three hours initially. Dosages may be tapered by increasing the time interval between doses as the condition responds. The usual duration of treatment is seven to ten days.<br />\r\n<br />\r\n<strong>For trachoma</strong>: Instill two drops into the conjunctival sac(s) of the affected eye(s) every two hours. Topical administration must be accompanied by systemic administration.</p>', '<p>Sulfacetamide preparations are incompatible with silver preparations.</p>', '<p>Sulfacetamide sodium ophthalmic solution is contraindicated in individuals who have a hypersensitivity to sulfonamides or to any ingredient of the preparation.</p>', '<p>Bacterial and fungal corneal ulcers have developed during treatment with sulfonamide ophthalmic preparations. The most frequently reported reactions are local irritation, stinging and burning. Less commonly reported reactions include non-specific conjunctivitis, conjunctival hyperemia, secondary infections and allergic reactions.<br />\r\n<br />\r\nFatalities have occurred, although rarely, due to severe reactions to sulfonamides including Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia, and other blood dyscrasias.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C. Animal reproduction studies have not been conducted with sulfonamide ophthalmic preparations. Kernicterus may occur in the newborn as a result of treatment of a pregnant woman at term with orally administered sulfonamides. There are no adequate and well controlled studies of sulfonamide ophthalmic preparations in pregnant women and it is not known whether topically applied sulfonamides can cause fetal harm when administered to a pregnant woman. This product should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Nursing mothers</strong>: Systemically administered sulfonamides are capable of producing kernicterus in infants of lactating women. Because of the potential for the development of kernicterus in neonates, 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>Prolonged use of topical anti-bacterial agents may give rise to overgrowth of nonsusceptible organisms including fungi. Bacterial resistance to sulfonamides may also develop.<br />\r\n<br />\r\nThe effectiveness of sulfonamides may be reduced by the para-aminobenzoic acid present in purulent exudates.<br />\r\n<br />\r\nSensitization may recur when a sulfonamide is readministered irrespective of the route of administration, and cross-sensitivity between different sulfonamides may occur.<br />\r\n<br />\r\nAt the first sign of hypersensitivity, increase in purulent discharge, or aggravation of inflammation or pain, the patient should discontinue use of the medication and consult a physician</p>', NULL, '<p>Ophthalmic antibacterial drugs.</p>', '<p>Store below 25&deg; C.</p>', '<p><strong>Pediatric use</strong>: Safety and effectiveness in infants below the age of two months have not been established.</p>', '2022-03-21 03:38:06', '2022-03-21 03:38:06'),
(1431, 1431, '<p>Sulfasalazine is indicated in:</p>\r\n\r\n<ul>\r\n	<li><strong>Rheumatoid arthritis &amp; Juvenile arthritis</strong>: In the treatment of patients with rheumatoid arthritis and pediatiric patients with polyarticular-course juvenile rheumatoid arthritis, who have responded inadequately to salicylates or other non-steroidal anti-inflammatory drugs (NSAIDs).</li>\r\n	<li><strong>Ulcerative colitis and Crohn&#39;s Disease</strong>: As adjunct in the treatment of ulcerative colitis with the usual supportive and dietary measures. In the treatment of active Crohn&#39;s disease, especially in patients with colonic involvement.</li>\r\n</ul>', '<p>The mode of action of Sulfasalazine is still under investigation, but may be related to the anti inflammatory and/or immunomodulatory properties that have been observed in animal and in vitro models, to its affinity for connective tissue, and/or to the relatively high concentration it reaches in serous fluids, the liver and intestinal walls, as demonstrated in autoradiographic studies in animals. In ulcerative colitis, clinical studies utilizing rectal administration of Sulfasalazine, Sulfapyridine and 5-Aminosalyclic Acid have indicated that the major therapeutic action may reside in the 5-Aminosalyclic Acid moiety. The relative contribution of the parent drug and the major metabolites in rheumatoid arthritis is unknown.</p>', '<p>The dosage of Sulfasalazine tablets should be individually adjusted according to the patient&#39;s tolerance and response to the treatment and taken in evenly divided doses preferably after meals.<br />\r\n<br />\r\n<strong>Adult dose for crohn&rsquo;s disease</strong>: 500 mg orally 2 to 4 times a day with food.<br />\r\n<br />\r\n<strong>Pediatric use (6 years or older) for Ulcerative Colitis</strong>: The initial dose 40 to 60 mg/kg/day orally divided into 3 to 6 doses.&nbsp;<br />\r\n<br />\r\n<strong>Adult&nbsp;dose for rheumatoid arthritis</strong>: 2 g daily in two evenly divided doses. It is advisable to initiate therapy with a lower dosage e.g. 0.5 to 1.0 g daily, to reduce possible gastrointestinal intolerance. A suggested dosing schedule is given bellow:</p>\r\n\r\n<ul>\r\n	<li><strong>First week</strong>: One tablet in the&nbsp;evening</li>\r\n	<li><strong>Second&nbsp;week</strong>: One tablet&nbsp;in the morning &amp;&nbsp;One tablet&nbsp;in the evening</li>\r\n	<li><strong>Third&nbsp;week</strong>:&nbsp;One tablet&nbsp;in the morning &amp; two tablet&nbsp;in the evening</li>\r\n	<li><strong>Forth&nbsp;week</strong>: Two tablet&nbsp;in the morning &amp;&nbsp;two tablet&nbsp;in the evening</li>\r\n</ul>\r\n\r\n<p><strong>In case of rheumatoid arthritis 6 years or older</strong>: initial dose 10 mg/kg/day orally in 2 equally divided doses.<br />\r\n<br />\r\n<strong>Juvenile rheumatoid arthritis-polyarticular course</strong>: Children 6 years of age and older: 30 to 50 mg/kg/day in two evenly divided doses. Typically the maximum dose is 2 g per day.<br />\r\n<br />\r\nFor other indications:<br />\r\nInitial therapy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 3 to 4 g daily in divided doses with dosage intervals not exceeding eight hours. It may be advisable to initiate therapy with a lower dosage e.g. 1 to 2 g daily to reduce possible gastrointestinal intolerance.</li>\r\n	<li><strong>Children 6 years of age and older</strong>: 40 to 60 mg/kg/day in to 3 to 6 divided doses.</li>\r\n</ul>\r\n\r\n<p>Maintenance therapy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 2 g daily.</li>\r\n	<li><strong>Children 6 years of age and older</strong>: 30 mg/kg/day in 4 divided doses.</li>\r\n</ul>', '<p>Reduced absorption of folic acid and digoxin has been reported when those agents were administered concomitantly with sulfasalazine.</p>', '<p>Hypersensitivity to Sulfasalazine, its metabolites, sulfonamides or salicylates, patients with intestinal or urinary obstruction and porphyria.</p>', '<p>The common adverse reactions are anorexia, headache, nausea, vomiting, gastric distress, dyspepsia, abdominal pain, dizziness, apparently reversible oligospermia etc.</p>', '<p><strong>Use in pregnancy</strong>: Pregnancy category B. This drug should be used during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: Caution should be exercised when sulfasalazine is administered to a nursing mother.</p>', '<p>Hepatic/renal impairment, G6PD deficiency, allergic bronchial asthma, lactation.</p>', NULL, '<p>Drugs for Irritable Bowel Syndrome, Drugs used for Rheumatoid Arthritis, Ulcerative Colitis.</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-21 03:39:45', '2022-03-21 03:39:45'),
(1432, 1432, '<p>Sulphinpyrazone is indicated for the treatment of: Chronic gouty arthritis, Intermittent gouty arthritis.</p>', '<p>Sulfinpyrazone increases urinary excretion of uric acid by competitively inhibiting tubular reabsorption of uric acid, thus lowering serum urate concentration and eventually reducing urate deposits in the tissues.</p>', '<p><strong>Initial dose</strong>: 200-400 mg daily in two divided doses, with meals or milk, gradually increasing when necessary to full maintenance dosage in one week.<br />\r\n<br />\r\n<strong>Maintenance dose</strong>: 400 mg daily, given in two divided doses, as above. This dosage may be increased to 800 mg daily, if necessary, and may sometimes be reduced to as low as 200 mg daily after the&nbsp;blood&nbsp;urate&nbsp;level has been controlled. Treatment should be continued without interruption even in the presence of&nbsp;acute&nbsp;exacerbations, which can be concomitantly treated with phenylbutazone or&nbsp;colchicine. Patients previously controlled with other uricosuric therapy may be transferred to Anturane (sulfinpyrazone) at full maintenance dosage.</p>', '<p>Decreased therapeutic effect when given with drugs that increase uric acid concentration (e.g. diuretics, pyrazinamide). May potentiate the action of coumarin anticoagulants (e.g. warfarin, acenocoumarol), hypoglycaemic agents and sulfonamides. May decrease plasma levels of theophylline. May increase plasma levels of penicillins and phenytoin. Increased risk of haemorrhage with substances affecting homeostasis (e.g. non-steroidal antirheumatic drugs). Probenecid may inhibit renal tubular secretion of sulfinpyrazone.</p>', '<p>Patients with an active peptic or symptoms of gastro-intestinal inflammation or ulceration should not receive the drug. The drug is contraindicated in patients with a history or the presence of hypersensitivity to phenylbutazone or other pyrazoles.</p>', '<p>The symptoms are upset stomach, vomiting, loss of appetite and joint pain. If you experience any of the following symptoms like difficulty in breathing, tightness in the chest, skin rash, unusual bleeding, fever, sore throat and mouth sores, call your doctor immediately.</p>', '<p>Pregnancy category C. This means that it is not known whether Sulphinpyrazone will harm an unborn baby. Don&#39;t take this&nbsp;without first talking to your doctor if you are pregnant.<br />\r\n<br />\r\nIt is also not known whether Sulphinpyrazone passess into breast milk. Do not take it without first talking to your doctor if you are breast-feeding a baby.</p>', '<p>Patients receiving Sulphinpyrazone should be kept under close medical supervision and periodic blood counts are recommended. It may be administered with care to patients with a history of healed peptic ulcer. It is suggested that Sulphinpyrazone should be used with caution in conjunction with sulfa drugs, the sulfonylurea hypoglycemic agents and insulin. Because Sulphinpyrazone is a potent uricosuric agent, it may precipitate urolithiasis and renal colic, especially in the initial stages of therapy. For this reason, an adequate fluid intake and alkalinization of the urine are recommended. Salicylates antagonize the uricosuric action of Sulphinpyrazone and for this reason, their concomitant uses are contraindicated in gouty arthritis.</p>', '<p><strong>Symptoms:&nbsp;</strong>Nausea, vomiting, diarrhea, epigastric pain, laboured respiration, convulsions and coma.<br />\r\n<br />\r\n<strong>Treatment:&nbsp;</strong>No specific antidote. Induce emesis, gastric lavage, supportive treatment (intravenous glucose infusions).</p>', '<p>Drugs used in Gout.</p>', '<p>Store between 15-30&deg; C.</p>', '<p><strong>Renal Impairment:</strong>&nbsp;Mild to moderate: Reduce dose. Severe: Contraindicated.<br />\r\n<br />\r\n<strong>Hepatic Impairment:</strong>&nbsp;Severe: Avoid.</p>', '2022-03-21 03:41:36', '2022-03-21 03:41:36'),
(1433, 1433, '<p>Sulindac is indicated for the symptomatic treatment of-</p>\r\n\r\n<ul>\r\n	<li>Rheumatoid arthritis</li>\r\n	<li>Osteoarthritis</li>\r\n	<li>Ankylosing spondylitis</li>\r\n	<li>Periarticular inflammatory disorders</li>\r\n	<li>Acute painful shoulder</li>\r\n	<li>Acute gouty arthritis</li>\r\n	<li>Diabetic neuropathy</li>\r\n	<li>Diabetic retinopathy</li>\r\n</ul>', '<p>Sulindac is a non-steroidal antirheumatic agent possessing anti-inflammatory, analgesic and anti-pyretic properties. Prostaglandin synthetase inhibition is probably the basis of the mechanism of action of non-steroidal anti-inflammatory agents. Following absorption, Sulindac undergoes two major transformations. It is oxidised to the sulphone and then reversibly reduced to the sulphide. The sulphide metabolite is the biologically active form which is an inhibitor of prostaglandin synthesis.</p>', '<p>Sulindac should be administered orally twice a day with food. The maximum dosage is 400 mg per day. Dosages above 400 mg per day are not recommended. In osteoarthritis, rheumatoid arthritis &amp; ankylosing spondylitis, the recommended starting dosage is 150 mg. In acute painful shoulder &amp; acute gouty arthritis the recommended dosage is 200 mg twice a day. The dosage may be lowered or raised depending on the response. After a satisfactory response has been achieved, the dosage may be reduced according to the response. Or, as directed by the registered physicians.</p>', '<p>Sulindac and its sulphide metabolite are highly protein bound. Patient should be monitored carefully until it is certain that no chance in their anticoagulant or hypoglycemic dosage is required. Aspirin has been shown to decrease the bioavailability of the active sulfide metabolite of sulindac. Prolonged concurrent use of Paracetamol with sulindac may increase the risk of adverse renal effects. That patient is under close medical supervision while receiving such combined therapy. Probenecid may increase the plasma concentration of sulindac and its sulfone metabolite and slightly decrease the plasma concentration of the active sulfide metabolite.</p>', '<p>Patients known to be allergic to Sulindac and those in whom acute asthmatic attacks, urticaria or rhinitis have been precipitated by Aspirin or other non-steroidal anti-inflammatory agents. Sulindac is also contraindicated in patients with a history of active gastro-intestinal bleeding or peptic ulceration. It should not be given to children, pregnant or lactating women.</p>', '<p>Gastrointestinal side effects are the most common and consist of abdominal pain, nausea and constipation. Gastrointestinal ulceration and bleeding may also occur. The most frequently reported central nervous system side effects are drowsiness, dizziness, headache and nervousness. Other adverse effects include depression, tinnitus, confusion, light-headedness, insomnia, psychiatric disturbances, syncope, convulsions, coma, peripheral neuropathy, blurred vision and other ocular effects, oedema and mass gain, hypertension, hematuria, skin rashes, pruritus, urticaria, stomatitis, alopecia and hypersensitivity reactions. A hypersensitivity syndrome consisting of fever and chills, skin rashes or other cutaneous manifestations, hepatotoxicity, renal toxicity (including renal failure), leukopenia, thrombocytopenia, eosinophilia, inflammed glands or lymph nodes, and arthralgia have been reported. Leucopenia, purpura, thrombocytopenia, aplastic anaemia, haemolytic anaemia, agranulocytosis, epitaxis, hyperglycaemia, hyperkalaemia and vaginal bleeding have been reported. There have also been reports of hepatitis and jaundice or renal failure.</p>', '<p><strong>Use in pregnancy</strong>: Sulindac should be used during the first two trimesters of pregnancy only if the potential benefit justifies the potential risk to the foetus. Use of Sulindac during the third trimester of pregnancy is not recommended.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: It is not known whether Sulindac is excreted in human milk. So a decision should be made whether to discontinue nursing or discontinue the medicine taking into account the importance of the medicine to the mother.</p>', '<p>Sulindac should be administered with caution to patients with impaired renal function and bleeding disorders, epilepsy, parkinsonism or psychiatric disorders. Patient with hepatic impairment the half life of sulindac is prolonged and a reduction of daily dosage may be required. Anemia is some time seen in patients receiving NSAIDs with sulindac.</p>', '<p>Reported symptoms have generally reflected the gastro-intestinal, renal and central nervous system toxicities of Sulindac. Treatment is symptomatic and supportive.</p>', '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Drugs used in Gout, Non-steroidal Anti-inflammatory Drugs (NSAIDs)</p>', '<p>Keep below 25&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Patient with renal impairment</strong>: Sulindac should be administered with caution to patients with impaired renal function and to those with bleeding disorders, epilepsy, parkinsonism or psychiatric disorders.<br />\r\n<br />\r\n<strong>Patient with hepatic impairment</strong>: In the presence of liver function impairment the half life of Sulindac is prolonged and a reduction of daily dosage may be required.</p>', '2022-03-21 03:48:01', '2022-03-21 03:48:01'),
(1434, 1434, '<p>Treatment of all forms of malaria due to Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae. The drug is also indicated for suppressive or prophylactic management, particularly in areas where resistance to chloroquine is known to exist.</p>', '<p>Sulphadoxine &amp; Pyrimethamine is an antimalarial agent embodying the concept of synergism. Individually the components of this preparation exert inferior result with higher doses in comparison with that obtained with the combination. Moreover, this preparation is effective against strains that are resistant to other antimalarial agents and the risk of resistance development is minimum with this preparation. It is extremely long acting drug, attacks the different development stages of the parasite and attains effective concentration with a single dose. The protective effect of a single dose lasts for approximately four weeks and this preparation is compatible with other antimalarial drugs and with antibiotics. It does not influence the action of antidiabetic agents.</p>', '<p>Curative treatment of malaria with a single dose-</p>\r\n\r\n<ul>\r\n	<li>Adults: 2-3 tablets</li>\r\n	<li>Children under 4 years: &frac12; tablets</li>\r\n	<li>4-8 years: 1 tablet</li>\r\n	<li>9-14 years: 2 tablets</li>\r\n</ul>\r\n\r\n<p>In severe cases, Sulphadoxine &amp; Pyrimethamine can be beneficially combined with quinine.</p>\r\n\r\n<p><br />\r\nSuppressive or prophylactic management-</p>\r\n\r\n<p>The dose given below should be taken at one time:<br />\r\n<br />\r\nFor semi-immune subjects (Dose: once every four weeks)-</p>\r\n\r\n<ul>\r\n	<li>Adults: 2-3 tablets&nbsp;</li>\r\n	<li>Children under 4 years: &frac12; tablets&nbsp;</li>\r\n	<li>4-8 years: 1 tablet&nbsp;</li>\r\n	<li>9-14 years: 2 tablets&nbsp;</li>\r\n</ul>\r\n\r\n<p>For non-immune subjects (Dose: Once every two weeks)-</p>\r\n\r\n<ul>\r\n	<li>Adults: 2 tablets</li>\r\n	<li>Children under 4 years: 1&frac12; tablets</li>\r\n	<li>4-8 years: 1 tablet</li>\r\n	<li>9-14 years: 1&frac12; tablets</li>\r\n</ul>\r\n\r\n<p>For malaria prophylaxis:&nbsp;The first dose of Sulphadoxine &amp; Pyrimethamine should be taken one or two days before departure for an endemic area in order to protect tolerance, administration should be continued in the above dosage during the stay and also for four weeks after return or as prescribed by the physician.</p>', '<p>Concurrent administration of other preparations containing folate antagonists (e.g. cotrimoxazole, methotrexate, anticonvulsants) can result in increased impairment of folic acid metabolism, which leads to haematological side effects.</p>', '<p>Prophylactic (repeated) use of Pyrimethamine + Sulphadoxine&nbsp;is contraindicated in patients with severe renal insufficiency, marked liver parenchymal damage or blood dyscrasias. Treatment must be immediately discontinued upon the appearance of any mucocutaneous signs or symptoms such as pruritus, erythema, rash, orogenital lesions or pharyngitis.</p>', '<p>Sulphadoxine &amp; Pyrimethamine at the recommended dose is well tolerated. Main side effects are given below</p>\r\n\r\n<ul>\r\n	<li><strong>Skin reactions</strong>: Drug rash, pruritus and slight hair loss have been observed.</li>\r\n	<li><strong>Gastro-intestinal reactions:</strong>&nbsp;Feeling of fullness, nausea, rarely vomiting, stomatitis.</li>\r\n	<li><strong>Haematological reactions</strong>: In rare cases, leukopenia, thrombocytopenia, and megaloblastic anemia have been observed.</li>\r\n	<li><strong>Other reactions</strong>: Fatigue, headache, fever, polyneuritis may occasionally occur.</li>\r\n</ul>', '<p>Sulphadoxine &amp; Pyrimethamine is contraindicated during pregnancy, premature and newborn infants during the first weeks of life and intolerance to sulfonamide. If pregnancy can not be excluded, possible risks should be balanced against therapeutic effect. Both Pyrimethamine and Sulphadoxine are excreted in maternal breast milk. Nursing mother should not take this preparation.</p>', '<p>Impaired renal or hepatic function, folate deficiency, severe allergy or bronchial asthma, G6PD deficiency, pregnancy. Take with plenty of water to prevent crystalluria. Avoid excessive exposure to sun. Discontinue at the first sign of rash. Discontinue if signs of folic acid deficiency develops. Regular CBC monitoring, LFT, analysis of urine for crystalluria when admin for &gt; 3 mth. Take with food to minimise Gi effects (e.g. anorexia and vomiting).</p>', NULL, '<p>Anti-malarial drugs.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-21 03:49:59', '2022-03-21 03:49:59'),
(1435, 1435, '<p>Cotrimoxazole is bactericidal in vitro to a wide range of Gram-positive and Gram-negative organisms, including Streptococcus, Staphylococcus, Pneumococcus, Neisseria, B. catarrhalis, Escherichia coli, Klebsiella, Proteus spp., Haemophilus, Salmonella, Shigella, Vibrio cholerae, Brucella, Pneumocystis carinii, Nocardia and Bordetella. A particularly high degree of activity is exhibited against Haemophilus influenzae, E. coli and Proteus spp., making Cotrimoxazole particularly suitable for the treatment of chronic bronchitis and urinary tract infections. Cotrimoxazole exerts its bactericidal action by the sequential blockade of two bacterial enzyme systems in the biosynthesis of Folinic acid in the micro-organisms. The synergy thus produced accounts for the high degree of bactericidal activity.<br />\r\n<br />\r\nIndications are :</p>\r\n\r\n<ul>\r\n	<li>Respiratory tract infections, including acute and chronic bronchitis (treatment and prophylaxis), bronchiectasis, lung abscess, lobar and broncho-pneumonia, Pneumocystis carinii pneumonitis, sinusitis and otitis media.</li>\r\n	<li>Genito-urinary tract infections, including urethritis, acute and chronic cystitis, pyelonephritis, prostatitis and gonorrhoea.</li>\r\n	<li>Gastro-intestinal tract infections, caused by Salmonella typhi and Salmonella paratyphi, including the chronic carrier state.</li>\r\n	<li>Other infections, caused by a wide range of organisms confirmed to be susceptible to Cotrimoxazole and where the therapeutic benefits are considered to outweigh the possible occurrence of adverse events.</li>\r\n	<li>Such infections include acute and chronic osteomyelitis, acute brucellosis, skin infections including pyoderma, abscesses and wound infections, septicaemia, bacillary dysenter</li>\r\n</ul>', '<p>Cotrimoxazole having broad spectrum bactericidal activity against a wide range of gram-positive &amp; gram-negative bacteria and some protozoa. Co-trimoxazole containing Trimethoprim and Sulphamethoxazole in a 1:5 combination exerts its bactericidal action by the sequential blockade of two bacterial enzyme systems in the biosynthesis of folinic acid in the microorganism.</p>', '<p>Cotrimoxazole double strength tablet: Over 12 years</p>\r\n\r\n<ul>\r\n	<li><strong>For mild to moderate infections</strong>: 1 tablet twice daily.</li>\r\n	<li><strong>For severe infections</strong>: 1.5 tablets twice daily.</li>\r\n	<li><strong>Long term therapy (&gt;14 days)</strong>: 0.5 tablet twice daily.</li>\r\n	<li><strong>Gonorrhoea</strong>: 2 tablets every 12 hours for two days or 2.5 tablets followed by a further dose of 2.5 tablets after 8 hours.</li>\r\n</ul>\r\n\r\n<p>Cotrimoxazole tablet: over 12 years</p>\r\n\r\n<ul>\r\n	<li><strong>For mild to moderate infections</strong>: 2 tablets twice daily.</li>\r\n	<li><strong>For severe infections</strong>: 2 tablets thrice daily.</li>\r\n	<li><strong>Long term therapy</strong>: (&gt;14 days): 1 tablet twice daily.</li>\r\n</ul>\r\n\r\n<p>Cotrimoxazole suspension: Under 12 years</p>\r\n\r\n<ul>\r\n	<li><strong>6-12 years</strong>: 2 teaspoonful twice daily.</li>\r\n	<li><strong>6 month-5 years</strong>: 1 teaspoonful twice daily.</li>\r\n	<li><strong>6 weeks-6 months</strong>: 0.5 teaspoonful twice daily.</li>\r\n</ul>', NULL, '<ul>\r\n	<li>Hypersensitivity to trimethoprim or sulphonamides.</li>\r\n	<li>Patients with documented megaloblastic anaemia due to folate deficiency.</li>\r\n	<li>Patients showing marked liver parenchymal damage, blood dyscrasia, severe renal insufficiency, glucose 6-phosphate dehydrogenase deficiency.</li>\r\n</ul>', '<p>The side effects like crystalluria, allergic reactions, haemolysis, thrombocytopenia, neutropenia, agranulocytosis etc. have been reported rarely with Sulphamethoxazole-Trimethoprim combination. Other side effects are less serious in nature such as malaise, headache, nausea and vomiting. These are normally transient and do not require withdrawal of treatment.</p>', '<p>Pregnancy and during the nursing period, because sulphonamides pass the placenta and are excreted in the breast milk and may cause kernicterus.</p>', '<p>Prolonged full dose treatment with sulfamethoxazole-trimethoprim combination is associated with the risk of macrocytic anaemia due to the drug&rsquo;s interference in the conversion of Folic acid into Folinic acid. If this occurs, it can be reversed by giving Folinic acid. Care should be taken when giving this combination to diabetic patients receiving sulphonylurea drug for possible potentiation of action of sulphonylurea.</p>', NULL, '<p>Anti-diarrhoeal Antimicrobial drugs, Sulphonamides &amp; Trimethoprim.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-21 03:51:41', '2022-03-21 03:51:41'),
(1436, 1436, '<p>Bar Cleanser for acne &amp; greasy skin. Liquid cleanser Soap-free cleanser for acne prone and oily skin conditions.</p>', '<p>Surfactants are compounds that lower the surface tension (or interfacial tension) between two liquids or between a liquid and a solid. Surfactants may act as detergents, wetting agents, emulsifiers, foaming agents, and dispersants.<br />\r\n<br />\r\nA wetting agent is a surfactant that, when dissolved in water, lowers the advancing contact angle, aids in displacing an air phase at the surface, and replaces it with a liquid phase. Examples of application of wetting to pharmacy and medicine include the displacement of air from the surface of sulfur, charcoal, and other powders for the purpose of dispersing these drugs in liquid vehicles; the displacement of air from the matrix of cotton pads and bandages so that medicinal solutions can be absorbed for application to various body areas; the displacement of dirt and debris by the use of detergents in the washing of wounds; and the application of medicinal lotions and sprays to surface of skin and mucous membranes.</p>', '<p>Use on the face or other affected areas. Wash as with an ordinary soap and massage the creamy lather into the skin. Wet skin, apply &amp; rinse off w/ water once or bid. Using warm water, gently rub the soap on the skin until a rich lather is formed. Massage briskly and rinse thoroughly.<br />\r\n<br />\r\nThis Liquid cleanser can be used both with water and without water for face. If the cleanser is used with water, apply liberal amount of cleanser to the skin. Massage gently in circular motion. Rinse with water. In case it is used without water, apply cleanser to the skin and massage gently in circular motion, remove excess with soft tissue or cotton wool.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity..</p>', '<p>Mild irritation, skin sensitization.</p>', '<p>Pregnancy Category- Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Avoid contact with eyes. Flush with water if lather enters the eyes.</p>', NULL, '<p>Benzoyl peroxide, Azelaic acid &amp; other preparations.</p>', NULL, NULL, '2022-03-21 03:53:18', '2022-03-21 03:53:18'),
(1437, 1437, '<p>Sumatriptan is indicated for acute treatment of migraine with or without aura in adults.&nbsp;<br />\r\n<br />\r\nLimitations of Use:</p>\r\n\r\n<ul>\r\n	<li>Use only if a clear diagnosis of migraine headache has been established.</li>\r\n	<li>Not indicated for the prophylactic therapy of migraine attacks.</li>\r\n	<li>Not indicated for the treatment of cluster headache.</li>\r\n</ul>', '<p>Sumatriptan Nasal Spray is an aqueous suspension of microfine Sumatriptan BP 10 mg for topical administration to the nasal mucosa by means of a metering, atomizing spray pump. Sumatriptan binds with high affinity to human cloned 5 HT1B/1D&nbsp;receptors. Sumatriptan presumably exerts its therapeutic effects in the treatment of migraine headache through agonist effects at the 5 HT1B/1D&nbsp;receptors on intracranial blood vessels and sensory nerves of the trigeminal system, which result in cranial vessel constriction and inhibition of pro-inflammatory neuropeptide release.</p>', '<p>Route of administration: Nasal</p>\r\n\r\n<ul>\r\n	<li>Single-dose of 10 mg of nasal spray.</li>\r\n	<li>The maximum dose in a 24 hour period: 30 mg; separate doses by at least one hour or as directed by the physician.</li>\r\n</ul>\r\n\r\n<p>Use in children and adolescents: Sumatriptan is not recommended for use in patients younger than 18 years of age.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>How to use the Nasal Spray-</p>\r\n\r\n<ul>\r\n	<li>Shake the bottle gently and remove the dust cover.</li>\r\n	<li>Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.</li>\r\n	<li>Gently blow the nose to clear the nostrils.</li>\r\n	<li>Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.</li>\r\n	<li>Breathe out through your mouth.</li>\r\n	<li>Repeat the above steps in the same/ other nostril for consecutive doses.</li>\r\n</ul>\r\n\r\n<p>Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-</p>\r\n\r\n<ul>\r\n	<li>Remove the dust cover.</li>\r\n	<li>Gently pull off the nasal applicator.</li>\r\n	<li>Wash the applicator and dust cover in warm water.</li>\r\n	<li>Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.</li>\r\n	<li>Gently push the applicator back on the top of the bottle and re-fix the dust cover.</li>\r\n</ul>', '<p><strong>With Medicine</strong>: Sumatriptan nasal spray is contraindicated with Ergot-Containing Drugs, Monoamine Oxidase-A Inhibitors, Other 5-HT1 Agonists and Selective Serotonin Reuptake Inhibitors/Serotonin Norepinephrine Reuptake Inhibitors.<br />\r\n<br />\r\n<strong>With food and others</strong>: No interaction with foods.</p>', '<ul>\r\n	<li>History of coronary artery disease or coronary vasospasm</li>\r\n	<li>Wolff-Parkinson-White syndrome or other cardiac accessory conduction pathway disorders</li>\r\n	<li>History of stroke, transient ischemic attack, or hemiplegic or basilar migraine</li>\r\n	<li>Peripheral vascular disease</li>\r\n	<li>Ischemic bowel disease</li>\r\n	<li>Uncontrolled hypertension</li>\r\n	<li>Recent (within 24 hours) use of another 5 HT1 agonist (e.g., another triptan) or of an ergotamine containing&nbsp;medication</li>\r\n	<li>Concurrent or recent (past 2 weeks) use of monoamine oxidase A inhibitor</li>\r\n	<li>Hypersensitivity to sumatriptan (angioedema and anaphylaxis seen)</li>\r\n	<li>Severe hepatic impairment</li>\r\n</ul>', '<p><strong>Common side effects</strong>: Unusual or unpleasant taste in the mouth; pain, burning, numbness, or tingling in the nose or throat; runny or stuffy nose after using the nasal medicine.<br />\r\n<br />\r\n<strong>Rare side effects</strong>: Anxiety, burning sensation, discomfort of the nasal cavity and throat, general feeling of illness or tiredness &amp; vision changes.</p>', '<p>There are no adequate and well-controlled studies in pregnant women and lactating mothers.</p>', '<ul>\r\n	<li>Myocardial ischemia/infarction and Prinzmetal&rsquo;s angina: Perform cardiac evaluation in patients with multiple cardiovascular risk factors</li>\r\n	<li>Arrhythmias: Discontinue Sumatriptan if occurs</li>\r\n	<li>Chest/throat/neck/jaw pain, tightness, pressure, or heaviness: Generally, not associated with Myocardial Ischemia; evaluate for coronary artery disease in patients at high risk</li>\r\n	<li>Cerebral hemorrhage, subarachnoid hemorrhage, and stroke: Discontinue Sumatriptan if occurs</li>\r\n	<li>Gastrointestinal ischemia and reactions, peripheral vasospastic reactions: Discontinue Sumatriptan if occurs</li>\r\n	<li>Medication overuse headache: Detoxification may be necessary</li>\r\n	<li>Serotonin syndrome: Discontinue Sumatriptan if occurs</li>\r\n	<li>Increase in blood pressure: Hypertensive crisis can occur</li>\r\n	<li>Hypersensitivity reactions: Angioedema and anaphylaxis can occur</li>\r\n	<li>Seizures: Use with caution in patients with epilepsy or a lowered seizure threshold</li>\r\n	<li>Local irritation: Burning and abnormal taste can occur</li>\r\n</ul>', '<p>No specific data is available on the overdose of Sumatriptan 10 mg nasal spray.</p>', '<p>5-HT Agonists.</p>', '<p>Store between 20&deg;C-25&deg;C temperature. Do not store in the refrigerator or freezer. Do not test before use.</p>', NULL, '2022-03-21 03:55:30', '2022-03-21 03:55:30'),
(1438, 1438, '<p><strong>Gastrointestinal Stromal Tumor (GIST)</strong>: Sunitinib is indicated for the treatment of gastrointestinal stromal tumor after disease progression on or intolerance to imatinib mesylate.<br />\r\n<br />\r\n<strong>Advanced Renal Cell Carcinoma (RCC)</strong>: Sunitinib is indicated for the treatment of advanced renal cell&nbsp;carcinoma.<br />\r\n<br />\r\n<strong>Advanced Pancreatic Neuroendocrine Tumors (pNET)</strong>: Sunitinib is indicated for the treatment of progressive, well-differentiated&nbsp;pancreatic neuroendocrine tumors&nbsp;in patients with&nbsp;unresectable&nbsp;locally advanced or metastatic disease.</p>', '<p>Sunitinib inhibits cellular signaling by targeting multiple receptor tyrosine kinases (RTKs).<br />\r\n<br />\r\nThese include all receptors for platelet-derived growth factor (PDGF-Rs) and vascular endothelial growth factor receptors (VEGFRs), which play a role in both tumor angiogenesis and tumor cell proliferation. The simultaneous inhibition of these targets therefore reduces tumor vascularization and triggers cancer cell apoptosis and thus results in tumor shrinkage.<br />\r\n<br />\r\nSunitinib also inhibits CD117 (c-KIT), the receptor tyrosine kinase that (when improperly activated by mutation) drives the majority of gastrointestinal stromal cell tumors. It has been recommended as a second-line therapy for patients whose tumors develop mutations in c-KIT that make them resistant to imatinib, or who the cannot tolerate the drug.<br />\r\n<br />\r\nIn addition, sunitinib binds other receptors. These include: RET, CD114, CD135. The fact that sunitinib targets many different receptors, leads to many of its side effects such as the classic hand-foot syndrome, stomatitis, and other dermatologic toxicities.</p>', '<p><strong>Recommended Dose For GIST And RCC:&nbsp;</strong>The recommended dose of Sunitinib for gastrointestinal stromal tumor (GIST) and advanced&nbsp;renal cell carcinoma&nbsp;(RCC) is one 50 mg oral dose taken once daily, on a schedule of 4 weeks on treatment followed by 2 weeks off (Schedule 4/2). Sunitinib may be taken with or without food.<br />\r\n<br />\r\n<strong>Recommended Dose For pNET</strong>: The recommended dose of Sunitinib for pancreatic neuroendocrine tumors (pNET) is 37.5 mg taken orally once daily continuously without a scheduled off-treatment period. Sunitinib may be taken with or without food.<br />\r\n<br />\r\n<strong>Dose Modification</strong>: Dose interruption and/or dose modification in 12.5 mg increments or decrements is recommended based on individual safety and tolerability. The maximum dose administered in the Phase 3 pNET study was 50 mg daily.<br />\r\n<br />\r\nStrong CYP3A4 inhibitors such as ketoconazole may increas e sunitinib plasma concentrations. Selection of an alternate concomitant medication with no or minimal enzyme inhibition potential is recommended. A dose reduction for Sunitinib to a minimum of 37.5 mg (GIST and RCC) or 25 mg (pNET) daily should be considered if Sunitinib must be co-administered with a strong CYP3A4 inhibitor<br />\r\n<br />\r\nCYP3A4 inducers such as rifampin may decreas e sunitinib plasma concentrations. Selection of an alternate concomitant medication with no or minimal enzyme induction potential is recommended. A dose increase for Sunitinib to a maximum of 87.5 mg (GIST and RCC) or 62.5 mg (pNET) daily should be considered if Sunitinib must be co-administered with a CYP3A4 inducer. If dose is increased, the patient should be monitored carefully for toxicity</p>', '<p>Increased plasma cone with strong CYP3A4 inhibitors (eg ketoconazole, ritonavir, itraconazole, erythromycin, clarithromycin, grapefruit juice). Decreased plasma cone with strong CYP3A4 inducers [eg rifampin, dexamethasone, phenytoin, carbamazepine, phenobarb, St. John&#39;s wort (Hypericum perforatum)]. Anticoagulants eg warfarin, acenocoumarol (periodically monitor platelets, prothrombin time/INR &amp; physical exam).</p>', '<p>Hypersensitivity, Renal impairment.</p>', '<p>Fatigue, GI disorders, skin discoloration, rash, palmar-plantar erythrodysesthesia, dry skin, hair color changes, mucosal inflammation, asthenia, dysguesia, anorexia, HTN, neutropenia.</p>', '<p>Pregnancy Category D. There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.</p>', NULL, '<p>Treatment of overdose with Sunitinib should consist of general supportive measures. There is no specific&nbsp;antidote&nbsp;for overdosage with Sunitinib. If indicated, elimination of unabsorbed drug should be achieved by&nbsp;emesis&nbsp;or&nbsp;gastric&nbsp;lavage. Cases of accidental overdose have been reported; these cases were associated with adverse reactions consistent with the known safety profile of Sunitinib, or without adverse reactions. A case of intentional overdose involving the ingestion of 1,500 mg of Sunitinib in an attempted suicide was reported without adverse reaction. In non-clinical studies mortality was observed following as few as 5 daily doses of 500 mg/kg (3000 mg/m&sup2;) in rats. At this dose, signs of toxicity included impaired muscle coordination, head shakes, hypoactivity, ocular discharge,&nbsp;piloerection&nbsp;and gastrointestinal distress. Mortality and similar signs of toxicity were observed at lower doses when administered for longer durations.</p>', '<p>Targeted Cancer Therapy.</p>', NULL, NULL, '2022-03-21 03:57:55', '2022-03-21 03:57:55'),
(1439, 1439, '<p>This is indicated in the following cases:</p>\r\n\r\n<ul>\r\n	<li>To develop immune system.</li>\r\n	<li>To prevent the well known deficiency diseases such as scurvey, beriberi, pellagra and others.</li>\r\n	<li>Prevent certain types of cancer by blocking the formation of cancer causing substances in the body.</li>\r\n	<li>It is also capable of combating cardiovascular and immunological disorders.</li>\r\n	<li>To prevent aging.</li>\r\n</ul>', '<p><strong>Vitamin A</strong>&nbsp;is essential for human health. Vitamin A is highly important for vision, cell development and immunity. Vitamin A&#39;s role on immunity contributes to its anti-cancer properties.<br />\r\n<br />\r\n<strong>Vitamin C</strong>&nbsp;is one of the most widely taken supplements and plays a primary role in the formation of collagen, which is important for the growth and repair of cells, gums, blood vessels, bones and teeth. Thus vitamin C helps in faster recovery after surgery or any other trauma. Vitamin C quenches free radicals in the water based cellular components and thus acts as an antioxidant.<br />\r\n<br />\r\n<strong>Vitamin E</strong>&nbsp;is a fat-soluble vitamin, which is stored in the liver, adipose tissues, heart, muscles etc. It is an active antioxidant, which prevents oxidation of fat compounds. It works in synergy with Selenium.<br />\r\n<br />\r\n<strong>Vitamin K</strong>&nbsp;is a key anti-aging vitamin and it prevents heart disease and osteoporosis.<br />\r\n<br />\r\n<strong>Zinc</strong>&nbsp;is an important mineral that can actually rejuvenate the shrinking thymus gland that involves the working of the immune system. Zinc is a co-factor in over 100 enzymes of the body.<br />\r\n<br />\r\n<strong>Selenium:</strong>&nbsp;Apart from being a co-factor in antioxidant enzymes, Selenium by itself has potent antioxidant capabilities. So, it prevents aging and hardening of tissues through oxidation. Vitamin E and Selenium are synergistic and seem to potentiate each other&#39;s antioxidant activities.<br />\r\n<br />\r\n<strong>Copper</strong>&nbsp;is an important co-factor of a number of enzymes present in our body. This enzymes act as endogenous antioxidant systems.<br />\r\n<br />\r\n<strong>Manganese</strong>, an antioxidant, is one of the minerals required to form SOD (Super Oxide Dismutase). SOD is an enzyme that protect against cell damaging free radicals.</p>', '<p>The adult dose is 1 (one) tablet daily, or as prescribed by the physician.</p>', NULL, '<p>This product is contraindicated in patients with a known hypersensitivity to any of the ingredients.</p>', '<p>Generally, this preparation is well-tolerated. Diarrhea may occasionally occur during treatment with beta carotene and the skin may assume a slightly yellow discoloration. The side-effects of vitamin A are reversible. Vitamin C and vitamin E may cause diarrhea and other gastrointestinal disturbances.</p>', '<p>This preparation is recommended in pregnancy and lactation.</p>', NULL, '<p>In case of accidental overdose, call a doctor or poison control center immediately.</p>', '<p>Anti-oxidant Multivitamin Multimineral preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-21 03:59:29', '2022-03-21 03:59:29'),
(1440, 1440, '<p>Suvorexant is indicated for the treatment of insomnia, characterized by difculties with sleep onset and/or sleep maintenance.</p>', '<p>Suvorexant is a highly selective antagonist for orexin receptors OX1R and OX2R. The mechanism by which Suvorexant exerts its therapeutic efect in insomnia is presumed to be through antagonism of orexin receptors. The orexin neuropeptide signaling system is a central promoter of wakefulness. Blocking the binding of wake-promoting neuropeptides orexin A and orexin B to receptors OX1R and OX2R is thought to suppress wake drive.</p>', '<p>Recommended dose is 10 mg, no more than once per night taken before 30 minutes of going to bed, with at least 7 hours remaining before the planned time of awakening. If the 10 mg dose is well-tolerated but not effective, the dose can be increased, not to exceed 20 mg once daily. Lowest dose effective should be used for the patient. Time to effect may be delayed if taken with or soon after a meal.</p>', '<p><strong>CNS-Active Drugs</strong>: An additive effect on psychomotor performance was observed when a single dose of 40 mg of Suvorexant was co-administered with a single dose of 0.7 g/kg alcohol. Suvorexant does not afect alcohol concentrations and alcohol does not afect Suvorexant concentrations.<br />\r\n<br />\r\n<strong>effect s of Other Drugs on Suvorexant</strong>: Strong (e.g., ketoconazole or itraconazole) and moderate (e.g., diltiazem) CYP3A inhibitors signifcantly increased Suvorexant exposure. Strong CYP3A inducers (e.g., rifampin) substantially decreases Suvorexant exposure.<br />\r\n<br />\r\n<strong>effect s of Suvorexant on Other Drugs</strong>: Suvorexant is unlikely to cause clinically signifcant inhibition of human CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19 or CYP2D6. Chronic administration of Suvorexant is unlikely to induce the metabolism of drugs metabolized by major CYP isoforms.</p>', '<p>Do not use in patients with narcolepsy..</p>', '<p>Common side effects are Sleepiness during the day, Not thinking clearly, Act strangely, confused, or upset, Sleep-walking.</p>', '<p>Pregnancy Category C. There is no adequate and well-controlled studies in pregnant women. Suvorexant should be used during pregnancy only if the potential beneft justifes the potential risk to the fetus.</p>', '<p><strong>Daytime somnolence</strong>: Risk of impaired alertness and motor coordination, including impaired driving; risk increases with dose; caution patients taking 20 mg against next-day driving and other activities requiring complete mental alertness.<br />\r\n<br />\r\n<strong>Need to evaluate for co-morbid diagnoses</strong>: Reevaluate if insomnia persists after 7 to 10 days of treatment.</p>', NULL, '<p>Miscellaneous sedatives &amp; hypnotics.</p>', '<p>Store in dry and cool place, protect from light &amp; keep away from children.</p>', NULL, '2022-03-21 04:01:28', '2022-03-21 04:01:28');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1441, 1441, '<p>Suxamethonium Chloride is a short-acting depolarizing neuromuscular blocking agent. It is used in anesthesia as a muscle relaxant to-</p>\r\n\r\n<ul>\r\n	<li>Facilitate endotracheal intubation</li>\r\n	<li>Aid in mechanical ventilation and</li>\r\n	<li>Assist a wide range of surgical and obstetric procedures</li>\r\n</ul>', '<p>Suxamethonium is a muscle relaxant. It acts as a depolarizing neuromuscular blocker by imitating the action of acetylcholine at the neuromuscular junction. Suxamethonium acts on muscle type nicotinic receptors. Binding of Suxamethonium to the nicotinic acetylcholine receptor results in opening of the receptor&#39;s nicotinic sodium channel; sodium moves into the cell, a disorganized depolarization of the motor-end plate occurs and calcium is released from the sarcoplasmic reticulum. This results in fasciculation. In the normal muscle, following depolarization, acetylcholine is rapidly hydrolyzed by acetylcholinesterase and the muscle cell is able to &#39;reset&#39; ready for the next signal. But Suxamethonium is degraded not by acetylcholinesterase, rather by butyrylcholinesterase, a plasma cholinesterase. This hydrolysis by butyrylcholinesterase is much slower than that of acetylcholine by acetylcholinesterase. Thus Suxamethonium has a longer duration of effect than acetylcholine and it does not allow the muscle cell to &#39;reset&#39; and keeps the &#39;new&#39; resting membrane potential below threshold. When acetylcholine binds to an already depolarized receptor it cannot cause further depolarization. Calcium is removed from the muscle cell cytosol independent of repolarization. As the calcium is taken up by the sarcoplasmic reticulum, the muscle relaxes. This explains muscle flaccidity rather than tetany following fasciculation.</p>', '<p>Suxamethonium Chloride is usually administered by bolus Intravenous or Intramuscular injection.<br />\r\n<br />\r\n<strong>Adults</strong>: The dose of Suxamethonium is dependent on body weight, the degree of muscular relaxation required, the route of administration and the response of individual patients. To achieve endotracheal intubation Suxamethonium is usually administered intravenously in a dose of 1 mg/kg. This dose will usually produce muscular relaxation in about 30-60 seconds and has a duration of action of about 2-6 minutes. Supplementary doses of Suxamethonium of 50%-100% of the initial dose administered at 5-10 minutes intervals will maintain muscle relaxation during short surgical procedures performed under general anesthesia. For prolonged surgical procedures Suxamethonium may be given by intravenous infusion as a 0.1 %-0.2% solution, diluted in 5 % glucose solution or sterile isotonic saline solution, at a rate of 2.5 to 4 mg per minute. The infusion rate should be adjusted according to the response of individual patients. The total dose of Suxamethonium given by repeated intravenous injection or continuous infusion should not be exceeded 500 mg per hour.<br />\r\n<br />\r\n<strong>Children</strong>: Infants and young children are more resistant to Suxamethonium compared with adults. The recommended intravenous dose of Suxamethonium for infants is 2 mg/kg. A dose of 1 mg/kg in older children is recommended. When Suxamethonium is given as intravenous infusion in children, the dosage is as for adults with a proportionately lower initial Infusion rate based on body weight. Suxamethonium may be given intramuscularly to infants at doses up to 4-5 mg/kg and in older children up to 4 mg/kg. These doses produce muscular relaxation within about 3 minutes. A total dose of 150 mg should not be exceeded.</p>', '<p>Certain drugs or chemicals are known to reduce normal plasma cholinesterase activity and may therefore prolong the neuromuscular blocking effects of Suxamethonium. These include: trimetaphan; specific anticholinesterase agents: neostigmine, pyridostigmine, physostigmine; cytotoxic compounds: cyclophosphamide, mechlorethamine, triethylene-melamine; psychiatric drugs: promazine and chlorpromazine, anesthetic agents and drugs: ketamine, morphine and morphine antagonists, pethidine, pancuronium.</p>', '<p>Suxamethonium has no effect on the level of consciousness and should not be administered to a patient who is notfullyanesthetized. Suxamethonium should not be administered to patients known to be hypersensitive to the drug. Suxamethonium is contraindicated in patients known to have an inherited atypical plasma cholinesterase activity. An acute transient rise in serum potassium often occurs following the administration of Suxamethonium in normal individuals (usually 0.5 mmol/Litre). But in certain pathological states it may cause excessive increase in serum potassium leading to serious cardiac arrhythmias and cardiac arrest. For this reason, use of Suxamethonium is contraindicated in patients recovering from major trauma, patients recovering from severe burns, patients with neurological deficits involving acute major muscle wasting and patients with pre-existing hyperkalemia. Suxamethonium causes a slight transient rise in intra-ocular pressure, and should therefore not be used in the presence of open eye injuries. The injection is contraindicated in new-born infants, especially in immature neonates.</p>', '<p><strong>Cardiovascular</strong>: bradycardia, tachycardia, hypertension, hypotension, arrhythmias.<br />\r\n<br />\r\n<strong>Respiratory</strong>: bronchospasm, prolonged respiratory depression and apnea.<br />\r\n<br />\r\n<strong>Musculoskeletal</strong>: muscle fasciculation, post-operative muscle pains, myoglobinemia.<br />\r\n<br />\r\n<strong>Others</strong>: hyperthermia, increased intra-ocular pressure increased intra-gastric pressure, rash, excessive salivation.</p>', '<p>Although Suxamethonium does not readily cross the placental barrier it should not be administered to pregnant women unless the potential benefit outweighs possible hazards.</p>', '<p>Suxamethonium should be administered only by or under close supervision of an anesthetist familiar with its action, characteristics and hazards, who is skilled in the management of artificial respiration and only where there are adequate facilities for immediate endotracheal intubation with administration of oxygen by intermittent positive pressure ventilation. The elderly may be more susceptible to cardiac arrhythmias, especially if digitalis-like drugs are also being taken.</p>', NULL, '<p>Depolarizing muscle relaxants.</p>', '<p>Store in a refrigerator between 2&deg;-8&deg; C. Do not freeze.</p>', NULL, '2022-03-21 04:03:10', '2022-03-21 04:03:10'),
(1442, 1442, '<p>Tacrolimus is a calcineurin-inhibitor immunosuppressant indicated for the prophylaxis of organ rejection in kidney transplant patients in combination with other immunosuppressants.</p>', '<p>Tacrolimus inhibits T-lymphocyte activation, although the exact mechanism of action is not known. Experimental evidence suggests that Tacrolimus binds to an intracellular protein, FKBP-12. A complex of Tacrolimus-FKBP-12, calcium, calmodulin, and calcineurin is then formed and the phosphatase activity of calcineurin inhibited. This effect may prevent the dephosphorylation and translocation of nuclear factor of activated T-cells (NF-AT), a nuclear component thought to initiate gene transcription for the formation of lymphokines (such as interleukin-2, gamma interferon). The net result is the inhibition of T-lymphocyte activation (i.e., immunosuppression).<br />\r\n<br />\r\nTacrolimus prolongs the survival of the host and transplanted graft in animal transplant models of liver, kidney, heart, bone marrow, small bowel and pancreas, lung and trachea, skin, cornea, and limb.<br />\r\n<br />\r\nIn animals, Tacrolimus has been demonstrated to suppress some humoral immunity and, to a greater extent, cell-mediated reactions such as allograft rejection, delayed type hypersensitivity, collagen-induced arthritis, experimental allergic encephalomyelitis, and graft versus host disease.</p>', '<p>Usual Adult Dose for Organ Transplant- Rejection Prophylaxis</p>\r\n\r\n<p>KIDNEY TRANSPLANT:</p>\r\n\r\n<ul>\r\n	<li><strong>In combination with azathioprine</strong>: Initial dose: 0.1 mg/kg orally every 12 hours. Initiate within 24 hours of surgery, but delay until renal function has recovered.</li>\r\n	<li><strong>In combination with mycophenolate mofetil (MMF)/interleukin-2 (IL-2) receptor antagonist</strong>: Initial dose: 0.05 mg/kg orally every 12 hours. Initiate within 24 hours of surgery, but delay until renal function has recovered.</li>\r\n</ul>\r\n\r\n<p>LIVER TRANSPLANT:</p>\r\n\r\n<ul>\r\n	<li><strong>Initial dose</strong>: 0.05 to 0.075 mg/kg orally every 12 hours. Initiate no sooner than 6 hours after surgery.</li>\r\n</ul>\r\n\r\n<p>HEART TRANSPLANT:</p>\r\n\r\n<ul>\r\n	<li><strong>Initial dose</strong>: 0.0375 mg/kg orally every 12 hours. Initiate no sooner than 6 hours after surgery</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Usual Pediatric Dose for Organ Transplant- Rejection Reversal</p>\r\n\r\n<p>LIVER TRANSPLANT:</p>\r\n\r\n<ul>\r\n	<li><strong>Initial dose</strong>: 0.075 to 0.1 mg/kg orally every 12 hours</li>\r\n</ul>', '<p>Since Tacrolimus is metabolized mainly by CYP3A enzymes, drugs or substances known to inhibit these enzymes may increase Tacrolimus whole blood concentrations. Drugs known to induce CYP3A enzymes may decrease Tacrolimus whole blood concentrations. Dose adjustments may be needed along with frequent monitoring of Tacrolimus whole blood trough concentrations when Tacrolimus is administered with CYP3A inhibitors or inducers. In addition, patients should be monitored for adverse reactions including changes in renal function and QT prolongation.</p>', '<p>Tacrolimus capsules are contraindicated in patients with a hypersensitivity to Tacrolimus. Tacrolimus injection is contraindicated in patients with a hypersensitivity to HCO-60 (polyoxyl 60 hydrogenated castor oil). Hypersensitivity symptoms reported include dyspnea, rash, pruritus, and acute respiratory distress syndrome.</p>', NULL, '<p><strong>Pregnancy</strong>&nbsp;Category C. There are no adequate and well-controlled studies in pregnant women. Tacrolimus is transferred across the placenta. The use of Tacrolimus during pregnancy in humans has been associated with neonatal hyperkalemia and renal dysfunction. Tacrolimus given orally to pregnant rabbits at 0.5 to 4.3 times the clinical dose and pregnant rats at 0.8 to 6.9 times the clinical dose was associated with an increased incidence of fetal death&nbsp;in utero, fetal malformations (cardiovascular, skeletal, omphalocele, and gallbladder agenesis) and maternal toxicity. Tacrolimus should be used during pregnancy only if the potential benefit to the mother justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: Tacrolimus is excreted in human milk. As the effect of chronic exposure to Tacrolimus in healthy infants is not established, patients maintained on Tacrolimus should discontinue nursing taking into consideration importance of drug to the mother.</p>', '<p><strong>Pediatric Use</strong>: The safety and efficacy of Tacrolimus in pediatric kidney and heart transplant patients have not been established. Successful liver transplants have been performed in pediatric patients (ages up to 16 years) using Tacrolimus. Two randomized active-controlled trials of Tacrolimus in primary liver transplantation included 56 pediatric patients. Thirty-one patients were randomized to Tacrolimus-based and 25 to cyclosporine-based therapies. Additionally, a minimum of 122 pediatric patients were studied in an uncontrolled trial of Tacrolimus in living related donor liver transplantation. Pediatric patients generally required higher doses of Tacrolimus to maintain blood trough concentrations of Tacrolimus similar to adult patients.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical trials of Tacrolimus did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.<br />\r\n<br />\r\n<strong>Use in Renal Impairment</strong>: The pharmacokinetics of Tacrolimus in patients with renal impairment was similar to that in healthy volunteers with normal renal function. However, consideration should be given to dosing Tacrolimus at the lower end of the therapeutic dosing range in patients who have received a liver or heart transplant and have pre-existing renal impairment. Further reductions in dose below the targeted range may be required<br />\r\n<br />\r\n<strong>Use in Hepatic Impairment</strong>: The mean clearance of Tacrolimus was substantially lower in patients with severe hepatic impairment (mean Child-Pugh score: &gt;10) compared to healthy volunteers with normal hepatic function. Close monitoring of Tacrolimus trough concentrations is warranted in patients with hepatic impairment.<br />\r\n<br />\r\nThe use of Tacrolimus in liver transplant recipients experiencing post-transplant hepatic impairment may be associated with increased risk of developing renal insufficiency related to high whole-blood trough concentrations of Tacrolimus. These patients should be monitored closely and dosage adjustments should be considered. Some evidence suggests that lower doses should be used in these patients</p>', '<p>Limited overdosage experience is available. Acute overdosages of up to 30 times the intended dose have been reported. Almost all cases have been asymptomatic and all patients recovered with no sequelae. Acute overdosage was sometimes followed by adverse reactions (including tremors, abnormal renal function, hypertension, and peripheral edema); in one case of acute overdosage, transient urticaria and lethargy were observed. Based on the poor aqueous solubility and extensive erythrocyte and plasma protein binding, it is anticipated that Tacrolimus is not dialyzable to any significant extent; there is no experience with charcoal hemoperfusion. The oral use of activated charcoal has been reported in treating acute overdoses, but experience has not been sufficient to warrant recommending its use. General supportive measures and treatment of specific symptoms should be followed in all cases of overdosage.<br />\r\n<br />\r\nIn acute oral and IV toxicity studies, mortalities were seen at or above the following doses: in adult rats, 52 times the recommended human oral dose; in immature rats, 16 times the recommended oral dose; and in adult rats, 16 times the recommended human IV dose (all based on body surface area corrections).</p>', '<p>Drugs affecting the immune response.</p>', '<p>Store at 25&deg;C</p>', NULL, '2022-03-21 04:48:47', '2022-03-21 04:48:47'),
(1443, 1443, '<p>Tacrolimus ointment is indicated for short-term and intermittent long-term therapy in the treatment of patients with moderate to severe atopic dermatitis in whom the use of alternative, conventional therapies are deemed inadvisable because of potential risks, or in the treatment of patients who are not adequately responsive to or are intolerant of alternative, conventional therapies. Tacrolimus ointment is also indicated in other skin conditions such as chronic cutaneous graft-vs-host disease, hand and foot eczema, allergic contact dermatitis, vitiligo, psoriasis, lichen planus, facial lichen, vulvar lichen sclerosus, pyoderma gangrenosum, leg ulcers in rheumatoid arthritis, steroid-induced rosacea &amp; alopecia areata, annular erythema, chronic actinic dermatitis and recalcitrant facial erythema.</p>', '<p>Tacrolimus is a macroiide immunomodulator produced by fungus, Streptomyces tsukubaensis. It has been demonstrated that Tacrolimus inhibits T-lymphocyte activation by first binding to an intracellular protein, FKBP-12. A complex of Tacrolimus-FKBP-12, calcium, calmodulin, and calcineurin is then formed and the phosphatase activity of calcineurin is inhibited. This leads to a general decrease in the entire inflammatory cascade.</p>', '<p><strong>Use in adults</strong>: Apply a thin layer of Tacrolimus&nbsp;ointment onto the affected skin areas twice daily and rub in gently and completely. Treatment should be continued for one week after clearing of signs and symptoms of atopic dermatitis. The safety of Tacrolim ointment under occlusion which may promote systemic exposure has not been evaluated. Tacrolimus ointment should not be used with occlusive dressings.<br />\r\n<br />\r\n<strong>Use in Children</strong>:</p>\r\n\r\n<ul>\r\n	<li>Tacrolimus 0.03% ointment can be used in pediatric patients 2 years of age and older.</li>\r\n	<li>Tacrolimus 0.1% ointment can be used in children 16 years of age and older.</li>\r\n</ul>\r\n\r\n<p><strong>Use in Elderly Patients</strong>: Patients &gt;65 years old received Tacrolimus ointment in phase 3 studies. The adverse event profile for these patients was consistent with that for other adult patients.</p>', '<p>Formal topical drug interaction studies with Tacrolimus ointment have not been conducted. The concomitant administration of known CYP3A4 inhibitors in patients with widespread and/or erythrodermic disease should be done with caution. Some examples of such drugs are erythromycin, itraconazole, ketoconazole, fluconazole, calcium channel blockers and cimetidine.</p>', '<p>Tacrolimus ointment is contraindicated in patients with a history of hypersensitivity to Tacrolimus or any other component of the preparation.</p>', '<p>Topically applied Tacrolimus ointment have very few and rare type of side-effects including skin burning, pruritus, flu-like symptoms, allergic reactions, skin erythema, skin infections, headache, etc.</p>', '<p>Pregnancy Category C. There are no adequate and well-controlled studies of topically administered Tacrolimus in pregnant women.&nbsp;Although systemic absorption of Tacrolimus following topical applications of Tacrolimus ointment is minimal relative to systemic administration, it is known that Tacrolimus is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Tacrolimus, 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>Cautions should be exercised while treatment with Tacrolimus ointment in patients with atopic dermatitis predisposed to superficial skin infections. The safety of Tacrolimus ointment has not been established in patients with generalized erythroderma.</p>', '<p>Tacrolimus ointment is not for oral use. Accidental oral ingestion of Tacrolimus ointment may lead to adverse effects associated with systemic administration of Tacrolimus. If oral ingestion occurs, medical advice should be sought.</p>', '<p>Drugs affecting the immune response.</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-21 04:50:29', '2022-03-21 04:50:29'),
(1444, 1444, '<p>Tadalafil is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Erectile Dysfunction (ED)</li>\r\n	<li>Benign Prostatic Hyperplasia (BPH)</li>\r\n	<li>Both Erectile Dysfunction and signs and symptoms of Benign Prostatic Hyperplasia</li>\r\n</ul>', '<p>Tadalafil is a selective phosphodiesterase type 5 (PDE5) inhibitor. Inhibition of PDE5 increases cGMP in smooth muscle cells. cGMP causes smooth muscle relaxation and increased blood flow into the corpus cavernosum, causing penile erection. PDE5 also is present in smooth muscles of the prostate and bladder wall. Inhibiting PDE5 increases cGMP concentrations leading to relaxation of smooth muscle in the prostate and bladder. Smooth muscle relaxation may improve blood flow to the urinary tract and widen the opening of the bladder neck, resulting in improved voiding.</p>', '<p><strong>Erectile Dysfunction</strong>: For most patients the recommended starting dose is 10 mg. The dose may be increased to 20 mg or decreased to 5 mg based on requirement. The maximum dosing frequency is once daily. Tadalafil is effective for up to 36 hours.<br />\r\n<br />\r\n<strong>Benign prostatic hyperplasia</strong>: The recommended dose is 5 mg taken at the same time every day.<br />\r\n<br />\r\n<strong>Combined Erectile Dysfunction and Benign prostatic hyperplasia</strong>: The recommended dose is 5 mg at the same time every day.</p>', '<p>May interact with Nitrates for example, Isosorbide, Nitroglycerin, Alpha adrenergic blockers, Antihypertensives, Alcohol, Antacids (magnesuim hydroxide/aluminum hydroxide), Ketoconazole, Ritonavir, Erythromycin, Itraconazole, Grapefruit juice, other HIV protease inhibitors, Rifampin, Carbamazepine, Phenytoin &amp; Phenobarbital.</p>', '<ul>\r\n	<li>Use of Nitrates (for example, Nitroglycerine, Isosorbide): may increase hypotensive effects of Nitrates</li>\r\n	<li>Hypersensitivity reactions to Tadalafil</li>\r\n</ul>', '<p>Headache, Dyspepsia, Back pain, Myalgia, Nasal pharyngitis, Nasal congestion are common side effects. Change in Color Vision, Sudden vision loss, Hearing loss, Stevens-Johnson Syndrome, Exfoliative dermatitis, Angina, Stroke, Myocardial infarction, Severe hypotension, Tachycardia may also occur rarely.</p>', '<p>Tadalafil has been assigned to pregnancy category B by the USFDA. Tadalafil is only recommended for use during pregnancy when benefit outweighs risk. There are no data on the excretion of Tadalafil in human milk. Caution should be used when administering tadalafil to nursing women.</p>', '<p>Angina, renal impairment, hepatic impairment, bleeding concomitant with Nitrates, Alpha Blockers, Alcohol, CYP3A4 Inhibitors (for example, Ritonavir, Ketoconazole, Itraconazole), other PDE5 inhibitors precaution should be taken in all these conditions.</p>', NULL, '<p>Drugs for Erectile Dysfunction.</p>', '<p>Keep in a dry place, away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-21 04:52:00', '2022-03-21 04:52:00'),
(1445, 1445, '<p>Tafluprost is indicated for reducing elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension.</p>', '<p>Tafluprost, a prostaglandin analog is a selective FP prostanoid receptor agonist which is believed to reduce intraocular pressure by increasing uveoscleral outflow of aqueous humor.</p>', '<p>Instill one drop in the affected eye(s) once daily in the evening.</p>', NULL, '<p>Tafluprost ophthalmic solution is contraindicated in patients who are hypersensitive to any component of this product.</p>', '<p>The most frequently reported treatment-related side effect is ocular hyperemia. Rare side effects observed include eye irritation and blurred vision.</p>', '<p><strong>Use in pregnancy</strong>: Pregnancy category C. There are no adequate and well-controlled studies in pregnant women. Tafluprost ophthalmic solution should be used during pregnancy unless the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: It is not known whether Tafluprost is excreted in human milk. Caution should be exercised while giving this ophthalmic solution to a nursing mother.</p>', '<ul>\r\n	<li>For ophthalmic use only.</li>\r\n	<li>To avoid possible contamination of the drops, do not touch the dropper tip or to any surface.</li>\r\n	<li>Should be used with caution in patients with active intraocular inflammation (e.g., iritis/uveitis).</li>\r\n	<li>If more than one topical ophthalmic drug is being used, the drugs should be administered at least five (5) minutes between applications.</li>\r\n</ul>', NULL, '<p>Drugs for miotics and glaucoma.</p>', NULL, '<p><strong>Use in children</strong>: Use in pediatric patients is not recommended.<br />\r\n<br />\r\n<strong>Use in elderly patients</strong>: No overall differences in safety and effectiveness have been observed between elderly and other adult patients.</p>', '2022-03-21 04:53:20', '2022-03-21 04:53:20'),
(1446, 1446, '<p>Tamoxifen is indicated for the treatment of breast cancer.</p>', '<p>Tamoxifen is a praparation of Tamoxifen which is a non-steroidal, triphenylene based drug and displays a complex spectrum of oestrogen antagonist and oestrogen agonist like pharmacological effects in different tissues. In breast cancer patients, at the tumour level, Tamoxifen acts primarily as an antioestrogen, preventing oestrogen binding to the oestrogen receptor. Additionally Tamoxifen has been reported to lead to maintenance of bone mineral density in post-menopausal women.</p>', '<p><strong>Adults (including elderly)</strong>: The dosage range is 20 to 40 mg daily, given either in divided doses twice daily or as a single dose once daily.</p>', '<p>When Tamoxifen is used in combination with coumarin type anticoagulants, a significant increase in anticoagulant effect may occur. Where such co administration is initiated, careful monitoring of the patient is recommended. When Tamoxifen is used in combination with cytotoxic agents, there is an increased risk of thromboembolic events.</p>', '<p>Tamoxifen must not be administered during pregnancy. Tamoxifen should not be given to patients who have experienced hypersensitivity to the product or any of its ingredients.</p>', '<p>Side effects can be classified as either due to the pharmacological action of the drug, e.g., hot flushes, vaginal bleeding, vaginal discharge, pruritus vulvae and tumour flare or as more general side effects, e.g., gastrointestinal intolerance, headache, light-headedness and occasionally fluid retention and alopecia. When such side effects are severe, it may be possible to control them by a simple reduction of dosage (within the recommended dose range) without loss of control of the disease.&nbsp;<br />\r\n<br />\r\nSkin rashes including isolated reports of erythema multiforme, Stevens Johnson syndrome and bullous pemphigoid and rare hypersensitivity reactions, including angio-oedema have been reported. A small number of patients with bony metastases have developed hypercalcaemia on initiation of therapy.<br />\r\n<br />\r\nFalls in platelet count, usually only to 80,000-90,000 per/mm3 but occasionally lower, have been reported in patients taking Tamoxifen for breast cancer.<br />\r\n<br />\r\nA number of cases of visual disturbances including infrequent reports of corneal changes and retinopathy have been described in patients receiving Tamoxifen therapy. An increased incidence of cataracts has been reported in association with the administration of the drug. Uterine fibroids and endometrial changes including hyperplasia and polyps have been reported. Cystic ovarian swellings have occasionally been observed in premenopausal women receiving Tamoxifen.<br />\r\n<br />\r\nLeucopenia has been observed following the administration of Tamoxifen, sometimes in association with anaemia and/or thrombocytopenia. Neutropenia has been reported on rare occasions; this can sometimes be severe. There is evidence of an increased incidence of thromboembolic events including deep vein thrombosis and pulmonary embolism during Tamoxifen therapy.<br />\r\n<br />\r\nTamoxifen has been associated with changes in liver enzyme levels and on rare occasions with a spectrum of more severe liver abnormalities, including fatty liver, cholestasis and hepatitis. Rarely, elevation of serum triglyceride levels, in some cases with pancreatitis, may be associated with the use of Tamoxifen.</p>', '<p><strong>Pregnancy:</strong>&nbsp;Tamoxifen must not be administered during pregnancy. There have been a small number of reports of spontaneous abortions, birth defects and foetal deaths after women have taken Tamoxifen, although no causal relationship has been established. Reproductive toxicology studies in rats, rabbits and monkeys have shown no teratogenic potential.<br />\r\n<br />\r\nWomen should be advised not to become pregnant whilst taking Tamoxifen and should use barrier or other nonhormonal contraceptive methods if sexually active. Premenopausal patients must be carefully examined before treatment to exclude pregnancy. Women should be informed of the potential risks to the foetus, if they want to become pregnant whilst taking Tamoxifen or within two months of cessation of therapy.<br />\r\n<br />\r\n<strong>Lactation:</strong>&nbsp;It is not known if Tamoxifen is excreted in human milk and therefore the drug is not recommended during lactation. The decision to discontinue Tamoxifen should take into account in case of the importance of the drug to the lactating mother.</p>', '<p>Menstruation is suppressed in a proportion of premenopausal women receiving Tamoxifen for the treatment of breast cancer. An increased incidence of endometrial cancer has seen reported in association with Tamoxifen treatment. The underlying mechanism is unknown, but may be related to the oestrogen-like effect of Tamoxifen. Any patients receiving or having previously received Tamoxifen, who report abnormal gynaecological symptoms, especially vaginal bleeding, should be promptly investigated.<br />\r\n<br />\r\nA number of second primary tumors, occurring at sites other than the endometrium and the opposite breast, have been reported in clinical trials, following the treatment of breast cancer patients with Tamoxifen. No causal link has been established and the clinical significance of these observations remains unclear.</p>', NULL, '<p>Hormonal Chemotherapy.</p>', '<p>Store between 20-25&deg; C. Protect from light.</p>', NULL, '2022-03-21 04:56:50', '2022-03-21 04:56:50'),
(1447, 1447, '<p>Tamsulosin Hydrochloride is indicated for the treatment of functional symptoms of Benign Prostatic Hyperplasia (BPH).</p>', '<p>Tamsulosin, a selective alpha1 adrenoceptor blocking agent, exhibits its selectivity for alpha1&nbsp;A adrenoceptors in human prostate. Blockade of these adrenoceptors can cause smooth muscle in the bladder neck and prostate to relax, resulting in an improvement in urine flow rate and a reduction in symptoms of BPH. Absorption of Tamsulosin hydrochloride capsule 0.4mg is essentially complete (90%) following oral administration under fasting conditions. The time to maximum concentration (Tmax) is reached by four to five hours under fasting conditions and by six to seven hours when administered with food. Tamsulosin hydrochloride is extremely bound to human plasma protein (94% to 99%). Tamsulosin hydrochloride is extensively metabolized by cytochrome P 450 enzymes in the liver and less than 10% of the dose is excreted in urine as unchanged form. Following intravenous or oral administration of an immediate-release formulation the elimination half-life of Tamsulosin hydrochloride in plasma ranges from five to seven hours. Because of the absorption rate controlled pharmacokinetics with Prostam capsules, the apparent half-life of Tamsulosin hydrochloride is approximately 9 to 13 hours in healthy volunteers and 14 to 15 hours in the target population.</p>', '<p>Tamsulosin Hydrochloride 0.4 mg (one capsule) daily, to be taken after meal at night. The dose may be increased after 2 to 4 weeks, if necessary, to Tamsulosin Hydrochloride 0.8 mg (two capsules) once daily. If Tamsulosin Hydrochloride administration is discontinued or interrupted for several days at either the 0.4 mg or 0.8 mg dose, therapy should be started again with the Tamsulosin Hydrochloride 0.4 mg (one capsule) once daily dose. The capsule should be swallowed whole with a glass of water (about 150 ml) in the standing or sitting position. The capsule should not be crunched or chewed, as this will interfere with the modified release of the active ingredient.</p>', '<p>Concurrent administration of other alfa1-adrenoceptor antagonists could lead to hypotensive effects. No interactions have been seen when Tamsulosin was given concomitantly with either atenolol, enalapril or nifedipine. Concomitant cimetidine brings about a rise and frusemide a fall in plasma levels of Tamsulosin, but as levels remain within the normal range posology need not be changed. No interactions at the level of hepatic metabolism have been seen during in vitro studies with liver microsomal fractions (representative of the cytochrome P450-linked drug-metabolizing enzyme system), involving amitriptyline, salbutamol, glibenclamide, and finasteride. Diclofenac and warfarin, however, may increase the elimination rate of Tamsulosin.</p>', '<p>Tamsulosin hydrochloride is contraindicated in patients with hypersensitivity to it; history of orthostatic hypotension; severe hepatic insufficiency.<br />\r\n<br />\r\nAs with other alpha1 blockers, a reduction in blood pressure can occur in individual cases during treatment with Tamsulosin, as a result of which, rarely, syncope can occur, at the first signs of orthostatic hypotension (dizziness, weakness) the patient should sit or lie down until the symptoms have disappeared. And they should be cautioned to avoid situations where injury could result (like driving, operating machinery or performing hazardous tasks).<br />\r\n<br />\r\nBefore therapy with Tamsulosin is initiated the patient should be examined in order to exclude the presence of other conditions which can cause the same symptoms as Benign Prostatic hyperplasia. Digital rectal examination and when the necessary determination of Prostate Specific Antigen (PSA) should be performed before treatment and at regular intervals afterwards.</p>', '<p>The following adverse reactions have been reported during the use of Tamsulosin: dizziness, abnormal ejaculation and; less frequently headache, asthenia, postural hypotension and palpitations.</p>', '<p>Use of Tamsulosin in pregnancy and lactation is not recommended.</p>', '<p>Rarely, transient postural symptoms have occurred during orthostatic provocation testing after the first dose. Use in patients with micturition syncope is not advised.<br />\r\n<br />\r\nEffects on ability to drive and use machines: No data is available on whether Tamsulosin adversely affects the ability to drive or operate machines. However, in this respect, patients should be aware of the fact that dizziness can occur.</p>', '<p>No case of acute overdosage has been reported. However, acute hypotension is likely to occur after overdosage in which case cardiovascular support should be given. Blood pressure can be restored and the heart rate brought back to normal by lying the patient down. If this does not help then volume expanders, and when necessary, vasopressors could be employed. Renal function should be monitored and general supportive measures applied. Dialysis is unlikely to be of help as Tamsulosin is very highly bound to plasma proteins. Measures, such as emesis, can be taken to impede absorption. When large quantities are involved, gastric lavage can be applied and activated charcoal and an osmotic laxative, such as sodium sulphate, can be administered.</p>', '<p>BPH/ Urinary retention/ Urinary incontinence.</p>', '<p>Store in a cool and dry place, below 30&deg;C, protected from light.</p>', NULL, '2022-03-21 04:58:25', '2022-03-21 04:58:25');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1448, 1448, '<p>Tamsulosin Hydrochloride &amp; Dutasteride capsule is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Treatment of moderate to severe symptoms of benign prostatic hyperplasia (BPH).</li>\r\n	<li>Reduction in the risk of acute urinary retention and surgery in patients with moderate to severe symptoms of BPH.</li>\r\n</ul>', '<p>Tamsulosin &amp; Dutasteride is a combination of two drugs with complementary mechanisms of action to improve symptoms in patients with Benign Prostatic Hyperplasia (BPH). Tamsulosin Hydrochloride, an antagonist of alpha1A-adrenoreceptors and Dutasteride, a dual 5 alpha reductase inhibitor (5ARI). Treatment of BPH with alpha1-adrenoreceptor blocking agents and 5ARIs results in an improvement in urine flow rate and a reduction in symptoms of BPH.<br />\r\n<br />\r\n<strong>Tamsulosin</strong>: An alpha1-adrenoreceptor blocking agent that affects the dynamic component of BPH by inhibiting alpha1-adrenoreceptors in the stromal prostatic smooth muscle and bladder neck. Blockade of these adrenoreceptors can cause smooth muscles in the bladder neck and prostate to relax. Specifically, Tamsulosin exhibits selectivity for both alpha&nbsp;1A&nbsp;and alpha&nbsp;1D&nbsp;receptors over the alpha1B-adrenoreceptor subtype. These three adrenoreceptor subtypes have a distinct distribution pattern in human tissue. Whereas approximately 70% of the alpha1-receptors in human prostate are of the alpha&nbsp;1A&nbsp;subtype, the human bladder contains predominantly the alpha&nbsp;1D&nbsp;subtype while blood vessels express predominantly alpha&nbsp;1B&nbsp;subtype. It is further believed that blockade of the alpha&nbsp;1D&nbsp;subtypes in the human obstructed bladder may be responsible for reducing detrusor overactivity and subsequent relief of storage symptoms.<br />\r\n<br />\r\n<strong>Dutasteride</strong>: A synthetic 4-azasteriod compound is a competitive and specific inhibitor of both Type I and Type II 5 alpha-reductase isoenzymes that affects the static component of BPH by inhibiting the conversion of Testosterone to Dihydrotestosterone (DHT) by the enzyme 5 alpha-reductase. 5 alpha-reductase exists as 2 isoforms, Type I and Type II, both of which are present in the prostate. It has been observed that compared to normal tissue, the expression of both isoenzymes are increased in BPH tissue. Dissociation from this complex has been evaluated under in vitro and in vivo conditions and is extremely slow. Dutasteride lowers DHT levels and leads to a reduction in prostatic volume, thereby treating an underlying cause of BPH. Dutasteride does not bind to the human androgen receptor.</p>', '<p><strong>Adults (including elderly)</strong>: The recommended dose is one capsule (Tamsulosin Hydrochloride 0.4 mg &amp; Dutasteride 0.5 mg) taken orally approximately 30 minutes after the same meal each day. The capsules should be swallowed whole and not chewed or opened. Where appropriate, this capsule may be used to substitute concomitant Tamsulosin Hydrochloride and Dutasteride in existing dual therapy to simplify treatment. Where clinically appropriate, direct change from Tamsulosin Hydrochloride or Dutasteride monotherapy to this capsule may be considered.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: The effect of renal impairment on Tamsulosin-Dutasteride pharmacokinetics has not been studied. No adjustment in dosage is anticipated for patients with renal impairment.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: The effect of hepatic impairment on Tamsulosin-Dutasteride pharmacokinetics has not been studied so caution should be used in patients with mild to moderate hepatic impairment. In patients with severe hepatic impairment, the use of this capsule is contra-indicated.</p>', '<p>There have been no drug interaction studies for Dutasteride-Tamsulosin combination.<br />\r\n<br />\r\n<strong>Effects of other drugs on the pharmacokinetics of Dutasteride</strong>: Use together with CYP3A4 and/or P-glycoprotein-inhibitors: Dutasteride is mainly eliminated via metabolism. In vitro studies indicate that this metabolism is catalysed by CYP3A4 and CYP3A5. No formal interaction studies have been performed with potent CYP3A4 inhibitors. However, in a population pharmacokinetic study, Dutasteride serum concentrations were on average 1.6 to 1.8 times greater, respectively, in a small number of patients treated concurrently with verapamil or diltiazem (moderate inhibitors of CYP3A4 and inhibitors of P-glycoprotein) than in other patients. Long-term combination of Dutasteride with drugs that are potent inhibitors of the enzyme CYP3A4 (e.g. ritonavir, indinavir, nefazodone, itraconazole, ketoconazole administered orally) may increase serum concentrations of Dutasteride. Further inhibition of 5-alpha reductase at increased Dutasteride exposure, is not likely. However, a reduction of the Dutasteride dosing frequency can be considered if side effects are noted. It should be noted that in the case of enzyme inhibition, the long half-life may be further prolonged and it can take more than 6 months of concurrent therapy before a new steady state is reached. Administration of 12 g cholestyramine one hour after a 5 mg single dose of Dutasteride did not affect the pharmacokinetics of Dutasteride.<br />\r\n<br />\r\n<strong>Effects of Dutasteride on the pharmacokinetics of other drugs</strong>: In a small study (N=24) of two weeks duration in healthy men, Dutasteride (0.5 mg daily) had no effect on the pharmacokinetics of Tamsulosin or terazosin. There was also no indication of a pharmacodynamic interaction in this study. Dutasteride has no effect on the pharmacokinetics of warfarin or digoxin. This indicates that Dutasteride does not inhibit/induce CYP2C9 or the transporter P-glycoprotein. In vitro interaction studies indicate that Dutasteride does not inhibit the enzymes CYP1A2, CYP2D6, CYP2C9, CYP2C19 or CYP3A4. Tamsulosin: Concomitant administration of Tamsulosin Hydrochloride with drugs which can reduce blood pressure, including anaesthetic agents, PDE5 inhibitors and other alpha-1 adrenergic blockers could lead to enhanced hypotensive effects. Tamsulosin-Dutasteride should not be used in combination with other alpha-1 adrenergic blockers. Concomitant administration of Tamsulosin Hydrochloride (0.4 mg) and cimetidine (400 mg every six hours for six days) resulted in a decrease in the clearance (26%) and an increase in the AUC (44%) of Tamsulosin Hydrochloride. Caution should be used when Tamsulosin-Dutasteride is used in combination with cimetidine. A definitive drug-drug interaction study between Tamsulosin Hydrochloride and warfarin has not been conducted. Results from limited in vitro and in vivo studies are inconclusive. Caution should be exercised with concomitant administration of warfarin and Tamsulosin Hydrochloride. No interactions have been seen when Tamsulosin Hydrochloride was given concomitantly with either atenolol, enalapril, nifedipine or theophylline. Concomitant furosemide brings about a fall in plasma levels of Tamsulosin, but as levels remain within the normal range posology need not be adjusted. In vitro neither diazepam nor propranolol, trichlormethiazide, chlormadinon, amitryptyline, diclofenac, glibenclamide and simvastatin change the free fraction of Tamsulosin in human plasma. Neither does Tamsulosin change the free fractions of diazepam, propranolol, trichlormethiazide, and chlormadinon. No interactions at the level of hepatic metabolism have been seen during in vitro studies with liver microsomal fractions, involving amitriptyline, salbutamol and glibenclamide. Diclofenac however, may increase the elimination rate of Tamsulosin.</p>', '<p>Tamsulosin-Dutasteride combination is contra-indicated in women and children and adolescents, patients with hypersensitivity to Dutasteride, other 5-alpha reductase inhibitors, Tamsulosin (including Tamsulosin- induced angio-edema), soya, peanut or any of other the excipients, patients with a history of orthostatic hypotension and patients with severe hepatic impairment.</p>', '<p>The most common adverse reactions reported in subjects receiving combination therapy were impotence, decreased libido, breast disorders (including breast enlargement and tenderness), ejaculation disorders and dizziness. The percentages of subjects with ejaculation disorders, decreased libido and impotence were higher in the combination therapy group compared with either monotherapy groups.</p>', '<p>Tamsulosin-Dutasteride combination is contra-indicated for use by women. There have been no studies to investigate the effect of Tamsulosin-Dutasteride combination on pregnancy, lactation and fertility. The following statements reflect the information available from studies with the individual components. Fertility: Dutasteride has been reported to affect semen characteristics (reduction in sperm count, semen volume, and sperm motility) in healthy men. The possibility of reduced male fertility cannot be excluded. Effects of Tamsulosin Hydrochloride on sperm counts or sperm function have not been evaluated.<br />\r\n<br />\r\n<strong>Pregnancy</strong>: As with other 5 alpha reductase inhibitors, Dutasteride inhibits the conversion of testosterone to dihydrotestosterone and may, if administered to a woman carrying a male foetus, inhibit the development of the external genitalia of the foetus. Small amounts of Dutasteride have been recovered from the semen in subjects receiving Dutasteride. It is not known whether a male foetus will be adversely affected if his mother is exposed to the semen of a patient being treated with Dutasteride. As with all 5 alpha reductase inhibitors, when the patient&rsquo;s partner is or may potentially be pregnant it is recommended that the patient avoids exposure of his partner to semen by use of a condom. Administration of Tamsulosin Hydrochloride to pregnant female rats and rabbits showed no evidence of foetal harm.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether Tamsulosin or Dutasteride are excreted in human milk.</p>', '<p>Combination therapy should be prescribed after careful benefit risk assessment due to the potential increased risk of adverse events (including cardiac failure) and after consideration of alternative treatment options including monotherapies.<br />\r\n<br />\r\n<strong>Cardiac failure</strong>: In two 4-year clinical studies, the incidence of cardiac failure was higher among subjects taking the combination of Dutasteride and an alpha blocker, primarily Tamsulosin, than it was among subjects not taking the combination. In these two trials, the incidence of cardiac failure was low (1%) and variable between the studies.<br />\r\n<br />\r\n<strong>Effects on prostate specific antigen (PSA) and prostate cancer detection</strong>: Digital rectal examination, as well as other evaluations for prostate cancer or other conditions which can cause the same symptoms as BPH, must be performed on patients prior to initiating therapy with Tamsulosin-Dutasteride combination and periodically thereafter. Serum prostate-specific antigen (PSA) concentration is an important component in the detection of prostate cancer. Tamsulosin-Dutasteride combination causes a decrease in mean serum PSA levels by approximately 50%, after 6 months of treatment. Patients receiving Tamsulosin-Dutasteride combination should have a new PSA baseline established after 6 months of treatment. It is recommended to monitor PSA values regularly thereafter. Any confirmed increase from lowest PSA level while on Tamsulosin-Dutasteride combination may signal the presence of prostate cancer or noncompliance to therapy with Tamsulosin-Dutasteride combination and should be carefully evaluated, even if those values are still within the normal range for men not taking a 5 alpha-reductase inhibitor. In the interpretation of a PSA value for a patient taking Tamsulosin-Dutasteride combination, previous PSA values while on Dutasteride treatment should be sought for comparison. Treatment with Tamsulosin-Dutasteride combination does not interfere with the use of PSA as a tool to assist in the diagnosis of prostate cancer after a new baseline has been established. Total serum PSA levels return to baseline within 6 months of discontinuing treatment. The ratio of free to total PSA remains constant even under the influence of Tamsulosin-Dutasteride combination. If clinicians elect to use percent free PSA as an aid in the detection of prostate cancer in men undergoing Tamsulosin-Dutasteride combination therapy, no adjustment to its value appears necessary.<br />\r\n<br />\r\n<strong>Prostate cancer and high grade tumours</strong>: Results of one clinical study in men at increase risk of prostate cancer revealed a higher incidence of Gleason 8-10 prostate cancers in Dutasteride treated men compared to placebo. The relationship between Dutasteride and high grade prostate cancer is not clear. Men taking Tamsulosin-Dutasteride combination should be regularly evaluated for prostate cancer risk including PSA testing.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: The treatment of severely renally impaired patients (creatinine clearance of less than 10 ml/min) should be approached with caution as these patients have not been studied.<br />\r\n<br />\r\n<strong>Hypotension</strong>: Orthostatic- As with other alpha-blockers, a reduction in blood pressure can occur during treatment with Tamsulosin, as a result of which, rarely, syncope can occur. Patients beginning treatment with Tamsulosin-Dutasteride combination should be cautioned to sit or lie down at the first signs of orthostatic hypotension (dizziness, weakness) until the symptoms have resolved. In order to minimize the potential for developing postural hypotension the patient should be haemodynamically stable on alpha-blocker therapy prior to initiating use of PDE5 inhibitors. Symptomatic: Caution is advised when alpha adrenergic blocking agents including Tamsulosin are coadministered with PDE5 inhibitors (e.g. sildenafil, tadalafil, vardenafil). Alpha adrenergic blockers and PDE5 inhibitors are both vasodilators that can lower blood pressure. Concomitant use of these two drug classes can potentially cause symptomatic hypotension.<br />\r\n<br />\r\n<strong>Intraoperative Floppy Iris Syndrome</strong>: Intraoperative Floppy Iris Syndrome (IFIS) has been observed during cataract surgery in some patients on or previously treated with Tamsulosin. IFIS may lead to increased procedural complications during the operation. The initiation of therapy with Tamsulosin-Dutasteride combination in patients for whom cataract surgery is scheduled is therefore not recommended. Discontinuing Tamsulosin 1-2 weeks prior to cataract surgery is anecdotally considered helpful, but the benefit and duration of stopping therapy prior to cataract surgery has not yet been established. Leaking Capsule: Dutasteride is absorbed through the skin, therefore, women, children and adolescents must avoid contact with leaking capsules. If contact is made with leaking capsules, the contact area should be washed immediately with soap and water.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Tamsulosin-Dutasteride combination has not been studied in patients with liver disease. Caution should be used in the administration of Tamsulosin-Dutasteride combination to patients with mild to moderate hepatic impairment.<br />\r\n<br />\r\n<strong>Breast neoplasia</strong>: Breast cancer has been reported in men taking Dutasteride in clinical trials and during the post-marketing period. Physicians should instruct their patients to promptly report any changes in their breast tissue such as lumps or nipple discharge. Currently it is not clear if there is a causal relationship between the occurrence of male breast cancer and long term use of Dutasteride.</p>', '<p>No data are available with regard to over dosage of Tamsulosin-Dutasteride combination. The following statements reflect the information available on the individual components.<br />\r\n<br />\r\n<strong>Dutasteride</strong>: In volunteer studies, single daily doses of Dutasteride up to 40 mg/day (80 times the therapeutic dose) have been administered for 7 days without significant safety concerns. In clinical studies, doses of 5 mg daily have been administered to subjects for 6 months with no additional adverse effects to those seen at therapeutic doses of 0.5 mg. There is no specific antidote for Dutasteride, therefore, in suspected over dosage symptomatic and supportive treatment should be given as appropriate.<br />\r\n<br />\r\n<strong>Tamsulosin</strong>: Acute overdose with 5 mg Tamsulosin Hydrochloride has been reported. Acute hypotension (systolic blood pressure 70 mm Hg), vomiting and diarrhoea were observed which were treated with fluid replacement and the patient could be discharged the same day. In case of acute hypotension occurring after over dosage cardiovascular support should be given. Blood pressure can be restored and heart rate brought back to normal by lying the patient down. If this does not help then volume expanders, and when necessary, vasopressors could be employed. Renal function should be monitored and general supportive measures applied. Dialysis is unlikely to be of help as Tamsulosin is very highly bound to plasma proteins. Measures, such as emesis, can be taken to impede absorption. When large quantities are involved, gastric lavage can be applied and activated charcoal and an osmotic laxative, such as sodium sulphate, can be administered.</p>', '<p>BPH/ Urinary retention/ Urinary incontinence.</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-21 05:00:48', '2022-03-21 05:00:48'),
(1449, 1449, '<p>Tapentadol is indicated for the relief of moderate to severe acute pain in patients 18 years of age or older.</p>', '<p>Tapentadol is a centrally-acting synthetic analgesic. It is 18 times less potent than morphine in terms of binding to human mu-opioid receptors. It also increases norepinephrine concentrations in the brains of rats via inhibition of norepinephrine reuptake. Selective mu-opioid antagonists like naloxone can block analgesia from tapentadol. It also has not effect on the QT interval.<br />\r\n<br />\r\nTapendadol causes large increases in levels of extracellular norepinephrine (NE) due to a dual mechanism of action involving mu opioid receptor (MOR) agonism as well as noradrenaline reuptake inhibition.</p>', '<p>As with many centrally-acting analgesic medications, the dosing regimen should be individualized according to the severity of pain being treated, the previous experience with similar drugs and the ability to monitor the patient.<br />\r\n<br />\r\nThe dose is 50 mg, 75 mg, or 100 mg every 4 to 6 hours depending upon pain intensity. On the first day of dosing, the second dose may be administered as soon as one hour after the first dose, if adequate pain relief is not attained with the first dose. Subsequent dosing is 50 mg, 75 mg, or 100 mg every 4 to 6 hours and should be adjusted to maintain adequate analgesia with acceptable tolerability.<br />\r\n<br />\r\nDaily doses greater than 700 mg on the first day of therapy and 600 mg on subsequent days have not been studied and are not recommended.</p>', '<p>Increased risk of serotonin syndrome with other drugs that enhance monoaminergic neurotransmission (e.g. TCAs, triptans, SSRIs, serotonin and norepinephrine reuptake inhibitors). Enhanced sedative effect with benzodiazepines, barbiturates, antipsychotics, H1-antihistamines and other opioids. Increased potential for addiction with mixed &mu;-opioid agonists/antagonists (e.g. nalbuphine, pentazocine) or partial &mu;-opioid agonists (e.g. buprenorphine). Increased systemic exposure with strong inhibitors of UGT1A6, UGT1A9 and UGT2B7 isoenzymes. Decreased efficacy with strong enzyme inducers (e.g. rifampicin, phenobarbital).</p>', '<p>This drug is contraindicated in patients with impaired Pulmonary Function, It is also contraindicated in patients with acute or severe bronchial asthma or hypercapnia in unmonitored settings or the absence of resuscitative equipment. This drug is contraindicated in any patient who has or is suspected of having paralytic ileus.</p>', '<p>The following treatment-emergent adverse events may happen: heart rate increased, heart rate decreased, visual disturbance, abdominal discomfort, impaired gastric emptying, irritability, edema, drug withdrawal syndrome, hypersensitivity, involuntary muscle contractions, sensation of heaviness, hypoesthesia, paresthesia, disturbance in attention, sedation, dysarthria, memory impairment, ataxia, presyncope, syncope, coordination abnormal, seizure, urticaria, blood pressure decreased etc.</p>', '<p>Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. This preparation should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\nNeonates whose mothers have been taking Tapentadol should be monitored for respiratory depression.</p>', '<p>Tapentadol should be administered with caution to patients with conditions accompanied by hypoxia, hypercapnia respiratory problems such as: asthma, chronic obstructive pulmonary disease etc. Besides this in case of patient with sleep apnea syndrome, myxedema, kyphoscoliosis, central nervous system (CNS) depression should have to be cautious prior administration of Tapentadol. Patients receiving other mu-opioid agonist analgesics, general anesthetics, phenothiazines, other tranquilizers, sedatives, hypnotics, or other CNS depressants (including alcohol) concomitantly with Tapentadol may exhibit additive CNS depression.</p>', '<p><strong>Symptoms</strong>: Vomiting, miosis, CV collapse, consciousness disorders up to coma, convulsions and resp depression up to resp arrest.<br />\r\n<br />\r\n<strong>Management</strong>: Re-establish a patent airway and institute assisted or controlled ventilation. GI decontamination with activated charcoal or by gastric lavage may be considered within 2 hr after intake. Pure opioid receptor antagonists (e.g. naloxone) may be given as antidote.</p>', '<p>Opioid analgesics</p>', '<p>Store in a cool and dry place, protected from light and moisture. Keep the medicine out of the reach of children.</p>', '<p><strong>Pediatric use:</strong>&nbsp;The safety and effectiveness of Tapentadol in pediatric patients less than 18 years of age have not been established.<br />\r\n<br />\r\n<strong>Use in elderly patients:</strong>&nbsp;In general, recommended dosing for elderly patients with normal renal and hepatic function is the same as for younger adult patients with normal renal and hepatic function. consideration should be given to starting elderly patients with the lower range of recommended doses.<br />\r\n<br />\r\n<strong>Use in Renal Disease:</strong>&nbsp;In patients with severe renal impairment, the safety and effectiveness of Tapentadol has not been established.<br />\r\n<br />\r\n<strong>Use in Hepatic Disease</strong>: Tapentadol should be used with caution in patients with moderate hepatic impairment. Tapentadol has not been studied in patients with severe hepatic impairment.</p>', '2022-03-21 05:02:33', '2022-03-21 05:02:33'),
(1450, 1450, '<p>Tazarotene is used to treat plaque psoriasis of the skin. It also works to treat acne on the face.</p>', '<p>Tazarotene is a retinoid prodrug which is converted to its active form, the cognate carboxylic acid of tazarotene, by rapid deesterification in animals and man. In cell culture and in vitro models of skin, tazarotene suppresses expression of MRP8, a marker of inflammation present in the epidermis of psoriasis patients at high levels. In human keratinocyte cultures, it inhibits cornified envelope formation, whose build-up is an element of the psoriatic scale.</p>', '<p><strong>For psoriasis</strong>: Tazarotene cream should be applied once per day, in the evening, to psoriatic lesions, using enough (2 mg/cm2) to cover only the lesion with a thin film. If a bath or shower is taken prior to application, the skin should be dried before applying the cream. If emollients are used, they should be applied at least one hour before application of Tazarotene cream.<br />\r\n<br />\r\n<strong>For acne</strong>: Cleanse the face gently. After the skin is dry, apply a thin layer (2mg/cm2) of Tazarotene cream 0.1% once per day, in the evening, to the skin areas where acne lesions appear. Use enough to cover the entire affected area.</p>', '<p>Concomitant dermatologic medications and cosmetics that have a strong drying effect should be avoided. It is also advisable to &quot;rest&quot; a patient&rsquo;s skin until the effects of such preparations subside before use of Tazarotene cream is begun. Topical steroid may be hazardous in psoriasis; careful patient supervision is important. Consider if infection spreads. Do not use near a naked flame.</p>', '<p>Retinoids may cause fetal harm when administered to a pregnant woman. Tazarotene cream is contraindicated in women who are or may become pregnant. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, treatment should be discontinued and the patient should be apprised of the potential hazard to the fetus. Women of childbearing potential should be warned to the potential risk and use adequate birth-control measures when Tazarotene cream is used.</p>', '<p>The most frequent adverse events reported with Tazarotene cream were limited to the skin. Those occurring in 10 to 23% of patients, in descending order, included pruritus, erythema and burning. For acne treatment, in 10 to 30% patients, it is reported desquamation, dry skin, face pain, irritation and stinging sensation.</p>', '<p><strong>Pregnancy</strong>: Tazarotene is not recommended during pregnancy. It has been shown to cause serious birth defects and problems in animals. Be sure you have discussed this&nbsp;with your doctor.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether tazarotene passes into breast milk. However, Tazarotene is not recommended during breast-feeding because it may cause unwanted effects in nursing babies.</p>', '<p>Tazarotene cream should be applied only to the affected areas. For external use only. Avoid contact with eyes, eyelids and mouth. If contact with eyes occurs, rinse thoroughly with water. Retinoids should not be used on eczematous skin, as they may cause severe irritation. Patients must be warned to use sunscreens and protective clothing when using Tazarotene cream. Some individuals may experience excessive pruritus, burning, skin redness or peeling. If these effects occur, the medication should either be discontinued until the integrity of the skin is restored, or the dosing should be reduced.</p>', '<p>Excessive topical use cause marked redness, peeling or discomfort. Accidental oral ingestion produces similar adverse effects as those associated with excessive oral intake of Vitamin A or other retinoids. Monitor and take supportive measures as necessary.</p>', '<p>Topical retinoid and related preparations.</p>', '<p>Store at 25&deg; C.</p>', '<p><strong>Pediatric Use</strong>: Studies of this medicine have been done only in adult patients, and there is no specific information comparing&nbsp;use&nbsp;of Tazarotene in children up to 12 years of age (gel) and up to 18 years of age (cream) with use in other age groups.<br />\r\n<br />\r\n<strong>Elderly Use (Over 65 year)</strong>: There is no specific information comparing the use of Tazarotene in the elderly with use in other age groups.</p>', '2022-03-21 05:04:19', '2022-03-21 05:04:19'),
(1451, 1451, '<p>This is indicated in bad breath, prevents common cold and flu, kills virus, bacteria &amp; fungus from oral cavity, gum protection, plaque control, enamel protection &amp; to maintain oral hygiene.</p>', NULL, '<p>1-2 sprays into the mouth in the morning and evening. To be dispensed only by or on the prescription of a registered physician.</p>', NULL, '<p>Hypersensitivity of any other ingredient of this preparation.</p>', NULL, NULL, NULL, NULL, '<p>Oral preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-21 05:05:22', '2022-03-21 05:05:22'),
(1452, 1452, '<p>ইহা নিম্নোক্ত উপসর্গে নির্দেশিত-</p>\r\n\r\n<ul>\r\n	<li>চোখের সুরক্ষায়</li>\r\n	<li>চোখ দিয়ে করোনা সংক্রামন প্রতরোধে</li>\r\n	<li>হাত জীবাণুমুক্ত করতে</li>\r\n	<li>চোখের পাতা ও ভ্রূ-এর খুশকী দূরীকরণে</li>\r\n	<li>চোখের শুস্কভাব দূর করতে</li>\r\n	<li>বলিরেখা প্রতিরোধে</li>\r\n	<li>কসমেটিকস পরিস্কার করতে।&nbsp;</li>\r\n</ul>', '<p>সানগ্লাস বা গগলস ব্যবহারের পাশাপাশি রোগজীবানু প্রতিরোধী Tea tree oil ও Geothermal water সমৃদ্ধ Shampoo দিয়ে প্রতিদিন দুইবার করে চোখ পরিস্কার করলে চোখ দিয়ে করোনা ভাইরাসে সংক্রামিত হওয়ার সুযোগ কমে যায় এবং চোখের স্বাস্থ্যও সুরক্ষিত থাকে।</p>', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '<p>Other preparations</p>', '<p>Keep out of reach of children, Store in a dry place, below 25&deg;C temperature and protected from light</p>', NULL, '2022-03-21 05:07:45', '2022-03-21 05:07:45'),
(1453, 1453, '<p>This shampoo is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Dandruff</li>\r\n	<li>Pityriasis versicolor</li>\r\n	<li>Seborrhoeic dermatitis</li>\r\n	<li>Wide spread of bodily fungal acne &amp; bacterial disease.</li>\r\n</ul>', '<p><strong>Tea Tree Oil</strong>: Tea tree oil comes from the leaves of&nbsp;Melaleuca alternifolia, a small tree native to Queensland and New South Wales, Australia. Tea tree oil contains a number of compounds, including terpinen-4-ol that have been shown to kill certain bacteria, viruses and fungi.<br />\r\n<br />\r\n<strong>Geothermal Water</strong>: It is natural hot water and has skin healing benefits.</p>', '<p>Seborrheic Dermatitis: Apply in the hair thrice in a weekend wash properly after 5 minutes.<br />\r\n<br />\r\nBodily Fungal Infection (Eczema, Acne, Bedsores, aging): Apply in infected or lesion area once daily and wash after 5 minutes.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Use a small amount of water to wet the scalp</li>\r\n	<li>Apply the shampoo &amp; massage gently until it forms a lather</li>\r\n	<li>Leave the shampoo on the scalp for 5 minutes</li>\r\n	<li>Rinse the shampoo with sufficient amount of water</li>\r\n</ul>', '<p>Topical treatment with Tea Tree Oil (TTO) enriched with geothermal water is generally well tolerated. As with other shampoos, a local burning sensation, itching or contact dermatitis (due to irritation or allergy) may occur on exposed areas. Oily and dry hair have been reported rarely with the use of Tea Tree Oil (TTO) enriched with geothermal water.</p>', NULL, NULL, '<p>Since Tea Tree Oil (TTO) enriched with geothermal water shampoo is not absorbed through the skin after topical application, pregnancy and lactation are not a contraindication for the use of Tea Tree Oil (TTO) enriched with geothermal water shampoo.</p>', NULL, NULL, '<p>Miscellaneous topical agents.</p>', '<p>Keep out of reach of children, Store in a dry place, below 25&deg;C temperature and protected from light.</p>', NULL, '2022-03-21 05:09:08', '2022-03-21 05:09:08'),
(1454, 1454, '<p>This gel is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Deeply clean acne-prone skin</li>\r\n	<li>Excessive sebum control</li>\r\n	<li>Acne Vulgaris</li>\r\n	<li>Dark Spot</li>\r\n</ul>', NULL, '<p>Twice a day in the morning and evening.</p>', NULL, '<p>Contraindicated in any other ingredient of this preparations.</p>', NULL, NULL, NULL, NULL, '<p>Miscellaneous topical agents.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-21 05:11:11', '2022-03-21 05:11:11'),
(1455, 1455, '<p>Tedizolid is an oxazolidinone-class antibacterial drug indicated in adults for the treatment of acute bacterial skin and skin structure infections (ABSSSI) caused by designated susceptible bacteria.<br />\r\n<br />\r\nTo reduce the development of drug-resistant bacteria and maintain the effectiveness of Tedizolid and other antibacterial drugs, Tedizolid should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria.</p>', '<p>After conversion to its active form by phosphatases, tedizolid exerts its antibacterial activity through inhibition of protein synthesis by binding to the 50S ribosomal subunit of susceptible Gram-positive bacteria. Cross-resistance between other non-oxazolidinone antibacterial drugs is unlikely as it inhibits bacterial protein synthesis through a different mechanism.</p>', '<p>Acute Bacterial Skin and Skin Structure Infection (ABSSSI):</p>\r\n\r\n<ul>\r\n	<li><strong>Intravenous</strong>: 200 mg Once daily 1 hour (Infusion Time) for&nbsp;6 days</li>\r\n	<li><strong>Oral</strong>: 200 mg Once daily for&nbsp;6 days</li>\r\n</ul>\r\n\r\n<p>No dose adjustment is necessary when changing from intravenous to oral Tedizolid. If patients miss a dose, they should take it as soon as possible anytime up to 8 hours prior to their next scheduled dose. If less than 8 hours remain before the next dose, wait until their next scheduled dose.</p>', '<p>Tedizolid (when administered orally) can increase the plasma concentrations of orally administered Breast Cancer Resistance Protein BCRP substrates. Monitor for adverse reactions related to the concomitant BCRP substrates if coadministration cannot be avoided.</p>', '<p>None</p>', '<p>The most common adverse reactions (&gt;2%) are nausea, headache, diarrhea, vomiting, and dizziness.</p>', '<p><strong>Pregnancy</strong>&nbsp;category C. There are no adequate and well-controlled studies of Tedizolid in pregnant women. Tedizolid should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: Tedizolid is excreted in the breast milk of rats. It is not known whether tedizolid is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Tedizolid is administered to a nursing woman.</p>', '<p><strong>Patients with neutropenia</strong>: The safety and efficacy of Tedizolid in patients with neutropenia (neutrophil counts &lt;1000 cells/mm3) have not been adequately evaluated. In an animal model of infection, the antibacterial activity of Tedizolid was reduced in the absence of granulocytes. Consider alternative therapies in neutropenic patients.<br />\r\n<br />\r\n<strong>Clostridium difficile-associated diarrhea</strong>: Evaluate if diarrhea occurs.</p>', '<p>In the event of overdosage, Tedizolid should be discontinued and general supportive treatment given. Hemodialysis does not result in meaningful removal of tedizolid from systemic circulation.</p>', '<p>Other antibiotic.</p>', '<p>Tablets and injection should be stored at 20&deg;C to 25&deg;C.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients below the age of 18 have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of Tedizolid did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. No overall differences in pharmacokinetics were observed between elderly subjects and younger subjects.</p>', '2022-03-21 05:13:17', '2022-03-21 05:13:17'),
(1456, 1456, '<p>Tegaserod is indicated for the symptomatic treatment of irritable bowel syndrome with constipation (IBS-C) in patients whose main symptoms are constipation and abdominal pain or discomfort. The maximum duration of treatment is 12 weeks and treatment should be discontinued if there has been no response after 4 weeks.</p>', '<p>Tegaserod is a serotonin type-4 (5HT4) receptor partial agonist. Tegaserod&nbsp;binds with high affinity at human 5HT4 receptors, present on caudate membranes, whereas it has no appreciable affinity for human recombinant 5HT3 receptors or human recombinant dopamine D2 receptors. In vitro and animal study has revealed that Tegaserod can trigger the peristaltic reflex via 5HT4 receptor activation and thereby enhance basal motor activity and normalize impaired GI motility.</p>', '<p><strong>General recommended dosage for adult:</strong>&nbsp;Tegaserod 6 mg twice daily taken orally with a glass of water 30 minutes before meal. The maximum duration of treatment is 12 weeks and treatment should be discontinued after 4 weeks if no response has occurred.<br />\r\n<br />\r\n<strong>Use in elderly</strong>: Dose adjustment is not necessary when administering Tegaserod to patients over 65 years old.<br />\r\n<br />\r\n<strong>Use in children</strong>: There is no clinical trial in document to safety and efficacy of tegaserod in children. Therefore, it is not recommended for use in children.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Administration</p>\r\n\r\n<p>Patient should be advised to take Tegaserod (6 mg twice daily) 30 minutes before meal.<br />\r\n<br />\r\nPatient should also be made aware of the possible occurrence of diarrhea during therapy. In most cases, the diarrhea occurred early, is transient, is most often observed as a single episode during the 12 week treatment period, and resolved with continued therapy.<br />\r\n<br />\r\nPatients should be instructed to consult their physician if they experience new or worsening abdominal pain not typical of their IBS symptoms.</p>', '<p>No clinically relevant drug-drug interactions have been observed with dextromethorphan, theophylline, digoxin, oral contraceptives, and warfarin.</p>', '<p>Tegaserod is not recommended in patients with severe renal or hepatic impairment. It is also contraindicated in patients with hypersensitivity to tegaserod or any excipient of this formulation.</p>', '<p>Abdominal pain, diarrhea, nausea, flatulence, headache, fatigue, back pain etc.</p>', '<p><strong>Pregnancy</strong>: In view of limited experience in human, use of Tegaserod during pregnancy is not recommended.<br />\r\n<br />\r\n<strong>Nursing mothers</strong>: Tegaserod should not be prescribed to nursing mothers.</p>', '<p>Diarrhea was reported in some of the patients receiving Tegaserod in the Phase III clinical studies. Caution is required in patients in whom increased diarrhea could have negative effects. Patients who are currently experiencing or frequently experience diarrhea should not initiate therapy with Tegaserod</p>', '<p>Signs and symptoms of overdosage may include diarrhoea, headache, abdominal pain and orthostatic hypotension. As in any case of over dose, general supportive measures should be utilized.</p>', '<p>Drugs for Irritable Bowel Syndrome</p>', '<p>Store at a cool and dry place, protected from light and moisture.</p>', '<p><strong>Renal impairment</strong>: No dosage adjustment is required in patients with mild to moderate renal impairment. Tegaserod is not recommended in patients with severe renal impairment.<br />\r\n<br />\r\n<strong>Hepatic impairment:</strong>&nbsp;No dosage adjustment is required in patients with mild to moderate hepatic impairment, however, caution is recommended when using Tegaserod in this patient population. It has not been studied in patients with severe hepatic impairment, and therefore, it is not recommended in this group.</p>', '2022-03-21 05:16:22', '2022-03-21 05:16:22'),
(1457, 1457, '<p>Teicoplanin injection is indicated for the treatment of serious infections due to staphylococci or streptococci. Following infections are treated more satisfactorily-</p>\r\n\r\n<ul>\r\n	<li>Prevention of infection (usually after surgery)</li>\r\n	<li>Oesteomyelitis</li>\r\n	<li>Septic arthritis</li>\r\n	<li>Septicaemia</li>\r\n	<li>Inflammation of the lining of the heart cavity and heart valves due to endocarditis</li>\r\n	<li>Treatment of serious staphylococcal bacterial infections</li>\r\n	<li>Non-cardiac bacteremia</li>\r\n	<li>Dialysis associated peritonitis</li>\r\n	<li>Severe infections-RTI, UTI, SSTI etc.</li>\r\n</ul>', '<p>Teicoplanin is a glycopeptide antibiotic that has shown in vitro bactericidal activity against both anaerobic and aerobic gram-positive organisms. Teicoplanin inhibits the growth of susceptible organisms by interfering with cell-wall biosynthesis at a site different from that affected by beta-lactams. It is active against staphylococci (including those resistant to methicillin and other beta-lactam antibiotics), streptococci, enterococci, Listeria monocytogenes, micrococci, group JK corynebacteria and gram-positive anaerobes including Clostridium difficile and peptococci.</p>', '<p>Adult or elderly patients with normal renal function:<br />\r\n<br />\r\n<strong>Intravenously</strong>: Intravenous injection may be administered by rapid injection over 3-5 minutes, or slowly over a 30 minutes infusion by diluting with 0.9% Sodium Chloride or Hartmanns Solution or 5% Dextrose etc.<br />\r\n<br />\r\n<strong>Intramascularly</strong>: An intramuscular injection of Teicoplanin should not exceed 3 ml at a single site.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>3 ml water for injection should be added slowly down the side wall of the vial of Teicoplanin&nbsp;200 mg or 400 mg. The vial should be rolled gently between the palms until the powder is completely dissolved. During the rolling, we have to be cautious about the solution that it does not become foamy. The solution must not be shaken. If foam formed then it should be allowed to stand for 15 minutes for the foam to be subsided. The entire contents from the vial should be withdrawn slowly into a syringe.</p>', '<p>Teicoplanin should be administered with caution in patients receiving concurrent nephrotoxic or ototoxic drugs such as Aminoglycosides, Amphotericin B, Cyclosporine and Frusemide.</p>', '<p>Teicoplanin is contraindicated in patients who have exhibited&nbsp;previous&nbsp;hypersensitivity to Teicoplanin.</p>', '<p>Teicoplanin is generally well tolerated. Serious side-effects are rare. Side-effects are gastrointestinal like nausea, vomiting, diarrhea, CNS associated with urticaria, rash, anaphylactic shock as well as hearing problems like vertigo, tinnitus and vestibular disorder may occur.</p>', '<p>There are no adequate and well-controlled studies in pregnant women about administration of Teicoplanin; this drug should be used during pregnancy only if clearly needed. Information about the excretion of Teicoplanin in milk is not known.</p>', '<p>Teicoplanin should be administered with caution in patients with renal insufficiency, patients who require concurrent use of drugs which have ototoxic and/or nephrotoxic properties.</p>', NULL, '<p>Glycopeptide</p>', NULL, '<p><strong>Patients with renal impairment</strong>: For patients with impaired renal function, reduction of dosage is not required until the fourth day of Teicoplanin treatment. From the fourth day of treatment-<br />\r\n<br />\r\n<strong>In mild renal insufficiency</strong>: Teicoplanin dose should be halved either by administering the initial unit dose every two days, or by administering half of this dose once a day when creatinine clearance is 40-60 ml/min.<br />\r\n<br />\r\n<strong>In severe renal insufficiency</strong>: Teicoplanin dose should be 1/3 of the normal either by administering the initial unit dose every third day or by administering 1/3 of this dose once a day when creatinine clearance is less than 40 ml/min and in haemodialysed patients. Teicoplanin is not removed by dialysis.</p>', '2022-03-21 05:18:12', '2022-03-21 05:18:12');
