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
(1317, 1317, '<p>This is a vaccine indicated for active immunization for the prevention of varicella in individuals 12 months of age and older.</p>', '<p>Varicella Virus Vaccine induces both cell-mediated and humoral immune responses to varicella-zoster virus. The relative contributions of humoral immunity and cell-mediated immunity to protection from varicella are unknown.</p>', '<p>Each 0.5 mL dose of Varicella Virus Vaccine is administered subcutaneously. Inject the vaccine subcutaneously into the outer aspect of the deltoid region of the upper arm or into the higher anterolateral area of the thigh.<br />\r\n<br />\r\n<strong>Children (12 months to 12 years of age)</strong>: The first dose is administered at 12 to 15 months of age but may be given anytime through 12 years of age. The second dose is administered at 4 to 6 years of age. At least 3 months should elapse between a dose of varicella-containing vaccine. At least 1 month should elapse between a dose of measles-containing vaccine and a dose of Varicella Virus Vaccine if the vaccines are not given concurrently.<br />\r\n<br />\r\n<strong>Adolescents (&ge;13 years of age) and Adults</strong>: Two doses of Varicella Virus Vaccine are administered at a minimum interval of 4 weeks.</p>', '<p>Reye syndrome has been reported in children and adolescents following the use of salicylates during wild-type varicella infection. Administration of immune globulins and other blood products concurrently with Varicella Virus Vaccine vaccine may interfere with the expected immune response. Varicella Virus Vaccine vaccination may result in a temporary depression of purified protein derivative (PPD) tuberculin skin sensitivity.</p>', '<p><strong>Severe Allergic Reaction</strong>: Do not administer Varicella Virus Vaccine to individuals with a history of anaphylactic or severe allergic reaction to any component of the vaccine (including neomycin and gelatin) or to a previous dose of a varicella-containing vaccine.<br />\r\n<br />\r\n<strong>Immunosuppression</strong>: Do not administer Varicella Virus Vaccine to individuals who are immunodeficient or immunosuppressed due to disease or medical therapy. Disseminated varicella disease and extensive vaccine associated rash have been reported in individuals who are immunosuppressed or immunodeficient who were inadvertently vaccinated with a varicella-containing vaccine.<br />\r\n<br />\r\n<strong>Moderate or Severe Febrile Illness</strong>: Do not administer Varicella Virus Vaccine to individuals with an active febrile illness with fever &gt;38.5&deg;C.<br />\r\n<br />\r\n<strong>Active Untreated Tuberculosis</strong>: Do not administer Varicella Virus Vaccine to individuals with active, untreated tuberculosis (TB).<br />\r\n<br />\r\n<strong>Pregnancy</strong>: Do not administer Varicella Virus Vaccine to individuals who are pregnant or planning on becoming pregnant in the next 3 months. Wild-type varicella is known to cause fetal harm.</p>', '<p>Frequently reported (&ge;10%) adverse reactions in children ages 1 to 12 years include:</p>\r\n\r\n<ul>\r\n	<li>fever &ge;102.0&deg;F (38.9&deg;C) oral: 14.7%</li>\r\n	<li>injection-site complaints: 19.3%</li>\r\n</ul>\r\n\r\n<p>Frequently reported (&ge;10%) adverse reactions in adolescents and adults ages 13 years and older include:</p>\r\n\r\n<ul>\r\n	<li>fever &ge;100.0&deg;F (37.8&deg;C) oral: 10.2%</li>\r\n	<li>injection-site complaints: 24.4%</li>\r\n</ul>\r\n\r\n<p>Other reported adverse reactions in all age groups include:</p>\r\n\r\n<ul>\r\n	<li>varicella-like rash (injection site)</li>\r\n	<li>varicella-like rash (generalized)</li>\r\n</ul>', '<p>Varicella Virus Vaccine&nbsp;is contraindicated for use in pregnant women because the vaccine contains live, attenuated varicella virus, and it is known that wild-type varicella virus, if acquired during pregnancy, can cause congenital varicella syndrome. No increased risk for miscarriage, major birth defect or congenital varicella syndrome was observed in a pregnancy exposure registry that monitored outcomes after inadvertent use. There are no relevant animal data.<br />\r\n<br />\r\nIt is not known whether varicella vaccine virus is excreted in human milk. The developmental and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for Varicella Virus Vaccine, and any potential adverse effects on the breastfed child from Varicella Virus Vaccine or from the underlying maternal condition. For preventive vaccines, the underlying maternal condition is susceptibility to disease prevented by the vaccine.</p>', '<p>Evaluate individuals for immune competence prior to administration of Varicella Virus Vaccine if there is a family history of congenital or hereditary immunodeficiency. Avoid close contact with high-risk individuals susceptible to varicella because of possible transmission of varicella vaccine virus. Immune Globulins (IG) and other blood products should not be given concomitantly with Varicella Virus Vaccine. Avoid use of salicylates for 6 weeks following administration of Varicella Virus Vaccine to children and adolescents.</p>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin</p>', '<p>Store between 2-8&deg; C. Do not freeze. Protect from light. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: No clinical data are available on safety or efficacy of varicella virus vaccine in children less than 12 months of age.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of varicella virus vaccine did not include sufficient numbers of seronegative subjects aged 65 and over to determine whether they respond differently from younger subjects.</p>', '2022-03-18 20:11:24', '2022-03-18 20:11:24'),
(1318, 1318, '<p>Vecuronium Bromide is indicated as an adjunct to general anaesthesia to facilitate tracheal intubation and to provide skeletal muscle relaxation during surgery.</p>', '<p>Vecuronium bromide is a non-depolarising neuromuscular blocking agent. It blocks the transmission process between the motor nerve-ending and striated muscle by binding competitively with acetylcholine to the nicotinic receptors located in the motor end-plate region of striated muscle.<br />\r\n<br />\r\nUnlike depolarising neuromuscular blocking agents, such as suxamethonium, Vecuronium bromide does not cause muscle fasciculations.<br />\r\n<br />\r\nWithin the clinical dosage range, Vecuronium bromide exerts neither vagolytic nor ganglion blocking activity.</p>', '<p>Like other neuromuscular blocking agents, Vecuronium should only be administered by, or under supervision of, experienced clinicians who are familiar with the action and use of these agents.<br />\r\n<br />\r\nLike with other neuromuscular blocking agents, the dosage of Vecuronium should be individualised in each patient. The anaesthetic method used, the expected duration of surgery, the possible interaction with other medicines that are administered before or during anaesthesia and the condition of the patient should be taken into account when determining the dose. The use of an appropriate neuromuscular monitoring technique is recommended to monitor neuromuscular block and recovery.<br />\r\n<br />\r\nInhalational anaesthetics do potentiate the neuromuscular blocking effects of Vecuronium. This potentiation however, becomes clinically relevant in the course of anaesthesia, when the volatile agents have reached the tissue concentrations required for this interaction. Consequently, adjustments with Vecuronium should be made by administering smaller maintenance doses at less frequent intervals or by using lower infusion rates of Vecuronium during long lasting procedures (longer than 1 hour) under inhalational anaesthesia.<br />\r\n<br />\r\nIn adult patients the following dosage recommendations may serve as a general guideline for tracheal intubation and muscle relaxation for short to long lasting surgical procedures.<br />\r\n<br />\r\nTracheal intubation: The standard intubating dose during routine anaesthesia is 0.08 to 0.1 mg vecuronium bromide per kg body weight, after which adequate intubation conditions are established within 90 to 120 seconds in nearly all patients.<br />\r\n&nbsp;</p>\r\n\r\n<p><strong>Dosages of Vecuronium for surgical procedures after intubation with suxamethonium:</strong></p>\r\n\r\n<p>Recommended doses:</p>\r\n\r\n<ul>\r\n	<li>0.03 to 0.05 mg vecuronium bromide per kg body weight.</li>\r\n	<li>If suxamethonium is used for intubation, the administration of Vecuronium should be delayed until the patient has clinically recovered from the neuromuscular block induced by suxamethonium.</li>\r\n</ul>\r\n\r\n<p>Maintenance dosing:</p>\r\n\r\n<ul>\r\n	<li>The recommended maintenance dose is 0.02 to 0.03 mg vecuronium bromide per kg body weight. These maintenance doses should best be given when twitch height has recovered to 25% of control twitch height.</li>\r\n	<li>Dose requirements for administration of Vecuronium by continuous infusion.</li>\r\n	<li>If Vecuronium is administered by continuous infusion, it is recommended to give a loading dose first (see &#39;Tracheal intubation&#39;) and, when neuromuscular block starts to recover, to start administration of Vecuronium by infusion. The infusion rate should be adjusted to maintain twitch response at 10% of control twitch height or to maintain 1 to 2 responses to train of four stimulation. In adults, the infusion rate required to maintain neuromuscular block at this level, ranges from 0.8 to 1.4 &micro;g vecuronium bromide/kg/min. For neonates and infants, see below. Repeat monitoring of neuromuscular block is recommended since infusion rate requirements vary from patient to patient and with the anaesthetic method used.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Dosing in elderly patients</strong>:</p>\r\n\r\n<ul>\r\n	<li>The same intubation and maintenance doses as for younger adults (0.08-0.1 mg/kg and 0.02-0.03 mg/kg, respectively) can be used. However, the duration of action is prolonged in elderly compared to younger subjects due to changes in pharmacokinetic mechanisms. The onset time in elderly is similar to younger adults.</li>\r\n	<li>In caesarean section and neonatal surgery the dose should not exceed 0.1 mg/kg.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Dosing in paediatric patients:</strong></p>\r\n\r\n<p>Because of the possible variation of the sensitivity of the neuromuscular junction, especially in neonates (up to 4 weeks) and probably in infants up to 4 months of age, an initial test dose of 0.01 to 0.02 mg vecuronium bromide per kg body weight followed by incremental doses until 90 to 95% depression of twitch response is achieved is recommended. In neonatal surgery the dose should not exceed 0.1 mg/kg. Dose requirements in neonates and infants (1-12 months) are the same as in adults. However, since the onset time of Vecuronium in these patients is considerably shorter than in adults and children, the use of high intubating doses in general is not required for early development of good intubating conditions.<br />\r\nSince the duration of action and recovery time with Vecuronium is longer in neonates and infants than in children and adults, maintenance doses are required less frequently.<br />\r\n<br />\r\nDose requirements in children (2-10 years) are higher. However, the same intubation and maintenance doses as for adults (0.08-0.1 mg/kg and 0.02-0.03 mg/kg, respectively) are usually sufficient. Since the duration of action is shorter in children, maintenance doses are required more frequently.<br />\r\n<br />\r\nAlthough there is very little information on dosage in adolescents, it is advised to use the same dose as in adults, based on the physiological development at this age.<br />\r\nDosing in overweight and obese patients<br />\r\nWhen used in overweight or obese patients (defined as patients with a body weight of 30% or more above ideal body weight) doses should be reduced taking into account an ideal body weight.<br />\r\n<br />\r\nHigher doses: Should there be reason for selection of larger doses in individual patients; initial doses ranging from 0.15 mg up to 0.30 mg vecuronium bromide per kg body weight have been administered during surgery both under halothane and neurolept anaesthesia without adverse cardiovascular effects being noted as long as ventilation is properly maintained. The use of these high dosages of Vecuronium pharmacodynamically decreases the onset time and increases the duration of action.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Vecuronium should be administered following reconstitution. Vecuronium is administered intravenously either as a bolus injection or as a continuous infusion</p>', '<p>The following agents have been shown to influence the magnitude and/or duration of action of non-depolarizing neuromuscular blocking agents:<br />\r\n&nbsp;</p>\r\n\r\n<p><strong>Effect of Other Agents on Vecuronium:</strong></p>\r\n\r\n<p><strong>Increased Effect:</strong></p>\r\n\r\n<ul>\r\n	<li>Halogenated volatile anaesthetics potentiate the neuromuscular block of Vecuronium. The effect only becomes apparent with maintenance dosing (see also Dosage and Administration). Reversal of the block with anticholinesterase inhibitors could also be inhibited.&nbsp;</li>\r\n	<li>After intubation with suxamethonium</li>\r\n	<li>Long-term concomitant use of corticosteroids and Vecuronium in the ICU may result in prolonged duration of neuromuscular block or myopathy.</li>\r\n</ul>\r\n\r\n<p>Other medicines:</p>\r\n\r\n<ul>\r\n	<li>antibiotics: aminoglycoside, lincosamide and polypeptide antibiotics, acylaminopenicillin antibiotics,&nbsp;</li>\r\n	<li>diuretics, quinidine, magnesium salts, calcium channel blocking agents, lithium salts, cimetidine, lidocaine and acute administration of phenytoin or &beta;-blocking agents&nbsp;</li>\r\n	<li>Recurarization has been reported after post-operative administration of: aminoglycoside, lincosamide, polypeptide and acylamino-penicillin antibiotics, quinidine and magnesium salts</li>\r\n</ul>\r\n\r\n<p><strong>Decreased Effect</strong>&nbsp;(possible higher dose requirements):</p>\r\n\r\n<ul>\r\n	<li>prior chronic administration of phenytoin or carbamazepine&nbsp;</li>\r\n	<li>Variable Effect</li>\r\n	<li>Administration of other non-depolarizing neuromuscular blocking agents in combination with Vecuronium may produce attenuation or potentiation of the neuromuscular block, depending on the order of administration and the neuromuscular blocking agent used.&nbsp;</li>\r\n	<li>Suxamethonium given after the administration of Vecuronium may produce potentiation or attenuation of the neuromuscular blocking effect of Vecuronium.&nbsp;</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Effect of Vecuronium on other agents:</strong></p>\r\n\r\n<p>Effect of Vecuronium on lidocaine: Vecuronium combined with lidocaine may result in a quicker onset of action of lidocaine.</p>', NULL, '<p>Side effects are rare (&lt;1/1000). The most commonly occurring side effects include changes in vital signs and prolonged neuromuscular block. The most frequently reported side effects during post-marketing surveillance is &#39;anaphylactic and anaphylactoid reactions&#39; and associated symptoms (reporting frequency &lt;1/100,000).</p>', '<p>There are insufficient data on the use of Vecuronium during animal or human pregnancy to assess potential harm to the foetus. Vecuronium should be given to a pregnant woman only when the attending physician decides that the benefits outweigh the risks.<br />\r\n<br />\r\n<strong>Caesarean section</strong>: Studies with Vecuronium, administered in doses up to 0.1mg/kg, have shown its safety for use in caesarean section. In caesarean section the dose should not exceed 0.1mg/kg. In several clinical studies Vecuronium did not affect Apgar score, foetal muscle tonus or cardiorespiratory adaptation. From umbilical cord blood sampling it is apparent that only very little placental transfer of Vecuronium occurs which did not lead to the observation of any clinical adverse effect in the newborn.<br />\r\n<br />\r\nReversal of a Vecuronium induced neuromuscular block may be inhibited or unsatisfactory in patients receiving magnesium sulphate for toxaemia of pregnancy because magnesium salts enhance neuromuscular block.Therefore, in patients receiving magnesium sulphate, the dosage of Vecuronium should be reduced and be carefully titrated to twitch response.<br />\r\n<br />\r\n<strong>Lactation</strong>: There are no human data on the use of Vecuronium during lactation. Vecuronium should be given to lactating women only when the attending physician decides that the benefits outweigh the risks.</p>', '<p>Since Vecuronium causes paralysis of the respiratory muscles, ventilatory support is mandatory for patients treated with this medicine until adequate spontaneous respiration is restored.<br />\r\n<br />\r\nAs with other neuromuscular blocking agents, residual curarization has been reported for Vecuronium. In order to prevent complications resulting from residual curarization, it is recommended to extubate only after the patient has recovered sufficiently from neuromuscular block. Other factors which could cause residual curarization after extubation in the post-operative phase (such as medicine interactions or patient condition) should also be considered. If not used as part of standard clinical practice, the use of a reversal agent should be considered, especially in those cases where residual curarization is more likely to occur.<br />\r\nAnaphylactic reactions can occur following the administration of neuromuscular blocking agents. Precautions for treating such reactions should always be taken. Particularly in the case of previous anaphylactic reactions to muscle relaxants, special precautions should be taken since allergic cross-reactivity to muscle relaxants has been reported.<br />\r\n<br />\r\nSince Vecuronium has no cardiovascular effects within the clinical dosage range, it does not attenuate bradycardia that may occur due to the use of some types of anaesthetics and opiates or due to vagal reflexes during surgery. Therefore, reassessment of the use and/or dosage of vagolytic medicines such as atropine for premedication or at induction of anaesthesia, may be of value for surgical procedures during which vagal reactions are more likely to occur (e.g. surgical procedures where anaesthetic medicines with known vagal stimulatory effects are used, ophthalmic, abdominal or anorectal surgery, etc).<br />\r\n<br />\r\nIn general, following long term use of neuromuscular blocking agents in the ICU, prolonged paralysis and/or skeletal muscle weakness has been noted. In order to help preclude possible prolongation of neuromuscular block and/or overdosage it is strongly recommended that neuromuscular transmission is monitored throughout the use of muscle relaxants. In addition, patients should receive adequate analgesia and sedation. Furthermore, muscle relaxants should be titrated to effect in the individual patients by or under supervision of experienced clinicians who are familiar with their actions and with appropriate neuromuscular monitoring techniques. Myopathy after long term administration of non-depolarizing neuromuscular blocking agents in the ICU in combination with corticosteroid therapy has been reported frequently. Therefore, for patients receiving both neuromuscular blocking agents and corticosteroids, the period of use of the neuromuscular blocking agent should be limited as much as possible.</p>', '<p>In the event of overdosage and prolonged neuromuscular block, the patient should continue to receive ventilatory support and sedation. Upon start of spontaneous recovery an acetylcholinesterase inhibitor (e.g. neostigmine, edrophonium, pyridostigmine) should be administered in adequate doses.<br />\r\nWhen administration of an acetylcholinesterase-inhibiting agent fails to reverse the neuromuscular effects of Vecuronium, ventilation must be continued until spontaneous breathing is restored. Repeated dosage of an acetylcholinesterase inhibitor can be dangerous.</p>', '<p>Non depolarizing muscle relaxants.</p>', '<p>Store between 20-25&deg; C. Protect from light.</p>', NULL, '2022-03-18 20:13:55', '2022-03-18 20:13:55'),
(1319, 1319, '<p>Venlafaxine tablets is indicated for the treatment of major depressive disorder.<br />\r\n<br />\r\nThe efficacy of venlafaxine tablets, in the treatment of major depressive disorder was established in 6 week controlled trials of adult outpatients whose diagnoses corresponded most closely to the&nbsp;DSM-III or DSM-III-R category of&nbsp;major depression&nbsp;and in a 4 week controlled trial of inpatients meeting diagnostic criteria for major depression with&nbsp;melancholia<br />\r\n<br />\r\nA major depressive episode implies a prominent and relatively persistent depressed or dysphoric mood that usually interferes with daily functioning (nearly every day for at least 2 weeks); it should include at least 4 of the following 8 symptoms: change in appetite, change in sleep, psychomotor agitation or retardation, loss of interest in usual activities or decrease in sexual drive, increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, and a suicide attempt or suicidal ideation.<br />\r\n<br />\r\nThe efficacy of venlafaxine hydrochloride extended-release capsules in maintaining an&nbsp;antidepressant&nbsp;response for up to 26 weeks following 8 weeks of acute treatment was demonstrated in a placebocontrolled trial. The efficacy of venlafaxine tablets in maintaining an antidepressant response in patients with&nbsp;recurrent&nbsp;depression who had responded and continued to be improved during an initial 26 weeks of treatment and were then followed for a period of up to 52 weeks was demonstrated in a second placebo-controlled trial (see&nbsp;Clinical Trials). Nevertheless, the physician who elects to use venlafaxine tablets / extended-release capsules for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patient.</p>', '<p>The exact mechanism of action of venlafaxine is unknown, but appears to be associated with the its potentiation of neurotransmitter activity in the CNS. Venlafaxine and its active metabolite, O-desmethylvenlafaxine (ODV), inhibit the reuptake of both serotonin and norepinephrine with a potency greater for the 5-HT than for the NE reuptake process. Both venlafaxine and the ODV metabolite have weak inhibitory effects on the reuptake of dopamine but, unlike the tricyclics and similar to SSRIs, they are not active at histaminergic, muscarinic, or alpha(1)-adrenergic receptors.</p>', '<p><strong>Initial Treatment</strong>: The recommended starting dose for venlafaxine tablets is 75 mg/day, administered in two or three divided doses, taken with food. Depending on tolerability and the need for further clinical effect, the dose may be increased to 150 mg/day. If needed, the dose should be further increased up to 225 mg/day. When increasing the dose, increments of up to 75 mg/day should be made at intervals of no less than 4 days. In&nbsp;outpatient&nbsp;settings there was no evidence of usefulness of doses greater than 225 mg/day for moderately depressed patients, but more severely depressed inpatients responded to a mean dose of 350 mg/day. Certain patients, including more severely depressed patients, may therefore respond more to higher doses, up to a maximum of 375 mg/day, generally in three divided doses&nbsp;<br />\r\n<br />\r\n<strong>Dosage For Elderly Patients</strong>: No dose adjustment is recommended for elderly patients on the basis of age. As with any antidepressant, however, caution should be exercised in treating the elderly. When individualizing the dosage, extra care should be taken when increasing the dose.<br />\r\n<br />\r\n<strong>Maintenance Treatment</strong>: It is generally agreed that acute episodes of major depressive disorder require several months or longer of sustained pharmacological therapy beyond response to the acute episode. In one study, in which patients responding during 8 weeks of acute treatment with venlafaxine hydrochloride extendedrelease capsules were assigned&nbsp;randomly&nbsp;to placebo or to the same dose of venlafaxine hydrochloride extended-release capsules (75, 150, or 225 mg/day, qAM) during 26 weeks of maintenance treatment as they had received during the acute stabilization phase, longer-term efficacy was demonstrated. A second longer-term study has demonstrated the efficacy of venlafaxine tablets in maintaining an antidepressant response in patients with recurrent depression who had responded and continued to be improved during an initial 26 weeks of treatment and were then randomly assigned to placebo or venlafaxine tablets for periods of up to 52 weeks on the same dose (100 to 200 mg/day, on a&nbsp;b.i.d.&nbsp;schedule) (see&nbsp;Clinical Trials). Based on these limited data, it is not known whether or not the dose of venlafaxine tablets / extended-release capsules needed for maintenance treatment is identical to the dose needed to achieve an initial response. Patients should be periodically reassessed to determine the need for maintenance treatment and the appropriate dose for such treatment.<br />\r\n<br />\r\n<strong>Discontinuing Venlafaxine Tablet</strong>: Symptoms associated with discontinuation of venlafaxine tablets, other SNRIs, and SSRIs, have been reported. Patients should be monitored for these symptoms when discontinuing treatment. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate.</p>', '<p>Increased risk of serotonin syndrome with TCA, SSRI, SNRI, lithium, sibutramine, tramadol. May increase serum levels with CYP3A4 inhibitors (e.g. ketoconazole, atazanavir, clarithromycin). May increase serum levels of haloperidol. May decrease serum levels of indinavir. May increase bleeding risk with aspirin, NSAIDs, warfarin and other anticoagulants.</p>', '<p>Concomitant use with MAOIs or within 14 days of discontinuing the MAOI. Use with linezolid or IV methylene blue.</p>', '<p>Changes in behaviour, suicidal ideation, agitation, tremor, nervousness, anxiety, insomnia, confusions, abnormal dreams, HTN, nausea, headache, asthenia, somnolence, dizziness, dry mouth, vomiting, constipation, diarrhoea, dyspepsia, abdominal pain, anorexia, sexual dysfunction, urinary frequency, visual disturbances, mydriasis, vasodilatation, paraesthesia, hypertonia, chills or fever, palpitations, wt gain or loss, arthralgia, myalgia, tinnitus, pruritus, dyspnoea, yawning, rashes, sweating, increased serum cholesterol, may impair platelet aggregation.</p>', '<p>Treatment Of Pregnant Women During The Third Trimester<br />\r\nNeonates exposed to venlafaxine tablets, USP, other SNRIs, or SSRIs, late in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and&nbsp;tube feeding. When treating pregnant women with venlafaxine tablets during the third trimester, the physician should carefully consider the potential risks and benefits of treatment.</p>', '<p>History of MI or unstable cardiac disease, seizure; hypomania or mania, increased intraocular pressure or at risk of acute narrow-angle galaucoma, at risk of bleeding. Renal and hepatic impairment. Gradual dose reduction is recommended rather than abrupt withdrawal. Pregnancy and lactation. Patient Counselling May impair ability to drive or operate machinery.</p>', '<p><strong>Symptoms</strong>: Sweating, dizziness, somnolence, mydriasis, convulsions, vomiting, ECG changes, cardiac arrhythmias and seizures.<br />\r\n<br />\r\n<strong>Management</strong>: Symptomatic and supportive treatment. Ensure adequate airway, oxygenation and ventilation. Initiate gastric lavage immediately after ingestion. Admin activated charcoal to reduce absorption. Monitor cardiac rhythm and vital signs.</p>', '<p>Serotonin-norepinephrine reuptake inhibitor (SNRI).</p>', '<p>Store between 20-25&deg; C.</p>', '<p><strong>Dosage For Patients With Hepatic Impairment</strong>: Given the decrease in clearance and increase in elimination half-life for both venlafaxine and ODV that is observed in patients with hepatic&nbsp;cirrhosis&nbsp;and mild and moderate hepatic impairment compared to normal subjects, it is recommended that the total daily dose be reduced by 50% in patients with mild to moderate hepatic impairment. Since there was much individual variability in clearance between subjects with cirrhosis, it may be necessary to reduce the dose even more than 50%, and individualization of dosing may be desirable in some patients.<br />\r\n<br />\r\n<strong>Dosage For Patients With Renal Impairment</strong>: Given the decrease in clearance for venlafaxine and the increase in elimination half-life for both venlafaxine and ODV that is observed in patients with renal impairment (GFR = 10 to 70 mL/min) compared to normals, it is recommended that the total daily dose be reduced by 25% in patients with mild to moderate renal impairment. It is recommended that the total daily dose be reduced by 50% in patients undergoing&nbsp;hemodialysis. Since there was much individual variability in clearance between patients with renal impairment, individualization of dosing may be desirable in some patients.</p>', '2022-03-18 20:15:49', '2022-03-18 20:15:49'),
(1320, 1320, '<p>Verapamil Tablet:</p>\r\n\r\n<ul>\r\n	<li>Essential hypertension</li>\r\n	<li>Angina pectoris and prevention of re-infarction</li>\r\n	<li>Supraventricular arrhythmias</li>\r\n</ul>\r\n\r\n<p>Verapamil Injection:</p>\r\n\r\n<ul>\r\n	<li>Tachycardias such as: Paroxysmal supraventricular tachycardias</li>\r\n	<li>Atrial fibrillation with rapid ventricular response (except WPWS)</li>\r\n	<li>Atrial flutter with rapid conduction</li>\r\n	<li>Extrasystoles</li>\r\n	<li>Acute hypertension</li>\r\n	<li>Acute coronary insufficiency</li>\r\n</ul>\r\n\r\n<p>For the prophylaxis and / or therapy of ectopic arrhythmias (predominantly ventricular extrasystoles) in halothane anaesthesia and in the application of adrenaline in halothane anaesthesia respectively.</p>', '<p>Verapamil is an L-type calcium channel blocker with antiarrhythmic, antianginal, and antihypertensive activity. Immediate-release verapamil has a relatively short duration of action, requiring dosing 3 to 4 times daily, but extended-release formulations are available that allow for once-daily dosing. As verapamil is a negative inotropic medication (i.e. it decreases the strength of myocardial contraction), it should not be used in patients with severe left ventricular dysfunction or hypertrophic cardiomyopathy as the decrease in contractility caused by verapamil may increase the risk of exacerbating these pre-existing conditions.</p>', '<p>Verapamil Tablet:</p>\r\n\r\n<ul>\r\n	<li>The dose of Verapamil should be individualized by titration and the drug should be administered with food.</li>\r\n	<li>For essential hypertension the initial dose should be given 180 mg in the morning. If adequate response is not obtained with 180 mg of Verapamil then the dose may be titrated by following manner: 240 mg each morning. 180 mg each morning plus 180 mg each evening. 240 mg every 12 hourly.</li>\r\n	<li>For angina the usual dose is 80 mg to 120 mg three times a day.</li>\r\n	<li>For arrythmias in digitalized patients, Verapamil should be given 240 mg to 360 mg in divided doses, depending on the severity of the condition. Divided doses up to 180 mg/day may occasionally be needed.</li>\r\n</ul>\r\n\r\n<p>Verapamil Injection:</p>\r\n\r\n<p><strong>Adults</strong>: 5 mg slowly intravenously, in tachycardias and hypertensive crises, if necessary repeat after 5 to 10 minutes. Drip infusion to maintain the therapeutic effect: 5-10 mg/hour in physiological saline, glucose, laevulose or similar solutions, on average up to a total dose of 100 mg/day.&nbsp;<br />\r\n<br />\r\n<strong>Children</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Newborn</strong>: 0.75-1 mg (0.3-0.4 ml)</li>\r\n	<li><strong>Infants</strong>: 0.75-2 mg (0.3-0.8 ml)</li>\r\n	<li><strong>Children age 1-5 years</strong>: 2-3 mg (0.8-1.2 ml)</li>\r\n	<li><strong>Age 6-14 years</strong>: 2.5-5 mg (1-2 ml)</li>\r\n</ul>\r\n\r\n<p>of Verapamil, given intravenously, depending on age and action. The injection should be made slowly under electrocardiographic control and only until onset of the effect. Intravenous infusion in hypertensive crises: initially 0.05-0.1 mg/kg/hour; if the effect proves to be insufficient, the dose is increased at 30-60 minute intervals until twice the dose or more is reached. Average total dose up to 1.5 mg/kg/day.</p>', '<p>May increase plasma level with CYP3A4 inhibitors (e.g. erythromycin, ritonavir), cimetidine. May decrease plasma level with CYP3A4 inducers (e.g. rifampicin), phenobarbital, sulfinpyrazone. Increased risk of bleeding with aspirin. May increase bradycardic and hypotensive effect with telithromycin. Increased AV blocking effect with clonidine. May increase plasma level of cardiac glycosides (e.g. digoxin, digitoxin), &beta;-blockers (e.g. propranolol, metoprolol), &alpha;-blockers (e.g. terazosin, prazosin), immunosuppressants (e.g. sirolimus, ciclosporin, tacrolimus, everolimus), lipid lowering agents (e.g. lovastatin, simvastatin, atorvastatin), colchicines, quinidine, carbamazepine, imipramine, glibenclamide, doxorubicin, midazolam, buspirone, almotriptan, theophylline. May potentiate hypotensive effect with diuretics, antihypertensives, vasodilators. May increase neurotoxic effect of lithium.</p>', '<ul>\r\n	<li>Severe left ventricular dysfunction</li>\r\n	<li>Hypotension or cardiogenic shock</li>\r\n	<li>Sick sinus syndrome (except in patients with a functioning artificial ventricular pacemaker)</li>\r\n	<li>Second or third-degree atrioventricular (AV) block (except in patients with a functioning artificial pacemaker)</li>\r\n	<li>Patients with atrial flutter or atrial fibrillation and an accessory by pass tract (eg. Wolff-Parkinson-White, Lown-Ganong-Levine syndrome)</li>\r\n	<li>Patients with known hypersensitivity to verapamil hydrochloride</li>\r\n</ul>', '<p>Verapamil is generally well tolerated. The following reaction to orally administered Verapamil appeared clearly drug-related or occurred at rates greater than 1% in clinical trials with approximately 5000 patients.</p>\r\n\r\n<ul>\r\n	<li><strong>Digestive system</strong>: Constipation, nausea;</li>\r\n	<li><strong>Cardiovascular system</strong>: Hypotension, edema, CHF, pulmonary edema, bradycardia, AV block;</li>\r\n	<li><strong>Respiratory system</strong>: Upper respiratory tract infections;</li>\r\n	<li><strong>Nervous system</strong>: Dizziness, headache, fatigue;</li>\r\n	<li><strong>Skin</strong>: Rash, flashing;</li>\r\n	<li><strong>Hepatic</strong>: Elevated liver enzyme.</li>\r\n</ul>', '<p>There are no adequate and well-controlled studies in pregnant women, so this drug should be used during pregnancy only if clearly needed. Verapamil crosses the placental barrier and can be detected in umbilical vein blood during delivery. Verapamil is excreted in breast milk. So nursing should be discontinued while Verapamil is administered.</p>', '<p>Care should be taken in 1st degree AV block, bradycardia &lt;50 beats/minutes, hypotension &lt;90 mm Hg systolic pressure, atrial fibrillation/flutter and simultaneous pre-excitation syndrome e.g. WPW syndrome, heart failure (previous compensation with cardiac glycosides/diuretics required). Verapamil may impair ability to drive or operate machinery, particularly in the initial stages of treatment and with concomitant consumption of alcohol. Verapamil markedly slows down the elimination of alcohol and prolongs the duration of the effects of alcohol.</p>', '<p>Treatment of overdose should be supportive. Beta-adrenergic stimulation or parenteral administration of calcium solution may increase calcium ion flux across the slow channel and have been used in the treatment of overdose with Verapamil. Verapamil cannot be removed by hemodialysis.</p>', '<p>Calcium-channel blockers.</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-18 20:17:59', '2022-03-18 20:17:59'),
(1321, 1321, '<p>Verteporfin therapy is indicated for the treatment of patients with predominantly classic subfoveal choroidal neovascularization due to&nbsp;age-related macular degeneration, pathologic myopia or presumed&nbsp;ocular&nbsp;histoplasmosis.<br />\r\n<br />\r\nThere is insufficient evidence to indicate Verteporfin for the treatment of predominantly occult subfoveal choroidal neovascularization.</p>', '<p>Verteporfm, when activated by low-intensity nonheat-generating laser light at a wavelength corresponding to its absorption peak, generates highly reactive, shortlived singlet 02 and reactive 02 radicals that cause local damage to neovascular endothelium, resulting in vessel occlusion. It appears to accumulate preferentially in the neovasculature e.g. choroidal neovasculature.</p>', '<p>A course of verteporfin therapy is a two-step process requiring administration of both drug and light. The first step is the intravenous infusion of Verteporfin. The second step is the activation of Verteporfin with light from a nonthermal diode laser. The physician should reevaluate the patient 3 months after treatment and if choroidal neovascular leakage is detected on&nbsp;fluorescein angiography, therapy may be repeated.<br />\r\n<br />\r\n<strong>Lesion Size Determination</strong>: The greatest linear dimension (GLD) of the&nbsp;lesion&nbsp;should be estimated by fluorescein&nbsp;angiography&nbsp;and color fundus photography. All classic and occult CNV, blood and/or blocked fluorescence, and any serous detachments of the&nbsp;retinal pigment epithelium should be included for this measurement. Fundus cameras with magnification within the range of 2.4-2.6X are recommended. The GLD of the lesion on the fluorescein angiogram must be corrected for the magnification of the fundus camera to obtain the GLD of the lesion on the&nbsp;retina.<br />\r\n<br />\r\n<strong>Spot Size Determination</strong>: The treatment spot size should be 1000 microns larger than the GLD of the lesion on the retina to allow a 500 micron border, ensuring full coverage of the lesion. The maximum spot size used in the clinical trials was 6400 microns.<br />\r\n<br />\r\nThe&nbsp;nasal&nbsp;edge of the treatment spot must be positioned at least 200 microns from the temporal edge of the&nbsp;optic disc, even if this will result in lack of photoactivation of CNV within 200 microns of the&nbsp;optic nerve.</p>', '<p>Increased rate of verteporfm uptake by the vascular endothelium with calcium channel blockers, polymyxin B or radiation therapy. Increased photosensitivity with photosensitizing agents (e.g. tetracyclines, sulfonamides, phenothiazines, sulfonylurea hypoglycaemic agents, thiazide diuretics and griseofulvin). Decreased verteporfm efficacy with compounds that quench active oxygen species or scavenge radicals e.g. dimethyl sulfoxide, betacarotene, ethanol, formate and mannitol. Decreased verteporfm efficacy with drugs that decrease clotting, vasoconstriction or platelet aggregation e.g. thromboxane A2 inhibitors. Anaesthetics may cause haemodynamic effects.</p>', '<p>Verteporfin is contraindicated for patients with porphyria or a known hypersensitivity to any component of this preparation.</p>', '<p>Visual disturbances; severe vision loss with or without subretinal or vitreous bleeding; inj site reactions; nausea; photosensitivity; asthenia; cataracts; blepharitis; conjunctivitis; dry eyes; ocular itching; flu-like syndrome; atrial fibrillation; hypertension; peripheral vascular disorder; varicose veins; eczema; constipation; Gl cancers; fever; lachrymation disorder; hypersensitivity reactions; increased LFT.</p>', '<p>Pregnancy Category- C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.</p>', '<p>Moderate to severe hepatic disorders; biliary disorders. Pregnancy. Use the largest arm vein possible (e.g. antecubital) especially in elderly and avoid small veins in the back of the hand. Stop infusion if extravasation occurs and protect extravasation area from direct light and apply cold compresses. Patient to be under close monitoring during verteporfm infusion and exercise caution when general anaesthesia is considered. Avoid exposure of unprotected skin, eyes or other body organs to direct sunlight or bright indoor light for 5 days after treatment. Protect all parts of skin and eyes by wearing protective clothing and dark sunglasses (sunscreens are ineffective) if going outdoors in daylight is necessary. Exposure to ambient indoor light is encouraged as it helps in gradual inactivation of any remaining drug.</p>', '<p>Overdose of drug and/or light in the treated eye may result in non-perfusion&nbsp;of normal retinal vessels with the possibility of severe decrease in vision that could be permanent. An overdose of drug will also result in the prolongation of the period during which the patient remains photosensitive to bright light. In such cases, it is recommended to extend the photosensitivity precautions for a time proportional to the overdose.</p>', '<p>Drugs for Age-Related Macular Degeneration (AMD)</p>', NULL, '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Approximately 90% of the patients treated with Verteporfin in the clinical efficacy trials were over the age of 65. A reduced treatment effect was seen with increasing age.</p>', '2022-03-18 20:19:48', '2022-03-18 20:19:48'),
(1322, 1322, '<p>This is indicated in-</p>\r\n\r\n<ul>\r\n	<li>For the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD).</li>\r\n	<li>For the maintenance treatment of asthma in patients aged 18 years and older.</li>\r\n</ul>', '<p>This cozycap is an inhalation powder drug product for delivery of a combination of futicasone furoate (an ICS), umeclidinium (an anticholinergic), and vilanterol (a LABA) to patients by oral inhalation. The pharmacologic efects of beta 2-adrenoceptor agonist drugs, including vilanterol, are at least in part attributable to stimulation of intracellular adenyl cyclase, the enzyme that catalyzes the conversion of adenosine triphosphate (ATP) to cyclic-3, 5 -adenosine monophosphate (cyclic AMP). Increased cyclic AMP levels cause relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from cells, especially from mast cells.<br />\r\n<br />\r\nThe precise mechanism through which futicasone furoate afects COPD and asthma symptoms is not known. Infammation is an important component in the pathogenesis of COPD and asthma. Corticosteroids have been shown to have a wide range of actions on multiple cell types (e.g., mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (e.g., histamine, eicosanoids, leukotrienes, cytokines) involved in infammation.<br />\r\n<br />\r\nUmeclidinium is a long-acting muscarinic antagonist, which is often referred to as an anticholinergic. It has similar afnity to the subtypes of muscarinic receptors M1 to M5 . In the airways, it exhibits pharmacological efects through inhibition of M3 receptor at the smooth muscle leading to bronchodilation.</p>', '<p>Adults: 18 years or older: For oral inhalation only. Should be taken by revolizer. Should be used at the same time every day, not more than 1 time every 24 hours. If shortness of breath or other asthma symptoms arise in the period between doses, an inhaled SABA should be taken for immediate relief.</p>\r\n\r\n<ul>\r\n	<li>Maintenance treatment of COPD: 1 inhalation of cozycap once daily.</li>\r\n	<li>Maintenance treatment of asthma: 1 inhalation of cozycap once daily.</li>\r\n	<li>Limitation of use: Not indicated for relief of acute bronchospasm.</li>\r\n</ul>', '<ul>\r\n	<li>Strong cytochrome P450 3A4 inhibitors (e.g., ketoconazole): Use with caution. May cause systemic corticosteroid and cardiovascular effects.</li>\r\n	<li>Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. May potentiate the effect of vilanterol on the vascular system.</li>\r\n	<li>Beta-blockers: Use with caution. May block bronchodilatory effects of beta-agonists and produce severe bronchospasm.</li>\r\n	<li>Diuretics: Use with caution. Electrocardiographic changes and/or hypokalemia associated with non&ndash;potassium-sparing diuretics may worsen with concomitant beta-agonists.</li>\r\n	<li>Anticholinergics: May interact additively with concomitantly used anticholinergic medications. Avoid administration of this preparation with other anticholinergic-containing drugs.</li>\r\n</ul>', '<ul>\r\n	<li>Primary treatment of status asthmaticus or acute episodes of COPD or asthma requiring intensive measures</li>\r\n	<li>Severe hypersensitivity to milk proteins or any ingredients.</li>\r\n</ul>', '<p><strong>COPD</strong>: Most common adverse reactions (incidence &ge;1%) are upper respiratory tract infection, pneumonia, bronchitis, oral candidiasis, headache, back pain, arthralgia, infuenza, sinusitis, pharyngitis, rhinitis, dysgeusia, constipation, urinary tract infection, diarrhea, gastroenteritis, oropharyngeal pain, cough, and dysphonia.<br />\r\n<br />\r\n<strong>Asthma</strong>: Most common adverse reactions (incidence &ge;2%) are pharyngitis/nasopharyngitis, upper respiratory tract infection/viral upper respiratory tract infection, bronchitis, respiratory tract infection/viral respiratory tract infection, sinusitis/acute sinusitis, urinary tract infection, rhinitis, infuenza, headache, and back pain.</p>', '<p>Insufficient data on the use of this preparation in pregnant women and lactating mothers.</p>', '<ul>\r\n	<li>LABA monotherapy increases the risk of serious asthma-related events.</li>\r\n	<li>Do not initiate in acutely deteriorating COPD or asthma. Do not use to treat acute symptoms.</li>\r\n	<li>Do not use in combination with additional therapy containing a LABA because of risk of overdose.</li>\r\n	<li>Candida albicans infection of the mouth and pharynx may occur. Monitor patients periodically. Advise the patient to rinse his/her mouth with water without swallowing after inhalation to help reduce the risk.</li>\r\n	<li>Increased risk of pneumonia in patients with COPD. Monitor patients for signs and symptoms of pneumonia.</li>\r\n	<li>If paradoxical bronchospasm occurs, discontinue and institute alternative therapy.</li>\r\n	<li>Use with caution in patients with cardiovascular disorders because of beta-adrenergic stimulation.</li>\r\n	<li>Worsening of urinary retention may occur. Use with caution in patients with prostatic hyperplasia or bladder-neck obstruction.</li>\r\n	<li>Use with caution in patients with convulsive disorders, thyrotoxicosis, diabetes mellitus, and ketoacidosis.</li>\r\n</ul>', NULL, '<p>Combined bronchodilators.</p>', '<p>Store below 25&deg;C, protect from light &amp; moisture. Keep out of reach of children.</p>', '<p><strong>Elderly population</strong>: Based on available data, no adjustment of the dosage in geriatric patients is necessary, but greater sensitivity in some older individuals cannot be ruled out.<br />\r\n<strong>Renal impairment</strong>: It has not been studied in subjects with renal impairment.<br />\r\n<strong>Hepatic impairment</strong>: It has not been studied in subjects with hepatic impairment.<br />\r\n<strong>Pediatric population</strong>: It is not indicated for use in children and adolescents. The safety and efficacy in pediatric patients (aged 17 years and younger) have not been established.</p>', '2022-03-18 20:21:47', '2022-03-18 20:21:47');
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
(1323, 1323, '<p>This is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Long-term, once-daily, maintenance treatment of airflow obstruction and reducing exacerbations in patients with chronic obstructive pulmonary disease (COPD).</li>\r\n	<li>Once-daily treatment of asthma in patients aged 18 years and older.</li>\r\n</ul>', '<p>This preparation contains both futicasone furoate and vilanterol, the mechanisms of action described below for the individual components. These drugs represent 2 diferent classes of medications (a synthetic corticosteroid and a LABA) that have diferent efects on clinical and physiological aspects. The pharmacologic efects of beta 2-adrenoceptor agonist drugs, including vilanterol, are at least in part attributable to stimulation of intracellular adenyl cyclase, the enzyme that catalyzes the conversion of adenosine triphosphate (ATP) to cyclic-3, 5-adenosine monophosphate (cyclic AMP). Increased cyclic AMP levels cause relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from cells, especially from mast cells. The precise mechanism through which futicasone furoate afects COPD and asthma symptoms is not known. Infammation is an important component in the pathogenesis of COPD and asthma. Corticosteroids have been shown to have a wide range of actions on multiple cell types (e.g., mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (e.g., histamine, eicosanoids, leukotrienes, cytokines) involved in infammation.</p>', '<p>Should be administered as 1 inhalation once daily by the orally inhaled route only.</p>\r\n\r\n<ul>\r\n	<li><strong>For COPD</strong>: 100 micrograms cozycap: 1 inhalation once daily. Should be taken by revolizer.</li>\r\n	<li><strong>For Asthma</strong>: 100 micrograms or 200 micrograms cozycap: 1 inhalation once daily. The maximum recommended dosage of 200 micrograms cozycap: 1 inhalation once daily. Should be taken by revolizer.</li>\r\n</ul>', '<ul>\r\n	<li>Other adrenergic drugs may potentiate efect. Use with caution.</li>\r\n	<li>Xanthine derivatives, steroids, diuretics or non-potassium sparing diuretics may potentiate hypokalemia or EDG changes. Use with caution.</li>\r\n	<li>Diuretics: Use with caution.</li>\r\n	<li>Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. May potentiate the effect of formoterol fumarate on cardiovascular system.</li>\r\n	<li>Beta-Blockers: Use with caution and only when medically necessary.</li>\r\n	<li>Anticholinergics: May interact additively with concomitantly used anticholinergic medications. Avoid administrations of Beviprex with other anticholinergic-containing drugs.</li>\r\n</ul>', NULL, '<p><strong>Common side efects in COPD</strong>: Most common adverse reactions (incidence &ge;3%) are nasopharyngitis, upper respiratory tract infection, headache, oral candidiasis, back pain, pneumonia, bronchitis, sinusitis, cough, oropharyngeal pain, arthralgia, hypertension, infuenza, pharyngitis, and pyrexia.<br />\r\n<br />\r\n<strong>Common side efects in Asthma</strong>: Most common adverse reactions (incidence &ge;2%) are nasopharyngitis, oral candidiasis, headache, infuenza, upper respiratory tract infection, bronchitis, sinusitis, oropharyngeal pain, dysphonia, and cough.</p>', '<p>Insufficient data on the use of this preparation in pregnant women and lactating mothers.</p>', '<ul>\r\n	<li>Candida albicans infection of the mouth and pharynx may occur. Monitor patients periodically. Advise the patient to rinse his/her mouth with water without swallowing after inhalation to help reduce the risk.</li>\r\n	<li>Increased risk of pneumonia in patients with COPD. Monitor patients for signs and symptoms of pneumonia.</li>\r\n	<li>Potential worsening of infections (e.g., existing tuberculosis; fungal, bacterial, viral, or parasitic infections; ocular herpes simplex). Use with caution in patients with these infections. More serious or even fatal course of chickenpox or measles can occur in susceptible patients.</li>\r\n</ul>', NULL, '<p>Respiratory corticosteroids</p>', '<p>Store below 25&deg;C. Protect from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Elderly population</strong>: It can be used at the recommended dose in elderly patients.<br />\r\n<strong>Renal impairment</strong>: No dosage adjustment is required in patients with renal impairment.<br />\r\n<strong>Hepatic impairment</strong>: Caution should be observed in patients with moderate or severe hepatic impairment.<br />\r\n<strong>Pediatric population</strong>: The safety and efficacy of this combination in children have not been established. No data are available.</p>', '2022-03-18 20:24:02', '2022-03-18 20:24:02'),
(1324, 1324, '<p>Vildagliptin is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus as monotherapy and in dual combination with Metformin, a Sulphonylurea, a Thiazolidinedione, or Insulin when diet, exercise and a single antidiabetic agent do not result in adequate glycemic control.</p>', '<p>Vildagliptin 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, 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, Vildagliptin increases insulin release and decreases glucagon levels in the circulation in a glucose-dependent manner.</p>', '<p>The recommended dose of Vildagliptin is-</p>\r\n\r\n<ul>\r\n	<li>50 mg or 100 mg daily for monotherapy.</li>\r\n	<li>50 mg twice daily (morning and evening) when used in dual combination with Metformin or a Thiazolidinedione;</li>\r\n	<li>50 mg once daily in the morning when used in dual combination with a Sulphonylurea.</li>\r\n</ul>\r\n\r\n<p>Vildagliptin may be taken with or without a meal. No dosage adjustment is required in the elderly, or in patients with mild renal impairment.<br />\r\n<br />\r\n<strong>Pediatric use</strong>: Vildagliptin is not recommended in patients 18 years of age.</p>', '<p>In pharmacokinetic studies, no interactions were seen with pioglitazone, metformin, glibenclamide, digoxin, warfarin, amlodipine, ramipril, valsartan or simvastatin. As with other oral antidiabetic medicinal products the glucose-lowering effect of Vildagliptin may be reduced by certain active substances, including thiazides, corticosteroids, thyroid products and sympathomimetics.</p>', '<p>Vildagliptin is contraindicated in patients with:</p>\r\n\r\n<ul>\r\n	<li>Hypersensitivity to the active substance or to any of the excipients</li>\r\n	<li>Patients with moderate to severe renalImpairment</li>\r\n	<li>Patients with Hepatic Impairment: patients with pre-treatment alanine aminotransferase (ALT) or aspartate aminotrasferase (AST) &gt;3 times the upper limit of normal (ULN).</li>\r\n	<li>Patients with type 1 diabetes</li>\r\n</ul>', '<p>The majority of adverse reactions were mild and transient, not requiring treatment discontinuations. A rare case of hepatic dysfunction is seen. Clinical trials of up to and more than 2 years duration did not show any additional safety signals or unforeseen risks when using this combination.</p>', '<p>Vildagliptin should not be used in pregnancy. Vildagliptin should not be used during lactation.</p>', '<p>Caution should be exercised in patients aged 75 years and older due to limited clinical experience. It is recommended that LFTs are monitored prior to initiation of Vildagliptin, at three-monthly intervals in the first year and periodically thereafter. If transaminase levels are increased, patients should be monitored with a second liver function evaluation to confirm the finding and be followed thereafter with frequent liver function tests until the abnormality returns to normal. If AST or ALT persists at 3xULN, Vildagliptin treatment should be stopped. Patients who develop jaundice or other signs of liver dysfunction should discontinue Vildagliptin. Following the withdrawal of treatment with Vildagliptin and LFT normalization, treatment with Vildagliptin should not be reinitiated. Due to limited clinical experience, use with caution in patients with congestive heart failure of New York Heart Association (NYHA) functional class I-II, and do not use in patients with NYHA functional class III IV.</p>', NULL, '<p>Dipeptidyl Peptidase-4 (DPP-4) inhibitor.</p>', '<p>Store below 30&deg;C temperature &amp; keep away from light &amp; moisture. Keep out of reach of children.</p>', NULL, '2022-03-18 20:26:17', '2022-03-18 20:26:17'),
(1325, 1325, '<p>This tablet is indicated as an adjunct to diet and exercises to improve glycaemic control in patients with type 2 diabetes mellitus whose diabetes is not adequately controlled on Metformin Hydrochloride or Vildagliptin alone or who are already treated with the combination of Vildagliptin and Metformin Hydrochloride, as separate tablets.</p>', '<p>Vildagliptin acts primarily by inhibiting DPP-4 (Dipeptidyl peptidase-4), the enzyme responsible for the degradation of the incretin hormones GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide). The administration of Vildagliptin results in a rapid and complete inhibition of DPP-4 activity resulting in increased fasting and postprandial endogenous levels of the incretin hormones GLP-1 and GIP. By increasing the endogenous levels of these incretin hormones, Vildagliptin increases insulin secretion from the pancreatic beta cell and decreases glucagon secretion from alpha cell. The enhanced increase in the insulin/glucagon ratio during hyperglycaemia due to increased incretin hormone levels results in a decrease in fasting and postprandial hepatic glucose production, leading to reduced glycaemia.<br />\r\n<br />\r\nMetformin Hydrochloride is a biguanide type oral antihyperglycemic drug used in the management of type 2 diabetes. It lowers both basal and postprandial plasma glucose. Its mechanism of action is different from those of sulfonylureas and it does not produce hypoglycemia. Glucomin decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity by an increase in peripheral glucose uptake and utilization.</p>', '<p><strong>Adults</strong>: Based on the patient&#39;s current dose of Metformin, this combination may be initiated at twice daily, 1 tablet in the morning and the other in the evening. Patients receiving Vildagliptin and Metformin from separate tablets may be switched to this combination containing the same doses of each component. Doses higher than 100 mg of vildagliptin are not recommended. There is no clinical experience of Vildagliptin and Metformin in triple combination with other antidiabetic agents. Taking this combination with or just after food may reduce gastrointestinal symptoms associated with Metformin.</p>', '<p>No clinically relevant pharmacokinetic interaction was observed when Vildagliptin (100 mg once daily) was co-administered with Metformin Hydrochloride (1,000 mg once daily). Vildagliptin has a low potential for drug interactions. Since Vildagliptin is not a cytochrome P (CYP) 450 enzyme substrate nor does it inhibit nor induces CYP 450 enzymes, it is not likely to interact with co-medications that are substrates, inhibitors or inducers of these enzymes. As a result of these studies no clinically relevant interactions with other oral antidiabetics (glibenclamide, pioglitazone, metformin hydrochloride), amlodipine, digoxin, ramipril, simvastatin, valsartan or warfarin were observed after co-administration with vildagliptin. On the other hand, furosemide, nifedipine and glyburide increase Cmax and blood AUC of Metformin with no change in renal clearance of Metformin.</p>', '<p>This combination is contraindicated in patients with known hypersensitivity to Vildagliptin or Metformin Hydrochloride or to any of the excipients. It is contraindicated in patients with renal disease or renal dysfunction, acute myocardial infarction, and septicaemia. It is also contraindicated in patients with congestive heart failure patients and in patients with acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma. It 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 side effects are headache, tremor, dizziness, nausea, hypoglycaemia etc.</p>', '<p>There are no adequate and well controlled studies in pregnant women and therefore, this combination should not be used during pregnancy unless the potential benefit justifies the potential risk to the foetus.&nbsp;No studies have been conducted with the components of this combination. As it is not known whether Vildagliptin and/or Metformin Hydrochloride is excreted in human milk this combination should not be administered to breast-feeding women.</p>', '<p>Lactic acidosis can occur due to Metformin accumulation. If metabolic acidosis is suspected, treatment should be discontinued and the patient should be hospitalized immediately. Serum creatinine should be monitored at least once a year in patients with normal renal function and 2&ndash;4 times a year in patients with serum creatinine levels at the upper limit of normal and in elderly patients. Special caution should be exercised in elderly patients where renal function may become impaired (e.g. when initiating antihypertensives, diuretics or NSAIDs). It is recommended that Liver Function Tests (LFTs) are monitored prior to initiation of this drug, at three-monthly intervals in the first year and periodically thereafter. If transaminase levels are increased, patients should be monitored with a second liver function evaluation to confirm the finding and be followed thereafter with frequent liver function tests until the abnormality return to normal. If AST or ALT persist at 3 x ULN, Vildagliptin &amp; Metformin tablets should be stopped Patients who develop jaundice or other signs of liver dysfunction. Following withdrawal of treatment with Vildagliptin &amp; Metformin and LFT normalization, treatment with Vildagliptin &amp; Metformin should not be reinitiated. Vildagliptin &amp; Metformin tablets should be discontinued 48 hours before elective surgery with general anaesthesia and should not usually be resumed earlier than 48 hours afterwards.</p>', NULL, '<p>Combination Oral hypoglycemic preparations.</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', '<p><strong>Use in pediatric patients</strong>: The safety and effectiveness of this combination in pediatric patients have not been established. Therefore, this combination is not recommended for use in children below 18 years of age.<br />\r\n<br />\r\n<strong>Use in geriatric patients</strong>: As Metformin is excreted via the kidney, and elderly patients have a tendency to decreased renal function, elderly patients taking this combination should have their renal function monitored regularly. This combination should only be used in elderly patients with normal renal function.<br />\r\n<br />\r\n<strong>Patients with renal impairment</strong>: This combination should not be used in patients with renal failure or renal dysfunction, e.g. serum creatinine levels &gt; 1.5 mg/dl (&gt;135 micro mol/L) in males and &gt; 1.4 mg/dl (&gt;110 micro mol/L) in females.<br />\r\n<br />\r\n<strong>Patients with hepatic impairment</strong>: This combination is not recommended in patients with hepatic impairment including patients with a pre-treatment ALT or AST &gt;3 X the upper limit of normal.</p>', '2022-03-18 20:27:56', '2022-03-18 20:27:56'),
(1326, 1326, '<p>Vinblastine is effective as a single agent, but its therapeutic effect is enhanced when used in combination with other antineoplastic drugs. Vinblastine has been used in the treatment of Hodgkin&rsquo;s disease (Stages III and IV) in combination therapy (with adriamycin (doxorubicin), bleomycin and dacarbazine as ABVD) and in the treatment of advanced testicular carcinoma (with cisplatin and bleomycin). Vinblastine has been used in the palliative treatment of lymphocytic lymphoma, histiocytic lymphoma, advanced stages of mycosis fungoides, Kaposi&#39;s sarcoma and Histiocytosis X.<br />\r\n<br />\r\nVinblastine may be used in the treatment of choriocarcinoma resistant to other chemotherapeutic agents; carcinoma of the breast, unresponsive to appropriate endocrine surgery and hormonal therapy. One of the most effective single agents for treatment of Hodgkin&rsquo;s disease is vinblastine. A protocol substituting cyclophosphamide for nitrogen mustard and vinblastine for vincristine in MOPP&nbsp;is an alternative therapy for previously untreated patients with advanced Hodgkin&rsquo;s disease. Patients suffering relapse have also responded to combination therapy that included vinblastine. Advanced testicular germ-cell cancers are sensitive to vinblastine alone but the administration of vinblastine concomitantly with other antineoplastic agents, produces better clinical results. Bleomycin effectiveness is enhanced when vinblastine is administered 6 to 8 hours prior to bleomycin administration; this schedule permits more cells to be arrested during metaphase, in which bleomycin is active.</p>', '<p>Vinblastine is M phase specific. It binds to microtubular proteins and arrests mitosis at the metaphase by disrupting mitotic spindle formation. It blocks glutamic acid utilization, thus inhibiting purine synthesis, the citric acid cycle, and the formation of urea. It may also interfere with nucleic acid and protein synthesis.</p>', '<p><strong>Adult (Intravenous)</strong>: Initially, 3.7 mg/m2, increase dose wkly based on WBC counts in increments of about 1.8 mg/m2&nbsp;until leukocyte count decreases to about 3000/mm3, or max wkly dose of 18.5 mg/m2&nbsp;reached. Do not increase dose if leukocyte count is reduced to approximately 3000 cells/mm3; administer the max dose that does not cause leucopenia for maintenance. Do not increase subsequent doses if onolytic activity occurs before leucopenic effect. Usual dose: 5.5-7.4 mg/m2&nbsp;per wk. Do not admin next dose, even though 7 days have lapsed unless the leukocyte count has returned to at least 4000/mm3.<br />\r\n<br />\r\n<strong>Child (Intravenous)</strong>: Initial 2.5 mg/m2&nbsp;of BSA, increased dose at wkly intervals in increments of about 1.25 mg/m2&nbsp;until leukocyte count decreases to about 3000/ mm3, or max wkly dose of 12.5 mg/m2&nbsp;reached. Do not increase dose once leukocyte count reaches approximately 3000 cells/mm3, instead, a dose of 1 increment smaller to be admin at wkly intervals for maintenance i.e. patient receives the max dose that does not cause leucopenia. If onolytic activity is encountered before leucopenic effect, then there is no need to increase subsequent doses. Do not admin next dose, even though 7 days have lapsed unless the leukocyte count has returned to at least 4000/mm3. Duration of maintenance therapy depends on disease state and the antineoplastic agent combination.</p>', '<p>Possible increase in vinblastine levels with aprepitant. Reduced vinblastine metabolism with miconazole. Variable interactions with phenytoin, monitor serum phenytoin levels. Reduced immune response with vaccines. Additive myelotoxicity with zidovudine. Concurrent admin of vinblastine with CYP3A inhibitors may cause an earlier onset and/or an increased severity of side effects.</p>', '<p>Severe bone marrow suppression; presence of bacterial infection; maglignant cell infiltration of bone marrow; Inj into extremity with poor circulation; porphyria; granulocytopenia. Elderly with cachexia or extreme skin ulcerations. Pregnancy; lactation. Intrathecal use may result in death.</p>', '<p>Alopecia, constipation, malaise, stomatitis, dose-limiting bone marrow suppression (e.g. granulocytopenia, thrombocytopenia, anaemia), hypertension, central and peripheral neurotoxicity, 8th cranial nerve damage resulting in vestibular and auditory toxicity, ischaemic cardiac toxicity, breathlessness, bone, tumour or jaw pain. Nausea, vomiting, GI bleed, syndrome of inappropriate antidiuretic hormone. Necrosis, cellulitis if extravasation occurs.</p>', '<p>Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Hepatic impairment; neurotoxicity; ischemic heart disease; preexisting pulmonary dysfunction; extravasation may cause tissue damage and pain. Discontinue immediately if extravasation occurs, with local Inj of hyaluronidase and local heat application to decrease discomfort and risk of cellulitis; remaining Inj to be injected into another vein. Routine prophylaxis against constipation recommended especially in high doses. Nadir in leukocyte count occur 4-10 days after vinblastine admin; recovery observed 7-14 days after treatment.</p>', '<p><strong>Symptoms</strong>: Severe bone marrow suppression and extensions of its usual side effects.<br />\r\n<br />\r\n<strong>Management</strong>: Treatment is supportive. Restrict fluid and use of loop diuretics to counteract the effects of syndrome of inappropriate secretion of antidiuretic hormone. Monitor the patient&#39;s CV system and daily blood counts for transfusion requirement.</p>', '<p>Cytotoxic Chemotherapy.</p>', '<p>Store at 2-8&deg; C.</p>', '<p><strong>Hepatic Impairment:</strong>&nbsp;Serum bilirubin &gt;3 mg/100ml: Reduce dose by 50%.</p>', '2022-03-18 20:29:45', '2022-03-18 20:29:45'),
(1327, 1327, '<p>Vincristine sulfate injection is indicated in&nbsp;acute leukemia. Vincristine sulfate injection has also been shown to be useful in combination with other oncolytic agents in Hodgkin&#39;s disease, non-Hodgkin&#39;s malignant lymphomas (lymphocytic, mixed&nbsp;cell, histiocytic, undifferentiated, nodular and diffuse types),&nbsp;rhabdomyosarcoma,&nbsp;neuroblastoma, and Wilms&#39; tumor.</p>', '<p>Vincristine arrests cell division at the metaphase stage by inhibiting microtubule formation in the mitotic spindle.</p>', '<p><strong>Adult (Intravenous)</strong>: Usual recommended dosage: 1.4-1.5 mg/m2&nbsp;once wkly. Max: 2 mg wkly. Subsequent doses may be modified based on clinical and haematological responses and tolerance of the patient. May be used in combination with other drugs. Prescribers should consult published protocols for the dosage, method and sequence of admin.<br />\r\n<br />\r\n<strong>Child (Intravenous)</strong>: Usual recommended dosage: 1.5-2 mg/m2&nbsp;once wkly; for patients &le;10 kg: Initiate at 0.05 mg/kg once wkly. Subsequent doses may be modified based on clinical and haematological responses and tolerance of the patient. May be used in combination with other drugs. Prescribers should consult published protocols for the dosage, method and sequence of admin.</p>', '<p>Decreased digoxin (tablets) and verapamil absorption with antineoplastic regimens. Increased etoposide serum levels with vincristine. Increased toxicity when ganciclovir given with, immediately before or after vincristine. Reduced vincristine metabolism with miconazole. Increased neurotoxicity with isoniazid, itraconazole, voriconazole, posaconazole and nifedipine. Decreased immune response when used concurrently with vaccines. Increased myelotoxicity with zidovudine. Increased risk of thromboembolic complications with tamoxifen. Increased risk of ototoxicity with ototoxic drugs (e.g. platinum-containing antineoplastic agents). Possible risk of earlier onset and/or increased severity of adverse effects with macrolides. Possible increase in vincristine levels with aprepitant. Possible decrease in antiepileptic levels with vincristine, monitor serum antiepileptic levels and effectiveness of chemotherapy.</p>', '<p>Patients with demyelinating form of Charcot-Marie-Tooth syndrome. Pregnancy and lactation. Intrathecal admin (may be fatal). Patients receiving radiation therapy through ports which include liver.</p>', '<p>Dose limiting neurotoxicity (e.g. motor function impairment, gait abnormalities), hyperuricaemia, bronchospasm, azospermia, amenorrhoea, alopoecia, leucopenia, urinary dysfunction, abdominal cramps, vomiting, diarrhoea, severe constipation, paralytic ileus, convulsions, hypertension, orthostatic hypotension, ptosis, hoarseness, optic neuropathies, hallucinations, blindness, neurological deafness, difficulty in walking, syndrome of inappropriate ADH secretion.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Elderly. Preexisting pulmonary dysfunction or neuromuscular disease; leucopenia or a complicating infection; impaired liver function; obstructive jaundice. Routine prophylactic laxative needed to ensure regular bowel movement. Discontinue immediately if extravasation occurs, and inj any remaining drug into another vein, followed by local Inj of hyaluronidase and topical heat application to the affected area to aid in drug removal and reduce discomfort. Discontinue in patients who develop progressive dyspnea. CBC to be checked before each dose admin. Frequent monitoring of uric acid during first 3-4 wk of treatment and watch out for uric acid nephropathy.</p>', '<p><strong>Symptoms</strong>: mainly extensions of its common adverse effects.<br />\r\n<br />\r\n<strong>Management</strong>: Treatment is supportive and includes prevention of side effects from syndrome of inappropriate antidiuretic hormone secretion (SIADH) (e.g. fluid restriction and admin of loop diuretic); admin of anticonvulsants and use of enemas (to prevent ileus). Closely monitor the CV system and determine the blood counts daily to guide transfusion requirements. Folinic acid 100 mg admin IV every 3 hr for 24 hr and then every 6 hr for at least 48 h may be admin. Haemodialysis unlikely to be useful.</p>', '<p>Cytotoxic Chemotherapy.</p>', '<p>Store at 2-8&deg; C. Protect from light.</p>', '<p><strong>Hepatic Impairment:</strong>&nbsp;Dose adjustment may be needed. Serum bilirubin &gt;3 mg/100ml: Reduce dose by 50%.</p>', '2022-03-18 20:31:52', '2022-03-18 20:31:52'),
(1328, 1328, '<p>Vinorelbine is indicated:</p>\r\n\r\n<ul>\r\n	<li>In combination with&nbsp;cisplatin&nbsp;for first-line treatment of patients with locally advanced or metastatic&nbsp;non-small cell lung cancer&nbsp;(NSCLC)</li>\r\n	<li>As a single agent, for the treatment of patients with metastatic NSCLC</li>\r\n</ul>', '<p>Vinorelbine, a semisynthetic vinblastine derivative, binds to tubulin and inhibits microtubule formation. This disrupts the formation of the mitotic spindle thereby arresting the cell at metaphase.</p>', '<p>Intravenous (Adult):</p>\r\n\r\n<p><strong>Cervical cancer</strong>:&nbsp;30 mg/m2&nbsp;days 1 and 8 of a 21-day treatment cycle.<br />\r\n<br />\r\n<strong>Breast cancer, Ovarian cancer</strong>:&nbsp;25 mg/m2&nbsp;dose every 7 days.<br />\r\n<br />\r\n<strong>Non-small cell lung cancer</strong>:&nbsp;</p>\r\n\r\n<ul>\r\n	<li><strong>As single agent</strong>: 30 mg/m2&nbsp;wkly as infusion over 20-30 minutes (after diluting in 125 ml normal saline or glucose 5%) or as slow bolus over 5-10 minutes (after diluting in 20-50 ml normal saline or glucose 5%). Delay subsequent doses if neutrophil count is &lt;2000 cells/mm3&nbsp;until recovery.</li>\r\n	<li><strong>As combination therapy with cisplatin</strong>: 25-30 mg/m2&nbsp;every 7 days.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Oral&nbsp;(Adult):</p>\r\n\r\n<p><strong>Non-small cell lung cancer</strong>:&nbsp;60 mg/m2once wkly for 3 wk, may increase subsequently to 80 mg/m2&nbsp;once wkly. If neutrophil count is &lt; 500 cells/mm3&nbsp;or between 500-1000 cells/mm3&nbsp;on 2 separate occasions, keep dose at 60 mg/m2&nbsp;for next 3 doses.</p>', '<p>Increased risk of granulocytopenia with cisplatin. Increased risk of neurotoxicity with paclitaxel, itraconazole, ketoconazole. Increased radiosensitising effects with prior or concomitant radiation therapy. Increased pulmonary toxicity with mitomycin. Increased myelotoxicity with zidovudine. Earlier onset and/or an increased severity of side effects with CYP3A inhibitors. Possible increase in vincristine levels with aprepitant. Possible infection with live vaccines.</p>', '<p>Hypersensitivity to vinorelbine or other vinca alkaloids; severe current or recent infection (within last 2 wk); neutropenia; thrombocytopenia; severe hepatic impairment. Intrathecal admin. Do not give concomitantly with radiotherapy if liver is in treatment field. Pregnancy, lactation.</p>', '<p>Neurotoxicity, peripheral paraesthesia, loss of deep tendon reflexes, abdominal pain, severe constipation, diarrhoea, alopecia, severe local irritation. Dose limiting granulocytopenia, leukopenia and anaemia. Intestinal obstruction, paralytic ileus, nausea, vomitinh, increased in LFT, chest pain, fatigue. Local pain and thrombophlebitis with repeated Inj.</p>', '<p>Pregnancy&nbsp;Category D. There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Hepatic impairment. Compromised bone marrow reserve due to prior irradiation or chemotherapy; recovering marrow function from the effects of previous chemotherapy. Prior radiation therapy; past history or pre-existing neuropathy. CBC with differentials to be monitored prior to admin of subsequent doses. Delay subsequent doses, if neutrophil count &lt; 2000 cells/mm3. Each admin to be followed by at least 250 ml of normal saline to flush the vein. Avoid extravasation. If extravasation occurs, stop infusion immediately, and flush the vein with normal saline solution; admin the remaining solution in another vein. Do not father a child during and up to six mth after treatment and females of childbearing potential to use effective method of contraception during treatment and three mth thereafter. When admin orally, capsules must be swallowed whole with water and not chewed or sucked.</p>', NULL, '<p>Cytotoxic Chemotherapy.</p>', '<p>Intravenous:&nbsp;Store at 2-8&deg;C. Protect from light. Oral:&nbsp;Store at 2-8&deg;C.</p>', '<p>Hepatic Impairment:<br />\r\nIntravenous:&nbsp;</p>\r\n\r\n<ul>\r\n	<li><strong>Cervical cancer</strong>:&nbsp;Dose adjustments may be needed.</li>\r\n	<li><strong>Breast cancer</strong>, Ovarian<strong>&nbsp;cancer</strong>:&nbsp;Dose adjustments may be needed.</li>\r\n	<li><strong>Non-small cell lung cancer</strong>:&nbsp;Massive liver metastases(&gt;75% of liver volume replaced by the tumour): Decrease dose by&nbsp;1/3. Bilirubin 2.1-3 mg/100 ml: Reduce IV dose by 50%. Bilirubin &gt;3 mg/100 ml: Reduce IV dose by 75%.</li>\r\n</ul>\r\n\r\n<p>Oral:&nbsp;</p>\r\n\r\n<ul>\r\n	<li><strong>Massive liver metastases(&gt;75% of liver volume replaced by&nbsp;</strong>the tumour<strong>)</strong>: Decrease dose by&nbsp;1/3. Bilirubin 2.1-3 mg/100 ml: Reduce IV dose by 50%. Bilirubin &gt;3 mg/100 ml: Reduce IV dose by 75%.</li>\r\n</ul>', '2022-03-18 20:33:36', '2022-03-18 20:33:36'),
(1329, 1329, '<p><strong>Acute Cerebro-Vascular Accidents (Strokes)</strong>: Ischaemic strokes due to cerebral thrombosis, cerebral embolism, acute circulatory disorder, hypertensive crisis; the acute cardiovascular disorders, ischaemic neurological defcit, complete stroke (CS), multiinfarct dementia, cerebral arteriosclerosis, hypertensive encephalopathy, post-apoplectic conditions with the background of haemorrhagic strokes etc.<br />\r\n<br />\r\n<strong>Senile Disorder</strong>: For relief of psychosomatic symptoms in the elderly due to cerebral insufciency eg. forgetfulness, memory disturbances, slow thinking, lack of concentration, dizziness, mood instability, aphasia, sleep disturbances, vasovegetative symptoms of menopausal syndrome etc.<br />\r\n<br />\r\n<strong>Visual Disorder</strong>: Vascular disorders of the choroid and retina due to arteriosclerosis. Vasospasm, macula degenerations, arterial or venous thrombosis or embolism and glaucoma secondary to the above mentioned disorders.<br />\r\n<br />\r\n<strong>Hearing Disorder</strong>: For the treatment of impaired hearing of vascular or toxic (iatrogenic) origin presbyacusis, meniere&#39;s disease, cochleovestibular neuritis, tinnitus and dizziness of labirynth origin.</p>', '<p>Vinpocetine increases cerebral metabolism; it increases glucose and O2 consumption; improves cerebral hypoxia tolerance; shifts glucose metabolism to the energetically more favourable aerobic pathway, but it increases the anaerobic pathway as well; it elevates the ATP concentration and the ATP/AMP ratio in the brain, and elevates the cerebral norepinephrine, dopamine and serotonin levels.<br />\r\n<br />\r\nVinpocetine considerably improves cerebral microcirculation by inhibiting platelet aggregation, reducing the pathologically increased blood viscosity, and increases erythrocyte deformability. It also promotes O2&nbsp;transport into the tissues by reducing the O2&nbsp;affinity of erythrocytes.<br />\r\n<br />\r\nIt selectively and intensely increases cerebral blood flow and the share of the brain in cardiac output, it reduces cerebral vascular resistance without affecting systemic circulation (blood pressure, heart rate, cardiac output, total peripheral resistance). It does not elicit steal phenomenon; on the contrary, it primarily improves the blood supply of the injured and ischaemic area while it remains unchanged in the intact areas (inverse steal effect). It further increases blood flow which is already increased as a result of hypoxia.</p>', '<p><strong>Tablet</strong>: 1-2 tablets thrice daily, the maintenance dose is 1 tablet thrice daily.<br />\r\n<br />\r\n<strong>IM Injection</strong>: Daily dose of 20-40 mg are to be given until improvement of symptoms is reached (for not longer than 10 days) then oral treatment should be applied. If this regimen fails, infusion treatment should be started.<br />\r\n<br />\r\n<strong>IV Infusion</strong>: The daily starting dose is 20 mg in slow drip infusion (2 ampoules in 500-1000 ml infusion solution). This dose can be increased to 1 mg/kg body weight during 3 to 4 days. Treatment should be continued for 10-14 days depending on the tolerance of the patients and the dose should be gradually reduced before discontinuation of treatment.</p>', '<p>The injection is chemically incompatible with heparin, therefore, it should not be injected in the same syringe.</p>', '<p>Parenteral treatment- Severe ischaemic heart disease, severe rhythm disorders and pregnancy.</p>', '<p>Transient hypotension, tachycardia may occur.</p>', '<p>In Pregnancy and Lactation the drug is contraindicated.</p>', '<p>In the acute stage until the improvement of symptoms parenteral treatment is recommended followed by oral treatment. In chronic cases oral therapy should be applied.</p>', NULL, '<p>Cerebral vasodilator &amp; Neurosensory oxygenator drugs</p>', '<p>Store in a cool and dry place, protected from light and moisture.</p>', NULL, '2022-03-18 20:35:11', '2022-03-18 20:35:11'),
(1330, 1330, '<p>Illness due to vitamin A deficiency in ophthalmology such as night blindness, xerophthalmia and dermatological such as changes in skin, hair and nails. Concomitant therapy of mucosa illnesses such as sinusitis, bronchitis, in acne vulgaris, ichthyosis, Darier&#39;s disease, psoriasis etc. To meet vitmin A demand in growth, resistance to infections and night blindness. This&nbsp;is also indicated to meet vitamin A deficiency after diarrhoea and prophylaxis of measles.</p>', '<p>Beta-carotene, retinol, and retinal have effective and reliable vitamin A activity. Retinal and retinol are in chemical equilibrium in the body and have equivalent antixerophthalmic activity. Retinal combines with the rod pigment, opsin, in the retina to form rhodopsin, necessary for visual dark adaptation.<br />\r\n<br />\r\nVitamin A prevents retardation of growth and preserves the epithe-lial cells&#39; integrity. Normal adult liver storage is sufficient to satisfy two years&#39;requirements of vitamin A. Vitamin A is readily absorbed from the gastrointestinal tract, where the biosynthesis of vitamin A from beta-carotene takes place. Vitamin A absorption requires bile salts, pancreatic lipase, and dietary fat. It is transported in the blood to the liver by the chy lomicron fraction of the lymph. Vitamin Ais stored in Kupffer cells of the liver mainly as the palmitate. Normal serum vitamin A is 80-300 Units per 100 mL (plasma range is 30-70 mcg per dl) and for carotenoids 270-753 Units per 100 mL.The normal adult liver contains approximately 100 to 300 micrograms per gram, mostly as retinol palmitate.</p>', '<p>For Adults: 50000 IU-100000 IU daily up to 200000 IU if necessary.<br />\r\n<br />\r\nChildren (Above 1 year):</p>\r\n\r\n<ul>\r\n	<li><strong>Night blindness, Bitot&#39;s spots, Xerophthalmia</strong>: 200000 IU 1st day, 2nd day, 14th day</li>\r\n	<li><strong>Measles</strong>: 200000 IU 1st day, 2nd day</li>\r\n	<li><strong>Diarrhoea, Respiratory tract infection</strong>: 200000 IU every time after disease</li>\r\n	<li><strong>Severe malnutrition</strong>: 200000 IU single-dose or as directed by the registered physician.</li>\r\n</ul>', NULL, '<p>Hypervitaminosis of vitamin A. Sensitivity to any of the ingredients in this preparation.</p>', '<p>Vitamin A intoxication includes irritability, vomiting, loss of appetite, headache, dry and pruritic skin, skin desquamation, fatique, pain in ankles and feet, myalgia, loss of body hair, papilledema, nystagmus, liver sclerosis and cirrhosis.</p>', '<p>Safety of amounts exceeding 6,000 Units of vitamin A daily during pregnancy has not been established at this time. The use of vitamin A in excess of the recommended dietary allowance may cause fetal harm when administered to a pregnant woman. Animal reproduction studies have shown fetal abnormalities associated with over-dosage in several species. Malformations of the central nervous system, the eye, the palate, and the urogenital tract are recorded. Vitamin Ain excess of the recommended dietary allowance is contraindicated in women who are or may become pregnant. If vitamin Ais used during pregnancy, or if the patient becomes pregnant while taking vitamin A, the patient should be apprised of the potential hazard to the fetus.&nbsp;<br />\r\n<br />\r\nThe U.S. Recommended Daily Allowance (RDA) of vitamin A (5,000 Units) is recommended for nursing mothers.</p>', '<p>Ensure Vitamin A free interval after long term therapy with vitamin A. No daily dose over 5000 IU during pregnancy. Vitamin A doses over 50000 IU under medical supervision only.</p>', NULL, '<p>Vitamin-A preparations.</p>', '<p>Keep below 25&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-18 20:37:20', '2022-03-18 20:37:20'),
(1331, 1331, '<p>This is indicated as a daily multivitamin maintenance dosage for adults and children aged 11 years and above receiving parenteral nutrition. It is also indicated in other situations where administration by the intravenous route is required. Such situations include surgery, extensive burns, fractures and other trauma, severe infectious diseases and comatose states, which may provoke a &quot;stress&quot; situation with profound alterations in the body&#39;s metabolic demands and consequent tissue depletion of nutrients.</p>', '<p>This&nbsp;is a sterile, lyophilized powder for injection/infusion which contains nine water-soluble and three fat soluble vitamins. Mixed micelles is used as a solubilizing agent. It is presented as a lyophilized, orange-yellow, sterile powder that is to be reconstituted with 5ml of Water for injections or other parenteral fluids, (e.g. as 0.9% Sodium chloride or 5% Glucose solution), prior to administration by parenteral route.</p>', '<p>Adults and children aged 11 years and above: 1 vial/day</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>The single dose vial&nbsp;is reconstituted by adding 5 ml of sterile Water for injection or other intravenous fluids like 0.9% Sodium Chloride injection or 5% Glucose injection. 5 ml of diluent should be added by means of sterile syringe into the vial and gently mixed to dissolve the lyophilized powder. The entire volume of the resultant solution should then be administered by slow Intravenous injection (at least over 10 minutes) or further diluted for intravenous infusion. To minimize vitamin losses in parenteral nutrition admixtures, add the vitamins immediately prior to administration and complete administration within 24 hours.</p>', '<p>Patients receiving drugs that bind to a1-acid glycoprotein should be closely monitored for increases in response to these drugs, e.g. propranolol, prazosin and quinidine. Folic acid may increase the metabolism of some antiepileptics, such as phenobartbitol, phenytoin and primidone. Pyridoxine can reduce the effect of levo-dopa. Bleomycin can be inactivated by ascorbic acid and riboflavin.</p>', '<p>This&nbsp;is contraindicated in patients with pre-existing hypervitaminosis or known hypersensitivity to any of the active ingredients. This product should not be injected to patients with pre-existing intolerance to thiamine. Similarly, this product should not be administered to patients with impaired hepatic function. This preparation should not be administered to those suffering from hyperparathyroidism due to hypercalcaemic complications.</p>', '<p>Anaphylactic reactions have been reported following large intravenous doses of Thiamine. Urticaria and rash have also been associated with this preparation. There have been very rare reports of anaphylactic reactions following IV injection/infusion with this preparation over 1-4 minutes.</p>', '<p>The use of this preparation has not been studied in human during pregnancy. This&nbsp;should be given to a pregnant woman only if clearly needed. The use of this product in lactating women is not recommended.</p>', '<p>Anaphylactic reactions may occur in allergic subjects who are susceptible to Thiamine (Vitamin B1) and nicotinamide components of this product. Mild allergic reactions such as sneezing or mild asthma are warning signs that further injection/infusion may give rise to anaphylactic shock. Due to glychocolic acid content, repeated and prolonged administration in patients with jaundice of hepatic origin or severe biochemical evidence of cholestatis requires careful monitoring of liver function. Also in the case of impaired kidney function, fat-soluble vitamin levels should be carefully monitored.</p>', NULL, '<p>Specific combined vitamin preparations.</p>', '<p><strong>Before reconstitution</strong>: Store below 25&deg;C. Protect from light and do not freeze.<br />\r\n<br />\r\n<strong>After reconstitution:</strong>&nbsp;The reconstituted product should be used immediately or it should be stored at 2&deg;C to 8&deg;C for no more than 24 hours. Discard any unused portion of the reconstituted solution.</p>', '<p>Accumulation of Vitamin A and Vitamin D may be occured with prolonged administration of high doses.</p>', '2022-03-18 20:39:06', '2022-03-18 20:39:06'),
(1332, 1332, '<p>Vitamin-B complex is indicated for prophylactic or therapeutic nutritional supplementation in physiologically stressful conditions. These include: Conditions causing depletion, or reduced absorption or bioavailability of essential B-vitamins manifested by glossitis, stomatitis, cheilosis, beriberi&nbsp;Vitamin-B complex is indicated for prophylactic or therapeutic nutritional supplementation in physiologically stressful conditions. These include: Conditions causing depletion, or reduced absorption or bioavailability of essential B-vitamins manifested by glossitis, stomatitis, cheilosis, beriberi.</p>', '<p>Vitamin-B complex&nbsp;contains the most important members of the vitamin B group in pure form and in therapeutically balanced proportions. The members of the vitamin B group contained in Vitamin-B complex&nbsp;are components of enzyme systems that regulate various stages of carbohydrate, fat and protein metabolism, each of the components playing a specific biological role. Deficiency of B vitamin causes glossitis, stomatitis, cheilosis, polyneuritis, beriberi, pellagra and vascularisation of cornea.</p>', '<p><strong>Tablet/ capsule:</strong>&nbsp;usual recommended dose is 1-2 tablet/capsule 3 times daily or as directed by the physician.<br />\r\n<br />\r\n<strong>Syrup:</strong>&nbsp;2-3 teaspoonful daily or as directed by the physician.<br />\r\n<br />\r\n<strong>Injection:</strong>&nbsp;It is for intramuscular and intravenous administration. Usual recommended dose is 2 ml daily or as directed by the physician. In addition with&nbsp;Thiamine, Riboflavin, Nicotinamide, Pyridoxine; injectable dosage from contains&nbsp;D-Panthenol 5 mg.</p>', '<p>As little as 5 mg pyridoxine daily can decrease the efficacy of levodopa in the treatment of parkinsonism. Therefore, Vitamin-B complex is not recommended for patients undergoing such therapy.</p>', '<p>Vitamin-B complex is contraindicated in patients hypersensitive to any of its components.</p>', '<p>Adverse reactions have been reported with specific vitamins and minerals, but generally at levels substantially higher than those in Vitamin-B complex. However, allergic and idiosyncratic reactions are possible at lower levels. Iron, even at the usual recommended level has been associated with gastrointestinal intolerance in some patients.</p>', '<p>It is safe to use Vitamin-B complex in pregnancy and lactation.</p>', NULL, NULL, '<p>Specific combined vitamin preparations</p>', NULL, NULL, '2022-03-18 20:40:37', '2022-03-18 20:40:37');
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
(1333, 1333, '<p>Vitamin B complex &amp; Vitamin C is indicated in the treatment of patients with deficiencies of, or increased requirement for, vitamin B-complex and vitamin C. Such patients and conditions include:</p>\r\n\r\n<ul>\r\n	<li>Decreased intake because of restricted or unbalanced diet as in anorexia, diabetes mellitus, obesity and alcoholism.</li>\r\n	<li>Reduced availability during treatment with antimicrobials which alter normal intestinal flora, in prolonged diarrhea and in chronic gastrointestinal disorders.</li>\r\n	<li>Increased requirements due to increased metabolic rate as in fever and tissue wasting, e.g. febrile illness, acute or chronic infections, surgery, burns and fractures.</li>\r\n	<li>Stomatitis, glossitis, cheilosis, paraesthesias, neuralgia and dermatitis.</li>\r\n	<li>Micronutrient deficiencies during pregnancy or lactation.</li>\r\n</ul>', '<p>Vitamin B-Complex and Vitamin C function as cofactors of various enzymes which regulate carbohydrate, protein and fat metabolism. Thiamine (B.,) acts as a cofactor in the decarboxylation of keto acids such as pyruvic acid.<br />\r\n<br />\r\nRiboflavin (B2) plays a vital role in cellular respiratory reactions in conjunction with nicotinamide.<br />\r\n<br />\r\nPyridoxine (B6) takes part in decarboxylation and interconversion of amino acids. It is also required for normal antibody-mediated and cell-mediated immune responses.<br />\r\n<br />\r\nVitamin B12 (cyanocobalamin) is required for synthesis of DNA (deoxyribo-nucleic acid) and maturation of RBCs (red blood cells). Nicotinamide (niacinamide) plays a vital role in cellular respiration in conjunction with riboflavin.<br />\r\n<br />\r\nCalcium Pantothenate functions as a cofactor for enzymes involved in transfer of acetyl groups. It is also required for normal antibody response in conjunction with pyridoxine.<br />\r\n<br />\r\nFolic acid, after conversion in the body to folinic acid, takes part in reactions involved in the synthesis of nucleotides and maturation of RBCs in conjunction with vitamin B12. It also plays an important role in lymphocyte-mediated immune response.<br />\r\n<br />\r\nAscorbic acid (Vitamin C) takes part in biochemical reactions involving oxidation, as in collagen synthesis, and in conversion of folic acid to folinic acid. It is also necessary for normal phagocytic function ofWBCs (white blood cells).<br />\r\n<br />\r\nThus an adequate supply of these water-soluble vitamins is required for the optimum function of various cells and tissues.Except for Vitamin B12, these water-soluble vitamins are not stored in the body to any significant extent, the excess quantities being excreted in the urine. Therefore, a regular and adequate intake of them is necessary to meet the metabolic requirements. Deficiencies of water-soluble vitamins often co-exist because of their overlapping dietary sources and metabolic interdependence. Initially the deficiency of these vitamins may be subclinical and demonstrable only by means of biochemical tests. If not corrected at this stage, it may become manifest as various symptoms, including impaired wound healing and increased susceptibility to infection.&nbsp;Classical deficiency diseases such as beri beri, pellagra and scurvy are rare, whereas mild and subclinical deficiencies are probably more common, even among apparently healthy individuals.</p>', '<p>One capsule daily or as advised by the physician.</p>', NULL, '<p>Hypersensitivity to any of the ingredients of this preparation.</p>', '<p>Hypersensitivity reactions have been reported with thiamine and folic acid, although these are rare.</p>', '<p>No data found.</p>', '<p>The use of this capsule in patients with deficiency or increased requirement of Vitamin B-complex and Vitamin C should be accompanied by specific therapy for the primary illness.<br />\r\n<br />\r\nTreatment with this capsule should be continued only until the deficiency is corrected or the need for supplementation exists. Pyridoxine in this capsule may reduce the therapeutic effects of levodopa in Parkinson&rsquo;s disease.<br />\r\n<br />\r\nRiboflavin in this capsule may color the urine yellow. During treatment with this capsule the urine may give a false positive result for sugar by Benedict&#39;s test because of the presence of ascorbic acid. Therefore, a test not affected by ascorbic acid should be used.</p>', NULL, '<p>Specific combined vitamin preparations.</p>', '<p>Store in a cool and dry place, away from light and children.</p>', NULL, '2022-03-18 20:42:09', '2022-03-18 20:42:09'),
(1334, 1334, '<p>This is indicated for the treatment and prevention of zinc and vitamin B deficiencies.</p>', '<p>Zinc is vital for many biological functions such as immunity enhancement, wound healing, digestion, reproduction, physical growth and mental development. Zinc supports normal growth and development during pregnancy, childhood, and adolescence. Zinc also has some antioxidant properties. Zinc is used to treat ADHD (Attention Deficit Hyper-activity Disorder) in children. In adult, due to zinc deficiency loss of appetite, poor sense of taste and smell, tendency towards depression, white marks on fingernails, frequent infections, low fertility, prostate problems, mental problems, poor wound healing, a poor immune system, diarrhoea, mental lethargy, rough skin and weight loss may occur.<br />\r\n<br />\r\nB-Vitamins are needed to release energy from food. They play an important role in ensuring healthy brain and nerve function, healthy red blood cells formation in children &amp; adults. They are specially needed for healthy growth and development of children. B-Vitamin deficiencies in adult cause profound fatigue and various types of neurologic manifestations, which may include weakness, poor balance, confusion, irritability, memory loss, nervousness, tingling of the limbs and loss of coordination. Additional symptoms of vitamin B deficiency are sleep disturbances, nausea, poor appetite, frequent infections, and skin lesions.</p>', '<p>Syrup-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 10 ml (2 teaspoonful) 2 to 3 times daily or as recommended by the physician.</li>\r\n	<li><strong>Children</strong>: 10 ml (2 teaspoonful) 1 to 3 times daily or as recommended by the physician.</li>\r\n	<li><strong>Infants</strong>: 5 ml (1 teaspoonful) 1 to 2 times daily or as recommended by the physician.</li>\r\n</ul>\r\n\r\n<p>Tablet-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults &amp; Children over 30 kg</strong>: 1 to 2 tablets 2 to 3 times daily or as recommended by the physician.</li>\r\n</ul>', '<p>Concomitant intake of tetracyclines and zinc may decrease the Gl absorption and serum levels of tetracyclines. Similarly concomitant administration of zinc and fluroquinolones may decrease the Gl absorption and serum&nbsp; levels of some fluroquinolones. Coadministration of Niacin and HMG-CoA reductase inhibitors (eg. lovastatin) may result mayopathy and rhabdomyolysis. Pyridoxine reduces levodopa&#39;s effectiveness by increasing its peripheral metabolism. Co-administration of pyridoxine with phenytoin may decrease serum levels of phenytoin.</p>', '<p>Vitamin B Complex &amp; Zinc is contraindicated in patients with a known hypersensitivity to any of the ingredients of this product.</p>', '<p>This is generally well tolerated. However, a few side effects like nausea, vomiting, diarrhoea &amp; stomach upset may occur. Side effects have been reported with specific vitamins but generally at levels substantially higher than recommended doses.</p>', '<p>This is recommended in pregnancy and lactation.</p>', '<p>In acute renal failure, zinc accumulation may occur, so dosage adjustment is needed. This is not intended for the treatment of severe specific deficiencies.</p>', '<p>In case of overdosage, initially epigastric pain, diarrhoea and vomiting can occur. In that case, one should seek emergency medical attention. Initially, an emetic should be given and then gastric lavage and general supportive measures should be employed.</p>', '<p>Specific mineral &amp; vitamin combined preparations.</p>', '<p>Store in a cool &amp; dry place, protected from light. Keep all medicines out of reach of children.</p>', NULL, '2022-03-18 20:44:27', '2022-03-18 20:44:27'),
(1335, 1335, '<p>It is indicated for supportive nutritional supplementation in conditions in which these vitamins are required. These include conditions causing depletion, or reduced absorption or bioavailability of vitamins such as gastrointestinal disorders, chronic alcoholism, febrile illness, prolonged or wasting diseases, hyperthyroidism or poorly controlled diabetes and conditions resulting in increased need for vitamins like pregnancy, severe burns, recovery from surgery. It is also used in beri-beri, peripheral neuritis, Wernicke&rsquo;s encephalopathy, impaired digestion of starch and sugar due to thiamine deficiency, cheilosis, angular stomatitis, glossitis, keratitis, seborrhoeic dermatitis, photophobia and corneal vascularization.</p>', '<p><strong>Thiamine&nbsp;</strong>(Vitamin B1) forms thiamine pyrophosphate by combining with adenosine triphosphate; essential coenzyme in carbohydrate metabolism.<br />\r\n<br />\r\n<strong>Riboflavin&nbsp;</strong>(vitamin B2) is required for energy utilisation from food. It is essential for normal tissue respiration. It is also necessary for the activation of pyridoxine and conversion of tryptophan to nicotinic acid.<br />\r\n<br />\r\n<strong>Pyridoxine</strong>&nbsp;(vitamin B6) is a water-soluble vitamin which functions in the metabolism of carbohydrates, proteins and fats. It is essential in Hb formation and GABA synthesis within the CNS. It also aids in the release of glycogen stored in the liver and muscles.</p>', '<p>Adults: 2 ml every day or alternate days intravenously or intramuscularly.</p>', '<p>Pyridoxine may increase the peripheral metabolism of levodopa, reducing therapeutic efficacy in patients with Parkinson&rsquo;s disease.</p>', '<p>Hypersensitivity to any of its components.</p>', '<p>Adverse reactions have been reported with specific vitamins, and generally at levels substantially higher than those in Vitamin B1, B2 &amp; B6. However, allergic and idiosyncratic reactions are possible at lower levels.</p>', '<p>The recommended dose should not be exceeded without medical advice.</p>', '<p>It should be given cautiously to patients taking levodopa as pyridoxine reduces the effect of levodopa. Hypersensitivity may develop in patients previously given thiamine, specially after repeated injections of concentrated solution; give subsequent injections with care. Discontinue drug if untoward reactions develop. Intramuscular administration may cause transient pain; when used undiluted, administer slowly.</p>', NULL, '<p>Specific combined vitamin preparations, Vitamin-B preparations.</p>', '<p>Store below 25&deg;C in a dry place, away from light.</p>', NULL, '2022-03-18 20:46:05', '2022-03-18 20:46:05'),
(1336, 1336, '<p>Vitamin B1, B6 &amp; B12 is indicated for the treatment of vitamin B1, B6 &amp; B12 deficiency syndrome. It is also indicated for the supportive treatment of neuritis &amp; non-inflammatory diseases of the nerves, e.g.-</p>\r\n\r\n<ul>\r\n	<li>Diabetic neuropathy</li>\r\n	<li>Peripheral neuralgin</li>\r\n	<li>Lumbago</li>\r\n	<li>Myalgia</li>\r\n	<li>Optic neuritis</li>\r\n	<li>Sciatica</li>\r\n	<li>Facial neuralgia</li>\r\n	<li>Intercostal neuralgia</li>\r\n	<li>Spinal pain.</li>\r\n</ul>', '<p>Vitamin B1 converts carbohydrates, fatty acids and amino acids into energy, promotes healthy nerves, improves mood, strengthens the heart. Vitamin B6 forms RBCs, helps cells to make proteins, manufactures neurotransmitters e.g. serotonin and releases stored forms of energy, helps to prevent CVS diseases and stroke, helps to lift depression and eases insomnia. Vitamin B12 is essential for cell replication and important for RBC production, prevents anemia, helps to prevent depression, reduces nerve pain, numbness, tingling and lowers the risk of heart diseases.<br />\r\n<br />\r\nThe vitamin ingredients are absorbed well in per oral reception. It is widely distributed to most tissues and appears in breast milk. Within the cell, thiamine is mostly present as diphosphate. Thiamine is not stored to any appreciable extent in the body and amounts in excess of the body&rsquo;s requirements are excreted in the urine as unchanged thiamine or as metabolites. Pyridoxine, pyridoxal and pyridoxamine are readily absorbed from the GIT following oral administration and are converted to the active forms of pyridoxal phosphate an pyridoxamine phosphate. They are stored mainly in liver where there is oxidation to 4-pyridoxic acid and other inactive metabolites, which are excreted in urine. As the dose increases, proportionally greater amounts are excreted unchanged in the urine.</p>', '<p>Tablet: 1-3 Tablets per day or as advised by the physician.<br />\r\n<br />\r\nInjection:</p>\r\n\r\n<ul>\r\n	<li><strong>In severe (acute) cases</strong>: 1 injection daily until the acute symptoms subside or taken as advised by the physician.</li>\r\n	<li><strong>In mild cases</strong>: 1 injection 2-3 times per week. Ampoules are preferably injected intramuscularly.</li>\r\n</ul>\r\n\r\n<p>Use in children: There is no information on the use of this drug in children.</p>', '<p>No drug interaction has been reported yet.</p>', '<p>Vitamin B1, Vitamin B6 and Vitamin B12 is contraindicated in patients on levodopa therapy, and in patients with hypersensitivity to any of the ingredients of the preparation.</p>', '<p>Generally well tolerated but allergic reactions may be observed in few cases.</p>', '<p>Oral tablet form is recommended but due to the presence of benzyl alcohol, injection is not recommended during pregnancy &amp; lactation.</p>', '<p>Cyanocobalamin should not be given in patients with subacute degeneration of the spinal cord. Cyanocobalamin is not suitable form of vitamin B12 for the treatment of optic neuropathies associated with raised plasma concentrations of cyanocobalamin.</p>', '<p>No overdosage symptoms are to be expected in the recommended dosage. If there is known overdose then treatment is symptomatic &amp; supportive.</p>', '<p>Specific combined vitamin preparations.</p>', '<p>Keep out of reach of children. Store in a cool (below 25&deg;C temperature) and dry place, protected from light.</p>', NULL, '2022-03-18 20:48:47', '2022-03-18 20:48:47'),
(1337, 1337, '<p>This is indicated for the prevention and treatment of Iron, vitamin B12 and Folic acid deficiency. Also indicated for the prevention of Iron deficiency during pregnancy and lactation and as prophylactic therapy of Iron deficiency to cover the recommended daily dietary allowance.</p>', '<p><strong>Vitamin B12 (cyanocobalamin):</strong>&nbsp;Required for the maintenance of normal erthropoiesis, nucleprotein and myelin synthesis, cell reproduction and normal growth; Coenzyme; metabolic functions include protein synthesis and carbohydrate metabolism. Plays role in cell replication and hematopoiesis.<br />\r\n<br />\r\n<strong>Iron:</strong>&nbsp;Essential component in the formation of hemoglobin; adequate amounts of iron are necessary for effective erythropoiesis; also serves as a cofactor of several essential enzymes, including cytochromes that are involved in electron transport. Replacement of iron stores found in hemoglobin, myoglobin, and enzymes; works to transport oxygen via hemoglobin.<br />\r\n<br />\r\n<strong>Folic acid:</strong>&nbsp;Required for nucleoprotein synthesis and the maintenance of normal erythropoiesis; folic acid is converted in the liver and plasma to its metabolically active form, tetrahydrofolic acid, by dihydrofolate reductase; prevents neural tube defects in women of childbearing potential and higher doses required during pregnancy.</p>', '<p><strong>Adult:</strong>&nbsp;1-2 capsules daily; as recommended by the physician.<br />\r\n<strong>Children:</strong>&nbsp;1 capsule daily; as recommended by the physician.<br />\r\n<strong>Infant:</strong>&nbsp;As recommended by the physician.</p>', '<p>Generally no interactions have been observed. Iron may decrease the absorption of antacids, tetracycline, quinolone antibiotics, levodopa, levothyroxine, methyldopa and pencillamine. Folic acid interacts with antiepileptic drugs, no plasma concentrations of Phenobarbital, phenytoin possibly reduced.</p>', '<p>Contraindicated in patients with known hypersensivity to any of its ingredients.</p>', '<p>Generally well tolerated. In individual cases, a few side-effects occur to oral Iron preparation, such as nausea, vomiting, constipation or diarrhoea.</p>', '<p>This preparation can be used in pregnancy and lactation.</p>', '<p>Caution should be applied where there is a risk of Iron overload, e.g. Haemochromatosis, Thalassaemia, Haemosiderosis or Haemolytic anaemia.</p>', '<p>Initially epigastric pain, diarrhea and vomiting can occur of overdose. Metabolic acidosis, convulsions and coma can occur after recovery. In case of overdose an emetic should be given followed by gastric lavage and general supportive measures.</p>', '<p>Iron &amp; Vitamin Combined preparations</p>', '<p>Store in cool and dry place. Protect from light.</p>', NULL, '2022-03-18 20:50:41', '2022-03-18 20:50:41'),
(1338, 1338, '<p>This&nbsp;tablets are indicated for the distinct nutritional requirements of individuals under a physician&#39;s treatment for hyperhomocysteinemia; nutrient malabsorption or inadequate dietary intake; with particular emphasis for individuals with or at risk for atherosclerotic vascular disease in the coronary, peripheral, or cerebral vessels, or neurological disorders.</p>', '<p><strong>Pyrodoxine (Vitamin B6)</strong>&nbsp;is a water-soluble vitamin which functions in the metabolism of carbohydrates, proteins and fats. It is essential in Hb formation and GABA synthesis within the CNS. It also aids in the release of glycogen stored in the liver and muscles.<br />\r\n<br />\r\n<strong>Folic acid (Vitamin B9)</strong>&nbsp;is essential for the production of certain coenzymes in many metabolic systems such as purine and pyrimidine synthesis. It is also essential in the synthesis and maintenance of nucleoprotein in erythropoesis. It also promotes WBC and platelet production in folate-deficiency anaemia.<br />\r\n<br />\r\n<strong>Cyanocobalamin (Vitamin B12)</strong>&nbsp;is vital to growth, hematopoiesis and nucleoprotein and myelin synthesis. As a hematopoietic agent, it is converted to coenzyme B12 needed in the conversion of methylmalonate to succinate and production of methionine from homocysteine, a reaction requiring folate. In the absence of folate, such metabolites cannot be formed and folate deficiency occurs. It is also involved in the maintenance of reduced sulfhydryl (SH) groups which are required by various SH-activated enzyme systems. Through such processes, cyanocobalamin participates in fat and carbohydrate metabolism as well as protein synthesis.</p>', '<p>Usual adult dose is one to two tablets daily or as directed by a physician.</p>', '<p>Pyridoxine Hydrochloride should not be given to patients receiving the drug levodopa, because the action of levodopa is antagonized by Pyridoxine Hydrochloride. However; Pyridoxine Hydrochloride may be used concurrently in patients receiving a preparation containing both carbidopa and levodopa. Concurrent use of phenytoin and folic acid may result in decreased phenytoin effectiveness.</p>', '<p>Known hypersensitivity to any of the components in the product is a contraindication.</p>', '<p>Allergic sensitization has been reported following both oral and parenteral administration of folic acid. Paresthesia, somnolence, nausea and headache have been reported with pyridoxine hydrochlloride. Mild transient diarrhea, polycythemia vera, itching, transitory exanthema, and the feeling of swelling of the entire body has been associated with cyanocobalamin.<br />\r\n<br />\r\nElevate your arsenal by taking things to the next level with&nbsp;louboutin herrenschuhe, two new additions to the collection that mirror Streetwall&#39;s attention to detail with matching perforated ecussons. Men just like herrenschuhe very much.</p>', '<p>Pregnancy category- Not classified.</p>', '<p>Folic acid when administered as a single agent in doses above 0.1 mg daily may obscure pernicious anemia in that hematologic remission can occur while neurological manifestations remain progressive. Unmetabolized Folic Acid has the potential to reduce natural killer cells cytotoxicity, which may result in an impaired immune response.</p>', NULL, '<p>Specific combined vitamin preparations, Vitamin-B preparations.</p>', NULL, NULL, '2022-03-18 20:52:22', '2022-03-18 20:52:22'),
(1339, 1339, '<p>Vitamin C is indicated for prevention and treatment of scurvy. It may be indicated in pregnancy, lactation, infection, trauma, burns, cold exposure, following surgery, fever, stress, peptic ulcer, cancer, methaemoglobinaemia and in infants receiving unfortified formulas. It is also prescribed for haematuria, dental caries, pyorrhea, acne, infertility, atherosclerosis, fractures, leg ulcers, hay fever, vascular thrombosis prevention, levodopa toxicity, succinyl-choline toxicity, arsenic toxicity etc. To reduce the risk of stroke in the elderly, long-term supplementation with Vitamin C is essential.</p>', '<p>vitamin C, the water-soluble vitamin, is readily absorbed from the gastrointestinal tract and is widely distributed in the body tissues. It is believed to be involved in biological oxidations and reductions used in cellular respiration. It is essential for the synthesis of collagen and intracellular material. Vitamin C deficiency develops when the dietary intake is inadequate and when increased demand is not fulfilled. Deficiency leads to the development of well defined syndrome known as scurvy, which is characterized by capillary fragility, bleeding (especially from small blood vessels and the gums), anaemia, cartilage and bone lesions and slow healing of wounds.</p>', '<p>Oral administration-</p>\r\n\r\n<ul>\r\n	<li>For the prevention of scurvy: 1 tablet daily</li>\r\n	<li>For the treatment of scurvy: 1-2 tablets daily; but dose may be increased depending on the severity of the condition.</li>\r\n	<li>For the reduction of risk of stroke in the elderly: 1-2 tablets daily.</li>\r\n	<li>In other cases: 1 tablet daily or as directed by the physician.</li>\r\n	<li>Maximum safe dose is 2000 mg daily in divided doses.</li>\r\n</ul>\r\n\r\n<p>Parenteral administration-</p>\r\n\r\n<ul>\r\n	<li>Vitamin C is usually administered orally. When oral administration is not feasible or when malabsorption is suspected, the drug may be administered IM, IV, or subcutaneously. When given parenterally, utilization of the vitamin reportedly is best after IM administration and that is the preferred parenteral route.</li>\r\n	<li>For&nbsp;intravenous&nbsp;injection, dilution into a large volume parenteral such as Normal&nbsp;Saline, Water for Injection, or&nbsp;Glucose&nbsp;is recommended to minimize the adverse reactions associated with intravenous injection.</li>\r\n	<li>The average protective dose of vitamin C for adults is 70 to 150 mg daily. In the presence of scurvy, doses of 300 mg to 1 g daily are recommended. However, as much as 6 g has been administered parenterally to normal adults without evidence of&nbsp;toxicity.</li>\r\n	<li>To enhance wound healing, doses of 300 to 500 mg daily for a week or ten days both preoperatively and postoperatively are generally considered adequate, although considerably larger amounts have been recommended. In the treatment of burns, doses are governed by the extent of tissue&nbsp;injury. For severe burns, daily doses of 1 to 2 g are recommended. In other conditions in which the need for vitamin C is increased, three to five times the daily optimum allowances appear to be adequate.</li>\r\n	<li>Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever the solution and container permit.</li>\r\n</ul>', '<p><strong>Potentially hazardous interactions</strong>: Ascorbic acid is incompatible in solution with aminophylline, bleomycin, erythromycin, lactobionate, nafcillin, nitrofurantoin sodium, conjugated oestrogen, sodium bicarbonate, sulphafurazole diethanolamine, chloramphenicol sodium succinate, chlorthiazide sodium and hydrocortisone sodium succinate.<br />\r\n<br />\r\n<strong>Useful interactions</strong>: Ascorbic acid increases the apparent half-life of paracetamol and enhances iron absorption from the gastrointestinal tract.</p>', NULL, '<p>Vitamin C has little toxicity and only mega-doses of vitamin C may cause diarrhoea, abdominal bloating, iron over-absorption that is harmful in patients with thalassaemia, sideroblastic anemia, and haemochromatosis; hyperoxaluria, hyperuricosuria, and hemolysis in patients with glucose-6 phosphate dehydrogenase deficiency. A pregnant woman taking more than 5 gm/day may suffer fetal abortion.</p>', '<p>The drug is safe in normal doses in pregnant women, but a daily intake of 5 gm or more is reported to have caused abortion. The drug may be taken safely during lactation.</p>', '<p>Ingestion of megadose (more than 1000 mg daily) of vitamin C during pregnancy has resulted in scurvy in neonates. Vitamin C in mega-doses has been contraindicated for patients with hyperoxaluria. Vitamin C itself is a&nbsp;reactive substance in the redox system and can give rise to false positive reactions in certain analytical tests for glucose, uric acid, creatine and occult blood.</p>', NULL, '<p>Vitamin-C Preparations.</p>', '<p>Should be stored in a dry place below 30˚C.</p>', NULL, '2022-03-18 20:53:52', '2022-03-18 20:53:52'),
(1340, 1340, '<p>Calcium and Vitamin-D is used for the treatment of osteoporosis, osteomalacia, rickets, tetany, and parathyroid disease. Also used in raised calcium requirement for children and adolescents at times of rapid growth, inadequate intake of calcium in the diet due to malnutrition, prevention and treatment of osteoporosis, disorders of osteogenesis and tooth formation (in addition to specific treatment), latent tetany and during pregnancy and lactation. It is also used as routine supplement and phosphate binder in chronic renal failure.</p>', '<p>Ascorbic acid (vitamin C) &amp; Folic acid (also known as Vitamin B9) are water-soluble vitamins. Vitamin D is fat-soluble. Ascorbic acid helps integration &amp; cohesiveness of cells by synthesizing collagen which is also known as biological glue. It is also a powerful antioxidant in the aqueous media. Vitamin D is also known as antirachitic and sun-shine vitamin which displays its roles like a hormone (pro-hormone). Vitamin D spares calcium in the body by reducing excretion and enhancing calcium absorption. Folic acid is crucial for proper brain function and plays an important role in mental and emotional health. It aids in the production of DNA and RNA, the body&#39;s genetic material, and is especially important during periods of high growth, such as infancy, adolescence and pregnancy. It controls blood levels of the amino acid Homocysteine. Elevated levels of this substance appear to be linked to certain chronic conditions such as heart disease. Indications: Deficiency states of Vitamin C, Vitamin D and Folic acid associated with cardiovascular diseases, Deficiency states of Vitamin-C (Scurvy, generalized weakness, gum bleeding, after acute infections, alcoholism and postoperatively), Wound healing, Prevention of cold, flue and influenza, Megaloblastic anemia and anemia of nutritional origin, Deficiency states of Vitamin-D (Intestinal malabsorption, chronic liver disease, osteomalacia, osteopenia, rickets, hypocalcemia, institutionalized patients, persons who use sunscreen, black people, person who covers most of the body surface due to cultural and religious purpose). Familial hypophosphatemia, Hypoparathyroidism, As adjuvant with calcium supplement, Prevention of osteoporosis and fracture alone or in combination with calcium supplement, Conditions where demand for Vitamin-C, Vitamin-D and Folic acid increases (pregnancy, lactation, smoking and old age, person living in polluted environment).</p>', '<p>One tablet twice daily with food or as directed by the physician.</p>', '<p>Concurrent administration of Thiazide diuretics may increase the risk of hypercalcemia. Calcium salts reduce the absorption of a number of other drugs such as Biphosphonates, Fluoride, some Fluoroquinolones and Tetracyclines.</p>', '<ul>\r\n	<li>Hypercalcemia and hyperparathyroidism</li>\r\n	<li>Hypercalciuria and nephrolithiasis</li>\r\n	<li>Hypersensitivity to the component of this preparation</li>\r\n	<li>Severe renal insufficiency</li>\r\n	<li>Concomitant digoxin therapy(requires careful monitoring of serum calcium level)</li>\r\n</ul>', '<p>Vitamin C, Vitamin D3 &amp; Folic acid combination&nbsp;is well tolerated. Mild gastrointestinal disturbances may occur.</p>', '<p><strong>Pregnancy:</strong>&nbsp;There is no contraindication to the use of this preparation in pregnancy.<br />\r\n<br />\r\n<strong>Lactation:</strong>&nbsp;There is no contraindication to the use of this preparation in Lactation. Contraindications: This combination is contraindicated in hypercalcemia, hyperparathyroidism, renal calculi, nephrolithiasis, Zoolinger-Ellison syndrome, concomitant Digoxin therapy (requires careful monitoring of serum calcium level).</p>', '<p>Caution should be taken in patients with Renal impairment, Sarcoidosis, Hypercalcemia and Hypercalciuria, Cardiac disease.</p>', '<p>Over dosage: If over dosage occurs, therapy should be immediately stopped.</p>', '<p>Specific combined vitamin preparations.</p>', NULL, NULL, '2022-03-18 20:55:29', '2022-03-18 20:55:29'),
(1341, 1341, '<p>Keratosis, Rough skin,Wrinkles associated with aging, Alzheimer&#39;s disease, Cancer Prevention, dementia, degenerative diseases, coronary heart diseases, end stage renal disease, growth and repair of body tissue, bone, skin, teeth and hair.</p>', '<p><strong>Vitamin C</strong>: Necessary for collagen formation and tissue repair; plays a role in oxidation/reduction reactions as well as other metabolic pathways including synthesis of catecholamines, carnitine, and steroids; also plays a role in conversion of folic acid to folinic acid.<br />\r\n<br />\r\n<strong>Vitamin E</strong>&nbsp;plays a role in protecting red blood cells against hemolysis; has protective effects against free radicals on polyunsaturated fatty acids found in cell membranes; plays a role in preventing oxidation of vitamin A and C.</p>', '<p>One tablet or capsule daily or as directed by a physician.</p>', '<p><strong>Vitamin C</strong>: Deferroxamine, hormonal contraceptives, flufenazine, warfarin, elemental iron, salicylates, warfarin, fluphenazine, disulfiram, mexiletine, vitamin B12.<br />\r\n<br />\r\n<strong>Vitamin E</strong>: Colestyramine, colestipol, and orlistat may interfere with vitamin E absorption. High doses of vitamin E potentiates the anticoagulant action of warfarin. Large doses of vitamin E may impair response to iron supplementation.</p>', '<p>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>Pregnancy Category A. Adequate and well-controlled human studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).</p>', '<p>Hypervitaminosis. Avoid use in early pregnancy. Patients on anti coagulant therapy should not use ascorbic acid prolonged period of time.</p>', NULL, '<p>Anti-oxidant Multivitamin preparations, Specific combined vitamin preparations</p>', NULL, NULL, '2022-03-18 20:57:10', '2022-03-18 20:57:10'),
(1342, 1342, '<p>This preparation is indicated for Age-related Eye Disease. This is an advanced new antioxidant supplement formulated to provide nutritional support for the eye. The formulation contains essential antioxidant vitamins, minerals, and Lutein.</p>', '<p>Vitamin C is highly concentrated in the lens compared to blood. A long term Vitamin C supplement use (10+ years) has been associated with reduced risk of cataract. Vitamin C has&nbsp;an important role in harmful free radicals scavenging activity.<br />\r\n<br />\r\nIn study, it is found that high serum Vitamin E concentrations have been associated with reduced risk of cataract (exact mechanism of action is not still established). As an antioxidant vitamin, it also plays an important role in harmful free radicals scavenging activity.<br />\r\n<br />\r\nLutein is a carotenoid, specially concentrated in&nbsp;the macula. Clinical and animaldata indicates that this caretenoid could protect the macula from oxidative or light damage.<br />\r\n<br />\r\nAlthough exact mechanism of action is not clear but onelarge&nbsp;study has found that high levels of dietary Lutein is associated with relatively lower risk of AMD (Age-Related Macular Degeneration). Zinc is an essential trace element involved in many enzymes system.<br />\r\n<br />\r\nSymptoms of less severe deficiency include distorted or absent perception of taste, smell and poor wound healing. Severe deficiency causes skin lesion, alopecia, diarrhea, increased susceptibility to infection and failure to thrive in children.<br />\r\n<br />\r\nCopper plays important role in growth, skeletal integrity, and development of nervous system. As a part of various enzymes, it takes part in numerous metabolic conversions.</p>', '<p>One capsule, one or two times daily or as directed by the physician</p>', '<p>No drug interaction has been reported.</p>', '<p>It is contraindicated in persons with a history of hypersensitivity to any of its ingredients.</p>', '<p>Large doses of Vitamin C are reported to cause diarrhoea and other gastrointestinal disturbances. Large doses of Vitamin E may cause diarrhoea, abdominal pain, and other gastrointestinal disturbances; fatigue and weakness have also been reported. Side effects of Zinc salt are abdominal pain and dyspepsia.</p>', '<p>Recommended in Pregnancy &amp; Lactation.</p>', '<p>Vitamin C should be given with care to patients with hyperoxaluria. In patients taking oral anticoagulants or oestrogen, Vitamin E should be given carefully because it has been found to antagonise the effects of vitamin K leading to an increase in blood clotting time in these patient.</p>', NULL, '<p>Anti-oxidant Multivitamin Multimineral preparations, Antioxidant vitamins &amp; minerals for eye.</p>', '<p>Store in a dry place below 25&deg; C. Protect from light.</p>', NULL, '2022-03-18 20:58:42', '2022-03-18 20:58:42'),
(1343, 1343, '<p>Helps to protect cells against oxidative stress.</p>', NULL, '<p>1 tablet per day during 3 to 6 months.</p>', NULL, '<p>Hypersensitivity to the active substance or to any of the excipients.</p>', NULL, NULL, NULL, NULL, '<p>Supplements &amp; adjuvant therapy</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-18 21:02:11', '2022-03-18 21:02:11'),
(1344, 1344, '<p>Voglibose is used in diabetes mellitus (DM) for reduction in Post-Prandial Hyperglycaemia (PPHG), only when diet and/or exercise with lifestyle modification or Oral Hypoglycaemic Agents (OHAs) or insulin preparations, in addition to diet and/or exercise, do not result in an adequate glycaemic control.<br />\r\n<br />\r\nThus, Voglibose is indicated:</p>\r\n\r\n<ul>\r\n	<li>In non-insulin-dependent diabetes mellitus (NIDDM) patients as immunotherapy</li>\r\n	<li>In combination with other OHAs</li>\r\n	<li>In addition to insulin in diabetes mellitus patients</li>\r\n	<li>In prevention of onset of type 2 diabetes mellitus in impaired glucose tolerance (only for Voglibose 0.2 mg Tablets) (However, Voglibose&nbsp;Tablets should be used only when impaired glucose tolerance has not been improved in patients already undergoing appropriate dietary treatment and/or exercise therapy.)</li>\r\n	<li>In elderly patients and in those with hepatic dysfunction or mild to moderate renal impairments in whom other OHAs are contraindicated or they need to be used with caution, Voglibose will be helpful.</li>\r\n	<li>In glycogen storage disease: Voglibose is helpful in prevention of hypoglycaemia in patients with type lb glycogen storage disease, it being an amylase (a glucosidase) inhibitor.</li>\r\n	<li>In non-diabetic Hyperinsulinemia, Voglibose is helpful in preventing hypoglycaemic attacks.</li>\r\n	<li>In steroid induced diabetes mellitus also, Voglibose is helpful. However, clinical data in this setting are limited.</li>\r\n</ul>', '<p>Alpha-glucosidase inhibitors are saccharides that act as competitive inhibitors of enzymes needed to digest carbohydrates: specifically alpha-glucosidase enzymes in the brush border of the small intestines. The membrane-bound intestinal alpha-glucosidases hydrolyze oligosaccharides, trisaccharides, and disaccharides to glucose and other monosaccharides in the small intestine. Acarbose also blocks pancreatic alpha-amylase in addition to inhibiting membrane-bound alpha-glucosidases. Pancreatic alpha-amylase hydrolyzes complex starches to oligosaccharides in the lumen of the small intestine. Inhibition of these enzyme systems reduces the rate of digestion of complex carbohydrates. Less glucose is absorbed because the carbohydrates are not broken down into glucose molecules. In diabetic patients, the short-term effect of these drugs therapies is to decrease current blood glucose levels: the long term effect is a small reduction in hemoglobin-A1c level.</p>', '<p><strong>Normal Adult Dose</strong>: Usually, Voglibose tablets are orally administered in a single dose of 0.2 mg, 3 times a day, before each meal. If the effect is not sufficient, the quantity of a single dose may be increased up to 0.3 mg.<br />\r\n<br />\r\n<strong>Pediatrics</strong>: The safety and effectiveness of Voglibose in children has not been established.<br />\r\n<br />\r\n<strong>Geriatrics</strong>: Since elderly patients generally have a physiological hypofunction, it is desirable that such caution be taken as starting the administration at a lower dose (eg, 0.1 mg at a time). Furthermore, this drug should be carefully administered under close observation, through the course of the disease condition, with careful attention to the blood sugar level and the onset of gastrointestinal symptoms.</p>', '<p>Voglibose should be administered with care when co-administered with the following drugs:<br />\r\n<br />\r\nAntidiabetic drugs: Derivative(s) of sulfonylamide and sulfonylurea, biguanide derivatives, insulin preparations and improving agents for insulin resistance.<br />\r\n<br />\r\nFor the concomitant use of antldlabetlc drugs and the drugs which enhance or diminish the hypoglycaemic action of antldlabetlc drugs:</p>\r\n\r\n<ul>\r\n	<li>Drugs enhancing the hypoglycaemic action of antidiabetic drugs: &beta;-blockers, salicylic acid preparations, monoamine oxidase inhibitors, fibrate derivatives for the treatment of hyperlipemia, warfarin, etc.</li>\r\n	<li>Drugs diminishing the hypoglycemic actton of antidiabetic drugs: Adrenaline, adrenocortical hormone, thyroid hormone, etc.</li>\r\n</ul>', '<p>Contraindicated in patients with Hypersensitivity to Voglibose or to any of the excipients; Diabetic ketoacidosis, diabetic pre-coma; Severe infection, before and after operation or with serious trauma; Gastrointestinal obstruction or predisposed to it.</p>', '<p>Diarrhoea, loose stools, abdominal pain, constipation, loss of appetite, urge to vomit (nausea), vomiting, heartburn, increased gas, and intestinal obstruction like symptoms due to increased intestinal gas. OHAs plus voglibose may cause hypoglycaemia (0.1% to &lt;5%), delay in digestion and absorption of disaccharides, fulminant hepatitis, serious liver dysfunction with increased liver enzymes, jaundice, anaemia, numbness, edema, blurred vision, hot flushes, malaise, weakness, hyperkalemia, increased pancreatic enzyme (serum amylase).</p>', '<p><strong>Pregnancy</strong>: The safety of Voglibose in pregnancy has not been established. However, no adequate and well controlled studies have been done on pregnant women.<br />\r\n<br />\r\n<strong>Lactatlng and Nursing Mothers</strong>: Although the levels of Voglibose reached in human milk are exceedingly low, it is recommended that Voglibose may not be administered to such women.</p>', '<p>Careful Administration (should be administered with care in following patients):</p>\r\n\r\n<ul>\r\n	<li>Patients who are receiving other antidiabetic drugs as hypoglycaemia may occur</li>\r\n	<li>Patients with a history of laparotomy or ileus (intestinal obstruction-like symptoms are liable to develop due to an increase in intestinal gas, etc.)</li>\r\n	<li>Patients with chronic intestinal disease accompanied by a disturbance in digestion and absorption (the action of this drug may aggravate the pathologic conditions)</li>\r\n	<li>Patients with Roemheld&rsquo;s Syndrome, severe hernia, Stenosis or ulceration of the large intestine, etc. (Symptoms may worsen due to an increase in the intestinal gas, etc.)</li>\r\n	<li>Patients with serious hepatic dysfunction (Because of possible changes in metabolic condition, the status of plasma glucose control may greatly vary. In patients with severe liver cirrhosis, hyperammonemia may worsen, followed by disturbance of consciousness.)</li>\r\n	<li>Patients with serious renal dysfunction (Because of possible changes in metabolic conditions, the status of plasma glucose control may greatly vary.)</li>\r\n	<li>Elderly patients</li>\r\n</ul>', '<p>Unlike sulfonylureas or insulin, an overdose of Voglibose tablets will not result in hypoglycaemia. An overdose may result is transient increase in flatulence, diarrhoea and abdominal discomfort. Because of lack of extra-intestinal effects soon with Voglibose, no serious systemic reactions are expected in the event of an overdose.</p>', '<p>Alpha-Glucosidase inhibitor.</p>', '<p>Keep in a cool and dry place. Keep out of the reach of children. Protect from light.</p>', '<p>Dosage in Renal Failure: Voglibose is poorly absorbed after oral doses and renal excretion is negligible, suggesting that no dose adjustment is required. However, pharmacokinetic studies in patients with renal insufficiency are not available.</p>', '2022-03-18 21:04:17', '2022-03-18 21:04:17'),
(1345, 1345, '<p>Voriconazole is an azole antifungal medicine. It is indicated for use in patients 12 years of age and older in the treatment of following fungal infections-</p>\r\n\r\n<ul>\r\n	<li>Invasive aspergillosis</li>\r\n	<li>Candidemia (nonneutropenic) and disseminated candidiasis in skin, abdomen, kidney, bladder wall and wounds</li>\r\n	<li>Esophageal candidiasis</li>\r\n	<li>Serious infections caused by Scedosporium apiospermum and Fusarium Species including Fusarium solani</li>\r\n	<li>Patients intolerant of, or refractory to other therapy.</li>\r\n</ul>', '<p>Voriconazole is a triazole antifungal medication used to treat serious fungal infections. Voriconazole binds and inhibits ergosterol synthesis by inhibiting CYP450-dependent 14-alpha sterol demethylase. The inhibition of 14-alpha sterol demethylase results in a depletion of ergosterol in fungal cell membrane.</p>', '<p>Oral-<br />\r\nVoriconazole tablet and powder for suspension are to be taken at least one hour before or one hour following a meal</p>\r\n\r\n<ul>\r\n	<li><strong>At or over 40 kg body weight</strong>: Loading dose regimen is 400 mg or 10 ml every 12 hours (for the first 24 hours) and maintenance dose (after first 24 hours) is 200 mg or 5 ml twice daily.</li>\r\n	<li><strong>Below 40 Kg body weight</strong>: Loading dose regimen is 200 mg or 5 ml every 12 hours (for the first 24 hours) and maintenance dose (after first 24 hours) is 100 mg or 2.5 ml twice daily. Or, as directed by the registered physician.</li>\r\n</ul>\r\n\r\n<p><br />\r\nInjection-<br />\r\nInvasive Aspergillosisd :</p>\r\n\r\n<ul>\r\n	<li><strong>Loading dose</strong>: 6 mg/kg 12 hourly for the first 24 hours.</li>\r\n	<li><strong>Maintenance Dose</strong>: 4 mg/kg 12 hourly.</li>\r\n</ul>\r\n\r\n<p>Candidemia in nonneutropenic patients and other deep tissue Candida infections:</p>\r\n\r\n<ul>\r\n	<li><strong>Loading dose</strong>: 6 mg/kg 12 hourly for the first 24 hours.</li>\r\n	<li><strong>Maintenance Dose</strong>: 3-4 mg/kg 12 hourly.</li>\r\n</ul>\r\n\r\n<p>Scedosporiosis and Fusariosis:</p>\r\n\r\n<ul>\r\n	<li><strong>Loading dose</strong>: 6 mg/kg 12 hourly for the first 24 hours.</li>\r\n	<li><strong>Maintenance Dose</strong>: 4 mg/kg 12 hourly.</li>\r\n</ul>', '<ul>\r\n	<li>CYP3A4, CYP2C9 and CYP2C19 inhibitors and inducers: Adjust Voriconazole dosage and monitor for adverse reactions or lack of efficacy</li>\r\n	<li>Voriconazole may increase the concentrations and activity of drugs that are CYP3A4, CYP2C9 and CYP2C19 substrates. Reduce doses of these other drugs and monitor for adverse reactions</li>\r\n	<li>Increase maintenance oral and intravenous dosage of Voriconazole with co-administration of Phenytoin or Efavirenz</li>\r\n</ul>', '<p>Known hypersensitivity to Voriconazole or any other components of this drug-</p>\r\n\r\n<ul>\r\n	<li>Co-administration with terfenadine, astemizole, cisapride, pimozide or quinidine, sirolimus due to risk of serious adverse reactions</li>\r\n	<li>Co-administration with rifampin, carbamazepine, long-acting barbiturates, efavirenz, ritonavir, rifabutin, ergot alkaloids and St. John&#39;s Wort due to risk of loss of efficacy</li>\r\n</ul>', '<p>The most common side effects are abdominal pain, anemia, blurred vision, headache, chest pain, nausea and diarrhea.</p>', '<p>There are no adequate and well-controlled studies in pregnant woman. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.</p>', '<p>Long term exposure (treatment or prophylaxis) greater than 180 days requires careful assessment of the benefit-risk balance. Squamous cell carcinoma of the skin (SCC) has been reported in relation with long-term voriconazole treatment.</p>', '<p>There is no data found about overdose of Voriconazole.</p>', '<p>Other Antifungal preparations.</p>', '<p>Keep out of reach of children. Store in a dry place, below 25&deg;C temperature and protected from light. Store Voriconazole powder for suspension between 2&deg; to 8&deg;C temperature.</p>', '<p>The efficacy to the children under 12 years of age is not established.</p>', '2022-03-18 21:06:18', '2022-03-18 21:06:18');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1346, 1346, '<p>S-Amlodipine is calcium channel blocker and may be used alone or in combination with other antihypertensive agents for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions.</p>', '<p>Amlodipine is a dihydropyridine calcium antagonist (calcium ion antagonist or slow channel blocker) that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. Experimental data suggest that amlodipine binds to both dihydropyridine and nondihydropyridine binding sites. The contractile processes of cardiac muscle and vascular smooth muscle are dependent upon the movement of extracellular calcium ions into these cells through specific ion channels. Amlodipine inhibits calcium ion influx across cell membranes selectively, with a greater effect on vascular smooth muscle cells than on cardiac muscle cells. Negative inotropic effects can be detected in vitro but such effects have not been seen in intact animals at therapeutic doses. Serum calcium concentration is not affected by amlodipine. Within the physiologic pH range, amlodipine is an ionized compound (pKa=8.6), and its kinetic interaction with the calcium channel receptor is characterized by a gradual rate of association and dissociation with the receptor binding site, resulting in a gradual onset of effect. Amlodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure. Amlodipine is a 1:1 racemic mixture of levamlodipine and dextro amlodipine, it has been demonstrated that levamlodipine is the pharmacologically active, anti-hypertensive isomer.</p>', '<p><strong>Adults</strong>: The usual initial antihypertensive oral dose of S-Amlodipine is 2.5 mg once daily, and the maximum dose is 5 mg once daily. Small, fragile, or elderly patients, or patients with hepatic insufficiency may be started on 1.25 mg once daily and this dose may be used when adding S-Amlodipine to other antihypertensive therapy. Adjust dosage according to blood pressure goals. In general, wait 7 to 14 days between titration steps. Titrate more rapidly, however, if clinically warranted, provided the patient is assessed frequently.<br />\r\n<br />\r\n<strong>Children</strong>: The effective antihypertensive oral dose in pediatric patients ages 6-17 years is 1.25 mg to 2.5 mg once daily. Doses in excess of 2.5 mg daily have not been studied in pediatric patients.</p>', '<p>Impact of Other Drugs on Amlodipine-</p>\r\n\r\n<ul>\r\n	<li><strong>CYP3A Inhibitors</strong>: Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. Monitor for symptoms of hypotension and edema when amlodipine is co-administered with CYP3A inhibitors to determine the need for dose adjustment&nbsp;</li>\r\n	<li><strong>CYP3A Inducers</strong>: No information is available on the quantitative effects of CYP3A inducers on amlodipine. Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers.</li>\r\n	<li><strong>Sildenafil</strong>: Monitor for hypotension when sildenafil is coadministered with amlodipine.</li>\r\n</ul>\r\n\r\n<p>Impact of Amlodipine on Other Drugs-</p>\r\n\r\n<ul>\r\n	<li><strong>Simvastatin</strong>: Co-administration of simvastatin with amlodipine increases the systemic exposure of simvastatin. Limit the dose of simvastatin in patients on amlodipine to 20 mg daily.</li>\r\n	<li><strong>Immunosuppressants</strong>: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. Frequent monitoring of trough blood levels of cyclosporine and tacrolimus is recommended and adjust the dose when appropriate</li>\r\n</ul>', '<p>S-Amlodipine is contraindicated in patients with known sensitivity to amlodipine.</p>', '<p>Most common adverse reactions to amlodipine is edema which occurred in a dose related manner. Other adverse experiences not dose related but reported with an incidence &gt;1.0% are fatigue, nausea, abdominal pain and somnolence.</p>', '<p>The limited available data based on post-marketing reports with amlodipine use in pregnant women are not sufficient to inform a drug-associated risk for major birth defects and miscarriage. There are risks to the mother and fetus associated with poorly controlled hypertension in pregnancy.<br />\r\n<br />\r\nLimited available data from a published clinical lactation study reports that amlodipine is present in human milk at an estimated median relative infant dose of 4.2%. No adverse effects of amlodipine on the breastfed infant have been observed. There is no available information on the effects of amlodipine on milk production.</p>', '<p><strong>Hypotension</strong>: Symptomatic hypotension is possible, particularly in patients with severe aortic stenosis. Because of the gradual onset of action, acute hypotension is unlikely.<br />\r\n<br />\r\n<strong>Increased Angina or Myocardial Infarction</strong>: Worsening angina and acute myocardial infarction can develop after starting or increasing the dose of amlodipine, particularly in patients with severe obstructive coronary artery disease.<br />\r\n<br />\r\n<strong>Patients with Hepatic Failure</strong>: Because amlodipine is extensively metabolized by the liver and the plasma elimination half-life (t&frac12;) is 56 hours in patients with impaired hepatic function, titrate slowly when administering amlodipine to patients with severe hepatic impairment.</p>', '<p>Overdosage might be expected to cause excessive peripheral vasodilation with marked hypotension and possibly a reflex tachycardia. In humans, experience with intentional overdosage of amlodipine is limited. Single oral doses of amlodipine equivalent to 40 mg amlodipine/kg and 100 mg amlodipine/kg in mice and rats, respectively, caused deaths. Single oral amlodipine doses equivalent to 4 or more mg amlodipine/kg or higher in dogs (11 or more times the maximum recommended human dose on a mg/m&sup2; basis) caused a marked peripheral vasodilation and hypotension.<br />\r\n<br />\r\nIf massive overdose should occur, initiate active cardiac and respiratory monitoring. Frequent blood pressure measurements are essential. Should hypotension occur, provide cardiovascular support including elevation of the extremities and the judicious administration of fluids. If hypotension remains unresponsive to these conservative measures, consider administration of vasopressors (such as phenylephrine) with attention to circulating volume and urine output. As amlodipine is highly protein bound, hemodialysis is not likely to be of benefit.</p>', '<p>Calcium-channel blockers.</p>', '<p>Store bottles at 20&deg;C to 25&deg;C.</p>', NULL, '2022-03-18 23:26:40', '2022-03-18 23:26:40'),
(1347, 1347, '<p>Saccharin Sodium is used as a sweetening agent. It is an artificial sweetener with effectively no food energy. It is about 300-400 times as sweet as sucrose but has a bitter or metallic aftertaste, especially at high concentrations. Saccharin is used to sweeten products such as drinks, candies, cookies, and medicines.</p>', NULL, '<p>As per advised by a the physician. 1 tab is equivalent in sweetners to 1 tespoon full of sugar.</p>', '<p>There are no known drug interactions and none well documented.</p>', NULL, '<p>Saccharin belongs to a class of compounds known as sulfonamides, which can cause allergic reactions in some individuals. Reactions can include: Headaches Breathing difficulties Diarrhoea and Skin problems</p>', '<p>Saccharin Sodium is safe in pregnancy &amp; lactation.</p>', '<p>Possibility of allergic reactions..</p>', 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, '2022-03-18 23:28:02', '2022-03-18 23:28:02'),
(1348, 1348, '<p>This is indicated:</p>\r\n\r\n<ul>\r\n	<li>To reduce the risk of cardiovascular death and hospitalization for heart failure in patients with chronic heart failure (NYHA Class ll-IV) and reduced ejection fraction.</li>\r\n	<li>For the treatment of symptomatic heart failure with systemic left ventricular systolic dysfunction in pediatric patients aged one year and older.</li>\r\n	<li>This is usually administered in conjunction with other heart failure therapies, in place of an angiotensin-converting enzyme inhibitor (ACEi) or other ARB.</li>\r\n</ul>', '<p>This tablet contains a neprilysin inhibitor, sacubitril, and an angiotensin receptor blocker, valsartan. This tablet inhibits neprilysin (neutral endopeptidase; NEP) via LBQ657, the active metabolite of the prodrug sacubitril, and blocks the angiotensin II type-1 (AT1 ) receptor via valsartan. The cardiovascular and renal effects of this tablet in heart failure patients are attributed to the increased levels of peptides that are degraded by neprilysin, such as natriuretic peptides, by LBQ657, and the simultaneous inhibition of the effects of angiotensin II by valsartan. Valsartan inhibits the effects of angiotensin II by selectively blocking the AT1 receptor, and also inhibits angiotensin II-dependent aldosterone release.</p>', '<p><strong>Adult Heart Failure</strong>: The recommended starting dose is 49/51 mg orally twice daily. Double the dose after 2 to 4 weeks to the target maintenance dose of 97/103 mg twice daily, as tolerated by the patient.<br />\r\n<br />\r\nReduce the starting dose to 24/26 mg twice daily for:</p>\r\n\r\n<ul>\r\n	<li>Patients not currently taking an angiotensin-converting enzyme inhibitor (ACEi) or an angiotensin II receptor blocker (ARB) or previously taking a low dose of these agents.</li>\r\n	<li>Patients with severe renal impairment.</li>\r\n	<li>Patients with moderate hepatic impairment.</li>\r\n</ul>\r\n\r\n<p><strong>Pediatric Heart Failure</strong>: Refer to Table 1 for the recommended dose for pediatric patients aged one year and older. Take the recommended dose orally twice daily. Adjust pediatric patient doses every 2 weeks, as tolerated by the patient.<br />\r\n<br />\r\n<strong>Recommended Dose Titration-</strong><br />\r\n<br />\r\nPediatric Patients Less than 40 kg:</p>\r\n\r\n<ul>\r\n	<li>Starting: 1.6 mg/kg</li>\r\n	<li>Second: 2.3 mg/kg</li>\r\n	<li>Final: 3.1 mg/kg</li>\r\n</ul>\r\n\r\n<p>Pediatric Patients At least 40 kg, less than 50 kg:</p>\r\n\r\n<ul>\r\n	<li>Starting: 24/26 mg</li>\r\n	<li>Second: 49/51 mg</li>\r\n	<li>Final: 49/51 mg</li>\r\n</ul>\r\n\r\n<p>Pediatric Patients At least 50 kg:</p>\r\n\r\n<ul>\r\n	<li>Starting: 49/51 mg</li>\r\n	<li>Second: 72/78 mg</li>\r\n	<li>Final: 97/103 mg</li>\r\n</ul>', '<p><strong>Dual Blockade of the Renin-Angiotensin-Aldosterone System</strong>: Should not be used with an ACEi, aliskiren in patients with diabetes, and use with an ARB should be avoided.<br />\r\n<strong>Potassium-sparing Diuretics</strong>: Serum potassium level may be increased.<br />\r\n<strong>NSAIDs</strong>: Risk of renal impairment may be increased.<br />\r\n<strong>Lithium</strong>: Increased risk of lithium toxicity.</p>', '<p>This combination is contraindicated:</p>\r\n\r\n<ul>\r\n	<li>In patients with hypersensitivity to any component</li>\r\n	<li>In patients with a history of&nbsp;angioedema&nbsp;related to previous ACE inhibitor or ARB therapy&nbsp;</li>\r\n	<li>With concomitant use of ACE inhibitors. Do not administer within 36 hours of switching from or to an ACE inhibitor&nbsp;</li>\r\n	<li>With concomitant use of aliskiren in patients with&nbsp;diabetes</li>\r\n</ul>', '<p>The most common side effects are Angioedema, Hypotension, Impaired Renal Function, Hyperkalemia, Cough, Dizziness.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness have not been established in pediatric patients less than 1 year of age.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No relevant pharmacokinetic differences have been observed in elderly (&gt;65 years) or very elderly (&gt;75 years) patients compared to the overall population.<br />\r\n&nbsp;<br />\r\n<strong>Hepatic Impairment</strong>: No dose adjustment is required when administering this tablet&nbsp;to patients with mild hepatic impairment (Child-Pugh A classification). This tablet&nbsp;is not recommended in patients with severe hepatic impairment, as no studies have been conducted in these patients.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No dose adjustment is required in patients with mild (eGFR 60 to 90 ml/min/1.73 m2) to moderate (eGFR 30 to 60 ml/min/1.73 m2) renal impairment. The recommended starting dose in patients with severe renal impairment (eGFR &lt;30 ml/min/1.73 m2) is 24/26 mg twice daily.</p>', '<p>This tablet may cause angioedema and must not be used in patients with a known history of angioedema related to previous ACEi or ARB therapy and in patients with hereditary angioedema.<br />\r\n<br />\r\nThis tablet lowers blood pressure and may cause symptomatic hypotension. Closely monitor serum creatinine, and down-titrate or interrupt this tablet in patients who develop a clinically significant decrease in renal function. In patients with renal artery stenosis, monitor renal function.<br />\r\n<br />\r\nMonitor serum potassium periodically and treat appropriately, especially in patients with risk factors for hyperkalemia such as severe renal impairment, diabetes, hypoaldosteronism, or a high potassium diet. Dosage reduction or interruption of this tablet may be required.</p>', '<p>Limited data are available with regard to overdosage in human subjects with this tablet. In healthy volunteers, a single dose of this tablet&nbsp;583 mg sacubitril/617 mg valsartan, and multiple doses of 437 mg sacubitril/463 mg valsartan (14 days) have been studied and were well tolerated. Hypotension is the most likely result of overdosage due to the blood-pressure-lowering&nbsp;effects of this tablet. Symptomatic treatment should be provided. This tablet&nbsp;is unlikely to be removed by hemodialysis because of high protein binding.</p>', NULL, '<p>Keep in a dry place and store below 30&deg;C. Protect from moisture and keep out of the reach of children.&nbsp;</p>', '<p><strong>Pediatric Use:&nbsp;</strong>Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use:</strong>&nbsp;No relevant pharmacokinetic differences have been observed in elderly (&ge;65 years) or very elderly (&ge;75 years) patients compared to the overall population<br />\r\n<br />\r\nRenal Impairment:</p>\r\n\r\n<ul>\r\n	<li><strong>Severe</strong>: A starting dose of 24/26 mg twice-daily is recommended for patients with severe renal impairment (eGFR &lt;30 mL/min/1.73 m&sup2;). Double the dose of Sacubitril &amp; Valsartan every 2 to 4 weeks to the target maintenance dose of 97/103 mg twice daily, as tolerated by the patient.</li>\r\n	<li><strong>Mild or moderate</strong>: No starting dose adjustment is needed for mild or moderate renal impairment.</li>\r\n</ul>\r\n\r\n<p>Hepatic Impairment:</p>\r\n\r\n<ul>\r\n	<li><strong>Moderate</strong>: A starting dose of 24/26 mg twice-daily is recommended for patients with moderate hepatic impairment (Child-Pugh B classification). Double the dose of Sacubitril &amp; Valsartan every 2 to 4 weeks to the target maintenance dose of 97/103 mg twice daily, as tolerated by the patient.</li>\r\n	<li><strong>Mild</strong>: No starting dose adjustment is needed for mild hepatic impairment.</li>\r\n	<li><strong>Severe</strong>: Use in patients with severe hepatic impairment is not recommended.</li>\r\n</ul>', '2022-03-18 23:30:23', '2022-03-18 23:30:23'),
(1349, 1349, '<p>Salbutamol is indicated as a bronchodilator for use in-</p>\r\n\r\n<ul>\r\n	<li>Asthma</li>\r\n	<li>Chronic Bronchitis</li>\r\n	<li>Emphysema and</li>\r\n	<li>Other conditions associated with airways obstruction.</li>\r\n</ul>', '<p>Salbutamol is a synthetic sympathomimetic agent with predominant beta-2 adrenergic activity. Salbutamol produces bronchodilatation through stimulation of beta-2-adrenergic receptors in bronchial smooth muscles, thereby causing relaxation of bronchial muscle fibers. This action is manifested by an improvement in pulmonary function as demonstrated by spirometric measurements.</p>', '<p><strong>Salbutamol tablet or syrup-</strong><br />\r\nChildren:</p>\r\n\r\n<ul>\r\n	<li>2-6 years: 2.5 ml syrup, 3-4 times daily</li>\r\n	<li>6-12 years: 5 ml syrup, 3-4 times daily</li>\r\n	<li>Over 12 years: 5-10 ml syrup, 3-4 times daily (2-4 mg tablet, 3-4 times daily)</li>\r\n</ul>\r\n\r\n<p>Adults: 2-4 mg tablet, 3-4 times daily. Maximum single dose is 8 mg tablet.<br />\r\n<br />\r\n<strong>Salbutamol Respirator Solution</strong>: To be used with a suitable nebulizer device under the direction of a physician. The solution must not be injected or ingested.<br />\r\n<br />\r\nMethod-1 (Intermittent Administration):</p>\r\n\r\n<ul>\r\n	<li>Adults (and the elderly): 0.5 ml-1.0 ml salbutamol up to four times a day. Up to 40mg per day can be given under strict medical direction in the hospital. 0.5-1 ml solution should be diluted to final volume of 2-4 ml with sterile normal saline solution. It will take time about 10 minutes.</li>\r\n	<li>Salbutamol respiratory solution may be used undiluted for intermittent administration. For this 2.0 ml of the solution is placed in the nebulizer and the patient allowed to inhale until bronchodilation is achieved. This usually takes 3-5 minutes.</li>\r\n	<li>Children under 12 years of age: 0.5 ml of the solution diluted to 2.0-4.0 ml with normal saline. Some children may however require higher doses of up to 1.0 ml of the solution. Intermittent treatment may be repeated four times a day.</li>\r\n</ul>\r\n\r\n<p>Method-2 (Continuous administration): 1-2 ml solution is diluted to make up to 100 ml with normal saline solution. The diluted solution is administered by a suitable nebulizer devise. When there is risk of anoxia through hypoventilation, oxygen should be added to the inspired air.<br />\r\n<br />\r\n<strong>Salbutamol nebulizer solution</strong>: To be used with a suitable nebulizer device under the direction of a physician. The solution must not be injected or ingested.</p>\r\n\r\n<ul>\r\n	<li>Adults &amp; Elderly: 2.5 mg to 5 mg Salbutamol up to 4 times a day. Up to 40 mg/day may be given under strict medical direction in the hospital.</li>\r\n	<li>Children under 12 years: 2.5 mg up to 4 times a day. A higher dose up to 5 mg four times a day may be used if required.</li>\r\n</ul>\r\n\r\n<p><strong>Salbutamol injection</strong>:<br />\r\nAdults:</p>\r\n\r\n<ul>\r\n	<li>Salbutamol I.V. infusion solution is used to prepare a solution for continuous intravenous infusion. It should not be injected undiluted. A suitable solution for infusion may be prepared by diluting 5 mL of Salbutamol I.V. infusion solution (1000 mcg/mL) in 500 mL of a chosen i.v. solution to provide a salbutamol concentration of 10 mcg/mL.</li>\r\n	<li>The only recommended diluents are Sodium Chloride Injection, or Sodium Chloride and Dextrose Injection.</li>\r\n	<li>Infusion rates providing 3 to 20 micrograms salbutamol/minute (0.3 to 2ml/minute of the above infusion solution) are usually adequate. Infusion rates can be started at 5 mcg of salbutamol/min., and can be increased to 10 mcg/min., and 20 mcg/min. at 15 - 30 minute intervals, if necessary.</li>\r\n	<li>As with all parenteral drug products, intravenous admixtures should be inspected visually for clarity, particulate matter, precipitate, discoloration and leakage prior to administration.</li>\r\n	<li>All unused admixtures of Salbutamol infusion solution with infusion fluids should be discarded 24 hours after preparation.</li>\r\n</ul>\r\n\r\n<p>Children and Adolescents (&lt;18 years of age): The dosage of Salbutamol infusion solution in the pediatric age group has not been established. At present, there are insufficient data to recommend a dosage regimen for children.<br />\r\n<br />\r\n<strong>Salbutamol Inhalation Capsule</strong>:</p>\r\n\r\n<ul>\r\n	<li>Adults: For the relief of bronchospasm and for managing intermittent episodes of asthma, one or two inhalation capsule&nbsp;may be administered as a single dose. The usual recommended dosage of Salbutamol inhalation capsule for inhalation for adults for maintenance or prophylactic therapy is the contents of one 200 microgram capsule every 4 to 6 hours using a&nbsp;device. In some patients, the contents of two 200 microgram capsules inhaled every 4 to 6 hours may be required. Large doses or more frequent administration is not recommended. The use of salbutamol powder for inhalation can be continued as medically indicated to control recurring/intermittent episodes of bronchospasm.</li>\r\n	<li>Children: One Salbutamol inhalation capsule is the recommended dose for relief of acute bronchospasm in the maintenance of episodic asthma or before exercise of children 4 years of age and older. One inhalation should be administered for three or four times a day for routine maintenance or prophylactic therapy. This dosage may be increased to inhalation of two inhalation capsule, if necessary. The bronchodilator effect of each administration of inhaled Salbutamol inhalation capsule lasts for at least four hours. Such patients should be warned not to increase the dose of inhaler, but should seek medical advice immediately.</li>\r\n</ul>\r\n\r\n<p>Excercise-induced Asthma:</p>\r\n\r\n<ul>\r\n	<li>Adults: 400 microgram</li>\r\n	<li>Child: 200 microgram, 15-30 minutes prior to any physical exertion.</li>\r\n</ul>', NULL, NULL, '<p>Salbutamol may cause fine tremor of skeletal muscles (particularly the hands), palpitations and muscle cramps. Tachycardia, tenseness, headaches and peripheral vasodilatation have been reported after large doses.</p>', '<p>The drug should be used during pregnancy only if the potential benefit justifies the potential risk of the fetus. It is not known whether this drug is excreted in human milk. Because of the potential of tumorigenecity shown for Salbutamol in some animal studies, 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>Salbutamol should be used with caution in patients with hyperthyroidism, cardiovascular disease, occlusive vascular disorders, hypertension and aneurysms. Hypokalaemia associated with high doses of Salbutamol may result in increased susceptibility to digitalis-induced cardiac arrhythmia. Tachyphylaxis with resistance may occur with prolonged use of high dosage. Care is necessary when treating patients with diabetes mellitus or closed angle glaucoma, and in those receiving antihypertensive therapy.</p>', '<p>The symptoms with overdosage are angina, headache, nausea, vomiting, tremor etc. The preferred antidote for overdosage with Salbutamol is a cardio-selective beta-blocking agent but beta-blocking drugs should be used with caution in patients with a history of bronchospasm.</p>', '<p>Short-acting selective &amp; &beta;2-adrenoceptor stimulants</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-18 23:33:54', '2022-03-18 23:33:54'),
(1350, 1350, '<p><strong>Bronchospasm</strong>: Salbutamol&nbsp;Inhaler is indicated for the treatment or prevention of bronchospasm in bronchial asthma and for the treatment of reversible airway obstruction associated with bronchitis and emphysema.<br />\r\n<br />\r\n<strong>Exercise-Induced Bronchospasm</strong>: Salbutamol Inhaler may be used to relieve attacks of acute dyspnoea and may also be taken prophylactically before exertion or to prevent exercise-induced asthma.</p>', '<p>Salbutamol is a selective &beta;2-adrenoceptor agonist. At therapeutic doses, it acts on the &beta;2-adrenoceptors of bronchial smooth muscle, with little or no action on the &beta;1-adrenoceptors of cardiac muscle. Salbutamol provides short-acting (4-6 hours) bronchodilatation with a fast onset (within 5 minutes) in reversible airway obstruction. It also has an anti-inflammatory effect on mast cells causing inhibition of release of bronchoconstrictor mediators including histamine, neutrophil chemotactive factor (NCF) and prostaglandin D2.</p>', '<p>Administer Salbutamol Inhaler by oral inhalation only. Shake Salbutamol Inhaler well before each spray.<br />\r\n<br />\r\nFor relief of acute episodes of bronchospasm:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 1 or 2 puffs as necessary. The maximum dose is up to 8 puffs in 24 hours.</li>\r\n	<li><strong>Children</strong>: Half the adult dose.</li>\r\n</ul>\r\n\r\n<p>To prevent allergen-or exercise-induced bronchospasm:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 2 puffs 15 minutes prior to exercise or exposure to the allergen. The maximum dose is 2 puffs, up to 4 times a day.</li>\r\n	<li><strong>Children</strong>: Half the adult dose.</li>\r\n</ul>\r\n\r\n<p>Chronic therapy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: Up to 200 mcg (2 puffs) four times daily.</li>\r\n	<li><strong>Children</strong>: Up to 200 mcg (2 puffs) four times daily.</li>\r\n</ul>\r\n\r\n<p><a href=\"https://medex.com.bd/news/104/danger-of-taking-medication-without-doctors-advice\" target=\"_blank\"><em>* চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন</em></a>&#39;</p>\r\n\r\n<p>Administration</p>\r\n\r\n<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>Salbutamol and non-selective beta-blocking drugs such as propranolol should generally not be prescribed together. Potentially serious hypokalaemia may result from &beta;2-agonist therapy. Particular caution is advised in acute severe asthma as this effect may be potentiated by concomitant treatment with xanthine derivatives, steroids, diuretics, and by hypoxia. It is recommended that serum potassium levels are monitored in such situations.</p>', '<p>Salbutamol inhaler is contraindicated in patients with a history of hypersensitivity to salbutamol or any other components of Salbutamol inhaler.</p>', '<p>Salbutamol is generally well tolerated. Few side effects have been observed during inhalation. There are tremors, anxiety, muscle cramps, headache, palpitation, a compensatory small increase in heart rate, cardiac arrhythmias (including atrial fibrillation, supraventricular tachycardia and extrasystoles), tachycardia may occur in some patients. Mouth and throat irritation may occur with inhaled salbutamol.</p>', '<p>Pregnancy Category C. There are no adequate and well-controlled studies of Salbutamol inhaler or salbutamol sulfate in pregnant women. This inhaler should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether the components of Salbutamol inhaler are excreted in human milk. Caution should be exercised when this inhaler is administered to a nursing woman.</p>', '<p><strong>Paradoxical Bronchospasm</strong>: Inhaled salbutamol sulfate can produce paradoxical bronchospasm, which may be life-threatening. If paradoxical bronchospasm occurs, the Salbutamol inhaler should be discontinued immediately and alternative therapy instituted. It should be recognized that paradoxical bronchospasm when associated with inhaled formulations; frequently occurs with the first use of a new canister.<br />\r\n<br />\r\n<strong>Cardiovascular Effects</strong>: Salbutamol inhaler, like all other &beta;2-adrenergic agonists, can produce clinically significant cardiovascular effects in some patients such as changes in pulse rate or blood pressure. If such effects occur, Salbutamol inhaler may need to be discontinued. In addition, beta-agonists have been reported to produce electrocardiograms (ECG) changes, such as flattening of the T wave, prolongation of the QTc interval, and ST-segment depression. The clinical relevance of these findings is unknown. Therefore, Salbutamol inhaler, like all other sympathomimetic amines, should be used with caution in patients with underlying cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmias, and hypertension.<br />\r\n<br />\r\n<strong>Immediate Hypersensitivity Reactions</strong>: Immediate hypersensitivity reactions may occur after administration of salbutamol sulfate inhalation aerosol, as demonstrated by cases of urticaria, angioedema, rash, bronchospasm, anaphylaxis, and oropharyngeal edema. Discontinue Salbutamol inhaler if immediate hypersensitivity reactions occur.<br />\r\n<br />\r\n<strong>Coexisting Conditions</strong>: Salbutamol inhaler, like other sympathomimetic amines, should be used with caution in patients with convulsive disorders, hyperthyroidism, or diabetes mellitus and in patients who are unusually responsive to sympathomimetic amines. Large doses of intravenous salbutamol have been reported to aggravate preexisting diabetes mellitus and ketoacidosis.</p>', NULL, '<p>Short-acting selective &amp; &beta;2-adrenoceptor stimulants.</p>', '<p>Pressurized canister. Do not puncture, break or burn even when apparently empty. Keep away from sunlight and heat. Store below 30&deg;C. Do not freeze. Keep away from eyes. Keep away from children. To be dispensed only on or by the prescription of a registered physician.</p>', '<p><strong>Use in children</strong>: The safety and effectiveness of Salbutamol inhaler in children 4 years of age and older have been established.</p>', '2022-03-19 01:48:07', '2022-03-19 01:48:07'),
(1351, 1351, '<p>This inhalation aerosol is indicated for use in patients with chronic obstructive pulmonary disease (COPD) on a regular aerosol bronchodilator who continues to have evidence of bronchospasm and who requires a second bronchodilator.</p>', '<p>This inhalation aerosol is a combination of Salbutamol (as Sulphate) and Ipratropium Bromide. It is a hydrofluoroalkane (HFA) based environment friendly inhaler. Because it does not contain chlorofluorocarbon (CFC) as propellant which is one of the main reasons of ozone layer depletion.<br />\r\n<br />\r\nSalbutamol is a short acting beta2-adrenergic bronchodilator and Ipratropium Bromide is an anticholinergic bronchodilator. When used in combination, Ipratropium Bromide prevents the increase in intracellular concentration of cyclic guanosine monophosphate, which are caused by interaction of acetylcholine with the muscarinic receptor on bronchial smooth muscle. This inhalation aerosol&nbsp;is expected to maximize the response of the treatment in patients with chronic obstructive pulmonary disease (COPD) by reducing bronchospasm through two distinctly different mechanisms, anticholinergic (parasympatholytic) and sympathomimetic. Simultaneous administration of an anticholinergic (Ipratropium Bromide) and a beta 2-sympathomimetic (Salbutamol) is designed to benefit the patient by producing a greater bronchodilatory effect than when either drug is utilized alone at its recommended dosage.</p>', '<p><strong>Adult dose (Including the elderly)</strong>: 2 puffs of Salpium 4 times a day (Patients may take additional puffs as required but a total number of puffs should not exceed 12 in 24 hours). Or as directed by the physician.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Using an Inhaler seems simple, but most patients do not know how to use it in the right way. If the Inhaler is used in the wrong way, less medicine can reach the lungs. Correct and regular use of the Inhaler will prevent or lessen the severity of asthma attacks.<br />\r\n<br />\r\nFollowing simple steps can help to use Inhaler effectively (According to &quot;<strong>National Asthma Guidelines for Medical Practitioners</strong>&quot; published by Asthma Association):</p>\r\n\r\n<ol>\r\n	<li>Take off the cap.</li>\r\n	<li>Shake the inhaler (at least six times) vigorously before each use.</li>\r\n	<li>If the inhaler is new or if it has not been used for a week or more, shake it well and release one puff into the air to make sure that it works.</li>\r\n	<li>Breathe out as full as comfortably possible &amp; hold the inhaler upright.</li>\r\n	<li>Place the actuator into mouth between the teeth and close lips around the mouthpiece.</li>\r\n	<li>While breathing deeply and slowly through the mouth, press down firmly add fully on the canister to release medicine.</li>\r\n	<li>Remove the inhaler from mouth. Continue holding breath for at least for 10 seconds or as long as it is comfortable.</li>\r\n	<li>If doctor has prescribed more than one inhalation per treatment, wait 1 minute between puffs (inhalations). Shake the inhaler well and repeat steps 4 to 7.</li>\r\n	<li>After use, replace the cap on the mouthpiece. After each treatment, rinse mouth with water.</li>\r\n	<li>Check your technique in front of a mirror from time to time, if you see a white mist during the inhalation, you may not have closed your lips properly around mouthpiece, or you may not be breathing in as you press the can. This indicates failure of technique. If this happens, repeat the procedure from step 4 carefully.</li>\r\n</ol>\r\n\r\n<p><strong>Instructions for Cleaning Inhaler</strong>: Clean your Inhaler at least once a week. Remove canister and rinse the plastic actuator and cap in warm water but do not put the metal canister into water. Dry the actuator and cap thoroughly and gently replace the metal canister into the actuator with a twisting motion. Put the cap on the mouthpiece.</p>', '<p>This inhalation aerosol has been used concomitantly with other drugs, including sympathomimetic bronchodilators, methylxanthines and steroids, commonly used in the treatment of COPD. No formal drug interaction studies have been performed with this inhalation aerosol and these or other medications commonly used in the treatment of COPD. Ipratropium Bromide should be co-administered cautiously with other anticholinergic agents and sympathomimetic agents, which may increase the risk of adverse cardiovascular effects. Beta-2-agonist containing drugs, like this inhalation aerosol, should be administrated with extreme caution in patients with non-potassium sparing diuretics, monoamine oxidase inhibitors or tricyclic antidepressants.</p>', '<p>This inhalation aerosol is contraindicated in patients with a history of hypersensitivity to Soya-Lecithin or related food products such as soybean and peanut. This inhalation aerosol is also contraindicated in patients hypersensitive to any other components of the drug product or to atropine or its derivatives.</p>', '<p>Due to presence of Salbutamol, mild tremor and headache have been reported. These usually disappear with continuous treatment. There have been very rare reports of treatments muscle cramp, hypersensitivity reactions including angioedema, urticaria, bronchospasm and hypotension.<br />\r\n<br />\r\nFor the presence of Ipratropium Bromide headache, influenza, chest pain, nausea, dyspnea, coughing, pharyngitis, sinusitis are rarely reported.</p>', '<p>Ipratropium Bromide: Pregnancy category B. Studies have demonstrated no teratogenic effects as a result of ipratropium.<br />\r\n<br />\r\nSalbutamol: Pregnancy category C. Salbutamol has been shown to be teratogenic in animals.<br />\r\n<br />\r\nThere are, however no adequate and well-controlled studies of Salpium Inhalation Aerosol (Salbutamol and Ipratropium Bromide combination) in pregnant woman. This inhalation aerosol should be used during pregnancy only if the potential benefit justifies the potential risk of the fetus. It is not known whether the components of the Salpium InhalationAerosol are excreted in human milk. As many drugs are excreted in human milk, Salpium should be cautiously administered to a nursing mother.</p>', NULL, '<p>The effects of overdosage are expected to be related primarily to Salbutamol Sulphate. Manifestations of overdosage with Salbutamol may include anginal pain, hypertension, hypokalemia and tachycardia.</p>', '<p>Combined bronchodilators.</p>', '<p>Do not puncture, break or incinerate the pressurized canister even when apparently empty. Avoid storage in direct sunlight or heat. Store in a cool and dry place. Keep away from children. Keep away from eyes.</p>', '<p>This inhalation aerosol contains Ipratropium Bromide and, therefore, should be used with caution in patients with narrow-angle glaucoma, prostatic hypertrophy or bladder-neck obstruction. Preparations containing sympathomimetic amines such as Salbutamol Sulphate should be used with caution in patients with convulsive disorders, hyperthyroidism, diabetes mellitus and in patients who are unusually responsive to sympathomimetic amines.</p>', '2022-03-19 01:50:09', '2022-03-19 01:50:09'),
(1352, 1352, '<p>Salbutamol sulfate &amp; Ipratropium bromide solution for inhalation is indicated for the treatment of reversible bronchospasm associated with obstructive airway diseases in patients who require more than a single bronchodilator.</p>', '<p>Ipratropium Bromide is quickly absorbed after inhalation. The systemic bioavailability following inhalation is estimated to be less than 10% of the dose. Renal excretion of Ipratropium Bromide is given as 46% of the dose after intravenous administration. The half-life of the terminal elimination phase is about 1.6 hours as determined after intravenous administration. Elimination half-life of drug and metabolites is 3.6 hours as determined after radio labelling. Ipratropium Bromide does not penetrate the blood brain barrier.<br />\r\n<br />\r\nSalbutamoi Sulphate is rapidly and completely absorbed following administration either by inhaled or oral route. Peak plasma Salbutamoi concentrations are seen within three hours of administration and it is excreted unchanged in the urine after 24 hours. The elimination half-life is 4 hours. Salbutamoi will cross the blood brain barrier reaching concentrations amounting to about five percent of the plasma concentrations.<br />\r\n<br />\r\nIt has been shown that co-nebulisation of Ipratropium Bromide and Salbutamoi Sulphate does not potentiate the systemic absorption of either component and that therefore the additive activity of this solution is due to the combined local effect on the lung following inhalation.</p>', '<p>Salbutamol sulfate &amp; Ipratropium bromide solution for inhalation in ampoule may be administered from a suitable nebulizer or an intermittent positive pressure ventilator.</p>\r\n\r\n<ul>\r\n	<li><strong>Adults (including elderly)</strong>: Use one 3 ml ampoule in the nebulizer four times a day. Two additional treatments may be used per day, if needed.</li>\r\n	<li><strong>Children</strong>: Use and dose must be determined by doctor.</li>\r\n</ul>\r\n\r\n<p>Patients should be advised to consult a doctor or the nearest hospital immediately in the case of acute or rapidly worsening dyspnoea if additional inhalations do not produce an adequate improvement.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p><strong>Step 1</strong>: Twist off the top of the ampoule. Be careful to hold the ampoule upright.<br />\r\n<strong>Step 2</strong>: Squeeze the desired amount of the nebulizer solution into the nebulizer chamber.<br />\r\n<strong>Step 3</strong>: If dilution is needed follow the physician&rsquo;s direction.</p>', '<p>The concurrent administration of other beta-mimetics, systemically absorbed anticholinergics and xanthine derivatives may increase the side effects.<br />\r\n<br />\r\nBeta-agonist induced hypokalaemia may be increased by concomitant treatment with xanthine derivatives, glucocorticosteroids and diuretics. This should be taken into account particularly in patients with severe airway obstruction.<br />\r\n<br />\r\nHypokalaemia may result in an increased susceptibility to arrhythmias in patients receiving digoxin. It is recommended that serum potassium levels be monitored in such situations.<br />\r\n<br />\r\nA potentially serious reduction in bronchodilator effect may occur during concurrent administration of beta-blockers.<br />\r\n<br />\r\nBeta-adrenergic agonists should be administered with caution to patients being treated with monoamine oxidase inhibitors or tricyclic antidepressants, since the action of beta adrenergic agonists may be enhanced.<br />\r\n<br />\r\nInhalation of halogenated hydrocarbon anaesthetics such as halothane, trichloroethylene and enflurane may increase the susceptibility to the cardiovascular effects of beta-agonists.</p>', '<p>This is contraindicated in patients with hypertrophic obstructive tachyarrhythmia and in patients with a history of hypersensitivity to atropine or its derivatives, or to any other component of the product.</p>', '<p>In common with other beta-agonists containing products, side effects of this solution can include fine tremor of skeletal muscles and nervousness and less frequently tachycardia, dizziness, palpitations or headache, especially in hypersensitive patients.<br />\r\n<br />\r\nPotentially serious hypokalaemia may result from prolonged and/or high dose beta2 agonist therapy.<br />\r\n<br />\r\nAs with use of other inhalation therapy, cough, local irritation and less commonly inhalation induced bronchospasm can occur. As with other beta-mimetics, nausea, vomiting, sweating, weakness and myalgia/muscle cramps may occur. In rare cases decrease in diastolic blood pressure, increase in systolic blood pressure, arrhythmias, particularly after higher doses, may occur.<br />\r\n<br />\r\nIn individual cases psychological alterations have been reported under inhalation therapy with beta-mimetics.<br />\r\n<br />\r\nThe most frequent non-respiratory anticholinergic related adverse events are dryness of mouth and dysphonia. There have been isolated reports of ocular complications (i.e. mydriasis, increased intraocular pressure, angle closure glaucoma, and eye pain) when aerosolised ipratropium bromide either alone or in combination with adrenergic beta2 agonist, has escaped into the eyes. Ocular side effects, gastrointestinal motility disturbances and urinary retention may occur in rare cases and are reversible.</p>', '<p>Pregnancy category C. Animal studies with Salbutamoi Sulphate have demonstrated a teratogenic effect. It is not known whether this medication is harmful to the fetus. No evidence of abnormalities has been reported in women receiving albuterol during pregnancy. This solution should be used during pregnancy only if the potential benefit justifies. This solution should be used with caution before childbirth in view of Salbutamol&#39;s inhibitory effects on uterine contractions.<br />\r\n<br />\r\nSalbutamol Sulphate and Ipratropium Bromide are probably excreted in breast milk and their effects on neonates are not known. Although lipid-insoluble quaternary bases pass into breast milk, it is unlikely that this will happen to any extent especially when taken by inhalation. However, because many drugs are excreted in breast milk, caution should be exercised when This solution is administered to a nursing woman.</p>', '<p>In the case of acute, rapidly worsening dyspnoea a doctor should be consulted immediately. Immediate hypersensitivity reactions may occur after administration of this solution as demonstrated by rare cases of urticaria, angioedema, rash, bronchospasm and oropharyngeal oedema.</p>', '<p>The effects of overdosage are expected to be primarily related to Salbutamol because acute overdosage with Ipratropium Bromide is unlikely as it is not well absorbed systemically after inhalation or oral administration.<br />\r\n<br />\r\n<strong>Symptoms</strong>: Manifestations of overdosage with salbutamol may include tachycardia, anginal pain, hypertension, hypotension , palpitations, tremor, widening of the pulse pressure, arrhythmia and flushing.<br />\r\n<br />\r\n<strong>Therapy</strong>: Administration of sedatives, tranquillisers; in severe cases, intensive therapy. Beta-receptor blockers, preferably beta1-selective, are suitable as specific antidotes; however, a possible increase in bronchial obstruction must be taken into account and the dose should be adjusted carefully in patients suffering from bronchial asthma.</p>', '<p>Combined bronchodilators</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-19 01:52:22', '2022-03-19 01:52:22');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(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
(1364, 1364, '<p>Selexipag is indicated for the treatment of pulmonary arterial hypertension (PAH, WHO Group I) to delay disease progression and reduce the risk of hospitalization for PAH.</p>', '<p>Selexipag is a selective non-prostanoid IP prostacyclin receptor agonist. Selexipag is a pale yellow crystalline powder that is practically insoluble in water. In the solid-state selexipag is very stable, is not hygroscopic, and is not light sensitive. Selexipag is an oral prostacyclin receptor (IP receptor) agonist that is structurally distinct from prostacyclin. Selexipag is hydrolyzed by carboxylesterase 1 to yield its active metabolite, which is approximately 37-fold as potent as selexipag. Selexipag and the active metabolite are selective for the IP receptor versus other prostanoid receptors (EP1-4, DP, FP, and TP).</p>', '<p>The recommended starting dose is 200 mcg twice daily. Tolerability may be improved when taken with food. Increase the dose by 200 mcg twice daily at weekly intervals to the highest tolerated dose up to 1600 mcg twice daily. The maintenance dose is determined by tolerability.<br />\r\n<br />\r\n<strong>Pediatric use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: No overall differences have been observed.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: For Moderate hepatic impairment patients starting dose is 200 mcg once daily, increase the dose by 200 mcg once daily at weekly intervals to the highest tolerated dose up to 1600 mcg. Avoid use of Selexipag in patients with severe hepatic impairment (Child-Pugh class C).</p>', '<p>Moderate CYP2C8 inhibitors (e.g., deferasirox and teriflunomide) may increase exposure to the active metabolite of Selexipag: CYP2C8 inducers (e.g., rifampicin) decrease exposure to the active metabolite &amp; Increase concentration up to twice the dose of Selexipag.</p>', NULL, '<p>The most common side-effects of selexipag are Nausea, Diarrhoea, Vomiting, Headache, Jaw pain, muscle pain, low appetite and low RBC count.</p>', '<p>There are no adequate and well controlled studies with Selexipag in pregnant women It is not known if Selexipag is present in human milk. Selexipag or breastfeeding should be discontinued in nursing mother.</p>', '<p>Discontinue Selexipag if the patient develops the sign and symptoms of Pulmonary Veno-Occlusive Disease (PVOD).</p>', '<p>Isolated cases of overdose up to 3200 mcg were reported. Mild transient nausea was the only reported consequence. In the event of overdose, supportive measures must be taken as required.</p>', '<p>Non-prostanoid IP prostacyclin receptor agonist.</p>', '<p>Keep in a dry place away from light and heat. Keep out of reach of children.</p>', NULL, '2022-03-20 03:47:23', '2022-03-20 03:47:23'),
(1365, 1365, '<p>Semaglutide is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Semaglutide is not recommended as a first-line therapy for patients who have inadequate glycemic control on diet and exercise because of the uncertain relevance of rodent C-cell tumor findings to humans. Semaglutide has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis. Semaglutide is not indicated for use in patients with type 1 diabetes mellitus or for the treatment of patients with diabetic ketoacidosis, as it would not be effective in these settings.</p>', '<p>Semaglutide is a GLP-1 analogue with 94% sequence homology to human GLP-1. Semaglutide acts as a GLP-1 receptor agonist that selectively binds to and activates the GLP-1 receptor, the target for native GLP-1. GLP-1 is a physiological hormone that has multiple actions on glucose, mediated by the GLP-1 receptors. The principal mechanism of protraction resulting in the long half-life of semaglutide is albumin binding, which results in decreased renal clearance and protection from metabolic degradation. Furthermore, semaglutide is stabilized against degradation by the DPP-4 enzyme. Semaglutide reduces blood glucose through a mechanism where it stimulates insulin secretion and lowers glucagon secretion, both in a glucose-dependent manner. Thus, when blood glucose is high, insulin secretion is stimulated and glucagon secretion is inhibited. The mechanism of blood glucose lowering also involves a minor delay in gastric emptying in the early postprandial phase.</p>', '<p>Instruct patients to take Semaglutide at least 30 minutes before the first food, beverage, or other oral medications of the day with no more than 4 ounces of plain water only. Waiting less than 30 minutes, or taking Semaglutide with food, beverages (other than plain water) or other oral medications will lessen the effect of Semaglutide by decreasing its absorption. Waiting more than 30 minutes to eat may increase the absorption of Semaglutide. Swallow tablets whole. Do not split, crush, or chew tablets.</p>\r\n\r\n<ul>\r\n	<li>Start Semaglutide with 3 mg once daily for 30 days. The 3 mg dose is intended for treatment initiation and is not effective for glycemic control.</li>\r\n	<li>After 30 days on the 3 mg dose, increase the dose to 7 mg once daily.</li>\r\n	<li>Dose may be increased to 14 mg once daily if additional glycemic control is needed after at least 30 days on the 7 mg dose.</li>\r\n	<li>Taking two 7 mg Semaglutide tablets to achieve a 14 mg dose is not recommended.</li>\r\n	<li>If a dose is missed, the missed dose should be skipped, and the next dose should be taken the following day.</li>\r\n</ul>', '<p><strong>Concomitant Use with an Insulin Secretagogue (e.g., Sulfonylurea) or with Insulin</strong>: The risk of hypoglycemia is increased when Semaglutide is used in combination with insulin secretagogues (e.g., sulfonylureas) or insulin. The risk of hypoglycemia may be lowered by a reduction in the dose of sulfonylurea (or other concomitantly administered insulin secretagogues) or insulin.<br />\r\n<br />\r\n<strong>Oral Medications</strong>: Semaglutide causes a delay of gastric emptying, and thereby has the potential to impact the absorption of other oral medications. Levothyroxine exposure was increased 33% when administered with Semaglutide in a drug interaction study. When coadministering oral medications instruct patients to closely follow Semaglutide administration instructions. Consider increased clinical or laboratory monitoring for medications that have a narrow therapeutic index or that require clinical monitoring.</p>', '<p>Semaglutide is contraindicated in patients with:</p>\r\n\r\n<ul>\r\n	<li>A personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).</li>\r\n	<li>Known hypersensitivity to semaglutide or to any of the components in Semaglutide.</li>\r\n</ul>', '<p>The following serious adverse reactions are described below or elsewhere in the prescribing information:</p>\r\n\r\n<ul>\r\n	<li>Risk of Thyroid C-cell Tumors</li>\r\n	<li>Pancreatitis</li>\r\n	<li>Diabetic Retinopathy Complications</li>\r\n	<li>Hypoglycemia with Concomitant Use of Insulin Secretagogues or Insulin</li>\r\n	<li>Acute Kidney Injury</li>\r\n	<li>Hypersensitivity</li>\r\n</ul>', '<p>Available data with Semaglutide use in pregnant women are insufficient to evaluate for a drug-associated risk of major birth defects, miscarriage or other adverse maternal or fetal outcomes. There are clinical considerations regarding the risks of poorly controlled diabetes in pregnancy. There are no data on the presence of semaglutide in human milk, the effects on the breastfed infant, or the effects on milk production. Semaglutide was present in the milk of lactating rats.</p>', '<ul>\r\n	<li><strong>Pancreatitis</strong>: Has been reported in clinical trials. Discontinue promptly if pancreatitis is suspected. Do not restart if pancreatitis is confirmed.</li>\r\n	<li><strong>Diabetic Retinopathy Complications</strong>: Has been reported in a cardiovascular outcomes trial with semaglutide injection. Patients with a history of diabetic retinopathy should be monitored.</li>\r\n	<li><strong>Hypoglycemia</strong>: When semaglutide is used with an insulin secretagogue or insulin, consider lowering the dose of the secretagogue or insulin to reduce the risk of hypoglycemia.</li>\r\n	<li><strong>Acute Kidney Injury</strong>: Monitor renal function in patients with renal impairment reporting severe adverse gastrointestinal reactions.</li>\r\n	<li><strong>Hypersensitivity Reactions</strong>: Discontinue semaglutide if suspected and promptly seek medical advice.</li>\r\n</ul>', '<p>In the event of overdose, appropriate supportive treatment should be initiated according to the patient&#39;s clinical signs and symptoms. A prolonged period of observation and treatment for these symptoms may be necessary, taking into account the long half-life of Semaglutide of approximately 1 week.</p>', '<p>GLP-1 receptor agonists.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and efficacy of Semaglutide have not been established in pediatric patients (younger than 18 years).<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No overall differences in safety or efficacy were detected between these patients and younger patients, but greater sensitivity of some older individuals cannot be ruled out.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: The safety and efficacy of Semaglutide was evaluated in a 26-week clinical study that included 324 patients with moderate renal impairment (eGFR 30 to 59 mL/min/1.73 m2). In patients with renal impairment including end-stage renal disease (ESRD), no clinically relevant change in semaglutide pharmacokinetics (PK) was observed. No dose adjustment of Semaglutide is recommended for patients with renal impairment.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: In a study in subjects with different degrees of hepatic impairment, no clinically relevant change in semaglutide pharmacokinetics (PK) was observed. No dose adjustment of semaglutide is recommended for patients with hepatic impairment.</p>', '2022-03-20 03:49:49', '2022-03-20 03:49:49'),
(1366, 1366, '<p>Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.</p>', '<p>Semaglutide is a GLP-1 analogue with 94% sequence homology to human GLP-1. Semaglutide acts as a GLP-1 receptor agonist that selectively binds to and activates the GLP-1 receptor, the target for native GLP-1. GLP-1 is a physiological hormone that has multiple actions on glucose, mediated by the GLP-1 receptors. The principal mechanism of protraction resulting in the long half-life of semaglutide is albumin binding, which results in decreased renal clearance and protection from metabolic degradation. Furthermore, semaglutide is stabilized against degradation by the DPP-4 enzyme. Semaglutide reduces blood glucose through a mechanism where it stimulates insulin secretion and lowers glucagon secretion, both in a glucose-dependent manner. Thus, when blood glucose is high, insulin secretion is stimulated and glucagon secretion is inhibited. The mechanism of blood glucose lowering also involves a minor delay in gastric emptying in the early postprandial phase.</p>', '<p>Instruct patients to take Semaglutide at least 30 minutes before the first food, beverage, or other oral medications of the day with no more than 4 ounces of plain water only. Waiting less than 30 minutes, or taking with food, beverages (other than plain water) or other oral medications will lessen the effect of Semaglutide. Waiting more than 30 minutes to eat may increase the absorption of Semaglutide.<br />\r\n<br />\r\nSwallow tablets whole. Do not cut, crush, or chew tablets. Start Semaglutide with 3 mg once daily for 30 days. After 30 days on the 3 mg dose, increase the dose to 7 mg once daily. Dose may be increased to 14 mg once daily if additional glycemic control is needed after at least 30 days on the 7 mg dose.</p>', '<p>Oral Medications: Semaglutide delays gastric emptying. When coadministering oral medications instruct patients to closely follow semaglutide administration instructions. Consider increased clinical or laboratory monitoring for medications that have a narrow therapeutic index or that require clinical monitoring.</p>', '<p>Personal or family history of medullary thyroid carcinoma or in patients with Multiple Endocrine Neoplasia syndrome type 2. Known hypersensitivity to semaglutide or any of the components in this preparation.</p>', '<p>The most common adverse reactions, reported in &ge;5% of patients treated with Semaglutide are: nausea, abdominal pain, diarrhea, decreased appetite, vomiting and constipation.</p>', '<p><strong>Pregnancy</strong>: May cause fetal harm.<br />\r\n<strong>Lactation</strong>: Breastfeeding not recommended.<br />\r\n<strong>Females and Males of Reproductive Potential</strong>: Discontinue Semaglutide in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide.</p>', '<p><strong>Pancreatitis</strong>: Has been reported in clinical trials. Discontinue promptly if pancreatitis is suspected. Do not restart if pancreatitis is confirmed.<br />\r\n<br />\r\n<strong>Diabetic Retinopathy Complications</strong>: Has been reported in a cardiovascular outcomes trial with semaglutide injection. Patients with a history of diabetic retinopathy should be monitored.<br />\r\n<br />\r\n<strong>Hypoglycemia</strong>: When semaglutide is used with an insulin secretagogue or insulin, consider lowering the dose of the secretagogue or insulin to reduce the risk of hypoglycemia.<br />\r\n<br />\r\n<strong>Acute Kidney Injury</strong>: Monitor renal function in patients with renal impairment reporting severe adverse gastrointestinal reactions.<br />\r\n<br />\r\n<strong>Hypersensitivity Reactions</strong>: Discontinue semaglutide if suspected and promptly seek medical advice.</p>', '<p>In the event of overdose, appropriate supportive treatment should be initiated according to the patient&rsquo;s clinical signs and symptoms. A prolonged period of observation and treatment for these symptoms may be necessary, taking into account the long half-life of Semaglutide of approximately 1 week.</p>', '<p>GLP-1 receptor agonists.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and efficacy of Semaglutide have not been established in pediatric patients (younger than 18 years).<br />\r\n<br />\r\n<strong>Geriatric Use</strong>:&nbsp;No overall differences in safety or efficacy were detected between these patients and younger patients, but greater sensitivity of some older individuals cannot be ruled out.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: The safety and efficacy of Semaglutide was evaluated in a 26-week clinical study that included 324 patients with moderate renal impairment (eGFR 30 to 59 mL/min/1.73 m2). In patients with renal impairment including end-stage renal disease (ESRD), no clinically relevant change in semaglutide pharmacokinetics (PK) was observed. No dose adjustment of Semaglutide is recommended for patients with renal impairment.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: In a study in subjects with different degrees of hepatic impairment, no clinically relevant change in semaglutide pharmacokinetics (PK) was observed. No dose adjustment of Semaglutide is recommended for patients with hepatic impairment.</p>', '2022-03-20 03:51:38', '2022-03-20 03:51:38'),
(1367, 1367, '<p>It is used to treat hard stools (constipation).</p>', '<p>Senna glycoside, also known as sennoside or senna, is a medication used to treat constipation and empty the large intestine before surgery. The medication is taken by mouth or via the rectum. It typically begins working in minutes when given by rectum and within twelve hours when given by mouth. It is a weaker laxative than bisacodyl or castor oil.<br />\r\n<br />\r\nSennosides A and B increase intestinal motility through release of active anthraquinones into the colon by colonic bacteria. Purified sennosides (sennosides A and B) are used similarly to senna.</p>', '<p>Constipation</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;15-30 mg (as total sennosides) 1-2 times daily.</li>\r\n	<li><strong>Child:</strong>&nbsp;2-6 yr: 3.75-7.5 mg once daily in the morning; 6-12 yr: 7.5-15 mg once daily at night or in the morning; &ge;12 yr: 15-30 mg at bedtime.</li>\r\n</ul>\r\n\r\n<p>Bowel evacuation</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;105-157.5 mg of sennosides on the day before the procedure. May be given as a liquid preparation.</li>\r\n</ul>', NULL, '<p>Nausea or vomiting, undiagnosed abdominal pain, intestinal obstruction.</p>', '<p>Mild abdominal discomfort e.g. colic and cramps; diarrhoea, hypokalaemia and atonic non-functioning colon (prolonged use); reversible melanosis coli (chronic use). May colour the urine yellowish-brown at acidic pH or red at alkaline pH.</p>', '<p>Sennosides has been assigned to pregnancy category C by the FDA. Animal studies have failed to reveal evidence of teratogenicity. There are no controlled data in human pregnancy. Sennosides should only be given during pregnancy when benefits outweigh risks.<br />\r\n<br />\r\nSennosides is not excreted into human milk. However, Sennosides is a prodrug which is metabolized in vivo to the active sennosides (glucosides of rhein). Rhein is excreted into human milk in very small amounts. No adverse effects have been observed in nursing infants. The American Academy of Pediatrics considers Sennosides to be compatible with breast-feeding.</p>', '<p>Inflammatory bowel disease. Avoid prolonged use.</p>', NULL, '<p>Osmotic purgatives.</p>', NULL, NULL, '2022-03-20 03:53:00', '2022-03-20 03:53:00'),
(1368, 1368, '<p>Sertaconazole cream is indicated for the topical treatment of interdigital tinea pedis and other topical fungal infections in immunocompetent patients 12 years of age and older, caused by Trichophyton rubrum, Trichophyton mentagrophytes and Epidermophyton floccosum.</p>', '<p>Sertaconazole, an imidazole antifungal agent, inhibits fungal cytochrome P450-mediated 14 alpha-lanosterol demethylase enzyme. Ergosterol is the key component of fungal cell membranes and lack of this component leads to fungal cell injury by leakage of key constituents in the cytoplasm from the cell.</p>', '<p>In the treatment of interdigital tinea pedis, Sertaconazole cream should be applied twice daily for 4 weeks. A sufficient amount of Sertaconazole cream should be applied to cover both the affected areas between the toes and the immediately surrounding healthy skin of patients with interdigital tinea pedis. Not for ophthalmic, oral, or intravaginal use.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: The efficacy and safety of Fungitac cream 2% have not been established in pediatric patients below the age of 12 years.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical trials of Fungitac cream 2% did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.</p>', '<p>Potential interactions between Sertaconazole cream and other drugs have not been systematically evaluated.</p>', '<p>Sertaconazole cream is contraindicated in patients who have a known or suspected hypersensitivity to sertaconazole nitrate or any of its components or other imidazoles.</p>', '<p>Most common adverse reactions observed in clinical trials are contact dermatitis, dry skin, burning skin, application site skin tenderness.</p>', '<p>There are no adequate &amp; well-controlled studies conducted with Sertaconazole cream in pregnant women. Sertaconazole cream should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known if Sertaconazole cream is excreted in human milk. Caution should be exercised when prescribing Sertaconazole cream to a nursing woman.</p>', '<p>Sertaconazole cream is for use on the skin only. If irritation develops, treatment should be discontinued and appropriate therapy instituted. Physicians should exercise caution when prescribing Sertaconazole cream to patients known to be sensitive to azole antifungals, since cross-reactivity may occur.</p>', '<p>There is no data availalble about overdose of Sertaconazole cream.</p>', '<p>Drugs used in Vaginal and Vulval condition, Topical Antifungal 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, '2022-03-20 03:54:38', '2022-03-20 03:54:38'),
(1369, 1369, '<p>Sertraline is indicated for the treatment of-</p>\r\n\r\n<ul>\r\n	<li>Major depressive disorder (MDD)</li>\r\n	<li>Obsessive-compulsive disorder (OCD)</li>\r\n	<li>Panic disorder (PD)</li>\r\n	<li>Post-traumatic stress disorder (PTSD)</li>\r\n	<li>Social anxiety disorder (SAD)</li>\r\n	<li>Premenstrual dysphoric disorder (PMDD).</li>\r\n</ul>', '<p>Sertraline has potent and selective inhibitory action on CNS neuronal reuptake of 5-HT resulting in increased 5-HT concentrations at the synaptic clefts, leading to facilitation of its sustained activity at the postsynaptic receptor sites. It ultimately results in an improvement of depression. Reduction of Serotonin turnover in brain by Sertraline is also another contributing fact implicated in its action. Its prolonged elimination half-life offers a benefit of once daily administration.</p>', '<p><strong>Adults</strong>-<br />\r\nMajor depressive disorder:</p>\r\n\r\n<ul>\r\n	<li>Starting Dose: 50 mg</li>\r\n	<li>Therapeutic Range: 50-200 mg</li>\r\n</ul>\r\n\r\n<p>Obsessive-compulsive disorder:</p>\r\n\r\n<ul>\r\n	<li>Starting Dose: 50 mg</li>\r\n	<li>Therapeutic Range: 50-200 mg</li>\r\n</ul>\r\n\r\n<p>Panic disorder, Post-traumatic stress disorder, Social anxiety disorder:</p>\r\n\r\n<ul>\r\n	<li>Starting Dose: 25 mg</li>\r\n	<li>Therapeutic Range: 50-200 mg</li>\r\n</ul>\r\n\r\n<p><strong>Pediatric Patients (ages 6-12 years old)</strong>-<br />\r\nObsessive-compulsive disorder:</p>\r\n\r\n<ul>\r\n	<li>Starting Dose: 25&nbsp;mg</li>\r\n	<li>Therapeutic Range: 50-200 mg</li>\r\n</ul>\r\n\r\n<p>The recommended interval between dose changes is one week.<br />\r\n<br />\r\n<strong>Premenstrual dysphoric disorder (PMDD)</strong>: Starting dosage for PMDD is 50 mg/day. Sertraline may be administered either continuously (every day throughout the menstrual cycle) or intermittently (starting the daily dosage 14 days prior to the anticipated onset of menstruation and continuing through the onset of menses). Intermittent dosing would be repeated with each new cycle.</p>\r\n\r\n<ul>\r\n	<li><strong>Continuous</strong>: Patients not responding to a 50 mg dosage may benefit from dosage increases at 50 mg increments per menstrual cycle up to 150 mg per day.</li>\r\n	<li><strong>Intermittent</strong>: Patients not responding to a 50 mg dosage may benefit from increasing the dosage up to a maximum of 100 mg per day during the next menstrual cycle (and subsequent cycles).</li>\r\n</ul>', '<p>Potential effects of co-administration of drugs that are highly bound to plasma proteins- As Sertraline is tightly bound to plasma protein, the administration of Sertraline to a patient taking another drug which is tightly bound to protein, (e.g. warfarin, digitoxin) may cause a shift in plasma concentrations potentially resulting in an adverse effect. Conversely adverse effects may result from displacement of protein bound Sertraline by other tightly bound drugs. Sertraline may interact with other drugs such as Cimetidine, CNS active drugs like Diazepam, Hypoglycemic drugs, Atenolol etc.</p>', '<p>Sertraline is contraindicated in patients with a known hypersensitivity to Sertraline or any of the excipients of drug. In patients with moderate to severe hepatic impairment is not recommended.</p>', '<p>Sertraline may cause side effects like upset stomach, diarrhoea, constipation, vomiting, dry mouth, loss of appetite, weight changes, drowsiness, dizziness, headache, pain, burning or tingling in the hands or feet, excitement, sore throat etc.</p>', '<p>Although animal studies did not provide any evidence of teratogenicity, the safety of Sertraline during human pregnancy has not been established. Sertraline is known to be excreted in breast milk. Its effects on the nursing infant have not yet been established. If treatment with Sertraline is considered necessary, discontinuation of breast-feeding should be considered.</p>', '<p>Precaution should be taken in case of liver problems, kidney diseases, seizures, heart problems and any allergies. This drug may cause dizziness or drowsiness. Caution should be taken in activities requiring alertness such as driving or using machinery. Caution is advised while using this product in the elderly because they may be more sensitive to the effects of the drug. Do not take this drug if you have taken monoamine oxidase inhibitor in the last five weeks. Risk of suicidal thinking and change of behavior may occur (close monitoring of the patient after 2 to 3 weeks of use is required).</p>', NULL, '<p>SSRIs &amp; related anti-depressant drugs.</p>', '<p>Do not store above 30&deg;C. Keep out of the reach of children.</p>', NULL, '2022-03-20 03:56:07', '2022-03-20 03:56:07'),
(1370, 1370, '<ul>\r\n	<li>It is completely natural and uses the goodness of cactus extract and beeswax which improves skin elasticity and scars</li>\r\n	<li>Reduces scar formation and improve physiological regeneration of the skin due to several skin trauma</li>\r\n	<li>It works by inhibiting hyperplasia of fibroblasts and improves epithelia cell growth</li>\r\n	<li>It flattens scars and recovers skin&#39;s natural beauty</li>\r\n	<li>Helps to relieve scar location and its symptoms such as skin hyperplasia, pruritus, skin chaps and functional restriction</li>\r\n</ul>', '<p>This Ointment is used primarily to remove scars and repair damaged skin. It helps to relieve symptoms of scars including pruritus, skin chaps and functional restriction. The ointment is chiefly used to heal scar formation caused due to injury of the skin or due to various skin disorders.</p>', '<p>Apply a thin layer of the ointment and gently massage the skin mark area for 5-10 minutes. Repeat 3 to 4 times daily. Continue using until the skin mark become soft and smooth. The duration of usages varies depending on the type of the skin, age and location of the skin mark.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Topical retinoid and related 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 04:27:59', '2022-03-20 04:27:59'),
(1371, 1371, '<p>Sevelamer Carbonate is indicated for the control of hyperphosphataemia in adult patients receiving haemodialysis or peritoneal dialysis. Sevelamer Carbonate is also indicated for the control of hyperphosphataemia in adult patients with chronic kidney disease not on dialysis with serum phosphorus 1.78 mmol/l. Sevelamer Carbonate should be used within the context of a multiple therapeutic approach, which could include calcium supplement, 1,25-dihydroxy Vitamin D3 or one of its analogues to control the development of renal bone disease.</p>', '<p>Sevelamer carbonate, a non-absorbed phosphate binding crosslinked polymer, free of metal and calcium. It contains multiple amines separated by one carbon from the polymer&nbsp;backbone. These amines exist in a protonated form in the intestine and interact with phosphate molecules through ionic and&nbsp;hydrogen&nbsp;bonding. By binding phosphate in the&nbsp;gastrointestinal tract&nbsp;and decreasing absorption, sevelamer carbonate lowers the phosphate concentration in the serum (serum&nbsp;phosphorus).</p>', '<p><strong>Starting dose</strong>: The recommended starting dose of Sevelamer Carbonate is 2.4 g (Three Sevelamer 800 mg tablets or Three Sevelamer 800 mg sachets of powder for oral suspension) or 4.8 g (Six Sevelamer 800 mg tablets or Six Sevelamer 800 mg sachets of powder for oral suspension) per day based on clinical needs and serum phosphorus level. Sevelamer Carbonate tablet or suspension must be taken three times per day with meals.<br />\r\n<br />\r\nFor patients previously on phosphate binders (Sevelamer Hydrochloride or calcium based), Sevelamer Carbonate should be given on a gram for gram basis with monitoring of serum phosphorus levels to ensure optimal daily doses.<br />\r\n<br />\r\n<strong>Titration and Maintenance</strong>: Serum phosphorus levels must be monitored and the dose of Sevelamer Carbonate titrated every 2-4 weeks until an acceptable serum phosphorus level is reached, with regular monitoring thereafter. Patients taking Sevelamer Carbonate should adhere to their prescribed diets. In clinical practice, treatment will be continuous based on the need to control serum phosphorus levels and the daily dose is expected to be an average of approximately 6 g per day.<br />\r\n<br />\r\n<strong>Paediatric population</strong>: The safety and efficacy of Sevelamer Carbonate has not been established in children below the age of 18 years. Sevelamer Carbonate is not recommended in children below the age of 18 years.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p><strong>Method of administration for Sevelamer Carbonate tablet</strong>: Tablets should be swallowed intact and should not be crushed, chewed, or broken into pieces prior to administration.<br />\r\n<br />\r\n<strong>Method of administration for Sevelamer Carbonate powder for oral suspension</strong>: Each sachet of 800 mg of powder is to be dispersed in 30 ml or 6 teaspoons of water prior to administration. The suspension should be ingested within 30 minutes after being prepared.</p>', '<p>Drug interactions: Interaction studies have not been conducted in patients on dialysis. In interaction studies in healthy volunteers, Sevelamer Hydrochloride, which contains the same active moiety as Sevelamer Carbonate, decreased the bioavailability of ciprofloxacin by approximately 50% when co-administered with Sevelamer Hydrochloride in a single dose study. Consequently, Sevelamer Carbonate should not be taken simultaneously with ciprofloxacin. Reduced levels of ciclosporin, mycophenolate mofetil and tacrolimus have been reported in transplant patients when co-administered with Sevelamer Hydrochloride without any clinical consequences (i.e graft rejection). The possibility of an interaction cannot be excluded and a close monitoring of blood concentrations of ciclosporin, mycophenolate mofetil and tacrolimus should be considered during the use of combination and after its withdrawal. Very rare cases of hypothyroidism have been reported in patients co-administered Sevelamer Hydrochloride, which contains the same active moiety as Sevelamer Carbonate, and levothyroxine. Closer monitoring of thyroid stimulating hormone (TSH) levels is therefore recommended in patients receiving Sevelamer Carbonate and levothyroxine. Patients taking anti-arrhythmic medicinal products for the control of arrhythmias and anti-seizure medicinal products for the control of seizure disorders were excluded from clinical trials. Caution should be exercised when prescribing Sevelamer Carbonate to patients also taking these medicinal products. In interaction studies in healthy volunteers, Sevelamer Hydrochloride, which contains the same active moiety as Sevelamer Carbonate, had no effect on the bioavailability of digoxin, warfarin, enalapril or metoprolol. Sevelamer Carbonate is not absorbed and may affect the bioavailability of other medicinal products. When administering any medicinal product where a reduction in the bioavailability could have a clinically significant effect on safety or efficacy, the medicinal product should be administered at least one hour before or three hours after Sevelamer Carbonate, or the physician should consider monitoring blood levels.</p>', '<p>Sevelamer Carbonate is contraindicated in patients with bowel obstruction. Sevelamer Carbonate is contraindicated in patients with known hypersensitivity to sevelamer carbonate, sevelamer hydrochloride, or to any of the excipients.</p>', NULL, '<p>Sevelamer carbonate is not absorbed systemically following oral administration and maternal use is not expected to result in fetal exposure to the drug. Clinical Considerations Sevelamer carbonate may decrease serum levels of fat soluble vitamins and folic acid in pregnant women.<br />\r\n<br />\r\nSevelamer carbonate is not absorbed systemically by the mother following oral administration, and breastfeeding is not expected to result in exposure of the child to Sevelamer carbonate. Clinical Considerations Sevelamer carbonate may decrease serum levels of fat soluble vitamins and folic acid in pregnant women.</p>', NULL, '<p>In CKD patients on&nbsp;dialysis, the maximum dose studied was 14 grams of sevelamer carbonate and 13 grams of sevelamer hydrochloride. There are no reports of overdosage with sevelamer carbonate or sevelamer hydrochloride in patients. Since sevelamer is not absorbed, the risk of systemic toxicity is low.</p>', '<p>Drugs for reduction of serum phosphorus in patients with ESRD.</p>', '<p>Store in a cool and dry place, protected from light.</p>', '<p><strong>Pediatric Use</strong>: The safety and efficacy of Sevelamer Carbonate in lowering serum&nbsp;phosphorus&nbsp;levels was studied in patients 6 years of age and older with CKD. In this study, Sevelamer Carbonate was apparently less effective in children with a low baseline serum phosphorus, which described children &lt; 13 years of age and children not on&nbsp;dialysis. Given its mechanism of action, Sevelamer Carbonate is expected to be effective in lowering serum phosphorus levels in pediatric patients with CKD. Most adverse events that were reported as related, or possibly related, to sevelamer carbonate were gastrointestinal in nature. No new risks or safety signals were identified with the use of sevelamer carbonate in the trial. Sevelamer Carbonate has not been studied in pediatric patients below 6 years of age.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of Sevelamer Carbonate 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.</p>', '2022-03-20 04:29:52', '2022-03-20 04:29:52'),
(1372, 1372, '<p>Sevelamer Hydrochloride is indicated for the reduction of serum phosphorus in patients with end-stage renal disease (ESRD).</p>', '<p>Sevelamer Hydrochloride is a new treatment for the control of serum phosphorus in patients with chronic kidney disease (CKD) on dialysis. Elevated serum phosphorus levels or uncontrolled hyperphosphatemia leads to development of secondary hyperparathyroidism, renal bone disease, calcification of vascular and nonvascular tissues, and cardiovascular disease. It is a calcium-free and aluminium-free nonabsorbed polymer phosphate binder, it does not cause calcium and aluminium toxicity. When taken with meals it inhibits intestinal absorption of ingested phosphate.</p>', '<p>Patients not taking a Phosphate Binder: The recommended starting dose of Sevelamer is 800 to 1600 mg, which can be administered as two to four 400 mg Sevelamer tablets, with meals based on serum phosphorus level. Renophos 400 Recommendation for the patients with hyperphosphatemia is given below-<br />\r\n<br />\r\nStarting dose of Renophos for dialysis patients not taking any phosphate binder:</p>\r\n\r\n<ul>\r\n	<li><strong>Serum Phosphorus &gt;5.5 and &lt;7.5 mg/dL</strong>: 800 mg (2 tablets) three times daily with meals</li>\r\n	<li><strong>Serum Phosphorus &ge;7.5 and &lt;9.0 mg/dL</strong>: 1200 mg (3 tablets) three times daily with meals</li>\r\n	<li><strong>Serum Phosphorus &ge;9.0 mg/dL</strong>: 1600 mg (4 tablets) three times daily with meals</li>\r\n</ul>\r\n\r\n<p>Starting dose for dialysis patients switching from calcium acetate to Sevelamer:</p>\r\n\r\n<ul>\r\n	<li>Calcium Acetate 667 mg (1 tablet): Sevelamer 800 mg (2 tablets)</li>\r\n	<li>Calcium Acetate 1334 mg (2 tablets): Sevelamer 1200 mg (3 tablets)</li>\r\n	<li>Calcium Acetate 2001 mg (3 tablets): Sevelamer 2000 mg (5 tablets)</li>\r\n</ul>\r\n\r\n<p>Dose titration guideline:</p>\r\n\r\n<ul>\r\n	<li><strong>Serum Phosphorus &gt;5.5 mg/dL</strong>: Increase 400 mg (1 tablet) per meal at 2 week intervals</li>\r\n	<li><strong>Serum Phosphorus 3.5-5.5 mg/dL</strong>: Maintain current dose</li>\r\n	<li><strong>Serum Phosphorus &lt;3.5 mg/dL</strong>: Decrease 400 mg (1 tablet) per meal</li>\r\n</ul>\r\n\r\n<p><strong>Dose titration for all patients taking Sevelamer</strong>: Dosage should be adjusted based on the serum phosphorus concentration with a goal of lowering serum phosphorus to 5.5 mg/dl or less. The dose may be increased or decreased by one tablet per meal at two week intervals as necessary.</p>', '<p>Sevelamer has been studied in human drug-drug interaction studies with ciprofloxacin, digoxin, warfarin, enalapril, metoprolol and iron.</p>', '<p>Sevelamer is contraindicated in patients with hypophosphatemia or bowel obstruction and in patients with known hypersensitivity to Sevelamer hydrochloride or any of its constituents.</p>', '<p>Sevelamer may cause dyspepsia, peritonitis, diarrhea, nausea, constipation, pruritus, abdominal distension, vomiting, fatigue, anorexia, arthralgia and less commonly ileus, bowel obstruction and bowel perforation.</p>', '<p>Pregnancy Category C. No adequate and controlled studies have been conducted using Sevelamer in nursing mothers. Sevelamer should be used during breastfeeding only if the potential benefit justifies the potential risks.</p>', '<p>The safety and efficacy of Sevelamer in patients with dysphagia, swallowing disorders, severe GI motility disorders including severe constipation, or major GI tract surgery have not been established. Caution should be exercised when Sevelamer is used in patients with these GI disorders.</p>', '<p>Over dosages of Sevelamer in patients was never reported. Since Sevelamer is not absorbed, the risk of systemic toxicity is low.</p>', '<p>Drugs for reduction of serum phosphorus in patients with ESRD.</p>', NULL, NULL, '2022-03-20 04:31:22', '2022-03-20 04:31:22'),
(1373, 1373, '<p>Sevoflurane is indicated for induction and maintenance of general&nbsp;anesthesia&nbsp;in adult and pediatric patients for inpatient and outpatient surgery. Sevoflurane should be administered only by persons trained in the administration of general anesthesia. Facilities for maintenance of a patent&nbsp;airway, artificial&nbsp;ventilation, oxygen enrichment, and&nbsp;circulatory&nbsp;resuscitationmust be immediately available. Since level of anesthesia may be altered rapidly, only vaporizers producing predictable concentrations of sevoflurane should be used.</p>', '<p>Sevoflurane is a volatile halogenated general anaesthetic that has a minimum alveolar concentration (MAC) value ranging from 1.4% to 3.3%. It alters the activity of fast synaptic neurotransmitter receptors like nicotinic acetylcholine, GABA, and glutamate. It may depress myocardial contractility and decrease both BP and sympathetic nervous activity. Additionally, it has muscle relaxant properties w/o analgesia</p>', '<p>he concentration of sevoflurane being delivered from a vaporizer during anesthesia should be known. This may be accomplished by using a vaporizer calibrated specifically for sevoflurane. The administration of general anesthesia must be individualized based on the patient&#39;s response.<br />\r\n<br />\r\n<strong>Replacement Of Desiccated CO2&nbsp;Absorbents</strong>: When a clinician suspects that the CO2&nbsp;absorbent may be desiccated, it should be replaced. The exothermic reaction that occurs with sevoflurane and CO2&nbsp;absorbents is increased when the CO2&nbsp;absorbent becomes desiccated, such as after an extended period of dry gas flow through the CO2&nbsp;absorbent canisters<br />\r\n<br />\r\n<strong>Pre-anesthetic Medication</strong>: No specific premedication is either indicated or contraindicated with sevoflurane. The decision as to whether or not to premedicate and the choice of premedication is left to the discretion of the&nbsp;anesthesiologist<br />\r\n<br />\r\n<strong>Induction</strong>: Sevoflurane has a nonpungent odor and does not cause respiratory irritability; it is suitable for mask induction in&nbsp;pediatrics&nbsp;and adults<br />\r\n<br />\r\n<strong>Maintenance</strong>: Surgical levels of anesthesia can usually be achieved with concentrations of 0.5-3% sevoflurane with or without the concomitant use of&nbsp;nitrous oxide. Sevoflurane can be administered with any type of anesthesia circuit</p>', '<p>Increased metabolism and toxicity with drugs that induce CYP2E1 isoenzyme (e.g. isoniazid). Reduced MAC with benzodiazepines, opioids. May cause ventricular arrhythmia with &beta;-sympathomimetic agents (e.g. isoprenaline), and &alpha;- and &beta;-sympathomimetic agents (e.g. adrenaline, noradrenaline). May cause crisis during operation with nonselective MAO inhibitors. May lead to marked hypotension and risk of additive negative inotropic effect with Ca antagonists (esp dihydropyridines).</p>', '<p>Sevoflurane can cause malignant hyperthermia. It should not be used in patients with known sensitivity to sevoflurane or to other halogenated agents nor in patients with known or suspected susceptibility to malignant hyperthermia.</p>', '<p>Cardiorespiratory depression, hypotension, bradycardia; laryngospasm, increased cough and salivation; urinary retention, acute renal failure, changes in liver enzyme values, liver damage; nausea, vomiting, delirium, seizure; rash, urticaria, pruritus, dyspnoea, wheezing, chest discomfort, bronchospasm, anaphylactic/anaphylactoid reaction; agitation, dystonic movements (childn).</p>', '<p><strong>Pregnancy</strong>&nbsp;Category B. Reproduction studies have been performed in rats and rabbits at doses up to 1 MAC (minimum alveolar concentration) without CO2 absorbent and have revealed no evidence of impaired fertility or harm to the fetus due to sevoflurane at 0.3 MAC, the highest nontoxic dose. Developmental and reproductive toxicity studies of sevoflurane in animals in the presence of strong alkalies (i.e., degradation of sevoflurane and production of Compound A) have not been conducted. There are no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, sevoflurane should be used during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Labor And Delivery</strong>: Sevoflurane has been used as part of general anesthesia for elective cesarean section in 29 women. There were no untoward effects in mother or neonate (see Pharmacodynamics - Clinical Trials). The safety of sevoflurane in labor and delivery has not been demonstrated.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: The concentrations of sevoflurane in milk are probably of no clinical importance 24 hours after anesthesia. Because of rapid washout, sevoflurane concentrations in milk are predicted to be below those found with many other volatile anesthetics.</p>', '<p>Patient with increased intracranial pressure, neuromuscular disease (esp Duchenne muscular dystrophy), mitochondrial disorders. Patient who are hypovolaemic, hypotensive, haemodynamically compromised, at risk of QT prolongation. Hepatic and renal impairment. Childn. Pregnancy and lactation.</p>', '<p>In the event of overdosage, or what may appear to be overdosage, the following action should be taken: discontinue administration of sevoflurane, maintain a patent airway, initiate assisted or controlled ventilation with oxygen, and maintain adequate cardiovascular function.</p>', '<p>General (Inhalation) anesthetics.</p>', '<p>Store between 15-30&deg; C. Protect from light.</p>', '<p><strong>Geriatric Use</strong>: MAC decreases with increasing age. The average concentration of sevoflurane to achieve MAC in an 80 year old is approximately 50% of that required in a 20 year old.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Induction and maintenance of general anesthesia with sevoflurane have been established in controlled clinical trials in pediatric patients aged 1 to 18 years. Sevoflurane has a nonpungent odor and is suitable for mask induction in pediatric patients.<br />\r\n<br />\r\nThe concentration of sevoflurane required for maintenance of general anesthesia is age dependent. When used in combination with nitrous oxide, the MAC equivalent dose of sevoflurane should be reduced in pediatric patients. MAC in premature infants has not been determined.<br />\r\n<br />\r\nThe use of sevoflurane has been associated with seizures. The majority of these have occurred in children and young adults starting from 2 months of age, most of whom had no predisposing risk factors. Clinical judgement should be exercised when using sevoflurane in patients who may be at risk for seizures.</p>', '2022-03-20 04:33:54', '2022-03-20 04:33:54');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(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');
